Relational Rounds

This podcast showcases a deeper discussion of psychological safety, described by Amy Edmondson, an expert on leadership, teaming, and organizational learning, as “a shared belief that the team is safe for interpersonal risk-taking.” You will hear Dr. Brian Park share stories of colleagues leading from where they stand to create safer spaces for those around them. With the current COVID-19 crisis, there has been an increase in fear, anxiety, and stress among healthcare workers. Psychological safety is always important, but now more than ever, we need to make sure people can speak up to share their concerns and seek the support they need. Key takeaways: [1:15] The four core models of relational leadership — and one of them is psychological safety. [1:40] What is psychological safety? [4:02] Brian Park introduces himself and the crucial importance of relational leadership practices. [7:14] Brian Park defines psychological safety. [9:54] Brian Park explains different factors associated with psychological safety. [11:13] What does psychological safety look like in a team? [12:23] Psychological safety in times of COVID-19 is more important than ever. [13:40] Brian Park shares how humanizing each other is a helpful behavior to cope with the stress of workers in health care teams who are dealing with the COVID-19. [16:10] A leader is just a human that feels, struggles, and is brave enough to share it. [16:25] Brainstorming should be an invitation to play. [18:23] Embrace a ‘fail forward’ mindset, a growth mindset. [19:20] Assign a balcony team member: Someone who can stay outside of the team and observe the relational dynamics. [23:50] How Brian Park models psychological safety. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Relational Rounds Response

Stories are powerful. Stories help us feel seen and give us a sense of being known. Listening to a colleague’s story can transform your relationship, allowing you to move from, “I know what she does” to “I understand what she cares about.” Listen for more on how to invite others to share their stories. Key takeaways: [1:26] PCP is reengineering the way of delivering the relational leadership curriculum. [2:50] Listen to understand. [3:10] Matt Lewis, senior strategic consultant at PCP. [5:24] The importance of feeling seen. [6:25] Storytelling to achieve a quick sense of community. [7:27] Stay curious. [10:04] Ask more questions and encourage people to “say more.” [10:32] Observe how you feel when you are listening to people’s stories. [13:13] Challenge the cultural narrative. [15:13] In moments of uncertainty and overwhelm storytelling can be liberating. [16:40] Look back to other moments of fear and uncertainty in your life and how you managed to go through them. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter

Dr. Mark Schuster is a physician, scientist, and advocate for healthy families and communities. Dr. Schuster is recognized as an international leader in research on child, adolescent, and family health, concentrating on topics such as quality of care, health disparities, family leave, obesity prevention, and bullying. Dr. Mark is a founding dean and CEO of Kaiser Permanente School of Medicine; he explains the most important aspects of their innovative approach in teaching medicine integrating foundational, clinical, and health system science together as well as giving students the opportunity to work with patients starting in the second year. Addressing burnout and social environmental factors are two areas of main importance in Kaiser too. The change in the health system starts in how physicians are being trained. Listen to this episode and discover a different approach to medical education. Key takeaways: [:33] Dr. Mark Schuster career briefing. [1:26] One of the one hundred most influential people in healthcare. [3:50] What need did Kaiser identify that Dr. Mark is trying to fill? The most effective approach for medical education. [5:38] How best to design medical education in the U.S? [6:38] Before, students used to absorb content passively in Medical training. [8:55] Kaiser provides a small-group, case-based learning approach. [9:22] Working in integrating foundational, clinical, and health system science together. [11:45] Spiral approach. [12:05] Students at Kaiser are not working on cadavers. [14:14] Humanism while studying medicine. [15:15] Second year at Keiser provides interaction with patients. [17:11] Using imaging for anatomy. [17:35] How can a health system address social environment risks? [22:13] Physicians have to address community health. [20:08] Addressing the social determinants of health. [23:22] Physicians have a privileged place in treating mass shooting victims. [25:32] Training students for them to keep their own self-care as a priority. [29:03] REACH (Reflection Education Assessment Coaching Health and Wellbeing) weeks are breaks from the regular curriculum. [32:14] Physician burnout also affects patients. [37:05] Hot seat! Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Kaiser School of Medicine

