Latest / Off the Chart: A Business of Medicine Podcast / S1 Ep115: Reinventing physician training, with AMGA President Jerry Penso, M.D., MBA, and Practicing Excellence founder Stephen Beeson, M.D.
Transcript
- 0:00 People are selecting and staying at organizations where they have a chance to grow and ascend. Personally, it's now as important as leadership behaviors, meaning I have a chance to grow and develop here. That's why this is an imperative now, because there is an imperative for retaining clinical talent, engaging clinical talent, and executing outcomes. So the time for that is is now welcome to off 0:33 the chart of business of medicine podcast featuring lively and informative conversations with healthcare experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. My name is Austin Luttrell. I'm the associate editor of medical economics, and I'd like to thank you for joining us today. In today's episode, Keith Reynolds, the editor of physicians practice, sat down with Dr Jerry penso, the President and CEO of the American Medical Group Association, or the AMGA, and Dr Steven Beeson, the founder of practicing excellence. The three of them are talking about a new strategic partnership between the two groups focused on physician development and practice performance. Specifically, they're talking about why AMGA members are saying that finances, access and workforce are their top concerns, how burnout and a war for talent are reshaping hiring and retention, and why traditional all day training sessions no longer meet. The moment Dr penso and Dr Beeson explain how AI enabled in the moment, coaching can better fit into clinicians daily workflows, help leaders build more engaged teams and move the needle on patient experience, turnover and other key metrics. So doctors, thank you both for joining us today. Let's get into the episode. Hello 1:39 there, folks. Today we're talking to Dr Jerry penso, the President and CEO of the American Medical Group Association, and Dr Steven Beeson, the founder of practicing excellence. So today we're talking about they've got a strategic partnership going. I'll just open up the floor. You know what's what's this entail? 1:56 Well, I'll start first of all. Thank you for having us on today, if you ask AMGA members, and these are medical groups and health systems across the country, what, what's top on their list? What are their top issues that they're they're facing their challenges. And if you ask them, number one, two and three is finances, access and workforce. And it's no accident that they're all interrelated, and probably the root is the workforce issue. Having an engaged, inspired workforce really helps you, helps the organizations begin to tackle those challenges. In fact, it's imperative. So right now, our members are saying that their workforce is one of their prime issues, and there's a war for talent. There aren't enough primary care physicians, anesthesiologists, radiologists or other physicians, let alone non professionals, to handle the volume and the demand that's coming in to their to their systems. So what they need to do, and what their imperative is, is to create an environment, a culture where clinicians want to practice and stay and help the organization deliver great care and and really provide the type of environment where clinicians will want to stay their entire career. So that's the imperative of why now? Why is AMG interested in this issue? It's because our members are interested, and this is important to them right now. And I'll let Steve highlight a little bit more on why that is so important to our members. 3:32 Yeah, thanks, Jerry. Thank you, Keith, for having me on I'm a family medicine physician, born and raised in San Diego, and I've spent much my career in the exam room, managing a large patient panel, but the part the 2.0 version of my life has been the application of human development to really allow clinical care teams to soar and to create, as Jerry said, conditions where people say, Man, I love coming at work. Yeah, we work hard, but, man, we're really taking an amazing care of patients. We're deeply collaborative with each other and working within teams that is really revitalizing, and our leaders are doing the things that help us feel seen, heard, appreciated, included, communicated with, cared about, that we matter here and we believe, and really, there's very, very good evidence that that a human development strategy can allow those behaviors and experiences to manifest. And as Jerry said, the top three issues of finance, access and workforce are all accessible through a really continuous human development strategy. And that's as I founded the company practicing excellence, that was the the contribution I wondered we as a company wanted to be able to make in healthcare, and I've known Jerry for a number of years, and we've done some good work together, so we thought we'll bring Human Development and the amazing convening organization of eight. Mga who does such amazing work together, and we've already got 30 partners with an AMGA as it is. So we're excited about the partnership and what the future holds. 5:10 All right. So what makes this moment the right moment for this partnership? 