Health Equity

Addressing social determinants of health, causes of health disparities, and improving access to care


AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.

Why is access to health care important? What are the effects of food insecurity on health? What are the benefits of a diverse workforce in health care?

 Our guest is Ketul Patel, CEO, Virginia Mason Franciscan Health, and president, Northwest Region of CommonSpirit. AMA Chief Experience Officer Todd Unger hosts.


  • Ketul Patel, CEO, Virginia Mason Franciscan Health; president, Northwest Region of CommonSpirit

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Unger: Hello and welcome to the AMA Update video and podcast. We're back with another episode in our What Keeps Me Up series, where we talk with health care leaders about one thing that's on their minds right now and what they're doing about it. My guest today is Ketul Patel, CEO of Virginia Mason Franciscan Health and president of the Northwest Region of Commonspirit in Seattle. I'm Todd Unger, AMA's chief experience officer in Chicago. Ketul, welcome.

Patel: That is wonderful to be here with you today.

Unger: Well, let's get going and find out what's keeping you up at night. Why don't you give us what's on your mind?

Patel: You know, that's a loaded question, but I will say this, obviously, one of the biggest things and challenges for us is always around our workforce. And I'm sure that anybody you interview in our industry is going to say that, but for me, another additional issue for us is—just a little background about me. I'm the CEO of VMFH as you said, but I actually was born in Kenya.

And very early on in my life I had an opportunity to see and spend some time with my parents, who one was a physician, father, my mom was a nurse. And we would go into remote parts of Kenya, and had a real chance to understand and see that there was deep concern and challenges around access to health care. And that has stayed with me throughout my entire life.

And it's one that I hold very, very accountable and responsible for our team here is making sure that we're always looking to find ways to create access for our communities and all those that we serve.

Unger: Why? I understand and it's a great story, and as you carry that in, why are social determinants of health such a pressing issue right now?

Patel: Yeah. You know, Todd, it's something in our industry that we've obviously always looked at. When you're a not-for-profit organization, you're obviously here for the needs of the community, but those are a lot of buzzwords that go with it. But we have a pretty significant mission here. Many years ago, our sisters came here from Philadelphia to serve those that were critically in need in this community.

And it's been always in the forefront of what we've done at what was historically CHI Franciscan and now Virginia Mason Franciscan Health. You know, we do, like many others, we actually collaborate in the community. We have deep relationships in the community. We go through—every organization goes through this, have a community needs assessment that's done. We have found that there's tremendous need out in the community.

And so what we focused on is actually we've created a community health improvement grants, and we have provided in this calendar year about $1.4 million to support some of the challenges in the community. And it's something that we are very proud of. It's something that we are committed to as a deep part of our mission. It's something that's part of our historical heritage, and something our sisters always want to make sure that we're doing one every single day.

Unger: You know, I've had a chance to talk to a number of different health care leaders, and one of the points that's come across is a lot of people talking about problems associated with social determinants, but we're kind of short on the action steps. And so I want to talk a little bit about the specific steps that your system is taking to address the concerns that you've outlined, and recognize the fact that you were named as one of modern health care's top diversity leaders last year.

So I know you have a portfolio of things going on. Tell us about one effort that's worked especially well so far.

Patel: You know, first of all, thank you for that recognition and acknowledgment. I take that very seriously. When you're recognized in that type of role, it also puts a little bit more meaning in terms of what you should do and need to do. As I mentioned, the commitment that we have as part of our mission is very important, but since around 2010, we have spent a lot of time focusing on our public health approach to preventing violence.

There's so much that goes on in this community, particularly in the BIPOC community and in our South King county, which is just south of Seattle, in the community called Federal Way, we have a Federal Way Youth Action Team. That's something that we are deeply committed to. We provide for over 400 young men and women of services around domestic violence, human trafficking, mentoring. We do a lot of education in the community.

