In this episode, Dr. Sarita Warwick explores how purpose, dignity, and human connection shape medicine — from the exam room to executive leadership. A family physician who now impacts care for more than 100,000 people across two states, Dr. Warwick reflects on scaling compassion without losing connection. She shares formative moments from training, deeply personal patient stories, and how Optum’s value‑based care model makes room for holistic, team‑driven care that improves outcomes, reduces unnecessary interventions, and honors patients’ goals.
Dr. Warwick’s journey bridges intimacy and scale. She speaks candidly about the sacred trust of the physician‑patient relationship, the emotional challenge of stepping into leadership, and the responsibility that comes with influencing care at scale.
Through stories of complex patients with multiple chronic conditions, she illustrates the power of medication reconciliation, shared decision‑making, and coordinated teams. She also explains why primary care is the backbone of value‑based care — and how Optum supports clinicians with data, technology, analytics, leadership development, and mission‑driven culture.
Episode Overview
A childhood promise to make a meaningful impact
Key Topics & Time Stamps
00:00–02:30 — Childhood purpose and the “starfish” moment
02:30–05:00 — Choosing medicine for relational impact
05:00–07:30 — Sacred physician‑patient trust
07:30–10:00 — Moving from exam room to leadership
10:00–12:30 — Team‑based care at scale
12:30–15:00 — Value‑based care and population health
15:00–18:00 — Complex patients and medication reconciliation
18:00–21:00 — Reducing ER visits through coordination
21:00–25:00 — Quality of life, dignity, and goals of care
25:00–30:00 — Coaching clinicians and leading with purpose
30:00–41:00 — Why Optum is different
Episode Highlights
Resources & Links
ADIA MORRIS: Welcome to Clinician Real Talk, where we explore the purpose, persistence, and human connection that power modern care. Today we're joined by Dr. Sarita Warrick, Chief Medical Officer for Optum Arizona and New Mexico, and a family physician whose leadership impacts thousands of patients and clinicians across two states. Sarita, thank you so much for being here. I'm really excited to talk with you, to explore the experiences and values that guide your work every day.
DR. SARITA WARRICK: Thank you so much. Wonderful to be here.
ADIA MORRIS: As a child, you knew that you wanted to make a meaningful and lasting impact. So take us back to the moment you first realized that caring for people, especially those usually not always seen or heard, was at the center of who you were becoming.
DR. SARITA WARRICK: I remember being eight years old and looking at the sky, and I still, even to this day, looking at the stars or looking at the ocean, things bigger than me, connect me to my sense of purpose. And I remember just thinking, I want to do something big. I didn't know what that was and I didn't know what that meant, but I knew it was to help people, not necessarily recognition or fame or name, but just how could I—there's good in this world, but there's so many other things that need love, attention, care. And so I thought, okay, I'm going to figure that out. I didn't know what it was yet. And then got to sort of the tween teen times and felt a little more discouraged by the world and felt, gosh, I'm just a person. I’m a kid. I don't know if I can change the world, really. And then what hit me was that story that people tell about the kid on the beach, throwing starfish into the sea and someone saying like, there's millions of starfish, what can you do? And the kid says, that one impacted starfish that I threw back is alive. I know it's kind of a story that's been told for a long time, but I think that's what helped me to realize that the impact of the one-to-one and how that quest for making that, and relationships, actually meaningful and impactful in a larger way. And I think my leadership journey has been about that, really being a much more relational person, and especially in medicine. Of course, we have to know science and numbers and all of that, but I gravitated always towards more of the connection aspect, interviewing skills, and could that actually be scaled? Because it feels like one-to-one is it, but I found in my career that, yeah, it can, and that makes me really excited.
ADIA MORRIS: Awesome. That's amazing. You've considered several paths, politics, journalism, I can see you in either of those, all with the potential for influence. What ultimately convinced you that medicine was the path that allowed both intimate connection and large-scale change?
