Latest / Becker’s Healthcare - Clinical Leadership Podcast / Mark G. Moseley, MD, MHA, President of USF Tampa General Physicians and Executive Vice President at Tampa General Hospital

Transcript

Mark G. Moseley, MD, MHA, President of USF Tampa General Physicians and Executive Vice President at Tampa General Hospital · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Hi, everyone. Thank you so much for tuning
• 0:03
  in to the Becker's Healthcare Podcast.
• 0:06
  I'm Erica Carbajal.
• 0:08
  And today, we're excited to be joined by
• 0:10
  doctor Mark Mosley, president of USF Tampa General
• 0:14
  Physicians.
• 0:15
  Doctor Mosley, welcome to the podcast. Thanks so
• 0:17
  much for taking the time to be on.
• 0:20
  Yes. Thank you so much for having me.
• 0:22
  Delighted to be here.
• 0:24
  Absolutely. Well, to get us started, do you
• 0:26
  mind just sharing a bit about your current
• 0:28
  role and your background and how you got
• 0:30
  there?
• 0:32
  Sure.
• 0:33
  I'm happy to. So I am president of
• 0:35
  USF Tampa General Physicians. So
• 0:38
  we're a managed service and physician practice,
• 0:41
  that oversees the physicians of Tampa General Hospital
• 0:46
  and the University of South Florida Morsani College
• 0:48
  of Medicine. So we're an academic practice of
• 0:50
  almost a thousand well, over a 1050 providers,
• 0:54
  physicians, and advanced practice providers.
• 0:57
  I hold a few other roles. I'm an
• 0:58
  executive vice president in the TGH health system,
• 1:02
  and I'm vice dean for clinical affairs in
• 1:04
  the Morsani College of Medicine at the University
• 1:06
  of South Florida. So,
• 1:08
  I'm an emergency physician by training and background.
• 1:10
  I went to the Ohio State University for
• 1:12
  medical school and graduate school,
• 1:15
  did my training in emergency medicine at a
• 1:17
  place called Christianicare Health System in Wilmington, Delaware,
• 1:20
  and then was an academic faculty member and
• 1:22
  leader
• 1:23
  at Ohio State for almost 12 years before
• 1:26
  being recruited here in 2017
• 1:29
  to to start as the chief medical officer
• 1:31
  at USF. And then I've had a delightful
• 1:34
  journey as the systems continued to grow. I've
• 1:36
  been able to grow with it, which has
• 1:37
  been, really wonderful.
• 1:40
  Thanks for walking us through your background there.
• 1:42
  I think
• 1:44
  wide oversight there. As you mentioned, overseeing over
• 1:46
  a 1050,
• 1:48
  physicians and advanced practice providers. So within that,
• 1:52
  can you share a little bit about
• 1:54
  thinking back over the past year, your most
• 1:56
  successful project or initiative
• 1:59
  at Tampa General?
• 2:00
  What did you do, and what were the
• 2:02
  results?
• 2:04
  Sure. There's there's so many things in many
• 2:06
  ways. We're we're a bit of a a
• 2:08
  a start up.
• 2:09
  We have these two wonderful parent companies in
• 2:12
  TGH and the University of South Florida, and
• 2:15
  we're carving out this space in between. So
• 2:17
  we're we're fortunate that we have a lot
• 2:18
  of parental,
• 2:20
  oversight and approval, but we're we're also
• 2:23
  defining
• 2:24
  the physician practice in the future. And
• 2:27
  I think one of the most meaningful things
• 2:29
  that we've been able to do
• 2:31
  is to
• 2:33
  ask some important questions about how we scale
• 2:36
  infrastructure
• 2:37
  in our practice assets for the future.
• 2:40
  So much of the ambulatory world of healthcare
• 2:42
  has been a bit of the Wild West
• 2:44
  compared to the inpatient setting.
• 2:46
  The inpatient setting for
• 2:48
  decades has been focused on rigor around operations
• 2:53
  and bed placement
• 2:54
  and
• 2:56
  quality and
• 2:57
  other really
• 2:59
  high data
• 3:01
  and sophistication
• 3:03
  around those topics,
• 3:06
  the ambulatory setting really hasn't been that.
• 3:09
  And so
• 3:10
  what I've really enjoyed over the last
• 3:13
  few years is bringing
• 3:15
  insights from the inpatient setting
• 3:17
  to the outpatient setting. Let me give you
• 3:19
  an example. So at any given time, if
• 3:22
  you ask a physician executive like me how
• 3:24
  many of your exam rooms in your ambulatory
• 3:28
  office buildings are full,
• 3:30
  most of us wouldn't be able to answer
• 3:32
  that question.
