Interview with Dr. Nilesh Dave – Episode 335

Today's podcast episode describes Dr. Nilesh Dave's four-year career transition to health system Chief Medical Officer. We pick up from his previous appearance 4 years ago in Episode 99, as he lists the steps he took on his interesting career journey.

Starting with his role as medical director at a regional Blue Cross Blue Shield subsidiary, he describes the steps he took to land his position as VP for Clinical Effectiveness and CMO for a large hospital system.

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Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Career Transitions and Leadership Growth

Dr. Nilesh Dave's evolution from medical director to CMO for a health system highlights the importance of diverse skill sets in nonclinical leadership roles:

1. Adaptability across domains
2. Cross-pollination for innovation
3. Strategic thinking
4. Learning and adapting to new technologies

Nilesh emphasized that a combination of clinical knowledge, business acumen, and the ability to adapt to new technologies is essential for success in these roles. Some of these skills developed as he pursued additional formal education, including an MBA and executive training in Artificial Intelligence in Health Care at M.I.T.

Navigating Challenges as Health System Chief Medical Officer

Dr. Dave's role as a CMO involved navigating the challenges of a complex healthcare system. It requires a combination of strategic leadership, analytical thinking, effective communication, and collaboration to drive improvements in clinical outcomes and overall system efficiency. He began developing many of these skills in his previous management roles.

Summary

If you're interested in connecting with Dr. Nilesh Dave and exploring more about his insights into nonclinical roles in the healthcare industry, you can reach out to him on LinkedIn. Dr. Dave often shares valuable perspectives on clinical effectiveness and leadership, making his LinkedIn profile a great platform for networking and staying updated on the latest developments in the field. You can find him on LinkedIn by searching for Nilesh B. Dave MD. 

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Nilesh Dave's LinkedIn Page
• First Gain Know-How Then Secure an MBA – 099
• The Eight Essential Abilities The CEO Wants In A Chief Medical Officer
• 6 Important Assignments of a Hospital CMO – 218
• How to Become CMO in a Year – 052
• Dr. Debra Blaine's Website

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 335

What Makes a Great Health System Chief Medical Officer?

- Interview with Dr. Nilesh Dave

John: I can't believe it's been four years since I last interviewed today's guest. I wanted to have him come back because his nonclinical career has flourished since he was here before. And he's in a leadership position now of a large hospital system, which is awesome. I think he has a lot to share with you all today. With that, let me welcome back Dr. Nilesh Dave. Hello.

Dr. Nilesh Dave: Hi, John. It's great to be back. I'm looking forward to chatting with you over what's been going on over the last four years and hoping that any of your listeners out there will hopefully get some nuggets of information and hopefully that'll help them get to the similar or whatever pathway they're on.

John: I think it's going to help a lot, and I have a lot of questions. But when we last spoke in July of 2019, I think it's okay I can mention you were basically working for one of the regional Blue Cross Blue Shield companies but you're no longer there, obviously. That's why I wanted to have you come back. You've made a couple of different changes and you've also done some other things in between. Why don't you tell us what happened, why you decided to move on and what the next job that you did was that would utilize all of your skills and education?

Dr. Nilesh Dave: Yeah, sure. I'm happy to. When I was working for one of the subsidiaries of Blue Cross Blue Shield, I was outreached by another insurer to join their team. And the resources there that they had in analytics and the opportunity to get involved with more business innovation in that space, as well as population health, was too hard to pass up. And so, I literally had to just drive down the street for that when I took that position and learned a ton. I was never someone who actually liked the utilization management component, and this was a minimal part of the entire role.

A lot of jobs in the nonclinical world will sort of describe themselves as working across a matrix or working across silos, so to speak. And I have to say that doing that transition to the other insurer ended up really teaching me some of those skills that it's not anybody that is above or below you in sort of a hierarchy. It's another department and group, but you've got a common client or something like that. And that's what brings you together in achieving some of the business objectives.

And when I was there COVID was starting up. And so, I was enjoying that role. And then I thought, you know what? I want to maintain my clinical skills. And so, I signed up to do some tele ICU moonlighting shifts. With being in a corporate position and having regular hours, it was not difficult to find time to do a clinical shift.

I started doing that and it was different. It kind of checked off the box of, yeah, it's critical care, and I'm an intensivist by training, but it was in a different way. It was tele ICU. I wanted to learn more about that because things were shifting towards telehealth and certainly COVID accelerated that and made telehealth a more accepted way to also deliver healthcare. And so, I just expanded my skill and exposure to it and signed it up.

And then I guess serendipity is what happened next, because I ended up being asked to oversee that multi-state tele ICU operation. And I almost did a double take when I was asked that because this was an opportunity that aligned my clinical skills. I had gotten a business degree before. I was in charge of quality, metrics and policies for the health system that this was a part of. And so, that had some inroads to my master's in public health I did in between medical school years. It just seemed like this makes complete sense. Like why not do something like this that you can get at all these skill sets in under one roof?

John: That's impressive in a way. But also what was the old saying? What is good luck? It's the combination of preparedness and opportunity. Unless you're open to it and you're prepared, however that preparation occurred, you just never know when you take a new position or volunteer somewhere or whatever, what opportunities might show up. What were you doing there? Just to clarify, I was going to ask you about the location, but it sounds like you did not have to move to take on this new role. You said it was down the street.

Dr. Nilesh Dave: No, in fact the company's headquarters moved from Boston to Dallas. And so, their operations for their tele ICU was also located literally within a block of the other two jobs I had previously. It was just sort of a business park, I guess, and that's why. I didn't have to drive really anywhere else.

John: Another serendipitous thing in the sense that there's a lot of movement out of many states, but Texas is one where there's a lot of movement in. And that includes corporations as well as people.

Dr. Nilesh Dave: That's for sure. Yes.

John: You loop selected a good place to live and grow in your career. That's another thing to keep in mind. Tell us again, at the beginning, before you were doing the moonlighting, before you were heading down this telemedicine service, what were the actual duties that you were doing that were different from what you had been doing earlier in your career?

Dr. Nilesh Dave: At both insurance positions, there was a new program that both insurers had started in terms of a white glove population health management service for employers, employees or members of the insurance. And looking at cost of care, drivers of care, managing and understanding the population of workers and really using your medical knowledge and understanding like, okay you've got diabetes, which is a risk factor for coronary disease, and the folks that work in the different divisions of this company. The company had 400,000 people in the Blue Cross Blue Shield subsidiary that I was overseeing. And so, that was a lot of that population health more so. But when I moved to the other insurer, there was more sort of KPIs, key performance indicator, and data associated with that that we focused on as we were managing.

I was managing three different companies with very disparate populations and risk factors. And so, I had one that employees would be in remote locations building solar farms, wind farms and stadiums, and another that was building nuclear subs and the third in drug development. And these are all employees with different kinds of health problems and some very similar.

But in that second role, there was a lot more of a business focus, a lot more strategy, data-driven analytics, and the opportunity to use that data capability that the company had to think of innovative approaches to some of those problems. And so, when I pivoted away from the Blue Cross Blue Shield position, that's what I got out of that second job.

And that retrospect, I think that set me up pretty well for when I started doing the tele ICU operations across multiple states. We had the same kind of set up. We had a lot of analytics. We were in charge of quality and metrics. We had key performance indicators that we had to meet. The usual ventilator length of stay, ICU length of stay, mortality. That's in the medical clinical world, that's when you're in these sort of hybrid clinical business positions, a lot of those things are what you're looking at. And so, being able to be in that tele ICU position really solidified that. And I was able to leverage then my clinical knowledge as well, knowing what does it take to take care of an ICU patient and translate that into the business side for health system.

John: That's what I think is great about physicians that move into these more executive positions, is that they do have that understanding of the relationship with the patient, the needs of patients, medical terms and all that. And if you can just add the business side of it, to me, it's an ideal situation. I think the companies you've worked for, they've recognized that. They have CMOs and they have physicians in pretty high leadership positions unlike a lot of hospitals. Some large hospitals do, but there are a lot of hospitals out there that the first thing they did when the pandemic hit was get rid of their CMO because it was an expensive position, at least from what I've heard. That's why I think physicians sometimes get frustrated working in a health system, but I think you still have to fight for that. And if your colleagues that are at the hospital recognize that they can hopefully encourage the leadership of the hospital to get more physician leaders like yourself. Tell us the next steps. Anything else you want us to tell us about that position you were just describing? I know after two or three years then you found something new to pursue?

