Relational Rounds

Dr. Nic Nguyen is actively working in bringing physicians together, to create a safe space for them to bring their worries and needs, to break the isolation, and to create communities of practitioners who are overloaded, tired and also suffering the consequences of sexism and discrimination against minorities. Is there a formula for being a leader in this field? Unfortunately, there is no secret but as Dr. Nick states, the first step is building human connections by just sitting down and listening to other physicians. Listen to this conversation among colleagues and be inspired to innovate and start changing the system in your community too, for healthier physicians that can deliver better service to patients.

Key Takeaways:

[:49] Dr. Nick career briefing.

[1:59] Importance of clinician community.

[3:36] Is there a nostalgic feeling for previous times’ medicine?

[5:10] Why community building, as a solution for burnout?

[9:52] What brought Dr. Nick into medicine?

[12:13] Why patients should care?

[14:35] Sexism in medicine.

[18:26] Leadership.

[22:35] Building a women primary care group to share narratives.

[27:10] How does Dr. Nicholas keep resilience?

[29:59] Advice to help create community.

[32:14] Creating psychological safety for clinicians.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Optum Care helping doctors and other healthcare providers deliver the best value

Dr. Dave Chokshi has been dedicating his time to improving primary care health. His work, providing care to middle-to-lower-class communities of New York City, has given Dr. Chokshi the chance to encounter face-to-face difficult realities such as racism and undiagnosed chronic illnesses, among others. Dr. Chokshi shares many of his team’s ongoing programs such as the Collaborative Care Program, The Lullaby Project, and The Music and Memory program for the elderly. Dr. Chokshi emphasizes the social responsibility that health care providers have, and how to exercise it, keeping humbleness and an open-minded perspective, and being always ready for innovation

Key Takeaways:

[:38] Dr. Dave Chokshi career briefing.

[1:52] Dr. Chokshi describes his work.

[2:48] Core value: Improving health is improving opportunity.

[3:06] Personal motivation.

[5:27] Interest in humanism and science but keeping our ‘public health hearts.’

[6:20] Experiences that influenced Dr. Chokshi´s perspective.

[9:29] NYC work.

[10:56] Transforming primary care, creating new care models.

[11:50] What is unique about Dr. Chokshi’s team.

[13:55] The patients we do not see.

[14:35] What is the role of health care providers to heal social wounds?

[15:08] Racism and health.

[18:10] Political component in health care.

[19:34] Life expectancy difference between men and women.

[20:44] Role of Public health in raising the voice about gun violence.

[23:10] Greater availability of guns leads to more violence.

[23:35] Obesity and opium epidemics.

[25:08] Burn out from the perspective of Dr. Chokshi.

[27:36] Consequences of loneliness on the health.

[28:40] Collaborative care program.

[29:15] Behavioral and physical health combined in a 15-minute visit.

[30:27] Connection among colleagues in health: bringing the arts as a bond.

[31:47] Music in healthcare: The Lullaby Project.

[34:20] Music and Memory Program.

[35:33] The future of medicine.

[36:35] It doesn’t matter how good your treatment is if you are not reaching to sick patients.

[37:58] Dr. Chokshi’s big idea: Open Notes.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

5 Dynamics — Human Performance System For Team Productivity

Jeff Thompson, M.D., is the executive advisor and chief executive officer emeritus at Gundersen Health System and a pediatrician, author, and speaker on values-based leadership. He shares his experience in leading communities by caring about what matters to patients and physicians and always having core principles as priorities in any decision-making situation from hiring personnel to financing. Health Care needs to start building more communities, finding strength in the diversity, and following the right motivation, which is to serve people. Be inspired by the words of a man that honors his words and walks the path and you, too, start being part of the change

Key Takeaways:

[:38] What brought Dr. Thompson to Aspen?

[1:11] Dr. Johnson’s background.

[3:46] Biggest ideas Dr. Thompson is taking from his time in Aspen.

[5:38] How can experiences with patients overseas be applied in a community like Wisconsin?

[8:24] Death panels.

[11:42] What does it take as a leader to speak up and defend your patients?

[15:55] Who taught Dr. Thompson how to be a leader?

[18:44] How does Dr. Thompson judge his own success?

[25:49] Advice for young leaders: Sticking with one's values over time is a priority.

[28:04] Live through your core values.

[28:14] Training the next generation of leaders.

[29:20] What is next for Dr. Thompson?

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Lead True: Live Your Values, Build Your People, Inspire Your Community, by Dr. Jeff Thompson

Dr. Tyree Winters is a pediatrician in Sewell, New Jersey but he found out that being a doctor could not be equal to his identity. Finding himself belonging to a minority and being the first black doctor in his place of work, gave him a different perspective of how burnout feels like. As a leader, Dr. Tyree conducts himself as a servant and with the same humbleness,  has no inhibitions in sharing his personal experiences to bring some authenticity to the topic of burnout in healthcare

Key Takeaways:

[1:58] Role of burnout for minorities.

