Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Todd Smith, Chief Physician Executive at Sutter Health

Transcript

Dr. Todd Smith, Chief Physician Executive at Sutter Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Imagine this. You're at the Hyatt Regency Chicago
• 0:03
  immersed in insightful discussions with the health care
• 0:06
  industry's top leaders.
• 0:07
  Welcome to Becker's 12th annual CEO
• 0:10
  and CFO roundtable from November 11th to 14th,
• 0:14
  2024.
• 0:16
  Picture yourself networking with over a 1000 executive
• 0:19
  level attendees,
• 0:20
  collecting business cards, and forging valuable connections.
• 0:24
  Feel the excitement as you engage in 4
• 0:26
  days of sessions featuring 400
• 0:29
  elite health system speakers.
• 0:31
  Envision yourself diving deep into critical topics like
• 0:35
  rural health care, digital transformation,
• 0:38
  health equity, and c suite diversity.
• 0:41
  Now imagine being inspired by our celebrity keynotes,
• 0:45
  pro football hall of famers Troy Aikman and
• 0:48
  Emmett Smith, 43rd president George w Bush, and
• 0:52
  author and journalist Jenna Bush Hager. Their stories
• 0:55
  will leave you motivated and energized.
• 0:58
  Don't miss this unparalleled opportunity.
• 1:00
  Get registered today. Visit beckershospitalreviewdot
• 1:04
  com and click on the events page to
• 1:06
  find the conference website. That's the beckershospitalreview.com
• 1:11
  events page. See you in Chicago.
• 1:15
  This is Laura Dierda with the Becker's Healthcare
• 1:17
  Podcast.
• 1:18
  I'm thrilled today to be joined by doctor
• 1:19
  Todd Smith, chief physician executive at Sutter Health.
• 1:22
  Doctor Smith, it's a pleasure to have you
• 1:24
  on the podcast today.
• 1:25
  Pleasure to be here, Laura. Thank you for
• 1:27
  having me.
• 1:28
  Now I know we've got a lot to
• 1:29
  talk about. There's so much happening in the
• 1:31
  health care space, and, certainly, Sutter has really
• 1:33
  been busy over the last few years and
• 1:35
  a lot going on with the organization as
• 1:37
  well. But before we dive in, I was
• 1:38
  wondering if you could tell us a little
• 1:39
  bit more yourself and your background?
• 1:42
  Yeah. I'd be happy to. So I'm an
• 1:44
  orthopedic hand surgeon by training, and I practiced
• 1:47
  here in,
• 1:48
  with Sutter for about 27 years 1997.
• 1:52
  Approximately 5 years ago, after doing a lot
• 1:55
  of medical group leadership, I took over as
• 1:57
  one of the foundation chief executive officers
• 2:00
  in one of our regions called the Central
• 2:02
  Valley.
• 2:03
  And about a year ago,
• 2:05
  right after Warner Thomas got here, the position
• 2:08
  for Chief Position Executive was created
• 2:11
  as a dyad for operations with the Chief
• 2:13
  Operating Officer, Mark Sevko.
• 2:15
  And so, for the last year, I've been
• 2:17
  working in that position at a system level,
• 2:20
  working with them particularly
• 2:22
  on a lot of our priorities like growth
• 2:24
  and access.
• 2:25
  That's great to hear. And, you know, I
• 2:27
  can imagine,
• 2:28
  there's always a lot happening within the growth
• 2:30
  access to care and a really cool model
• 2:32
  you have with the dyad
• 2:34
  partnering the clinical leader with the operational leader.
• 2:36
  Based on our previous conversations, it seems like
• 2:38
  you've had some great successes in in being
• 2:41
  able to,
• 2:43
  design and develop some models of care and
• 2:45
  operations that are really gonna be impactful,
• 2:47
  for health care in the future.
• 2:50
  Absolutely. It's been a real pleasure to work
• 2:52
  with someone like Mark. And because we both
• 2:54
  got the same values as far as, really
• 2:57
  trying to promote our people, and
• 3:00
  really put our patients first.
