Interview with Dr. Mark Olsyzk – 356
In today's interview, outstanding CMO Dr. Mark Olszyk provides his advice and that of his co-authors from The Chief Medical Officer's Essential Guidebook.
He discusses the critical skills required for effective medical leadership and practical tips for navigating complex healthcare challenges. And he emphasizes the importance of continuous learning and collaboration among healthcare professionals to be successful.
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The Journey to Becoming an Outstanding CMO: Insights and Experiences
John leveraged resources from the American Association for Physician Leadership (AAPL), including its Certified Physician Executive (CPE) program, to enhance his leadership skills. That is where he met Dr. Mark Olszyk, a seasoned physician leader with a rich background in military service and medical administration.
Dr. Olszyk, co-author and editor of “The Chief Medical Officer's Essential Guidebook,” shares his extensive experience in medical leadership. From his early days in the Navy to his decade-long tenure as a Chief Medical Officer (CMO), he highlights the importance of learning from successes and mistakes. The book serves as a comprehensive guide for aspiring CMOs, offering practical advice and lessons distilled from the experiences of various medical leaders.
The Role of a Chief Medical Officer: Responsibilities and Challenges
Dr. Olszyk outlines the multifaceted role of a Chief Medical Officer, emphasizing the importance of building bridges between various stakeholders in a hospital. He describes the evolution of the CMO role from the Vice President of Medical Affairs, focusing on credentialing, privileging, quality reviews, and regulatory compliance.
A CMO is a liaison between the medical staff, hospital administration, and the board of directors, ensuring effective collaboration. Dr. Olszyk also discusses his journey in medical leadership and the fulfillment he has experienced during his career.
Advice for Aspiring Medical Leaders: Steps to Take and Skills to Develop
Mark offers practical advice and steps to gain relevant experience for those considering a career in medical leadership. He encourages involvement in leadership roles within hospitals and joining professional organizations like the AAPL and the American College of Healthcare Executives (ACHE).
He also emphasizes the value of networking, seeking mentorship from current medical leaders, and continuously developing leadership skills through education and practical experience. By engaging in paid and volunteer leadership opportunities, physicians can significantly influence the future of healthcare while developing new skills, on their journeys to outstanding CMO.
Summary
In this interview, Dr. Mark Olszyk shares his extensive experience as an outstanding CMO and co-author of “The Chief Medical Officer's Essential Guidebook.” For those interested in purchasing the book, it is available on Amazon or through the American Association for Physician Leadership (AAPL) website, where volume discounts are also offered. You can reach Mark directly via LinkedIn.
NOTE: Look below for a transcript of today's episode.
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- Dr. Mark Olszyk's LinkedIn Page
- The Chief Medical Officer's Essential Guidebook
- AAPL: The Chief Medical Officer's Essential Guidebook
- 4 Things the CMO Should Never Say to the CEO – 251
- 6 Important Assignments of a Hospital CMO – 218
- What Makes a Great Health System Chief Medical Officer?
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Transcription PNC Podcast Episode 356
The Essential Guidebook to Being An Outstanding CMO
- Interview with Dr. Mark Olszyk
John: During my efforts to improve my skills as a physician leader, I naturally took advantage of the AAPL, the American Association for Physician Leadership, including its CPE program. And it was during the final week of that CPE program that I met today's guest. He's a consummate physician leader, starting with way back when he was in the military. He may still be in the military, I'll ask him about that. But anyway, he's held numerous leadership and executive positions, and he's also the co-author and editor of a new book, well, it came out last year, The Chief Medical Officer's Essential Guidebook. Let's welcome Dr. Mark Olszyk to the show. Good to see you again, Mark.
Dr. Mark Olszyk: Good to see you, John. It's been too long, but thanks for having me and inviting me to your podcast. I'm really excited to be here.
John: Excellent. I have brought up the issue of physician leadership, and especially in the hospital setting, many times over the years on the podcast. And as far as I know, there are books written about the job and different aspects. But really, when I saw this book, with excellent collaboration with the AAPL and yourself with all your experience, this is just perfect for those in my audience who are thinking about moving along those lines, and actually a "how to" to get there. I really appreciate you putting this book out there.
Dr. Mark Olszyk: Oh, well, thanks. To answer your previous question, I'm not still in the military. I got out in 2003, kind of hard to believe, but I'm a proud Navy veteran, and my son is an Army ROTC. So, get that out of the way.
John: Nice.
Dr. Mark Olszyk: Yeah, yeah. The book, I think everybody at some point in their lives, reflecting on their experiences, and their travels and their journey, say, "Yeah, I should write a book about that." And I'm no different. But I've been a CMO, chief medical officer for about 10 and a half years. But I've been in medical leadership since the first year after finishing residency, I went into the US Navy. And the military, unlike almost any other sector, will put you in to leadership positions as soon as possible. And you find a way to get the skills and find the maturity and the leadership is thrust upon you and you have to rise to the occasion. I've always been grateful for that.
But I had gone to conferences at AAPL, others where I met other chief medical officers, and we would share stories. And I thought, boy, it'd be great to write this stuff down and distill this because these are some really valuable lessons, not just the things that we had done correctly, but all of the mistakes that we had made. And wouldn't it be better for other people to learn from our mistakes rather than repeat them themselves.