DR. SARITA WARRICK: I thought about, as you mentioned, politics. And something about probably just family things that happened, a lot of folks go into medicine had to deal with health scares or situations in their life, and I have plenty of those. But I think it was that one-to-one, I didn't see it as much in politics. I'm sure it's there. But being privy to stories and secrets, that's what I found when I talk about the sacredness of the exam room. People share things that their own family members don't know, maybe their spouses don't know, their children, maybe things that they hadn't really even discovered until they spoke to their clinician. We strive for safety in an exam room. And so something about stories and connection, and plus some of those health things that happened in my family, kind of pushed me more into the medical side of things. I did, after residency in family medicine, do a fellowship in health policy, kind of to see, can I marry the two? And I just missed clinical medicine so much. I felt the impact more immediately, I guess, than I did when I was working in politics and medicine, if you will.
ADIA MORRIS: You mentioned that the physician-patient relationship is sacred. So what early experiences taught you the depth and responsibility of that connection?
DR. SARITA WARRICK: I remember in medical school, Introduction to the Patient was the class, and some of those classes were exactly what you think, we’re listening to hearts and looking in ears. And then some of them were much more intimate, learning about women's health and men's health. The urge was there for many of us to sort of feel embarrassed or giggle. Even in that moment, I felt this person, even though this is not a true medical encounter, believes in medical education and that sacredness, and we need to take this seriously. And I just remember thinking, we have access, as clinicians, to places and areas that other people just don't have access to. So it's something very important about that, allowing people to feel safe, allowing people to feel comfortable, or we won't get the whole story, and we might not be able to help.
ADIA MORRIS: Can you share a specific early encounter in training or practice where you felt the weight of that sacred trust for the first time and what stayed with you from that moment?
DR. SARITA WARRICK: Yeah, absolutely. One was, this was in obstetrics training, and it was a young teen mom and her boyfriend, and they knew that they were going to be giving this baby up for adoption. And I remember just connecting with them and trying to be there, but not too there. They needed the time to kind of process. And I remember, after she gave birth, just there was a lot of hubbub. Things were going kind of chaotic around us. And just seeing her holding the baby and kind of having her moment and knowing that we were able to be a part of that, as poignant and difficult as that was, to be able to set that up in the middle of an exam, a clinical space, I found that so important. That whatever the space is, we can find ways to make it poignant and meaningful and valuable to the people that we serve.
ADIA MORRIS: Definitely. Decisions you make can affect more than 100,000 people across Arizona and New Mexico. Can you take us inside the feeling of what it means to carry purpose at that scale?
DR. SARITA WARRICK: Yeah, absolutely. I think I'd like to highlight, because I think it's important for clinician leaders, that move from the one-to-one relationship in the exam room to moving into leadership. Because there is a letting go there. And I mourn that sometimes. I miss sometimes being full-time patient care because there's this laser intense relationship that you develop when you have long-term patients. I remember when I first became a lead physician and I had to take on some admin time and additional clinical care, I really had to let go of that laser intense relationship and share that with my team so that the patients didn't say, well, I'm just waiting for Warwick, right? They ended up in the hospital, they ended up in the emergency room, they ended up not picking up medications because they were waiting for Warwick. And it was not good for them. And I realized then I have to endorse my team. I have to say, hey, you're going to see nurse practitioner, Melissa, next time. She’s going to take great care of you, and we meet every week to talk about our patients. So really endorsing the team, our medical assistants, the front desk staff. Because a lot of patients would call and say, I must speak to Dr. Warwick. It's like, no, you have to leave a message. Please leave a message. So I think it was important to move from craving that laser intense to making it more of a bond, a web, a strong web with the whole team. And that I found, team-based care, that approach was better for patient care, for value-based care. And especially with what we're trying to do at Optum, everything can't rest on squarely on the shoulders of a clinician. There has to be a team involved. And our patients need to know that that's good for them. So that was the sort of the start of kind of moving into leadership and understanding scale. Not only to help more patients, but also to scale my impact through my team. So then, thinking through as I moved up in leadership and in the value-based world, we take a look at things in terms of our panel sizes. And at first, my itty-bitty panel was 200 patients. I knew them by name. It was lovely. And then as we grew to 500 and 1,000, and in Texas, there are super panels. Everything's bigger in Texas, right, so having more patients. And then moving from that to even more administrative and leadership work was tough, again, because I knew them by name and now I have to work through others and inspire others and teach others. But realizing I'm not giving up on that dream that I had as a kid, because now it's 10,000 lives or 20,000 lives, where I was in Texas. And then here, now in New Mexico and Arizona, again, we're counting our patients as 100,000 lives, but it's not just them, it's their families, it's their caregivers. It's the folks that work in the clinics that interact with them on a day-to-day basis. So finding that at each level, maybe I'm giving up a little something, but I'm also gaining something, and I'm still on that trajectory to making good on what I promised myself when I was eight.
