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Physician leadership profile: Dr. LaMar Hasbrouck brings rare perspective to healthcare’s most vexing issues

By | December 5 th,  2018 | physician leadership, healthcare executives, population health, value-based care, leadership traits, healthcare disparities, mission-based leadership | Add A Comment

Hasbrouck-LamarAt a time when the healthcare industry is putting a premium on physician leadership, while seeking to address the disparities threatening value-based care, few executives are better positioned at the convergence of those streams than LaMar Hasbrouck.

 

Hasbrouck, who holds an MD and an MPH, is Senior Advisor for Strategy and Growth with the American Medical Association. He helps design and build the association’s equity portfolio, as well as cultivate corporate and private foundation relationships. He also guides the association’s chronic disease initiatives and heads efforts to improve internal team cohesion.

 

“I describe my job as a strategy whisperer,” he says. “I’m a fresh set of eyes to look at problems in healthcare and advise the Group VP where we should be putting our resources and what types of talent we should hire.”

 

But don’t be fooled; that fresh set of eyes has experienced a lot. Hasbrouck has worked at the local, state, federal and international level in healthcare. He worked at the Centers for Disease Control and Prevention for 11 years, first as a senior medical officer and later as the director of its work in Guyana, South America.  He was health commissioner of New York’s Ulster County, leader of the Illinois Department of Public Health and CEO of the National Association of County & City Health Officials.

 

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That’s a rare perspective on some of healthcare’s most vexing issues. As such, he finds that the various entities don’t often work well together. That’s a challenge, because all hands are needed to try to solve the tenacious problems in healthcare.

 

“The local level works best with the state level, and the state works well with the federal, but the local and federal levels don’t work well together,” he says. “Then, at the global level, there tends to be a real disconnect in that the U.S. government tends to be one small layer in a very large pool with a lack of fluidity.”

 

Despite his distinguished track record, Hasbrouck is bold in championing solutions outside traditional thinking and is eager to bring his experience to bear on a wide range of issues. His international experience, from South America to Africa, also has molded his views.

 

“What I have learned in my travels is that innovation is essential for solving problems, yet it’s the simple things that you take for granted,” he says. “For instance, when I was in Uganda, we had problems getting medications into hard-to-reach areas. We considered flying the medicine in, but then we came up with the idea of a motorcycle tag team using dry ice to keep the medicine cool.

 

“We didn’t stop there. We trained some laypeople as health workers to address the most common side effects with the patients.”

 

Hasbrouck grew up in a world where preventive health didn’t exist. His family, led by a single mom, was, for a period, reliant on welfare to survive.

 

“It might be surprising to some people, but it was a very happy time,” he says. “We were materially poor, but spiritually and culturally rich. We were inventive in our play because we didn’t have material things. I didn’t know I was deprived, although there were clearly not a lot of male role models who were white-collar professionals.”

 

Yet it’s precisely that upbringing that gives Hasbrouck his mission in stamping out inequity in care.

 

“I have lived that experience and it gives me credibility,” he says. “I’m very driven by my personal narrative. I have chosen roles carefully by the impact I can have through my skills and competencies.

 

“That’s who I am.”

 

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Leadership development and experiences construct a strong foundation for Geisinger's Ryu

By | August 27 th,  2018 | Geisinger, Jaewon Ryu, Leadership Development, Top 25 Minority Executives in Healthcare, physician leadership | Add A Comment

 

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Jaewon Ryu, the executive vice president and chief medical officer for Geisinger Health System, trained as both a physician and a lawyer, but says his greatest leadership development came through experiences like the White House Fellows (WHF) Program, a yearlong, non-partisan education program that places early/mid-career people in high-level cabinet offices and trains them for leadership and public service.

 

“Whether training or working as an attorney or a physician, nowhere in that process do you really learn leadership,” says Ryu, a native of suburban Chicago. “You pick up some skills along the way through your training and work, but the WHF Program was a wonderful way to immerse in leadership development – seeing how decisions are made within complex organizations, being able to hear from great leaders, and taking on projects to apply these learnings.”

 

Ryu’s description is apt. Many healthcare executives, including clinical leaders, might believe that taking a seminar or getting a few sessions of executive coaching fortifies them for the work of leadership. But trained, focused work in leadership development is best accomplished with trained facilitators and convened as part of a thoughtful program within a team, allowing a leadership group to find alignment and cohesion. ...

 

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Decisive leadership: Baltimore Health Commissioner Leana Wen sees the ER as a valuable training ground for physician leaders

By | August 13 th,  2018 | Leana Wen, women leaders, physician leadership, Top 25 Minority Executives | Add A Comment

WenThe number of physicians and nurses transforming into administrative leaders capable of running major organizations is growing rapidly.