I guess it came to a head in our system. Physician was made chief medical officer of another hospital. And I just kind of casually passed along here's 10 things to do, like the 10 commandments, but not nearly as inspired, but just 10 things. And about six to eight months later, I guess he lost it. It was that impactful. But he lost it and said, hey, can you send it to me again? I just didn't have it. And I thought, "You know what? If I'm going to write some stuff down, let me make it into something." And it just kind of grew. And I talked to some of my colleagues and contacts. And I said, would you guys be interested in collaborating on a book? Because I think it'll be enormously boring if it's just me telling the stories. But if we have a whole chorus of voices, I think that might really strike a note.
I just had no idea how to publish a book. I just didn't want to do it on my own. I approached AAPL. And Nancy Collins was very gracious. We actually met in a Starbucks in Maryland. And she showed me some of her other publications that came out recently, one of which was a collaborative effort. And it just kind of grew from there.
I reached out to everybody I knew in my life who was a CMO or medical leader. And there was a lot of enthusiasm. I learned a lot in trying to shepherd people together for a collective effort where I was not their boss. They were not getting paid. And there was no way I could really enforce any sort of deadlines or standards. That in itself could be a book, a book about how to write a book. But it was a fun journey. I'm glad it's out there and I've received some excellent feedback.
John: Yeah, when I look through it, of course, most physicians, actually, most clinicians, of course, they like teaching, like helping their peers and so forth. And I think many, if not all, not all of the section writers or physicians, of course, you tapped into other expertise, which I like. There's a lot covered there.
And when I think about the CMO role, it's in my mind is like this iconic what does a CMO do? But everyone does it differently. Everyone does different aspects, more depending on each job. It's unique. But yet, I think you covered everything that I could think of in terms of what questions would I have if I was thinking about being a CMO or I was and I was missing something. So tell me a little bit more about the process. How did you herd all these cats and get this thing done? How long did it take you to do?
Dr. Mark Olszyk: From start to finish, it took about a year. Some of the author contributors returned their submissions in two weeks. Others took about eight months. Some needed multiple revisions, some needed none. I did recruit two co-editors, Aaron Dupree and Rex Hoffman. They helped out a lot.
I learned a lot about copy editing and all of the back office productions and placing it and formatting it. From what had existed only as a series of, I'll say, not too well organized Word documents on my desktop, to see that transform into an actual written book was pretty fascinating and eye-opening. But originally I had an idea for a structure and like all initial ideas, it went away pretty quickly.
And so I just asked people to write about what they felt that they were knowledgeable about or passionate. And the outlines of a puzzle began to come together. And then after about 75% of the submissions were in, at least an outline form, then I could actually target what was missing.
As a frustrated or wannabe classicist, I used the model of the medieval concept of the human being. The first set of chapters, the first section is about the anatomy of the CMO, the basics, the blocking and tackling, metrics and patient experience and all the quotidian day-to-day activities that were going to be the guts and the sinews and the bones.
And then we would move on to the heart, which is all about relationships and how the CMO relates to the chief nursing officer, the chief executive officer, to the board of directors, to departmental chiefs or chairs, and also their perspectives, what they think a CMO should be, or how a CMO should act to be successful in their eyes.
And then we moved on to the brain, the strategic thinking, extra hospital relationships, like how do you deal with third-party rating agencies and auditors and joint commission and dealing with the media, especially when the memories refresh from the pandemic, what if you're asked to appear on TV, on live TV, on the radio and newspaper articles how do you prepare for that?
And then finally, the soul or the spirit, which would be the transformational values and ethics and diversity, inclusion, aspirational type things. It was kind of a journey from the very basic things that a CMO would do day-to-day to the more long-range aspirational goals or values. And I think the way it's written, you can skip around. You can say, gee, I want to learn more about how to prepare for a media interview or how to relate to the board of directors. And you can go right to that section. So it doesn't have to be read in order. It can be used as a reference or it could be read as a story in itself.
John: I think it's pretty comprehensive. And probably in anyone who serves as CMO may not even be exposed to all the things that are covered. There's so much and again, because each role is slightly different. So it's awesome. One of the things I like to do when I'm bringing on an editor and author is pick their brain. So I have an ulterior motive for having you here other than just to talk about the book, although again, it's fairly comprehensive.
But just to keep what our audience's appetite here for this job because some are a little reluctant maybe they have a negative feeling about working in hospitals being abused by somebody or another, but there are good systems out there. And the other thing is being the CMO, you can make a big difference in how that organization is run. Tell me what you would say, if you were to boil it down, what are the most common areas that a chief medical officer is sort of responsible for? Maybe another way to look at it is like who reports to them, because it kind of makes me think about, okay, well, I do this because this person reports me. So however you want to answer that question in terms of the core roles of a CMO.
Dr. Mark Olszyk: I think the CMO role evolved from what was previously and still exists, usually in a hyphenated title, Vice President of Medical Affairs. That being the mechanics and the support staff for the organized medical staff. And every hospital per joint commission guidelines and through history, has had an independent organized medical staff who are largely responsible to establish their own standards for credentialing and privileging. And that was made ever more important back in the 1960s, when there were landmark cases, lawsuits, where patients began to sue hospitals. And the hospital said, hey, we have to really have some quality standards, and we're going to ask the medical staff, almost as a guild to police itself. But the medical staff have full-time jobs taking care of patients, and it's hard for them to keep the files and the minutes and the records and organize the meetings and stay abreast of all of the regulatory changes.
