Susanna M. Fier Interview Transcript

The following is a transcript of my interview with Susanna M. Fier. To find links to the audio files and more information about the interview, please click here.

These transcripts are made possible by a gift from the NNEAHE.

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Bonica:	What is The Mary & John Elliot Charitable Foundation?
Fier:	It is the fundraising arm of Elliot Health System and Elliot Health System, most people know as Elliot Hospital but that's it. They've fundraise for the Elliot and only the Elliot.
Bonica:	Is it a separate organization from the Elliot and how separate?
Fier:	It is. Yeah, it's a separate 501C3 but it literally is a pass through so 100% of the funds donated are given to Elliot and served to support pediatrics and cancer care and all these wonderful things.
Bonica:	You mentioned you had some exposure to healthcare because your mom was a pharmacist and your dad was a pediatrician. Had you been involved in any other kind of healthcare delivery up to that point?
Fier:	No, I haven't. I haven't. I felt like it because we grew up at a house and office combination and the patients were physical there.
Bonica:	Oh, really? Okay.
Fier:	Yeah, they're physically at our house but no.
Bonica:	Had you had development experience other than critiquing your mom and telling her she wasn't going to [get some money 00:01:09]?
Fier:	My experience was through my volunteerism as a lawyer with the American Heart Association so I was on their board and I had chaired the Heart Walk and different things like that. Fundraising came naturally to me as well so it just wasn't hard for me to ask people for money. If your passionate about what you're doing and the charity that you're asking for, it just seems like it's easy. I understand that people really have a problem with it. Some people don't feel like they could ask you for money but if I believe in the American Heart Association, for example or I believe in the Elliot Health System and the great work they do for people with issues in cancer or behavioral health matters or whatever the case is, why can't I say, "Here's what I believe in. Mark, join me. I would love you to support this cause and here's the great things that are going to happen with the funds that you donate." I don't have a problem with that, it's easy.
Bonica:	What was the learning curve like moving into the new role?
Fier:	The learning curve was more around what you touched on before, the healthcare. I mean, Elliot is huge so I had so much to learn in terms of that organization and all that they offer for the community but once I had that figured out, then the real challenge was understanding who's my audience, so who are the donors out there who would be interested in all this incredible work that's being done for the people of Southern New Hampshire. Because I didn't live in Manchester and I lived in Concord, it's not that far away, it's far enough but you really have to understand the community in Manchester. I worked hard to get to know some of the shakers and movers who could introduce me to those people who would then become donors. It took a little bit of time for me to develop all that.
Bonica:	Why do people become donors? I mean, I'm assuming you're not talking about I'll give you $5. It's not ...
Fier:	It's both though. The annual [appeal 00:03:24] that you go out to all the staff and say, "Hey, we work in a charitable organization. We should believe in our organization and we should show it by joining this campaign." Now, I'm going to go out to the community and I'm going to tell them that we believe in it and we've already raised this much and ask them to join us with a gift. I typically like to ask for, at the time, I like to go to someone and have some knowledge about their background and who they are and make an ask that was reasonable for them.
	I may sit down and have lunch with you and after you've cultivated a relationship overtime and not the first time you meet them obviously but I may say, "I'd really like you to consider a $10,000 gift to support the cancer center and here's what we're thinking about with that $10,000. We want a name such and such or we want to buy this piece of equipment." Make it meaningful for you but hopefully at the point of which I'm asking, I've already gotten to know you. I know where your interest lie. I know that you care about Elliot or that you have a dad who died of cancer and so that's something that's important to you. You get it?
Bonica:	Yeah, yeah. Okay. What were your duties as the vice-president for the foundation? What's ... ?
Fier:	Everything?
Bonica:	I mean, aside from having lunch and asking for money. What ... ?
Fier:	Everything? Let's see.
Bonica:	How big was the staff that was working with you or for you?