Dr. Nilesh Dave: Yeah. There were a few variables that sort of were in the mix, that the health system where I was doing the tele ICU had some struggles and things that were financially related. And so, the tele ICU program was being contracted and expansion was being halted. And being able to grow in that position, it was pretty clear it was going to be delayed for several years. And a lot of the planning and things that we had at the beginning of when I took it a few years later, that was all sort of cut. And so, at that point, an opportunity at a Dallas based health system, the largest one by footprint, in terms of hospitals and things, was advertising a clinical effectiveness chief medical officer position.

And so, I threw my hat in the ring. And obviously after rounds of interviews and things, they offered me the position. One of the things, my background is a divergent one. When you look at, I'm at a system level. We have a system CMO. In some ways you could say I'm an associate system CMO, but they carved out a different CMO role with different parameters. And my background does not fit the "Hey, I've been in a hospital CMO for years and now transitioning to a system level." I was at a system level with the tele ICU, and in some ways I was the critical care subject matter expert overseeing our tele ICU operations and quality and meeting all those metrics. In some ways, there was some similarity to that CMO role, but I did not follow a traditional pathway. And in fact, I think I was very fortunate to be in a company now that actually appreciated my payer experience and my telehealth experience, which they've never had that background. And they thought that that would be an advantage for them based on the personnel and skillsets that they had which was a nice refreshing thing to hear.

John: When you were looking at the job title, if they posted it as such clinically effective CMO, they could have said chief clinically effective as medical officer or something else, but I've heard the term clinically effectiveness, but I've never heard that applied to a CMO. What were you thinking when you first looked at that?

Dr. Nilesh Dave: I figured that there were probably service lines or clinical service lines that between hospitals, they were probably performing at different levels. And I'm sure I expected that there would probably be similar sized hospitals with similar availability of specialties, but their quality metrics, we're not predictably the same. And so, I was sort of trying to figure out what's driving that? And it turned out that thinking before learning more about the position, the position was a new one that they had. It wasn't one that they had established years ago. They got rid of one position and sort of reformatted it. And so, for them it was also a new thing. And it was not only clinical effectiveness from the way you would think in the service line area, but also risk management, safety, credentialing, medical staff affairs.

I'm also involved in deploying our telehealth strategy. I'm on their AI governance task force, the tele ICU. And I've always been into the tech stuff. And so, now with AI, generative AI and things really versioning and so many platforms and vendors out there trying to get a piece of the pie, we had to create a governance structure, and I helped create a framework and took some time to take a certification course from MIT on AI and healthcare as a way to just compliment that because I knew some, but I didn't think I knew enough. And I just did that on my own while in the role taking classes and things online and learning that stuff. Once I saw some of these other aspects of clinical effectiveness, and it really is just making the clinical engine run, as smoothly as it can, that's what it kind of boils down to now. And it's been a phenomenal experience.

John: Describe some of the things that you do in that role, that are more leadership management and so forth. I think it's difficult sometimes for physicians to understand what it's like to move from that strictly clinically, even if you're the head of a service line or something, to working at the level of let's say a senior VP chief medical officer. But it's going to be different for every system as well. You move from one to another. What does it look like for your system? Who are your peers? Which other senior leaders do you regularly meet with or report to for that matter? That would be interesting to hear how that's structured.

Dr. Nilesh Dave: Yeah. Interesting. I'll add one other point is that when I was in the tele ICU position, I had 40, 50 nurses, and probably the equivalent number of physicians on our internal tele ICU operations. I had a whole team, had administrative folks helping to run the operations, a nursing counterpart, and a few other internal business partners. When I joined my current role, the directive was to get things done working through the business. Other than an administrative assistant who's fantastic, I do not have a hundred person team under me or any of that. That's one big difference that I have already in the job, which was a bit strange to me, based on the projects and things.

But I came to learn through listening to interviews like this, that there are many folks who are in these sort of officer positions that work through the business and get things done. And so, on a day-to-day basis, the folks that I interact with could be other VPs who oversee our hospital channel, for example. We have all our hospitals in a channel. We have an ambulatory channel and telehealth channel. And so, we have VPs that oversee that and a lot of them are nonclinical, business trained background. And so, I work a lot with them on different aspects of my projects. I even will directly collaborate with the COO of the company, and occasionally with the CEO and CFO as well as the strategy officer.

It's not a completely sort of flat organization in that sense, but the opportunities are there, and at times necessary. And I also work with the chief medical officers of each hospital. They don't all report to me. They're sort of a dotted line to myself and my colleague. And so, we collaborate together with them. We work with the chief nursing officers, hospital presidents are sort of in the business channel, but we work with those executives at the local hospital levels and then their sort of system counterparts who are maybe senior VPs or executive VPs or whatever. It's all across the board. I work closely with the VP of care transition management who oversees all of the folks in the hospitals. And so, it really is a pokery of various officers. At all levels, it's not just officers.

John: Yeah. When I was working as a CMO, of course, it was a small, it was a hospital, so it was very contained. But we just say that was a matrix relationship. We knew that if we had something we had to get done, it wasn't that I had to go through another VP. I would just deal with whoever I had to deal with to get it done. And then hopefully we're all on the same page, had sort of the same strategic plan and management plan that we were working on. And so, at that level, you even have to learn how to give up a little bit of something. You have to make someone else's thing work, because it's for the overall improvement of the organization, not your own little fiefdom within it. That sounds really goods.

The other thing that it makes me think about is when going through some of the courses at the AAPL and what I've taught when I've heard from others doing MBAs and so forth, the importance of things like negotiation, communication, persuasion even as a thing. And it's all about doing that rather than there's no such thing really anymore for the most part of just saying, "Okay, I'm the boss, so I'm going to tell you what you're going to do."

Dr. Nilesh Dave: I think that's a great point because one of the things you had mentioned is that a lot of times folks with these opportunities sometimes struggle, and in reflection, I think there's a struggle. Part of the struggle comes from just the language. A lot of us who may be doing day-to-day clinical practice and maybe are involved in some greater hospital initiatives or maybe it's the health systems doing your cardiologist and there's some cardiovascular service line initiative, and you're doing some of that, but being able to translate that into business speak.

And in fact, when I had to do my resume as I was pivoting into the nonclinical world, I think on our last discussion, I had mentioned that it took me a while to understand how to convert "Hey, I set up a system-wide inpatient hospice program." Well, there is another way of saying that on a resume that resonates with the nonclinical business executives that you might end up working with.

And to your point about getting allies and strategizing, it's a lot easier when you have that one patient in that one room and you're talking with different consultants. For one consultant or for a combo, your hand is forced because of the clinical scenario situation and the direction it is going in. And so, you have no choice but to agree and just take care of it. On this side, you know that is going on, but you're doing things system-wide that aren't directly related to that patient and related to operations or strategy, and a lot of that maneuvering, change management negotiating, let me do a solid favor for them now and hopefully that'll be repaid when I'm in dire need of something as well. And I'm not keeping a little notebook of what I've done, but the people you work with, you kind of know, they'll remember and sometimes you have to bring it up. That's a different skillset. I had to learn a lot of it. I wasn't like one of those schmoozers who could easily just do that kind of thing naturally. That's not always the kind of people who can get things done in these roles. There are skills to learn.

John: Yeah. Yeah. If you have a culture where that's the way things are done, it helps, but there's always individual personalities and some people are more forthcoming. I remember I had a director that reported to me, and I loved her dearly, but she may be crazy because if somebody didn't do something they promised like within a week, she'd be like, "It's not my problem. But they said they were going to do it." It's like, no, you have to take responsibility beyond yourself and enable those other people to do what they are supposed to do without being so black and white. That's just another example.

I'm glad you're here because I did have one or two other things I wanted to ask your opinion on, because you have some experience with these things. For example, you did that MPH back while you were in med school or between years or whatever, you did get an MBA and at Kellogg too, I think it was. It's not a community college MBA. And you've done other things. I don't know if you've ever been a member of the AAPL. I'm just wondering your opinion on all of those things, whether there's a prioritization, if someone hasn't done any of them, or what your advice is on deciding on an MBA, deciding on doing an MPH or doing some other things. Like you said that you got some additional training in telemedicine and AI and that kind of thing.

