Latest / Becker’s Healthcare Podcast / Advancing Rural Otolaryngology Through Professionalism and Innovation with Dr. Kenneth Altman

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Advancing Rural Otolaryngology Through Professionalism and Innovation with Dr. Kenneth Altman · Becker’s Healthcare Podcast

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  The most important health care decisions don't happen
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  in isolation.
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  They happen when leaders come together.
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  Becker's sixteenth annual meeting brings together more than
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  3,500
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  hospital and health system executives this April in
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  Chicago.
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  With 800 speakers from Ascension, Cleveland Clinic, CommonSpirit
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  and more, the conversations get real. Leaders will
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  share how their scenario planning for policy shifts,
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  breaking through value based care barriers, and building
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  clinical teams that translate new ideas into real
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  world care.
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  Join top decision makers in the room April
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  13 through the sixteenth.
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  For the agenda and event details, visit beckers
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  hospital review dot com and click on the
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  events tab in the upper right.
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  This is Laura Dirda with the Becker's Healthcare
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  podcast.
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  I'm thrilled today to be joined by doctor
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  Ken Altman, chair of the department of otolaryngology
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  head and neck surgery at Geisinger Health System
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  and professor at Geisinger College of Health Sciences.
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  Doctor Altman, it's a pleasure to have you
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  on the podcast today. Thank you. Now I'm
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  excited for our conversation because I know Geisinger
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  is such an innovative health system, and the
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  work you do there is so fascinating. So
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  I'm looking forward to hearing more and spotlighting
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  some of the cool things you've been doing
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  in the last year as well as, you
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  know, get your perspective on growth in the
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  future. But before we dive in, can you
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  introduce yourself and tell us a little bit
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  more about Geisinger?
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  Well, I I start off in Brooklyn where
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  I grew up, and,
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  I'm really privileged to have been in many
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  great places throughout the course of my career.
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  Very proud of my patient care and that
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  I'm, still a frontline worker.
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  So I understand,
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  the immediate needs of the patients and the
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  community and how to translate that into leadership
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  and to a larger health system.
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  That's fantastic. And, you know, definitely having that
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  perspective of being on the provide provider side
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  of things continuing to,
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  have that close connection to patient care, I
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  can imagine, makes a big difference as you're
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  looking at, you know, some of your leadership
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  roles and connecting with the other colleagues,
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  and making big decisions for the health system
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  in the direction it's headed.
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  Thank you. Yeah. You know, Geisinger has a
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  very,
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  elaborate health system. We we started off with
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  humble beginnings in 1915 in Central Pennsylvania,
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  and now we've grown into a nine hospital
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  campus system, 10 if you include our children's
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  hospital.
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  And if we know we account for about
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  three and a half million lives,
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  and,
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  we have our own health insurance.
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  So that that puts us in a a
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  good situation with regard to our quality and
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  outcomes based care, but it also affords us
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  the opportunity to have an open shop model
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  where we can really care for anyone else
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  in the community too.
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  That's amazing to hear. And, you know, it's
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  so important to have those opportunities to provide
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  additional access to care when needed. Now when
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  you think about the last year or so,
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  what was the most important initiative that you
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  led? What did you do, and what were
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  the results?
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  Well, just for context,
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  we have a a department that is not
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  a hub and spoke model. I like to
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  think of us as a multiple access points
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  for patients in a broad geographic area that
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  we care for and to create a seamless
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  journey for them. And, you know, part of
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  that was a selling pitch because I couldn't
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  hire anyone to be a spoke who wants
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  to be a spoke.
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  But really when I thought about it,
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  we really are truly interconnected. Even before COVID,
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  we put in this teleconferencing,
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  set up so that we can pool our,
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  morbidity and mortality conference, our head neck cancer
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  tumor board, and really serve a centralized
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  one one centerpiece for the entire system.
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  And everyone could participate, everyone's valued.
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  So, with that in mind, you know, it
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  was a it was a tough build out
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  over the last seven years since we had
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  COVID and then the,
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  all the post COVID fallout.
