Latest / The Advancing Healthcare Innovation Show / E195: Healthcare Treats Its Equipment Better Than Its People | Dr. Katherine Meese

Transcript

E195: Healthcare Treats Its Equipment Better Than Its People | Dr. Katherine Meese · The Advancing Healthcare Innovation Show

0:11
Hello and welcome back to the Advancing
0:13
Healthcare Innovation Show. I am your
0:15
host, Michael Stamatinos. And if you're
0:18
new to us, welcome. We are so excited to
0:22
have you here because we're bringing
0:23
some of the best leaders having amazing
0:26
conversation with these leaders that are
0:29
actually painstakingly reshaping the
0:32
future of healthcare. We're pretty
0:34
passionate about a few different areas.
0:35
We're passionate about access, about
0:37
leadership, about innovation, about
0:40
innovation adoption. And if it's your
0:42
first time tuning in, let me just take a
0:44
very quick step back, give you the
0:46
lowdown on what we're trying to get done
0:48
here. So our aim, our focus is on
0:51
bringing real stories of leadership and
0:54
innovation to life, giving folks the
0:56
opportunity and our guests to share
0:58
their stories, share their learnings,
1:01
share their little wins,
1:03
and share some of the losses because
1:05
obviously when uh you know things aren't
1:08
going well, you're learning. So, if you
1:10
haven't had the opportunity to check out
1:12
any of our historical interviews,
1:14
wherever you are, however you're
1:16
consuming this, if you're watching this,
1:19
if you're listening to this, please hit
1:21
the subscribe button now so that any of
1:24
the new interviews come directly to you.
1:29
So, um really excited about today's
1:32
conversation.
1:33
One of the things that I keep coming
1:36
back to, been doing this show for a
1:38
minute now, it's this is that healthc
1:41
care is full of brilliant people,
1:45
amazing people that genuinely care about
1:47
the patients. And yet somehow um
1:51
somewhere between the mission and the
1:53
day-to-day,
1:55
our industry just keeps burning through
1:58
people.
2:00
It's terrible. nurses, physicians,
2:04
techs, administrators and the likes.
2:07
These people show up every single day
2:10
and they give everything they have and
2:12
for some reason on the other side they
2:14
come out broken. And this is a number,
2:17
this is a stat I was researching that I
2:18
want to sort of want you to sit with it.
2:21
75%.
2:23
Okay, that's how many healthcare workers
2:26
reported serious burnout by 2022. So,
2:30
three out of every four people that are
2:33
inside of your hospital, your clinic
2:35
right now are carrying something that is
2:38
wearing them down. Like, that's a huge
2:42
number. So most leaders see that number
2:46
and what they do is they maybe reach go
2:49
into the wellness program bucket or they
2:52
put together a resilience workshop or
2:54
maybe they deploy an app. And today's
2:57
guest
2:59
sees something completely different. She
3:01
is a trusted authority when it comes to
3:05
human workforce. She sees a system that
3:09
never actually designed to keep its
3:12
people. Just think about that for a
3:14
second. And she spent north of the last
3:17
15 plus years building the science that
3:20
is going to change it. No, no, not if.
3:22
Like she's going to change it. And she's
3:25
published dozens of peer-reviewed
3:27
studies. She's co-authored five books.
3:31
Um her CDs, it's just ridiculous. Um but
3:34
two of them are organizational behavior
3:37
textbooks that are being used in over
3:40
160 schools across the country right
3:43
now. So uh her most recent book is
3:46
called Genfluence. It is about leading
3:49
across generations in healthcare. This
3:52
is so timely. Um it's right at the exact
3:55
moment because Dr. Katherine Mace, who's
3:58
our guest today, she is on a mission.
4:01
She is on a mission to rehumanize the
4:04
work of healthcare using science, using
4:07
data, using research that most leaders
4:11
have never had access to before in a
4:14
form that they can actually use and
4:17
implement and deploy at scale. So Dr. Me
4:20
is the CEO of Hugh Margin Group. I'm
4:24
saying that slow because if I say it
4:26
fast, I don't say it well. She teaches
4:28
and mentors at UAB and she's honestly
4:31
one of the sharpest, most original
4:33
thinkers working inside of healthcare
4:35
workforce um today. So, Katherine, great
4:39
to see you. Welcome to the show.
4:42
>> Thank you so much for having me. I feel
4:44
like I need to record that preamble and
4:45
just like play it back to myself on a
4:47
bad day. So, thank you so much for the
4:48
kind words. It's it's an honor to be
4:50
here.
4:51
>> It's a pleasure to have you. And
4:52
fortunately, we are um we are recording
4:55
it. So, maybe it could be like play
4:57
back.
4:58
>> Yeah, maybe you will play it back.
4:59
That's what we wanted. We wanted people
5:00
to feel comfortable here. This is this
5:02
is all about what we're trying to get
5:03
done here. So, um, Katherine, before we
5:06
kind of dig into the meat of things,
5:08
before before you authored all these
5:10
books, before UAB, before your research,
5:13
um, kind of where you started, you know,
5:15
you had a you got a masters in public
5:17
health, but then somewhere in there you
5:20
um, and and I was just kind of
5:22
researching before this, so I'm not
5:24
stalking you or anything. It's just I
5:26
know you were working across like 10
5:27
different countries on four different
5:29
continents
5:30
>> that's like a really cool path and for
5:34
someone who ends up becoming a leading
5:36
voice in healthcare workforce in America
5:39
like take me back
5:41
>> what was happening in your life uh
5:43
during that time and like what what were
5:45
you looking for?
5:47
>> Yeah. So, um I feel like the earlier
5:49
part of my professional career was maybe
5:51
a lot more exciting locationally than
5:53
what I'm doing now, but I actually
5:55
didn't start my career in healthcare. I
5:57
started working in oil and gas. And so,
6:00
um worked in a number of different
6:01
locations, including a long expatriate
6:04
assignment. And that's actually what got
6:06
me started in healthcare. I realized
6:08
that I loved being in a high reliability
6:10
industry where mistakes really matter uh
6:13
and and safety is involved but was very
6:16
excited about the mission for
6:17
healthcare. So I took a lot away from
6:19
that environment and from that space.
6:20
But when I transitioned to healthcare,
6:22
one of the things that was so surprising
6:24
to me, Michael, is that in oil and gas
6:26
there's pretty clear alignment that what
6:28
is producing
6:30
>> revenue and what is what is building the
6:31
business is generally property and large
6:35
equipment, right? So a rig in the middle
6:36
of the ocean. um wells that you might
6:38
have in a field, pipeline
6:40
infrastructure, and humans help maintain
6:42
that and they help keep the system
6:43
running. Um and so those pieces of
6:46
equipment are extremely wellmaintained.
6:48
They do routine maintenance, scheduled
6:49
downtime, because if you don't do that
6:50
to a refinery, it's thousands of moving
6:53
parts filled with combustible fluid. One
6:54
of them breaks and the entire thing
6:56
explodes and people die and it costs
6:57
tens to hundreds of millions of dollars.