Fier:	When I got there, let's see, we had a board and there continues to be a board 'till this day. You report to the board and the board are volunteers from the community so they have other jobs but they oversee the work of the foundation and they're really a helpful group of people because they're guiding some of what you're doing. I had oversight of the budget, I was responsible for setting up the campaigns. Everything from events and events are a lot of work. You don't raise as much money, you put a ton of time into creating them and they're wonderful. All the golf tournaments you see out there, they're a lot of work and they end up being really wonderful social days. Not all golf tournaments are huge fundraisers but events matter.
Bonica:	Why do they matter then? They're not raising a lot of money, why do they matter?
Fier:	For me, at Elliot, when we would hold the golf tournaments, it gave me an opportunity to get the senior leaders of the organization, some of the doctors out of the hospital onto the golf course where they could press the flesh with some of the donors that I wanted them to meet. Getting them out to sit down and have a sandwich wasn't going to work but getting them on the golf course for a day of fun and pressing the flesh worked. When I say it works, because people want to know who these folks are that they're donating to, who's running the organization, who are the doctors taking care of my child or my mother, whomever and it helps them believe a little bit more in what the cause is. You put faces to an organization and I think it changes things. We're not bricks and mortar, we're sitting here at UNH, it's a beautiful school but when you get to know people and you believe in people, you typically will consider giving to them. At least that's how I approach it and it works.
Bonica:	Now the donors, they've paid whatever the fee is to play but that's not really what you're after. You're after trying to create that relationship so that when you go back to them and say, "Donate $10,000," because you've met Dr. Jones and you know what he does and [crosstalk 00:07:19].
Fier:	It has the dual role. I mean, you're fundraising that day. You've got sponsors and all that stuff so at the end of the day, have you made money? Yes and it's very important. Has something else happened during the day that leads to cultivation of the relationship in a way that wouldn't happen without some of that time together? That's what's also very important.
Bonica:	I see, I see. You'd mentioned your board and this is a board that's different than the board for the hospital or for the health system?
Fier:	Yes.
Bonica:	Okay, so how does someone become to be on the foundation board?
Fier:	The board was in place when I arrived and I recalled that they actually would go through a selection process of various people in the community and invite them to be on the board. It's funny you ask that, I don't recall being personally involved. In other words, I don't think I had a vote. I could certainly bring them names but they decide who fill the seats.
Bonica:	What kind of criteria do they use to fill those seats, do you recall?
Fier:	I don't recall, I'm sorry. [crosstalk 00:08:28] but I'm sure that it has to do with who can bring other donors to the table, who knows who, who can open certain doors. I mean, that's how it works in fundraising. You don't want someone sitting on your board who isn't willing to a) donate themselves, b) open doors to other resources, people with money, and I shouldn't say it that way, of means and just find the opportunities that wouldn't otherwise exist.
Bonica:	This board is focused on fundraising only because this is the foundation as opposed to the board of the health system would be focused on?
Fier:	Operations, financials, everything.
Bonica:	Okay. You were in this role until 2006. You were in the role of vice-president for the foundation 'till 2006 but in 2004, you also started working as the Vice-President of Public Affairs and Marketing for The Elliot Health System. You've talked about that a little bit but I just want to backup a second. Can you tell us a little bit about the Elliot Health System just so we can get a sense of how big is it, what does it do?
Fier:	Yeah. Elliot Health System is a healthcare provider in Southern New Hampshire with Elliot Hospital, A Visiting Nurse Association, the foundation, a for-profit one day surgery center and an expansive primary care practice throughout Southern New Hampshire as well as specialists throughout Southern New Hampshire.
	We have many ambulatory care sites so those are buildings where you walk-in, you receive care and you go home. At the end of the day, there are no hospital beds in those buildings. The Elliot at River's Edge is a great example where there's urgent care and there's orthopedics and that you can get an x-ray or an MRI but it's a out-patient facility.
	For Elliot now, two thirds of our revenue comes from out-patient care and not in-patient care at the hospital because people don't want to go to a hospital unless you're really sick. You will receive your healthcare in a place that is a beautiful environment where you can get in, get out, park and you have a great patient experience.
	That's where Elliot Health System is going and I know we're a leader in Southern New Hampshire in this area and it's an enormous organization. It's probably a $500 million organization. How many doctors do we have? Probably like 300 doctors and we continue to grow so it's a pretty exciting place to be.
