Creating a New Healthcare

Dr. Jonathan Fisher, a cardiologist dedicated to the intersection of heart health and emotional well-being, dives deep into the profound impact of managing thoughts and emotions on overall health. He shares insights from his book, emphasizing the importance of ‘heart waker’ emotions versus ‘heart breakers.’ Listeners will discover the practical ‘BESTLIFE’ routine to cultivate positivity each morning. Personal anecdotes and mindfulness techniques highlight the path to healing and happiness, making his approach both relatable and actionable.

Dr. Robert Pearl, former CEO of Kaiser Permanente and a pioneering healthcare leader, discusses the significant role of generative AI in revolutionizing healthcare. He shares insights from his book 'ChatGPT MD' and explains how AI can save lives while reshaping patient care. Pearl argues that generative AI should be viewed as an assistant, capable of transformative impacts if studied and implemented effectively. He urges the medical community to embrace this technology, overcoming fears and inertia to unlock unprecedented advancements in healthcare.

If you’ve ever wondered, ‘But what can I do? – please listen to this episode. Dr. Stella Safo, a Harvard-educated, Ghanaian-American physician, provides us all with her wisdom, experience and courageous efforts in addressing that question.  In this interview we’ll cover: Some shocking and saddening stats on healthcare inequities & disparities in the US The enabling power of community and civic engagement The importance of sharing our ‘inexpert knowledge’ Understanding and confronting our own internal ‘othering’ Why Diversity, Equity & Inclusion is critical in healthcare delivery The origin and creation of the “Green Book survival guide”  for healthcare that Dr. Safo and her colleagues are creating AfterShock – the 2022 documentary about two young healthy black women who died after childbirth from preventable causes.   An introduction to the ‘Wake Up Everybody’ community. The major lessons I learned from Dr. Safo – challenging our assumptions about ourselves and about our relationship to ‘the system’. Dr. Stella Safo is a practicing primary care physician, public health advocate, and the founder of ‘Just Equity for Health’. She is an assistant professor at the Mount Sinai Health System in NYC and has served as the Chief Clinical Transformation Officer at Premier. Dr. Safo is a founding member of several organizations dedicated to gender, racial equity and civic engagement in medicine – including ‘Equity Now’ at Mount Sinai, ‘Civic Health Alliance’ and the ‘Coalition to Advance Antiracism in Medicine’. If you’re interested in learning more about her work, follow her on LinkedIn  or check out Just Equity for Health and Thriving in the Last Mile. 

So, it turns out that how we frame failure is far more important than how we manage success, in determining our motivation and our ability to sustain healthful and positive behavior change.  Our guest today, Dr. Kyra Bobinet, is a long-standing expert, clinician and entrepreneur in the field of behavior change. Her company, Fresh Tri, applies a unique approach to embedding state-of-the-art behavior change techniques into software apps – something she learned at Stanford, in one of the most illustrious behavioral labs in the world.  The approach Kyra offers us is a liberating reversal of the motivational approaches we’ve used for decades – in our organizations, with our patients, and in our own personal efforts to form healthful habits. It’s a shift from the predominant ‘performance-based mindset’ to an ‘iterative mindset’, which essentially prevents demotivation. This iterative approach to sustained behavior change is far more kind and creative, and likely to be far more successful. Since learning about the iterative mindset from Kyra, I’ve begun to use it in my professional and personal life – and it works – which is why I’m excited to read Kyra’s new book on the subject, ‘Unstoppable Brain: The New Neuroscience That Frees Us from Failure, Eases Our Stress, and Creates Lasting Change’ which is available on Amazon. If you’re interested in learning more you can find Kyra’s work here. Zeev Neuwirth, MD

Neal Khosla, co-founder and CEO of Curai Health, has been recognized as one of Time's 100 most influential leaders in AI. He discusses the pressing shortage of primary care providers and how AI can enhance patient engagement and chronic disease management. Khosla describes Curai's innovative text-based, AI-empowered primary care model, emphasizing its accessibility through platforms like Amazon. He also highlights efforts to serve vulnerable populations and community health initiatives, proving that technology can revolutionize healthcare for all.

