In the latest installment of our occasional conversations with Fort Worth leaders, Dr. Karen Duncan, the new president and CEO of JPS Health Network, discusses her journey into medicine and what she envisions for JPS moving forward. 

This conversation has been edited for length and clarity. For the unabridged version, please listen to the audio file attached to this article.

Alexis Allison: Dr. Duncan, thank you for joining us today. To begin, can you tell us why you pursued medicine as a career path?

Dr. Karen Duncan: The older I get, the further I get from at what point in my life I made that decision. I’m not sure that there was any one point in my life in which I said, ‘This is what I want to be.’ I think it was more that it became somewhat natural for me. I did well in the sciences and school. My mother retired as a biochemist. So I was surrounded by a very high academic and scientific background and continue to be impressed with my mom.

So it started as I went off to college, and it was interesting, you either were pre-med, or you were pre-law, and I knew I would not make a good lawyer. I sat in on the pre-med and having done well in the sciences and math started taking a lot of that curriculum. It wasn’t until I started to volunteer that I began to understand what a physician could be. With that, I found a lot of enjoyment — more so in being able to help others. I continued on my path and entered medical school. And it’s been a great path forward since.

Allison: You’ve served in several different roles at JPS Health Network. I’m wondering if you can tell us about those roles and what you did in each one.

Duncan: I had the opportunity — and it’s been a great opportunity — to join a great organization with a great culture. I have to say that about Fort Worth, and I have to say it about JPS. The people really do come together to help others. But I had the opportunity to come here first as a consultant, and to help the county in outlining the health care needs for the community. During that time, I spent a lot of time at JPS. It really became my home base. I got to know the team and got to know the executive team, and as I finished up on the project here and returned back into consulting, I received a call from JPS to say, ‘Hey, listen, you have a great community interest, would you mind coming and helping us build our community program?’ And of course, that was music to my ears, and I came running as a consultant and was here for about six months before I was asked to stay on. 

I feel very humbled. That’s where my passion is: closer to the patient, closer to our communities, empowering our communities to lift themselves and to help them with that. I have a large interest in being closer to the community. As our chief operating officer had made the decision to retire, our CEO at the time asked if I would step in. And so that was a different look for me. 

And I always compare this to the airplane, and everybody compares things to the airplane industry. But community was more the time in which you’re taking off, you’re closer to the ground. Then as I moved into the COO position, I was lifting and going up to cruising altitude. You were above that community and you were overseeing all things that pertain to the operations of the hospital, the operations out in the community. That was a wider view than I had. I’m a fixer, my son will tell you, ‘Mom’s a fixer. She wants to fix everything.’ So, that has been extremely rewarding. 

Now, I will say that I assumed that position a month before COVID hit. You can imagine how that looked very different for me. I could not draw upon previous experiences. I really had to look forward and take it day by day as to what that looks like and how we continue to care for our patients that come here and ask for care or need care. I did that through COVID. We also had that wonderful ice storm last year and our old facilities were really stressed during that time. But I have to say, the team here came together. They always come together and really were able to support each other and able to take us through. Looking back on that, I don’t know why we did so well, but we did well through that. 

And then as our CEO decided to retire — I really thought I was gonna be the first one to retire. I teased him about that, ‘How dare you do that before I decided to retire?’ But when he decided to go spend time with his family, which I think is really great. I think as people came out of COVID, they really did begin to reassess their lives, what was important in their lives. I commend him that he really did see the time with his parents to be most important. The board reached out to me at that time and asked me to step in and help in the CEO position. 

So being on that plane, I’ve reached cruising altitude now. And it really is kind of like, think on a plane, you’re looking out there, and there’s just all of this that’s out there. And so that’s been, I would say, the mindset or the transition that I’ve gone through. Not only did I hit cruising altitude, but I no longer was facing inwardly toward the hospital, but really had to begin to face exteriorly and begin to partner and begin to understand, who are the players? They’re the county commissioners, our board who I report to, the communities themselves, the taxpayers, all of those now are kind of my bosses as opposed to more internal, where I was overseeing a lot of different leaders and a different team. That’s kind of where I’m at right now. 

At times, it feels safer to turn inside where I’m comfortable. But it’s been really exciting to get to know really the great people that are out in the community and the work that they’re doing. Just everyday I look forward to new individuals that I’m meeting and then also beginning to partner with other hospitals and other entities to, again, empower our communities.

Allison: Thank you for sharing that journey with us. My understanding is that you’re planning to stay in this position just for the next two years. Can you tell us a little more about that?

