As part of my series about the “How Business Leaders Plan To Rebuild In The Post COVID Economy”, I had the pleasure of interviewing Dorothy Gibbons.
Dorothy’s leadership has led to many firsts — she employed patient navigators when no one had heard of that terminology, established a 500 + member strong Physicians Network that provides pro-bono care for the uninsured; brought in the first truly portable and business adaptable Mobile Mammography units which now serves a 35 county area in Southeast Texas, created the Breast Health Collaborative of Texas, was the first female selected for the Community Health Leadership Award in 2008 by the Episcopal Health Charities, named Houston’s first “Fearless Woman” Awardee in 2011, was the first recipient of the Trekker Award, and her first national award was as Yoplait’s Breast Cancer Champion in 2012.
Reminded almost daily that access to care in Texas is still not guaranteed, she has led The Rose to be more than a medical facility, to become, in fact, a caring community. Her nonprofit experience involves healthcare, education and women’s issues. She has served as Founder or on the Founding Board for the Breast Health Collaborative of Texas, the North Pasadena Community Outreach, the Breast Care Center in Washington DC., Gateway to Care and the Texas Medical Centers Women’s Health Network in Houston. She has served on the boards of the Texas Executive Women, the Association of Business Professional Women, Brigid’s Place and was the primary organizer of the Mary Magdalene Community started in 2005.
Like most women she juggles her professional and personal life, seldom finding a true balance. As a CEO, community leader, published author, wife, mother, yoga instructor, lecturer at the Jung Center, rancher, and advocate for women, her labels are many. Her true education began at the bedside of her dying mother, then continued through the real-life experiences of leading The Rose. With a Bachelor’s in Communication, she is also a student of women’s roles in world religions, mythology and history.
Thank you so much for your time! I know that you are a very busy person. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
Poverty, sickness and the lack of healthcare were constant companions throughout my childhood. I’ve sometimes wondered if that history was preparation for the work I do today.
My father’s third heart attack left him jobless with no hope for future work. His solution was to abandon my uneducated mother to care for four children, the oldest ten and the youngest nine-months old. Mother’s family took us in and we spent years moving from place to place, living at the whims of resentful people who were doing their duty, knowing no home of our own. Those were years of watching my mother slip deeper into mental illness and depression. As the oldest, I was expected to look after my siblings. My mother died of metastatic cancer in a charity hospital when I was 20 years old. She knew something was wrong but working part-time meant no health coverage. By the time her cancer was detected, it was too advanced for any treatment. I remember holding her hand as she took her last breath and wondering what would have been different for her if she had had insurance.
When she died, my role as mother to my youngest sister became real. I married too young, went to school at night and worked full-time while raising a son after surviving a divorce. I had worked my way up the management chain at an HCA hospital, Bayshore Medical Center, and was the PR/Marketing Director. That was when I met Dr. Dixie Melillo.
My job was to promote the hospital and its medical staff and when Dixie came on staff, I finally had something I could sell. At a time when only 3% of physicians were women, she had been only the second woman to complete a surgical residency at UTMB making her marketable indeed. Her story, her winning personality and passion about breast cancer and early detection were all contagious. Mammography screening was just getting a toehold in healthcare and she charmed countless audiences during community presentations. I arranged those talks, created the slides, carried the projector and hauled her around. After a couple of hundred presentations, we became friends.
But it was the women who were her patients that made the biggest impression on me. Case after case of late-stage cancer, women who were doomed to die, came to see Dixie. As a medical photographer, my job was taking pictures of those women, documenting fungating cancers that erupted through the skin. Their stories were always the same; no money, no insurance, and they didn’t know of any doctor or place to go for help.
In 1985, we met journalist and breast cancer advocate Rose Kushner. When hearing Dixie talk about the women and help that was needed, Rose told Dixie to “get off her duff and go start a non-profit!” After that meeting, Rose proceeded to call me every Friday, insisting I do ‘something’ to get our nonprofit going!
Believe me; starting a nonprofit was not on either of our lists. Dixie’s general surgery practice was growing by leaps and bounds and I was part of the management team of HCA’s flagship hospital and on HCA’s training faculty with unlimited opportunities.
But as these things go, by July 1986, The Rose was officially a nonprofit. Although she died before she ever saw our Center, Rose Kushner’s dogged determination is still with us today.
I’m proud to be a Texan, I’ve lived here since I was two years old. I love the people and their big generous hearts, the open spaces, and the unpredictable weather. I can’t imagine living anywhere else, but I sure can imagine Texas restructuring its state health program.
