Interview of Morgan Wills, October 15, 2021

Morgan Wills, transcript, October 15, 2021

Elizabeth: Hi Dr. Wills. I have a few interview questions for you today. This is Dr. Wills: would you mind by starting with your position at Siloam?

Wills: Yes, I am Morgan Wills. I am president and CEO at Siloam Health, and also a staff internal medicine physician.

Elizabeth: Great, so the first question on here is: what part of your personal biography or background led you to this position?

Wills: Well certainly, my background in healthcare was a piece of what led me to be in this position. AS a practicing physician, I have an on-the-ground understanding of what we do at Siloam Health, but I was not trained, or sort of developed in the administrative side of healthcare, so that is a little unusual for a practicing physician to assume the role the role of CEO in a non-profit. Not unheard of, but a little less common, but I think from the further background of my life that prepared me for this, certainly it was growing up as a longtime resident of Nashville and having a deep love for the community mixed with an experience I had overseas after college living and serving in West Africa in a Christian medical mission environment that was indigenously led, so I was the only American, only white person there. It was an African led healthcare ministry there that I served at, and I was not planning to go into medicine at that time, but I encountered God's power and presence in my life in a way that put me on a path towards really seeking an alternative vocation. If I had not had that experience, I am not sure I would have ever pursued work at a place like Siloam.

Elizabeth: How long were you in Africa?

Wills: Three months in Ghana and five months total in Africa, and about a nine-month total abroad travelling with a backpack.

Elizabeth: Wow, I did not know about that. That is so cool. That kind of answers part of the next question, but what cultural identities or experiences are most salient for you?

Wills: So reiterating that I am a ninth-generation Nashvillian, my cultural identity is as a southern middle Tennessean from way back with Anglo roots to England, and then really that experience abroad after college, and then about four summers I spent at medical school doing an inner-city vaccination campaign and door to door ministry campaign in Philadelphia working primarily in a Puerto Rican neighborhood with an inner city healthcare center that was very formative for me and kind of furthered that comfortability bridging a cultural and socio-economic divide, so that was another way of bringing that experience from Africa to home in this country. Then, volunteering with Siloam as a medical student and resident was a key for me to bridge those worlds.

Elizabeth: Wow okay, that is incredible. What experiences (or specific experience) would you say have most shaped you as a leader?


Wills: Probably my time leading those projects in med school. That was the most formative stage in your 20s. You know, you are hitting that era of life, and I had not married and settled down yet and I had more margin for time to give and I was involved in some pretty intentional formation relationships with mentors in the context of those summer projects and the campus ministry with Vanderbilt Medical school and I had the chance to pour into the lives of some younger students during that decade of my 20s. Many ways, the practical lessons in leadership I learned through that ministry and through those cross-cultural projects have shaped me for a lot of the work I do at Siloam. I have learned a ton more on the job here and been blessed to have a great mentor and predecessor in this role, Nancy West. She taught me a lot in the way she led an organization-- It was a lot different than just leading individuals.

Elizabeth: This question kind of goes along with what you had mentioned earlier, especially since we come from the same faith background, but were you called into leadership, or did you seek it because of held convictions? If you want into this from a Christian aspect, that is totally fine.

Wills: --In particular, I feel like my convictions prepared me to respond to the invitation... In terms of my role as CEO, I did not seek it out. I gave the board three reasons I thought it was a bad idea, including I was not good at it, at least what I saw my predecessor doing. She was a phenomenal manager and detail person and also, I was a physician, so I would have a split in responsibilities and then third, God had been calling me to spend more time with my family, not less. So, for me to really sense that this was actually an opportunity God had for me to grow me as an individual as well as to help the organization. It involved actually meeting with a spiritual director for a month with me and my wife, each going through some prayer and scripture exercises and coming back together at the end of that month and looking at the whole request with a new set of eyes after that process.

Elizabeth: Yeah, that is a really cool way to look at it. How have you learned from the obstacles and challenges you have faced?

