The Mark of Strong Leadership: Judiann Smith

Lisa Belisle: Hello, I'm Dr. Lisa Belisle and you are listening to or watching Radio Maine. Today I have with me in the studio Judiann Smith, who is the executive director of the Daniel Hanley Center for Health Leadership here in Maine. Thank you for coming in today.

Judiann Smith: Thanks for having me.

Lisa Belisle: So you and I are neighbors. Our kids went to school together. I went to the Hanley Institute, so there's a lot of crossovers, but I don't think I knew just how professionally impressive you were until I saw you in action as one of the people leading this course that I took. I guess it was a year and a half ago now.

Judiann Smith: Thanks for saying that.

Lisa Belisle: It's amazing to me that you are trained as an attorney, but you haven't taken a straight path.

Judiann Smith: No, definitely not a straight path. And I have only practiced as an attorney for a little over a year back in Boston, right after I got out of law school. It was not the experience I had anticipated. Let's just say I was the only female attorney at an all-male construction firm, and some of the things that went on at the firm made me very uncomfortable. So once my husband and I decided we wanted to move out of state and buy property and start a family, we started looking around and we looked at Vermont and we looked at Maine. Maine won, and I started my first job in state government as the supervisor of elections under the Secretary of State Bill Diamond as my first Maine job. And I never looked back. I never went back to for-profit. Money was not what I was after. I was after making a difference and being challenged. And the law degree opened a lot of doors for me, but I never needed to practice ever again.

Lisa Belisle: Well, it sounds like for you, that wasn't a bad thing.

Judiann Smith: No, it wasn't at all. I've had great opportunities. My biggest career move was to move to Spurwink, which is a mental health agency. I like to say I grew up at Spurwink. I spent 18 years there until I took the current gig, and I loved it there. Just an amazing organization doing amazing work all over the state. The largest mental health agency out there working with toddlers and children and adults, all with mental health challenges, intellectual disabilities, autism. Just a great organization. But at some point I took the leadership course at Hanley, and I decided I needed to do something like that. And once I took the course, it really changed me as to what I wanted to do. I had lots of growth at Spurwink. I kept having different leadership roles there, but then I wanted a change, something different. And when the role opened up at the Hanley Center, the then executive director was a mentor of mine and a friend, and I found out that he was retiring. I put my name in the hat and I feel really fortunate to have been chosen for the job. It's been really fun.

Lisa Belisle: You also spend time on the school board here in Yarmouth?

Judiann Smith: I did. I did two terms as an elected member of the school committee. And that was also great. I got to meet a lot of people. When you're on school committee, you know a lot of people in town. When I stepped off school committee, it was like I moved into a closet because you're just not in on the stuff anymore. But it was really fun. We had a lot of great times. We had a lot of challenges. We had a lot of winning teams in Yarmouth, a lot of accolades for the schools, and we did a lot of hard work. The school committee probably doesn't get enough credit for how much time and effort they put in. I really loved those years, and I think I want to go back into some form of service like that in the future. I just don't know what or when.

Lisa Belisle: So you're waiting for the call.

Judiann Smith: Waiting for the call and the time to be able to do it. My current job keeps me busy in the evenings as well as the days, as well as the weekends at times. And so it's really hard to try to fit in any other kind of volunteer work.

Lisa Belisle: It is true that when I reach out to you, I'm apt to hear from you anytime day or night. You're very responsive. Whether it's by text message or whether it's by email, you're right there, you're on top of it. So I would think that level of responsiveness, and also just meetings and reaching out to people, that would require a lot of on time.

Judiann Smith: It is a lot of on time. And you know what, if you don't respond in the moment, you lose the opportunity, as well as things build up and then you're inundated. So I prefer to just get things taken care of when they come in as much as I can.

Lisa Belisle: I think that's sort of my approach as well. Some people have argued, maybe we're a little bit too on, or we should block our schedules and only respond between six and eight at night. But I feel the way that you do. If you can keep your asynchronous communication somewhat synchronous, then you can really calm things down pretty significantly. If you let people sit with the story in their mind that they've created, good or bad, sometimes it can go in a direction that is probably not optimal.

