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Question all Assumptions

Episode 366

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It’s Your Ship

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Question all Assumptions with Andrew Chacko, Founder & Principal at ChackoMD | Convert audio-to-text with Sonix

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Saul Marquez:
Welcome back to the podcast, Saul Marquez here and truly excited that you tuned in once again. I have the privilege of hosting Dr. Andrew Chacko today. He is Principal at Chacko M.D. He’s a psychiatrist and founder of his firm. He specializes in health care innovation and leadership, teaches clinicians and engineers how to become design thinkers and leaders in health care. He draws extensively on his medical knowledge, his training and work as a designer and innovator and his long career focused on leadership established by his service as a naval officer. He’s taught workshops and design thinking across the continuum of learners from high school students to graduate engineers and seasoned clinicians. When taking a look at the things that we could do to impact health care. It’s super important that we consider these broad base of perspectives. As a psychiatrist, he served as a medical director at the addiction consultant and treatment team for the veteran affairs Palo Alto Health Care System teaching hospital for Stanford University System. So it’s a true pleasure to have him here on the podcast. He’s had a number of accolades and accomplishments through his career. But I want to do is open up the microphone to him to open up any of his key interests and things that I may have left out in the intro. So true pleasure to have you here, Andrew, welcome.

Andrew Chacko:
Hi Saul. Thank you so much for having me. And I apologize about we’ll be tough with an apology that in my bio – that was great. Thank you by the way. You said it much better than I can say to myself. One thing has changed. I have recently left clinical full time clinical practice so Stanford… to UCSF and the SFPA and finally really took the leap into trying to do this innovation work that I’ve been building on this side into doing that full time and put my money where my mouth was and embrace the fear of leaving a full time clinical practice that was in a robust and find and rewarding during this stuff that I think can really actually make even more of an impact. That’s been a few months since I did that.

Saul Marquez:
Well congratulations Andrew and thanks for clarifying that. I definitely give you kudos for making the jump. I think the more physician leaders that have been there and done that the frontline that we have the better I think the results will be so I commend you for that choice and just curious what is it that got you in the health care to begin with?

Andrew Chacko:
So really it’s a great question. I was working as a designer. I spent 12 years in the Navy and had stumbled into this program at Stanford which was a joint program in mechanical engineering and art and just found my home in many ways. I’d been an engineer my professional life and an artist my whole life and I thought, “This is amazing”. And that turned out to be the design program. So as I began to work as a designer and I was working at IPO and teaching design and practicing design independently as well, I was coming up short. I was actually working on a Swiffer and making lint so we could test the Swiffer. And from there have got to be better uses for my brain than making it. So I started looking around and thinking,” well what problems need solving where can I really apply these design skills?”. And I happened to see doctors carrying pagers. I thought that is absolutely ridiculous to the 21st century. I can build something better than that. And then started investigating the space. I saw that show where some of my really very smart colleagues having a heart. I’m bridging that gap connecting with clinicians and being able to really make what they need to make. And I was looking very early at the medical device design and so I saw it again rather simplistically and this is how many great projects start. Well I’m a pretty good student. How hard is medical school? Maybe if I just go become a doctor I can design from the inside and meet some of those problems. So that led me to medical school and I went with the intention of punching out right afterwards and going straight into the innovation space and actually had an offer lined up at Media Lab at M.I.T. to go and build.. What is the future of healthcare. Straight out of medical school. And as I was getting closer to the end I realized that there’s a lot of smart people coming straight from medical school and this echoes back to what you had said previously about having been there and done that. And I thought those people are going into consulting roles might not. And yet we’re still facing some of these fundamental problems in the healthcare space. I think what I need I’m really going to tackle this problem is some more clinical experience. So that led me from my dream job at Media Lab which I honestly probably would have paid to do instead of getting paid. I would have loved it that much that I would have paid to do it. They did offer to pay me ofcourse to. Many people described as hell on earth residency but it was actually a really smart decision from a standpoint that really shaped so much of my thought and ideas about how we can transform health care into the system and this kind of living breathing entity that can really serve humanity instead of how it’s kind of struggling along or feels like it is these days.

Saul Marquez:
What a great story. What a great story, Dr. Chacko. You’re definitely not afraid to do the work and you’re not afraid to get in the trenches and do what it takes. So very cool that you took less traditional route but said, “you know what I’m going to go all the way get the experience”. You’ve been there, you’ve done that. You’ve been a designer, you’ve been a psychiatrist physician. What would you say is a hot topic that needs to be on health leaders agenda today and how do we have to approach it?