Dr. Nilesh Dave: Yeah. Funny enough, when I was in med school, my desire was to be in infectious diseases. And at the time, I wanted to learn more about epidemiology, biostats and health outcomes. At the time that was the buzzword. And when I did mine at Johns Hopkins, they had a program for with all that, and it was just a one year program. I didn't go into infectious disease but I did learn some skills, especially with the epidemiology and the biostats that from a data analytics perspective, which I would not have predicted back then, ended up helping me out. I pursued that because in the moment it made sense for what I was trying to do.

The business degree, I've been asked and I also hear the question of, "Well, I wanted to do something nonclinical so I better go ahead and get my MBA because that's like a lot of our physician pathway, we've got to get a medical degree, or a doctor of osteopathic medicine degree or something and be able to be that doctor." But here, an MBA is not mandatory. There is the American College of Physician or I forget, Healthcare Executives or something. The ACHE or something.

John: Yes. That's the one that's more for the hospital. ACHE.

Dr. Nilesh Dave: Yeah. There's an MBA like program you can go through there. I did it because I knew I lacked the ability, and when I was doing system-wide stuff as a practicing intensivist, getting involved in some of the health system initiatives, I was having a hard time trying to communicate effectively with nonclinical business leaders. And if anything, I felt like I was just oversimplifying things and as I listened closely in meetings, I saw that there was a gap. And so, I did that.

But at the time, I was not doing it hoping that it's going to open a thousand doors of opportunities. That did not open really any doors right away. Even with an alumni network that was strong in all of that. That was not something that was automatic. You still have to hustle and try to find those opportunities and hope that one thing builds on another and sort of strategize like that. And those skills ultimately will come in handy and they have for me now.

But it's a false way of thinking if getting an additional degree is the gateway to doing things like this. There are plenty of folks that I know that don't have a public health degree or an MBA or Master's in Health Administration, or any of those, that are fantastic leaders. And whether they've done work on the side to learn that stuff, it's possible, I don't know. But it's not necessary.

John: What I'm hearing, it was like the MPH, there was a reason at the time that you did that, and then with the MBA, you were already understanding, I don't know, maybe budgets, maybe financial statements. You had the people you were talking to at that time and you thought, "Okay, this is going to help me to address that need."

Dr. Nilesh Dave: Yes. And I was also at the time thinking a little bit entrepreneurial that maybe I'll sort of do something different on my own. I wanted some of that background and I thought about should I go and pursue a healthcare related MBA or not? And I actually decided conscientiously to not do a healthcare one. I wanted to meet people from all kinds of industries because my background is divergent, my thinking is divergent. I like to cross-pollinate with folks in other industries to have a better innovation mindset. And so, I looked at it that way and chose a program.

John: Yeah. That makes sense. Because I do hear the same thing. "I don't know what I want to do. I want to get out of medicine, so I'm going to get an MBA." And it's like, well, that's a little bit of a shotgun approach in the sense that it doesn't really give you any particular direction. And I think employers too, they're going to be working for someone like a big system or insurance company or pharma. They're going to look at that and say, "Well, it doesn't really fit in any kind of logical step in your career." You just decide one day to get an MBA while you're practicing full-time in family medicine or something. I'm sure those things long-term can benefit in unknown ways as well, but it's a lot of time and money to invest without having necessarily a direction that you're shooting for.

Dr. Nilesh Dave: I wanted to add, especially for the benefit of the listeners, that when I took on this role, and even when I was in my previous role, I had started to work with an executive coach. And at first I was like, "Well, I don't know. Do I really need that? We're all smart and savvy enough. Maybe we can figure this out." But no, emotional intelligence is probably the number one most valuable skill and capability that you need to grow and mature when you're in these types of positions.

And there's frameworks of how to manage workloads and how to have those conversations and negotiating the talking with different folks and trying to not only get the stuff on your table moved forward, but a collaborative project as well. There's skills there, not necessarily soft skills, but there are some hard skills as well that for me, it was something that I thought would play into the brand that I wanted for myself. What I want to be known for and how do I want to execute on that.

An executive coach was something that continues to make sense. I've been working with the same person now on a second year, monthly, before it was more frequently, especially when I was onboarding in this new role at the end of April. I throw that out there just because not everything is in the books. You do need it. You do need sometimes some coaching. Will there be a time where I won't need it? I'm not sure. It just depends.

John: Yeah. Unless you've had a coach like that, you really can't imagine the amount of wisdom that you can get from a coach. And they're kind of like a therapist in a way. They don't just tell you what to do. They get you to generate the "aha" moments and just help you to clarify your thinking. The bottom line is it doesn't make you a better person. Everything you would've maybe eventually learned, I think just happens faster when you're in that situation.

Dr. Nilesh Dave: I agree. And sometimes in the chaos, they can help tell you "Yeah, that's not the way for your role, what it is. You should be really having this resource or support, or you should really be looking at things this way. Or you're now in a position that's different than what you did before." You got to start sort of shifting, to have executive presence or to do those things which are skills to get success.

John: No, it's a really good point. Because we know how we feel in our internal talking to ourselves. When you have someone who's objective and really has no vested interest other than in your success, it's just a different perspective that just really can open your eyes. It reminds me too of something that one of my friends colleagues, advised me, and he was a hospital leader way before I was, and he said, "The next time when you apply for a job at one of these hospital systems or something, you should ask them to provide you with a business or leadership coach as part of your contract." I thought that was a brilliant idea. I never had the chance to implement that, but I thought that is a really good idea.

Dr. Nilesh Dave: Yeah, I agree. I had been told that after a year into the job that my company also provides that.

John: Okay. Nice.

Dr. Nilesh Dave: I was like, "Whoa, really? You guys actually provide that kind of stuff?" I'm very blessed to be in a company that really invests in their own people, with innovation programs for officers and things like that, to really understand the business. That was one of the other things that I went through as I was learning the company. They're like, "Well, we're going to throw you in this program for seven weeks." And I heard from all the strategy leaders, finance leaders, and it kind of fast tracked me in my education of just knowing where am I working at? What have been their goals? Where are they trying to get to? And how do I fit into that? And that's just investing in their people. Not every company does that kind of thing.

John: Yeah. That's awesome. It really is. I think outside of medicine, it's very common for large businesses to invest in coaches for their CEOs and senior leadership team, and even managers sometimes. We're a little bit over time here, but I do want to ask you any thoughts about AI in medicine? It sounded like you have some experience. Is this something we can ignore for a while or do we have to really start to learn about AI if we want to get into clinical or nonclinical future jobs?

Dr. Nilesh Dave: Yeah, I've been involved in my own current job and just reading and talking to different folks in the AI space. I think that some of the takeaways that I would say to answer your question is, one, the physicians and the healthcare teams that learn to work with AI as a tool are going to do better than those who say, "Well, I'm not getting into this. Or maybe reject the idea or think that it's a fad and eventually it'll go away." I don't think it's going to go away.

But with that said, the most important thing is understanding how do you evaluate a proper AI partner for your clinical operations? What they're calling AI, why are they calling it AI? How do they develop it? How do they test it? How is it biased? What's the risk that it can create harm? And that's a lot of the governance, sort of points that we set up. For anyone working in the hospital side, if your health system or your independent hospital doesn't have a governance structure, you need that.

Secondly, you need a framework to evaluate all the different vendors and folks that are going to come at you with, "Hey, we've got this cool thing." And you never know, it could be half baked. And they're just looking for a partner to use data to test it and iterate on it. Well, do you want to be that partner or do you want to wait till it's baked more?

But I think overall it's going to be a very helpful tool. We're using it, we're piling it in our outpatient clinics, especially generative AI. There are ambient AI programs that can listen to in a HIPAA secure fashion physician patient interactions and create a soap note or an APSO note and then you can edit that and clean it up a little bit. But it's screened by human and then sent to you very quickly so you can just focus on talking to the patient and not even need Scribe.

We have it being used in imaging, some of our business side, like revenue cycle. And so, we're looking at that, even looking at programs that will evaluate when patients call a hospital and have a conversation, what's the tonality and what is that doing from a business side? What's the engagement? What are they mad at? What are they telling us that we may not have picked up on? Because it's otherwise done manually. There's some cost savings potentially there, but in all of these, you want to have a governance structure to work through. Because data security is also a very important thing.