Friends, I think you’ll all understand this. Every once in a while an issue comes along which has such importance and urgency that you’re compelled to do something about it. In this case, I had a phone call with our expert guest a week ago, and ten minutes into the discussion, I stopped him and said ‘we have to do this podcast interview immediately and get it out there’.   The compelling issue includes: (1) the severe and worsening nursing burnout and subsequent shortage; (2) the overcrowding of Emergency Departments with prolonged ED “boarding” and (3) morbidity and mortality in our hospital systems.  These are indeed critically urgent issues. A recent Becker’s report noted that nursing and staff shortages is the #1 concern for hospital CEO’s. ED overcrowding is a worsening national crisis – well documented in the medical and lay press. In fact, 90% of hospitals report having to keep patients in the ED because of lack of hospital capacity; and this ED “boarding” is associated with significant increases in patient deaths and harm in the hospital.  Our guest today has been studying and addressing this problem for over two decades. Eugene Litvak, PhD is an adjunct professor at the Harvard T.H. Chan School of Public Health who has published dozens of articles in peer-reviewed journals like the NEJM, JAMA, and Health Affairs. He’s also served as an advisor on patient safety and quality to the American Hospital Association as well as within the prestigious Institute of Medicine (now called the National Academy of Medicine). More to the point, Dr. Litvak developed a proven solution that he’s been deploying for years and which is now the focus of a recent book – Hospital Heal Thyself: One Brilliant Mathematician’s Proven Plan for Saving Hospitals, Many Lives, and Billions of Dollars – by Mark Taylor, a veteran healthcare reporter.  So, we’ve had a proven, doable, financially viable solution to the problem of ED and hospital overcrowding, for years. But, for reasons that are unclear to me, most hospitals in the US are either unaware of or have not adopted his solution – which is the motivation for sharing this interview. In this discussion we’ll discover: The true cause of overcrowding in Emergency Departments and hospitals and how it is largely unrelated to the variability in the number of patients coming to the ED. A detailed explanation of the ‘variability methodology’ that Dr. Litvak has developed which addresses the actual problem causing overcrowding.  Published examples of hospital systems that have deployed Dr. Litvak’s method resulting in dramatic improvements in safety and quality, reductions in burnout and turnover amongst nurses, and increased hospital productivity and margin.  Examples of how Dr. Litvak’s approach is being used in federally qualified health centers (FQHC’s) contributing to improved health equity. In addition to improving quality and safety, the operational excellence that Eugene is talking about creates a working environment in which clinicians and staff can demonstrate the empathy, compassion and love that brought them into healthcare in the first place. Operational excellence enables clinicians to manifest their professionalism, to listen and “attend” to their patients, and to build trusting relationships. One thing I realized through this interview is that there are many paths to love – and in this case it’s through mathematical modeling and operations management.  My purpose in putting this podcast out there with some urgency is to create awareness so folks can make their own decision about its validity and importance, and then take positive action. In terms of action – if you’re moved by this interview, my request is that you preorder the book, ‘Hospital Heal Thyself’ on Amazon, check out Dr. Litvak’s website, and share this interview and the book with your colleagues – particularly hospital-based leaders. And if you disagree or have alternative solutions, please let us know. I choose to be an optimistic realist. What continues to fuel that optimism are humanistic leaders like Dr. Litvak. He’s a renowned expert in healthcare operations management who could rest on his laurels. But instead, he’s been out there for over two decades trying to radically improve healthcare – trying to save lives. The integrity, humanitarian purpose, commitment and perseverance he’s demonstrated are beyond inspiring for me. And I think there’s a lesson in there for all of us – not just in what he’s doing, but in who he’s being.   Zeev Neuwirth, MD

