Redefining Leadership: Q&A with RI Department of Health’s Dr. Alexander-Scott

*This ongoing series profiles female powerhouses who are making their mark in their leadership roles. In the spirit of paying it forward, each profiled woman is asked to nominate another peer to fuel the series.**

I was so grateful to be introduced by my good friend and colleague Tim Hebert to Dr. Nicole Alexander-Scott, Director of the Rhode Island Department of Health. Dr. Alexander-Scott is the epitome of a strong female leader. In addition to overseeing a department of approximately 450 people and finding the time to be an Associate Professor at the Brown University School of Public Health and at Brown University’s Warren Alpert Medical School, she is committed to carving a strong vision centered upon health equity for the state of Rhode Island. She is also particularly passionate about paving the way for the next-generation of female leaders and bringing to light pertinent topics like empowerment, parity and advocacy.

We sat down to discuss everything from how the practicing physician ended up working for the state to what she has learned about modern-day leadership along the way. What follows is a glimpse into our conversation…

Me: Dr. Alexander-Scott, it’s such a pleasure to meet you! My wonderful friend and mentor Tim Hebert, a true powerhouse in the state of Rhode Island, spoke so highly of you and nominated you for inclusion in this series. To begin, how did you and Tim, former CEO of Atrion, Inc., and now Chief Client Officer of Carousel Industries’, first connect?

Dr. Alexander-Scott: Tim and I first connected when I was honored to be appointed to Governor Gina Raimondo’s cabinet in April of 2015. She is such a visionary and determined that each of the cabinet members would benefit from receiving mentorship by leaders in the private sector. It’s a move that not only strengthens and expands the private-public sector partnership, but also allows leaders to support other leaders. Tim was selected to be my mentor.  

Me: Speaking from experience, having worked for Tim for almost three years, you really hit the jackpot with that one!

Dr. Alexander-Scott: I really did! He’s given me such wonderful advice, specifically in how to engage your staff as a leader, set the vision, make them part of it and message it effectively. I clearly remember him saying you can never discuss the vision enough with your team.

Me: That’s wonderful! You have been the Director of the Rhode Island Department of Health since May 2015. How did you come into this role?

Dr. Alexander-Scott: I am originally from Brooklyn and the quick version is that I went to Cornell University, majoring in Human Development and Family Studies, and graduated from medical school in 2001 from SUNY Upstate Medical University at Syracuse. After completing a combined internal medicine-pediatrics residency at SUNY Stony Brook University Hospital in 2005, I finished a four-year combined fellowship in adult and pediatric infectious diseases at Brown University in 2009.

During that time, I began to develop a relationship with the Department of Health and had the wonderful opportunity to help establish public health policy through legislation.  For example, I helped bring about a legislative change that made it so that HIV testing consent could be obtained verbally instead of written, thereby decreasing the barrier that was caused by providers having to stop to get written consent.

By the time I finished my fellowship at Brown, I decided to stay on as faculty and began seeing patients. During that time, I had the opportunity to work with the Department of Health as a consultant and the agency's interim director. The Governor appointed me in April of 2015. I was confirmed by the General Assembly in May of 2015.

Me: How did it feel to join a department that you had previously had the opportunity to work for in a consulting capacity?

Dr. Alexander-Scott: It was an honor to join a department I had the pleasure of working in since 2009 and it gave me a familiarity of what was important. The staff already had an understanding of who I was and what I was hoping to accomplish. On day two, I was already able to share the vision with my team, which includes ending the health disparities based on zip code, race, ethnicity, sexual orientation, gender orientation, level of education or level of income.

Me: How have you communicated the vision to your team and, more importantly, helped them be inspired by the vision?

Dr. Alexander-Scott: My team knows that I personally connect to this vision and I’ve shared the reason why with all of them. My mom was from South Virginia and moved to New York City when she was 12-years-old. When she got to the city, she was told that because of the color of her skin, she would never be able to hold anything beyond a vocational position. In fact, she was sent to a vocational school that wouldn’t allow her to get college credits.