There is an Office of Medical Affairs in every hospital. And the Vice President of Medical Affairs, now the CMO, is largely responsible for ensuring the quality of the medical staff, making sure the medical staff leaders understand what they're supposed to do, making sure that they do it. And it's challenging in that the medical staff can be employees of the hospital or healthcare system. They can be contractors or vendors, or they can be completely independent. And when I started out at this hospital, it was about one-third of each.
To get all those different folks with their different interests aligned in a common effort proved to be a challenge, but one I thought was very fun because I had to look at their world through their eyes and also convince them that what we were doing was necessary and important and create a team not of rivals or competitors, but of people who didn't necessarily all fall into the same silo.
We're largely responsible for the credentialing, privileging, presenting those applications to the medical executive committee and to the governing body, which is usually the board of directors, making sure everyone is completing their FPPEs, their OPPEs, the ongoing professional performance assessments, making sure they're up to standards with joint commission, reviewing and knowing the bylaws. I probably know the bylaws better than anybody in the hospital. We've rewritten them 10 times since I've been here. Quality review, and then making sure that the medical staff were involved in all of the various intra-hospital, extra-hospital committees radiation safety, prescribing, that sort of thing.
What I'd like to say is that the chief medical officer is a bridge builder between the hospital administration and the medical staff, but also between the medical staff and the board of directors, between the hospital and the community. Sometimes the CMO, I found myself as the spokesperson during the pandemic especially. It was on local radio, on TV trying to break down in very understandable terms what was happening, but also bring back to the hospital and tell them, hey, this is what the community is concerned about. Here are the questions they have.
We have to be mindful of that, responsible for that. Also within the hospital, being a bridge builder between the various departments translating the needs of the hospitalist team to nursing or between medicine and surgery and sometimes refereeing, sometimes being just the host getting folks together.
But I always come back to bridge building. And again, if you look through history, through cinema, through literature, bridges always figure prominently in history, battles of the Milvian Bridge with Constantine changing the nature of the Roman Empire, Stamford Bridge, which ended the Viking Age in England. All these great events happen on bridges. Even if you've seen Saving Private Ryan, which came out, in 1998. The last ultimate scene, Tom Hanks losing his life is actually on a bridge. And if you're a fan of The Lord of the Rings, that's where Gandalf the Grey transforms into Gandalf the White. And again, Jimmy Stewart, It's a Wonderful Life. The transformational scenes occur on a bridge.
I was a scoutmaster. When the Cub Scouts become Boy Scouts, they cross over this bridge and they don't really pay much attention to it. But I gave a little speech to the parents, like, look, this is a special time, you're going from one part of your life to another. And this is punctuated by going over a bridge. Bridges represent liminal spaces, liminal time, when you're not here, or there. Bridges are a great metaphor, because they're very narrow. And they're very risky, because if you fall off one way or another, if you don't keep a straight path, if you don't keep your eyes on the goal, tragedy can ensue. And sometimes it's foggy, sometimes it's slippery. So, it takes somebody who's been back and forth a few times, who's surefooted, who is focused to to cross that bridge.
And bringing together all those communities, translating their needs and their goals and their concerns from one party to another, can be very risky. If you don't do it correctly, it can really backfire. That's why I consider the role as bridge builder. The Pope himself is the official title is Pontifex Maximus. The greatest bridge builder. I don't think the CMO is the Maximus, but I think it's a very important bridge builder, we can all build bridges. And hopefully, the CMO can exemplify that.
John: The ironic thing is that if you go back the last 20-30 years, for a while there, there weren't that many physicians in leadership positions, at least on the community hospital side you always had academic hierarchies. But I think in the 50s, up to half of hospitals might have been owned by physicians, and then over time, it just everything got split. And so I think what you just said, it's important that physicians be in those roles. So I'm glad that there are more physicians and when I started as VPMA, our hospital had never had a VPMA or a CMO. So many hospitals now do.
Building on that, tell me in your opinion, the pros and cons of being a CMO. Like I say, I have many people that are a little reluctant to make that commitment. But to me, it was a natural thing to pursue. So, what are your feelings and some of the challenges and also just what you love about it?
Dr. Mark Olszyk: Yeah, for me,this can sound a little pollyannish or saccharine, but for me, there's no downside. I guess it just fits my personality. When I was a brand new attending physician, I would see these larger forces at work in a hospital, budget, staffing challenges. And I'm like, man, I just want to be able to fix that I want to get involved in that. So it was kind of a natural course. I got my MBA so I could talk the talk and understand some of the discussions a little bit better, and then got more and more involved.
And it's just hard for me to resist trying to represent my fellow medical staff members, physicians, but pretty much trying to weigh in. If we're planning an expansion to the hospital or adding a new service line, or how do we go about on some major quality initiative, I really want to have a seat at the table and have a voice. So the best way to do that is to get into the C-suite, you get into medical leadership, develop those relationships and connections.
What I love most about the job is probably as a CMO, I'm an ambassador, plenty potentiary, I can go to any clinical department, I can go right down to pathology right now, talk to my chief pathologist. And he's got a two sided microscope, and he'll show me some slides which look like pink and purple squares. And he'll say, what is this, and I'll get it wrong every single time. Then we talk about his family. I get to know him as a person. And that builds a bond of trust, it furthers our relationship. I can walk out of there and I can go up to radiology and look at some of the images with the radiologists. And then I can walk in to the surgical suite and get gowned up and just see what the surgeons are going through, see what their day is like. Yeah, I can do the same thing for the hospitalists, for pediatrics.