Judiann Smith: Agreed. Agreed. My youngest daughter used to hide my phone after hours all the time and on the weekends, because she knew that if something came in, I'd be on my phone trying to respond for work. Even when I was at Spurwink, it was the same thing. It was a seven-day job. I was an administrator, but there were no weekends where I wasn't working. And she used to hide it all the time. I used to be like, give me my phone back. I heard something come in. Give me the phone back.

Lisa Belisle: Well, don't you think that that is one of the hard lessons that people eventually learn, is that once you move into a leadership position, there is not really an off button?

Judiann Smith: No, not at all. That is a big lesson no one tells you about. For sure. But you have to have your balance too. And so those were really strong messages from my daughter. And I tried hard to make sure I was focusing on my family. I have three kids. Had to focus on them as much as they needed me to be focused. You always feel like you did it wrong or maybe you didn't do it right enough, but you do your best in the moment. And that's all we can do.

Lisa Belisle: And to be clear, I go to bed early and I wake up early. I don't keep my phone right next to me. I put it outside my room. I'm not listening continually to text messages unless I'm actually on call. So yes, I agree with you. There is a balance, and there is what we're role modeling for our kids. Being on constantly does have a toll. So it's a kind of a funny place to try to negotiate, I think.

Judiann Smith: For sure.

Lisa Belisle: So tell me about the Hanley Institute. I know my experience, but yours is very different, because my program was specific to physicians, and I was with a physician cohort, and we met for, I think it was around nine months over the course of a year. We had in-person sessions. COVID was still going on, so there was an opportunity to do some remote, but really we were in person, I think the vast majority of the time. But you have multiple different courses that you run at the Hanley Center.

Judiann Smith: Yeah, so the Hanley Center's a 501c3 nonprofit. Actually, now it's not its own 501c3 anymore. I keep reminding myself, January one, we merged to be part of a different 501c3 called the Maine Medical Education Trust. And so this is an organization that has been around for a long time. It's an arm of the Maine Medical Association. But we are still operating independently from that organization in terms of how we do our operations, how we do our budgeting, and we're running all the same programs. So nothing's really shifted on our end, which is why sometimes I forget to say it. I can't say anymore we're an independent 501c3. But we have been around for about 20 years. We're founded to carry out the legacy of Dr. Dan Hanley, who is an extremely well-known and well-appreciated physician leader in Maine. And what we do is run leadership development courses. That's how we started. We started by acknowledging fantastic leaders in healthcare in Maine through awards. And at some point a board of directors was formed, and it was determined that there was really a lack of leadership development availability or opportunities for doctors. And so a couple of different levels of courses were created, a foundational and an advanced course. You took the advanced course for physicians, but we also have an interprofessional course, which is the one I took. So I'm a closet lawyer who was doing policy work and lobbying at the State House for Spurwink. But I took the course then and it was a fantastic experience, life-changing for me and how I thought about my leadership. So we run that one, it's entering its 17th year, the HLD course, it's called Health Leadership Development. The physician courses, the advanced course, we're recruiting for that right now. It's going into its eighth session. And we're just launching some other new exciting things. Our second version of a Women in Health Leadership Seminar series. So women leaders coming together to network and learn together over three sessions. We have a new nursing curriculum that we just put together with all the chief nursing officers. A bunch of them from the state got together and we developed a curriculum together that's starting up at the end of November for emerging nurse leaders. We have a course that's also going to be starting up just for rural providers, really specialized in what they need to learn. So many doctors and so many providers out there that need different skills around community and coalition building and network and community engagement and advocacy. So different skills, a different course. We also run an internship program because Dr. Dan was the college physician at Bowdoin College for about 34 years. And as such, he really cared about undergrads. So we have an undergraduate internship program we run every summer. We have about 22 interns this summer. We're going to have a leadership day up at Bowdoin College's coastal center next Wednesday. It's going to be really fun. And they're spread out all over the state in different organizations doing all kinds of cool projects over the summer. And I'm sure I'm leaving some stuff out because we have so many programs that we're running. But those are the big ones right now that I'm thinking hard about because we are in recruitment mode.