But she determined that thinking to be false. When she finished high school, while working full time, she attended another high school to receive the credits needed to go to college. She worked full time through college and became a nurse. She ultimately retired as Director of Nursing. I have shared with my team the values that I learned through my mom and how that experience plays a role in the vision I have for the state today.

A major focal point of the department this year is to promote health equity and that begins by ensuring that the public understands what we mean when we say “health equity.” The term refers to more than just healthcare and what goes on in the examination room. When we say “health equity” we are referring to making sure people have equal access to services no matter the environment in which they live. Regardless of zip code, everyone should have equal opportunity to live the healthiest life they can.

Everyone on my team contributes to the vision—from the person working in the lab performing tests to the folks issuing licenses to our healthcare professionals. Every person’s tasks contribute to the social and environmental factors that promote health equity.

Me: It’s a powerful story and I am sure one that resonates with so many members of your team. In addition to fighting for health equity, what other issues do you hope to address this year?

Dr. Alexander-Scott: Another issue is the unfortunate and significant overdose epidemic that we have in the state of Rhode Island. This year, we saw more than 280 people tragically lose their lives as a result of an overdose and we have set the goal of decreasing the numbers by a third by 2018.

We will also focus on the expansion of the newly created Rhode Island Department of Health Academic Center, established to strengthen the integration of scholarly activities with public health practice by instilling a culture of learning and innovative problem solving along with continuous quality improvement. The center allows us to bring together the needs of public health, like achieving health equity, with new advances in academia. When we blend both of these worlds, we can really advance the work we do.

Me: It’s important work ahead! With so much on your plate, what part of your job do you find the most exciting?

Dr. Alexander-Scott: For me, one of the most exciting facets is the team with whom I work. The team is made up of individuals who are committed to what we do and want to make sure that we do good work. That motivates me each and every day. It motivates me to advocate on their behalf, to always tout the work they do and to be ready to defend anything about what they do. The people make it an honor for me to hold this role.

Secondly, I am inspired by the impact I can have in this role; the ability to make an impact is what drew me to public health in the first place. As a physician, you want to make a difference and you can make a real difference when you can affect legislative policy.  

Me: As someone with a rich history in medicine and academic, did you always know you would end up in a role like this?

Dr. Alexander-Scott: I did not! What I enjoy sharing with my medical students and team members is that you need to pay attention to what you begin to be passionate about. Don’t resolve to being fit into some box that you are supposed to fit into. Instead, go after what you deem to be important and find the path to get there.

When talking with medical students about the career path they are going to choose, I spend the majority of the time asking them: What have you been so interested in during your college career that you could go hours without moving from your seat because you were so fascinated?

For all of us, no matter our professions, it’s about unpeeling the layers of our own gifts and determining where we need to put our focus. That will help us see which career path aligns with our gifts. Though I didn’t necessarily predict it, I ended up choosing a profession that is important to me and that I enjoy thoroughly.

Me: That’s great advice! To that end, what is the best piece of advice you’ve ever received?

Dr. Alexander-Scott: If you don’t define yourself, someone will always take the chance to define you for you. It’s important for women to take the reins in establishing what that definition is for themselves, instead of leaving a void so that someone else fills it with their own answer.

Me: I think that advice is particularly powerful for today’s female leaders, many of whom are struggling to define themselves while remaining authentic. To that end, what other advice do you have for today’s leaders?

Dr. Alexander-Scott: Continue to be true to yourself. Women often carry that burden to assimilate and become one of the guys in order to be successful. But maintain who you are and the gifts that you bring to the table. Strive to be confident and genuine to who you are.

Women supporting other women is also an important goal and bringing along the men who want to recognize and support women. It shouldn’t just be women saying that “We need more women in leadership roles”, in the same way that it shouldn’t just be people of color saying “We need more people of color in leadership roles.” It should be everyone.

Diversity brings strength to teams and if organizations really want to grow and be transformative, they need to bring different perspectives to the table—and that means people of differing genders, races, sexual orientations, geographies and ethnicities. Those that understand this philosophy—and embrace it—can thrive in a way that is substantiated over time.