Latest / Becker’s Healthcare Podcast / Dr. Kapil Dhingra on Leadership, AI, and Value-Based Care at The Permanente Medical Group

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Dr. Kapil Dhingra on Leadership, AI, and Value-Based Care at The Permanente Medical Group · Becker’s Healthcare Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
• 0:04
  leaders together to unpack the most pressing issues
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  facing the industry.
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  And every year, those conversations shift in profound
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  and unexpected ways.
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  This April, more than 3,500
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  healthcare executives will return to Chicago for Becker's
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  sixteenth annual meeting. Seven ninety five elite speakers
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  will offer new lessons, new case studies, and
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  predictions about what comes next.
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  Join us April 13 through the sixteenth.
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  For the agenda and event details, visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right.
• 0:38
  This is Scott Becker with the Becker's Health
• 0:40
  Care podcast.
• 0:41
  I am thrilled today to be joined by
• 0:43
  a brilliant physician leader. We're joined today by
• 0:46
  doctor Kapil Dhingra,
• 0:47
  and doctor Dhingra is the physician in chief
• 0:50
  and health care executive at the Permanente Medical
• 0:53
  Group. He he serves specifically as the chief
• 0:55
  physician executive at the Kaiser Permanente San Leandro
• 0:59
  Medical Center.
• 1:00
  He also is the chief of staff at
• 1:02
  at the at that center.
• 1:04
  Doctor Dhingra,
• 1:05
  thank you for taking the time to join
• 1:07
  us today. I've been incredibly impressed by the
• 1:09
  Kaiser Permanente growth over the last thirty, forty
• 1:11
  years, particularly the quality that that that Kaiser
• 1:15
  Permanente has come to represent in the Permanente
• 1:17
  Medical Group. Can you take a moment to
• 1:19
  introduce yourself and and tell us a bit
• 1:21
  about yourself and your career?
• 1:23
  Great. Thank you, Scott, and I appreciate being
• 1:25
  on this podcast. I'm a big fan of
• 1:27
  Becker's and
• 1:28
  how you connect health care leaders from different
• 1:31
  areas together to improve health across our communities.
• 1:35
  So my name is Kapal Dhingra. I'm clinically
• 1:37
  trained as an emergency physician, and I'm the
• 1:40
  physician in chief and chief of staff at
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  Kaiser Permanente
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  San Leandro Medical Center, which is a city
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  just South of Oakland.
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  And we have multispecialty
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  clinics and hospitals that care for a little
• 1:51
  over 375,000
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  patients.
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  As you may know, Kaiser Permanente is an
• 1:56
  integrated health care system.
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  We're fortunate to take care of, just over
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  4,600,000
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  patients
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  across Northern California,
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  a very diverse area.
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  What's special about the territory that I have
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  a privilege of leading within is
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  that we are an incredibly
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  diverse
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  territory or service area,
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  and the diversity spans a lot of different
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  ways that makes me excited as not only
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  a practice position, but also to lead in
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  this space.
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  We have incredible socio ethnic diversity, socioeconomic
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  diversity.
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  We're on the tip of Silicon Valley, some
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  areas, and in some areas,
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  many of our patients are just above the
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  federal poverty line.
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  Another unique fact is that we speak over
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  88
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  different languages in the GSA. Please don't ask
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  me to name all of them for you,
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  but it it is truly a privilege to
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  to care for such a diverse population.
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  Thank you so much. And and and take
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  a moment, doctor Dingra. You've been a lifelong
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  learner.
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  You're you're a physician.
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  You've also gone back and done an MBA.
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  Talk about the commitment to lifelong learning and
• 3:04
  and why you've committed to it.
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  Thanks, Scott. I you know, lifelong learning for
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  me really came from my my father. I
• 3:12
  I learned a lot from my father. He's
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  a first generation
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  immigrant from India, and, he's a retired electrical
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  engineer.
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  Got some training in India. I went to
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  Columbia.
