Relational Rounds

This podcast showcases a deeper discussion of psychological safety, described by Amy Edmondson, an expert on leadership, teaming, and organizational learning, as “a shared belief that the team is safe for interpersonal risk-taking.” You will hear Dr. Brian Park share stories of colleagues leading from where they stand to create safer spaces for those around them. With the current COVID-19 crisis, there has been an increase in fear, anxiety, and stress among healthcare workers. Psychological safety is always important, but now more than ever, we need to make sure people can speak up to share their concerns and seek the support they need.

Key takeaways:

[1:15] The four core models of relational leadership — and one of them is psychological safety.

[1:40] What is psychological safety?

[4:02] Brian Park introduces himself and the crucial importance of relational leadership practices.

[7:14] Brian Park defines psychological safety.

[9:54] Brian Park explains different factors associated with psychological safety.

[11:13] What does psychological safety look like in a team?

[12:23] Psychological safety in times of COVID-19 is more important than ever.

[13:40] Brian Park shares how humanizing each other is a helpful behavior to cope with the stress of workers in health care teams who are dealing with the COVID-19.

[16:10] A leader is just a human that feels, struggles, and is brave enough to share it.

[16:25] Brainstorming should be an invitation to play.

[18:23] Embrace a ‘fail forward’ mindset, a growth mindset.

[19:20] Assign a balcony team member: Someone who can stay outside of the team and observe the relational dynamics.

[23:50] How Brian Park models psychological safety.

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Relational Rounds Response

Stories are powerful. Stories help us feel seen and give us a sense of being
known. Listening to a colleague’s story can transform your relationship, allowing you to move
from, “I know what she does” to “I understand what she cares about.” Listen for more on how to
invite others to share their stories.
Key takeaways:
[1:26] PCP is reengineering the way of delivering the relational leadership curriculum.
[2:50] Listen to understand.
[3:10] Matt Lewis, senior strategic consultant at PCP.
[5:24] The importance of feeling seen.
[6:25] Storytelling to achieve a quick sense of community.
[7:27] Stay curious.
[10:04] Ask more questions and encourage people to “say more.”
[10:32] Observe how you feel when you are listening to people’s stories.
[13:13] Challenge the cultural narrative.
[15:13] In moments of uncertainty and overwhelm storytelling can be liberating.
[16:40] Look back to other moments of fear and uncertainty in your life and how you managed to
go through them.
Mentioned in this Episode:
Relational Rounds at Primary Care Progress
Primary Care Progress on Twitter

Dr. Mark Schuster is a physician, scientist, and advocate for healthy families and communities. Dr. Schuster is recognized as an international leader in research on child, adolescent, and family health, concentrating on topics such as quality of care, health disparities, family leave, obesity prevention, and bullying. Dr. Mark is a founding dean and CEO of Kaiser Permanente School of Medicine; he explains the most important aspects of their innovative approach in teaching medicine integrating foundational, clinical, and health system science together as well as giving students the opportunity to work with patients starting in the second year. Addressing burnout and social environmental factors are two areas of main importance in Kaiser too. The change in the health system starts in how physicians are being trained. Listen to this episode and discover a different approach to medical education.

Key takeaways:

[:33] Dr. Mark Schuster career briefing.

[1:26] One of the one hundred most influential people in healthcare.

[3:50] What need did Kaiser identify that Dr. Mark is trying to fill? The most effective approach for medical education.

[5:38] How best to design medical education in the U.S?

[6:38] Before, students used to absorb content passively in Medical training.

[8:55]  Kaiser provides a small-group, case-based learning approach.

[9:22] Working in integrating foundational, clinical, and health system science together.

[11:45] Spiral approach.

[12:05] Students at Kaiser are not working on cadavers.

[14:14] Humanism while studying medicine.

[15:15] Second year at Keiser provides interaction with patients.

[17:11] Using imaging for anatomy.

[17:35] How can a health system address social environment risks?

[22:13] Physicians have to address community health.

[20:08] Addressing the social determinants of health.

[23:22] Physicians have a privileged place in treating mass shooting victims.

[25:32] Training students for them to keep their own self-care as a priority.

[29:03] REACH (Reflection Education Assessment Coaching Health and Wellbeing) weeks are breaks from the regular curriculum.

[32:14] Physician burnout also affects patients.

[37:05] Hot seat!

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Kaiser School of Medicine

The statistics are now known by everyone: by September 2018 it was reported by the Physicians Foundation that 78% of doctors are presenting symptoms of burnout. Physicians have the highest rates of suicide in the nation; interns experience a 10-fold increase in depression during the first year of internship; it is a very tough time to be in medicine. There are many institutions fighting back against this trend; one of them is OptumCare, which is an incredible team that is working hard to reverse this trend.