The statistics are now known by everyone: by September 2018 it was reported by the Physicians Foundation that 78% of doctors are presenting symptoms of burnout. Physicians have the highest rates of suicide in the nation; interns experience a 10-fold increase in depression during the first year of internship; it is a very tough time to be in medicine. There are many institutions fighting back against this trend; one of them is OptumCare, which is an incredible team that is working hard to reverse this trend. OptumCare is a subsidiary of United Health, the world largest healthcare provider, serving 115 million individuals. Optum is working to transform the U.S. health system into one that serves people with greater value, with a focus on ambulatory, community-based and primary-care-driven solutions. Today guests are Stephanie Bartz, VP, strategy and chief of staff of OptumCare; Curtis Mock, physician executive, serving as Culture facilitator, a member of Optum diversity and inclusion council, and a member of culture leadership team; Todd Staub, senior VP of physician relations; and Kay Stevens Madler, director of the office for provider advancement, focusing on provider development and engagement. Key takeaways: [1:37] Stephanie Bartz [1:51] Curtis Mock [2:18] Todd Staub [2:35] Kay Stevens Madler [3:06] Why wellness? [5:19] What bring Curtis Mock into this space? [6:20] The space of culture. [9:18] Biggest challenges. [11:14] Building resiliency. [13:18] Creating community. [14:23] What can be done? [16:01] People were seeking for purpose but were missing a place to go. [16:49] Meaning of leadership in healthcare today. [18:06] Co-creation at OptumCare. [21:39] Medical Culture. [22:15] Primary care to keep people out of hospitals. [25:20] Is the healthcare system heading to a “bank bailout” moment? [27:28] Is there a physician shortage in the U.S.? [29:10] Rethinking healthcare. [30:32] Realities on the inside and the outside of the clinic. [32:20] Primary care is a mirror of society. [34:12] Optum going beyond the clinic with their Mobile Clinics. [37:48] Social determinants of health. [38:42] Using technology to support relationships. [39:33] Empowering patients. [41:05] Burnout. [42:16] The difference in OptumCare practices. [44:36] Clinicians are building a resilient and positive culture. [45:10] The crucial value of inclusion. [46:17] Rapid Fire questions! Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter OptumCare Clinician Insights

A physician, scientist, educator, and advocate for healthy families and communities, Dr. Mark Schuster is an international leader on quality of care, health disparities, and prevention. Author of two books and more than 200 journal articles, Dr. Schuster was appointed founding Dean and CEO of the Kaiser Permanente School of Medicine in 2017. The school is set to open its doors to an inaugural class of aspiring clinicians this year. As talk of graduate medical education reform continues to reverberate in the healthcare community, Kaiser Permanente is betting on a more integrated approach that brings students into a large health system at the very beginning of their training, with an emphasis on primary care, prevention, and innovation. Key takeaways: [:30] Dr. Mark Schuster career briefing. [1:37] Why is Dr. Schuster a “man to watch”? [2:14] Uniqueness about Kaiser Permanente. [4:10] A school focused on medical education with the most effective approach [5:29] What is wrong with the current medical education? [6:38] What does Dr. Schuster wish he had learned in his medical training? [8:54] Changes Kaiser Permanente is implementing in the ways students are learning. [9:29] Integrating foundational science, clinical science, and health system science. [11:52] Spiral approach. [12:13] No cadaver labs. [14:03] Does being in direct contact with a body provide a level of humanism? [14:16] Medical students in the first year will be with physicians and the medical team, seeing patients in a primary care setting. [17:05] Tackling social determinants of health in medical education. [20::30] The power of each individual physician as a local advocate [22:53] Role of physicians in gun violence. [24:20] Burnout, training for doctors to keep their own self-care. [25:48] Students connected to faculty. [26:19] Regular consultations of students with a psychologist [27:15] Academic support. [27:50] Encouraging students to take breaks [28:12] REACH weeks. [29:50] Are we going soft? [33:07] Being a dean of a medical school. [34:44] Rapid fire questions Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Kaiser Permanente School of Medicine