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  And, he was always learning. He was always
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  reading. He was
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  always educating and teaching, me things even when
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  I maybe
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  wasn't interested. But you kinda picked up on,
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  the power of of of so not only
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  improving oneself,
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  but doing it for something that you really
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  believe in.
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  And so I've always been super passionate about
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  health care and been interested in not only
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  delivery of of care, but the systems that
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  make that easier for physicians, for nurses, for
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  staff to do the work.
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  And,
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  it's it's a challenge because health care, in
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  particular, when you think about just even medicine,
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  we're always learning. There's new therapeutics. There's new
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  ways to deliver care. And now with health
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  care systems that are rapidly evolving with technology,
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  say artificial intelligence,
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  you really have to be alert. You have
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  to be willing to also be humbled because
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  things are changing so quickly and question our
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  status quo so that we can do better
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  for our patients.
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  Thank you, Nolan. I love that. I'm a
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  huge fan and and can't tell you enough
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  how much I'm a fan of people that
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  are lifelong learners.
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  And and your dad was an immigrant from
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  India, electrical engineer.
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  In in the household I grew up in,
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  you were allowed to be a and this
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  goes back a generation,
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  a doctor or lawyer or or an accountant.
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  Those were the three choices.
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  You ended up being a doctor. Did you
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  have multiple choices, or were your parents open
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  to you doing anything? I came from a
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  generation where my parents were not open to
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  me doing anything, so I ended up having
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  to do what they told me to do.
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  Tell me about that with yourself.
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  Yeah. Thanks, Scott. You know, my parents were
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  very supportive. They definitely,
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  first, they they preach the importance
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  of getting a better education. You know, I
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  have I have three kids, and my wife
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  and I always think about
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  our role is to love our children and
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  provide a supportive environment where they could be
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  their best selves, and I think I learned
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  that from my parents.
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  My my exposure to health care first off,
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  I'm the first physician in our family,
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  first in health care.
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  And the thing that got me into health
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  care was when my mother was diagnosed with
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  breast cancer, now a little over twenty five
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  years ago.
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  And I remember being in college, hearing about
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  the diagnosis. At the time, I was an
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  economics major and not quite sure where I
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  was headed. And
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  what ended up happening for me is is
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  I
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  saw the compassion
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  that she was treated by the nurses, by
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  the physicians, and the staff
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  when she had, you know, double mastectomy,
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  complications,
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  chemotherapy,
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  really a long road. As As we know,
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  breast cancer treatment has really evolved.
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  But what that did for me is it
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  exposed,
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  the potential to care for others,
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  and
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  that really made it easy to to want
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  to go into medicine.
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  The decision to pursue an MBA really came
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  from
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  wanting to help systems
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  improve. As an emergency physician, we're often at
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  the nexus
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  of everything that's happening in a hospital, in
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  a system. You see patients that maybe are
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  not receiving the most optimal care
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  or coming to you because you're their last
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  resort or patients who have very complex needs
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  are already getting tertiary care services,
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  and you're able to really see how systems
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  come together
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  across multiple pairs.
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  That always fascinated me, and that really led
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  me wanting to pursue an MBA and to
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  to lead and support others,
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  to make the work better for our patients.
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  That's fantastic. And and what a beautiful story,
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  what led you to medicine. I I I
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  thank you so much.
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  Fantastic.
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  Talk for a second about,
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  doctor Dhingra, what are you most focused on
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  and excited about
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  this year?
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  Well, there's a lot happening in health care.
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  You know, I I recently had an opportunity
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  to attend the JPMorgan Healthcare Conference, and, you
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  know, there's there's a lot of focus
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  certainly on the cost of health care. And,
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  you know, whether that's looking at
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  you know, the the CMS is looking at
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  how to eliminate fraud, waste, and abuse such
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  that it improves the the cost of care,
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  the total total spend in our on our
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  GP.