6:59
So when I came to healthcare, I think
7:01
one of the most surprising things to me
7:03
is there was not broad alignment that
7:06
our humans are the core means of
7:08
production. I mean at our very core,
7:10
healthcare is humans working with humans
7:11
to heal humans.
7:12
>> And even given that uh from a a
7:16
financial perspective, we're not
7:17
treating them as well as we might treat
7:19
equipment in another industry. So we
7:20
weren't doing routine maintenance. We
7:22
weren't doing scheduled downtime. And so
7:23
it's not surprising to me that we're
7:25
seeing some of these issues with
7:27
workforce burnout, disengagement, and
7:29
people in many instances saying, you
7:31
know what, I'm done with this. I don't
7:32
have capacity for it.
7:36
>> Interesting. You're talking about upkeep
7:37
and maintenance. Was there was there
7:39
like a specific moment during the oil
7:41
and gas kind of phase that you maybe you
7:44
came across either a situation you
7:47
witnessed something and you're like
7:49
something clicked and you're like, "All
7:50
right, I got to I kind of need to move
7:51
into healthcare." What was that?
7:54
>> Yeah. So, I'll never forget I was
7:55
sitting on the international crude
7:56
trading floor and um was had already
7:59
planned my transition into healthcare
8:00
and I I ran across a conversation with a
8:03
colleague who or future colleague who
8:05
mentioned that medical residents were
8:07
working 30-hour shifts. And I said, "I'm
8:09
sorry, what?" And they said, "Oh, yeah,
8:11
they work 30-our shifts." And I'm
8:12
thinking, okay, this this human that is
8:14
doing life-saving work is working 30
8:16
hours straight.
8:17
>> Why? And that theme has sort of
8:19
continued for the last 15 years. And I
8:21
think at that time my perception was um
8:25
we have built you know healthcare
8:27
workers are extremely altruistic right
8:28
they're going into this work because for
8:30
many it's a passion it's a calling
8:33
they're highly trained individuals they
8:34
dedicate their 20s and all their healthy
8:36
years to developing these skill sets and
8:40
they're there because of a trend
8:41
tremendous sense of altruism and so then
8:43
we built a system on top of that right
8:46
and without altruism that entire thing
8:48
falls apart and this was in 2010 and I
8:49
think right now we're seeing
8:51
the effects of the system that was built
8:52
that way.
8:53
>> I mean, I think about that so much.
8:57
Healthcare is full of people, many of
8:59
whom are my dearest friends. They went
9:02
into the field because they want to make
9:03
a difference. They genuinely care. Like,
9:05
literally genuinely care deeply. And
9:09
they're just some of the most
9:10
missiondriven humans I've ever come
9:11
across. And yet our industry has like
9:15
one of the worst track records of any
9:19
sector for actually taking care of its
9:22
own people. It's like if you want to
9:23
have a record like that's not the record
9:26
that you want. How do you how do you
9:29
explain that? Because from the outside
9:32
someone's looking from the outside in.
9:34
It just seems almost paradoxical.
9:37
>> Yeah, it doesn't make sense, right? Um I
9:40
think there are a couple dynamics at
9:41
play here. One is that because people
9:44
are so committed to their patients and
9:45
to the work or to the, you know, the
9:47
nonclinical ways that they support the
9:48
mission that they will endure things
9:51
that someone who's just there for the
9:52
paycheck is not going to put up with,
9:53
right? So people in other industries
9:55
that have a transferable skill set would
9:58
just walk away and find a new job. I
10:00
think in healthcare also because it
10:01
takes such a long time frame to build
10:04
this very unique skill set that many of
10:05
our uh people in our workforce have, you
10:08
can't easily repurpose that in a way
10:10
that is still meaningful just you know
10:12
outside of a traditional healthcare
10:14
environment. And so I think that keeps
10:16
people um in a position where they're
10:19
willing to endure that discomfort longer
10:21
than we would see in any other industry.
10:22
So then that kind of props up some of
10:24
these environments and behaviors. I do
10:26
think and I'd be curious for your
10:28
thoughts on this that after the pandemic
10:30
that willingness to endure and stick
10:33
with a bad culture or over chronic
10:35
overwork or broken systems got a lot
10:37
less sticky and I think people said you
10:39
know what I'm actually I'm actually not
10:41
going to spend my life doing this and so
10:42
we saw a huge exodus from the workforce
10:44
then
10:45
>> yeah that was like the straw that kind
10:47
of broke the camel's back for a lot of
10:49
people and they were just like you know
10:50
what like no um not not for me I think
10:53
there was a there was a threshold that
10:56
people were willing to accept and they
10:58
were just like this is just part of the
10:59
territory. This is just this is part of
11:01
the job and then you kind of build um
11:04
just just like a threat like just like
11:06
you're okay with dealing with that and
11:08
then it was a magnitude
11:11
way higher and I think that was the the
11:15
breaking point for a lot of people and
11:18
we haven't necessarily recovered.
11:21
You know, I think what was really
11:22
interesting to me, I started researching
11:24
healthcare worker well-being during that
11:25
time frame. And when we started looking
11:28
into what factors were actually
11:30
explaining um overall well-being among
11:32
the workforce, I mean, my first guess
11:34
would have been uh you're in harm's way,
11:37
you might die, and you don't have PPE,
11:38
right? Like the real hazards of the job
11:41
that we were seeing then. And what was
11:43
so shocking to me, Michael, is that
11:45
really the top things explaining overall
11:47
well-being during that time of of the
11:49
clinical workforce were durable
11:52
components of the work, right? Heavy
11:54
workload, long hours, lack of trust, a
11:56
feeling of betrayal by leadership. Um,
11:59
so I think what we saw in the data
12:01
during that time was people saying, I
12:03
train for this. I'm showing up to do the
12:04
work, but all of these other systems
12:06
that are not supporting me are causing
12:08
me this intense sense of moral distress,
12:09
and that's the part I can't endure. And
12:11
I think that's really a fundamental
12:13
mistake that we make when we're thinking
12:14
around this problem is
12:16
>> it is we do not have a lack of
12:17
resilience issue. Healthare workers are
12:18
some of the most resilient people on the
12:20
planet. Yeah.
12:21
>> But we have to design in ways that allow
12:22
them to access their own resilience and
12:24
sometimes in our current systems we're
12:25
not doing that. Hm. Does does more
12:29
recent data show that that's still the
12:33
pressing issue or is there newer data
12:35
that's revealed something else that you
12:37
know maybe leaders are are thinking that
12:40
it's it's another cause?
12:42
>> Um yeah, you know, we generally um in
12:45
the research literature would pinpoint
12:47
sort of six things across industries
12:49
that tend to contribute to burnout and
12:51
workload is only one of those. I think
12:53
that's the one that we tend to point to
12:54
the most.
