The Exec: Rutherford Regional Health System CEO Tory Shepherd Talks About Perspective

Tory Shepherd details her career journey from respiratory therapist to CEO and shares advice for future leaders.

Editor's note:This article appears in the March 2023 edition of HealthLeaders magazine.

Rutherford Regional Health System, a 140-bed acute care hospital in Rutherfordton, North Carolina that's operated by Duke LifePoint Health, recently announced its new CEO.

Tory Shepherd, who became interim CEO of RRHS in September, was named the rural hospital's permanent CEO at the end of November. Originally a respiratory therapist by training, Shepherd brings both a clinical and operational perspective due to her work at the bedside and in executive leadership roles.

In a recent interview with HealthLeaders, Shepherd detailed her journey from respiratory therapist to CEO and shared advice for future leaders.

This transcript has been edited for brevity and clarity.

HealthLeaders: What have the past few months looked like as you get settled into your role?

Tory Shepherd: The last few months for me, coming into this new community, it was important for me to listen: Listen to staff, listen to the physicians and providers, listen to the hospital, as well as the community at large. I spent a great deal of time not only within the walls of the hospital, but also externally listening and trying to build relationships with local officials, first responders, [and] our physician practices. You have to build a relationship on trust, and it's important to me to be transparent and genuine so that they understand where I stand and [that] I am open and available to them.

In addition to that, I was able to assess the community needs, get to know the community a bit more, and then focus on strategic growth and quality initiatives. As fate would have it, we had our tri-annual Joint Commission survey within that first three months as well. I am glad to say that the staff, physicians, and providers are the ones to hold the credit for … a successful tri-annual Joint Commission survey.

In addition to that, within these first three months, we've had our fall Leapfrog score come out, and we were able to report a score of an A. In addition to that, we were able to reaccredit our mammography clinic as well. We're also working to get our interventional cardiology program up and running.

HL: What are your top priorities as CEO and what pain points do you hope to start addressing?

Shepherd: Everything resides around patient care and quality. What I would like to focus on first is to continue with and refine the good work that's already in place as it is related to patient quality and patient satisfaction. There are always things that we can improve upon, so we want to take that and run with it.

I want to be able to continue to assess and build up services for the community. Rutherford County is quite vast, so it is important being the only community hospital for that county that we offer as many core services as we can. We want to be able to build up services such as cardiovascular services. We already had OB and we already have orthopedic service lines, but I want to be able to expand on that. [I'm] looking to stand up some vascular procedures as the year rolls around, as well as support for our orthopedic service line, such as an athletic training program and a total joint program.

Pain points are, for us, no different than anywhere else, and that's staffing. We're already working collaboratively with our local community college and our universities to create pipelines. Given this as a rural community, it is critically important that we are hand-in-hand with our community college, universities, and even high school programs to create some grassroots efforts there. We're engaging with our current students as well as our past students to determine if there were any barriers that exist. Maybe there were areas in the hospital they wanted to rotate into that may not have been allowed during COVID times. That's something that we need to reassess and make sure that we can offer those to the students.

I also want to touch on that recruitment extends to our physicians and providers, as well as our staff. Physicians and providers lead the teams, and without them, it's hard to do the work that we need to do. We're going to work with Lifepoint to leverage an ability to gain access to applicants which, if we were a standalone hospital, would be quite difficult to do.

We need to make Rutherford Regional, in the surrounding communities, unforgettable by gaining an understanding of what is important to each candidate and ensure their experience with us, and [that we] address each and everything that they need.

HL: How does your background as a respiratory therapist, and your experience working on both the clinical and operational side of things, help you lead as a C-suite executive?

Shepherd: I would have to say it's perspective. It's perspective because I have walked a mile in their shoes. I am genuine, transparent, probably sometimes to a fault, and I have an acute understanding of the interoperation of most departments. I truly have a drive to better the community by engaging the frontline staff. Oftentimes, the frontline staff has the answers to the issues that we see every day; we just need to ask them and engage them, and make sure that they are also leaving with a sense of feeling like they've added value as well.

HL: How would you describe your leadership style?

Shepherd: I truly feel anyone in healthcare is in the service of others, and I feel that servant leadership style is what is best in this setting. I'm deliberate in my efforts to be collaborative and inclusive; I think that's very important. In the hospital and clinic setting, there are many departments, all with their own operations, but all of us are interconnected. I often say that the clinics are the front door to our outpatient services at the hospital, whereas EMS is the front door to our emergency services department. Without each other, we cannot effectively deliver care to our patients in our community. It is important that everyone is included and engaged; it takes a village. I tell my team all the time, and this includes the executive team: we cannot function in silos. We have to make sure that we are all engaged toward the same mission.

HL: What inspired you to work in healthcare and to become a leader?

Shepherd: When I came into medicine, I actually did this after high school at age 17. I graduated [from] high school a little bit early, and I went right into the respiratory therapy program. I went right into healthcare because I always knew I wanted to help other people and I chose respiratory therapy because it fascinated me and I was eager to learn more about it. It is unique in that you work with all departments; you work in multiple capacities, and you come to know and learn to work collaboratively with almost everyone in the hospital.

I served at the bedside for 10 years. I was a supervisor, as well as a clinical instructor for a local community college. Then in 2011, my director experienced some unforeseen health issues, and I was asked to take the role interim. The scope of that position covered multiple departments, from the cath-lab to wound care to the sleep lab to respiratory therapy. It was then that I learned the specific needs and operations of other departments. I learned how to flow from one to the other with ease and I was able to adapt as needed. This is when I realized how much I enjoy the challenge as well as the rewards of leading multiple departments. I enjoy working with the teams to see a shared vision become a reality.

After several months, the position was offered to me as permanent, and I accepted. I often tell people leadership found me. But it is a great feeling to have been able to expand, refine, and start new services, to have the ability to help so many, and provide care close to home. I pressed forward by obtaining my MBA so that I would have the ability to continue to grow in leadership roles when opportunities presented.

HL: What advice do you have for those in the workforce who might want to make the jump into the C-suite?

Shepherd: If someone finds that they have a passion for healthcare, either accidentally or purposefully, you have to go after it. You have to be fierce, and you have to never give up. You need to find a mentor that can help give you guidance. You always have to remember your "why;" you're going to have to lean on that often. Healthcare can be a challenge, and some days are hard, and you're going to need to remember that and lean on that.

You need to be genuine and transparent. You have to be present in every moment. If you are a leader, you are a teacher. Delegation and succession planning, that's key. The sign of a great leader is not that the organization runs well while you're there, it's that it runs well when you're not.

Personally, I have had many barriers and detours to get here. I feel you have a choice as to the legacy you leave. I'm happily married, I have three beautiful children. I became pregnant during my MBA program and delivered our second child before the completion of that program. I never stopped. I pushed forward even when it was hard and sometimes seemed unattainable. Likewise, we found out that we were pregnant with our third child after I had just accepted the director role. There was a tremendous amount of stress at that time, if you can imagine, but I was determined to see it through.

The thing is, you have to remember that this is a marathon, this is not a sprint. There's only one person who can win the race and no one else is going to do it for you.

HL: Do you have anything you'd like to add about being CEO of a rural hospital?

Shepherd: I have an appreciation for rural healthcare, and I also have an appreciation for working for a larger system that can support that as well. Lifepoint gives you the ability to keep the community feel and stay connected to the community, but it also gives you the support that you need. It would be difficult to continue operating in this environment if you were a standalone hospital, not to say that it can't be done, but certainly a challenge.