Interview with Stephen Schleicher of Tennessee Oncology

Stephen Schleicher, MD, MBA, is the Chief Medical Officer of Tennessee Oncology. Dr. Schleicher, was previously the Medical Director of Value-Based Care across both Tennessee Oncology and OneOncology, a national platform for independent community oncology practices that now includes over 700 oncology providers across the US. Dr. Schleicher also spent time as a consultant with Mckinsey and Company prior to completing his medical training. Dr. Schleicher received his medical training from Harvard's Brigham and Women's Hospital and oncology training at Memorial Sloan Kettering (MSK).

ROS Team: We wanted to dive into questions and begin by hearing about your journey to becoming a physician. The goal of this is to give physicians who are interested in healthcare leadership a primer on how you got to where you are!

Stephen: Personality wise, I wanted to do something that was very people centric; to be able to make a personal impact. Both my parents are psychologists, and I think this is where the people centric aspect came from. I went into med school wanting to do oncology, and I ended up at Brigham in Boston for internal medicine where I had this unique opportunity to enroll at HBS while completing residency. Here, I got to step away from patients and understand how outsiders felt about healthcare. This led to one of my earliest, major career questions - academic vs non-academic medicine? One of my mentors, Regina Herzlinger, was key in helping me decide because she gave me the insight that academic medical centers are not the ones disrupting healthcare. Fast forward a bit and the Affordable Care Act came out, and I caught the healthcare policy bug. One of my mentors in business school had been the COO at MD Anderson who was coming up to HBS to work with Michael Porter on value-based care, and sitting in on these meetings was so important for my early career development and taught me how to think about the future of medicine. From here, I went to MSK and though I learned a ton from some excellent physicians, I realized no one was thinking about how ACOs work and how do primary care-based models integrate with specialty care, etc. I met Jeff Patton, who was CEO of Tennessee Oncology who essentially brought me on to lead value-based care because it was so new. I decided to take him up on that opportunity. Here, I got to sit in on monthly meetings with the CEO, work with the analytics team, and showcase that I can work with a larger team. From there, I was made medical director of the platform and was thrust into the role of a physician leader. And finally, once I became a partner in the practice after 3 years, they made me CMO. So much of this came down to mentorship and learning from visionary leaders in oncology who had been doing this for 20-30 years.

Aakash: Would you advise an MBA for everyone? And if not, how else would you recommend aspiring leaders to get that same experience, especially if you are within an academic circle?

Stephen: Frankly, it's impossible to see outside of the circle when you are deep in it. Especially, if you have never seen or experienced the other side. People always say you can’t go back once you leave, but honestly, I have personally never once thought about going back given the many abundant opportunities for innovation and patient impact in the private sector.

But here are the things I would recommend exploring if the non-academic realm is something you are considering. Oncology Business Review is a great news source, and it helps you stay updated on not only new FDA approvals but also has a robust policy section. It’s a great way to keep updated and see the people who are actively involved within the business space. Twitter is also great for active debates and conference information to get an understanding of what people are most concerned about.  For me the biggest source of information and keeping my pulse on the space is LinkedIn. You see acquisitions, healthcare deals, start-ups, and get to stay connected with other likeminded people doing interesting things. I cannot say the MBA is for everyone, but the MD/MBA world is getting larger, and being able to differentiate yourself is very important. I’ve found a great way to keep connected and circumvent the MBA is to connect with a few individuals who are key in the space you are looking and using them to help connect you to others.  Also, don’t be afraid to cold email people, you never know what will turn into a great conversation and an even better opportunity.

Waqas: Thanks for all those insights, one of the challenges of being a resident/full time doctor is that many of these things happen when you are off work. How do you balance?

Stephen: The short answer – it’s hard. Some programs are more lenient and allow more time for career building vs others are very clinically intense. I would recommend asking yourself two questions. The first is what my long-term goal or plan is, and while figuring that out, ask yourself, what will make me happy? For me, it was a career that involved wearing multiple different hats, where every day was exciting and different. Also, this may seem obvious, but your first job doesn’t have to be your last job. Its okay to do something, realize its not for you and pivot.

Waqas: As someone who has specialized from internal medicine to oncology what are your thoughts specializing vs not?