12:56
Yeah. So, other things include lack of
12:58
fairness, um lack of autonomy, which I
13:01
think is has been on a steady decline
13:02
for many healthcare roles for a long
13:04
time. Um a sense of moral distress. So,
13:07
I can't show up and and live out my
13:09
values at work. So, if you think about
13:11
someone who who their entire calling is
13:13
to take great care of patients and
13:15
you've got a broken process or system
13:17
that's in the way of that, that's going
13:18
to cause a sense of moral distress every
13:19
day. Um, and then a sense of community
13:22
at work, which you know, if I'm being
13:23
asked to see an extra five patients a
13:25
day, I'm not going to have time to ask a
13:27
colleague how their kid is, you know,
13:28
how their kid's soccer game went. And,
13:30
um, so, and then lack of recognition and
13:33
reward. People want to feel appreciated
13:34
for for the work that they do. So,
13:37
>> one of the things I'm seeing, and I'd be
13:39
curious if you're seeing glimmers as
13:41
this as well, is that people will say,
13:44
you know, we're really mindful of
13:46
workload right now and my people are
13:47
still saying they're burned out or
13:48
people just got here. How can they be
13:50
burned out? We still need them to work
13:51
another 40 years. And it's because it's
13:52
typically one of those other factors.
13:55
>> H how I guess how how wellversed are
13:59
leaders on those other factors? I mean,
14:01
is there do they know that this is
14:03
happening or is this just something that
14:04
they they know and are turning a blind
14:07
eye to or is it genuinely they're just
14:09
not aware of this?
14:11
>> You know, that's a great question and
14:13
and I I would say I've been on a journey
14:15
in my thinking on this and it's evolved
14:17
over time. Um, I think we can think of
14:19
some exceptions. I'm sure we all can.
14:20
You just have to read the news. But in
14:22
general,
14:23
>> I believe that most healthcare leaders
14:26
want to do a good job and they want to
14:28
do the right thing.
14:28
>> Yeah.
14:29
>> I don't think they always have the tools
14:30
and information they need to do that.
14:32
And so, um, some of that problem is even
14:34
in the way that we measure these things
14:36
organizationally. So, you might get a
14:37
report that's a a list of averages and a
14:40
glorified word cloud that's telling you,
14:42
okay, you've got a burnout problem, but
14:43
it's not really diagnosing the why
14:45
behind it or the what. So then you don't
14:47
know what levers to push and pull. And
14:49
so I think with everything healthcare
14:51
leaders are having to deal with and
14:53
manage and all of the uncertainty in the
14:55
market and the information coming in,
14:57
it's not surprising to me that some of
14:59
that nuance would not be top of mind.
15:03
>> You know, I'm thinking uh I always ask I
15:05
remember some of my senior leaders like
15:08
what's your sleep well at night number
15:10
when it comes to workforce? And I know
15:12
that there's a lot of data that's out
15:14
there. What is the most telling metric
15:18
that you can think of that actually
15:22
gives a leader a real clear picture of
15:25
how healthy or unhealthy their workforce
15:27
is? What's that sleep well at night
15:29
number that they kind of look at on
15:31
Friday and they'll be like, "All right,
15:33
like we're in good shape or we're not."
15:36
What is that? Or there or is there more
15:38
than one metric?
15:39
>> Yeah, I wish there was just one. Um, a
15:42
few that I think about though that would
15:44
be great.
15:45
Um I a few that I think about I tend to
15:49
enjoy or or look at uh turnover and
15:52
tension for a couple reasons. Um one is
15:56
that sometimes healthcare workers will
15:58
put up with things for so long that they
16:00
just won't leave. And so if you're just
16:01
looking at actual turnover numbers,
16:03
there are a number of reasons that
16:04
people stay in their organizations that
16:06
have nothing to do with them having a
16:07
good experience or a good culture.
16:09
>> Whether they would like to leave
16:10
probably says a little bit more about
16:12
how they're actually feeling in that
16:13
environment. So I think that one is a
16:14
real like if I had one
16:15
>> but how do you measure that?
16:17
>> I mean you ask people do you want to
16:18
leave essentially I mean it's a little
16:19
more nuanced than that but you know in
16:21
the next time period uh do you intend to
16:25
leave the organization or search for
16:26
another job? Um
16:28
>> so that's a good one. I think questions
16:31
around uh trust in senior leadership are
16:33
really important. It's interesting. We
16:36
have seen increasingly in our own
16:37
research that trust in senior leaders is
16:40
predicting more of the story and
16:42
turnover intention and net promoter
16:44
score and um organizational performance
16:47
in some other ways than trust in
16:49
supervisor. And that was not what I
16:51
expected.
16:52
>> But I think healthcare workers see their
16:54
work as so important, such a calling
16:55
that if I don't trust that the people up
16:57
here have my back, it's it's morally
16:59
distressing. It's not a place that I can
17:00
stay. And so that is something to really
17:03
pay attention to. But we also know in
17:05
the research Michael that those things
17:07
that are predicting senior leader trust
17:09
are
17:10
>> a very small portion of that is the
17:11
senior leaders behaviors. A lot of that
17:13
is happening um by things in the middle.
17:15
So that one metric tells you a lot about
17:18
what's happening at the top of the
17:19
organization and every level below it.
17:21
>> Can we talk about things in the middle
17:23
because I feel like sometimes it's the
17:24
game of telephone and everything might
17:27
be dandy up here but then it kind of
17:29
goes through this filter and then down
17:31
to the frontline workforce. Can we talk
17:33
about maybe things that are misaligned
17:36
because I feel like there's such a huge
17:37
cost to misalignment? You know, and we
17:40
mentioned this in an kind of off the
17:41
camera conversation is that there's just
17:44
a talent misalign a huge talent
17:45
misalignment problem which is a huge
17:47
opportunity by the way for those that do
17:48
get it right. It's a huge opportunity.
17:51
Talk to me about that.
17:52
>> Yeah, absolutely. So, in every
17:55
organization we see this process of
17:56
selective filtering where people sort of
17:58
listen to what they want to listen to
17:59
and they tend to filter out the rest.
18:01
And I think as you go through different
18:03
levels of the organization there there's
18:05
an upward and a downward filtering
18:06
process that happens. The upward process
18:09
is I'm a frontline supervisor and I
18:11
don't want to look like I can't handle
18:12
this problem. So I'm going to sugarcoat
18:13
a little bit on the way up. That manager
18:16
doesn't want to look like they can't
18:17
handle it themselves. So it gets um
18:19
sugarcoated all the way up and by the
18:21
time it reaches senior leadership
18:22
they're like everything's great, you
18:24
know, so it's not necessarily their
18:25
fault that they're disconnected from
18:26
what's happening on the front line. And
18:28
then sometimes the same thing goes back
18:30
down but sometimes in the opposite
18:31
direction where senior leaders will say
18:33
one thing and then by the time it
18:35
reaches the bottom it's like those
18:36
villains at the top you know have
18:37
decided to ruin our lives. Um and so
18:40
there are a couple things that I tend to
18:42
recommend and that I see working really
18:43
well in organizations.
