Latest / Becker’s Healthcare - Clinical Leadership Podcast / Amir Barzin, DO, President of UNC Health Faculty Physicians and Chief Operating Officer of UNC Health Physicians

Transcript

Amir Barzin, DO, President of UNC Health Faculty Physicians and Chief Operating Officer of UNC Health Physicians · Becker’s Healthcare - Clinical Leadership Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
• 0:51
  - Hello everyone. Welcome to the Becker's Healthcare Clinical
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  - Leadership podcast.
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  - I'm Mackenzie Bean, associate vice president and managing
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  - editor of Becker's
• 1:00
  - Hospital Review.
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  - Today I'm joined by Doctor. Amir Barzin, who
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  - is president of UNC Health Faculty Physicians and
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  - chief operating officer of UNC Health Physicians.
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  - Doctor. Barzin, thanks for joining us on the
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  - podcast today.
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  - Thanks, Mackenzie. I'm really glad to be here
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  - with you today.
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  - We're excited to have you and,
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  - get into the conversation. I thought you could
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  - start off maybe sharing a little bit more
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  - about,
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  - your role and background
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  - and of UNC Health
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  - in general to help kind of ground the
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  - audience listeners.
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  - Yeah. Happy to do so. So, you know,
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  - just as a little bit about myself, I'm
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  - a family medicine physician by background and training,
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  - and I've been fortunate in the world of
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  - family medicine to do full spectrum care.
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  - And that's buried in my career in different
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  - ways that I've done that and working at
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  - an emergency room in a critical access hospital
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  - or doing inpatient medicine or outpatient medicine or
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  - labor and delivery.
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  - And, I think that that's really helped me
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  - have a broad spectrum or perspective on the
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  - work that's necessary to meet our communities at
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  - where they're at for their health needs.
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  - And that's given me the opportunity to to
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  - step into some leadership roles that have gotten
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  - me to where I am today and being,
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  - our president for our faculty physician group that
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  - oversees the clinical work
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  - of our 20 clinical chairs that we have
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  - here at UNC and how they interact with
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  - our healthcare system.
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  - And, over the past year, I've also served
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  - as our chief operating officer for our UNC
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  - health physicians group.
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  - And that has allowed me, as we're thinking
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  - about our mission, to be both a community
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  - and academic powerhouse that serves the need of
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  - the state of North Carolina.
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  - It's really thinking about the ability to see
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  - through
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  - both our community and academic group
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  - and support services like what we do in
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  - care access, physician recruitment, network development, our virtual
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  - care strategy,
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  - and that has been brought together under our
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  - umbrella, UNC Physicians Group. So gives me a
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  - little bit of picture to see the the
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  - wide spectrum of what we're doing as a
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  - system, and then also narrowed into what we're
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  - doing as an academic arm to ensure that
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  - we're maintaining our mission.
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  - Yeah. I think it's helpful for the listeners
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  - to understand your role. And as I understand
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  - it, you're really serving as a bridge builder
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  - between the faculty physicians and then hospital administration
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  - and leadership. And I think historically, there can
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  - be this idea that those two groups don't
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  - always necessarily speak the same language every day.
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  - So I'm curious in in your sort of
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  - dual role, what have you learned about translating
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  - between those two worlds? Is there something you
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  - think administrators
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  - understood better about faculty positions or vice versa?
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  - Yeah. It's a it's a wonderful question.
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  - And,
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  - I think that to get to the point
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  - of how that interaction works, it's it's probably
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  - helpful to understand who we are at UMC
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  - Health. So when we started off as a
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  - health care system that was really designed to
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  - serve the state of North Carolina,
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  - it it was really localized
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  - within the walls of a medical center that's
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  - a a quaternary academic medical center here in
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  - Chapel Hill.
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  - And over the years, we've evolved to this
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  - health care system that's spread across the state
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  - and is serving,
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  - from the mountains to the coast,
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  - 20 different hospitals.
