As Told To: Gayle Shier Kricke

Kricke (BS07) is director of primary care operations at Northwestern Medicine and an assistant professor of internal medicine and geriatrics at the Feinberg School of Medicine

I worked at a funeral home in high school and part of college—I wanted to study mortuary science and become a funeral director.

After my practicum in older adult programs at Rush University Medical Center, I decided I wanted to intervene earlier in people’s lives. At the funeral home, I saw how survivors’ experiences with end-of-life care influenced how they grieved.

SESP was the foundation of everything I’ve done since. It changed my direction and gave me the resources I needed to follow that different path. I was in human development and psychological services, but I draw on what I learned in learning and organizational change and social policy all the time.

My passion has always been healthcare quality and, specifically, working with older adults, especially those with multiple chronic conditions.

I became the second person in the nation to earn a doctorate in healthcare quality and patient safety, offered through the Feinberg School of Medicine’s Health Sciences Integrated PhD Program.

Professor Dan Lewis hammered it home that you can’t change a person—can’t put them back in a broken system and expect it to stick. You have to intervene at all levels.

I look for the gaps between people and settings: between patients and providers, between clinicians and academics, and between hospitals and communities.

I am a caregiver. My husband was born with hydrocephalus—his brain can’t drain his own spinal fluid. When he aged out of pediatrics, there weren’t a lot of places for him to go as an adult. Why do we have the pediatric system keeping patients alive but then the adult healthcare system isn’t ready to take them? I’m constantly thinking, “Is this a gap I can help close?”

Systems are where my passion lies. It’s also where I have the greatest chance to affect how people experience health- care. So often we run into the mentality that “we can’t do it this way because we’ve never done it that way.” But that’s rarely true.

I love to learn. I love tackling new problems and trying to learn about different things that I don’t already know. That’s why I went to Northwestern in the first place.

Primary care is so often the front door of healthcare, the place where people have long-term relationships and where they go when they need help. It’s the setting where patients have the most constant and consistent relationships.

But primary care is also in a bit of a crisis. We’re aware there’s an issue with the supply of physicians. The other piece is trying to figure out how you make the job more desirable for those who are in it.

I teach in the new Master’s in Healthcare Administration program at the School of Professional Studies. It’s a class on designing healthcare that is centered on patients and meets their care goals. I love teaching as much as I love learning.

What anchors me is that how well you do at the end of life does not just depend upon what happens at the end of life. It depends on the lead-up, the relationships with people who know you, who you trust, and who can help you negotiate some of the decisions.

Every road leads back to older adults. If I go back to being solely focused on the end of life, I’ll do it knowing more about how people got there in the first place, which I think makes me more able to make the changes that improve the end.