18:44
>> Yeah.
18:45
>> The first one is when people don't know
18:48
how to answer hard questions about
18:50
something that's going on in the
18:51
organization or the environment
18:54
>> they are going to make up a story and
18:55
the leader will likely be the villain of
18:57
that story. Okay. So,
18:59
>> it goes a little something like, "I
19:01
asked for your raise, but those greedy
19:02
evil people upstairs said no." Because
19:04
they want that win in the moment, right?
19:06
>> Yeah. Yeah.
19:07
>> Ultimately, people don't want to work
19:09
for an organization that is run by
19:11
greedy evil people. They want to wear
19:12
that little soft shell black jacket to
19:14
the grocery store and be super proud.
19:15
And so, it backfires.
19:17
>> Um, and so one of the biggest things
19:19
that leaders can do is to ask their
19:20
people at every level of leadership,
19:22
what hard questions are you hearing?
19:25
The reason I like that question better
19:27
than like what questions do you have or
19:29
how do you need help explaining this is
19:31
because they're not outing themselves as
19:33
not understanding what's going on. They
19:36
are just reporting what they're hearing,
19:37
right? So it allows them to save face
19:39
and I think that lends itself to a more
19:40
honest conversation and then we give
19:43
them a values aligned authentic response
19:44
that positions the organization well. So
19:46
that's kind of like one concrete thing
19:48
that organizations who do this well are
19:50
doing.
19:51
>> I love that. Um, that's such a powerful
19:55
question that a leader I mean it's such
19:57
a great question. What hard questions
19:58
are you hearing? Because they can
20:01
basically they're databasing all these
20:03
things and then hopefully ideally
20:04
they're aggregating them and then
20:06
they're they're saying all right here's
20:07
here's like a training on how to deal
20:09
with this. This happens you go this
20:11
route this route. So it's like to be
20:13
doing that at such a large scale to me
20:15
seems
20:17
it it doesn't seem so difficult.
20:19
Obviously you know we're human beings.
20:21
were imperfect.
20:23
When it is working right, what happens
20:26
when they start feeling these types of
20:29
hard questions? What have you seen in
20:30
terms of like good positive results?
20:33
>> Yeah. So, I think it gives it it does a
20:36
couple things. One is it gives senior
20:38
leaders a much more realistic
20:40
understanding of how their messaging is
20:42
landing um around big organizational
20:44
changes and it allows them to pinpoint
20:46
potential for damage before it fully
20:48
takes root. So humans are sensemaking
20:51
beings. Like if we have two disconnected
20:52
points of information, we're going to
20:53
put them together in a story. That is
20:55
just that is what humans do. And so it
20:58
allows leaders to understand what story
21:00
is evolving between disconnected points
21:01
of information so that they can get out
21:03
in front of it. What I also think it
21:06
does for leaders both at the top and the
21:08
bottom is it opens up that communication
21:10
pipeline and it and it lets senior
21:13
leaders in many ways experience the full
21:16
heat of their decision-m. So there are
21:19
some messages that I think should not be
21:21
cascaded um because your your lower
21:24
levels of management should not have to
21:25
feel the heat from your decision-m and
21:27
you're immune to it. And so I think that
21:30
also lets leaders sort of pinpoint like
21:31
what are the messages that I need to be
21:33
the messenger so that people can be mad
21:34
at me, right? And I can handle my
21:36
response in real time versus something
21:38
that could be cascaded and communicated.
21:40
Well,
21:42
>> that's so fascinating. So when we spoke
21:44
off offline, um you mentioned something
21:48
about trust and I wrote it down. I
21:50
actually put it on a post-it note. Um,
21:52
and this is how you define trust, which
21:54
is what matters to me is safe with you.
21:58
Can you unpack that a little bit?
22:01
>> Yeah. So, when I've been doing this work
22:03
around trust in organizations,
22:05
you know, a lot of times people think,
22:08
okay, trust is about my behavior. Like,
22:09
am I being honest? Am I am I a person of
22:12
integrity? Um, am I owning my mistakes?
22:15
Like, those are trust building
22:17
behaviors.
22:18
And yet we see leaders that are doing
22:20
those things really well that still
22:22
nobody trusts them. And so what I like
22:25
about this definition of trust is that
22:27
it indicates a couple things. One, trust
22:29
is a highly personal perception. Um
22:33
>> you know if I am getting a very
22:35
complicated surgery,
22:38
pretty much the only thing that matters
22:40
to me in that trust relationship with a
22:42
surgeon is is this person extremely
22:44
competent? I don't care if they're like
22:46
cheating on their taxes. I want this
22:47
person to be great and that's going to
22:49
be enough for me to trust them in that
22:50
way because they're protecting what
22:51
matters most to me which is my physical
22:52
health and safety.
22:54
>> Um it might so so to bring that more
22:56
into the workplace environment you know
22:58
what matters to me my ability to leave
23:00
work on time so I can coach my son's
23:01
soccer team is safe with you.
23:03
>> What matters to me my ability to take
23:05
care of the patient in front of me and
23:07
give them the best possible outcomes
23:09
because you fixed all the broken systems
23:10
in the way is safe with you.
23:13
I also think Michael what is really
23:16
important in that definition right now
23:18
is I am hearing left right and center
23:20
everywhere that you know we're doing
23:22
these massive tech adoptions AI adoption
23:25
tech changes coming
23:26
>> and it's ultimately all about trust and
23:28
humans in our organizations to make sure
23:30
that that investment is landing on
23:31
fertile soil
23:33
and where I think this is getting sticky
23:36
and organizations are saying gosh I
23:37
think people trust us we're trying to do
23:38
the right thing my future matters a lot
23:41
to me and I think everybody's future
23:43
matters a lot to them. So, if I don't
23:45
know if my future is safe with you
23:47
because of all of this innovation and
23:49
change that's happening and you haven't
23:50
made that very clear to me, I'm not
23:52
going to trust you and I'm not going to
23:53
trust the technology you're asking me to
23:54
use either. And so, I think that
23:57
definition is why we are seeing that
23:58
dynamic so heavily in this moment.
24:00
>> Yeah. Inadvertently, I think unbeknownst
24:02
to someone, it's like they're doing
24:04
things that are triggering the response
24:06
and they're like, "What's going on?"
24:07
Well, it's like you're doing something
24:08
that's triggering fight or flight. I
24:10
mean, human beings, it's either fight or
24:11
flight. Um,
24:14
you you coined you coined a term,
24:18
human margin, which I think is really
24:20
neat. Um, I kind of want to understand
24:22
where that came from because I
24:24
understand financial margin and
24:25
operating margin, and those have been
24:28
like languages of healthcare leadership
24:30
for a while. And you just decided to add
24:32
a third. Like, tell me about that.