Lisa Belisle: I think that what you're describing is so interesting and important, because we think about leadership just as a huge looming topic. And I've actually heard people in leadership who I've interviewed who have said, there's a secret sauce and we're all looking for the secret sauce. And when I think about that, I'm like, but aren't there lots of sauces? And they're probably not that secret. It really does depend somewhat on context. There are some overarching things that I think many people should know if they're going to be leaders. And also if you are a nurse or a nurse leader, it's going to look different than if you're working at Spurwink. It's the groups that you're a part of. It's how the power structure is laid out. It's your educational background. So the fact that the Hanley Center is making all these different types of opportunities available to people is really important.

Judiann Smith: Yeah, I mean, I know I've drank the Kool-Aid, but there's so much happening in healthcare and there's so much change, not just because of the pandemic, but the pandemic certainly increased, ramped up the volume and the quickness of the changes coming at folks, that you need skilled leaders. You need people that have the tools in their tool belt that know how to handle and implement change. And some people think leaders are born. I agree that some people are born with some excellent skills and some balance and some diplomacy, and they have some natural ability for people to follow them. But that does not mean you're a great leader. It just means you have that natural ability. There are a lot of theories and skills that people need to learn and understand to be able to implement change and move forward. There's so much going on in healthcare right now, and health equity is such a new issue. It's not a new issue, but it's a new issue for the world. The world all of a sudden is thinking about health equity. Hanley's been thinking about it for 20 years. We've been training on it for most of our existence. But the world has now come to understand how important it is to think about all the different communities and making sure care is equitably delivered. Right? And talking about the importance of mitigating what are social determinants of health, impacting people based on their zip code and where they live and where they work and play. All those things are so important. You need strong leaders for that. And I think that's why it's so important that we're out there, because medical school and nursing school don't teach you how to be leaders. They give you great clinical skills. And what happens, as you know, is great doctors, great nurses, great social workers, doesn't matter your industry, they get put into these supervisory and leadership roles because they're good at their clinical work. And then they get there and they're leading teams and projects and budgets, and they have no idea how to do it well. And so that's where we come in, really help give them those skills and the tools that they need.

Lisa Belisle: Well, I'm glad to know that Hanley was thinking about social determinants of health from the beginning. Because as a family doctor, our profession certainly was thinking about social determinants of health. I know the pediatricians and other primary care specialties were thinking about social determinants of health. It is really interesting that as a result of the pandemic, all of a sudden we're thinking about this, but we're not. I think anybody that practices clinically, or really does anything, if you're on the school committee for example, you always have to be thinking about the context, the ecosystem, the impacts of things that make it possible for people to be healthy or to learn. And sometimes it has nothing to do with the space that they're actually in while they're learning or while they're gaining healthcare.

Judiann Smith: No, it has to do with the barriers that may exist that you don't see. And the things that keep them from being able to stay healthy, and the adverse experiences they've had across their lives that cause them to be in a situation that's not going to help them thrive. And I think that's really important. And that's what we do at Hanley. We run all these courses, but we also, when we are lucky enough to get some grant work, we do work in health equity and trying to help people mitigate differences, mitigate the challenges that they have and what they experience in healthcare. So those are really important pieces to us at the Hanley Center. That's why we teach about it in every one of our courses. And it's like leadership is a journey. No one has ever drunk all the Kool-Aid or had all the secret sauce. You have to keep trying different sauces because you keep evolving. And I think that's an important thing for everyone to remember. No one at any point in time can just say, well, now I'm a leader. You're never really evolved completely.

Lisa Belisle: Or you just recognize that being a leader just means that you will continue evolving and you will continue learning. And most importantly, part of learning is maybe not doing it exactly the way that it would be optimal the first time around.

Judiann Smith: Right, right. You've got to try a few things. Sometimes failure's okay, because you learn, take a different direction.

Lisa Belisle: Yes. I think that's true. It's also interesting to me because you talked about being the only female attorney at a construction firm. When I went into medicine, even though half of my medical school class were female, that was not the leadership structure. And it still is not. Across the country, only 15% of the higher-level executive-level leaders are women. And that's just women. We're not talking about minorities. We're not talking about people who have different backgrounds, different cultural backgrounds. And here in the state of Maine, on the list of names of these higher-level leaders, we're at 11%. In my organization, I'm one of three at the chief medical officer level, and I'm a woman. So I guess that gives us 33%. So we're kind of ahead. But it's a thing. You and I, we are not that far away from not having anybody around who kind of looks like us. Now we don't have enough leaders who are actually leading the people. There's plenty of women, but don't we need more women doing this work? Don't we need more people who are not white, middle-aged males?