We know that with these community relationships and partnerships, we can do significant good by providing those kind of resources to the community. It's a really important part of our journey. Given the fact that we see so many of these young men and women come into our hospitals in different ways, it's more important that we get to them where they are, which is in their homes, and in some cases not in their homes, to help provide that level of education so that they can grow in a way that you and I, Todd, probably have grown in our lives as well.

Unger: Now, one of the other initiatives that we talked about, I'm curious for the folks out there to hear more details, is this total health roadmap. Can you tell us a little bit about what that is? And what impact it's had?

Patel: You know, we've learned so many things through the pandemic, right, Todd? I mean, you've done that through your time in Chicago, obviously. In the Northwest we've also had some pretty deep challenges. You know, food insecurity has become a big challenge for us in the community. And something that—I want to keep repeating this. We are very much responsible for health care.

It impacts so much of what we do. It impacts the kind of care that we have to provide. We have had pilot programs in our organization that really have connected into community and some of the community asked for. We've provided many food insecure patients at one of our cardiovascular clinics in Tacoma, opportunities to have more food and different kinds of food, and pride and nutrition that is important, so they can work on their journey.

We provided over 50 patients that level of care. We're going to do that over a hundred in 2024. We've also got an edible food recovery program, providing access of food from Saint Joe's Medical Center out in the community. We've provided that for over 1,100 people. And we're going to do a lot more with different hospitals around our health system in the coming years.

Unger: Now, one thing that you talked about before was community partnerships. That seems to be a theme of what you're talking about today. And it is something that I've heard before, of course, even here in Chicago, when we talk with health care leaders too. It's just kind of the need is so great that health system cannot do this on their own. And having those kind of deep partnerships across communities is so important.

You've gone through this. What's the piece of advice you'd give to other health systems out there about working with partners in their community?

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Patel: Well, first, you've got to know your community, right? And I think that's a very easy thing to say, but the reality is it's not. I spend time with many of our pastors in the community. We have a lot of community leaders that provide that level of education, our school districts, all those types of things. And so, the first thing I would say is be open to what you're hearing, because sometimes what you think is you know is not what you should know.

That's a very vital part of our journey. Second, you have to be open to unique partnerships and relationships. I think our first job is always to take care of our patients, OK? We have a 19,000-member team that provides care every single day to a variety of different people and patients around the community, but we have to go deeper than that. We have to go into the community so we find ways to make sure that we can prevent some of the needs that might come down the road.

So those openings for us to be open, transparent, learn, are all very vital parts of our journey within the organization. So that's the advice I would give to anybody that's interested in hearing that from me.

Unger: Well, Ketul, in our family, we have a joke about the pez dispenser of anxiety. It's once that tablet's out, it's just another one kind of jumps back in behind it. So I'm curious as you think about the year to come and what you're lying in bed worrying about, what's on tap for you next year.

Patel: Yeah. You know, we've also known and realized that one of the big challenges that we have is that when patients do come into our hospitals, they feel a lot more comfortable when the providers that are in front of them look like them, have some of the—have walked through their—through their journey. We have found that even though we use the word diversified workforce, we are not a diversified workforce.

We have to do a lot more, particularly on the physician side of the world, to have physicians that are representing the community. We have a very deep investment in that. We've got very unique partnerships. Morehouse School of Medicine is a very prominent partner of us. We are going to be—we're training now medical students in Seattle that will grow over their period of time and learn.

So, you know, historically Black college, if you will, is now coming into this community with that level of residency and training. And it's our obligation to make sure that we continue to perpetuate that, foster that, and obviously, invest in that. And so that's going to be a big part of our journey over the next year and coming years for all of us.

Unger: Well, Ketul, thank you so much for joining us and sharing all the great work that Virginia Mason Franciscan Health is doing. To support the AMA's work, to address the challenges that we've talked about in this episode in health care and more, you can become an AMA member at

That wraps up today's episode and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at Thanks for joining us today. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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