1 00:00:00,437 --> 00:00:02,662 Hi, everyone, and welcome to the Becker healthcare 2 00:00:02,662 --> 00:00:03,400 care podcast. 3 00:00:03,774 --> 00:00:06,794 I'm Mackenzie Bean, Av and managing editor of 4 00:00:06,953 --> 00:00:08,383 Becker hospital review. 5 00:00:09,274 --> 00:00:11,506 Today, I am so thrilled to be joined 6 00:00:11,506 --> 00:00:13,978 by doctor John Barb who with the chief 7 00:00:14,138 --> 00:00:17,907 Medical Officer and vice President of Ambulatory services 8 00:00:18,380 --> 00:00:20,539 at Burg New bridge Medical Center, 9 00:00:20,940 --> 00:00:23,179 doctor Barb. Thank you so much for joining 10 00:00:23,179 --> 00:00:24,140 me. How are you? 11 00:00:25,019 --> 00:00:26,460 I'm good. Thank you so much for having 12 00:00:26,460 --> 00:00:27,100 me Mackenzie. 13 00:00:27,674 --> 00:00:29,981 Yeah. I'm I'm excited for our conversation. I 14 00:00:29,981 --> 00:00:32,924 think you bring such a valuable perspective from 15 00:00:32,924 --> 00:00:34,140 your medical center 16 00:00:34,928 --> 00:00:37,640 Before we dive in though, can you introduce 17 00:00:37,640 --> 00:00:38,837 yourself and tell us a little bit more 18 00:00:38,837 --> 00:00:39,815 about your background 19 00:00:40,272 --> 00:00:42,107 for anyone who is not familiar with some 20 00:00:42,107 --> 00:00:43,702 of your past podcast episodes? 21 00:00:44,834 --> 00:00:46,588 Sure. As you said, my name is Doctor 22 00:00:46,747 --> 00:00:49,299 John Barb. I'm Chief Medical Officer and Vice 23 00:00:49,379 --> 00:00:50,814 President of Ambulatory Services. 24 00:00:51,213 --> 00:00:53,525 My background is I'm an internal medicine physician. 25 00:00:54,018 --> 00:00:55,609 I was 1 of the early hospital list. 26 00:00:55,768 --> 00:00:57,916 So the first part of my career, I 27 00:00:57,916 --> 00:01:00,621 spent building hospitals programs in a few different 28 00:01:00,621 --> 00:01:02,629 places I founded it 1, I basically help 29 00:01:02,629 --> 00:01:04,942 build up 2 other ones. I started off 30 00:01:04,942 --> 00:01:07,175 in lot of the big academic centers and 31 00:01:07,175 --> 00:01:10,819 got very involved in improving patient quality and 32 00:01:11,099 --> 00:01:11,500 safety. 33 00:01:12,459 --> 00:01:14,540 Eventually, I ended up... I I was the 34 00:01:14,540 --> 00:01:17,340 person was always arguing with the administration. So 35 00:01:17,500 --> 00:01:19,155 I decided to go back and get an 36 00:01:19,274 --> 00:01:21,342 Va, so that I could speak their language 37 00:01:21,342 --> 00:01:23,172 because I realized that I was speaking doctor, 38 00:01:23,331 --> 00:01:24,683 and nobody... But was hearing me. 39 00:01:25,717 --> 00:01:27,965 And So I kind of fell into a 40 00:01:27,965 --> 00:01:30,439 leadership position more out of the, you know, 41 00:01:30,598 --> 00:01:32,274 what I'll do it myself kind of thing. 42 00:01:32,513 --> 00:01:33,631 There's a little bit of Arrogance. 43 00:01:34,283 --> 00:01:36,988 And eventually, ended up getting pulled and got 44 00:01:36,988 --> 00:01:38,579 involved in starting a lot of different programs. 45 00:01:38,817 --> 00:01:40,988 My career kind of took a pathway where 46 00:01:41,377 --> 00:01:43,281 I either help start a few different things 47 00:01:43,360 --> 00:01:45,105 I help found the residency program in a 48 00:01:45,105 --> 00:01:47,351 medical school in a clinically integrated network 49 00:01:47,723 --> 00:01:49,644 or I helped turnaround broken things. 50 00:01:50,359 --> 00:01:52,344 Was that another hospital of my first Cmo 51 00:01:52,344 --> 00:01:54,250 job that had been failing for a few 52 00:01:54,250 --> 00:01:55,442 years I was there for about 2 and 53 00:01:55,442 --> 00:01:56,633 a half years when we helped turn that 54 00:01:56,633 --> 00:01:57,999 around. And now it's been at Bergen New 55 00:01:57,999 --> 00:02:00,870 bridge for the last 6.5 plus years in 56 00:02:00,870 --> 00:02:02,944 the Cmo in total about 9 years now. 57 00:02:03,263 --> 00:02:04,937 But at Bergen New Bridge is a County 58 00:02:04,937 --> 00:02:07,545 hospital in Northern New Jersey that was failing 59 00:02:07,664 --> 00:02:09,892 badly for decades on 6 and a half 60 00:02:09,892 --> 00:02:12,199 years ago, they basically had a complete leadership 61 00:02:12,199 --> 00:02:14,745 change. They dissolved the old corporation formed the 62 00:02:14,745 --> 00:02:16,177 new enough for profit to manage it. 63 00:02:16,828 --> 00:02:19,446 And we've been pretty successful in helping to 64 00:02:19,446 --> 00:02:21,430 turn the place around. We've created a whole 65 00:02:21,430 --> 00:02:22,803 bunch of new innovative programs 66 00:02:23,334 --> 00:02:23,834 and 67 00:02:24,144 --> 00:02:25,737 we've won all kinds of quality awards and 68 00:02:25,737 --> 00:02:27,091 receive recognition for a lot of the work 69 00:02:27,091 --> 00:02:28,445 we've done here. Mh. 70 00:02:28,844 --> 00:02:30,835 That's amazing. You know, you have quite a 71 00:02:30,835 --> 00:02:32,667 bit of experience and as you say, 72 00:02:33,639 --> 00:02:36,516 turning around broken things, getting new programs, whether 73 00:02:36,516 --> 00:02:39,233 it's residency, hospitals programs off the ground. 74 00:02:40,432 --> 00:02:43,044 I'm curious looking ahead, say, in the next 75 00:02:43,323 --> 00:02:46,663 year at new Ep New bridge Medical? What 76 00:02:46,663 --> 00:02:48,572 do you foresee as the biggest challenge? 