Hi, everyone, and welcome to the Becker healthcare
care podcast.
I'm Mackenzie Bean, Av and managing editor of
Becker hospital review.
Today, I am so thrilled to be joined
by doctor John Barb who with the chief
Medical Officer and vice President of Ambulatory services
at Burg New bridge Medical Center,
doctor Barb. Thank you so much for joining
me. How are you?
I'm good. Thank you so much for having
me Mackenzie.
Yeah. I'm I'm excited for our conversation. I
think you bring such a valuable perspective from
your medical center
Before we dive in though, can you introduce
yourself and tell us a little bit more
about your background
for anyone who is not familiar with some
of your past podcast episodes?
Sure. As you said, my name is Doctor
John Barb. I'm Chief Medical Officer and Vice
President of Ambulatory Services.
My background is I'm an internal medicine physician.
I was 1 of the early hospital list.
So the first part of my career, I
spent building hospitals programs in a few different
places I founded it 1, I basically help
build up 2 other ones. I started off
in lot of the big academic centers and
got very involved in improving patient quality and
safety.
Eventually, I ended up... I I was the
person was always arguing with the administration. So
I decided to go back and get an
Va, so that I could speak their language
because I realized that I was speaking doctor,
and nobody... But was hearing me.
And So I kind of fell into a
leadership position more out of the, you know,
what I'll do it myself kind of thing.
There's a little bit of Arrogance.
And eventually, ended up getting pulled and got
involved in starting a lot of different programs.
My career kind of took a pathway where
I either help start a few different things
I help found the residency program in a
medical school in a clinically integrated network
or I helped turnaround broken things.
Was that another hospital of my first Cmo
job that had been failing for a few
years I was there for about 2 and
a half years when we helped turn that
around. And now it's been at Bergen New
bridge for the last 6.5 plus years in
the Cmo in total about 9 years now.
But at Bergen New Bridge is a County
hospital in Northern New Jersey that was failing
badly for decades on 6 and a half
years ago, they basically had a complete leadership
change. They dissolved the old corporation formed the
new enough for profit to manage it.
And we've been pretty successful in helping to
turn the place around. We've created a whole
bunch of new innovative programs
and
we've won all kinds of quality awards and
receive recognition for a lot of the work
we've done here. Mh.
That's amazing. You know, you have quite a
bit of experience and as you say,
turning around broken things, getting new programs, whether
it's residency, hospitals programs off the ground.
I'm curious looking ahead, say, in the next
year at new Ep New bridge Medical? What
do you foresee as the biggest challenge?
And how are you really preparing for that
now?
I think there were a few big challenges.
I think 1 is the 1 that everybody
is kind of dealing with is that healthcare
care is changing so rapidly
that I think we have to keep up
and keep ahead of And I think that's
on everybody. New bridge we're a safety at
hospital. And we have a lot of competition
around us. And as I mentioned, we've been
failing for so long. We started with a
negative reputation. Although we've build stuff up. We
still have to break through that. But I
think the bigger issue is just
everybody kind of does the same things in
health.
And I think we really have to start
thinking more outside the box and looking at
things more from a patient perspective.
So it's figuring out what
are going to be successful building them so
that they take good care of patients with
high quality, but doing them also efficiently.
You wanted into all kinds of other issues
as you do that. Staffing is a major
1. We're no longer in the staffing crunch
that we were in post immediately post pandemic.
But there's still a national physician shortage. So
recruiting quality physicians and then maintaining them,
making sure that people don't burn out making
sure people engaged and that's both physicians and
other staff, whether it's other clinical staff like
nursing or social workers or even the non
clinical staff it's all really important to keep
people engaged and really believing in what they're
doing,
so that they can
so that you can get more
with with with what you do have from
it because you you're never really gonna to
be that's the way you would like to.
You can always have more staffing, but I
think we really need to ways to do
things better and
smarter
than we've been doing for many, many years.
I think that those are the big challenges.
And of course,
then there's all the other challenges going on,
like, how do you incorporate other new technologies?
You know, kind of... It'll all... It's all
kind of a piece. Right? Like if you're
trying to innovate and trying to new programs.
Technology can be helpful there, but there's also
a tendency I think in healthcare
run after technology for technology sake and not
think about how to use it wisely.
At the same time, I think that there's
tremendous opportunities
if a lot of different things, Ai obviously
being that the sexy 1.