Judiann Smith: We do. And what's interesting is that especially for our interprofessional course, where we get a lot of administrative healthcare leaders coming through, and some physicians, it's mostly women, which is really cool to me to see. It is mostly women who usually, out of 30 or 35 people, we might have six, eight men. But it's mostly women leaders who are ascending into this class, which I love. You're right. And I think sometimes I put blinders on, but when you look around the state, I'm always so proud of people who have made it to those CEO-level positions. Like Lois Skillings who just retired at Mid Coast. There's a woman who's running the hospital up I think in Washington County. It's just phenomenal that they've made it to the CEO level and were women. There was a woman CEO up at Cary Medical Center in Aroostook County. But there's not enough. I agree with you a hundred percent. And I do hope that'll change. I do hope organizations like us will provide what women need to feel like they have the confidence and the skills to push forward into those positions.

Lisa Belisle: And I should say, I'm married to a middle-aged white male and I value him and his leadership skills. So I have no, and the people that I work with who happen to have those characteristics, there's nothing that I have that's bad to say about that. I'm just saying, let's make the table a little bigger. Let's invite a few more people. Let's start to have more of a conversation. And let's stop just assigning characteristics based on sex assigned at birth. I've now been in multiple conversations where somebody said, oh, well that person is a woman doctor, so of course she has to act that way. I'm like, but what does that mean? If you're a female leader, do you have to have a harder edge? Do you have to be more defensive? Why do we have to make it a gender thing? Or why are we the nurturing leaders that are going to bring the cookies in for the board meeting? Why does that have to be?

Judiann Smith: It's a great question. And that is something we talk a lot about in the Women in Health Leadership Seminar series. We really get into what are those stereotypes, and how can we break out of those stereotypes or use what is unique about women to our advantage in leadership. So it's an important conversation for sure to have. And it's hard. It's really hard. I remember when I was starting to join different kinds of boards when I was at Spurwink, and I was sitting in on lots of different senior-level leaders. I was typically one of two or three women around a table of 15 men. And it took me years to even want to speak at those meetings. I was really having a hard time putting forward my thoughts. It took me years to feel comfortable with that. So I totally get it.

Lisa Belisle: Yeah. And so that's an important point, right? So even inviting people to the table and saying, well, you're here, we're letting you speak, as if let is the word. But it's not enough. There actually has to be the ability to draw people into the space and say, Judiann, tell me what you think about this. And I don't know that everybody has even the leadership and facilitative capacity to understand that that is necessary. You can't just put people there and expect that they're going to feel comfortable enough sharing their voice.

Judiann Smith: Yeah, so true. So true. You have to create that safe space, that safe environment for everyone to feel like they can add to the conversation. And unfortunately that just doesn't happen around every leadership table.

Lisa Belisle: Well, I should say that not only is our now-retired CEO from our health system, but our incoming CEO, I have only good things to say about our leadership structure. So I feel like I'm actually really spoiled. But I do know that it continues to exist in other places. You know that I have my MBA in leadership, I'm almost done my doctorate in leadership. And I'm even astounded by the fact that it all begins with the great man theory, that not only were the great men the ones that were born with these leadership skills, and it was typically in a military setting, but also the studies that are initially done were that tall men were actually the best leaders. So our studies of leadership that go back 150 years or something are all founded on something that is a fundamentally flawed presupposition.

Judiann Smith: Yeah, no doubt. I haven't seen the one about the tall men. That's interesting.

Lisa Belisle: Well, I only know this because I'm a tall woman and apparently there's no relationship. So that doesn't help me in any way. It helps me to get stuff off the top shelf. So I'll take it either way. But I think the other thing, we've talked about skills, but one of the things that I really enjoyed learning about when I was at Hanley in the physician section was kind of subject matter, some of the basic stuff that I don't think a lot of doctors do have access to. So you brought in people who discussed economics and policy and finance, and I think that's really eye-opening, because as doctors and clinicians we're taught to be really good at knowing stuff about health, but we don't necessarily know stuff about all the things that go into delivering healthcare.