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  Obviously, GLP ones are still continuing to be
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  an area of focus given the cost of
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  pharmaceuticals,
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  but the great potential that they have is,
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  improving chronic disease.
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  And then this other piece that I think
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  all of us are talking about in any
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  industry, including my own kids all the time
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  is artificial intelligence
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  and how is that gonna show up. And
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  I recently
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  read a read a book that described artificial
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  intelligence,
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  as almost like electricity.
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  We didn't quite know what it was
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  when when it came out, but then soon
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  it became something that
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  all of us relied on all the time.
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  And so there's so much that health care
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  is learning with this evolution of of AI.
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  What I'm excited about
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  is that
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  I think our practice is gonna look different
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  in just a few years. And I think
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  that patients are gonna receive better care because
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  we're gonna have richer
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  information,
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  more nuance that is gonna be supported because
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  it's hard to be a clinician.
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  You have so many pressures on you,
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  and,
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  technology has such an amazing potential to to
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  help us. An area that I'm I'm very
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  proud of is, the in the Permanente Medical
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  Group, our CEO, doctor Maria Ansari,
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  she had the prescience to unleash
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  ambient listening technology
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  to all 10,000 of our physicians in Northern
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  California,
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  and the uptake has been amazing.
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  We're able to now
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  chart more effectively,
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  more quickly,
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  and accurately in a way that allows us
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  to spend more time with our patients.
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  So that's an example of an application. Many
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  of you have heard of these these technologies,
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  and more are coming. And that's what excites
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  me is to make it easier to do
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  the right thing.
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  Talk for a second about
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  technology,
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  doctors.
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  You started a few minutes ago
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  with some of the challenges in oncology,
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  or or your your your mom's
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  breast cancer.
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  Talk for a second about, if if you
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  don't mind, about oncology and information overload and
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  AI,
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  because it seems like oncologists in our country
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  with the aging population are just overwhelmed.
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  They have information overload.
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  At what point will that turn a corner
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  to where AI is really helpful to oncologist
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  versus just right now, people sort of feeling
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  like oncologist, particularly specialist, oncologist just overwhelmed.
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  Any thoughts there? And I know it's
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  a not planned question and a little bit
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  off base, but I'm curious to your thoughts
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  on this AI versus oncology. And AI in
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  some specials where you see this evolution.
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  You know, our our oncologists,
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  are doing heroic work. They are constantly
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  reacting to changes in data,
• 9:54
  changes in the science, the the new peer
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  reviewed articles that come out almost all on
• 9:57
  a daily basis.
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  Or, you know, another way is to think
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  about off label
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  therapeutics that can really improve,
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  cancer care.
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  And they need to sift through this information
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  on a daily basis. When I speak to
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  my oncology department and my chief,
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  you know, he is talking about how there's
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  there is this information overload.
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  Yet
• 10:19
  there are systems that are out there that
• 10:21
  can really look at multiple nodes of care.
• 10:23
  So whether it's care here in Northern California
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  or or care across the country about where
• 10:29
  those best practices live,
• 10:31
  how we can pull all that information together,
• 10:33
  and put it at the fingertips of an
• 10:35
  oncologist so she can make quick and rapid
• 10:37
  decision for our patients.
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  At Kaiser Permanente, you know, we have one
• 10:41
  of the largest oncology groups in the country.
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  And, one thing that we're very proud of
• 10:45
  is that we bring in multidisciplinary
• 10:48
  teams, whether it's oncologists or surgeons or radiologists,
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  and
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  look to make the most effective decision
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  that's personalized.
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  And that's the potential that we have with
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  artificial intelligence as well is we can personalize
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  care much like we're doing with many of
• 11:04
  the precision medicine to have the right treatment
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  that that you may need,
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  but also do it in a much quicker
• 11:11
  way. Reducing that cycle time
• 11:14
  from diagnosis to treatment
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  to recovery
• 11:18
  is critical, especially in cancer care. And what
• 11:20
  that will do for us is it'll improve
• 11:22
  health span for for our patients.
