Compassionate Quality Care For Seniors with Dr. Terrell Bacchus, Physician at ChenMed

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: Welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring health leaders. Today we have a wonderful guest. His name is Dr. Terrell Bacchus. He’s the associate chief medical officer of dedicated senior medical centers in Jacksonville, a member of the ChenMed family of companies dedicated physician practices aimed to bring concierge style medicine and better health outcomes to the neediest populations. Low income seniors managing multiple complex chronic conditions. We all know this is an area that we’re always seeking to do better with the limited funding and the high needs. And Dr. Bacchus is a physician leader in this space for the new Jacksonville market where three dedicated centers will open this summer. Previously Dr. Bacchus was the medical director in Atlanta for five JenCare senior medical centers also part of the ChenMed family in Atlanta. The quality care of Dr. Bacchus and his team led to Jane care rates of emergency room visits that are 50 2 percent lower than the regional average. If that didn’t put a hook in on the amazing things that this man and his team are doing I don’t know what will happen but I’m sure it did. And so Dr. Bacchus just want to say welcome to the podcast.

: Well thank you for having me so I appreciate it.

: Absolutely. Now did I miss anything in that intro that you want to fill in that you want the audience to know about you?

: No I think that covers it all.

: Awesome. So what is it that got you into this health care business?

: Everybody asking why did you get into medicine and I think it started with my father. He was a very bright man he always knows everything that’s going on very mechanically inclined and he spark this inquisitive that this in me to really understand everything around me and so on. It’s one of those kids that broke everything I had apart and tried to figure out how it worked. And one thing I couldn’t break apart to understand was the human body. And you know that led me on a on a journey as I went through school and got to medical school and started learning more and more about medicine. And as I got there and got the residency I realized there is such a big need for medical care to the underserved. And you see people that are that are just being left in the shadows and that’s what led me kind of to ChenMed, to learn their vision to be America’s leading primary care provider Transforming Care of the neediest populations really resonated with me. So I investigated further and you know I have been happy to join this organization that’s taking on such a honorable mission.

: What a great story Terell, and you know it’s so wonderful that you’ve found this field where the challenges will always be there and you’ve honed into a very specific market. I think that it’s definitely going to be rewarding what you could do for the market as well as what you’ll get out of it as far as fulfillment. What do you think is a hot topic that needs to be on every medical leaders agenda today Terrell and what are you guys doing about it?

: You know I think everybody should be focusing on value-based patient centered care. The most important thing that we can do right now. We understand that we need a change. And I think that’s the change that everybody’s looking towards. You know specifically ChenMed as an organization. Our mission is that we honor seniors with affordable VIP care that delivers better health. And if I can break that down a little bit we honor seniors and we’re very patient oriented and that way we want to take the best care of the needy seniors. And then also the affordable part. We want it to be affordable to them. And this is what we do in our centers. We have door to door transportation. We have onsite med dispensaries. We have Silver Sneakers classes for the folks to come and exercise and we have our specialist all on site so that our patients are driving all over the city, paying for transportation, paying for parking and then paying copays to see these folks. They get very expensive and you know as you know our populations that we deal with are low to middle income seniors and the majority of my patients are at or below the poverty line. So you know we have to keep that affordability not just to them but also we’re trying to create and affordability to the system. And we know that you know we’re spending exuberant amount of money and really only coming in middle to last place of healthcare outcomes in this country. So one of the important things that we do and also that VIP care section really delivering that concierge type medicine that really is affordable to the rich. We want to get back to the people that need it the most. And another part of that is VIP care versus health care. I think we separate that out because we realize it’s not just big health care that we’re taking care of. We’re looking at the person as a whole and we realize that 80 percent of that equation is not just intended to remove medications and health issues it’s you know the socioeconomic issues that surround them. And so for that respect we have the case managers, have transitional care team, behavioral medicine therapists and a number of different ancillary staff that help us to really get the whole picture of the patient and that helps us deliver that care. And then in turn when you deal with that 80 percent and you’re able to deal with them that delivers better health. And that’s kind of our mission here. So I think keeping that value in mind and then also keeping the reason we’re here is for our patients, keeping all that in mind is really what should be important to everybody right now.