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  - We have our ability to be, in academic
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  - work and in community work, and it really
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  - has evolved us to to think differently about
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  - the way that we interact. And one of
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  - the things that I think is very important
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  - to the point that you've said
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  - is that you have to have alignment between
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  - your work force, whether that's a physician or
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  - an APP
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  - or other clinicians that are doing the work,
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  - and the resources and the ability to provide
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  - care in a hospital based setting, if that's
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  - where you're at, or an ambulatory based setting.
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  - So what we have to do better as
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  - a as a team is come to alignment
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  - on
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  - what are the key motivators or key areas
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  - that we wanna be focused on, and how
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  - do we wanna get to that end game
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  - goal of providing that care
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  - and doing that synergistically together. And so that
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  - has required us to have more, more open
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  - conversations, more candid conversations, even down to the
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  - level of how do we budget together
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  - so that we don't have,
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  - abnormal growth in one area that may not
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  - be an area of emphasis for, like, a
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  - hospital, for example,
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  - that may,
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  - may cause some some problems down the line
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  - if we over invest in one area or
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  - under invest in another area. And that's an
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  - area that we're working on and doing, what
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  - I would say really well at UNC is
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  - trying to make sure that we have that
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  - alignment from day one, and we're really working
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  - side by side. I consider,
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  - one of my closest partners, we actually,
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  - have our start date for our positions to
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  - be the same, to
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  - just know that we're starting together in this
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  - journey of being both the UNC Medical Center
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  - Hospital president and the UNC faculty physician president,
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  - and really doing that together hand in hand,
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  - is very important in us being able to
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  - be successful as a whole.
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  - And I imagine there's both cultural elements and
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  - then also just operational administrative elements that really
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  - support that integration and alignment in so many
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  - ways, even to something as, like, a start
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  - date.
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  - Yeah. And and there's there's a layer of,
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  - the executive level of working together to strategize
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  - and come up with a great plan, but
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  - there really has to be incorporation of all
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  - of that,
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  - from every layer of your team down to
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  - the the ground level work that's being done
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  - across the system.
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  - So it's it's not this philosophy or concept
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  - that I think that sometimes we think about
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  - whenever there's a a tension point is that,
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  - well, one administrator or one leader doesn't see
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  - eye to eye with another one.
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  - That's not the reality. It's the reality is
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  - that there there's gotta be alignment in understanding
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  - why we're working together across the board.
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  - And so it really starts with a clear
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  - vision and a clear plan, but everyone in
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  - that whole book has to be involved in
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  - in buying into the philosophy.
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  - Mhmm. And one thing that really grounds us
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  - is that our our mission is grounded in
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  - serving the people of the state of North
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  - Carolina.
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  - So there's not a single person that is
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  - in our group that doesn't buy into that
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  - understanding of that mission. We can always come
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  - back to that and say, well, what are
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  - we doing to make sure that our patient
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  - experience is better? And that's a really key
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  - part of why we need to work together.
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  - Mhmm.
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  - I'm curious, like, what do you think the
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  - largest misconceptions
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  - are? Not necessarily even at UNC, but just
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  - generally between the two groups where if both
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  - sides just understood each other a little bit
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  - more, you know, you'd see that better integration
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  - or the efficiency come.
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  - I think
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  - as health care systems are evolving
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  - and if we look at external pressures that
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  - are evolving and
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  - and that that's a big bucket, but we
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  - can maybe simplify it for the sake of
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  - this discussion to, like, let's just talk about
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  - financial impacts. Right? Mhmm. And let's just say
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  - that the financial impacts are the area of
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  - emphasis, and there's the stressors of,
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  - payment structure that's going on or contracting structures
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  - that are going on that that decrease at
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  - the end of the day
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  - the way that an operating
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  - budget can function for someone. It's very easy
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  - from one lens to look at that and
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  - say, the finance numbers don't make sense.