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  Thank you very, very much. And and and
• 11:27
  and take a moment, sort of trends you're
• 11:30
  watching right now, when talked about technology some,
• 11:34
  you you talked about the, you know, your
• 11:36
  most multicultural
• 11:37
  area,
• 11:39
  obviously, shortages of doctors.
• 11:41
  What are some of the trends that you're
• 11:42
  watching currently that you're most focused on, doctor
• 11:45
  Dhingra? So, Scott, I'm thinking about our workforce
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  all of the time. And, you know, I
• 11:50
  think one of the benefits of of being
• 11:52
  a clinical leader is
• 11:54
  you get to
• 11:55
  see and experience
• 11:57
  what our people are experiencing
• 12:00
  twenty four hours a day
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  and then have the privilege of understanding those
• 12:04
  issues and putting in systems that that make
• 12:06
  you successful.
• 12:07
  And so I I think about our 800
• 12:09
  physicians.
• 12:10
  I think about our over 3,000 staff here
• 12:13
  and the work that they do. And
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  I I think about you know, we talked
• 12:18
  about the complexity of of being a clinician
• 12:20
  in this day and age and the requirements,
• 12:23
  and the potential of the technology.
• 12:25
  And so what I what I think a
• 12:26
  lot about is this is how do we
• 12:28
  make that work more seamless, more easy? How
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  do we reduce waste
• 12:32
  that doesn't add value to the patient's journey?
• 12:35
  And I and I think there's a lot
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  of potential certainly in artificial intelligence, but I
• 12:38
  also think there's a there's a human component
• 12:40
  that I wanted to spend a little bit
• 12:42
  of time on, which is the power of
• 12:44
  listening.
• 12:45
  Ultimately,
• 12:45
  you know, as as health care leaders, we
• 12:47
  have lots of great ideas, we have experience,
• 12:50
  But truly, to get to the most effective
• 12:52
  solution, you have to listen.
• 12:53
  You have to constantly be listening to to
• 12:55
  your people,
• 12:56
  what their ideas are,
• 12:58
  and and really, they're gonna provide the breakthrough
• 13:01
  performance for us to be successful. I always
• 13:03
  say our people point us in the direction
• 13:04
  we need to go. Our job is to
• 13:06
  make the pathway smoother.
• 13:08
  Thank you. And and and doctor Dingle, let
• 13:10
  me ask you this question. You had mentioned
• 13:12
  the first name is Capelle, like like David
• 13:14
  Chappell, but Capelle
• 13:16
  and and so I guess the question for
• 13:18
  you is,
• 13:20
  is he funnier than you, or do you
• 13:22
  win that that that award?
• 13:24
  So I I would say that it depends
• 13:27
  on who you ask. If you ask my
• 13:28
  kids, they would say Dave Chappelle's a lot
• 13:30
  funnier because my dad jokes to hold the
• 13:32
  candles.
• 13:33
  But, yes, it's, my name does rhyme with
• 13:36
  Dave Chappelle.
• 13:37
  You're so fantastic.
• 13:39
  And and and talk a little bit about
• 13:41
  you've had this great career, emergency physician by
• 13:44
  background,
• 13:45
  and then physician in chief, leadership career. What
• 13:48
  was the transition like from straight practice to
• 13:51
  to transitioning to leadership and practice? Talk about
• 13:54
  that for a moment.
• 13:56
  So, Scott, you know, in the Permanente Medical
• 13:59
  Group, we are a physician led and physician
• 14:01
  owned medical group. Our CEO
• 14:03
  is is a physician. We have a a
• 14:05
  board of directors
• 14:07
  that are physician led that partners closely with
• 14:09
  our our Kaiser Foundation Hospital and Health Plan.
• 14:13
  And one thing that is in that attracted
• 14:15
  me to this this opportunity because, you know,
• 14:17
  you you come out of residency and there's
• 14:19
  so many choices. You could be in an
• 14:21
  academic practice. You could be in a in
• 14:23
  a large integrated health care system like ours.