: That is fascinating. And the way that you guys are tackling that is very purpose-driven Dr. Bacchus I find it very very inspiring folks if you go to ChenMed.com you’ll see some of the the mission and things that Dr. Bacchus was guiding us through. ChenMed.com. You’ll see all the things that they’re up to their facilities really span from Florida up to the east coast and some of the Midwest and Louisiana but they’re really broadening their footprint because this is a huge need. And thankfully somebody like ChenMed and Terrell are really focused on addressing it. How do you guys partner with providers and payers Dr. Bacchus?

: We partner with specialists that are in the areas trying to find the best providers that are in the areas that we’re going to you know we’re opening. We have over 40 plus clinics in six different states. And I think this year we’re opening over 10 new clinics right now. The growth is just exponential and I think we’re finding that there’s a lot of places that need our help and so when we go into a new market, we look for a specialist and payers that are willing to work with our model and that want to provide the kind of care that we really strive to provide here. And sometimes we find some people that don’t want to. But majority the time we find like-minded people and really build and cultivate relationships with them.

: That’s fascinating. So mainly focused on seniors. The Medicare Advantage you guys covering also Medicaid?

: Yes. So it’s all Medicare Advantage but also the mix of Medicare and Medicaid as well.

: Got it. Medicare Medicaid as well. Very interesting. Very interesting and you guys are very focused and you’re expanding the need is there. Can you tell the listeners Terrell an example of how your organization ChenMed has created results and improved outcomes by doing things differently?

: At ChenMedand in our group we do a lot of things differently than you know the regular fee for service world. But one example that comes to mind quickly was we think face time with their doctor is one of the most important things you can have. And on average we have 10 times more time with our patients than a regular physician in the community.

: Wow.

: It’s amazing. It true it hasn’t made them more time to take the more time that you get to spend with the patient. The more you learn about little things and if somebody is able to come with us instead of per day and learn the little things that we see on the patients you know whether it be an unsteady gait walking into the office or medicine bottles that shouldn’t be full that are full right now. You learn these little things the more that you see that patient. Every little touch point is so important. And then we create accessibility to your doctor. Not only do you get that more face time but you have you have the ability to call the center anytime you need us. But also every patient of all of our doctors gets doctors phone number when they have a cell phone and you can call them and get that immediate access that you need so that our seniors aren’t ending up in the emergency room or ending up and sitting at home in pain or having distress. And I think that really changes things for us. And like you mentioned earlier, this has happened has led us to here in Atlanta lowering our E.R. visits by more than 52 percent. And so we really celebrate our walk-ins. We have walk-ins all day long and there is no specific little period of time that you can only come in. We celebrate them when they come in. We’re happy that our patients trust us enough to come and see us first. And we can help direct their care.

: That’s amazing. Folks I just got goosebumps when Terrel said they celebrate their walk-ins. Think about that. I mean that is tremendously insightful. And when you think about the future of health care, you guys are definitely where the puck is going. I agree. So can you share a time when you guys had a setback. Terrel, I know it maybe hasn’t always been this smooth you guys felt like you hit the mark but maybe you missed it. Can you share a time when you had a setback and then what you learned from that setback to make you guys who you are where you are right now?

: I think a good thing that highlights a good example that highlights our model here is a mistake that I made when I first came out of residency and I joined ChenMed. You know I had a patient like had come in and blood pressure is a little bit on the lower side. Sweet little lady and I said you know let’s switch are under medicines and stop one and change this and change the course on that. And I did some changing probably more changes I should have done in that little visit. And whatever diuretics her water pills. And then I said hey you know we’ll see you back in two months. You know and I thought that was sufficient. And next thing I know it about two weeks later you know we get alerts and we have we have meetings where all our providers come together and we review or inpatient or hospital patients that are there. And her name popped up on the list. And I was astounded by you know what happened and I realized that you know she had stopped that water pill and eventually you know food has started building up and she went to food overload and had to be seen in the hospital had a very short stay that I have Easterns go back out. What I learned from that was you need to see patients frequently especially when you’re making changes in the elderly population. There’s no more of this. Oh we’ll see you in six months we’ll see your doctor twice a year. It’s really. We can see our patients here at ChenMed every day fighting to our patients that I see two or three times a week just to keep them stable. And this was an example of where I could have made that medication change on a Monday. And seen her back on Friday or seen her back at all on Monday to monitor that. And if I saw her, I would have been able to. How about you. Your legs are a little bit more swollen here. You know that’s, I mean reassess what’s going on. And I think it really helped the model get into my head and understand why we should be seeing her patients more frequently and really being more cognizant of the changes that we’re making in our elderly population.

