Building Community Relationships Through RVU-SU’s Executive Advisory Council

Donna Milavetz, MD, MPH, FACP, joined RVU-SU’s Executive Advisory Council (EAC) in 2017. In that time, she has supported the Council’s efforts in integrating RVU-SU into the Ivins, Utah community, most notably by providing a diverse voice at the Council’s table.

In our interview with Dr. Milavetz, she talks about her work with the EAC, what inspired her to become a physician, and her mission of improving health outcomes in the U.S through her leadership role at Steward Health.

What prompted you to join RVU-SU’s EAC in 2017?

“[It’s] important for physicians in the community to give back. I think having that relationship between a community physician who is actually practicing and the medical students…is a really important part of the medical education experience. For those reasons, I thought it would be important to be a voice in that conversation.

“I also think that as a female physician and [leader], it’s important to model a spectrum of possibilities – not only for women but for anyone – in terms of my circuitous career path: what I thought as a medical student versus what I’m actually doing today.”

What does the RVU-SU EAC do and/or what is it tasked with doing?

“The mission of RVU-SU’s EAC is to have an advisory board for leadership at the medical school and for community relations in Ivins and the greater St. George communities. The Young Doctors’ program, a project that the EAC raised and operationalized, was two-fold. [The EAC] had to be thoughtful on how to craft it, so we provided input as to what age group to start it at. It was intentional from the EAC as to the age group that we started it at, because with kids, once they hit late middle school and definitely high school, there are more biases on education in STEM studies, especially with girls who tend to fall off the curve. [The EAC] really wanted to make sure that we were reaching students at a much more impressionable age to show the possibility of what could be.”

Dr. Milavetz also explained that, between seventh and eighth grade, girls fall off of the STEM curve for math and science because they don’t want to be perceived as smarter or more aggressive in any way.

“Our intention is ultimately to have [the program] in every elementary, junior high, and high school in Southern Utah because each school has different needs and different opportunities for exposure. Ultimately, you’ll see that trajectory happen and [it will] probably be guided by the EAC. Some of it is resource and time-dependent, but I see that happening.

[The program also] serves many purposes [including for RVU’s students]. One is early exposure to how to lead a group. Number two is how one is perceived as a leader in the community. I say that all the time to young, up-and-coming physicians. Whether or not you want to agree with it or admit it, by being given the label of physician, you have a status in the community and you have an obligation based on that status. How you conduct yourself and the decisions that you make in your personal life will reflect upon that. We are held, for better or for worse, to a slightly higher standard. Having that exposure and that experience [through the Young Doctors’ Program] in a low-risk group is part of cultivating those leadership skills. Leaders aren’t born, they’re created by experiences, and [the program] creates that opportunity. The fact that it is run by students is also by design. It created that opportunity to really say ‘okay, this is not only teaching philanthropy, we want to promulgate that as a physician community.”

Recently, RVU-SU’s EAC has experienced a handing off of the baton, so to speak, as Tim B. Anderson, JD, the Council’s inaugural chairman, steps down and Terri L. Kane steps up. Likewise, the RVU-CO EAC is going through a transition phase, as well. Dr. Milavetz also spoke about these new changes in our interview:

“The goal is to have community resources and people that bring a different vantage point to the leadership of the medical school to help create a more enriched environment for students. How we get to that path is probably campus and resource-dependent.

Additionally, healthcare is local, and there are different barriers and opportunities, and different markets. The spirit of that commitment from the EAC is to promote RVU-SU from a branding recognition standpoint and from an endorsement standpoint. I endorsed it as a leader in the community and that increases brand value for RVU. I’m a big advocate.”

Local elementary school students attend a session for the Young Doctors Academy in Southern Utah.

What projects have you worked on with RVU and/or other members of the EAC?

“We spend a lot of time in the EAC talking about how to integrate [RVU] – and this is specific to Ivins – into the community. The Young Doctors’ Program is one [way we that do that] and we all gave input and insight into that [program].”

While a hands-on approach to the program is not possible for Dr. Milavetz, she has also taught a couple of leadership track classes on different medical practice styles and negotiating contracts. She views these classes and the information they provide as an important part of medical education.  

“Lastly, we brainstorm with medical leadership at RVU. I’ll use the example of women matriculating [at RVU-SU]. When we started, [the percentage of female students] was 19% for the first COM class, and now we’re up to 45%, which is fantastic! Having those diverse voices as an advisory board and helping the leadership teams in recruitment and outreach efforts is part of the role of [the EAC]. We help in whatever way we can in terms of providing out-of-the-box ideas for how to solve problems.”

How does RVU’s mission align with your own goals/projects in improving health outcomes in the U.S.?

“I believe in a holistic approach to health, and I think that is a part of RVU’s mission. I also believe that, overall, health is really about communities. Healthcare – the actual act of going to the doctor or going to a hospital – constitutes only 10-15% of all the social determinants of health: food insecurity, a safe environment to live and exercise, access to clean water and clean air are much larger aspects of determining one’s overall health.” RVU embodies the ideals of community both within its four walls and extending into the community.

Dr. Milavetz was not exposed to osteopathic physicians until after her residency, as she took the allopathic route to obtain her medical training. While running a medical group and a primary care practice, Dr. Milavetz explained, she employed osteopathic physicians all the time. For her, it was less about the “DO” or “MD” initials and more about if the physician’s value system or mission-aligned with this idea of total health.

“[At RVU], I love the idea of a community within a medical school, as well. RVU really strives to set itself apart in that regard. When I went to medical school, it was very competitive. It wasn’t necessarily a nurturing environment. Not to say that RVU doesn’t have some competitiveness – you have 150 competitive people by nature – I also think that you don’t have to tear somebody else down to build yourself up. That culture of inclusiveness, community, and philanthropy –within the four walls of the medical school – are really promoted and it is an outstanding culture as a result.”

What inspired you to become a physician and/or to choose internal medicine as a specialty?

“My personal journey to becoming a doctor was probably shaped by both of my parents being ill when I was a child. My mother had breast cancer when I was in the second grade and, in the 1970s, they did not have a lot of advances other than surgery and radiation. Seeing that experience at a young age definitely shaped me. My father then had a massive heart attack when I was in the fifth grade; he was one of the first cases of triple bypass surgery at New York University.

These two sentinel events in my life as a very young person shaped me in terms of wanting to help others and probably not wanting to feel helpless. I have always been fascinated by science and learning and pursuing unanswered questions. For me, it was a natural progression.”

Can you tell us more about your work with Steward Health Care?

“I practiced general and internal medicine for a long time, then picked up my Master’s degree in Public Health Administration along the way. I started working in the community at Intermountain Healthcare and decided to start my own healthcare company. That business was acquired by Steward Health Care in 2019. After the acquisition, Steward asked me to come over to their leadership team.  I ran the medical group for Utah for a year. Now, I run the Accountable Care Organizations as the Regional Vice President for all of their clinical operations for UT and AZ.

Steward Healthcare’s approach to their Accountable Care Organization is to marry the idea of ‘how do we manage total medical expense and the holistic approach to the patient ‘ with community physicians. It’s interesting to be in that space as we move from a traditional fee-for-service model to a fee-for-value one, which we’ll get to eventually in healthcare. I hope to do my part as a physician leader to help transform healthcare.   I’ve learned a lot about value-based care.  I get to meet with great doctors every single day and meet with hospital leadership to help manage this idea of population health, which is my passion.”

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