Marketing and Availability of Unhealthy Foods: Fast foods and sodas are inexpensive and easy for families who work long hours and are often too tired to cook when they get home. The fast food industry has recognized this and spends millions of dollars on advertising that is especially attractive to young children. According to Dr. Mercola, “The majority of Americans (adults and children) are becoming insulin-resistant due to their junk food based diets, loaded with sugar, processed grains, and chemical additives. Insulin dysfunction is putting many in a state of perpetual inflammation and driving up the rates of chronic disease. Americans consume nearly 4,000 calories per day on average — more than anyone else in the world. Yet, they are malnourished because most of these calories are from processed food, therefore devoid of nutrition. The processed food they offer is high in calories and is a big factor in our country’s growing problem of obesity among adults and children.” Soda is the new tobacco and many of our children are addicted before they reach age five. Cities like Berkley have instituted a soda tax and consumption of sodas has been reduced. This should become the model for all our communities.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Viveka Rydell-Anderson. Viveka came to the US in 1989, received her J.D. from UC Berkeley School of Law (Boalt Hall), her B.A. with honors from UCLA, and completed the Stanford Business School’s Executive Program for Nonprofit Leaders in 2008. She worked for eight years as a litigator before being tapped by the PDI Board of Directors in 2006 to bring their dream of a non-profit surgery center to reality. She wrote a business plan, secured a construction loan, completed a $1.3M Capital Campaign, oversaw construction, hired key surgery center staff, and took PDI from start-up to a dependable resource for patients from 33 Northern California counties, building a strong, bi-cultural team as well as growing partnerships in corporate and philanthropic world, negotiating insurance contracts, securing a special exemption from Center for Medicare & Medicaid Services (CMS), and promotes health equity on the local, state and national level.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Iwas working as a litigator in San Francisco when my children were small. While I enjoyed the intellectual aspect of the work, I wasn’t comfortable with the confrontational aspects. I wanted to spend more time with my kids, be more creative and innovative, and above all, to have a more positive impact on the world. One day I was shocked to receive a call from my son’s pre-school teacher. My son had painful toothache and I needed to pick him up at once. Shortly after that, I heard that a group of healthcare advocates trying to form a nonprofit to serve low-income kids suffering from severe tooth decay were looking for a CEO. I asked to be considered for the position. I was hired and began the task of making their dream of a surgery center a reality.
Can you share the most interesting story that happened to you since you began leading your company?
A couple of years ago, I was invited to attend the Aspen Institute’s Ideas Festival in Colorado and speak about PDI’s unique business mode. While at first I was taken aback as I imagined only important or famous people were invited, I was assured that the mission and vision of PDI would find many eager listeners at the event. This proved very true. Not only that. The event and exposure also opened doors for me. I was invited by other leaders in social change and healthcare to speak about PDI’s unique business/nonprofit model. I soon learned that PDI has much to share with other nonprofits and health organizations, most recently at the Institute for Healthcare Improvement (IHI) conference in San Francisco. There, I presented a poster about specialty care referrals provided by PDI to clinics and dental offices in a 33-county-wide area.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I have never thought of myself as an authority in the healthcare field, but after 12 years of heading a very successful specialty health center, I have learned a lot. Whenever possible, I contribute what I know at health conferences, and join groups dedicated to children’s and families health. I also seek out and listen to the advice and wishes of clinicians and health workers at every level. This has allowed not only me, but everyone at PDI to grow and improve at a very fast pace. I am proud of being able to recognize and hire talented, passionate and dedicated people who are committed to high quality, and who value a team-based approach. Being attuned to the PDI team helps me to provide staff with the best tools when they need them. We have eliminated bureaucracy, so that when a patient or family needs change, innovative ideas, and tweaks, quickly reach leadership, and can be tested and implemented quickly and effectively
What makes your company stand out? Can you share a story?
PDI is Northern California’s only pediatric ambulatory surgery center that not only provides oral surgery under anesthesia for treatment of severe tooth decay, but also offers case management, outreach, prevention education, and aid in accessing insurance and a permanent dental home. We are unique in the nation. 98% of our patients are Medicaid (low-income), yet we make it work, though specialized, high-volume, and efficient, yet patient-centered care. Years ago, a young boy, Deamont Driver, died in Maryland, because the infection from of an untreated abscessed tooth spread to his brain because he had not access to treatment. PDI was started in an effort to make sure we don’t have such senseless and preventable deaths. So every story I think of are the countless children we treat who had an abscessed tooth. We help them get seen quickly, and even help them with transportation assistance, or connecting them with a payment form, if they come from a rural area, and/or have no transportation.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
PDI is a specialty care provider, doing something completely unique. Every year we treat more than 2,000 children from 33 Northern California counties who are suffering from such severe tooth decay that they require oral surgery under anesthesia. Their average age is three and the average number of teeth requiring treatment is 12. We are also the dental home for special needs patients up to the age of 25 whose families have been unable to find a dentist to treat them. PDI also make home visits to at risk families, and offers a Train the Trainer program to other organizations, to help build dental health literacy at partner agencies.
