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This is Laura Dierda with the Becker's Healthcare
Podcast.
I'm thrilled today to be joined by doctor
Todd Smith, chief physician executive at Sutter Health.
Doctor Smith, it's a pleasure to have you
on the podcast today.
Pleasure to be here, Laura. Thank you for
having me.
Now I know we've got a lot to
talk about. There's so much happening in the
health care space, and, certainly, Sutter has really
been busy over the last few years and
a lot going on with the organization as
well. But before we dive in, I was
wondering if you could tell us a little
bit more yourself and your background?
Yeah. I'd be happy to. So I'm an
orthopedic hand surgeon by training, and I practiced
here in,
with Sutter for about 27 years 1997.
Approximately 5 years ago, after doing a lot
of medical group leadership, I took over as
one of the foundation chief executive officers
in one of our regions called the Central
Valley.
And about a year ago,
right after Warner Thomas got here, the position
for Chief Position Executive was created
as a dyad for operations with the Chief
Operating Officer, Mark Sevko.
And so, for the last year, I've been
working in that position at a system level,
working with them particularly
on a lot of our priorities like growth
and access.
That's great to hear. And, you know, I
can imagine,
there's always a lot happening within the growth
access to care and a really cool model
you have with the dyad
partnering the clinical leader with the operational leader.
Based on our previous conversations, it seems like
you've had some great successes in in being
able to,
design and develop some models of care and
operations that are really gonna be impactful,
for health care in the future.
Absolutely. It's been a real pleasure to work
with someone like Mark. And because we both
got the same values as far as, really
trying to promote our people, and
really put our patients first.
That's really allowed us to really look at
our priorities, which have been around
growth of the organization
as well
as growth of our services and access to
our patients.
Access has been one of our biggest challenges
across the organization as well as just in
the industry itself.
And partnering with somebody like Mark allows us
to bring the administrative plus the clinical views
to attempt to,
address some of the very difficult challenges we've
had.
That makes a lot of sense. And, you
know,
spring boarding from there, are some of your
top priorities for the rest of the year?
What are you really focused on?
Really focused we're focused on several things, obviously,
Laura. But if I had to boil it
down to 2 or 3, really it's around
clinician and clinical growth,
really
to focus on a couple of things, to
bring in top quality individuals who can provide
the best quality care for our patients and
create the centers and destination of excellence, but
also really about access,
improving our access. We know that the just
access to healthcare, whether it's primary care, whether
it's behavioral health, whether it's surgical care really
is a challenge across
the environment.
And so we're moving forward and trying to
do that in a way that actually makes
it easier for the patients.
And in so doing, we're actually focusing on
developing
service lines, so that as people move through
the system and receive their care, it becomes
seamless
and it becomes
a journey that we are on with them
in the process. But if I had to
boil it down, it's around service lines, it's
around access, it's around, clinician growth.
That's really fascinating to hear. And, you know,
in particular, you mentioned
that access a few times already in our
conversation.
Is there anything you can share with us
that you've done in particular around expanding that
access to care that has, been beneficial or
really,
shown some great results for the system?
It's interesting. I wish I could tell you
that there were things that we've really decreased
the wait times.
And right now, the demand is so high
that as we add clinicians,
so we've had a record year in 2023
and even in
2024,
we've added another 500 physicians and APCs across
the organization, which
is up from approximately 4,500.
So really almost about a 10% increase in
number of clinicians over time. We're still seeing
challenges in
people being able to get in. However, one
of the things that we've been able to
do is really work on our referrals
and really decrease the time to referral,
so that the patients, when they do need
a referral, they know they've been heard, they
know there's a spot for them, and they
at least know they're they're being taken care
of. The other thing we're doing a lot
is really working toward implementing
virtual care, in a way that everybody's doing
some virtual care, but how do we actually
improve this? How do we increase the accessibility
to it such that there is a mechanism
for somebody to get care when they need
it and when they want it in the
process. All of those are in flight.
And we also hope to kind of see
improvements in that. We've seen increases in the
number of digital online appointments as well, which
really helps to decrease that barrier to care,
so that people can really connect with us
in a way that makes more sense for
them.
That is really helpful to know and understand
and, you know, wow. That that's a lot
of, clinicians to bring in between the physicians
and APP is adding 500
over the last, you know, 12 to 18
months or so. I can imagine that has
been a huge undertaking for the organization, but
good to hear that, you know, that coupled
with some of the other strategies around referrals
and and potentially virtual care coming as well,
could make a difference for accessibility,
within the community.
