Latest / Becker’s Healthcare - Clinical Leadership Podcast / Joseph Ng MD, MBA, Medical Director, Mather Hospital Northwell Health, President of Mather Medical Group

Transcript

Joseph Ng MD, MBA, Medical Director, Mather Hospital Northwell Health, President of Mather Medical Group · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  - Welcome to the Becca's Clinical Leadership Podcast. I'm
• 0:03
  - Mariah Taylor, assistant editor, and I'm thrilled to
• 0:06
  - be speaking with Joseph Eng, vice president and
• 0:08
  - chief medical officer at Northwell's Mather Hospital and
• 0:11
  - president of Mather Medical Group. Thank you so
• 0:14
  - much for joining me today. I'm really excited
• 0:17
  - to learn more about how you're transforming physician
• 0:19
  - leadership.
• 0:20
  - But before we dive into that, I'd love
• 0:22
  - for you to introduce yourself and tell us
• 0:23
  - a little bit about your background.
• 0:25
  - Thank you, Mariah. And as you said, I
• 0:27
  - am the CMO and VP at Northwell Mather
• 0:30
  - Hospital, a four time CMS five star hospital.
• 0:33
  - We've also achieved 24 leapfrog a's in one
• 0:36
  - of the 16 hospitals in the nation this
• 0:38
  - year who have won all three of the
• 0:39
  - health grades awards in clinical excellence,
• 0:42
  - so something to be very proud of. And
• 0:44
  - as president of Mather Medical Group, I am
• 0:46
  - part of a team leading over 50 providers
• 0:48
  - across more than a dozen multispecialty practices.
• 0:52
  - But prior to my current role, I was
• 0:54
  - Mather's chief medical information officer for twelve years
• 0:57
  - as well as a founding program director for
• 0:59
  - eight years of a transitional year residency here
• 1:01
  - at Mather as well. It's all of these
• 1:02
  - great experiences that have given me the insight
• 1:04
  - I have today.
• 1:06
  - Amazing. Well, recently, you and I talked a
• 1:09
  - lot about how your hospital is restructuring leadership
• 1:12
  - roles to improve the work life balance. Can
• 1:14
  - you tell us a little bit more about
• 1:16
  - when you started doing this and what the
• 1:17
  - strategic thinking was behind it?
• 1:20
  - Sure. So Mather has always been very sensitive
• 1:22
  - to burnout,
• 1:24
  - especially when we began to see and hear
• 1:25
  - more frequently about physicians and clinicians committing self
• 1:28
  - harm. We had to ask ourselves what role
• 1:30
  - we could play as an organization in preventing
• 1:33
  - clinicians
• 1:33
  - from reaching that point of despair.
• 1:36
  - It was especially important to us as a
• 1:38
  - training hospital where we had over a 100
• 1:40
  - residents to role model adaptive behaviors
• 1:42
  - and ways of thinking that promote resilience.
• 1:45
  - So at Mather, we have access to all
• 1:47
  - the resources that Northwell provides,
• 1:50
  - programs like TeamWell
• 1:51
  - and TeamWell Physicians,
• 1:53
  - which offer a spectrum of support for team
• 1:55
  - members,
• 1:56
  - as well as the employees assistance program or
• 1:58
  - EAP.
• 1:59
  - The EAP
• 2:01
  - provides not only emotional counseling, but also financial
• 2:04
  - counseling and assistance. And all of these resources
• 2:06
  - are free for our team members.
• 2:08
  - And the benefit of having these resources
• 2:11
  - helps us support our people, and especially our
• 2:14
  - leaders during times of stress. When it comes
• 2:16
  - to the strategic thinking behind keeping our leaders
• 2:18
  - sane and supported,
• 2:20
  - the reasoning is pretty self evident.
• 2:22
  - Leaders are expected to support those that they
• 2:24
  - lead. How can they do that when they
• 2:26
  - themselves lack support?
• 2:28
  - Our more innovative way of thinking about this
• 2:30
  - isn't so much work life balance, but work
• 2:33
  - life integration.
• 2:35
  - Especially as a leader, it's hard to have
• 2:37
  - a clear delineation between what is work and
• 2:39
  - what is not.
• 2:40
  - Because as I mentioned in previous interviews,
• 2:42
  - leaders may sometimes be expected to be called
• 2:45
  - upon twenty four seven.
• 2:46
  - This is why Northwell and by extension Mather
• 2:49
  - has made a conscious effort to foster social
• 2:51
  - support circles among colleagues.