Judiann Smith: Yeah. The course is really very broad, and most of our courses are. We try to bring in all the different components, and we think about the course as talking about the science of medicine. And the science of medicine includes all the inputs, and the inputs are the policy, right? The laws, the policies, federal, state and local, under which you practice as a physician and under which we receive care as patients. And it includes having to understand what is going on in the big picture of healthcare economics. That's such an important piece of it. And it is always astounding to me how much physicians appreciate that session in particular. They learn a lot about healthcare economics and it's very eye-opening, how to create value in healthcare. And all of those, extraneous people might think those sessions are, are actually really important pieces for everyone, including the one on health equity and strategies to mitigate the inequities that we have.

Lisa Belisle: Well, I was really struck by one of the sessions that we had, and you probably remember this, where we had people who were brought in from insurance companies and from other maybe not-so-popular fields, and how incensed people in our group really got, because they just felt like, they're trying to do the best they can for their patients and the perception is that maybe other people are taking advantage. And I think it's hard when you're a clinician, because we really just need to understand where other people are coming from. But I think our immediate response is one of, but why is it this way?

Judiann Smith: Yeah. That was an interesting session. And part of what I usually talk about when I'm talking about the Hanley Center, and the outcome of all of our courses, is broaden the perspective. And I think that's a really important piece. And that session in particular is meant to do that, really broaden your perspective. We brought in three individuals who work in carrier situations or in advocacy for employer groups. And from the doctor's standpoint, they're just holding up things, right? They're putting up all these prior authorization requirements. They're denying claims. And I sit on the board of Community Health Options, which is a health insurance company, and that CEO, Kevin, was there at that session. Good people running Community Health Options, doing the best they can trying to improve the health of Maine, but within the parameters of the health insurance industry. And there's a perspective there to learn about. So sometimes that is a learning experience about building the perspective and understanding that everyone has a reason for the reason they do their job and how they do it, and trying to have that conversation in a way that is productive as opposed to polarized. And our session that time became a little bit heated. You're right. But I think in the end, everyone understood and appreciated that those guys were coming into a room they knew could be a little bit challenging for them, but they were there to say, this is who we are, this is how we're trying to help provide the best services for patients in Maine as insurance companies. They're all working toward that. And especially Community Health Options is not a big national company. They're a nonprofit.

Lisa Belisle: Well, I think that that is a huge leadership lesson, is that there are always going to be stakeholder groups. And if you remain part of a stakeholder group, then you will never evolve a situation to the next level. I think that the stakeholder groups all do have to understand each other, and they may not like the other people's mission and vision, but you do actually have to co-create and co-generate the next step. And if you immediately shut down and say, well, I'm going to remain over here with my group and I'm not going to be open to how other people are experiencing this, it's not a bad thing. It just kind of limits how far you can actually move.

Judiann Smith: Absolutely. Absolutely. One of the basic tenets of our HLD course is about collaboration, and we spend a whole lot of time talking about what true collaboration is. And some people think about coordination and cooperation, and those are not true collaboration, which takes time where you build trust in a relationship and you start each giving into the other to benefit the other before you get to a point of mutual benefit and really working together. And in a situation where we're just having a session, it's hard to build those relationships. But that's why we do what we do. Our idea is that we have a statewide network of leaders that are now across Maine in all of our courses, who have had a little bit of the Hanley sauce. And we know that if you as an alum were to call up any other alum in another class and say, I was in this Hanley class, they will talk to you, they will work with you. They will want to help, because they're all part of the same network, had similar training. And we believe that a strong networked group of healthcare professionals will help move the state forward. And our alumni are at all the leadership tables around the state, and they've ascended into those because of the skills that they have. So I think you're right. I think collaboration is so important, and you can't possibly move anything forward if you're not building a long-term trusting relationship with your stakeholder groups.

Lisa Belisle: And at the same time, admittedly, it's not easy. Especially as a physician, to our great credit, we are wonderful champions, hopefully, for our patients, for our colleagues, for our other people that we work with. So absolutely we feel like we want to be the advocates. And so absolutely nothing wrong with that. But on a regular basis, what I see in my organization as I'm bringing people forward in leadership is that they have to find a way to be a both/and. They have to be able to say, okay, yes, I'm a family doctor, I'm a practice medical director, I'm a service line director, and also what does the larger institution need to be doing? And what does the larger context of healthcare need to be doing? And that's very hard, because it really speaks to, at least with physicians, a very core identity that we all hold.