77 00:02:48,970 --> 00:02:50,720 And how are you really preparing for that 78 00:02:50,720 --> 00:02:50,958 now? 79 00:02:52,485 --> 00:02:54,871 I think there were a few big challenges. 80 00:02:55,428 --> 00:02:57,655 I think 1 is the 1 that everybody 81 00:02:57,655 --> 00:02:59,894 is kind of dealing with is that healthcare 82 00:02:59,894 --> 00:03:01,266 care is changing so rapidly 83 00:03:01,718 --> 00:03:03,462 that I think we have to keep up 84 00:03:03,462 --> 00:03:04,969 and keep ahead of And I think that's 85 00:03:04,969 --> 00:03:08,330 on everybody. New bridge we're a safety at 86 00:03:08,330 --> 00:03:10,330 hospital. And we have a lot of competition 87 00:03:10,330 --> 00:03:12,009 around us. And as I mentioned, we've been 88 00:03:12,009 --> 00:03:13,610 failing for so long. We started with a 89 00:03:13,610 --> 00:03:16,100 negative reputation. Although we've build stuff up. We 90 00:03:16,100 --> 00:03:18,249 still have to break through that. But I 91 00:03:18,249 --> 00:03:20,023 think the bigger issue is just 92 00:03:20,717 --> 00:03:22,309 everybody kind of does the same things in 93 00:03:22,309 --> 00:03:22,786 health. 94 00:03:23,279 --> 00:03:24,710 And I think we really have to start 95 00:03:24,710 --> 00:03:27,094 thinking more outside the box and looking at 96 00:03:27,094 --> 00:03:28,605 things more from a patient perspective. 97 00:03:29,400 --> 00:03:31,013 So it's figuring out what 98 00:03:31,322 --> 00:03:33,383 are going to be successful building them so 99 00:03:33,383 --> 00:03:35,047 that they take good care of patients with 100 00:03:35,047 --> 00:03:36,949 high quality, but doing them also efficiently. 101 00:03:38,947 --> 00:03:40,298 You wanted into all kinds of other issues 102 00:03:40,298 --> 00:03:42,364 as you do that. Staffing is a major 103 00:03:42,364 --> 00:03:44,509 1. We're no longer in the staffing crunch 104 00:03:44,509 --> 00:03:47,052 that we were in post immediately post pandemic. 105 00:03:47,624 --> 00:03:50,261 But there's still a national physician shortage. So 106 00:03:50,261 --> 00:03:52,817 recruiting quality physicians and then maintaining them, 107 00:03:53,696 --> 00:03:55,788 making sure that people don't burn out making 108 00:03:55,788 --> 00:03:58,366 sure people engaged and that's both physicians and 109 00:03:58,585 --> 00:04:00,743 other staff, whether it's other clinical staff like 110 00:04:00,743 --> 00:04:02,740 nursing or social workers or even the non 111 00:04:02,740 --> 00:04:04,914 clinical staff it's all really important to keep 112 00:04:04,914 --> 00:04:07,314 people engaged and really believing in what they're 113 00:04:07,314 --> 00:04:07,715 doing, 114 00:04:08,435 --> 00:04:09,574 so that they can 115 00:04:10,115 --> 00:04:11,495 so that you can get more 116 00:04:12,208 --> 00:04:14,361 with with with what you do have from 117 00:04:14,361 --> 00:04:16,116 it because you you're never really gonna to 118 00:04:16,116 --> 00:04:17,950 be that's the way you would like to. 119 00:04:18,030 --> 00:04:20,583 You can always have more staffing, but I 120 00:04:20,583 --> 00:04:22,429 think we really need to ways to do 121 00:04:22,429 --> 00:04:23,803 things better and 122 00:04:24,416 --> 00:04:24,916 smarter 123 00:04:26,006 --> 00:04:27,834 than we've been doing for many, many years. 124 00:04:28,231 --> 00:04:29,344 I think that those are the big challenges. 125 00:04:29,503 --> 00:04:29,980 And of course, 126 00:04:30,949 --> 00:04:33,100 then there's all the other challenges going on, 127 00:04:33,259 --> 00:04:35,490 like, how do you incorporate other new technologies? 128 00:04:35,649 --> 00:04:37,163 You know, kind of... It'll all... It's all 129 00:04:37,163 --> 00:04:38,756 kind of a piece. Right? Like if you're 130 00:04:38,756 --> 00:04:41,001 trying to innovate and trying to new programs. 131 00:04:42,513 --> 00:04:44,981 Technology can be helpful there, but there's also 132 00:04:44,981 --> 00:04:46,754 a tendency I think in healthcare 133 00:04:48,578 --> 00:04:50,888 run after technology for technology sake and not 134 00:04:50,888 --> 00:04:52,561 think about how to use it wisely. 135 00:04:53,437 --> 00:04:55,450 At the same time, I think that there's 136 00:04:55,587 --> 00:04:56,804 tremendous opportunities 137 00:04:57,514 --> 00:04:59,988 if a lot of different things, Ai obviously 138 00:04:59,988 --> 00:05:01,584 being that the sexy 1. 139 00:05:02,302 --> 00:05:04,796 But again, you can you can also 140 00:05:05,268 --> 00:05:07,257 can also blow up on you if you're 141 00:05:07,257 --> 00:05:09,564 not really thinking it through well in advance. 142 00:05:09,803 --> 00:05:11,394 And, again, we have a tendency to either 143 00:05:11,394 --> 00:05:13,621 in healthcare take way too long thinking about 144 00:05:13,621 --> 00:05:15,306 stuff. Or to rush into things. And I 145 00:05:15,306 --> 00:05:17,294 think finding that just right level is the 146 00:05:17,294 --> 00:05:17,851 main challenge? 