Texas has the highest uninsured rate in the nation, at 17.7% of the population, making our rate twice as high as the national average. It’s been that way for two decades, plenty of time to figure out how to care for that population.
We have nothing to brag about when it comes to the State’s healthcare for its poor citizens nor its attitude towards women’s health. Every day, I deal with our State’s meager health programs and the dogmatism that perpetuates its limitations and failures.
I’ve seen way too many women die because access to health care for the uninsured does not exist.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or ‘take aways’ you learned from that?
We started The Rose by holding a Bachelors Auction. It was our first fundraiser and we sold every man we could convince or cajole to be a part of it. Its proceeds, a whopping $7,000, created the seed money to rent an office space that housed the donated $160,000 mammography machine and opened our doors.
Today, when I tell people that we sold men to raise money to start The Rose, they look at me aghast. I remind them it was the 80’s and things like that happened. Whether or not this was a mistake, looking back, it was funny — ironic may be a better description, and taught me so much.
We didn’t have a clue what we were doing. Dixie was a physician with no business sense, I was a marketing director who knew nothing about healthcare delivery, and neither of us knew anything about nonprofits. Yet we forged ahead mainly because so many people helped and believed in what we were doing. It was years later before I realized what a miracle it is that The Rose survived. Not many nonprofits from that decade did.
Is there a particular book that you read, or podcast you listened to, that really helped you in your career? Can you explain?
If such a thing existed, I would have a Ph.D. in self-help. My library is lined with hundreds of how-to books all boasting to make one a better person and live a better life. I’ve given away as many as are on my shelves. I can’t say a specific one helped, they all did.
I truly believe that the more anyone knows about themselves, the more we can understand our own motivations and the ‘whys’ behind our individual responses to the world, all make us stronger and enable us to better manage and enjoy life. Among my favorites are Jean Houston’s The Possible Human and Maryann Williamson’s Return to Love.
Extensive research suggests that “purpose driven business” are more successful in many areas. When you started your company what was your vision, your purpose?
Our purpose in 1986 is the same as today — access to care regardless of the ability to pay. We believe that a woman should not have to die from breast cancer because she can’t afford the cost of a mammogram. We believe all of our patients deserve dignity and respect no matter what walk of life she is from, the color of her skin, the level of her education or bank account.
We also understand that it is hard to ask for help, especially when you never had to before. The majority of the women we ‘sponsor’ for services, over 90%, have a job. True, it’s low paying and her employer doesn’t offer insurance but she’s working, sometimes at two jobs and she’s most often the single head of household with people depending on her.
The Rose is there for her during a time in her life when she is most vulnerable: she’s found a lump in her breast and doesn’t have insurance. We get her through that time and beyond. We provide so much more than screening mammograms. Our services also include diagnostic work-ups, ultrasounds and biopsies plus physician consultations and physical breast exams. When we detect breast cancer, our Patient Navigators help the uninsured woman find treatment and care. They stick by her side throughout the treatment process, helping her locate other needed services, rental assistance, food, childcare, gas cards, and the list is endless.
Cancer treatment is costly even when a person has insurance; it’s the same for an uninsured woman. Parking alone is outrageous; at the medical center parking costs can reach $5,000 by the end of a year’s regiment of treatment. That’s one reason why we work so hard to move the woman into a local community hospital.
Both insured and uninsured face the loss of wages due to missing time from work; it’s another hardship when trying to recover.
However for the woman who is uninsured and can’t afford treatment, the cost is higher; without The Rose she’ll pay the ultimate cost, her life.
Do you have a “number one principle” that guides you through the ups and downs of running a business?
I truly believe people are doing the best they can. Whether it is the people who turn to us for help or my employees, or those one-time encounters, I have great faith in the goodness of people. I am a spiritual person, and although my opinions of traditional religion and their doctrines have endured radical changes, I believe there is a greater power at work in all aspects of life.
I get irritated at the idea that the pandemic is some kind of punishment meant to point out our ill ways and return us to God. That’s not the God I know and have walked with throughout my life.
Those two beliefs, people doing their best and a loving God, have carried me through.
I have always treasured the scene from the movie Starman. The alien, who is near death and attempting to return to his world, is talking to Sherman, the government agent, who has orders to capture and detain him. Starman says his world has always been interested in the earth species and he adds that earth was unlike the other species and there were many others. Then Starman says to Sherman, “Shall I tell you what I find beautiful about you? … You are at your very best when things are worst.”