Judiann Smith: I think it's important for every physician to figure out where they can insert themselves in that way. There's a place for every physician leader to think about the difference they want to make and the passion they have inside of themselves, and figure out how to insert themselves in, whether it's an advocacy way or not. There's a place for everybody that wants to be making a difference. And I appreciate that so much about the physicians that come through our courses. It's somewhat of a self-selected group. You all come to this because you want to make a difference. You're so passionate, you're so smart and you're so dedicated, and that's why you want to learn more. And a lot of people would think, we went through medical school, residency, all these fellowships, what the heck do you want to go to another class for? But these are the folks that self-select and take our courses, because they're going to be the rock stars.

Lisa Belisle: Yeah. And to be clear, I have no problem with people whose primary goal is always going to be advocacy. And that's leadership, right? It just kind of depends upon which direction you go in, exactly as you've said. What is my niche? What is my place in all of this? So I also really love the fact that this is the Daniel Hanley Center for Health Leadership. And it isn't specific to, okay, we're only going to have doctors do it, we're only going to have this particular group. You're actually seeking to strengthen the entire leadership team, both in and out of institutions and across the state, really.

Judiann Smith: Right, right. We have courses for advanced practice providers, that's the one I left out. The PAs and the NPs of the world are in a professional course. It's such a cool class. We get physical therapists, healthcare architects, healthcare attorneys and policy people, people from the state CMS or MaineCare. We get nurses and NPs and doctors and psychiatrists, social workers, finance people, HR people. Anybody in healthcare can apply to be in that course. And that's what makes it so rich, because the perspective building there is pretty astounding in what they learn from one another. I remember learning so much about hospitals. When you work in the siloed mental health of, I would say, the early two thousands, late nineties, it was very siloed in mental health and the brain was thought not to be connected to the rest of the body in any way, shape, or form. And that has thankfully changed. But now, I learned so much then because I didn't understand how hospitals ran. You thought about the hospitals in a certain way. You thought about long-term care and elderly care in a certain way. And the folks in my class were working in those arenas and they taught me so much. It was just an amazing experience that I wish everybody could have.

Lisa Belisle: Well, and that's kind of where we all need to get to. And it's not even within health per se. It is working with people who have an interest in health really across the spectrum. So the classes that I've taken in both of my additional degrees, a lot of the people are teachers. So I'm learning things from them that I'm like, oh, I had no idea that you have a mitten closet at your school, because you have children on a regular basis who come in in a snowstorm and have nothing to put on their hands. And that they are called to also be frontline workers and to feed these children and to put mittens on their hands and to send them home with a bag of clothes. And so I think understanding where we each are doing really good work and really important things that impact health is going to make us feel a lot more hopeful about possibly where we can eventually get to.

Judiann Smith: Yeah, for sure. For sure. Back when I, before I started at Hanley, right after I took my Hanley course, Hanley offered some other kinds of volunteer opportunities, and I took an opportunity which allowed me to develop a proposal for Maine. It hasn't flown anywhere yet, but I've presented it to a few governors and it was all about coalition building, like you're talking about. It was to end stigma in mental health. And so it brought together the police, the educators, the employer market, the healthcare people for sure, just all different parts and different sectors of our environment that all have a stake in what to deal with. The churches were involved to deal with mitigating stigma in healthcare so that folks came forward and got the services they needed. I think that's what you're saying is so important, that we shouldn't stay in our silo either in healthcare. We need to broaden it and think outside.

Lisa Belisle: Well, I think the time might be right for your initiative, because I think people are finally starting to come around to exactly what you're describing. And we're finally seeing, and maybe sadly it's because of COVID and the impact of COVID on mental health, but I think we're finally there. There's some light at the end of this, what has been, I think, a very dark tunnel for a very long time.

Judiann Smith: It has been.

Lisa Belisle: Do you know the governor now? Can you bring this forward to her?

Judiann Smith: I know the governor's sister pretty well.