 

In the age of value-based care, organizations are leaning on clinicians to lean in to leadership. This opens new vistas for physicians and nurses, but health systems and insurers must do their homework. A physician who heads his or her own practice may have valuable leadership skills, but leading, say, a staff of 12 is different from overseeing a $2 billion budget and ensuring a board and a C-suite are in sync with your vision.

 

One such physician who has made the jump is Leana Wen, MD, the Baltimore City Health Commissioner, who leads a staff of 1,000 employees. Since being named to the role in December 2014, Wen has shown a predilection for taking decisive action, perhaps unsurprising as someone trained as an emergency room physician:

  • She led the creation of Vision for Baltimore, which provides free eye exams and glasses to children in grades K-8 in all Baltimore City public schools. She created a partnership with the schools, Johns Hopkins, the glasses manufacturer Warby Parker, and a national nonprofit, Vision to Learn, to make it happen. “That’s an example of directly translating policy into action,” she says.
  • Wen was a pioneer as a public-health leader in issuing a standing prescription for all Baltimore residents to obtain and administer naloxone, the antidote that can save a person’s life in the event of an opioid overdose. “Since then, residents have saved the lives of more than 2,500 fellow residents in the last two and a half years,” she says.
  • She supported the expansion of a program called Safe Streets, which calls upon former felons to intercede and help defuse tense situations in Baltimore. She also employs people who are in recovery from addiction, others who are living with HIV, and still others who learned about lead poisoning from home visits from the health department and now are outreach workers themselves. “It is my obligation as a leader to ensure a workplace of diversity, equity and respect, and it’s my privilege to work with those who are using their lived experience to help lift up others in similar circumstances,” Wen says.

Decisive leadership is at a premium these days. Writing in Forbes, leadership expert Sunnie Giles points out that the increasingly complex world in which we live can be paralyzing for leaders. Those who can adapt, like Wen, and use the complexity as a positive catalyst for their team are poised for success.

 

Decisive leaders should:

  • Accurately define the challenge – gathering as much information as possible in a short period of time from a number of reliable sources, being sure to gain a better holistic picture from all sides of the issue
  • Encourage constructive discourse surrounding the challenge and possible solutions and alternatives
  • Act quickly to set a course of action
  • Support the execution of that action plan by breaking down hurdles and providing additional direction as needed

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The ER as a leadership crucible

 

Wen’s transition from physician to leader had some elements of a baptism by fire. She was greeted with a measles outbreak erupting at the same time as several possible Ebola cases. Three months after she became health commissioner, Freddie Gray, an unarmed African-American man, died in police custody and riots ensued. In all, 13 pharmacies were burned down or closed. “We had to figure out how to get people food, and how to get seniors their medications because their pharmacies were closed,” Wen says. “We had to figure out how to get people to dialysis, chemotherapy and other life-saving treatments.”

 

Leading her team, in collaboration with city, state, federal, and private sector partners, she figured it out quickly. So quickly that, a year later, the American Public Health Association honored her with its highest award for local public work, the Milton and Ruth Roemer Award. Achievements have come through steely determination for Wen, who grew up as the child of Chinese political dissidents in a rough Los Angeles neighborhood.

 

Nonetheless, she graduated from college at 18, became a Rhodes Scholar and studied at Oxford, and completed her medical training at Brigham & Women’s Hospital and Massachusetts General Hospital before becoming Director of Patient-Centered Care Research and an attending physician in the Department of Emergency Medicine at George Washington University in Washington, D.C.

Wen sees three direct correlations between her ER work and her leadership role now.

 

“Working in the emergency department is all about doing what you can right now,” she says. “That bias to action is the same bias that is necessary in public health where there are so many urgent matters that demand our attention.”

 

The second lesson is “assisting those who are most vulnerable,” she says. The naloxone prescription that has saved so many people from opioid deaths is one example of this, as is providing something as basic as glasses to children who are in need.

 

Finally, Wen says she learned the importance of speaking up. “In the ER setting, you can never wait to speak up,” she notes. “If there’s something that you suspect is wrong, you need to speak up right now. And that directly translates into the workplace. There are many issues we need to speak up on right now, including issues of discrimination and harassment, health as a human right, the cost of prescription drugs, and evidence-based, science-based programs like teen pregnancy prevention.”

 

Even for those not in public health or policy-oriented roles, clinicians can sometimes underestimate the power of their voice in the age of patient-centered care. While it is true that healthcare administrators often have years of mentoring and on-the-job training for executive roles, physicians can be prepared for new opportunities through accelerated physician leadership training.

This type of training allows physicians to gain valuable skills and insights into leadership principles that challenge their core training. By working through real world scenarios, physicians can begin applying these principles right away. In our experience, many notice impactful outcomes within weeks with this type of leadership development and support.

 

The goal is to bring the physician from thinking in terms of their solitary influence on the goal to shift them into leading an enterprise, which takes a much broader perspective. An accelerated physician leadership training uses three phases:

 

Coaching and mentoring – which moves them through the leading self to leading others

 

Collaboration and change management – which transitions them into leading the business

 

Driving systemic change – which allows them to lead the enterprise

It’s no easy task to work through these phases, especially without the proper guidance. The accelerated nature of these programs helps physicians gain in months and years what may have been elusive in that solitary mindset within which they were trained to operate.   