Yeah, you should get on to the bandwagon, but carefully I see. With structure, with a framework and see where it can help you the most. I think all these burdens and cumbersome tasks that have been attributed to burnout, there's an opportunity here to reduce some of that. Doing all your notes at the end of the day and all that stuff. There are tools out there that are good.

John: Yeah. Okay. Good to know. We need to embrace it at some point but also to make sure there are ways to monitor it and make sure it's safe and it's secure.

Dr. Nilesh Dave: Absolutely.

John: I really thank you for being here today. I hope the listeners get the same that I got out of it. It's very interesting and it's inspiring and it's also a lot of good points to think about and remember as maybe my listeners are pursuing a career in hospital management or any kind of management or leadership position. I know that we'll probably have some questions for you. I think LinkedIn would probably be the simplest way for people to reach out. I know they can just look up Dr. Nilesh Dave and they're going to find you. If you do have a question, those of you at home listening, then Nilesh can help you out.

Dr. Nilesh Dave: I'm happy to.

John: This has been really good. I'm going to have to catch up with you again in a few years. Maybe I'll have you come back, even maybe a panel on AI. Again, I'm just afraid it's going to become overwhelming very quickly. All right. Thank you very much for being here and with that I'll say goodbye.

Dr. Nilesh Dave: Thank you very much for having me. Happy holidays and happy New Year.

John: Thank you.

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The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post What Makes a Great Health System Chief Medical Officer? appeared first on NonClinical Physicians.

In today's interview, Dr. Peter Angood explains why the best way to empower physician leaders is to join the American Association for Physician Leadership.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

American Association for Physician Leadership's Benefits

The 50-year-old AAPL was founded to empower physician leaders and managers. The evolution of healthcare has evolved and grown increasingly complex. And it is imperative that physicians assume leadership roles in all aspects of healthcare.

The range of services offered by the AAPL is quite impressive:

1. Strong and in-depth information sources (journals, newsletters, and archives);
2. Webinars, Podcast Series, and 85+ educational courses;
3. The Certified Physician Executive Credential; and,
4. Access to advanced business degrees with 5 Universities and 7 Master's Degree specializations.

The benefits of membership are supported by dedicated employees and an excellent technical platform. And the organization provides 350 to 400 educational programs each year.

Importance of Certified Physician Executive

The CPE provides certified physicians with practical insights and a strong healthcare network. Acquiring the designation also requires at least a full year of meaningful experience in leadership and management work. Recruiters now recognize the value of the CPE and often list it as a desired credential in job candidates.

…some of the search firm consultants out there, if they're honest with you, they'll tell you [they] would rather have a candidate with a CPE than a candidate with a master's program.

Summary

Joining the AAPL will help surround you with other physicians already working in management and executive leadership roles. By networking with other members, you will find mentors and coaches to help you follow your leadership path.

By attending live or online courses, you will develop your business and management skills, while demonstrating your commitment to leadership to practice partners and current and potential employers.

If you pursue the CPE and or fellowship, oyo will distinguish yourself as a recognized physician leader.

NOTE: Look below for a transcript of today's episode.

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• American Association for Physician Leadership
  • CPE Program
  • Masters Programs
  • Fall Institute
  • Physician-Mapped Leadership Assessment & Development Tool.
• How a Great Physician Executive Combines QI Expertise with Strategic and Operational Skills – 198
• Are You Ready to Become a Certified Physician Executive? – 219
• 5 Steps I Took to Be a Hospital Executive – 175
• Advice for an Emerging Physician Leader – 032
• Dr. Peter Angood's email address: pangood@physicianleaders.org
• NewScr!pt

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 264

What Is the Best Way to Empower Physician Leaders?

- Interview with Dr. Peter Angood

John: I've spoken about the AAPL many times on the podcast over the past five years mainly because it was a big part of my career transition. I was working as a physician advisor and a little bit of medical directorships and joined the AAPL. And eventually it really helped me to pursue my job as a chief medical officer for a hospital. I thought I would devote an entire episode to this topic today, the American Association for Physician Leadership. And who better to have on as a guest than the president and CEO of the organization, Dr. Peter Angood. So hello, Peter, it's nice to have you on the podcast.

Dr. Peter Angood: Hey John, thank you so much. And I very much appreciate the opportunity and I look forward to our conversation.

John: This should be fun. We're going to give it about 30 minutes or so. There's so much. The organization is really very complex and has a lot of offerings, but before we get into the details of the AAPL, how about just a thumbnail sketch of your background and how did you end up there at the organization?

Dr. Peter Angood: Oh gosh, thank you for the opportunity. I'm a surgeon by background. I spent a better part of 25 years in the academic side doing trauma surgery, surgical critical care. And both of those are multidisciplinary and very systems oriented. So, as I got into mid-career, I found myself thinking more and more about how to create larger scale systems change as opposed to patient-by-patient hospital by hospital.

I was very fortunate as I made that shift, I became the first chief patient safety officer at the joint commission. And that was just one of those career opportunities that really opened my eyes to a lot of the intricacies of our industry and how complex healthcare is actually. I looked after all of the safety initiatives at the joint commission and we did a lot also internationally as well as a bunch of work with the world health organization. Again, that national international exposure was wonderful.

I did that for a number of years and then shifted over to the national quality forum and looked after their safety initiatives and NQFs are all about measurement and how do we get better measurement tactics inside of healthcare. I spent a very brief bit of time with GE Healthcare looking after their patient safety organization.

So, a little insight to the for-profit side of life, but those experiences, John, made me really appreciate that it's all fun and fine to be doing policy development and deployment and all that sort of stuff. But those organizations often didn't have enough physician insight as to really how to deliver care. Take GE for example, a multi-billion-dollar international organization and their true appreciation of how healthcare is delivered from a physician perspective, if you will, was absent.

After those experiences and my ongoing desire for trying to create larger change, I was looking for an opportunity to work in that gap zone, if you will, where I'm still involved and aware of what's going on at that policy level, but also strongly connected to the front line. And I was very fortunate to be chosen as the successor CEO. AAPL at the time was the American College of Physician Executives. The organization is nearly 50 years old now, and I've been here about 10 years and it's been just a wonderful journey in the organization. Truly does sit right in that gap so it influences the policy side, but also very strongly tied to the frontline.

John: Yeah. It's grown, it's morphed over the years. And so, we're glad to have you there. It's been awesome since you've been there these last 10 or so years.

Dr. Peter Angood: Out there. Yeah.

John: Yes. Why don't you give us in a nutshell what the AAPL is? If someone is listening that never heard of it or maybe has heard of it, but has really not looked into it. What is it? What does it do? How does it help physicians with their career advancement?

Dr. Peter Angood: Sure. Well, as I mentioned, it's nearly 50 years old as an organization and the originating CEO, Roger Schenke was a clear innovator in his own right back in the day. And he ran the place for 35, 37 years. And almost I think created the whole concept of physician executives, physician leaders.

While he was running the ship, wound up with a strong constituency of physician leaders who mostly were mid-career, mostly looking at administrative roles in hospitals. And the pinnacle was you get to be a CMO. And yet healthcare's continued to evolve, as you said, in the opening, healthcare's very complex as an organization and so we've become more complex. And as we've been transforming the organization from Roger's beginnings, we really took a different philosophy and that is our society as a whole really continues to look at physicians as leaders.

And the medical profession is still by and large, strongly trusted, and the medical profession is a lead profession. I've taken the philosophy at some level, all physicians are leaders and how do we help physicians embrace that? It's like a responsibility, but it's also a privilege. And so, we're really all about that leadership development, but also professional development along the entire trajectory of a career.

We've expanded and diversified the variety of things that this organization offers. So, we've got very strong and deep information resources. We run a couple of journals, a number of newsletters. We've got a great archive. We've got webinars. We have our own podcast series, had some great guests on that, but then as well, we've obviously continued to expand our educational offerings. We have 85 plus different courses. We have our certified physician executive credential, which is an industry recognized credential. And then you can continue on to become a fellow of the organization. And that's not an automatic, you got to earn the fellowship, all those sorts of things.

And then as well, we have partnerships with five universities and offer seven different master's degrees in there. We've got a large community as you might well expect, and we've got a terrific technical platform to support all of this, the information resources, the education, the networking, the community.