• 3:02
  That's really allowed us to really look at
• 3:04
  our priorities, which have been around
• 3:07
  growth of the organization
• 3:09
  as well
• 3:10
  as growth of our services and access to
• 3:12
  our patients.
• 3:13
  Access has been one of our biggest challenges
• 3:16
  across the organization as well as just in
• 3:18
  the industry itself.
• 3:19
  And partnering with somebody like Mark allows us
• 3:21
  to bring the administrative plus the clinical views
• 3:24
  to attempt to,
• 3:25
  address some of the very difficult challenges we've
• 3:27
  had.
• 3:28
  That makes a lot of sense. And, you
• 3:30
  know,
• 3:31
  spring boarding from there, are some of your
• 3:33
  top priorities for the rest of the year?
• 3:35
  What are you really focused on?
• 3:37
  Really focused we're focused on several things, obviously,
• 3:40
  Laura. But if I had to boil it
• 3:41
  down to 2 or 3, really it's around
• 3:45
  clinician and clinical growth,
• 3:47
  really
• 3:48
  to focus on a couple of things, to
• 3:50
  bring in top quality individuals who can provide
• 3:52
  the best quality care for our patients and
• 3:55
  create the centers and destination of excellence, but
• 3:57
  also really about access,
• 4:00
  improving our access. We know that the just
• 4:02
  access to healthcare, whether it's primary care, whether
• 4:04
  it's behavioral health, whether it's surgical care really
• 4:07
  is a challenge across
• 4:09
  the environment.
• 4:10
  And so we're moving forward and trying to
• 4:12
  do that in a way that actually makes
• 4:13
  it easier for the patients.
• 4:15
  And in so doing, we're actually focusing on
• 4:18
  developing
• 4:19
  service lines, so that as people move through
• 4:22
  the system and receive their care, it becomes
• 4:24
  seamless
• 4:25
  and it becomes
• 4:26
  a journey that we are on with them
• 4:28
  in the process. But if I had to
• 4:29
  boil it down, it's around service lines, it's
• 4:32
  around access, it's around, clinician growth.
• 4:36
  That's really fascinating to hear. And, you know,
• 4:38
  in particular, you mentioned
• 4:40
  that access a few times already in our
• 4:42
  conversation.
• 4:43
  Is there anything you can share with us
• 4:45
  that you've done in particular around expanding that
• 4:47
  access to care that has, been beneficial or
• 4:50
  really,
• 4:51
  shown some great results for the system?
• 4:54
  It's interesting. I wish I could tell you
• 4:56
  that there were things that we've really decreased
• 4:58
  the wait times.
• 4:59
  And right now, the demand is so high
• 5:01
  that as we add clinicians,
• 5:04
  so we've had a record year in 2023
• 5:06
  and even in
• 5:08
  2024,
• 5:09
  we've added another 500 physicians and APCs across
• 5:12
  the organization, which
• 5:14
  is up from approximately 4,500.
• 5:16
  So really almost about a 10% increase in
• 5:19
  number of clinicians over time. We're still seeing
• 5:22
  challenges in
• 5:24
  people being able to get in. However, one
• 5:26
  of the things that we've been able to
• 5:27
  do is really work on our referrals
• 5:30
  and really decrease the time to referral,
• 5:32
  so that the patients, when they do need
• 5:34
  a referral, they know they've been heard, they
• 5:36
  know there's a spot for them, and they
• 5:38
  at least know they're they're being taken care
• 5:39
  of. The other thing we're doing a lot
• 5:41
  is really working toward implementing
• 5:45
  virtual care, in a way that everybody's doing
• 5:48
  some virtual care, but how do we actually
• 5:50
  improve this? How do we increase the accessibility
• 5:52
  to it such that there is a mechanism
• 5:55
  for somebody to get care when they need
• 5:57
  it and when they want it in the
• 5:58
  process. All of those are in flight.
• 6:01
  And we also hope to kind of see
• 6:03
  improvements in that. We've seen increases in the
• 6:06
  number of digital online appointments as well, which
• 6:09
  really helps to decrease that barrier to care,
• 6:12
  so that people can really connect with us
• 6:15
  in a way that makes more sense for
• 6:16
  them.
