1 00:00:00,235 --> 00:00:02,205 - Prepare to dive into the forefront 2 00:00:02,225 --> 00:00:05,525 of healthcare innovation at our 14th annual meeting coming 3 00:00:05,545 --> 00:00:06,645 up on April 8th 4 00:00:06,645 --> 00:00:10,765 through 11th at the Hyatt Regency in Chicago, with thousands 5 00:00:10,765 --> 00:00:13,965 of industry leaders converging over four dynamic days 6 00:00:13,985 --> 00:00:16,805 of discussions on crucial topics from health IT 7 00:00:17,185 --> 00:00:18,685 to executive leadership. 8 00:00:18,995 --> 00:00:21,325 It's where the future of healthcare takes shape. 9 00:00:21,865 --> 00:00:24,085 We can't wait to connect with you in person 10 00:00:24,305 --> 00:00:26,685 and engage in these important conversations. 11 00:00:27,595 --> 00:00:30,005 - This is Laura Dedo with the Becker's Healthcare Podcast. 12 00:00:30,545 --> 00:00:32,085 I'm thrilled today to be joined by Dr. 13 00:00:32,085 --> 00:00:34,485 Alexa Kimball, CEO of the Harvard Medical Faculty, 14 00:00:34,485 --> 00:00:37,205 physicians and Board member of Beth Israel Lehe Health. 15 00:00:37,785 --> 00:00:38,965 Dr. Kim Melissa, it's a pleasure 16 00:00:38,965 --> 00:00:40,085 to have you on the podcast today. 17 00:00:40,745 --> 00:00:42,125 - Thanks so much for having me 18 00:00:43,105 --> 00:00:44,645 - Now, I know we've got a lot to talk about 19 00:00:44,665 --> 00:00:46,925 and I'm certainly really excited to learn more about 20 00:00:46,925 --> 00:00:49,525 what you're doing at Harvard Medical Faculty Physicians. 21 00:00:49,605 --> 00:00:51,285 I think there's just so much happening in healthcare 22 00:00:51,285 --> 00:00:52,285 and things are changing so quickly. 23 00:00:52,465 --> 00:00:54,325 But before we dive into our discussion, 24 00:00:54,325 --> 00:00:55,405 can you tell me a little bit more about 25 00:00:55,565 --> 00:00:56,645 yourself and your background? 26 00:00:58,485 --> 00:01:01,265 - Uh, thanks so much. So I have been, uh, president 27 00:01:01,265 --> 00:01:04,705 and CEO of this amazing organization for about eight years. 28 00:01:05,035 --> 00:01:09,105 We're a a specialty academic faculty practice plan 29 00:01:09,245 --> 00:01:11,265 of about 2000 providers 30 00:01:11,325 --> 00:01:13,945 and 2200 employees here in Eastern Massachusetts. 31 00:01:14,485 --> 00:01:16,905 Uh, I'm proud to say about two thirds of our faculty 32 00:01:17,445 --> 00:01:20,225 are Harvard, uh, medical school faculty members, 33 00:01:20,285 --> 00:01:22,425 and the rest are amazing Clinicians 34 00:01:22,425 --> 00:01:24,705 who work in our community are a critical part 35 00:01:24,765 --> 00:01:26,145 of everything we do every day 36 00:01:26,145 --> 00:01:27,345 to take great care of patients. 37 00:01:28,705 --> 00:01:30,465 I am also a dermatologist by training, 38 00:01:30,565 --> 00:01:32,505 and I continue to see patients 39 00:01:32,505 --> 00:01:35,265 and manage them with complex dermatologic diseases. 40 00:01:35,945 --> 00:01:38,505 Uh, while it's sometimes hard to squeeze it all in it, 41 00:01:38,665 --> 00:01:41,225 I think makes me much better at my job in understanding 42 00:01:41,575 --> 00:01:44,105 what it is our physicians are trying to do every day, 43 00:01:44,105 --> 00:01:45,585 what our patients are experiencing, 44 00:01:46,005 --> 00:01:48,065 and how we put it all together in a way 45 00:01:48,065 --> 00:01:49,985 that is really holistic to take the best care 46 00:01:49,985 --> 00:01:51,265 of people. Well, 47 00:01:52,215 --> 00:01:54,735 - That's great to hear and certainly so exciting 48 00:01:54,805 --> 00:01:57,175 that you've got a great vantage point in terms of 49 00:01:57,235 --> 00:01:58,895 so many physicians within the organization. 50 00:01:58,915 --> 00:02:00,735 And then too, as you continue to practice 51 00:02:00,755 --> 00:02:02,015 and bring that knowledge 52 00:02:02,015 --> 00:02:04,215 and expertise to your role, what are some 53 00:02:04,215 --> 00:02:05,215 of the biggest issues that you're 54 00:02:05,215 --> 00:02:06,255 following in healthcare today? 