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  - It's very,
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  - easy to look at it from one lens
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  - to say,
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  - I've got three physicians that are working twenty
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  - four hours a day, staffing our OR because
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  - that's the only capacity that we have for
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  - our physicians.
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  - And then when you put the two together,
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  - you can see that there's, like, this very
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  - clear
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  - moment
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  - of saying,
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  - it's not in our best interest to not
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  - help fully support and give the resources and
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  - the tools that are necessary to grow a
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  - sustainable workforce because we know at the end
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  - of the day, actually, turnover costs us more,
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  - especially in high value or or high salary
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  - positions.
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  - So if we just think a little bit
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  - more clearly about that together, you can see
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  - how it kinda layers on top of each
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  - other to come to a more cohesive plan.
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  - And I think that that's one area where
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  - sometimes if you if you don't come together
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  - early and often and talk about it
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  - in in the same room, in the same
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  - context, with the same core values,
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  - you may see this divide. And that's where
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  - I think sometimes you feel the tension between
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  - an administrative function and a physician function, and
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  - then how do the leaders interact together. That's
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  - where sometimes you feel that.
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  - I'm fortunate to work in an organization where
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  - we're we're really working on revamping that and
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  - and engaging in true partnership
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  - from day one. So
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  - Mhmm. Yeah. I think it's a very
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  - valid watch out to flag.
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  - Let's zoom in though on some pretty impressive
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  - results that you've been able to achieve at
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  - faculty physicians under your leadership.
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  - As I understand it,
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  - you were able to,
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  - help see 9,000 more new patients than projected
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  - over the past year and really at a
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  - faster rate than
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  - before.
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  - Can you talk through
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  - what what led to that success? What actually
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  - changed operationally or culturally to make that happen?
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  - Thanks for asking that. This is one of
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  - the things that I think I, if I
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  - were to look back on this year,
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  - they even would I would have said that
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  - this would have been a huge stretch goal
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  - for us in a way that we were
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  - working and the way that we were starting
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  - our our footing.
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  - But it's just the,
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  - amazing work of an incredible team and a
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  - few people that I'll mention that have just
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  - been just so pivotal to this. But
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  - we came together early, talking back earlier about
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  - aligning on core values and core missions.
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  - What we understood
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  - as as we were evolving as a health
• 10:50
  - care system is, maybe our support structures in
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  - the way that we approached our work and
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  - access didn't evolve
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  - from the singular department level to more of
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  - a system wide lens and view. So
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  - we very quickly identified,
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  - as a health care system, that we we
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  - have value in going into a common access
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  - center that has visibility across the board.
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  - And so, for example, in primary care, we
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  - have this flexibility to say that patients, if
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  - they call for an appointment at one spot
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  - that maybe has a little bit of a
• 11:24
  - delay in time,
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  - our team can look to try to find
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  - them a new clinic that's close to them
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  - or has more availability,
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  - or we can latch them into our virtual
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  - care team to start their journey with us
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  - as they're waiting for that appointment for that
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  - one person they really wanna see. Those are
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  - some of the examples of how we evolve
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  - to be able to better fit the needs
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  - of people.
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  - And our access team, which is led by
• 11:47
  - Ashley Arie, took a really deep dive and
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  - partnered with our departments
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  - in our specialty care groups
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  - to say, let's just make sure that we
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  - have the right view of getting the patients
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  - in. Let's make sure that when you say
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  - you're going to an outpatient clinic for the
• 12:02
  - day,
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  - do you have enough slots to see new
• 12:05
  - patients?
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  - What do we need to do to help
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  - you maximize the way that that looks on
• 12:09
  - a schedule so that patients can actually get
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  - in there and be seen? And then we
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  - know that that patient behavior is really important
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  - in this. So what tools can we do
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  - so that we give patients the opportunity to
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  - move their appointment up if a new if
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  - a slot opens up because someone had to
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  - cancel?
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  - So these are all parts of the the
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  - the moving wheel that we have had. We
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  - worked in, and Ashley's team did a tremendous
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  - job of working together with departments to to
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  - redo template design. Then we leveraged our tools.
