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This is the Becker's Healthcare Podcast,

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Thanks for listening.
Now here's the episode.

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This is the Becker's Healthcare
Podcast. I'm Molly Gamble,

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vice President editorial, and today
I'm spending time with Paul Hilts.

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Paul is the president and c e o of n
c h healthcare system based in Naples,

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Florida. Paul, welcome and thank you
so much for being my guest today.

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Where does the podcast find you?

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Oh, good afternoon, Molly. Yep.

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I'm in Naples today for people
not familiar with Naples, Florida.

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It's on the southwest coast and
a very beautiful area of Florida.

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Oh, that's great.

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I was actually fortunate enough to spend
some time in Naples this past winter

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spring. Uh, a nice respite from
the Midwest winter Paul. So, um,

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it was a beautiful trip and visit.
I I really enjoyed the scenery.

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It is, it is a great
community too, and a very,

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a very generous community and
a great, uh, place to, uh,

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to be working in healthcare.

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Very much so. Well, let's learn
more about that, you know,

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for listeners who may be less
familiar with N C H Healthcare,

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can you share a couple key facts or
insights that would help them better

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appreciate and understand
your perspective today?

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Absolutely. Uh, n c is a unique
thing, we think in America,

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we're on our way to becoming what we
call an advanced community healthcare

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system. And, uh, what does that mean?

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It means that we wanna remain
an independent, locally
governed health system,

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and we're gonna focus in on
quality and advancing quality

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through key partnerships.
Partnerships, uh,

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like the hospital for special surgery
out of New York, uh, Nicholas Children's,

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uh, encompass rehabilitation,
uh, hospitals and, uh,

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partners that can really help us advance
a quality agenda here for the residents

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of Southwest Florida.

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And I understand too,

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a major component of the annual strategic
plan at N C H right now is physician

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integration,

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ensuring physician voices and perspectives
are heard and driving the system

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forward in into that vision.

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You just described it being an advanced
community healthcare system. Paul,

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can you talk about what this looks like?

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What are some specific initiatives
that are supporting this big aim?

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Sure. The, one of the main pillars of
our strategic plan right now is physician

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integration, and it represents the
voice of the physicians to drive

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initiatives that are gonna
further the mission, vision,

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and values of this organization. So
I think as leaders in healthcare,

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we have to really spend a lot of time, uh,

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creating an environment where physicians
and other providers really enjoy

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practicing medicine, enjoy taking
care of patients. So we've spent, uh,

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a fair amount of time recruiting
in great physician leaders, uh,

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giving them the tools, uh,

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and equipment to provide great care.

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And we really wanna make
this a place where, uh,

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practicing medicine is fun.

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So important. I mean,

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especially over the past couple of
years probably you've seen these trends,

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not e not even exclusively in healthcare,
but just more broadly of quiet,

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quitting, uh, the great
resignation, of course.

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So to get back to making sure work
is enjoyable and bringing people joy

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and so many people and
physicians especially talk
about the bedside time with

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patients, how much that fulfills 'em,

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and that's really why they went
into practicing medicine. So I I,

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it's really great to see that this is so
front and center for your organization

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right now. Um,

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ha have you done any work or is there any
initiative in play specifically toward

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physician wellness?

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There's a lot of emphasis on
the physician wellness. We, uh,

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we survey doctors frequently talk to
doctors and really listen to doctors.

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And one of the things
that's been interesting this
year is that our physician

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leaders really determine the need
for some type of an innovative

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physician leadership program to, uh,

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to enhance their effectiveness and their
collaboration and communication and

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ability to work as teams.
So with our medical staff,

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we co-created a leadership, uh,

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program for physicians and it's
really unique and it's, um,

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it's used, it uses the, uh, gallup's, uh,

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strength finders or strength-based,
uh, approach. And, uh,

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the reaction from the doctors
has really been, uh, strong.

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We have almost 50 doctors enrolled
in the program, which is, uh,

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an eight month program, but we're
about a third of the way through it.

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And really the feedback has
been, has been wonderful. Mm-hmm.

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<Affirmative>, that's great. I
know just last week I saw a story,

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I believe it was in Harvard Business
Review about primary care physicians and

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the integral role they play
in our healthcare system,

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but how often it can take some extra
encouragement because they might be

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reluctant to take on bigger leadership
roles in healthcare. Hmm. Um,

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so it just goes to show your point
about how these formal educational

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opportunities and structures
can really go a long way,

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cuz sometimes people might feel, feel,

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whether it's imposter syndrome or
they're not sure they're cut out for it,

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they might question their own abilities
when really you see great potential and

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great need for their leadership.

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I think you're exactly right.
And you mentioned Harvard.