Yeah. Absolutely. It really, and we are partnering
with
our clinicians in the community as well to
try and improve that as well. We've got
programs that are working with them to help
them with some of the digital access
pieces,
too. And so it's an and strategy, not
an either or strategy.
Got it. And that's really living in that
and is such an important place to be.
Now what other programs or initiatives have been
the most needle moving for your you over
the last
our mission, vision, values. And really when you
think about, you know, that our mission, vision,
values and really when you think about
that sort of mission statement, it became
patients first and people always.
And really what that speaks to is the
fact that we're all here to serve the
patients and we have to take care of
our people in the process. And so it's
really about taking care of our people so
that they can take care of our patients.
That's been needle moving and that we've been
investing in our people,
investing in creating a culture of working together,
working as a team,
getting to a culture of yes.
And so what that's allowed us to do
is to increase the transfers into our system,
with approximately 10% more transfer we've been able
to accept. We've been working very hard on
how do we actually improve our length of
stay and so doing utilize our resources better
and really improve our overall volume. So we're
able to take care of more patients
and have more patients come into the system.
And all of those really have helped us
serve our patients better, but also take care
of our people while we're doing it.
That makes a lot of sense. And, you
know, I I love that idea of being
able to,
have the clinicians and caregivers be in a
great spot to take care of patients. I
know physician wellness is something that's on top
of so many different,
people's minds and health systems and organizations across
the nation.
And, you know, when you look at Sutter,
being able to invest in that and invest
in having a great culture,
you know, it it seems easy, but I
can imagine it's a lot harder, to actually
do and implement and live out on a
daily basis.
What makes Sutter unique? I you know, especially
in given,
like like I said, a lot of organizations
are trying to do this. So what actually
makes you your culture and your, programs around
physician wellness different from what everybody else is
doing?
You know, I I I think it I
don't I'm not sure it's unique as much
as it is it's a focus.
And so from the corner office from when
Warner started to the elevation of the physician
presence
at the executive leadership team to focus
on engaging the clinicians in decision making both
on a strategic and operational front.
I think what that's done is that's
elevated and reengaged
them
in a way that we have not seen
in other areas. What this has resulted in
at the end of the day is not
only excellent hiring from that standpoint, but our
retention has actually been pretty good as well.
Currently our projected
turnover for this year for 2024
is going to be around 3%,
which is down from 5% the year before
and 7% the year before that.
That coupled with
the increased
retention on the staff side has really made
for stabilization
of the workforce itself
that actually has allowed us to move forward
in the process.
We also just started a program with the
American Medical Association,
looking at joy of work and how do
we engage better. And so we've got a
lot of opportunities there
and it really is top of mind. But
I think engaging the medical groups we work
closely within this, has really been very helpful
for that.
That's great to hear. Now before we wrap
up, I'm wondering how are you thinking about
growth and patient experience going forward?
So, I really appreciate the question, really. If
we think about growth, it's really gonna be
about supporting and expanding the workforce. We've talked
about the physicians and the APCs,
but it's also about expanding where we provide
the care in both ambulatory surgery centers as
well as urgent cares,
and then really looking at how do we
organize around service lines, so that provides that
growth vehicle and that growth opportunity for us
and making the work that the clinicians do
for the patients easier
as opposed to harder and allowing them to
connect with them.
If you think about patient experience, it's a
lot of it we're thinking about meeting the
patients where they are,
redesigning
our online presence, redesigning the way that we
interact with them and that digital engagement is
so important.
Looking at things like online appointments, virtual care,
continuous home monitoring,
if you look year over year,
we
increased our online appointments by approximately
250,000
year over year,
which is really pretty important because that is
that's the way that a lot of people
want to interact with us. And so creating
an opportunity for them really I think will
be helpful for us moving forward.
And then creating that consistency across the organization,
I mean, how do we ensure that the
patients when they are with us,
they get a warm welcome. They know that
we're happy that they've chosen us for their
care. We can narrate their care. We can
let them know what is going on and
what will be there and take some of
the unknown out of it. And then fond
farewell. Let them know that we're happy they
chose us. We appreciate the honor and the
ability to be able to take care of
them and create
that constant and lasting relationship. So as we
move forward, that's sort of how we're thinking
about both growth as well well as patient
experience.
That's amazing to hear. Doctor Smith, thank thank
you so much for joining us on the
podcast today. This has been such a fun
conversation, and I look forward to connecting with
you again soon.
Absolutely. Thank you for having me, Laura.