24:35
>> Yeah. So, um, I'm I have a finance
24:37
background. That's my original training.
24:39
And so you're probably very familiar, I
24:41
imagine most people are, with the phrase
24:42
no margin, no emission. And that phrase
24:44
in healthcare was actually made popular
24:46
by Sister Irene Krauss. She was a nun
24:48
CEO at a time where healthcare was
24:49
transitioning from being run like a
24:51
charity to needing to be run more like a
24:53
business. And so when she championed
24:55
that phrase, it was very much if we
24:57
don't treat this more like a business,
24:58
we will not keep our doors open and be
25:00
able to care for the poor. I think over
25:02
time that phrase in healthcare has
25:04
evolved into we are going to make an
25:06
unpopular decision for the sake of
25:08
financial performance. No margin, no
25:09
mission. And what I was seeing in my
25:13
work is that really again going back to
25:16
that idea that humans are the core means
25:17
of our production. Without our humans,
25:19
we have no other margin. We have no
25:21
other mission. So for example,
25:23
>> in 2020, we were cancelling elective
25:25
surgeries, which is the financial
25:26
lifeblood of most healthcare systems
25:29
because we were preventing the spread of
25:30
the virus. In 2021 and beyond, we were
25:33
cancelling elective surgeries because we
25:34
couldn't staff the O in the PACU. So
25:37
without our humans, we really have no
25:39
operational margin. We have no financial
25:40
margin. And so my goal originally in
25:42
this work is not to say that financial
25:44
performance doesn't matter. Of course it
25:46
does.
25:46
>> Or that operational performance doesn't
25:48
matter. Of course it does. And there's a
25:49
lot of accountability around those.
25:52
>> But that hum the human margin deserves
25:54
to be on equal footing. And I was seeing
25:57
from governance all the way to the front
25:58
line that the accountability around the
26:00
human margin was not uh treated with the
26:02
same diligence that those other two
26:04
margins were. H. All right. So, you've
26:08
been in a lot of really interesting
26:09
rooms, meet with a lot of really
26:11
interesting leaders. I want a story.
26:14
Like, give me a specific leader. You
26:15
don't have to name them, but someone
26:17
that you've worked with, um, who kind of
26:20
came in super skeptical about some of
26:22
the things, some of the concepts that
26:23
you've been kind of talking through
26:25
today and something changed. Like, what
26:28
happened?
26:30
What did they see or experience that
26:34
shifted them?
26:37
>> Yeah. Well, I'll tell I'll tell you
26:39
about two specific instances. Um, the
26:41
first one might be the biggest feather
26:43
in my cap. I uh taught undergrads for
26:45
many years and they are very hard to
26:47
please. And so after teaching this
26:50
content, I overheard two people in the
26:51
front row talking like I was right
26:53
there. I could hear them but they were
26:55
loud. Um, and they one leaned over to
26:57
the other and said, "You know, this
26:59
wasn't as bad as I thought it was going
27:00
to be. I only wanted to remove one of my
27:02
eyeballs instead of two. So, I'm out
27:04
here saving eyeballs, okay, with this
27:05
work." Um, so that was that was a big
27:09
accomplishment. But, um, another
27:10
example, and this has happened
27:12
repeatedly, I'll get someone who is a
27:14
scientist, they're a physician, they're
27:15
a CEO.
27:15
>> Yeah.
27:16
>> And they we are making no traction with,
27:19
"Hey, take care of your people because
27:20
it's the right thing to do." They think
27:22
that I'm asking for kumbaya and hugs.
27:24
And when I'm able to make that
27:26
connection between the human margin and
27:28
those other margins that they care a lot
27:30
about and have accountability around and
27:32
put a lot of science and data behind
27:33
this, I think there's that aha moment of
27:36
this is not a nice to have. This is
27:37
absolutely mission critical. And so I
27:39
tend to believe that when we come in
27:42
with the same set of information, like
27:44
if I understand all the constraints of
27:46
an of a situation or a decision, we
27:48
arrive at the same logical answer
27:49
typically. And so my goal is to help
27:51
them see or get visibility into what do
27:54
we actually know about this that is hard
27:56
and evidence-based so that you'll arrive
27:58
at the same logical decision. And so I
28:00
see those aha moments happening all the
28:02
time which is the joy of my work.
28:06
>> What what is the hardest leader the
28:10
hardest type of leader um or
28:12
organization to like reach with this
28:14
work? And I say that because when you've
28:17
seen a lot of things, it just seems as
28:19
though even though you're doing amazing
28:20
work, there's there's an overwhelming
28:22
number of things that are happening. And
28:24
to me, I've seen leaders that have
28:26
gotten
28:28
say desensitized to this. So is there
28:31
like a type of leader that's just like
28:34
you kind of going in, you're like, this
28:36
might be a tough nut to crack. Like
28:37
describe that type of leader.
28:40
>> Yeah. So, I think most leaders who are
28:44
dealing with workforce issues in their
28:45
organization, who have holes to fill,
28:47
who have people that are quiet quitting,
28:48
disengaging, or threatening to leave or
28:50
leaving,
28:52
there's not a lot of convincing that has
28:53
to be done. They they know they have a
28:55
problem, right? They're trying to figure
28:56
out how do we solve it. I think for me,
28:58
the most challenging leader, there's
28:59
there's two challenging leaders or
29:01
organizations. The first one is the
29:04
leader that thinks they already have it
29:05
all figured out and is not open to
29:09
learning or hearing new information. And
29:12
I have found in general that the best
29:13
leaders are those who are curious and
29:15
always want to know what they don't
29:17
know. And so if you already know
29:18
everything, like there's not a lot that
29:20
I can do with you, right? Um, the second
29:23
type of leader that I see that is, I
29:27
think, a challenge is the one that
29:30
actually does not care about their
29:31
people. And I've come across a few of
29:33
these. So, there are some people who
29:35
like they care about.
29:36
>> What does that look like? Like, what
29:37
does that look like when you say they
29:38
don't care about their people? That's so
29:39
hard to believe.
29:41
>> Yeah. Um it is I would say in general
29:45
and I don't see these people often thank
29:47
goodness you know and if if you are one
29:48
of these I would encourage you to leave
29:50
healthcare and don't let the door hit
29:51
you on the way out but um
29:53
>> they don't they don't listen to this
29:54
show believe me
29:55
>> okay good
29:56
>> we have good people here
29:58
>> you know I think these are people who
30:01
probably would not be able to even
30:03
verbalize this but here's the one
30:05
behavior that I see that is a big tip
30:07
off to me is they keep leaders in place
30:11
in their organization
30:13
>> who are absolutely terrible to people.
30:15
>> And so maybe this leader up here cares,
30:18
but when I'm not willing to to replace
30:20
or manage out a leader who is being
30:22
awful to their people or who is being
30:24
reported to HR frequently or who has
30:26
been involved in harassment or who just
30:28
is a terrible person, then really what
30:30
I'm signaling in is I care, but I don't
30:32
actually care that much, right? I care
30:33
about whatever person is doing.