147 00:05:20,157 --> 00:05:20,657 So 148 00:05:21,032 --> 00:05:22,701 a broad range of challenges, like you said, 149 00:05:22,861 --> 00:05:25,108 many health systems are facing right now in 150 00:05:25,108 --> 00:05:25,847 terms of 151 00:05:26,386 --> 00:05:28,543 up with the rapid changes in health care. 152 00:05:28,942 --> 00:05:30,915 It's really needing to start to think out 153 00:05:31,034 --> 00:05:32,463 side of the box in terms of some 154 00:05:32,463 --> 00:05:34,869 of the care delivery programs, how you're navigating, 155 00:05:35,480 --> 00:05:38,974 staffing shortages, and then, how technology really pleased 156 00:05:38,974 --> 00:05:39,768 piece into that. 157 00:05:40,499 --> 00:05:43,229 Is there a specific example or initiative 158 00:05:43,685 --> 00:05:46,552 that you're particularly excited about that you're hoping 159 00:05:46,552 --> 00:05:49,181 will really help the medical system get ahead 160 00:05:49,181 --> 00:05:50,311 of based challenges? 161 00:05:51,188 --> 00:05:53,020 So I think that there's AAA 162 00:05:53,020 --> 00:05:55,251 general piece. We're just trying to launch now 163 00:05:55,251 --> 00:05:56,924 a whole bunch of new different clinical programs. 164 00:05:57,084 --> 00:05:58,279 So they all have a similar, 165 00:05:59,887 --> 00:06:02,118 a similar bench, which is what we've really 166 00:06:02,118 --> 00:06:04,587 done successfully is the way I described is 167 00:06:04,587 --> 00:06:06,203 is democrat concierge 168 00:06:06,595 --> 00:06:08,435 and concierge most and typically for rich people 169 00:06:08,435 --> 00:06:11,014 who safety at hospital. But it's really 170 00:06:11,555 --> 00:06:13,634 making things patient centric have heard people talk 171 00:06:13,634 --> 00:06:15,154 about population held for decades. 172 00:06:15,970 --> 00:06:17,729 But again, a lot of times she could 173 00:06:17,729 --> 00:06:18,930 do a lot of the same stuff. And 174 00:06:19,009 --> 00:06:21,329 I think creating systems so that it's easy 175 00:06:21,329 --> 00:06:22,370 for the patients to use. 176 00:06:23,024 --> 00:06:23,762 Or services 177 00:06:24,375 --> 00:06:26,624 and also to prevent the services they need 178 00:06:26,840 --> 00:06:28,747 when they need them is the key piece. 179 00:06:28,986 --> 00:06:30,417 You know, We have this tenancy in healthcare 180 00:06:30,417 --> 00:06:31,927 care to do these things to patients. 181 00:06:32,499 --> 00:06:33,931 Where we make it hard for them even 182 00:06:33,931 --> 00:06:35,523 with things like my chart and other stuff, 183 00:06:35,682 --> 00:06:37,274 which is easier than it used to be 184 00:06:37,274 --> 00:06:37,774 and 185 00:06:38,229 --> 00:06:40,776 so difficult. You know, most people don't have 186 00:06:40,776 --> 00:06:43,742 medical knowledge. We tend to forget that. People 187 00:06:43,742 --> 00:06:45,340 have to take off from work to come 188 00:06:45,340 --> 00:06:47,338 see us. That, you know, we can bring 189 00:06:47,338 --> 00:06:49,016 stuff to them. We can make things easier 190 00:06:49,016 --> 00:06:49,915 for them. So 191 00:06:51,022 --> 00:06:52,688 we're doing all kinds of things everything from 192 00:06:52,688 --> 00:06:54,830 adding on all kinds of new navigators to 193 00:06:54,830 --> 00:06:58,106 trying to to use It systems to 194 00:06:58,732 --> 00:07:01,592 alleviate some of that work, making follow phone 195 00:07:01,592 --> 00:07:04,055 calls with patients, not and not just the 196 00:07:04,055 --> 00:07:05,540 typical, you know, follow phone 197 00:07:06,135 --> 00:07:08,677 but really trying to navigate them through through 198 00:07:08,677 --> 00:07:10,821 things. And then the other big piece is 199 00:07:10,821 --> 00:07:12,807 rethinking how we clinically take care of patients, 200 00:07:13,124 --> 00:07:13,283 know, 201 00:07:14,092 --> 00:07:15,917 Again, we have the tendency to bring patients 202 00:07:15,917 --> 00:07:17,767 in for these long visits 203 00:07:18,139 --> 00:07:19,250 where they have to take off from work. 204 00:07:19,409 --> 00:07:20,996 They have to come in, they have to 205 00:07:20,996 --> 00:07:22,480 do all kinds of different stuff. They have 206 00:07:22,600 --> 00:07:24,360 find somebody to watch their kids if the 207 00:07:24,360 --> 00:07:25,720 if their kids are home, you know, it's 208 00:07:25,720 --> 00:07:27,800 a summertime time now, so that that becomes 209 00:07:27,800 --> 00:07:29,000 an issue for some people. 210 00:07:30,120 --> 00:07:33,247 You know, instead, know, Telemedicine was 1 of 211 00:07:33,247 --> 00:07:35,153 the big breakouts of the pandemic, 212 00:07:36,106 --> 00:07:38,750 I think that doing more frequent shorter visits 213 00:07:39,044 --> 00:07:40,020 and point telemedicine. 214 00:07:40,885 --> 00:07:43,345 Is very helpful and we've been very successful 215 00:07:43,345 --> 00:07:44,059 in doing that. 216 00:07:45,408 --> 00:07:46,305 I think that 217 00:07:47,551 --> 00:07:48,368 the real 218 00:07:49,154 --> 00:07:50,935 challenge in all of this 219 00:07:51,314 --> 00:07:51,814 is 220 00:07:52,754 --> 00:07:54,354 bringing people along for the ride. 221 00:07:55,235 --> 00:07:57,314 While everybody says that they want change people 222 00:07:57,314 --> 00:07:59,638 don't really want change a lot of the 223 00:07:59,638 --> 00:07:59,797 time. 224 00:08:03,051 --> 00:08:04,821 I learned this when I was building hospital 225 00:08:04,877 --> 00:08:05,353 programs. 