Taking a Break from the Physician Grind with Stephen Beeson, Founder of The Clinician Experience Project at Practicing Excellence
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.
: And welcome back to the podcast. Today we have Dr. Stephen Beeson. He's a nationally recognized author, physician, and speaker, who's provided approaches for developing clinicians and leadership for hundreds of medical groups and hospitals across the country to transform care for patients and those providing care. Today, it's super important to have a background of somebody that has been there and done that at the frontlines both as a clinician and as an Administrative Executive. And Dr. Beeson is just that he's board certified in family medicine. He's been practicing with Sharp Rees-Stealy Medical Group in San Diego for over 18 years. His tenure with the medical group. He was selected by Sharp Healthcare Leadership to serve as the Physician Director for the Sharp Experience and Organizational Commitment to serve and operational excellence. He's an author of a book called Practicing Excellence and it's also the name of the practice that they are doing this work in. And so it's a true pleasure to have Stephen on the podcast. I want to open up the intro for him to fill in the gaps of anything that I may have missed. Stephen welcome.
: A great thanks Saul. I'm delighted to be here and I think the only other gaps outside of the fact that I'm father of two and a husband is we have recently done some really compelling work in helping and supporting and engaging and supporting physicians in something called the Clinician Experience Project with thousands of clinician members across the country and just super excited about the kind of results that we're seeing and what happens when you help and support and create practice conditions that allow clinicians to love the work that they do and do it really well. So super excited about talking to you and dive it in.
: Thank you. Yeah the work you're doing is truly impactful you're working with some big names. And really the feedback that I've heard from your work is inspiring. What is it that got you into health care to begin with?
: Well you know when I was in high school I wanted to be a musician. I was playing trumpet my parents really like imagine a living doing that and after I finished high school I actually spent some time with my uncle Dr. Robert Hazelbrook who's a neurologist and he told me about a day in the life of being a clinician and what that's like and the ability to diagnose, manage three, and sometimes cured disease and the master endeavor of learning a body of knowledge that allows you to make an impact in patients lives. And I was so intrigued by that day in a life that in that moment, on that day I switch from music to a biochemistry major at University of California San Diego now and the journey was on.
: That's a big shift.
: That's a big shift but a good reason to do it. Wow. So the years have passed and now you've sort of given from the front line and now you're taking a much more macro approach through what you're doing. Obviously there's a big void in what clinicians need and tell us how you're feeling that?
: What we've seen and dating back to Around 2001 I began and was selected and appointed to coach trained to develop clinicians in a very competitive health care marketplace driven by consumers and patient choice. And we as a group were in bottom decile in terms of patient experience. I was tasked with how do we help and support clinicians to provide better care to patients? And I really for the next 15 years became a student of what are the things that physicians need to really become the kind of clinicians that they want to be and really what I discovered that drove me into the work today is that clinicians make massive sacrifices to get into positions that they are and they are 90% of all clinical activity. There are 80 cents of every dollar spent in healthcare. Their principal cultural drivers and the fundamental skills by which to make health care better are never developed. Yeah and we're in a field now where over 50% of clinicians despite what I consider to be the most beautiful precious profession that there is anywhere to make a difference in the lives of those we serve. And over 50% are experiencing symptoms of burnout. And I consider that now to be a life calling. And again the night is for the work that we're doing now is helping supporting clinicians to do the work extraordinarily well, to connect to the patients they serve, to collaborate with their colleagues beside them, and to lead in a way that brings the very best of each other, and to use that to drive not only patient experience, harm reduction but also at the end of their day week month year life. They look back over their shoulder and they say this is everything I hoped it to be and that's the essence of really what we're trying to do is help drive the clinician experience and the clinician experience being the gateway to all the other health care imperatives in front of us and harm reduction, patient experience, patient loyalty, clinical excellence, and all those things.
: Well you know I think this is a truly inspirational work and very mission-driven. Folks when you're in the airplane and you're getting ready for takeoff, the flight attendant will tell you to put the oxygen on your mask before anybody that you love that's next to you. And really when we're working with clinicians it's so important that their gas tank be full and the work that you're doing Dr. Beesob is truly dedicated to keeping their gas tank full. So as health care leaders listening to this, looking for ways to improve, what would you say an example of something you and your organization has done to help say a health care executive improve that leadership culture for physicians?