• 6:17
  That is really helpful to know and understand
• 6:19
  and, you know, wow. That that's a lot
• 6:21
  of, clinicians to bring in between the physicians
• 6:23
  and APP is adding 500
• 6:25
  over the last, you know, 12 to 18
• 6:27
  months or so. I can imagine that has
• 6:30
  been a huge undertaking for the organization, but
• 6:32
  good to hear that, you know, that coupled
• 6:34
  with some of the other strategies around referrals
• 6:37
  and and potentially virtual care coming as well,
• 6:40
  could make a difference for accessibility,
• 6:43
  within the community.
• 6:45
  Yeah. Absolutely. It really, and we are partnering
• 6:48
  with
• 6:49
  our clinicians in the community as well to
• 6:51
  try and improve that as well. We've got
• 6:53
  programs that are working with them to help
• 6:55
  them with some of the digital access
• 6:57
  pieces,
• 6:58
  too. And so it's an and strategy, not
• 7:01
  an either or strategy.
• 7:04
  Got it. And that's really living in that
• 7:06
  and is such an important place to be.
• 7:08
  Now what other programs or initiatives have been
• 7:10
  the most needle moving for your you over
• 7:12
  the last
• 7:21
  our mission, vision, values. And really when you
• 7:22
  think about, you know, that our mission, vision,
• 7:23
  values and really when you think about
• 7:26
  that sort of mission statement, it became
• 7:29
  patients first and people always.
• 7:31
  And really what that speaks to is the
• 7:33
  fact that we're all here to serve the
• 7:34
  patients and we have to take care of
• 7:36
  our people in the process. And so it's
• 7:38
  really about taking care of our people so
• 7:40
  that they can take care of our patients.
• 7:42
  That's been needle moving and that we've been
• 7:44
  investing in our people,
• 7:46
  investing in creating a culture of working together,
• 7:49
  working as a team,
• 7:51
  getting to a culture of yes.
• 7:53
  And so what that's allowed us to do
• 7:55
  is to increase the transfers into our system,
• 7:59
  with approximately 10% more transfer we've been able
• 8:02
  to accept. We've been working very hard on
• 8:05
  how do we actually improve our length of
• 8:07
  stay and so doing utilize our resources better
• 8:10
  and really improve our overall volume. So we're
• 8:13
  able to take care of more patients
• 8:15
  and have more patients come into the system.
• 8:18
  And all of those really have helped us
• 8:20
  serve our patients better, but also take care
• 8:23
  of our people while we're doing it.
• 8:26
  That makes a lot of sense. And, you
• 8:27
  know, I I love that idea of being
• 8:29
  able to,
• 8:30
  have the clinicians and caregivers be in a
• 8:32
  great spot to take care of patients. I
• 8:35
  know physician wellness is something that's on top
• 8:37
  of so many different,
• 8:39
  people's minds and health systems and organizations across
• 8:42
  the nation.
• 8:43
  And, you know, when you look at Sutter,
• 8:45
  being able to invest in that and invest
• 8:47
  in having a great culture,
• 8:49
  you know, it it seems easy, but I
• 8:51
  can imagine it's a lot harder, to actually
• 8:54
  do and implement and live out on a
• 8:55
  daily basis.
• 8:57
  What makes Sutter unique? I you know, especially
• 9:00
  in given,
• 9:01
  like like I said, a lot of organizations
• 9:03
  are trying to do this. So what actually
• 9:04
  makes you your culture and your, programs around
• 9:07
  physician wellness different from what everybody else is
• 9:09
  doing?
• 9:11
  You know, I I I think it I
• 9:13
  don't I'm not sure it's unique as much
• 9:15
  as it is it's a focus.
• 9:17
  And so from the corner office from when
• 9:20
  Warner started to the elevation of the physician
• 9:23
  presence
• 9:24
  at the executive leadership team to focus
• 9:28
  on engaging the clinicians in decision making both
• 9:32
  on a strategic and operational front.