I see that often when things are the worst, I watch people rise to their best and become their most beautiful. Over and over, I see them doing good, helping each other, raising money for strangers in trouble. Their kindness and generosity is nothing less than miraculous.
Thank you for all that. The Covid-19 pandemic has affected nearly every aspect of our lives today. For the benefit of empowering our readers, can you share with our readers a few of the personal and family related challenges you faced during this crisis? Can you share what you’ve done to address those challenges?
When I think of my friends who had loved ones go through the nightmare of being ill from COVID-19 or who have lost people they love, or who have been forced to remain separated from parents or children, in comparison I have had no challenges. My son is an essential worker and I’m proud of him for facing the perils of his work but so far he and all the rest of my family are well.
My husband was in the hospital having neck surgery (anterior cervical discectomy and fusion) on the day when Houston was put under the Stay at Home order. With a 10-week recovery ahead for him, my biggest concern was getting him out of the hospital and away from the city. We immediately drove to our little isolated cabin in the country, not knowing when or if we would return.
Can you share a few of the biggest work related challenges you are facing during this pandemic? Can you share what you’ve done to address those challenges?
There has been no end to work-related challenges and I’m incredibly fortunate to have a most capable leadership team to help navigate through a thousand decisions.
One of the toughest parts of being a leader is saying: ‘I don’t know’ to questions that have no clear answers, but I’ve said that phrase often since March.
Two issues consumed our last weeks before the city shut down. First, over a hundred women were waiting for biopsies and several hundred needed diagnostic evaluation for highly suspicious areas in their breast and many would need biopsies. Second, we were running out of Personal Protective Equipment (PPE) and every supply order was delayed or cancelled.
The Rose is a high volume operation. We serve 40,000 women annually, perform over 73,000 procedures. We average serving 200 women on a daily basis between our two centers and on the mobile mammography coaches.
On March 9, we stopped doing routine screening in our Centers and concentrated on biopsies, doing 60 in that final week. We knew we would not finish all with our current low PPE supply. Initially, we tried to send the women waiting for diagnostic evaluations to other unaffiliated breast centers, but few centers remained open, and none were willing to take the uninsured.
We ceased services on Friday, March 20.
During the next seven weeks, two new issues consumed my life — my employees and how they would live without a paycheck and the future of our patients, especially those needing diagnostic procedures.
Breast cancer isn’t going to wait until this pandemic is over.
I have never worked as hard as I did during those weeks; neither has my executive team. With the help of a board member and banker, we immediately applied for a Payroll Protection Plan Loan which was approved in an amazingly short time on April 15. It was funded shortly thereafter.
At the time we closed, of course I didn’t know that we would receive the loan; I didn’t even know whether our loan application would be approved. I lay awake nights worrying about my employees, so many would face the weeks ahead with no pay and for some that paycheck was all they had.
That was when I decided to step out on faith and approve continuing to pay our employees. At half a million dollars a month for payroll, it was no small decision.
That faith was rewarded when our anonymous donor called two weeks later. In January, she’d given us $1.4 million to start a new program that would care for 3,000 uninsured women. When she called she told me to go ahead and use the funds, saying: “It sure won’t do much good for you to have funds for a new program if your employees can’t pay rent or buy groceries!”
During those first weeks, we started transitioning employees to working from home. I knew the days of over-crowded work spaces, two or three people to an office were over. Identifying which positions could transition, finding ways of providing equipment and direction, setting up processes would consume days. We faced head-on a new worry among staff and had to reassure them that Remote doesn’t mean Removed. We have a long way to go, but our future success depends on a lot of communications and a true cultural change.
From my cabin, I created videos and messages for employees, board, donors and the public. I want to communicate openly and often, but I’d never done videos of myself before and, heavens knows, I couldn’t trust my recovering husband to do them. It was another learning experience and I got used to having to go through 20 or 30 ‘attempts’ before I had one that could be used. Our cabin does not have internet (or TV) so all my work and emails were done via a hotspot. On some days, work was constantly interrupted due to poor connectivity and those videos were painstakingly slow in forwarding. Thank goodness, my communications team made them work and kept me informed and aware of needs.
It was with a great deal of relief and a heck of a lot of trepidation that we reopened our main Center on Monday, May 4, 2020. Relief because so many women had waited six weeks for their biopsies, trepidation because no one knows what the COVID-19 virus will bring next.
