Swift Healthcare

22. How to Deal with Resistance Lead Effectively & Find Joy in Your Work

How do you Deal with Resistance, Lead Effectively, & Find Joy in Your Work? Nancy Jacoby RN, MBA, MHSA, FACHE, ACC guests on Swift Healthcare Podcast where we discuss all this and more! Tune in because you do not want to miss it!
 
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
 
Nancy Jacoby on LinkedIn:
https://www.linkedin.com/in/njacobyfache/
 
Music Credit: Jason Shaw from Audionautix.com
 
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript 
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast. I'm Patrick Swift, your host, I'm so excited about Nancy Jacoby being on the show. Nancy, welcome to the show.
[00:00:08] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:00:08] Thank you, Patrick. It's a pleasure to be here with you today.
[00:00:11]Patrick Swift, PhD, MBA, FACHE: [00:00:11] It's a joy and the title of our show here is how to deal with resistance lead effectively and find joy in your work. I love that. And so folks, let me share with you Nancy's bio here, which I love doing the top of the show. Nancy Jacoby is a former healthcare executive with 25 years of experience in the industry. She's a board certified. She is board certified in healthcare management by the American college of healthcare executives and is a fellow of the college go ACHE. I'm a FACHE as well. So I'm delighted that you're on the show prior to serving in leadership positions, Nancy, as a registered nurse with a passion for caring for the geriatric patients, she's actually still licensed in two States and she founded Nancy Jacoby [00:01:00] consulting and Nancy Jacoby coaching and consulting. And I have to call out that you went to Xavier university in Cincinnati. Having a great love for the Jesuits. I got, I got to give a shout out for your you're a Jesuit education and being a Xavier.
[00:01:13] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:01:13] That's right. I'm proud to be a Xavier alum.
[00:01:16] Patrick Swift, PhD, MBA, FACHE: [00:01:16] Outstanding. So we're going to talk about how to deal with resistance lead effectively and find joy at work. And if I may, let me also ask you, we did a little prep folks on before the show and about, you know, the arc of the book. Podcasts we're taping here, but I want to also ask you what got you into health care. If I may what drew you into healthcare and the passion you have because it's so strong and the impact you're having you know, what's your, what's your, why? What drew you into healthcare?
[00:01:44] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:01:44] Well, you know, Patrick, it's funny because you know, you fill out these child books that your parents give you, you know, year by year with, you know, your grade school teacher and your friends. And what do you want to be when you grow up and early on, I identified looking back, I identified a lot of focus [00:02:00] on. What I would call helping professions, you know, being a nurse, being a teacher and nurse stayed there for a good couple of years. Right. And you know, when I, when I first went to college at Xavier I started out as a psych major because I always had a gravitation towards people with, you know, emotional health needs. And I just, I got attracted to nursing because I felt like I could serve the whole patient and the whole person. And the mission of caring for the sick. I mean, what, what's more noble than that, right? I've always been attracted to something where in some way, shape or form, I'm going to have an impact. That's more than just on paper. Like I wanted to have a tangible impact
[00:02:44] Patrick Swift, PhD, MBA, FACHE: [00:02:44] Yeah. Yeah.
[00:02:45] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:02:45] and that that's, that's really what drew me to nursing. And. It drew me into healthcare administration, believe it or not, because I could make an impact on so many different levels. You know, people might say, well, that sounds [00:03:00] strange. How do you do that? Well, because you can, you can touch the patient. You can touch the organization. And then in a leadership role, you have the awesome responsibility to lead mentor and develop others. And it was probably one of the most fulfilling parts of my job.
[00:03:17] Patrick Swift, PhD, MBA, FACHE: [00:03:17] Aw. Oh, I mean, it's really, I love that because it's, it's pulling together all of the intention you had of being in the helping profession, even as a young person. And then, and then being in the workforce and being a healer and coaching and helping others heal and. You know, I hope listeners are thinking about what got you into health care yourself, or if you're thinking about healthcare the show is for, from the CEO to the new employee, to the aspiring healthcare professional we all can learn, we can all find inspiration and joy from each other.
[00:03:45] And thinking about what drew you into healthcare, Nancy I think is beautiful for our listeners also to think about what drew you into healthcare. Cause hell if we can connect more and more to a purpose, it is a protective. Barrier protective factor from [00:04:00] burnout. Because if we're dealing with burnout, one of the biggest things we can do is connect to our meaning and purpose. And so I love you sharing that short story as a neuropsychologist. I know listeners can't help, but be thinking about that question for themselves. Well, why am I doing this? And it gets back to purpose. So. One of the challenges in dealing with burnout, whether you're a provider, whether you're a physician, a nurse, a clinician, or a leader, or both is we all deal with resistance. And so I'd love to, I love this. You've got amazing blog. You've got a lot of great content out there. Let's talk about, here's the question? What do you mean by making friends with resistance?
[00:04:38] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:04:38] Absolutely. And people who are listening right now, they, they must be thinking, you're crazy. How can you make friends with resistance? Right. It's, you know, it's funny because when people think of resistance, a lot of the times it's, it's something negative, you know? So if I'm doing a workshop or if I'm having a conversation like this, when I, when I ask people, well, what's the first thing that comes to mind. When you think of resistance, it's [00:05:00] often negative words like, you know, right. I hear words like obstacle, blockade, stubborn impeding progress, you know challenge, you know, conflict. Right. And it doesn't have to be that way because resistance is really a natural part of any change that we're bringing to the table. Whether it's
[00:05:22] Patrick Swift, PhD, MBA, FACHE: [00:05:22] And you said the change work. Cause then people, then we can't help, but think of like, Oh, blood pressure. Right. And what you're doing is normalizing that normal part of what we do, right?
[00:05:33] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:05:33] absolute normal part of what we do, whether whether we're undergoing an individual change that we think might be very simple, or whether we're helping a team go through a change or, you know, Patrick at the organizational level, if we're doing something huge, you know, like a merger and we're going to bring two organizations together, like. The potential for resistance there on so many levels is very high because it's normal. It's, [00:06:00] it's, it's, it's like a friend that you have next to you all the time. Just welcoming it to the table and saying, I know you're here. Glad you're here with us. Let's figure out how to use you.
[00:06:11] Patrick Swift, PhD, MBA, FACHE: [00:06:11] I love that angle about how to then use resistance, because I love to contemplate the notion of the yoga of healthcare being a meditator and, and the notion of. Yoga of healthcare, this notion of developing our flexibility and our, our, our, our, our skills and our abilities and using resistance as part of the physical yoga. But here, you're talking about using resistance  to be more. More, whether it's effective, be more healthy, to be more happy to be more effective as a leader, this, this you know, you've written it can be a gift. So what are your thoughts about, you know, how, how is resistance a gift?
[00:06:53] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:06:53] Absolutely. Well, you know, if you think about why re why we resist, right. [00:07:00] Oftentimes on some level, there's some sort of fear factor in there, whether it's, you know, at the individual level we're undergoing some sort of change or we're trying something new, right. We may be kind of afraid of it. Going back to that big organizational context, like, you know, Holy smokes, we're bringing two organizations together. And. This is huge, right? It's huge on so many levels. We're bringing together cultures and finances and teams and information systems, all these things that are coming together when the resistance is coming to the table. And you know, it's funny. Cause I, I read a great book about resistance, a guy named Rick Mauer wrote beyond the wall of resistance and he talks about three levels of resistance.
[00:07:43] And when I think about some of the projects that I've led in healthcare, it's, it's just so on the money because when resistance shows up, it can, it can tell us three things. It can tell us that, all right, we don't, we don't get what's going on. Like, you know, the, I don't get it. I don't, I don't understand this. [00:08:00] Like, I don't understand this change. I don't understand the parts. Right. It could tell us that. Okay, we get it. But we just don't like it. Right. So it's like, I understand we're merging. I understand we're doing this and I am, I don't like it. And oftentimes when that's happening there is that very, very strong fear, underlying, underlying what's in there.
[00:08:25] Right. And then on the third level, there's, there's the resistance that comes to the table. I don't like you. And when he says, I don't like you, it's not necessarily, I don't like you, Patrick. It's, there's something here that I don't trust. Maybe it's something from the past, you know, let's say, you know, you and I are working on a merger team together. And we met in a past life. We were on a project and somehow I wronged you or I did something that violated your values. You don't trust me. And you're showing up with it. The point of talking about all of this is that. In those three [00:09:00] levels of resistance, there is so much information that's coming to the table.
[00:09:05] If we just pay enough attention to what's really going on. So a lot of the times when resistance shows up, particularly on a team where, you know, we're doing some serious business in healthcare, those these are high stakes patients' lives are at risks. Profit margins are at risk. I mean, we we've got some fundamentally serious stuff going on here. It's easy to, to knee-jerk and take things personally and be very wrong active, but really when it, when we think about resistance showing up, it's, it's a gift because it's giving us so much information into the state of mind, of our team members and what they're thinking and what they're feeling. And it's telling them, it's telling us, Hey, slow down leader. Pay attention to what's going on here, because there could be some knowledge in here that's useful to you in whatever you're trying to do with your team, with your department, with your organization.
[00:09:57] Hmm.
[00:09:57] Patrick Swift, PhD, MBA, FACHE: [00:09:57] I appreciate that. Cause you're you, you touched on [00:10:00] resistance being. I don't, I don't get it. I don't understand it. I, I, I understand it, but don't like it On a personal level. The interaction, the dyad, the pair, the the, I don't like you or trust you. And you're touching on the great wisdom there because it's not just leaders, but heck listeners may have a coworker that they're in a clinical setting or they're in finance or in their they're in other departments, whether you're frontline back office, there's always that. Resistance that can occur in the workplace. Right. And you're touching on some wisdom that people can practically, at least you're starting to, with the awareness. I mean, earlier I was reading your bio increasing awareness because once you're aware, then you can do something about it. If you're coming to the table and saying, I don't get this, or I don't like it, I get it. I don't like it, or I don't trust it as person. Practically. Is there coaching suggestion that you have folks for how to turn that into a gift?
[00:10:56] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:10:56] Yeah. Yeah, absolutely. You know, when, when you're thinking [00:11:00] about, you know, the fear factor or the trust factor, it's I tell my clients it's a wonderful time. To sit down and engage in conversation with whatever is bringing that resistance. So if it's if it's you know, face-to-face kind of conflict or there's a one-to-one relationship where something's amiss or, you know, you're leading a team and you're sensing good grief, this dynamic is just not feeling good. And this is, this is really getting in the way it's I, instead of running away from it, which. People want to do, because sometimes this is uncomfortable. Patrick, it's uncomfortable to engage in these sorts of things. I tell them, this is the precise time to lean in with your authentic self and get curious about what's going on with you. What's going on with this team, but then being a leader, you know, what's going on with us, like, you know, asking those questions and getting to what I [00:12:00] call the why's. And, you know, peeling back that onion and saying, let's, let's dig in here and really, you know, understand with a spirit of compassion and generosity, you know, how we can, how we can use this fear or how we can learn from what's happened with, you know a misunderstanding that created this.
[00:12:22] This lack of trust, if you will, you know, really, really showing up with a transparency with an openness. And then, you know, just thinking back to a client situation, I had the other day where we talked through how he was going to approach somebody who he had wronged and showing up and saying, you know, look, I I'm aware that this happened in the past and I, and I want to tell you, I'm sorry, I understand that I've, I've hurt you. And I understand that this is what I did, and it made you feel this way and I'm going to do my best to. To show up better and to repair this. So it's, it's really about coming to the table and leaning in engaging and being [00:13:00] curious.
[00:13:01] And then there's an element of accountability where it's like owning your role in, you know, am I, am I triggering resistance in somebody or am I triggering resistance in my team because I'm, maybe I'm not leaning in enough or, you know, maybe I'm. I'm rushing things when it comes to just, you know, pounding this change through, because Patrick you've been in healthcare long enough, you know, the deadlines are fierce, the pressure is high. You know, the stress is huge, right. And we're all well-intentioned people. And we bring to that table that high achieving excellence, we're going to get it done. But I Al I always remind people of what costs right.
[00:13:40] Patrick Swift, PhD, MBA, FACHE: [00:13:40] right. Yeah, because ultimately it's about people and not the numbers. And you said a lot of great content there. And, and I just comment on the lean in. I'm glad you said lean in. Because of the back of my mind, I am thinking it's, it's your message here. I'm hearing and feeling is that when there is resistance, you've essentially got a choice. We've [00:14:00] got a choice we withdraw and we may end up avoiding something and may have a short-term benefit from it, but we lose. When we disengage actually we, we hurt ourselves. And so if there's a listener, I want to encourage folks to think about what resistance you may be facing in your day. Well, heck and your personal life too, but in your workflow work-life if you're, if you're leaning back. And what consequences having, as opposed to leaning into it. And you said the word compassion earlier, and I was pleased and like surprised because it does tie into this and that's a practical wisdom that the benefit of coaching and you and I, both coach people and. It's more than just effectiveness and outcomes and, and these, these numerically driven concepts, but the deeper, more meaningful about compassion and meaning and joy, you know, this, the episode being titled the how to deal with resistance lead effectively and find joy at work. [00:15:00] I love that you touched on, on, on the, the compassion and, and so how does one Navigate this any other  story that comes to mind that that, that was inspiring that you came across.
[00:15:12] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:15:12] You know, it's, it's funny because I, I had changed jobs at one point and I was meeting with a new, very senior physician who, was in a very senior position on his service. And yeah, I'm brand new and I'm in my suit and pearls and I'm going to meet him, you know, as the new administrator. Right. You know, all excited to meet this guy. Well, Patrick, this guy was not excited to meet me. So I get into his office, you know, he's got all the diplomas on the wall and things going on, right. He's in his white coat with a  shirt and tie . Right. He's got his arms folded and it's glaring at know, I'm thinking, Oh dear, this is going to be fun. Right. And you know, after I greet him, you know, I'm Nancy Jacoby, blah, blah, blah, blah. I don't know why you're here. I don't need you here. I don't want you here [00:16:00] now. You're you're talking about some serious, some serious levels of resistance going, right. I think we got, I think we got a winner here. You both. Right.
[00:16:10] And you know, if I think about it, you know, retrospectively, I understand why, because a lot of administrators that he dealt with, you know, come in. And the first thing that I want to do is cut his budget and come in and tell him everything he's doing wrong and everything that he should be doing. And here's what you should do. And start like nine different change initiatives at a time and boss him around. So what he's thinking, you know, so I'm. In my little suit and pearls, I'm representing the administrators that have been in the past and he's thinking, Oh, here's another flavor of the month. That's going to come in and, you know, whack my budget and tell me what to do. And I said, all right. So in coaching mode, meet the person where they are. Right. You know, so I said to him, all right, You know, I'm really glad you shared that with me. And, and I appreciate your candor and, you know, I understand that it's frustrating to have new people come in and what I really want to do with [00:17:00] you today, if it's all right with you is just to learn from you because I'm, I'm new and I'd really appreciate you sharing with me. What's going on on the service and what are the challenges that you're facing right now? You know, what's keeping you up at night. And then maybe you and I could talk about if there's any possible way that I could help you, you know, at some point, yeah. Let's, let's just kind of hash that out and he kind of settled down a little bit and, and I'm not saying that, you know, we were peas and carrots from that day. We were not, it took a lot of time. Patrick was me, you know, showing up at his office, you know, showing up at his office again, showing up at his office. The same sorts of thing until , one day he, he looked at me, he said, you, you want to know, what's keeping me up at night, come over to this computer.
[00:17:45] I want to show you this, you know, this EMR, I want to show you how many clicks I have to make. And I'm like, okay, okay. We're getting somewhere. Right. Yeah. So fast forward, working with him, working with the team, we did get to be peas and carrots and it did [00:18:00] get to be a really great relationship. But, you know, you really, you really have to hang in there and make, be that way and lean in and get curious about, you know, what, you know, why is this guy so upset? He's you said something before about intention. When we were talking about, you know, why I got into health care and nursing. So intention for a minute, thinking about resistance because we're humans and the logical place, sometimes that we go is, Oh my God, this guy is such a pain in the neck. Why is he being this way? If we just stop and say, all right, this guy's human to who like what's what's hap right compassion. Like what's, what's happened to him. That's creating this reaction. Like what, what is it about me? That's causing him to feel this way. And then how, how can I help?
[00:18:45] Patrick Swift, PhD, MBA, FACHE: [00:18:45] ties beautifully to, to values. You know, one of the thing I want to ask you is what what am I values have to do with it, of how to lean into resistance? How does that tie into it, Nancy?
[00:18:55] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:18:55] Yeah. Well, you know, Patrick, for me, two of the most important [00:19:00] values at my core are integrity and courage. Right? So. Saying saying what we mean, meaning what we say, doing what we say we're going to do and saying what we're going to do and having all of those match. So if I'm going to, if I'm going to call myself a leader, right. But then I'm when, when things are hitting the fan, so to speak, or I've got a difficult conversation or, you know, there's something brewing, whatever you want to call it. If I'm kind of shirking away, you know, you know, I don't, I don't want to deal with that. Right. There's a misalignment for me there. Right. We, we. I believe we have to have the courage to go there and open up that box and say, you know, listen, and, you know, showing up with our compassionate selves because I know in healthcare we're compassionate, otherwise we wouldn't be here. Right. So there's my third value is I would, I would call it really kindness. That's the way I think about it. But, you know, integrity, courage and kindness, you know, leading with those three values. at [00:20:00] core
[00:20:01] Patrick Swift, PhD, MBA, FACHE: [00:20:01] I really appreciate that Nancy, because it is protection from burnout by knowing what your values are and for our listeners, I want to encourage folks to what are your values? Because when, when the proverbial stuff hits the fan to fit hits the Shan what are you, what are you falling back on? What are we falling back on? You're touching on something I think really is beautiful. Personally professionally as a leader, as a healthcare person, Whatever your role is, if you, if you have a strong sense of what your values are, if you have some clarity, your value, you're speaking about being able to have a clarity of your values that then helps dealing with resistance and not only dealing with it, but making it your friend and you be it. I think he did a beautiful job of it's like this is a martial arts jujitsu of as opposed to going against the resistance to actually. hapkido , I think with the, with the letting, letting that resistance flow like that physician example you gave instead of obliquely going head on and [00:21:00] banging into people to, to be able to lean in with, and this takes courage.
[00:21:04] This takes courage, what you're talking about. So with the episode title here, how do we deal with resistance lead effectively and find joy at work? I trust that that listeners are getting a better sense of how to deal with resistance, how to lead more effectively. By having that clarity to be able to join with folks, whether it's on a personal leadership level or you're a CEO of a hospital I don't care. We're all human beings walking each other home. And there can be joy in that. So I love that you talking about the values and. And that leads me to be able to ask you my favorite question as my guests, which is if you, for a brief moment had the attention of all the healthcare people around the whole planet for a brief moment, what would you say to us?
[00:21:46] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:21:46] Oh, gosh, you know, I would say, I would say healthcare is a serious business and we deal with some pretty serious stuff. Right. But we don't always have to be so serious. So, you know, I would say [00:22:00] laugh, love, relax, and, and enjoy the ride
[00:22:03]Patrick Swift, PhD, MBA, FACHE: [00:22:03] Hmm. I really appreciate that, Nancy. And I think about when I was a young clinician, when I had hair, no gray and coming into the healthcare profession, there is the sense of the gravitas  of healthcare. I wish I had had that within my quiver of arrows when I started. To recognize. Yes, there's a gravitas,  but also the, to live laugh. Find that joy along the way. So thank you for saying that and for our listener if you're new to the profession God, hang on to that wisdom from Nancy. And if you're near the end of a career or nearing retirement, it's not too late. This is the time, especially in the face of everything we've been dealing with in healthcare. With burnout and COVID and, and changes and, and resistance and all of this to be able to find some joy in what we do. So thank you for sharing that Nancy. And I want to ask you, if folks are interested in following up with you and learning more [00:23:00] about what you do where can they go?
[00:23:03] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:23:03] Patrick, they can visit my website njacoby.com. I also have a great guide. If they're interested in learning more about resistance or want an exercise that they can go through when they're experiencing resistance, they can text outcomes to 42828 , and they'll get my free resistance guide that they can use over and over and over again, to help them navigate.
[00:23:23] Patrick Swift, PhD, MBA, FACHE: [00:23:23] Love it. That is so cool. Four, two eight, two eight.
[00:23:26] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:23:26] Four two eight, two eight
[00:23:28]Patrick Swift, PhD, MBA, FACHE: [00:23:28] want to encourage folks if you want to follow up please follow up on that. It's a great resource. I'll have that in the show notes for the, for the podcast asked on the, on the website, Swift healthcare slash podcast. And I encourage folks to check that out, but Nancy I'm so grateful that you could be on the show and just thank you for bringing you're you're strengthened, compassion and wisdom and experience to be able to share with folks.
[00:23:49] Nancy Jacoby RN, MBA, MHSA, FACHE, ACC: [00:23:49] Well, Patrick has been a true pleasure. Thank you for having me.

21. How to Lead People & Places that Thrive w/ Quint Studer

How do you lead people & places that thrive? Quint Studer guests on Swift Healthcare Podcast where we discuss his Wall Street Journal bestseller “The Busy Leaders Handbook,” the importance of addressing our own emotional health as well as the emotional health of our workforce, and critical concepts that all leaders and aspiring leaders can benefit from hearing. Plus what’s next on the horizon from Quint’s upcoming book titled, “The Calling.” It’s a MasterClass from a legend in healthcare and you do not want to miss it!
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
Listen & Watch: https://swifthealthcare.com/podcast/
Apple Podcasts: http://apple.co/3aFpEpl 
YouTube: https://youtu.be/g5QLzwVc9CM
(A Top Healthcare Leadership YouTube Channel)
 
Quint Studer Links for Show notes:
www.quintstuder.com
https://thebusyleadershandbook.com/
https://gratitude-symposium.heysummit.com/ 
www.studeri.org
Music Credit: Jason Shaw from www.Audionautix.com
 
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough – even with the errors – to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript
 
