Enhancing Patient-Centered Care through Servant Leadership

“I had one patient very early on in my career who I went to visit to address a concern,” shared Dr. Debra Vermette, Vice President, Chief Medical Officer, Hospice & Community Care. “My employer at the time wanted me to meet with the patient to encourage him to continue our services. He had metastatic cancer but was independent. After a very long meeting with him, he decided to remain in our care.

“I continued to visit him monthly for the next five months. He was my first hospice patient that I had an opportunity to have that longitudinal of care. He shared his books with me, his writings and his hobbies. We developed a special relationship and connection that I don’t always get to have with my hospice patients if they seek out support too late in their illness. On our final visit together, I sat down beside him, and he looked at me very pale and fragile and asked, ‘Am I dying now?’ I looked at him and said yes, I am sorry you are. He looked at me and patted my hand and said, ‘It’s okay doc, I know where I am going.’ I always remember that because it reminds me of why I do what I do. When I get into the minutiae and the details and the stresses, I just think of him. This is why we do this. He was one of the special ones; they’re all special.”

Getting Started
“I went to college as an English major but eventually changed my area of study to psychology,” shared Dr. Vermette. “I wanted to be a psychologist and had an externship towards the end of my training with plans of applying to a PhD program. My externship was with methadone maintenance patients. During my externship, all my ideas or questions were answered with, ‘You’ll have to ask the doctor.’ After a while, I thought, why don’t I just be the doctor?”

Fortunately, Dr. Vermette had an interest in science and had already taken all but one of the required premed sciences, physics. Dr. Vermette graduated from Texas Christian University in Fort Worth, Texas, earning a B.S. in Psychology. She applied to the University of Texas Southwestern Medical School in Dallas, Texas, where she initially planned to be a psychiatrist.

Concerned that she would be narrowing her focus studying psychiatry, Dr. Vermette opted for her residency to be in family medicine at the University of Texas Family Medicine Program in Houston. She is Board Certified in Family Medicine.

“Family medicine is very holistic in its approach to patients, it’s the whole patient and all aspects of patient care, such as psychosocial and spiritual,” explained Dr. Vermette.

After graduation, Dr. Vermette entered private practice in a small town in Oklahoma. From there she and her family moved back to Texas where she eventually joined her husband’s private practice. It was there that she discovered her passion for hospice and palliative care.

“While in Oklahoma, I loved being in the hospital and taking care of patients in their homes or senior living facilities,” commented Dr. Vermette. “As they approached the end of life, I helped manage their symptoms so they could stay at home, if they wished, and remain comfortable. I didn’t realize at the time that I was providing hospice care.” Hospice care had not been well known or formally established in the small town where Dr. Vermette practiced medicine.

“As I was leaving a patient’s home, I was in my car and had an epiphany, this is why I’m a doctor,” smiled Dr. Vermette. From that moment, she sought out mentors, participated in educational sessions, and received training in hospice and palliative medicine. She received her Board certification in Hospice and Palliative Medicine in 2004.

After serving as the Medical Director for a hospice in Fort Worth, Texas, Dr. Vermette relocated to Delaware in 2011 to devote her energies to the advancement of end-of-life care for patients. In 2015 she moved to the Philadelphia area, where she oversaw the clinical leadership of both the Hospice and Palliative Care Programs and advanced to Senior Medical Director. While in Philadelphia, Dr. Vermette also served as clinical faculty at two Hospice and Palliative Medicine Fellowship Programs, providing hospice education and experience during their training. She is a Fellow of the American Academy of Family Medicine and the American Academy of Hospice and Palliative Medicine.

Making an Impact
Dr. Vermette joined the Hospice & Community Care team in March 2023. In her role, she is responsible for providing leadership, strategic direction and medical oversight for Hospice & Community Care’s hospice and palliative care services. She provides education and support for staff, physicians, and other medical professionals to foster quality palliative care and increase access to services. Dr. Vermette shared that while 80% of her role is administrative and 20% clinical, she knows that to implement change and gain the respect of her colleagues, she needs to immerse herself in the day-to-day with clinicians.

“There are different styles of leadership,” commented Dr. Vermette. “I prefer servant leadership.” Servant leaders prioritize serving the greater good. They serve their team and organization first. They don’t prioritize their objectives.

Dr. Vermette was engaged quickly. She started in the organization’s Access Department, often known as admissions. She spent three months answering phone calls and addressing questions from team members, patients, and families.

“I was answering those calls to learn where we needed to adjust and what we could do to strengthen how we approached patient care,” explained Dr. Vermette. “It also allowed me to examine ways to enhance collaboration and communication between our physicians and nurses.” Dr. Vermette is also working directly with clinical teams as the physician on-call. “I like getting into the nitty gritty to have a better understanding of the organization’s operations,” expressed Dr. Vermette. “Even though these hands-on responsibilities are not technically in my job description for my day-to-day work, I see them as something I need to do to be able to develop our services.”

Dr. Vermette’s reputation in the hospice and palliative care community has been instrumental in bringing new physicians and nurse practitioners to Hospice & Community Care. Staffing shortages continue to be an issue in the healthcare industry and Dr. Vermette is taking a hands-on approach with Hospice’s recruitment efforts. “It’s important that we are always looking at ways to grow our team,” shared Dr. Vermette. “We want to ensure that patients and families continue to receive quality care and comfort in a timely manner while ensuring that staff are able to have good work-life balance.”

Dr. Vermette is also helping to strengthen the organization’s collaboration with local healthcare providers. “During my interactions with providers they often ask how I like my new role and if I am happy,” shared Dr. Vermette. “I’ve not once questioned whether I made the right decision. Hospice & Community Care is an amazing, forward-thinking organization and I am excited to be part of the team and help enhance patient-centered care now and in the future.”