Elizabeth Metraux is having two thoughtful conversations at Unity Health Care in Washington, DC, a Teaching Health Center connected with The Wright Center for Graduate Medical Education. She speaks with Patrick Kinner and Dr. Nickia King about the gap between what is taught in medical schools and the realities of daily practice, particularly the social determinants of health. Patrick Kinner is an evaluator with the Vermont Department of Health and the Center for Behavioral Health Integration, where he lends his evaluation expertise to statewide and national population health initiatives. Patrick shares his views on medical school programs, burnout, and the length healthcare providers go to take care of patients. Nickia King, DO, is a third-year family medicine resident at Unity Health Care. She discusses her experience as a Wright Center resident working in community healthcare, the role of advocacy in care, and ways providers can address the myriad problems of illness that go far beyond the walls of the clinic. This episode aims to raise awareness about the work of Teaching Health Centers, a crucial part of the solution for moving American healthcare forward. Listen to this inspiring episode for a fresh perspective and a promising future for healthcare. Key takeaways: [:30] Partnership with The Wright Center for Graduate Medical Education. [2:05] Teaching Health Centers’ purpose and impact. [2:30] Unity Health Care [4:21] Patrick Kinner’s work motivation. [5:14] Bringing a family residency program into underserved areas. [6:15] Consistent themes nationwide. [7:31] Difference between what school prepares you for and what your actual job is. [8:22] Medicals schools are not well-equipped to be nimble and change. [8:53] Differences between DO and MD programs. [10:22] Burnout and professional disengagement [11:30] Reaching a saturation point. [12:37] Mental health clinicians’ burnout rates. [16:02] Patrick Kinner’s insights about himself as a patient. [20:16] Healthcare providers have been self-diagnosed and self-treated for decades, as well as treating issues that should not be presented to them. [22:04] Big public institutions reflect the community that they are in. [23:58] Nickia career briefing. [24:18] What brought Nickia into medicine? [24:50] Washington, DC living experience. [26:08] Why working at a community health center? [28:23] Focusing on advocacy [28:57] Nickia started teaching in health centers. [31:12] Access to healthy food, safety, and education. [32:45] What ought we to do as providers? Take care of the whole person. [34:22] Social determinants of health. [34:56:] Statistics about black individuals’ health. [36:44] Prison population [38:43] What did the experience in DC teach Nickia about herself? [40:01] Nickia starting to work in the prison system. [40:52] Crying for the first time with a patient. [44:24] Treating both the illness and the illness experience. [44:59] Humanism in medicine. [46:50] Coming from a long line of strong women. [48:47] Seven months away from getting out of residency, what are Nickia’s plans for the future? [49:37] Preventing burnout. [50:07] What does Nickia wish she would have known in her first year of residency? [52:06] Advice to young black women who are considering a career in medicine. Mentioned in this Episode: The Wright Center Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Jonathan M. Adler, Ph.D. is Chief Academic Officer and Co-Director of Healing Story Sessions for Health Story Collaborative, an amazing organization that champions the use of story and medicine as a tool for connection, healing, and action. Jonathan Adler has a Ph.D. in clinical and personality psychology from Northwestern, he is a clinical psychologist, member of the editorial team of the Journey of Personality and professor at Olin College. His research focuses on how we make sense of challenging experiences in the way that meaning-making impacts our sense of self and psychological well being. Jonathan Adler uses his personal narrative as a vehicle for studying meaning-making and identity, with a special interest in the experience of illness and healing. In this outstanding episode, Jonathan Adler deeply shares his passion and knowledge about narrative and how it is intricately involved in every part of human life, even recognizing our ability to tell stories as the most distinctive human adaptation. Jonathan brings light to the fact that people find meaning and identity when telling stories; and how at the same time in the act of narrating, connections are being made among individuals and with society as a whole. Key takeaways: [:37] Jonathan Adler’s career briefing [2:05] How did Jonathan Adler enter this particular space? [4:15] Science and stories. [5:21] How do we use stories for healing? [6:54] Narrative is everywhere. [7:42] Narrative is the tool we use to make sense of our lives. [8:00] What has Jonathan Adler learned about himself in this work? [9:36] Master narratives: What a culture believes is supposed to be narrated. [10:18] Why U.S. narrative is so focused on redemption? [13:16] Narrative is the nexus between self and society. [14:10] Finding compatible narratives. [15:17] Every political movement has its own narrative. [17:03] Jonathan Adler’s work with illness. [19:35] Telling your story is an intervention itself. [21:35] Many people go into medicine because of the relational aspect with their patients. [23:31] We need more space for the connections that only stories can provide. [24:04] How can someone start in storytelling? [26:02] Stories of people that acquire major disabilities in adulthood. [28:16] Rapid-fire questions. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Email Jonathan Adler: jadler@olin.edu Health Story Collaborative