Wills: Gosh, what have I not learned? I think to pick out a few scenes or threads maybe, we have faced financial challenges in terms of-- earned revenues-- About five years ago, when the --refugee source... Of course, the pandemic posed unique financial and individual challenges. But I think one of the key lessons is that you cannot build trust in a crisis, so the trust you build through the small acts of faithfulness, service, leadership, day in and day out over time show up when you need them in terms of other people who trust you and vice versa. For instance, I mentioned earlier that I did not feel particularly administratively gifted. I could see the big picture, I could help cast a vision and move it forward, but I really perceived weaknesses in ability to bring closure to ideas and quantitative training in terms of the finances, operational training, aspects of fundraising and development, which I did not feel I was particularly good at. In all those areas, I have recognized the need to depend on other people and so probably the greatest gift I have given to my organization has been finding and creating space for other good people who bring gifts that I do not have. People I hired to help us fulfill our mission.

Elizabeth: I know this is not a question on the list, but I know for Siloam that a big part of what you all do is provide affordable healthcare for the refugee population in Nashville, so how does that work in terms of the financial aspect? I know you had talked about having to build that trust before, so how does that work?

Wills: There are several different models of health centers for the underserved. On one end of the continuum are the free clinics that are only opened on the weekend in a church basement. For all intents and purposes, the way Siloam started was kind of like that. It was only opened on Monday nights, Saturday mornings. Two dollars would get you in the door, no one would be turned away for ability to pay so it was basically free.

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And so, at the other end of that continuum are federally qualified health centers that get large federal grants and increase reimbursement rates to care for the uninsured. And in between are what we called charitably funded clinics that are not free, but are largely subsidized by charity organizations. And that is where Siloam falls out. We do get a modest reimbursement from the state of Tennessee for every 18--65-year-old patient we see, but that is maybe $20 per patient, maybe $25 at most, when the average cost of a visit is $150-$160 per visit. Patients contribute on a sliding scale at Siloam, so the Melrose clinics, which has been the longest running clinic we own, where your father served on the board: once someone has been screened and qualified, they will be able to be seen on a sliding scale and pay anywhere from twenty dollars to fifty to sixty dollars. The vast majority just pay twenty dollars for the visit plus any lab fees that they have. That obviously will not pay for most of the visits, so we fundraise for about two thirds of every dollar we spend at Siloam. The good news is that provides about four to five times the amount of healthcare for the investment just because of the volunteers, the services either given or made available to our patients and the way we can leverage community resources. So, charitably funded care model is how we operate. Individuals are the biggest group of donors, then foundations, then churches and businesses.

Elizabeth: What would you say your professional strengths or weaknesses are?

Wills: Professional strengths would be an understanding of the front-line impact of our services on patients. Being a practicing physician myself, I can see how the decisions in the boardroom trickle down to impact the lives of patients. Similarly, I bring a sense of vision about what is happening in the community and the innate ability to go out and bring resources, that is sort of an orientation for me. Whether it is people or funding opportunities, or benefits for our patients.

My challenges or weaknesses as a leader, I have alluded to them before, but I am not a particularly good manager. I am better at starting things than I am at following through. That is why I submit and report to a board of directors. Not only is that the best governance for an organization that is a non-profit, but it gives me accountability and a deadline, and people I know I want to be accountable to and with our goals for the year and stewarding our resources.

In the developing process, I would be really challenged. Some of my weaknesses are just in that middle management realm where I really rely on a team to provide that for the benefit of the organization. Also, I am somewhat conflict avoidant, so you will inevitably have conflict in any team and that is something I have really had to work on: is sort of leaning into uncomfortable situations and not postponing or avoiding those conversations until I feel fully adequate to respond to them. So, you are never fully prepared to make all the decisions you need to make in a leadership role. I like to be prepared on the issues, but in reality, you could only be 60-70% prepared.

Elizabeth: Okay, so that kind of helps with the next question, which is how do you measure success, and how do you learn from failure?

Wills: Well one of the things I love about working at Siloam: our mission statement is to share the love of Christ, serving those in need through healthcare. So, that is the lens in which I view all of my work and my team's work. It is broad, not super grandeur but at the end of the day, it revolves more around the concept of faithfulness than success to me. I think primarily in those categories, Lord have I been faithful with the job you have entrusted me today or this year? And we leave the outcomes up to Him. In terms of sharing the love of Christ, it is hard to quantify how we do that. We try different ways to survey patients and staff to access their need in terms of bio-psycho-social. We report out on some of these categories to various committees of the board, so there are some more measurable outcome measurements. But at the end of the day, it is about loving the patients.

