Latest / Becker’s Healthcare - Clinical Leadership Podcast / Nariman Heshmati, MD, MBA, FACOG, Chief Physician and Operations Executive at Lee Physician Group

Transcript

Nariman Heshmati, MD, MBA, FACOG, Chief Physician and Operations Executive at Lee Physician Group · Becker’s Healthcare - Clinical Leadership 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,
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  Cleveland Clinic, CommonSpirit and more, the conversations get
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  real. Leaders will share how their scenario planning
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  for policy shifts, breaking through value based care
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  barriers, and building clinical teams that translate
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  This is Laura Dirda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Nari Hashmati, chief physician and operations executive
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  at Lee Physicians Group in Fort Myers, Florida.
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  Doctor Hashmati, it's a pleasure to have you
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  on the podcast today.
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  Thanks for having me.
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  Absolutely. Now I'm excited for our conversation because
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  I know there's so much happening in health
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  care right now and and particularly, you know,
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  for physicians and clinicians. It's just been a
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  particularly,
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  interesting couple of years and then, you know,
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  will continue to be a lot of evolution.
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  So, I'm looking forward to getting your perspective
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  on all of those things. But before we
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  do, can you tell us a little bit
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  more about yourself and lead physician group?
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  Yeah. Yeah. So, Narayesh, Mani, I'm an OBGYN
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  by training.
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  I am the chief physician operations executive for
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  Lee Physician Group. We are a 1,300
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  plus,
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  clinician
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  group,
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  based down in Fort Myers. We're at a
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  100 different outpatient sites, and we are part
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  of the Lee Health System,
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  which is a five hospital, four adult, one
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  children's hospital system down in Southwest Florida.
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  Awesome news in here. And, you know, what
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  a huge,
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  population that you're accountable for and group that
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  you have. I mean, that's incredible and impressive
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  to think about. Now, you know, when you
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  look at the last year or so, could
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  you tell me about initiative that you're most
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  proud of? What did you do, and what
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  were the results?
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  Yeah. I mean, it's really hard to pin
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  down one initiative because I feel like in
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  health care, we're getting pulled in so many
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  directions. There's so many deliverables that we're having
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  to do. You know, I I think, ultimately,
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  if I had to choose one thing, it
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  always comes down to patient care because we
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  do this to make sure we take care
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  of patients.
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  And, you know, we took a look at
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  our patient population. And we're starting to have
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  a lot more chronic disease management programs. How
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  do we keep people healthy? How do we
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  move from just acute episodic care to you're
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  sick and you come in, to how do
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  we fully manage your care to avoid you
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  coming in necessarily for hospitalizations or things like
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  that? Doctor. David Trainer (zero twenty three:fifty seven):
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  And, you know, one of the big targets
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  out there is diabetes. So we took a
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  look at how many patients saw us who
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  had type two diabetes and who didn't have
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  good control when you check their hemoglobin A1C.
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  And we designed a program
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  where we reached out to patients, got them
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  enrolled, set them up with a dietician for
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  counseling, talked about exercise,
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  walked through how do you manage your diabetes,
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  how do you check your blood sugars, all
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  those things that we just assume
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  take place,
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  but we really wanted to hammer those down.
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  And then we connected them with a clinical
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  pharmacist,
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  to try to get rapid management of medications.
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  You know, what we ended up seeing is
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  the first three, four hundred people we've enrolled
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  in this, we've, we've reduced their hemoglobin A1Cs
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  by an average of about 1.7.
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  And that's a huge number.
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  And so we were really happy about that
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  because, you know, we try to translate the
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  things we do into the impact they have
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  on our communities.
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  If you take a look at the data
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  out there,
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  that kind of a reduction in hemoglobin a
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  one c in a poorly controlled diabetic
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  probably adds two, three years to their life
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  expectancy. And so, you know, that's an important
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  thing for us. We just we just passed
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  the holiday season. And so that program allowed
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  a couple 100 peoples to potentially spend three
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  more holidays with their families.