And what a lot of people don't appreciate is that we also do a lot of institutional organizational work. As those of us who are physicians know there's a long-spotted history of the medical staff versus the general administrative staff of hospitals. And they don't always get along. But with the employment trends in about a half of physicians are now employed, many of them by hospitals and health systems, what we're finding is that those institutions are looking for ways to better integrate and engage and to get physicians into leadership roles. And the traditional HR offices are not necessarily all that good at that.

And so, we are working with a good number of institutions. We probably put on 350 - 400 programs a year with different types of organizations to help them with not only the physician leadership pieces, but how to better manage with their medical staff and that whole interface as well. And that's been just wonderful.

And then, yeah, there are a couple of pieces within the international arena. There are not that many countries that have similar organizations such as ours. There are maybe 12 or 14, and they all tend to view us as that best organization, sort of best of breed type of thing into that. And we were just doing some analytics on some of our website stats and purchasing stats. And could you believe this, John? There were 135 countries represented who had been poking around on our website and trying to sort things out. Physician leadership is strong, we're strong and it's just a privilege to be in that role where people want to learn more about it. It's a new era for physician leadership. It really is.

John: Yeah. Things are always evolving. And yeah, I think I've definitely spoken with physicians from other countries and they're looking for assistance in thinking about what direction their career should go and how to get more exposure to leadership and management principles and working together with teams and so forth.

Now, the last thing you mentioned in that whole long litany was working with these organizations. Now I'm kind of thinking some of that with the medical staff is like dealing with let's say burnout and resilience. Does that get into that? Because that seems to be something that's in big demand.

Dr. Peter Angood: Oh yeah. And all those of us that have been in this profession, we all know burnout was happening before the pandemic. The pandemic has brought it forward. The stats are horrible. And yet the way I view it, physicians are resilient as a breed. We got these incredibly long education tracks and then that whole startup of your practice. And so, to walk around telling physicians to be more resilient is kind of a lost cause in my mind.

John: You are talking my language there. We are already resilient.

Dr. Peter Angood: We are.

John: To deal with these other issues.

Dr. Peter Angood: And that's the point, John. It's those other issues, the systems and processes that create frustration that then lead down to the anxieties and the stressors and take this job and shove it kind of attitude that shows up sometimes. And our approach is really kind of in a few different ways. One is clearly there are some individuals who are truly burnt out and they need some assistance and they have to be helped and it's unfortunate, but that's just a reality.

John: True.

Dr. Peter Angood: But we also have to help organizations appreciate and understand that improving their systems and processes will go a long way to improving workforce wellness. And then the third piece therefore then is how to help the physicians in other healthcare professionals to understand better that systems change takes time. Don't just sit and complain about it, but look for ways to engage, help to create more change in the systems and processes. And that will help with sort of an improved awareness of why you're feeling frustrated. And it gives you a longer-range view on things.Because of the respect that the physicians get in organizations inherently and the medical profession as a whole, if we have a strong responsibility to engage in trying to help all of the organizations, whether it's our private practice, our hospital, our post-acute care systems, help them all because folks tend to listen to physicians. So, it's a wonderful opportunity to help abate the burnout by taking that broader based approach.

John: That kind of ties in with something we were talking about before we went live or went on the recording. And that is how the AAPL, although it's an organization for physicians run by physicians, you told me that we were kind of getting involved with other nonphysician components of the system.

Dr. Peter Angood: Yeah. Thanks for bringing that up, John. For a number of years now, multi-professional team-based care has been out there. And a lot of it started in ICUs and emergency departments, transplant programs, all those sorts of things. And so, it's natural that leadership begins to become more interprofessional as well. And as many of your listeners will recognize there's dyad models and triad models. Some of them work, some of them don't. All those sorts of things.

But what we're recognizing in our institutional programs is that as much as 20% - 25% of the participants are actually nonphysicians and organizations are looking more and more for physicians to be the CEO of places. And in that type of setting, obviously then that interprofessional leadership is critical. For those organizations that are more progressive, they're very much encouraging interprofessional leadership. And so, physicians are like "Hey, we're trained and we like being the boss of the team." That's a cool thing, but that's shifting and you can be a strong contributor of a team without having to be the leader of the team.

John: Yeah. That's something that I was not aware of. The extent to which the AAPL was getting involved in that component. So that's awesome. I do want to go back to something you mentioned briefly earlier and you were talking about the different programs and that's the CPE, because I get a lot of listeners who ask about, "Should I get an MBA? Should I get a CPE?" And then I kind of explain what that means. But why don't you give us your take on that? What is the CPE? Who would benefit from it and maybe even how that ties into the MBA and similar business degrees?

Dr. Peter Angood: Yeah. Let's state the other obvious upfront though first, and that is unfortunately medical schools and residency training programs still pretty much do not offer any leadership education or management training. It's gradually shifting a little bit, but that's still going to take a good number of years before that's more common within the undergrad graduate and postgrad areas.

In many ways then AAPL functions as this bridge organization. And as we've said, both of us, healthcare's a complex industry. There are still phenomena occurring. You seem to be a good person, patients like you, your results are pretty good. Your peers seem to like you, congratulations. You're the new CMO here. And you have no background experience. You're holding this high responsibility, high stakes job. How the heck am I going to do this?

So the reality is in this day and age, is that for those individuals who are wanting to help create more change, want to get engaged creating change, you pretty much need some further education and certainly more experiences, whether it's committee work, project work, et cetera. You got to figure out this new arena of leadership and management and how best to fit in there. And again, as we said a few minutes ago, you don't just get to go in and do the command-and-control thing that we've trained to do. So, that takes a new skillset. And as I said at the beginning, it's been 15 years since I've been in the operating room as a trauma surgeon, but I'm still unlearning all that behavior as a trauma surgeon.

John: Yeah, it's different.

Dr. Peter Angood: It is different. I go through all of that to answer your question finally. With the need for some added education, you can do some fundamental stuff and you can do a variety of courses, but we've recognized and for 20 plus years have had this certified physician executive credential. And that is now about 170 hours of coursework. Majority of it is sort of prescribed and there's about 20% of it is elective time.

And then at the end of that 170 hours, there's a three-, three- and half-day capstone weekend, which uniformly is transformative for the people that come in and participate. And the way we view the CPE is different than a master's program and it's very complimentary. And we have had several individuals who've got master's degrees come through the CPE program, do the capstone event and they'll off say, "Darn, I wish I knew about this CPE program before my master's because it's so much more practical, so much more real and it provides me the better tools in which to really do my job." Master's degree programs are great and that's why we offer some. But often as we all know, they're more theoretical, not necessarily healthcare based. And they'll give you a good construct of some of the higher learnings needed to manage and lead, but they don't give you that practical insights. And they don't necessarily give you a strong healthcare network either, which is the benefit of the CPE.

So, you need something, the higher performing organizations that are looking to recruit physicians into leadership roles are often looking for advanced degrees of some sort. And I would love to say that the CPE trumps everything else. No, it's complimentary to those master's degrees. And I can't think of an individual who's taken it that's been disappointed.

John: Not everyone actually completes it when they start it because it is rigorous and it does require some demonstrated performance at the end in terms of what the goals of the program are. Correct?

Dr. Peter Angood: Correct. Yes, absolutely.

John: And by the way, I've mentioned this before in the podcast, I do see that the CPE is sometimes mentioned in job postings for physician executives which is very interesting. And it's been several years that that's been true. So, it really shows that it's a separate complimentary demonstration of one's expertise and experience because like you said, MBA is like book learning. I mean, unless you've actually done it. And I think the CPE also requires at least a year's experience doing some kind of leadership and management work. So, it really shows to those recruiters that there's a different level of ability and expertise there.

Dr. Peter Angood: Yeah, you're absolutely right. That by the time you get to capstone, you've got a well reformulated leadership philosophy, you'll have had to do a project and you will have had to have some experience as you describe. And a dirty little secret, some of the search firm consultants out there, if they're honest with you, they'll tell you I would rather have a candidate with a CPE than a candidate with a master's program.

John: I want to mention before we get to the very end actually the website for the AAPL, which is physicianleaders.org, correct?

Dr. Peter Angood: Correct. Yes. And fresh news. By the time you put this podcast out, I think our new fresh-looking website will be up too. So, I'd encourage folks to have a look.