226 00:08:05,925 --> 00:08:07,604 I would go in and people would be 227 00:08:07,604 --> 00:08:09,845 all excited. And it would say, this is 228 00:08:09,845 --> 00:08:11,204 exactly what we need. And the person who 229 00:08:11,204 --> 00:08:12,805 was saying that was the person who became 230 00:08:12,805 --> 00:08:13,464 the biggest 231 00:08:14,175 --> 00:08:16,580 complain or once we actually implemented the changes 232 00:08:16,635 --> 00:08:18,381 because whatever I'm reason when they think the 233 00:08:18,381 --> 00:08:20,602 change is needed, what they actually mean is 234 00:08:20,602 --> 00:08:22,773 everybody else needs to change, they don't realize 235 00:08:22,773 --> 00:08:24,291 how it's going to impact them, and it's 236 00:08:24,291 --> 00:08:26,528 really important to put yourself in the shoes 237 00:08:26,528 --> 00:08:27,028 of 238 00:08:27,408 --> 00:08:29,485 both your staff and the patients and everybody 239 00:08:29,485 --> 00:08:31,519 around you when you're try implement these changes 240 00:08:31,979 --> 00:08:33,820 because you're always going to get pushed back 241 00:08:33,820 --> 00:08:36,139 and you need to prepare for that and 242 00:08:36,139 --> 00:08:37,899 you need to anticipate it and you need 243 00:08:37,899 --> 00:08:38,399 to 244 00:08:38,793 --> 00:08:39,985 be ahead of the curve on it. 245 00:08:40,779 --> 00:08:42,448 And we've done a good job of doing 246 00:08:42,448 --> 00:08:44,355 that. It was never it's never smooth. 247 00:08:46,279 --> 00:08:49,159 Yeah. Change management is hard right and gaining 248 00:08:49,159 --> 00:08:51,000 by. And it is no easy for you. 249 00:08:52,039 --> 00:08:54,292 No. Not at all. What what have you 250 00:08:54,292 --> 00:08:56,626 found most effective in those areas with your 251 00:08:57,322 --> 00:08:57,960 physician teams? 252 00:09:00,194 --> 00:09:03,559 I think that, you know, I I it 253 00:09:03,559 --> 00:09:04,675 sounds kinda h, 254 00:09:05,234 --> 00:09:07,887 but but my typical answer to this is 255 00:09:07,946 --> 00:09:08,743 is empathy. 256 00:09:09,940 --> 00:09:12,093 It's really important to be able to put 257 00:09:12,093 --> 00:09:14,282 yourself in other people's shoes. I think that 258 00:09:15,293 --> 00:09:16,827 everybody thinks they're doing that. But 259 00:09:17,759 --> 00:09:19,668 you know, and look, there are... That's what 260 00:09:19,668 --> 00:09:21,758 works for me. You know, that that might 261 00:09:21,758 --> 00:09:23,676 not be other people style and it's okay. 262 00:09:24,395 --> 00:09:25,914 But for me, the way I've been able 263 00:09:25,914 --> 00:09:28,471 to manage it is to really try to 264 00:09:28,471 --> 00:09:28,971 understand 265 00:09:29,844 --> 00:09:31,355 what it looks like on their level. And 266 00:09:31,514 --> 00:09:34,139 I think in healthcare leadership, we forget that 267 00:09:34,139 --> 00:09:34,537 sometimes. 268 00:09:35,094 --> 00:09:36,924 There's a it's really easy and that's not 269 00:09:36,924 --> 00:09:38,570 just in healthcare leadership, this is 270 00:09:39,085 --> 00:09:41,305 nature, right to few things from your own 271 00:09:41,305 --> 00:09:42,836 point of view and to think that 272 00:09:43,843 --> 00:09:45,350 your little corner of the world is the 273 00:09:45,350 --> 00:09:45,746 whole world. 274 00:09:48,071 --> 00:09:49,668 Again, when I was somebody who's kind of 275 00:09:49,668 --> 00:09:50,945 working up to the system, it used to 276 00:09:50,945 --> 00:09:52,243 really frustrate me 277 00:09:53,100 --> 00:09:55,357 that sometimes leadership would think 278 00:09:56,068 --> 00:09:57,577 that everything that was going on the hospital 279 00:09:57,577 --> 00:10:00,435 was happening in their executive suite. And now 280 00:10:00,435 --> 00:10:02,341 that I'm in the executive suite, I I 281 00:10:02,341 --> 00:10:04,906 remember that, and it's really important. I think 282 00:10:05,041 --> 00:10:06,894 for people to get out there. I I 283 00:10:06,894 --> 00:10:09,535 have a natural easy pathway. I'm the physician. 284 00:10:09,695 --> 00:10:11,934 I feel practice clinically. So I practice at 285 00:10:11,934 --> 00:10:12,434 my 286 00:10:12,989 --> 00:10:15,087 at my facility. You know? And, 287 00:10:15,467 --> 00:10:16,985 I mentioned at the beginning, I started as 288 00:10:16,985 --> 00:10:18,903 a hospital, so I I do in internships, 289 00:10:19,063 --> 00:10:19,702 but I also, 290 00:10:20,581 --> 00:10:22,991 once they became a Cmo, I started doing 291 00:10:22,991 --> 00:10:24,896 primary care again, so I work in our 292 00:10:24,896 --> 00:10:27,381 ambulatory settings too. And I think that really 293 00:10:27,993 --> 00:10:30,001 1, it gets me buy in not just 294 00:10:30,629 --> 00:10:32,225 positions but from the staff because they see 295 00:10:32,225 --> 00:10:34,459 me as 1 of them, You know, I'm 296 00:10:34,619 --> 00:10:36,295 I'm there with them in the trenches doing 297 00:10:36,295 --> 00:10:36,614 the work. 298 00:10:37,572 --> 00:10:40,565 And 2, it allows me to understand 299 00:10:41,105 --> 00:10:42,625 issues from their perspective and to kind of 300 00:10:42,625 --> 00:10:44,304 be ahead of stuff because I'm they're doing 301 00:10:44,304 --> 00:10:45,985 it and I face the same challenges that 302 00:10:45,985 --> 00:10:46,465 they do. 303 00:10:47,198 --> 00:10:48,975 And I do think it's really important 304 00:10:49,591 --> 00:10:51,288 for leaders to 305 00:10:51,745 --> 00:10:54,717 to stay connected with what's actually happening out 306 00:10:54,855 --> 00:10:57,344 on the floors or in the in the 307 00:10:57,344 --> 00:10:59,262 offices or any of those types of things. 