MasterClass: How to Lead People & Places that Thrive w/ Quint Studer
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to another episode of the Swift  healthcare video podcast. I am so excited about our guest for this show. Today, we have Quint Studer, Quint. Welcome to the show.
[00:00:10] Quint Studer, MS: [00:00:10] I'm pumped about you being here, in fact, and I own a minor league baseball team and it's all about high energy, high fun. And if you're not, if you're thinking about getting a side job on healthcare, we could use you at the ballpark now. So thank you.
[00:00:24] Patrick Swift, PhD, MBA, FACHE: [00:00:24] I would, I would jump at that chance, , you know, be careful what you ask for Quint. I'm a,
[00:00:28]Quint Studer, MS: [00:00:28] We're ready.
[00:00:29] Patrick Swift, PhD, MBA, FACHE: [00:00:29] My wife's in Miami right now, visiting some family. I think I'd be happy to get down on the Pensacola. Folks, if you can feel the love. , I hope you can because the man we have on the show here, , I, , have the greatest respect for, and you are in in for a treat and, , Quint. I know you're a humble man. , and I just want to acknowledge how, , you have impacted this profession. So folks, if you are listening, pay attention because I have a master class for you in this conversation.
[00:00:56] And most importantly, with my values, it's about joy, [00:01:00] hope, compassion, courage. And who better to have on the show than Quint Studer. So here's Quint's bio. If you don't know who Quint Studer is, listen to this Quint Studer is a well-known healthcare operator, author, coach, and mentor to many, many, many, many.
[00:01:15] He has dedicated the last three decades to creating tools and techniques that make healthcare a better place for physicians to practice medicine, patients, to receive care and employees to work. He's written numerous books. I've got a couple here on my desk. I'm going to show you articles. And his work is always based on evidence, research and tools and techniques. So Quint Studer, welcome to the Swift healthcare video podcast.
[00:01:40] Quint Studer, MS: [00:01:40] No, no, I'm excited to be here. Thanks for the opportunity.
[00:01:43] Patrick Swift, PhD, MBA, FACHE: [00:01:43] Absolutely Quint. So let's kick it off with some fun here. And, , uh, I want to ask you in your own words what got you into healthcare? Why do you do what you do? Quint?
[00:01:54] Quint Studer, MS: [00:01:54] Well, it's going to be way different than most people think. , alcoholism got me into healthcare. [00:02:00] Um, I was,  When I was 31 years old, December 24th of 1982, I crashed, I surrendered personally. All of a sudden I had that moment of clarity. They talk about, and I said, this isn't my life's not trending in the right direction.
[00:02:16] And so I sought help and I'm a recovering alcoholic. I'm in my 39th year of sobriety. So how I got into healthcare was I was, it's going  to 12 step meetings at a hospital that treated people for alcoholism. And I was going to meetings and, , I saw an ad that they were looking for someone to work at the treatment center in, in working with school districts and employers. And because I was a teacher of children with  special needs. and when, once I got in recovery, I started something called a student assistance program. It mirrored an employee assistance program, but for students that they could reach out, particularly if they had a family member or so on. So i.
[00:02:55] Patrick Swift, PhD, MBA, FACHE: [00:02:55] you did Quint. That's great. That's fantastic!
[00:02:59] Quint Studer, MS: [00:02:59] I, I, [00:03:00] um, talked to them and they hired me as a community relations rep. And I did that for three years and one employee, a worked in a hospital before they went back to work, we did something called a back to work. And I, , went with them to talk to the human resource person about how do they reenter the workplace. And one day a human resource person at a hospital in Wisconsin said, you know, we have an opening here. In marketing community relations, you really do a good job. Why don't you come here? So that's how I got into healthcare. So when I speak to colleges, they want to know my career track. I say, well, it might not be the one you want to follow, but it is what it is.
[00:03:38] Patrick Swift, PhD, MBA, FACHE: [00:03:38] Uh, I, I love that Quint because I love the expression. , Turning your, your kryptonite into super your super power. And, , what you've done in the arc of this story even is acknowledging, , the, the sorrow and the rock bottom and the insight and the compassion that arose from that. And by [00:04:00] that suffering and sorrow has led to, a global impact on raising the bar in healthcare,
[00:04:06] Quint Studer, MS: [00:04:06] Yeah, we
[00:04:07] Patrick Swift, PhD, MBA, FACHE: [00:04:07] in
[00:04:07] Quint Studer, MS: [00:04:07] You know in recovery when you help, when you help somebody recover, they call it 12 stepping or bringing 12 steps to them. And I tell people I've been 12 stepping healthcare now for a while.
[00:04:17] Patrick Swift, PhD, MBA, FACHE: [00:04:17] I love it. I love it. So folks, , step on up let's step here. , I I'm, I'm inspired by that. , , , Phrase, turn of phrase. We're we're, we're 12 stepping healthcare here. , there's so much for us to talk about in thinking about this conversation. One of the first questions I want to ask you, , is listen, folks I've got Quint has published many books. I've got. , the busy leaders handbook, how to lead people in places to thrive, building a vibrant community. , but the first one I read of Quint's , this is my favorite. , you can see it's dog ear-ed and got all kinds of notes on it  ears, hardwiring excellence. And, , I happen to love this book and I wanted to ask the author. , what, , what about that book, , is your favorite [00:05:00] part, your favorite message that stands out of that book?
[00:05:02] Quint Studer, MS: [00:05:02] Well, I think that my favorite part is when you read the stories about people recapturing their purpose in healthcare. For example, on page 251, I got, I got a letter from a person who I'm and I'll just read it real quick and I'll, I won't read the whole, whole thing. It says, ,
[00:05:18] I know I make a difference. One of my employees who had been here just about a year, became employee of  the month when it was announced, she received the recognition of brought tears to her eyes. She was pleased during the whole month. Usually she was very quiet and somewhat withdrawn. During this month. She was one of the girls. We talked about things with their coworkers that she had never talked about before.
[00:05:37] The moment I realized just how much it meant to her was when she was diagnosed with cancer is during the month she was employee of the month while talking to her husband about a return to work. He mentioned to me that she never felt so included and proud in her whole life. The job here at the hospital is a dream job for her, and she had really not felt worthy of working here.
[00:05:55] Just so proud of her employee, of the month plaque , that she  hung in her living room for all to see during your [00:06:00] illness. She felt she had an extended family. She said she felt loved by her coworkers. We visited her on a regular basis and called her several times a week to see if she needed anything about five months later, Susan, our coworker died. We were very sad at her passing. I personally attended her funeral with four other women from our office. As we approached the coffin, we saw something at the exact same moment that we could not believe on the back of her coffin. next to her  shoulder was her  employee of the  month plaque and a card signed by all of us in the office at that moment in my life. I thought of you for, I had made a difference.
[00:06:32]That's that's what I love, you know, health care. We come in with a full emotional bank account, but because what happens there there's withdrawals . So what I love the most is when I see people, , sort of recapturing it. And once you recapture it, you realized how much you missed it, and then you keep it.
[00:06:51] Patrick Swift, PhD, MBA, FACHE: [00:06:51] Yeah. Yeah. I love that. And in the face of the burnout and the suffering and the sorrow that our colleagues in healthcare, whether you're [00:07:00] new to the profession, whether you're a CEO, whether you're near retirement, it doesn't matter. There's been, there's been so much sorrow and suffering and burnout and, and what you're touching on, , is connecting to that purpose.
[00:07:13] And connecting to that meaning and that's embedded in the book. And, , I'd add, , the title hardwiring excellence. , if you've been in healthcare while you've heard that term used about we're hard wiring things, and even with some cynicism, , we're hard-wiring things as if we're we're we're, , can be programmed.
[00:07:32] And you're speaking to, it's not about the, the, the hard-wearing, , these, , tactics, just for the tactics sake, you hit the nail on the head in the whole cycle of life. In that story, I think because it touches on in healthcare, we're, we're saving lives, we're improving lives, but we're also helping people, , through their whole life transition and finding meaning in what they do. So I think that's a, a [00:08:00] beautiful, , beautiful story. I appreciate your you're touching on that one.
[00:08:03] Quint Studer, MS: [00:08:03] Well, thank you. I think also not only, , think of the impact the coworker had , and I think what happens here is in healthcare, like you're, you're absolutely right. You know, there's a lot of withdrawals that happen in healthcare just naturally, that just happens naturally. And so I think we've got to get to way to the . Maybe to the extreme of making sure we're doing deposits for people because there's natural withdrawals and I'm sorta in looking at deposits and the thing I've been talking a lot, , this last eight, nine months, Patrick is. tools and techniques to actually help people see that seeking help. You know, we, I think we've overplayed, resiliency. I think we said, Oh, we gotta be resilient. We have people teaching resiliency, coaching resiliency, but you need to add in there. That part of resiliency is getting help. So you can be resilient. It's not playing through pain, it's not sucking it up [00:09:00] and cause, and not saying you don't have to suck it up once in a while, but it really means that.
[00:09:05] And what I look at in healthcare is one of the top one, two or three, um, pharmaceuticals that employees are going to be. They're looking at in any healthcare system you go to as an antidepressant. I'm not against anti-depressant whatsoever. I'm on the board of Hazelton and Betty Ford, but I do believe that. It's good to match it with other things and other type of services. Um, yet, one of the least utilized services in all health care is the employee assistance program. So we've got a, uh, an industry that has some of the best mental health benefits in the country yet. And some of the best EAPs in the country. Yet we have a stigma. I've been speaking a lot to medical schools. Medical school and residents and they, uh, I can give the name of the school, but I give them credit for surveying all their medical students and residents. And 50% of them said they were eating different, not sleeping well, but eight to 10 said they were [00:10:00] using substances. That probably aren't the best for long-term health or short-term health of them. So they've said we're really. Sort of off grid here a little bit or getting off grid, then the question is, would you seek help? And it went almost down to zero because they were terrified of the stigma, terrified what would happen. So, you know, I think part of
[00:10:19] Patrick Swift, PhD, MBA, FACHE: [00:10:19] got a lot of work to do.
[00:10:20] Quint Studer, MS: [00:10:20] is healing our inside. And when we heal our inside, when we, you know, leadership's an inside job and when we get our inside, right, the outside gets better.
[00:10:29] Patrick Swift, PhD, MBA, FACHE: [00:10:29] We've got a lot of work to do. I love that quote. Um, we've got a lot while we're to, you know, I'm a, as a, as a psychologist, I'm treating patients in
[00:10:35] Quint Studer, MS: [00:10:35] Yeah, I almost want to lay down here. I most want to lay down for the
[00:10:39] Patrick Swift, PhD, MBA, FACHE: [00:10:39] get comfortable. My job
[00:10:40] Quint Studer, MS: [00:10:40] night. My wife said I've never met a mental health therapist. I didn't want to lay on the couch for a few hours.
[00:10:45] Patrick Swift, PhD, MBA, FACHE: [00:10:45] yeah, yeah. But what you have to do share Quint is so from the heart, um, and I so value that, and I really hope folks are your, if you are listening, um, please open that heart, open those ears on what we're talking about are [00:11:00] profound concepts that can transform health care.
[00:11:03] And, um, as a, as a psychologist, I'm supporting burnt out healthcare professionals and as an executive coach supporting healthcare professionals, Trying to move the needle forward. Um, Quint what you're touching on is that it's critical to ask for help. And there's a stigma against asking for help.
[00:11:20] Quint Studer, MS: [00:11:20] Yeah. And people say to me, I'm lucky. You're pretty open about this. And I said, well, because it allows me to help people. And so for example, I was speaking to a university virtual to MBA, MHA students, and I just brought it up. And two days later I got contacted by one of the students and he said, I really know, I know I have an alcohol problem. And he said, but I'm so terrified if anyone finds out, it'll ruin my career. What do you think? So I don't think it's hurt mine all that much, you know? And, and the good news is I was happened to be on, uh, with him virtually, uh, about two weeks ago. And he celebrated his first 30 days of sobriety. And I know [00:12:00] that's not what this conversation is about, but I think in healthcare, we've just got, you know, when I say make it a better place for employees to work.
[00:12:08] I think sometimes we think, um, you know, we, if we teach them how to handle. A difficult situation, which I get, I mean, I went, I do TM the whole bit, get, you know, what I really want. I just want to places to run better. I think sometimes we treat, we think that the symptom is the cause. And the story I tell is a physician was coming to see me one time. And the nurse manager on the unit said he was very caustic, a rude to us this morning. And he's coming down to see you and you need to tell him he can't do that. I said, well, did anything happen? Before that she said, well, he's a surgeon and he was waiting for the patient and surgery. We didn't read the orders.
[00:12:46] Right. We fed the patient, he had to cancel the surgery. And I said, I get, he shouldn't have said that. And I'm not trying to put up. Put a blame, but I talk a lot. I wrote a book called healing, physician burnout, [00:13:00] and one of the ways we reduce burnout is just running better organizations and investing in our leaders.
[00:13:06] So they have better skillset, making sure people have the tools and equipment to do the job and making sure. They know that it's okay to call the EAP. It's okay. To get help. So I'm really pumped about healthcare. I've never been more excited about healthcare as I think the pandemic has been terrible, but it's also shined the light on certain things that we've needed to do for years that we haven't done deep enough in which is again, making sure we provide people that training. That they need, because the other thing with COVID is a lot of training has been stopped or paused, and I get that it had to be, so I think we'd get back into the training, the development, but also really looking at the whole, like, we want to look at the whole patient. Um, you know, I, I saw a cartoon years ago on a neurosurgeon and he went in and he looked at the person's head and he said, he looks all right to me. And then they showed there was no body there they're [00:14:00] so busy looking at the, you know, they're part of the person. And, and I think this, this pandemic has, has made it, uh, we can no longer not touch on the emotional health of our workforce.
[00:14:13] Patrick Swift, PhD, MBA, FACHE: [00:14:13] Amen to that. Amen to that. That's a perfect segue to the next question I want to ask you, which is, uh, using the parallel of a primary care physician for our listeners. You've coined the phrase  being a primary care leader. And that is such a powerful concept. And I want to ask you to share with us, what do you mean by that?
[00:14:39] Quint Studer, MS: [00:14:39] Well, I, I thank you. I think as a primary care physician, I have great respect for primary care specialist. Is is they can look at the broad picture, but they also know what they can treat and what they shouldn't treat. When somebody calls me and say, my doctor's referred me to a certain specialist. I said, well, then you have a good doctor [00:15:00] because they recognize their limits.
[00:15:01] That's not bad. That that's good. And, and I believe I'm more of a primary care person. So for example, um, when I go to an organization I'm really good at, I can tell them some things they can do. I mean, I have certain tools, certain techniques that I think are really quite good right now. I can tell them how to measure. Well in a stress and burnout. I have a tool for that, but now for certain, um, I can tell them like the other day, a healthcare system called me and said, Quint, we're really looking at creating better metrics to measure our leaders on. Now I could have sent them some metrics, but I said, well, here here's who you should call.
[00:15:39] This person would be really helpful because this is what they do. Full-time or, you know, I'm looking at, um, looking at teaching, um, the clinicians, how to have difficult conversations with family members. We're here. I've been around long enough that I like have a Rolodex of people that are better at these things than I am.
[00:15:58] So I, I try, [00:16:00] um, Supply chain management. I know some of the best supply chain management people in the world. So what I try to say as a primary care doctor, I can help your organization and I can help them do some things where you are self need. You don't need to get a consultant. You don't need to go anywhere else, but I also can provide them with really good services of who are the best people in the country for, for what, what they're looking for.
[00:16:24] So for example, if you look at the gratitude symposium, um, We have Susan keen Baker. Who's just great at helping people look at empathy in a different way.
[00:16:35] Patrick Swift, PhD, MBA, FACHE: [00:16:35] Steven Beeson.
[00:16:37] Quint Studer, MS: [00:16:37] yeah, if you're looking at that, if you're looking at that at what you are, one of those great people.
[00:16:41] so you look at that's what I meant by a primary care. You know, I, I think, and I like it because I think sometimes, um, organizations want to provide everything. So, you know, I can, you know, sort of like go into a law firm and they keep wanting you to use lawyers that they're affirmed, but maybe they're not the best lawyers at their firm. [00:17:00] Um, just cause they're there.
[00:17:01] So what I've tried to do is always find the right resource for a healthcare system that I think fits their needs. And the beauty is I do it in a way where there's no relationship with me. There's no referral for me. I'm just trying to find them the best person to meet their needs.
[00:17:18] Patrick Swift, PhD, MBA, FACHE: [00:17:18] You love with your customer and addressing your customer's needs, whether it's you doing that or someone else. And I know the point of this podcast is to explore the intersection of healthcare and leadership for listeners that are from the CEO to the new employee in a hospital, from environmental services to any part of the organization. Right?. And your describing this, , primary care leader. concept and you have grown to become essentially a primary care leader. For the planet and that's not, , hot air, , folks Quint Studer. , if you don't know, has had a profound impact on healthcare around the globe. And so, um, you've you Quint have grown into [00:18:00] this primary care leader who can consult on a national level international level community level, down to Pensacola level, right. For our listeners. , for someone who wants to grow as a primary care leader, what advice would you have for someone who let's say in middle management or aspiring to management, um, how to, how to become a better leader in the sense of primary care leader. If you're not going to be a specialist in one certain area, um, how, what would Quint Studer say is, is important for becoming a primary care leader?
[00:18:35] Quint Studer, MS: [00:18:35] If you're a , middle manager. You're a primary care specialist cause you you've got to do it all. And you know, I was on a curriculum committee at the Harvard business school and we went through like the 15 fundamental foundational skills that every leader needs. Now, some of them you need more than others. So for example, if you're a med surge nurse manager, you probably don't have a revenue stream, you have to worry about, but there are, there are a number of things you have to be. And I [00:19:00] think the key is you really need to be good at benchmarking. And I think that's sort of a missing skill in healthcare because we're so busy. , you don't get to see other managers doing it cause you know, you're on your unit. The only time you might see the other managers is that the month-to-month manager meeting almost, you don't see them.
[00:19:20] And it's a tough profession. I own a minor league baseball team and they see each other all the time. This batter sees this batter. This pitcher sees this pitcher is constant benchmarking against each other. So like one of the skills that every manager needs is to go out and be okay, figuring out who can I learn from and not feeling like I'm less than because I have to.
[00:19:42] So. For example, , when you look at rounding, the person who really, we learned rounding from us, Michelle Wasco, and she's passed away. She was a nurse manager at Holy cross hospital in 1993, and we were trying to improve our patient experience and we were pretty [00:20:00] bad. We thought. You just came back and we said, we're in this percentile, this percentile, then Don Dean started digging into the data and said, you know what?
[00:20:09] One of our nursing units is people are alot. Patients are a lot happier on this nursing unit than the other nursing units. And, you know, it's the same. Semi-private room, the same Intercom system, the same, everything. So what's different in that unit. So Don went up, I said, Don go spend a week with Michelle.
[00:20:29] I'll pull it. He was the radiology tech. I said, I'll pull you out of radiology for a week. And watch her. Cause we asked Michelle what she was doing. And she said, Oh, nothing, nothing different than anyone else because she didn't know. So, so Don went up on the unit and just watched her and watched her Monday, watched her Tuesday and Wednesday .
[00:20:50] He said, you know, Michelle, I noticed when you come to work here, right, good morning. The first thing you do is visit every patient. And she said, Well, what doesn't everybody do that? Nah, no, [00:21:00] we really weren't doing that. So should we call her the mother of rounding? Um, you know, we've perfected over the years, but see that's that benchmarking and, and we have to be careful because, um, sometimes our stuff gets in the way of benchmarking, you know, we rationalize or we blame or we, you know, why their different, I call it terminal uniqueness.
[00:21:19] So I think there'll be a primary care physician. You really need to have good self-awareness which knows what you're good at. And what you need improvement on and you also really need to be coachable. And then you also very much need to be comfortable seeking out, help people that can help you be better.
[00:21:38] Patrick Swift, PhD, MBA, FACHE: [00:21:38] Love that love that, uh, folks, I really wanna encourage you to listen to that point, , to be, , open, to looking for help asking for help and Quint spoke about rounding. I know a lot of healthcare folks have heard about the concept of rounding, right? And so if you've heard that, I know there can be a cognitive bias to think, okay, I've heard this stuff.
[00:22:00] [00:21:59] But what Quint just shared was the process recognizing, okay, benchmark, where are the numbers? How, how am I doing? How are we doing? And then looking for the solutions and what I just want to underline Quint . What you just shared is the process of looking at the numbers and then being curious, well, what is working and what's not working. And the answer in this story, you just shared was rounding.
[00:22:24] Quint Studer, MS: [00:22:24] Well, and then I think also having, having this specific outcome, you want my. You know, so, so for example, um, I'm a big believer in peer interviewing. So when I was president of the hospital, we introduced peer interviewing. Okay. So that means when I'm rounding, I'm going to be asking employees, are you involved in peer interviewing? Have you been, has your manager told you about peer interviewing? What do you think appearing peer interviewing ? All it takes is about three days and every manager knows I'm out there asking about peer interviewing and everybody knows about peer interviewing, , for in fact .
[00:22:56] Patrick Swift, PhD, MBA, FACHE: [00:22:56] Could you unpack that for the audience? What is peer? What [00:23:00] is peer interviewing?
[00:23:01] Quint Studer, MS: [00:23:01] Yeah. Well, uh, uh, doctors, uh, we were dealing with, um, hospital acquired infection rate, which was way too high. So we started drilling down. And every day I saw a doctor, I would ask them about, are your patients getting any hospital acquired infections here? Cause we're really focusing on that. But if we've gone down to 2%, which is best practice, but I still want to go down to zero.
[00:23:23] What are you noticing? So I think the challenge with my book. It gave an example and everybody thinks those are the four or five questions I have to ask. Nah, it rounding's just a toolkit. You asked the question on the outcome you want to be looking for at that moment. So for example, doctor, we've read our first case start case now is up to 92% of our first cases as are starting on time. Have you noticed the improvement in the, or, Oh yeah, I think I have or one, no, I haven't look at it. So yeah, I, I think. You know,
[00:23:56] Patrick Swift, PhD, MBA, FACHE: [00:23:56] It's the conversation.
[00:23:57] Quint Studer, MS: [00:23:57] you learn from others. One of my [00:24:00] stories and I'll, I'll quit with this. It's just such an example, go to a big healthcare system and you find a certain department that does something really, really well. And then, and then you tell everyone that this place does really, really well. And you encourage them to go visit this manager. Then 90 days later, you asked that manager, how many people have visited you? And it's, it's very small, but I think that's where leadership comes in to make those comfortable conversations, to make those safe conversations that you're not thinking.
[00:24:32] Less of someone when they seek help either. You're you're think more of someone. I was just talking under the owner of the Jacksonville jumbo, shrimp and baseball, and he's a AAA  guy and I'm a AA guy we're talking, talking about, you know, exchanging staffs so we can learn from each other. So every industry learns from each other, but healthcare is a little more difficult because we're, our managers are pretty isolated.
[00:24:55] They don't see each other. They're out in their unit . And, and that's why [00:25:00] I think we've really got to work really hard at providing them resources to improve their own skills. So that's the values, the other part of my heart wrong outcomes. I like, I make a very strong statement. You can tell the values of the organization on the investment they make in training and development. Because who would want somebody to be in a job without having training and development and healthcare? Sometimes we, we have, we got better, but I think the COVID just naturally has paused some of that. So I think as the pandemic, it changes a bit too. Healthcare is going to have to play some real catch up on training and development.
[00:25:36] Patrick Swift, PhD, MBA, FACHE: [00:25:36] Couldn't agree with you more and, and the notion of hardwiring excellence, what you're . Sharing and pointing out is the thought process. The mentality I love that you touched on earlier, , that, , the rounding, you acknowledged that you'd written in the book and then people saw these questions said, okay, I need to go ask these specific questions and your point, isn't ask these specific questions.
[00:25:57] It's the mindset. About being [00:26:00] curious and having those conversations. And that's what hard-wearing excellence is about. It's, it's the, the, the number one, the psychology of the mindset of how to go about, , , fomenting and driving excellence in an organization through tactics, but we've got to adapt them, right. We have to adjust and be curious and, and, and look at what's working and then do more of that.
[00:26:21] Quint Studer, MS: [00:26:21] Yeah, but what I look at hardwiring really what I was trying to get across is putting in systems. So there's consistency. Because one thing that drives doctors crazy is in his inconsistency. The one thing that drives employees crazy, isn't it. Is inconsistency is one thing that drives middle managers. Crazy is inconsistent. You've heard that doctors would say to me, I want my patients on this unit, uh, employ, will say, I'll work. I'll go I'll, I'll take our skull work as a nurse on that unit, but I'm not going on that unit. And really my whole goal was just to provide resources, to create a more consistent experience for everyone.
[00:27:00] [00:27:00] Patrick Swift, PhD, MBA, FACHE: [00:27:00] Love it. Love it earlier. You said, and I was planning on asking you this, but earlier in the show you said, um, leadership is an inside job before you can get the outsides, right? You have to get the insights, right? What do you mean by that Quint?
[00:27:13] Quint Studer, MS: [00:27:13] Well, I go back to self-awareness again. And I asked Harry Groener who's runs a pretty big venture capital firm. Before you invest in a company. What do you look for? And he said self-awareness of the founder and coachability, and I've really taken that over the years as self-awareness I, I entered into recovery with, when I finally could look at myself differently.
[00:27:37] Not through Rose colored glasses, not being, you know, I used to tell people I lived in two islands, the Island of self-pity and the Island of being a delusion anyway. So I think what I mean, getting the inside right is there's great books out there on leadership. There's great coaches out there on leadership.
[00:27:56] Most, every organization I know, wants their leaders to do well. There [00:28:00] is no C-suite CEO that wants their managers not to do well. There's resources. So, you know, I look at an organization of 900 leaders and 800 of them are having a lot of success and a hundred of them are struggling and they've all gone through the same training, the same book, the same consulting.
[00:28:21] So what's getting in the way of those hundred now, I don't know, but I can give you some thoughts that get in the way of people. Number one is, um, blame. They fall into the trap of blaming somebody for their poor results. You know, it's either the room I'm in or my corporate headquarters or my boss. That's why we always try to find
[00:28:43] Patrick Swift, PhD, MBA, FACHE: [00:28:43] The staff, the patients.
[00:28:45] Quint Studer, MS: [00:28:45] Well, we try to find success in the same organization. Cause if all of a sudden Quint says, it's the problem is compensation and benefit yet, Patrick's got the same compensation benefit plan for his employees and he's having success. It takes away that, [00:29:00] that blame. So I think we have to look inside. Have we fallen in the trap of blaming somebody for the issues instead of looking.
[00:29:07] Really, what can we do? I think there's rationalization in healthcare. I mean, I call it sort of terminal uniqueness, but, but we're a little bit different here. You don't understand, you know, we're, we're, we're Minnesota nice are where we're, but South, you know, we got into geography reasons. Why, w w we're not, or it's usually, well, we don't have enough staff yet.
[00:29:29] You find another person with, you know, Exact same staffing levels that are having success. So what I meant by that is you got to get rid of your blockages and sometimes what's holding us back is us, but we don't know it. So once somebody can say, okay, what's getting in my way. Am I blaming? Am I feeling sorry for myself?
[00:29:50] Am I rationalizing? I think envy has a lot to do with issues of benchmarking. Then if I, if I, you know, I say this, [00:30:00] Patrick is. I go into an organization and a CEO will say, Hey, look at this unit. Wow. They're doing really, really good. Let's everybody. give  them a nice round of applause and I can tell the culture right then. Because of everybody applauses they've got a good culture. Now the CEO has just asked you to be compliant with a very simple ask clap. So when I look around and people aren't clapping, I'm wondering, did they not hear the CEO? Do they not know how to clap or are, they may be possibly a little envious of somebody getting recognized.
[00:30:38] And one of my things I always would ask organizations to send me some of your success. I was in Detroit and they sent me the fact that on the ninth floor, this patient care unit was just having great success in patient experience. So I just got up and thanked them and I didn't know what type of floor I just knew it was the ninth floor. And immediately two people ran up [00:31:00] to me at breaks. I want you to know that's the OB unit now. Why, why did think they needed to know that?
[00:31:06] Patrick Swift, PhD, MBA, FACHE: [00:31:06] I know that story.
[00:31:07] Quint Studer, MS: [00:31:07] Yeah. Well, and I, you know, this idea that birth
[00:31:11] Patrick Swift, PhD, MBA, FACHE: [00:31:11] a happy place. There's new births. It's it's, it's, they're, they're unique. They're unique. And that's why they're doing
[00:31:15] Quint Studer, MS: [00:31:15] right. So that's what I mean, you, you, you, you've gotta be willing to get your inside, right. And once you get rid of the blockages, then all of a sudden you become more coachable. And then you're on your way to have an, a great, great success.
[00:31:29] Patrick Swift, PhD, MBA, FACHE: [00:31:29] Yeah. And that's that's leadership is, is the growth and, and I want to transition to, um, your book and, and here's the copy of the book. I encourage folks to check this out. It is a delicious book, the busy leaders handbook. How to lead people and places that thrive sounds like a great episode title for our conversation here, how to lead people in places that thrive. , tell me about the, the, the latest book and, , , , , what that means to you.
[00:31:53] Quint Studer, MS: [00:31:53] Well, I think, I think that the latest book, I'm going to talk about a little second, cause that's coming
[00:31:57] Patrick Swift, PhD, MBA, FACHE: [00:31:57] Yeah, yeah, yeah.
[00:31:58] Quint Studer, MS: [00:31:58] that's coming out in June. But, [00:32:00] um, what, what I did over the last couple of years is I look at, you know, if my son or daughter came to me and said, you know, Hey, you've been in this healthcare or you've been in leadership, just leadership for a long time. What are some best practices? So I went about and collected, I thought 41 best practices, and I've always been a Peter Drucker fan right on my desk at home as the Peter Drucker daily book reopened it up and every day you learn something. So I, I think I wrote that book because of my love for middle managers and recognizing their tough job they have. And I can go as a middle manager to a two day LDI leadership development Institute. And it's nice. I hear great things. But I probably won't really learn it until I have to use it. So that book is meant to do is Whoa. I, I do have to have a difficult conversation. Let me, let me catch up on how to do that. Or I do have to do this. So it's really 41, just it's 41 best practices. That can be a [00:33:00] desk reference guide. And it was really neat because the other two things happened recently. One, I spoke at Baylor university's MBA program. And, and they were supposed to all come up with a question for me. And one of the people  wrote me and said, you know what?
[00:33:14] I had a bunch of questions, but then I read busy leader handbook and they're all answered in there. The other thing is yesterday, I talked to neonatal specialist on burnout and stress. And when I got introduced, the physician said, Hey, I've read busy leader handbook. And it's really been helpful to me. So, so that's it. But now in June, in June, I'm very
[00:33:34] Patrick Swift, PhD, MBA, FACHE: [00:33:34] Quint hang on. Before you get to the book, this, this busy leaders handbook. What I love about this is there's three sections. The leader in you. , there is, we share with listeners here, optimizing employee performance, and the third section is strategic foundational topics. There is an arc here.
[00:33:53] I have benefited from this book. There's a focus on you and there's focus on you being a leader and then there's [00:34:00] strategy. And this is a great resource for folks, to get, , very practical, , manual that can be on your desk as a resource for you. It will come in handy if you get a copy of it. , so I wanna, , I want to endorse that, but, , so what's coming down the pike.
[00:34:14] Quint Studer, MS: [00:34:14] Well, , I'm very excited. , , I've been, you know, I teach people, you know, I've written a lot of books, but, , I'm like that musician where your first album was your, your greatest album and you've been trying to. Yeah, you're trying to duplicate it for the last 20 years. Yeah, yeah, yeah. Oh, absolutely. More than a feeling anyway.
[00:34:32] So, um, Hardwiring Excellence  is, you know, is really it's, it's so gratifying um, my other books since then, I think have, been I wanted to write hardwiring excellence  I wanted to write it, uh, passion, you know, as a book, uh, a passionate textbook is what I called it. It's got the passion, but it's like a textbook of tools and techniques. I think my book since then, have gone more tools and techniques because there are workshops I've done. There's things I've done. So [00:35:00] they're very tactical oriented. So over the last year, With what's been going on. I've just been looking more and more into what is it that makes healthcare so special. And I believe there are some common things that make healthcare worker so special.
[00:35:17] Number one is they want to be helpful and useful. And while other people run away from danger and responsibility and accountability, healthcare people run. To it. And I say healthcare I'm including emergency medical personnel and all sorts of things.
[00:35:33] Patrick Swift, PhD, MBA, FACHE: [00:35:33] All of us.
[00:35:33] Quint Studer, MS: [00:35:33] So, so the thought is, I think healthcare, people have a calling in their DNA. I think healthcare is called them as much as they've called it. So when I've traveled the country, I'll say to people in healthcare, when did you first think about being in healthcare and I'd hear stories like fifth grade. Eighth grade high school. Now they might know exactly. Most physicians knew they wanted to be in medicine in high school almost, [00:36:00] or maybe college.
[00:36:01] They didn't know exactly until they went to medical school and rotated exactly what area, but they sorta  had a calling. Then I talk about people that aren't clinicians. So if you look at the pandemic. , we've got environmental services. We've got IT . People we've got security people, we've got food and beverage workers.
[00:36:20] We've got all these people , that could work, do their job anywhere. And one of my stories I love is the parking lot attendant who convinced a family, they were in the right place. Cause he just said, you're, I've been praying for you. And they said that parking lot attendant. Changed everything for them. Now, if you come out of the mall and the parking lot attendance, as I've been praying for you, you're not going to have the same feeling. So I wrote this book called  The Calling: Why Healthcare is Special , and I'm very excited about it because it really talks about our DNA. And so if people want to be helpful and useful, [00:37:00] then our job. Is to create cultures that don't get in the way of them being helpful and useful. And so that's really what the book is about. Um, I'm very excited about it.
[00:37:10] I met John Maxwell years about two years ago and they asked John Maxwell what's his favorite book. And he said, the one I'm writing right now. And I thought for me, hiring excellence was always my favorite, but the other books are nice, but that was the one. That was my favorite. And now I know what he means because the callings really resonated with me. So I'm started trying to create the 2021 , , version of Hardwiring Excellence
[00:37:36] Patrick Swift, PhD, MBA, FACHE: [00:37:36] Yeah. Yeah. And I've seen, uh, you've, you've shared a advanced version of it and I've had the great, good fortune to be able to, to, to read through it. And, , I'm really excited about what you're doing with that book and where it's going, because it really speaks to, especially in the face of all the burnout and challenges we're facing in healthcare.
[00:37:53], this is a time to, to double down on why we do what we do and find meaning in [00:38:00] the work we do, because there's so much burnout and sorrow that we're dealing with and being able to connect with that, meaning connects us to that. Calling connects us to our, our soul. It connects us to our strength that connects us to the joy of the work we do.
[00:38:13] So, , I'm excited about where that that book is going and, for, for, for this episode, I. want to ask you , there's been an amazing arc of your career Quint, and I want to ask you, you know, what's next for Quint Studer? The book comes out, where are you going? What's next in the work that you're doing?
[00:38:33] Quint Studer, MS: [00:38:33] well, if you look at my, my career, normally I, I take it a day at a time and, um,
[00:38:41] Patrick Swift, PhD, MBA, FACHE: [00:38:41] I kind of believe that and I kind of don't.
[00:38:44] Quint Studer, MS: [00:38:44] Well, I think there's a couple things. Number one, I certainly am very, very excited about healthcare. Um, I, I think healthcare needs leaders and needs more than they ever have before, but they need a different type of leader. They need a [00:39:00] leader that's not, not lives and dies on metrics, but lead, but understands relationship leadership,
[00:39:07] Patrick Swift, PhD, MBA, FACHE: [00:39:07] And that speaks to strategy that speaks to strategy. How about how you think about the now and the future?
[00:39:12] Quint Studer, MS: [00:39:12] I got asked a question yesterday and they said, quit. What's the number one skillset, a leader needs today. And I said, how to show empathy? I wouldn't have said that maybe four or five years ago.
[00:39:22] I so-so. But, but, so I think that the other thing Patrick is, is you might know that I've been very involved in his brain development of young children and, uh, About four or five years ago. I got very, I just, I didn't know what I didn't know, but I knew that we are having problems supposedly in third grade, reading fourth grade math, and I started looking into it and I got into looking at kindergarten readiness. And I, then I ended up at the university of Chicago with John List, PhD. Who's in the economics department and Dana Suskind, MD a physician who's at Comer children's hospital. [00:40:00] And we're looking at, they were studying brain development both from the medical term and the economic term. John List feels  that at the kindergarten readiness is the longterm economic health of a community. So we met with Dr. Suskin and they were doing some neat work in communities. And I said, what, what if we got mom before she left the hospital? Because of 80, 85% of the brain is developed by age three, it seems like every day. That goes by, we miss an opportunity. And she said, do you think you could get hospitals to do that?
[00:40:33] I said, well, I know I can get three hospitals in Pensacola, Florida do it. So we became the pilot for the university of Chicago. Now over the three-year period that every mom, before she leaves the hospital, gets a tutorial on how to build her baby's brain and they then have followed it up. And now we have peer reviewed research that shows that we are making progress.
[00:40:56] Then we partnered with Harvard on something called basics. [00:41:00] So every mom gets a text message twice a week, depending on the age of her child on tips that they should be doing to build their baby's brain. We were in the pilot for them too. So we now have peer reviewed research on that. So  somebody asked me the other day.
[00:41:16] If I had a billion dollars, what would I do? I'd say I would make sure every mom that leaves a hospital has been given the gift of understanding how to build her baby's brain, because that's the difference maker. So I've got this thing called, build a brain, build a life, build a community. And I'm really hoping now that we can take this everywhere. Um, cause we do have now a few other hospitals that are. Implementing it or even putting it into the electronic health record for pediatricians, for well-baby chucks to have that brain conversation. What our peer referred shows, Patrick is women with a higher social economic. Probably, um, [00:42:00] don't have as big a gain from what we're doing, because they're already doing it. But children that are in a lower socioeconomic here, 30% less words, which are the deal that drives the brain and our period versus research shows that we're doing quantum leaps with that group. So I'm, this probably wasn't what we were talking about, but I think the reason I'm excited about being in healthcare, because if you know me, no matter what we're talking about, By the time I leave, we're going to have that early brain conversation.
[00:42:30] No matter why you let me come into your organization, we're going to talk early brain. And, uh, I was just, I'm in Dixon, Illinois. And you know, once you explain it, The CEO goes, why? Gosh, we've got to do this. And the labor and delivery manager says, my nurses would love this because when a mom leaves, she knows how to bathe her patient. She knows so many things to do with her baby , but we've never touched on how to build your baby's brain. It's like we only touched the shoulders down when they leave. And I think we have to move [00:43:00] up the shoulders up also. So I'm very excited about the work we're doing and build a brain build a life and build a community.
[00:43:06] Patrick Swift, PhD, MBA, FACHE: [00:43:06] That is outstanding and I pray that just continues to grow and grow and grow literally as the brain's growing. But I, but this has a global implication and, , it's profound and, and I, I pray that that, um, is, is very successful Quint .
[00:43:19] Quint Studer, MS: [00:43:19] That's very inexpensive. That's the beauty. I try to create things that are scalable and the way you scale things is make them affordable because remember the staff is already there. So we've made it very, very inexpensive to the organization.
[00:43:33] Patrick Swift, PhD, MBA, FACHE: [00:43:33] And you said earlier, if he had a billion dollars, that's what you'd invest in. , I want to ask you a similar kind of question. If you had the attention of all the healthcare folks around the planet, all of us for a brief moment, what would you say to us Quint ?
[00:43:47] Quint Studer, MS: [00:43:47] Be kind to yourself. I think we're too hard on ourselves. I think healthcare people tend to look at what's wrong instead of what's right. I get that. We'd look at negative variances. We look at, we usually talk to [00:44:00] someone. We, when we have something negative to say, you know, nobody calls, facilities and engineering and says the temperature, the temperature is good.
[00:44:08] So I think we really have to. Be kind to ourself. I said, if I did a cartoon of a healthcare worker in a boxing ring, there'd be no other boxer with them and they'd be wondering who's hitting them cause they hit themselves. So I think kindness is really what I would tell people is give them, you know, just pause and, and love yourself a little bit.
[00:44:28] And I don't mean it in a self-centered way, but you do great work. You'd make huge differences. And sometimes I think healthcare workers just are too hard on themselves.
[00:44:39] Patrick Swift, PhD, MBA, FACHE: [00:44:39] Hmm This show. is about courage, compassion, joy, and hope, and what you just depicted with the notion of this boxer hitting themselves, , and the need for us to be compassionate with ourselves. , I, I wish people could hear that. I wish people would hear your voice every day. Hearing that message as a reminder, , whether you're beginning your career, the middle of your [00:45:00] career, the nearing the end, the sunset of a career, or to hear that message to be compassionate, because you started with your kryptonite becoming your superpower, , in this arc of this episode, , , being compassionate with yourself and here we're talking about, , helping our colleagues, , whether you're. , developing tactics and tools for leadership. It all boils down to being compassionate with yourself and then having the mindset to be able to make that difference. I love it.
[00:45:26] Quint Studer, MS: [00:45:26] Well, thank you. I, I get a lot, I do a lot of work  with AUPHA does, um, programming for, um, student faculty and students and healthcare ministration. I'm on the board of Cammy, which accredits universities in healthcare administration . And so I'll be like, I think with George Washington university next week, and one of those things, the students always ask me, if you could give me one piece of advice in healthcare, what would it be? And I say, be kind to yourself.
[00:45:52] Patrick Swift, PhD, MBA, FACHE: [00:45:52] Yeah. You just heard it right from the mouth of  Quint Studer. I love it. Quint . If folks are interested, I want to encourage folks, [00:46:00] where can they go? Where can they get copies of your book work? And they learn about this brain development program , where can they  learn more about, , what the, the, the Studer family foundation is doing.
[00:46:08] Quint Studer, MS: [00:46:08] No, no. Um, well, I, I like getting direct people, you know, people write me and, or they're surprised because I've responded. It's quint@quintstuder.com  that's my email my phone number's  (850) 232-4648. So they can text me, they can email me, um, and I will respond and try to be as good a primary care person as I can possibly be.
[00:46:38] Patrick Swift, PhD, MBA, FACHE: [00:46:38] I love it. I love it. Folks. Bear in mind, a Quint is on Eastern standard time, New York city time. So bear that in mind, depending on the hour that you text him, one. Two , is there a website folks can go to, to learn more about the books etc?
[00:46:54] Quint Studer, MS: [00:46:54] A couple of websites. Um, I get mixed up
[00:46:56] Patrick Swift, PhD, MBA, FACHE: [00:46:56] put them in the show notes. I'll put them in the show notes too.
[00:46:58] Quint Studer, MS: [00:46:58] Yeah. , I think [00:47:00] there's, , www.quintstuder.com  there's Studer I . I think www.studeri.org is a real good one. If they're looking at brain, it's www.studeri.org.
[00:47:09] Patrick Swift, PhD, MBA, FACHE: [00:47:09] Nice. Well, I want to encourage folks to check that out, man. Quint . I could stay here, us talking for hours, , getting to chat with you about all these topics, but I'm just so deeply grateful, , that you could be a guest on, on the podcast,  and just want to thank you for your time and all the wisdom and the impact you've had in the past. , what you're doing currently and just the best wishes and all the efforts you're doing in the future Quint .
[00:47:31] Quint Studer, MS: [00:47:31] All right. Well, I love you. Patrick's Swift . I appreciate it.
[00:47:34] Patrick Swift, PhD, MBA, FACHE: [00:47:34] I love you, Quint . Thank you so much, brother. All right. Thank you.
[00:47:38] Quint Studer, MS: [00:47:38] Bye-bye.
 