55 00:02:07,765 --> 00:02:10,055 - Well, of course, as a leader of a physician group, 56 00:02:10,235 --> 00:02:12,175 my biggest concern is about the welfare 57 00:02:12,435 --> 00:02:13,855 and wellbeing of our physicians. 58 00:02:14,675 --> 00:02:17,655 And we've talked a lot about burnout over the past several 59 00:02:17,655 --> 00:02:20,855 years, and, and I think we've made some good progress in 60 00:02:20,855 --> 00:02:24,255 understanding what's affecting people, what we can, um, 61 00:02:24,435 --> 00:02:27,055 change for them, where we can address some issues. 62 00:02:27,555 --> 00:02:29,935 But we're entering another very dynamic period 63 00:02:30,355 --> 00:02:33,655 as we've seen physicians continue to move into employment, 64 00:02:34,155 --> 00:02:36,535 uh, largely because of both the administrative issues, 65 00:02:36,555 --> 00:02:39,015 but also the tremendous financial pressures. 66 00:02:39,435 --> 00:02:41,495 Uh, we are seeing, um, lots 67 00:02:41,495 --> 00:02:43,655 of changes in certain specialties due 68 00:02:43,655 --> 00:02:45,015 to private equity acquisitions 69 00:02:45,475 --> 00:02:47,655 and an astounding number of physicians in some fields 70 00:02:47,995 --> 00:02:50,895 who are changing their jobs with rapidity. 71 00:02:52,165 --> 00:02:55,415 Some of the most dramatic data I've seen recently is in both 72 00:02:55,415 --> 00:02:58,455 dermatology and ophthalmology, where 50% 73 00:02:58,715 --> 00:03:00,805 and about 35% respectively 74 00:03:00,805 --> 00:03:03,125 of those physicians had changed their sight 75 00:03:03,125 --> 00:03:04,965 of practice over a five year period. 76 00:03:05,345 --> 00:03:07,165 So it's a very dynamic time. 77 00:03:07,985 --> 00:03:10,005 The financial pressures are real, 78 00:03:10,465 --> 00:03:14,645 and until we finish advocating for more, um, 79 00:03:15,265 --> 00:03:17,245 uh, increases for Medicare, for example, 80 00:03:17,525 --> 00:03:19,845 I think these trends are inevitable to continue. 81 00:03:21,915 --> 00:03:23,815 - Oh, that's fascinating to hear, you know, and, 82 00:03:23,815 --> 00:03:26,975 and certainly, um, just really critical 83 00:03:26,975 --> 00:03:29,215 as you were talking about, to look at that, um, 84 00:03:29,475 --> 00:03:31,735 not only the physician wellness 85 00:03:31,875 --> 00:03:35,175 and how they're doing combating burnout is clear, um, 86 00:03:35,175 --> 00:03:36,775 but then to some of these other dynamics 87 00:03:36,775 --> 00:03:39,135 and forces coming into the healthcare space, 88 00:03:39,135 --> 00:03:40,215 whether it's private equity 89 00:03:40,315 --> 00:03:41,455 or other, um, 90 00:03:42,115 --> 00:03:44,375 non-traditional healthcare companies coming in. 91 00:03:44,515 --> 00:03:46,655 And then too, you talked about dermatology 92 00:03:46,715 --> 00:03:48,735 and ophthalmology changing the site of practice. 93 00:03:49,515 --> 00:03:51,975 Are are they going more outpatient, inpatient? 94 00:03:52,045 --> 00:03:53,045 What are you seeing? 95 00:03:55,325 --> 00:03:57,095 - What I think we're seeing for some 96 00:03:57,095 --> 00:03:58,455 of the specialties like dermatology 97 00:03:58,515 --> 00:03:59,855 and ophthalmology, is 98 00:03:59,855 --> 00:04:02,255 that their practices are being acquired. 99 00:04:02,595 --> 00:04:04,895 Um, and so they are being rolled up into 100 00:04:04,895 --> 00:04:05,935 larger organizations. 101 00:04:06,075 --> 00:04:09,375 So while some of those physicians stay in those practices 102 00:04:09,375 --> 00:04:13,055 and continue to practice there, um, both the locations 103 00:04:13,055 --> 00:04:14,615 where they're practicing and the ownership 104 00:04:14,615 --> 00:04:16,175 of those practices are changing. 105 00:04:16,435 --> 00:04:18,855 And so that's where we're seeing, if you look at, 106 00:04:18,855 --> 00:04:22,335 for example, the Medicare databases that their practice, um, 107 00:04:22,375 --> 00:04:24,055 affiliations have been adjusted. 108 00:04:24,675 --> 00:04:26,375 Uh, you know, it didn't used to be that way, right? 