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Hi, everyone. Thanks so much for tuning in
to this episode of the Becker's Health Care
Podcast.
I'm Erica Carbajal.
For this one, we're excited to be joined
by Jason Raybard,
executive administrator of UChicago Medicine and Biological
Sciences.
Jason, welcome to the podcast. Thank you so
much for being on.
Thank you for having me.
Yeah. To start off, do you mind just
sharing a bit more about your current role,
your organization, and then a little bit how
you got there on the background?
Sure. Yeah. I'll give you the Reader's Digest
version. So, Jason Raebard. I am currently the
Executive Administrator
over the Department of Ophthalmology at the University
of Chicago.
I've been here now about two and a
half years at this point. It's been a
wonderful experience. The University of Chicago is a
phenomenal academic medical center.
They do terrific research. They provide a terrific
education
and also
providing a variety of different clinical services. Mine
in particular is ophthalmology.
I myself have been in healthcare now
over 21 years.
Most of that 19 years at the beginning
or 18.5 thereabouts,
I was serving as either a practice manager
or a operations director
or some kind of administrative coordinator and usually
it was multi specialty settings. This is actually
my first
single specialty
endeavor
and
I enjoyed healthcare operations.
This role is a bit more strategic
and focused, a little bit more focused on
business
strategy. So, I'm enjoying that. I love the
operations. I love my operations people and I
don't think I'll ever be able to remove
fully my operations cap.
But it has been fun to be able
to do some different things as far as
the other parts of healthcare. So, that's just
a little bit about myself.
Yeah. Absolutely. Such a rich
or initiative from the last
year, including what you did and what the
results were? I know you said you've been
more focused on the business and strategy side,
so maybe something on that front.
Sure. Sure. Yeah. We've had a couple of
different
I wouldn't say there's just one.
But as far as the strategy goes or
we're focusing more on the business,
I think we've done a really good job
of
recruiting and expanding
at a time when we'll talk about this
a little bit later when there are shortages
of physicians,
not just in ophthalmology but throughout the country
and in all different
aspects whether primary care or specialty care. I
think we've really done a good job of
being able to,
when we've had physicians leave or retire,
not only be able to replace them timely
but
replacing them with really good quality people
and developing our 3 to 5 year strategic
plan for hiring,
developing a strategic plan to identify other markets
that we plan on going into.
I think that's been a successful endeavor. And
to put it on perspective,
relatively speaking, my current Chair, Doctor. Harry Prasad,
has only been in his role for about
a year. So, we've only had
initiatives
even though we both have been around longer
than that in this institution, he was in
an interim role prior.
There are some other things offshoots
related to that as far as initiatives, projects
that went well. And I think
all of them
whether we're talking about our development of our
first faculty handbook,
which is a comprehensive
30 plus page document that gives us different
operational and strategic procedures and explains to both
existing and new faculty and
staff of who does what and why,
we
we also have been able to
keep our employee engagement scores high.
So even though we've gone through
a good leadership transition,
even though with myself and and my chair,
we still have been able to keep engagement
scores, at least within our department, high.
And a lot of that has to do
with just
having
open conversations about virtually anything, just being easy
to talk to, being transparent,
listening. I think listening is very critical.
When we go back to the first project
I talked about when you're developing our strategic
3 to 5 year plan,
I walked into this role.
I didn't necessarily
have complete knowledge of the department
nor the market per se, at least in
ophthalmology,
but you ask questions. You ask questions of
people in your industry. You ask questions of
the people that you work with.
You're humble,
and you learn and then you can sprinkle
in your own expertise and thoughts and meld
that together to come up with, in this
case, a 3 to 5 year strategic plan.
I think that's really critical to be able
to do those sorts of things. There is
one other thing I do want to mention
and I think this is more of institutional
wide. The university just went through a transition
of updating its financial system.
We're using an Oracle system. And I think
everyone,
not just within my department, but all the
departments have done a fantastic job
of converting
from an existing system to new. And for
those of you who are listening who have
ever changed financial systems, changed electronic medical record
systems, whether it was 15 years ago from
paper to electronic or electronic to electronic,
those changes are not easy. But if you
have a plan
and you're transparent
and I even had a team meeting today
and we were talking about some of the
hiccups that we faced and we just said,
okay, let's have a pause. Let's see what
I can do to support you as a
leader.