Sejal Hathi, MD, MBA is a resident physician at Massachusetts General Hospital and an award-winning social entrepreneur dedicated to building better health systems for vulnerable populations globally. Presently, she serves on the national boards of political organization Arena and civic organization Indiaspora. Previously, she founded and led two social enterprises advancing women's rights and agency around the world. Sejal received her MD/MBA from Stanford and her BS with honors from Yale. She has been named to the Forbes 30 under 30, Paul & Daisy Soros Fellows, Truman Scholars, and Newsweek "150 Women Who Shake the World." Sejal and Elizabeth engage in a deep and thoughtful conversation about healthcare, politics, social determinants of health, burnout and the role of women. Being a young woman advocating for the rights and needs of women from a very young age has given Sejal a unique perspective. Listen to this episode to find an encouraging, critical and inspirational testimony about healthcare, its extensions, and challenges. Key takeaways: [1:02] Sejal Hathi career briefing. [1:55] Sejal’s journey into medicine. [3:43] Recovering after being diagnosed with Anorexia Nervosa. [4:22] Reclaiming dignity. [5:43] The role of medicine is continuously in debate. [7:51] Health is not just a diagnosis. [9:32] Acknowledging the social determinants of health. [10:50] Burnout is a public health crisis. [12:14] Medicine is a shadow of what it used to be. [14:40] Opportunities to come together. [17:05] Innovations that are working for residencies. [17:50] Coaching benefits. [18:43] Connection with mentors in residency programs. [20:01] Women need more female mentors. [25:25] Being a woman in a position of authority. [26:49] Starting nonprofit organizations to support women. [30:25] Creating community to make a difference. [31:08] Healthcare becoming more political. [32:08] Domestic advocacy. [34:23] Silence is political, we have to take a side. [35:20] Rapid fire questions. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Dr. Oliver served as the Deputy Commissioner for Population Health for the Virginia Department of Health. Before accepting the Deputy Commissioner position, Dr. Oliver was the Walter M. Seward Professor and Chair of the Department of Family Medicine at the University of Virginia School of Medicine. As Chair, Dr. Oliver helped lead the transformation of the Departments clinic sites into patient-centered practices focused on population health. In his role as the Deputy Commissioner for Population Health, Dr. Oliver worked with others in the health department, other state agencies, and healthcare systems across the state to improve the health and well-being of all citizens of the Commonwealth. He remains committed to a cross-agency and multi-sector approach to implementing population health initiatives. Dr. Oliver has a long record of accomplishment. Studying health inequities, particularly as they affect racial and ethnic minorities, has been the focus of his research. Listen to this episode where Dr. Oliver shares his experience, expertise, and personal perspective regarding healthcare, social determinants of health, the opioid epidemic and the reality hitting women and minorities in the healthcare system. Key takeaways: [:42] Dr. Norman Oliver career briefing. [1:31] What brought Dr. Norman into medicine? [4:58] Top priorities in the social determinants of health. [7:06] Identifying social and economic conditions that impact health. [9:33] What are the topics Dr. Norm is tackling now? [14:33] The opioid epidemic. [15:18] How is the opioid epidemic impacting Virginia? [17:34] The opioid problem has always been with us. [20:55] The opioid epidemic is a medical problem and needs to be treated as a disease. [22:05] Who will attack the problem of despair that leads to addiction — policymakers or clinicians? [27:37] We don’t talk politics, we talk about human stories. [28:40] Dr. Norman’s crazy bold idea. [33:20] Population health work. [37:40] What did Dr. Norm learn about his role as a clinician? [40:11] As a clinician, I am a consultant, I am not there to tell you what to do. [41:58] Being a black man in medicine. [45:22] Latinos and African Americans are a third of the state of Virginia [47:22] “You have to be twice as good to get half as far.” [48.35] Dr. Norm as a representative of the African American community. [51:02] Code switch. [51:50] How are Dr. Norm’s kids like him? [55:04] Rapid-fire questions. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Erin E. Sullivan, Ph.D., is the Research and Curriculum Director at the Harvard Medical School Center for Primary Care. In this role, Erin leads the Center’s research program, where her team studies high-functioning domestic and international primary care systems. She also holds a faculty appointment in the Department of Global Health and Social Medicine and co-directs the Physician as Leader course for fourth-year medical students. Erin and Elizabeth discuss in depth primary care foundations as seen through the eye of an expert in qualitative research. Listen to this episode to find out about the crucial importance of relationships and the diversity of organizational cultures around the world, their impact on employees and patients, and how comparative research can help the U.S. primary care system to lift for higher standards of service. Key takeaways: [:33] Erin’s career briefing. [1:33] How did Erin start into research and primary care? [2:04] Why Erin got interested in medicine. [3:33] Finding excitement in the qualitative aspects of research. [5:04] Finding those aha moments! [7:30] Organizational culture in a clinic. [10:30] Speaking the same language. [11:24] Different cultures in different organizations. [13:07] How do research groups get involved in primary care? [14:30] Why research in Spain and the Netherlands on primary care? [17:25] In Netherlands, Primary Care is considered a specialty. [19:50] Relationships comes up in data everywhere! [23:35] Key elements in primary care: relationships and culture. [25:38] Erin’s curiosity about future possible researches. [27:15] Patient’s expectations. [28:55] Challenges in measuring the outcomes of leadership development programs. [30:26] Teaching in healthcare in the near future. [31:27] Hot seat! Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Erin Sullivan Bio Harvard Center for Primary Care Erin E Sullivan on Linkedin