109 00:04:26,395 --> 00:04:27,895 You used to go into private practice 110 00:04:27,895 --> 00:04:30,215 and you stayed there for 20 or 30 years. 111 00:04:30,835 --> 00:04:32,735 So we're seeing a lot of changes there. 112 00:04:33,635 --> 00:04:36,495 The other groups that are being affected very dramatically 113 00:04:36,495 --> 00:04:39,015 are things like anesthesia and hospitalist medicine 114 00:04:39,075 --> 00:04:42,335 and emergency department medicine, um, as well 115 00:04:43,365 --> 00:04:46,935 what we see there, again, sometimes the aggregation 116 00:04:46,995 --> 00:04:48,175 of these physician groups 117 00:04:48,675 --> 00:04:51,815 and more of a turn to almost a gig economy 118 00:04:52,065 --> 00:04:54,575 where physicians can travel around the United States 119 00:04:54,715 --> 00:04:57,695 and pick up employment temporarily in some places 120 00:04:57,695 --> 00:04:59,175 where there are are needs, 121 00:04:59,515 --> 00:05:02,295 but it's leading to a very unpredictable 122 00:05:02,295 --> 00:05:04,095 physician, uh, landscape. 123 00:05:05,875 --> 00:05:06,935 - It is really fascinating, 124 00:05:06,955 --> 00:05:08,975 is something we're certainly watching very closely as well. 125 00:05:09,435 --> 00:05:10,695 Now, when you're looking ahead, 126 00:05:10,765 --> 00:05:12,975 what makes you excited and what makes you nervous? 127 00:05:14,355 --> 00:05:16,845 - Well, I'll start with the nervous, which I think, uh, 128 00:05:16,845 --> 00:05:19,125 you know, is synergistic with what I just talked about is, 129 00:05:19,125 --> 00:05:20,805 is that we have been projecting 130 00:05:20,805 --> 00:05:22,285 physician shortages for some time. 131 00:05:22,585 --> 00:05:23,645 But I think all the changes 132 00:05:23,675 --> 00:05:26,645 that we are seeing in the physician workforce right now, uh, 133 00:05:26,645 --> 00:05:28,925 including physicians reducing their overall hours, 134 00:05:28,965 --> 00:05:32,885 particularly their patient facing hours, will continue 135 00:05:33,745 --> 00:05:36,285 the concept that people are gonna retire early has 136 00:05:36,285 --> 00:05:37,485 never really panned out. 137 00:05:37,585 --> 00:05:40,205 But we definitely see overall in the trends 138 00:05:40,235 --> 00:05:41,845 that physician hours are down. 139 00:05:41,905 --> 00:05:43,845 And so access to physicians, 140 00:05:44,015 --> 00:05:46,165 which is already a major problem in most places, 141 00:05:46,385 --> 00:05:47,565 uh, is only gonna continue. 142 00:05:48,745 --> 00:05:52,925 Now, that said, uh, I am incredibly excited about what, uh, 143 00:05:53,445 --> 00:05:54,645 medicine has to offer patients 144 00:05:54,705 --> 00:05:57,285 and, uh, you know, even just over the past few days, 145 00:05:57,635 --> 00:06:01,205 it's an amazing feeling when you have, um, a sick child 146 00:06:01,425 --> 00:06:02,525 or a sick adult 147 00:06:02,945 --> 00:06:04,845 and you get them to the right expert 148 00:06:04,985 --> 00:06:07,805 who can just look at the problem and say, I know what to do. 149 00:06:08,165 --> 00:06:10,525 I know how to help you all. I'm not confused by this. 150 00:06:10,985 --> 00:06:12,325 Uh, and I have experience in this, 151 00:06:12,945 --> 00:06:16,165 and we make people so much better when we make 152 00:06:16,165 --> 00:06:18,845 that connection of, of that experience. 153 00:06:19,345 --> 00:06:21,165 Um, and it's incredibly gratifying. 154 00:06:22,025 --> 00:06:24,685 We do so many things so well in medicine. 155 00:06:24,905 --> 00:06:27,845 We just have to figure out how to organize the system better 156 00:06:27,865 --> 00:06:29,525 to get the the right care to the right people. 157 00:06:30,805 --> 00:06:32,245 I know that sounds a little bit trite, 158 00:06:32,425 --> 00:06:35,365 but again, that feeling of getting the right patient 159 00:06:35,425 --> 00:06:37,645 to the right expert in the moment that they need, 160 00:06:37,645 --> 00:06:39,005 it makes such a difference. 