For Avein Saaty-Tafoya, MD, MBA, HCM, EDAC, CEO of Adelante Healthcare, life has been all about embracing the bumps in the road. “You do the best with what you’re handed,” says the 45-year-old executive who was one of the youngest to assume the role of a health system CEO at just 34.
Born in Kurdistan in northern Iraq, Saaty-Tafoya’s family moved to Iran when she was a child. Her parents taught at American schools there in a time when the Middle East had a much closer relationship with the Western world. By the 1970s, all that had changed based on political and social upheaval. The Saaty family eventually became refugees, moving to Germany for a year. They later came to America and settled in a small town in rural Ohio, near where her uncle lived. The farming community was a far cry from the Middle East and Germany. “We might as well have been Martians who landed there,” Saaty-Tafoya recalls.
Despite the initial culture shock, she describes her childhood in Ohio as idyllic, supported by the Midwestern culture and work ethic of the rural region. But the low socioeconomic status of the area, low literacy rates, and lack of access to health care there had a lasting effect on her.
“I think my earliest exposure to health care was as a refugee myself, going into clinics and public health. I have those personal points of empathy,” Saaty-Tafoya says. “That’s where I found the seeds of attachment to social justice and really believing that health care is a basic human right.”
The Art of Medicine
With her undergraduate degree from Capital University in Columbus, Ohio, Saaty-Tafoya didn’t directly pursue a career in health care immediately, though. A self-proclaimed artist at heart, she majored in biochemistry and fine art. She loved science and academics, and also painting and sculpting. With teachers for parents, she developed a love of learning early on and has let her curiosity and drive to know more serve as her foundation in life.
As she pursued studies in medical illustration as a way to marry her two passions, an unexpected development occurred. Computer illustration began to replace the artist’s hand, throwing a wrench into her career plans.
“When those forks in the road come before you, you really have to think not just one or two steps down the road, but eight or 10 steps down the road, and think ‘what’s the opportunity to learn?’” Saaty-Tafoya says. So she embraced the change and transitioned to medical school at The Ohio State University, but her experiences and ideals clashed at times with the traditional program there.
During her clinical experiences, she took a more human approach to her role than just performing medical diagnosis and prescribing medications. Recalling a woman who came to the clinic who was clearly experiencing domestic violence, Saaty-Tafoya took the extra steps to find the patient resources to get out of her situation and address the real cause of her health concerns.
“I was that student and future healer who was on the phone making calls after clinic and trying to figure out how to help this person,” she says. Her efforts, however, were met with rebuke, and she was told to focus on her assessment and diagnosis skills.
“I wasn’t buying it,” she says. “I saw the futility of how we were delivering healthcare to the people who were most underserved and in the greatest need. I just had too much insider knowledge and exposure to those things.” So, she started to work with mentors to explore her passion for public health. “I shifted from a mind-set that I wanted to be a doctor in a hospital,” she says. “I wasn’t convinced that that was my future.” The transition also led Saaty-Tafoya to question the healthcare system and why things like Eastern medicine hadn’t been researched more thoroughly.
It helped guide her to become more involved in clinical research. “I’m very open to what we know and what we don’t know, and there have to be other explorations if we’re really going to be effective as professionals in this system,” Saaty-Tafoya says.
She wrote grants, worked with preceptors, and participated in FDA clinical trials. As a project director for a childhood immunization project, she helped study disease outbreaks across Ohio, eventually visiting every community health center in the state, allowing her to interview clinicians and engage with patients across the spectrum.
Her work led her to California and then Arizona, where she continued her research work, eventually joining a startup that enabled her to work internationally and pursue her MBA. It wasn’t the career path she set out on, but Saaty-Tafoya says it helped her understand the business of health care and how to respond to shareholders and address finance issues.
She’s grateful for the diversion. “Without that decision and another fork in the road, I wouldn’t have had the competencies, perspective, or experience to move up as early as I did to into leadership roles,” Saaty-Tafoya says. “That couple of years that I spent—two years at a full clip—I completed my MBA, traveled to 14 countries, and had a clarified picture of health systems around the world and how they worked from a business standpoint.”
Forks in the Road
The fork in the road is an important concept, she stresses, because it’s so transformative. “Women are often at disadvantage because we often come to a fork in the road and are scared to follow the road not taken and tend to stay in environments where there are already other women and safe zones,” Saaty-Tafoya says.
Not only did she move out of her safe zones, but she was thrown into the fire. Saaty-Tafoya recalls an early mentor and boss who intentionally would not show up to meetings and presentations, forcing her to take charge and forge ahead. “For the longest time, I just had this feeling of permanent error. But he was brilliant because he was preparing me for more and desensitizing me,” she says. “He believed in me enough to throw me into the fire, but he also helped me understand that I had to over-prepare, I had to be better, I had to be prepared to fail.”
The experience left her feeling exposed but helped her to become more authentic, she says. “When people around you believe in success and that it is earned, it’s empowering and allows you to push forward,” she says. “These are the pivotal moments.”
It is these moments that motivated her to eventually take a job at Adelante Healthcare, a small, rural health system. Its leader had just died, and the health system’s staff was in a state of grief and turmoil. Loving a challenge, Saaty-Tafoya took the position with a plan to stay for two years and turn the company around. What unfolded was much different.
Leading With Sympathy and Vision
Instead of coming in and making sweeping changes that were good for business, she took the advice of her mother, a licensed social worker, and took the time to listen to her new employees and help them grieve. She was a sympathetic ear and took on their burdens. Little by little, small changes were put in place and the culture shifted.
But assuming such a demanding role at a young age, with a husband and a young child, began to weigh on her. She had an opportunity to take a sabbatical and study hospitality—a niche not usually embraced by healthcare executives. Saaty-Tafoya saw the potential in the sabbatical, and it resonated with her artist’s soul. When she returned to her position, she felt empowered to transform Adelante into a facility that would appeal to its clients and make them feel comfortable in a sustainable way.
Again, however, she was faced with roadblocks when some of her colleagues questioned the practicality of investing so much into the brick-and-mortar facilities for the low-income population that the health system served. But she pushed forward and created the first LEED Platinum-certified health center in the nation at Adelante’s Mesa, Ariz., location.
The health system is continuing this work, and colleagues have realized that not only have the changes saved money and increased sustainability, but they have empowered patients and served the community in ways they never expected. Trees grow inside the hospital, and the cool, inviting spaces draw mothers and young children who otherwise would be home with no air-conditioning.
Aside from her professional forks in the road, Saaty-Tafoya stresses that no one can have it all. It takes a lot of work to preserve time with her family, and she balks at the idea of work-life balance. “It’s no balance; it’s integration,” she says. “I didn’t go through all that work to have [my children] just to hire someone else to spend those precious hours with them.”
Divorced since 2012, the single mother to two sons, ages 6 and 11, says she focuses her efforts on them when they are with her and on work when they are with their father. “My team fully understands that this is my priority, and that if there’s something that they need me for from 7 p.m. to 9 p.m. at night, it’s probably not going to happen during a week I have those boys,” she says.
People laugh when she suggests that young women struggling with the idea of “having it all” consider freezing their eggs to buy themselves more time to have children. Early adulthood is consumed with finding one’s self and starting a career; it can be too much to ask to expect to be able to balance a family, too. “There’s no trophy for that; it’s what is your goal, and how are you working back from that goal,” she says. “These are modern ideas that women can champion.”
Rachael Zimlich, RN, is a healthcare writer from Cleveland.