• 9:34
  I think what that's done is that's
• 9:36
  elevated and reengaged
• 9:38
  them
• 9:39
  in a way that we have not seen
• 9:42
  in other areas. What this has resulted in
• 9:45
  at the end of the day is not
• 9:47
  only excellent hiring from that standpoint, but our
• 9:50
  retention has actually been pretty good as well.
• 9:52
  Currently our projected
• 9:54
  turnover for this year for 2024
• 9:57
  is going to be around 3%,
• 9:59
  which is down from 5% the year before
• 10:01
  and 7% the year before that.
• 10:04
  That coupled with
• 10:06
  the increased
• 10:07
  retention on the staff side has really made
• 10:10
  for stabilization
• 10:12
  of the workforce itself
• 10:14
  that actually has allowed us to move forward
• 10:16
  in the process.
• 10:17
  We also just started a program with the
• 10:20
  American Medical Association,
• 10:22
  looking at joy of work and how do
• 10:25
  we engage better. And so we've got a
• 10:27
  lot of opportunities there
• 10:29
  and it really is top of mind. But
• 10:31
  I think engaging the medical groups we work
• 10:34
  closely within this, has really been very helpful
• 10:37
  for that.
• 10:39
  That's great to hear. Now before we wrap
• 10:41
  up, I'm wondering how are you thinking about
• 10:43
  growth and patient experience going forward?
• 10:46
  So, I really appreciate the question, really. If
• 10:49
  we think about growth, it's really gonna be
• 10:51
  about supporting and expanding the workforce. We've talked
• 10:54
  about the physicians and the APCs,
• 10:56
  but it's also about expanding where we provide
• 10:58
  the care in both ambulatory surgery centers as
• 11:01
  well as urgent cares,
• 11:03
  and then really looking at how do we
• 11:04
  organize around service lines, so that provides that
• 11:07
  growth vehicle and that growth opportunity for us
• 11:10
  and making the work that the clinicians do
• 11:13
  for the patients easier
• 11:15
  as opposed to harder and allowing them to
• 11:18
  connect with them.
• 11:20
  If you think about patient experience, it's a
• 11:22
  lot of it we're thinking about meeting the
• 11:24
  patients where they are,
• 11:26
  redesigning
• 11:27
  our online presence, redesigning the way that we
• 11:30
  interact with them and that digital engagement is
• 11:33
  so important.
• 11:34
  Looking at things like online appointments, virtual care,
• 11:38
  continuous home monitoring,
• 11:40
  if you look year over year,
• 11:42
  we
• 11:43
  increased our online appointments by approximately
• 11:47
  250,000
• 11:48
  year over year,
• 11:50
  which is really pretty important because that is
• 11:52
  that's the way that a lot of people
• 11:54
  want to interact with us. And so creating
• 11:56
  an opportunity for them really I think will
• 11:58
  be helpful for us moving forward.
• 12:00
  And then creating that consistency across the organization,
• 12:03
  I mean, how do we ensure that the
• 12:05
  patients when they are with us,
• 12:07
  they get a warm welcome. They know that
• 12:09
  we're happy that they've chosen us for their
• 12:11
  care. We can narrate their care. We can
• 12:14
  let them know what is going on and
• 12:15
  what will be there and take some of
• 12:18
  the unknown out of it. And then fond
• 12:20
  farewell. Let them know that we're happy they
• 12:22
  chose us. We appreciate the honor and the
• 12:25
  ability to be able to take care of
• 12:27
  them and create
• 12:28
  that constant and lasting relationship. So as we
• 12:31
  move forward, that's sort of how we're thinking
• 12:33
  about both growth as well well as patient
• 12:36
  experience.
• 12:37
  That's amazing to hear. Doctor Smith, thank thank
• 12:39
  you so much for joining us on the
• 12:40
  podcast today. This has been such a fun
• 12:43
  conversation, and I look forward to connecting with
• 12:44
  you again soon.
• 12:45
  Absolutely. Thank you for having me, Laura.