Bonica:	You wear a dual hat working both for the system and the foundation?
Fier:	Correct.
Bonica:	How did that come about? How did it come that you were both still raising money and now, you're also a vice-president for the health system now doing the public affairs and marketing role?
Fier:	We lost our Director of Marketing. I don't recall that there was a VP, there was a director. My present CEO called me into his office and he said, "Susanna, I want you to take over marketing as well," and I said, "Absolutely not. Nice talking to you, see you later." We had that exact conversation four times, I refused. He would bring me back and ask me again. He was being very nice about it. He finally, on the fifth time, said, "Susanna, please tell me why you won't take this job?" I said, "Doug, you're going to fire me. That's why I'm not taking the job. I love Elliot, I want to stay here and you're going to fire me. I'm not stupid, I'm not taking the job." He said, "I'm not going to fire you," I said, "Oh yes, you will."
Bonica:	Why did you think he was going to fire you?
Fier:	He's going to fire me because I had zero knowledge. No studies, no background, zero knowledge of public affairs and marketing. I thought he was crazy. He said, "You are the best marketer we have and trust me, you can do this job," so he won. I took the job and I said, "Be gentle with me 'till I figure this out because I'm going to learn this on the job and I'll do the best I can but I'm warning you, I really don't know this area." Of course, I quickly rolled up my sleeves and started to learn as fast as I could.
Bonica:	You had the dual hatted job until ... Was it 2006, I think?
Fier:	Mm-hmm (affirmative).
Bonica:	At that point, you then left your responsibilities with the foundation and just focused on your current role which is public affairs and marketing. What made that necessary? Why did you stop with the foundation, that is?
Fier:	Now at this point in my life, I'm a mom. I have both roles and I was back to finding myself at the kitchen table at 2:00 in the morning writing articles and doing all my public affairs and marketing work basically in the middle of the night. During the day, I'm trying to get out and when you're fundraising, you have to be with people, you can't be in your office. If you're going into fundraising and you want to be in an office? You're in the wrong profession. You have to be out, you have to be social, you have to be with people.
	I finally sat Doug down and said, "I really can't do both. The organization is getting bigger and bigger, the foundation is expanding. You really need to cultivate those relationships. I can't do both and do them both as well as you want me to so I think you should select." He said, "Okay. I pick marketing. I told you'd be the best person for us in public affairs and marketing and I'm going to put you there." Where we were in the foundation wasn't a great place. We had built ourselves to a really steady state and I agreed with him that they're probably is somebody else who works in philanthropy that is more expert than me who could come in and advance Elliot even further and that has happened which is exciting.
Bonica:	What do you do as the Vice-President of Public Affairs and Marketing? What's in a day of the life of Susanna Fier like?
Fier:	Let's see, the nice and the exciting is whatever I planned for the day is typically not what happens. Healthcare is a moving target and things happen that are very unexpected. The media is a big part of my life and my day so no matter what I plan, if the media calls me, I'm very responsive and I think that people should be. The media are trying to do their job so as much as we are busy in healthcare and we're taking care of patients.
	Things happen with either a newsworthy accident, let's say or someone of interest is ill. Of course the media is going to call and they're going to want to know how people are doing, what they call patient condition or they want experts, your doctors, to talk to them about what does it mean when the new suggestion is that mammograms don't have to be given at age 40. That mammograms shouldn't take place until women are 50, how do your doctors feel about that?
	It's controversial. Well, we might want to weigh in on that. You might want to find a doctor who would be willing to talk and that means stop what you're doing, find a doctor. Just so you know, the media doesn't usually wait, their deadlines are very short so it completely changes your day. I have a schedule, meetings and different things that I'm going to be doing and then I always, in the back of my mind, "You got to be nimble, you got to be ready to drop everything and it'll all be waiting for you when you come back."
Bonica:	You're the organization's primary point of contact for media relations?
Fier:	Yes. With Elliot, just so you know, we only have two people in our department. It's an enormous organization and ...