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  But to build a,
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  system standards throughout the system, for interoperability
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  and creating centralized databases for each of our
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  service lines was a real cool, I think,
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  that set the stage for some of the
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  accomplishments that we focused on in the last
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  year.
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  That's fascinating to hear. And I I think
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  especially, you know, when you look at,
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  some of the different ways that you can
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  integrate technology
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  and bring that into,
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  the clinical care space too. When we talk
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  about interoperability, talking about care coordination, talking about
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  working altogether,
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  you know, what was that like, that process
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  like? Where you know, what did you learn,
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  I guess, throughout it, and how are you,
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  you know, really troubleshooting not only,
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  the the change management for the team, but
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  also,
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  you know, the technology side of it as
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  well?
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  I think we all went into health care
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  because we have such passion
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  for what we do. We wanna make a
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  difference. We wanna care for our community.
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  We
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  really want to uphold the highest levels of
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  professionalism no matter how we carry ourselves or
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  where we are throughout our career. And then
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  what we find in many circumstances is that
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  the immediacy of the moment, the transactional things,
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  the creating an RVU or,
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  the productivity or efficiency or throughput
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  are all terms that,
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  of course, they're necessary, but they they could
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  be compromising
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  to how we think of professionalism.
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  So when you asked
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  what was the most impactful or proud moment
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  in the last year with regard to my
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  initial, initiatives,
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  I'd see my focus on service and professionalism.
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  I mean, what distinguishes us as a department,
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  between
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  here at Geisinger or anywhere else in the
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  country, and it has to do with
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  how we conduct ourselves as professionals.
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  And that that's a real challenge. But part
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  of that professionalism journey
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  is providing service service to your department, to
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  the institution,
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  to the profession, and to the community.
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  And, you know, you were talking about, initiatives
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  or innovations.
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  And I would say that any innovation comes
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  with a great research project.
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  It has to be a good research, sound
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  research design, and the conclusions have to be
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  sound and hypothesis driven.
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  So I've got plenty of examples of of
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  how,
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  service, research, innovation, and professionalism
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  all folded together to really enhance,
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  the impact that Geisinger could make in our
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  community.
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  That's helpful to understand, you know, and it
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  is a great way of framing it. Now
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  when you look into the future, where do
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  you see some of the big priorities and
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  headwinds that you'll be focusing on for 2026?
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  I think it's down into the weeds right
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  now. It's the minutiae. I'll give you an
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  example. We have a head and neck cancer
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  database, and we have about 350
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  patients in our region that we care for.
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  Everyone goes through the head and neck cancer,
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  tumor board.
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  And,
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  we looked at the timeline for access to
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  care between the five the time that someone
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  picks up the telephone to make that appointment
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  and the time that they're presented a tumor
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  board in order to start,
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  their treatments. And we found that that is
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  at least three weeks.
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  Compares to national averages very nicely.
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  But I don't think that three week is
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  a nice timeline.
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  So what we did was we drilled down
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  the different types of cancers, different stages, and
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  we made some, inquiries about, do you need
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  PET CT scan for every cancer all the
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  time? And the answer is no. We found
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  certain types of cancers at certain stages.
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  We can actually cut that journey and eliminate
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  ten days waiting for a pet CT and
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  the official read and the logistics of of,
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  presenting it at tumor board. So we're shortening
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  the journey for that patient already from twenty
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  days down to ten days to get to
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  tumor board. And we're looking into other initiatives
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  to make it shorter.
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  Another example is cough is a common problem.
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  It's about three percent of all physician visits.
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  Geisinger in the last three years saw a
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  hundred and five thousand cough patients.
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  So we drill down that population,
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  and we figured out at what point is
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  an acute cough versus chronic and is best
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  practice being delivered at that third visit when
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  it really has become a chronic cough.
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  And what we discovered is that coding accuracy
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  is an opportunity,
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  and,
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  delivering best practice is an opportunity because the
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  very front lines
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  can be better empowered by us otolaryngologists.
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  Therein lies the service. How can we get
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  frontline providers to deliver better
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  versions of best practice? There's one version of
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  best practice.