I actually like being a medical student in my third and fourth years because you have a different rotation every month. It was always fresh, it was always interesting. And that's why I went into emergency medicine where you're expected to be somewhat proficient in almost anything because you don't know what's going to walk through the door. So, you have to know about pediatric medication doses, you have to know how to treat people struck by lightning or bitten by rattlesnakes or CHF in a hundred-year-old.
So, you have to know everything you have to know enough about every specialty. And then you wind up calling every specialty, sometimes in the middle of the night, but often during the course of your shift, either for follow-up or for intervention. And so, you have to learn how to speak their languages. And I just never really wanted to give that up. I didn't want to find myself just in one specialty and not continuing to learn and stay abreast of all the others.
So, I think that's the most fascinating aspect of being a CMO is, I'm pretty much given a hall pass to go wherever I want in the hospital and no one questions that. In fact, they kind of expect that. And that carries over. I get to go to the board meetings, to the finance meetings.
I can drop in on the chief nursing officer, chief quality officer. So for a person who's emergency medicine docs tend to be a little bit restless and always looking for some new stimulus, that was just a perfect job for me. So, that's my favorite aspect and one I would not ever want to give up.
John: Excellent. Now, it's interesting. We all have our own particular things that we like. I loved interacting with the board. I was on the every board meeting. I had an official presentation and I actually love spending an hour or two preparing that. I like being alone in my office and doing things to prepare for that. Whereas other people are like I want to be out there in the public. There's so many different things that one can do.
So, if there's someone in the audience who's either thinking about, well, would I like this or should I do this? Or I'm about 50% sure that I want to do this. What advice would you have for that person early in the thought process of pursuing a leadership position, let's say, rather than and it may be eventually CMO?
Dr. Mark Olszyk: Yeah, I'll approach that a little bit obliquely. So, I've given a number of leadership talks over the years and folks are always asking, well, how do I get experience being a leader? I'm like, there's no end of opportunities. Having been in the Boy Scouts, I have three sons, and they're all Eagle Scouts now. But people are always looking for leaders. And it might not be the thing you want to do forever.
But whether it's your church or civic group, the schools, they're always looking for someone to step up. And I said, boy, if you can be a Scout leader, and hold the attention of 60, 10 and 11 year olds for 90 minutes, you can do anything. First of all, brush up your leadership skills wherever you can find the opportunity doesn't have to be in the hospital.
Secondly, the hospitals are always looking for medical leaders. I've seen a ocean sea change in the last 10 years. It used to be that our medical staff meetings, our quarterly medical staff meetings, were raucous affairs, we would have 60 or 70 people there.
As our models have become more contracted or employed physicians, I guess they don't have the same feeling of being community stakeholders as when it was mostly independent physicians in the community who had been there for decades. Now the days are long. And I think after a 12 hour shift, the hospitalists want to go home. And there's also the opportunity to Zoom into a meeting. So we don't see as many people attend in person. And it's getting harder and harder to get people to volunteer to spend an hour or two, even if it's once a month, in a peer review committee, because it does take some commitment to read over the cases and then show up for the committee. And we don't stipend or remunerate anyone except for the chair or the chief.
So it's volunteer work. We're always hungry for that. I'm sure every hospital has opportunities. If you want to get involved in peer review or bylaws or credentialing, or on the pharmacy and therapeutics committee, there's definitely opportunities there. Or the foundation or fundraising, or there's lots of opportunities.
And then you begin to network. I guess the next opportunity would be just to ask your chief medical officer. You could probably shadow him or her for the day. We all like to talk about ourselves. I'm doing it right now. If someone came to my office and said, hey, I'm interested in one day being a CMO or an assistant or vice, what's the path? And it depends on the person, on their personality, what they would like to do. Everyone does it differently. Every hospital has a different set of requirements or needs. So it's dependent, but I would be very willing to talk to them. I think anybody would.
Next you could buy the book and look through that. A little selfish promotion, or you could join one of the organizations, AAPL, ACHE. States have their own chapters. Every specialty has its own chapter as well. I think there's lots and lots of opportunities. You can write articles. Journals are always looking for articles. So there's a lot of ways to just get more involved. I don't think anybody in a medical leadership position would be reluctant or hesitant just to make the time for someone who expressed an interest and wanted to learn more.
John: The other thing I found useful, I don't know if it's still the same, but talking to the CEO, hey, what's your perspective on physician leaders and what should I do if I want to get up and be part of the senior executive team? So there's tons of opportunities.
Dr. Mark Olszyk: Absolutely.
John: But we are going to run out of time. So let's talk about the book again. Let's start with what do you think is the best way to get the book? Should we go to the AAPL? Should we go to Amazon? Are there other ways of finding the book?
Dr. Mark Olszyk: Either one of those is fantastic. If you go through AAPL and you want to order a lot, there are volume discounts or you can go to Amazon, it's easy. You can type in chief medical officer or even my last name, which is not too common, Olszyk book, and it'll pop up. You'll see a couple of Amazon reviews. Unfortunately, some were written by my children. Ignore those. And if your listeners or podcast watchers do get a copy, please do leave a review. It's important. But yeah, either way, you go through AAPL. I think there are some other platforms out there, but those are probably the two most common and easiest to go through.