: That’s fascinating. And so you mentioned there an inpatient component. So you guys do have some inpatient services?

: Correct. So if our patients end up in the hospital usually have a hospital team that can take care of them some of them are employed by some of our hospital groups but they’ll manage the patient alongside of us so our patients going to the hospital we’re not just oh you guys take care of it. You know let us know what happens after. It’s very much that the doctors are involved. Our PCPs will call the hospital list and disgusting. It’s important for the person that knows that patient the best to give some information and some context to what’s going on. You know patients may show up in the hospital with some sort of a decrease in their kidney function. So for somebody that doesn’t know them they’ll say oh this is a huge change and so quickly whereas the person has seen them for the past five years can said Hey no it’s just been like this for about two years it’s not much change. No need to go and do a million dollar workup on it right now. Let’s watch it and see what we can do together to help get this patient back out with things more healthy days outside of the hospital. I think those little pieces of information from the PCP are so important and so that’s why we on Wednesdays we usually need as a group or doctors in or in our markets and goal for these inpatients to really understand why they ended up in the hospital. How did they get there and what can we do to get them to the next level of care get them back home to a family. And we also you know it’s a component of accountability for doctors is examine why where did we go wrong. Is there something that we could have done better for this patient. Like I said in my last story. It’s where I learned I should have seen that patient sooner. It helps us to really take better care of seniors. You know we really treat each of these Hollywood missions as a failure and we have to examine that breakdown and be accountable to our peers on what we did and what we’re going to do better next time.

: So fascinating I love it. And that’s thanks for the clarification there. Dr. Bacchus I was thinking that you guys were also a you know had a hospital component but you were saying to just you flow with the patient the patient is the person is not a baton. You don’t just hand them off to the hospital and forget about them.

: Exactly.

: I love it. So what would you say today is your proudest medical leadership experience that you’ve had to date?

: I was thinking about this and I think it’s my most recent one is actually just happened. We certainly Naggar inaugurate. Yes and we just inaugurated two new position partners here in the Atlanta market. And to become a physician partner. Thank you, to become a physician partner is is quite the feat. It takes a period of time a specific time to get to this level and then you have to reliably produce results, are outcome based results that show that you’re taking very good care of your patient. ChenMed takes this very seriously because we want our doctors to be the best in the community and provide outstanding care for patients. So they’ve developed a training program that’s a yearlong program that helps develop these other skills you know outside of just the medicine books but you know how to run and and you know manage a team because you have a team at that position here in JenCare You have a team that consists of your nurse referrals coordinator and a frontdesk statff that really help you manage this patient panel that you have and you know things like the business side of medicine. Looking at how to do the IP service, things that you don’t learn in medical school. So it really helps get our patients. I mean our doctors to that level and to see some of my doctors here in this Atlanta Market. Get to that stage is truly amazing and makes you feel really good that our patients are getting that kind of care.

: That’s beautiful. That’s beautiful. Well congratulations to those two new members. It’s not easy you guys made it. You guys and gals made it. Congratulations. So folks this is this is fascinating. And when you take a look at a company like ChenMed it makes you wonder why you know why are they doing things right. Whereas it’s hard sometimes for us to change how we are doing things. It can be frustrating. If you go to ChenMed.com, you’ll see the story of Dr. Jenling James Chen. He’s the founder of ChenMed. He was diagnosed with cancer ten years ago. Given two months to live and during his care, he experienced firsthand the frustrations associated with navigating these choppy waters. Today, that’s why this is their mission and they’ve aligned with amazing people like Dr. Terrel Bacchus to help them drive forward this mission and accountability. Compassion is at the center of it.

: Indeed>

: So tell us about an exciting project Terrel that you’re focused on today.

: So my and my most exciting project that I have going right now is Transforming Care and Jacksonville. We’re going out to the Jacksonville market and we’re going to bring the same level VIP care that we deliver in all of our markets to the Jacksonville folks that really, really need it. There is a need and we’ve seen it, we’ve identified it and now we’re going to help take care of it. And I think putting all the pieces together, we’re going to do the beautiful market out there and really help the seniors who truly need our help and like we have mentioned before you know we’re getting into the market and we’re meeting with the hospital CEOs and we’re meeting with the specialists in the area and really getting our model out there and trying to find like-minded individuals right now.