• 3:33
  But if you ask a hospital chief operating
• 3:36
  officer
• 3:37
  how many beds are full in your hospital
• 3:39
  at any given time, they could ask answer
• 3:42
  that question with exact precision. So we're looking
• 3:43
  at how can we do that in the
• 3:52
  the so we can better manage our capacity?
• 3:54
  Just like in the inpatient setting of the
• 3:56
  hospital
• 3:57
  where those beds are a precious resource, our
• 4:00
  exam rooms in the ambulatory setting are a
• 4:02
  precious scarce resource that we need to manage
• 4:04
  effectively.
• 4:05
  So why is that?
• 4:07
  We need to manage it because
• 4:09
  we don't have unlimited capital to go out
• 4:11
  and buy a new building. We don't have
• 4:14
  operational
• 4:15
  funds to lease additional space. We need to
• 4:17
  be operationally efficient and effective
• 4:20
  in the space that we're in. So
• 4:22
  we have some partners that we're working with
• 4:24
  that are trying to do that. We took
• 4:26
  500 rooms
• 4:28
  in our largest clinic buildings, and we're trying
• 4:30
  to run it much more like the inpatient
• 4:33
  setting of the hospital with some analogies to
• 4:35
  the operating room. We want our physicians and
• 4:38
  providers to achieve a high level of room
• 4:40
  utilization,
• 4:42
  and we're gonna try and help them to
• 4:43
  the best of our ability do that.
• 4:46
  If they can't meet that room utilization goal
• 4:49
  with our support and aid, we have to
• 4:51
  look at how we can reallocate those resources.
• 4:53
  Because, again, we we have to be accountable
• 4:55
  stewards of the resources that we're given. And,
• 4:58
  of course, that's a partnership. So what I've
• 5:00
  really enjoyed about that, in addition to just
• 5:02
  it's innovative, it's a chance
• 5:05
  to do something differently and to take from
• 5:08
  a part of medicine that we've done very
• 5:10
  well
• 5:11
  in recent years in the inpatient setting of
• 5:12
  the hospital and put it in the outpatient
• 5:14
  setting. It's just been the partnership with our
• 5:16
  physicians, our providers, and our staff. I I
• 5:19
  think that's been the real fun part just
• 5:21
  to see the the light bulb or the
• 5:23
  moment to say, hey. At any given time,
• 5:25
  we know we have this unused capacity. Let's
• 5:27
  go
• 5:35
  Yeah. You raise a fascinating point there that
• 5:38
  we truthfully don't hear
• 5:40
  as much about just in terms of really
• 5:43
  taking
• 5:45
  factors of how well,
• 5:48
  tightly managed and well known certain things are
• 5:50
  on the inpatient setting and really bringing that,
• 5:52
  integrating it into the outpatient setting.
• 5:55
  Doctor Mosley, as you've gotten working on this
• 5:58
  and it's kind of become a larger priority,
• 6:01
  how physicians,
• 6:02
  like, really responded there? Have they been engaged
• 6:05
  in that and and and ready to take
• 6:06
  on that that challenge and understanding the why
• 6:09
  there?
• 6:11
  Yeah. It's a it's a good question. I
• 6:13
  think
• 6:15
  change management is hard,
• 6:17
  wherever we are, and, you know, we're all
• 6:20
  guilty, I think, as leaders and in in
• 6:22
  as big systems of sometimes
• 6:25
  splitting rather than lumping. And I think what
• 6:27
  we have to do is connect
• 6:29
  our initiatives to a sense of why are
• 6:32
  we doing it, how does it connect to
• 6:34
  our shared purpose, our vision, our values,
• 6:37
  Why are we doing this, and what are
• 6:39
  the reasons that you should care about it?
• 6:41
  And let's have that discussion fundamentally before we
• 6:44
  talk about the particulars.
• 6:47
  I find when I do that and I
• 6:49
  talk to our physicians, our providers, and our
• 6:52
  staff
• 6:53
  about
• 6:55
  why
• 6:56
  we're doing things and what's the why behind
• 6:58
  it and how it impacts patients,
• 7:01
  how it impacts them,
• 7:02
  I I find that it's a it's a
• 7:04
  more productive discussion. It's an easier starting place.
• 7:08
  And then, hopefully, we can tie that to
• 7:10
  some of our strategic initiatives. All of us
• 7:12
  have key performance indicators,
• 7:15
  organizational action pillars.
• 7:17
  You know, you can call them different things,
• 7:19
  but we're all trying to be efficient and
• 7:21
  effective in what we do.