Elizabeth: I love how Siloam is founded on sharing the love of Christ, I think that is a really cool aspect of what you all do. What are two or three action steps you think are essential to enable others to be successful? --More in terms of being in a leadership position.

Wills: I think you have got to know yourself. That is the first thing, and living in community and transparency. For someone in theirs 20s or 30s, often it is about trying a lot of different opportunities to serve, to lead, to go to where the need is and show up. Showing up is half the battle, and in the process you get to know yourself if you allow the feedback, if you allow yourself to learn from failures and hear the impact on others. The more you can get to know yourself, I think doing that in the context of just serving. Going to where the need is, and sometimes you find the calling comes to you as you enter into various needs. And maybe they do not all have to be socio-economic, poverty like our patient faces. There are different types of needs in the culture and society. Different leaders train backgrounds and cultures will lead them to different places, but there is brokenness out there. Learning about yourself along the way would be two really important action steps.

Elizabeth: those are really encouraging, thank you. I know you touched on this earlier about building trust, but what advice do you have for building relationships and trust in an organization?

Wills: Well, we talk about giving whole person care to patients is our philosophy of care, and if we are not doing that with one another, then it will inevitably seem inauthentic or come back to bite you. So I would say, bring your whole self to the work. Do not be afraid to get to know the whole person, and the person sitting next to you, your boss, the person reporting to you, your colleagues. That does not mean you spend all your day at the water cooler talking about Saturday Night Live, but it might mean you do that for the beginning of a meeting or in between. We try and encourage teams to get to know one another outside of work, and/or create third spaces where they can do that safely and have some natural margin to build relationships. That is the glue that holds a team together. Just like a piece of paper that you are writing on for a presentation is not filled up all the way to the margin. It is not totally covered up with black ink. In fact, the most effective presentation deliberate3ly leaves margins both between paragraphs and around them, and highlights and emphasizes certain words versus others. The same for the way you structure your work life: if you do not leave that margin, there is not air circulating oxygen for the teamwork and collaboration to happen. So that is hard for many of us in America, who are just workaholics and driven, and feel like we cannot relax the throttle. Really, the art of working well and effectively and sustainably is knowing when and how to relax the throttle so you can go longer together.

Elizabeth: That is really good. This question is tough in my opinion, but what do you want your legacy to be as a leader, or in general?

Wills: My hope would be a really simple verse: John 3:30: I must become less, He must become greater. If people were left more in love with Christ and becoming more like him because of their time with me, then I would consider that quite a success. If there was a particular way in which I could help bring that about that they would remember and cherish, that would be fun too.

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I think just day-to-day work and life together are avenues to point people towards the love of God in their lives. My hope would be that people loving and knowing Him more because of my role in their life.

Elizabeth: That is so good. Thank you. I had two more personal questions that I had come up with, and first is what is your favorite part of working in Siloam?

Wills: It is easy: it is the people. Where else can I spend time caring for a middle-aged woman from Egypt, a Ugandan man whose son is on scholarship at Michigan State playing football, an eighty year old Korean woman who has not seen a doctor in thirty-two years living in the United States, and now is most concerned about caring for her 101-year-old mother, and an Afghan refugee all in the same afternoon; with the help of a medical resident from Ethiopia, a nurse from Cuba, and a staff of people who come from all over the world? It just brings all kinds of rich experience and laughter and gifts. I love the people, that is easily the top thing about my job.

Elizabeth: That kind of led right into my other question because the last question I had is do you ever think of what you do as a job, or is more than that because of the people you get to help?

Wills: it is definitely a job-- I think even in optimal circumstances, the things you do and love to do and would do regardless in your job, you are lucky if that is over 50%, you are really lucky is it is 70 or 80% of that. So, I would say a majority of my job, there are parts of my job I would rather not do like preparing for difference committee meetings and learning about electronic medical system documentation, and I could list a series of things I probably would not naturally do every day, but I am so grateful I am alongside this team every day, being reconnected to the love of God through the practices we do together to be part of something bigger than myself. Times like covid-19 were really big opportunities to realize that God has a purpose for us. We are here, everyone else is shutting down, but we are going to show up, be open, and risk disease if we need to, but try to be a part of the solution for the city, building on all the good things that happened in the past, so it is a delightful place to work.

Elizabeth: I love hearing that, thank you so much for your time, it really inspires me to hear about Siloam and what you guys are doing there.