As a physician specializing in infectious diseases at a hospital in Slovenia, Federico Potočnik was on the front lines of the battle against COVID in the small Central European country. Not only did he treat patients on the wards but, using some of the leadership skills he had acquired as a youthful political organizer, he led a team that guided long-term care facilities on how to deal with the pandemic. “Those were very difficult times,” he recalls of the double shifts, the lack of effective treatments, and, worst of all, the losses of the patients to the disease despite the heroic medical efforts.
But now, Potočnik, 34, is recharging his batteries in the MSx program at Stanford GSB, where he is hoping to acquire management skills that he can use to help reform the antiquated, Communist-era healthcare system in Slovenia. “My endgame is to give my community the healthcare system they deserve,” he says.
What was it like dealing with COVID and how did it affect you?
At the beginning, there was a lot of anxiety. We knew there was this disease coming from China that seemed to be more dangerous than others and seemed to be killing lots of people and doctors. In March of 2020, we knew nothing about the disease; we didn’t have any successful medicine to treat people with and the infrastructure was not ready to deal with a pandemic of such proportions. When you are in the ER and you see one ambulance arriving after another, knowing you don’t have any available beds, the feeling is desperate.
Initially, the adrenaline and sense of duty keep you focused. But after two years of repeating this, you’re emotionally drained. You’re also professionally tired because you deal with one single disease instead of the whole spectrum you are trained to work with and, of course, our families suffer, and your personal life suffers. The worst is that even after all that sacrifice, it was still not enough. We all ended up burned out.
During the pandemic, were there things that you thought the Slovenian health system was not managing properly?
Yes. I was a board member of a larger hospital in Slovenia, and we were choosing a new CEO. Hospitals are managed by two directors — one’s a medical director and the other is a general director. Usually, the medical director is a physician; the general director may or may not be a physician. We were interviewing a candidate for the position who was a surgeon. He was a very good clinician. But he didn’t have any real experience as a general director. So my question to him was, “What’s your experience as far as the management side of such a large organization as a hospital?” His answer was that he was reading books on the topic. That was for me a pivotal moment because that person, who was an amazing doctor and surgeon and professor, was applying for a job that he could not fulfill because he was not schooled for the management side of leading such an organization.
What reforms are needed in the medical system in Slovenia?
We have a very outdated system that was designed under the Communist regime. It has not evolved fast enough, which means that even what was once perhaps positive, is nowadays obsolete. The ownership of a hospital is in the hands of the Ministry of Health, so even if you’re the CEO of a hospital, you cannot control the flow of money that comes into the hospital because it’s decided by the only insurance company [Slovenia] has, and you cannot control the outflow of money because the unions and the Ministry of Health decide the wages. So you don’t have any real power over the day-to-day management of your own hospital.
It comes back to the question of a nation’s design of institutions. As a Christian Democrat, I believe in subsidiarity, which implies bringing the decision-making closer to the citizen. In practice, I would prefer to decentralize the management of hospitals so one hospital can try to improve themselves and compete with another hospital. If there’s no competition, there’s no incentive to grow and improve.
How did you end up choosing the MSx program at Stanford?
What pushed me into applying to Stanford was that it was so different from what I’m used to. I wanted to be the farthest away as possible from my comfort zone, which is where I can explore the most and grow.
What stands out to you about the MSx program?
My classmates have been the highlight of this program. I feel I have learned as much or more from my classmates as from the professors that are here.
It]s one thing to be talking about reforming a hospital, another thing to be talking to a person that owns a hospital. It’s one thing to be talking about healthcare regulations, another thing to be talking to the person who wrote the regulations for a country.
We were discussing in class a marketing campaign from the company Expedia. One classmate raised his hand and said, “I was vice president of Expedia for Latin America at this time and we made this decision because of this and this and that.” You can learn different, valuable lessons from these not only astonishingly accomplished professionals, but also genuinely inspiring human beings with whom I’ve had the most insightful and life-changing conversations.
Has this new training changed the way you think about healthcare management?
It’s doing two things. First, it’s opening my mind to a world that was unknown to me — finance, valuations, microeconomics. These are things they don’t teach you at medical school. There, the thinking is convergent, since you are trying to find the right diagnosis from a variety of symptoms, whereas in business school the process is opposite: from a problem, you need to creatively look for solutions, which is a fascinating mind-shifting exercise. As a clinician, I have been working inside a hospital environment, treating patients. I could not see the operations in the back or the decision-making that happens above and beyond my position. That’s the space where you can do the most meaningful change. Once the design of the healthcare system is right, the rest of the pieces fall naturally into place.
And second, I want to bring into the [Slovenian] system the element of choice, where you can choose one hospital over another based on actual data about their quality of care. Some are better than others, but we don’t publish statistics of quality in hospitals. We measure some of it; we don’t publish it. I feel it’s our duty to offer them a way to compare. By comparing, they can vote with their feet and go to the place that has the better treatment outcomes. By doing that, we create an environment where everybody is trying to improve the quality of care instead of maintaining a lethargic belief that healthcare institutions are all equal, which inevitably leads to stagnation.
What is your game plan for after you graduate?
When it comes to Stanford, everybody says there’s this entrepreneurial bug around and it’s true. I came here thinking that I would change the Slovenian healthcare system from the government side. But here I learned you can also create — through an enterprise, through a startup or through innovation — something good and new and better. And by applying that, then the government will follow or the public healthcare system follows. Politics may be a good way to change things, but it is also true that interests in this space are immense. As a result, it is very difficult to actually move something; you may work for a number of years and still achieve nothing. So I’ve started thinking that maybe by creating something better in the private space, we can nudge the public system into improving itself. Slovenia is a small country. In a country of two million, that is doable.
You like hiking in the Julian Alps in Slovenia. Have you done any hiking in California?
We go every now and then around here, but I can’t wait to go back to my mountains. That was one of the things that helped me a lot with dealing with the [COVID] burnout, with the stress — to go to the mountains and breathe and enjoy and walk. Amazing.
Photos by Elena Zhukova