Brian Souza is the new CEO at Primary Care Progress. He believes in the power of community, the importance of teams, and understands how to leverage the head and the heart – beliefs that are at the core of PCP and the people in its network. Brian is committed to lead the PCP team, its values, and approach to leadership transformation designed to strengthen the community at the heart of care. Listen to this episode, meet Brian and learn from his innovative ideas about uplifting the providers, and his fresh perspective concerning a new kind of “relational” leadership. Key takeaways: [:51] Brian Souza, new CEO at PCP, career briefing. [1:55] What motivated Brian to join PCP? [4:30] Building national movements. [6:07] Different approach to leadership. [6:30] Team value. [7:22] Building communities takes time. [8:50] What is that makes progress so slow in health care? [11:59] Why does Brian care about providers? [14:43] Supporting practitioners in healthcare. [16:29] How can leadership transform the healthcare system? [18:56] Teaching people to be human. [20:25] The art of asking questions. [21:50] Creating safe spaces where is OK to be vulnerable and to connect. [22:31] The line between being the boss and creating safety and vulnerability among the team. [25:33] Healthcare needs more love. [27:11] Building the team as individuals. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Dr. Deb Cohen is an expert in qualitative and mixed measured research with more than two decades of experience, half of that focused on primary care practices, clinician-patient communication, and health IT. Dr. Cohen’s work in EvidenceNOW has as an ultimate goal to really dig into the understanding of what changed and why in primary care, how much facilitation support was needed and the touches that facilitators made with the practices which finally are what really are going to make the field move forward. Dr. Cohen shares in this episode a unique perspective about primary care and its challenges and projections for the future. Key takeaways: [:35] Dr. Deb Cohen career briefing. [1:32] Being a qualitative methods specialist. [2:37] What does Dr. Cohen find attractive in primary care? [4:10] The importance of a family doctor. [4:45] Primary care doctors’ overloads of work. [6:08] How did Dr. Cohen’s project start and unfold? [8:37] Challenge that doctors have to unlearn things when evidence is pointing in other direction. [12:06] Mixing quantitative and qualitative data. [13:41] EvidenceNOW is not an evaluative entity. [14:10] Are there any prevailing themes for particular kinds of clinics? [14:45] Small clinician-owned practices in the last decades. [17:19] Detecting burnout. [20:21] Investment in primary care. [23:02] The art of finding out what are the active ingredients of an intervention. [24:05] Learning about the work of community health workers. [25:03] Why don’t researchers talk to each other? [26:42] What is next for Dr. Cohen? [29:03] The adaptive reserve. [32:33] Rapid fire questions. Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter EvidenceNOW