: It's a great question and I think it's a complicated answer. What are the conditions and what are the personal approaches that clinicians take. So they love the work that they do. And we we are able to create and generate and execute on something called the clinician experience. We define the clinician experience as this is everything I wanted it to be. I provided the kind of care that I believe in were driven by evidence for getting great outcomes. And on Sunday night before a clinical day, I'm excited about tomorrow. That's the essence of the clinic. The question is what do we have to do to help support that? And if you look at that data in terms of what are the greatest influences on the clinician experience. First and foremost it is the conditions in which physicians work under it's not their personal resilience or their endurance. It's the conditions that clinicians work under so as I speak with leadership teams there is a composite of what leaders do where clinicians say I love it here. Number one they are out front and authentic, leaders are deeply committed to what's right and best for patients and they communicate in a way to their clinical body that connects with physicians values system so when we as leaders say hey you need to improve your patient satisfaction scores and see as regulations say we have to do this that and the other and the payer feel that saying we have to see more patients for less money. That's not what engages us to change. Well it prompts us to sit in the back seat cross our arms and say this is not at all what I thought was going to be. But the leadership approaches of outfront authenticity of a commitment to what's right and best for patient, we found in our research that the clinician experience project that when physicians feel as though their leaders are deeply connected to what's right and best for patients the probability of burnout among those physicians is 4x less than what leaders are not led by that nature. So number one they're outfront authentic and deeply committed and communicate in a way that's consistent with the position value system. Number two they tap clinicians to help solve care delivery problems. They don't mandate, dictate, and bullhorn solutions, they say "here we've got a challenge in regards to or start times you've got a challenge in regards to patient access. We've got a challenge regarding variance around diabetes composite. What are your best ideas? For us to innovate solution?" So they're tapping team intelligence and accessing the innovation of clinicians at the front line as a way of leading the organization. So physicians feel like I've got a voice, I can participate, and we're getting results done together. That's what leadership teams do. The third thing that leaders do where clinicians say I love it here is they simply appreciate their clinical team members, they recognize them, and they appreciate them, and they take it to a hospital as to get a phone call from their CEO who was rounding up patients up in the hospital and said hey I'm talking to patients and talking to nurses about your multidisciplinary round. You're making more impact than you can imagine and what patients and team members are saying about the difference that you're making and as this hospital was telling me the story of the CEO calling her she was welling up some it's just it's unreal to get appreciated for the work that we do. So what do we do to advance a clinician experience, we lead in a way authentically committed to what's best for patients. We tap the ideas of clinicians at the front line. We appreciate them and we take on administrative burden, reduction, as an imperative of leaders. We found in our research that when physicians believe their administrative burden is not reduced and taken on by the leadership team, connectivity to patients from their angle is reduced by nearly 80% and organizational cynicism doubles. So our ability as leaders to say what are the tasks that we can take off their plate to allow them to practice medicine? So four things reduction of interim, administrative burden, appreciate your clinicians have their ideas to innovate care solutions, and communicate in a way that's storytelling and authentic regarding what's best and right for patients. And we're seeing unreal results when leaders do that sort of thing.
: That's amazing. So folks here's the blueprint for creating that engaged culture. It's tough right. I mean you could have a blueprint but how do you follow through? So a question for you is what are you guys doing and maybe you provide an example Dr. Beeson of how you guys have helped an organization take this blueprint and make it actionable?
: No for sure. And again part of what we've done we've formed this community called the clinician experience project which is a learning collaborative community with over 15,000 clinician members across the country with some of the biggest names in health care and they're using this community as a catalyst, as an enzyme to allow the individual clinician to better connect with patients in the exam room meaning when I am interacting well with my patients. My love for the game is fundamentally different and driver number two is we help teams form communities a collaborative culture and getting better together. The clinical micro system level where they feel like there's esprit de corps and getting better together. And the third channel is what we talked about initially is developing leaders with skills to best engage their teams so we're using the Clinician Experience Project as a programmatic progression of how do we better connect, do we better collaborate, and how do we lead. We consider those things three legs of a stool and a stool does not stay on two legs.
: If you've got positions that are deeply connected to patients with toxic top-down administrative leadership you're going to destroy that clinicians. So they, the clinician as we've defined it is about connecting, collaborating, and leading, and then we use the clinician experience project and we've got fantastic results out of Kaiser Colorado, fantastic results and Centera Medical Group with measured outcomes and improvements in things like patient experience, physician engagement, and attrition reduction in documented case studies.