But again, you can you can also
can also blow up on you if you're
not really thinking it through well in advance.
And, again, we have a tendency to either
in healthcare take way too long thinking about
stuff. Or to rush into things. And I
think finding that just right level is the
main challenge?
So
a broad range of challenges, like you said,
many health systems are facing right now in
terms of
up with the rapid changes in health care.
It's really needing to start to think out
side of the box in terms of some
of the care delivery programs, how you're navigating,
staffing shortages, and then, how technology really pleased
piece into that.
Is there a specific example or initiative
that you're particularly excited about that you're hoping
will really help the medical system get ahead
of based challenges?
So I think that there's AAA
general piece. We're just trying to launch now
a whole bunch of new different clinical programs.
So they all have a similar,
a similar bench, which is what we've really
done successfully is the way I described is
is democrat concierge
and concierge most and typically for rich people
who safety at hospital. But it's really
making things patient centric have heard people talk
about population held for decades.
But again, a lot of times she could
do a lot of the same stuff. And
I think creating systems so that it's easy
for the patients to use.
Or services
and also to prevent the services they need
when they need them is the key piece.
You know, We have this tenancy in healthcare
care to do these things to patients.
Where we make it hard for them even
with things like my chart and other stuff,
which is easier than it used to be
and
so difficult. You know, most people don't have
medical knowledge. We tend to forget that. People
have to take off from work to come
see us. That, you know, we can bring
stuff to them. We can make things easier
for them. So
we're doing all kinds of things everything from
adding on all kinds of new navigators to
trying to to use It systems to
alleviate some of that work, making follow phone
calls with patients, not and not just the
typical, you know, follow phone
but really trying to navigate them through through
things. And then the other big piece is
rethinking how we clinically take care of patients,
know,
Again, we have the tendency to bring patients
in for these long visits
where they have to take off from work.
They have to come in, they have to
do all kinds of different stuff. They have
find somebody to watch their kids if the
if their kids are home, you know, it's
a summertime time now, so that that becomes
an issue for some people.
You know, instead, know, Telemedicine was 1 of
the big breakouts of the pandemic,
I think that doing more frequent shorter visits
and point telemedicine.
Is very helpful and we've been very successful
in doing that.
I think that
the real
challenge in all of this
is
bringing people along for the ride.
While everybody says that they want change people
don't really want change a lot of the
time.
I learned this when I was building hospital
programs.
I would go in and people would be
all excited. And it would say, this is
exactly what we need. And the person who
was saying that was the person who became
the biggest
complain or once we actually implemented the changes
because whatever I'm reason when they think the
change is needed, what they actually mean is
everybody else needs to change, they don't realize
how it's going to impact them, and it's
really important to put yourself in the shoes
of
both your staff and the patients and everybody
around you when you're try implement these changes
because you're always going to get pushed back
and you need to prepare for that and
you need to anticipate it and you need
to
be ahead of the curve on it.
And we've done a good job of doing
that. It was never it's never smooth.
Yeah. Change management is hard right and gaining
by. And it is no easy for you.
No. Not at all. What what have you
found most effective in those areas with your
physician teams?
I think that, you know, I I it
sounds kinda h,
but but my typical answer to this is
is empathy.
It's really important to be able to put
yourself in other people's shoes. I think that
everybody thinks they're doing that. But
you know, and look, there are... That's what
works for me. You know, that that might
not be other people style and it's okay.
But for me, the way I've been able
to manage it is to really try to
understand
what it looks like on their level. And
I think in healthcare leadership, we forget that
sometimes.
There's a it's really easy and that's not
just in healthcare leadership, this is
nature, right to few things from your own
point of view and to think that
your little corner of the world is the
whole world.
Again, when I was somebody who's kind of
working up to the system, it used to
really frustrate me
that sometimes leadership would think
that everything that was going on the hospital
was happening in their executive suite. And now
that I'm in the executive suite, I I
remember that, and it's really important. I think
for people to get out there. I I
have a natural easy pathway. I'm the physician.
I feel practice clinically. So I practice at
my
at my facility. You know? And,
I mentioned at the beginning, I started as
a hospital, so I I do in internships,
but I also,
once they became a Cmo, I started doing
primary care again, so I work in our
ambulatory settings too. And I think that really
1, it gets me buy in not just
positions but from the staff because they see
me as 1 of them, You know, I'm
I'm there with them in the trenches doing
the work.