H. Clifton “Clif” Knight, M.D., is Senior Vice President of AAFP. He oversees all AAFP activities related to medical education. These areas include education and training of medical students and residents; student interest in the specialty of family medicine, including federal policies that affect it; and CME curriculum development, production, accreditation, and regulations. Dr. Clif has dedicated his life to family medicine and strongly believes in the need of giving the attention clinicians are craving for, the increasing amounts of burnout, depression, and isolation are proof that the health care system needs a change, bringing back the patient value over the corporate value. Dr. Cliff inspires with his passionate, sensitive, and human perspective on the role of physician, and shares practical proposals to shift the course of health care. As Dr. Clif says, “the best is yet to come.” Key takeaways: [:35] Dr. Clif Knight career briefing. [1:26] How Dr. Clif got into medicine. [3:55] Why family medicine is the least sexy of the specialties? [5:34] American Academy of Family Physicians: assisting members to provide the best care for patients, families, and communities. [8:31] Administrative work receives three-quarters of the time. [10:28] EHR were developed to meet billing requirements. [12:08] Generational differences between clinicians. [13:07] Physicians are willing to adapt for the better care of their patients. [14:02] Where Dr. Clif is investing the most time and energy for the wellbeing of the physicians. [16:51] Finding the balance between accomplishment, humanity, and connection. [19:10] There is an avid appetite for connection and validation. [19:40] Don’t try to fix me, fix the system! [22:43] Denial about the impact of burnout. [25:11] Clinician wellbeing is a component of providing the safest care to patients. [25:40] There is a public health epidemic. [27:08] Higher rates of depression and disconnection. [28:20] The impostor syndrome. [33:20] There has to be more investment in primary care. [36:16] There is a need of doubling the number in family medicine slots. [37:40] What did Dr. Clif learn about himself? Mentioned in this Episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Reach Dr. Clif at AAFP

Carol Bernstein, M.D. is a Board Certified psychiatrist who is Associate Professor of Psychiatry, Vice Chair for Education in Psychiatry and Director of Residency Training in Psychiatry at the NYU School of Medicine. She is also a Past-President of the American Psychiatric Association and currently serves on the Board of Directors of the Accreditation Council for Graduate Medical Education and the Board of Regents of the American College of Psychiatrists. Dr. Carol engages in a deep conversation with Elizabeth about the differences between burnout and depression, the loss of connection among caregivers, the loneliness and isolation — all these factors that are causing the highest suicide rate ever recorded in the healthcare system. According to Dr. Carol, some of the reasons for this suicide escalation can be found in the quality of our current leaders, and the hope lays on the features of the future leaders who could introduce the changes we want to see in this field. Key Takeaways: [:33] Dr. Carol Bernstein career briefing. [1:16] How did Dr. Carol get interested in the mental area? [4:07] Suicidal increment in health care. [6:21] The emphasis on making money is compromising the quality of patient care. [6:54] Loss of connection, loneliness, and isolation among caregivers. [7:45] Burnout is not depression. [10:40] How do we talk about burnout? [14:23] Is language perpetuating the problem? [15:38] Fear Of Missing Out (FOMA) [19:30] This is an anxious generation. [23:11] People are living longer with chronic illness so the experience of the illness is as important as the illness. [27:02] The healthcare system is in need of the right leaders. [30:51] What we cannot measure is the most important. [32:02] Prediction for the next two to four years depends on the leadership. [33:30] Technology needs to come after the face-to-face interaction. [35:12] ‘Whole patient, whole connection’ doesn’t have any substitute. Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Jeremy Topin, M.D. dared to change a work model that was not only affecting his physical and mental health but influencing his family bonds. Jeremy started a blog after a bold decision that was to cut back, moving to part-time work, regaining health and renewing his love for his profession. Burnout takes different shapes, it is not universal, is definitely an accumulation and it's simply OK until is not! The only universal aspect is that it is happening to more people more frequently. Listen to this podcast and be inspired by Jeremy and Becky’s journey regaining their lives and passion, while battling with the challenges this kind of change presented. Key Takeaways: [1:12] Jeremy’s personal journey. [4:16] Ignoring how life would look like when he became a resident. [11:02] Being a parent and working in the ICU. [13:02] His wife had a miscarriage but Jeremy knew he needed to go back to work. [17:45] Burnout: Saying you are fine until you are blown away. [18:25] Realizing you can’t go on in the same way anymore, the cutback moment. [21:38] Dealing with the financial consequences. [24:51] The support network Jeremy and Becky got as a couple. [30:10] Burnout is not tangible. [32:41] Finding the balance between wins and losses. [33:32] High amount rate of divorces among residents, advice for the couples. [36:14] A family team. [40:46] Refusing to wrap up his identity around being a doctor. [50:56] What fulfills Jeremy? [52:17] As the wife of a doctor: What to say when you really need him to show up? Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter

Monica Bharel, M.D., MPH, is the Commissioner of the Massachusetts Department of Public Health, appointed in February of 2015. She is responsible for spearheading the state’s response to the opioid crisis, implementation of health care cost containment legislation, reducing health disparities, finding public health solutions for health care reform, finding innovative solutions using data and evidence-based practices, and other health care quality improvement initiatives. Dr. Monica served as the Chief Medical Officer of the Boston Health Care for the Homeless Program, the largest nonprofit health care organization for homeless individuals in the country. In this episode, Dr. Monica explains the origins of the opium epidemic, as well as the program that is being implemented in Massachusetts after a rapid increase in the number of deaths by overdose. Prevention, intervention, treatment, and recovery — the plan to face an addiction that has risen exponentially and needs an integral approach to stop threatening the lives of Americans. Key Takeaways: [:40] Dr. Monica Bharel career briefing. [1:50] What else does Dr. Monica want to accomplish in healthcare? [2:50] Thoughts only days away from the health care reform. [4:23] Health in all policies. [5:30] The opium epidemic. [6:44] Plan in Massachusett against the opium epidemic: Prevention, Intervention, Treatment, and Recovery. [8:25] The Opium epidemic took everyone by surprise, how did it happen? [9:16] Fentanyl is 50 to 100 times more powerful (and deadly) than heroin. [11:33] Recently more attention has been paid to pain. [13:06] Doctors are not been trained to treat addiction properly. [15:50] Pain is subjective and doctors are being trained to help people screen that pain. [17:33] In a society that wants instant gratification, pain is treated the same way. [19:34] The role of interventions. [20:16] The use of methadone. [22:44] Individuals with a non-fatal overdose when treated with methadone, decreased the chances of death by overdose in 50%. [24:47] Opium used disorder is political. [26:05] Highlighted attention to addiction nowadays. [28:26] Recovery and treatment. [28:55] The other crisis: the Me Too Movement. [30:30] Being a woman in healthcare. [32:41] Best advice Dr. Monica received in her career: You can have more than one mentor. [34:15] The artificial division between public health and the traditional medical space. [37:41] Use your strength to help individuals that do not always have a voice. Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux on Twitter Massachusetts Department of Public Health Massachusetts Department of Public Health on Twitter.

Cheryl Fattibene, NNCC Chief Nurse Practitioner Officer, is an experienced Nurse Practitioner who has worked in both the for-profit and non-profit health care sectors as a provider and a clinical leader. Cheryl brings a nurse’s perspective on how to approach a new era of healthcare. Her experiences overseas as well as with migrant people in the U.S. have contributed to her innovative and integrative perspective over the healthcare system where a team-based care is the necessary direction. Listen to this episode and be inspired by Cheryl’s story, find out the simplicity in improving healthcare by making real connections, reaching out and giving back locally. Key Takeaways: [:38] Cheryl career briefing. [1:46] What led Cheryl into the world of nursing? [4:30] Living in Africa transformed Cheryl’s life. [9:10] What is Cheryl working on right now? [10:56] Foundational Public Health Work. [13:06] Barriers to team-based care. [14:14] Nurse practitioners’ challenges. [16:49] Team-based care under different statuses and salaries. [19:13] Wellness for the workforce applied to nurses. [20:30] Nurses and burnout. [25:06] How do you learn to be a mentor? [27:11] Advice to young women that are new to healthcare: Find a Mentor. [29:33] What worries Cheryl currently? [30:31] Give back locally. [33:52] Working in a migrant center. [36:34] Regardless of your age, just reach out to others. [38:28] People feel disconnected. [38:41] Upcoming projects for Cheryl. [40:45] High School for nurses. [42:50] Space redesign. [43:46] Big crazy idea for fixing healthcare: A unified approach. Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Elizabeth Metraux in Twitter National Nurse Led Care Consortium Contact Cheryl: cfattibene@nnlcws.com National Conference