[6:05] Being a representative for a minority in healthcare.

[7:44] How did Dr. Tyree learn to be a leader?

[9:10] Mentorship according to Dr. Tyree.

[11:36] Clinician burnout around the country.

[13:30] Avoid centering your identity in being a doctor.

[15:02] Definition of burnout for Dr. Tyree.

[19:30] Losing empathy for others when you feel they don't have it for yourself.

[20:36] How can you heal yourself when feeling broken? Run.

[24:07] What is next for Dr. Tyree? Teach how to prescribe physical activity to patients.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Al Kurose, M.D. is President and CEO of Coastal Medical, a primary-care-driven Accountable Care Organization (ACO). Coastal Medical provides care to 120,000 patients in more than 20 medical offices across Rhode Island. Dr. Al’s current experience in the administrative area, as well as many years with direct attention to patients, have given him an amazing perspective on how health service can be improved. Key concepts like team-based care, burnout, and patient-centered care are approached in this succulent talk. Dr. Alan also shares insightful tips for new medical students and practitioners to have under consideration in the first career choices. Healthcare can be transformed; listen to this podcast and find out how to start

Key Takeaways:

[1:05] What brought Dr. Alan Kurose into medicine?

[2:44] What is the best part of practicing medicine?

[5:04] The value of seeing patients at their home.

[7:27] How burnout will affect new practitioners.

[8:18] The solution to burnout will come from the started collaborative process.

[8:50] Renaissance of primary care contrasted with burnout and suicidal rates going up.

[9:58] What is working and what is not working?

[11:15] Stay realistic in what you can and can’t offer patients.

[13:20] Burnout is an individual problem but there are systemic factors that can help..

[14:15] Team-based care.

[16:40] Coastal Medical Care success formula.

[20:08] Patients in medical homes.

[22:38] Training and support Dr. Alan got at the beginning of his practice.

[27:21] Dr. Alan’s big crazy idea to fix healthcare: Patient-centered service.

[30:20] Advice to new medical students: Don’t be distracted.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Coastal Medical Care

IHI Leadership Alliance

Facts: One in four medical students are depressed and 11% have contemplated suicide; at the beginning of the internship 4% have reported feeling depressed and by the end,  40% meet the criteria for depression. We are facing a real crisis in the medical arena; interns and physicians are suffering in silence, and the suicide rates have been escalating terribly in the last two decades. Dr. Elisabeth Poorman has gone through the suffering herself and is now dedicating her efforts to bringing awareness about this critical situation as well as the proper attention that medical students, interns, and physicians are needing. Listen to this thoughtful and difficult conversation and be encouraged and inspired to make the transition from intellectual empathy to real compassion

Key Takeaways:

[1:29] How did Dr. Poorman get interested in this field?

[3:25] Is it really depression?

[4:30] Accepting vulnerability.

[5:05] Different definitions about burnout.

[6:30] Crisis of depression and suicide among physicians.

[7:21] Stigma in seeking treatment.

[9:35] Seeking an alternative to an inadequate attention to depressed interns.

[12:01] Suicidal crisis statistics.

[14:55] How can practitioners seek help when having suicidal ideation respecting their privacy and dignity?

[15:45] When understaffed and someone is feeling depressed the question is “who is going to cover his shifts?”

[16:58] Suicide has increased more than 25% in the last 17 years across the country.

[18:10] Patients should care if their physicians are not feeling well.

[20:08] Challenges are different for women.

[20:25] Sexism when a woman physician treats patients and also among colleagues.

[23:43] From intellectual empathy to compassion.

[27:18] Safety practice is not about pleasing one another.

[28:21] Suffering should not define a doctor.

[28:49] How does Dr. Elisabeth Poorman take care of her own mental health?

[31:30] Relearning yourself after residency.

[32:47] Advice to medical students.

[34:12] Doctors should be able to share more stories with one another.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Toll-free National Suicide Prevention Lifeline (NSPL) at 1–800–273–TALK (8255)

Learn more about Dr. Poorman’s work.

Dr. Amy C. Edmondson is the Novartis Professor of Leadership and Management at the Harvard Business School; she received her Ph.D. in organizational behavior, AM in psychology, and AB in engineering and design from Harvard University too. She is also the author of several books about teaming and psychological safety. Dr. Edmondson joins Elizabeth Metraux to talk about key topics like how to create a work environment where people can feel confident and safe to share their worries and expose their weaknesses and errors. Dr. Edmondson explains how hierarchy and teaming are not exclusionary, and how learning to ask the right questions can be more important than clever answers. Listen to this podcast and be inspired by the amazing work of Dr. Edmondson in human interactions to make the world a better place, one team at a time.