John: That makes sense. What if they have a question for you? Can they reach out to you?
Dr. Mark Olszyk: They can reach out to me. Yeah, I'm on LinkedIn, as you know so you can direct message me. People have done that and I've responded quickly.
John: Okay, good. Excellent. It's good sometimes just really to talk to the editor or author. Of course, you wrote several of the sections of the book in addition to being the chief editor and you said you had some help with that. But okay, well, any last bit of advice before I do let you go in terms of the future of medicine and physician leadership therein? Any other words of wisdom before I release you from this torture?
Dr. Mark Olszyk: No, it wasn't torture at all. I really enjoyed it. It's good seeing you again. And again, thank you for the opportunity. Clearly, like everything else, medicine is going to change more in the next 10 years than it has in the last two generations. So if you want to be part of that change, get into a leadership position, let your voice be heard. I think a pessimist is someone who takes no joy in being proven right. And an optimist is someone who thinks the future is yet uncertain. So if you want to help craft the future, get involved.
John: That's awesome advice again. And I think physicians do resonate with that for the most part. I want to thank you again for being my guest. I might have to have you come back and dig into one of these topics that's in the book, maybe in more detail at some point, but it's been great talking to you again. We appreciate you sharing your expertise with us today.
Dr. Mark Olszyk: Cool. Thanks, John.
John: You're welcome.
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Transcription PNC Podcast Episode 356
The Essential Guidebook to Being An Outstanding CMO
- Interview with Dr. Mark Olszyk
John: During my efforts to improve my skills as a physician leader, I naturally took advantage of the AAPL, the American Association for Physician Leadership, including its CPE program. And it was during the final week of that CPE program that I met today's guest. He's a consummate physician leader, starting with way back when he was in the military. He may still be in the military, I'll ask him about that. But anyway, he's held numerous leadership and executive positions, and he's also the co-author and editor of a new book, well, it came out last year, The Chief Medical Officer's Essential Guidebook. Let's welcome Dr. Mark Olszyk to the show. Good to see you again, Mark.
Dr. Mark Olszyk: Good to see you, John. It's been too long, but thanks for having me and inviting me to your podcast. I'm really excited to be here.
John: Excellent. I have brought up the issue of physician leadership, and especially in the hospital setting, many times over the years on the podcast. And as far as I know, there are books written about the job and different aspects. But really, when I saw this book, with excellent collaboration with the AAPL and yourself with all your experience, this is just perfect for those in my audience who are thinking about moving along those lines, and actually a "how to" to get there. I really appreciate you putting this book out there.
Dr. Mark Olszyk: Oh, well, thanks. To answer your previous question, I'm not still in the military. I got out in 2003, kind of hard to believe, but I'm a proud Navy veteran, and my son is an Army ROTC. So, get that out of the way.
John: Nice.
Dr. Mark Olszyk: Yeah, yeah. The book, I think everybody at some point in their lives, reflecting on their experiences, and their travels and their journey, say, "Yeah, I should write a book about that." And I'm no different. But I've been a CMO, chief medical officer for about 10 and a half years. But I've been in medical leadership since the first year after finishing residency, I went into the US Navy. And the military, unlike almost any other sector, will put you in to leadership positions as soon as possible. And you find a way to get the skills and find the maturity and the leadership is thrust upon you and you have to rise to the occasion. I've always been grateful for that.
But I had gone to conferences at AAPL, others where I met other chief medical officers, and we would share stories. And I thought, boy, it'd be great to write this stuff down and distill this because these are some really valuable lessons, not just the things that we had done correctly, but all of the mistakes that we had made. And wouldn't it be better for other people to learn from our mistakes rather than repeat them themselves.
I guess it came to a head in our system. Physician was made chief medical officer of another hospital. And I just kind of casually passed along here's 10 things to do, like the 10 commandments, but not nearly as inspired, but just 10 things. And about six to eight months later, I guess he lost it. It was that impactful. But he lost it and said, hey, can you send it to me again? I just didn't have it. And I thought, "You know what? If I'm going to write some stuff down, let me make it into something." And it just kind of grew. And I talked to some of my colleagues and contacts. And I said, would you guys be interested in collaborating on a book? Because I think it'll be enormously boring if it's just me telling the stories. But if we have a whole chorus of voices, I think that might really strike a note.
I just had no idea how to publish a book. I just didn't want to do it on my own. I approached AAPL. And Nancy Collins was very gracious. We actually met in a Starbucks in Maryland. And she showed me some of her other publications that came out recently, one of which was a collaborative effort. And it just kind of grew from there.
I reached out to everybody I knew in my life who was a CMO or medical leader. And there was a lot of enthusiasm. I learned a lot in trying to shepherd people together for a collective effort where I was not their boss. They were not getting paid. And there was no way I could really enforce any sort of deadlines or standards. That in itself could be a book, a book about how to write a book. But it was a fun journey. I'm glad it's out there and I've received some excellent feedback.
John: Yeah, when I look through it, of course, most physicians, actually, most clinicians, of course, they like teaching, like helping their peers and so forth. And I think many, if not all, not all of the section writers or physicians, of course, you tapped into other expertise, which I like. There's a lot covered there.