5:16 You know, AMJ Members, we're a trade association, and what we do, typically is education, convening members and also advocacy. Because we're in the Washington, DC area, our members said they want more from AMGA. They want more than just convening and discussing these type of problems. They want solutions, and they want AMGA to help them find the best solutions that are in the market, we vet them through a strategic growth committee that we've created, and we have specific criteria like, is this an important issue to our members? Are there real outcomes from this partner? Is this partner trusted by AMGA members and already working with many of them, we came up with 10 different criteria. Practicing excellence met all of those criteria with flying colors. So we decided it was right to partner with the organization like practicing excellence. We will only do so many of these strategic partnerships, but we're going to do it where it really counts, 6:19 you know. And concurrently to that. You know, we have found, if you look under the hood of what's keeping clinical talent right now, it's not only how the organization has led, how collaborative the teams are and how purpose focused they are, so the people that are providing care can be really proud of who they work with and the kind of work that they do, but what we're finding as an emerging priority is organizations. People are selecting and staying at organizations where they have a chance to grow and ascend personally as a result of being a part of an organization, it's now as important as leadership behaviors, meaning I have a chance to grow and develop here. And so, you know, in my conversations with Jerry and AMGA and the work that we're doing in human development, it is, that's why this is an imperative now, because there's an imperative for retaining clinical talent, engaging clinical talent, and executing outcomes. So the time for that is, is now 7:21 AI powered human development. Can mean a lot of things in plain, you know, plain terms, what's different, like, what will feel different for a physician or a practice leader using this platform, versus, you know, traditional training. 7:38 Well, let me cover the traditional training and why that doesn't really meet the moment, and why this solution is different and unique in the marketplace. Let's start with traditional training that might be a half day or all day seminar. People have to get out of their offices, out of their practices, where they're not seeing patients, and it'll be lectures, PowerPoint, really kind of top down leadership, telling you what to do, that sort of training that ain't working anymore. What, what clinicians really want is something that really fits into their workflow, that doesn't take them away from their their clinical practice, but can really be integrated in the moment, into the challenges that they're facing. That's what practicing excellence has really developed. And I'll let Steve talk a little bit more about some of the real world examples where this is being effective. 8:34 Yeah, it's there's so many incredible impacts of AI on the prospects of human development and a good friend of mine and colleague said to me once, he said, you know, in the past, in the human development space, it was content was king. Now it's context is king. And what I mean by that is that the learning and development strategies that are deployed, they have to be personalized to the to the learner, meaning their role, their experience, their ambitions, their accountabilities, their interests. I and it has to help them really do two things. Number one, the learning experience has to help them become contributory to what the organization wants to become, and that's how we are with patients, how we are for each other, how it is that we're leading the safety behaviors that we're creating. Whatever that whatever the behaviors are that allow them to be contributory to the enterprise goals, is critical, and learning, historically, has not translated into human behavioral change. It creates lots of learning and certifications and completions, but it's not translating to I'm changing what I do for patients, for colleagues and as a leader. And that's that's the critical chasm that learning has to meet right now. The learning also has to do the second thing. In addition to them becoming contributory, it has to help them become Kate. Intented in their work, meaning when they finish a day as a really effective leader, mobilizing their teams with the team, saying, Man, I feel seen, heard and valued here, that's a different experience as a leader or a clinician, learning how to interact with a patient. So the patient at the end of a clinical encounter says, I've never had a physician say these kind of things. To me, you have no idea the impact that you're making that is an oxytocin, serotonin, dopamine pulse, and God knows, we know needs some of that in healthcare right now, and what contextualized personalized in the moment in the work learning, as opposed to going to a classroom miles away. It allows you to learn while you're working using technology enabled AI, personalized, contextualized learning. And it's a really, really powerful prospect. And the other thing is that learning historically has been a cohort, a group, a class. We want to democratize learning so everybody learns at the same time, and technology enables that allows scalable, personalized, contextualized learning, but also maps to key organizational imperatives, and that's what some of the technology allows the learning experience to become. 