OptumCare is a subsidiary of United Health, the world largest healthcare provider, serving 115 million individuals. Optum is working to transform the U.S. health system into one that serves people with greater value, with a focus on ambulatory, community-based and primary-care-driven solutions.

Today guests are Stephanie Bartz, VP, strategy and chief of staff of OptumCare; Curtis Mock, physician executive, serving as Culture facilitator, a member of Optum diversity and inclusion council, and a member of culture leadership team; Todd Staub, senior VP of physician relations; and Kay Stevens Madler, director of the office for provider advancement, focusing on provider development and engagement.

Key takeaways:

[1:37] Stephanie Bartz

[1:51] Curtis Mock

[2:18] Todd Staub

[2:35] Kay Stevens Madler

[3:06] Why wellness?

[5:19] What bring Curtis Mock into this space?

[6:20] The space of culture.

[9:18] Biggest challenges.

[11:14] Building resiliency.

[13:18] Creating community.

[14:23] What can be done?

[16:01] People were seeking for purpose but were missing a place to go.

[16:49] Meaning of leadership in healthcare today.

[18:06] Co-creation at OptumCare.

[21:39] Medical Culture.

[22:15] Primary care to keep people out of hospitals.

[25:20] Is the healthcare system heading to a “bank bailout” moment?

[27:28] Is there a physician shortage in the U.S.?

[29:10] Rethinking healthcare.

[30:32] Realities on the inside and the outside of the clinic.

[32:20] Primary care is a mirror of society.

[34:12] Optum going beyond the clinic with their Mobile Clinics.

[37:48] Social determinants of health.

[38:42] Using technology to support relationships.

[39:33] Empowering patients.

[41:05] Burnout.

[42:16] The difference in OptumCare practices.

[44:36] Clinicians are building a resilient and positive culture.

[45:10] The crucial value of inclusion.

[46:17] Rapid Fire questions!

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

OptumCare

Clinician Insights

A physician, scientist, educator, and advocate for healthy families and communities, Dr. Mark Schuster is an international leader on quality of care, health disparities, and prevention. Author of two books and more than 200 journal articles, Dr. Schuster was appointed founding Dean and CEO of the Kaiser Permanente School of Medicine in 2017. The school is set to open its doors to an inaugural class of aspiring clinicians this year. 

As talk of graduate medical education reform continues to reverberate in the healthcare community, Kaiser Permanente is betting on a more integrated approach that brings students into a large health system at the very beginning of their training, with an emphasis on primary care, prevention, and innovation. 

Key takeaways:

[:30] Dr. Mark Schuster career briefing.

[1:37] Why is Dr. Schuster a “man to watch”?

[2:14] Uniqueness about Kaiser Permanente.

[4:10] A school focused on medical education with the most effective approach

[5:29] What is wrong with the current medical education?

[6:38] What does Dr. Schuster wish he had learned in his medical training?

[8:54] Changes Kaiser Permanente is implementing in the ways students are learning.

[9:29] Integrating foundational science, clinical science, and health system science.

[11:52] Spiral approach.

[12:13] No cadaver labs.

[14:03] Does being in direct contact with a body provide a level of humanism?

[14:16] Medical students in the first year will be with physicians and the medical team, seeing patients in a primary care setting.

[17:05] Tackling social determinants of health in medical education.

[20::30] The power of each individual physician as a local advocate

[22:53] Role of physicians in gun violence.

[24:20] Burnout, training for doctors to keep their own self-care.

[25:48] Students connected to faculty.

[26:19] Regular consultations of students with a psychologist

[27:15] Academic support.

[27:50] Encouraging students to take breaks

[28:12] REACH weeks.

[29:50] Are we going soft?

[33:07] Being a dean of a medical school.

[34:44] Rapid fire questions

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Kaiser Permanente School of Medicine

Elizabeth Metraux is having two thoughtful conversations at Unity Health Care in Washington, DC, a Teaching Health Center connected with The Wright Center for Graduate Medical Education. She speaks with Patrick Kinner and Dr. Nickia King about the gap between what is taught in medical schools and the realities of daily practice, particularly the social determinants of health.

Patrick Kinner is an evaluator with the Vermont Department of Health and the Center for Behavioral Health Integration, where he lends his evaluation expertise to statewide and national population health initiatives. Patrick shares his views on medical school programs, burnout, and the length healthcare providers go to take care of patients.

Nickia King, DO, is a third-year family medicine resident at Unity Health Care. She discusses her experience as a Wright Center resident working in community healthcare, the role of advocacy in care, and ways providers can address the myriad problems of illness that go far beyond the walls of the clinic.

This episode aims to raise awareness about the work of Teaching Health Centers, a crucial part of the solution for moving American healthcare forward. Listen to this inspiring episode for a fresh perspective and a promising future for healthcare.

Key takeaways:

[:30] Partnership with The Wright Center for Graduate Medical Education.