By May 12, one of our mobile coaches was deployed and on May 22, our second Center reopened at its new location. Who else but The Rose would undertake a move of facilities during this time?! I was so proud of my employees and how fearless and determined they were about returning to work.
Since closing on March 23, we had cancelled over 1,000 diagnostic appointments and twice as many routine annual screenings. We already had 200 women waiting for diagnostic evaluations, 71 needing biopsies.
Sadly, the very first biopsy we performed resulted in cancer for an uninsured, sponsored woman. By week’s end, we had several more.
I’ve dealt with women having breast cancer for over three decades and intimately know what lies ahead for an uninsured woman, but the results of our first week really bothered me. It isn’t enough that so many folks are struggling with the impact of COVID-19, but now women who have no resources, no insurance, and no support will also face breast cancer. It’s just mind-boggling.
Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have understandably heightened a sense of uncertainty, fear, and loneliness. What are a few ideas that you have used to offer support to your family and loved ones who were feeling anxious? Can you explain?
I stopped watching the popular network news years ago.
Throughout this pandemic, I’ve been very selective about where I go for information. Granted, I’m fortunate to work with brilliant colleagues and physicians. I’m blessed with a mate who possesses a unique global understanding and questions everything. His logic has been a lifeline. I refuse to give away my sanity and peace of mind to fear mongers or unfounded theories.
Limiting our exposure to media is healthy, as is reaching out to people we care about. Nothing is more nourishing than discussing things that really matter. I think we have all learned how loneliness feeds anxiety and the value of talking with someone, especially those people we always meant to talk to but never found time to because our days were just too busy.
I never really appreciated how much my consistent and honest communications meant to my employees until now. On the day we closed I sent them a special message to them not as their boss, but as Dorothy. I shared practices that help me during times of stress. As an old yogi, I’m well aware of the benefits of breathing and focusing thoughts with intention.
One of my favorite stress relievers is the Alphabet Game. When I awake in the middle of the night with my mind going 90 miles an hour from worry, I force it to stop by mentally going through the alphabet and finding positive words to describe myself. I use the phrase I am or I feel and then go from A to Z. For instance: A= I am able; B= I am bold; C= I am curious and on and on. I usually get stuck on the letter ‘J’ because the only word that ever pops into my head is jolly and that’s a stretch for my personality. By the time I’ve plowed through to the letter Z, those crazy mind-numbing thoughts have stopped and I usually fall back to sleep.
Digging in the dirt is the best way for me to get rid of anxiety. I love working in my garden, chopping down dead trees, walking in the woods, anything that lets me be outdoors.
Nature is the ultimate healer and a definite reminder that life goes on.
Obviously we can’t know for certain what the Post-Covid economy will look like. But we can of course try our best to be prepared. We can reasonably assume that the Post-Covid economy will be a trying time for many people across the globe. Yet at the same time the Post-Covid growth can be a time of opportunity. Can you share a few of the opportunities that you anticipate in the Post-Covid economy?
In the same way travel was never the same after 9–11, the working environment is positioned to change. Many companies, including mine, are accommodating their employees to working remotely. That is a huge opportunity to positively impact the health and life balance for employees and could also prove to be helpful for the environment; both have an enormous potential to ultimately keep us healthier.
In my world, most people had to learn new skills, especially with technology. It was time to get out of our comfort zones. We may grumble about the inconveniences but we learned new things, connected in new ways, reassessed our life and routines. We were challenged and frustrated by the new, often terrified by the unknown but in the end, we grew. That was a gift.
We had a chance to connect with others, to get to know those in other countries as well as those in our own neighborhoods. Those connections were another gift.
We learned the danger of ‘just in time’ delivery of supplies and maintaining minimum inventories for the sake of profit and dividends for the few at the risk of life for many. Hopefully that lesson is remembered and innovations recreate the supply chain processes.
I believe that the advances in technology and the newfound respect for our scientists will bring a shift like no other time in history. We have the ability to move light years ahead in all fields.
How do you think the COVID pandemic might permanently change the way we behave, act or live?
Our healthcare infrastructure was woefully underfunded and under prioritized. The old saying that ‘when public health works nothing happens but when it doesn’t work people die’ was never truer than during this time.
I believe the healthcare system is in for a complete revolution. It took a pandemic to expose what we in nonprofits have known for decades: a huge segment of the population is at dire risk and their lack of access to healthcare could result in death for everyone.