Key takeaways:

[:35] Dr. Edmonson career briefing

[1:13] How did Dr. Edmondson started working in the field of teaming?

[5:15] Psychological safety and its relationship with performance.

[5:37] How do you teach a human skill like psychological safety?

[7:09] Essential importance of teamwork specially in healthcare.

[9:18] Hierarchy and Teaming, when one or the other?

[12:04] Basic advice for a new leader in creating trust and safety in teamwork: Ask Questions.

[13:45] Humility is strength.

[16:18] How challenges like demographic diversity should be acknowledged?

[19:05] Making room for belonging.

[23:05] Psychological safety in hierarchies.

[26:30] Opportunities and vulnerabilities across the career stage in leadership.

[28:20] Being a leader can be a lonely job but also a meaningful one.

[29:30] There is an increasing burnout issue in health care, can a change be made or is too late for that?

[34:35] Not just sick care but health care.

[35:53] What Dr. Edmondson has learnt about herself during her time in teamwork?

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Learn more about Dr. Amy Edmondson.

The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth, Dr. Amy C. Edmondson.

William J. Doherty is an educator, researcher, therapist, speaker, author, consultant, and community organizer. Bill shares his work in the field of relationships and how the interactions of many have been enriched by creating accountability and responsibility in each member of different groups, bringing them closer instead of highlighting their differences. Creating bridges and bonds between citizens is the key to solve current social hardships. Be inspired by this passionate talk about our most candent social topics and get good ideas and tips to face everyday obstacles.

Key takeaways:

[1:05] Bill Doherty’s career briefing.

[1:40] Why is Bill in the business of relationships?

[2:11] Bill’s current projects.

[3:16] Why are people so polarized?

[4:40] Tribalism vs. the sense of loss of community.

[5:17] Bonding and bridging social capital.

[6:03] Lack of trust throughout different areas.

[8:45] Bringing groups together that could not solve the problem on their own.

[9:50] We need each other to accomplish our goals.

[10:25] Sexism in healthcare.

[14:27] How can polarization be shifted?

[15:38] Advice to someone facing a difficult conversation.

Mentioned in this episode:

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter

Join Better Angels

Andy Ellner is the founding co-director of Harvard Medical School’s Center for Primary Care, and founding director for Harvard Medical School’s Program in Primary Care and Social Change. He is sharing his perspective and opinion on today’s most important challenges in primary care and healthcare in the U.S. Andy presents his new venture: Firefly Health, where technology aims to simplify healthcare while providing patients a team of professionals who will be available according to the case’s needs. Listen to this podcast and find out how technology is reconciling with personal interaction in the field of healthcare

Elizabeth Metraux leads a two section podcast, starting with Audrey Provenzano, MD/MPH, who is a General Internist in the Boston area, cares for patients in a community health center, and works in quality improvement. Audrey is the host and producer of the primary care and health policy podcast Review of Systems and shares her secrets for podcasting on Primary Care and how this activity influenced her career. On the second part of this show, Elizabeth welcomes Krisda Chaiyachati, board-certified general internist and the medical director for Penn Medicine First Call Virtual Care. Krisda studies and designs strategies for improving healthcare accessibility and patient engagement. He leads a research about how ride-sharing apps, like Uber or Lyft, are now being used to assist low-income patients to attend their medical appointments and treatments. To innovate in healthcare is not always an easy task, Krisda explains the obstacles and findings in the efforts for using different resources to better accessibility and engagement to the entire population of patients.

Key takeaways:

[:54] How did Audrey Provenzano start podcasting?

[2:16] Jeff Bremer claims that authentic healing relationship to fixing healthcare.

[3:31] What’s Audrey’s favorite question to ask?

[4:05] Podcasting influence on Audrey’s practice.

[5:44] Preparation for a podcast.

[7:18] Audrey’s new job endeavor in primary care.

[8:58] Ride sharing and increasing (or not) accessibility for patients.

[10:02] Research initiative.

[12:26] Patient access to the clinics with transportation apps.

[14:08] Services designed for low-income patients are not always meant for their needs.

[15:50] Patients look for stability.

[16:35] Designing clinical trials for a particular population without “othering.”

[19:15] Bringing healthcare into the home.

[21:26] Healthcare system has to be more creative on how to spend funds.

[22:13] New research about accessibility of healthcare to all population.

[24:02] Why healthcare is so far behind in the development of new technologies to communicate with patients?

[26:30] Obstacles for innovation in healthcare.

Mentioned in this episode:

Review of Systems

Audrey Provenzano on Twitter.

Relational Rounds at Primary Care Progress

Primary Care Progress on Twitter