 

Diverse voices matter at the top

 

As an immigrant, Wen experienced vivid episodes that crystallized for her the importance of speaking up.

 

Shortly after arriving in the U.S., Wen saw a neighbor die from an asthma attack; his grandmother was too afraid to call an ambulance because of their family’s immigration status. And the #MeToo groundswell in the last year refreshed Wen’s memory of watching her mother come home from a job at a video store sobbing because of an unnamed incident that occurred with her physically and verbally abusive boss.

 

“I have always thought from that time, that if I’m ever in a position of leadership where I can do something about these things, I need to speak up for her and for so many women who have suffered in silence.”

 

Wen has done just that. She’s proud to have recruited a diverse leadership team. Her Chief of Staff and all three of her deputies are women. She actively recruits from the communities the Health Department serves.

 

Commitment to diversity is a powerful engine to create organizations that are more profitable and thoughtful as they face the business world externally, and catalysts for employee engagement and leadership development internally. Leaders at the top of an organization should not underestimate the power they have to recalibrate an organization’s perspective, because many challenges remain, something Wen knows personally.

 

 “As a minority and a female, I have faced entrenched racism and sexism,” she says.

 

Some are mundane – patients requesting to see the “real” doctor, or CEOs calling her by her first name while addressing her male counterparts by their titles. Some are overt – “at one event, I was introduced as a ‘cute little thing’ and openly questioned on how a female person of color can lead 1,000 people.”

 

How to overcome that?

 

“We must foster a culture of diversity, inclusion and equity,” Wen says. “The key to doing that is for boards and management teams to have diverse leadership. We cannot expect for others to do what we are not willing to do ourselves.”

 

EXECUTIVE’S TOOLKIT: Strategies for physicians moving into leadership roles

 

Looking back, Wen sees several lessons that can help her fellow doctors if they choose to become physician executives leading the entire enterprise:

  • “Be intentional as you consider your move. Working clinically gives you many leadership skills. Channel these skills into leading on a different level.”
  • “Find multiple mentors from within and outside your organization who can help guide you and problem-solve. Gain management experience.”
  • And, finally: “Never forget why it is that you are here: to serve our most vulnerable individuals during their time of need.”

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SreyRam Kuy's field guide to developing physician leaders and diverse teams

By | June 28 th,  2018 | SreyRam Kuy, diversity, physician leadership | Add A Comment

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One in a series of interviews with the top executives in healthcare


 

SreyRam Kuy wears two hats for the Department of Veterans Affairs. She is the associate chief of staff for the Michael DeBakey VA Medical Center in Houston and a senior advisor to the Secretary of the VA.

 

In an interview with Furst Group and NuBrick Partners as part of the 2018 Top 25 Minority Executives in healthcare awards program for Modern Healthcare, she explains how her background as a surgeon has been ideal training for becoming a leader. 

 

“When you have a trauma bay and are doing an emergency thoracotomy (cracking open the chest to access the heart)," she says, "you have nurses and technicians and anesthesiologists and the ER team and students and residents in play. Sometimes, there are even family members of the patient whom you’re trying to get out of the way. It’s definitely a master class in learning how to manage crisis.”

 

Kuy almost didn't get the chance to use her gifts. She was born in Cambodia's killing fields and was badly injured as a child when a rocket-propelled grenade hit her family's tent in a refugee camp. A volunteer American surgeon performed emergency surgery on both Kuy and her mother.

 

Kuy also credits three formal leadership programs in which she has participated as also being pivotal catalysts for her career:

  • Presidential Leadership Scholar (under the aegis of Presidents George W. Bush and Bill Clinton)
  • Robert Wood Johnson Clinical Scholar
  • American College of Surgeons (ACS) Health Policy Scholar at Brandeis University’s Heller School of Management

The Presidential Scholar program in particular, she says, helped her during a stint as chief medical officer for Medicaid for the state of Louisiana. She learned how to build consensus and turned some of the biggest detractors of her policies into champions. By creating more diversity of thought and backgrounds you can gain a broader sense of the issue and gain more traction. 

 

“When you exclude people, there will be opposition," Kuy says. "But when you bring people into the fold, you give them an opportunity to use their talents. That’s how you engage people and drive initiatives that are successful.”

 

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Wharton Healthcare Quarterly features article on developing physician leaders by Clarke, Mazzenga

By | May 5 th,  2017 | Blog, Bob Clarke, Furst Group, Joe Mazzenga, Leadership Development, NuBrick Partners, organizational leaders, physician leadership, University of Pennsylvania, value-based, Wharton Healthcare Management, Wharton Healthcare Quarterly | Add A Comment

 

The latest issue of the Wharton Healthcare Quarterly is out, and it features a pertinent article from Furst Group's Bob Clarke and Joe Mazzenga on the challenge and reward of developing physician leaders to lead the entire enterprise, not just a clinical department.