308 00:10:59,742 --> 00:11:00,721 You know, I 309 00:11:01,660 --> 00:11:03,258 again, it's easier as a Cmo than it 310 00:11:03,258 --> 00:11:04,717 isn't in some of some other 311 00:11:05,416 --> 00:11:06,455 positions. Mh. 312 00:11:06,948 --> 00:11:09,563 But even Cmos, I mean, most Cmos, I 313 00:11:09,563 --> 00:11:12,020 meet don't practice clinically anymore. And I think 314 00:11:12,020 --> 00:11:12,496 that's a shame. 315 00:11:13,447 --> 00:11:15,210 You know, I again, I think I get 316 00:11:15,210 --> 00:11:16,724 so much out of doing plus. I still 317 00:11:16,724 --> 00:11:17,760 enjoy it. But 318 00:11:18,318 --> 00:11:20,469 but I I think it's just really important 319 00:11:20,469 --> 00:11:23,348 to to find some way to actually be 320 00:11:23,348 --> 00:11:25,177 in the trenches with your people, at least 321 00:11:25,177 --> 00:11:26,211 a little bit of time You don't have 322 00:11:26,211 --> 00:11:27,960 to do it a time. But I think 323 00:11:27,960 --> 00:11:28,914 it's really important. 324 00:11:29,789 --> 00:11:30,584 Because again, 325 00:11:31,394 --> 00:11:32,453 you know, my staff 326 00:11:33,070 --> 00:11:34,825 knows that I never ask him to do 327 00:11:34,825 --> 00:11:36,660 anything. I'm not willing to do first. You 328 00:11:36,660 --> 00:11:38,988 know, when when Covid hit, and we were 329 00:11:38,988 --> 00:11:39,945 in the sick of it because we're in 330 00:11:40,025 --> 00:11:41,859 Northern New Jersey, so we were hit when 331 00:11:42,019 --> 00:11:43,534 New York city was the same way. 332 00:11:44,412 --> 00:11:45,927 You know, everybody was afraid to see patients. 333 00:11:46,166 --> 00:11:47,522 I was the first doctor here to see 334 00:11:47,602 --> 00:11:48,240 Covid patients. 335 00:11:49,053 --> 00:11:50,650 You know, and it became very hard for 336 00:11:50,650 --> 00:11:52,566 people to not wanna do stuff when I 337 00:11:52,566 --> 00:11:54,482 was doing it already. And it wasn't... I 338 00:11:54,482 --> 00:11:55,679 didn't do it for that reason. I did 339 00:11:55,679 --> 00:11:57,037 it to show people, like, I'm willing to 340 00:11:57,037 --> 00:11:59,606 do this as well. And again, it it 341 00:11:59,606 --> 00:12:01,761 makes it makes me 1 of them and 342 00:12:01,761 --> 00:12:03,996 so they understand that I see things from 343 00:12:03,996 --> 00:12:05,832 their perspective too. And then it's just listening 344 00:12:05,832 --> 00:12:07,603 to them and not blowing things off. 345 00:12:08,800 --> 00:12:11,035 That's the other important piece, I think to 346 00:12:11,035 --> 00:12:14,148 change management. It's the other big 1 is 347 00:12:14,148 --> 00:12:15,425 to not be too precious. 348 00:12:16,399 --> 00:12:17,618 It's really easy 349 00:12:17,997 --> 00:12:20,095 to we make all these plans 350 00:12:20,474 --> 00:12:23,031 and the reality is that things never go 351 00:12:23,031 --> 00:12:23,830 according to your plan. 352 00:12:24,484 --> 00:12:24,803 Never. 353 00:12:25,680 --> 00:12:27,354 And it's really easy to get stuck and 354 00:12:27,354 --> 00:12:28,470 think what we have to do because this 355 00:12:28,470 --> 00:12:29,825 is how we planned it and you got 356 00:12:29,825 --> 00:12:31,260 to be loose and you got to be 357 00:12:31,260 --> 00:12:32,376 willing to pivot quickly. 358 00:12:33,189 --> 00:12:35,027 And say, okay, that part's not working this 359 00:12:35,027 --> 00:12:36,865 part is, let's adjust it and just be 360 00:12:36,865 --> 00:12:38,884 able to change stuff so that it fits 361 00:12:39,183 --> 00:12:41,740 for what works, because your original plan is 362 00:12:41,740 --> 00:12:43,593 never where you end at least not if 363 00:12:43,593 --> 00:12:44,551 things are working well. 364 00:12:46,706 --> 00:12:47,445 And biggest 365 00:12:47,823 --> 00:12:49,580 the biggest thing that's going to cost you 366 00:12:49,580 --> 00:12:51,176 in terms of quality in terms of time 367 00:12:51,176 --> 00:12:53,027 and in terms of financial cost is when 368 00:12:53,027 --> 00:12:53,586 you make an error. 369 00:12:54,304 --> 00:12:55,123 And so 370 00:12:55,661 --> 00:12:57,337 being able to get away from the ever 371 00:12:57,337 --> 00:12:59,913 and being open do that and trying to 372 00:12:59,972 --> 00:13:01,983 anticipate the errors is probably the most important 373 00:13:01,983 --> 00:13:03,901 thing. III know that was a very long 374 00:13:03,901 --> 00:13:04,061 answer. 375 00:13:05,259 --> 00:13:06,558 No. I think all 376 00:13:06,937 --> 00:13:08,636 variant insightful remarks 377 00:13:09,589 --> 00:13:11,825 you're a great example of servant leadership at 378 00:13:11,825 --> 00:13:13,743 its finest. I've been giving how powerful an 379 00:13:13,743 --> 00:13:15,261 impact that can have on a team, 380 00:13:16,471 --> 00:13:18,456 I wanna Zoom a little bit more And 381 00:13:18,456 --> 00:13:21,076 look at the Chief Medical officer roles specifically. 382 00:13:21,235 --> 00:13:23,061 I know you've been in that goal for 383 00:13:23,061 --> 00:13:24,966 some time. I think over the past decade 384 00:13:24,966 --> 00:13:26,836 plus we've already seen it evolve 385 00:13:27,612 --> 00:13:30,084 to not... To become a lot more strategic. 386 00:13:30,323 --> 00:13:32,316 We're seeing chief medical office have a broader 387 00:13:32,316 --> 00:13:34,071 seat that the table regarding. 