• 7:23
  And I think if we can tie that
• 7:24
  to the sense of why and say we're
• 7:26
  doing this because we also really want to
• 7:30
  achieve our strategic goals, which hopefully,
• 7:33
  in an academic health system, are linked to
• 7:35
  our mission of serving patients and to the
• 7:37
  community.
• 7:39
  I find when I do that, and I'm,
• 7:40
  you know, I'm not always effective like everybody
• 7:43
  is in in doing that. But when I
• 7:44
  am effective in doing that, I think those
• 7:46
  discussions go really well because change is hard,
• 7:48
  and there's a lot of it. Yeah. I
• 7:51
  think some great points there just around
• 7:54
  tying it back to efficiency and effectiveness, but
• 7:57
  also the mission and the why of of
• 7:59
  serving more patients and making sure we have
• 8:01
  as much access as as possible,
• 8:04
  doing what we can to provide that.
• 8:06
  Well, doctor Mosley, looking ahead, what do you
• 8:09
  see as really the biggest challenge, or what
• 8:11
  are you really bracing for, expecting to face
• 8:13
  in the next year or so, and how
• 8:15
  are you preparing?
• 8:17
  So
• 8:19
  I was recently,
• 8:22
  asked to be on a panel where we
• 8:23
  where we answer some of these similar questions,
• 8:26
  and I I think
• 8:28
  there there's so much coming at us in
• 8:30
  health care right now, so many challenges. I
• 8:32
  I think if you think back to COVID
• 8:34
  and coming out of COVID with a great
• 8:36
  resignation,
• 8:38
  we realized how vulnerable we were from a
• 8:40
  workforce perspective.
• 8:42
  So, I think like most organizations,
• 8:45
  you know, we have
• 8:46
  been thoughtful or at least tried to be
• 8:48
  thoughtful of how how we approach that. There's,
• 8:50
  of course, recruitment and retention of, you know,
• 8:52
  world class staff and physicians and providers.
• 8:56
  But but how do we invest in them?
• 8:58
  How do we upscale them appropriately?
• 9:00
  How do we deal with the fact that
• 9:02
  we may have
• 9:04
  staffing shortages in perpetuity in health care because
• 9:07
  there just aren't enough people going into
• 9:10
  particular areas. An example might be revenue cycle
• 9:13
  on the physician practice side.
• 9:15
  Right? You you don't go to college to
• 9:17
  be
• 9:19
  a revenue cycle specialist.
• 9:21
  There's there's no degree for that.
• 9:23
  Right? So how do we take somebody that
• 9:26
  comes into our organization that has the good
• 9:28
  raw skills, that has the connection to our
• 9:30
  mission, vision, and values, wants to have a
• 9:32
  sense of purpose and meaning in what they
• 9:34
  do,
• 9:35
  understands that the work that we do matters,
• 9:37
  how do we take that good substrate,
• 9:40
  and how do we skill them appropriately?
• 9:43
  So that skilling is, you know, people skills,
• 9:46
  leadership skills,
• 9:48
  enhanced
• 9:48
  roles and responsibilities, but it's also the application
• 9:51
  of technology.
• 9:53
  We need technology to be a force multiplier.
• 9:57
  How do we do that?
• 9:59
  You know, if you think about checking into
• 10:00
  a doctor's office
• 10:02
  or scheduling a doctor's appointment,
• 10:05
  we're not particularly innovative in that.
• 10:08
  And if you think back to, you know,
• 10:10
  40 or 50 years ago, my my father-in-law
• 10:12
  graduated from medical school in 1957.
• 10:15
  And when you checked into his office in
• 10:17
  the late 19 fifties, early sixties,
• 10:20
  checking into an office is not a whole
• 10:21
  lot different today. There may be some technological
• 10:24
  enablement to it, but we have to get
• 10:26
  better at that.
• 10:28
  Right? We have to help be and and
• 10:31
  it's not just being more consumer focused for
• 10:34
  for patients that are tech savvy and want
• 10:36
  to have multiple ways in how they interface
• 10:38
  with us. It's helping our staff,
• 10:41
  deal with their new realities.
• 10:45
  I think all of us are trying to
• 10:47
  keep up with the the monumental change that
• 10:49
  we're seeing in the health care marketplace and
• 10:52
  the demand for patients,
• 10:54
  you know, the access challenges, the staffing challenges,
• 10:57
  those are all across the country. That's not
• 10:58
  unique to any particular system or area.
• 11:01
  But I think what we're gonna be focused
• 11:03
  on in the next year is really investing
• 11:05
  in our people.
• 11:06
  Right? How can we invest in our people?
• 11:08
  How can we
• 11:11
  give them
• 11:12
  that connection to the purpose that's so meaningful,
• 11:16
  that they wanna stay, they wanna invest in
• 11:19
  our what we're doing,
• 11:20
  right, for the betterment of our patients in
• 11:23
  our community.