And, alright, let's make some tweaks,
you know, talk to everyone openly about what
they're seeing and what they're dealing with and
how they're feeling,
it's
it's easy to get good results and success
out of that. It's easy to then at
that point see the engagement scores go up.
I think that's part of the recipe
for me is just being honest, transparent and
open. That's how a lot of these initiatives
were able to be successful.
Yeah. It sounds like really I think what
you said there just highlights
how
knowing what you know and being open about
not knowing what you don't know and transparent
with with your teams, how far that that
can really go in making progress on really
strategic goals and all the different areas.
With the 3 to 5 year strategic plan
that you that you mentioned on hiring,
Can you speak to, like, what the collaboration
looks like? Or who are the other core
leaders that that were involved or that you're
working with on that plan?
Sure. I mean, it it it's it's a
variety of folks,
and it depends if we're talking about expanding
here at our main campus or looking at
off sites. But you have,
our strategy team. Mark Helms is the Executive
Director of Strategy. He does a fantastic job.
It's starting with him. The prior Executive
administrator,
to me,
shared with me the documents that had been
carried over from the prior strategic plan. So,
looking at that, reviewing it with Mark and
his team, doing some analysis
through SG2 and,
you know, frankly,
talking to the staff, whether it's the Director,
whether it's the Nurse Manager getting their opinions,
whether it's data driven based on reports that
they're seeing,
Maybe
it's how long it takes for someone to
get into clinic or how many new patients
we can actually get in within 14 days.
We have
Tableau is the system that we use for
a lot of our analytics in the ambulatory
world. And using that is very helpful to
kind of determine where you're at, at least,
from
perspective.
So, being able to talk to the people
on the ground that
in the roles that I was in before
and engaging them because I can't tell you
the number of times that I have not
been included when I was a manager or
director. And you may be seeing something different
than the executive and the executive never engages
you. I've always said when I get into
one of these executive roles, I'm never going
to do that and I don't. So, you're
talking about that. You, of course, have your
own internal physician leadership, your chair, the vice
chairs. And then you also have
stakeholders in the dean's office,
stakeholders in the c suite of the health
system.
And you have open collaborative conversations about what
you're thinking about, and, you know, people will
be once they develop a trust with you
and that that takes a little time to
build up. But if you're open and vulnerable,
if you're transparent of what you're trying to
do, if you ask for help, that breaks
down a lot of walls in any system,
most any system.
And I think that lends itself to eventually
having a positive outcome as far as being
able to outcome as far as being able
to just not only collaborate on a document,
but then seeing it through over time.
If everyone is on board and there's a
trusting environment, there's an open environment, and there's
an environment where you can share ideas, you
can do almost anything.
And I think that was just kind of
my approach with helping, you know, our department
and my chair develop a strategy for the
next handful of years.
Yeah. Thanks for sharing that, Jason.
If you're looking ahead, what are really the
biggest challenges that
you see within your role in health care
over the next few years? I know you
mentioned physician
workforce challenges at the beginning. So I'm not
sure if it's better or maybe something else
that you're seeing in your role.
Yeah. I I think I'll I'll if you
don't mind, I'll expand it to
if you don't mind, I think it's
health care in general, whether you're me in
ophthalmology in Illinois, in Chicago, or if you're
someone in San Diego with Multispecialty Surgical Services,
or you're out in Maine,
I think you are correct.
The lack of physicians,
and actually Scott Becker and I talked about
this. We did
a panel on operational excellence. This must have
been
maybe over a year ago with ILMGMA.
I'm a Board member with the Illinois
Medical Group Management Association, their Illinois chapter. And
we were talking about the number of slots
of residents and the support from CMS has
not changed in many, many, many years. But
the population, the older population now, the Boomers
that need
a variety of different pieces of care has
that
push or that stress on the health care
system has has gone up. So, we've increased
demand but not increased supply of physicians, right,
or even advanced practice providers and implementing some
of those changes in certain states or throughout
the United States hasn't caught up. And I
fear
that you're already seeing the effects today where
people are out of care for multiple weeks
depending on where they live in the country.
There is already scarcity in health care in
certain parts of the country.
And it's just going to be tougher and
tougher
not just to recruit
physicians, but to retain. Because I think a
lot of health systems and medical groups forget,
sure, you can recruit a physician or a
nurse practitioner or a PA,
but you have to keep them. And I
think, you know, that's going to be a
challenge for a lot of health systems and
medical groups and other medical institutions that don't
do that well.