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  Oh,
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  that's amazing to hear. And, you know, really
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  important when you think about it that way
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  and you look at the actual impact on
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  patients and their lives and and the families
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  that,
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  you know, are able to spend more time
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  with them. I love that kind of as
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  a measurement and the metric to really tell
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  the story of what health care is trying
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  to do.
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  And, you know, it's really interesting to have
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  that kind of focus and build this program,
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  in order to better manage,
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  patients with diabetes and, some of those chronic
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  care issues. So I think when you were
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  setting up the program,
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  you know, how did you do that,
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  and what, you know, really did you learn
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  throughout the process, especially for other organizations that
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  might be wanting to try to do something
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  similar or see a similar need within their,
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  communities?
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  Yeah. Yeah. You know, I I think one
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  of the things we just have to take
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  a step back and look. You know, often
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  when you look at worldwide rankings,
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  people will comment that there are areas of
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  the world that provide better health care than
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  The US. And I would push back on
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  that. I think we have some of the
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  greatest healthcare and some of the greatest advancements
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  in healthcare in The US of anywhere else
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  in the world. I think the challenge we
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  have is healthcare systems are complicated. They're hard
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  to navigate.
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  And so, you know, we see that every
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  day I get texts, phone calls from friends,
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  neighbors, colleagues, and they've got something, and they
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  wanna know how to navigate that. And so,
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  you know, a lot of this started from
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  saying, let's look at it from a patient
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  lens. If you are a type two diabetic,
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  why would you not have control?
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  What are all the things that you've gotta
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  do to get control? And how do we
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  make that easy? And how do we do
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  it? And, you know, when we started looking
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  at this, we we said we're not gonna
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  have any any preconceived notions of how things
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  were done, meaning we don't want any barriers.
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  Just let's design what would be the easiest,
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  most accessible to get those improvements and outcomes,
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  and then let's see if we can do
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  it.
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  And, you know, when you really when you
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  parallel it, if you think about it, it's
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  been a very long time that we've had
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  coordination of care in cancer centers around the
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  country. And the thought is,
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  cancer
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  is a stressful, difficult diagnosis. It's hard to
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  manage all of your appointments, all the things.
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  But following those care pathways is really critical
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  to getting a good outcome. So what do
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  we do? We set up your appointments with
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  your different specialists on the same day in
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  the same location. We have care navigators that
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  help you manage it. That's the exact same
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  thing we did with the diabetes program. We
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  basically looked at it and said, what are
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  all the steps? What does the evidence say
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  is gonna give us the best outcome? And
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  then how do we make it on autopilot?
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  So it's very easy to access. So you
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  don't turn around as a patient and say,
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  who am I calling? What am I doing?
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  I can't remember if I have to do
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  this. We just made it simple. And I
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  think that's a good lesson for us to
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  learn in this program for other systems to
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  learn about any program. We can really go
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  a long way if we just make it
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  easy for patients
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  to access the programs that we've got.
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  I love that. I think it's so simple,
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  but so critical and and something that, you
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  know, any organization
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  can do as they're thinking about how they
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  wanna expand that access point and and really
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  make those improvements. So, thank you so much
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  for digging a little bit deeper there. Now
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  looking ahead for 2026, what are some of
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  the priorities and headwinds that you're focused on?
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  Yeah. Yeah. You know you know, as I
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  started early on, I think for us and
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  many other systems, we're kinda getting pulled in
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  a lot of directions, and there's a lot
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  of expectations.
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  But it's good because I think the outcomes
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  of those are gonna really improve the quality
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  of care delivery.
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  You know, on one hand, you know, we
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  just talked about a disease management program. I
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  think we've gotta do a lot more of
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  that.
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  As a nation, the expectation is that we
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  are moving more towards chronic disease management or
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  keeping people healthy. So I talked about a
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  diabetes program. Well, what about hypertension? What about
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  COPD? What about CHF? What about weight loss?
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  So those are all things we've gotta put
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  in place, and we've gotta make it easy.