And 2, it allows me to understand
issues from their perspective and to kind of
be ahead of stuff because I'm they're doing
it and I face the same challenges that
they do.
And I do think it's really important
for leaders to
to stay connected with what's actually happening out
on the floors or in the in the
offices or any of those types of things.
You know, I
again, it's easier as a Cmo than it
isn't in some of some other
positions. Mh.
But even Cmos, I mean, most Cmos, I
meet don't practice clinically anymore. And I think
that's a shame.
You know, I again, I think I get
so much out of doing plus. I still
enjoy it. But
but I I think it's just really important
to to find some way to actually be
in the trenches with your people, at least
a little bit of time You don't have
to do it a time. But I think
it's really important.
Because again,
you know, my staff
knows that I never ask him to do
anything. I'm not willing to do first. You
know, when when Covid hit, and we were
in the sick of it because we're in
Northern New Jersey, so we were hit when
New York city was the same way.
You know, everybody was afraid to see patients.
I was the first doctor here to see
Covid patients.
You know, and it became very hard for
people to not wanna do stuff when I
was doing it already. And it wasn't... I
didn't do it for that reason. I did
it to show people, like, I'm willing to
do this as well. And again, it it
makes it makes me 1 of them and
so they understand that I see things from
their perspective too. And then it's just listening
to them and not blowing things off.
That's the other important piece, I think to
change management. It's the other big 1 is
to not be too precious.
It's really easy
to we make all these plans
and the reality is that things never go
according to your plan.
Never.
And it's really easy to get stuck and
think what we have to do because this
is how we planned it and you got
to be loose and you got to be
willing to pivot quickly.
And say, okay, that part's not working this
part is, let's adjust it and just be
able to change stuff so that it fits
for what works, because your original plan is
never where you end at least not if
things are working well.
And biggest
the biggest thing that's going to cost you
in terms of quality in terms of time
and in terms of financial cost is when
you make an error.
And so
being able to get away from the ever
and being open do that and trying to
anticipate the errors is probably the most important
thing. III know that was a very long
answer.
No. I think all
variant insightful remarks
you're a great example of servant leadership at
its finest. I've been giving how powerful an
impact that can have on a team,
I wanna Zoom a little bit more And
look at the Chief Medical officer roles specifically.
I know you've been in that goal for
some time. I think over the past decade
plus we've already seen it evolve
to not... To become a lot more strategic.
We're seeing chief medical office have a broader
seat that the table regarding.
Value based care, care delivery strategies
outside of really just being Liaison for the
medical team.
How do you see this role evolving going
forward?
I think it's going to be a lot
more of the same of that same stuff
you just mentioned.
If you talk to different chief medical officers,
I don't think any of us... I I
don't I don't think there's any 2 chief
medical officers in the country who have the
exact same job.
Even within the same system frequently, you know,
you'll speak different people, and their jobs are
always a little different because every place is
a little different.
I do a lot of stuff outside of
the traditional Cmo roles. And I think it's
really important
for
chief medical officers to have a voice in
all of that.
Again, I think that for too long, I
think clinical leaders kind of sat to the
side
and
kind of sat there and complain that things
were happening to them and didn't have a
voice and things. And I think it's really
important to have those voices that at the
table and I think it's really important for
Chief Medical Officers to be more involved as
you've mentioned in strategic decisions and financial decisions
in
in building up value based care in It
development and deployment and governance,
really in kind of everything because it touch
is everything.
Things true of nursing obviously.
You know,
I I think that it's just very, very
important.
And I think that that's going to continue
to happen. And I think that that's a
good thing. And I think it's imperative on
on us the current leadership group to make
sure that there are young people coming up
who are trained to do that. When I
was coming up,
you know, they're
sound like I'm a hundred years old and
not. I'm under 50 for at least a
couple more months. When I was coming up,
you know, not a lot of physicians were
doing this kind of stuff.
And so there wasn't really a way to
learn it. And the good thing is that
there now
a lot more people interested.
The bad news for them is there's less
opportunity because there's more people interested. When I
started doing these things, now I was able
to get a lot of experience early
because I was like, okay. I'll take that
I'll take that on. And so that was
a good thing.
But I do think it's important for physicians
to get that other piece of training. Want
to get involved and see how things work
and also to get other perspectives too, because
again, we can
physicians tend to
think to doctor
sometimes. And so, like, for me 1 of
the most important things was getting that Mba
because it really did give me a
different perspective. I went there originally to learn
the vocabulary.