• 2:54
  - I can tell you personally that having that
• 2:55
  - circle of work friends makes problem resolutions
• 2:59
  - 10 times easier.
• 3:00
  - That decreases the time you need to spend
• 3:02
  - on a problem, which allows you to get
• 3:04
  - back to your family quicker and with less
• 3:06
  - stress.
• 3:07
  - Even when I was a program director, I
• 3:09
  - made it a priority for my residents to
• 3:11
  - spend time with each other outside of work.
• 3:13
  - My tagline at the time was, it's much
• 3:15
  - easier to ask a friend to cover your
• 3:17
  - clinic than it is to ask a colleague.
• 3:20
  - So it's hard enough to adapt to the
• 3:21
  - challenges of leadership and the potential moral harm
• 3:24
  - that comes with making decisions that are tough.
• 3:27
  - But creating the right environment for leaders to
• 3:29
  - not only survive, but to thrive and grow
• 3:31
  - within a career focused social circle
• 3:33
  - helps them feel less lonely and more supported
• 3:36
  - in their role, and that's what decreases burnout.
• 3:40
  - I love that. I think often when I
• 3:42
  - speak with leaders about burnout, we are usually
• 3:44
  - focusing on the front line workers and often
• 3:47
  - overlooking leaders.
• 3:48
  - So this is such a great reminder that
• 3:50
  - leaders need just as much support as our
• 3:52
  - frontline staff.
• 3:54
  - Now when you've been looking at restructuring some
• 3:57
  - of these roles, what are the different ways
• 3:59
  - you're doing it?
• 4:01
  - So physician leadership roles are increasingly being restructured
• 4:04
  - to actively combat this burnout,
• 4:06
  - not only among the physicians they lead, but
• 4:09
  - also within the leaders themselves.
• 4:11
  - The traditional model often
• 4:13
  - saw physicians taking on leadership responsibilities
• 4:15
  - on top of a full clinical load with
• 4:18
  - little formal training or support.
• 4:20
  - So first, there's the concept of protected time
• 4:23
  - and reduced clinical burden.
• 4:25
  - Instead of piling leadership responsibilities on top of
• 4:28
  - a full time clinical schedule and giving them
• 4:30
  - a stipend,
• 4:31
  - we are now formally allocating a specific percentage
• 4:34
  - of time, whether it's 20%
• 4:36
  - or 50% or more, dedicated to just the
• 4:39
  - leadership duties.
• 4:41
  - With a corresponding reduction in clinical responsibilities,
• 4:44
  - it gives leaders dedicated time for administrative tasks,
• 4:47
  - strategic planning, and mentorship without sacrificing patient care
• 4:51
  - quality or personal time.
• 4:53
  - Then there's formal leadership training and development.
• 4:56
  - Northwell has programs for physicians entering leadership roles
• 4:59
  - to undergo training in areas like organizational
• 5:02
  - management,
• 5:03
  - finance,
• 5:04
  - human resources,
• 5:05
  - conflict resolution,
• 5:07
  - change management, and emotional intelligence.
• 5:09
  - This can range from internal workshops
• 5:12
  - to multi year long programs
• 5:14
  - to sponsor MBA
• 5:16
  - or master's of health care administration degrees.
• 5:18
  - When you equip leaders with relevant management skills,
• 5:21
  - you reduce frustration and inefficiency.
• 5:23
  - They feel more competent
• 5:25
  - confident in their roles, which leads to better
• 5:28
  - outcomes and less stress, both for themselves and
• 5:31
  - for their teams.
• 5:32
  - And, also, even though this is not really
• 5:35
  - a change, we've emphasized their role in decision
• 5:38
  - making and strategic influence. Instead of being figureheads,
• 5:41
  - physician leaders especially have authority and a seat
• 5:44
  - at the table of strategic planning, resource allocation,
• 5:47
  - and policy development.
• 5:49
  - They're empowered to implement changes that improve clinical
• 5:51
  - workflow and patient care.
• 5:54
  - And the reason we do that is when
• 5:55
  - leaders feel their voice is heard
• 5:58
  - and they can genuinely influence the system,
• 6:00
  - it reduces feelings of moral injury and helplessness.
• 6:04
  - They really become agents of change rather than
• 6:06
  - just implementers of top down directives.
• 6:09
  - And that really trickles down to reducing burnout
• 6:12
  - among the physicians they leave as well. Finally,
• 6:15
  - another important piece is clear role definition expectations.