Andrew Chacko:
That’s a great question and thank you for asking it. I would say one thing that I found truly transformative that helps me conceptualize the problem and I think that we can all benefit from is really understanding this concept of design thinking and how it can help an organization or even the institution itself better to do what it’s trying to do. So at its core design thinking is simply beyond the buzzword is simply a process for creative problem solving and that’s all it is. And when I conceive of it I break it down into three parts. The first is to really understand the problem that you’re facing. And the second is this ideation phase where you come up with all these crazy ideas and this is a posted no craziness that most people think of when they think of designers if they think of designers and with all their wild ideas. And the final part is to prototype and test out these hypotheses. We have about solutions it’s quickly and crudely it’s possible. And then try to implement what we learned from those tests back into this growing solution. But all of this I would say that that first phase to really understand the problem is. probably the most crucial and why say that is we often as we’re going to innovate and trying to come up with new solutions., one of the mistakes we commonly went into is confusing a current solution for the problem. So take the example out of medicine and think about it like if I were designing a new fridge for young adults millennials who are living in really small apartments, for example, we might start with the assumption that the problem is that the fridges are too big for these small apartments. And that we’d set off on this process like designing a smaller fridge. But if I have the latitude and the ability to zoom out and really understand things we can notice that these aren’t the problem and the fact they’re too big isn’t the problem. The real problem is the food spoils and humans don’t do well when we eat spoiled food. So then it just opens up a whole host of other possible solutions that we can explore, right? What if we could make food that doesn’t spoil what if we could explore this idea of delivering food in such a timely manner that you don’t actually need to store it. So then it obviates the need for a fridge what’s altogether. So what if eating by yourself in your space is not the solution. I mean there’s a whole host of different avenues we could explore that can take us away from this idea of like what we need at this box. That’s cool. That keeps food preserved.

Saul Marquez:
It’s an interesting point that you bring up you know because if we really dial in to some of the some of the issues that we come up with I think it’s worth examining this initial assumption as what you’re saying.

Andrew Chacko:
Yeah that’s a great point Saul. And the way one way to do that is this technique called a five wise. And many people learn in business school about life when you look at a process going back to well why are we doing it that way and then why are we doing it that way and why is that keep going. Five times to really get to the root. Ideally that helps you question some of those assumptions that we sometimes have it. Well we make it to the point where we think Well we’ve always done it that way but we stop a five because if we keep going we get back to the whole life. What’s the meaning of life and why are we here and why not so stop a little bit shy of that to.. Part of..

Saul Marquez:
..a lot. Now it’s it’s a great great approach and I think one that that maybe we don’t think about as often as we should. Right. We oftentimes just make that initial assumption and that initial assumption could really set us off course.

Andrew Chacko:
Definitely.

Saul Marquez:
So you’re focused on identifying the problem. You want to ideate. You want to engineer put it all together. Give us an example of how you or one of your customers have done this.

Andrew Chacko:
So one of the things that I’ve been doing around this is my focus has been looking at why I think I’ve been blessed with a ton of great ideas and I have a lot of opinions about how to transform healthcare. I know that all the great ideas don’t rest with me and where we can really get some traction is to create this kind of army of problem solvers right. So that’s been my mission and the reason I created ChackoMD is to democratize some of these tools so that clinicians and entrepreneurs and innovators everywhere can start really solving the problems that they’re facing in the healthcare space or at least have the vocabulary for clinicians to talk to the innovators or solving the problems and can be part of the solution. So it kind of plays on this African proverb about “Give a man a fish or a woman a fish in this case or that case you feed him for a day; teach them to fish and you can feed them for a lifetime”. So how I’ve been going back and turning that whole process on my own process turning this design thinking process in me as I’ve been looking at what are the different ways that I can more and more effectively reach these different audiences. So I’d been working on writing and doing workshops and how can I deliver those workshops more effectively to keynotes to videos. Just playing with this whole exercise of how do we best democratize these tools. And that is good design is an ongoing process and I’ve had some good fortune and good luck with some of the stuff that I’m doing now.

Saul Marquez:
That’s great. And yes you know creating an army of problem solvers instead of just going in there and helping them solve one problem you want to enable and the word you used was democratize these tools. I went to a meeting a couple of months ago and it was fun. We did a little workshop with ideas on some creative problem solving. The issue was pediatric patients that stay at the hospital longer than a week. How do you get them to be mobile. And some of the stuff that came up was just crazy right. The posted notes and you know the interesting thing was the experience and having gone through it and leaving with those skills. That was a very valuable.

Andrew Chacko:
That’s right. And that is some of the feedback I get after doing so this exposure to people to these ideas that have not really had the luxury of going through before it can be life changing atmtimes.

Saul Marquez:
And it’s the even the smallest idea you know that even go at the craziest idea. And what ended up happening and you know this. Andreas we know that our crazy eye is a modified version of a crazy idea. But we adopted it. That’s what we decided to go forward with.