John: We'll have to all go and take a look at that. Excellent. All right. Let's see. I want you to tease something out a little bit, because you said that CPE is complimentary. A lot of my listeners will ask me this question. "I want your advice. And it's probably difficult to give, but should I get an MBA? I'm unhappy in what I'm doing now. I'm doing some medicine, I'm thinking of moving into some kind of management position. Should I go get an MBA?"

Dr. Peter Angood: Yeah. We often tease. You give a physician a textbook on a weekend and by Monday he'll come back and he's an expert or she's an expert on whatever the topic was. So part of our reflex is to want to learn more.

John: Right.

Dr. Peter Angood: I think there's a deeper set of issues underneath that question. And it gets back to in part we're not exposed to leadership and management through our training, we are idealistic and altruistic by nature. And so, we're looking to create larger scale changes beyond our practice. Not everybody, there's a lot of docs out there perfectly happy seeing their patient volume every day and all that stuff and I commend that. I'm not saying you shouldn't do that.

But even if you're running a practice, you're a leader. The staff are looking to you, the patients are looking to you, your consultants are looking to you, et cetera, et cetera. And so, the onus is on us to sort of own the need to sort of improve our leadership and management as best as we can. And I think if we recognize that then as individuals, or even as a group practice, it's worthwhile getting everyone exposed at least some introductory elements of management, leadership, et cetera.

Organizations, especially the higher performing organizations, more and more are expecting all of their clinical leaders, whether it's a physician and nurse, et cetera, to have some type of added credentialing or education. And I've been told by some of our CPE folks who are strong believers in the CPE, but they're in recruiting type jobs in their delivery system. Their delivery system is like "Hey, you got to recruit the docs with a master's or some other added credential." And so, there's an industry expectation that's evolving.

Does that mean you got to have an itch to create change and go into leadership? You don't have to get a master. You don't have to get a CPE, but just know that the industry oftentimes is looking for something. So, you have to be able to explain your choices. And for time pressures, monetary pressures, family pressures, there's a lot of people who can't afford to do a master's or a CPE, but recognize you have to be able to explain that as you go.

John: Yeah. And there's no way around it, I guess. It's kind of a chicken and egg, but I would say that too, if you join the AAPL and start taking some courses, that demonstrates your commitment and that kind of ties in with the CPE later. What I was advised is if you can get some level of management or leadership job and then get that company to pay for the rest of your education at getting the MBA and or the CPE at the same time, that might be a way to go.

Dr. Peter Angood: Yeah. And what we're seeing more and more is the institutional are sponsoring those kinds of programs. And a little bit of a shameless plug but we've got our fundamentals cluster of courses. You don't have to do the CPE. And we've also got a series of what we call the academies, which are shorter segment focus types of offerings. So, there's the CMO academy. There's the quality academy, there's the safety academy, there's the finance academy. And those types of things can be shown as credentials. And again, to your institution, you're showing commitment to want to do more with leadership and management.

John: There's so many options at the association that didn't exist when I joined 28 years ago. It's great. It's a fantastic organization. So, let's see, if people have questions or are curious, number one, I know you're on LinkedIn, of course. So, if people just want to learn more about you and your background and so forth, again, I'm going to let you give us the website for the AAPL one more time.

Dr. Peter Angood: Sure, sure. It's www.physicianleaders.org. And if your listeners want to reach out to me either through LinkedIn, or you can catch me through my email address, which is pangood@physicianleaders.org. Also, if you're interested, we have a bunch of advisors that can help you sort of guide yourself in terms of where you want to go. And hey, we got a whole bunch of psychometric assessment tools out there as well. You can get a better sense of who you are and what you are. And our technical platform will really help guide you in many, many ways with recommendation engines.

John: The list of services keeps growing as we just spend another minute. So that was a question I was going to have before we close. A lot of physicians asked me about coaching and you said you have advisors at the organization. So how does that work exactly? Is that free if you're a member? Are there paid coaches?

Dr. Peter Angood: There's a spectrum of stuff there, John. The advisors I just mentioned are more staff who will help you understand AAPL better and how to navigate it. But we also offer a lot of professional development services and I neglected to mention that earlier and that's anywhere from we can help you build a better resume cover letter and LinkedIn profile. We can help you with interview skills. We have some mentorship matching and then as well we have a network of executive coaches for those who may want to pursue that line as well. And for some folk's coaching's very, very beneficial. It's shifting coaching. It used to be thought you're in trouble, you better get a coach, but that's not the case anymore. If you just want to get better at who you are, coaching can help. And we've got a nice network of those, but the mentorship is a good way to go also.

John: Yeah. The CEOs and CFOs have been using coaching for years and years, and it's definitely not a negative that's for sure. Okay. Well, that last bit you told me about was actually new to me as well. So, I really appreciate that. Well, we're at our time now, so Peter, this has been fascinating. It's the most in-depth review of the organization I've heard in a long time. So, I really appreciate taking the time and sharing that with me and our listeners.

Dr. Peter Angood: Well, thank you, John. It's been a real privilege to be here. It's a wonderful profession that we all have, and it's a complex industry and physician leadership is really on the forefront of helping to create the next stage of change in the industry. So, it's good stuff.

John: Absolutely. All right. Thanks Peter. And with that, I'll say goodbye.

Dr. Peter Angood: Bye John.

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Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post What Is the Best Way to Empower Physician Leaders? – 264 appeared first on NonClinical Physicians.

Today I will present factors affecting your decision to become a Certified Physician Executive.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

What Is the Business School Mindset?

Dr. Patty Fahy states that the BSM reflects these beliefs:

• “…graduates are assured that an MBA degree has prepared them to manage in any industry: a tattoo parlor, a government entity, or a hospital system (emphasis mine – JJ).
• “Managers are an elite caste, separate from those who are managed, monitored, and controlled.
• “Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards…
• “The principle that… an action is rational only if it maximizes self-interest…”

Not all hospitals are managed in this way, all of the time. But, when I was Chief Medical Officer, there were definitely times when I could feel the BSM “vibe” coming through… even though I worked at a non-profit hospital.

This leads me to believe that Business School Mindset leads to a different kind of BSM… Bulls**t Medicine. – Dr. John Jurica

To counter this, I implore my colleagues to pursue a career in hospital management. Such a career is intellectually stimulating, pays well, and is the only way we’re going to steer this industry in a new direction.

Getting Ready to Become a Certified Physician Executive

One way to accelerate your career progress as a leader is to become a Certified Physician Executive.

The Certifying Commission in Medical Management grants the Certified Physician Executive designation. It demonstrates to employers that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

Listeners have asked me to compare earning the CPE to obtaining an MBA. However, one should not compare the two, because the CPE can only be obtained after completing the MBA or equivalent business and management training.

Summary

There is evidence that employers use the CPE as a factor when considering job candidates. And there are several ways to meet the requirements for the CPE. But they all include getting the basic business and management education, plus real-world healthcare management experience. Physicians should consider several factors when deciding how to best acquire the CPE designation if they choose to pursue it.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

• 3 Reasons to Pursue the CPE Qualification – 033
• The Ultimate Resource to Spark Your Transformation to Physician Leader with Dian Ginsberg – 024
• Certifying Commission in Medical Management
• Canadian Certified Physician Executive Website

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 219

Are You Ready to Become a Certified Physician Executive?

John: Today, I thought I would discuss another topic related to the pursuit of a job in hospital management. I mentioned this topic in a recent daily email and episode #33 of the podcast back in 2018.

Let me paraphrase what I wrote in the recent email related to this topic. It's really related to physicians working in the hospital environment, both as a clinician and then possibly as a leader. This is what I wrote about. I had read an article on Kevin MD by Patty Fahy MD. So, Dr. Patty Fahy. In it, she said that she was talking about BSM. It's an acronym for Business School Mindset. She thought I had a big impact on physicians and how they're working and the environment that they're in, which oftentimes is not very favorable.

The author, Dr. Fahy gives examples of the BSM mindset. Here are quotes from her article.

"Graduates are assured that an MBA degree has prepared them to manage any industry, a tattoo parlor, a government entity, or a hospital system. Managers are an elite cast, separate from those who are managed, monitored, and controlled. Efficiencies gained by controlling the behavior of professionals and other workers garner financial rewards. And the principle that an action is rational only if it maximizes self-interest".

Those are the characteristics that Dr. Fahy says represent BSM or the Business School Mindset. I don't know if all hospitals are managed in this way all of the time, but when I was chief medical officer, there were definitely times when I could feel the BSM vibe so to speak coming through, even though I worked at a nonprofit hospital.