• 6:19
  - Developing highly specific and transparent job descriptions for
• 6:22
  - position leadership roles,
• 6:24
  - outlining what their responsibilities really are, authority,
• 6:28
  - reporting structures, and expected outcomes,
• 6:30
  - that makes a real difference. When leaders know
• 6:32
  - exactly what's expected of them and where their
• 6:35
  - boundaries are, it reduces ambiguity
• 6:37
  - and role conflict,
• 6:39
  - which in turn decreases stress and improves focus.
• 6:42
  - Absolutely.
• 6:43
  - Now when you're looking at restructuring a leadership
• 6:46
  - role, which ones
• 6:48
  - are you taking on? And at what point
• 6:50
  - are you taking them? Like, for example, is
• 6:52
  - this restructuring usually coming when a role is
• 6:55
  - vacant and needs to be refilled, or are
• 6:57
  - you also changing the positions where somebody is
• 7:00
  - holding it and will be for a long
• 7:01
  - time?
• 7:02
  - That's a great question. So
• 7:05
  - you it it it's nice that you made
• 7:07
  - that distinction between a role that someone's already
• 7:09
  - in versus a brand new role that's being
• 7:11
  - created or that's being filled. So
• 7:15
  - in our case, all of our leadership roles
• 7:17
  - are slowly being restructured.
• 7:19
  - But I wanna be clear about that. It's
• 7:21
  - not a sweeping overhaul happening overnight.
• 7:24
  - There are some roles that have always functioned
• 7:27
  - well the way they are, and my mentality
• 7:29
  - with those is simple. If it ain't broke,
• 7:31
  - don't fix it.
• 7:33
  - The one thing I always wanna make sure
• 7:35
  - of, though, is that the people in those
• 7:36
  - roles feel
• 7:38
  - truly well and supported,
• 7:40
  - that they can do their jobs effectively without
• 7:42
  - us imposing modifications or adding layers of intervention
• 7:46
  - that they don't need.
• 7:47
  - Because sometimes change for the sake of change
• 7:51
  - can be just as disruptive and stressful as
• 7:53
  - the problems you're trying to solve.
• 7:55
  - With that said, those positions that naturally turn
• 7:58
  - over, it's always a good opportunity to start
• 8:01
  - fresh, to rethink how we'd like things to
• 8:03
  - look going forward.
• 8:05
  - It does still doesn't mean that there's a
• 8:07
  - one size fits all solution to burnout and
• 8:09
  - work life integration,
• 8:11
  - but it's a good it's good to start
• 8:13
  - from a baseline that's proven to be effective
• 8:15
  - and is as aligned as possible with the
• 8:17
  - culture we're trying to create and foster here
• 8:19
  - at Mather.
• 8:21
  - I love that. Now you're doing a lot
• 8:23
  - of work to restructure these leadership roles, but
• 8:26
  - I'm curious to know how well has these
• 8:28
  - restructurings been received, and what have been some
• 8:31
  - of those results?
• 8:33
  - Well, when someone is filling in a role
• 8:35
  - de novo, they don't know any different. They're
• 8:37
  - starting fresh. We give the new leader very
• 8:40
  - defined task
• 8:41
  - as well as deliverables for someone in their
• 8:43
  - role at our site. And I say our
• 8:46
  - site specifically because each hospital in each location
• 8:48
  - may have a different need. As you know,
• 8:50
  - Northwell is a very large organization
• 8:53
  - with 28 hospitals. So each hospital is gonna
• 8:56
  - need something different.
• 8:57
  - But it's our responsibility as leaders,
• 9:00
  - as leader of leaders to know what the
• 9:02
  - needs are in our building and structure the
• 9:05
  - roles and key performance indicators to what we
• 9:07
  - want them to be. Regarding changes in legacy
• 9:10
  - roles, which are currently filled by someone who
• 9:12
  - has been in the role for a long
• 9:13
  - time, the most minor restructuring is a welcome
• 9:16
  - change. And mostly, it's because it's seen as
• 9:18
  - recognition,
• 9:20
  - recognition of how hard their job is and
• 9:22
  - how much they've been sacrificing to do it
• 9:24
  - well, and giving incumbent leaders an opportunity
• 9:27
  - to expand their professional support system and protecting
• 9:30
  - their time so they can be properly compensated
• 9:33
  - for their efforts as well as giving them
• 9:35
  - time back to spend with their family while
• 9:37
  - keeping them financially whole has been genuinely appreciated.