Bonica:	It's you and one other person?
Fier:	Myself and one other person, that's it.
Bonica:	Okay, all right. How do you manage your relationships with the press and are there differences between how you interact with reporters from different kinds of media?
Fier:	Elliot's relationship with the media, when I took the role, was not good. Both Doug and I knew that we had to improve the relationship with the union leader, WMUR, the major outlets that if you really think about it will help you in the end because there is going to be a day that there's a crisis, that you actually need them to help you get the word out to the community about something taking place.
	We set ourselves on that path and showed as much respect as we could to reporters that were calling on us to try to offer that expertise when they needed it. Now years later, I have a relationship with a lot of these people and they are good people, they are nice people, as I said before they're doing their jobs. I don't treat them differently unless, and I have done this, they break the rules.
	For instance, the rules are: if you want to get an interview or you want information about a patient, you call me or you page me. I will respond to you or e-mail, I guess, but the point being you contact me and I will work, I will stop what I'm doing, I will work on it and I will let you know if we can help you, if we can't help you, why we can't help you, I will get you a statement, I will get someone on camera, whatever.
	I have had a situation where I have gone up to a patient room to talk to them on behalf of one of the major news outlets that called me to ask, "Would you like to be interviewed by a reporter?" When I got in the room to talk to that patient, there was a reporter in the room from another outlet, not wearing their credentials so unidentified, in the patient's room and hadn't called me.
	You didn't show me respect, you're respecting the patient and the family, you're violating the rules and I walked him out immediately and I had security make sure he was leaving. Now, I will still work with him to this day but it's totally inappropriate. That changes the relationship and it breaches that trust that you have to have to really get through some of these things together. I work really hard for them and I [think a day 00:19:20] for all of us but I am more than willing to draw a line if you're not going to play by the rules.
Bonica:	How is social media changed your interaction with the press? You came in just as social media is really taking off.
Fier:	We were a leader in getting out on Facebook. I was asked by the New Hampshire Hospital Association to speak to my colleagues early on about what we are doing and why we were doing it. The big concern is losing control so I hired experts. There are firms out there, obviously, that have many clients and they're posting all day and we didn't do it on our own. We did get the expertise of a firm that works in that land of social media who could help us with making sure our posts were professional.
	We looked at why we would be even on social media and we've decided that this was going to be another avenue for education and information for the public. It was not going to be a place where the public can post whatever they wanted. If you don't like the fact that you've got a bill, for instance, that doesn't make people happy. For some reason, I think they're going to have healthcare with no bill but anyway, if you want to write on our Facebook page about your bill and your frustration with that, I'm going to take it down and I'm going to block you.
	Just having some set of parameters around why we're doing it, it helps you have control and maintain control. We wrote a policy internally so that our staff understood what they can and can't do because they're ambassadors of the health system so they're part of our image, our brand. On your individual page, if you are disparaging Elliot, you're representing Elliot and we have a problem with that. Now, I get that people have First Amendment Rights and they're free to speak to a point because if you are now looking like you're speaking on behalf of Elliot as a representative and we haven't asked you to do that for us, that's where you can get in some trouble.
Bonica:	Do you run to those kinds of situations?
Fier:	Yes, I think it's been a learning curve. Unfortunately, you have those situations where people, I think, don't mean to do something that's harmful to the organization but they do and they don't quite understand the rules. They'll do a course correction if you point it out. If they want to do a course correction, you get a little bit of a different issue.
Bonica:	You mentioned the rules working with reporters, are there rules of public affairs that you try to follow?
Fier:	Rules of public affairs ...
Bonica:	Or guidelines that you follow.
Fier:	I guess it depends on how you define public affairs because I'm not sure how you're defining it in your mind.
Bonica:	Why don't you define it because you're the Vice-President of Public Affairs? You tell me.
Fier:	I mean, for me, public affairs is everything visible. Again, I don't have a background in this so I don't know what the textbook definition of public affairs is but anything that reflects Elliot is my business and it should be. Does that answer your question?
Bonica:	Well, yeah. My next question was how do you go about trying to nurture the brand and what is a brand and what's Elliot's brand and how do you try to develop that?