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  And how can we empower them? And so
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  those are the headwinds that we have to
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  play to face that that when we do
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  these inquiries, when we try to innovate,
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  we have to be humble and recognize our
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  limitations.
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  And therein lies opportunities for further improvement.
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  So we're really moving at Geisinger toward a
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  high, reliability organization where there's continuous process improvement.
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  So what I started last year
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  has many years ahead of it, to be
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  perfect. Absolutely. I think we could all appreciate,
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  you know, getting things started, and then having
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  to to, you know, wait in overtime to
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  see how it all plays out and really
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  comes to fruition and grows into,
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  what it could potentially be. But I think
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  that's, you know, fascinating and and really cool
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  to understand,
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  how you've been able to,
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  you know, really develop those best practices and
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  then, make sure that they are,
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  distributed to throughout the organization and see the
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  impact that they can make on patients.
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  Yeah. Thank you. You know, you talked about
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  headwinds.
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  No conversation about headwinds in 2026
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  is complete.
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  I'm not even gonna mention the AI side,
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  but let's talk about
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  generational cultural divide.
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  And,
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  look, I got my own kids now that
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  grew up with a a keyboard in their
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  crib.
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  So, you know, are they talented? Holy cow.
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  And in terms of multitasking, again, I like
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  to focus and get something done and close
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  on it. But but their mind is working
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  in a very parallel fashion,
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  whereas, traditionally, we grew up in very serial
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  tasks.
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  And I think their capabilities
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  are
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  are fantastic.
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  What they don't have is necessarily institutional memory
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  or the momentum of the professionalism that dates
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  back 2,000 years.
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  So I I think the challenge here is
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  going to be bridging
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  the great new talents of the younger generation
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  with the professionalism conscience
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  that
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  really,
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  helps direct our motivation
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  and our our ethics and morality moving forward.
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  That's such a fascinating observation and point. And,
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  you know, I think when you are looking
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  at the new generations of clinicians and and
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  leaders coming in,
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  what can you do? Or how do you
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  communicate with them some of this institution
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  institutional knowledge and the consciousness that you were
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  talking about? How do you instill that in
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  a way that makes sense, for a generation
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  too, as you put it, that had,
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  keyboards in their crib and really have grown
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  up with technology and, a different way of
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  looking at the world and thinking?
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  It's a it's a tough sell because there's
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  an increasing monetization in our society of every
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  little thing that we do. And there's the
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  thought that, well, if we're gonna pay docs
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  by RVUs, that means that the only thing
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  that that we value. We don't value their
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  professionalism or their
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  devotion to an innovative project or their time
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  to travel to a national meeting to be
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  part of the national discussion.
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  So we have to change how we think
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  about
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  encouraging
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  greatness.
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  And, Geising has done a great job of
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  doing that and has been very supportive of
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  the efforts that I've had in otolaryngology.
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  But it's the idea that
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  it's not all about money.
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  Once you have,
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  you know, what you need to support your
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  family and the roof over your head, your
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  aspirations for the future and some security,
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  I mean, we are really well off. I
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  I, I just finished my MBA two years
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  ago,
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  year and a half ago. And one of
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  the classes was a global health course.
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  And,
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  you know, one of the conclusions that I
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  came to at the end
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  was that, well, we have global health right
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  here in America. There's a big disparity of
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  care,
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  and it's not always socioeconomic
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  or, racial divides, which which it certainly can
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  be. A lot of it is geographical,
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  and,
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  there are challenges with the rural health system
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  that we're facing.
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  I'm very inspired to be here because I
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  think I can make a bigger impact with
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  this open ground territory of rural America,
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  and I believe I'm connecting with the community
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  and it's it's very satisfying to do that.
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  That's amazing to hear. And, you know, certainly,
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  it's a very unique community. Each one is
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  a little bit different, but especially when you're
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  looking at rural health care and, you know,
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  those close knit communities that have been around
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  for so long. It just really has a
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  a unique air to it and, deep, deep
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  roots. Now when you think about the next
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  year or so, what do you think the
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  hardest thing you'll have to do, in the
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  coming year will be?