Andrew Chacko:
When I teach the workshops one of the things they do is I encourage people to go for ideas like really at least come up with the ideas that are physically impossible. And one of my favorite examples was I was doing a brainstorming teaching brainstorming to a bunch of Asian medical students in a tradition that had come over to Stanford to understand the American health care process and we think the problem about how do you get patients more effectively to their appointments. Because oftentimes that can be a harrowing experience. People hospital they don’t know where they’re going. They got to follow the Purple Line on the floor and then they’re confused and they get laid. There’s parking issues and the crowd had I disclosed that I love superheroes. I’m a big superhero fan. And so the idea they came up with was why do we have superheroes. Greet them at the door and fly them to their appointments. And I got really excited about that idea and because in it there’s a nugget of something really interesting. What if the greeters were dressed up like superheroes. How could that transform that experience of going to the hospital and the hospital could then be transformed into the Justice League if you’re a DC fan or whatever like The Avengers will be if you’re a Marvel fan. Right. So if you look at that how much do Disney do that and transform the experience by getting people to dress up like a mouse or a mermaid in these show up we know that that’s not really Ariel or even a mermaid for that matter and yet because it’s part of the experience it can be transformative. And now you take this thing that’s historically been this negative experience about going to the hospital and it can be rather fun and entertaining or distracting at the very least. So I think there’s a lot of beauty in reinventing that process.

Saul Marquez:
That’s a great example. And yeah it’s it’s amazing how these things come to life. Folks will provide a way for you to take a look at some of the things that Dr. Chacko does. So you could take a deep dive and see if some of it is right for you. But definitely something I recommend because it was it was really insightful for me. Tell us about an exciting project you’re focused on.

Andrew Chacko:
So yeah. One of the things and people that know me well will tell you that I get excited about a lot of projects and I have my hands on a ton of things started with this idea of writing a book about how to transform healthcare. And as I was again designing or in that process have decided to make a movie around that because video is such an accessible medium for so many people. And then also the idea of capturing a multi dimensionally the less it is so we can learn both visually and audibly all these different ways to pull it in. But one thing that I’m doing currently that investing a lot of time in is building just 2-day workshop about design thinking and leadership in the healthcare space and partnering with a hospital in the New England area and taking we’ll be looking at one problem specifically around access to care for the elderly and really using this workshop as a vehicle to learn design thinking tools and leadership tools as they apply in this space and using that problem as a vehicle to learn those tools. And what I’m really excited about is designing what’s a workshop like soup to nuts. Right. If I can design every aspect of it what I would like to do is create a profoundly transformative experience for people so that they can come away with not only a fun experience but something that is where they’ve learned something that they can translate into something – lessons both personally and professionally. That’s super exciting.

Saul Marquez:
That is exciting putting together a little opportunity for folks that not just think an academic thing that you go to but something that you remember and you take away with for really the rest of your life.

Andrew Chacko:
Ideally yes.

Saul Marquez:
That’s really neat that you’re approaching it in that way.

Andrew Chacko:
Yeah it’s I had somebody turn my when I was first going to be doing a workshop for Stanford for their big and I think it’s their second biggest PNB they host And I’m standing on the stage with these big names psychiatry and this is early at my psychiatry career and they said well we want you to teach it workshop and design thinking somehow I got exposed to this side of like what if I turn it on its head. It doesn’t have to be a dry boring presentation like we’re so used to a lot of these medical conferences but if we just make it funyou know turned up the music. We had people moving I kind of made people uncomfortable. I had all these psychiatrist share like personal experiences with each other and to get them emotionally engaged and then just started getting into brainstorming how we can reinvent CNE and had a really amazing session that came out of it. And so like that to just kind of taking on life of its like how do we create these like transforming experiences and realizing that having fun and learning are like just finally linked.

Saul Marquez:
No it’s key and it’s the power of questions to, right. I mean you could go all right and not create an effective course or create a transformative experience. I mean which one would you all want. I want a transformative experience that’s all I know. Yeah. Kudos to you and definitely excited to hear how that goes. So you’re getting close to the end here. This section is a lightning round so I’ve got several questions for you. It’ll be quick answers followed by a book you recommend to the listeners. You ready.

Andrew Chacko:
Great.

Saul Marquez:
All right. What’s the best way to improve health care outcomes?

Andrew Chacko:
So focusing on improving the lives of clinicians really giving them the tools they need to thrive and the freedom and autonomy to do their best. The lesson I learned in the Navy was when I really focused on making my sailors lives as productive and positive as possible they really turned up and far exceeded my expectations. So that would go definitely the same for clinicians.

Saul Marquez:
It’s a great message. What’s the biggest mistake or pitfall to avoid?