And when I think about the CMO role, it's in my mind is like this iconic what does a CMO do? But everyone does it differently. Everyone does different aspects, more depending on each job. It's unique. But yet, I think you covered everything that I could think of in terms of what questions would I have if I was thinking about being a CMO or I was and I was missing something. So tell me a little bit more about the process. How did you herd all these cats and get this thing done? How long did it take you to do?
Dr. Mark Olszyk: From start to finish, it took about a year. Some of the author contributors returned their submissions in two weeks. Others took about eight months. Some needed multiple revisions, some needed none. I did recruit two co-editors, Aaron Dupree and Rex Hoffman. They helped out a lot.
I learned a lot about copy editing and all of the back office productions and placing it and formatting it. From what had existed only as a series of, I'll say, not too well organized Word documents on my desktop, to see that transform into an actual written book was pretty fascinating and eye-opening. But originally I had an idea for a structure and like all initial ideas, it went away pretty quickly.
And so I just asked people to write about what they felt that they were knowledgeable about or passionate. And the outlines of a puzzle began to come together. And then after about 75% of the submissions were in, at least an outline form, then I could actually target what was missing.
As a frustrated or wannabe classicist, I used the model of the medieval concept of the human being. The first set of chapters, the first section is about the anatomy of the CMO, the basics, the blocking and tackling, metrics and patient experience and all the quotidian day-to-day activities that were going to be the guts and the sinews and the bones.
And then we would move on to the heart, which is all about relationships and how the CMO relates to the chief nursing officer, the chief executive officer, to the board of directors, to departmental chiefs or chairs, and also their perspectives, what they think a CMO should be, or how a CMO should act to be successful in their eyes.
And then we moved on to the brain, the strategic thinking, extra hospital relationships, like how do you deal with third-party rating agencies and auditors and joint commission and dealing with the media, especially when the memories refresh from the pandemic, what if you're asked to appear on TV, on live TV, on the radio and newspaper articles how do you prepare for that?
And then finally, the soul or the spirit, which would be the transformational values and ethics and diversity, inclusion, aspirational type things. It was kind of a journey from the very basic things that a CMO would do day-to-day to the more long-range aspirational goals or values. And I think the way it's written, you can skip around. You can say, gee, I want to learn more about how to prepare for a media interview or how to relate to the board of directors. And you can go right to that section. So it doesn't have to be read in order. It can be used as a reference or it could be read as a story in itself.
John: I think it's pretty comprehensive. And probably in anyone who serves as CMO may not even be exposed to all the things that are covered. There's so much and again, because each role is slightly different. So it's awesome. One of the things I like to do when I'm bringing on an editor and author is pick their brain. So I have an ulterior motive for having you here other than just to talk about the book, although again, it's fairly comprehensive.
But just to keep what our audience's appetite here for this job because some are a little reluctant maybe they have a negative feeling about working in hospitals being abused by somebody or another, but there are good systems out there. And the other thing is being the CMO, you can make a big difference in how that organization is run. Tell me what you would say, if you were to boil it down, what are the most common areas that a chief medical officer is sort of responsible for? Maybe another way to look at it is like who reports to them, because it kind of makes me think about, okay, well, I do this because this person reports me. So however you want to answer that question in terms of the core roles of a CMO.
Dr. Mark Olszyk: I think the CMO role evolved from what was previously and still exists, usually in a hyphenated title, Vice President of Medical Affairs. That being the mechanics and the support staff for the organized medical staff. And every hospital per joint commission guidelines and through history, has had an independent organized medical staff who are largely responsible to establish their own standards for credentialing and privileging. And that was made ever more important back in the 1960s, when there were landmark cases, lawsuits, where patients began to sue hospitals. And the hospital said, hey, we have to really have some quality standards, and we're going to ask the medical staff, almost as a guild to police itself. But the medical staff have full-time jobs taking care of patients, and it's hard for them to keep the files and the minutes and the records and organize the meetings and stay abreast of all of the regulatory changes.
There is an Office of Medical Affairs in every hospital. And the Vice President of Medical Affairs, now the CMO, is largely responsible for ensuring the quality of the medical staff, making sure the medical staff leaders understand what they're supposed to do, making sure that they do it. And it's challenging in that the medical staff can be employees of the hospital or healthcare system. They can be contractors or vendors, or they can be completely independent. And when I started out at this hospital, it was about one-third of each.
To get all those different folks with their different interests aligned in a common effort proved to be a challenge, but one I thought was very fun because I had to look at their world through their eyes and also convince them that what we were doing was necessary and important and create a team not of rivals or competitors, but of people who didn't necessarily all fall into the same silo.
We're largely responsible for the credentialing, privileging, presenting those applications to the medical executive committee and to the governing body, which is usually the board of directors, making sure everyone is completing their FPPEs, their OPPEs, the ongoing professional performance assessments, making sure they're up to standards with joint commission, reviewing and knowing the bylaws. I probably know the bylaws better than anybody in the hospital. We've rewritten them 10 times since I've been here. Quality review, and then making sure that the medical staff were involved in all of the various intra-hospital, extra-hospital committees radiation safety, prescribing, that sort of thing.
What I'd like to say is that the chief medical officer is a bridge builder between the hospital administration and the medical staff, but also between the medical staff and the board of directors, between the hospital and the community. Sometimes the CMO, I found myself as the spokesperson during the pandemic especially. It was on local radio, on TV trying to break down in very understandable terms what was happening, but also bring back to the hospital and tell them, hey, this is what the community is concerned about. Here are the questions they have.