30:35
>> What do you tolerate? You know, what you
30:36
tolerate says everything about your
30:38
culture says everything.
30:41
>> Yep. Absolutely. So, those are my two
30:44
tough ones.
30:45
>> Okay. Um, let's switch gears for a
30:48
minute. I want to talk about Genfluence
30:50
because I love this book. Uh, and I want
30:53
to talk about there's a there's a
30:54
chapter that challenges like some
30:57
narratives. Um, I think a lot of people
31:00
take as as gospel. So, let me ask you
31:03
directly.
31:06
What is like the most widely
31:08
believed thing
31:11
about uh generational differences in the
31:14
healthcare workforce that your research
31:19
simply says like no this is wrong. I
31:22
feel like there's a lot of misnomers.
31:25
>> Yeah. I I will tell you I learned so
31:27
much doing the research for this book
31:29
and I I didn't um I drew I drew a lot of
31:31
on the work of others. Right. Um, the
31:34
biggest aha for me was
31:38
I frequently hear leaders who are very
31:41
confused about what to do with Gen Z,
31:42
which is our our youngest major uh group
31:44
in the workforce right now. And they
31:47
feel like these people are fragile. They
31:49
don't want to show up to work. They
31:50
don't want to work hard. They cry when
31:51
they get feedback. They call in sick for
31:53
mental health days instead of showing up
31:55
to their nursing shift. And the
31:56
resounding theme that I hear is
31:59
>> people are so weak and fragile. Is every
32:01
day a mental health day? And I will be
32:03
honest with you, I was kind of in the
32:04
mindset of like, yeah, maybe um the
32:08
research in this area has completely
32:10
flipped that thinking upside down for
32:12
me. So if I could summarize to say
32:14
essentially there were two core
32:16
technologies that were introduced
32:19
um the iPhone in our pocket 24/7, okay,
32:22
internet in our pocket
32:23
>> and social media with the like feature
32:25
specifically. Um, those things allow
32:29
people to quantify social acceptance or
32:31
rejection. And
32:32
>> the dopamine hit, the damn dopamine hit,
32:35
>> the dopamine hit, but also like it's the
32:37
measuring stick, right? I don't just
32:39
know if I'm I'm rejected. I know exactly
32:41
how much I'm rejected because this
32:43
person got that many hearts and I
32:44
didn't. And so those two technologies
32:47
um have opened up a pathway for humans
32:50
that we are very sensitive to. So humans
32:51
are very sensitive to social rejection
32:53
or reductions in the social hierarchy.
32:55
In fact, we have long uh longitudinal
32:58
studies in a variety of settings to show
33:00
that there is a direct correlation
33:01
between reduction in the social
33:03
hierarchy and physical and mental
33:04
health. It's not the other way around.
33:06
>> So, we essentially gave people a means
33:08
for that in their pocket 24/7. Now, you
33:10
and I were both there, right? And um the
33:14
difference is that our brains were
33:15
largely fully cooked when this
33:17
technology was being introduced. I mean,
33:18
there was some light duty construction,
33:20
but like the major construction was
33:21
done.
33:22
>> Yeah. for Z and this is based on the
33:24
wonderful work by uh Dr. Jonathan height
33:26
and Gene Twingy um for Gen Z
33:29
specifically their brains were in a
33:31
period of development that was most open
33:32
to outside influence in their adolescent
33:34
years. So there was a fundamental
33:37
rewiring of the sense of whether or not
33:40
I'm socially safe or accepted. And that
33:42
has led to hockey stickshaped
33:46
um increases in things like anxiety,
33:50
depression, suicidality, um actual
33:53
suicide and emergency room visits for
33:55
self harm. And so when you look at that
33:58
data and see the fundamentally different
34:00
healthcare mental health landscape that
34:02
we're building a career and skills on
34:05
top of um my biggest challenge to
34:09
leaders is to reframe this as these
34:11
people aren't fragile. If that was my
34:13
lived experience protecting your mental
34:15
health is wise, right? That's why it's
34:17
not fragile.
34:18
>> And these people still showed up to do
34:20
the hard work of healthcare knowing that
34:22
it was difficult, right? So, there's
34:24
something to be appreciated about that,
34:26
>> right?
34:26
>> Um, that was the biggest aha for me.
34:31
>> There's I've been in many conversations
34:33
where I hear these things like, man,
34:35
they're just too soft. Like, I can't
34:37
even, you know, you hear it a lot. Or,
34:40
you know, hey, this this new generation
34:41
just so entitled, so entitled. It's
34:43
like, well,
34:45
I don't think people realize that like
34:47
entitled is kind of like a learned
34:48
thing. So, you know, me as a parent, am
34:52
I teaching my children to be entitled?
34:54
So, it's like, have we taught our
34:56
workforce to to to be this way? And it's
34:59
like, do we need to be looking at
35:00
ourselves as leaders to say like, what
35:02
what did we cause here? So, do we need
35:04
to course correct? Is that a wrong way
35:06
to think about that?
35:08
>> Well, I think there's actually there's
35:09
some links to that. So, um I'll use the
35:11
millennials as an example, and I am one.
35:12
So, full disclaimer, you know, I'm going
35:14
to be tempted to sugarcoat this, but
35:16
millennials had the were the first ones
35:17
that were really labeled as entitled.
35:19
And when you actually look at measures
35:20
over time that we've been capturing for
35:22
decades of rates of narcissistic
35:24
behavior or traits, um, uh, incidence of
35:28
words like I am special, um, measurement
35:32
along these dimensions, which is really
35:34
interesting. So, for millennials, 66%
35:37
would answer in high school that I'm of
35:38
above average intelligence compared to
35:40
my peers. So, in case math's not your
35:42
thing, like 66% can't be above average.
35:45
>> 78% of college freshmen would say, uh, I
35:49
have above average leadership capability
35:51
compared to my peers. So, there was some
35:52
actual data to back up this this title
35:55
that millennials were given.
35:56
>> What's so interesting about that,
35:58
Michael, is that when you look at those
35:59
graphs over time, and then you have the
36:01
2008 crash where people went from
36:04
showing up at work saying, "Hi, like,
36:06
where's my leadership role on day one?"
36:08
>> Yeah.
36:08
>> Saying, "Hi, I would love a job. how
36:10
would you like to burn me out today?
36:11
Those rates plummeted. And so there is a
36:14
component of this, I think, with our
36:15
current workforce.
36:17
>> We've been dealing with shortages for
36:18
the last 5 years. No one can fill all
36:20
their spots
36:22
>> that has not met a new economic reality.
36:24
And so some of that gets sorted, right,
36:26
when the when the job market is scarce
36:27
and you can't just go find a job
36:29
anywhere else. So you kind of hang on to
36:30
what you have and you're a little more
36:32
willing to engage differently. Um, so I
36:34
think that's one dynamic like at a macro
36:36
level that's playing into this as well.