20. Challenges Facing Women Physicians Today w/ Diane Shannon, MD, MPH, ACC

Tune into Swift Healthcare Podcast with guest Diane Shannon, MD, MPH, ACC
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
Dr. Diane Shannon is a former primary care physician, a certified coach, and co-author of the book, Preventing Physician Burnout: Curing The Chaos And Returning Joy To The Practice Of Medicine. Her personal experience with burnout and conversations with hundreds of physicians motivated her to pursue coaching training and certification. She now helps women physicians harness their superpowers and create lives in which they can thrive. She also continues to advocate for health system change through her writing, which you can find on LinkedIn or her website, dianeshannon.com.
Links for Diane Shannon, MD, MPH, ACC:
https://www.linkedin.com/in/dianewshannon/
www.dianeshannon.com.
Music Credit: Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript 
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks. In another episode of the Swift healthcare podcast, I'm delighted that you're here and I've a wonderful guest for us. Diane Shannon, Diane. Welcome to the show.
[00:00:09] Diane Shannon, MD, MPH, ACC: [00:00:09] Thank you so much, Patrick. Glad to be here.
[00:00:11] Patrick Swift, PhD, MBA, FACHE: [00:00:11] It's a joy having you here, Diane and folks. Let me share with you. Diane's bio I want to encourage you to perk your ears. This is, this is going to be a good one. Dr. Diane Shannon is a former primary care physician. She's a certified coach and a co author of the book, preventing physician burnout, curing the chaos and returning joy to the practice of medicine. Isn't that delicious title. And I'm sure the wisdom in that book, doesn't just apply to physicians. It applies to addressing burnout in general, but, uh, with a passion for addressing physician burnout is what that book is about.
[00:00:46] And her personal experience with burnout and conversations with hundreds of physicians and motivated her to pursue coaching, training, and certification. She now helps women physicians harness their superpowers. I love that [00:01:00] and create lives in which they can thrive. She also continues to advocate for health system change through her writing, which you can find on LinkedIn.
[00:01:07] And we'll talk about her website. So stay tuned on that. But Diane. Welcome to the show. I'm delighted to hear Diane. And so let's jump right into it. And the focus of the show we're going to be talking about here is challenges. Facing women physicians today. And today is a loaded term because there's so much going on.
[00:01:32] Socio-politically in health care. COVID the aftereffects of COVID. There are so many elements in here that I'm, I'm delighted that we can be spending some time talking about this with Diane and talking about her research, but I'd love to start Diane with just your, why w what got you into this work recognizing you described yourself as a former physician.
[00:01:52] But I expect my MDs and respect what you've accomplished in your academic career. So tell us about that, uh, in, in how you perceive [00:02:00] yourself and how you've been contributing.
[00:02:02] Diane Shannon, MD, MPH, ACC: [00:02:02] Right. So I was inspired to become a physician because of my mother. Like a lot of physicians are inspired by family members. My mother was a nurse midwife. And I was lucky enough to be able to shadow her. At times with her patients, she had her own independent birth center, and I saw this incredible experience where she had these amazing connections with her patients.
[00:02:28] And I saw how satisfying her career was. It was really amazing and meaningful every day. And so that's what inspired me and I, uh, I happen to be good in biology. And so it was an easy movie, you know, Mo moved right into pre-med and then into med school and then into training and I chose primary care.
[00:02:48] Because I really, I really wanted that kind of connection with patients that, that meaningful connection that's healing. And now I understand healing both ways when that [00:03:00] connection works. And what I found is really starting in the clinical years, the third year of medical school, that the environment, the clinical environment was not really conducive to supporting that optimal relationship with patients.
[00:03:17] And one of the things I noticed first, I think was patient safety issues. And that really concerned  me. Um, and this was back before the IOM report came out in 2001 that really, or 1999 and then 2001 that really focused attention on patient safety. So I was constantly aware of, okay, what do I have to navigate in order to protect my patients from something that might fall through the cracks?
[00:03:44] And I looking back now, I can say, I think that's part of what led to the burnout I experienced. Um, it probably wasn't all was also exacerbated by the conditions then, you know, there weren't work hour restrictions and was regularly working a hundred [00:04:00] hours a week. And sometimes as many as 130, I mean, it really was, um, overwhelming.
[00:04:06] So, uh, I thought about leaving, but I kept thinking, Oh, I'll just do the next thing. I'll just finish internship. I'll just finish residency. I'll just, you know, get my boards on, you know, pass my boards and then I'll, I'll start practicing and things will be better. And they were a little better, the worst rep, the worst burnout experience or symptoms that I had were actually during residency.
[00:04:29] Um, and I really, uh, I struggled, I, I felt like I gave up so many parts of who I am in order to, to be present for patients and get through training. Um, I, and I actually started having memory problems at home. Like within work, I was fine, but then I would come home and I'd forget things like zip codes, you know, just. Basics. Um, and I just, when I practiced, I, you know, I, I thought about, well maybe if this were a little bit different, so I changed [00:05:00] to a different practice site. Maybe if this were a little bit different and I just didn't see the kind of wholesale change to create an environment where I would feel I could connect with patients and also have a life. And so I made the decision to switch. And so I, I actually, in the last year I was practicing was part-time got a master's in public health because I really love looking at the big picture. And then I transitioned into a job at a communications company. So really overseeing the accuracy of medical documents that they had and what I found, I fell into writing while I was there.
[00:05:42] I loved it. And I thought this is what I want to do. So I left and I was a freelance writer for more than 20 years. And I gravitated towards writing about the healthcare system to try to understand what's going on with it. What are some of the patient's safety issues? How could things be [00:06:00] better and was I'm so inspired by. Individuals and organizations who see that and then make a change and have improvement and watching how that improvement can have a ripple effect. So that was really inspiring to me. And while I was doing that happened to, um, run across the definition of professional burnout, a light bulb went  off and I thought, Oh, there's a name for it. I had no idea.
[00:06:28] Patrick Swift, PhD, MBA, FACHE: [00:06:28] Uh huh.
[00:06:29] Diane Shannon, MD, MPH, ACC: [00:06:29] And I happen to be working with a coach at the time. And she said to me, Diane, why have you never told your story publicly about leaving medicine and burnout? And I said, are you kidding? Why would I do that? Like, it just, it felt like such a w and I carried shame about it. Like, I should have been able to hack this.
[00:06:53] You know, and so over time I began to see that it actually was courageous to leave something that [00:07:00] wasn't working and to recreate a life that had some meaning. Right. And that worked for me. And so I did, I told my story, um, I wrote it, um, In a guest post on an NPR website and there was this amazing uptake.
[00:07:17] So there was something like 26,000 views in the first week. And this was, this was before much was written about physician burnout. So I think that came out in 2012 and physicians began contacting me and they'd say, I didn't know, anyone else felt this way. Right. Here. Here's what, here's what my life looks like right now.
[00:07:40] And I can't do this. Right. So that just inspired me to continue writing about it. I started a blog, um, ended up writing the book with my coauthor, Paul DeChant another physician. Now the book after interviewing all these experts about healthcare and the healthcare [00:08:00] system and burnout and physicians with burnout, what became so clear to us in writing the book is burnout is a reflection of a system problem.
[00:08:09] Patrick Swift, PhD, MBA, FACHE: [00:08:09] amen to that.
[00:08:10] Diane Shannon, MD, MPH, ACC: [00:08:10] Yeah. So I left that experience of, you know, writing the book. It's thinking. The only way to fix burnout for clinicians is to fix these deep complex system problems. And that's the only way that that was my thinking.
[00:08:27] Patrick Swift, PhD, MBA, FACHE: [00:08:27] yeah.
[00:08:29] Diane Shannon, MD, MPH, ACC: [00:08:29] And then I had an experience. What has helped me to see that it's a, both and situation.
[00:08:35] So that is the core of what drives burnout are system problems? No, it's the, it's the incredible amount of administrative work, the documentation, um, all of the, you know, changing patient expectations, the productivity pressure. Right. All of those kinds of outside factors that are in the system. And at the same time, what I now [00:09:00] understand is that there are actions that individuals can take that mitigate some of those factors for them so that their individual daily work experience or life experience is better.
[00:09:14] Patrick Swift, PhD, MBA, FACHE: [00:09:14] Diane. And I'm sure that the experience you had as a physician absolutely must have helped you. Number one, have the empathy and the compassion and the wisdom to guide the colleagues that reached out to you right after you, right throughout that NPR article, , to , have that conversation, but then I'm sure that made you an even better coach, , because you've been in on both sides, , , in the direct care, as well as supporting the efforts that our colleagues are, , making and providing, and you acknowledging the, the documentation loads and stuff like that.
[00:09:46] I've, I've kind of crossed my eyes there first. Yeah. Cause I'm, I'm seeing patients and it's just the thought of documentation still. It's just it's , I've I've got to shift that, that word for myself because documentation, all the struggles our colleagues you're experiencing is very [00:10:00] frustrating. And the system that we work in, the healthcare system, so there's systemic issues.
[00:10:05] And I, I want to acknowledge it and celebrate, , your decision to follow your Dharma, to, to follow that calling and to be there for others, , and bring your wisdom to it. And I know you're doing some incredible research. , I know you were working on a white paper last we spoke. , and I'd love to hear, , , what drew you into this topic?
[00:10:24] Um, and what have been some of the top findings that had come out of the research you've been doing?
[00:10:30] Diane Shannon, MD, MPH, ACC: [00:10:30] Well, I I've been working with a number of women physicians and was really more, became more interested in what are the challenges that they're facing. And I knew what I had experienced, but I really wondered beyond my experience and what I've. Noticed or observed with these women that I've worked with. What, on a larger scale are the challenges women physicians are dealing with today. And so I started thought, well, I'll interview a few people, right. A few women physicians. [00:11:00] So I thought I'll interview three. Just didn't kind of set up some questions and I'm, um, I feel like I'm an experienced interviewer after years of writing.
[00:11:09] Like that's a lot of what I did and I love interviewing and their responses were so interesting that I decided to expand the project and interviewed 30 women from across the country. And I really try to get different specialties, , different kind of demographics. So they're women from post-training.
[00:11:31] So I, I worked on worked focused on those post-training through post retirement and ask them about their top , their top challenges, what they want what's getting in the way.
[00:11:44] Patrick Swift, PhD, MBA, FACHE: [00:11:44] Uh, uh,
[00:11:46] Diane Shannon, MD, MPH, ACC: [00:11:46] what I learned was some of it was, you know, what you might expect. Right. The top challenge that they virtually, all of them named on their own was work-life balance. Others [00:12:00] call it work-life integration or work-life harmony. And when I looked at the, the demographics of the 22 women who had caretaking. , responsibilities at home. So either children or caring for an elderly parent, every single one of them said work-life balance was a top challenge. And then most of the other eight did as well. So it's kind of a, a widespread, this is what we're seeing. Other things that came up kind of very, , more commonly than I would've thought, imposter syndrome and self doubt. And also some of the issues related to what's been called the motherhood penalty. So policies that are in place that make it really challenging to come back to work after having a child or just parenting young children.
[00:12:54] So policies around maternity leave around lactation [00:13:00] support around child, uh, childcare access. , so that those were the, probably the top three that came up. What surprised me was how many times women mentioned some of those very particular challenges they faced, for instance, the lactation that came up over and over again.
[00:13:21] And what they said was we need more than a room in the basement. We can't get there. We don't know where the room is. We don't have time to get there. And if we go to go down to the room to pump we've then run behind in our clinic. Like there there's just so the stress for coming back, you've got a newborn, you're trying to manage all of these new responsibilities and trying to get back to work.
[00:13:49] Patrick Swift, PhD, MBA, FACHE: [00:13:49] okay.
[00:13:49] Diane Shannon, MD, MPH, ACC: [00:13:49] So I see that as really, um, you know, an equity issue. And we want really, ideally we want to [00:14:00] support everyone with the accommodations. They need to do their best work and remain sustainable clinicians. Right.
[00:14:08] Patrick Swift, PhD, MBA, FACHE: [00:14:08] Yup. Yup. Yup. And I, I, you you've covered so much there. And, , I want to unpack that, , also in. The research that you did touched on the work-life balance and a listener, and God-willing, there are those who identify, however you identify. , but certainly not just women listening to the show. , yes. You touched on the work-life balance.
[00:14:32] Work-life integration. , but it's so much more than that. And, , you're touching on the, the motherhood penalty, , the challenges, , in even having lactation rooms that are accessible and not coming back to an onslaught of having to catch up essentially even a penalty, , for, for taking time to, to pump, , and balancing all that.
[00:14:51], from your perspective, Diane, what can we do to address this in addition to, in addition to just colleagues saying, yeah, that's [00:15:00] an important issue.
[00:15:00] If someone's thinking about that, what can we do about that? What needs to change from your perspective?
[00:15:06] Diane Shannon, MD, MPH, ACC: [00:15:06] And are you talking specifically about lactations.
[00:15:09] Patrick Swift, PhD, MBA, FACHE: [00:15:09] I'm talking specifically about, , , if we acknowledge there's a larger cultural challenge here and you've identified, um, challenges women physicians are facing today, , I guess tying it to your findings, , that work-life balance. , I think of. , the administrator is willing to have a conversation having been in a hospital administrator, administrator myself, , having that for goodness sakes, just to bring up the topic of work-life balance with these female physicians.
[00:15:35], first we got to have a conversation about it, right.
[00:15:39] Diane Shannon, MD, MPH, ACC: [00:15:39] Yeah. So, so I'll mention too two, um, initiatives I think are really interesting and there are a lot of, this is what gets me really jazzed is when I learned about some of these things going on. So one of them is that after I wrote a piece about, um, lactation specifically on my blog,
[00:15:57] Patrick Swift, PhD, MBA, FACHE: [00:15:57] okay.
[00:15:58]Diane Shannon, MD, MPH, ACC: [00:15:58] , I learned that at [00:16:00] UCF, they started a program recently, specifically to support lactations for physicians.
[00:16:06] And so they looked at how do we provide education and resources that work for them. And they started without physicians in the outpatient setting and, and what they also did was for every four hour shift or, or clinic session they provided, I think it's 20 minutes of paid time to go and pump. So now they're working with, okay,
[00:16:31] Patrick Swift, PhD, MBA, FACHE: [00:16:31] That's a strategy we can implement.
[00:16:33] Diane Shannon, MD, MPH, ACC: [00:16:33] Right. So that, that is for the outpatient. Now they're looking at, let's go talk to the anesthesiologists, the surgeons, and find out what do they need, because that same system is not process. Isn't going to work for them. So that's one. And that was, that was, you know, it's, it's understanding what are those pebbles in the shoe for specific groups and, and, you know, [00:17:00] And then what can we do?
[00:17:01] What's an innovative piece that we can do to address that. And the feedback they got from women who were, had accessed the program, once it started was phenomenal.
[00:17:12] Patrick Swift, PhD, MBA, FACHE: [00:17:12] yeah. Yeah, that's phenomenal. And the retention also, I mean, medical centers, health systems in a, so much in recruiting their staff and the phys, our physician colleagues want to have a diverse workforce. There's no one there's, uh, if, if they are, it's a Neanderthal, the stuck in the past, we want to have a diverse workforce of, of, , colleagues from, from multiple perspectives.
[00:17:35], and so if we're going to have an inviting workforce, we're going to have women. That can take time to do what needs to be done in the short term. This isn't a forever thing for goodness
[00:17:44] Diane Shannon, MD, MPH, ACC: [00:17:44] That's exactly right. It's not a forever thing. And I think the same applies for men, right? When you have young children, you want to be there. So if it's possible to have a more flexible schedule for physicians with young children, right, that's supporting [00:18:00] them, they're going to be more loyal to that organization.
[00:18:03] And later when their time frees up in a different way, they will be able to, you know, work a different schedule or work longer hours. So I think it really pays to understand. What are the top challenges for this individual and maybe for this group of, of individuals. Um, and the other thing I'll mention with that is that, um, it, one of the, the, I interviewed the physicians who founded this program at UCF.
[00:18:29] And one of the things they said was there was a physician couple. Right. So the, the parent, they had a newborn, so the wife was going to pump and she was losing time and money and falling behind and getting stressed while the father of the child was working the same hours and had no right, right. Cause he wasn't needing to go and leave to pump for their child.
[00:18:51] And somehow that just brought it home to me that these physicians, you know, they're both trying to do their best job at work. [00:19:00] And she is struggling in a way that could be helped and that eventually they started the program and that has helped other physicians there.
[00:19:07] Um, the other, uh, another program that, or initiative I'll mention is, was started at mission health in North Carolina, and it's called immersion day.
[00:19:17] And in the course of this, uh, program, they invite. Co of top leaders. So the C-suite basically executives and other leaders who don't have clinical backgrounds to shadow a clinician for an entire shift. So they signed privacy agreements. They put on scrubs, they are with them in the OR . They're sitting next to them.
[00:19:42] As they click a thousand times, they're seeing the inefficiencies they're seeing where there may be understaffed. Um, or staff who are not trained in, in the way they need to be to support the clinic. Other clinicians. And it, the effect of it in [00:20:00] terms of the relationships between the clinicians and top leaders, the understanding that top leaders then have of what the clinicians daily life is like, opened up so much for them.
[00:20:12] And. They also began to extend it and offer legislators, local legislators and journalists to come so that they had a better sense of what is it really like to be a clinician. And I just think that kind of opening up and what that says about the for for the culture of the organization is huge.
[00:20:33] Patrick Swift, PhD, MBA, FACHE: [00:20:33] Speaks volumes. And I love, uh, that, that this full circle of acknowledging the experience overall, um, for being aware of what the provider, the professional's experiences are, uh, the focus of physician experience or provider experience to the C-suite paying attention to what, um, the healthcare professionals are going through.
[00:20:55] Um, and I love that it also heightens, um, the awareness [00:21:00] about. Challenges women physicians are facing today. Um, especially in light of, um, is getting back to lactation rooms time, uh, to be able to do what needs to be done, um, support from caregivers, um, uh, looking at the bigger picture. And so this, this compassion we're talking about in leadership, this compassion, we're talking about changing, moving the culture of health care toward, um, toward, toward more a heart-centered approach, um, is a benefit to all.
[00:21:29] And so I just, I, Diane, I want to applaud the work you're doing in looking deeply at that these challenges women, physicians are facing, but also being part of conversations about bigger pictures and how this is all connected. And I'd love to ask you the, the, the question I love to ask my guests, which is if, if you had the attention of all the healthcare professionals, all of us around the whole planet for a brief moment, what would you say to us?
[00:21:54] Diane Shannon, MD, MPH, ACC: [00:21:54] I would say the same thing that I wish I had known. When I was in training [00:22:00] and that is it's okay to be human. And that means you have feelings, you have needs, like you need to sleep, you need to eat, you know, you need to exercise. Um, you need to have a place to talk about a strong emotions when they come up from work.
[00:22:16] Um, All of those human needs that we have, that it can be so easy in medicine to just try to deny, you know, we learn so much about, um, just denying our needs to keep going and push through that delayed gratification that it can become a way of life. And I think one of the lessons that I learned from my burnout was, no, I am human.
[00:22:40] And by embracing that and helping others to embrace that, um, I think that that leads to, you know, stronger clinicians and a more resilient workforce and better satisfaction, um, you know, for work and also for your whole life.
[00:22:58] Patrick Swift, PhD, MBA, FACHE: [00:22:58] I love it. I love it. And [00:23:00] I heard many things in that one, um, being you may push through. Something I, what I hear between the lines, you're also saying, yeah, push through. If you got to push through, push through, but I heard you say the word  about a way of life. And if it's becoming a way of life, then that's a zero sum game.
[00:23:17] And if you need some support on that, um, that's a great opportunity to reach out to Diane. So I'm going to, I'm going to just turn it to, if folks are, uh, interested in continuing this conversation, , , this delicious conversation. How can folks learn more about you and the work you're doing?
[00:23:34] Diane Shannon, MD, MPH, ACC: [00:23:34] Yes. So my website, very easy to remember DianeShannon.com. And the report that we were talking about is available on that, on my website. And I'd be happy to speak with people. Um, short conversation, longer conversation. Yes.
[00:23:51] Patrick Swift, PhD, MBA, FACHE: [00:23:51] Good. Good. Outstanding. Diane, thank you so much. And thank you for, , I think it's a good point to,  just say thank you and, and, , encourage folks to follow [00:24:00] up, , and take care of yourself. Apply this wisdom that Diane is touching on. And, , Diane, I just want to say thank you for being on the show
[00:24:07] Diane Shannon, MD, MPH, ACC: [00:24:07] Thank you.  It's a  pleasure.
[00:24:09]
 

19. Compassion, Optimism, & Practical Wisdom To Prevent Burnout w/ Madina Estephan, MD, MPH, CWO

This episode records from Paris, France where we discuss the impact of COVID, keys to resilience for healthcare professionals, and practical wisdom to prevent burnout.
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
Dr. Estephan on LinkedIn:
https://maison-estephan.com/
https://www.linkedin.com/in/madinaestephanhealthcarecwo/
Music Credit:
Jason Shaw www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to another episode of the Swift healthcare podcast . I'm Patrick Swift, your host, and I want to thank you for being here. Thank you for listening from South Africa and Latin America and Europe and the United States and all over. I'm grateful for our listeners and thank you for your support, uh, for the podcast as well. So for our show today, I have a wonderful guest, Dr. Madina Estephan, Madina . Welcome to the show.
[00:00:24] Madina Estephan, MD, MPH: [00:00:24] Hello. Hello, Dr. Swift . Thank you very much for inviting me. I'm so glad to be here today on show.
[00:00:34] Patrick Swift, PhD, MBA, FACHE: [00:00:34] I'm delighted you're here. I know that I know you used the word to let it all the time because I am delighted. Uh, and I'm so delighted to hear folks. Um, Dr. Estephan  Madina , uh, is in Paris, France. And so I'm just like jump up and down. Pinch myself, excited, having been to Paris, having a great love for Paris as in American, how wonderful it is to have a guest on the show that's  broadcasting from Paris, so, and a physician from Paris. So. [00:01:00] Here's Dr. Madina Estephan's  bio coming from a family of three generations of healthcare professionals. Dr. Estefan, whose  passion for the medical field was inspired at an early age. Can you imagined growing up at that household? , it led her to earn a medical degree. Obtain a master's degree in public health and as a multilingual multicultural health professional with over 20 years, clinical practice and international management experience, her career has been focused on training and consultancy. And she's focused on empowering you.
[00:01:31] She's focused on empowering healthcare professionals, healthcare leaders, healthcare providers, um, to unfold their therapeutic excellence. Unlock internal resources and unleash practical wisdom. I love that. I think we could all, you know, I got some gray hairs and lost all the hair on the top of my head. I think we could all use some, um, some wisdom and practical tools.
[00:01:51] So we're focusing on compassion, optimism, and practical wisdom for this episode. So that being said, Dr. [00:02:00] Estefan, let's just jump in Medina or a question here. Um, you know, welcome to the show from Paris. What's going on in Paris, right in here. What's the what's what's the latest. How, how, how are things.
[00:02:12]Madina Estephan, MD, MPH: [00:02:12] Listen, the good news. I have two news. Good news. Bad news. I'll start with the good one. The good news is that we have wonderful weather and the spring came. And so, uh, that's, uh, gives your energy, right? And the other staff is that we were in the middle of the pandemic. That's a bad piece of news, but we're rather struggling and the making all the best in the healthcare systems,  this, , third wave  slowly but surely so, and hopefully we'll be over that. And then we will welcome guests from the other side of a planet in Paris. One day.
[00:03:00] [00:03:00] Patrick Swift, PhD, MBA, FACHE: [00:03:00] Of course, of course I was listening to BBC and, uh, yesterday world service. And, um, there was a piece on, I believe, 80,000 new cases and, , you as a leader in, um, services and consulting and support, um, I know that you're in the middle of, , , helping healthcare professionals, , dealing with the burnout and the struggle and the pandemic and, and for the show, we're focusing on compassion, practical wisdom, and optimism.
[00:03:30] One of the things you talk about as soft skills and the importance of soft skills, and I would call them survival skills as well. What are the, what are the soft skills that, that healthcare professionals can be mindful of in their daily life right now? Just to get through everything going on.
[00:03:49] Madina Estephan, MD, MPH: [00:03:49] So you're absolutely right. It's not only survival skills. So I will say like French people also, so savoir vivre , right. Uh, [00:04:00] to know how to leave, you have to know  to know how to be in Samoa fair, to know what to do. So let's call them survival or even human skills or skills of how to be, right. So, because somewhere what to do, we know as healthcare professionals and patient is expecting from us, the knowledge they expertize.
[00:04:32] So knowledge in your specific specialty, the hard knowledge, right? And the other side, we need those survival skills, uh, to know how to be ourself, how to protect ourselves, how to give the best of ourselves. Right. So, and amongst those soft skills for me, there are some which is absolutely [00:05:00] necessary to have in your toolbox, like a tool of books, like compassion, optimism, or those ma uh, practical wisdom skills, which are in a capacity.
[00:05:14] I think of the health care professionals. So, and when talking about compassion, Coming from the Latin word com passion , literally, which means I suffer with is the capacity of feeling suffering of the other's pain. Right. But all the other sides there is another part of the story is the willingness to act and do something to relieve suffering from the other one .
[00:05:45] Right. This is the, the, uh, the most, let's say demanding part of the compassion to be compassionate. I like the composition  that compassion is in love in [00:06:00] action. It means to be able to put. Some kind of action plan to relieve the suffering from others. But as healthcare professionals, we're deeply suffering ourselves.
[00:06:14] Right? When we exercising our duty everyday duty activities, we have plenty of professional risks. There, including emotional exhaustion, distress, burnout, et cetera, and, uh, compassion, fatigue. So, first of all, we have to learn how to be compassionate with ourself, right. To stop and use the skills of compassion toward ourselves as the healthcare professionals and be able to them.
[00:06:48] Patrick Swift, PhD, MBA, FACHE: [00:06:48] I'm so glad you said that because it's about. If, if we are reminded every day to be compassionate with our selves with ourselves, it's still not enough. [00:07:00] We in the health care profession, you saying the importance of self compassion and for a listener right now, whether you're a healthcare leader, healthcare provider, um, healthcare professional, anyone working in healthcare, uh, Dr. Estephan's . Voice I'm telling you the importance of self-compassion. We needed that every day, uh, to be compassionate with ourselves and, and Medina, you speak about, um, emotional assertiveness of, of, um, come across some things you've written. And, um, I would appreciate your thoughts about emotional assertiveness in light of preventing burnout or addressing burnout or reducing burnout.
[00:07:38] What's the importance of emotional assertiveness? What's that about?
[00:07:43] Madina Estephan, MD, MPH: [00:07:43] Thank you Patrick, for this question because emotional assertiveness actually is a tool. Let's say, well, it's not invented by me. It was invented by invented or concept alive by John Parr, who is a UK, uh, doctor of [00:08:00] psychology. And actually it's a kind of tool which helps you regulate difficult emotions.
[00:08:09]Okay. In the way of understanding that we all are looking for the inner state of happiness, right? And this inner state of happiness can be of different degree for, from calm to joy. Right. And to get the Zener state of happiness we're always handling or, um, uh, facing different type of emotions. I, those emotions, the principal one is an anger.
[00:08:42] When something's going on around ourselves, in the environment, something goes wrong. We react in the first reaction is always anger. Then there can be anger, which is not expressed. Right. And then w [00:09:00] we can not handle the singer or express it authentic when it's happened. We're going to. focus  and anger deeply inside of ourself and hurting somewhere else, self knowing what's going on with you, internalized anger, which is actually the part of the story.
[00:09:23]So facing these anger and be able to express anger in the right manner and the right place with the right person is the kind of emotional assertiveness . Yes.
[00:09:38] Patrick Swift, PhD, MBA, FACHE: [00:09:38] I love it. I love it. The notion of being angry at the right person at the right reason at the right time,
[00:09:45] Madina Estephan, MD, MPH: [00:09:45] authentically  yes, typically affected that's that's the most important and how to learn, how to, to learn, to express the singer. First of all, to feel it, to [00:10:00] understand why, where. And from which part of you is coming from the past experience over the future experience, and then anchor yourself here in here now.
[00:10:11] So emotional assertiveness  to express your rights and do what is right to do without harming others and taking the right of others.
[00:10:24] Patrick Swift, PhD, MBA, FACHE: [00:10:24] Beautiful. Beautiful. And these are all critical, um, skills, soft skills, emotional assertiveness, that the self-reflection what you're speaking about or that self-awareness and applying it. I want to move on to, um, the current pandemic and what that's revealed. Um, is it the bottom, if there were an iceberg, uh, going on right now in healthcare, um, uh, what has the pandemic revealed? Is that the bottom of the iceberg of the challenges we're facing in healthcare? Preventing Burnout.  What's that iceberg? What's the bottom of the iceberg right now, in your perspective.
[00:11:00] [00:11:00] Madina Estephan, MD, MPH: [00:11:00] Yeah. Uh, I think the, the bottom of the iceberg is there. We don't, I mean, we all know that, uh, exercise as a healthcare professional, where facing the professional risks of mental health or physical health risks. And mental health risks because they are known . Right. We know that the burnout among  the healthcare professionals are, uh, the risk of burnout is higher than a different to other professions. Right. Uh, and the risk of mental health problems . Is, especially during the pandemic, most evident, we have a more anxiety depression, suicide, uh, amongst the healthcare professionals. That was the recent reports and servers are showing from different countries, right from the UK, from United States, from France. And, uh, we faced also the. tremendous amount of health, [00:12:00] healthcare professionals quitting their  job. I mean, there have been 10,000 nurses since the pandemic in France who quit their jobs and they don't want to continue. Yeah. It just in   France, hundreds, thousands in the UK, 8,000 midwives . Every second physician in France declared to be burnout declared. So it's auto declaration means that it's a largely underestimated. So, uh, um, pandemic previous,
[00:12:36] Patrick Swift, PhD, MBA, FACHE: [00:12:36] if I may jump in and it's perfect, there's a siren in the background and Paris right now. It's, it's, there's a siren going around the planet have you seen. um, it's, it's, it's R it's poetic that that's happening. And so this is an elephant in the room in healthcare. And so why do you think burnout remains an elephant in the room in healthcare?
[00:13:01] [00:13:00] Madina Estephan, MD, MPH: [00:13:01] We know this elephant, right   from long, long ago, many, many years, why it remains ? Because. From my side. I think system is itself. It's a rigid system, right? And to me maintaining the, uh, the heirarchical system or rigid system, um, they do not have interests to give the power or to empower the healthcare professionals.
[00:13:33] Completely, that's one on the other side, this elephant, everyone is looking from the different parts. I mean, we are completely blinded. You're like blinded, but absolutely. And you are looking from the side of the head, I'm looking on the size of the tail and each one is giving their own prescriptions what to do and how to make sure that this elephant can be okay. Yeah. taken [00:14:00] off  from this room. Without crashing the whole house and somewhere we are afraid  to do so, because we don't know exactly from what to start. From
[00:14:14] Patrick Swift, PhD, MBA, FACHE: [00:14:14] fear and the
[00:14:14] Madina Estephan, MD, MPH: [00:14:14] I'm convinced that yeah. Fear and emotions. Yeah. Fear, fear, fear, because it's unknown. What's going to happen doctor, but I'm convinced that the, the, uh, strengths which community can bring each individual can bring. In healthcare system is enormous. I mean, giving the power to doctors, giving the power to healthcare professionals, empower them, giving them skills, right? Skills of leadership, the survival skills to exercise better. Their professional protect themselves from the, uh, professional risks will somewhere [00:15:00] makes this elephant  smaller. Then we need systemic changes. Of course, organizational and other.
[00:15:07] Patrick Swift, PhD, MBA, FACHE: [00:15:07] So true. So true. So true. And I, as a side note, I have to apologize about the over-talking. Um, there's a little delay US to Paris. So my apologies, if I've, I've been I've, over-talked what you've been saying here, but I want to move to, um, practical wisdom as well. We're talking about compassion, optimism, practical wisdom.
[00:15:26] Um, what are your thoughts about what are, what are, what is some practical wisdom? Number one? What's your sense of what practical wisdom is is to, um, what are some, um, perspectives that healthcare professionals can embrace or use to help improve themselves their lives, address, burnout, address their professional development, um, what's practical wisdom. And then how does it apply to what we're doing as healthcare professionals
[00:15:51] Madina Estephan, MD, MPH: [00:15:51] it's a great question, Patrick. Great question. And
[00:15:58] Patrick Swift, PhD, MBA, FACHE: [00:15:58] in five minutes?
[00:16:00] [00:16:00] Madina Estephan, MD, MPH: [00:16:00] tons of literature, tons of publication on the subject into words. Okay. So, um, I found the great definition of Leo Tolstoy, but I will give it to you later. I think as a physicians, we're really, uh, trained to face the, uh, uncertain situations. Unpredictable sometimes situations. And we're definitely that case. Now our Canadian colleagues are using the abbreviation CINE .
[00:16:42] To describe what's going on with pandemic C is control, no control, right? Or difficult to control. I is unpredictable because we, I don't know if there will be another fourth or fifths wave and so on and how the patients are reacting. [00:17:00] We know better than disease now situation now, but still there's some unpredictability, right? CINE, and it's a new, it was new for everyone. We never faced it before. Right. And in healthcare we used sometimes on the new situations, which never faced before. And an E is ego or threat to ego threat to ego. Uh, currently we have direct threat to healthcare professionals, health. Right and threat to the health of the patient.
[00:17:35] So anyway as a healthcare professional. So world were used to these four factors and we, as much as we can find solutions, so solutions are by Aristotle thought was needed. The prudence or practical wisdom or pronounces, right. Is knowing. [00:18:00] The right thing to do in a particular circumstances, through understanding those circumstances, rightly knowing what metric matters and effective means and reasoning to bring out what matters it means for me, it is a healthcare practice practitioners.
[00:18:24] We can't know everything. We can't have all the knowledge, but knowing what is not necessary or less necessarily, well, even not to at all necessary somewhere is the capacity of putting right action in the right place. So those famous wisdom skills, and also we can look at some wisdom skills, the skills of self regulation self-reflection [00:19:00] taking action , uh, without us, uh, socially oriented to actions who pro-social behaviors. Right? So, uh, Starting from that we can cultivate it. We can nurture cultivate and have the kind of tools and programs to strengthen them or to bring them on the surface to practice them. Yeah.
[00:19:29] Patrick Swift, PhD, MBA, FACHE: [00:19:29] Madina Estephan  THAT is practical wisdom. I, uh, I appreciate that perspective. Love that. Love it. And, and let me ask you my favorite question to ask my guests, which is If you had the attention of all the healthcare professionals around the planet for a brief moment and all of us, what would you say to us?
[00:19:47]Madina Estephan, MD, MPH: [00:19:47] I know how difficult is it right now? And many of you are on the front line and many of you  can feel alone  and [00:20:00] can feel hopeless. Uh, I would say asking for help is not a kind of weakness or despair. It's the sign of strengths and resolution, and actually it's a part of problem solving. So asking for help actually is a part of the problem solving.
[00:20:30] Patrick Swift, PhD, MBA, FACHE: [00:20:30] I love it. I love it. I love your encouragement for folks to be aware that it's not a sign of weakness. It's actually a sign of strength to ask for help. Uh, we,
[00:20:39] Madina Estephan, MD, MPH: [00:20:39] Thanks and resolution. Yeah.
[00:20:42] Patrick Swift, PhD, MBA, FACHE: [00:20:42] we can. I only do this together. This is not about just, um, this is not about the ego. It's about, it's about caring. It's about concern. It's about compassion. So beautifully said, Madina . If folks are interested in following up with you, um, where, where can they go?
[00:21:00] [00:21:00] Madina Estephan, MD, MPH: [00:21:00] They can easily find me on LinkedIn and I would reply to everyone who is interested.
[00:21:07] Patrick Swift, PhD, MBA, FACHE: [00:21:07] Outstanding. Well, I will be including, , your LinkedIn, uh, link on the, uh, the show notes for the show. And of course your name will be in the graphic below you. So folks can look you up that way. So, and we're connected. So folks can connect through me through LinkedIn. If, if, um, you don't see her, but please take a look, uh, find, uh, Dr. Madina Estephan , um, wonderful resource, a lot of practical wisdom, , making a huge difference in the work she does. So, , Dr. Estephan , I wanna thank you for being on the show and thank you for all the work you're doing for, for helping, uh, healthcare professionals in these difficult times.
[00:21:42] Madina Estephan, MD, MPH: [00:21:42] Thank you Patrick and thank you for inviting me on your show.
[00:21:46] Patrick Swift, PhD, MBA, FACHE: [00:21:46] My pleasure. All right. Well be well, and my best, my send my love to Paris.
[00:21:53] Madina Estephan, MD, MPH: [00:21:53] Accepted
 

