Leaving our prejudices and preconceived notions of patients and their behaviors at the door. We all have subconscious biases that influence our decision making, but our system is so riddled with jaded ideas of patient qualities that when compounded with medical malpractice liability and profitability concerns, care is being delivered through a very warped lens. It is true that women receive substandard care to men. People of color receive substandard care to Caucasians. Immigrants receive substandard care to native-born. These truths leave large swaths of the US populace without care that meets their needs.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Shital Mars, Chief Executive Officer of Progressive Care Inc., a personalized healthcare services and technology company. Shital’s passion for creating an ethical proactive pharmacy model led her to her current position in January 2016. As CEO, Shital has guided Progressive Care and its wholly-owned subsidiary PharmCo LLC on a rapid growth trajectory with the signing of an investment deal in June 2018 and the acquisition of Touchpoint pharmacy. In June 2019, Progressive Care Inc. acquired Family Physicians RX, Inc. dba Five Star RX and Florida corporation and now boasts 4 physical pharmacy locations with 5-star performance ratings and nearly 125 employees from which to launch further expansion and sales growth. Shital has continued to focus on creating and implementing systems that improve patient adherence and provide risk management practices for physicians and providers. She is also responsible for spearheading Progressive Care’s campaign focused on pain management alternatives to opioids.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Icome from a family of healthcare professionals. My father is an ER physician and my mother has a Ph.D. in Healthcare Administration. My brother is a doctor and a lot of cousins are doctors. However, I wanted to work with numbers and get into the business and political world. At 4 years old I wanted to be a senior economic advisor to the President or whatever a 4-year-old can think Alan Greenspan did. I studied economics and math and went into investment banking out of college. And somehow, I ended up in healthcare anyway. The group at the investment bank were also key personnel at PharmCo (one of the pharmacies my company owns). When the investment bank was closing, I was sent to the pharmacy to guide its transition. I love healthcare and particularly love health leadership and strategy, so it worked out for the best.
Can you share the most interesting story that happened to you since you began leading your company?
This past year I had an emergency medical situation. I was suffering from internal bleeding due to ectopic pregnancy that nearly cost me my life. I am blessed with health insurance, but even with that, I found myself making decisions based on the cost of care. I was in writhing pain and I debated foregoing treatment because I didn’t want to be saddled with a medical bill. Of course, I didn’t know what was wrong when I had this debate in my head, but even still, I wondered how many people are making life and death healthcare decisions based on whether they could afford the bill. I begrudgingly made the decision to go to the ER, even though the idea of being sent home for bad menstrual cramps was abhorrent to me. It’s lucky I made that decision because had I delayed even an hour more, I would have died.
And after all of that, the claim for my life-saving surgery was still denied. It was denied even after peer-to-peer. So after everything I had just been through, I now had to fight insurance over nonsense. This is healthcare in America and I am one of the lucky ones.
What makes your company stand out? Can you share a story?
At Progressive Care, we pride ourselves on being a healthcare company. I tell everyone, we do the right thing because it’s the right thing. My company doesn’t get paid for a lot of the work it does. We don’t get paid to coach patients on the medication regimens. We don’t get paid to guide doctors on the most cost-effective formulary compliance method. We don’t get paid to go to a patient’s home and clean out their cabinets of expired medications, triage medication needs, and optimize treatment plans. We don’t get paid to do outreach in our community and provide education, support, and resources for caregivers. We do everything we can to be advocates for our patients and physicians. We do everything we can to get patients the medications they need. We deliver necessary medications to the homeless and the most at-risk and we don’t do this because it is profitable. We do it because it’s the right thing and it’s what our community needs. We are in the business of healthcare and that is what we provide and that’s what makes us stand out.
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?
The next incarnation of my company will be bringing innovation to have more personal healthcare interactions and better control of healthcare data by patients and providers. We want to improve healthcare and we want to empower those involved in care to do just that. We will be working on technologies that will allow providers to understand their patients’ needs better and have better information on how they are accessing care outside of the primary relationship. Our technology will also allow patients to control their health information and be able to provide that information to any person in their care team at their discretion. We want the mantra of “patient-centered care” to be more of a reality than it is and by addressing the issue of hands-off healthcare, we think we will be able to improve outcomes and the quality of care provided.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
1) I wish someone told me how limiting it can feel to be in a powerful position. When you are a CEO, entrepreneur, or leader, your personality is always to go and get done whatever comes to your mind. Yet the more I move forward, the more patience I feel l need to have to allow for everything to happen the way they should. I hate hearing that something “can’t” be done or something else has to wait, but I have to remind myself that I can’t control everything.