• 11:24
  And there was a great study that was
• 11:25
  recently published by Deloitte that looked at, Gen
• 11:28
  z's
• 11:29
  and millennials
• 11:31
  in how they're changing the multigenerational
• 11:33
  workspace.
• 11:35
  And one of the key things and takeaways
• 11:37
  from that article was
• 11:39
  it's really incumbent on us as leaders to
• 11:41
  connect people to a sense of purpose.
• 11:43
  I'm not there to just hit a button
• 11:45
  in the electronic medical record. I'm here to
• 11:48
  help take care of patients.
• 11:49
  And what I'm doing in the electronic medical
• 11:51
  record
• 11:52
  is a part of our high reliability
• 11:55
  practice that delivers world class outcomes, which is
• 11:58
  good for patients and good for the community.
• 12:01
  Right? I think we have to do a
• 12:02
  better job of telling stories about how we're
• 12:04
  connecting those things. So for us and what
• 12:06
  I see in the future in this coming
• 12:08
  year, it's really investing in our people. It's
• 12:10
  investing in appropriate technologies, using that technology,
• 12:13
  as I mentioned before, to be a false
• 12:15
  force multiplier,
• 12:17
  to be innovative in the ways that we
• 12:19
  do things,
• 12:21
  and hopefully
• 12:23
  be more efficient and effective so that we
• 12:25
  can better achieve our mission and
• 12:29
  service to the community.
• 12:31
  Yeah. Doctor Mosley, I think a lot of
• 12:33
  what you said just parallels to or speaks
• 12:36
  to the reality that we hear from a
• 12:38
  lot of leaders of that, you know, staffing
• 12:41
  shortages are are here to stay and staffing
• 12:44
  will always
• 12:45
  be a priority.
• 12:46
  But as you mentioned, how do we integrate
• 12:49
  technology
• 12:50
  and get people to see that investing in
• 12:52
  tech
• 12:53
  is part of investing and supporting staff for
• 12:56
  the foreseeable future and really getting everyone to
• 13:00
  understand,
• 13:01
  the why there and how it can support
• 13:03
  efficiency,
• 13:04
  throughout the organization.
• 13:07
  Mhmm. Mhmm. Well said.
• 13:10
  Doctor Mosley, next here. How do you see
• 13:13
  obviously, physician
• 13:15
  c suite leaders are have a broad scope
• 13:17
  of responsibility,
• 13:19
  depending on
• 13:21
  what area of an organization they work in
• 13:23
  or the size of the system or hospital.
• 13:25
  But generally or broadly speaking, how do you
• 13:28
  see
• 13:29
  physician c suite roles evolving in the coming
• 13:32
  years?
• 13:34
  Yeah. So that's such a great question because
• 13:37
  it it might lead me to say something
• 13:39
  that there's some hack for the future
• 13:41
  that would allow us to be more successful
• 13:44
  than we've been in the past.
• 13:46
  I tend to be
• 13:48
  somebody that looks to the past
• 13:50
  to say what's always been true.
• 13:54
  The author, Morgan Housel, has a book called
• 13:56
  Same as Ever, where he talks about this
• 13:58
  concept. And just sort of learning the things
• 14:01
  that have always been true might help us
• 14:03
  worry less about the future. So for me,
• 14:06
  and for as a physician executive and what
• 14:08
  I encourage our leaders to focus on is
• 14:10
  what's always been true about leadership. Leadership's always
• 14:13
  been hard. Right? It's always challenging.
• 14:16
  We're always gonna have things that are uncertain
• 14:18
  or ambiguous,
• 14:19
  but there's ways that we can deal with
• 14:21
  that complexity.
• 14:22
  We can manage it
• 14:24
  through sound blocking and tackling,
• 14:27
  excellent communication.
• 14:28
  Right? How do we how do we deal
• 14:30
  with challenges with
• 14:32
  physician alignment and engagement?
• 14:35
  I've always found that communicating very clearly, effectively,
• 14:38
  and consistently with people
• 14:40
  really is helpful. Because if I behave erratically
• 14:43
  as a leader, it's really hard to trust
• 14:45
  me. And I think, ultimately, it comes down
• 14:47
  to that.
• 14:48
  You know, as a leader, we're trying to
• 14:50
  build trust with the people that we work
• 14:52
  with. We're trying to build trust with our
• 14:54
  physician colleagues, our our provider colleagues, and our
• 14:57
  and our team members. And in order to
• 14:59
  do that, you have to be visible, you
• 15:01
  have to communicate clearly,
• 15:04
  you know, things like town hall meetings, answer