36:40
Interesting. That kind of leads me to my
36:42
next thought because you you you spoke
36:44
about this which is around disrespect
36:47
and I want to sort of sit with that for
36:48
a moment.
36:50
What does that look like inside of a
36:53
hospital? What does disrespect look like
36:55
inside of a give me give me the scene
36:58
how that plays out.
37:01
>> What makes me sad about answering this
37:03
question is that probably a really
37:05
honest answer is the scene looks like
37:07
every day in healthcare. I mean, this is
37:09
so widespread in just the the lack of
37:12
respect that we have in communicating
37:13
with each other, but um I'll give you an
37:16
example that has a specific generational
37:18
component.
37:19
>> Jenzi is so lazy.
37:21
>> I they they don't want to work hard,
37:23
right?
37:25
>> That's disrespectful to characterize an
37:26
entire generation that way based on the
37:28
behavior of one person or or a few
37:29
people, right? And so the tricky thing
37:32
about this, Michael, is that first of
37:34
all, disrespect is the top predictor of
37:35
toxic corporate culture. So when people
37:37
say it's a toxic culture, that's the
37:38
number one predictor um in the research.
37:41
The other tricky thing about that is
37:43
that there's this concept called
37:45
stereotype threat. Stereotype threat is
37:47
different than stereotyping, which we
37:48
all know is not a great thing to do.
37:51
>> It is this idea that has been proved in
37:52
the research again and again that just
37:55
knowing of a stereotype around my kind
37:58
of people actually can change
37:59
performance. So some of the original
38:01
experiments in this area, yeah, it's
38:03
fascinating. So, some of the original
38:05
experiments in this area looked at um a
38:07
stereotype that women don't perform as
38:09
well in math and science. Okay, which as
38:11
a female scientist I'm like, boo. Um so
38:15
they they had two groups and they
38:17
reminded one group of the stereotype and
38:19
they didn't say anything to the other
38:20
group and then they had these women do a
38:22
math and science test and what they
38:23
found is that the women who were
38:24
reminded of that stereotype beforehand
38:26
performed worse and it's because they
38:29
were more likely to second guess
38:30
themselves and go back and change the
38:31
answers than the other.
38:33
This experiment has been replicated over
38:35
300 times in a variety of sports
38:37
settings, business settings, testing
38:38
settings. And so I think that element of
38:41
disrespect, which is you people out
38:43
there are terrible, can actually change
38:46
performance even if we're not treating
38:48
people any differently. And I think
38:50
that's something for us to really be
38:51
aware of in how we communicate.
38:52
>> Like we've known this for hundreds of
38:54
years in terms of communication. Like
38:56
words can be really harmful. They can
38:59
also be really uplifting, which means
39:00
that we do have a choice. It's like do
39:03
you say something that is going to be a
39:05
culture buster or are you going to say
39:08
something that's going to be a culture
39:10
builder? That's that in the space of a
39:14
leader like that has to cross your mind.
39:15
Like you have a decision like we
39:17
ultimately control that.
39:20
problem is is that you know sometimes
39:23
and I'll say this for myself emotion
39:26
gets the best of me and I'll say
39:28
something I'm like all right probably
39:30
wasn't the best thing to say right there
39:32
but like how do you how do you do that
39:34
at scale
39:36
>> so I'm thinking about two things um we
39:39
have a new study out looking at uh toxic
39:42
corporate culture as reported by nurses
39:44
and we looked at how they described
39:45
their culture and whether or not they
39:46
believed that it was toxic and what was
39:48
so interesting to me is the top two
39:49
themes
39:51
were what I expected but the order of
39:52
those was not what I expected. So
39:55
bullying, gossip and aggressive behavior
39:57
I thought was going to be number one
39:58
predictor. That was actually second
40:00
place. Poor leadership was in the first
40:02
place. And so I think when we have those
40:04
things going on in the workplace,
40:06
a huge element of that is because the
40:08
leader is not shutting it down, right?
40:10
And so there's a there's a passivity
40:12
around this. We're allowing this to
40:13
happen that is damaging to people. And
40:15
so I think that's our responsibility as
40:17
leaders. The other part of that that I
40:19
would say relative to your example is
40:21
>> how do they shut it down? Like they see
40:22
someone doing something like right then
40:24
and there like hey written up next one
40:26
like you're gone like is there just a
40:30
very clear line that they draw in front
40:32
of people.
40:34
>> Uh my recommendation and and sort of
40:36
what I see working well is uh has a few
40:39
prongs to it. The first one is that we
40:41
are going to get crystal clear about our
40:43
expectations for behavior before people
40:45
walk in the door of the organization.
40:47
Um, and those are shared expectations
40:49
that we co-create together. Not, hey,
40:50
assign this handbook so that when I try
40:52
to fire you, I have documentation that
40:53
you signed it.
40:54
>> Um, so some of it starts there, right?
40:58
Then I think there's an element of
40:59
addressing that when it's happening.
41:01
Okay. And so that I would always
41:03
recommend a private personal
41:04
conversation that is very much delivered
41:07
in a way of we are shoulder-to-shoulder
41:08
looking at this problem together. And so
41:09
it might go something like this. You see
41:10
this happening. You pull the the
41:13
gossiper in and say, "Hey, I wanted to
41:16
talk to you about this. I know that you
41:18
really care about this being a great
41:19
environment, and I know you really care
41:20
about your patients. My concern is, I
41:22
noticed you gossiping today, and I'm not
41:25
sure that that's creating the
41:26
environment that's going to help
41:27
everybody feel like they can take the
41:28
best care of their patients." And so,
41:30
I'd love for us to brainstorm how we can
41:32
find another outlet for some of that
41:33
frustration. Right.
41:35
>> Um, so
41:36
>> you're making it more collaborative. you
41:38
make it more collaborative in nature. So
41:40
there's sort of a formula here and and
41:43
then you you set the expectation.
41:47
>> I think expectation comes first ideally,
41:48
right? Sometimes we're already down the
41:50
path. Uh I think corrective conversation
41:53
comes next and this is this is assuming
41:54
that you yourself are not the gossiping
41:56
like that you're modeling the right
41:57
behavior.
41:58
>> Then I think if it becomes a persistent
42:00
issue that's when you might take more of
42:02
a disciplinary approach. But I I tend to
42:04
believe that like when people get called
42:06
out, a lot of people are like, "Man, I
42:07
don't like that I did that either. It's
42:09
just kind of how we do things here." And
42:11
a lot of people would like to course
42:12
correct and to be given that
42:13
opportunity.
42:17
>> So,
42:19
I have a question.
42:21
It might be uncomfortable,
42:23
>> but in like a good way.
42:25
>> Bring it on. because you've been you've
42:27
been in the game for a while and I know
42:30
you know we both know that like
42:31
healthcare is kind of kind of slow to
42:34
accept things. Um, has there ever been
42:38
like a moment in your work kind of life
42:41
where you generally questioned whether
42:44
any of this is like making a difference
42:47
and
42:48
where even where you thought about like
42:51
kind of walking away uh from this fight?
