Dr. Michael Fratkin, Director/Founder at ResolutionCare

How to Improve Care Giver Well-Being with Dr. Michael Fratkin, Director/Founder at ResolutionCare

: [00:00:01] Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:18] Outcomes Rocket listeners welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring healthcare leaders really want to thank you for tuning in again and I invite you to go to outcomesrocket.health/reviews leave us a rating and review through Apple podcasts. This gives us the information that we need to get this show to be amazing for you so that you could go back and improve outcomes with what you do so without further ado, I have an amazing guest for you today. His name is Dr. Michael Fratkin. He’s a director and founder at Resolution care. They’ve done an amazing job. It’s really been just an opportunity for them to follow their mission to bring capable and compassionate care to everyone everywhere. They use innovative technology payment models and strength of the community to help their patients. But more importantly the people that they help go through the end stages of life. I want to open up the microphone to Michael so he could open up that introduction with anything that I may have missed. Welcome to the podcast Dr. Fratkin.

Michael Fratkin: [00:01:26] Thank you so much, please call me Michael as he started to and I think he gave me like four amazing in that introductions I’m not sure having a go at all is amazing. No the work that we do is amazing that people gather together and do the work are amazing people we care for amazing. So I see your for amazing. And for more.

Saul Marquez: [00:01:51] I love it. And you know one of the things I really appreciate you Michael is just your you’re a very present individual. And it’s something that is valuable in today’s day in health care. A lot of times they leave the care out of health care and I think you do a really amazing job of that. So let me ask you what got you into this sector to begin.

Michael Fratkin: [00:02:13] Oh I am myself I’m 55 years old. I’m a dad and my husband brother. So I got great friends I hope to be a great friend if that’s what they say at the end of my life, Michael is a great friend would be a pretty good cash for my life. I started my exploration around serious illness and like when I was just early in college and a friend of mine who was gay and I started talking about all the young men that were dying of HIV. And he didn’t know that I knew he was gay. That’s a sort of suicide. I was worried because I was watching the stories about a young man coming out into the world having their full experience and to be treated with a mysterious horrible disease like HIV infection. I wondered what it was like to be a man that was dying. And so we both became volunteers in a hospice program in south Florida and we got a look at a few experiences how these young men made their way to complete their lives. And it wasn’t with us. It wasn’t just a horror story. It wasn’t just terrible. It was terrible for grief and discomfort and trouble fear for us. There’s also something pretty extraordinary and how resourceful a serious human beings are. And so that definitely planted the seed for me. It was a long time before I decided that I was going to go to health care. But once I started in the emergency room. So you’re intact I got more and more interested and thinking about my status as a paramedic or a nurse. But I got through it cursed by a couple of important physicians to keep on going and never forget. And I you know just like everybody else did all of the free stuff from an University of Utah Medical School that again was created by the HIV epidemic during medical school and worked as HIV medicine was turning for sure hospice care is something else. It’s a change where there was a whole bunch of therapeutics that were being applied. So when I came out there became an HIV doctor internist and the rest is history.

Saul Marquez: [00:04:56] That’s so interesting and definitely sounds like you were awestruck by everything that was happening and history of the human experience and also the surprise of what you saw these these young men going through and it’s evolved and it’s created into what you’ve got here now and thing that you guys are doing with your organization what would you say Michael. A hot topic that every leader in health care should be focused on today and how are you all focused on.

Michael Fratkin: [00:05:26] Economics economics economics. It’s so easy to be distracted by policy and politics but ultimately human beings behave in a fairly predictable fashion. They follow incentives and the sentence should it ought to be improved quality of life living for people that has better satisfaction and reduction in the horrendous wasteful and excessive suffering that comes with excessive utilization. So the triple aim is critically important area particular focus for me in my work because my working emerge my personal burnout has under-resourced position in a crazy healthcare system. This idea of quadruple this idea that those people over there that are in discomfort or pain or money are no more or no less importance than those of us that have dedicated our artwork that we matter as much. We are people they are people. We need to build new kinds of healthcare structures that tend to be both of those critical stakeholders as well as all the rest. Two sailors move from the center with the industrial design of our system of health care to 20th century now into the 21st. That’s where our focus is on the people actually receiving and providing care.