Neil Baker M.D. is an organizational and leadership consultant and coach and serves as faculty for the Institute for Healthcare Improvement. He works with healthcare organizations and individual executives to enhance leadership and team impact through In-the-Moment Leadership Strategies. This means using any work situation, even the most complex and difficult, as an opportunity to achieve immediate impact on quality of work relationships and on progress toward results. Listen to this episode and discover how Neil redefines leadership, what positional authority means, and how it can be applied to physician leaders. Humbleness, relations, listening and finding out what people and organizations truly care about — it might be simpler than we think to see a transformation in healthcare hierarchies. Key takeaways: [:37] Neil Baker career briefing. [1:34] How did Neil get into medicine? [2:15] The sick role: exploring different understandings of being sick. [3:50] Learn, change, grow and develop. [4:54] Evidence Guidelines: Systematic process to grade the level of confidence to be able to give recommendations. [6:11] Every field has its professional and technical side and a human relational side. [8:15] Definition of leadership: Owning your responsibilities for outcomes and the quality of relationships you’ve done. [9:00] Positional authority core functions. [9:35] Followership. [10:06] Failing as a leader. [13:48] Self-defeating behavior happens to 100% of the population. [15:18] Our brains are wired for survival, you need to make a rapid assessment of the environment and take action; this complicates social situations. [17:13] Responsibility: Leader or Team? Everyone is responsible. [20:53] Creating norms. [23:30] People wants to be listened to. [25:25] Most of the times, experts in conflict resolution are not needed, we just need to listen to each other. [28:57] Why no one is talking about organizational culture in healthcare? [30:38] Is it unrealistic to have physician leaders? [36:17] Role of hierarchy in healthcare. [39:05] Gallup studies on engagement. [41:28] Clarity in decision making. [43:13] Stronger relationship with manager leads to better work. [45:45] Creating change in healthcare through relations. [50:19] Advice for the ones struggling to form a team. [51:33] What do you care about? [53:09] Rituals to center yourself before meetings: Spend time in preparation and know yourself. [55:35] What preoccupies Neil? Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter Neil Baker Consulting

Karen Gordon is the President/CEO of 5 Dynamics. As a high-energy problem solver and tireless worker, Karen thrives on helping companies revolutionize work culture and collaboration. Karen developed a methodology as a groundwork to help people collaborate more efficiently in teamwork. Healthcare dramatically benefits from this approach, helping in forming better teams while finding the strengths of each member, and at the same time, greatly easing teamwork, reducing stress and burnout. Listen to this podcast and find out more about this revolutionary approach that changes the ideology concerning leadership, group work, and efficiency. Key Takeaways: [:35] Karen Gordon career briefing. [1:35] What is 5 Dynamics? [2:40] Is 5 Dynamics a personality profile? [3:48] What are the different strength areas? [4:43] What is the best-formed team? Blended energies work best. [5.34] Growth mindset. [8:02] Need for more collaboration in teamwork. [9:05] Once you know your strength, how do you integrate this knowledge into your work? [11:03] What Karen learned about herself in the process of helping others. [13:29] Patterns in the data regarding minorities. [16:17] Karen’s mentor as a woman leader — her unstoppable mother. [18:08] Why Healthcare teams can benefit from the 5 Dynamics tool. [19:16] Understanding the strengths of your team members. [19:54] Physicians do not play a team sport — they don´t know how to work with others. [20:50] Healthcare case scenario working with 5D Dynamics. [21:31] No one does it all; we need other people. [22:30] Understanding our energies helps us find the solution to the burnout epidemic. [23:43] Finding the joy in the letting go. [25:34] Not everybody is that self-aware. Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter 5 Dynamics Get in touch with Karen: karen@5dynamics.com

David Blumenthal, M.D., M.P.P., is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. From 2009 to 2011, he served as the National Coordinator for Health Information Technology, with the charge to build an interoperable, private, and secure nationwide health information system and to support the widespread, meaningful use of health IT. Dr. David engages in a thoughtful conversation with Elizabeth Metraux about the past, present, and future of healthcare in America, the inner conflicts that the system is facing and the audacious ideas to fix it. Key takeaways: [:30] Dr. David’s career briefing. [1:40] What has Dr. David not yet accomplished? [2:30] What drives Dr. David’s mission? [4:55] Healthcare is built around the workforce. [6:56] How did the U.S. get to the current situation of Healthcare? [9:25] Changes are being implemented in the Affordable Care Act. [11:01] The cost of care is not sustainable. [13:58] Work in coverage expansion and delivery system reform. [17:08] Obama’s administration and the opportunity that was given to healthcare. [22:53] Electronic Health Records. [26:06] Is healthcare too big to fail? [28:21] Audacious idea to fix health care: everyone having a digital health advisor. [30:25] Dr. David Blumenthal Foundation celebrates 100 years. [32:45] The delivery system reform. Mentioned in this episode: Relational Rounds at Primary Care Progress Primary Care Progress on Twitter David Blumenthal on Twitter Commonwealth Fund The Heart of Power: Health and Politics in the Oval Office, David Blumenthal and James Morone.