Duncan: There seems to be a lot of rumor. When I stepped into this position, there was a contract that the board has given me that has been a two-year contract, which is not unusual as people are stepping into positions. So I do have a two-year contract with the hospital system. I do see where hospital systems have to look at where are they going in this new post-COVID time. We know that we have a lot of challenges with people returning to work. We know that the type of health care that we will need to deliver in the future, a lot of that was set during COVID. So we moved a lot of our visits from face-to-face visits to telehealth. There’s no way that we can return back and not offer that option of access for our patients. 

So two years gives the board time to begin to have those conversations about where’s the hospital going. We do have a strategic plan, so there is direction in that way. But where’s the hospital going? And what kind of leader do they need during that time? They came off of a CEO who had been here for 12-13 years, has had a very strong culture here. And now they’re taking the next step. It gives the board that time. There’s also work that has to continue to be done. Working through the bond that we have. Beginning to actually begin building some of the structures that the bond promised is important for our commissioners and for our board. So I do see my work that I started there to continue through that. We do have a strategic plan that does map out for the hospital where it is that we see ourselves going and what is that work that we need to do in order to build the structures so that we can be successful in implementing our strategic plan. 

I also see that I bring as a physician, as a female and as an African-American that I bring to this community and to the board and to the commissioners, a different lens by which to look at health care, and the more differences that we bring around the table, in which we are looking through these different lens, the better. We will be able to make some good decisions. And so I see that my role is to bring that information forward, as I see it. The patient, for me, is always at the center. The community is always at the center. As I start to veer off, I can always bring it back. And as I start to veer off, and need to look at how it is we’re going to pay for it, so having someone who knows how it is that you’re fiscally responsible. So I’m having all those different lenses by which to bring forward and have those conversations, both with our board and our county commissioners and our community will help this hospital move forward.

Allison: Would it be possible for you to stay on beyond those two years?

Duncan: I’m just going to be honest with you, Alexis. Two years is a long time in health care. It really is, and especially at a time in which you are really operating in more of a gray area. I cannot say, ‘No, that would not happen.’ But I really do see that my work is cut out for me. If at the end of that two years, we’re in a place in which the board or the selection committee decides that, ‘Hey, we like what we see.’ I mean, there is that possibility. Again, I think this is opportunity, and I think every hospital does this, in which they are always looking to make sure they have the right leader at the helm.

Allison: You mentioned the strategic plan, for example, and the bond and these big projects. I’m wondering, in two years, if you were to look back, what’s one thing that you hope you would have accomplished in your two-year tenure?

Duncan: That I haven’t turned completely gray. (laughs)

I think if I look back, it’ll be about the teams and the people that surround me, and really having them prepared to be able to lead health care. It’s leaving those individuals that are going to be able to move health care in the direction that it needs to go. And so, developing those leaders that have the opportunity to be innovative and creative in their thinking — something that’s very foreign to health care. Really leaving behind a team of leaders that are going to be able to carry health care, especially as it pertains to this Fort Worth community.

Allison: Speaking of a team of leaders that’s around you, the Tarrant County Commissioners Court selects the members on the board of managers. I’m wondering how you think the upcoming elections for the commissioners court could affect the board of managers and/or the direction of JPS?

Duncan: You’re talking about a lot of change. I’m probably the one person that actually likes change. I really do. I work well in change, because I do think that it stimulates me and creates that part of my brain that does like to think differently. So, I don’t know. I’ll be honest with you. I don’t know what this is going to mean. Health care and the services that it provides to the community are going to have to stay out in front. What that looks like, what those priorities will be, I think may look a little different. As it regards the bond, I’m hoping that we get this train on the track, and that that plan is pretty much set from this year until the time that we do our last building. That’s pretty set as to how that will map out for the community. I think it’s going to be important for the community to hear a lot of consistency. I have all the confidence that the new commissioners, new board members, and our new judge will all work together to have a consistent message to the community and create the confidence that’s needed.

Allison: To wrap us up, I’d like to ask about something that brings you joy in your job.

Duncan: Seeing others with joy. I think I’m funny — my son tells me I’m not really funny. But I do laugh at my own jokes. And often the team laughs. And I don’t know if it’s because they report to me, but it’s really about the joy of others. That’s what brings me joy, besides the fact I’ll be honest with you, there is so much work to do across the world, in our community in really helping others. It’s about not boiling the ocean, but understanding what you can do today and just making today a better day for others. That’s what brings me joy.

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis AllisonHealth Reporter

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....

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