This leads me to believe that the business school mindset leads to a different kind of BSM, what I call BS medicine. The approach that doesn't recognize a physician-patient relationship, or that puts quality safety and dignity behind the bottom lines. That's the BSM that I'm talking about. And I think we're caught in that. We're caught sometimes in that business school mentality and it leads to really miserable working conditions.

And so, the question is what are we to do? And I see three logical answers to that question.

The first is to keep working in the medical-industrial complex until we can't take it anymore and then retire. I think I've had a lot of colleagues that have done that. They've toughed it out and then just retired as soon as they could.

Number 2 is to leave for a nontraditional career, which of course, that's something that I talk about all the time.

And number 3, is to work your way into hospital management as either CMO, COO, or CEO and fix the system from within. And you probably already know that I'm partial to option number 3 because I believe we need a whole lot more physicians leading health care if we want to reduce both forms of BSM in our healthcare system.

Please consider a career in hospital management because it's intellectually stimulating, it pays very well and is the only way we're going to steer this industry in a new direction.

And by the way, as far as the income goes, I just went to salary.com today. And the median salary for a CMO is $418,000 with a range of $319,000 to $549,000. When I say it's lucrative, I'm really serious. It pays well over any primary care practice. And even for specialties, it's a much better lifestyle and you still make a good income.

One of the things that I'm convinced of is that if you want to consider a hospital management career, it's important for you to understand what the CPE is. That's what I want to talk about today. We all know what an MBA is. An MBA is a business degree. And then there is the MMM and MHA and other types of business degrees.

But the CPE comes up from time to time because it represents something that employers are sometimes looking for in the hospital setting. CPE stands for Certified Physician Executive.

As I was going through some CMO job descriptions before preparing for today's presentation, I looked specifically to see if the CPE was listed. And I found two hospitals in North Dakota and one hospital in Pennsylvania, just in a short review of the job ads that I saw. And they listed the CPE as a preferred designation. And the reason is that it represents something that puts the holder in a position perhaps a little bit better than simply having completed a business degree.

But the thing is, it takes more time and it takes some money to achieve. And so, I want to talk about this. And part of this came from a question that I received from a reader or listener back a few months ago, specifically asking whether I thought it was important to proceed with getting the CPE.

I want to try and answer that again. I addressed this, like I said, back in 2018, but let me bring things up to date today and really take a moment to walk through this for those of you that might be interested. This is how I look at the CPE as compared to an MBA. And it's not a fair comparison, I'll explain why in a minute. And these are my thoughts. These are my opinions as a holder of the certification and a former CMO and a member of the American Association for Physician Leadership, which is the AAPL, which originally created the certifying commission in medical management to create and to provide the designation of CPE.

Keep in mind, I am not speaking for the AAPL, although I've been a member of the AAPL for more than 25 years. And I have actually been involved in several of the committees that are involved with evaluating those that are sitting for the CPE, so to speak, by participating in the capstone.

Let's back up and talk about some definitions, and then we'll get into some more detail on this.

What is the CPE? The Certified Physician Executive designation. It's granted by the certifying commission and medical management. And it's designed to show that the holder of the certification has the knowledge, skills, and core competencies to be an effective manager and leader.

And to me the CPE is valuable because it demonstrates that not only does a holder have that MBA training. Now, remember MBA is a degree. It's kind of book learning, but the CPE has the MBA or the equivalent degree or the equivalent training and demonstrates experience in management and or administration.

And also, has sat through what they call a capstone, which is an opportunity for these applicants for the CPE to demonstrate that they can apply all of these principles in real-life situations, rather than simply take some curriculum and pass a few exams.

Let me get into a little more detail on it. An MBA is granted like any other degree. You complete a certain core curriculum plus some electives, and it ensures a certain level of knowledge. It's usually finances, marketing. In the programs that address physician executive MBA, they do focus on things like healthcare finances and the situation that we find ourselves in, the business principles in healthcare itself. Some programs do have a mandatory project that gets completed during the term of the schooling. So that gives them a little bit of real-life application of what they're learning.

But again, I'm going to mention why the CPE is distinguished from that. Because the CPE requires not only the knowledge base, which you can get from an MBA and MMM, and MHA or a similar degree, but it also requires that you have at least a year of clear management and leadership experience that does not include running a small private practice. And it has to be in a setting where you're really in a matrix with lots of other people. You're interacting. You're applying your communication skills, your marketing skills, your finance skills in a real-life situation. And so, it's more than just the book learning.

And in fact, you have to get a letter acknowledging and attesting that you have demonstrated these skills that are being sought for the CPE during those activities. If you've served as a medical director for a year or two or three, or you've been a CMO already, or you've done other things, let's say chair of a big committee at an academic institution and you've had exposure to management, to finances, to HR issues, to legal issues, then you can qualify for the CPE.

And on top of that, then you also need to spend four days doing what's called the capstone where you're getting a little bit more education about some of these topics, just to pull it all together. And you're actually being assessed for your ability to communicate and to lead teams and other skills of that nature.

To compare the CPE to the MBA is not really valid. The MBA or its equivalent is required to be even qualified to request certification for the CPE. That's why it's different. It does give you a little edge. If you have the CPE, it indicates that these skills are demonstrated, and it gives you a little edge. As I said, there were at least three hospitals just to my 10-minute review earlier today that said that the CPE would be recommended or preferred.

If you're competing with two or three or four people, and they all have the equivalent of an MBA or an MMM or something like that, and you have the CPE designation, which really attests pretty well to the fact that you've got the skills and experience to apply those skills, then you're going to have a bit of an edge over those others. That is I think primarily where it comes in handy.

The other thing to keep in mind, though, when we talk about this is that you can meet the requirements without having one of those degrees. In a way, if you were going to get the MBA or the MMM, or MHA, anyway, my case was actually an MPH. I got some credit for that. Well, then that's fine. And you can use that as the basis for proceeding onto the CPE if you're in some kind of leadership or management position.

But sometimes you can meet the same requirement by taking the equivalent courses through the AAPL. The AAPL is known for providing education and training and management and leadership for physicians since it was called the American College of Physician Executives.

They have a lot of ultra-high-quality courses that many physicians have taken. You can use this alternative pathway. Many hospitals and health systems provide leadership training through the AAPL, or physicians themselves will seek the training on an as-needed basis through the AAPL. And so, they do these courses and over time, there is a core curriculum through the AAPL, that if you accomplish that, then you've basically shown that you have the equivalent book learning that would be obtained through the MBA or other similar degree.

You can think of different scenarios here. If you've already taken, let's say one half to two-thirds of the CPE coursework through the AAPL, it may definitely be quicker and less costly to simply complete the curriculum through the AAPL than to enter an MBA program and spend $50,000 - $70,000.

I'm not saying that the AAPL courses are cheap, but even if he had to do another 5 or 6, 7, 8 courses, it's going to be much quicker and less expensive than matriculating in a business degree program.

The other thing to keep in mind is that sometimes the AAPL, or actually the certifying commission on medical management, which grants the CPE will accept courses done for a business degree that maybe you didn't complete. That's the other way that that can be effective.

You want to be efficient. You want to use and get the information you need. But there is no reason if you've already taken a course in healthcare finance to take another course in healthcare finance as part of your MBA or vice versa. You should be able to get credit for that in whichever direction you go.

It can be complicated. If you find yourself in a situation where you have some of the AAPL courses and you're contemplating going to a degree program, then you would check with the degree program, see if any of those courses would apply to the degree, and then you might get a reduction in your tuition, and it would speed things up.

And vice versa, if you've done let's say six months on a business degree, and now you've already got some other AAPL courses and you want to apply for the CPE, you can find out if those courses from the other business degree would apply to that.

There are certain business degrees that are aligned with the AAPL. For example, the master of medical management is a specific program geared for physicians only. And there was a lot of overlap in the content of the MMM and the courses through the AAPL.

So, you would want to really ask both sides of that if it would apply. In other words, you would check with the AAPL. They have a career or education department that will tell you if you've done some of the work for the MMM that would apply for the CPE if let's say you decided to finish it up with the AAPL courses.

Now, if I was just getting started, I would investigate my options. I would look at the cost, the location, the time commitment, and I would just figure out which one is the most efficient way to go. If you haven't been exposed to any of those, then you can make a valid decision.

