Rising Through the Ranks: Q&A with Rural Hospital President Soniya Fidler

by Hallie Vonk

In 2000, Soniya Fidler moved to Steamboat Springs, Colorado, drawn by the allure of mountain living and the promise of a unique lifestyle. She found her way to UCHealth Yampa Valley Medical Center (YVMC) in 2005 where she worked as a senior recruiter for the hospital. Nearly 20 years later, Fidler reflects on the journey that took her from an entry-level position to president. She discusses perspectives and lessons learned rising through the ranks, why rural health leadership pipelines are important, and advice for "grow your own" programs in rural health settings.

When you moved to Steamboat Springs, you were working in the property management/hospitality industry. Can you please share some pivotal moments that influenced your career trajectory and ultimately led you to pursue leadership positions in a rural hospital?

My natural tendency is always to do more. I am intrigued by the multiple facets it takes to run a hospital, let alone all the services that support patient care. My journey from the ski resort industry to healthcare leadership was marked by a pivotal shift in perspective. Transitioning from the vibrant world of hospitality to the complexities of healthcare was a leap aligned with my evolving career ambitions. At the time, I wasn't necessarily seeking out healthcare or other employment, but the opportunity aligned with being in human resources and I thought, "Why not?" I vividly recall my interview at YVMC — it was a significant and memorable crossroad.

My innate drive to embrace new opportunities and take on whatever was needed, no matter what it was, propelled me from an entry-level role to my role as president.

Reflecting on your journey from the time you were in mid-level management to President of UCHealth Yampa Valley Medical Center, identified as a Top 20 Rural & Community Hospital in America by the National Rural Health Association in 2023, what were some of the biggest challenges you faced, and how did you overcome them?

Every day in healthcare presents a different challenge. Do we have enough staff? What is the criticality of our census? Is technology and equipment working as it should? And in our part of the Rocky Mountains, will the weather present any patient transfer difficulties?

One of the biggest challenges that ultimately was a success was our decision to join Colorado's largest healthcare system, UCHealth. Until September 2017, YVMC was an independent hospital. Our leadership and board were strong in their goal to remain an independent organization and felt we had the strategies in place to do so. Over the years, with different perspectives at the table, we transitioned to a strategy that focused on remaining independent until we say otherwise. For years, we worried about the future of healthcare, the impact it would have on rural hospitals, how to ensure reimbursement allows us to sustain critical services in our community, et cetera.

Finally, when we were in a position of financial strength, we took the opportunity to seek a clinically integrated network and system partner. We wanted to be in the driver's seat choosing our partner instead of having to wave a white flag in hopes that someone would rescue us. The due diligence process was significant, with YVMC and UCHealth ultimately choosing each other as our missions, culture, and patient-focused values were well aligned.

While we were excited about and confident in the decision, there were challenges ahead of us. From systems integration and operational facets, to marketing overhauls and community relations impacts, there wasn't a part of YVMC that was immune from change. Leaders spent significant time focused on change management with their teams. Externally, we faced criticism within pockets of the community — how could we let "corporate" take over, would we lose the feel of our community hospital, would the personalized care be the same? Through persistence and transparent communication, we successfully navigated this transition, solidifying our commitment to advancing patient care while preserving our community's values. Having been part of UCHealth for almost seven years now, I can confidently say the challenge ended in success. We are proud to be part of an elite health system that offers us great resources to enhance the already high levels of patient care provided at YVMC.

As you progressed through your career, how did you navigate the difficult transition from management to leadership? What skills and competencies were needed for that transition?

When discussing leadership development, oftentimes you hear the sentiment, "Are leaders born or made?" The transition from management to leadership is truly difficult and often not seen as something every leader can or needs to do, let alone knowing when that transition might or should occur.

A leader needs the ability to be aware of not only oneself, but also what surrounds you as well as knowing how to react to that through social skills, empathy, and motivation.

I believe it's a gradual transition that occurs naturally as you progress in your career. It's a realization that your role is no longer executing functions and day-to-day operations, but now needing to achieve objectives through others and motivating them towards a common goal and vision. Strong emotional intelligence is needed for this transition. A leader needs the ability to be aware of not only oneself, but also what surrounds you as well as knowing how to react to that through social skills, empathy, and motivation. Seeking out feedback, understanding what others around you need, being clear on what they can expect from you, continuously working on self-improvement, adjusting based on your environment and audience — these are all skills and competencies that allow for a fluid transition from management to leadership.

When I took on the role of president, my focused competency was to drive vision and purpose in painting a compelling picture of the vision and strategy that motivates others to action. With this as a focus, I worked on storytelling and found myself repeating the same messages to motivate, realizing that repetition showed that it was what I believed and that translated to the rest of the organization in focusing towards our common goal.

What role did mentorship, both internally and externally, and sponsorship play in your development as a rural healthcare leader? Were these relationships developed formally through a program that UCHealth established or informally through your own network?

Mentorship played a fundamental role in my growth. As soon as I began as a recruiter in healthcare, my leader immediately and naturally became my mentor, giving me opportunities to expand my knowledge and grow, while sharing tangible and direct feedback on areas of opportunity and carving a growth path for me to follow. I was advised in big and small ways so that I could work on setting myself up for success. Partnering with internal coaches and executive mentors further refined my leadership acumen, nurturing a continuous journey of self-improvement and accountability.