ADIA MORRIS: I truly believe that, like the starfish story, like as I'm listening to you, I can see the impact that you have from your position on those people, and then they have that impact on those people. So it's not just you with the one starfish. Your impact is spreading across there. How do you feel like Optum helps you to meet that scale and to be able to disseminate that sense of care?
DR. SARITA WARRICK: Yeah, absolutely. I think it is based on the care team approach. It's also exposure to so much more about medicine than I ever knew existed. I grew up in a family that was very pro-medicine. So that's something that they sort of pushed. I was a pretty independent kid. So I know I went into medicine because I wanted to, but thanks, mom and dad, for helping with that extra push. But I always thought it was, patient care is it, is 100% of it. And now I realize that it is the most integral part of it, but it's a part, and there's so much more out there that I did not realize. So having that exposure to the fact that we have relationships with our payer partners, with our hospital partners, with the leading cardiology groups and orthopedic groups in the community, and that many of our care delivery organizations also employ specialty, and learning about how do we have great clinical programs, but also add a bit of organization, structure, almost a project management look to it. But not to make people become numbers, but to make sure that we're really having an impact. We're measuring that people are getting healthier, that people do feel that their needs are being met, and that they have a medical home.
ADIA MORRIS: That’s a great way to put it. You carry a longstanding passion for serving people who often experience the margins of our system, so especially unhoused folks. How does this purpose guide the way you think about value-based care?
DR. SARITA WARRICK: I think my husband said it best when I joined Optum South Region, gosh, maybe 12 years ago. And at that time, our main population were Medicare beneficiaries. And I remember my husband saying, why don't we have, WellPeds? Because I was with WellMed medical group. Why don't we have WellPeds or WellAdults? I want this kind of care, too, because he would hear how much passion I had about value-based care. So the goal is exactly that, is that the work that we do, if we can demonstrate excellence in certain populations, that we would be able to, with the scale that we have at Optum, really change the way healthcare is delivered in America. And can we affect populations that are forgotten or wouldn't necessarily receive care that do interact with the system and utilize the system? How much of that if we could wrap care around earlier in the process, whether it's behavioral health resources, connection to social work and social services. Maybe we could actually change the trajectory of some people's lives. I really believe that the work that we do at this level, again, if we demonstrate that excellence, that we could show that this is the way to really save American healthcare.
ADIA MORRIS: I love that. I love that. Big dreams.
DR. SARITA WARRICK: Definitely.
ADIA MORRIS: Walk us through your story about your elderly patient with multiple, chronic conditions, someone caught in a cycle of ER visits and frequent hospitalizations.
DR. SARITA WARRICK: Gosh, I love this patient. I might get choked up.
ADIA MORRIS: Oh, that's okay.