 

Published by the Wharton Healthcare Management Alumni Association at the University of Pennsylvania, the latest issue of the Quarterly also features articles on the transition to value-based payment, the coming challenges posed by post-acute care, and creating a culture of value.

 

Clarke is the chief executive officer of Furst Group and NuBrick Partners. Mazzenga is managing partner of NuBrick Partners, our leadership consulting firm, and a Furst Group vice president.

 

The authors acknowledge that both administrators and physicians have work to do to achieve success in this endeavor and that, ultimately, "True leadership is about building teams who create an empathetic and collaborative culture."

 

To read the complete article, click here.

 

 

U.S. healthcare is broken. Sachin Jain and colleagues want to help transform it

By | October 12 th,  2016 | Anthem, Blog, CareMore Health System, CMS, extensivists, Harvard, Modern Healthcare, physician leadership, readmissions, Sachin Jain, Top 25 Minority Executives in Healthcare | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

In his mid-30s, the laundry list of accomplishments that Sachin Jain, MD, MBA, has already achieved stretches like the curriculum vitae of an executive twice his age. As a medical student at Harvard, he and some friends started a medical clinic for the homeless. He eventually became a lecturer for Harvard Medical School and was a physician for Brigham and Women’s Hospital and the Veterans Affairs Boston Healthcare System. He and a friend founded a new medical journal that is growing by leaps and bounds.

 

He was a senior advisor to Don Berwick at CMS and has been a leading advocate for quality and safety. He was the chief medical information and innovation officer at Merck, the pharmaceutical giant. Now, he’s the president of CareMore Health System, an innovative blend of payer and provider that’s owned by Anthem.

 

So what exactly drives this guy?

 

“On some levels, it’s outrage,” Jain says candidly. “Healthcare could be better and should be better. I’ve always been drawn to problems related to our failure to effectively apply the knowledge that we already have. Healthcare is full of those problems.”

 

The mission aspect of healthcare comes naturally to Jain. His father, Subhash Jain, MD, founded the pain management service at Memorial Sloan Kettering Cancer Center. One of his aunts, Shanti Jain, MD, went against the grain in her native India by opting not to marry. She devoted her life to rural healthcare in India, going places other clinicians were loathe to go.

 

“She was somebody who saw problems in the world and came up with solutions,” says Jain of the woman who was an early pen pal of his as he grew up in New Jersey. “It wasn’t just about healthcare. She went to one community and saw the kids didn’t have a good education, so she built a school. She saw that the sanitation system was an obstacle to good healthcare so she started fixing the tatters of the sanitation system there.”

 

When Jain’s aunt died of ovarian cancer, her sister, Kanti Jain, MD, who was a diabetes researcher at Cornell University, moved to India to take over the work. Jain says he himself toyed with the idea of moving to Asia as well but decided against it, although he has volunteered with the medical mission there.

 

“Somewhere along the way, as the first person in my family to be born in the U.S., I became American and decided that America was my home,” he says with a chuckle. “And, frankly, I also had this realization that there are lots of people suffering from healthcare injustices right in our own back yard.”

 

With a background that includes mentors like Berwick, David Blumenthal (now head of the Commonwealth Fund) and Michael Porter (author and economist at Harvard Business School), Jain says he feels he has found an ideal outlet at CareMore for his passion around quality and safety. The organization actually was founded as a physician group by California gastroenterologist Sheldon Zinberg, MD, who created an innovative way to care for chronically ill elderly patients.

 

 

The idea is to be omnipresent via extensivists, who provide continuity of care, as well as home care to help prevent readmissions, whether that means supplying car rides to the doctor’s office or even delivering a refrigerator to keep insulin cold. It morphed into a health plan, focused on Medicare patients, and is now is a $1.2 billion enterprise that has more than 100,000 members in eight states and manages care for Medicaid patients in Memphis and Des Moines as well.

 

The results have been impressive:

 

• CareMore’s patients are hospitalized 20 percent less than the industry average, even though its population tends to be sicker than the average Medicare patient. (If one adjusts for the health of the patients, the admission rate is 40 percent less.)
• Its Congestive Heart Failure program participants on average experience 43 percent fewer hospital admissions than the average Medicare patient with CHF.
• For patients with end stage renal disease, there are 45 percent fewer admissions.

 

And its members pay lower costs as well.

 

Jain admits that the CareMore model won’t fit every situation. “The CareMore model is disruptive and transformative, so we have to be very thoughtful about how and where we integrate and pilot it,” he says. “But I do think there are a number of opportunities to take the work that we’ve done successfully serving Medicare patients to serve similar patients in commercial and Medicaid populations.”