Workforce shortages are a key challenge facing rural hospitals. In your opinion, what role do rural health leadership pipelines play in creating sustainable recruitment strategies for healthcare facilities in rural areas?

YVMC is located in a rural resort community with a high cost of living and lack of affordable and attainable housing. Recruitment strategies must be focused on targeting individuals who have the passion to live in a community like ours. We then must individualize our approach to address any barriers new employees may have in relocating to our area.

Our people are our greatest asset, and we work to identify ways to invest in them and their career development.

UCHealth invests in programs to help grow our own pipelines, such as Periop 101, Sterile Processing Academy, nursing fellowships, and more. In addition to standard tuition reimbursement programs, in the last few years, we launched the Ascend Career Program that provides fully funded tuition assistance for select education programs. We also work closely with educational institutions to bring healthcare programs closer to our community, such as a certified surgical technologist track. Our people are our greatest asset, and we work to identify ways to invest in them and their career development. Often, the talent for an open position may already be part of our team. If we can enhance existing skill sets, we can accomplish both skill advancement and career development at the same time.

For decades, we have offered transitional housing to those relocating to our area as a way to provide them with a landing place while they explore long-term housing options. The COVID-19 pandemic caused substantial increases in housing prices and decreases in inventory, making the local housing market even more unattainable. In order to provide an additional housing option for our staff, UCHealth invested in a 42-unit housing development to provide secure housing in the form of long-term leases. We suspect housing will be an ongoing strategy for retention and recruitment purposes for years to come.

Access to quality child care is also a challenge in a rural resort community. Since 1981, YVMC has provided an onsite, employer-based childcare center. What started as one of the first intergenerational programs in the country, integrating children within aspects of activities and socialization within skilled nursing care, UCHealth GrandKids Child Care Center continues to play a vital role in our ability to staff qualified talent even as the skilled nursing facility moved offsite and is now independent of YVMC. Alleviating the burden to secure reliable child care for over 40 years makes an impact in retention and recruitment.

In addition to your commitment to UCHealth, you also serve on the Board of Directors for a variety of community businesses and nonprofits. Can you speak about the importance of community engagement and collaboration that comes with being a rural hospital leader? Are there other aspects of being a leader in a rural community that you believe to be critical for success?

In rural areas, a hospital is often seen as one of, if not the most respected anchor within a community. Community involvement by hospital leadership is critical in developing relationships with key leaders of various organizations in order to establish trust and allow for collaboration. The hospital serves the entire community, and the community is the hospital's ally when situations like a pandemic arise. A positive relationship with our community during a very scary and uncertain time allowed people to feel safe and well taken care of, thanks in part to their trust in their local hospital. Additionally, the community is your ally when it comes to the legislative environment and protecting the services the hospital can provide, especially in a rural setting. For us, it's key in that we are a very robust and sophisticated health system within our valley, providing services that often are not seen in a community of our size.

What have been your biggest challenges and greatest successes in your leadership position?

I'm a firm believer that success doesn't always come easily and that some of the biggest wins are felt after the most difficult battles.

Developing various partnerships with physicians based on our community needs often brings both challenges and successes. Embracing these challenges allows us to improve the services that our community needs and deserves to access close to home. We've been able to grow our services in the last several years to include neurology, rheumatology, endocrinology, urgent care, and an ambulatory surgery center. We also have been able to maintain services when independent practitioners move on, such as otolaryngology services.

As healthcare leaders, if we don't continually push boundaries and think innovatively in every way and in every nook and cranny of our organization and operations, we may not be able to be there when our patients need us most.

Securing a future housing option for our talented and dedicated staff has been the most recent challenge and success at YVMC. We're the first UCHealth facility to offer something like that and while being first is exciting and literally groundbreaking, the challenges we encountered to get here led our housing taskforce to work harder and think more critically than anticipated. As healthcare leaders, if we don't continually push boundaries and think innovatively in every way and in every nook and cranny of our organization and operations, we may not be able to be there when our patients need us most.

What advice do you have for individuals who find themselves rising through the ranks of a rural healthcare facility?

Embrace curiosity, ask questions, show vulnerability, and take advantage of opportunities that come your way, even if it doesn't look attractive to you. Develop relationships early, as first impressions make a difference, especially in a rural community. Build trust and connections with your medical staff, as these partnerships are crucial. Finding the ability to balance the needs of all of your stakeholders will ultimately allow you to achieve your mission. Seek out discomfort: Do things that are uncomfortable and spend time in the areas that you can improve. Prioritize continuous learning across various domains — clinical, operational, financial — to broaden your expertise. Understand your strengths and areas of opportunity and work on them: Learn from failures. Strengthen emotional intelligence and, in healthcare especially, approach challenges with resilience and adaptability, knowing that you may take a different direction based on what you see and hear. Most importantly, give yourself grace and have fun through it all.

Opinions expressed are those of the interviewee and do not necessarily reflect the views of the Rural Health Information Hub.