: So that's outstanding. Congratulations that's huge. And one thing that I really love about your approach Dr. Beeson is the database approach, your outcome-based approach, you're documenting everything, you're doing the research, you know this isn't like a feel good exercise although part of it is but you're really getting the data to back up what you're doing.
: Yeah I know for sure. I mean I think it's you know data is the currency of healthcare today. And if you're not in metrics it's not it's not why we're we're not here to move metrics. But it's a consequence when we better connect with patients and better collaborate with each other and lead more effectively. There's quantitative metrics that will move. One great example we're doing some work with Beth Israel Deaconess and they had one of their strategies was building a community and a collaborative sense of we're in this together. And what they had done and with some are worked together was started monthly meetings where they carved out one hour work clinicians and clinical team members could get together and talk about solutions to care delivery problems. And they did shorts rounds where they had a chance to sort of take a bow for what they flailed on that we do create vulnerability. And I'm not alone. And that once a month one hour they were able to reduce physicians sense. I went to women's organization from 78%. They had a five year plan that 70% of their physicians when to leave within five years that's not good. And just a year later got it down to around 35% and drop their physician turnover from 30% to 5%.
: That's amazing.
: So these are the kind of quantitative impact of what happens when we build collaboration and when we give physicians tools to connect with patients and when we start to lead in a way that brings the very best of our teams. And you know we are so deeply committed to helping clinicians love their work. And as you said you get to take care of your own oxygen mask I mean the literature on what happens to physicians and the care that we deliver when they're burned out from medical error to cost of care to patients were poor to med mal risk to care coordination and all those things that we consider to be imperatives all are significantly harm. But I think most importantly you use clinicians us we have sacrificed everything to get here personally, professionally, financially. And you finally get to the place that you dreamed of and 400 of us commit suicide because of the misery that we're experiencing. I mean it's like it's hell we can't have that in this sacred profession of impacting lives, collaborating with each other, and making diagnosis. I mean it's got, it should be great. And it's not. And that's why we're here.
: That's amazing. That's amazing and I love your commitment to it. So as you've built this and you've been thinking about these problems and the solutions to these problems you've been implementing things you've written a book on it. What have you learned a setback that you had as you were trying to implement these things? What did you take from that setback that now has become a principal of your organization?
: Well I think that if you had a 7 or a podcast we could talk about all the mistakes you engaging physicians. What I have learned and the learnings emerge from mistakes is that almost every clinician that I've ever met wants to be a great clinician and is deeply committed to it and sometimes it's so covered up by burnout and dismay and cynicism. But I think I think one of the big mistakes that I was part of number one not including physicians in key decisions and skipping that step and telling them what they need to go do. I think that would somehow be faster better easier if that had massive consequences and delayed improvements wherever I've been witness to literally years and the other mistakes that I think was part of of getting giving physicians data on patient experience, patient complaints, and even clinical data and not giving them the tools by which to improve that data. I think it's cool. I've shadowed over 600 physicians. We have 15,000 I have never met a physician who could articulate why the patients say what they say about and they go I'm not what. It's just unfair to give data when and again data is important without giving specific tangible. I can move the needle on this by virtue the solutions that I know I have. And so that was a big learning.
: And now it's a core principle. It's one of the three stools, are one of the three legs of the stool.
: Absolutely and a library of human contentment is mastery. Now our ability to accomplish achieve, improve, whether it be a golf swing, playing the banjo, or better connecting with their patients or leading in a way. I mean when you watch leaders learn skills that allows them to practice team intelligence and watch the innovation and enthusiasm emerge, leaders go "I wish I would've started doing this 10 years ago.'.
: It's easier and we're getting better results and everybody's on board. I'm dropping the bullhorn. It just doesn't work. And so but one of the things that I wanted to mention was all this composite of the clinician experience we have recently year leaders I would love to get their feedback. I wrote in my next book it's an e-book called The Clinician Experience which is the data and the approach for how do we tackle the Wellness Challenge. I would love for your...
: That's really interesting.
: So the best way folks that we can get you to engage with this e-book. Check out the show notes and I'm going to get a link from the team over there Practicing Excellence, Dr. Beeson's team. So you could get a copy of this book when you go to outcomesrocket.health/excellence you're gonna find that link and we'll provide a way for you to leave feedback for Dr. Beeson and his team.
