Careers in Family Medicine: Supportive Executive Leadership - The Foundation

When we think about Careers in Family Medicine, our minds often go first to the physician role itself, the many ways a family physician can practice and the variety of paths within the specialty. But the reality is that too many healthcare systems make it hard for physicians to do their best work, leaving it to individual doctors to create pockets of sustainability and well-being in spite of the system.

That’s why I want to start this round of the series by highlighting an exception, an executive leader who was intentional about creating the conditions for family physicians and their teams to thrive (and whom I've indirectly benefited from). Tammy Green, MPH, PCC served as CEO of Anchorage Neighborhood Health Center (ANHC) from 2015–2021, stepping into a period of instability and leading a culture transformation that still shapes the clinic today.

When I wrote about my time filling in at ANHC in Residency 2.0, I described the “contagion of kindness” and “culture of calm” I found there, qualities that didn’t happen by chance. In this interview, Tammy shares how she approached “culture by design,” the systems and values that made it stick, and how she now works with leaders across healthcare to bring the same intentionality to their own organizations. Enjoy our conversation below:

You were recruited to take the helm of the Anchorage Neighborhood Health Center (ANHC) after a period of high turnover in the CEO role. What drew you to that specific challenge, and what did you observe about the culture when you first arrived?

I was in a system-level leadership role at Providence Health & Services when a couple of board members from ANHC approached me about the CEO position. Throughout my career, I had moved through different leadership roles, and at each level, I found myself looking up and thinking about what might be possible if I had the chance to lead from the top. I had a very clear vision of the kind of leader I wanted to be and the culture I wanted to create. This felt like the perfect opportunity to put that vision into practice.

The board chair was candid with me, explaining that the culture needed repair and that the staff felt disconnected after several leadership transitions in a short period. When I arrived in June of 2015, I could feel that skepticism and a low level of trust. My first priority was simply to listen and observe, to resist the urge to jump in and "fix" things immediately. It was clear the organization was operating with a culture by default, not by design. It wasn’t anyone’s fault; it was just what happens when instability becomes the norm. I knew that my most important, non-negotiable responsibility as CEO would be to intentionally create a new culture—one where people felt welcomed, valued, seen, and heard.

You’ve said that you believe “culture is the CEO’s job.” What kind of workplace culture did you believe was possible, and what core values guided your approach to building it?

I fundamentally believe that culture is one of the top responsibilities of a CEO and the executive team; it’s not just an HR function. When the commitment to culture truly comes from the top, it has a “stickiness” and authenticity that you can’t achieve otherwise.

My vision was guided by the philosophy of the book The Patient Comes Second. The idea is that if you don't first create a culture where your people feel cared for and can thrive, your patients will never get the best of them. My 'north star' was creating psychological safety. This meant building an invitational culture where diverse opinions and ideas were not just welcomed but actively sought out, especially from frontline staff and emerging leaders. I have a particular passion for mentoring and developing women leaders, ensuring we elevate the collaborative, relationship-focused skills that are so vital to healthcare. Ultimately, I believe healthcare will only change from the inside out, by cultivating leaders at every level of an organization.

How did you begin to translate that vision into reality? What were some of the first tangible changes you made to shift the culture and systems at ANHC?

The first year was about stabilizing and building a foundation. We immediately focused on recruiting providers, as we were significantly understaffed.  Alongside that, we began the deeper work. After my first year, we held an all-staff retreat and conducted our first formal culture survey. This was the first time many staff had been brought together in that way, and it gave us a baseline to work from.

From that, we launched a quarterly employee engagement "pulse" survey. Instead of a single, massive annual survey, this gave us timely data points and allowed us to be more responsive. As a leadership team, we reviewed the data from every survey—even when it was tough to hear—and made a commitment to act on the themes we saw. This led to initiatives like creating a "Service Excellence Committee" and launching peer-to-peer appreciation programs.

In parallel, we tackled the systems. You can’t ask people to thrive if their basic operational tools are broken. The organization lacked certain infrastructures, such as a comprehensive policies/procedures document management tool, and more, so we undertook a massive two-year project to overhaul and streamline more than 600 policies and procedures. These structural improvements were critical because they provided the stability and systems that enable people to do their best work with the most ease.

A core part of your philosophy is building trust and empowering your team. How did you help your leaders and staff embrace and carry forward this new way of working?

It all comes down to demonstrating that you are listening and that people’s voices are valuable. The key is closing the feedback loop. When you ask for people’s thoughts, you have to be willing to report back and say, "Here's what you told us. Here's what we can do about it, and here's what we can't, and why". That authenticity builds incredible trust.

I also believe a leader’s two most powerful tools are curiosity and the ability to balance humility with confidence. Instead of assuming I had the answers, my approach was to start from a place of curiosity. When a problem arose, I would ask questions and seek input from a wide range of people—from the front desk staff to the providers to the IT team—to understand the root cause. Great leaders know when to lean into their confidence and make a decision, and when to lean into humility and admit they don’t know something. Modeling this from the top gave my leadership team and staff the permission and safety to do the same.

You concluded your tenure as CEO in December of 2021 to pursue executive coaching and consulting full-time. What are you focused on now, and what keeps you hopeful about the future of healthcare?

Yes, after 6 and half years, I left my role at ANHC to answer a calling to support leaders on a broader scale. My passion has always been developing leaders and helping them discover their unique voice and purpose. Today, as an executive coach and leadership consultant, I partner with healthcare leaders, executives, and physician leaders to help them cultivate authentic leadership practices, build high-performing teams, and lead organizational transformations. I get to help them navigate complexity, enhance their executive presence, and create cultures of connection and accountability.

What brings me hope and joy is witnessing the moment a leader’s insight ignites—when they see their own capacity to lead with courage, curiosity, and heart. I’ve watched these sparks ripple outward, transforming teams, shaping cultures, and elevating the care delivered to countless patients. Every “aha” moment is a seed for a new era in healthcare—one where leaders grounded in self-awareness and compassion create a future that is healthier, more humane, and filled with possibility for everyone.

Tammy Green, MPH, PCC, is an executive coach and consultant with over 25 years of experience in healthcare leadership. You can learn more about her work at tammygreenconsulting.com or contact her at [email protected].

Tammy’s story is a reminder that the conditions for meaningful, sustainable work in family medicine are often shaped by those at the helm, and that intentional leadership can leave a legacy long after the leader has moved on.

With that foundation laid, we’ll turn next to our first physician feature in this round of the series: Dr. Murray Buttner, whose career in rural family medicine offers a different kind of lesson in resilience, adaptability, and joy in the work.

Have a joy-filled week! Tonya