Fier:	I think Elliot's doing a good job of nurturing the brand in a couple of different ways. The first and foremost, for me, is starting with people. I go to new hire orientation and do a welcome so 50 people in a room who are bright and shiny and about to start their career with Elliot which is exciting. I really, truly mean that. They get their badge and I do a brief Power Point representation but part of what I'm telling them is you just got invited into a really special family. A family where we hold a place of trust in this community.
	The community looks to us for their healthcare needs. They're scared, they're frustrated, they're sick, they want to be well, they want to be inspired, there's a lot going on and you are part of the family and the team that will allow that fabulous experience or not. Here's what's not acceptable: not performing in a way that helps people, that is caring, that is compassionate, that is thoughtful and that reflects well on us as an organization. I tell them, I take my badge off and I hold it up, I said, "Not everyone gets one of these and when you do, you are now an ambassador of this health system.
	I promise you, you will have a fabulous career here if you remember that. Today, that's what I want you to take away. I'm going to tell you something else, if you don't and you're not a good ambassador, we take this away from you and you will have to go find a career elsewhere. The grass is not greener so really care about this and be a good ambassador." I think starting with people is the most critical thing. Outside of that, nurturing our brand, we do in a number of different ways.
	Part of it is in terms of our strategy and what we set for goals as an organization, what we want to do for the community, part of it has to do with the work that I do that's visible and what you see and what you read. When you get a newsletter in your home that comes from the Public Affairs and Marketing Department, is it useful to you? Is it good information? Do you enjoy the articles? Are you finding the programs and classes that you want to keep you healthy and well? Did you enjoy having a, I don't know, a recipe, a new recipe for your grill? That kind of thing. It's everything but I think we nurture the brand in endless ways.
Bonica:	Is there a difference between public affairs and marketing in your mind or is it all kind of one continuum?
Fier:	No. I guess, the difference in my mind is in marketing, the work I'm doing to create top of mind awareness in the community. I want people to think Elliot when they think healthcare. When we're marketing, we're trying to saturate the market with either a name, a service or an attribute like trust in our doctors that draws the public to us to choose us for healthcare. I mean, that's what's it all about. Are you voting or not with your feet? We'll know by the numbers.
Bonica:	What's the difference between internal and external communication and why do you need internal communication? You were saying about your newsletter and some other intentional stuff. What about internal communication, what is that?
Fier:	Internal communication is absolutely critical in our organization, probably in any organization but in our organization, because we're so big, we talk a lot about communication internally. It starts with the audience, what's the difference between our audience. Internally, you're talking to your doctors, your nurses, your staff. You're talking to the people who are wearing that badge that I talked about earlier who are or are not going to make patient experience excellent, who are or not going to take care of each other. We communicate in many different ways.
	A lot of it is e-mail communication, we do open forums where we stand in front of our staff and our doctors and have a dialog about what's going on, we do celebrations and events, we have internal newsletters. I mean, the reason why we round and physically all go to departments and say, "Hi, I'm Susanna. Tell me what you do. Are you happy? What can I do to help you? Tell me more about what makes you feel like you're supporting the strategic plan of Elliot."
	Sometimes they know, sometimes they don't. "Do you even understand the strategic plan? Can I help you understand it? How are we doing financially?" When you get into the department, they get excited to show you what they do all day. Typically, they are even more jazzed to say, "Here's how we're advancing the overall mission of the organization," which is so exciting. All of that communication really matters because it makes you a cohesive group of people and we're so spread out across Southern New Hampshire. It's not easy, I don't think we're perfect at it but we do try very hard.
Bonica:	Are there important ways to communication strategy that has evolved over the 14 years, 13 years you've been doing this role now?
Fier:	Yeah, I think the most important way it's evolved is getting back to face-to-face communication. There are so many ways to communicate that do not put you face-to-face with other people, that you lose the personal connection, the relationships and at the end of the day, we all want to feel like we are cared for, somewhat, by our leaders, our mentors, each other. Our internal survey tells us that our staff actually really loves working together. They really enjoy each other. You see that when you go out and round in the departments but you're face-to-face. We have evolved now to a place where the open forums where we have that dialog and the rounding by senior leaders is critical to our communication and I think to, sort of, the overall feeling and culture of the organization. That direct communication is probably the best thing that we've gotten back to.