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We are using the Harvard
Managed Mentor, uh,

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online tools as part of
our leadership program,

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but we are also injecting
doctors into a lot of the,

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the business problems we're
trying to solve here with,

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with some great results actually. And, um,

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and we went through a conversion to
Epic and the doctors have been very much

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involved in that. We had a great
conversion there and, uh, we're taking,

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trying to take clinical waste out
of the system and trying to, again,

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make this a place that
doctors enjoy coming to.

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Mm-hmm. <affirmative>.
Mm-hmm. <affirmative>. Well,

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let's zoom out a little bit too, Paul,

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because you are in such an
interesting part of the country. Uh,

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I wanted to touch on a couple things that
I think are unique to Naples that are

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listeners might find interesting.
One is the housing crisis, you know,

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other areas of the country can
sympathize and understand this challenge,

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um, especially for areas that are
high with tourism. Um, snowboard,

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snowbirds, excuse me. But the
housing crisis in the area of Naples,

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it's been a really important
contributing factor to the workforce,

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constrictions facing your system,
um, resulting in longer wait times,

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other downstream effects.

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Can you tell us more about the housing
market in your area and the consequences

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this is having on the health system?

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Well, the housing issue here is, um,

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significant and it was actually
exacerbated by Hurricane Ian

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last, um, September too,

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which destroyed a lot of homes and
made things even more acute for us.

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But we have a number of
different initiatives that we're,

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we're undertaking now to address
that. Uh, during this last year with,

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with the hurricane and
so forth, we did, um,

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lease out a part of a,

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of a hotel where we created
affordable housing for our workforce

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here near both of our hospitals.
Uh, there's been a recent, uh,

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bill, uh, passed here in Florida by
Senator PAs Domo called Live Local.

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And it's gonna offer developers
tax incentives to produce,

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create affordable workforce
housing. So that will also help.

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And we've got a number of initiatives
we're looking at on properties we own to

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help address this housing crisis for our,

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our workforce because it's, we think
it's gonna be a, a longstanding issue.

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It has been a longstanding issue.

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We're gonna have to get creative with
partners to other businesses to help

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address this.

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Mm-hmm. <affirmative> and
the leased out hotel space,

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was that meant for full-time employees
or was it something that you used

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for contract labor?

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Can you talk a little bit more
about the strategy behind that tech?

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Yeah, the le originally started as
being the, for more of the seasonal,

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but one of the things that we're finding
here in this last year, um, Molly,

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is that we are gonna have more full-time
residents and therefore more full-time

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employees. So we think that this, uh,

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notion of subleasing or leasing out, uh,

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hotels and apartments will be kind of
a permanent thing for us as we work

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to, um, make this a great
place to be an employee too.

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Mm-hmm. <affirmative>
mm-hmm. <affirmative>. Well,

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and some of those full-time residents
might be taking up what has become a craze

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in the US and that is pickleball. I mean,

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this might seem lighthearted
to touch on with you, Paul,

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but it's been coming up
in business reporting, um,

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including that from some
of the big insurers.

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I I wanted to get your take on this.

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U UnitedHealthcare last month said an
increase in joint replacements contributed

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to rising costs for the health insurer
and in a market rich with retirees

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and, and pickle ballers.

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What have you seen in N C H in terms of
joint replacement trends and patterns?

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Is there any link between that activity
and then also joint replacement volumes?

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This is the pickleball capital of the
United States here in Naples, and it's a,

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it's a great sport. We love
all the participation. And
to answer your question,

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yes, the orthopedic volume in general,

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both sports medicine and
joint replacements is

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on the increase here in Naples.

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One of the reasons that we decided to
form a strategic partnership with the

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hospital for special surgery is that they
are the number one orthopedic hospital

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in the country,

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and we're gonna create one of the
top destinations for orthopedic care

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in the United States here in
conjunction with hss. So to your point,

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we think that this trend of pickleball,
tennis and other activities and,

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and what comes along with that is, uh,

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is gonna be here with us for a long time
and we're gonna be in a position now

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to, uh, take care of those
patients at a level, um,

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that will be the best
in the United States.

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Can you talk more about the partnership
with H H s, because you're right,

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I mean, esteemed and orthopedic care,

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but also I understand Florida is a
big destination among New Yorkers.

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Can you talk about why this makes
such a great fit? And then also how,

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how does it play out? Is are you
doing second opinions via h hs, H s s,

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um, teleconsults?

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What are some of the finer prints
of how this partnership plays out?

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Yeah. The partnership with HSS is, is
gonna be sort of twofold. On the one hand,

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they are gonna manage our
orthopedic service line,

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what we just recently
named Dr. David Helford,

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who's one of the outstanding orthopedic
surgeons in America. He will be, uh,

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moving to Naples,

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Florida and leading all things
orthopedic in our health system.

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As a part of that, we're gonna be cons,

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begin construction in
August on a brand new

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state-of-the-art orthopedic center,

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which will include inpatient orthopedic
rooms as well as an ambulatory

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surgery center, uh, that will be doing,

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it will be a joint venture
with H S S and N C H.