• 14:26
  You could go into a smaller private practice.
• 14:28
  But But one of the things that attracted
• 14:30
  me to the permanent medical group was mentorship.
• 14:33
  I really appreciated the ability
• 14:36
  to be around,
• 14:37
  physician leaders that were passionate,
• 14:39
  supported by administrative leaders who saw the mission
• 14:43
  of what value based care is that, you
• 14:45
  know, we were real our incentives are truly
• 14:47
  aligned around improving outcomes because everything else falls
• 14:51
  the derivative from that, including finance.
• 14:53
  And so when I when I think about
• 14:55
  that in my journey,
• 14:57
  you know, one thing that I still feel
• 14:59
  strongly about is maintaining my clinical practice. Now
• 15:01
  it is smaller than when I first started
• 15:03
  as a new emergency physician,
• 15:05
  yet what it what it again does is
• 15:07
  it it strengthens your leadership. And the transition
• 15:10
  initially was challenging in that, you know, you're
• 15:12
  trying to balance, really two full time jobs.
• 15:15
  But over time, you realize that your clinical
• 15:18
  role really supports your leadership practice.
• 15:20
  And,
• 15:21
  I still enjoy seeing patients. It it brings
• 15:23
  me a lot of joy, and a lot
• 15:25
  of times I get less text messages than
• 15:26
  I might get when I'm seeing my seeing
• 15:29
  patients.
• 15:30
  But it but it really is a joy
• 15:31
  and really what drew me into medicine in
• 15:33
  the first place.
• 15:35
  Thank you very, very much. No. I I
• 15:37
  absolutely love that.
• 15:40
  Thank you. Any advice to emerging leaders wanting
• 15:42
  to have impactful careers?
• 15:45
  Yeah. I would say there's probably two things
• 15:47
  that that I think of.
• 15:49
  The first thing is is is
• 15:51
  surround yourself with mentors
• 15:53
  and start asking the question of who are
• 15:55
  my mentors
• 15:56
  because,
• 15:57
  whether those are people that you work shoulder
• 16:00
  to shoulder with or maybe those are outside
• 16:03
  of your practice or your discipline is is
• 16:05
  really having that feedback loop and circle. Because
• 16:08
  as you ascend in leadership, it can sometimes
• 16:10
  feel lonely. And you may not always get
• 16:12
  that feedback that's important for you to be
• 16:14
  a better person, be a better leader. But
• 16:16
  when you when you create that mentorship
• 16:18
  circle and you get to know people across
• 16:20
  health care,
• 16:21
  you really get the feedback that helps you
• 16:23
  be, frankly, a better person too.
• 16:25
  The other advice I give,
• 16:27
  emergent leaders is
• 16:29
  the power of yes. Consider saying yes,
• 16:32
  and particularly say yes when you're not sure
• 16:35
  of yourself.
• 16:36
  Oftentimes, when I approach an emerging leader and
• 16:38
  I I have a project or an idea
• 16:40
  or a need,
• 16:42
  and they they you know, we've all been
• 16:44
  there. I've been there before experiencing that sense
• 16:46
  of imposter syndrome. Am I good enough to
• 16:48
  do this this big audacious task I was
• 16:50
  asked?
• 16:51
  Well, oftentimes,
• 16:52
  you are because that's why someone asked. And
• 16:55
  it's taking that leap of faith and learning
• 16:57
  and understanding that it may not go as
• 16:59
  well as you planned. You might fail at
• 17:01
  it, but, ultimately, you're gonna grow through that.
• 17:03
  And so my my two piece of advice
• 17:05
  to get mentors,
• 17:06
  just say yes.