DR. SARITA WARRICK: I met her probably seven or so years ago. I inherited her from a physician, great physician, had just kind of joined the group from that traditional style of medicine, but had been in a system where her physician probably saw 35, 40 others besides her. She had multiple medical conditions that were at odds with each other. So heart failure and kidney problems. The medicines that treat the heart usually hurt the kidneys. But if you already have kidney problems, I have to kind of sacrifice one for the other, sort of thing. So diabetes that was very brittle and hard to manage, and those medicines can work through the kidneys as well. And so a lot of medications. Showed up to me with her son, sweet loving son, with a bag full of medicines. We’re talking 20, 30 meds. In our Optum value-based system, I had more time because it was a hospital follow-up. I wouldn't have had that normally. So I was able to go through medication by medication and realize, okay, a lot of these are duplicates. This one is a medicine that was a temporary from a couple years ago that you still happen to be on, that just someone kept refilling.
ADIA MORRIS: Oh my gosh.
DR. SARITA WARRICK: We were able to really cut down about a third of her medicines right there. I was also able to have frequent visits with her because of the analytics that we have tell us who our highest risk patients are. So not only did I see it in front of me, but I knew that based on her risk, that she should be seen at least once a month. And at first, seeing her once a week, for a long time, until we got everything in order. It was a dramatic change. Just having less medicines, the burden of lots and lots of meds, even three or four to some people who are medicine naive, it can make you feel like, I just feel like I'm a sick person. We're trying to guide folks to health. It was nice to kind of take medications off, eliminate duplicates. They're bringing around now, now it's a nice Optum, little cute little Optum med bag instead of a big old trash bag of medicines. So there was some, just a lightening of the shoulders right away, which I love to see. And then little by little, we kind of chipped away at some of the medication and medical problems and got to a place where she needed the emergency room and the hospital so much less. She was probably going to the emergency room three to four times a month, and then at least one or two of those would be an admission. So we were able to get down to really rarely using the emergency room. It was incredible to see that. And it was just by doing the things that the team-based approach that Optum is about. Plugging her into the resources, to the team, to educators, to a health coach. It's like there's a whole team, and we have a contingency plan. And we're able to do that for a lot of folks. But I remember her specifically because she's kind of my first major success story in value-based care.
ADIA MORRIS: That's awesome. Medication, reconciliation, and careful de-prescribing were the turning points in her care, right? So what opens your eyes to the opportunities hidden inside her medication list and specialist care patterns?
DR. SARITA WARRICK: There's several things to think about here. The clinician standpoint, there's always pressure to do something. People want to walk out. Back in the day, it was a little blue script. They want something, usually an antibiotic or some kind of…And so having time to explain why just adding another medication or a medication for the side effect of another medication, these are deep philosophies in medicine that we need to think about. As much as you can, almost never prescribe a medication for a side effect of a medication unless that initial one is so important that we must. When medicine is in that way, where we're seeing so many, so many patients each day, it's really hard to actually think about those things and take a holistic approach and say, hey, you don't need this anymore. And actually, that's causing a side effect, and that's why you're on that pill. Guess what? We just stopped three. So it's really kind of applying that and having the time to do that.
ADIA MORRIS: When you think about her now, what emotions come up, and how has her story changed the way you approach other complex patients?
DR. SARITA WARRICK: I knew she had lived a beautiful full life, family that absolutely loved her, and I thought that I might be able to be around for the end and be able to honor that with her family, who I'd become very close with. And I actually ended up moving out of state, to New Mexico. But I found out from the patient's daughter, who I was still connected with, there's part of me that says, man, I could have been there. But the beautiful thing is, I think in a very healthy way, we prolonged her time. She didn't expect to have that many more years, and it was quality time. There's something beautiful about that. I'm not a palliative care clinician, but those principles are important to me in terms of what is someone's goals of care? What is their definition of quality of life? And what is their definition of a dignified end? And can we help get there? But knowing that I had an impact in extending a quality end, and maybe even quantity, is extremely memorable for me and something I won't forget.
ADIA MORRIS: You've said that success means knowing your patient's goals and becoming their consultant, not just their clinician. How do you help your teams bring that philosophy into everyday practice?