388 00:13:34,802 --> 00:13:36,813 Value based care, care delivery strategies 389 00:13:37,665 --> 00:13:39,414 outside of really just being Liaison for the 390 00:13:39,414 --> 00:13:40,210 medical team. 391 00:13:41,164 --> 00:13:43,629 How do you see this role evolving going 392 00:13:43,629 --> 00:13:44,027 forward? 393 00:13:45,394 --> 00:13:46,587 I think it's going to be a lot 394 00:13:46,587 --> 00:13:48,814 more of the same of that same stuff 395 00:13:48,814 --> 00:13:49,610 you just mentioned. 396 00:13:51,614 --> 00:13:53,287 If you talk to different chief medical officers, 397 00:13:53,526 --> 00:13:54,960 I don't think any of us... I I 398 00:13:54,960 --> 00:13:56,315 don't I don't think there's any 2 chief 399 00:13:56,315 --> 00:13:57,909 medical officers in the country who have the 400 00:13:57,909 --> 00:13:58,467 exact same job. 401 00:13:59,200 --> 00:14:01,440 Even within the same system frequently, you know, 402 00:14:01,679 --> 00:14:03,440 you'll speak different people, and their jobs are 403 00:14:03,440 --> 00:14:05,600 always a little different because every place is 404 00:14:05,600 --> 00:14:06,320 a little different. 405 00:14:06,814 --> 00:14:08,333 I do a lot of stuff outside of 406 00:14:08,333 --> 00:14:11,050 the traditional Cmo roles. And I think it's 407 00:14:11,050 --> 00:14:11,950 really important 408 00:14:12,489 --> 00:14:12,989 for 409 00:14:13,607 --> 00:14:15,605 chief medical officers to have a voice in 410 00:14:15,605 --> 00:14:16,165 all of that. 411 00:14:17,058 --> 00:14:20,090 Again, I think that for too long, I 412 00:14:20,090 --> 00:14:22,404 think clinical leaders kind of sat to the 413 00:14:22,404 --> 00:14:22,904 side 414 00:14:23,282 --> 00:14:23,782 and 415 00:14:24,334 --> 00:14:25,932 kind of sat there and complain that things 416 00:14:25,932 --> 00:14:28,089 were happening to them and didn't have a 417 00:14:28,089 --> 00:14:29,527 voice and things. And I think it's really 418 00:14:29,527 --> 00:14:31,937 important to have those voices that at the 419 00:14:31,937 --> 00:14:33,608 table and I think it's really important for 420 00:14:33,687 --> 00:14:35,914 Chief Medical Officers to be more involved as 421 00:14:35,914 --> 00:14:39,574 you've mentioned in strategic decisions and financial decisions 422 00:14:39,574 --> 00:14:40,074 in 423 00:14:40,464 --> 00:14:43,270 in building up value based care in It 424 00:14:44,361 --> 00:14:46,270 development and deployment and governance, 425 00:14:47,304 --> 00:14:48,950 really in kind of everything because it touch 426 00:14:49,069 --> 00:14:49,624 is everything. 427 00:14:50,338 --> 00:14:52,083 Things true of nursing obviously. 428 00:14:52,480 --> 00:14:52,718 You know, 429 00:14:54,067 --> 00:14:56,471 I I think that it's just very, very 430 00:14:56,526 --> 00:14:56,923 important. 431 00:14:57,494 --> 00:14:58,932 And I think that that's going to continue 432 00:14:58,932 --> 00:15:01,089 to happen. And I think that that's a 433 00:15:01,089 --> 00:15:03,586 good thing. And I think it's imperative on 434 00:15:04,618 --> 00:15:07,642 on us the current leadership group to make 435 00:15:07,642 --> 00:15:09,869 sure that there are young people coming up 436 00:15:09,869 --> 00:15:11,779 who are trained to do that. When I 437 00:15:11,779 --> 00:15:12,813 was coming up, 438 00:15:13,624 --> 00:15:14,603 you know, they're 439 00:15:15,379 --> 00:15:16,575 sound like I'm a hundred years old and 440 00:15:16,575 --> 00:15:18,170 not. I'm under 50 for at least a 441 00:15:18,170 --> 00:15:20,084 couple more months. When I was coming up, 442 00:15:20,323 --> 00:15:22,078 you know, not a lot of physicians were 443 00:15:22,078 --> 00:15:23,035 doing this kind of stuff. 444 00:15:23,768 --> 00:15:25,843 And so there wasn't really a way to 445 00:15:25,843 --> 00:15:28,238 learn it. And the good thing is that 446 00:15:28,238 --> 00:15:29,137 there now 447 00:15:29,993 --> 00:15:31,270 a lot more people interested. 448 00:15:32,002 --> 00:15:33,513 The bad news for them is there's less 449 00:15:33,513 --> 00:15:35,660 opportunity because there's more people interested. When I 450 00:15:35,660 --> 00:15:37,807 started doing these things, now I was able 451 00:15:37,807 --> 00:15:39,421 to get a lot of experience early 452 00:15:39,795 --> 00:15:41,600 because I was like, okay. I'll take that 453 00:15:41,798 --> 00:15:43,309 I'll take that on. And so that was 454 00:15:43,309 --> 00:15:44,343 a good thing. 455 00:15:45,854 --> 00:15:47,842 But I do think it's important for physicians 456 00:15:47,842 --> 00:15:49,750 to get that other piece of training. Want 457 00:15:49,750 --> 00:15:51,554 to get involved and see how things work 458 00:15:51,912 --> 00:15:54,297 and also to get other perspectives too, because 459 00:15:54,297 --> 00:15:55,750 again, we can 460 00:15:56,363 --> 00:15:57,499 physicians tend to 461 00:15:57,873 --> 00:15:59,009 think to doctor 462 00:15:59,398 --> 00:16:01,222 sometimes. And so, like, for me 1 of 463 00:16:01,222 --> 00:16:03,150 the most important things was getting that Mba 464 00:16:03,602 --> 00:16:06,085 because it really did give me a 465 00:16:06,394 --> 00:16:09,266 different perspective. I went there originally to learn 466 00:16:09,266 --> 00:16:10,144 the vocabulary. 