161 00:06:40,775 --> 00:06:43,735 - I can imagine. You know, as you mentioned, it is just, um, 162 00:06:44,195 --> 00:06:46,335 so, uh, broad of a task to do that 163 00:06:46,335 --> 00:06:48,775 with every single patient, but certainly exciting 164 00:06:48,775 --> 00:06:50,175 that the possibility is there. 165 00:06:50,315 --> 00:06:52,895 And now, especially as you were talking through, is some 166 00:06:52,895 --> 00:06:54,135 of the different technology 167 00:06:54,475 --> 00:06:57,175 and ability to connect with patients on different levels. 168 00:06:57,715 --> 00:06:59,895 Um, it'll be interesting to see how 169 00:06:59,895 --> 00:07:01,055 that continues to play out. 170 00:07:02,235 --> 00:07:04,095 - Uh, and I think, you know, while there's a lot of hype 171 00:07:04,095 --> 00:07:06,575 around AI that probably exceeds its, um, 172 00:07:06,605 --> 00:07:09,455 reality in many levels, um, one of the areas 173 00:07:09,455 --> 00:07:12,255 where I do think there can be some real health isn't 174 00:07:12,455 --> 00:07:14,495 reducing some of the administrative burden for physicians. 175 00:07:14,675 --> 00:07:16,895 Um, and that's where I'm excited about seeing some 176 00:07:16,895 --> 00:07:18,255 of the applications really emerge. 177 00:07:19,745 --> 00:07:21,035 - That makes sense. That makes sense. 178 00:07:21,175 --> 00:07:22,875 So, you know, given the, these trends, 179 00:07:22,875 --> 00:07:24,835 whether we're looking at, um, you know, 180 00:07:25,055 --> 00:07:26,155 the physician workforce 181 00:07:26,695 --> 00:07:28,275 or some of the, the different ways 182 00:07:28,275 --> 00:07:30,675 that specialties are changing, um, the, 183 00:07:30,775 --> 00:07:33,395 the really whole field is changing, what do you see 184 00:07:33,395 --> 00:07:36,355 as being most effective, um, for he healthcare leaders? 185 00:07:36,355 --> 00:07:38,635 What do they need in order to be successful over the next 186 00:07:38,655 --> 00:07:39,715 two to three years or so? 187 00:07:41,095 --> 00:07:43,635 - Uh, healthcare leaders have better be able 188 00:07:43,655 --> 00:07:46,835 to hang on a tight, it's gonna be a little bit 189 00:07:46,835 --> 00:07:47,835 of a rollercoaster ride. 190 00:07:47,915 --> 00:07:50,235 I think, uh, as we get to the next few years, 191 00:07:50,235 --> 00:07:51,795 there's a lot of things on the horizon. 192 00:07:52,295 --> 00:07:54,275 Uh, the fiscal pressures as we talked about, 193 00:07:54,695 --> 00:07:56,395 the regulatory changes, um, 194 00:07:56,395 --> 00:07:57,795 and I think some of the oversight 195 00:07:57,825 --> 00:08:00,035 that is now being discussed in a lot 196 00:08:00,035 --> 00:08:01,995 of different areas, uh, ahead. 197 00:08:02,335 --> 00:08:04,995 So I think it's about maintaining your compass in the middle 198 00:08:05,135 --> 00:08:08,795 of all of this and being able to adapt to changes that 199 00:08:08,985 --> 00:08:10,155 that are coming, 200 00:08:10,335 --> 00:08:12,835 but also be thinking proactively about the changes 201 00:08:12,865 --> 00:08:14,395 that are likely to happen, uh, 202 00:08:14,395 --> 00:08:17,515 and be a little bit ahead of the game where you can, um, it, 203 00:08:17,575 --> 00:08:20,195 uh, be aware, make sure you're talking to your colleagues. 204 00:08:20,595 --> 00:08:23,195 Everyone is experiencing many of the same problems, 205 00:08:23,255 --> 00:08:24,875 but everyone's solving them a little bit differently. 206 00:08:25,375 --> 00:08:28,555 Uh, and I think the more that we have conversations about 207 00:08:28,615 --> 00:08:30,755 how to address these things, the better off we're gonna be. 208 00:08:32,285 --> 00:08:33,695 - That makes a lot of sense. Dr. 209 00:08:33,695 --> 00:08:34,855 Kimball, thank you so much for joining 210 00:08:34,855 --> 00:08:35,935 us on the podcast today. 211 00:08:35,935 --> 00:08:37,735 This has been such a fun conversation 212 00:08:37,755 --> 00:08:39,575 and I look forward to connecting with you again soon. 213 00:08:40,795 --> 00:08:42,385 - Great. Thanks so much for having me today.