 

It’s also making its presence felt in academic medicine circles. Leaders at Emory Healthcare in Atlanta recently chose CareMore to help them transform their care model for Medicare Advantage patients. It’s a provider-payer relationship that Jain says he is excited about.

 

“The leaders at Emory were visionary in their thinking that a California-based managed-care company could be a transformation partner,” Jain says. “They were able to think beyond the stereotypes of the payer industry and get into the guts of what CareMore actually does – and how it might be relevant in their setting.”

 

A year after joining CareMore as chief operating officer and chief medical officer, Jain was promoted to president in April 2016. With that distinction, he joins a growing list of physicians who are at the helm of healthcare organizations. He continues to see patients on a limited basis, and says he knows why physicians are willing to take on a bigger role.

 

“For the first time, you have a generation of physicians who are seeing that the system is broken,” Jain says. “They believe they can and should lead change, and that their insights as physicians can drive better care.

 

“We want to deliver better healthcare. We want to bring back the joy of work to actually delivering healthcare. There are few better jobs in the world than being a physician or a nurse where you get to take care of patients and be a part of their lives in that intimate way. There’s nothing quite like it.”

 

 

The healthcare system is broken. Sachin Jain and colleagues want to help transform it

By | May 6 th,  2016 | Anthem, Blog, CareMore Health System, CMS, extensivists, Harvard, Modern Healthcare, physician leadership, readmissions, Sachin Jain, Top 25 Minority Executives in Healthcare | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

In his mid-30s, the laundry list of accomplishments that Sachin Jain, MD, MBA, has already achieved stretches like the curriculum vitae of an executive twice his age. As a medical student at Harvard, he and some friends started a medical clinic for the homeless. He eventually became a lecturer for Harvard Medical School and was a physician for Brigham and Women’s Hospital and the Veterans Affairs Boston Healthcare System. He and a friend founded a new medical journal that is growing by leaps and bounds.

 

He was a senior advisor to Don Berwick at CMS and has been a leading advocate for quality and safety. He was the chief medical information and innovation officer at Merck, the pharmaceutical giant. Now, he’s the president of CareMore Health System, an innovative blend of payer and provider that’s owned by Anthem.

 

So what exactly drives this guy?

 

“On some levels, it’s outrage,” Jain says candidly. “Healthcare could be better and should be better. I’ve always been drawn to problems related to our failure to effectively apply the knowledge that we already have. Healthcare is full of those problems.”

 

The mission aspect of healthcare comes naturally to Jain. His father, Subhash Jain, MD, founded the pain management service at Memorial Sloan Kettering Cancer Center. One of his aunts, Shanti Jain, MD, went against the grain in her native India by opting not to marry. She devoted her life to rural healthcare in India, going places other clinicians were loathe to go.

 

“She was somebody who saw problems in the world and came up with solutions,” says Jain of the woman who was an early pen pal of his as he grew up in New Jersey. “It wasn’t just about healthcare. She went to one community and saw the kids didn’t have a good education, so she built a school. She saw that the sanitation system was an obstacle to good healthcare so she started fixing the tatters of the sanitation system there.”

 

When Jain’s aunt died of ovarian cancer, her sister, Kanti Jain, MD, who was a diabetes researcher at Cornell University, moved to India to take over the work. Jain says he himself toyed with the idea of moving to Asia as well but decided against it, although he has volunteered with the medical mission there.

 

“Somewhere along the way, as the first person in my family to be born in the U.S., I became American and decided that America was my home,” he says with a chuckle. “And, frankly, I also had this realization that there are lots of people suffering from healthcare injustices right in our own back yard.”

 

With a background that includes mentors like Berwick, David Blumenthal (now head of the Commonwealth Fund) and Michael Porter (author and economist at Harvard Business School), Jain says he feels he has found an ideal outlet at CareMore for his passion around quality and safety. The organization actually was founded as a physician group by California gastroenterologist Sheldon Zinberg, MD, who created an innovative way to care for chronically ill elderly patients.

 

 

The idea is to be omnipresent via extensivists, who provide continuity of care, as well as home care to help prevent readmissions, whether that means supplying car rides to the doctor’s office or even delivering a refrigerator to keep insulin cold. It morphed into a health plan, focused on Medicare patients, and is now is a $1.2 billion enterprise that has more than 100,000 members in eight states and manages care for Medicaid patients in Memphis and Des Moines as well.

 

The results have been impressive:

 

• CareMore’s patients are hospitalized 20 percent less than the industry average, even though its population tends to be sicker than the average Medicare patient. (If one adjusts for the health of the patients, the admission rate is 40 percent less.)
• Its Congestive Heart Failure program participants on average experience 43 percent fewer hospital admissions than the average Medicare patient with CHF.
• For patients with end stage renal disease, there are 45 percent fewer admissions.

 

And its members pay lower costs as well.