Bonica:	You mentioned rounding. Is that a part of your strategy? Is that something that you promote and try to push your leaders to do or is it something that they're doing as part of a different aspect of the strategy?
Fier:	It is a strategy by the senior leaders and we all agree. Nobody has to push each other. We agreed as a group that we will get out and round. We've blocked our calendars and set aside weeks to go out, leave our offices and know that each of us were all out somewhere in the healthy system rounding. This month, I have a ton of rounding. I just looked at it.
	I don't know, I must be hitting, at least, 15, 16 departments and you just go one after the other, after the other. It's a little exhausting but it's so exciting and you realize that it's time well spent at the end of the day, get a lot of e-mails thanking us for the time. People meet me and they go, "Oh my God, you're the person who sends us the newsletter.
	I get your e-mails all the time where you're trying to keep us up-to-date on what's going on with affiliation or something like that." They put a face to the name, that they're getting all these other communication electronically. Now, they get to know me as a person and I get to know them and it's just so much better. Rounding is something that we are very committed to as a senior team and it's definitely having a positive impact.
Bonica:	What do you do with that information? You go out your round, is there something that you follow up afterwards with that as a group, as a leadership team or ... ?
Fier:	Yes. We do spend some time working on things we've learned, issues that are popping up in various areas that seemed to be a trend. We are not there to resolve human resource issues, those do come up and you just have to redirect people. I mean, I'm not going to be able to change your benefits while I'm standing in your department and that's not what I'm there. We just redirect them on how to get help with something they may not understand. Yeah, as a senior leadership team, we do talk about what we're learning, what we're seeing. The pulse of the organization, what we think is needed to adjust culture or that kind of thing so we take it seriously but we're not doing it so that we come back and have a list of 65 things we now have to fix like that Sue has a broken chair or this person needs a new piece of equipment. It's not that, it's more of a relationship and culture setting.
Bonica:	You've talked about culture a couple of times. What is your role as the public affairs and marketing person with respect to nurturing the culture at Elliot? What is organizational culture and why is it important?
Fier:	I actually don't think it's my responsibility, I think it's our responsibility. I think every member of the organization has some responsibility for the culture. I know that at the senior leadership table and from the board, we want to set a culture of our mission, inspiring wellness, healing our patients and serving with compassion in every interaction. That service piece is big and that service piece is internal and external.
	How we serve each other and how we serve the community and the patients and families that come to us and we take it seriously. I think that in healthcare, you want to do the best you can by people everyday. Oftentimes, that empathy can fall to the wayside because you have things going on in your own life but we try to instill in people that we're here because we care about other people and we want to inspire, heal and serve.
	As I walk around, if I'm grumpy and I walk by three people and I don't ever say hello, I'm setting the culture but so are they if they walk by me and have their head down and don't say hello. We have service excellence training, we have people working hard to make sure that the environment in which we're working is respectful, somewhat welcoming, joyous, not off the wall because obviously, it's healthcare but friendly at the end of the day and transparent and communicative, all of those things that ultimately results in staff engagements and satisfaction and positive patient experience.
Bonica:	What mistakes do healthcare executives make when dealing with the press?
Fier:	Well, speculation, guessing. I always tell people, you can't quote silence. Stop talking if you don't know it. Don't speculate, don't guess. Wait, tell me your question again.
Bonica:	Well, what kind of mistakes do leaders, the healthcare leaders, make when dealing with the press?
Fier:	Man, I think what I said earlier is correct.
Bonica:	Don't speculate?
Fier:	Yeah and let me say it differently. I think, the biggest mistake you can make when dealing with the press is not being factual. I always, when the press calls, especially if it's a controversial issue and you typically know those calls are coming. You probably have already started working on a strategy to communicate externally if there is an issue internally that you are aware of that is likely to be newsworthy.