Lisa Belisle: There you go. So maybe this is the opportunity, because sometimes it is a timing, right? Sometimes if you look at the change management, change leadership spectrum, none of this happens overnight anyway.

Judiann Smith: No, no, for sure. I joke sometimes when I get back to the State House and I look around and I see the same folks wearing the same suits, having some of the same conversations, that I think it's a little bit soap opera. Things have changed, things have gotten better, but it's such slow incremental change that with eight years at Hanley, some of the same conversations are still in place and they haven't really moved the ball very far forward. And that's just policy work. It's not saying that these folks are doing a bad job, it's just policy work is slow, incremental change in order to bring people together and come up with consensus, because you can't make a big change and get consensus at the same time. It just doesn't happen.

Lisa Belisle: And I think this is one of the reasons why I was so interested to have the opportunity to speak with you in this setting, because I know that you and I have had sort of parallel professional lives over time, and we also have children that are the same age that have gone to school together. So I think about the educational experience of my children going through, and likely a parallel educational experience for your children. And again, the context is so different from when we were going through. And so how do we help people understand how far we've come and how we get even further? And to me that's intensely personal, because I'm talking about my own kids.

Judiann Smith: I've seen a difference in our children's experience just across my three children when I look at their experiences at Yarmouth High School, from my son Mike, who's 28 now, to my daughter Lindsay who's the youngest, who's 21, and then Abby in the middle. Each one of them had a very different experience based on what was going on in the universe, how much were phones implemented, social media, all the different things that are changing just for their little world here at Yarmouth High School.

Lisa Belisle: As I was even talking, I was having that same thought, because my kids also span somewhat of an age range. And it is true that so much can be different even in 5, 7, 10 years. And that for me is another important point. I was at the Maine Hospital Association. They were talking about generational interdependency, let's call it. Because often we can say, well, why does this millennial group act this way? And we can easily kind of paste on characteristics that may or may not be valid. I think the larger point is exactly what this particular speaker was saying, which is, hey, everybody grew up in a slightly different timeframe, and understanding where people are coming from so that you don't just say, oh, that person's a Karen in a really insulting way, or go away Boomer or something. Like, why do that? It's not going to actually get you any further. So I feel like coming to the Hanley Center and talking with other leaders, regardless of their age, is really just an opportunity to say, okay, so where's this person coming from, and how do I get to know them better? And how can we actually come to a place of somewhat cohesiveness so that we can move forward?

Judiann Smith: Yeah. Yeah. It's so important in the state. And we think about the new Mainers that are here. That's the place where we can all start, is to try and understand other people and try to understand different cultures. And that's sort of what you're talking about, is how do we get to know people without labeling them or making these assumptions? And that's on every one of us. That's the burden we all have, to make sure that we're stopping ourselves before something comes out of our mouth, before the thought hits the air, to stop ourselves and think, is this what I really want to say? Or do I really understand this person? Do I really understand their space in the world and what they've been through, so you don't create more discord.

Lisa Belisle: Yes. There's an old saying about having two ears and one mouth for a reason.

Judiann Smith: Right.

Lisa Belisle: And I think about that a lot. In my own life, it's okay, since I probably don't know a lot about everything. In fact, I've over time realized I know very little about most things. I'm like, oh, I think I'm just going to sit and listen, because I think I'm probably going to be better off, and I'm frequently surprised by what I find. And I've really enjoyed spending time with you today, Judiann.

Judiann Smith: Me too. This has been great. Thanks so much for having me.

Lisa Belisle: Well, thank you. And thank you for the work that you do for the Hanley Center.

Judiann Smith: Thank you.

Lisa Belisle: How can people find out about the Daniel Hanley Center for Health Leadership?

Judiann Smith: Go to our website, hanleyleadership.org, and everything is right there for you. And if you want to get in touch with me, my information is there as well. So I'd be happy to take any inquiries from people in and outside of healthcare.

Lisa Belisle: Very good. Thank you. I've been speaking with Judiann Smith. She is the executive director of the Daniel Hanley Center for Health Leadership. And as an alum, I can certainly attest to the importance of the work they're doing and the manner in which they are offering this information. So please do go out and learn a little bit more and perhaps sign up for a class. And thank you very much for everything that you do.

Judiann Smith: Thank you.