 

Jain admits that the CareMore model won’t fit every situation. “The CareMore model is disruptive and transformative, so we have to be very thoughtful about how and where we integrate and pilot it,” he says. “But I do think there are a number of opportunities to take the work that we’ve done successfully serving Medicare patients to serve similar patients in commercial and Medicaid populations.”

 

It’s also making its presence felt in academic medicine circles. Leaders at Emory Healthcare in Atlanta recently chose CareMore to help them transform their care model for Medicare Advantage patients. It’s a provider-payer relationship that Jain says he is excited about.

 

“The leaders at Emory were visionary in their thinking that a California-based managed-care company could be a transformation partner,” Jain says. “They were able to think beyond the stereotypes of the payer industry and get into the guts of what CareMore actually does – and how it might be relevant in their setting.”

 

A year after joining CareMore as chief operating officer and chief medical officer, Jain was promoted to president in April 2016. With that distinction, he joins a growing list of physicians who are at the helm of healthcare organizations. He continues to see patients on a limited basis, and says he knows why physicians are willing to take on a bigger role.

 

“For the first time, you have a generation of physicians who are seeing that the system is broken,” Jain says. “They believe they can and should lead change, and that their insights as physicians can drive better care.

 

“We want to deliver better healthcare. We want to bring back the joy of work to actually delivering healthcare. There are few better jobs in the world than being a physician or a nurse where you get to take care of patients and be a part of their lives in that intimate way. There’s nothing quite like it.”

 

 

Innovation keeps George Brown, Legacy ahead of the curve

By | October 20 th,  2014 | Blog, CEO, diversity, executive, Furst Group, George Brown, healthcare reform, leadership, Legacy Health, Modern Healthcare, physician executive, physician leadership, quality, safety, Top 25 Minority Executives in Healthcare, Walter Reed | 1 Comments

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

George Brown, the CEO of Legacy Health System in Portland, Ore., has had a long and distinguished career as a physician and leader, but his talents in innovation help him keep his organization on the industry’s leading edge.

 

From collaboration and affordable care to medical homes and information technology, Brown and his team have been unafraid to adapt and take risks, providing an example to the northwest region and the country at large.
Legacy joined with a number of organizations to form an integrated delivery system, Health Share of Oregon. It’s partnering on the OHSU Knight-Legacy HealthCancer Collaborative. In an era bursting with mergers and acquisitions, the path Brown has charted is intriguing.

 

“I have accepted the need to change from a completely competitive mindset to a collaborative mindset,” he says. “Competition doesn’t help the economics of healthcare – it divides communities.”

 

The Affordable Care Act has prompted soul-searching on the part of many executives, and Brown applauds the arrival of reform.

 

“I believe healthcare is too large of an issue for this country not to have a thoughtful and near-universal solution,” he says. “The Affordable Care Act is a step in the right direction.”

 

Although Brown has a sterling history in healthcare, it’s clear he doesn’t waste time looking back. He is especially proud to be on the board of Cover Oregon, despite some of the hits that the exchange took in the media for its early problems.

 

“We’ve enrolled 400,000 people,” he says. “We are moving in the direction to have affordable healthcare for all Oregonians.”

 

The ACA, he says, mirrors some of the measures Legacy has already been working on for some time, foremost of which is quality.

 

“The number one project we have been working on is how to make our organization more efficient,” he says, “and what we’re driving efficiency to mean is quality. We believe if you do things right, you don’t have to do them all over again, and that means it’s also less expensive.”

 


Brown also has led Legacy as an early adopter of the patient-centered medical home, an area in which some other health systems are just getting started.

 

“It’s important for me to say that all of our primary care clinics are Tier 3 certified patient-centered medical homes, and they’re doing very well,” he says. “Patient satisfaction scores are going up and we think we’re making an impact. In fact, we were recently recognized by the Oregon Health Leadership Council as being one of the top performers, so we’re quite proud of that.”

 

It’s also been a learning experience, Brown says candidly. He says Legacy has three main takeaways from the experience thus far:

 

--Specialization is needed. “If you have a population that’s heavy with patients who have congestive heart failure, diabetes, hypertension and obesity, a lot of contact is required with patients.”

 

--The influx of Medicaid patients changes preconceived notions for providers and patients alike. “There are a significant number of people who have not had access to healthcare services. We are evaluating those people and their needs. Some of these people have never seen us before, so that’s going to be an area of revelation for us.”

 

--Mental health is a gaping need in the community. “We’re realizing that behavioral health, mental health and addiction issues are a lot more prevalent in the population than I think we realized, so we’re looking at how best to provide access to those services for our patients who are in medical homes.”

 

Legacy also earned kudos via a Stage 7 award from HIMSS last year. Brown has long been a proponent of how technology can improve care.

 

“I think the lesson we’ve learned – and we have to remind ourselves so we don’t get to learn it again – is that a lot of IT projects really are not IT projects. They are clinical projects that require IT expertise,” he says.
“If you get the clinicians involved early they can become champions of the initiative, where before there may have been some naysayers. It’s important to listen to the clinicians, particularly in their early experience and exposure with products, so that you can modify and incorporate those things that they think are essential.”