	What you have to do and what you have to media train the spokesperson to do is understand, know the facts and stick with the facts because if you don't, you will head down a road that is very tricky and really may end up being bad for you in your career, it can be a career changer and very bad for the organization which is also typically a career changer.
	I like to, first, gather facts and help people understand what are the facts we're dealing with, stick with those and I always media train people before they talk to the press because I don't want them guessing, I don't want them speculating and as I say all the time, shut your mouth and be quiet because they can't quote silence.
Bonica:	That sounds like a lawyerly kind of answer.
Fier:	Maybe it is.
Bonica:	Well, let me ask you that. How did your previous work as an attorney and then also, you're a Director of Development Work prepare you for the role you're in now?
Fier:	I think I use my skills everyday in everything I do. I mean, from simple things like writing memos, that's intimidating for some people. Writing is not intimidating for me because when you're a lawyer, you have to write. You have to write your pleadings, you have to write your memos of law so communication is very important and words are important, the use of words. I think that being able to stand on your feet represent yourself or another person or an organization is something that I am well-equipped to do because of the practice of law. I think I use these skills everyday. I mean, if people are listening to this and trying to figure out what career to go into, you're never, ever making a bad decision by becoming a lawyer. A lot of lawyers do not practice law, they do a million other things but it's just incredible skills that you learn in law school.
Bonica:	You're a vice-president, what does that mean and what responsibilities does that imply beyond your formal title of public affairs and marketing?
Fier:	As a vice-president and a leader of Elliot Health System, we have responsibility for everything we talked about from culture but also to the strategic plan, the direction of the organization, how we're doing financially, are we taking care of our people, are we planning for the future. In other words, if you have a practice of physicians for example and three are about to retire and there's only five, you better have a plan for how you're going to fill those positions and continue to serve the patients. As leaders of the organization, as vice-presidents, I don't consider myself just public affairs and marketing. I consider myself a vice-president of a huge not-for-profit organization upon which the community relies and 4,000 staff members rely for their career, for their paying of their mortgage, taking care of their kids. I mean, there's a lot of responsibility with it but I love that part. I love being one of those nurturers from the position of a vice-president.
Bonica:	You mentioned strategy. Where are you involved, how are you involved in the creation and development of the strategic ... ?
Fier:	All the vice-presidents are involved and we work with the board directly on strategic planning and looking at what are the current goals, we set our strategic plan as a three year plan, we love to have a three to five year plan. My involvement after strategy is set and all the meetings that take place to get to the strategic plan which is like brainstorming sessions and understanding data and some presentations. We have six strategic pillars, so I participate on pillar teams and we also help push the information down to directors, managers and the staff so that they get an understanding of what the strategy is and how they individually play a part in each of our strategic pillars.
Bonica:	You've been working as the Vice-President of Public Affairs and Marketing since 2004. How has your role evolved over that time and what have you learned?
Fier:	My role has evolved mainly because I've become more knowledgeable in what I'm doing, more confident in what I'm doing and we've had a change in leadership so as a 16 year CEO leaves the organization and a new one comes in, my role shifts to not just being one of the vice-presidents who report to that CEO and help carry out the mission of the organization, now I become a teacher.
	The new CEO comes in, he doesn't know us and someone has to take them by the arm, which is each of the vice-presidents in their own way, become the teachers as well as the staff to be honest. I mean, everybody became a teacher but all of us have had to do some evolving because the organization is going through change.
	Our CEO came and went in two years so we're in a different transition again now where we're all linking arms tightly because we don't have a CEO at Elliot at this moment. The entire staff, all the physicians, are looking to the vice-presidents to steady the ship and make sure everything is going well and that we really have our eyes on all of the operations, making sure we're in a good place. Elliot's in a wonderful place.
	The truth is we have such a good leadership team. The vice-presidents are so strong in their knowledge base and what they're doing and their skill and expertise that we are in a good place and the board feels comfortable while they go out for a nationally search which will take months and months and months to get the next CEO.