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So world-class orthopedic care.

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We've already recruited several
surgeons who trained at H S s,

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who will be full-time here in Naples,

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and we continue to build out that
team with local doctors who are

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interested in that kind of care and
with, uh, doctors who trained in,

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in the leading orthopedic
centers in America.

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That's great. Thank you, Paul. And,
you know, now we've touched in on,

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on Naples specifically.

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I wanted to zoom back
out and if we can, I,

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I'm always curious about
this question. You know,

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so many of the challenges that are
facing health systems and its leaders are

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relatively constant,

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really important that they play
out over long stretches of time.

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I'm curious to stay fresh
and to stay with you.

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Is there anything new or emerging
on your radar that you find is

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demanding more and more of your
attention or time as of late?

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You know, the thing that
I find in, in today,

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just coming out of covid that I think
is gonna be the theme is really gonna be

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the workforce engagement
and developing a pipeline of

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healthcare workers, new ones,

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but also re-engaging doctors, nurses,

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and other clinicians in the
work. And I think to do that,

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we have to get really good at listening
to the providers and then trying to

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eliminate the, uh, the friction points,

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the things that really
just drag doctors down. I,

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I still think the doctors I'm talking
to on a day-to-day basis are still

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passionate about taking care of patients.

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I think they're just frustrated with
all of the bureaucracy and all of the

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impediments, uh, put in
front of them, uh, that,

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that take away from patient care. So I'm,

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I'm really passionate about
creating a work environment where

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healthcare providers really look
forward to coming to work and taking

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care of patients.

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Mm-hmm. <affirmative> and that perspective
is so important because you see,

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at the national level,

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the conversation is often focused
on the deficit of workers,

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those who are missing those that we
need to get to a healthy baseline for

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access. But to your point, Paul,

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if we're not talking about those who
are still working and with us and in the

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system reporting to their,

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their duties and making sure those
experiences are going as swimmingly as

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possible for them,

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that's a really important part of the
equation that might be under tended to.

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I believe so,

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and I think we've gotta start maybe
looking outside of our industry a little

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bit. I just recently took a trip up
to Chick-fil-A headquarters in Atlanta

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to look at how they engage
and train their workforce.

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Um, I also went over and visited some
folks at the Atlanta Falcons and, and, uh,

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Mercedes-Benz Stadium up in Atlanta
because they have the number one fan

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experience in the nfl.

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So we're trying to look
at other industries to see
what we can learn to engage

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our workforce, to satisfy our workforce,

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and therefore create an experience
for the patient that will be second

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to none. Mm-hmm.

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<Affirmative>, did anything,

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did any key takeaway or surprise really
stand out to you most in those visits?

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Well, the theme at both
of those companies is,

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is really what we just
talked about a minute ago.

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They're trying to just eliminate
the friction points of, uh,

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whether it's coming to a football
game or coming to a fast food

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restaurant. Um,

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how do we make the experience as
easy as possible for the consumer?

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And how do we broaden our
mission a little bit more and,

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and think about creating just an
experience, not for one thing. You know,

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we wanna take great care of
the patient when they're sick,

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but we also wanna take care of the
entire experience from the appointment

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scheduling to the final bill. How
do we make that something that is,

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uh, is somewhat enjoyable for the,
for the consumer or the patient.

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Mm-hmm. <affirmative>. Mm-hmm.
<affirmative>, well pause.

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Is there anything we haven't
touched on yet that we'd,

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we'd be remiss not to make mention of?

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Well, you know, one thing that,

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that we're really excited about here is
the teaching aspect of what we're doing

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as an advanced community health system.
We now have, if you can believe this,

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up about 80 residents that we're
training in conjunction with the

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Mayo Clinic here. So very
excited for our interns,

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our fellows, and, uh, the teaching
and training is gonna be, I think,

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a vital part of, of healthcare going
forward. And we're in it in a big,

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big way.

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And we're gonna combine that with doing
some clinical trials and other kinds of

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research to engage and excite these
young, uh, doctors and young clinicians.

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Well, this has been a delight.

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I'm so happy we were able to get some
time to check in with you at N C H

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Healthcare System on its way to becoming
an advanced community healthcare

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system, so many different
strategic initiatives in
play to support that mission.

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I, I wanna wish you continued success
throughout the rest of this year in,

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in driving that home.

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And I think we'll stay in touch and
continue to keep abreast of the progress

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that's unfolding at
your, your organization.

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Molly, thanks so much.

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It's so important for leaders at the
top of organizations to keep learning,

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00:17:09,000 --> 00:17:10,730
stay sharp, grow their networks,

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00:17:11,120 --> 00:17:14,250
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00:17:14,310 --> 00:17:18,170
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