Saul Marquez: [00:07:07] So Michael I think this is such a great cause and we’ve had previous guests talk about you know that quadruple aim and making sure that we take care of our physicians. And I think it’s such a great point. What’s the best way to get there. I mean from your standpoint what do leaders provider leaders need to be focused on to make this happen.

Michael Fratkin: [00:07:29] Well we had to get into the DNA of the organization. I mean the amount of pressure there is to think about people as a populate spreaadsheets rather than the way the real world is enormous. And so we as an organization have done is engage with certification as a corporation. So for those that don’t know anything about that because or organizations that have committed to a rigorous assessment of their practices and isolation that measures that assesses all their practices are position with all of their stakeholders including their workforce the people that care for their heart in their heart. Companies that are willing to commit at the very core of their structuring to delegate themselves to the well-being of all stakeholders and to do good with their business. Our business is actually outperform in our financial markets. And so by engaging with the lab and becoming the elite who are certified it puts us in the same category of companies that have an identity that they are clear. So Patagonia and charities matter. So this New Belgium Brewery there’s a few companies that are willing to say out front now that they a good product you provided incredible service that you will hear each other and themselves and that is that their heart as well as.

Saul Marquez: [00:09:07] I think that’s really great and a distinction between what you and your team are doing and I guess the majority of companies in healthcare and outside of healthcare. One of the things that really got my attention Michael was was a quote from your one of your sites says we’re an inspired team of palliative care professionals who understands that people are more than their bodies more than their diseases and more than merely patients. Walk us down that in the context of what resolution care your team there is doing to improve outcomes.

Michael Fratkin: [00:09:40] Yeah for sure. Well I mean I introduced myself as a dad and husband and a good friend for good reason because that’s where I happen to have a skill set as a physician. Now I’m currently focusing on enterprise and as a person is really at the core of how I made my way through life. And it turns out it might surprise you. And that’s exactly how he’s doing. They’re doing it from the center where they identify themselves. And so people who are sick do not apply or else and less that sort of thrust upon it. People are saying get who they are but they’re stuck in a system where for example a person with cancer is undergoing cancer corrective treatment may in the last six months their wife have 150 doses for doctors appointments. Xrays last hundred thirty times leaving her home getting themselves together. How did their daughter take half a day of work to drive them to the doctor’s office. Walk into the door to sit in a crabby waiting room with 10 year old People magazines and the sick people in to be sitting there and have another clipboard that same clipboard shoved in your face for 150 a time while you’re noticing and asking yourself in a sort of distress existential just say is that person next to me sicker than me am my sister than them that person calls something or a hole in my direction and distant are so afraid 150 times in the last six months of your life. Right. Those people begin to see themselves as a patient and they are processed through a system and gas cylinder example where a doctor sits down the room and then turns their shoulder so that they can tap away at the computer keyboard and gather all the data. That isn’t necessarily there to serve that person but he’s there to serve the box checking algorithmic crowing based guidelines that everybody’s breathing down that provider’s neck out and then you rebirths that you’re and get a resolution care is people power technology enabled Health Care Services takes care of people not patients in their homes not in clinics. And so when we engage with a person we send them to got that time we send down an e-mail hyperlinking they split into their health care see the doctor nurse a social worker that sharply dockworker who is right there with perfectly framed not invading their house or the home and read their mind to find out how we can be of service whether it’s to improve their symptoms whether it’s helped them understand their situation the choices depending on whether they’re here planning discussions documentation whether it’s to coordinate it so that the other members of their family can all be included on the same page about what they’re facing. We do that not having to drive people out of their homes and make patients on them.

Saul Marquez: [00:13:00] I think that’s really you you’ve got a really interesting and very interesting is not the word human way of taking care of this. You’ve obviously given the topic a lot of thought. You do something over and over again it becomes part of your identity. And so how do you deconstruct this system in such a way that helps treat people as people. And I think you guys have done a really beautiful job of that where you’re at. What would you say an example of how this has helped families recently.

Michael Fratkin: [00:13:34] Well I can say to say that last week in Cary for a guy youngish man the long history of addiction and very serious had cancer it was estranged from his family. We connected and four members of his family in four different locations in the U.S. to talk it through he hadn’t seen their faces or over eight years. We walked through we talked it through and let them know that his addiction was a big part of what was challenging his cancer care how he really needed the support. And so within three days his sister who is now provide caregiving with she’s provided a structure that will get him out of the hospital and then will complete his cancer care program. His cancer treatment a new cancer treatment and then as he recovers from that we expect to help him relocate and resell it to his favorite Bacchis without the technology. There is no family meeting totally. There is no talking through the complexities of issues facing and. Trying to find its way at his family. And so using this video conferencing technology we were able to do something simple and it wasn’t. How great is the technology how it works. All I know is that I could set it up and how human conversations with human beings are seamlessly.