If you don't know how to retain your
people,
physicians or otherwise, we're just going to focus
on physicians
and health care providers
providing direct patient care, you do a poor
job. That is going to be a big
cultural and financial stressor on your health system.
And given that we've got other challenges in
health care such as dwindling payments, whether we're
talking CMS or individual payers,
insurance payers,
or we're talking about the increasing costs associated
with newer technologies that we need to integrate
into our systems,
whether it's anything to do with our medical
records or equipment that we use in the
operating room,
those stressors add up to
a series of very difficult circumstances
to navigate.
And there will be some health systems, the
haves, that will be able to survive
and weather it if they have the right
culture, they have the right processes and procedures
and systems in place,
and they have nots. And and some of
the have nots will struggle because they lack
the capital,
or or perhaps they're so small, they don't
have the expertise or they just don't have
enough bandwidth to to do anything. And then
that's why we've seen so many
hospitals and health systems integrate or, in some
cases, fold.
And I fear that it's only gonna get
worse.
I am hopeful, though, that
perhaps in time, there'll be some policy changes
that will bring us some additional physicians and
maybe loosening
of bringing
physicians in a little bit easier by opening
more slots. It's a little pie in the
sky
and it may not take care of things
in the next couple of years. But I
certainly think of it in terms of
how can we ensure that health care is
stable
for the country, not just now because we
do need some things
taken care of now, but in the future
for for for someone that is
maybe just born yesterday
once they hit 60.
Decisions that occur now from a policy standpoint
of ensuring that we have the right amount
of medical supply, medication or physicians in a
country,
that's
impacted by for many, many years. That can
have multiple generations and decades impact.
So, time is of the essence. It always
has been of the essence. And I'm hopeful
things will get better. But those are the
challenges that at least I'm seeing right now.
Yeah. Absolutely. And it sounds like really
excelling on if you're not excelling on retention
right now, you know, now is the time
to really
level that up,
as as things
may get worse with with the physician
pipeline challenges. And I know with the residency
component too, hearing some leaders say that in
the past, especially in rural areas where they've
seen majority of residents
stay in that area. They're seeing that start
to shift. We're more and more starting to
leave where they did did those residencies as
well. So lots of challenges
around retention that that leaders are trying to
wrap their arms around right now.
Jason, next here, can you talk about obviously,
very challenging environment, I think, just generally across
the board for new executives and managers who
may be entering
the field of health care or just more
broadly entering leadership positions. So what advice would
you provide for them as they embark on
a newer journey in health care?
Sure.
So if we're talking about someone,
we'll we'll use the example of whether it's
a new practice manager, maybe they're fresh out
of fellowship or maybe it's a new executive
that is fresh out of fellowship and is
trusted in a Director or VP role, which
happens quite often.
You know, I think the challenge that I've
seen
I do a lot of mentoring through my
my alma mater, Lake Forest College, Northern
Illinois University where I went to grad school,
and then
through MGMA,
Medical Group Management Association. And what I what
I see is when I first got into
health care over 20 years ago, it was
a little bit different. We still people went
through fellowships and such, but
I think one of the things that was
unique back then is there were so many
private practices, and I worked for 1 for
6, 7 years. So you really learn every
aspect of how to eat what you treat
as far as a small business or medium
sized business, and you learn a lot of
aspects of survival and, and,
you know, I think that you still can
do that within health systems, but I think
you're not touching as much
as as would have when I look at
different managers that are new into their positions
or different directors or VPs that may be
fresh out of fellowship. I think there might
be a combination of not getting exposed to
all aspects. I mean, I remember back in
those days, I was picking up the phone
and calling to collect on claims which
you know, a lot of that has gone
away because everything's so automated now. But at
the same time, there are definitely issues where
you need to talk the payer about why
we're not getting paid for certain services or
timeliness and things. And I'm not sure how
much, you know, in that role as a
practice manager, how much today a typical practice
manager would experience that because they have a
whole rev cycle team deal with that. So,
for me, when I can go into different
meetings, I have a completely different perspective and
can almost reverse engineer the process
of what the rev cycle partners I have
deal with
and can help them construct solutions.
So it it it's something that if you're
newer in this role
or you've come out of fellowship or or
maybe you got a job and you were
the administrative coordinator or something like that,
wanna do your best to
expose yourself to as many areas.
It's easy to do that in operations.
Sometimes certain areas, if you know, if like
you're in a compliance area or quality area,
you might not be as exposed to multiple
areas. But let's say you did work in
a quality area. Let's say one of your
primary roles was to ensure the safety of
the hospital floors or the clinics based on
Joint Commission standards.
