The path to becoming a health system CEO was not typical for RUTH BRINKLEY. The president and CEO of KentuckyOne Health grew up on a farm in rural Georgia and, after a bumpy start, earned two nursing degrees in Chicago. On her second stint in Louisville, a city she loves, Brinkley has become a role model for minorities aspiring to work in hospital management. She delivered an address on the subject at this year’s American College of Healthcare Executives Congress on Healthcare Leadership in Chicago. | Interviewed by Paul Barr

How important is the issue of diversity and reducing disparities in health care right now?

BRINKLEY: The short answer is that disparities and diversity in health care are more important than ever before. I’m sure you expected me to say that, but let me tell you why. Our country is more diverse than ever in terms of ethnicity, in terms of racial background and religiosity, so we have to understand each other better, especially in the helping and the healing professions like health care. We have to understand our customers, who are changing. The demographics also are changing. If we are going to be effective in serving those who come to us for our health care needs, we have to pay attention.

A recent American Hospital Association survey found that diversity on boards and in the C-suite is fairly static. Do you feel that’s the case? Will diversity get better?

BRINKLEY: I don’t have statistics to back up what I will say, but my sense is that it is static for both women and people of color. We have to be much more intentional in our searches and our promotions. I don’t know the answer. I don’t think we’re on an immediate upswing, but as we begin to see ethnic groups move through the educational system, it will change. I don’t think it’s going to be in one generation; it’s going to be a couple, maybe three. It will have to change.

Is there an area in which hospital CEOs could jump right in and have a big effect in reducing disparities in health care?

The Brinkley File

CV: The president and CEO of KentuckyOne Health also is a senior vice president of operations for parent system Catholic Health Initiatives. Brinkley had a major leadership role with Ascension Health, and for five years was a performance improvement consultant. She earned graduate and undergraduate degrees from DePaul University in Chicago and attended the University of Chicago, studying psychology.

FAMILY: Brinkley is a mother of two and a grandmother of two.

ABOUT THAT HAT: “I’ve got some hats. It’s all about the hat,” Brinkley says with a laugh when asked about tips for experiencing the Kentucky Derby. “It is really such a fun festival for the city and the region. It’s almost like Mardi Gras and the World’s Fair and the Olympics all rolled into one.”

BRINKLEY: What immediately comes to mind is the makeup of our boards of directors, the makeup of our executive teams, our health care professionals. Now, I will grant you that sometimes finding people from varied ethnic groups who are health professionals or [are qualified for] boards is not easy. Typically, everybody is looking for the same people. So we have to figure out a way to cast a broader net and to really pay attention to the people who might not necessarily have everything you need, or to growing our own from within the ranks of our own organizations. That’s what leadership succession planning is all about.

So, leadership has to take a more active role?

BRINKLEY: Yes, if the CEO doesn’t think it’s important, nobody else is going to think it’s important.

What could or should health care leaders do?

BRINKLEY: Having a transparent conversation about where we are. All you need to do is pick up a newspaper or turn on the television to see that we’re struggling with [race] in our country. But the good news is that as challenging as some of the things in the news recently have been, we’re talking about it. We’re having discussions that were long overdue. We have to continue to have these discussions and really start to get to know each other and, as health care providers, to get to know what people need as consumers of health care, and help them meet those needs.

Do you think the industry’s move toward more of a consumer focus is going to help?

BRINKLEY: Yes, I think that it will. As consumers start to have a better understanding [of their care], as people start to understand their own health needs and health history, they will demand that we pay attention to these things. And, hopefully, we health care providers will start doing it and doing it well before consumers have to take a hard stand. We’re moving in that direction, yet the progress hasn’t been fast enough. It needs to be part of our everyday discussions.

Was your career affected by working in a field that’s predominantly male and white?

BRINKLEY: I’m sure that I’ve been on the receiving end of discrimination. Maybe I wasn’t astute enough to recognize it, but I’d like to think that it’s not a question of astuteness. I still believe that I’m going to end up where I’m supposed to end up. You can’t let it define you, you just keep on going. I prefer to define myself in positive terms and not let others define me.

Who were your mentors, if anyone?

BRINKLEY: I’ve admired and learned from a lot of people. I’ve had some people over time who have helped me, mostly men — there were a couple of women, but there weren’t a lot of female role models. I don’t have a specific mentor, and that’s a problem. What I could’ve used and most people could use, was an advocate. We all need someone to look out for us — someone you can call who’s there to help you.

You’ve lived and worked in some diverse regions. Have you noticed any differences in how health care systems operate with regard to disparities and diversity?

BRINKLEY: I’ve lived all over the country. I grew up in rural [Girard] Georgia; I wouldn’t even call it a town. It has about 160 people today. I did, though, have the opportunity to go to bigger high schools in Augusta, and then I came to Chicago where I got my postsecondary education, and lived there almost 20 years. But I ‘ve never forgotten what it was like to grow up in a rural area with less than ideal — much less than ideal — access to health care.

So, yes, there are differences. A lot of it has to do with access to providers and knowledge about when you [should] seek a provider. When people are in rural areas, often they don’t have insurance. And even if they have insurance, they’ve got to [schedule a doctor’s visit] on a day they have to do their farm work, so people put things off.

How has your experience on the clinical side affected you as a manager?

BRINKLEY: I’m a nurse by background. It has served me well over the years. I think that background certainly is becoming more valued today than it was previously. I’ve spent more time on the business side of health care and that’s gotten me to where I am today.

But I’ve never forgotten why we’re here and what we do. Sometimes that is unpopular. I don’t think you have to be a clinician to understand all that, but it certainly helps.