11:12 Steve and I are both physicians. We both trained in the typical physician training mode, which had has was described to see one Do One, Teach One. That was how physicians learned. You learn from older physicians experience. They watched you, taught you, and then the next thing you know, you were doing it, and you learned by doing well, that model had its value in the day, but healthcare has so many more imperatives these days, and organizations really need to invest in their physician employees and in their physician workforce in different ways, and that old way just isn't working anymore. We need a physician workforce that can adapt the rapidly changing healthcare environment, and for that, you need a new a new type of tool, and that's that's where I'm really excited about, where practicing excellence can really fit that need, yeah, 12:10 how will members of the AMGA actually be able to access this? Is it a member benefit, a discounted add on, a pilot for certain groups or something else. You know, what's the expected adoption path for for this? 12:26 Well, let's just start that 30 AMJ members, these are medical groups, and health systems across the country are already using it, and the best way for members to learn what's working is from each other. So they'll be discussing in their discussion groups. Hey, these are the challenges that we're facing, and these are the type of solutions that we're finding. AMGA plays the role of facilitator here with our strategic partners. So we make sure that they're aware that practicing excellence is a strategic partner, that it's been fully vetted by AMGA. They'll work directly with practicing excellence on all things like contracting and making sure that the product's working good, and they'll get special discounted rates to make sure that they know that this is an AMGA partner. 13:20 Hey there. Keith Reynolds here, and welcome to the p2 management minute in just 60 seconds, we deliver proven, real world tactics you can plug into your practice today, whether that means speeding up check in, lifting staff morale or nudging patient satisfaction north. No theory, no fluff, just the kind of guidance that fits between appointments and moves the needle before lunch. But the best ideas don't all come from our newsroom. They come from you got a clever workflow, hack, an employee engagement win, or a lesson learned the hard way. I want to feature it. Shoot me an email at kreynolds at mjh, lifesciences.com with your topic, a quick outline or even a smartphone clip. We'll handle the rest and get your insights in front of your peers nationwide. Let's make every minute count together. Thanks for watching, and I'll see you in the next p2 management minute. 14:13 What does this sort of development actually look like in practice? You know, Can you can you share any concrete examples of a skill or scenario that the platform targets for a practice administrator, leader 14:25 there, there's really four domains that we build content around. So one and the domain is a declaration by the organization with that first question, which is, what do you want to achieve? The first domain is is patient experience. So I if that were the declared intention, we would deploy learning pathways and evidence based skills across the clinical enterprise on the behaviors that are known to transform how the patient's experience. Care, meaning, you know, if patients feel heard, cared about, listened to, included, they're going to at all touch points of care. There are certain behaviors that allow that sentiment to arise. So for example, just to give you an example, I what one of the one of my favorite coaching tips on within practicing excellence is to is to close a clinical encounter, I at the appropriate time and the appropriate context, to say to the patient, you know, we're going to be with you every step of the way. I mean, it sounds like an intuitively, really simple thing, but imagine we as an organization, everybody began to learn their own way of expressing that, and we were to deploy that across a clinical enterprise, and what that does to the to how patients see and experience care. And there's about 100 other simple, simple things that we can do that can render the patient experience. So patient experience is one domain, so we set up, you know, evidence based skills that can allow that to manifest. The second is team engagement, and those are leadership behaviors and team collaboration behaviors that allow engagement to happen. Engagement is mapped towards retention, discretionary effort. I willingness to recommend as a workforce member, and they're they're very, very specific evidence based leadership skills that we can learn and apply that can optimize team engagement. The second or the third is leadership effectiveness. Some organizations say we want to certify each and every one of our managers and above on the 12 leader competencies to advance engagement or retention of our clinical talent with technology, we're able to go through that process and make it not episodic, not pulling them out of work, but use technology to have micro learning that allows them to learn and apply skills that are known to advance leadership effectiveness. And the fourth domain is what we call Clinical Excellence for those on the high reliability journey on safety behaviors and authority gradient reductions and I the domains that manifest high reliability. So we use micro learning applied to a particular organizational intent, use use analytics and AI to personalize and contextualize it, to give tips while you work. 17:27 So we talked a bit about, you know, how to measure this, but let's, you know, let's nail it down. You know, how are we going to measure success, and how quickly should practices expect to see, you know, success in this are you looking at patient experience metrics, engagement or turnover, safety and events, teamwork measures or operational outcomes? Like, what are we looking at here? 17:50 Yeah, as I mentioned, workforce is a huge issue for our members, and the fight for talent is real. So number one is turnover. Are the physicians and the clinicians finding that they want to stay at that location and stay with that organization and really have a long, productive career there, there's also burnout. Are you decreasing the metrics of burnout, and many, many of our members are doing provider satisfaction surveys, provider engagement surveys, where they can measure these sort of things. There's other metrics as well, of success, and I'll let Steve talk about them, but these are, again, the reason, one of the