 

Listening to the clinicians, Brown adds, “has been the key element of our success.”

 

It surely helps that cause that Brown is a physician himself, a gastroenterologist and internist who rose to the rank of brigadier general in the U.S. Army and led several military healthcare installations, including Walter Reed Health Care System in Washington, D.C.

 

At one time, he found little interest among his colleagues for administrative work. Now, under reform, that has changed as clinicians see their input as essential to changing the industry.

 

“I think the old attitude of some of my colleagues was, ‘I just want to be a physician. I don’t want to be bothered with running an organization.’ Now, clinicians are more involved. They realize they need to help shape the future of healthcare if they want to see things change in a way that’s commensurate with their beliefs. You shouldn’t be passive about change.”

 

Working hard to achieve change, he says, is an attitude he inherited from his parents, who saw him become the first family member to graduate high school and were unwavering in their support of Brown and his two siblings, seeing education as the door to opportunity.

 

“They would tell me, ‘You have the ability. If you apply yourself, you’ll be able to achieve whatever you want.’ “

 

It’s a lesson he’s applying at Legacy, facing the future with resolve.

 

Profiles in Leadership: Top 25 Minority Executives Kimberlydawn Wisdom overcame obstacles; now, she helps her community do the same

By | December 4 th,  2012 | Blog, Detroit, emergency medicine, executive, Furst Group, health system, Healthcare, Henry Ford Health System, hospital, Kimberlydawn Wisdom, leadership, Minority Executives, Modern Healthcare, physician leadership, Top 25 Minority Executives | Add A Comment

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

As a successful physician executive at Henry Ford Health System, Kimberlydawn Wisdom, MD, has attracted the attention of governmental leaders far and wide. Jennifer Granholm, then governor of Michigan, named her as the state surgeon general in 2003, a post she held for eight years. More recently, President Obama appointed her to his Advisory Group on Prevention, Health Promotion and Integrative Public Health. But the path to a medical degree was one that Wisdom had to clear of a number of obstacles.

 

First and foremost was the era in which she grew up, a formidable boulder indeed.

 

“In the 1950s and ‘60s, there wasn’t a plethora of physicians of color,” notes Wisdom, Senior Vice President of Community Health & Equity and Chief Wellness Officer of Henry Ford Health System in Detroit and an assistant professor for the University of Michigan Medical Center. “In my junior year of high school, my guidance counselor said I should choose a profession that was more suited for my race. For her, saying ‘I want to be a doctor’ was like someone saying, ‘I want to be an astronaut.’ She actually did want to ensure my success. But I think her sense was, ‘Let me bring you back down to something that’s manageable and achievable.’ “

 

Yet Wisdom’s mother, who grew up in the small community of Coatesville, Pa., did in fact have an African-American physician. And Wisdom became a caregiver for her mom at home as she dealt with severe migraines.

 

“During my childhood, she spent a lot of time in bed and I was regularly bringing her aspirin or some other type of pain medication,” Wisdom says. “It was very impactful to me as a young child to watch her go through that. But on another level, I could bring her water, I could bring her comfort. That began to ignite this desire to consider how I could care for people long-term.”

 


She was exposed to a wonderful hospital atmosphere from a tonsillectomy as a child, and soon had dolls and bears lined up in shoeboxes around her room, where she would tend to their medical needs. She graduated 20th in her high school class of 600, but her supportive parents weren’t so sure that marrying a young mechanical engineer was the best way to get through medical school. But when she crossed the stage to become an M.D., both her husband and parents celebrated together.

 

“They were all very proud,” she remembers. “It was a tremendous sense of accomplishment, and a tremendous sense of being thankful, because I couldn’t have done it without the support of family and without a strong spiritual grounding. It took a lot of prayer. I beat the odds in many respects.”

 

Despite her challenges, Wisdom says she had an idyllic childhood growing up in Mystic, Conn., the town made semi-famous by Julia Roberts’ first movie, “Mystic Pizza.” Those experiences, she says, have shaped her career as she sought to give her patients and her community the opportunities she was afforded.

 

“In part, I wanted to create a Mystic for the community in which I practiced, so they would have a safe place to grow up. So families could thrive. So people could reach their maximum potential, because they had a place where they felt they could achieve all that they were expected to achieve.”

 

But Wisdom has spent more than 30 years in Detroit at Henry Ford Health System – more than 20 as an emergency room physician – and she readily acknowledges that Detroit is worlds away from Mystic. As she saw the issues confronting her patients – violence, diabetes, obesity, teen pregnancy – she determined to take healthcare to them and not wait for them to come to her. Today, such goals are commonplace in any metro hospital, but back then her ideas were seen as unorthodox. Nonetheless, her bosses at Henry Ford told her to go for it.