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  You know, the other part of it is,
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  you know, the big buzz out there, IT,
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  what's all the AI solutions? So there's a
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  lot of products out there. We enrolled and
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  brought online AI scribes last year, and it's
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  been a phenomenal hit among our docs. We're
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  exploring, I don't know, thirty, forty different solutions
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  right now.
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  And, you know, you really have to look
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  at, you know, what's gonna be the game
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  changer? What's gonna improve care versus what's kind
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  of the fad that's an overlay of AI
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  over something that's just already there? But I
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  do think systems are gonna have to incorporate
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  that in order to provide the highest level
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  of care.
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  And then, you know, when you look at
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  it, we've gotta figure out how do we
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  retain our docs? How do we fruit?
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  How do we improve that clinician wellness and
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  that experience?
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  That has been a major focus for us.
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  We actually created a new role, a clinician
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  liaison,
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  experience individual who really is heading up our
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  effort. How do we make sure that
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  our docs, our APPs
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  find this as the best place to work?
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  We've got a survey that we're partnering with
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  the AMA on this year that's gonna really
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  dive into that that we want really honest
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  feedback of what can we improve.
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  And, you know, I think some of my
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  colleagues around the country will think we're crazy
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  when they hear this part. You know, when
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  we say we wanna commit to being the
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  best place to work, we we go as
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  far as,
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  our senior leadership gives out our personal cell
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  phone numbers to our clinicians.
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  You know, I I don't get calls at
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  all hours, of the day and night and
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  the weekends, but it lets them all know
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  they can reach us. We can't always solve
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  every problem, but we at least can be
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  there to listen so that they know that
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  we care about it. And we're gonna do
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  everything we can to make things as as
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  improved as humanly possible.
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  I love that. I mean, I think it
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  really brings that human, connection into the leadership
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  role and how you can really make sure
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  you're there to support folks is not just
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  a mantra, but actually something you're living out.
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  And so,
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  you know, great to hear that it,
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  again, is something that, you know, is very
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  simple, but can really make a big difference
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  for clinicians who are going through a lot
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  right now. And as you mentioned, you know,
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  something that is so, so important to building
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  the right team and and, retaining a great
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  workforce.
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  Now what do you think the hardest thing
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  that you're going to have to do next
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  year will be?
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  You know, I I think recruitment is really
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  gonna be it, because
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  for a lot of things, we can take
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  a look at the systems we currently have
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  in place. And, okay, you know, how how
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  do we have we've got smart IT people.
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  We've looked at these solutions. What's gonna help
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  us? What's not? You know, we've got all
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  the pieces for these chronic management programs. How
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  do we do that? But ultimately,
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  the clinician workforce is shrinking out there.
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  The number of physicians for the population
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  is is getting less and less. And so
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  that's a true challenge. And so that's gotta
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  be a huge, huge focus because if we
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  don't have people here to take care of
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  our patients,
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  then we're not gonna be able to deliver
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  that care. And that's why that is that
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  is just a massive focus for us. And,
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  you know, I I can tell you a
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  lot of our approach on it. I remember
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  when I was freshly out of residence, I
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  was trying to think about where to go.
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  You've got the things. Is this a place
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  that I want to stay long term?
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  What are the things? Are people happy there?
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  Are they not happy there? Am I getting
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  paid fairly?
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  And, you know, we've got processes in place
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  now to make sure all those check marks
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  are there. But something when I get the
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  opportunity to sit down with potential new recruits
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  who wanna join us, I tell them, look,
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  here's the comp plan, but I'm committing to
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  you that we're always gonna pay out or
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  above market
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  pay. Here, let me tell you about what
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  the work life experience here is. But, again,
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  here's my cell phone number. If you get
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  here and there's something that's just not working,
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  that's not what you thought it was, I
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  don't want you to become frustrated and leave.
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  I want you to call, and let's talk
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  about it, and let's figure out a way
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  to make it better.