We have to be mindful of that, responsible for that. Also within the hospital, being a bridge builder between the various departments translating the needs of the hospitalist team to nursing or between medicine and surgery and sometimes refereeing, sometimes being just the host getting folks together.
But I always come back to bridge building. And again, if you look through history, through cinema, through literature, bridges always figure prominently in history, battles of the Milvian Bridge with Constantine changing the nature of the Roman Empire, Stamford Bridge, which ended the Viking Age in England. All these great events happen on bridges. Even if you've seen Saving Private Ryan, which came out, in 1998. The last ultimate scene, Tom Hanks losing his life is actually on a bridge. And if you're a fan of The Lord of the Rings, that's where Gandalf the Grey transforms into Gandalf the White. And again, Jimmy Stewart, It's a Wonderful Life. The transformational scenes occur on a bridge.
I was a scoutmaster. When the Cub Scouts become Boy Scouts, they cross over this bridge and they don't really pay much attention to it. But I gave a little speech to the parents, like, look, this is a special time, you're going from one part of your life to another. And this is punctuated by going over a bridge. Bridges represent liminal spaces, liminal time, when you're not here, or there. Bridges are a great metaphor, because they're very narrow. And they're very risky, because if you fall off one way or another, if you don't keep a straight path, if you don't keep your eyes on the goal, tragedy can ensue. And sometimes it's foggy, sometimes it's slippery. So, it takes somebody who's been back and forth a few times, who's surefooted, who is focused to to cross that bridge.
And bringing together all those communities, translating their needs and their goals and their concerns from one party to another, can be very risky. If you don't do it correctly, it can really backfire. That's why I consider the role as bridge builder. The Pope himself is the official title is Pontifex Maximus. The greatest bridge builder. I don't think the CMO is the Maximus, but I think it's a very important bridge builder, we can all build bridges. And hopefully, the CMO can exemplify that.
John: The ironic thing is that if you go back the last 20-30 years, for a while there, there weren't that many physicians in leadership positions, at least on the community hospital side you always had academic hierarchies. But I think in the 50s, up to half of hospitals might have been owned by physicians, and then over time, it just everything got split. And so I think what you just said, it's important that physicians be in those roles. So I'm glad that there are more physicians and when I started as VPMA, our hospital had never had a VPMA or a CMO. So many hospitals now do.
Building on that, tell me in your opinion, the pros and cons of being a CMO. Like I say, I have many people that are a little reluctant to make that commitment. But to me, it was a natural thing to pursue. So, what are your feelings and some of the challenges and also just what you love about it?
Dr. Mark Olszyk: Yeah, for me,this can sound a little pollyannish or saccharine, but for me, there's no downside. I guess it just fits my personality. When I was a brand new attending physician, I would see these larger forces at work in a hospital, budget, staffing challenges. And I'm like, man, I just want to be able to fix that I want to get involved in that. So it was kind of a natural course. I got my MBA so I could talk the talk and understand some of the discussions a little bit better, and then got more and more involved.
And it's just hard for me to resist trying to represent my fellow medical staff members, physicians, but pretty much trying to weigh in. If we're planning an expansion to the hospital or adding a new service line, or how do we go about on some major quality initiative, I really want to have a seat at the table and have a voice. So the best way to do that is to get into the C-suite, you get into medical leadership, develop those relationships and connections.
What I love most about the job is probably as a CMO, I'm an ambassador, plenty potentiary, I can go to any clinical department, I can go right down to pathology right now, talk to my chief pathologist. And he's got a two sided microscope, and he'll show me some slides which look like pink and purple squares. And he'll say, what is this, and I'll get it wrong every single time. Then we talk about his family. I get to know him as a person. And that builds a bond of trust, it furthers our relationship. I can walk out of there and I can go up to radiology and look at some of the images with the radiologists. And then I can walk in to the surgical suite and get gowned up and just see what the surgeons are going through, see what their day is like. Yeah, I can do the same thing for the hospitalists, for pediatrics.
I actually like being a medical student in my third and fourth years because you have a different rotation every month. It was always fresh, it was always interesting. And that's why I went into emergency medicine where you're expected to be somewhat proficient in almost anything because you don't know what's going to walk through the door. So, you have to know about pediatric medication doses, you have to know how to treat people struck by lightning or bitten by rattlesnakes or CHF in a hundred-year-old.
So, you have to know everything you have to know enough about every specialty. And then you wind up calling every specialty, sometimes in the middle of the night, but often during the course of your shift, either for follow-up or for intervention. And so, you have to learn how to speak their languages. And I just never really wanted to give that up. I didn't want to find myself just in one specialty and not continuing to learn and stay abreast of all the others.
So, I think that's the most fascinating aspect of being a CMO is, I'm pretty much given a hall pass to go wherever I want in the hospital and no one questions that. In fact, they kind of expect that. And that carries over. I get to go to the board meetings, to the finance meetings.
I can drop in on the chief nursing officer, chief quality officer. So for a person who's emergency medicine docs tend to be a little bit restless and always looking for some new stimulus, that was just a perfect job for me. So, that's my favorite aspect and one I would not ever want to give up.