 

“As an emergency medicine physician, the community comes to you in various states of disarray. I thought that, if I could go out and meet them where they are, I could have a greater impact,” she says. “When I look at many communities, so many people have not had the ability to realize their potential because they have made choices based on the choices they had available, not based on the best choices that would be ideal for them at any given time.”

 

So Wisdom started small, taking physicians, nurses and social workers out into the community, setting up shop in a community center or a faith-based organization. With each endeavor, Wisdom received more funding as she slowly and quietly attempted to address health disparities in the African-American community.

 

She and the health system now have major grant funding from the U.S. Department of Agriculture to address child obesity reduction. Several foundations fund her work in attempting to reduce infant mortality in the Detroit area, a region that has one of the highest rates in the country. A faith-based program she designed received funding from the National Institutes of Health, and she serves on the president’s group that advises his cabinet regarding the National Prevention Strategy, a wellness initiative created by U.S. Surgeon General Regina Benjamin.

 

The Ford system recently earned the Malcolm Baldrige Quality Award, one of the highest honors for any industry, in terms of service excellence, and has established the Wellness Center of Excellence, called “Henry Ford LiveWell” for short, that focuses on preventative and lifestyle health.

 

It’s a long way from dolls in shoeboxes, but Wisdom says that, if anything, her passion and excitement for healthcare have grown.

 

“Empowering people,” she says. “That’s what it’s all about.”

Profiles in Leadership: Intermountain’s Linda Leckman aims for consistency, transparency

By | August 8 th,  2011 | accountable care, ACO, Blog, CEO, consistency, executive, Healthcare, Linda Leckman, Modern Healthcare, physician leadership, quality, surgeons, Top 25 Women, transparency, Utah | Add A Comment

medical group,

 

One in a series of profiles of Modern Healthcare’s Top 25 Women in Healthcare (sponsored by Furst Group)

 

Linda Leckman was in her car – again – driving up to Ogden, Utah, from Salt Lake City, to meet with a group of thoracic surgeons. Road trips like this one – which Leckman actively seeks out to keep in touch with her colleagues and staff -- are common for the vice president of Intermountain Healthcare and the CEO of the Intermountain Medical Group.

 

“I’ve learned the value,” says Leckman, a general surgeon herself, “of sitting down face to face and actively listening to people.”

 

While Leckman’s reputation precedes her as one of the Top 25 Women in Healthcare, she is transparent about her growing pains in moving from a career as a surgeon in private practice to an administrator. Listening, she says, was actually something she had to grow into.

 

“One of the things I did not do very well, initially, was to listen. I guess, as a cliché, you could say, ‘Well, what would you expect from a surgeon?’ ” she jokes. “But I also got some bad advice in regard to approaching a contract situation, and I learned from that.”

 

Leckman is not one to waste a lesson. These days, the people around her know “listening” is a Leckman staple. Another is consistency.

 

“The medical group is spread across the whole state of Utah,” she says. “We have more than 130 clinics, so my management structure is geographic. My managers need to be able to make decisions on their own that will be consistent across the organization, so it’s very important that I be consistent, that we set up procedures and standards that are consistent.”

 

What’s also consistent is the way Leckman diverts attention away from herself and toward Intermountain.

 

“I believe one of the reasons I was recognized by Modern Healthcare was because I work for Intermountain Healthcare,” she says simply. “I take it as much of an acknowledgement of Intermountain’s role in leading clinical quality development as of anything that I specifically did. But that’s OK, because I’m a real cheerleader for my organization.”

 

Intermountain was in the spotlight several months ago when it was one of several prestigious systems, along with Mayo, Cleveland Clinic and Geisinger, to announce it had no plans to sign up for the government’s ACO program as it was then structured.

 

“The idea of accountable care is one that we totally support, the idea that quality needs to be improved and costs need to be reduced – that’s something we’ve been doing for years,” Leckman says. “One of the big concerns was that we were going to be measured basically against ourselves in terms of whether there is improvement or not. And since we have been working on it for a long time, a lot of what would be considered as potential gains for managing better are things we have already achieved. And so we really had more to lose than gain from being involved.”

 

If such a stance surprised the industry, it was not out of character for Intermountain, or for Leckman, who has been something of an unintentional pioneer. After graduating from Texas Christian University with a degree in history (and a minor in combined science, which included pre-med classes), Leckman enrolled at the University of Nevada to work on a master’s in history. It didn’t last. In her second year, she decided she really wanted to become a physician. A surgeon, no less.

 

“But this was the 1960s, and it was unusual for a woman to go to medical school,” she says. “And I was raised by my mom to be a housewife.”

 

Undaunted, she got her M.D. from the University of New Mexico in Albuquerque and became the first woman resident to finish the surgery program at the University of Utah.

 

“That’s been a pattern in my life – I end up in areas dominated by men,” Leckman says with a laugh. “But it’s worked out OK.”

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