18. (Part 2) Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD

Part 2 - Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD.
Tune into Swift Healthcare Podcast to hear Robert Pearl, MD discuss his new book which has already become a #1 New Release in multiple Amazon categories and is soon to be a NY Times Bestseller!
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
In his new book, Dr. Pearl shines a light on the unseen and often toxic culture of medicine. Today’s physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us.
Robert Pearl, MD Links:
https://robertpearlmd.com
https://robertpearlmd.com/books/
https://www.linkedin.com/in/robert-pearl-m-d-32427b98/
Music Credit: Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript
Patrick Swift, PhD, MBA, FACHE: [00:00:00] [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast. I'm delighted that you're here and I have an amazing guest for our episode to Dr. Robert Pearl. Welcome back to the Swift healthcare video podcast, Dr. Pearl.
[00:00:13] Robert Pearl, MD: [00:00:13] It is a privilege to be back, Patrick , looking forward to it all week long.
[00:00:17] Patrick Swift, PhD, MBA, FACHE: [00:00:17] I'm glad, I'm glad. I'm glad. And we are talking about your book that is coming out Uncaring: How the culture of medicine is killing doctors and patients. I'm going to say that title again. It is packed Uncaring: How  the culture of medicine is killing doctors and patients. And in this episode, last episode, hopefully you've dialed in and heard that one.
[00:00:40] This episode, we're going to be talking about doctors. We're going to be talking about providers and it wouldn't do justice without giving  a little intro for Dr. Pearl here. So Dr. Pearl bear with me and for listeners, please take this in who you're listening to. This is Dr. Robert Pearl. He's the former CEO of the Permanente medical group, [00:01:00] the nation's largest medical group.
[00:01:01] At the time he was there in 99 to 2017, former president of the Mid-Atlantic Permanente medical group, 2009 to 17. He's led 10,000 physicians, 38,000 staff. These are people that get up in the morning and report to work. We're looking at 50,000 plus that he supported, uh, 5 million Kaiser Permanente members.
[00:01:20] He's been listen to this named one of modern healthcare's 50 most , influential physician leaders. And you're listening to him right now. He has a. Authored several books I'm gonna  touch on that, but he's also hosting podcasts, fixing healthcare, another one, Coronavirus, the truth. And then he has a newsletter Monthly Musings on American healthcare.
[00:01:42] He's a regular contributor to Forbes. And the first book I'm sure we'll touch on one was Mistreated: why we think we're getting good healthcare and why we're usually wrong. Holy crap. That is just a great title. Uh, and then this new book coming out, uncaring, how the culture of medicine kills doctors and patients.  With that [00:02:00] said the intro, Dr. Pearl, let's just jump right into it. And, , you have done some amazing things. I want to ask you number one, thanks for being on the show
[00:02:10]Robert Pearl, MD: [00:02:10] Thank you.
[00:02:11] Patrick Swift, PhD, MBA, FACHE: [00:02:11] Two , uh, we're talking about providers, folks, This book that's coming out is supporting doctors without borders, all the , all the proceeds of the goes to the doctors, to the borders. He's done some really cool stuff involving Ebola response to tsunamis, and I've got to pick his brain, uh, just because, um, share some insight being there. We're talking about providers, we're talking about professionals, we're talking about physicians. Um, what was your experience supporting providers, physicians, um, particularly, um, but supporting providers in response to Ebola and, uh, the tsunami
[00:02:45] The tsunami was fascinating because it was a lot more than just physicians. A lot of psychologists actually participated because the mental health issues of the people in Sri Lanka, which is where we went along with doctors without borders, [00:03:00] uh, was tremendous. So this happened, people may remember a little over a decade ago, a tsunami hit the area. Uh, it was the day after Christmas, but we knew that there were a lot of people who were killed, harmed and about to be harmed because the upcoming diseases with the communicable diseases and the contaminated water or the malaria then invariably would come. And so we worked with doctors without borders, uh, to figure out how we could send teams of volunteers there. I sent a secure email out to my physicians. Uh, they 10,000 of them. And I said, how many of
[00:03:47] day after Christmas.
[00:03:49] Robert Pearl, MD: [00:03:49] The day after  Christmas? So half of them were on vacation with their family. And I said, how many of you would be willing to volunteer? And they're not going to get paid. We'll provide the [00:04:00] supplies. We'll provide the transportation, but they're, they're on vacation.
[00:04:03] This is their vacation to go to Sri Lanka. And then of course I'm a physician. So I have to provide informed consent. Number one, there may not be any food. Number two, the water could easily be contaminated. And number three there's been a civil war for 20 years. I figured maybe I get five or six over 200 people volunteered that week.
[00:04:26] Or we ended up sending 10 trips, saving tens of thousands of lives, providing the psychological support to them, avoiding malnutrition, avoiding death from diarrhea, avoiding malaria, all the different pieces, depending upon how the epidemic happened. And then we said teams to Guatemala. After the earthquake struck there, we sent teams to the South.
[00:04:55] After hurricane Katrina to Louisiana, we sent them [00:05:00] a great story. They arrived there and the police have a barricade up. So no one can come into the area where Katrina has been. So what do they do? They rent a car at night and they go around the police barricade so they can get in there and provide care to these people who were in tremendous need.
[00:05:17] And then the Ebola comes, uh, Liberia and the physicians there. And they're all physicians in this case because you need infectious disease, expertise and emergency expertise. They actually have to have IVs going into their arms while they're providing care, because they're wearing the protective suits that are so hot.
[00:05:36] It's 120 degrees inside the suit.
[00:05:39] Patrick Swift, PhD, MBA, FACHE: [00:05:39] Oh my God.
[00:05:39] Robert Pearl, MD: [00:05:39] are alive unless they're receiving IVs.
[00:05:43] Patrick Swift, PhD, MBA, FACHE: [00:05:43] Oh my God.
[00:05:44] Robert Pearl, MD: [00:05:44] And this to me is the amazing piece. Patrick, I talked to  everyone who came back. Now just try to think about what it's like to be, be there. That 120 degree suit we're sitting there in the midst of a tsunami with knowing that there's civil war around you or the [00:06:00] hurricane debris of, uh, of central America. I have never seen happier physicians. The ones who went there made me think about all the trips that I've done. I fixed kids with cleft lip and cleft pallet. I've probably done a dozen trips to central South America, to some other countries as well. You know, you go there, you work 12 hour days, the ORs are not air conditioned.
[00:06:23] Food is rice and beans and everyone comes back fulfilled. Now think about in the context of burnout, what is missing? It's not the comfort, it's not the money. It's the mission and purpose. I think that we have lost that. And that's part of why I wrote on caring, how the culture of medicine kills doctors and patients, because I think some of it, much of it has been done to us, but much of it we've done to ourselves.
[00:06:53] And hopefully we'll get into that in greater detail. So people can start working on ways to [00:07:00] minimize the harm that they're experiencing.
[00:07:02] Patrick Swift, PhD, MBA, FACHE: [00:07:02] Yeah, your a story. It brings tears to my eyes. You're just talking about these people who are, um, volunteering. I mean, it's hope you speak about hope, Dr. Pearl. There's so much pessimism and confusion and misinformation and, and sarcasm and negativity and your story of expecting five and you get 200, um, people putting them their, their lives at risk, um, uh, giving up not only just vacation, but risking their lives, um, in Liberia and, and, and Sri Lanka. And, and these are stories of, of the reason why we go into healthcare. We all want to make that difference. Healthcare people are mission-driven people. And what you're talking about is, uh, facilitating folks, being able to follow their Dharma, follow their calling. And I know in the previous episode, we talked about you following your Dharma and your calling, and, um, it's so beautiful.
[00:07:57] That's why we go into healthcare we're mission [00:08:00] driven people, and you touch on being done to us as providers and doing it to ourselves, and that leads to a conversation about culture. Um, and, um, uh, I'm curious about your thoughts in this, in light of the amazing book that you have coming out, um, your thoughts about culture and how we're doing this to ourselves.
[00:08:20], in light of, , this episode, focusing on providers and physicians.
[00:08:24] Robert Pearl, MD: [00:08:24] If you ask physicians, why are 44% of physicians burned out? And why do they talk about moral injury? They'll tell you it's three things. At least the three most common we don't get paid enough. We have to do so many bureaucratic tasks and the computers in the exam rooms and the offices are so slow and clunky.
[00:08:52] They make a spend a huge amount of time documenting rather than providing the care.
[00:08:59] Patrick Swift, PhD, MBA, FACHE: [00:08:59] that is [00:09:00] maddening. I got to tell you.
[00:09:01] Robert Pearl, MD: [00:09:01] And they're all right, all those three things are there. But I wrote the book because my first book mistreated was about the systemic issues. And as I went around talking to people and I researched areas like burnout, there was still a piece missing.
[00:09:21] So let me give you a couple of examples. The people who were paid the least are pediatricians, but their rate of burnout is not that high, primary care is a much higher rate of burnout than pediatrics, even though the salaries are higher. What was even more amazing to me was the specialty that had the highest rate of burnout over 50% is urology.
[00:09:48] Now think about it. Urologists make almost a half million dollars a year. It's not the salary. They're making as much money now as they did in the past, when they [00:10:00] had low rates of burnout and compared to orthopedics or ophthalmology, they make just as much money, but they have 20% higher burnout rates.
[00:10:12] How do you explain this? It's not a lack of salary, because they're making a lot more than primary care and just as much, and even more than the other specialties, it can't be the bureaucratic tasks that goes into the same authorization processes. They have the same restrictions, the same regulations, and they're using exactly the same computers.
[00:10:31] So there's nothing different that explains it. If you look at the data over time, you start to see an interesting phenomenon, which is that urology used to have a low burnout rate, similar to some of the other surgical specialists specialties. And then what happened almost a decade ago is that the national preventive care oversight groups.
[00:10:50] Decided that the PSA, the prostate specific antigen that's used to find prostate cancer was causing as much harm, as good as [00:11:00] people underwent a huge number of biopsies and other tests. And people were also discovering that lo and behold, not intervening had as good a long-term expectancy in a lot of cases without the risk of impotence and urinary incontinence.
[00:11:18] And so the number of cases they did start going down a why is that important? Because in the hierarchy of medicine, it's not rational in the hierarchy of medicine, the cooler, the procedure, and this robotic prostatectomy, it's like a star Wars of surgery gave urologists this high status. And now as fewer and fewer urologists can do the procedure or have the opportunity to do the procedure.
[00:11:51] All of a sudden this level of satisfaction. One that's not created from the outside, because remember I said, urologist's are  making just as much [00:12:00] money, but simply from this hierarchy of medicine, I'm sure you're familiar with the work of Sir  Michael Marmot who looked at the relative hierarchies in British society amongst workers. And he could show a clear correlation. The lower down you were, the more dissatisfied, unfulfilled, fatigued. You were the exact same symptoms as burnout.
[00:12:26] Patrick Swift, PhD, MBA, FACHE: [00:12:26] beautiful point and you're not picking on urologist, obviously you're not, but I think it's worth pointing out. You're not picking on urologists. You're you're pointing out. You're shining a light on culture. And how we, we, like you said, we do to ourselves, we get caught up in this hierarchy and socially our families and culture and environment looks at us in pressure.
[00:12:48] There's this whole environment. you get to the, you get to 40 and don't give a shit what people think you get to 50. You don't give a fuck what people think I'll , bleep that out. But, but the notion that as you get older, you have to recognize praise and blame weigh the [00:13:00] same.
[00:13:00] All these, all this external, um, is,  Maya, this illusion , this, this farce. And so you're speaking to one is the  Occams' razor of cutting right through it. And that even saying that you breathe a little clearer of, of recognizing your own value. And that's the coaching I do as a psychologist and as an executive coach, it's about cutting through.
[00:13:23] So personally, there's that decision you touch on the other is now the culture, external culture. What can we do to move that culture, Dr. Pearl? Because your voice is so powerful that it speaks to putting a light on this, but there's also organizational institutional cultural things that, that, that needs to happen in order for this to shift in medicine.
[00:13:44] Right? The incentive.
[00:13:46] Robert Pearl, MD: [00:13:46] So, this is the piece of the book that I think is the most important, which is the way that culture and system move together. [00:14:00] So if you're going to try to create, you're going to try to create a, a logical way to say which specialties should be near the top of the hierarchy. And I told you that adding 10 community increases longevity two and a half times more than adding 10 specialists, you would say primary care should be at the top of the hierarchy. And yet they are not now in the minds of a lot of physicians, the order is we're not paid a lot, so we're not at the top of the hierarchy. And I'm making the point in this book that some of the reason why primary care is not paid as much is because the physician hierarchy does not put them higher enough.
[00:14:43] Because when you look at groups, the Mayo clinic or Kaiser Permanente, what you see as their primary care physicians are paid a lot more than in the community, because their value is seen more clearly.
[00:14:56] Patrick Swift, PhD, MBA, FACHE: [00:14:56] say that again. Please say that again.  [00:15:00] did you just say, I think I heard you say this, but I want our listeners to hear this. You just said in the Kaiser Permanente group, the primary care are compensated more because they're valued for the life-saving essentially, now  I'm putting words in your mouth, but it's also impacting preventing it saving lives.
[00:15:19] Is that what you said? That there's more compensation?
[00:15:22] Robert Pearl, MD: [00:15:22] If you look around the United States, I was also the chairman of the accountable care organization. And we had 24 groups, including the Mayo clinic and the Kaisers and the Geisinger's ad. And every group primary care is paid more in a group practice than it is an individual. But what, so what can be done?
[00:15:41] I think that physicians,
[00:15:43] Patrick Swift, PhD, MBA, FACHE: [00:15:43] one is they move their right to be part of that culture.
[00:15:49] Robert Pearl, MD: [00:15:49] the good part is they wouldn't have to move there
[00:15:51] Patrick Swift, PhD, MBA, FACHE: [00:15:51] Okay. How
[00:15:53] Robert Pearl, MD: [00:15:53] I think in the post, I think in the postcard, a virus era, there will [00:16:00] be everywhere. And what I mean by that is the following. You know, the United States will have borrowed $8 trillion that we'd have to pay back or we'll have to pay interest on by law every state in the United States has to have a balanced budget. They're going to have more unemployment claims, more Medicaid and less revenue. And small businesses that are the engine that drives employment. The people that drive the stock market are Amazon, Netflix, Apple, but the people who drive employment are this small businesses and they've been hammered a third of them saying they can't actually get through this year.
[00:16:39] without  continued government support. You know, we've talked about the need to lower the cost of healthcare for decades instead of we should. We must. I'm saying now that we will, because people won't be able to afford to pay the projected five to 6% costs [00:17:00] increased year over year. And when you can't afford something, you don't do it even if you want to do it.
[00:17:07] And I think that that's where our nation is going to be, and we're going to face.
[00:17:11] Patrick Swift, PhD, MBA, FACHE: [00:17:11] So hang on. Are you saying then that I agree with you that people are less likely to go to the, basically they're less likely to go to doctors. Ones are likely less likely to have procedures done those less likely to get care. They're less likely to get screening. So then mortality increases and then there's death.
[00:17:31] We're talking, we're talking over more mortality. So where, where is the, where's the solution here? How do we, how do we get, how do we address this before the tsunami, um, of poor care? Comes because of lack of access because of lack of resources to be able to pay for it.
[00:17:51] Robert Pearl, MD: [00:17:51] Look at the options you have, where you have a budget that cannot be exceeded a fee for [00:18:00] service system, which providers can just do more and more can't work. So you're left with two options. We'll either ration care or we'll transform care. Under a single payment, the technical word is capitation. And here's where the interesting part starts, which is that the physician culture that for decades has avoided progress because it's been the interest of physicians and hospitals and others to be paid in a fee for service type way when that's no longer possible.
[00:18:34] And the choice shifts into one of rationing versus capitation. I think we're going to see people start to move forward. Not everyone at once, but some people will move forward. I'm hopeful. It's going to be similar to when Roger Bannister broke the four minute mile. Once some people are doing it, as you know, with it, it was thought to be [00:19:00] impossible.
[00:19:00] And there were three years, there were 10 people who had done it because now once you're in a capitated system, you see the culture start to change. And what do I mean by
[00:19:09] Patrick Swift, PhD, MBA, FACHE: [00:19:09] Your lips to God's ears.
[00:19:11] Robert Pearl, MD: [00:19:11] Well, what you see is that in a capitated system, prevention becomes far more important. Primary care becomes far more important. Patient safety avoids a complication for chronic disease. All of these become positive
[00:19:29] Patrick Swift, PhD, MBA, FACHE: [00:19:29] and this is a provider, this is a provider of focus. Right? And so satisfaction goes up,
[00:19:35] Robert Pearl, MD: [00:19:35] and exactly,
[00:19:36] Patrick Swift, PhD, MBA, FACHE: [00:19:36] provider experience goes up the, the quality of life work-life balance. All of the benefits. There is a sea change for us as providers with that kind of model.
[00:19:48] Robert Pearl, MD: [00:19:48] where you ha you start to have the control, but you also have the risk. And this is why I think it's the risk aversion of physicians. That's kept them out of the model, but once you have the [00:20:00] risk, you need to find ways to obviate it, which means you've got to form groups. Working together in collaborative and cooperative ways, which I think psychologically is far better than everyone out for themselves.
[00:20:16] You have to find technology that's going to work. I mean, look what happened in COVID all of a sudden physicians started doing 60 to 70% telemedicine patients got better care. Everyone's talking about it as it as good. The fact that can address your problem right now, rather than telling you to come back.
[00:20:36] I mean, when I was the CEO in Kaiser Permanente, we set up a system whereby if a patient was seeing a primary care physician, this was pre COVID and the physician wanted to send the referral rather than sending a referral. We created a video link with a specialist. Dermatology was a great example of this.
[00:20:55] I don't know what it's like in your community. Most places in the United States, this is a six week wait, [00:21:00] the primary care physician, rather than telling the patient call. The dermatologist took a digital picture. Sent it to a dermatologist who was assigned that day to oversee this entire area for, for quite a number of physicians.
[00:21:14] and , within six minutes, there was an answer. So care was started that day, not six weeks later. How can you say this inferior care to seeing a doctor in his or her own office six weeks from now that opportunity physicians will figure out and I have tremendous faith that they will do the right things for patients. Once the incentives align and the culture evolves.
[00:21:43] Patrick Swift, PhD, MBA, FACHE: [00:21:43] You said something profound to me in another conversation we had in which you said, you tell me the incentives and I will tell you the behaviors. Is that what you said? Am I quoting you correctly? Or the outcomes you tell me the incentives. And you said, you tell me a sentence and I can [00:22:00] tell you what's gonna happen.
[00:22:01] Robert Pearl, MD: [00:22:01] I can tell you how people are going to behave.
[00:22:02] Patrick Swift, PhD, MBA, FACHE: [00:22:02] Yeah, yeah, yeah.
[00:22:04] Robert Pearl, MD: [00:22:04] commonly used business school phrase that somehow it in the culture of medicine, we don't think it's true. We don't think that the 30% of procedures that we do that have been shown to add no value. And I'm talking about by the Mayo clinic and a new England journal of medicine summaries of this that's somehow that's the right thing to do because the culture of medicine tells us somehow that it's okay.
[00:22:30] The reality says that is money, we could be better investing whether we want to invest it in prevention, whether we want to invest it in more primary care, whether we want to invest it in better education to make up for what's happened in COVID. Whether you want to invest in development of cities, I can come up with a lot of reasons why it is wasted.
[00:22:51] It makes us overlook things like surprise billing. I mean, the fact that we not only give people bills when they come to [00:23:00] get care, because we're battling an insurance company and we put the patient in the middle and then the hospitals that employ us Sue the patient when they can't pay. And we talk about moral injury, talk about inflicting  harm the culture. Doesn't let us see it. You're the psychologist. But to me, it's like a fine grain sieve. It seeps out. And I believe that it erodes the purpose and the mission. And I think that it contributes to the 400 suicides of physicians a year.
[00:23:33] Patrick Swift, PhD, MBA, FACHE: [00:23:33] Yeah. Grossly underestimated too.
[00:23:35] Robert Pearl, MD: [00:23:35] both doctors and patients.
[00:23:37] Patrick Swift, PhD, MBA, FACHE: [00:23:37] Yeah. Yeah. Ah, yeah, incredible. And this episode is your message is one of hope in the face of, you know, full circle in the face of acknowledging, , physician suicide, , the degree of suicide, , in providers and quite frankly, in the country and on a global scale, , providers around the planet right now, moral distress, everything we're going through, , to [00:24:00] the scope of this conversation about the culture of the self-inflicted wound and this wound we're born into, , , in medicine in a previous episode, we taped together, Dr. Pearl, you acknowledged a culture from the 18 hundreds. , and so the environment we're working in and beginning this episode, when you brought tears to my eyes, talking about Liberians, the tsunami, , this is there's such sacrifice on the part of our, our patients. And on the part of our providers, , there is such sacrifice in that his heart, , and what you speak of your message here is one of courage. , the, the courage, , to do something about this and your book is about that. Is it not
[00:24:41] Robert Pearl, MD: [00:24:41] Uncaring other culture, medicine kills docs and patients. It is. And I point out in one last thing and again, colleges, so you're more of an expert than I am to this, but the five stages of loss or grief, the Kubler Ross has the fond. And my understanding is they really can't be avoided. [00:25:00] And so the viewers should understand that they may not feel it's going to be necessary.
[00:25:06] They're going to deny the change is going to be there. And I hope that they're right, but I don't think they will be for the reasons that we said, and then what's going to happen. They're going to get angry because they feel like something's being done to them. I think some of that's already started
[00:25:21] Patrick Swift, PhD, MBA, FACHE: [00:25:21] Oh yeah.
[00:25:21] Robert Pearl, MD: [00:25:21] looked at the issue of moral injury as an example of burnout. Then what happens? Third, they start to bargain. Okay, I'll do it Tuesday and Thursday, but not Monday, Wednesday and Friday. I'll do it for some patients and not others. And then they get depressed. And I'm worried about that phase. And I'm hoping that they're going to get through that phase to acceptance, which is not the same thing as saying, it's what I want the saying under the circumstances, it's the best option that's there.
[00:25:49] And I'd be a miss to not also mention the article I'll be publishing in Forbes next week, about the impact of COVID-19 [00:26:00] on physicians, particularly in critical care and in infectious disease, the newest Medscape’s study has shown that actually urology is now number four with critical care and ID above because of the experience. I think these physicians are having, I talked to one doctor who said he lost four patients in one day. I talked to another one. She was a resident and she said that on day one of the rotation, she inherited six patients. By the end of the month later, they were all dead. I talked to people who are a woman, who's a double boarded physician, probably the grittiest smartest person. I know. And she said she can't go to sleep at night. And she wakes up before sunrise and sweats, sweating in bed. Uh, I think that we have got to understand that PTSD doesn't happen in the midst of the war. It happens afterwards. And I'm hoping [00:27:00] that if listening in are people who run residencies who run hospitals, this is the time to make sure that the psychological resources are there as a conversations can happen. If not, we're going to see as you call it a tsunami of problems with these individuals who have dedicated their life. And risked their life to take care of people infected with this horrible Corona virus pandemic experience.
[00:27:30] Patrick Swift, PhD, MBA, FACHE: [00:27:30] Absolutely. And, and I really want to encourage folks to take a look at Dr. Pearl's book, because it is a message of truth, recognizing what is going on here, but it's also a message of hope. There's the question of what can we do? And Dr. Pearl earlier you touched on, um, I, I wanted to bring up, , seeing the stages of grief, , and getting to that acceptance and that not being just, okay, I'm going to just take it, but it's about personal [00:28:00] leadership.
[00:28:00] I'd add personal leadership and professional leadership. That's the work I do with, with people is the personal professional leadership is about seeing things as they are not worse than they are. Not better than they are, but seeing things as they are. And then what do we do? And I know they're going to be QANON and wing nuts and people with propagating all kinds of garbage, um, as we have to adjust.
[00:28:23], but the vast majority of us are reasonable people, , who bring heart to what we do in caring for our patients and caring for our system. , and, and I couldn't think of a more, , global voice, um, to bring, , courage, compassion, joy, and hope, in the work we do. So it's my prayer that this episode may lift uplift people. And I, and I get to ask you my favorite question at the end of the show here, which is if you had the attention of all the healthcare professionals around the whole planet for a brief moment, what would you tell them? Dr. Pearl.
[00:28:55] Robert Pearl, MD: [00:28:55] First thing I would tell them is that the [00:29:00] culture of medicine is getting in the way of fulfilling the reason they chose medicine in the first place that the systematic problems around us they're real. But you know, the people in generations before us. They didn't have effective treatments or they didn't have necessarily the right procedures to perform . There's always difficulties that need to be overcome. And in this particular situation, I think the physician culture and again I  called the physician culture is really a clinician culture. It's just that I'm more knowledgeable. A lot of physicians is getting in the way, you know, the fact that, um, hypertension, the number one cause of strokes and kidney failure is controlled 55 to 60% of the time across , the country. And there are groups, large medical groups that control at 90%. That's not [00:30:00] a criticism. It's just the fact as you point out the question is what are we going to do about it? In the last episode, we talked about racism and the fact that black patients don't receive the same care as white patients, there's systemic issues as well. But the things that we can control. Again, you're the psychologist, but my sense is start with what you can do rather than starting with what you can't do and what you often will find that as you start to do the things that you can to raise quality, to provide care, that's more convenient, that's  more compassionate to be able to make care more affordable, low and behold.
[00:30:42] You're going to discover that the happiness and fulfillment that you experience, whether it's a combination of gratitude or there's a combination of being generous is going to come back and have people become more satisfied. I go [00:31:00] back to the tsunami experience, international experience, the happiest people I ever saw were clinicians who went over there and were able to do the right thing. Despite the fact that as you say that you volunteered, despite the risks that were out there, despite the hours, we need to work to change the system, but we also need to work to change the culture.
[00:31:25] Patrick Swift, PhD, MBA, FACHE: [00:31:25] incredible, incredible, Dr. Pearl , if folks are interested in following up with you learning more about your podcasts, your newsletters, the book, uh, where can they go?
[00:31:34] Robert Pearl, MD: [00:31:34] Best place to go is the website, RobertPearlmd.com. RobertPearlmd.com. They can order the book, pre-order the book. And if they pre-order the book, they'll get the signed book plate to discussion guide. They'll get the bibliography and they'll get the book delivered to their home. On the first day it's available.
[00:31:53] Uh, they could also get a lot of other information on the monthly musings on the articles that are being [00:32:00] written, the opportunity to broaden the knowledge and in all of my monthly musings, I always ask for reader feedback. And when it comes to this book, I'm encouraging people. Please read it if you love it, or you hate it. If you agree with it or disagree, let me know. That's how I learned. And I want to learn from all of your viewers and from all of the people who already are following the things that I get a chance to write and say, it's just a privilege to be able to work to transform medicine on behalf of people. And I appreciate all of you viewers who are going to come along on this journey,
[00:32:35] Patrick Swift, PhD, MBA, FACHE: [00:32:35] I pray they do. And he does read his email folks and, and the proceeds of the book goes to
[00:32:41] Robert Pearl, MD: [00:32:41] Doctors without borders, a tremendous organization that is running healthcare for those who can't contain it around the globe.
[00:32:51] Patrick Swift, PhD, MBA, FACHE: [00:32:51] Love them, love them. Outstanding, Dr. Pearl. It is a pleasure and an honor. Thank you so much for being on the Swift  healthcare podcast. Thank you so much for the heart and courage and [00:33:00] joy  and compassion that you bring to the show.
[00:33:02] Robert Pearl, MD: [00:33:02] Thank you, Patrick. I've had a lot of fun and I really appreciate you taking the time and educating your viewers. I can't wait to hear their feedback. Thanks so much.

17. Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD

Part 1 - Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD. Tune into Swift Healthcare Podcast to hear Robert Pearl, MD discuss his new book which has already become a #1 New Release in multiple Amazon categories and is soon to be a NY Times Bestseller!
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
In his new book, Dr. Pearl shines a light on the unseen and often toxic culture of medicine. Today’s physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us.
Robert Pearl, MD Links:
https://robertpearlmd.com
https://robertpearlmd.com/books/
https://www.linkedin.com/in/robert-pearl-m-d-32427b98/
Music Credit: Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript:
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome  folks to another episode  of the Swift healthcare video podcast, I am delighted that you're here welcome to our listeners in Latin America and Eastern Europe and the United States and all over the planet because I have an amazing guest.
[00:00:12] I'm so excited about Dr. Robert Pearl, Dr. Pearl. Welcome to the show.
[00:00:17] Robert Pearl, MD: [00:00:17] Thank you, Patrick. It's an honor. And a privilege to be here.
[00:00:20] Patrick Swift, PhD, MBA, FACHE: [00:00:20] Well, delighted you're here. And folks, I want you to take a seat, get comfortable. You're about to experience a masterclass. And, um, I could not ask for, uh, a better guest for a show. That's looking at the intersection of healthcare and leadership. Pop the hood. Look at the engine of healthcare. Talk about it from a, from a, uh, heart and head, an understanding perspective and someone who can see the big picture.
[00:00:47] Uh, Dr. Robert Pearl, I have this bio, I've got to read you a portion of his bio. Dr. Robert Pearl is the listen to all this, the former CEO of the Permanente medical group, the nation's [00:01:00] largest medical group former president of The Mid-Atlantic Permanente Medical Group in these roles, he led 10,000 physicians, 38,000 staff, healthcare professionals, responsible, nationally recognized medical care and 5 million Kaiser Permanente members.
[00:01:15] That's one. Two: one  of the nation's Modern Healthcare's 50  most influential. Physician leaders. I know Robert is going to try to stop me, but hang on there. I want to share this with listeners. He's the author of mistreated, why we think we're getting good healthcare and why we're usually wrong. Can you not resonate with that?
[00:01:33] Uh, his next book coming out, which I'm so excited about uncaring, how the culture of medicine kills doctors and patients, ah, such a great title. He hosts multiple podcasts, fixing healthcare, coronavirus the truth. We got to hear the truth about coronavirus God, uh, publishes a newsletter with over 12,000 subscribers.
[00:01:52] If you're not subscribed, please subscribe a monthly musings on health American healthcare. He's a regular contributor to Forbes. Um, [00:02:00] the man is a dynamo, um, leading with heart and, uh, let's start with the book uncaring, how the culture of medicine is killing doctors and patients at the top of the show.
[00:02:12] We're going to end on this, but at the top of the show, uh, Robert, please just share with folks, um, the book and how folks can get it and who it's helping. This is listen to this. Who's helping.
[00:02:24] Robert Pearl, MD: [00:02:24] Well, thank you so much, Patrick. When I wrote the book mistreated, I was talking about the systemic problems, how healthcare is paid for how healthcare is organized, how it's technologically or not technologically supported. And as I travel around the country and I talked about this in patients, it was clear to me there was something else missing.
[00:02:49] And I researched trying to figure out what it was. And I wrote the book about what I believe it to be, which is the physician culture. I don't know. I call it the physician culture is really the [00:03:00] culture of all people provide care. I just know the physician side, having been the head of the medical group far better than I know all the other pieces, but it equally applies.
[00:03:10] And for those of your viewers who do pre-order the book. They go to my website, Robert Pearl md.com, where they can find access to a lot of providers, all the profits go to doctors without borders, if five Oh one C3 charity providing healthcare around the globe as did the profits from Mistreated  and anyone who pre-orders, the book will get some freebies, including a signed book plates, including the discussion guide, a bibliography of other books on the same topic and a chance to pre-read the introductory chapter.
[00:03:48] And it will be delivered to your home on May 18th, the official pub date.
[00:03:53] Patrick Swift, PhD, MBA, FACHE: [00:03:53] love it. I love it. I love it. And again, folks that the proceeds of this book are going for doctors without borders, Medecines [00:04:00] Sans Frontieres. Uh, this is for good. Um, and it encapsulates some wisdom and love and compassion and courage. and joy  that Dr. Pearl was compelled in that composing that book. So this up number one.
[00:04:13] Thank you. And two. This episode, we're going to do the show in two segments. The book is titled uncaring, how the culture of medicine is killing doctors and patients and being providers. We were talking who who's, who we going to focus on first. And we agreed the patients were going to start with an episode on the patients.
[00:04:29] And so we're going to touch on, um, the elements of the book, but from the patient perspective. And, um, part of this is a conversation about culture. And I want to start with your why you became a physician, because I know this influences your perspective on culture and, and your parent experience and, and how all this comes together.
[00:04:51] So, so where does this passion come from? Dr. Pearl?
[00:04:55] Robert Pearl, MD: [00:04:55] So as a naive 17 year old, I headed off to college [00:05:00] and I wanted to be a university professor. I wanted to teach philosophy and my hero who ultimately became the chairman of Reed college. He was brilliant. Didn't get tenure because of his political views. And I decided I wanted to go with this, something that would have no politics and that would Medicine. We're talking about life and death, Patrick, how could you be?
[00:05:30] How could there be politics? So I went to medical school and then I went on to Stanford to become a heart surgeon. And guess what? I found the best physicians didn't always get the referrals. Yeah, it was politics who you knew the club you belong to. And I, I almost dropped out of medicine,
[00:05:53] Patrick Swift, PhD, MBA, FACHE: [00:05:53] Yeah. Wow. Wow.
[00:05:55] Robert Pearl, MD: [00:05:55] and then I have a chance to go to Mexico on a volunteer [00:06:00] trip and fix children with cleft lip and cleft palette. And I fell in love with that opportunity, the mission and the purpose. And that's how I became what I do today, which is a reconstructive plastic surgeon.
[00:06:16] Patrick Swift, PhD, MBA, FACHE: [00:06:16] I love that. I love that story. And in your bio, your, you serve as a clinical professor of plastic surgery at Stanford university school of medicine and your faculty of Stanford graduate school of business, where you teach courses on strategy and leadership in lectures on informational tech and healthcare policy. And so you're taking the wisdom and the heart of your calling and the love for caring for patients that cleft lip surgeries, you, you, you it's, it's tangible how you can transform lives. Um, with, uh, medicine and how you've, you've brought that into the work you're doing here. So let's talk about patients and, and culture.
[00:06:53] And so, you know, from that perspective of, of, uh, which that just made me laugh, it's, it's, uh, you know, didn't want to go [00:07:00] into a career that involved politics that you went in medicine, and here we are, who am I? God, talk about politicized. Um, let's put the lid and let's put the politics aside. If we, if we put the heart of healthcare to this conversation and kick the politics to the curb, um, let's talk about the culture, um, of medicine and how it's impacting patients.
[00:07:22] Robert Pearl, MD: [00:07:22] Culture represents beliefs, the values, the norms that we as clinicians learn medical school residency, or we carry the with us throughout our entire career. It's not written down in any textbook. It's not giving a lecture, but it's through the stories through the language that people use. When I try to explain to people about culture, I start in the 1850s with Ignaz Semmelweis.
[00:07:57] He's a physician in [00:08:00] Austria, in Vienna at the leading hospital, and he's appointed the head of the delivery service and he's appalled. He's embarrassed. 18% mortality rate. What's really irksome is that the adjacent facility one run by nurse midwives has two thirds lower mortality. Now at the time when patients died from was puerperal fever, overwhelming infection of the uterus spread throughout the body and the cause was felt to be miasmas . Foul smelling particles that wafted up from the streets below, but he said, why should my patients be dying 18% when the nurse midwives' (patients)  are dying, two thirds lower. Now, as you know, Patrick, we often make our best discoveries through serendipity. And that's what happened. A colleague doing an autopsy  on a woman who died from puerperal [00:09:00] fever, nicks, his finger develops a local infection and goes on to have a clinical course identical to these women who will die so  he hypothesizes ,  maybe there's something being carried from the autopsy room into the delivery room, either on the hands or the leather aprons. These physicians wore the days they had underlying three piece suits that's being  given to women in labor. So he decides that every doctor before they go into the delivery area will change that leather apron.
[00:09:34] Dip their hands in chlorinated, water and low and behold mortality drops from 18 % to 2% 90% reduction. He writes it up in the leading journal. He writes letters to every delivery service. And guess what happens, Patrick?
[00:09:50] Patrick Swift, PhD, MBA, FACHE: [00:09:50] what
[00:09:51] Robert Pearl, MD: [00:09:51] Nothing. No one pays attention exactly right now. Well, why don't we? Well, it's not indifference. [00:10:00] See, in the culture of medicine, the doctors were elevated high esteem. The only way to think about them was healers. They were incapable of carrying disease and those leather aprons, the more blood, the more pus the more experience, the last thing they would be as associated with an infection. He dies  four years later alone in a mental institution where no one will listen to them and now we leap forward 150 years. And what do we find? Hospital acquired infections are the number one cause of death for hospitals. 1.7 million people develop a hospital, acquired infection, a hundred thousand die. The bacteria is called claustrum difficile . We know it gets carried on the hands of humans. Doesn't go through the air. And if we have some researchers hiding in the corners, where do they see what? In three [00:11:00] times today, doctors don't wash their hands
[00:11:03] Patrick Swift, PhD, MBA, FACHE: [00:11:03] it's so true. It drives me nuts. I was CEO of a hospital in which I was trying to have a conversation with one of my physician colleagues saying I'm a PhD clinical neuropsychologist, not a physician, but talking to a physician saying, I'm not going to say the person's names. I don't wanna give a gender, but the person is saying I do. So it's, it's it's there are individuals who say that they are doing the right thing because they want to believe they're doing the right thing. People don't choose evil for evil sake. They mistake it for happiness. And when, when they're not doing the right thing, people want to believe they are doing the right thing. So it's to your, to your point, uh, they're still not doing it. Like they should , we, are not doing it like we should.
[00:11:46] Robert Pearl, MD: [00:11:46] no, this is just humans. . I mean, that's, that's what you have to understand doctors are just humans with the same, uh, for foilties , the same, uh, weaknesses, uh, they'll have excuses. Well, I didn't really plan to  [00:12:00] touch, the patient or I  wore gloves not  we can put it on top of the gloves. Um, and when someone dies. The culture provides the excuse that it had to be someone else. It wasn't a doctor. It had to be the nurse or that housekeeper.
[00:12:17] Patrick Swift, PhD, MBA, FACHE: [00:12:17] housekeeper. That's a big one. Thank you. I used to oversee support environmental services and they were the first ones that were brought up as well. They clearly didn't clean the room and they're the ones who are wearing the right PPE. I've got story. After story, I went undercover boss as a CEO to know what it was like to be an EVs worker and you touch on culture.
[00:12:37] Um, I, I'm so glad you're talking about this because we've got to look at the culture who we are as healthcare professionals is impacting patients, this episode is on the patients . Um, and, and, and we're talking about quality safety, uh, and this leads to disparities too. It's it's impacting everything. So, but so in your book, um, you're talking about culture, you're talking about moving forward to the future to now. [00:13:00] Um, what do you see is, is where we're going in this culture right now and how can we improve patient care?
[00:13:05] Robert Pearl, MD: [00:13:05] Well, I think it's important to look at what's happened during COVID-19 to get a good sense of this culture. And I want to make the point culture's invisible to the people who are in it. I often think about  smokers in North Carolina, they can sit in a small room and they don't notice all the smoke around them.
[00:13:27] If you or I walked in the room, we'd start coughing immediately. That's where the culture is. Like others can see it, but not the individuals in that culture. You know, what, what physicians say about washing their hands? Well, first they'd say, as you said, they do it, but they might talk about, you know, expense.
[00:13:46] Why don't they do the right thing? Well, it's expense. There's bureaucratic regulation. No, that  takes no time with an alcohol based disinfectant, the cultural lets them not see what is going [00:14:00] on. So during COVID 19, the clinicians were heroes, what they did when they couldn't get protective gear, they put on garbage bags and salad lids .
[00:14:12] They went to the hospital and when they pass tubes through the mouth, down the throat, into the lung, they knew the patient would cough spewing virus in their face. They did it anyway. And when they didn't have enough ventilators, they figured out how to put two patients on one machine. Something  that had never been done, not even thought about before they were heroes.
[00:14:33] Culture has that ability to make people do remarkable things. And the physician culture is no exception at the same time, all the things I didn't see. That we can tell from the data that exists. Number one 88% of people died from with chronic disease with two or more chronic diseases. Now think about that.
[00:14:57] You don't hear the big societies [00:15:00] going on, about what a poor job physicians are doing relative to chronic disease, you don't hear people. In fact, even talk about the value of prevention and avoiding complications for chronic disease. They talk about the cardiologist who goes in and unblocks a coronary artery, not the person who prevents it from happening.
[00:15:22] We'll talk in the next show about primary care and how the physicians there are suffering to some extent from the systemic issues, but equally inside the cultural let's look at some of the other pieces. If you ask physicians, why do black patients have three times the mortality of white patients during COVID-19.
[00:15:44] They'll give you a litany of answers. They work in jobs that they have to be there rather than being on zoom from home. They take buses and subways. They live in multi-generational homes and they're all true. What they don't talk about it as the fact that early in the pandemic, [00:16:00] when a black patient or white patient came to the ED with the same symptoms the white patient got tested for COVID twice.
[00:16:08] As often as the black patient, they don't talk about the fact that give 40% less pain medication. They don't talk about the fact that, uh, women in labor have three times the higher chances of dying. If there are black patients, except when the attending physician is a  black physician,
[00:16:25] Patrick Swift, PhD, MBA, FACHE: [00:16:25] True.
[00:16:26] Robert Pearl, MD: [00:16:26] when you put these pieces together, what's going on there.
[00:16:30] This is the nature of culture. We see people inside our group differently than we see people outside our group. We think they are more. Worthy. We have greater empathy sympathy. It's not that doctors want to harm anyone. This is not negative. This is just what culture does. But if you want to change that, you need to address the cultural issues.
[00:16:59] And that's [00:17:00] why I wrote uncaring, how the culture of medicine kills doctors and patients.
[00:17:06] Patrick Swift, PhD, MBA, FACHE: [00:17:06] In credible. And when a colleague, whether you're a physician healthcare professional, hearing the data you just said, knowing, knowing the data about disparity in pain management, for women in labor and long bone breaks, all the disparities you were touching on Dr. Pearl, there are colleagues of ours who will say in the back of their head, they'll think to themselves.
[00:17:29] Well, you're calling me racist. There are people I'm a neuropsychologist. I know though the process for some of our colleagues is that instead of hearing the message, basically, if you practice evidence-based evidence-based medicine, the disparages go down, what's heard in the ego is, well, you're calling me racist.
[00:17:46] Somehow I'm giving different treatment treatment and it's like the Monty Python response,  "No I'm Not" . So what do you say if there were a colleague sitting here with us now and whether they said it or implied [00:18:00] it, and they said, well, you're basically saying I'm racist  in my care . How do you get around that in a dinner conversation with a colleague sitting next to us, having a glass of wine, talking about this data, how do you get around? When, when someone gets defensive and says, well, you're calling me racist.
[00:18:16] Robert Pearl, MD: [00:18:16] As a neuropsychologist, I'm sure you're very familiar with the literature on what's called implicit bias. You take someone and you show them various images and they've got to match. A particular word, be it a positive word, like intellectual or a negative word, uh, against an image with the same word on it.
[00:18:39] And what you see is that white physicians will be much slower to put the positive label with the picture of a black patient or a black individual with that same word on his or her picture versus, um, a [00:19:00] white, uh, person with the exact same photos and everything else. That's how our brains work. That's the impact that culture has
[00:19:09] Patrick Swift, PhD, MBA, FACHE: [00:19:09] Yes.
[00:19:09] Robert Pearl, MD: [00:19:09] now. That's not racist. That's just simply the facts of how our brain work what's racist is if you don't pay attention to it. Now, there are, I'm not saying there's no one out there who intentionally discriminates or is racist, but almost all of these people we're discussing right now. are  not aware. And so if you want to be, what's often called anti-racist, which you have to do is understand the data. That's there recognize that it didn't start with something you decided to do, but now you have the opportunity to do things about it. When you order pain medication and the patient is black, a black patient, you ask yourself, is it possible? I'm ordering the wrong medication. You may not be, but if you stop yourself and ask when you're [00:20:00] seeing a patient in the emergency department, and there's a shortage of supplies, this case COVID testing, you have to just ask yourself if this were my friend, if this was someone who looked a lot more like me, would I do it differently? If you're on rounds in the maternity area. Are you checking all of the patients and recognizing where the bias is likely to be? You know, I often refer to it like golf. If you know, you have, what's called a hook and you hit the ball right handed to the left all the time, you might be smart to consider aiming occasionally to the right, especially when there's water hazard to your left.
[00:20:38] The same thing exists within racism. What's interesting is there was an article on artificial intelligence published about a year ago where the headline was, AI is racist. Now what happened is United health group's   subsidiary Optum. decided they wanted to invest some dollars in the patients who were sickest. [00:21:00] So there's an AI application to figure out who those patients were.
[00:21:04] The problem was that as a insurer, they had claims data. What they didn't have was actual care delivery. So they made the assumption that the more money that's spent on you, the sicker you are now in actuality, physicians provide $1,800 a year, less care to black patients with the same insurance as white patients.
[00:21:27] So guess what happened? It picked a disproportionate number of white patients. Not black patients only had 14% black patients that should have been over 40%. The headlines blamed AI. It wasn't AI. It's the way we practice medicine
[00:21:44] Patrick Swift, PhD, MBA, FACHE: [00:21:44] that's , it's the question they ask.
[00:21:45] Robert Pearl, MD: [00:21:45] All AI is  doing is duplicating the results that we get doing it even better than we can do it. But if we have an implicit bias, we have to be aware of it. And I think hopefully researchers will be aware about this in the future.
[00:21:58] Patrick Swift, PhD, MBA, FACHE: [00:21:58] incredible, [00:22:00] incredible. I, I love everything you've said. And the notion of AI being described as being racist when we're just asking the wrong questions and I love the analogy you gave about golf, and if you've got a hook to the left, you adjust your, your, your, your, your golf club. Um, and then you will hit more straight.
[00:22:22] I think the parallel goes on to say, if you're rounding in the maternity ward, for example, Pick your patient population. But when we take care of our patients, if we're more mindful that there are these biases, at least that'll help us adjust to be more in the center. And that is the opposite of perceiving it as being, just being, giving disproportionate extra effort, which also gets people defensive.
[00:22:47] Thanks. No, I'm not going to give extra effort to someone else. That's not what you're saying. You're saying, just adjust your club so you can hit straight. How about you just get the right diagnosis for everybody? Not just for some so, [00:23:00] before I run out of time on this, I want to ask you, I know there's a chapter in your book. Nine questions patients should ask doctors.
[00:23:06] Could you tell us a little bit about that please?
[00:23:09] Robert Pearl, MD: [00:23:09] This goes back to what you just said, Patrick, about the golf story, which is that if you know that there's a water hazard, you want to do things to try to avoid it. If the culture of medicine, the physician culture is one in which there's potential hazards. How do you minimize them? And again, I want to stress to the viewers.
[00:23:36] I could not be more positive about medicine, about  the profession, I encourage everyone to try to be part of it, to have the ability to provide care, to go home at the end of the night. knowing , you saved a life. So it's not negative in that way. It's just a recognition of that culture that exists that we need to get over. [00:24:00] But until that happens, there are dangers out there. So I don't have time for all nine, but I'll give you three areas. One area is if, as a patient you have the kind of problem. That's not very significant, but it requires some kind of follow-up. For the physician to see how you're doing over the possibility that maybe it was the wrong diagnosis or the possibility you might need more care.
[00:24:28] There's a set of questions you should ask. Can I contact you with email? Can I send you a text message? Can we just speak over the phone? Can we have a video visit? How can I get care without having to miss another day of work or school ? If the answer is I don't do any of those things, at least you're prepared for what's likely to happen in the follow-up period.
[00:24:57] If you need a procedure done, the [00:25:00] questions to ask is how many of these did you do last year? And how many did the most experienced person do in this community last year? And what's the worst complication you ever had? And how many of these procedures would you require someone to have done for  you to let them operate on you or do whatever the intervention is going to be.
[00:25:25] Patrick Swift, PhD, MBA, FACHE: [00:25:25] great question.
[00:25:26] Robert Pearl, MD: [00:25:26] then you can figure out whether that experience that this person has is worth it. It's not necessarily a right wrong answer. And then finally, for people who have advanced disease, heart failure, lung failure, they'd been in the hospital a couple of times or cancer. That's recurred multiple times. You want to know what are the other options that I have for care. You want to know when, as my problem progresses, will you be able to keep my pain adequately managed? [00:26:00] Maybe the most important question to me is when I decide that I do not want any more intervention, you still be with me or will you desert me? And that to me , I think, is what people want to know as they face a terminal illness and end of life set of decisions.
[00:26:20] Those are the kinds of questions. They're all put into the context of the physician culture, but people who want to understand what to ask doctors respectfully, but for the information they need to participate in the decision-making process will find that chapter particularly relevant and helpful.
[00:26:39] Patrick Swift, PhD, MBA, FACHE: [00:26:39] Absolutely  powerful questions, Dr. Pearl. I, I recall, uh, a, a dear colleague of mine, who I was interviewing for another episode, and she's currently battling ovarian cancer a silent killer. And she was with a urologist who, um, uh, was not doing [00:27:00] the testing and the assessment necessary to get to the bottom of it to help.
[00:27:04] And when she shared, there were some abdominal pain, uh, some GI symptoms, he turned around and said, well, I guess I'm off the hook. And it's the antithesis about what you described? Uh, this episode coming up was with Diane Powis . Um, when this episode comes out, we'll see, which comes out first, but, um, uh, in Diane show, she speaks about the urologist saying, well, I guess I'm off the hook.
[00:27:28] Your question, the third question you touched on there. If, if, if there's no longer care required, will you abandon me? You're touching on, are you still caring for me? You're not asking, are you going to continue to treat me gratis and forever be my best friend? No, you're talking about really the question is, do you respect me enough to keep a relationship? If I need care, if I just need you to care, um, is there connection there, right? Is that where you're going?
[00:27:58] Robert Pearl, MD: [00:27:58] In the culture of medicine [00:28:00] as physicians, death is not something we're used to, but something we don't really like. We see it as our own failure.
[00:28:07] Patrick Swift, PhD, MBA, FACHE: [00:28:07] Oh, sure.
[00:28:08] Robert Pearl, MD: [00:28:08] We feel powerless. Um, we worry that how people are gonna view us as a failure. Of course, that's not the reality, but that is the culture.
[00:28:21] Patrick Swift, PhD, MBA, FACHE: [00:28:21] A hundred, a hundred percent of us die.
[00:28:23] Robert Pearl, MD: [00:28:23] I can't necessarily cure you. In fact, I probably can't, but I'll be there for you and I'll make sure you're comfortable and I'll make sure you have the information you need and I'll help you find the resources. And again, people will point to the systemic issues. Well, that kind of conversation is not reimbursed and that conversation is not adequately funded, but it's why we chose medicine in the first place. When we get to the episode around physicians, I think not doing that creates the loss of mission and purpose [00:29:00] and harms doctors, as much as it harms patients.
[00:29:04] Patrick Swift, PhD, MBA, FACHE: [00:29:04] and your book is titled uncaring. How the culture of medicine is killing doctors and patients, and for listeners, viewers, where can people get a copy of that? Dr. Pearl
[00:29:17] Robert Pearl, MD: [00:29:17] The easiest thing to do is to go to my website, Robert Pearl md.com because there they'll have a choice of nine different providers, including Amazon and Porchlight and Barnes and noble, they can pick what they want to have the purchase go through. Uh, and they also can get, if they pre-order all the freebies that are available and they can check out other pieces of information, uh, I'll be writing an article next week. About the impact that the COVID-19 pandemic has had on physicians, particularly critical care physicians and infectious disease individuals, because I think they're going to have post-traumatic stress disorder [00:30:00] and it's going to be a crisis in medicine. If we don't act now and provide the mental health and psychological support that they need and deserve.
[00:30:11] Patrick Swift, PhD, MBA, FACHE: [00:30:11] there is that crisis. As a practicing psychologist, I'm caring for health care professionals, struggling with that burnout. And, um, as an executive coach, I'm supporting, um, executive struggling with that. Dr. Pearl, you, you hit the nail on the head, um, that that crisis is occurring as we speak. And I'm just so grateful that you've worked on this book, it's the culmination of the love and passion and care that you bring to medicine, uh, and our culture. So I want to thank you for being on this show on the Swift healthcare podcast. And I want to encourage folks to tune in for our next episode which we'll be touching on uncaring, how the culture of medicine, killing doctors and patients, um, as we discuss in the next episode, we'll be focusing on our, our providers, our doctors, and the [00:31:00] providers in healthcare.
[00:31:00] So Dr. Pearl, thank you so much for being on the show.
[00:31:03] Robert Pearl, MD: [00:31:03] Thank you, Patrick. I'll look forward to the next episode next week.
 

