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This is the Becker's Healthcare Podcast. I'm Molly Gamble,
vice President editorial, and today I'm spending time with Paul Hilts.
Paul is the president and c e o of n c h healthcare system based in Naples,
Florida. Paul, welcome and thank you so much for being my guest today.
Where does the podcast find you?
Oh, good afternoon, Molly. Yep.
I'm in Naples today for people not familiar with Naples, Florida.
It's on the southwest coast and a very beautiful area of Florida.
Oh, that's great.
I was actually fortunate enough to spend some time in Naples this past winter
spring. Uh, a nice respite from the Midwest winter Paul. So, um,
it was a beautiful trip and visit. I I really enjoyed the scenery.
It is, it is a great community too, and a very,
a very generous community and a great, uh, place to, uh,
to be working in healthcare.
Very much so. Well, let's learn more about that, you know,
for listeners who may be less familiar with N C H Healthcare,
can you share a couple key facts or insights that would help them better
appreciate and understand your perspective today?
Absolutely. Uh, n c is a unique thing, we think in America,
we're on our way to becoming what we call an advanced community healthcare
system. And, uh, what does that mean?
It means that we wanna remain an independent, locally governed health system,
and we're gonna focus in on quality and advancing quality
through key partnerships. Partnerships, uh,
like the hospital for special surgery out of New York, uh, Nicholas Children's,
uh, encompass rehabilitation, uh, hospitals and, uh,
partners that can really help us advance a quality agenda here for the residents
of Southwest Florida.
And I understand too,
a major component of the annual strategic plan at N C H right now is physician
integration,
ensuring physician voices and perspectives are heard and driving the system
forward in into that vision.
You just described it being an advanced community healthcare system. Paul,
can you talk about what this looks like?
What are some specific initiatives that are supporting this big aim?
Sure. The, one of the main pillars of our strategic plan right now is physician
integration, and it represents the voice of the physicians to drive
initiatives that are gonna further the mission, vision,
and values of this organization. So I think as leaders in healthcare,
we have to really spend a lot of time, uh,
creating an environment where physicians and other providers really enjoy
practicing medicine, enjoy taking care of patients. So we've spent, uh,
a fair amount of time recruiting in great physician leaders, uh,
giving them the tools, uh,
and equipment to provide great care.
And we really wanna make this a place where, uh,
practicing medicine is fun.
So important. I mean,
especially over the past couple of years probably you've seen these trends,
not e not even exclusively in healthcare, but just more broadly of quiet,
quitting, uh, the great resignation, of course.
So to get back to making sure work is enjoyable and bringing people joy
and so many people and physicians especially talk about the bedside time with
patients, how much that fulfills 'em,
and that's really why they went into practicing medicine. So I I,
it's really great to see that this is so front and center for your organization
right now. Um,
ha have you done any work or is there any initiative in play specifically toward
physician wellness?
There's a lot of emphasis on the physician wellness. We, uh,
we survey doctors frequently talk to doctors and really listen to doctors.
And one of the things that's been interesting this year is that our physician
leaders really determine the need for some type of an innovative
physician leadership program to, uh,
to enhance their effectiveness and their collaboration and communication and
ability to work as teams. So with our medical staff,
we co-created a leadership, uh,
program for physicians and it's really unique and it's, um,
it's used, it uses the, uh, gallup's, uh,
strength finders or strength-based, uh, approach. And, uh,
the reaction from the doctors has really been, uh, strong.
We have almost 50 doctors enrolled in the program, which is, uh,
an eight month program, but we're about a third of the way through it.
And really the feedback has been, has been wonderful. Mm-hmm.
, that's great. I know just last week I saw a story,
I believe it was in Harvard Business Review about primary care physicians and
the integral role they play in our healthcare system,
but how often it can take some extra encouragement because they might be
reluctant to take on bigger leadership roles in healthcare. Hmm. Um,
so it just goes to show your point about how these formal educational
opportunities and structures can really go a long way,
cuz sometimes people might feel, feel,
whether it's imposter syndrome or they're not sure they're cut out for it,
they might question their own abilities when really you see great potential and
great need for their leadership.
I think you're exactly right. And you mentioned Harvard.