: Outstanding. So if you’re in Jacksonville listening to this or anywhere in the surrounding area, in the end of the podcast we’ll be able to provide a way to get in touch with Dr. Bacchus. So you too can join the movement. Let’s pretend Dr. Bacchus you and I are building a medical leadership course and what it takes to be successful in medicine. It’s the 101 of Dr. Terrel Bacchus. We’re going to write out a syllabus and we’ve got four questions followed by the book for the syllabus your all time favorite book. You ready for it?

: Sounds good, let’s do it.

: Alright. What’s the best way to improve health care outcomes?

: The best way to improve healthcare outcomes is to get patients in front of doctors more often. I believe that’s the key to everything that we do here. More face time the better health outcomes we’re going to have.

: What’s the biggest mistake or pitfall to avoid?

: Overlooking the importance of the relationship between the doctor and the patient. I think it piggybacks on that first question. But the stronger the relationship, the more that the patient tests the doctor and that they’re able to accept the care that they’re trying to get.

: How do you stay relevant as an organization despite constant change?

: I think you know at ChenMed, were focused on being America’s leading primary care provider. And I think we understand that change is needed and we embrace that. We know that the medical system is not work should be. And we know that there’s much improvement to be made. And I think focusing on that and being nimble and dynamic enough to continue to move down the road towards a better health system.

: Beautiful. Well it’s one area of focus that should drive everything in a health organization?

: The focus again comes back down to the patient. I think building the patient relationships and also developing physician leaders the company does this very well and helping to develop doctors to help run the organization. I think it’s commendable and something that’s not done very much in the outside of ChenMed.

: Are you guys hiring physicians?

: We are hiring physicians who are looking for great doctors that are like-minded and want to be on this journey with us to really help transform care of the neediest populations specifically in Jacksonville and over all our new markets that we’re opening but we would love to have anybody that wants to join our mission and is ready to you know transform this care with us.

: There’s a little plug and if you’re a physician listening to this by all means and you’re tired of the status quo. I think this is a wonderful wonderful practice for you to consider. ChenMed.com, you’re going to be able to find all the show notes as well as outcomesrocket.health/chenmed that’s C H E N M E D. What book would you recommend to the listeners Terrel?

: You know my favorite book that really relates to what we do here as Being Mortal by Atul Gawande. I think it really opens your eyes to this end of life issue that we deal with on a daily basis with our seniors and what it truly means to them and how we can take it as people that aren’t at that stage and really be empathetic and really understanding of what’s of what they’re going through. It really changed a lot of how I practiced and how I’d present myself to the patient.

: What a great recommendation. Mr. Gwanda has come up several times, this one definitely is a great one. Folks if you haven’t read it, take Dr. Bacchus note on this one, read it again. Everything that we’ve discussed the show notes, the transcript, resources, everything’s available at outcomesrocket.health/chenmed. Before we conclude Dr. Bacchus I’d love if you could just share a closing thought. And then the best place where the listeners can get in touch with you to collaborate.

: I think the most important thing we talk about you know in all times is what we’re doing here in ChenMed and how we’re so different and I think it’s hard for people to really understand what it is. So I am sure everybody to come and visit and I guarantee you’ll be glad that you did. You spend some time in the waiting room talk to patients. Meet our staff, meet our doctors. I think you’ll be pleasantly surprised. And we’d love for everybody to come and join the ChenMed family.

: Outstanding. And what would you say the best place for listeners that want to collaborate to connect with you is at the Web site. You have a different account that you want them to get a hold of you with?

: Yeah you can definitely get a hold of us through the website. And also you get through to me personally at terrell.bacchus@jencaremed.com.

: Outstanding. Thank you for that. We’ll include that in the show notes folks. This has been a pleasure. Dr. Bacchus, again I’m inspired by the work that you all are up to and we’re looking forward to staying in touch.

: I truly appreciate the opportunity. So thank you for letting me. Get the word out to the masses. I appreciate it.

Thanks tuning in to the outcomes rocket podcast. If you want the show notes, inspiration, transcripts, and everything that we talked about on this episode just go to outcomesrocket.health. And again don’t forget to check out the amazing healthcare thinkathon where we could get together to form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that’s outcomesrocket.health/conference and be one of the 200 that will participate. Looking forward to seeing you there.

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