467 00:16:10,782 --> 00:16:12,777 But what it really did was it gave 468 00:16:12,777 --> 00:16:15,184 me the ability to see things from a 469 00:16:15,184 --> 00:16:17,575 different angle that I was not seeing things 470 00:16:17,575 --> 00:16:18,473 from beforehand. 471 00:16:18,929 --> 00:16:21,103 And so I was able to 472 00:16:21,654 --> 00:16:22,394 to 1 473 00:16:22,774 --> 00:16:24,294 look at the finances and look at the 474 00:16:24,294 --> 00:16:25,815 strategy and think in that way, but I 475 00:16:25,815 --> 00:16:27,115 was also able to discuss 476 00:16:27,654 --> 00:16:29,894 those things intelligently. And it's it's a different 477 00:16:29,894 --> 00:16:30,214 skill set. 478 00:16:31,108 --> 00:16:32,704 Them being a good physician. I think that's 479 00:16:32,704 --> 00:16:34,561 the other thing. I think a lot of 480 00:16:34,700 --> 00:16:37,174 times people end up in these leadership roles 481 00:16:37,174 --> 00:16:38,951 because they're a good physician and 482 00:16:39,744 --> 00:16:42,880 leadership does require some different scales. Some things 483 00:16:42,939 --> 00:16:43,179 overlap, 484 00:16:43,818 --> 00:16:45,496 but there are some things that are different 485 00:16:45,496 --> 00:16:46,315 and I think 486 00:16:47,188 --> 00:16:48,566 it's really important 487 00:16:49,583 --> 00:16:51,819 as the role evolves for people to have 488 00:16:51,819 --> 00:16:52,638 those skills 489 00:16:53,336 --> 00:16:55,172 because I think that's just going to continue. 490 00:16:56,701 --> 00:16:59,582 Yeah. A good physician doesn't always equate to 491 00:16:59,717 --> 00:17:01,304 a good leader. As you said, you'd really 492 00:17:01,304 --> 00:17:03,367 need to fluency in both. So language of 493 00:17:03,367 --> 00:17:05,316 dot and language of 494 00:17:05,853 --> 00:17:06,730 administrator or leader. 495 00:17:07,448 --> 00:17:10,638 Any other advice for listeners out there who 496 00:17:10,638 --> 00:17:12,792 might be physician leaders and aspire to be 497 00:17:12,792 --> 00:17:14,641 a chief medical law or 1 day, What 498 00:17:14,641 --> 00:17:15,357 would you tell about? 499 00:17:16,473 --> 00:17:17,270 I would tell them, 500 00:17:18,067 --> 00:17:20,776 get as much experience in different things that 501 00:17:20,776 --> 00:17:23,086 you can. I kind of alluded to it 502 00:17:23,086 --> 00:17:25,258 before. But, you know, when I was coming 503 00:17:25,258 --> 00:17:27,016 up, you know, I was the person always 504 00:17:27,016 --> 00:17:28,954 said, yes. You know, it became a joke 505 00:17:29,174 --> 00:17:30,852 where, you know, I I mentioned I came 506 00:17:30,852 --> 00:17:32,610 my academic sense. The residents used to joke 507 00:17:32,610 --> 00:17:32,850 about it. 508 00:17:33,741 --> 00:17:35,255 They actually, I heard it from several of 509 00:17:35,255 --> 00:17:37,008 them over the years. Like, I expect you 510 00:17:37,008 --> 00:17:39,159 to come down the hallway pushing a broom 511 00:17:39,159 --> 00:17:41,805 1 day because you have every other job 512 00:17:41,805 --> 00:17:43,399 it seems like in this place. You know, 513 00:17:43,479 --> 00:17:44,914 I was a person who they've, you know, 514 00:17:45,153 --> 00:17:46,429 became a thing of, like, they couldn't get 515 00:17:46,429 --> 00:17:47,705 anybody to do it see if John do 516 00:17:47,705 --> 00:17:50,194 it. And, you know, I typically if I 517 00:17:50,194 --> 00:17:51,954 thought that I could add something I did. 518 00:17:52,994 --> 00:17:55,234 Don't take things on just for the sake 519 00:17:55,234 --> 00:17:56,755 of taking them on. Do it if you 520 00:17:56,755 --> 00:17:58,207 think you have an afford it or if 521 00:17:58,207 --> 00:17:59,723 you think there's something you can learn doing 522 00:17:59,723 --> 00:17:59,882 it. 523 00:18:00,600 --> 00:18:02,594 Sometimes you can over extend yourself too, 524 00:18:03,312 --> 00:18:04,429 you want to do a good job on 525 00:18:04,429 --> 00:18:06,045 those things, but try to get involved 526 00:18:06,502 --> 00:18:07,002 in 527 00:18:07,633 --> 00:18:10,417 projects or an ideas where you can learn 528 00:18:10,417 --> 00:18:12,667 something and you can get experience because there's 529 00:18:12,803 --> 00:18:15,110 you can talk about things theoretically about what 530 00:18:15,110 --> 00:18:15,928 you would do 531 00:18:16,239 --> 00:18:18,470 but there's nothing better than getting hands on 532 00:18:18,470 --> 00:18:20,940 experience. If you don't have an opportunity to 533 00:18:20,940 --> 00:18:23,625 do stuff, the other thing that I recommend 534 00:18:23,824 --> 00:18:26,860 people to do is to watch other people 535 00:18:26,860 --> 00:18:28,778 or leaders. You can always learn stuff from 536 00:18:28,778 --> 00:18:28,937 them, 537 00:18:29,896 --> 00:18:30,695 both good and bad. 538 00:18:31,269 --> 00:18:31,508 You know, 539 00:18:32,385 --> 00:18:34,377 you can watch people you can say what 540 00:18:34,377 --> 00:18:36,130 decision would I make in that circumstance. You 541 00:18:36,130 --> 00:18:37,405 can try to think through why they made 542 00:18:37,405 --> 00:18:39,888 the decision they did. What worked what didn't. 543 00:18:40,605 --> 00:18:42,037 You can learn things from, like I said 544 00:18:42,037 --> 00:18:43,708 from bad leaders. There were people who I 545 00:18:43,708 --> 00:18:45,220 worked with who I thought were bad leaders 546 00:18:45,220 --> 00:18:45,959 and I 547 00:18:46,509 --> 00:18:48,744 