We are using the Harvard Managed Mentor, uh,
online tools as part of our leadership program,
but we are also injecting doctors into a lot of the,
the business problems we're trying to solve here with,
with some great results actually. And, um,
and we went through a conversion to Epic and the doctors have been very much
involved in that. We had a great conversion there and, uh, we're taking,
trying to take clinical waste out of the system and trying to, again,
make this a place that doctors enjoy coming to.
Mm-hmm. . Mm-hmm. . Well,
let's zoom out a little bit too, Paul,
because you are in such an interesting part of the country. Uh,
I wanted to touch on a couple things that I think are unique to Naples that are
listeners might find interesting. One is the housing crisis, you know,
other areas of the country can sympathize and understand this challenge,
um, especially for areas that are high with tourism. Um, snowboard,
snowbirds, excuse me. But the housing crisis in the area of Naples,
it's been a really important contributing factor to the workforce,
constrictions facing your system, um, resulting in longer wait times,
other downstream effects.
Can you tell us more about the housing market in your area and the consequences
this is having on the health system?
Well, the housing issue here is, um,
significant and it was actually exacerbated by Hurricane Ian
last, um, September too,
which destroyed a lot of homes and made things even more acute for us.
But we have a number of different initiatives that we're,
we're undertaking now to address that. Uh, during this last year with,
with the hurricane and so forth, we did, um,
lease out a part of a,
of a hotel where we created affordable housing for our workforce
here near both of our hospitals. Uh, there's been a recent, uh,
bill, uh, passed here in Florida by Senator PAs Domo called Live Local.
And it's gonna offer developers tax incentives to produce,
create affordable workforce housing. So that will also help.
And we've got a number of initiatives we're looking at on properties we own to
help address this housing crisis for our,
our workforce because it's, we think it's gonna be a, a longstanding issue.
It has been a longstanding issue.
We're gonna have to get creative with partners to other businesses to help
address this.
Mm-hmm. and the leased out hotel space,
was that meant for full-time employees or was it something that you used
for contract labor?
Can you talk a little bit more about the strategy behind that tech?
Yeah, the le originally started as being the, for more of the seasonal,
but one of the things that we're finding here in this last year, um, Molly,
is that we are gonna have more full-time residents and therefore more full-time
employees. So we think that this, uh,
notion of subleasing or leasing out, uh,
hotels and apartments will be kind of a permanent thing for us as we work
to, um, make this a great place to be an employee too.
Mm-hmm. mm-hmm. . Well,
and some of those full-time residents might be taking up what has become a craze
in the US and that is pickleball. I mean,
this might seem lighthearted to touch on with you, Paul,
but it's been coming up in business reporting, um,
including that from some of the big insurers.
I I wanted to get your take on this.
U UnitedHealthcare last month said an increase in joint replacements contributed
to rising costs for the health insurer and in a market rich with retirees
and, and pickle ballers.
What have you seen in N C H in terms of joint replacement trends and patterns?
Is there any link between that activity and then also joint replacement volumes?
This is the pickleball capital of the United States here in Naples, and it's a,
it's a great sport. We love all the participation. And to answer your question,
yes, the orthopedic volume in general,
both sports medicine and joint replacements is
on the increase here in Naples.
One of the reasons that we decided to form a strategic partnership with the
hospital for special surgery is that they are the number one orthopedic hospital
in the country,
and we're gonna create one of the top destinations for orthopedic care
in the United States here in conjunction with hss. So to your point,
we think that this trend of pickleball, tennis and other activities and,
and what comes along with that is, uh,
is gonna be here with us for a long time and we're gonna be in a position now
to, uh, take care of those patients at a level, um,
that will be the best in the United States.
Can you talk more about the partnership with H H s, because you're right,
I mean, esteemed and orthopedic care,
but also I understand Florida is a big destination among New Yorkers.
Can you talk about why this makes such a great fit? And then also how,
how does it play out? Is are you doing second opinions via h hs, H s s,
um, teleconsults?
What are some of the finer prints of how this partnership plays out?
Yeah. The partnership with HSS is, is gonna be sort of twofold. On the one hand,
they are gonna manage our orthopedic service line,
what we just recently named Dr. David Helford,
who's one of the outstanding orthopedic surgeons in America. He will be, uh,
moving to Naples,
Florida and leading all things orthopedic in our health system.