The other shift that must happen is changing the compensation system for hospitals and physicians; the current one is based on fee-based services. Instead, we must move to a value-based and outcome oriented payment system.
Finally, people must have the ability to experience healthier lifestyles and preventative services must be fully funded and available to everyone. Both require a cultural and access change, the second would mean a complete overhaul of our regulatory organizations.
We need to place a tangible value on keeping people healthy as much as we profit from people being sick.
The number one advantage people had to beating COVID-19 was being in good health. The fact that so many struggled or died due to countless underlying health issues is terrifying.
COVID-19 gave us the opportunity to regain a sense of our own self-reliance, to learn to trust our own reasoning and to question at a profound level the meaning of success.
Perhaps the compassion we so generously showered on others will finally find its way to our own selves.
Considering the potential challenges and opportunities in the Post-Covid economy, what do you personally plan to do to rebuild and grow your business or organization in the Post-Covid Economy?
We will keep on, keeping on.
In the weeks and months, maybe years ahead, The Rose must be prepared to meet the needs of all our patients. I am deeply concerned about the skyrocketing unemployment rates. I know unemployment means no health insurance.
At the same time, I worry about a predicted decline in our insured population, which will impact care to the uninsured. Our business model has always relied on revenue from the insured population to offset the costs to care for our uninsured patients. Women are reluctant to return for routine screening. We must keep their safety and that of our staff as a top priority. Our success depends on them returning and I know that for many, their life and survival will depend on them having their annual mammogram.
As we must maintain social distancing and deliberately limit our patient schedules going forward, we anticipate a revenue loss of over $3,000,000 by the end of June.
Our ability to serve the uninsured in the overwhelming numbers we anticipate will depend as much upon funding and the generosity of this community as it does on the insured using our facilities.
I know that of all the difficult decisions we’ve had to make, none will compare to the ones ahead. The Rose will need to do much reengineering, replace outdated processes and systems and reorganize how we work.
Still, I also know that my team will refuse to turn away uninsured patients. Access to care is our mission. It is a mission that has meant life for thousands. We’ll keep true to that mission and somehow get it done. We’ll continue to step out on faith, turning again to our supporters trusting in their willingness to help.
We will also continue to be a voice for those who are most in need. In the years ahead, The Rose must be a stronger advocate, insisting on access for all and becoming immune to criticism or scorn. We can no longer accept the status quo or believe that change is too difficult or takes too long. The world was turned upside down in a matter of weeks; we have the opportunity to play a big part in righting the world and moving it in a new direction.
At this time, when life remains so very fragile, we cannot afford to do less.
Similarly, what would you encourage others to do?
I believe we all have the same opportunity to rise to the level of leadership that is needed now. Whether leading a business or guiding a family, we have to be willing to take a lot of risks, to stumble and fall down, then get up and try again. We are in a new world and no one has a map yet, we’re making one together.
We have to be willing to say ‘goodbye’ to the old way of being and ‘hello’ to the new, but not without pause. We can’t go back and there isn’t anything normal, new or otherwise, there never was. But if we can let go with gentleness and gratitude, pausing to savor those extraordinary moments that could only happen because of the pandemic, then we’ll be ready to move forward.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Years ago, I saw a quote that went something like this: Power without wisdom is dangerous, but wisdom without power is useless.
I understand that concept. I’ve seen too many people who didn’t have the power to make or enforce decisions about their own life. I experienced it firsthand in mine. Extreme poverty creates a world without options and the prejudice of poverty keeps that world locked up tight.
I’ve seen that prejudice, a presumption that poor people are poor because they are lazy or waiting for hand-outs. That’s not what I see in the women we serve and why it is so important to me that The Rose provides that safe space for them.
We only have to look at the leadership of the past months to appreciate the importance of wisdom. We saw it in the leaders who understood the extreme responsibility they held, those who were thoughtful and also determined. It’s not easy to be a leader during a crisis, there are so many unknowns, and every decision is fraught with the possibility of failure. But indecision is a guarantee for failure.
I have learned the importance of trusting my gut, especially during tough times and I pray my leadership is guided by wisdom.
The pandemic has also given us an opportunity to witness the dangers of having power without wisdom. It’s more than dangerous; it’s fatal.
How can our readers further follow your work?
Anyone interested in my work can visit my website dorothygibbons.com or follow me on Facebook at @DorothyGibbonsAuthor and Twitter at @DgibbonsDorothy. If someone is looking for more information on The Rose, visit therose.org.