That person
should integrate themselves and get to know their
operations people to understand why the operations people
do what they do so that eventually when
you get to survey time, your team is
fully prepared because you as an internal surveyor,
if you will, a quality expert within whatever
health system we're talking about, hypothetically,
you can know that you have partners on
the operations side if we need to implement
last minute changes or shore up an area
that is a little bit weak.
And I've seen over the years quality people
do that.
There are people that I've worked with in
quality and I'm just using this as an
example. I don't mean this to use it
as a punching bag or anything like that,
where they've just kind of stayed in their
lane and they've just stuck to policies and
and not really gone beyond that.
And I think if you are willing to
integrate yourself,
whether it's that or you're in operations and
you're willing to understand how the registration process
works, how the rev cycle process works, even
how the prior authorization process works. You're willing
to get involved in details, heck, even how
marketing
works. I think you'll overall
be a more well rounded employee and a
well rounded administrator and executive.
And I think people will see that
and they'll appreciate your willingness to learn. I
can't tell you enough.
And I love this man for this professionally.
One of our our our deans, Dean Otto
here,
who's very high up within the dean's office,
great physician leader, the one thing I can
say about him is he always
asks thoughtful questions and has a genuine interest
in wanting to learn. Now, he's an experienced
leader,
experienced executive position leader,
but yet he still
asks the questions many years later.
No matter how small they may sound to
most people, it's important to him because he
wants to understand the why. Why is someone
experiencing a barrier? Why is someone experiencing
a certain reason why something is working or
not working?
That's impressive.
And if you are an existing
something that, yeah, I somewhat adopted but I
really enhanced by watching
him. And so I think if you see
good examples and you can find good mentors
from from up close or far, use them
to your advantage
to help you help other people, your patients
as well as your team, whether it's physicians
or staff,
or you're in your vendors for that matter.
And I think if you're able to implement
some of these things,
you become more well rounded
and more respected
And strategies like we talked about earlier, implementing
projects, become so much easier because they're already
challenging to start the day.
But at least you have a common bond
with people and support and trust. If you
have that,
people are gonna respect you, and it's gonna
be much easier to, integrate and implement.
Yeah. Jason, I think it's such a timeless
and tangible piece of advice there. And, you
know, things are always changing, and there's always
gonna be new people to lead and,
to learn from no matter how long you've
been in your role or with an organization.
Thanks for sharing that.
Before we close out here, can you share
how your leadership approach aligns with the values
of UChicago Medicine
right now?
Sure. I I mean, I think
one of the things that,
has been nice as far as
University of Chicago is
Dean Anderson,
who's been with the organization now, I think,
going on
a little over a year.
We've
changed our
mission, vision, and values slightly,
not abandoning prior mission, vision and values. But
we have 6 pillars
that talk about a variety of different areas
such as raising curiosity,
embodying equity, committing to excellence, growing together, making
a difference and taking ownership.
One of the key critical pieces
that he brought to the table that I
really enjoyed that I think hopefully has been
resonating throughout our conversation today in this podcast
has been being able
to include
and being able to reach out to different
stakeholders, different parties, different departments,
really
allowing the
Biological Services Division, which is where a lot
of the physician contracts are held and where
the physicians
provide teaching services and and work with the
health system. But both the health system and
then our Pritzker School of Medicine
really shifting the mindset of these are not
3 separate entities under an umbrella. These are
3 entities that need to work hand in
hand.
And I think if you can change your
culture, enhance your culture to move that direction,
I think that's not only going to be
successful for you in whatever you're trying to
do, in this case as a health system
and a university, but for me, it aligns
well because it means you're breaking down walls
and breaking down barriers and breaking down silos.
And that for me is what I'm all
about.
So, I love the openness and transparency that
is
derived and implied
in the new mission, vision and values. And
it's been quite successful since it started about
a year ago this past September I think
is when it originally started.
Jason, thank you so much for being on
today. It's been a pleasure to connect and
hear your thoughts on some key topics right
now in health care and learn more about
your leadership style and advice for upcoming leaders
as well.
Thank you. I appreciate your time in allowing
me to to contribute on the podcast.
Absolutely. And listeners, thank you so much for
tuning in. You can listen to additional episodes
of the podcast and hear from more leaders
by visiting the podcast page on our website
at beckershospitalreview.com.
Thanks, everyone.