	It'll continue to evolve but I think with anything, day-to-day I've gotten better at what I'm doing just because I know the ropes now. Where I didn't know how to place media before, I can call WMUR, call my account executive, the union leader, I know how to negotiate my rates and get my placement and have a run and so forth. It's evolved partly based on just knowledge base that has increased overtime.
Bonica:	I want to ask just a couple of questions about leadership. What would you say is your leadership philosophy?
Fier:	My leadership philosophy is definitely there is nothing that I'd ask you to do that I won't do myself. I am an extremely hard worker, I hold myself to a high standard and I feel like I instill, in other people, the ability to do the same. They might not believe in themselves quite as much as they should but I think if they apply themselves a little bit more and really roll up their sleeves, they're going to find that they can do just about anything they set their mind to and I think I'm an example of that. I mean, I still laugh, I giggle.
	Do I really have any business in public affairs and marketing but here I am and you know what? I'm not half bad at it. I may not be the best but I'm not half bad and it's because I really try my heart out all the time. I think that people respect and like me as a leader because I get my hands dirty right there next to them. I am real, I'm a mother, I tell people who have families, "You're a mother first. You're a father first. Go home, take care of your sick child." You don't have to apologize or beg me, that's part of life and that's probably a more important part of life than being here. All of those things are my style. Being just nice and a good person to people.
Bonica:	Yeah. Well so in our role, you've been a vice-president for a long time but you also, in your role as a person in charge of communications, you get a chance to see a lot of leaders operating. What makes a good leader?
Fier:	I think a good leader is someone who is willing to share knowledge and expertise, mentor other people up, recognize and congratulate and give the accolades deserve to the people who are actually responsible for things that make you look good. I think the biggest pitfall that I see in leaders who don't make it in my world, vice-presidents of healthcare systems, directors, others, there's power that comes with it. Power can be a very dangerous thing for some people because they'll misuse it. I saw it as a lawyer and I sued people for it and I see it now and if you misuse power, you're not going down in a positive road. It will bite you. It will get you sooner or later and I typically identify it pretty quickly and I watch it and I have even asked people to course correct. Some people do and some people don't. Their fate is theirs and when they fail, they failed because of themselves, not because of anybody else.
Bonica:	You've held positions both of direct leadership as well as positions of influence without necessarily direct authority. You're just talking about power. What's important about the difference and how do you lead without necessarily having the authority?
Fier:	That's an interesting question. I mean, I can't call a group of doctors together, make a decision and then go to the chief medical officer and say, "Well, we had this meeting and we made this decision." That would be wrong but what I can do is sit with a group of doctors and say, "What's on your minds? What's happening? How do you feel? Let me take this back to the chief medical officer who couldn't be here today and share with him this session and see what we can come up with." You have the authority to gather information, you have the authority to understand what's going on good and bad and if you're a good leader, you know how to take information and use it for the greater good and find ways to get to the right people, inform them in a non-threatening way that helps lead to things that have to happen, either a decision or a change or an improvement or something like that. I guess, that's how I see it. Does that make sense?
Bonica:	Yeah, absolutely. Last question, what advice would you give early careerists who are thinking that a career, maybe in marketing and communications, sounds interesting. If they're saying, "I'd like to do what Susanna does." What should they be studying? What experiences should they seek out? What guidance would you give them?
Fier:	Well, if they're interested in it then pursue it. Certainly, there are college courses that will help them advance their knowledge but most of all, you have to experience it. If you can get in the door somewhere to act as an intern or spend even a day so you walk in the shoes of someone like myself, you're going to see firsthand and experience it and perhaps either love it or decide this isn't for me. When I give the example way back at the beginning of this interview of me going and sitting in a courtroom when I was in law school, I was, I guess in a way, just trying to see if I like it and I loved it. I'm back, day after day after day after day. It's that kind of self-motivation to experience things that I think really will help determine whether you are in the right field or not. Find the courses, study hard, get as much knowledge as you can. The way I did this, learning on the job, is definitely challenging.
Bonica:	Well, it sounds like you've done very well so ... Thank you so much for your time today. It's been great.
Fier:	Thanks for having me.

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