In 2017, we were awarded the Jefferson Award described by Jacqueline Kennedy as a “Nobel Prize for Civic Engagement.”
The “pain point” PDI is addresses is the debilitating pain of tooth aches. On a larger scale of course, we are trying to prevent such tooth decay. With community healthcare workers doing outreach, we support families, and empower them. We provide families with information, and help them access dental care community clinics, address food insecurity, and help connect then with food banks and vouchers to Farmer’s Market’s so they can have healthy foods and beverages at home. A parent’s empowerment with a toothbrush can be a life changing thing: a seemingly small daily routing, can have a huge impact on the trajectory of a child’s life since dental health affects overall health.
What are your “5 Things I Wish Someone Told Me Before I Started” and why.
- Trust your instincts: When I heard that PDI was looking for a CEO I just knew that it was the job for me. Several friends thought I was a little crazy — “You have a great job as lawyer! It pays well. You have a great reputation. Why would you take a chance on an organization that’s not even up and running?” they asked. My answer was that it just felt right to me and I was already becoming passionate about the mission of making sure disadvantaged children suffering from severe tooth decay had access to safe oral surgery under anesthesia, and was excited at the idea of trying to inform and educate families about the value of good oral health. I was so convinced that I signed as a guarantor on the construction bank loan to stay with PDI for five years. Now in my 12th year, I would do it again.
- Ask for help. It doesn’t make you look weak: I was lucky enough to begin my role as CEO of PDI with some wonderful board members to support me. They let me know that coming to them if I had questions or problems meant that they could connect me to someone in their network of friends and colleagues who would be willing and able to help. I also asked every successful local business owner about their business model, and spoke to dentist I met the most basic questions about dental health. Every person was helpful and totally non-judgmental. I learned so much from them and continue to do so. It really does take a village!
- It’s okay to try things, fail, and try another angle: I learned this very early in my nonprofit career when I was trying to start a capital campaign for PDI. After asking a couple of prospective donors and being politely turned down, I was feeling defeated and not sure if I was up to the task. I told a board member who said, “Ask friends to introduce you to people and start from there.” I soon learned that not one approach fits all and began writing letters, knocking on doors and cozying up to people at events and telling them my story. Sometimes it worked and sometimes it didn’t, but I did manage to raise $1.3 million in 13 months. PDI was on its way to reality. Raising money for good business ideas takes a bold mission and vision, and perseverance, whether it’s a start-up entrepreneurial business or an innovative new healthcare service provider. Being scrappy, and finding Angel Investors where we can, to be able to try smarter and better ways of delivering services. I am fascinated about the healthcare transformation going on in our country, and excited to be part of it for many years to come. Some things we have tried in the US are not working, and we are many working on new ways forward.
- Speak out more boldly — the world needs change makers: It wasn’t until I was invited to the Aspen Institute and found that people were genuinely interested in the story of PDI that I fully embraced this concept. If you have something to say, make sure people hear you. We the people have a lot more power than we think. We can affect change. If we want healthier bodies, families, communities and environment, we have to speak up and act. We are the consumers that corporations sell goods to. We can make demands. We can vote with our dollars and our feet, taking business to those that do good. You’ll find that other will also be grateful for your input and boldness in speaking up. And our next generation wants a good world to live in to. Doing good is good for all of us.
- Invest more in internal hires to become tomorrow’s leaders (build it into the work model, not just as an add-on, extracurricular?)
Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
I can think of so many reasons but there are some that are obvious and must be addressed:
- Affordability: The families of children who come to PDI for oral surgery to treat severe tooth decay are all at or below the poverty level. Fortunately most of their children are covered by Medical insurance, and we provide those who aren’t with pro-bono treatment. If a child is taken to a hospital emergency room for the treatment we provide, it will cost up to $10,000 — an impossible amount for low-income families. Nearly one-third of Americans are uninsured or underinsured. Twenty-five percent do not visit a doctor when they’re sick, due to the cost. Twenty-three percent can’t fill their prescriptions. Thirty-five percent of Americans have difficulty paying their medical bills and nearly two-thirds of all bankruptcies are linked to inability to pay medical bills due to being uninsured or underinsured. The cost of drugs is exorbitant and pharmaceutical and insurance companies are able to charge what they want, with little or no transparency about pricing and price increases while executives make huge amounts of money. This needs to be reined this in.