reasons we picked practicing excellence, is that they have a proven track record in these and a whole bunch of other metrics with our organizations, 18:38 the results that emerge from an effectively deployed, systemic human development strategy can really be breathtaking. I and we've got over 20k studies now that demonstrate quantitative improvement as a result of raising human capability through continuous learning. I and and as I mentioned before, part of the work stream is step number one, declaring what you want to achieve. It could be patient experience, it could be retention, it can be turnover, it can be well being. And then we build learning pathways to help and support that enterprise goal. And we a critical part of the step is, how will we measure the success? So we do a couple of things. Not only do we identify the metric that tightly corresponds to a quantitative proof of an organizational intent. So if you say, Gosh, team engagement is our goal, then we say retention, turnover and well being will be the metrics that we use to verify that we're achieving that organizational intention. So then we build learning pathways for leaders and team members that can begin to turn the dials through human behavior consistency that allow those metrics to move. The other thing that we do is we have robust use analytics, because. Is worse joint accredited for CME, and so, you know, those that participate can begin to accrue, you know, continue medical education through the process. And we also want to know, are they using the platform? We're very proud of our use analytics and how people find value and return and use and participate in the learning pathways. So we have quantitative outcomes that are mapped to organizational intentions. We have use analytics. I, we have CME and the numbers of CME hours that are earned. I, and then our favorite is the qualitative collection, the voices of participants, because we have 10s of 1000s of comments within the learning platform, and those are fun to harvest as well. And we report those back to the leaders to say, here's what your clinicians are doing, committing to and saying as a result of becoming better at the work that they do. 20:59 You know, I go around and visit healthcare systems across the country. It's one of the best parts of my job, and Steve does that as well. And what I will tell you is that successful organizations have very clear metrics of success. They really define what a success look like, and then they communicate that throughout the organization. And if they can communicate that part of their success scorecard is really taking care of their clinicians, really taking care of their workforce. That really resonates with organizations, and I find organizations that do so are really successful in the long term. And in addition, they don't just put that metric up on a scorecard, but they give their clinicians tools to really make sure that that can happen, right? 21:44 And I would even say, and this is something that I feel very, very passionate about, and I know Jerry does as well, is you can't hold anyone accountable for an outcome without giving them the tools to become successful. And we, Jerry and I have had a history together where there was accountabilities for things like patient experience without specific tools to help them. And I had a chance in that era to be able to coach, train and develop clinicians that were meeting criteria for needing coaching, and they had no idea why patients were saying about them, and it's just, quite frankly, cruel to say, achieve this and you get this without giving them. The other critical element, which is I have help and support and evidence based clinician design tool to help me in the moment while I do my work. So they get something like, gosh, I get these patients coming in demanding antibiotics for violent illness. What the heck do I do? Well, that's, that's what we do. We help them with those kind of scenarios, so they can learn how to manage a patient demanding antibiotics for viral illness, and a couple of quick, you know, tips to be able to help that and support that. 22:53 It seems to be the the condition of practices everywhere that they are overloaded with the, you know, one more tool. So what are you guys doing to make implementation more lightweight? You know, is there fitting into the workflow, time, expectations per week, change management, support, like, how are you guys making it so this doesn't just become another checkbox that, you know, staff have to have to click every day. 23:19 Yeah, this is, you know, Keith, probably the most important intention in the founding of practicing excellence. It has to be enriching to the individual user. I and we also found through, you know, studying the science of human development, particularly in the context of overwhelmed clinicians that learning must occur in work in minutes at a time, the idea of watching long modules sitting in a classroom stepping away from the demands of your work i is, is no longer an option. So we were very, very deliberate about the design of this, taking seconds into and minutes at a time to be in the flow of work. So again, I have a patient demanding an MRI scan for non radicular low back pain. I need some guidance on that. Boom. What's something I can do that has evidence based behaviors to help and support and guide me. And then the clinician learns and applies that and says, Oh, that was way better. I wish I would have learned that 110 years ago. Then they say, Gosh, this thing is helpful. I've got a I've got a coach in my pocket that allows me to become better at my work, to release my burden. And then, and then, even, even a leader who is struggling with team engagement learns a skill of identifying and recognizing and appreciating and telling