• 9:41
  - And as I think and I think the
• 9:43
  - most important result from all of these efforts
• 9:45
  - has been improved morale and deepening of culture
• 9:49
  - where people heart people's hard work is genuinely
• 9:51
  - recognized and valued, and that's what it's really
• 9:54
  - about.
• 9:56
  - Absolutely.
• 9:57
  - Now you all have had some great success
• 9:59
  - with this, and I know across the nation,
• 10:01
  - a lot of hospitals are looking at restructuring
• 10:03
  - leadership roles and trying out a bunch of
• 10:05
  - different things. But as somebody who's done this
• 10:08
  - for so long, had a lot of success,
• 10:10
  - what advice do you have for other hospital
• 10:12
  - leaders that are looking to make those first
• 10:14
  - steps to restructure their own leadership roles?
• 10:18
  - Thank you for the opportunity for me to
• 10:19
  - do that. So the first piece of advice
• 10:22
  - I give is don't overthink it. Start by
• 10:24
  - listening.
• 10:25
  - Talk to your leaders.
• 10:27
  - Find out how they're actually doing, not how
• 10:29
  - you assume they're doing. We do that very
• 10:31
  - often, right, as leaders. Because I think a
• 10:33
  - lot of organizations make the mistake of designing
• 10:36
  - solutions before they truly understand the problem.
• 10:39
  - And every building, every site, every team is
• 10:41
  - different. What works at Mather may not work
• 10:44
  - exactly the same way at another hospital, and
• 10:46
  - that's okay.
• 10:47
  - The second thing I'd say is don't be
• 10:49
  - afraid to start small. You don't need a
• 10:51
  - massive overhaul on day one.
• 10:54
  - As I mentioned, even the most minor restructuring
• 10:56
  - can be a welcome change just because it
• 10:58
  - signals to your leaders that you see them,
• 11:01
  - that you recognize how hard they're working, and
• 11:03
  - that you're invested in making things better for
• 11:05
  - them. Sometimes that's that recognition alone shifts the
• 11:08
  - culture.
• 11:09
  - Third, and this is something we've really leaning
• 11:12
  - to leaned into here at Mather,
• 11:14
  - build the support system before you need it.
• 11:16
  - Don't wait until someone is burned out to
• 11:18
  - start thinking about peer networks, mentorship,
• 11:21
  - or protected
• 11:22
  - time. Be proactive.
• 11:24
  - Create those social support circles I talked about
• 11:26
  - earlier. Make it easier for your leaders to
• 11:28
  - connect with each other and lean on each
• 11:30
  - other. Because when a crisis hits,
• 11:32
  - and it always will, you want those relationships
• 11:35
  - already in place.
• 11:37
  - I'd also say be thoughtful about the difference
• 11:39
  - between change and disruption.
• 11:41
  - Change for the sake of change could be
• 11:43
  - just as stressful
• 11:45
  - as the problems you're trying to fix. If
• 11:47
  - you have leaders in legacy roles who are
• 11:49
  - functioning well and feel supported,
• 11:51
  - don't impose a new framework on them just
• 11:53
  - because it looks good on paper.
• 11:54
  - Check-in with them. Make sure they're truly doing
• 11:57
  - well. And if they are, if it ain't
• 11:59
  - broke, then don't fix it.
• 12:01
  - But when there's a natural turnover when someone
• 12:04
  - new is stepping into a role for the
• 12:06
  - first time, that's where the opportunity is. That's
• 12:09
  - when you set the new baseline,
• 12:11
  - give them clear expectations,
• 12:13
  - define deliverables, and a support structure from day
• 12:16
  - one. Let them start fresh within the culture
• 12:18
  - you're trying to build.
• 12:20
  - And finally,
• 12:21
  - I'd say make well-being a leadership priority, not
• 12:24
  - an afterthought.
• 12:25
  - When your leaders feel supported and valued,
• 12:28
  - that trickles down to everyone they lead. It
• 12:30
  - improves morale. It strengthens your culture, and, ultimately,
• 12:34
  - it leads to better patient care. And at
• 12:36
  - the end of the day, that's what we're
• 12:37
  - all here for.
• 12:39
  - Incredible. Well, this has been such an amazing
• 12:41
  - and informative discussion. I really appreciate you joining
• 12:44
  - us on the podcast today and sharing all
• 12:46
  - of your thoughts.
• 12:47
  - Thank you very much for the opportunity, and,
• 12:50
  - I hope to talk to you soon.