Saul Marquez: [00:15:11] Yeah I think that’s really important. This is such a wonderful story. Super happy to hear that this gentleman was able to reunite with his family and now on a road of recovery. Whereas before hey you know what could have happened to him. You know I think it’s likely.

Michael Fratkin: [00:15:27] He said without our support all the way over this last month he couldn’t have completed his cancer treatment because he was too socially behaved really burdened by his homelessness and ongoing drug abuse. It took our advocacy are holding hands together. And what could well be cured cancer treatment could translate just by working with all the social determinants of health getting it from place to place getting fat getting in house and all of this can translate into 20 30 40 years of life and with a little luck may surprise us too.

Saul Marquez: [00:16:12] That’s wonderful. I think that’s so interesting and tell me something Michael. So you’ve had some success in this area. Give us an example of maybe a shortcoming or a setback that happened and what you learned from it in order to make it even better.

Michael Fratkin: [00:16:29] Let’s see that’s a good question. As I pause to reflect it’s hard to ask that you are so used to saying I’m crazy. It hasn’t worked. What I would say is it’s really really hard to construct from the raw materials of the status quo. So they are actually very fresh and new. It’s very hard to take nothing and make it into something and a step along the way. There are these inflection points these evolutionary moments where everything turns gets turned upside down in those moments I freaked out a little and it was like wow that was exactly what was necessary for any of the listeners or parents they’ll understand exactly where you get to a certain place and you’re like oh my god this is so crazy I can’t go another step. And then you do you learn something about the process of creation. So for me I miss a lot of the space I think with being so emotional reactive when really what was happening wasn’t normal illusion and growing and developing new review.

Saul Marquez: [00:17:47] I think that’s a great call out and listeners think this is a good message as you move forward in your endeavors to provide healthcare to improve outcomes. Whenever something happens that you’re not expecting just think this is part of the process accept it and what comes from here will actually be something that’s happening for you not to you. And then it becomes an opportunity that helps you be stronger. And you know I take this message very very to heart. Michael and I appreciate you sharing it.

Michael Fratkin: [00:18:18] Yeah I mean it actually doesn’t take too much imagination to bring it out of the sort of enterprise environment and to ask yourself how you made your way through life in a series rising and then collapsing and rising and collapsing and being so caught up in the pain and grief difficulty that you almost can’t remember what it was to feel otherwise but then you keep putting your feet and you keep taking steps forward. Keep learning. And all of a sudden you realize that without that conflict there is no tomorrow. You can’t get to the future that you. And so are you.

Saul Marquez: [00:19:01] Yeah. No I think it’s great. I think it’s a really powerful message. And the other thing that it reinforces is the thought. And it really jives really well into what you’re doing is that the power of now I was a similar story but a little bit different when I was in college I went to volunteer at a hospice and it was around the holidays and we were putting together holiday cards. And so I’m sitting there and I’m about to work on my first one. Michael. And I’m like What do I write like I’m so used to writing hey you know. Have a wonderful you. I hope next year is awesome and you know what I mean. And so I’m in this place where all of a sudden I’m forced to be in the now and we spend so much time yesterday or tomorrow. And I just zoomed in and then I sort of gained an appreciation for the Power of Now. I said hey you know and I remember my first letter that I wrote was enjoy. Today it’s a beautiful day. It might be sunny. It might be windy but everything is there for you. And just a note that I have never forgotten. And it’s just kind of you polished it off with some of your thoughts right now. So thank you for that. And yet listeners so be present in the moment and make it work for you.

Michael Fratkin: [00:20:11] Exactly. And this is Resolution care is simply of that position. That kind of thinking integrated into a complicated crazy healthcare system. Health care financing system taking advantage of the economics of incenting outcomes that we wish to get to than fee for service structure which has constrained our ability to grow better manage the well-being of our society. So by leveraging this payment and structuring our relationship to health. That’s not to say I was sick but actually I’m not around that bill. Will now we’re paddling in the same direction and were able to do what makes sense for the very individual people that are caring for her. It’s not about her protocols it’s not being responsive to the people we care for. Define what success looks like for now and then it turns out their quality goes up their satisfaction goes up and lo and behold we get them an alternative to the emergency room in a hospital. And their costs go down. Everybody’s happy at rocket science.

