Miriam Marcus-Smith: MHA, 1995
I have two concurrent positions, each at 50% time: Pay for Performance Coordinator in the Quality Improvement Department at Harborview Medical Center, and Program Director, Washington Patient Safety Coalition, at the Foundation for Health Care Quality.
Brief job history
My healthcare-related job history began when I received my associate degree in nursing and worked as an RN first at St. Joseph Hospital in Bellingham and then at Group Health in Seattle, where my focus was oncology and end of life care. I moved from clinical care to the insurance side as a case reviewer for several local insurance companies and eventually transitioned back to the hospital environment: I worked for several years, the last three while in the UW MHA Program, at Virginia Mason Medical Center (VMMC) as a Quality Improvement Specialist. At VMMC, I was fortunate to support the Bioethics Committee and to learn from the Chair. When I graduated in 1995, I went to work for Professor Doug Conrad as a research coordinator for three years. Subsequently, I was at Premera as Disease Management Administrator. From 1999-2005, I was Quality Improvement Program Director at the Foundation for Health Care Quality (FHCQ). Before returning to the FHCQ and joining Harborview for my current positions, I was Research Manager in the Department of Medical History and Ethics at the University of Washington.
What decisions/choices led to your current position?
I really believe in doing what I find interesting, and in working in organizations with values that are aligned with mine. I am most creative, efficient, and effective when my work entails a lot of variety and challenge, so I am attracted to positions that are complex and challenging, and in which I honestly feel I am contributing to positive changes in health care.
What are the unique rewards inherent in what you do?
Harborview is a safety-net hospital, and I am helping to maintain its margin and continue its mission. It is very rewarding to help bridge the gap between quality and finance and help the people working in these areas understand each other's priorities and challenges. At the FHCQ, which is a neutral, 'safe table' environment, I am privileged to work with a large number of health care leaders and stakeholders across the state in collaborative efforts to improve patient safety.
What challenges do you face in the current health care environment?
As always, achieving and sustaining change is hard. It is even more difficult with financial challenges, fragmented care (despite our best efforts), increased numbers of under- and uninsured people of all ages, and the risk of burn out among those trying to make effective change. It is hard to remain optimistic and positive with unrelenting challenges.
What impact has the UW MHA Program had on your career?
The MHA Program helped me see the bigger picture of health care: policy, financing, and organizations. As a nurse, I was familiar with health care at the ground level but naive about larger issues and challenges.
Which aspects of the UW MHA Program have been of greatest benefit to you?
The Program helped me become a good generalist and prepared me to work in many different organizations.
Name the highlight(s) of your student years
1) Professor Cindy Watts's Advanced Healthcare Economics course was probably the best class I've ever had anywhere, 2) I started graduate school when both my kids were in diapers and we survived all three years, 3) celebrating graduation with my family and closest friends.
What advice do you have for students/recent alums?
Stay open-minded intellectually, be non-judgmental, and remain flexible. You may not follow the path you expect, but if you are open to new opportunities you'll discover and learn all sorts of amazing of things you hadn't anticipated. My own academic and professional paths have been quite interesting because I've pursued situations in which I could continue to learn.