• 17:08
  No. I I I love that. And there's
• 17:10
  this great concept, particularly as you're evolving your
• 17:12
  career,
• 17:13
  to constantly say yes to new experiences, new
• 17:15
  opportunities, and not be secured to. I mean,
• 17:17
  you almost have to stretch yourself to grow
• 17:19
  and figure out what you're gonna be great
• 17:20
  at, what you're gonna love. And then at
• 17:22
  some point in your career, you have to
• 17:23
  learn to say no too. But I think
• 17:25
  this concept, you know, it's it's probably not
• 17:27
  till you're 50 that you start to say
• 17:28
  no all the time and much or that
• 17:30
  that's the right timing or date. But but
• 17:31
  I think saying yes to opportunities,
• 17:33
  not being scared of them, and you're as
• 17:35
  good as anybody else, do it and try
• 17:37
  it and go for it. You know? And
• 17:39
  and if it doesn't go great, you move
• 17:41
  on to the next thing that you love.
• 17:42
  But I think that advice
• 17:44
  is such important advice, and it gets so
• 17:46
  mixed in the busy world today where people
• 17:48
  are taught so much. Oh, you gotta say
• 17:50
  no. You gotta protect your time. You gotta
• 17:51
  do this. You gotta do that. And I
• 17:52
  think that's saying yes. Most of us got
• 17:54
  to where we got to prevent success. And
• 17:56
  being an emergency physician, being a physician in
• 17:58
  chief,
• 17:59
  you teach at Berkeley. By ultimately saying yes
• 18:02
  to opportunities,
• 18:03
  and not viewing yourself as so closed off
• 18:05
  that you can't take on those opportunities,
• 18:07
  and I think it's great, great advice. Doctor
• 18:09
  Dhingra, thank you so much.
• 18:11
  Thanks, Scott. And I I appreciate the opportunity
• 18:13
  to to to be with Becker's. And,
• 18:16
  really, I I do think this is such
• 18:18
  an amazing forum that you all have created
• 18:20
  because you get to hear from health care
• 18:21
  leaders across the country
• 18:23
  that offer such amazing perspectives and grow the
• 18:26
  grow the health of this entire community.
• 18:29
  Well well well, thank you. It's amazing to
• 18:30
  me to watch over the thirty four years
• 18:33
  I've been doing this, the evolution
• 18:35
  of Kaiser Permanente into the quality that Kaiser
• 18:38
  brings to the health care to the health
• 18:40
  care world. Just literally amazing culture that's been
• 18:42
  developed there. So, thank you for taking the
• 18:44
  time to join us, and share your experiences
• 18:47
  and share your experience with Kaiser. I think
• 18:48
  you've been at Kaiser for fifteen, twenty years
• 18:49
  now. Right?
• 18:50
  That's correct. That's correct. Actually, my, little little
• 18:53
  story on that is,
• 18:54
  as a my professional career as an attending
• 18:56
  physician and physician leader is is just over
• 18:59
  sixteen years.
• 19:00
  I actually trained at a joint Kaiser Permanente
• 19:03
  and academic program at UC Davis.
• 19:06
  And when I was a college student at
• 19:08
  UC Berkeley,
• 19:10
  my first part time job was working at
• 19:12
  the Permanente Medical Group where I supported
• 19:14
  access and service assessment in the econometrics department.
• 19:18
  And so I've been
• 19:20
  fortunate, like you said, to be part of
• 19:22
  an organization that has a rich history
• 19:24
  over over seventy five years of mission driven
• 19:27
  value based care.
• 19:28
  And, you know, we've had our ups and
• 19:30
  our downs, but what's been consistent, what keeps
• 19:33
  me here,
• 19:34
  why my own family and friends get care
• 19:36
  at Kaiser Permanente is our mission. We truly
• 19:39
  care about our patients and the communities we
• 19:41
  serve.
• 19:42
  Thank you so much. And and, doctor Dhingra,
• 19:44
  what a pleasure to visit with you and
• 19:46
  and tell the kids you're funnier than Dave
• 19:48
  Chappelle. I don't I don't take it. I
• 19:49
  don't I don't believe it. Thank you so
• 19:51
  much. Thanks, Scott.