stories of how the people that they are leading are are are contributing to great things, and they're seeing their teams begin to feel. Appreciated and seen, and they go, Gosh, I learned and applied something that allowed me to become more effective and less overwhelmed and frustrated as a leader. So what we're finding is in the moment, minutes and seconds at a time, in the work mapping to the pebbles in their shoes that is with them continuously, to face the challenges that they have in front of them. I and so we put that composite together to create this human development journey to allow people to become really the best version of themselves, while mapping to organizational 25:34 priorities when when you know AI is involved, a lot of leaders worry about trust and guardrails and things like that. So what data is the platform using or not using? You know what privacy security and governance expectations should member organizations have? 25:52 Every one of our organizations is working on AI governance and making sure that any solution that they are working with, any any vendor has AI, as you mentioned, guardrail cybersecurity, all sorts of protections to make sure that the organization's intellectual property as well as privacy concerns are addressed. So every organization, I will tell you that is an AMGA, takes this very seriously and works very closely with any vendor that they're working to make sure that those those safety precautions are taken with regards to all sorts of clinician as well as any patient information. 26:36 And from our standpoint, security is critical. I mean, you cannot play in the healthcare game unless you have robust protection and security. We're going through and well into our SOC two certification right now, we work with every technical team to go through their criteria for security and privacy, and that's just part of the onboarding process. And I can tell you, we haven't gotten hung up yet, and we've onboarded quite a few organizations, but we continue to invest in the security of our data, the protection of important information, and we have no patient information at all within our ecosystem. 27:17 So I can tell you if this product is in 30 organizations, that means it's been through 30. It or CIOs, they have very strict criteria about which ones will be allowed on their systems. And if he's made it through, if practicing excellence has made it through 30, I can tell you it is. It has passed the bar. 27:38 I think those are all the questions I've got for you guys. Is there anything else you all want to add, or anything you think I'm overlooking? 27:45 Yeah, I'll just end with one, one statement. You know, there's a lot of good books out there, business books. One of my favorite is Marshall Goldsmith. What got you here? Won't Get You There. We can't use the solutions from the past to get us where we need to go. Healthcare is changing so rapidly. The needs of our clinicians, the needs of our patients, healthcare financing environment is changing so rapidly. So we can't look at the older solutions and say, hey, that's that's what's going to get us where we need to go. We really need to look at new solutions that are really going to change, change the evolution of our healthcare systems? Yeah. 28:28 I think my final comment is, first of all, grateful to be here, and thank you for allowing us to tell the partnership story. My strong belief, and certainly as a part of practicing excellence, is that we believe that the life in healthcare can really be an extraordinary one, still by how we are with patients, how we are with each other, how it is that we lead, and the cultures that we help create. And I and we believe, with now really good evidence, that the answer lies in your people and the ability to grow, develop, enrich the people so they work together with purposeful impact in the lives of patients and lead so the people that they Touch ascend. All of those are accessible and and we want to be able to unleash the power of people to really make healthcare amazing for communities, for patients, and I think even, most importantly, those that have dedicated lives to this healing profession, which is under quite a bit of duress at the moment, if you haven't noticed. So anyway, really excited about the future together, and I get to be at a number of the different AMGA conferences, hanging out with Jerry and crew and excited to for the adventures ahead. Alrighty. 29:52 Well, thank you gentlemen, so much for joining us today. Hopefully we'll have somebody out from physicians practice at the big conference. Difference in April, yeah. Other than that, thank you so much. Thank you for your time. 30:14 Once again, that was physicians practice editor Keith Reynolds with Dr Jerry penso, the President and CEO of the American Medical Group Association, and Dr Steven Beeson, the founder of practicing excellence. My name is Austin Latrell, and on behalf of the whole medical economics and physicians practice teams, I'd like to thank you for listening to the show and ask that you please subscribe so you don't miss the next episode. Be sure to check back on Monday and Thursday mornings for the latest conversations with experts, sharing strategies, stories and solutions for your practice. You can find us by searching off the chart wherever you get your podcasts. Also, if you'd like the best stories that medical economics and physicians practice published delivered straight to your emails six days of the week, subscribe to our newsletters at medical economics.com and physicianspractice.com off the chart. This is a medicine podcast. Is executive produced by Chris masslini and Keith Reynolds and produced by Austin Latrell. Medical economics and physicians practice are both members of the MGH Life Sciences family. Thank you. You.