As a part of that, we're gonna be cons,
begin construction in August on a brand new
state-of-the-art orthopedic center,
which will include inpatient orthopedic rooms as well as an ambulatory
surgery center, uh, that will be doing,
it will be a joint venture with H S S and N C H.
So world-class orthopedic care.
We've already recruited several surgeons who trained at H S s,
who will be full-time here in Naples,
and we continue to build out that team with local doctors who are
interested in that kind of care and with, uh, doctors who trained in,
in the leading orthopedic centers in America.
That's great. Thank you, Paul. And, you know, now we've touched in on,
on Naples specifically.
I wanted to zoom back out and if we can, I,
I'm always curious about this question. You know,
so many of the challenges that are facing health systems and its leaders are
relatively constant,
really important that they play out over long stretches of time.
I'm curious to stay fresh and to stay with you.
Is there anything new or emerging on your radar that you find is
demanding more and more of your attention or time as of late?
You know, the thing that I find in, in today,
just coming out of covid that I think is gonna be the theme is really gonna be
the workforce engagement and developing a pipeline of
healthcare workers, new ones,
but also re-engaging doctors, nurses,
and other clinicians in the work. And I think to do that,
we have to get really good at listening to the providers and then trying to
eliminate the, uh, the friction points,
the things that really just drag doctors down. I,
I still think the doctors I'm talking to on a day-to-day basis are still
passionate about taking care of patients.
I think they're just frustrated with all of the bureaucracy and all of the
impediments, uh, put in front of them, uh, that,
that take away from patient care. So I'm,
I'm really passionate about creating a work environment where
healthcare providers really look forward to coming to work and taking
care of patients.
Mm-hmm. and that perspective is so important because you see,
at the national level,
the conversation is often focused on the deficit of workers,
those who are missing those that we need to get to a healthy baseline for
access. But to your point, Paul,
if we're not talking about those who are still working and with us and in the
system reporting to their,
their duties and making sure those experiences are going as swimmingly as
possible for them,
that's a really important part of the equation that might be under tended to.
I believe so,
and I think we've gotta start maybe looking outside of our industry a little
bit. I just recently took a trip up to Chick-fil-A headquarters in Atlanta
to look at how they engage and train their workforce.
Um, I also went over and visited some folks at the Atlanta Falcons and, and, uh,
Mercedes-Benz Stadium up in Atlanta because they have the number one fan
experience in the nfl.
So we're trying to look at other industries to see what we can learn to engage
our workforce, to satisfy our workforce,
and therefore create an experience for the patient that will be second
to none. Mm-hmm.
, did anything,
did any key takeaway or surprise really stand out to you most in those visits?
Well, the theme at both of those companies is,
is really what we just talked about a minute ago.
They're trying to just eliminate the friction points of, uh,
whether it's coming to a football game or coming to a fast food
restaurant. Um,
how do we make the experience as easy as possible for the consumer?
And how do we broaden our mission a little bit more and,
and think about creating just an experience, not for one thing. You know,
we wanna take great care of the patient when they're sick,
but we also wanna take care of the entire experience from the appointment
scheduling to the final bill. How do we make that something that is,
uh, is somewhat enjoyable for the, for the consumer or the patient.
Mm-hmm. . Mm-hmm. , well pause.
Is there anything we haven't touched on yet that we'd,
we'd be remiss not to make mention of?
Well, you know, one thing that,
that we're really excited about here is the teaching aspect of what we're doing
as an advanced community health system. We now have, if you can believe this,
up about 80 residents that we're training in conjunction with the
Mayo Clinic here. So very excited for our interns,
our fellows, and, uh, the teaching and training is gonna be, I think,
a vital part of, of healthcare going forward. And we're in it in a big,
big way.
And we're gonna combine that with doing some clinical trials and other kinds of
research to engage and excite these young, uh, doctors and young clinicians.
Well, this has been a delight.
I'm so happy we were able to get some time to check in with you at N C H
Healthcare System on its way to becoming an advanced community healthcare
system, so many different strategic initiatives in play to support that mission.
I, I wanna wish you continued success throughout the rest of this year in,
in driving that home.
And I think we'll stay in touch and continue to keep abreast of the progress
that's unfolding at your, your organization.
Molly, thanks so much.
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