2) I wish someone told me how difficult it would be to balance the needs of everyone in my Company. One of the hardest parts of my job is navigating all the diverse needs of the people involved with my company. From employees, to patients, to doctors, and shareholders, they all have their unique expectations of what success looks like. Trying to find a way to offer solid benefits, while investing in the business, and growing the services and infrastructure, and delivering positive results quarter after quarter is a lot of pressure. Plus, I’m the type to care about everyone all the time, so I take the responsibility really seriously.
3) I wish someone had told me how to prioritize my wellbeing. This is the thing I struggle with the most. I tend to give myself to everyone and everything other than myself. I don’t take time for myself and often feel like my life doesn’t have room for me in it. I devote myself to my work and my family and that’s a good thing, but I do get lost in the shuffle. I still don’t know how to build-in the “me time” I need without feeling like I’m not taking care of my obligations.
4) I wish someone had told me how real mom-guilt is. I love my work and I know I would not be as good a mom without having the fulfillment that I get from my career. That being said, mom-guilt is no joke and it can be really hard when I feel like I should be doing better for my child. Dropping him off to school and leaving him when he’s crying is the worst even though I know he’s happy as soon as I shut the door.
5) I wish someone told me how important social media would be in my career. I always say that I am the worst millennial ever. I’m a very private person and sharing my life and all my thoughts do not come naturally to me. I hate listening to myself or seeing myself in videos or pictures. However, in this job, I have had to come to terms with being a public figure and all that comes with it. That being said I still don’t know the logins for half my social media platforms and desperately wish there were a person who could handle all that for me.
Let’s jump to the main focus of our interview. According tothis study cited 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?
The problem with the US Healthcare system goes far beyond the delivery of care. We can inject all the technology and efficiencies we want, but if the system is fundamentally unsound it won’t make a difference. I think the issues all stem from some global questions that remain unanswered in the US and what sacrifices we are willing to make to have a system that’s different and in some ways won’t be perfectly better.
First, we need to, in the simplest of terms, decide as a nation whether healthcare is a right or a privilege. As people, we fundamentally understand that no person’s economic status should be the determining factor in whether they receive quality healthcare or not. Yet, once we determine that healthcare is a right, we live fearfully about how the government will deliver and protect that right. It is this fear of government-run healthcare that prevents even small meaningful progress.
Secondly, and both physicians and patients will agree on this, is that those involved in the receipt and delivery of care often have their expertise, opinions, and priorities diminished in the system. There are so many without clinical or technical healthcare knowledge deciding healthcare policy that the process of receiving healthcare is more onerous and less beneficial than it should be.
Injection of profitability is having a damaging effect on the quality of care and not having the effect of generating positive competition. Capitalism can do a lot of great things like spur innovation, provide drive and motivation. So while health institutions in America can provide some of the best acute care in the world, the capitalist mindset is preventing quality care from reaching our most vulnerable populations. When your provider brings the metaphorical checkbook into the exam room, he/she is weighing your care against a bottom line, which shouldn’t happen. Insurance companies along the same vein routinely deny covered care simply because it forces patients to advocate for themselves, and if many won’t or can’t, the company will save money. The system is a labyrinth on purpose to generate profits under the guise that it prevents fraud or excessive healthcare spending.
Beyond this, our healthcare is hurt by our very culture and systems in the US. Education, income inequality, environmental, criminal justice, and other societal factors all play a role in how we understand and access care. We would benefit greatly from broader reforms that are designed for Americans to live better, healthful, and happier lives. Because so many people lack so many common-sense resources, we use healthcare as a patch for our nation’s ills and it is not equipped to produce the results we want.
We can institute some regulations and remove some others, but broadly we need a full-scale change of mindset to guide reform, without which the US will continue to be ranked last despite its ability to generate capital and innovate technologically.
You are a “healthcare insider”. 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.