: Yeah that would be fantastic. I mean we're trying to start a movement here of supporting those that care for others. And then when we do that everything anything becomes possible.
: That's outstanding. So we're getting close to our end point here Stephen, let's see if you could give us a little bit of maybe a sneak peek on a project that you're focused on today and I'm gonna roll into the lightning round part of the podcast and will conclude.
: That sounds great. One of the things that we do within the clinician experience project is we partner with organizations and we ask the question "what are the things you want to achieve and how can we help you as a enzyme to help and support clinicians to get there?" And we've got some really exciting projects that we're working on with some great organizations on how do we reduce harm and the safety culture. We've got some really exciting things coming in high reliability and patient connectivity and leadership development that we're doing in placing inside the clinician experience project and beginning to expand and deepen our research and assessing and tracking and measuring the clinician experience and always looking for collaborative partners to figure out innovative solutions supporting not only the clinician experience in terms of I love what I do but also clinician contribution to I now know how to better connect collaborate with my teams and provide really great care.
: That's powerful stuff. Now for the folks that want to engage with you and your team Dr. Beeson where did they reach out?
: Yeah I think probably the easiest way is just you know our website which is practicingexcellence.com and you can get a hold of any one of us through that site. And the book will be there for free as well. And I think with it the e-book in particular it begins to ask a different question. I mean there's thousands of publications now on burnt out. We've seen it, heard it. We wanted to ask a different question which is "what is present in organizations where clinicians really truly love what they do?" Of course there's tremendous overlap in addressing the principal causes of burnout. No question but the connect collaborate lead and all the literature and research behind it is very compelling. And again it's a different way of looking at a very high profile threat to American health care which is the wellness of the care team. And again we'd love to get some banter and chatter regarding how to approach this challenge differently than I put it on e-book.
: Thanks for the invitation. Folks go to a practicingexcellence.com to get access to that, for the show notes outcomesrocket.health/excellence. You'll find all that there. All right. This has been a ton of fun Stephen. We're in the lightning round okay so we're going to build a syllabus with four questions for the listeners on what it takes to be successful in the business of medicine and happiness and medicine. I got four questions followed by a book outside of the two that you've already written that you recommend to the listeners. You ready?
: Okay I'm ready.
: Alright. What's the best way to improve outcomes?
: Lead your teams with relentless passion.
: What's the biggest mistake or pitfall to avoid?
: Lead by a regulatory call to action.
: How do you stay relevant despite constant change?
: Tap your team and their innovations in what they think you should do differently to create value for the patients and serve together.
: Love that. And what's one area of focus that drives everything in your organization?
: Commitment to making a difference in the lives of others. Constantly telling stories about impact this is to be accessible.
: Yeah stories are powerful. What book would you recommend to the listeners?
: Well one of my favorite books is Cutting for Stone. It's a fascinating story about empathy and the journey of surgeons and how it's really one of my favorite books I've read it twice.
: Oh that's a good book.
: That's my recommendation. When Breath Becomes Air. I think it's another great book if your, that was hard to read but it's a beautiful, beautifully told story.
: Awesome. Some great recommendations there and a great syllabus for us to use as a framework to drive the things that we're doing. Again find the syllabus and the full transcript go to outcomesrocket.health/excellence. This has been fun and what I love Dr. Beeson is if you could just leave us with your closing thoughts and then the best place for the listeners can engage.
: I think the most important thing we can do as leaders in health care is to care for those that care for others and you know we frequently skip that step and we go on to the list of things on our scorecards that we're accountable for. But I can tell you in 15 years of experience and hundreds of healthcare systems and tens of thousands of clinicians that the headwind and friction of getting those things done is overwhelming when clinicians are overwhelmed, burdened, and not supported. So help and support and engage your clinicians, make their wellness a number one imperative. And when we do that, harm reduction, clinical variation reduction, patient experience, talent retention, top and bottom line, can all follow. And without that all those things are really hard.
: That's amazing.
: And again you can practicingexcellence.com. We'd love to help and support anybody that's looking to take the. We want to take care of our clinicians journey. We get some incredible stories that are emerging and data that's coming forward when we do that right.
: So they have it folks. That is your call to action. If something today resonated with you, take action, don't wait 10 years like Stephen mentioned. Do it now because the results will be a ripple effect of greatness. Stephen this has been great. I really appreciate your time and definitely looking forward to staying in touch.
: All right thanks Saul. Appreciate it.
Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.