[2:05] Teaching Health Centers’ purpose and impact.

[2:30] Unity Health Care

[4:21] Patrick Kinner’s work motivation.

[5:14] Bringing a family residency program into underserved areas.

[6:15] Consistent themes nationwide.

[7:31] Difference between what school prepares you for and what your actual job is.

[8:22] Medicals schools are not well-equipped to be nimble and change.

[8:53] Differences between DO and MD programs.

[10:22] Burnout and professional disengagement

[11:30] Reaching a saturation point.

[12:37] Mental health clinicians’ burnout rates.

[16:02] Patrick Kinner’s insights about himself as a patient.

[20:16] Healthcare providers have been self-diagnosed and self-treated for decades, as well as treating issues that should not be presented to them.

[22:04] Big public institutions reflect the community that they are in.

[23:58] Nickia career briefing.

[24:18] What brought Nickia into medicine?

[24:50] Washington, DC living experience.

[26:08] Why working at a community health center?

[28:23] Focusing on advocacy

[28:57] Nickia started teaching in health centers.

[31:12] Access to healthy food, safety, and education.

[32:45] What ought we to do as providers? Take care of the whole person.

[34:22] Social determinants of health.

[34:56:] Statistics about black individuals’ health.

[36:44] Prison population

[38:43] What did the experience in DC teach Nickia about herself?

[40:01] Nickia starting to work in the prison system.

[40:52] Crying for the first time with a patient.

[44:24] Treating both the illness and the illness experience.

[44:59] Humanism in medicine.

[46:50] Coming from a long line of strong women.

[48:47] Seven months away from getting out of residency, what are Nickia’s plans for the future?

[49:37] Preventing burnout.

[50:07] What does Nickia wish she would have known in her first year of residency?

[52:06] Advice to young black women who are considering a career in medicine.

Mentioned in this Episode:

The Wright Center

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Jonathan M. Adler, Ph.D. is Chief Academic Officer and Co-Director of Healing Story Sessions for Health Story Collaborative, an amazing organization that champions the use of story and medicine as a tool for connection, healing, and action. Jonathan Adler has a Ph.D. in clinical and personality psychology from Northwestern, he is a clinical psychologist, member of the editorial team of the Journey of Personality and professor at Olin College. His research focuses on how we make sense of challenging experiences in the way that meaning-making impacts our sense of self and psychological well being. Jonathan Adler uses his personal  narrative as a vehicle for studying meaning-making and identity, with a special interest in the experience of illness and healing.

In this outstanding episode, Jonathan Adler deeply shares his passion and knowledge about narrative and how it is intricately involved in every part of human life, even recognizing our ability to tell stories as the most distinctive human adaptation. Jonathan brings light to the fact that people find meaning and identity when telling stories; and how at the same time in the act of narrating, connections are being made among individuals and with society as a whole.

Key takeaways:

[:37] Jonathan Adler’s career briefing

[2:05] How did Jonathan Adler enter this particular space?

[4:15] Science and stories.

[5:21] How do we use stories for healing?

[6:54] Narrative is everywhere.

[7:42] Narrative is the tool we use to make sense of our lives.

[8:00] What has Jonathan Adler learned about himself in this work?

[9:36] Master narratives: What a culture believes is supposed to be narrated.

[10:18] Why U.S. narrative is so focused on redemption?

[13:16] Narrative is the nexus between self and society.

[14:10] Finding compatible narratives.

[15:17] Every political movement has its own narrative.

[17:03] Jonathan Adler’s work with illness.

[19:35] Telling your story is an intervention itself.

[21:35] Many people go into medicine because of the relational aspect with their patients.

[23:31] We need more space for the connections that only stories can provide.

[24:04] How can someone start in storytelling?

[26:02] Stories of people that acquire major disabilities in adulthood.

[28:16] Rapid-fire questions.   

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Email Jonathan Adler: [email protected]

Health Story Collaborative

Sejal Hathi, MD, MBA is a resident physician at Massachusetts General Hospital and an award-winning social entrepreneur dedicated to building better health systems for vulnerable populations globally. Presently, she serves on the national boards of political organization Arena and civic organization Indiaspora. Previously, she founded and led two social enterprises advancing women's rights and agency around the world. Sejal received her MD/MBA from Stanford and her BS with honors from Yale. She has been named to the Forbes 30 under 30, Paul & Daisy Soros Fellows, Truman Scholars, and Newsweek "150 Women Who Shake the World."

Sejal and Elizabeth engage in a deep and thoughtful conversation about healthcare, politics, social determinants of health, burnout and the role of women. Being a young woman advocating for the rights and needs of women from a very young age has given Sejal a unique perspective. Listen to this episode to find an encouraging, critical and inspirational testimony about healthcare, its extensions, and challenges.

Key takeaways:

[1:02] Sejal Hathi career briefing.