But what it really did was it gave
me the ability to see things from a
different angle that I was not seeing things
from beforehand.
And so I was able to
to 1
look at the finances and look at the
strategy and think in that way, but I
was also able to discuss
those things intelligently. And it's it's a different
skill set.
Them being a good physician. I think that's
the other thing. I think a lot of
times people end up in these leadership roles
because they're a good physician and
leadership does require some different scales. Some things
overlap,
but there are some things that are different
and I think
it's really important
as the role evolves for people to have
those skills
because I think that's just going to continue.
Yeah. A good physician doesn't always equate to
a good leader. As you said, you'd really
need to fluency in both. So language of
dot and language of
administrator or leader.
Any other advice for listeners out there who
might be physician leaders and aspire to be
a chief medical law or 1 day, What
would you tell about?
I would tell them,
get as much experience in different things that
you can. I kind of alluded to it
before. But, you know, when I was coming
up, you know, I was the person always
said, yes. You know, it became a joke
where, you know, I I mentioned I came
my academic sense. The residents used to joke
about it.
They actually, I heard it from several of
them over the years. Like, I expect you
to come down the hallway pushing a broom
1 day because you have every other job
it seems like in this place. You know,
I was a person who they've, you know,
became a thing of, like, they couldn't get
anybody to do it see if John do
it. And, you know, I typically if I
thought that I could add something I did.
Don't take things on just for the sake
of taking them on. Do it if you
think you have an afford it or if
you think there's something you can learn doing
it.
Sometimes you can over extend yourself too,
you want to do a good job on
those things, but try to get involved
in
projects or an ideas where you can learn
something and you can get experience because there's
you can talk about things theoretically about what
you would do
but there's nothing better than getting hands on
experience. If you don't have an opportunity to
do stuff, the other thing that I recommend
people to do is to watch other people
or leaders. You can always learn stuff from
them,
both good and bad.
You know,
you can watch people you can say what
decision would I make in that circumstance. You
can try to think through why they made
the decision they did. What worked what didn't.
You can learn things from, like I said
from bad leaders. There were people who I
worked with who I thought were bad leaders
and I
know, had opinions y. And I like, well,
that thing doesn't work because they're doing XYZ
Or, oh, well, that thing did work for
them. Why? You know,
I think thinking through all that stuff is
really
important because it prepares you to be able
to make other decisions. When I became a
chief medical officer, I hadn't been 1 before,
obviously,
had done all the parts of it. Like,
I had never done 1 job that where
I did them all together, But I had
done all the pieces of it separately. So
I kind of walked in having the comfort
level
in the role. It's also really important as
a young
aspiring Cmo to
get mentorship, find
people who are
who you admire, who you think do a
good job and who are in interested in
you and Willing to give you their time.
You'll find there's a lot of people who
wrong. I do it all the time for
young because people that are for me.
I was very lucky in my career that,
a couple of times, I found people who,
really
taught me. And took care of me. There
are several who come to mind very quickly.
Several were physicians some were not, I always
think of there was a a Chief Financial
Officer place I worked at, who took an
interest in me and really taught me a
lot, and I learned a lot from him.
That job actually was great because my boss
was so fantastic and I learned a left
from him because he had skill sets I
didn't have.
And so that's another important thing. Figure out
what you're bad at.
And try to work on those things and
find people are good. That the things you're
bad at and see what you can learn
from them.
I was very lucky in 1 of the
positions I had where my boss, he was
a ne neurologist, he was a chair of
medicine.
But what he was good at was all
the things I was bad at.
And
and he was a wonderfully nice man. He
taught me a time. I I am a
much better
position a much better physician leader in a
much better Cmo because the time I spent
working with him.
So there's a lot of little pieces, but
I think that those are
the important things if You're a physician who's
looking to
get into leadership and and to grow.
Yeah. I love that all great pieces of
advice.
Doctor. Barbara. Thank you so much for joining
us on the podcast today. It's always set
a pleasure to speak with you.
It's a pleasure speaking with you too as
well, Mackenzie. Have a wonderful day.
Thank you. I hope you as well. And
listeners, you can catch more of doctor Barb
at our upcoming clinical leadership forum at the
Becker E Cfo round payable,
November eleventh to fourteenth in Chicago. We do
still have some limited space available for attendees
and sponsors.
So please contact us at agenda team at
ak
dot com to learn more.