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  - Like, one of our tools that's been very
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  - successful is FastPass. And so,
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  - we're an epic based program, and so FastPass
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  - enables us when a when a visit opens
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  - up
• 12:48
  - to send a text to people who are
• 12:49
  - enrolled in it to say, hey. An earlier
• 12:51
  - appointment is available. Do you wanna take it?
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  - So we're we're able to keep schedules full
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  - more often.
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  - And we also then realized that we had
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  - to invest in the provider workforce to see
• 13:02
  - more new patients. So as we were growing,
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  - we didn't just approach this from saying, add
• 13:07
  - more people to see patients. We said, let's
• 13:09
  - take take it down to the bones and
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  - rebuild it the way that we would wanna
• 13:13
  - try to see it.
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  - It's still evolving, and every day, it'll continue
• 13:17
  - to evolve as our AI tools become,
• 13:19
  - stronger and more used. But it is something
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  - that we are very proud of is that
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  - that's that's 9,000 more patients that started in
• 13:27
  - our system that really needed care at a
• 13:29
  - Courtenay Medical Center with a specialist, and and
• 13:31
  - we're very excited to be able to do
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  - that. So, it was a huge win for
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  - us this past year.
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  - Yeah.
• 13:38
  - Amazing to hear that accomplishment. I think it
• 13:40
  - speaks to a trend I'm
• 13:42
  - really seeing talking to so many physician
• 13:45
  - leaders in terms of really reimagining
• 13:48
  - access and what primary or specialty growth looks
• 13:51
  - like of, like you said, not just expanding
• 13:53
  - your workforce or adding new physical sites, but
• 13:55
  - really using technology and other creative ways to
• 13:57
  - to redefine access really.
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  - Yeah.
• 14:01
  - I know you're also
• 14:02
  - very passionate and focused on,
• 14:05
  - technology
• 14:06
  - as it relates to also unburdening physicians or
• 14:09
  - bringing back the joy in medicine. You obviously
• 14:12
  - mentioned a lot of technology to help improve
• 14:13
  - access in the patient experience, but can you
• 14:15
  - talk about that really from the physician perspective
• 14:18
  - or
• 14:18
  - effort you're proud of?
• 14:20
  - Yeah. I think one thing that our system
• 14:22
  - has done really well, and kudos to our
• 14:24
  - our,
• 14:25
  - executive leadership team for thinking about this. It's,
• 14:29
  - I mentioned before long term sustainability
• 14:31
  - and and, like, making sure that the people
• 14:34
  - who start working with us stay with us.
• 14:36
  - And burnout in the physician workforce is is
• 14:39
  - a huge problem,
• 14:41
  - and that has looked different and for different
• 14:43
  - people. But if there are opportunities for us
• 14:45
  - to to make ease of practice better, then
• 14:49
  - we should do that.
• 14:51
  - And so, as part of our strategic planning,
• 14:54
  - we set up a group that was look
• 14:55
  - as that was laser focused on just that.
• 14:58
  - How do we make the practice of medicine
• 15:00
  - easier for those that are doing it? And
• 15:03
  - two things emerged. And,
• 15:05
  - we we adopted,
• 15:08
  - pretty early on a ambient listening tool that
• 15:11
  - would help us in our scribing.
• 15:13
  - And it has made a world of difference,
• 15:15
  - especially for our our high outpatient clinicians
• 15:18
  - who see a lot of patients. They they
• 15:20
  - have the ability to connect with our ambient
• 15:22
  - listening tool. They have their notes transcribed for
• 15:26
  - them. They get to spend more time looking
• 15:28
  - at the patient, being in the patient room,
• 15:30
  - like, really enjoying that relationship that's there.
• 15:34
  - And the feedback has been phenomenal.