[1:55] Sejal’s journey into medicine.

[3:43] Recovering after being diagnosed with Anorexia Nervosa.

[4:22] Reclaiming dignity.

[5:43] The role of medicine is continuously in debate.

[7:51] Health is not just a diagnosis.

[9:32] Acknowledging the social determinants of health.

[10:50] Burnout is a public health crisis.

[12:14] Medicine is a shadow of what it used to be.

[14:40] Opportunities to come together.

[17:05] Innovations that are working for residencies.

[17:50] Coaching benefits.

[18:43] Connection with mentors in residency programs.

[20:01] Women need more female mentors.

[25:25] Being a woman in a position of authority.

[26:49] Starting nonprofit organizations to support women.

[30:25] Creating community to make a difference.

[31:08] Healthcare becoming more political.

[32:08] Domestic advocacy.

[34:23] Silence is political, we have to take a side.

[35:20] Rapid fire questions.

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Dr. Oliver served as the Deputy Commissioner for Population Health for the Virginia Department of Health. Before accepting the Deputy Commissioner position, Dr. Oliver was the Walter M. Seward Professor and Chair of the Department of Family Medicine at the University of Virginia School of Medicine. As Chair, Dr. Oliver helped lead the transformation of the Departments clinic sites into patient-centered practices focused on population health. In his role as the Deputy Commissioner for Population Health, Dr. Oliver worked with others in the health department, other state agencies, and healthcare systems across the state to improve the health and well-being of all citizens of the Commonwealth. He remains committed to a cross-agency and multi-sector approach to implementing population health initiatives. Dr. Oliver has a long record of accomplishment. Studying health inequities, particularly as they affect racial and ethnic minorities, has been the focus of his research.

Listen to this episode where Dr. Oliver shares his experience, expertise, and personal perspective regarding healthcare, social determinants of health, the opioid epidemic and the reality hitting women and minorities in the healthcare system.

Key takeaways:

[:42] Dr. Norman Oliver career briefing.

[1:31] What brought Dr. Norman into medicine?

[4:58] Top priorities in the social determinants of health.

[7:06] Identifying social and economic conditions that impact health.

[9:33] What are the topics Dr. Norm is tackling now?

[14:33] The opioid epidemic.

[15:18] How is the opioid epidemic impacting Virginia?

[17:34] The opioid problem has always been with us.

[20:55] The opioid epidemic is a medical problem and needs to be treated as a disease.

[22:05] Who will attack the problem of despair that leads to addiction — policymakers or clinicians?

[27:37] We don’t talk politics, we talk about human stories.

[28:40] Dr. Norman’s crazy bold idea.

[33:20] Population health work.

[37:40] What did Dr. Norm learn about his role as a clinician?

[40:11] As a clinician, I am a consultant, I am not there to tell you what to do.

[41:58] Being a black man in medicine.

[45:22] Latinos and African Americans are a third of the state of Virginia

[47:22] “You have to be twice as good to get half as far.”

[48.35] Dr. Norm as a representative of the African American community.

[51:02] Code switch.

[51:50] How are Dr. Norm’s kids like him?

[55:04] Rapid-fire questions.

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Erin E. Sullivan, Ph.D., is the Research and Curriculum Director at the Harvard Medical School Center for Primary Care. In this role, Erin leads the Center’s research program, where her team studies high-functioning domestic and international primary care systems. She also holds a faculty appointment in the Department of Global Health and Social Medicine and co-directs the Physician as Leader course for fourth-year medical students. Erin and Elizabeth discuss in depth primary care foundations as seen through the eye of an expert in qualitative research. Listen to this episode to find out about the crucial importance of relationships and the diversity of organizational cultures around the world, their impact on employees and patients, and how comparative research can help the U.S. primary care system to lift for higher standards of service.

Key takeaways: 

[:33] Erin’s career briefing.

[1:33] How did Erin start into research and primary care?

[2:04] Why Erin got interested in medicine.

[3:33] Finding excitement in the qualitative aspects of research.

[5:04] Finding those aha moments!

[7:30] Organizational culture in a clinic.

[10:30] Speaking the same language.

[11:24] Different cultures in different organizations.

[13:07] How do research groups get involved in primary care?

[14:30] Why research in Spain and the Netherlands on primary care?

[17:25] In Netherlands, Primary Care is considered a specialty.

[19:50] Relationships comes up in data everywhere!

[23:35] Key elements in primary care: relationships and culture.

[25:38] Erin’s curiosity about future possible researches.

[27:15] Patient’s expectations.

[28:55] Challenges in measuring the outcomes of leadership development programs.

[30:26] Teaching in healthcare in the near future.

[31:27] Hot seat! 

Mentioned in this Episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Elizabeth Metraux on Twitter

Erin Sullivan Bio

Harvard Center for Primary Care

Erin E Sullivan on Linkedin