16. Advance Women's Health and Prevent Ovarian Cancer w/ Diane Powis, PhD

What can we do to promote women’s health, increase health equity, and prevent Ovarian Cancer? LOTS! If you want inspiration and practical ideas to improve your health and the health of those you love, then tune into Swift Healthcare Podcast with guest Diane Powis, PhD, Chief Spokeswoman at Aspira Women's Health.
Ranked a Top 60 Healthcare Leadership podcast by Feedspot.
Diane Powis, PhD is a licensed healthcare provider, an advocate for women’s health, and the Chief Spokeswoman at Aspira Women's Health. Through her advocacy, storytelling, coordination and management of an ethnically diverse patient advisory board, she is working toward empowering women to take control over their gynecological health by increasing their awareness of symptoms, understanding their genetic risks, and knowing that Aspira’s life saving biomarker tools exist.
Special Note:
Dr. Patrick Swift/Swift Healthcare do NOT have any financial relationships with any commercial interests with Aspira Health. Dr. Swift invited Dr. Powis on the show because they are grad school friends and Dr. Powis has an amazing and powerful story to share with the world. The information in this episode is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this video podcast/web site is for general information purposes only.
Dr. Diane Powis, PhD Links:
https://www.linkedin.com/in/diane-powis-a7885a37/
https://aspirawh.com/
Music Credit:
Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript:
Advancing Women's Health, Change the Story w/ Diane Powis, PhD
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome to another episode of the Swift healthcare video podcast. I'm delighted that you're here and I have a fantastic guest for us today. Diane Powis, Diane. Thanks for being on the show. Welcome to the show. Welcome to the Swift healthcare podcast.
[00:00:12] Diane Powis, PhD: [00:00:12] Thank you. It's an honor to be here, Patrick. Thanks for having me.
[00:00:16] Patrick Swift, PhD, MBA, FACHE: [00:00:16] It's a joy having you here and the show title is Advancing Women's Health, Change the Story with Diane Powis . And let me tell you about Diane Powis, a dear colleague of mine. Diane has worked as a clinical psychologist since 2001. She did her training at NYU medical center, the Rusk Institute of rehab medicine.
[00:00:37] And then she suffered through the postdoctoral fellowship in neuro-psychology rehabilitation, psychology at Mount Sinai medical center in neuro-psychology rehab psychology. I say suffered because she and I both went through the same program LOL.
[00:00:51] Diane Powis, PhD: [00:00:51] We survived together?
[00:00:53] Patrick Swift, PhD, MBA, FACHE: [00:00:53] fellows and, um yes!, uh, the, and inspiration and trainingand outstanding training and all the wonderful stuff [00:01:00] that came with that as well. Right. Um, but since then, Diane, um, served as a rehabilitation psychologist neuropsychologist at Stanford hospital. And then she was at Greenwich hospital where she specialized in behavioral medicine.
[00:01:14] And, um, here's where it gets real. Not that that is a significant enough, um, in her training and the services done for patients and, and, and the community. Um, but here's where it really gets interesting in the work Diane's done; since 2019, Diane  served as the chief spokeswoman for the MAT , Marilyn Ann Trahan  charity program aimed at raising awareness.
[00:01:36] For health care providers on how to better prevent and detect early stage breast and ovarian cancers. And since then in November, 2020, Diane joined ASPIRA women's health, senior leadership team as chief spokeswoman and through her advocacy, storytelling, coordination management of an ethnically diverse patient advisory board, she's working toward empowering women.
[00:01:59] All [00:02:00] of us have benefit to that. She's, she's working on empowering women to take control over their gynecological health by increasing their awareness of symptoms and to understanding their genetic risks and knowing that APIRA's life-saving biomarker tools exist. Diane Powis, Dr. Diane Powis . Thank you for being here.
[00:02:16] Diane Powis, PhD: [00:02:16] Thank you, Patrick, what a lovely introduction. I really appreciate that. And, um, I'm really looking forward to our conversation today and trying to get the message out there. So
[00:02:27] Patrick Swift, PhD, MBA, FACHE: [00:02:27] and that's why we're doing absolutely. I'm happy to do it. So I'm going to give you the title again. Folks,  Advancing Women's Health, Change the Story with Diane Powis.  Folks, . I want you to bear in mind. This is about women's health, but it's. It's advancing healthcare in general, whether we're healthcare leaders, we're healthcare providers, whether we're healthcare leader providers, or whether we support the work being done in health care.
[00:02:50] These are issues that we all at least need to have a working knowledge of. And I'm grateful that Diane is on the show to talk with us about it. So Diane, if we could start [00:03:00] with your journey of misdiagnosis to diagnosis and the relevance to what we're talking about here now.
[00:03:07]Diane Powis, PhD: [00:03:07] Thank you. So yeah, my, my journey to diagnosis, , I, um, fortunately just have been so blessed with a very healthy life up until age 45. , I have beautiful family, husband and children, two great kids. , a working as Patrick mentioned, , it a very rewarding position as a clinical neuropsychologist rehab psychologist at various hospitals. , and suddenly after my 45th birthday. I started to develop some strange new problems and symptoms. , this period lasted for over 10 months overall. , and the symptoms varied. , it started with, , heavy menstrual periods, , with my gynecologist, , and the symptoms ranged from. [00:04:00] Pelvic discomfort and urinating frequently again, with my gynecologist to, , lower back pain to bowel problems, to, , just not feeling exhausted and just knowing something was wrong. , what happened over the 10 month period is I was bounced from specialist to specialist and the diagnosis of ovarian cancer. Was missed. , and I was misdiagnosed with everything and anything from perimenopause to, , urinary tract infections, which the tests were negative, but the doctor said, well, it must be a false negative because, , you're still healthy. Nothing else would be wrong with you? , this is by my gynecologist along the way, I was referred to a urologist because, , since the many antibiotics I took for my faux bladder infection, , didn't seem to help. He said, well, , sorry. My faux , , urinary tract infection didn't seem to help. He said it must be a bladder infection.
[00:05:00] [00:04:59] So he referred me and this was a new doctor for me. He did his in-office evaluation and he did an, an office scan. And I told him I was really worried. Something just felt wrong. And he looked me in the eye and he said, um, Diane, you're perfectly fine. And as I was. Leaving the office. I, you know, I still wasn't convinced that, you know, as he put it, I have an overactive bladder and just take these new pills and that will help me.
[00:05:27] Um, I said, you know, doctor, look, I really think something's wrong. In fact, it's not just my, my bladder when I have to have a bowel movement, um, having some severe cramping and pain. And he smiled, chuckled, looked me in the eye and this is a direct quote. He said, well, that sounds like a gastrointestinal problem. So I guess I'm completely off the hook. So, uh,
[00:05:54] Patrick Swift, PhD, MBA, FACHE: [00:05:54] guess I'm completely off the
[00:05:55] Diane Powis, PhD: [00:05:55] guess I'm completely off the hook. Um, and that was the end of [00:06:00] that appointment and that interaction. Uh, from there I was passed. I saw my GP. She diagnosed me with diverticulitis because of the stomach pain and cramping, based on an in-office exam, more antibiotics after which, uh, those didn't help.
[00:06:17] I went to a gastroenterologist. She thought I had colitis. Um, ultimately this is 10 months after my initial heavy menstrual periods where I had peri-menopause. Um, she was, she had me for a colonoscopy to confirm the colitis and I woke up from the Twilight of the procedure and she stood over me and said, um, listen, I, I can't, I couldn't get the tube through.
[00:06:45] Cause there was a blockage. Um, you have cancer. So I was completely. I was completely blindsided. Yeah. It was devastating
[00:06:54] Patrick Swift, PhD, MBA, FACHE: [00:06:54] Incredible to be going through that months and months, and months, and months and months of seeing our colleagues in [00:07:00] healthcare who go to work every day with the intention of doing good. Um, but if we work in a siloed mentality and we think we're either on the hook or off the hook, then it's no longer putting the patient in the center of the care, but.
[00:07:16] Um, uh, put in the hero as the center of the care instead of the patient and that's backward, and that resulted in your journey there. Diane, and I'm so sorry, you went through that experience and that's why you're here. I mean, there's so much at stake cause your, your, unfortunately your story is not an exception.
[00:07:35] Um, you're a spokeswoman. Um, what's at stake for women here in general, and those who love them, we should be all of us. We should all be supporting one another in this team, human, um, in women's health. What's at stake here.
[00:07:47] Diane Powis, PhD: [00:07:47] Yeah. Um, well what's at stake is women are dying. And, um, even though it's not the most prevalent cancer, ovarian cancer is the deadliest gynecological cancer. Over [00:08:00] 50% of those diagnosed, um, die within five years. That's about the prognosis. Uh, the reason why is that? Uh, first of all, there's no screening for ovarian cancer.
[00:08:11] There's a common misconception, , among women I think, and, and. , I'm not sure how much I knew about this myself, but that, , a pap smear protects you from ovarian cancer, which is absolutely untrue. A pap smear is a screening for only cervical cancer. No other gynecological. Issues or problems. So there's no screening, , no screening ever existed and still doesn't exist, which is shocking given the state of, , of science and what's been developed out there.
[00:08:43], another reason for the horrific, , prognosis for these patients is that the symptoms are often considered vague and, , can. Perhaps be written off as other kinds of [00:09:00] problems are not so serious. And I think both patients don't really know the symptoms or understand them. And many providers don't either, unfortunately, and you know, they call it the disease that whispers and these symptoms whisper.
[00:09:14] But for me, You know, in hindsight, having gone through this, I see them more as shouts than whispers and things were just missed. And again, as you, so aptly put it. It's not just, this is something that happens over and over and over again to so many women. ,
[00:09:34] Patrick Swift, PhD, MBA, FACHE: [00:09:34] Yeah, Diane. And I'd also , I'd also argue that there, it can be described as whispers, but it also described them as, um, voices calling out to be heard that are being ignored. Right. And knowing the cardiac data on women, more likely to die of a heart attack in a hospital than men because of how gender differences are perceived.
[00:09:54] It's, it's astonishing and ridiculous that women are more likely the [00:10:00] data in disparities in care. Uh, even when you control for socioeconomic status level of income, education insurance, um, women are more likely, uh, so the heart attacks are missed. Um, we need to be more sensitive to ova. Ovarian cancers are, are, are missed.
[00:10:17] Um, and that leads to your, your, your message here. This is a critical list, not this. This is about ovarian cancer. Detection, but it's more than that. And I heard you speak on, you touched on the, the test it itself. Um, so I'd love to hear what your organization is about that your spokesperson for, um, and how they're helping being part of the solution.
[00:10:40] Folks. This is not an ad folks. Aspire health is not a sponsor of the show. They didn't send me a coffee or a Starbucks. Card or a sponsorship. This is not an ad. This is real conversations about what we can do to improve women's health. So that being said, what's, ASPIRA women's health doing [00:11:00] to help prevent, you said 50% of women mortality rate in five years
[00:11:07] Diane Powis, PhD: [00:11:07] Yes, in fact, and
[00:11:08] Patrick Swift, PhD, MBA, FACHE: [00:11:08] and ASPIRA health has been part of the solution to reduce that and stop it.
[00:11:11] Yes.
[00:11:12] Diane Powis, PhD: [00:11:12] Yes, absolutely. And that's the idea, the issue with this, you know, with, with these misses and, and I'll, I'll talk about ASPIRA and just one moment, but time is everything in this disease and like so many cancers, the longer it festers and, and there's no awareness of what the problem is.
[00:11:31] The later you get in stages and the five-year survival rate, if it's caught in stage one, Is 90%. If it's cotton stage two, it's 70% stage three and four considered late stage caught stage tree. Your five year survival rate is 39%. If it's cotton stage Ford, 17%. So clearly what's happening. Um, and 80% of all ovarian cancers are [00:12:00] diagnosed at late stage three or four because of what I'm talking
[00:12:03] Patrick Swift, PhD, MBA, FACHE: [00:12:03] 80% of diagnosis as your journey was Dianne. And these numbers are not just numbers they're people's experience,
[00:12:12] Diane Powis, PhD: [00:12:12] Exactly. These are women. These are women.
[00:12:14] Patrick Swift, PhD, MBA, FACHE: [00:12:14] experience. So, you what's ASPIRA  doing to help be part of the solution.
[00:12:18] Diane Powis, PhD: [00:12:18] So ASPIRA as mission is to, , globally transform women's health, starting with ovarian cancer. Okay. , And when they say women, they, they mean all women, all ages, stages of life, all races, ethnicities, socioeconomic status. , they really are doing everything they can to, , treat all women the same and have their products available to everybody. , and remove some of the disparities that exist in healthcare for women, because they're really they're out there. , To the fact that their chief spokeswoman, I think speaks to the company and their real desire to
[00:12:57] Patrick Swift, PhD, MBA, FACHE: [00:12:57] A patient being you, you as the chief [00:13:00] spokeswoman.
[00:13:00] Diane Powis, PhD: [00:13:00] would be me. Yes. , they really want to understand the patient's journey and, , think about, you know, what's important as they develop their products and deliver them to the public, to providers.
[00:13:11], and they, they want to really be a support, , in that way. And I think that's quite unique in this world as a public company. You know, there are a lot of healthcare companies out there that develop products and they forget that they're really treating. Patients, and this is about saving lives and these are real women and these are real lives they're talking about. So
[00:13:30] Patrick Swift, PhD, MBA, FACHE: [00:13:30] Amen to that, to
[00:13:32] Diane Powis, PhD: [00:13:32] yeah. So what they're trying to do is develop, , comprehensive, , risk assessment products, tools that can be used. There's no screening tools, as I said, but the real focus is how do we take that 80% late stage and flip it and have women. Who, , and in a system where this can be discovered and detected at a much earlier stage, because the [00:14:00] saddest part of all of this, that women are dying is it's preventable. It does not have to be this way. , so the way
[00:14:08] Patrick Swift, PhD, MBA, FACHE: [00:14:08] a part of that. I encourage people to follow ASPIRA health on LinkedIn to find out what they're up to though. And there again, they're not there. There's no incentive for me to say that I, I it's, as far as health is doing the right thing and they, uh, they're worth following.
[00:14:21] Diane Powis, PhD: [00:14:21] we've developed, , biomarker tools. These are, , protein biomarkers, and it's a simple blood test. One in five women will have a pelvic mass at some point in their life. And, , and with that pelvic mass many will have to contemplate a surgical procedure to address the mass. What currently is the standard of care is to use the CA one 25 bio-marker um and it's a test that's been around a long time.
[00:14:52], but it's really insufficient. It does not pick up early stage disease. For ovarian cancer. What they've developed is [00:15:00] ovo  one. Plus they've done a tremendous amount of research with, you know, large studies with large populations of women with pelvic masses. They've directly compared ovo one plus to , the CA one 25. And if they. If you sort of did a meta analysis of all of those studies that they've done, the sensitivity of the CA one 25 is much lower. In fact, it's around 65% to pick up stage one and two early stage ovarian cancer for women with pelvic masses. Whereas the OVA1®PLUS is at 91%. So there's
[00:15:38] Patrick Swift, PhD, MBA, FACHE: [00:15:38] plus.
[00:15:38] Diane Powis, PhD: [00:15:38] OVA1®PLUS
[00:15:41] Patrick Swift, PhD, MBA, FACHE: [00:15:41] OVA1®PLUS, yeah, you lost me on some of the numbers there, but the OVA1®PLUS . I  my listeners. So, you
[00:15:47] Diane Powis, PhD: [00:15:47] Yeah. So
[00:15:48] Patrick Swift, PhD, MBA, FACHE: [00:15:48] then remember the OVA1®PLUS.
[00:15:50] Diane Powis, PhD: [00:15:50] significantly better than CA one 25 at detecting early stage ovarian cancer for women with pelvic masses. Yeah. So, [00:16:00] um, with that being said also for black women, the CA one 25 is just known to be a poor measure. It's the, the numbers come out low. Lower than for white women, um, there, where it's not as good a measure,
[00:16:18] Patrick Swift, PhD, MBA, FACHE: [00:16:18] sensitivity is weaker.
[00:16:20] Diane Powis, PhD: [00:16:20] the sensitivity is weaker for black women versus the ovo one. Plus that disparity doesn't exist between white and black women. So, you know, it's another reason to think about, you know, what to do. The problem is. Women aren't aware of to ask for OVA1®PLUS providers are very uncomfortable with making change sometimes and they go with the standard of care because that's what they know.
[00:16:46] And they unfortunately miss  a number of early stage diagnoses and time loops forward. , ASPIRA is also doing a lot of continued research. , they're working towards. , further [00:17:00] developing their over one product. There's a lot of pipeline coming down, , with, with the research that they're doing to continue to monitor the women who have pelvic masses and also monitor women who have a high risk from a hereditary standpoint of ovarian cancer.
[00:17:16], the second that they have right now is called genetics with an X and it's. It's a very, uh, specialized genetic test for. , the mutations that could be connected to a gynecological cancer. So, , there are 33 potential mutations that are included in the test and it allows women to really have the knowledge of their genetics.
[00:17:46] There's nothing, there's no substitute for that because that's really the only way to prevent the disease, , is to know you have a genetic predisposition. , and it's, it's something that, you know, in my story, for [00:18:00] example, I have a very significant history of breast cancer in my family. My mother was diagnosed at age 40.
[00:18:06] She died at 48. Um, I have a number of great aunts who had breast cancer. , clearly that should should've rang a bell with any of my doctors. Over the years, I was very, , conscientious of. Of, , you know, I will not go down with breast cancer. So I was really vigilant. It was in a high risk program. , but I had no idea there was a genetic link between breast and ovarian cancers.
[00:18:32] Patrick Swift, PhD, MBA, FACHE: [00:18:32] not about  OVA1®PLUS, and this also in the pipeline, the genetics
[00:18:37] Diane Powis, PhD: [00:18:37] Oh, it's out. It's not
[00:18:39] Patrick Swift, PhD, MBA, FACHE: [00:18:39] Good. Good, good, great, good, good, good, good. We got enough. Love to ASPIRA . And what they're doing, focusing on you also, um, I want to talk with you about your experience. Diane, what was it like in finding your voice to, to you?
[00:18:52] Didn't just wake up one day and say, I want to be a spokeswoman.
[00:18:54] Diane Powis, PhD: [00:18:54] No.
[00:18:55] Patrick Swift, PhD, MBA, FACHE: [00:18:55] what was the journey like for you and finding your voice? And I understand there's a little book, project
[00:19:00] [00:19:00] Diane Powis, PhD: [00:19:00] Yes.
[00:19:02] Patrick Swift, PhD, MBA, FACHE: [00:19:02] I love to hear about your finding your voice and this book you're working on.
[00:19:05] Diane Powis, PhD: [00:19:05] Thanks for asking about that. , yeah. You know, I think like so many women, , I grew up. , I grew up in the seventies, , but I think we're socialized a certain way. And I, I, my, my take on that is, you know, how to be a good girl and how to be compliant and listen to authority and not necessarily speak up and be an advocate.
[00:19:31], and I feel like, you know, there's that aspect of it for me. , and I'm also an introvert and I'm a private person. , and I have been my whole life, however, being faced with my mortality at, , you know, once I was diagnosed and recognize the severity of my situation and that, you know, I had a five-year prognosis and 39%.
[00:19:55], so I, I sort of realized I had a [00:20:00] choice. This was the crossroads for me. I could either. You know, like a raft without a paddle B be pushed through the system as a cancer patient. And, , like I was bounced from doctor to doctor, just not take charge of things in a way that would give me some semblance of control or start to speak up for myself and, and advocate for what I felt was best in terms of my care and all my treatments.
[00:20:26] And. , there are a lot of examples of that, but it really helped. And I think that translated ultimately to reaching out to others, you know, realizing I'm not the only one with ovarian cancer, connecting to other women and learning how many of them. Shared a very similar story of late stage diagnosis that could have been prevented because of misses, misdiagnoses blowing off symptoms, you know, attributing them to perhaps manifestations of stress. , for example, one woman was [00:21:00] given anti-anxiety pills and told, you know, because her belly's ex just, ,
[00:21:05] Patrick Swift, PhD, MBA, FACHE: [00:21:05] extending and there, yeah.
[00:21:07] Diane Powis, PhD: [00:21:07] she's, you know, sick or just not feeling right? Oh, it's anxiety. Um, you know, so many stories that I realized, you know what, I'm not alone in this. And
[00:21:17] Patrick Swift, PhD, MBA, FACHE: [00:21:17] You are not alone..
[00:21:18] Diane Powis, PhD: [00:21:18] even though my window has long closed for early detection, you know, maybe there's something that I can do to facilitate, , change and.
[00:21:28] Patrick Swift, PhD, MBA, FACHE: [00:21:28] if there's one listener that changes their behavior as a practitioner, or if there's one listener who is a partner and advocates for their. Their loved one to go through this, get this kind of testing or a potential patient themselves who may be brewing some ovarian cancer to be aware of this demand, you know, your lips to God's ears that, uh, this be heard and, and, um, even just saving one life.
[00:21:53] Um, but imagine getting this message out there more and more. So the what's the title of the book that you're working on it.
[00:21:59] Diane Powis, PhD: [00:21:59] thank you. [00:22:00] Um, the book is called what's a good girl to do. Records and revelations of a cancer survivor. And, um,
[00:22:07] Patrick Swift, PhD, MBA, FACHE: [00:22:07] Do you have a publisher?
[00:22:09] Diane Powis, PhD: [00:22:09] I'm working on
[00:22:10] Patrick Swift, PhD, MBA, FACHE: [00:22:10] All right. So we'll put that include those show. Diane Powis on LinkedIn.
[00:22:14] Diane Powis, PhD: [00:22:14] want to publish
[00:22:14] Patrick Swift, PhD, MBA, FACHE: [00:22:14] she needs a publisher folks. Um,
[00:22:17] Diane Powis, PhD: [00:22:17] It's with an editor right now.
[00:22:19] Patrick Swift, PhD, MBA, FACHE: [00:22:19] okay. Well still let's get the word out there.
[00:22:21] Diane Powis, PhD: [00:22:21] yeah. The goal is to get it out there though, and, you know, try to make a difference if I can and be heard.
[00:22:27] Um, but yeah, you know, women, women do need to know. And, you know, uh, just the opportunities that came my way to speak up. I just couldn't say no.
[00:22:37] Patrick Swift, PhD, MBA, FACHE: [00:22:37] Yeah. God bless you for doing that. And, uh, more power to you, and that is your call to action, um, for folks to act based on this information and, and save a life and it may be your own or one that someone that you love. And so this may be a good time to ask you then, um, um, if you had an opportunity.
[00:22:56] To speak to all the healthcare folks around the whole planet. You had [00:23:00] other attention for a brief moment. Diane, what would you say to them?
[00:23:05] Diane Powis, PhD: [00:23:05] Well, that would be incredible. I know how busy and overwhelmed a lot of healthcare folks are. Um, I would say, uh, a couple of things, first of all, please, you know, I know you're busy. I know you work so hard and not saying, you know, these are good people. These are people who have entered a profession to help others.
[00:23:24] And with all good intentions, do no harm, you know? Um, but I would say, please, please get educated. Learn about. Ovarian cancer, you know, other gynecological diseases and problems like endometriosis. It's another one that's often missed overlooked, shunned aside for women. Um, they go years without, without knowing what's wrong with them.
[00:23:49], but please get educated. , know the symptoms, know the early warning signs. , learn about Aspira's  products. I mean, you know, if your go-to is the CA [00:24:00] one 25, if you have a woman with a pelvic mass who's contemplating surgery, please look into, you know, the ovo  one, plus it's FDA cleared. It's been around for 10 years now.
[00:24:11] So no excuse let's let's think about what better options exist out there that. All the mechanisms are there. The technology's there that the scientists have developed this, please take advantage of it. I would also say too. My group of healthcare listeners, please, please listen to your patients. Um, I know time is limited.
[00:24:36] Your schedules are busy. You know, the, the drive is to get through a lot of people and maybe your waiting room is full and, and, you know, you're, you're just trying to get through your day and you have so much to cover. So when a woman comes in wondering, you know, something's really wrong with her, if she's having these pelvic.
[00:24:55] Pains and discomfort, please stop and listen, and [00:25:00] think comprehensively. Try to get a full picture of what's going on. What brought her to you? What other symptoms and problems she has been experiencing lately? Has she, what other doctors has she seen coordinate care with those other doctors so that you're not operating in that vacuum of your specialty because you're gonna miss it.
[00:25:20] You're gonna miss it. And, um, it's so important to think comprehensively so that, you know, women have. That chance, you know, that window of opportunity with early detection, they're not going to the gynecological oncologist. At that point, they're going to their GP. They're going to the gastroenterologist, the urologist, the chiropractor.
[00:25:43] These are the folks that have the opportunity to catch it early. And, um, it's just so important that they pay attention in a certain way. Take a history. And also consider genetics for women. I think a lot of doctors think about genetics. Testing is a [00:26:00] nice option sometimes, but it's essential. Knowing a woman's knowing her genetics could make the difference between life and death and give her choices about, um, prophylactic surgeries, ways to prevent completely prevent.
[00:26:17] Breast cancer, ovarian cancer, and other other issues and problems, um, and a lifetime of pain and suffering and medical uncertainty, and, um, real real hit to the quality of life
[00:26:34] Patrick Swift, PhD, MBA, FACHE: [00:26:34] A passionate and comprehensive full of heart, um, call to action folks. Um, if you take one thing away, it's listen to your patients. The of a one, plus the, the, the genetics testing, the, the whole context to all of it. Um, there's so much that you share Diane. I'm so grateful for what you have to say and for your heart and your passion for this, and, um, the takeaway to listen to your patients and [00:27:00] really it's to listen to one.
[00:27:00] And also it's still to listen to one another, um, in the work we do, um, we, we need to care for one another and, and the signs, the signs are there. If we, if we, um, listened to our heart and listened to our gut and pay attention to it.
[00:27:15] Diane Powis, PhD: [00:27:15] And you can tools available. Um, and also, you know, it's, it's about all the women in our lives. You know, I think about my daughter who has a 50% chance of. Of inheriting my Brock of mutation. Um, but it's not just about her. It's about all of our daughters, our mothers, our sisters, wives, friends, you know, the list goes on and on.
[00:27:39] Um, you know, please think about what can be done for prevention and really change the story for women.
[00:27:48] Patrick Swift, PhD, MBA, FACHE: [00:27:48] changing the story about there we go  or we're talking about change. The story is to Advancing Women's Health, Change the story with Diane Powis , Dr. Diane Powis . Diane, thank you so much for being on the show. It's been [00:28:00] a pleasure and an honor, and thank you for your message and your heart and, and all that you shared. I really appreciate your, your being here.
[00:28:06] Diane Powis, PhD: [00:28:06] Thank you for having me, Patrick, it's been a pleasure. Thank you!
Special Note:
Dr. Patrick Swift/Swift Healthcare do NOT have any financial relationships with any commercial interests with Aspira Health. Dr. Swift invited Dr. Powis on the show because they are grad school friends and Dr. Powis has an amazing and powerful story to share with the world. The information in this episode is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this video podcast/web site is for general information purposes only.
 