DR. SARITA WARRICK: That's a great question. Because again, that requires connection, time, and really thinking through what would a patient want? It kind of makes me think of my mother is considering cataract surgery. They explain the different types of lenses that she can use. And one was pretty fancy and had maybe a little more side effects and a lot more expensive. And the other was good, decent. It will work. It'll make her vision clearer. It'll be fine. And at first she said, I'm going to get those fancy ones. And I was like, oh, in my mind, I'm like, that's not like her. She’s the kind of person that her goals and values are she’s willing to forego dealing with side effects and extra visits and that kind of thing, to have something that's good when it comes to her medical care. Maybe not all the bells and whistles that might require more. So we were able to talk through that and I kind of said, hey, what's your thinking? She said, I'm having second thoughts. I don't know why I said I wanted those fancy ones. It doesn't really seem like something I want. I don't want to go back for more visits and this and that. I said, yeah, you should do what you want. But based on what I know about you and your typical values, the second option that you're leaning towards now seems to make more sense with what I know about you. So I think about that when I see patients as well in that some patients are really excited and ready for maybe a natural alternative supplement. Natural supplements are active, so that shouldn't be done in a vacuum. We need to know about all of those, so consulting in that is important. A lot of times people think over-the counter meds are safe, and so I don't need to tell my doctor about that. Yeah, we have to talk about that because they interact. And then some other patients I know are maybe more worried about their health, more anxious, more likely to want imaging or testing. And having that conversation of risks and balances and why we're ordering this testing or why it might not be the time, that kind of thing.
ADIA MORRIS: How do you help your teams bring that philosophy into everyday practice?
DR. SARITA WARRICK: I think it's talking about shared decision-making. So how do we move from a culture, a previous culture of patients also just wanting to be told. That was the general culture of like, tell me what to do, doc, and I will do it, to that shared decision-making model, which sometimes we can overshoot, where we're like, well, what would you like to do? And the patient's like, I don't know, I'm here to talk to you, right? So how do we find that in-between, where we know someone's goals and values, and then there are a few options. And if there are options that are equally appropriate, which one connects? So really learning and teaching through shared decision-making. One of the things that we're implementing at Optum New Mexico is adding that to the onboarding process. There's wonderful articles out there outlining shared decision-making and a framework on how to do it efficiently, so it doesn't sort of hijack the rest of the visit.
ADIA MORRIS: Right. How do you coach clinicians to stay anchored in what matters while navigating the realities of modern practice?
DR. SARITA WARRICK: That's a great one. I think it's, even in administrative meetings or weekly meetings or huddles, taking a moment to bring it back to gratitude or the why. Because a lot of times we're doing things and we don't really know why we're doing them, or we pivoted a decision and our teams find out later on. They never understand why, they just feel the turbulence. And so I think if we can explain why, why did we make this decision? Why did we pivot on that? Why did we go forward with this? And really make sure that each level down can explain that why as well, that's kind of a lot of the coaching that we've done, is we have to know the why.
ADIA MORRIS: Yeah, that's really good.
DR. SARITA WARRICK: And who we're serving.
ADIA MORRIS: Yeah. So there's a misconception that primary care clinicians are simply referralists. How do you explain the true complexity and value of primary care, especially within value-based care?
DR. SARITA WARRICK: Absolutely. I think that question, there's a regional flavor to it. Again, depending on how much primary care is acknowledged, valued, understood, I think in a value-based system, even more so, we see the importance of holistic primary care with wrapping around a patient earlier in the process, rather than waiting until there's a lot of emergency room visits and hospitalizations, et cetera. And it can be tough. I acknowledge that. But there are fellow family physicians and internal med docs that feel similar, that feel they are in that situation. And that's why all the more, I am idealistic and a proponent for value-based care. Primary care is kind of the backbone of that. Specialty care, there's absolutely a need for specialty care and value-based specialty care as well. We're demonstrating that in many states. But the backbone being strong primary care and managing to the top of our licenses and referring when appropriate. It's even, it's important in areas that don't have healthcare shortages, which is one of my states, in terms of the Phoenix metro area of Arizona. But then also the healthcare shortages in northern and southern Arizona and in New Mexico, which is another. So it's kind of like a tale of two cities. But in both cases, strong primary care helps with high-risk patients, helps with reducing low-value or unnecessary care. I find that it also fuels mission for primary care clinicians, that we feel, yes, we are making an impact and a part of this care team. And it's not just about writing prescriptions and sending referrals. It can feel like that at times because of the task burden and the documentation burden and those kinds of things, which, again, having a care team but also really thinking through reducing any unnecessary care. There's a part of what we do that is protecting our patients from care, if you will.