John: Excellent. Now, it's interesting. We all have our own particular things that we like. I loved interacting with the board. I was on the every board meeting. I had an official presentation and I actually love spending an hour or two preparing that. I like being alone in my office and doing things to prepare for that. Whereas other people are like I want to be out there in the public. There's so many different things that one can do.
So, if there's someone in the audience who's either thinking about, well, would I like this or should I do this? Or I'm about 50% sure that I want to do this. What advice would you have for that person early in the thought process of pursuing a leadership position, let's say, rather than and it may be eventually CMO?
Dr. Mark Olszyk: Yeah, I'll approach that a little bit obliquely. So, I've given a number of leadership talks over the years and folks are always asking, well, how do I get experience being a leader? I'm like, there's no end of opportunities. Having been in the Boy Scouts, I have three sons, and they're all Eagle Scouts now. But people are always looking for leaders. And it might not be the thing you want to do forever.
But whether it's your church or civic group, the schools, they're always looking for someone to step up. And I said, boy, if you can be a Scout leader, and hold the attention of 60, 10 and 11 year olds for 90 minutes, you can do anything. First of all, brush up your leadership skills wherever you can find the opportunity doesn't have to be in the hospital.
Secondly, the hospitals are always looking for medical leaders. I've seen a ocean sea change in the last 10 years. It used to be that our medical staff meetings, our quarterly medical staff meetings, were raucous affairs, we would have 60 or 70 people there.
As our models have become more contracted or employed physicians, I guess they don't have the same feeling of being community stakeholders as when it was mostly independent physicians in the community who had been there for decades. Now the days are long. And I think after a 12 hour shift, the hospitalists want to go home. And there's also the opportunity to Zoom into a meeting. So we don't see as many people attend in person. And it's getting harder and harder to get people to volunteer to spend an hour or two, even if it's once a month, in a peer review committee, because it does take some commitment to read over the cases and then show up for the committee. And we don't stipend or remunerate anyone except for the chair or the chief.
So it's volunteer work. We're always hungry for that. I'm sure every hospital has opportunities. If you want to get involved in peer review or bylaws or credentialing, or on the pharmacy and therapeutics committee, there's definitely opportunities there. Or the foundation or fundraising, or there's lots of opportunities.
And then you begin to network. I guess the next opportunity would be just to ask your chief medical officer. You could probably shadow him or her for the day. We all like to talk about ourselves. I'm doing it right now. If someone came to my office and said, hey, I'm interested in one day being a CMO or an assistant or vice, what's the path? And it depends on the person, on their personality, what they would like to do. Everyone does it differently. Every hospital has a different set of requirements or needs. So it's dependent, but I would be very willing to talk to them. I think anybody would.
Next you could buy the book and look through that. A little selfish promotion, or you could join one of the organizations, AAPL, ACHE. States have their own chapters. Every specialty has its own chapter as well. I think there's lots and lots of opportunities. You can write articles. Journals are always looking for articles. So there's a lot of ways to just get more involved. I don't think anybody in a medical leadership position would be reluctant or hesitant just to make the time for someone who expressed an interest and wanted to learn more.
John: The other thing I found useful, I don't know if it's still the same, but talking to the CEO, hey, what's your perspective on physician leaders and what should I do if I want to get up and be part of the senior executive team? So there's tons of opportunities.
Dr. Mark Olszyk: Absolutely.
John: But we are going to run out of time. So let's talk about the book again. Let's start with what do you think is the best way to get the book? Should we go to the AAPL? Should we go to Amazon? Are there other ways of finding the book?
Dr. Mark Olszyk: Either one of those is fantastic. If you go through AAPL and you want to order a lot, there are volume discounts or you can go to Amazon, it's easy. You can type in chief medical officer or even my last name, which is not too common, Olszyk book, and it'll pop up. You'll see a couple of Amazon reviews. Unfortunately, some were written by my children. Ignore those. And if your listeners or podcast watchers do get a copy, please do leave a review. It's important. But yeah, either way, you go through AAPL. I think there are some other platforms out there, but those are probably the two most common and easiest to go through.
John: That makes sense. What if they have a question for you? Can they reach out to you?
Dr. Mark Olszyk: They can reach out to me. Yeah, I'm on LinkedIn, as you know so you can direct message me. People have done that and I've responded quickly.
John: Okay, good. Excellent. It's good sometimes just really to talk to the editor or author. Of course, you wrote several of the sections of the book in addition to being the chief editor and you said you had some help with that. But okay, well, any last bit of advice before I do let you go in terms of the future of medicine and physician leadership therein? Any other words of wisdom before I release you from this torture?
Dr. Mark Olszyk: No, it wasn't torture at all. I really enjoyed it. It's good seeing you again. And again, thank you for the opportunity. Clearly, like everything else, medicine is going to change more in the next 10 years than it has in the last two generations. So if you want to be part of that change, get into a leadership position, let your voice be heard. I think a pessimist is someone who takes no joy in being proven right. And an optimist is someone who thinks the future is yet uncertain. So if you want to help craft the future, get involved.
John: That's awesome advice again. And I think physicians do resonate with that for the most part. I want to thank you again for being my guest. I might have to have you come back and dig into one of these topics that's in the book, maybe in more detail at some point, but it's been great talking to you again. We appreciate you sharing your expertise with us today.
Dr. Mark Olszyk: Cool. Thanks, John.
John: You're welcome.
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