15. Influential and Effective Leadership for Good w/ Michael Frisina, PhD, MBA, LTC(R)

In this episode, we explore the four fundamental human needs, strategies for developing your influence as a leader, and best practices to not only increase your effectiveness but also build your character as a person who does good in the world.
What are our four fundamental human needs as individuals and leaders – and how do highly collaborative relationships and social networks meet our needs as individuals and leaders? Tune in and find out!
Our guest is Michael E. Frisina, founder and president of The Frisina Group, LLC. and The Center for Influential Leadership who is responsible for teaching, publishing, and speaking on the current trends in organizational performance.
Dr. Frisina serves as Chairman of the Health Administration Advisory Council for the American Public University/American Military University and is also an Executive in Residence with The University of North Texas School of Public Health.
Dr. Michael Frisina links:
https://www.thefrisinagroup.com/
https://www.linkedin.com/in/michael-e-frisina-phd-ltc-r-united-states-army-717a9614/
Music Credit:
Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Transcript:
Influential & Effective Leadership for Good w/ Michael Frisina, PhD, MBA, LTC(R)
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast.
[00:00:03] I'm Patrick Swift. And I'm delighted that you're here listening, watching, and we have a fantastic show for you. And the focus of our show is influential and effective leadership for good. And we have the illustrious Michael  E. Frisina . Michael, welcome to the show.
[00:00:22] Michael Frisina, PhD, LTC(R): [00:00:22] Thank you, Patrick. Great to see you. Great to be with you.
[00:00:25] Hello everyone.
[00:00:26]Patrick Swift, PhD, MBA, FACHE: [00:00:26] . Thank you Michael, for being here and folks, let me share with you. Michael's bio. This is impressive. And here we go. Michael E. Frisina is founder and president of the Frisina group and the center for influential leadership. Responsible for teaching. Publishing and speaking on the current trends and organizational performance, Dr. Frisina  is a retired career officer of the United States army medical department, and a former civilian healthcare executive. He served in multiple roles in his career. Uh, currently he serving as, uh, including all the work he's [00:01:00] doing as chairman of health administration advisory council with American public university American military university.
[00:01:06] He's the author of two books, influential leadership. Change your behavior, change your organization, change healthcare. I love that title and leading yourself to a higher level of performance. And he's working on a third book right now. All right. With the ACHE . Is that right? Michael? Yeah.
[00:01:22] Michael Frisina, PhD, LTC(R): [00:01:22] Health administration press titled effective leadership behavior.
[00:01:26] Patrick Swift, PhD, MBA, FACHE: [00:01:26] Awesome. This is great. I'm excited. I'm looking forward to seeing that, um, you've authored over 50 papers and published articles on leadership and organizational effectiveness, and he's a longterm ACHE faculty member in the executive leadership track and two-time educational grant awardee. And lastly, I'll share he's an executive in residence with the university of North Texas school of public health. Welcome Michael.
[00:01:50] Michael Frisina, PhD, LTC(R): [00:01:50] Thank you, Patrick.
[00:01:52] Patrick Swift, PhD, MBA, FACHE: [00:01:52] Yeah, man. And as a salute to Texas, um, for those of you watching the show, I've got my cowboy hat here. This is a 10 gallon resist all [00:02:00] hat and being a native Texan. I just have to, I have to throw out some, some heres to Texas, uh, for, um, for the show. And Michael, I want to begin by saying thank you for your service,
[00:02:11] Michael Frisina, PhD, LTC(R): [00:02:11] well, thank you. I'd still be doing it. If they didn't tell me I was too old, but I still, I can still pass the old physical fitness test. I don't know. I can do the new one, but I can still do the old
[00:02:20] Patrick Swift, PhD, MBA, FACHE: [00:02:20] one. That's fantastic. I wish I could say that. Um, but thank you for your service and my pleasure in honor of, um, veterans.
[00:02:28] Um, there's two things. One I want to bring up folks, um, is I'm a regular contributor to the wounded warrior project, monthly contribute my wife and I support the wounded warrior project. Um, very supportive of that. Um, and if you watch my show, you know, I drink a lot of coffee. And, um, I'm constantly sipping on my coffee as I'm talking to my guests and I have some coffee that someone sent me.
[00:02:51] This is not a paid endorsement. Um, this is just, uh, a dear colleague of mine sent me Trident coffee, um, which is a veteran owned business. So we need to support our veterans. [00:03:00] And it sounds a little like mariachi and their son of a son of a sailor is, um, uh, organic Mexico, choppa Chiapas , us and my Mexican grandmother.
[00:03:09] I is from Chiapas , the, the birthplace of, uh, some very, um, uh, socially progressive, uh, leaders in Mexico for a revolution. And certainly we need a revolution in healthcare. So a lot of good stuff to throw out here in the beginning of our show, and
[00:03:25] Michael Frisina, PhD, LTC(R): [00:03:25] it's not bad coffee. Uh, if you'd like to, uh, Try it, um, it's Navy coffee.
[00:03:30] It's not army, you know, army good army coffee. You can stand a spoon up inside a cup of coffee, but as the Navy goes, you know, go army beat Navy, um, former faculty at West point, I've got to make sure I stay true to the core. So, um, go army beat Navy, but it's not bad coffee.
[00:03:50] Patrick Swift, PhD, MBA, FACHE: [00:03:50] Uh, for an army guy, uh, saying that about me coffee that's high praise. So, uh, Dr. Frisina , thank you. And, and, um, we've got a good sense of humor at the same time. [00:04:00] You know, we've got some good content for you. Um, uh, and we're going to be talking about, um, effective leadership, influential and effective leadership for good. So let's get right to it. So starting with influential leadership, you and I had a little brief conversation before, and what we started touching on was fascinating to me.
[00:04:16] And I want you to you to ask you to share with us. From your framework in all your experience and the perspective you've had. You've distilled a lot of great content for folks who are listeners, whether you're a leader or you're an aspiring leader. I don't care if you're in high school. I don't care if you're a 68 year old CEO of a hospital, we all can learn about leadership.
[00:04:36] And this show is about best practices. As about understanding leadership and new, a new, a new, even if you're a black belt, if you maintain a white belt attitude, you can learn more and you can be better and you can do good. That being said, let's talk about the four fundamental human needs. Dr. Frisina .
[00:04:53] Michael Frisina, PhD, LTC(R): [00:04:53] Sure. If, if leadership is anything, it's a social activity. We live our lives in a variety of social [00:05:00] networks. Our family is a shelter network. You have a group of friends and colleagues you can serve and service organizations, and then you have work. And if work isn't anything, the workplace, it's a network of social activity.
[00:05:12] So because of that, we can look at what, what I. Like to base the majority of our work on is the brain itself and how the brain functions from a physiological perspective, not psychology, but neuroanatomy, the different parts of the brain and different parts of the brain and how they interact. Uh, as we engage in these social networks and the neurochemicals that are stimulated from.
[00:05:35] Uh, social network behavior, uh, very simply, you know, the idea of leadership for good changing the world for good relieving. Some of the burden, the pain, the chaos of the world around us, you know, there's enough behavior that contributes to evil. We need to be focusing on behavior that focuses on contributing good and overcoming the evil with good.
[00:05:56] And so fundamentally the whole idea of [00:06:00] influential leadership and how you measure your effectiveness. As in your leadership behavior, there is no more critical element to your teams. Being able to function, to work, to focus on your objectives, to line objectives, to key results to you, getting the results you desire as a leader, then your individual leader behavior.
[00:06:17] And so the foundational thought that I had that got all of this started. Patrick about 10 years ago, was this one thought that individual leader behavior is the single most important predictor to how a team performs and believing that to be true. I wanted to be able to have science-based approach to proving it.
[00:06:36] And so we turned at that time about 10 years ago, this burgeoning growth in neuroscience and discovering parts of the brain and neurochemicals and how the brain works. And one of those very quickly as an example, leading to these four fundamental human needs of social networks and how we exchange and pour into each other.
[00:06:53] And these four fundamental human needs was simply through the act of kindness. Uh, we know that, uh, when [00:07:00] you engage in an act of kindness or someone does an act of kindness to you, and this is what's really amazing. If you just observe an act of kindness, you watch somebody else, right. In kind to somebody else, your brain responds exactly the same way and releases a neurochemical called oxytocin and oxytocin is essential.
[00:07:18] High levels of oxytocin are essential for creating connection in social networks. So that leads to then to, well, what is it? And fundamental, legitimate human needs in any social network, within a family, within service communities within work, and they are trust, compassion, stability, and security, or I just like to say safety because it brings stability and security together.
[00:07:42] So we have trust, compassion, safety, and hope. So as a leader, if you can find ways through your behavior to do tangible acts into the life of another person. That manifest a neurochemical response and neurophysiological response in brain [00:08:00] cells, wiring together, firing together as the neuroscience community likes to say neurons that fire together wire together.
[00:08:07] So
[00:08:08] Patrick Swift, PhD, MBA, FACHE: [00:08:08] as a neuropsychologist, as a neuropsychologist, I endorse that statement
[00:08:12] Michael Frisina, PhD, LTC(R): [00:08:12] and yeah, and see right now your upper brain is just blowing up and we'll talk about the upper brain momentarily.
[00:08:17] Patrick Swift, PhD, MBA, FACHE: [00:08:17] The caffeine I'm drinking or well,
[00:08:19] Michael Frisina, PhD, LTC(R): [00:08:19] That that'll do some of it short term, but that dopamine and some neuro epinephrin and a goodly amount of oxytocin just from the social exchange that we're having right now.
[00:08:31] Uh, so this, you know, and this goes to points of influence at work. So as a leader, you know, um, and I talk about leaders showing up. Let's say, for example, your team is in a conference room waiting for you to show up for the meeting and you walk into the room, does their upper brain, the prefrontal cortex, the cingulate cortex that lies just below it.
[00:08:52] You have your prefrontal cortex right up here. And the singular cortex sits right underneath it. That's where all your executive skill sets are. [00:09:00] That's where your decision-making process skill is. That's where your competency skill is. That's where you manage perspective on decision-making your strategy, the plan that you've created.
[00:09:11] So everything related to process and execution is right up here in a prefrontal cortex, but there's another part of the brain. I just call it the lower brain. Uh, neuroscience research has found a clump of different types of brain anatomy that they just have now referred to as the limbic brain. And that's the emotional brain.
[00:09:29] And that's what your process, how am I feeling about what I'm experiencing? So the influence dynamic of a leader. Is are people willing to follow you? Are people willing to execute your plan? At high levels of performance outcomes are people engaged in their work? And, and my definition of engagement differs from the literature to the degree that that for me engagement is if you've got people waking up in the middle of the night, disappointed, it's not time to go to work yet.
[00:09:56] You've got leadership influence. Now that's an ideal obviously, but [00:10:00] if you aim at the ideal and you strive at the ideal somewhere, Between where your teams are now and where they could be. You're going to raise a level of performance excellence. And at the end of the day, while we make how we behave toward people and end in of itself, how we create high, effective, uh, and highly collaborative relationships and these social networks by meeting these four fundamental human needs as leaders, we now can take that.
[00:10:27] In itself as an end in itself and use it as a means for driving performance and getting results and what that means in the lives of others. And particularly in healthcare that translates to performance and high levels of safety, higher levels of quality and higher levels of patient experience. So performance then becomes a function of two skill sets.
[00:10:44] Your executive skillset. In your prefrontal cortex and your behavior capacity, how you're affecting the emotional component of someone else's brain, the limbic brain, and for fun, uh, in my teaching sessions, coaching sessions, I just like to call this neurochemical [00:11:00] bartending. If you know how to mix the right drink in somebody's head,
[00:11:03] that's my leadership style.
[00:11:04] They'll follow you anywhere. They'll follow you anywhere. Now. Here's the thing,
[00:11:09] Patrick Swift, PhD, MBA, FACHE: [00:11:09] Neurochemical bartender! 
[00:11:10] Michael Frisina, PhD, LTC(R): [00:11:10] Your, your team members, your team members get to bring the mixers. But you, as the leader provide the main ingredient, I
[00:11:17] Patrick Swift, PhD, MBA, FACHE: [00:11:17] Amen to that.  That. I meant to that I, I love that you've touched on so many  and so many elements here of engagement of neuroanatomy of, uh, the, the four fundamental needs that you're touching on.
[00:11:28] And you also said, That when folks aren't waking up in the middle of the night, excited about going to work. Um, you've, you've got, I think you said a problem there. If you're not having folks fully engaged, how let's I want to unpack that Michael, because I resonated with it because I have worked in environments where I could not wait to get to work.
[00:11:55] And I've worked in environments where I dreaded going to work and it's [00:12:00] all, well, that's a larger as to larger statement. It is largely due to the leader. Right. And, um, my question to you is whether you are a frontline worker, whether you're a middle manager or you're the senior executive in an organization, he, she or they are in those roles.
[00:12:18] Tell me what a listener right now can do to address their own needs, because we've spoken about neurochemical, bartending and leadership. Amazing. I love that idea. I'll be thinking about that all day. Um, but I also want to drive it toward what can individuals do to address those needs?
[00:12:36] Michael Frisina, PhD, LTC(R): [00:12:36] Well, the first thing is we've heard recently, particularly the last year because of the pandemic, but even before then, people didn't take seriously the idea of self care.
[00:12:47] Uh, leaders, uh, tend not to think of themselves as champions as I like to refer to it. You know, if you're an Olympic athlete you're involved in a tremendous amount of self care, [00:13:00] do your exercise, your diet, your sleep regimen, you're avoiding, uh, bringing toxins into your body through cigarettes and, and consumption of too much alcohol.
[00:13:10] Right? A little wine in moderation. Yeah. You know, that type of thing, but, but excessive use of alcohol, there's a whole source of things. So stress, dynamic, and inability to relieve stress or to avoid stress. You know, there's this phenomenon that you're aware of. I'm sure called an Allostatic Load.
[00:13:27] Whenever you're put in a threat environment that lower brain just lights up like the 4th of July. And that's a good thing because we want to be able to recognize I'm at risk. There's a real threat here. My life could really be in danger in a military scenario that saves your life. Many times is this rapid, immediate, acute stimulation of threat response and the cortisol that comes with it as a neuro hormone, that's letting you know, you're at risk.
[00:13:52] Do something, respond, react, take action for survival, but when you're not in a real threat [00:14:00] environment and that threat is perceived or that threat is, uh, more emotional. Than it is physical because of the dysfunctional energy exchange of behaviors in your social networks. And you're getting cortisol day after day after day after day, you now get what becomes an Allostatic Load.
[00:14:17] And we're all familiar with the, the metaphor, the straw that broke the camel's back. You get to a point where this Allostatic Load removes the homeostatic functioning of your brain. And when that happens, it's like a light switch goes off and your prefrontal cortex just turns off. You lose the ability, both cognitive and emotional and physiological ability to connect to the part of the brain where all of your performance skillset resides.
[00:14:44] Patrick Swift, PhD, MBA, FACHE: [00:14:44] And so your ability to make decisions declines , your ability to make good decisions declines, , right?
[00:14:50] Michael Frisina, PhD, LTC(R): [00:14:50] Execution of the plan declines , uh, you don't come to work ready to connect with and engage and aligned to the key objectives and advanced the key objectives of the organization's [00:15:00] to results you're coming to work to survive.
[00:15:02] Patrick Swift, PhD, MBA, FACHE: [00:15:02] Yeah. So Michael then. For a listener right now. Yes. Think being aware, great imagery, athletes take care of themselves. Health care providers, leaders, people in general, don't prioritize self care in general because not the part of the professional identity. I'm a professional athlete. Therefore I need to stretch in the morning, um, as a professional healthcare folks, whether we're leaders or providers, we don't stretch in the morning.
[00:15:27] We just go right into work. So, um, we're talking about those needs. So I want to hear from you, what can folks do to address those needs on a regular basis? What's a best practice one. Um, and let's talk about the influential leadership piece to it as well.
[00:15:42] Michael Frisina, PhD, LTC(R): [00:15:42] Yeah. I call it an executive fitness. Patrick, you need to create a fitness regimen to be an effective leader. If you, if you lack physical energy, but if executive work. Requires anything. It requires a large degree of stamina because typically [00:16:00] the length of the Workday that most executives put themselves into. And so the, the physical energy, uh, and that goes right to the first idea of the amount of sleep you're getting.
[00:16:10] Well, I think
[00:16:10] Patrick Swift, PhD, MBA, FACHE: [00:16:10] all of us, not just the executives, I've been an executive, but it's also the nurse reporting to work.
[00:16:16] Michael Frisina, PhD, LTC(R): [00:16:16] This applies to anybody, right? Yeah. Please.
[00:16:18] Patrick Swift, PhD, MBA, FACHE: [00:16:18] All of us, I hope everyone's listening. This is helpful.
[00:16:21] Michael Frisina, PhD, LTC(R): [00:16:21] Sleep deprivation is a major impediment to cognitive performance. So when you're tired, you're not only lose dexterity, you know, manual physical, uh, ability in the use of your hands and eye coordination.
[00:16:35] Uh, but you, you don't have physical energy. You, you physically wear out and then as you start to physically wear out, then you can start to emotionally and mentally. Uh, fatigue. Uh, so the idea of performance fitness, uh, you know, whether it's executive fitness or if you're a frontline folks, you know, you've got to be in a position, uh, spiritually, emotionally, mentally, and physically to come to work, [00:17:00] uh, and, and, and perform.
[00:17:02] Work is about performance. So if you've ever gone, if you ever gone to a play and, and you, you watched actors on stage and they were slow and they were sluggish and they weren't quick to pick up a line. You sat there and disappointed. And what do we say? We say that was a poor performance. Yeah. Uh, if it's a concert pianist or a violinist, you know, we evaluate based on our perception and experience of the performance.
[00:17:31] Well, work is no different than that. Uh, and this is why, again, getting back to the four fundamental needs, leaders need to behave in ways, very tangible, real ways. that are  an expression of building trust, because if you don't have trust, you don't have connection in social network. If you don't have connection, social network, you don't have engagement.
[00:17:48] These are literal cause and effects. Physical cause and effect relationships that line up with each other.
[00:17:54] Patrick Swift, PhD, MBA, FACHE: [00:17:54] So let's talk about Michael let's then talk about influential leadership. So I'm making a [00:18:00] commitment to one's own executive fitness, whether you're an executive or whether you're aspiring executive or whether you're a frontline worker.
[00:18:06] What you're teaching Michael is making a commitment to your own wellbeing. Yes, fundamentally. And then as a leader, whether you're a formal leader or an informal leader or someone, part of a social network that you want to have influence, how do you know when you're having influence and how do you build that in?
[00:18:25] Michael Frisina, PhD, LTC(R): [00:18:25] Yeah. Before I answer that question, I just want to make one more statement about this idea of self care. You know, we had the notion of self care long before the pandemic, the pandemic just sort of exacerbated and brought a higher degree of alertness awareness to it because of what was happening. To frontline healthcare workers as they try to engage work every day.
[00:18:45] But the reason people tend not to do it, Patrick, cause they don't have self-compassion. We will love our pets and care for our pets in ways that we don't care for ourselves. We will care [00:19:00] for total strangers, uh, you know, wounded warrior project, and we will volunteer and care and express compassion to total strangers.
[00:19:10] And not do it to ourselves. The first mental thought that needs to change because I'm people who around me a lot. And I have some groups that I meet with on a regular basis, uh, in, in, in just sort of pro bono way of helping them with life. And the challenges of life is nothing changes to your thinking changes.
[00:19:30] So until you can change your thinking about yourself and you can love and care for yourself. As if you believed your yourself was worthy of that care that you give away to others, then it's very hard to build the discipline and the diligence into tangible behaviors for improving the level of self care.
[00:19:50] Patrick Swift, PhD, MBA, FACHE: [00:19:50] Beautiful point.
[00:19:51] Michael Frisina, PhD, LTC(R): [00:19:51] You've got to be willing to care for self have compassion. Self-compassion so, um, That translates directly then [00:20:00] into how leaders can build influence with their teams. Because if you can express that very idea into the lives of others, you're making a neurochemical and neurophysiological to connection with people that they'll want to be around.
[00:20:13] You they'll want to be with, you they'll want to work for you. They'll want to make sure that you achieve and achieve results as a leader. So back to this idea, if your team is waiting for you in a conference room for a meeting, And you walk into that room. What happens to the brain, to their brains at your presence?
[00:20:32] Is there a prefrontal cortex lighting up? Are they ready to engage? Are they ready to perform? Are they ready to go? You know, you know, uh, have a killer day at work, if you will. And just. You know, knock out all that work in a highway, a performance outcome, uh, or when you walk into the room deserve for brain shut down, do you exacerbate?
[00:20:49] Do  do you antagonize their lower brain is your very presence as sense of threat to them. And so we've heard this phrase about leader presence or executive presence, and it has a whole [00:21:00] list of traits, and I'm not a big fan of trait theory for leadership or leadership effectiveness. I'm about your behavior and here's why your behavior is real.
[00:21:10] I get to see it. I can measure it. Um, imagine if everybody in your team meeting in that conference room, waiting for you was hooked up to a biometric device with a video screen over their head recording elements of homeostasis, blood pressure, internal body core temperature. The releasing of cortisol, you know, and you walk in a room and you could see signals on a screen.
[00:21:34] It looked like they're having tachycardia. You'd have visible evidence that you just showed up and they're not connecting and you don't have any influence.
[00:21:44] Patrick Swift, PhD, MBA, FACHE: [00:21:44] Now we've got to have it as a you're the problem.
[00:21:45] Michael Frisina, PhD, LTC(R): [00:21:45] Yeah, exactly. Now, ironically, somebody is making a wristband, some kind of watch that will we'll give some biometric feedback.
[00:21:54] Somebody is trying to do that. You know that, that you will get this kind of, uh, response [00:22:00] dynamic real time. Um, so, uh, that's, that's the whole point of this, right? And the whole idea of effective leadership is in the results, but you don't get the results. You know, you can't be an effective leader, a truly effective leader, effectiveness, meaning are we getting what we're supposed to get in results, leadership, you know, creating strong. Um, highly effective personal relationships in that social network, because leadership is about serving into the needs of other people, not getting
[00:22:32] Patrick Swift, PhD, MBA, FACHE: [00:22:32] let's talk about that. What is effective leadership?
[00:22:36] Michael Frisina, PhD, LTC(R): [00:22:36] Effective leadership is, is, are you getting results? You know, and if you're a leader that doesn't get results, then you're in trouble because ultimately that's the point of having leadership positions.
[00:22:46] Somebody has to be responsible and accountable for the outcomes and results that any organization, whether it's a military organization, a healthcare organization, and, um, non-Profit tax exempt organization, you know, public [00:23:00] institution, a university. Now are you producing a product that you've promised to produce it at a high level of value to other people?
[00:23:09] And we tended to call those people customers, you know, in healthcare, we call them patients creating the patient experience. You know, effectiveness has got to be able to be measured. In results, but that doesn't happen. If a team won't work for you as a leader. So without influence, you're disconnected from the team they're disconnected from their work, they don't produce work at a high level. You're not getting the results you desire as a leader. And that's a testimony to your, uh, lack of influence. Is now measurable and observable in the lack of results that you desire. Yeah.
[00:23:44] Patrick Swift, PhD, MBA, FACHE: [00:23:44] And I know in the work that you do and the, the writing you've done, uh, we're talking about influential leadership. We're talking about effective leadership and effective leadership getting results. And it is, there's so much depth to that as well. Michael. And I know that you can speak to what's behind [00:24:00] effective leadership, and I know that ties to values and you speak very eloquently about that. And I want to ask you, how does, how do values tie into effective leadership?
[00:24:09] Michael Frisina, PhD, LTC(R): [00:24:09] Yeah, it's amazing. The number of people in leadership positions that I get to meet and talk to. And one of the first things I ask them is tell me about your core values. And I get sort of this deer in the headlight look most of the time, uh, occasionally someone will say, Oh, well, let me see if I can remember. You know, your core values, oughta roll right off the tip of your tongue.
[00:24:29] Patrick Swift, PhD, MBA, FACHE: [00:24:29] Courage, Compassion, Joy, Hope!
[00:24:30] Michael Frisina, PhD, LTC(R): [00:24:30] Mine are  integrity, compassion and excellence. Uh, now interestingly enough, the values we typically choose as our core value, uh, emanate  , and flow into behaviors that we typically gravitate to. That's
[00:24:47] Patrick Swift, PhD, MBA, FACHE: [00:24:47] true. And if you don't want your value, if you don't know what your values are, then what is flowing. It's not clear and you're not effective personally, that leads to burnout, correct, personally. [00:25:00] And that also leads to poor leadership as well.
[00:25:02] Michael Frisina, PhD, LTC(R): [00:25:02] Yeah. And it doesn't have to go to the extreme of the engagement, burnout perspective. That's that's something else we could do a whole another discussion about and you've had other. Valuable guests talk about the idea of burnout, but you know, the absence of burnout doesn't mean I'm engaged. It just means I'm not burned out. It doesn't mean I'm not disengaged. It doesn't mean I'm disaffected. It doesn't mean I'm not paying attention, right. It just means I'm not burned out. Yeah.
[00:25:28] Patrick Swift, PhD, MBA, FACHE: [00:25:28] So let's talk about that. The values, value, effective leadership values, and then how that influences.
[00:25:33] Michael Frisina, PhD, LTC(R): [00:25:33] So what your core values serve for you is as a grounding rod, a stake in the ground, every military unit has what are called the colors as a unit flag. Uh, it's it's assembling a symbol and, and, uh, an identification point of where the leader is on the battlefield. So wherever you see the colors, that's, you know where your leader is. So the colors are moving forward. You know, your leaders moving forward, you can move forward with your leader. Um, Shakespeare wrote [00:26:00] about my kingdom for the want of a nail, uh, King Henry blacksmith leaves a nail out of one of the shoes of his horse.
[00:26:07] So charging into battle, the horse throws the shoe, the horse stumbles Henry goes down, the unit flag goes down and the. His army is routed in chaos because they don't know where the leader is. Uh, and Henry is a famous line from Shakespeare is my kingdom for the want of a nail. Uh, and so the point of that is to say that your core values serve as that, that marker that anchor point, that identification point you're going to be in tremendous contextual variables as a leader. In fact, I think that the one thing
[00:26:40] Patrick Swift, PhD, MBA, FACHE: [00:26:40] As a worker too, as a worker too.
[00:26:42] Michael Frisina, PhD, LTC(R): [00:26:42] Yes. And again, I emphasize leaders, but workers are in that contextual variability as well and how it shifts. Uh, but the effectiveness of leaders is managing that context. Uh, and, but you have to manage the context from two perspectives. You have to manage context and the variability of [00:27:00] context from how well is our plan working and how we'll are our people functioning.
[00:27:04] And it's most times people put these in, um, dilemmas. It's either the plan or people or people or the plant take out the, or, and replace it with an end. It's your plan and people you can't separate. And, and oftentimes your real plan are your people, because without them, you can't execute the plan, you don't get results.
[00:27:25] So by managing context, And, and understanding managing context. But what happens when you, as the leader gets under this allostatic load, what happens when your brain is constantly being flooded with cortisol and fear, loss, worry, doubt, anxiety as the leader, what brings you back to homeostasis? It's those core values.
[00:27:43] It's filtering everything back and reminding yourself that you're supposed to be a person whose behavior is a reflection of integrity. So we can't see integrity. Do you ever have, you know, as this values are not observable, But behavior, [00:28:00] that's a reflection of the value is observable and that behavior is also measurable.
[00:28:05] So when we talk about intention, we see behavior in honesty, in truth-telling the lack of duplicity, uh, not lying, uh, you know, not even quibbling, you know, or hedging on something. Uh, when you think of compassionate, we see acts of kindness. That are a reflection of the value of compassion. We excellence. We see people who are committed and they're engaged and they're following through on possibility and they're accountable to the outcomes that they're producing.
[00:28:35] So we see excellence. In behaviors as a manifestation of those core values. So if you don't know your core values, if you've never done a core value exercise, when you're in very difficult times of high stress changing variability, the, the whole VUCA term of, of volatility and uncertainty and chaos, right. And, and all the rest of it. Um, where do you go [00:29:00] to, to regain your sense of composure? Your mental, emotional composure. So then you can lead effectively. It's got to come from core values,
[00:29:09] Patrick Swift, PhD, MBA, FACHE: [00:29:09] and I want to tie that back to what you said earlier about, uh, executive fitness preparedness. You were touching on doing the work of that self compassion for oneself, doing the exercise of being fit and committing to one's own well-being or fitness. And that exercise of being aware of your values as being part of the, uh, logs that go on the fire that can reignite you, which can support you. And I hope listeners, viewers are thinking about today and what can you do today to connect to those values and the wisdom that you're touching on in this beautiful, I'm loving this conversation because we're talking about influential, effective leaders and you've touched on elements of, of self-awareness.
[00:29:57] Of committing to one's own, [00:30:00] well-being connecting to your values and then displaying those in what and behavior. And that is leadership, regardless of what title you have. Uh, you can be pushing a mop and demonstrate leadership and demonstrate profound leadership. So, um, whether, regardless of what role you ran, I love what you're sharing here, Michael, because it's, it's practical, it's useful and it's empowering
[00:30:22] Michael Frisina, PhD, LTC(R): [00:30:22] if you. In your behavior are having an impact and an effect in the life of another person. And you, you, in, in the behavior that you demonstrate. Make a difference in the life of another person you're influencing and you don't even have to add the word leader to it. You're simply being an influencer. And so you can influence look, my healthcare career started in a janitor's closet.
[00:30:49] So I like to see I've gone from the janitors, was it to the, the CEO closet, you know? Uh, and, um, so I've been in the gamut. I know how people treated me when I was a [00:31:00] janitor at my local critical access hospital at 16 years old. And I noticed how people treated me in a C-suite and, uh, you know, oftentimes we don't see, there's an iceberg thing that says, well, who somebody is above.
[00:31:16] The water line and it's all these wonderful things, but they don't see the journey. They don't see the tragedy, they don't see the pain, they don't see the effort of growth. Right. And, uh, so this term fit to lead. It really has a double meaning. If you think about it, right? The there's a sort of, uh, very, uh, much of, uh, what we would call ambiguity two clear meanings.
[00:31:39] Are you fit? To lead. In other words, do you have what it takes to be a leader? The other meaning is, are you fit to lead? Are you worthy of the calling? Do you have the character? Do you have the core values? Do you care about other people? Are you selfless  in your desire? Why do you want to be in a [00:32:00] leadership role?
[00:32:00] You know, I think there's only about 7,000 or just under 7,000 CEO positions in the entire us healthcare system. Now add up the number of MBAs and MBAs and nursing, doctorate degrees, and other sorts of degrees of people who are aspiring to fill one of those 7,000 roughly positions. You know, there, there are far more many people who want them than are available to get them.
[00:32:25] Right. And so the percentage is very small, but the ultimate that the question is why would you aspire for it? What is it about you that makes you want to be. The senior leader of the healthcare organizations. Cause that's what we're talking about. Yeah.
[00:32:41] Patrick Swift, PhD, MBA, FACHE: [00:32:41] Beautiful. Beautiful. Because if it's about you, the reason someone wants to be a CEO is it's about you about themselves. That's a problem. If it's influential,
[00:32:50] Michael Frisina, PhD, LTC(R): [00:32:50] I can guarantee you. If you make getting that position about you, you won't be influential. You won't be able to make a difference in the lives of other people. [00:33:00] And you certainly will not be effective. You might be in that position in short term three to five years, but you do not have sustainability in that position. If your reason for seeking that position is simply to be about you.
[00:33:13] Patrick Swift, PhD, MBA, FACHE: [00:33:13] Amen to that. Let me ask you my favorite question to ask my guests, which is if you were, if you were standing at the top of the world and you have the attention of all the healthcare folks run the whole planet for a brief moment, what would you say to them right now?
[00:33:26] Michael Frisina, PhD, LTC(R): [00:33:26] Uh, first of all, I'd say thank you. Uh, you know, right now, um, serving in any capacity in a healthcare system in our country, uh, in, in the world for that matter, uh, is, uh, the word hero has been used. And it's a word I don't take lightly, but it's a word that I believe in that there, there are people who are demonstrating selfless behaviors that have gone well above and beyond.
[00:33:50] Um, in, in the military, the, the highest award you could receive as a congressional medal of honor. Interestingly enough, the highest number of medal of honor, [00:34:00] winners of the United States army are from the army medical department. They're not the combat fighters, they're not the infantry leaders. I don't mean to offend any of my combat arms, you know, colleagues.
[00:34:11] Um, but it's the combat medic. Uh, one of the most historical story to counts of, of a combat medic with the medal of honor comes from world war II, Okinawa and Hacksaw Ridge, uh, a combat medic. Without a weapon save 58 lives of his compatriots. And he was a Quaker. So he was a pacifist and he wouldn't even carry a weapon.
[00:34:34] And when he was in basic training here in Columbia, South Carolina, where I live at Fort Jackson, he was ostracized. He was beat up by his military comrades and the irony is he never retaliated. Uh, but when he was put in the position where he was required to do his job in his core values, many of the 58 men that he's saved.
[00:34:54] Off of that Ridge were men who had treated him abominably with disdain [00:35:00] and disgust and hatred, and he ended up winning the congressional medal of honor for it. I wish there were ways we could give up something of thanks and to acknowledge the courage. Of those who are still in operational health care, uh, both in, in clinical practices and the support roles before them.
[00:35:20] Um, but to, to that end in your fatigue and, and in that moment of, of desperation where you're just about to give up that last bit of hope, what I would say to you is, remember why you're there. It isn't about you. It's about somebody else. If you can see this portrait behind me, it's the only thing I have hanging in my office, uh, because it's the only thing that constantly reminds me every day that I need to be finding a way to give my life away to others.
[00:35:48] The motto of the army medical department from this world war II print was service above self. Um, and if you can connect to that and you can live in that and your behavior reflects [00:36:00] that into the lives of others. Uh, ladies and gentlemen I'll guarantee you not only it will be influential, but you'll be highly effective and you will live a life that will give you a great lasting joy.
[00:36:10]Majorem Dei Gloriam  Oh, God bless you, Michael. I love your message. And I love the work you do. And want to ask you folks are interested in following up with you. Um, where can they go? What can they do?
[00:36:22] Very easy. https://www.thefrisinagroup.com/ . You can find our website. Uh, I encourage you to connect with me on LinkedIn, Dr. Michael Forcina on LinkedIn. https://www.linkedin.com/in/michael-e-frisina-phd-ltc-r-united-states-army-717a9614/ Um, all of my professional papers are there. They're in an open format. You can start reading through them. Um, and just email me personally. I'll give you my personal email, michael.frisina@gmail.com . I'd love to hear from you. Would love to help you. Uh, we'd love to be a part of your social network, uh, professionally or otherwise.
[00:36:53] Patrick Swift, PhD, MBA, FACHE: [00:36:53] Outstanding outstanding doctor Frisina thank you so much for being a guest on the show. I'm grateful for your wisdom, your service, your [00:37:00] heart, and just thank you so much.
[00:37:02] Michael Frisina, PhD, LTC(R): [00:37:02] My pleasure. Thank you, sir.
 
 

14. Why Engaging Leadership is Better Leadership w/ Dan Edds, MBA

In this episode, we discuss what engagement is all about and what healthcare folks should be expecting from their leaders. The guest is Dan Edds MBA, who for 25 years has been a practicing management consultant, working with state & local government, healthcare, K-12 education, higher education, and nonprofits.
Dan Edds, MBA is the author of 2 books, the first, Transformation Management, and his most recent, Leveraging the Genetics of Leadership, Cracking the code of sustainable team performance. His latest book demonstrates how organizations are revolutionizing the practice of leadership, recreating the world of work, and setting new standards for employee engagement and customer value.
Dan Edds, MBA links:
https://danieledds.com/
https://www.linkedin.com/in/danieledds/
Music Credit:
Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Why Engaging Leadership is Better Leadership w/ Dan Edds, MBA
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to the Swift healthcare video podcast. I'm Patrick Swift. And I want to thank you for tuning in dialing in for watching being here. And I have a wonderful guest for us, Dan EDS, Dan, welcome to the
[00:00:12] Dan Edds, MBA: [00:00:12] show. Thank you. Great to be with you.
[00:00:15]Patrick Swift, PhD, MBA, FACHE: [00:00:15] Well, let me share with everyone your bio.
[00:00:18] This is a good one. Listen to this for 25 years. Dan EDS has been practicing, as a management consultant, working with state and local government healthcare, K through 12 education and nonprofits. He's the author of two books. The first was transformation management and his most recent leveraging the genetics of leadership cracking the code of sustainable team performance.
[00:00:39] Is out and available. And his latest book describes how organizations are revolutionizing the practice of leadership. Recreating the world of work. You hear that he's recreating, not just keeping with the status quo and setting new standards for employee engagement and customer value. Dan, welcome to the show.
[00:00:56]Dan Edds, MBA: [00:00:56] Thank you, Patrick.
[00:00:57]Patrick Swift, PhD, MBA, FACHE: [00:00:57] And I'd like to add also Dan, uh, [00:01:00] uh, doesn't have, I mean, it'd be saying this, but he's also a part of the advisory board and his local salvation army. So thank you, Dan, for your service to humanity. And, uh, I will ring a bell, uh, in celebration of the salvation army for a timeless recording.
[00:01:14] Someone may listen to this in December or maybe July, but, uh, thank, thank you. Support the salvation army, right? Abs absolutely. It's a, it's a, one of the world's fabulous organizations. It truly is. So in our episode today, uh, talking about engagement, talking about driving engagement, talking about, uh, leadership, discussing the intersection of healthcare and leadership, whether a listener is a leader.
[00:01:37] Whether a listener is a aspiring leader, whether someone's just seen a leader, uh, or someone is considering moving into a leadership position or wanting to be part of the conversation. The intention with this show is to. Pop the hood and give a chance to look under the hood about what's going on in healthcare from how we think about healthcare as leaders and as human beings, caring for [00:02:00] human beings.
[00:02:00]And Dan has a wealth of experience helping, uh, executives, helping organizations and helping leaders do better, not just a. Improve the metrics, but also to make a bigger impact on this planet. So, Dan, again, welcome to the show and I appreciate all your expertise. You're bringing to the table here.
[00:02:17] Dan Edds, MBA: [00:02:17] Thank you, Patrick. I'm honored.
[00:02:19] Patrick Swift, PhD, MBA, FACHE: [00:02:19] Yeah. So let's talk about engagement and I'd like to ask you in your own words to define engagement can mean a lot of different things in different people. And you've got a great perspective here on what is it engagement about?
[00:02:32]Dan Edds, MBA: [00:02:32] Well, that's a great question. And, uh, there's a couple of definitions. , but basically engagement means we are intellectually, psychologically and emotionally engaged with our work. , practically the way that works out is we like going to our work every day. We don't see it as drudgery. We see it as a place where we can contribute where we can give our best when we can feel that we are, , our, our voices valued and [00:03:00] respected where we, you know, I say where we can contribute.
[00:03:03] One of the interesting things I've noticed in my consulting journey is. I have never yet found a worker or a team that didn't want to contribute. in spite of what their boss has said sometimes, um, I consistently find that people want to feel good about what their work they want to feel proud of, who they work for. Right. And consistently time after time, after time, I find they are willing to sacrifice personal time so that they could work for an organization or a team that's a high performing.
[00:03:39] Patrick Swift, PhD, MBA, FACHE: [00:03:39] I love that. You said that Dan, because we, and we'll get into this, but you and I both know there's a certain percentage of the workforce that's actively disengaged, right?
[00:03:47] Sure. Sure. But what you're saying is hopeful. And there was a part in back of my mind. I'm like Dan, really? And, , what you're touching on is the hope that, , I think I've said before in another show, people don't choose evil for evil sake. They mistake [00:04:00] it for happiness. And what you're touching on is that.
[00:04:03] People want to make a difference. Even the one who's actively disengaged. If you ask that person, are you a jerk? That person won't say, no, I'm not a jerk. I just don't like the way things are done around here. Or I do want to make a difference. It's just, you guys suck as leaders and your message here. Dan is how can we, as leaders do a better job to engage everyone and not just the top. 87%, uh, who are making that difference. But even including the folks who are actively disengaged and quite frankly, have some good to tell us that we can improve in our leadership.
[00:04:34] Dan Edds, MBA: [00:04:34] Yep. You know, Gallup tells us that within, within the U S right now, uh, two thirds, 65% of the American workforce is either not engaged means they go to, they go to their job, they do their work. Uh, they do what they're told. They don't make any waves and they go home and forget about it. They basically don't care. Um, another 13% are, you know, drilling holes in the back of the [00:05:00] lifeboat. worldwide, that number is 85%. So that is the percentage that's not engaged right now. According to Gallup is in the, in this, here in the States, it's 52%, half of us go to work and we are, we don't care.
[00:05:15]Yeah. If, if organizations that intentionally seek to engage that middle 50%, when they do, they see an automatic bump in productivity and automatic bump in innovation in. Customer satisfaction and Oh, by the way, a huge bump in employee engagement. And they end up with employees that want to be there.
[00:05:39]Patrick Swift, PhD, MBA, FACHE: [00:05:39] That sounds like joy to me. So Dan, tell me, what is your, why behind all this? What, what, what, what about you? Yeah,
[00:05:47] Dan Edds, MBA: [00:05:47] so my, why. , has developed over time. There was never a one point that said, Oh, this is my why, but, uh, I'll give you one example. , it was maybe seven, eight years ago. , I was doing a project for a fairly [00:06:00] sizable state agency. , this agency happened to, , license 450,000 healthcare providers. And, , And they were a certifiable mess. And I can personally attest to having experienced that for licensure with the state agency. And I'm sure other healthcare providers listening to this show have done the state agencies, trying to get their license renewed and all that. Yeah, it was all that. And this group was a mess and, , it was my last, , meeting with the deputy director and, , You know, it was going to take them probably 18 months to implement what, what we had done.
[00:06:31]Uh, but there was some light at the end of the tunnel. And, , I was about ready to walk out the door. I had my coat on, I had my computer bag in my hand. My hand was on the door and almost in a confessional tone. She said, you know, I don't even tell my friends where I work anymore. Oh. And I turned around. I said, why?
[00:06:50]And she said, it's just too embarrassing. And I'd love to say I've never heard that ever before or since, but your reality is I've heard it [00:07:00] dozens of times in various ways in various venues. Um, P. And I come back to the same thing. People want to be excited. They want to be proud of where they work. And when I looked at this particular deputy director in the organization that she was working for, there is no bad people there, but she was working in a system that rewarded the executive leaders for their position and, placement to the governor.
[00:07:27]And they were not working in a system that required them or rewarded them to take care of their people, to take care of their customers, if you will, and to create an atmosphere within the organization or a culture within the organization that people wanted to come to. Um, and when I walked out of her office, the something just struck me out of that. You know, this was a crime, this is, this is real crime, a crime that a bright, smart well-educated caring, [00:08:00] compassionate, hardworking woman would feel embarrassed to tell her friends where she works.
[00:08:06] Patrick Swift, PhD, MBA, FACHE: [00:08:06] Wow. That's powerful. And when I think about. The amount of hospitals across this country. And there's those that are in the top 50%, there are those in the bottom quarter and ratings. So there's possibly a listener. Who's part of a health system or hospital or medical practice. That's in the bottom quarter where they're not proud of where they work and that's not a good feeling. And, and we as leaders have an opportunity. To influence that. So God bless you for choosing to do this kind of work. Number one, Dan too. How can leaders sustain employee engagement and drive quality?
[00:08:49] Dan Edds, MBA: [00:08:49] Yeah. Great question. I'll reference to studies. So you get to the technical part first. Gallup says that 70% of the engagement of employees  is a direct [00:09:00] relationship to their manager. Kind of the old idea of people don't leave their companies or their organizations.
[00:09:04] They leave their manager truth and the MIT Sloan,  management review report that came out right out exactly a year ago. , a report in there said that the number one factor in employee engagement is a spirit of collaboration with the team. Now you could add a lot of things to that.
[00:09:24] You could add what Google has found. Something called psychological safety, where people feel psychologically safe to express themselves, to express an opinion to say, Hey, I don't agree with this direction. Or I have an idea over here and to express those opinions without. It's a fear of ridicule. Um, in my research for the book, I found organizations that said, , we value respect.
[00:09:49] And, and everything is going to be driven off of a culture of respect. I found in the United States army, , I had, I had interviews with two senior officers. One was a full Colonel [00:10:00] member of the special forces, us army ranger, and another one, a retired four star general, who also served in the Clinton administration in a cabinet position.
[00:10:08]I asked both of these guys, , how does the army approach leadership? And they both said we practice servant leadership. And then the next breath they started using a word that totally blew me away. And they started talking to me about love and how to love a soldier. Yes, that's the word? That's the word they used love.
[00:10:31]And, and to my discredit, when I was talking to the Colonel,  I somewhat discounted his perspective because he was also chaplain. Okay. And I, and I thought, okay, he's a chaplain that sort of fits. But later I'm talking with, , his name of general Barry McCaffrey, and you'll still see him on the news. He's a, he's a consultant for NBC news  , on issues of national security.
[00:10:56]And I said, so how does the army approach leadership? And he says, well, we [00:11:00] practice servant leadership. And the next. Literally the next breath he's telling me about love, love on the battlefield. He's telling me about his experience with general Norman Schwarzkopf in the first Gulf war. And he said I was in is exactly what he said.
[00:11:16]I was one of his divisional commanders, which for us non army types, that means that general McCaffrey had a small workforce. The 26,000 soldiers. And he said, and this is exactly what he said. He Schwarzkopf actually loved me. Oh. And I'll be honest. I
[00:11:34] Patrick Swift, PhD, MBA, FACHE: [00:11:34] didn't say that about their CEO is.
[00:11:37] Dan Edds, MBA: [00:11:37] Yeah, I didn't hear that when I was talking to him, I didn't even hear it till I was reading the transcript. And then I read, I thought, could he really say that? And here you have a guy. He has led men into combat. He knows what that means. And did they end today? It would be men and women. he holds three
[00:11:58] Patrick Swift, PhD, MBA, FACHE: [00:11:58] purple hearts
[00:12:00] [00:11:59] Dan Edds, MBA: [00:11:59] for wounds received in combat in Vietnam. And here he is talking to me without shame about. Love in the United States army as a senior officer,
[00:12:12] Patrick Swift, PhD, MBA, FACHE: [00:12:12] that gives me chills. That gives me chills. Beautiful point, beautiful point. And I've I actually got a quote here in your book and you didn't know this morning. I was going to be highlighting this, but you've got a quote that I want to, I want to read here to here, cause we're talking about servant leadership. Servant leadership is a philosophy that says the best leaders serve the workforce. They look out for the welfare of their subordinates. They willingly share power and help those. They serve grow. It's a nice idea. A lot of people talk and write about, but few know how to implement it. And I think what you're touching on there, the DNA of growing that and implementing it is love.
[00:12:51]Dan Edds, MBA: [00:12:51] It is. And, and, and frankly that word in the context of, you know, organizational leadership and management and, uh, it, it [00:13:00] makes me uncomfortable. Um, it, it just, I'm just not used to that
[00:13:04] Patrick Swift, PhD, MBA, FACHE: [00:13:04] word. Good on you for still hanging in there. Cause I'm gonna, I'm going to go on and read here one more little part here. Cause this is delicious. And in a conversation I had with a senior executive of an international nonprofit. She joked that she'd had a supervisor who understood servant leadership as serving the coffee at the Monday morning staff meetings, the rest of the week, he just acted like a jerk. I mean, coffee, coffee is the way to my heart, the prospect that, that, um, uh, the way she describes that, that solemn perceived servant leadership is, you know, pouring your coffee in the morning and then.
[00:13:37] I just act like a jerk the rest of the week. Um, there are leaders in healthcare. , there are leaders in all disciplines that have that perspective, but there are also leaders who stand on a foundation of love and grace and compassion and respect. And it's those leaders that, , we want to, to emulate, to highlight, to celebrate.
[00:13:57] And the fact that you wrote a book on a [00:14:00] transformational roadmap for engaging your workforce. and we're talking about love. , it gives me chills. So, so thank you
[00:14:05] Dan Edds, MBA: [00:14:05] for that. Yeah. Well, and the, and the point of the book is, is really, we can talk about engaging the workforce and improving the leadership of individual leaders. 99% of the books that get written on leadership is all about improving your leadership so that you are, you will either, you will do a better job of, uh, hiring a following. Yeah. , unfortunately that can't scale to, let's say a hospital with 5,000 employees.
[00:14:36] Patrick Swift, PhD, MBA, FACHE: [00:14:36] Yeah. So throw me some meat here, front of the book, , about three things to listen to right now, driving down the road, um, jocking down the road or at the desk, um, that can, talk away. Yeah, or how to drive engagement, , driving value in the organization by, , celebrating the, the,  we, and then the human in the work that we do. . So
[00:14:56] Dan Edds, MBA: [00:14:56] I'll give you one example. it's one of my, , it's one of the case studies in the [00:15:00] book it's with a hospital that has consistently ranked as one of the safest hospitals in the country. Uh, some have, , suggested it might even be one of the safest hospitals in the world and, , Everything in this hospital starts out with a value of respect, respect for the work, respect for the worker and respect for the patient. And I think virtually every decision they make is made through this lens of respect.
[00:15:25]So when it comes to the worker, , how do they respect the worker? Well, one way they do it, and this is one of the, , the major findings that I saw. High-impact organizations that consistently are able to engage their employees, see their employees, not as an asset to be managed, which is a nice way of saying controlled.
[00:15:48] Patrick Swift, PhD, MBA, FACHE: [00:15:48] Yeah, yeah. Or a widget to
[00:15:49] Dan Edds, MBA: [00:15:49] produce or a widget. Right. As a unit action. Yeah. They see their employees. Their workforce has human beings that are worthy of being [00:16:00] developed forever. Increasing value. So, for example, , this healthcare, , organization by rule, they train their leaders to not to be problem solvers.
[00:16:11]Now for you and us, myself, and those people in leadership positions. That's, that's a whole different paradigm because we are trained to be problem solvers. This hospital says, no, we don't want our leaders and clinic managers to be problem solvers. In fact, we want them to push problem solving down to the. To the level where the problem is actually occurring because those people understand the problem better. And so if you are my say, my boss and I came to you with a problem, there's automatically two issues to deal with. Number one, I am coming to you by training leaders ought to be coming to me. In fact, you should be visiting with me at my workstation probably every day at a specific point in time.
[00:16:58]So, , that's the first problem. [00:17:00] You're not doing your job. If I'm coming to you with a problem, second thing is your job is to help me think through the problem, understand the scope of the problem, understand who the other people that may be effected by that problem, who they are, and maybe how they are being impacted by that problem. But ultimately your job is to tell me, I trust you. You solve the problem and I'll support you. And I
[00:17:26] Patrick Swift, PhD, MBA, FACHE: [00:17:26] I'm loving what you're saying, because there's two elements I want to underline here. One is some that some of the folks are very familiar with, which is leader, rounding and connecting with your staff. Yep. But there's also one thing is moving your feet to your, your, your people, right? The other is how you listen and what you're proposing, which is radical. For some, I think it's radical is to not be the person with the answers intentionally not being the person with the answers, but intentionally listening to what people have to say about how we can do things better, how to solve the problem.
[00:17:58] Right. And I want to ask [00:18:00] you, there is someone listening who works in environment, where they would love to do that, and that's their style. They're even servant leaders and they work in an organization that says that they value that. But the senior leadership at the very top expects the next layer down to have all the answers.
[00:18:17] And then the next layer then has to have all the answers. And then you've got leaders on conference calls, zoom calls that are after report. Why, why are the metrics where they are? And you've got to have all the answers. So there's a conflict here. Help me solve this in which you've got a middle, someone who's part.
[00:18:32] Part of the solution, whether you're a leader or an informal leader where you make a difference, all of us, but to work in a place where the culture doesn't respect, that the folks that are closest to the problems have the answers. And it's the senior leaders expect , , the leaders to have all the answers to begin with. So how would you navigate that?
[00:18:53]Dan Edds, MBA: [00:18:53] Well, that is a huge problem. And it's not going to be a problem. It's going to get fixed overnight because
[00:18:57] Patrick Swift, PhD, MBA, FACHE: [00:18:57] you give an answer in 20 seconds or less. [00:19:00] This is a complicated question, but what advice do
[00:19:02] you
[00:19:02] Dan Edds, MBA: [00:19:02] have? Well, so, let me put it this way. So let's say that this person that you're talking about is a millennial, probably a hype, probably a high probability. They are high performance, a high-performing millennial that really espouses to some kind of leadership they want, they want to expand their, , , , responsibilities. Um, this is what I would, I would tell them, frankly,
[00:19:25]Patrick Swift, PhD, MBA, FACHE: [00:19:25] get out, get out, get out. Hmm. Um, I like that. That's brash, man. That's I that's interesting.
[00:19:32] Go
[00:19:33] Dan Edds, MBA: [00:19:33] on. Well, so, you know, millennials, I think millennials get a bad rap in a lot of different ways. Hmm. I happen to love him, maybe it's because I raised one. So maybe I'm biased. Uh, millennials are not comfortable sitting around waiting for their turn to be a leader. They don't see a reason to do that.
[00:19:55] They, they are smart enough to know that they are as well-educated, if [00:20:00] not better educated than their boss. At least technically. Yeah. , and they've been told since the moment of birth, if not before that you are special that, , you can, you can accomplish anything you want to in life. And then we put them in these organizations where they are told to wait their turn and we wonder why they're not loyal.
[00:20:22]And so, , I actually had this question the other day, , you know, what would I tell a millennial? Let's say my son who was working in that kind of an organization and I'd say get out because you're never going to change the culture. And if you can find an organization that will intentionally develop you.
[00:20:40]And by the way, millennials are the first generation in the history of mankind that will take a cut in pay to work in a culture that's positive, , where their voice can be heard. And so I would tell that person go
[00:20:54] Patrick Swift, PhD, MBA, FACHE: [00:20:54] find another job. Yeah, whether they're a millennial or not, it's whether the voice of follow your Dharma, , but follow a [00:21:00] follow that, that vocation and be making that difference.
[00:21:03] Dan Edds, MBA: [00:21:03] Yeah. Yeah. No, I mean, that, that sounds, that sounds pretty rash, but you, you, you know, someone who's that low in the, and I hate the idea of the hierarchy, someone who's in that position, you know, they're, they're never going to change the culture, which is part of my, why. Is, I want to change the culture, the system of leadership, because systems of leadership, like every other system can be designed to capture that voice, but it does require a system that in effect builds a
[00:21:33] Patrick Swift, PhD, MBA, FACHE: [00:21:33] culture.
[00:21:34] Mm Hmm. So that being said, I'm going to, I'm going to plug your book. Thank you. Dan's book leveraging the genetics of leadership, cracking the code of sustainable team performance. , an excellent read. I've enjoyed that. And we've touched on communication. We've touched on respect. We've touched on being present to people.
[00:21:49]These are the, the, the, this is the DNA of improvement. This is the DNA of, of healthcare. This is the DNA of how things are going to turn around in this, this [00:22:00] battle cry for improving healthcare around the planet. And. It all connects to love. So, Dan, I want to honor you for bringing love into this conversation.
[00:22:11] I want to ring that bell. Yeah. Again for the Natalie for the salvation army for love. So one of my favorite questions I love to ask folks on the show is if you, for just a brief moment had the attention of all the healthcare folks on the planet, the doctors, nurses, the, the, even the lawyers that work in the hospital, everyone in healthcare from the staff, the pharmacists. For a brief moment on the whole planet, you have their attention. What would you say to them?
[00:22:35]Dan Edds, MBA: [00:22:35] I would say if you want to turn around your organization, healthcare in general, but more specifically your hospital, your clinic, your organization, if you want to massively transform that organization, there's one thing you need to do, and that has transformed the experience of your workforce. And I'm not saying that that's easy, but it is as simple as [00:23:00] that. If you transform the experience of your workforce, you will transform your organization and do it on a massive scale. I'll give you one example. It doesn't happen. Doesn't happen to be in healthcare book. Give you one
[00:23:14] Patrick Swift, PhD, MBA, FACHE: [00:23:14] example. I want to hear your example, and I want to point out this applies to everyone, whether you actually. Are at the HR level of transforming the experience or just being part of transforming the experience? Yes. Well, you're touching on Dan is that we can all be part of that. And frankly, the leaders also need the support of the frontline for also transform the experience. So I'm curious, what's your exhibit.
[00:23:35]Dan Edds, MBA: [00:23:35] Okay. So the example actually is, , , an elementary school. And I'm know that somebody, somebody goes driving down the road, making yell elementary school. What does that have to do with me? I'm a, I'm a CEO of a  major hospital .
[00:23:45] Patrick Swift, PhD, MBA, FACHE: [00:23:45] No, I want to hear this. This
[00:23:46] is great. Okay. All right. I'm a former hospital CEO. I want to hear
[00:23:49] this.
[00:23:50] Dan Edds, MBA: [00:23:50] Okay. And I, and I would, , I would argue that. , anybody in an executive position in a large organization not practice, or you ought to try being a principal of an elementary school [00:24:00] for a day? I think they would go running back to their executive suite. but this, this elementary school school of 450 students, , When Aaron became the principal of the, ratio, the, , free and reduced lunch rate was right around 65%.
[00:24:15]That means that 65% of the student population lived in an economic, social, economic environment where they, they qualify to free, free and, or reduced lunch. And, , When Aaron took this school over, it was the lowest performing school in a district of 18 elementary schools. So it's the lowest performing school. The prior principal had been run out of town by the union. There is open hostility and in-fighting with the staff. She actually had the opportunity to go to very prestigious school, , full of people with lots of money and lots of, , high academic expectations for their children.
[00:24:54]So, but true to form, she takes the more challenging opportunity. Five years later, it's the highest [00:25:00] performing elementary school in a district of 18 elementary schools. Wow. And when that wasn't good enough, they kicked it up another notch and became one of the few schools in the nation to actually close the achievement gap, which, and public K-12 education is a.
[00:25:17] Massive. Yeah. Massive accomplishment landing on the moon. That's like, that's like throwing a dart and hitting the moon. And, , when I was asking her, her approach to leadership exactly what she said, leadership, I don't know anything about leadership. She then went on to describe for me the most eloquent system of leadership I found outside the United States government, uh, nice States army.
[00:25:39]And, , when I asked her how she approaches the subject of leadership that she says she doesn't know anything about, she says, well, this won't be very popular, but love and grace. And again, I was like, where did those words come from? And then she started talking. Yeah. And then she started talking to me about
[00:25:56]Collaboration. And, and designing a [00:26:00] culture for her organization where people could collaborate. And what it really was, was the experience of her team, 75 educational professionals, including the janitors and custodians.
[00:26:12]They all wanted to feel part of a team. They all wanted to collaborate. They all wanted to feel as they, as they sit, as they, as they said in their, in their team charter. Optimistically hopeful. So at the end of the day, they wanted to feel optimistically, hopeful that they were doing a job that was going to impact students.
[00:26:33]And, uh, it was all about the experience of her workforce. Having that feeling of. I am valued here. I belong here. My input is, is, is important and I am free and open to collaborate with other, teachers and innovate. In fact, when we got done with the conversation, , she had talked about.
[00:26:57] Love and collaboration. Hint, hadn't [00:27:00] worked said the word grace again, since the first question. I, so I said, well, so you've talked about love and collaboration, but you haven't talked about grace. Where does that come from? And , , she pulls back the sleeve of her blouse. She said, and she points to the word, grace that she had tattooed to her wrist.
[00:27:17]She said, this is how we do innovation. She said, sometimes we get a brilliant idea of how to teach, you know, fourth grade math. And we think it's going to be the next greatest thing on the planet. And she said, sometimes it doesn't work. And she said, we have to learn to forgive ourselves. And as she says that she's pointing out to me, multiple Kleenex boxes around her office.
[00:27:42]And she said, yes, When we innovate, we have to take a risk. And my job as the principal is to support that. And sometimes that means I hand a teacher, a clean X-Box because they're heartbroken that they just spent two weeks teaching math and it didn't.  work .
[00:27:59]Patrick Swift, PhD, MBA, FACHE: [00:27:59] Powerful. [00:28:00] Powerful optimistically hopeful. Yeah.
[00:28:03] The optimism that there is a solution and the hope that it will be implemented. It's part of the restore assessment. Actually, I, I use your consulting, our work that I do with, with healthcare folks. , I'm so glad that you touched , on that. , Optimistically hopeful, Grace Love compassion. I think that, , there has been so much sorrow in healthcare, , when we lose a patient that we sure, , that, that it is heartbreaking every time.
[00:28:27]and, , there, also needs to be. Self-forgiveness , when you do your best and, and you're not able to perform, , , and, and the moral dilemma that healthcare people are going through right now with COVID, you just, this, this is just so delicious episode. I, I hope you've enjoyed this, Dan. I certainly have enjoyed getting to talk with you and I hope our listeners have been able , to have a feast, , in this conversation , and hopefully, , uh, nurturance and support for the heart as well.
[00:28:52] So if folks are interested in following up with you learning more about you or getting a copy of your book, , where can folks go?
[00:28:58] Dan Edds, MBA: [00:28:58] Well, best place is my [00:29:00] website, Daniel eds.com. I've got a resource page where. I've got to actually have a whole special re to special reports that are free. , one is titled four strategies to engage the workforce where I go into that in more detail, as well as 16 specific action items they could take to engage the workforce and then a newer one called creating a courageous culture where instead of focusing on developing courageous leaders, we flip that around and say, why don't we think about developing a courageous workforce?
[00:29:30]Patrick Swift, PhD, MBA, FACHE: [00:29:30] I love it. One of my daily contemplations is, is to embrace courage, compassion, joy, and hope. And, uh, when you, , talk about, , creating a courageous culture, it's not only fun alliteration to say, it, it speaks to hope. And optimism. So, Dan, thank you for that. Thank you for that. I'll be including your website in the show notes. Dan, thank you so much for being part of the show and let's just, thank you.
[00:29:51] Dan Edds, MBA: [00:29:51] Great honor. Thank you.
 