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  Figure out a way to pay for it
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  all. Because it's a question of penny wise
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  dollar foolish if if we don't invest in
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  our future and and we don't invest in
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  our people.
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  So how to invest in our people and
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  cultivate
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  their sense of professionalism
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  and do that in a way that improves
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  their clinical efficiencies
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  and improving the patient outcome.
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  At the same time, it's a tall task.
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  It it almost sounds like it's all transactional.
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  But if you take a couple of steps
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  back and create a vision
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  of what the new tools offer
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  and the context in which we
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  value professionals
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  at really at the top of their profession.
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  I'm not just talking about physicians and surgeons.
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  There's a profession in everything that we have
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  here. Our medical assistants, for example, are certified
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  medical assistants and they're aspiring to be LPNs
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  and nurses. And there's a career track that
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  that people can go on.
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  You know, there there are two things that
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  I tell everyone in our department when they're
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  first joining us.
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  One is
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  you're never alone.
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  You are not alone. You're not out there
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  in some remote location and you don't have
• 13:35
  any recourse.
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  I am a text away and we use
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  these apps that that put our clinical,
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  exam pictures
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  inside of the body
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  onto a secure post or into
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  our electronic health record. So you're never alone.
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  We're a second away, a microsecond away. And
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  the second is
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  that you should never be bored in our
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  department,
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  or I believe at Geisinger. There's so much
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  more to do. There's so much opportunity for
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  growth. There's so much more fulfillment that you
• 14:04
  can have through your professional career once you
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  just kinda
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  strap in and
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  go on the ride. It is so fulfilling.
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  I love that. And, you know, I I
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  think being able to have that type of
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  career where you're making an impact on people's
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  lives, on communities, and as you mentioned, you
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  know, you can be fulfilled,
• 14:23
  on daily basis. It makes a big difference
• 14:25
  on how you're showing up and the way
• 14:27
  you're able to connect with your patients and
• 14:30
  their families. Now when you look into the
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  future, where do you see some of the
• 14:33
  best opportunities for organizational growth?
• 14:36
  I would say that the more that we
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  build bridges and we learn from each other,
• 14:41
  I think the better off
• 14:43
  our mission will be fulfilled. And
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  I I would say that probably everyone I've
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  met at that Becker's community
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  and in every one of the meetings
• 14:52
  is buying into the same mission,
• 14:54
  to care for the community and to do
• 14:56
  it better.
• 14:57
  And that means that we can all be
• 14:59
  working together. I'm not talking about socializing or
• 15:02
  politics or anything like that. I'm talking about
• 15:04
  the idea of this national discussion, learning from
• 15:07
  each other, building bridges, getting to know each
• 15:09
  other, and learning from the lessons that we've
• 15:12
  we've, learned that have been successful and those
• 15:14
  that have not. That's actually scientific. It's the
• 15:17
  research literature.
• 15:19
  There's plenty of research out there that says
• 15:21
  we had an idea and it failed, but
• 15:23
  we learned that this idea doesn't apply here.
• 15:25
  And so I I think the more that
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  we can bring ourselves together, learn from each
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  other, perhaps through research forums, perhaps through these
• 15:32
  national meetings,
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  it's already happening when people move from one
• 15:36
  health system to another.
• 15:38
  But I I just love to see this
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  interprofessional
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  kind
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  of bigger that that, that comes out of
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  these discussions.
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  Absolutely. Yeah. You know? And I think that's
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  exactly what we're trying to do at Becker's.
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  I know you'll be at our annual meeting
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  in April, and and speaking on a panel.
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  So I'm excited to connect with you and
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  and see you and catch up in person
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  when while you're there. I'm sure we'll be
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  speaking on many of the same things that
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  that we've talked about today, and,
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  it'll be just amazing to have that type
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  of, you know, connections and relationships and opportunity
• 16:08
  to meet new people. So looking forward to
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  that. Yeah. So am I. It's always a
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  great time.