42:57
>> Yeah. You know, I think I think we
42:59
probably all have our moments of doubt
43:01
when we're trying to do hard things. I
43:03
think for me when those moments tend to
43:06
occur is when
43:09
um
43:11
I see just a direct rejection of the
43:15
understanding that that this is a good
43:16
thing to work towards. Right? So people
43:18
either like it's not a problem, doesn't
43:19
matter. People need to suck it up. Our
43:22
work environment doesn't really matter.
43:23
It's just about what we pay people. And
43:24
I don't think a lot of leaders are in
43:25
that space, but I've certainly had those
43:27
interactions where I feel like oh my
43:28
gosh, I'm ramming my head against a
43:30
wall. I think where I've had to pivot,
43:32
at least on my own journey, is um I'm
43:35
not here to fix healthcare. I'm here to
43:37
change a conversation and I'm going to
43:39
put every tool at my disposal
43:41
>> to do that.
43:42
>> And that's my purpose. Like that's what
43:44
I'm going to direct my effort and energy
43:46
toward. And if some people aren't
43:48
takers, then fine. Like do that at your
43:50
own peril and come back around to it
43:53
when you have a people issue, right? And
43:55
so, Michael, a lot of times when I hear
43:57
people say, "Oh, we don't have a problem
43:58
with this or we don't need to do that or
44:00
focus on it." My next question is just
44:02
great. How's that going for you? Right?
44:04
And if they're being really honest about
44:05
their retention, about their data, about
44:07
their scores, it's not going that great.
44:08
So, um, just like, okay, if you think
44:12
you don't have a problem, how's it
44:13
going?
44:14
>> All right. So for the leader that's
44:17
listening right now, maybe they they
44:19
lead a team inside of a health care
44:21
system or organization. They genuinely
44:24
care about their people.
44:26
However,
44:28
uh they feel like those those forces
44:30
around them are bigger than anything
44:32
that they can actually move themselves.
44:36
What do you what do you say to that
44:37
person? not like the research version,
44:39
but like practical day-to-day that they
44:43
can use to like actually incorporate
44:46
this into their into their work.
44:50
>> Um, okay. I'm still going to talk about
44:51
the research version, but I am going to
44:53
answer your question. It's like I can't
44:54
take off my research.
44:56
>> Um, I know you're trying and I would
44:58
love to. I just can't do it. Um so what
45:01
I would say to that person is that the
45:02
great news is and this is what gives me
45:04
hope personally. Um the great news is
45:07
that we know in the data that most of
45:11
the things that will make movement on
45:12
this problem are largely fixable,
45:15
largely free and within the span of an
45:17
individual leader. So creating a culture
45:20
of belonging, mattering, recognition,
45:22
trust, um support, encouragement,
45:26
leading for hope. All of those things
45:28
are things that I don't have to wait
45:29
from up here to do. Now,
45:31
>> yeah,
45:31
>> if up here's not doing it, it's going to
45:33
make my job a lot harder, right? But I
45:35
think a lot about this idea that
45:39
>> um if it's raining and I'm trying to
45:42
hold up a bucket to catch all the rain
45:44
so it doesn't land on my people,
45:46
>> um water is 8 pounds a gallon, my arms
45:48
are going to get tired. I'm going to
45:49
wear out and it's not going to work.
45:51
Right. It feels too heavy.
45:53
>> Yeah. Yeah.
45:53
>> But if I flip that and think about
45:54
holding up an umbrella
45:56
>> that is going to not keep everybody dry,
45:59
but it's going to create a pocket of
46:01
hope for the people that I serve,
46:03
>> I could probably do that for a long
46:04
time. You know, I could hold that
46:05
umbrella up for a long time. And I think
46:06
that mindset for me makes this work
46:09
>> easier to keep doing even when I don't
46:11
see the fast progress that I'm hoping
46:12
for.
46:15
>> That's a really good answer. Damn it.
46:19
Hey, before I forget, can you uh just do
46:22
like a commercial work? Can people find
46:24
you, follow you, uh get resources, get
46:27
tools? We'll obviously put this in the
46:28
description, but just sort of share that
46:30
with everyone before we uh before we
46:32
wrap.
46:33
>> Yeah. So, um I have an active presence
46:35
on LinkedIn. Certainly, if you're there,
46:37
connect with me there. I write a
46:38
newsletter there that I'm trying to
46:40
really distill this into very usable
46:41
things for leaders at all levels. Um, I
46:44
have a I have a a website where um
46:46
people will find me to come speak or
46:48
work with organizations and I'm always
46:50
looking for partners in this work who
46:52
want to go make changes together and so
46:55
um try to be as easy to find as
46:56
possible.
46:58
>> Awesome. You know, this has been it's
47:00
been super fun conversations. It's
47:01
actually it's going to be memorable uh
47:04
because I actually had a few things that
47:05
I was writing down and my freaking pen
47:08
ran out. But thankfully we uh we
47:10
actually have recorded this so I'll be
47:12
able to go back through it. But I think
47:13
you've given for those that are
47:15
listening um yes the science the
47:18
research but but more than that I think
47:20
your rigorous honesty uh on what's
47:23
happening inside of these organizations
47:25
and what what does this actually take to
47:28
change it just a visual of the bucket to
47:32
the umbrella in my mind that was like
47:34
pure pure gold. So, I'm just so grateful
47:37
that you have been able to sort of
47:39
sprinkle a lot of those golden nuggets
47:41
in this conversation and um yeah, with
47:45
all the work that you're doing, congrats
47:46
and thank you for continuing on and
47:50
staying in the industry. We need to have
47:52
our best leaders
47:54
well equipped and staying longterm.
47:57
That's what's going to help us out long
47:59
term. So, uh, if you're listening to
48:01
this and you found it super helpful,
48:04
please, the thing that you can do to be
48:06
supportive would be to engage, would be
48:09
to reshare it, to like it, maybe share
48:11
it with a friend. Uh, that would that
48:13
would go a long way. If you don't mind,
48:15
that'd be great. And if you do have
48:17
someone that you think would be
48:19
appropriate to come on to the show, we
48:20
always take suggestions. We look at we
48:23
look at comments. Let us know. And if
48:25
there is, you know, even a topic, that'd
48:26
be fine. So again, this is a platform
48:28
that isn't just about content. It
48:30
actually is an interactive community.
48:32
I've said this so many times, but you
48:34
got to feed the ecosystem if you're
48:36
going to eat from it. So this is a way
48:37
of us being able to feed the ecosystem.
48:40
So thank you for listening. Thank you
48:43
for just being here, being attentive,
48:45
keep building with purpose, and we will
48:47
see you next time on the Advancing
48:50
Healthcare Innovation Show.
48:52
>> Thanks everyone.
48:54
>> You bet.