know, had opinions y. And I like, well, 548 00:18:49,622 --> 00:18:51,777 that thing doesn't work because they're doing XYZ 549 00:18:51,857 --> 00:18:53,453 Or, oh, well, that thing did work for 550 00:18:53,453 --> 00:18:54,491 them. Why? You know, 551 00:18:55,384 --> 00:18:56,819 I think thinking through all that stuff is 552 00:18:56,819 --> 00:18:57,319 really 553 00:18:57,697 --> 00:18:59,691 important because it prepares you to be able 554 00:18:59,691 --> 00:19:01,605 to make other decisions. When I became a 555 00:19:01,605 --> 00:19:04,157 chief medical officer, I hadn't been 1 before, 556 00:19:04,476 --> 00:19:04,795 obviously, 557 00:19:05,368 --> 00:19:06,564 had done all the parts of it. Like, 558 00:19:06,803 --> 00:19:08,317 I had never done 1 job that where 559 00:19:08,477 --> 00:19:10,151 I did them all together, But I had 560 00:19:10,151 --> 00:19:12,223 done all the pieces of it separately. So 561 00:19:12,382 --> 00:19:15,028 I kind of walked in having the comfort 562 00:19:15,028 --> 00:19:15,528 level 563 00:19:16,224 --> 00:19:18,615 in the role. It's also really important as 564 00:19:18,615 --> 00:19:19,275 a young 565 00:19:20,130 --> 00:19:21,587 aspiring Cmo to 566 00:19:22,532 --> 00:19:24,459 get mentorship, find 567 00:19:24,831 --> 00:19:26,124 people who are 568 00:19:26,575 --> 00:19:28,161 who you admire, who you think do a 569 00:19:28,161 --> 00:19:29,924 good job and who are in interested in 570 00:19:29,924 --> 00:19:31,362 you and Willing to give you their time. 571 00:19:31,761 --> 00:19:32,880 You'll find there's a lot of people who 572 00:19:32,880 --> 00:19:34,578 wrong. I do it all the time for 573 00:19:34,797 --> 00:19:36,235 young because people that are for me. 574 00:19:36,968 --> 00:19:39,192 I was very lucky in my career that, 575 00:19:39,749 --> 00:19:41,759 a couple of times, I found people who, 576 00:19:42,609 --> 00:19:43,109 really 577 00:19:43,563 --> 00:19:45,804 taught me. And took care of me. There 578 00:19:45,804 --> 00:19:47,792 are several who come to mind very quickly. 579 00:19:49,542 --> 00:19:51,689 Several were physicians some were not, I always 580 00:19:51,689 --> 00:19:53,438 think of there was a a Chief Financial 581 00:19:53,518 --> 00:19:56,074 Officer place I worked at, who took an 582 00:19:56,074 --> 00:19:57,662 interest in me and really taught me a 583 00:19:57,662 --> 00:19:59,011 lot, and I learned a lot from him. 584 00:19:59,884 --> 00:20:01,552 That job actually was great because my boss 585 00:20:01,552 --> 00:20:03,325 was so fantastic and I learned a left 586 00:20:03,325 --> 00:20:04,765 from him because he had skill sets I 587 00:20:04,765 --> 00:20:05,404 didn't have. 588 00:20:05,964 --> 00:20:07,964 And so that's another important thing. Figure out 589 00:20:07,964 --> 00:20:08,684 what you're bad at. 590 00:20:09,419 --> 00:20:11,097 And try to work on those things and 591 00:20:11,097 --> 00:20:12,456 find people are good. That the things you're 592 00:20:12,456 --> 00:20:13,814 bad at and see what you can learn 593 00:20:13,814 --> 00:20:14,134 from them. 594 00:20:14,853 --> 00:20:17,091 I was very lucky in 1 of the 595 00:20:17,091 --> 00:20:19,493 positions I had where my boss, he was 596 00:20:19,493 --> 00:20:21,159 a ne neurologist, he was a chair of 597 00:20:21,159 --> 00:20:21,635 medicine. 598 00:20:22,032 --> 00:20:23,856 But what he was good at was all 599 00:20:23,856 --> 00:20:24,808 the things I was bad at. 600 00:20:25,459 --> 00:20:25,959 And 601 00:20:26,498 --> 00:20:28,176 and he was a wonderfully nice man. He 602 00:20:28,176 --> 00:20:29,934 taught me a time. I I am a 603 00:20:29,934 --> 00:20:30,754 much better 604 00:20:31,293 --> 00:20:32,971 position a much better physician leader in a 605 00:20:32,971 --> 00:20:34,662 much better Cmo because the time I spent 606 00:20:34,662 --> 00:20:35,300 working with him. 607 00:20:36,816 --> 00:20:38,490 So there's a lot of little pieces, but 608 00:20:38,570 --> 00:20:39,628 I think that those are 609 00:20:40,085 --> 00:20:42,876 the important things if You're a physician who's 610 00:20:42,876 --> 00:20:43,490 looking to 611 00:20:44,086 --> 00:20:45,837 get into leadership and and to grow. 612 00:20:46,951 --> 00:20:49,259 Yeah. I love that all great pieces of 613 00:20:49,259 --> 00:20:49,578 advice. 614 00:20:50,214 --> 00:20:52,045 Doctor. Barbara. Thank you so much for joining 615 00:20:52,045 --> 00:20:54,207 us on the podcast today. It's always set 616 00:20:54,207 --> 00:20:55,956 a pleasure to speak with you. 617 00:20:56,830 --> 00:20:58,500 It's a pleasure speaking with you too as 618 00:20:58,500 --> 00:21:00,328 well, Mackenzie. Have a wonderful day. 619 00:21:01,298 --> 00:21:03,529 Thank you. I hope you as well. And 620 00:21:03,529 --> 00:21:05,942 listeners, you can catch more of doctor Barb 621 00:21:06,000 --> 00:21:08,231 at our upcoming clinical leadership forum at the 622 00:21:08,311 --> 00:21:10,238 Becker E Cfo round payable, 623 00:21:10,795 --> 00:21:13,821 November eleventh to fourteenth in Chicago. We do 624 00:21:13,821 --> 00:21:16,131 still have some limited space available for attendees 625 00:21:16,131 --> 00:21:16,949 and sponsors. 626 00:21:17,578 --> 00:21:20,185 So please contact us at agenda team at 627 00:21:20,185 --> 00:21:20,685 ak 628 00:21:21,134 --> 00:21:22,477 dot com to learn more.