I firmly believe that healthcare is a right and I say that as both a person running a for-profit healthcare company and a person who accesses healthcare in the United States. I have lived without insurance, I have lived with insurance that makes getting care a path of landmines, and I have watched as patient after patient comes to my company with story after story of how their family is struggling with paying for just the bare necessities of care. The system simply doesn’t work the way it should and there isn’t a person, no matter the political affiliation, who can say that our healthcare system is doing what it should. That being said my position on how that right translates to policy is not so cut and dry and I would need a thousand more pages to go through what I think healthcare should be. But in the interest of brevity, here are some of my suggestions:
1.) More healthcare providers are involved in the decision making about healthcare policy at all levels. Whether it’s at a hospital, MSO, or government organization, more people who actually provide care deciding best practices. Insurance companies and politicians make a lot of decisions about what should go on in an exam room and in many instances, their policies are more about what is best for themselves and not what’s best for the patient.
2.) Better healthcare education and health resources for all. Education is the best preventive medicine we have. Schools and parents are starved of resources that would allow them to make sound healthcare decisions. A basic understanding of how our bodies work and the resources to keep it healthy would prevent many of the conditions that we face as Americans and help us make better decisions in an emergency.
3.) Integrated healthcare information systems. Healthcare data in the US is very fragmented. Part of this is to preserve the sensitivity of the information, but mostly this is for economic value for those who own the data. The oddest part of this is that patients themselves don’t own their data nor do they have easy access to this information. Healthcare is better when patients and providers have complete histories and are able to see the full picture of the issues at hand.
4.) More personalized medicine. The US has been on a journey of commoditizing healthcare. The impetus is that when more broadly base standards are applied, the less time a physician spends with a patient, the less costly the care. However, it would seem that the opposite is true. The less time a physician spends with a patient, the more at risk that the patient is of an adverse health event and the more costly those events are. When patients and physicians have more substantive conversations, the more likely the person is to stick to a treatment regimen, the more likely they are to have a higher quality of life and the less likely they are to access expensive points of care.
5.) Leaving our prejudices and preconceived notions of patients and their behaviors at the door. We all have subconscious biases that influence our decision making, but our system is so riddled with jaded ideas of patient qualities that when compounded with medical malpractice liability and profitability concerns, care is being delivered through a very warped lens. It is true that women receive substandard care to men. People of color receive substandard care to Caucasians. Immigrants receive substandard care to native-born. These truths leave large swaths of the US populace without care that meets their needs.
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?
There are a lot of things that people can do to get better results out of the system we have.
1) Go see a primary doctor and get routine check-ups so that there is a history of what normal looks like for you.
2) Get educated on your body and listen to it.
3) Review your healthcare policy documents and talk to a professional about whether your policy adequately meets your needs given your budget. The same goes for employers when determining coverage for employees.
4) Stick to your treatment plan.
5) Advocate for your rights and benefits. Often coverage for care is denied right away with the assumption that most people won’t fight back. If you need care and are being denied, contact your insurance company and provider and demand that they work it out.
6) Find a provider you trust, then trust your provider.
7) Employers can provide infrastructure support and develop healthy work environments.
8) Comprehensive cultural and gender competency training for physicians.
9) Healthcare companies can work to unify standards of care and records so that patients have ease of use and access to their data.
10) Healthcare companies need to remind themselves that at the end of the day, they need to help people get well. We are all human and we have a lot of differing priorities, but when you choose to be involved in healthcare you need to prioritize human wellbeing.
11) A nuanced look at healthcare regulations to remove those that are not working and add those that are necessary to improve transparency, efficacy, safety, and quality
Beyond these simple steps, it will take a lot of work and will to have a substantial change to the system. The government must play a role and healthcare companies must come to the table knowing that certain changes will need to be made.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I read a lot of news both domestic and international. I try to stay up to date on everything going on around me so I have a good sense of how people live, what’s better and what’s worse from varying perspectives. I read the Economist because it’s probably the best single publication that can balance political ideologies while also being comprehensive in its content about world affairs. I don’t always agree with everything in it, but I do find the information helpful. I also love history and read a lot of history. I think history gives meaning and context to life. It’s interesting for me to know how people made certain choices and how they came to be. I listen to a lot of TedTalks and try to get a very well rounded cultural education. I do this because I believe that healthcare is first and foremost about helping people and I feel like it’s easier to help people when you understand where they come from.
How can our readers follow you on social media?