13. Hyper Collaboration and Compassion in Healthcare Leadership w/ Funso Olufade, PhD, MBA

Hyper Collaboration and Compassion in Healthcare Leadership w/ Funso Olufade, PhD, MBA
In this episode, we pop the hood and look at the engine of healthcare from the perspective of a pharmaceutical CFO, exploring patient-centered care and the power of hyper-collaboration to make a difference in not only the lives of our patients, but our co-workers and stakeholders alike.
Dr. Funso Olufade, PhD, MBA is a healthcare finance leader and pharmaceutical executive. He has held roles in various roles at various multi-national companies with the quest of improving global patient access to medicines. Funso holds a Ph.D. in Health Sciences from Seton Hall University, an MBA in Finance, and a Bachelor of Science degree in Economics from Rutgers University.
Funso is also a member of the American College of Healthcare Executives of New Jersey (ACHENJ) and Chairs the Diversity and Inclusion Committee. He is the founder and Managing Director of Devoted Skies, a non-profit organization bridging the healthcare disparity gap in developing countries.
Funso Olufade Ph.D, MBA links:
https://www.linkedin.com/in/funsoolufade/
https://devotedskies.org/
Music Credit:
Jason Shaw from www.Audionautix.com
THE IMPERFECT SHOW NOTES
To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we’d love to offer polished show notes. However, Swift Healthcare is in its first year. 
What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it’s close enough - even with the errors - to give those who aren’t able or inclined to audio interviews a way to participate.  Please enjoy!
Hyper-Collaboration and Compassion are Key to Healthcare Leadership
[00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast. I'm Patrick Swift, your host. I'm delighted that you're here and I have a fantastic guest for us today. I am delighted to welcome. Funso welcome to the show.
[00:00:13] Funso Olufade, PhD, MBA: [00:00:13] Thank you so much, Patrick. Very, truly an honor to be joining you on the podcast, delighted, .
[00:00:18]Patrick Swift, PhD, MBA, FACHE: [00:00:18] Thank you for being here for the zone. And I'm delighted to share for our listeners today. Celebrates an email I got yesterday that this podcast is ranked in the top healthcare leadership podcast from feed spot. So I want to give a kudos to feed spot, and I want to thank our listeners and viewers.
[00:00:33]. And let me tell you about our wonderful guest  . Funso Olofade is a healthcare finance leader. He's a chief financial officer and he's a pharmaceutical executive he's held roles in various multinational companies with a quest of improving global patient access to medicines. What a novel idea, someone committed to improving.
[00:00:57] Uh, access to global to [00:01:00] medicines, um, Funso , uh, holds a PhD in health sciences from Seton hall university go Seton hall, an MBA in finance. Of course you'd want to have an MBA in finance as a CFO and a bachelor of science degree in economics from Rutgers university. And I'd also say he has a heart of gold.
[00:01:16] I know him personally, and he's got a heart of gold. Suunto is a member of the American college of healthcare executives of New Jersey and chairs, the diversity inclusion committee. And he's also a founding and managing director of devoted skies, a nonprofit organization bridging the healthcare disparity gap in developing countries.
[00:01:35] We're going to talk about all this and Funso welcome to the show.
[00:01:38] Funso Olufade, PhD, MBA: [00:01:38] now. Thank you again, Patrick. Congratulations on the Feedspot  recognition. This is great.
[00:01:43]Patrick Swift, PhD, MBA, FACHE: [00:01:43] Let's get to it. So, um, what are you up to these days? I want to start with that.
[00:01:48] Funso Olufade, PhD, MBA: [00:01:48] Fantastic. Thank you. Thank you. It's a, again, truly an honor to be sharing this with you. Believe it or not. , it's, , you know, staying who I am, , maintaining, , this, this long journey and continue the adherence that it takes [00:02:00] to, , continue to provide, , global patient access to medicines, , in the world of COVID.
[00:02:04] I think everyone, , as struggled in balancing being a professional. Being a parent and also being teachers of our children at home too. So that challenge in the last year, I think we can all relate to. And that is really been my, my journey. , that's where I am, , every now and then I sit back and just still reflect on kind of the modern day challenges that we have in healthcare.
[00:02:26] Right. How can we create this integrated, , patient journey? , from diagnostics to, , how patients pay for medicines and they care themselves. , how does drug development evolved, , at a fastest speed? , we saw what happened with COVID, , drug development that used to take us years. Seven years happened, , when a matter of nine months.
[00:02:45] So all of these healthcare, , modern challenges as I call it, , it's things I like  to tinker on and, , you know, continue to find ways contribute to, to advance them.
[00:02:54] Patrick Swift, PhD, MBA, FACHE: [00:02:54] Hmm. Funso and you're the first chief financial officer [00:03:00] in pharma on the show and, you know, finance and healthcare is not sexy. And I, here's a great opportunity to hear from someone who we can pop the hood and healthcare. We can look, look under the hood of what's going on in healthcare and what is giving you joy?
[00:03:16] And the work that you're doing in pharma that relates to CFO activities, but where's the joy. And what can our listeners learn about what the joy is in the work that you're doing for the company you're working for and what you're doing for, for, uh, access to medicine.
[00:03:29] Funso Olufade, PhD, MBA: [00:03:29] great. Great, great questions. Um, honestly, the analogy I give people is that, uh, you know, people like to say Benchside . To bedside. That's what happens in healthcare for scientists, at least, uh, because I started in a cubicle as a finance person, I figured I still had a longer way to go to get to the bedside.
[00:03:48] It's all about patients and the humanizing care delivery. That's really what healthcare is all about. So even as a CFO, what I try to do is to find ways where [00:04:00] all of my efforts and inputs can make that patient experience a lot better. These are our relatives. These are our friends, these are our community members.
[00:04:11] So what can I do in that journey to make sure that the patient experience is better? That is really, uh, what I embark on every day. And again, it's very rewarding. I tell a quick story here. Uh, the first time, , when I met a patient, , I was on a flight, , going from,  , New Jersey to, to California. And one of the air stewardess, , was driving the cart and  stopped near me, I was sitting in business class, , of course, , much earlier in my career days.
[00:04:38] And, , you know, approached me and said  at that. Hey, Mr. Bigshot, how did you get to sit in this business class row? And I said, well, now it's not me. It is my company that afforded me this row. So, so great. What company do you work for? So I paused and I shared at what point company that makes a drug and you probably don't know anyone with this disease is very, very [00:05:00] debilitating. , the stores, no, tell me more. I want to know about this disease. So Ms. Multiple sclerosis is a really, really debilitating disease and, , what we have a disease modifying therapies and people don't get to live long once they're diagnosed with this disease, but we have a medicine again that slows the progression, and this is how patients get to live normal lives.
[00:05:20] Patrick Swift, PhD, MBA, FACHE: [00:05:20] Outstanding,
[00:05:21] Funso Olufade, PhD, MBA: [00:05:21] So as soon as she walked away, she came back to me to tell me that you don't think I know anyone with Ms, but I am actually an Ms. Patient. And the drug that you just described is what I'm on . And that's still what enables me to be able to function. So from that moment, , Patrick, and that moment, Patrick, I've realized that staying close to the patient is really what transforms everything we do in health care and challenges, decisions we've made and how we get a therapist in the marketplace, , on a daily basis.
[00:05:51] Patrick Swift, PhD, MBA, FACHE: [00:05:51] oh  . That's, that's such a sweet story for them. So it's, it's a sweet story because you're, you're a CFO that talks about patient experience. [00:06:00] You also got asked by a stewardess, what are you doing in first class? And, um, there are diversity equity considerations there. If I were sitting in first class, the stewardess, wouldn't be asking me, what am I doing there?
[00:06:13] You got to ask that. And how did you respond? You responded with heart and it brings tears to my eyes because you. Focused on the cure of the patient and you're helping her. And that is the heart of healthcare. And I'm sorry to get teared up, but that's the power of, of what we can do in healthcare. I'm just so proud of you that you responded with.
[00:06:35] Well, this is how I serve and she responded with, Oh, I'm benefiting from that. That's beautiful. And it's just so dharmic and, and, and, and joyous in the work we do. So thank you for sharing that story. And I want to move to your professional journey. Um, what was this like for you personally? Uh, I'd love for you to share where you [00:07:00] started and got to where you are now.
[00:07:02] Funso Olufade, PhD, MBA: [00:07:02] Yes now. Great question. , and again, you, you, you described it a little bit in your intro. My biography, , I grew up on three continents and that's the way I like to do it. , born in West Africa, , grew up in the States in New Jersey to be specific, but professionally. I grew up in Europe and this is where I got to see the world and reflect on experiences that are different than what I experienced either in the U S or, , in Africa.
[00:07:27], I also benefited from great mentors, great mentors that challenged me, , great mentors that, uh, fully understood what my strengths are, and also pushed me further than that. And I think those are the elements. Oh, what has guided me through all of the different organizations that works with in healthcare, , and gotten me to where I am today as a CFO of a pharma company.
[00:07:50], again, I'm a healthcare guy, I'm an ambassador for teaching and learning within healthcare. So it's whatever brings out the element of curiosity in people. [00:08:00] That is how they can further their career. You know, you don't know it, go after a challenge yourself, figure it out. And also the, uh, you can get rewarded with a, with a, , incredible, , job, , , that you can pursue continue, foresee what you're passionate about.
[00:08:13] Patrick Swift, PhD, MBA, FACHE: [00:08:13] I love it because you, you also touched on the mentorship you received, um, recognizing your strengths, but also the areas for improvement as an executive coach. That's part of the work that I do with my clients is recognizing what are our strengths and then, and then how can we build on those? And the beauty is that you've had mentors.
[00:08:33] That have also supported you. And that is a, uh, give and take it's it's, uh, the contribution, the heart that you brought, the heart that you displayed earlier is about that dynamic of the giving and taking of life. It's not just meeting our needs. It's, it's contributing, it's the growth and contribution. So I'm grateful for that.
[00:08:50] And I'm, um, I want to ask you about. Any, let's talk about wisdom. Let's talk about wisdom to share with aspiring healthcare leaders, aspiring healthcare folks, [00:09:00] someone who wants to make a difference from someone who is making a difference. What lessons learned wisdom do you have?
[00:09:06] Funso Olufade, PhD, MBA: [00:09:06] Patrick, you, you know me very well. , well, you know, I consider you a great friend and, , the way I come across in my leadership style and where I put it, it's still always about authentic leadership. How can you lead an organization? Lead a team if they're fully don't know who you are. I have this famous phrase I use when I, when I eventually get comfortable with anyone that I'm meeting for the first time, , asking them, what do you see when you look at me?
[00:09:33], and again, you know, it's, it's not the first time. It's not, hello. Hi, how you doing? What do you see while you look at me? But over time you actually get in people too. , clarify whatever, , stereotypes or the way they perceive you. So you can actually share them where you are. I think the ability to be authentic, the, the opportunity to share your stories basically makes you vulnerable, makes you relatable.
[00:09:57] And provides the opportunity for people [00:10:00] to relate to you and be able to follow whatever the vision that you are advocated. So again, , authentic leadership, , keep an open mind about ideas, , at the same time, the vulnerability that comes with all of this is so incredible. And that's what makes, uh, leaders of great teams, , very successful.
[00:10:18] Patrick Swift, PhD, MBA, FACHE: [00:10:18] authentic leadership, openness. And you're also sharing a, uh, the secret sauce of leadership Funso that you shared, you ask people, what do you see your vulnerable? And you're open to feedback. And that is leadership that you can be a CEO of a hospital and you still gotta ask, what do you see? And make that connection.
[00:10:44] You can be a new employee. In healthcare or in any profession, I get feedback from folks. They know they're not, they don't work in healthcare, but they watch my podcast because they get something out of it that inspires them. And I'm, I'm so touched that you brought that up. It's authentic leadership.
[00:10:59] Geoffrey Hall was [00:11:00] speaking about that in a previous podcast we did earlier and that's, you're touching on the special sauce that is so powerful and. And that is part of the DNA of leadership that, where we really are not just getting people to do things. That's not li it's not you do this. It's come this way.
[00:11:20] Let's go this direction. So I love that. Um, I understand you were putting this perspective into practice with the nonprofit. So I want to talk about your nonprofit and, and hear about what's. What are you up to please share my listeners? What are you up to? What's your why? And, and also let's talk about lessons learned and how you're applying that back to your healthcare leadership.
[00:11:40] Funso Olufade, PhD, MBA: [00:11:40] absolutely. So I'm a devoted Skye, the nonprofit that you reference, I really it's based in New Jersey, but the goal is to see how we can increase patient access to modern medicine in developing countries. , we do it as in three ways. , Patrick, the first is philanthropy. We collect our supplies and donate to [00:12:00] these, , community hospitals in these countries.
[00:12:02] The second is partnerships partnerships with health systems and local governments and community clinics to see how can we help them create. A health care infrastructure that connects to either specialists, either teaching hospitals that actually enables a patient to continue that care continuum. So it's webinars series, understanding what kind of, , payment types they have in these countries.
[00:12:27] And how can we help facilitate them, our patients within these communities to continue to do that. So we'll partner with other NGOs to achieve that.
[00:12:34] Patrick Swift, PhD, MBA, FACHE: [00:12:34] awesome.
[00:12:35] Funso Olufade, PhD, MBA: [00:12:35] The third of this is just research, collecting data from other NGOs and people that volunteer to see, , how effective is given back in the regions that they've participated in because people donate, people do want to give back.
[00:12:47] But what kind of impact is it having? So these are the things that we do within the Devoted Skies , but in reflection, as you ask at the end of the day, it's about compassion, right? , you know, humanizing healthcare and knowing that, [00:13:00] , you know, the whole concept of no money, no mission still exists. But at the end of the day, I think, , as a finance guy living be the first to tell you this, that we need to reimagine.
[00:13:09] We need to reinvent capitalism when it comes the healthcare delivery.
[00:13:14] Patrick Swift, PhD, MBA, FACHE: [00:13:14] Well, take it to another level, take it to that next level, right. To, to, to take that, um, th th the power and the beauty of what capitalism is has, has helped create such, um, wealth and health and goodness, but there's also that shadow side. And what you speak about is that transformation to, to that next level, right?
[00:13:33] Funso Olufade, PhD, MBA: [00:13:33] So we didn't have this conversation before now, just so the listeners know that is exactly the point that I'm saying there's so much benefit in the, , the innovation, the, the competitiveness that comes with capitalism, but when it comes to the delivery, Within healthcare. I think there are opportunity areas that we all have we saw.
[00:13:52] Yeah. We saw their examples of this. with COVID , right. You know, you see, , , competitors working together, not just to develop a drug, but also to [00:14:00] distribute the drug, , to manufacture the drugs. Those are things that shouldn't be a one-time pandemic event, but the way healthcare is delivered compassionately and that's, that's really, , what, what are Devoted Skies  looking to help, , advance.
[00:14:13] Patrick Swift, PhD, MBA, FACHE: [00:14:13] I'm loving that I'm loving that. And any lessons learned or wisdom from the nonprofit sector that you're bringing back to the work you're doing in healthcare.
[00:14:23] Funso Olufade, PhD, MBA: [00:14:23] Great question. Good question. And again, , the way I see this, that, you know, the challenges of modern healthcare is so profound. It's not one person or one organization that can solve these problems. It does take really, it takes policymakers. It does take. Drug manufacturers, , , healthcare providers, it takes insurance companies, payers, the, the, the, the closeness, the collaboration between all of these entities is really what's going to help us address some of these challenges that we have in healthcare.
[00:14:56] And that is what I'm seeing in working with these, , regional, , community [00:15:00] clinics and all these countries that you can't just go work with a particular hospital entity. It does really take involvement with those four PS that I described providers, policy makers, , payers, as well as patient groups, those four PS is really what's going to help us address some of these healthcare issues.
[00:15:18] Patrick Swift, PhD, MBA, FACHE: [00:15:18] Absolutely from zone. I love that. It's a beautiful point. And I'd love to move to my favorite question, which is if you had the attention of all the healthcare folks on the whole planet for a brief moment, all the folks that work in healthcare for a brief moment, what would you say to them?
[00:15:36] Funso Olufade, PhD, MBA: [00:15:36] Wow. So profound and, and, um,
[00:15:40] Patrick Swift, PhD, MBA, FACHE: [00:15:40] Well, it's a profound, depending on what you say.
[00:15:41] Funso Olufade, PhD, MBA: [00:15:41] well, I am thinking about it now. I'm, you know, struggling with, you know, what question or what answer best fit. Cause this is my one chance from the healthcare mountaintop as you
[00:15:50] Patrick Swift, PhD, MBA, FACHE: [00:15:50] Yes, sir.
[00:15:51]Funso Olufade, PhD, MBA: [00:15:51] , at the end of the day, , Patrick, cause I just shared with you, it's about hyper-collaboration. Talking to each other again, between policy makers, [00:16:00] providers, payers, and the patients themselves, we're not treating diseases. Talk to the patients. What are they experience as they go through this journey? It's about all of these groups working together. Hyper-collaboration between these groups is really what will help us address the challenges we think we know. But we might not have all the answers. My, uh, one, uh, CEO leader in the past used to say, when we sit in a boardroom having discussion and say, okay, if a patient was in the room, would you still make the same decisions without the patient being in the room? So again, this is really what it takes, thinking about all these different contexts and keeping that in mind and collaborating and working with all of these stakeholders is really what we get us to advance care delivery in the future.
[00:16:45] Patrick Swift, PhD, MBA, FACHE: [00:16:45] collaboration, collaboration, and humility and vulnerability, all of this Funso  I love this. Well, if folks are listening, folks are interested in learning more about what you're doing, connecting with you. How can folks get in touch with you?
[00:16:58] Funso Olufade, PhD, MBA: [00:16:58] Absolutely. My [00:17:00] LinkedIn is, is definitely a way to reach out to me. , but also, , you can check out the Devoted Skies website, DevotedSkies.org, , two great ways to reach out to me. And I'll definitely, , be a respondent.
[00:17:11]Patrick Swift, PhD, MBA, FACHE: [00:17:11] . I'm going to be putting that on the show notes. It'll be as part of the podcast. And you don't know I'm about to say this, but I just earlier you were talking about devoted skies, right? And, um, uh, generating, um, uh, the Goodwill and the goodness that that devote skies  does. And I'm making a commitment that, um, I want to encourage folks to go to DevotedSkies.org  and make a contribution.
[00:17:34] And if you do send an email and I will respond with, uh, a copy, a free copy of my book, one mountain, many paths. Um, folks, if you make a contribution to devoted skies send an email to a podcast@swifthealthcare.com, you're going to get a response of the PDF version of my award-winning book.
[00:17:57] One mountain, many paths , I don't need to know how much you gave to [00:18:00] voted Davos guys. That's up to you. But if you are supporting devoted skies and from the Swift healthcare platform, I want to encourage folks to make a contribution to Devoted Skies.
[00:18:10] And if you do shoot an email to podcast@swifthealth.com and just in the subject line, put free book I'm going to shoot you a reply with a, with a link to be able to download a copy of the book. So Funso  I
[00:18:21] Funso Olufade, PhD, MBA: [00:18:21] Thank you so much,
[00:18:22] Patrick Swift, PhD, MBA, FACHE: [00:18:22] Absolutely absolutely surprise. I wasn't playing.
[00:18:25] Funso Olufade, PhD, MBA: [00:18:25] now very
[00:18:26] Patrick Swift, PhD, MBA, FACHE: [00:18:26] you inspire me. You inspire,
[00:18:28] Funso Olufade, PhD, MBA: [00:18:28] now. Thank
[00:18:28] Patrick Swift, PhD, MBA, FACHE: [00:18:28] you inspire me. So listen, thank you for being on the show. And it's just been a joy to get to talk with you, friend.
[00:18:34] Funso Olufade, PhD, MBA: [00:18:34] Absolutely
[00:18:34] Patrick Swift, PhD, MBA, FACHE:  This is how we reduce burnout in healthcare workers plus reduce healthcare disparities!