Stephen: Honestly, there's no right answer. It depends on, what you want your career to encompass. For me, I knew that if I was going to see patients, I wanted to see cancer. But if you aren’t so committed to seeing a handful of disease states, then a hospitalist career is also warranted. It’s a hybrid career that allows for great flexibility. However, I will say that specializing helps when building a brand. For example, I think I happened upon this coincidentally, but there aren’t that many oncologists who know business and policy. But there are plenty of general MD/MBA Internal Med physicians. Being able to differentiate yourself is key. It makes finding a job easier too, because there are fewer qualified people for the role and the competition isn’t as severe.

Veeral: Given the rise of the MD/MBA, we wanted to ask you what that experience was like and what would be your key takeaways? Also, what was your experience like with Mckinsey and Company?

Stephen: Great question. I will say the value initially is the skillset - 10-15% of the value was the hard skills, the rest was the soft knowledge. For example, HBS is purely case-based and it focuses on you being able to convey a viewpoint powerfully and succinctly, which is incredibly important in the real world. It sounds easy, but it’s incredibly difficult to master. And again, I am not saying you will know more than a finance person about a balance sheet, but you will know more than your medicine counterparts. Mckinsey, on the other hand, was essentially a deep dive into “how can I convey the information I have gleaned into an effective presentation”. Now, after being almost 10 years out, , the value has become the network. So many of my classmates are out there doing incredible things and it pushes you to become better and having the network and resources to tap into is key.

Waqas: Could you take us through a typical day at Tennesse Oncology?

Stephen: So it varies a lot. My admin days right now are Monday and Wednesday. And then I'm in clinic Tuesday, Thursday, Friday. Clinic is very important for me because it allows me to maintain my credibility as a physician leader and helps me keep in mind the pain points of a typical oncologist. It also keeps me grounded and reminds to always put the patient first. The admin days on the other hand, can vary from executive team meetings which involve a combination of operations, nursing, HR, revenue cycle leaders to performance meetings to meeting with new hires/future hires. The admin days also allow me to do things like advocating on Capitol Hill or traveling to other practices to give a talk on our business model. All in all, most of my days are spent around people, which I absolutely.

Aakash: What do larger organizations look for when they are hiring a CMO and how can students, residents and attendings formulate their CVs to become attractive candidates?

Stephen: Yeah, so two things. The first is how you present yourself.  It’s going to be very difficult, if not impossible to jump straight into the C Suite. So I would first start with small projects that allow you to work with the financial and operations teams. This allows you to get some facetime with key decision makers, the higher up the better. It also gives you the opportunity to show accountability, which is so valuable because, once you prove yourself, eventually people start reaching out to you with projects that allow you to showcase your capacities. The second piece of this is management – managing up, laterally, and below. Use these opportunities to manage up by overcommunicating with your boss, getting their feedback and executing. Manage below you by getting your team excited and fired up to work on your project. And lastly, building up the team around you so that it’s not all about you and show that you are willing to spread the credit for a job well done. I would highly recommend the book The Motive to dive deeper into this.

Veeral: You’ve mentioned mentorship multiple times and it seems that people in the business world do such a great job of finding and maintaining mentors. Could you dive a little deeper on how to do that and what that looks like for you?

Stephen:  Absolutely, one of the greatest things I’ve learned is that growing your network is as much giving help and guidance as much as it is receiving it. I try to connect every person that reaches out to me with at least 2 other people. This gives them the chance to not only hear what other people think about but it allows me the opportunity to stay connected with my network and give the other party a major compliment by painting them as someone who is worthwhile knowing. It’s also partially selfish on my end because who knows what that person will end up doing in the future and how our paths may cross again. One of my favorite examples of this is Joel Katz, the ex-PD at Brigham, he’s the master of this. He connects you with someone new and important every time you meet with him, He’s done this for so many people that when he calls you for a favor, you jump to help because it grows not only their network, but yours as well. In terms of finding a mentor, you don't have to make it super formal and nor do you need just one. If you find someone online or within a company that you think is interesting – don’t be afraid to shoot your shot. Plus, odds are, if they don't respond, they literally just didn't see your email cause they got a hundred a day. But there's no downside of emailing someone.

Veeral: As we wrap, we wanted to know what your information diet looks like? So many resources out there, how do you keep up?

Stephen: For me its combination of podcasts, OBR, Linkedin, people sending me interesting things to read and keep up with. I am lucky that my medical focus is breast cancer and so it makes it easier to stay up to date with the literature.

Want to learn more about Dr. Schleicher? Find him at https://tnoncology.com/physicians/stephen-m-schleicher-m-d-mba/