ADIA MORRIS: I understand that.
DR. SARITA WARRICK: I think in America we seem to think more, more, more is better. And it's like, not always, not with healthcare. Some of it might be unhealthy or dangerous. Having the time and the ability to think through, is this high value, is this top of license, is this going to help my patient with their goals of care?
ADIA MORRIS: Switching gears a little bit, your path wasn't predetermined, but discovered through opportunity, support, and autonomy at Optum. What made Optum different from other environments you've been part of?
DR. SARITA WARRICK: When I first started at Optum, I was at one of the tiniest clinics in a smaller market and just seeing patients and trying to learn, what is this value-based care thing? I didn't learn about it in med school or residency. But I loved it. I loved having data to say, hey, Sarita, you have 200 folks with diabetes, and 50 of them or 100 of them are not at goal. So I just really jumped into that style of medicine, and it was noticed. Which it was just fascinating to me, when I think back to be at one of the smallest clinics in a small market, and yet be noticed by leadership. And my medical director, she was always looking for folks that had mission and focus in caring, and she believed she could add the knowledge to that. So now I try to do that too. It's like, look everywhere. Look everywhere for that person that's asking more questions, really interested, trying to make sense of it all. And is there a way to bring that person up as we build our bench and build future leaders and this team.
ADIA MORRIS: It sounds like you're saying that the possibilities for growth are kind of inexhaustible. Can you share a moment when you watched a clinician discover their voice, step into leadership, or realize their potential in a new way?
DR. SARITA WARRICK: There's a clinician in New Mexico who was part of one of our community center teams and fantastic individual contributors seeing patients, home visits, all kinds of things. And seeing how he made the system with his dyad partners even more efficient and even more operational so that more patients could be seen and reached. We saw like, wow, we can actually apply that to not just this slice of the work that we do, but bring that level of detail, rigor, structure, discipline, analytics to our own clinics as well. So seeing that individual contribution translate to actually training and teaching, not only APCs, physicians as well, he's been really successful with that. So that's been amazing.
ADIA MORRIS: Awesome. If someone is thinking about joining Optum, what are they going to get here that they might not get somewhere else?
DR. SARITA WARRICK: Across the nation, we employ the majority of clinicians. It’s being able to bring that same mentality of folks deserve this type of care and having the scale and the capacity and the resources to actually do it. And you won't get that somewhere else. The community centers that we have for patients to connect and take classes and exercise and the well-being, that's something that you don't always see other organizations, the leadership potential that we talked about, the ability to really interact with the system around you and actually affect it. The impact that we can have, we have a lot of ability to partner with systems in the community and actually implement change. We wouldn't get that at most other places.
ADIA MORRIS: Excellent. I just want to thank you so much for being here. Thank you for sharing all of your joy and optimism and expertise. It's really inspiring.
DR. SARITA WARRICK: Thank you so much. Appreciate it.
ADIA MORRIS: Sarita's journey reminds us that care isn't just delivered. It's led, shaped, and sustained by clinicians who bring purpose and compassion into every decision. If you're a clinician looking for a model that supports your independence, simplifies your workflow, and helps you bring care to where it's needed most, this is your sign. Take the quick readiness quiz linked in the show notes to understand your next step in the value-based care journey. And make sure you subscribe to Clinician Real Talk for more conversations with clinicians making real impact. Keep leading with purpose and care. We'll see you next time.