Friends, The digital/data revolution in healthcare is upon us, and amongst other things, it’s recreating public health, population health and health equity. One of the groups at the forefront of this movement is the ‘Data Humanity Lab’ at Finthrive.   In this episode, we’ll hear directly from one of the emerging leaders in the field, Brian Urban – the Director of Innovation & Emerging Markets at Finthrive. Brian and his colleagues are not just advancing health equity and public health – they’re redefining what it means. To achieve this, they’re partnering with hospital systems and provider groups, health plans, device & tech manufacturers, as well as leading universities and academic medical centers. I learned a lot during this interview, including: The radical contribution the Data Humanity Lab is making by providing its exclusive data sets and expert services for free to health equity programs and researchers across the country.  How the ‘Gramm-Leach-Bliley Permissible Use Act’ protects consumers from both intended and unintended harmful use of their personal data. The gaps in public health education that we need to get beyond. The severe limitations of the claims, clinical and outcomes data we’re currently using in allowing us to understand the health-related conditions and needs of people.   How expanded data sets (i.e. consumer marketing data) are being used to greatly improve our ‘whole-person’ understanding of the social determinants of health. Examples of specific projects in which healthcare systems, such as Dartmouth and UPMC, are partnering with the Data Humanity Lab. Many of my colleagues talk about how entrenched the system is. Well, here is an example of how individuals in a visionary organization are not accepting that belief, radically transforming healthcare for the better. What Brian and his colleagues are doing is a wonderful example of an emerging humanistic leadership mindset in American healthcare. You’ll have to listen in to really understand what I’m talking about, but in this interview Brian challenges us all to reframe our business models from a more humanistic lens.  Zeev Neuwirth, MD

Chris Deacon, a distinguished consultant and legal expert in employee health benefits, dives into the complexities of employer-sponsored healthcare. She discusses the systemic issues driving costs and the lack of accountability under ERISA. The conversation highlights the need for employers to reclaim negotiation power to enhance employee care. Chris also unpacks the implications of the Consolidated Appropriations Act, revealing how it introduces new transparency requirements and could lead to significant legal challenges for self-insured employers.

Friends, The number one question I get asked after my presentations and seminars is, “But Zeev, what can I do?”  Making positive humanistic change in healthcare seems daunting, if not impossible. The system is incredibly entrenched. And yet, in this interview we’re going to hear examples of leaders who have used the principle of ‘love’ to create positive, impactful, and measurable change in their healthcare organizations.   Our two guests in this episode – Dr. Apurv Gupta and Stephanie Feals – have been on a journey to explore and share how ‘love’ is being deployed in healthcare organizations – not just as a vision or mission, but as a tactical operating principle. They co-founded and co-host a wonderful podcast entitled, ‘Making Healthcare Work For You’, which I highly recommend. In addition, Dr. Gupta – who is VP of Advisory Services at Premier Inc – has been consulting to organizations who are interested in creating a ‘loving’ healthcare organization. I find this to be incredibly encouraging and inspiring – that a publicly held company with the size, stature and reputation of Premier is supporting its people and its clients in working to rehumanize healthcare.  In this episode, we’ll hear about nationally renowned leaders and organizations who have been deploying love as a leadership principle. There are many pearls of wisdom that Apurv and Stephanie shared.  I’ll briefly mention three:   If we believe ‘love’ to be an important component and principle in healthcare delivery, we need to make it part of our daily narrative. Dr. Gupta puts it this way, “The conversation changes with us. Organizational culture is about conversation. Healthcare relationships are about conversation. If we think ‘love’ is important, we have to include it in the conversation.” The principle of ‘love’ has to become integral to the daily operations of organizations. It has to be manifest in strategic decisions, policies and protocols, and in the daily management approach. Rather than placing the onus on individuals, the focus should be on the organizational infrastructure. Ultimately, ‘love’ is the responsibility of leaders – in creating the conversation, the culture and the infrastructure that supports a loving organization. As Dr. Gupta put it, “… it starts with one person – with that spirit of courage, optimism and hope…” I would love to hear your thoughts about this.  If this interview resonates with you, please comment on it and share it with others. Zeev Neuwirth, MD

Glen Tullman, CEO of Transcarent and former leader of Livongo Health, shares insights on transforming healthcare for self-insured employers. He discusses the staggering burden of medical debt affecting over 100 million Americans and the inflation of employee healthcare costs due to mismanagement. Tullman highlights the need for innovative solutions, like Transcarent's user-friendly platform that integrates various healthcare services. He emphasizes the importance of comprehensive care and strategic partnerships to enhance employee access to benefits.