- Marketing and Availability of Unhealthy Foods: Fast foods and sodas are inexpensive and easy for families who work long hours and are often too tired to cook when they get home. The fast food industry has recognized this and spends millions of dollars on advertising that is especially attractive to young children. According to Dr. Mercola, “The majority of Americans (adults and children) are becoming insulin-resistant due to their junk food based diets, loaded with sugar, processed grains, and chemical additives. Insulin dysfunction is putting many in a state of perpetual inflammation and driving up the rates of chronic disease. Americans consume nearly 4,000 calories per day on average — more than anyone else in the world. Yet, they are malnourished because most of these calories are from processed food, therefore devoid of nutrition. The processed food they offer is high in calories and is a big factor in our country’s growing problem of obesity among adults and children.” Soda is the new tobacco and many of our children are addicted before they reach age five. Cities like Berkley have instituted a soda tax and consumption of sodas has been reduced. This should become the model for all our communities.
- Prevention Education: We learned very early that parents who come to PDI have little or no idea of the importance of good oral health or good dietary practices. We have developed an aggressive prevention education program with an in-house educator working one-on-one with parents while their child is undergoing oral surgery, and our promotores (lay health workers) go out into the communities we serve to explain the causes and dangers of poor oral health and ways to prevent it. I believe that this kind of service should be offered at the national, state, and local levels with children learning about good health practices as early as kindergarten.
- Social Determinants of Health: As a country, we have far too long ignored societal barriers to care. Many in our society have no access to housing, clean parks, clean water, good schools, job opportunities, and healthy foods. These are the “social determinants of health.” We can’t afford not to address these societal inequities, because in the end, not only are people in unnecessary pain but it will cause unrest and cost more to treat them.
If, as a society, we were to address these problems, obesity, heart disease, tooth decay, heart failure and so many other health problems could be prevented.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- A toothbrush in every hand! PDI hands out thousands of toothbrushes each year and encourages regular brushing and flossing. I would love to see other organizations doing the same thing no matter whether they focus on other health areas, arts, or sports. Oral health affects overall health and it’s important to encourage people to do all they can to stay healthy if they are to participate freely in community activities.
- Collaboration: It is important that we understand the goals of other agencies and be prepared to share ideas and work together when possible. PDI partners with more than 100 other agencies, and most recently, PDI has begun partnering with the Redwood Empire Foodbank to provide bags of healthy food together with simple recipes to our patients’ families to encourage good dietary habits.
- Models like dcgreens, an organization that levers education, access, and policy to advance food justice in the nation’s capital by recognizing and addressing the structural inequalities in our food system. At PDI we see the damage sugary drinks, and other items like gummy vitamins that parents buy because they think they are good for their child. Through our oral health education, we have learned than many parents have no understanding of how to prepare a healthy meal and so we provide bags of healthy groceries, fruit and vegetables with simple recipes to every family we serve.
- Investment in Prevention Education: More than 2,000 children come to PDI every year for treatment of severe tooth decay. Often their teeth are rotted to the gum line. Parents are shocked to learn that giving their baby fruit juice or milk in their sippy cup was rotting their teeth. “But milk is good for you!” they often exclaim. We would love to be put out of business because there was such a good national health education program that we had no more patients!
- Development of policies and programs at the local, state, and national level that recognize and seek to improve the social determinants of health: Behaviors, Social and economic factors, our physical environment, and Clinical care. We’ve seen the awful effects of poor water quality in Flint Michigan. Children in low-income neighborhoods do not receive the same quality of education as their more affluent peers. The problem of drug use (especially tobacco use and opiate addiction) is now considered a national crisis. These are all factors that affect quality and length of life and must be addressed if we are to have an equitable society.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
As individuals, we can attend meetings at the local, county, state and, if possible, national level and make sure our ideas are heard. Younger consumers are increasingly making their voices heard and expressing their desire for corporations to have a positive social impact, and not just make more money for shareholders. We can all write letters to the editor, our representatives, and corporate leaders demanding that they conduct business in any community as if their own children lived there and become more inclusive including more women, LBQT and diversity on their staff and boards. We all need to step forward and speak up!
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
While I’m in the car, I enjoy listening to Podcasts like Matters from the Heart by Rachel Brathen (“Yoga Girl”), Dr. Weil Podcasts (food as medicine), The Healthcare Podcast, HealthSounds Podcast, and 2Docs Podcast. They help me keep up-to-date and learn different beliefs and attitudes as well as what’s new in the healthcare world. I also read and re-read A Pebble in My Pocketand Peace is Every Step by Thich Nhat Than because they challenge and inspire me. The world needs a lot of healing, and we are all connected. We owe it to our children and grandchildren to work to make a difference before we go too far down the road of greed and profit that is destroying our natural environment, our communities, and our health. Being in nature, holding a family member’s hand, having a potluck with coworkers and neighbors — these are all times we can reflect, share, and consider our concerns! In the end, we must be present for each other.
How can our readers follow you on social media?
On LinkedIn: Viveka Rydell-Anderson
On Instagram: vivekananda68
On Facebook: Viveka Rydell-Anderson
Thank you so much for these insights! This was so inspiring!