Andrew Chacko:
Not being conscious of the technology that we introduced into the clinical space and what the ramifications are. And a quick example is as a consequence of EMRs and how we’ve incorporated them. Most patient physician encounters are spent with the clinician facing the screen and so much is lost in that process especially this invaluable relationship between the patient and provider. And it’s also a huge driver and clinician Burnout. So not thinking about like oh well what if we do this and it seems on the surface a good idea but what’s the larger ramification what are we losing in the process.

Saul Marquez:
So how do you stay relevant despite constant change?

Andrew Chacko:
Great question. I think I’m focusing on some fundamental paradigms in the healthcare space, stuff that are really looking at some of these core pillars. The change seems to be much more on the surface of how we approach different smaller problems. So because I’m zoomed out looking at systemic change in these fundamental arena it’s about leadership and problem solving and how to get the health care providers to work more cohesively as a team. That seems to be universal.

Saul Marquez:
Love it. What is your number one health habit?

Andrew Chacko:
Oh yeah I’ve been adopting a few. So every morning I try to wake up first thing and jump into a cold pool and swim a few laps and then jump into a hot tub. It’s an act of both discipline as well as kind of taking charge of shocking my system. Yeah it’s a great way to reconnect with my body. But one of the things I’ve been less successful about doing that I am a huge advocate of though is daily meditation. I do try I’m not perfect at it.

Saul Marquez:
Some good practices I don’t get to it daily but definitely as often as I can. I would say quantifying it maybe three to four times a week makes it different.

Andrew Chacko:
It’s great.

Saul Marquez:
I did the cold shower the other day Oh my gosh. It got me going, it got me going.

Andrew Chacko:
Gonna wake you up.

Saul Marquez:
It does. It does. And how about your number one success habit?

Andrew Chacko:
That’s a great question. I would say really trying to absorb material from every venue that I can. TED talks for example are some of my favorite guilty pleasures. I also love Malcolm Gladwell’s podcast or on revision is history just because one of the things that they’ll do is just question some of the things that we just take for granted or walk through the world not even like questioning and it’s why I never thought about how sea slugs live in eastern Africa or you know I just made that up I know that that’s actually a TED talk but my bullets it’s a low.

Saul Marquez:
This is really good. And he goes back to your point right. Understand the problem. Qestion and don’t just assume that the right right thing. So.

Andrew Chacko:
Yeah.

Saul Marquez:
All right. So what book would you recommend to the listeners, Andrew.

Andrew Chacko:
Oh I was dreading that question because I still don’t have a great answer. I had so many books that I think are really fantastic. I love all of Glasgow’s books and they speak really well to me. I would say David and Goliath. It’s great. The tipping point is great. They’re actually they’re all fantastic. I do like a book by a guy by the name of Mike abo chef who was a fellow Naval Academy graduate and about what he did when he took command of the USS Ben Ford and how he questioned some of the practices. You know I just thought of it in the book I would recommend is the one I’m writing of that but it’s not done yet. So before then. Brooks will be safe. It will be good.

Saul Marquez:
Listen when you when you do come up with it. We’ll get you back on give you an opportunity to actually share it with us.

Andrew Chacko:
Definitely. Thank you.

Saul Marquez:
Absolutely. So definitely has been fun. Dr. Choco I love if you could just leave us with a closing thought and then the best place where the listeners could get in touch with you or follow your work.

Andrew Chacko:
Great. Well thank you so much. It has been a total pleasure to talk to you this morning. So closing thoughts. I really want to help transform this space and make it something that’s just really a life affirming institution that I know that it can be. And there’s so many of us that struggle in these silos trying to do that. If there is a way that I can help please feel free to reach out to me the easiest way to do that is through my website which is. www.chackomd.com. It’s I’ll say it’s in the middle of transformation itself it’s not exactly where I want it to be but nonetheless it’s a good way to reach out and see some of the stuff that I’ve done and also a more comprehensive list of books that I recommend.

Saul Marquez:
Love it.

Andrew Chacko:
And yeah I think this has been fantastic.

Saul Marquez:
And Andrew you know what? I believe that you’ve got a ship and so it’s not going to be perfect. When we started the podcast our website wasn’t perfect. We redesigned the website and it’s so much better now. But the point is start and that’s what you’ve done. You’ve taken the leap. You’re doing some amazing things now full time. So definitely kudos to you and listeners, I recommend you definitely check out Andrew’s work and how design thinking can help you question maybe some assumptions that are holding you back. So I truly appreciate your time, Andrew. Appreciate you carving it out for us.

Andrew Chacko:
Definitely it’s been a pleasure. Thanks so much Saul.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at wwwoutcomesrocket.com for the show notes, resources, inspiration and so much more.

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