Saul Marquez: [00:21:33] I love it. It’s great. It’s so wonderful. So we’ve got some really cool ideas crank in here. Michael let’s pretend you and I are building a medical leadership course on what that be successful today. It’s a one on one or the ABC of Dr. Michael Fratkin. And so we can write a syllabus right now for the listener really go for questions. Lightning round and then finish up with a book. You ready.

Michael Fratkin: [00:21:58] Yeah.

Saul Marquez: [00:21:58] Awesome. Awesome. What’s the best way to improve healthcare outcomes.

Michael Fratkin: [00:22:02] Focus on aligning yourself with the people you care for the people doing the care center your care around human stakeholders that need to be re front and center.

Saul Marquez: [00:22:16] What’s the biggest mistake or pitfall to avoid.

Michael Fratkin: [00:22:19] Getting sucked into the status quo compromising too greatly for expediency what seemed like a good idea to create something new turns out to be just another iteration of what’s broken.

Saul Marquez: [00:22:34] How do you stay relevant as an organization despite constant change.

Michael Fratkin: [00:22:38] We talk to the people we care for. It was a way. We’re so immersed in the mystery of the human experience and the care that we provide to people that there’s no way to get bored. There’s no way to lose that sense of.

Saul Marquez: [00:22:52] What’s one area of focus that should drive everything else in your organization.

Michael Fratkin: [00:22:56] Love

Saul Marquez: [00:22:58] Powerful. I love that. What book would you recommend to the listeners Michael

Michael Fratkin: [00:23:03] I heard Michael Lewis talking on the radio today see us doing projects and there’s two reasons. So the new project is a story Tversky and Kahneman as they sort of redefined social economics or economic theory around issues. There’s two reasons why it is that I always loved opera singers don’t leave everything and think that. Their work is entirely about how we lose ourselves thinking we understand what we see and how we work. I love that part. The other is the story of the human relationships that led to tries to quirky Israeli scientists very different personalities. The story of their relationship the professional relationship interactions with those around them and their relationship. Guys I thought that was beautiful and brilliant. So Undoing Project, Michael Lewis.

Saul Marquez: [00:24:07] Love it. Some really great shares there. And listeners don’t worry if you don’t have a pan or if you’re out for a jog or driving just go to outcomesrocket.health/Fratkin that’s F R A T K I N as Nancy FRATKIN.

Michael Fratkin: [00:24:22] And don’t forget www.resolutioncare.com as well.

Saul Marquez: [00:24:28] No absolutely. And that. And Mike you know in the show notes when you got to that site that I think you’ll be able to find links to Michael’s company you’ll be able to find a link to his LinkedIn profile answers to the syllabus as well as a link to the book. So everything you’ll be able to find right there. But for the sake of reiteration and clarity. Michael’s Website is Resolution care just as it sounds www.resolutioncare.com. Pretty cool place where you’ll be able to learn a little bit more about what he does. Michael thank you so much for this. Before we conclude I just want to ask you for a closing thought and then the best place where the listeners could get a hold of you.

Michael Fratkin: [00:25:11] Don’t sell yourself short to think you got the job or that you are your job. Or that you’re a patient or that you’re a doctor or you’re an entrepreneur. Show up to your life free of all those labels. Bring your stuff out or be a part of collaboration with other people. Don’t get fooled into thinking that the role you have is who you are. You know who you are and if you don’t know who you are your wife or your husband can probably help you figure that out. I can be reached any way at www.resolutioncare.com, michael@resoluioncare.com on Twitter. @michaeldfratkin And I don’t know if you send smoke signal, I might see you.

Saul Marquez: [00:26:01] Love it. Michael listen I really want to thank you for taking the time today. It’s been a really big pleasure. Dove through some really great things and just want to say thank you very much.

Michael Fratkin: [00:26:11] Thank you so much, Saul, really has been fun. Really appreciate it

: [00:26:17] Thanks for listening to the outcomes Rockett podcast. Be sure to visit us on the web at www.outcomesrocket.health for the show notes resources inspiration and so much more.