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  Wow. That,
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  is really cool to hear and definitely seems
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  like it would be, you know, music to
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  the ears of many clinicians as you you've
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  mentioned who are trying to find the right
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  place to build their career and build their
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  practice
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  and make a difference in the community.
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  I think, you know,
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  obviously, over time, and every generation has a
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  little bit of a different, desires and needs
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  as they're coming in the workforce. But,
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  you know, when you're looking at that recruitment
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  right now and and trying to bring in
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  additional clinicians, is there anything that you've noticed,
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  you know, is more and more something that,
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  clinicians who are coming into the workforce today
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  are looking for and wanting a a great
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  workplace?
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  Yeah. Yeah. You know, I think, number one,
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  what has not changed in health care, people
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  wanna know that they're able to do the
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  right thing to take care of patients without
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  barriers,
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  and they wanna be happy where they're working.
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  That hasn't changed. And so I think that
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  has to continue to remain a major focus.
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  But the other thing is, you know, a
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  lot of physicians coming out today,
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  they may have different work life balance needs,
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  different desires than we've seen in prior generations.
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  And systems have to have flexibility for them.
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  And so you don't want to approach it
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  with a very rigid approach and say, look,
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  this is the rule, and it's going to
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  be the same, and we're not going to
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  adapt it at all.
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  You know, there is a lot of flexibility.
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  You know, if somebody tells me, look, I
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  wanna start later in the day because I
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  wanna be able to drop my kids off
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  at school and I'm willing to work later
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  in the day, fantastic.
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  You know what? That probably provides access for
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  patients who wanna come in the afternoon because
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  I probably have somebody else who wants to
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  do the reverse of that schedule. And so
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  I think it's really critical to have the
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  flexibility and just know what are the places
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  that we can adapt roles
• 13:10
  so that we can meet somebody else's needs
• 13:11
  while continuing to provide high quality patient care.
• 13:14
  Doctor. And I mean, I think in our
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  boat, it seems like it's working. We added
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  something, I think it was about 200, two
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  zero eight clinicians in the last twelve months.
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  We anticipate adding another two or 300
• 13:26
  multi specialty.
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  You know, we've been able to recruit some
• 13:29
  of the best talent, you know, among neurosurgeons,
• 13:31
  advanced GI docs, or just highly effective primary
• 13:34
  care physicians.
• 13:37
  That was impressive to hear. Like you mentioned,
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  something must be working, you know,
• 13:42
  to bring in those types of numbers and
• 13:44
  and really make a difference in terms of
• 13:46
  access to care for the community. So that's
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  amazing. Before we wrap up here, I wanted
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  to touch a little bit more on growth.
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  Where do you see some of the best
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  opportunities over the next year or so,
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  to to really continue growing the organization?
• 13:58
  Yeah. Yeah. You know, I I think when
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  you take a look at where we're situated
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  in Southwest Florida, a very large portion of
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  the community there really trusts us with their
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  care.
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  I think we've got an ability to expand
• 14:10
  out to other regions of Florida as we
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  take a look at it. And I think
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  we've got a great care model. We we've
• 14:16
  got a good model that balances work life
• 14:18
  balance that people wanna join. And I think,
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  you know, the sky's the limits there. So
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  it's really hard to say, hey. You know,
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  what's gonna happen in three years or five
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  years or not? I think what we're gonna
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  see is we're gonna see we health system
• 14:31
  grow significantly because we're gonna continue to put
• 14:34
  patients first. We're gonna continue to put our
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  clinicians at the forefront of how we're doing
• 14:38
  it, and that equation seems to be paying
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  off.
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  Amazing.
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  Well, thank you so much for joining us
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  on the podcast today, doctor Hashmati. I think,
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  you know, I really truly appreciate your perspective.
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  This has been an inspiring conversation for sure,
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  and I look forward to seeing you as
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  well at our annual meeting. I know you'll
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  be, speaking with us in April, and so
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  I'm looking forward to learning more from you
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  and continuing this conversation.
• 15:03
  Thanks a lot. Thanks for having me.