• 15:37
  - And and many people like, one of the
• 15:39
  - quotes that I remember from one of our
• 15:41
  - providers was, like, I was to the point
• 15:42
  - of where I didn't know if I could
• 15:44
  - sustain working in medicine anymore because the burden
• 15:47
  - of the notes was getting to be too
• 15:49
  - much, and and this has changed everything.
• 15:53
  - And so that would if you can do
• 15:55
  - that for someone, that is such a huge
• 15:57
  - joy, and that is such a win. And
• 15:59
  - so we're lucky that we have that live
• 16:01
  - across our system. So any any provider that
• 16:04
  - is seeing patients can use our Ambient Listening
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  - tool.
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  - And then we took it a step further.
• 16:10
  - We we get a lot of complicated referrals
• 16:12
  - as a coordinator
• 16:13
  - medical center. So we get people with very
• 16:15
  - complex medical conditions. And you can imagine if
• 16:18
  - you're an IBD specialist,
• 16:21
  - and you're sitting down to digest all the
• 16:23
  - information that's there,
• 16:25
  - there may be things that we see in
• 16:26
  - paper records
• 16:28
  - that are lost in translation or we never
• 16:31
  - get the paper records or, for example,
• 16:33
  - it was in somewhere in Epic in a
• 16:36
  - Care Everywhere tab or in a Media tab.
• 16:40
  - And you kinda the old process would be
• 16:42
  - you comb that, and you would have to
• 16:44
  - spend the time, like, opening every single document
• 16:47
  - and looking at it.
• 16:48
  - We we have a a digital summary tool
• 16:51
  - that we have used and has made life
• 16:54
  - so much better for for our our clinicians.
• 16:57
  - So you can, with a prompt,
• 16:59
  - be able to go in and say,
• 17:01
  - I'm seeing this person for concern
• 17:04
  - of,
• 17:05
  - a VTE.
• 17:06
  - Tell me their clot history, what medications they've
• 17:09
  - been on, when they started and stopped, and
• 17:11
  - why they did that. And it really produces
• 17:13
  - this beautiful summary. So what would have taken
• 17:16
  - me thirty minutes, forty minutes, fifty minutes
• 17:19
  - to do by hand is now spit out
• 17:21
  - to me in like ten minutes. And that
• 17:23
  - is a huge time saver. So then feeds
• 17:25
  - into the ability. Again, if you have that
• 17:27
  - time back, maybe you can see more patients.
• 17:29
  - Right? And so that's been a a a
• 17:32
  - huge,
• 17:33
  - win for us as well as a health
• 17:34
  - care system as well. Mhmm. Yeah. Sports access,
• 17:38
  - patient experience, and the physician
• 17:40
  - experience. And patient safety too. Like, if we
• 17:42
  - have all of the ability to know what
• 17:43
  - has happened to them,
• 17:46
  - that's good for the patient to be able
• 17:48
  - to know their whole care and and not
• 17:50
  - revisit things that were either, like, failure therapies
• 17:52
  - or or therapy failures
• 17:54
  - or things that didn't work for them in
• 17:56
  - the past. Now now we have that on
• 17:58
  - our tool. So we really do think that
• 18:00
  - it it hits all of the points of
• 18:01
  - the mission of great high quality care. Mhmm.
• 18:05
  - Well, Doctor. Barzin, talking to you, it's
• 18:08
  - no surprise why
• 18:09
  - UNC faculty physicians is, having such amazing results.
• 18:13
  - You're such an impressive leader, and I just
• 18:15
  - wanna thank you for taking some time to
• 18:16
  - join us on the podcast and share your
• 18:18
  - insights.
• 18:19
  - Yeah. Mackenzie, thank you for the time and
• 18:21
  - and truly is a fantastic team
• 18:24
  - that we get to work with here at
• 18:25
  - UNC, and we wouldn't be anywhere without just
• 18:28
  - the tremendous amount of work for from everyone.
• 18:31
  - And it's just a joy to have had
• 18:32
  - this chance to talk to you. Yeah. I
• 18:35
  - feel safe. So thank you again, doctor Parson.