On the website at the AAPL, which I'll put a link to in the show notes, for those that are listening to this on the podcast, you can go there and it will give you pretty clear which direction to go in. And it explains which of the business degree programs have courses that would cross over, or which ones would accept the AAPL courses.

Again, to find out for sure, it'd be best to check with staff at the AAPL. I think if I were starting out, this is like the master plan you might have in your mind if you were going to do this. I would look around, find a good low-cost convenient option to get your business degree. I would probably go to something like the University of Illinois, or even a smaller public university.

There's one nearby that's called Governor State University. And I know many people that have gotten their MBA through that. It's a four-year college. It's not a big-name college, but you get the MBA. And then if you want to go ahead and move on to the other requirements for the CPE. And then while you're doing that, you should acquire some clear management experience either by finding a paid medical director position, being on one or two really important, big committees where you're involved in big projects, let's say in a hospital.

And that way, when the degree is done, or the coursework is done, then you'll have the management experience. And then you can apply for the capstone and things will move forward very smoothly. If you get the MBA, but you really don't get any management experience in the meantime, you can't apply for the CPE.

Before I go, I do want to mention, I found this just recently. I didn't know this existed, but there's something called the Canadian Certified Physician Executive - CCPE. I don't know that it's exactly equivalent to the CPE that we're talking about today, but I know it does exist and you can look that up online. I will put a link in the show notes, again, for those who are listening to the podcast.

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The post Are You Ready to Become a Certified Physician Executive? – 219 appeared first on NonClinical Physicians.

In this week's interview, Dr. Fisayo Ositelu explains how technology, including artificial intelligence (A.I.), can help save small group practices.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

The Classic Silicon Valley Approach

During our conversation, Fisayo explains how he followed the classic Silicon Valley approach to starting the company. 

I always wanted to be an entrepreneur. And at that time there was a lot of excitement about tech and it just made a lot of sense. – Dr. Fisayo Ositelu

He tapped into his network of investors, including former MBA program classmates, and identified a few key angel investors. And he explains in detail the start-up of his company, should we wish to emulate what he has done.

Revenue Cycle AI Saves Small Group Practices

Some employed physicians dream about returning to private practice. But the hassles of running a practice can be overwhelming. And if a practice cannot quickly bill and collect for its services, it will struggle to succeed.

Fisayo describes how his company is helping to save small group practices by improving their revenue cycle management and cash flow. Gentem has gone a step further, by offering some clients the ability to access current accounts receivable when needed, rather than seek expensive short-term loans.

Summary

Gentem and companies like it can simplify the business side of private practice. By making them easier to run, they might save small group practices.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

• Gentem
• Dr. Fisayo Ositelu's LinkedIn Page
• Gentem Webinar featuring John Jurica: Life Outside Medicine: Top NonClinical Income Streams for Physicians
• Gentem Blog Page
• The Best Healthcare Leaders Never Give Up and Never Stop Learning – 196
• How to Nurture a Career in Cutting-Edge Healthcare Technology – 156

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Episode 205
How Revenue Cycle AI Can Save Small Group Practices
Interview with Dr. Fisayo Ositelu

John: I was introduced to today's guest by a previous guest, Omar Khateeb from episode 194, because he works for today's guest who's the CEO of Gentem. So, I would like to welcome Dr. Fisayo Ositelu. Welcome to the podcast.

Dr. Fisayo Ositelu: Thank you, John. It's a pleasure to be here.

John: This is going to be fun. It's cool to have a couple of guests from the same place. We had Omar on because we were talking about branding and marketing and that kind of thing. But as soon as I was doing the background check on him, I found that, oh, wait, he works for a company that is founded and run by a physician. And let's see, who's the CEO and so forth. So, this would be really interesting today.
We're going to get into the details, but why don't you start by telling us a little bit about your background, your education in particular. And I'm sure my audience is going to want to know how and why you decided to go the MBA MD route rather than pursue let's say a residency.

Dr. Fisayo Ositelu: Absolutely. It's nice to be here and thank you for having me. I'm originally from West Africa, a country called Nigeria, and I came out here for college back in the day. The whole idea was to become a doctor. I came here to the United States to become a doctor from the get-go. My parents were in the medical field and so, I had a lot of context and background to this space.

I did my undergraduate at Johns Hopkins pre-med, molecular cell biology and then decided to come out to the west, which is where I am today. I did my MD at Stanford School of Medicine, over in Palo Alto. And one of the reasons why I chose Stanford instead of some other medical schools is because it had a very, we called it open campus policy where you can essentially take classes at any department.

So, I ended up taking classes in law school, engineering school, and of course the business as well. The curriculum was also way ahead of his time in my opinion. It was all pass/fail. That might've changed now, but at the time I was there, it was all pass/fail. And so, I really got a chance to really explore and really see all the cool things that the university had to offer. And Stanford is a world-class university, so I definitely got a lot of exposure to those other spaces. My idea in being a doctor was not just to be a clinician, but also to do something more, more than that. Especially coming from another country and seeing how much things can be improved on a systems level.

I went through my first couple of years to take step one, all that good stuff. And when I started, when I got into clinics into my rotations, I noticed something that would essentially make me pivot away from clinical care while I loved my patients and I did enjoy interacting with them. I just could not really get over the fact, overall the administrative work that I was doing even as a med student. I look over at my attending and they're not doing that much better than I am with respect to the notes and running all over the place and all that stuff. And at the end of the day, I could not really put myself in their shoes long-term. I could not see myself doing what they were doing in the long term. And so, I decided to long story short, take a different approach and go in the nontraditional route, so to speak.

John: Very interesting. You must be a really quick learner because I think in medical school and even in residency, we're kind of shielded from all that paperwork sometimes. And at least in my experience, personally, of course, that was in another century, but the way med students and occasional residency interface with now, I still don't think they know what they're in for when they really get into practicing. They're going to be basically spending two-thirds of their time doing things that don't really directly affect an individual patient. And a lot of them are going to be upset.

Dr. Fisayo Ositelu: Yeah, that's crazy.

John: You notice that early on, so that's awesome. And then when I was looking at your LinkedIn profile, I thought, well, maybe he did an MD-PhD program because there are schools that say, okay, you come in to the program, but you obviously were kind of on a mission to learn what you could and then you were just drawn to the business side of things apparently.

Dr. Fisayo Ositelu: Yeah, yeah, absolutely. So, as I said, I learned a lot in my time at Stanford, especially in the first couple of years when I still had some time. And once you end up in clinics, it's all-consuming. So, around the end of my third year, I decided to actually apply to business school and to see if I got in and just keep my fingers crossed about that possibility.
I had also looked into consulting. So, the usual suspects, McKinsey, I think they had the professional non-traditional sort of pathway. So, if you're an MD or a PhD, you have a master's and those kinds of things. I looked into that as well but I ended up being lucky enough to get into the business school of Stanford, which was a fantastic place.

I think one of the reasons why it really stands out even amongst other business schools is it's focused on entrepreneurship and really how immersed the school is in the broader tech ecosystem. And so, I was lucky to have the opportunity to be a part of that, and definitely immersed myself in the venture capital world and the startup world and more so to be able to vary in a good network of people that can help out.

John: So, that was part of the experience in the business school. It was getting involved with, like you said, the venture capital or at least learning about it and being exposed to that.

Dr. Fisayo Ositelu: Oh yeah, yeah, absolutely. The interesting thing is that with business schools, most of what you learn is fairly standard. Finance, accounting, strategy. It's really the relationships you build that count. So, the network of people, the relationships, those are the softer things that really make the difference in my opinion.

John: Well actually that's something that I hear about all the time in almost any MBA program, is that one of the biggest things is just the networking and getting to work with a team or you've got projects you're working on.

Even our sponsor, Haslam College of Business - The University of Tennessee, they have 700 grads. So, in a way, they have a network of like 700 and they're all physicians. That's a physician-only executive MBA. So that's what I hear a lot.

Dr. Fisayo Ositelu: Yeah, the MBAs are very interesting. Coming from the medical space, I had not done any kind of business before I went directly from high school to college then from college to med school directly. So, I was fairly young, being in a class with seasoned professionals, people that run companies or executives. It was intimidating. It was not a cakewalk. And you are expected or you were expected to actually share your thoughts and opinions and analysis on things on business problems in front of everybody. We did a case approach where they give you a case and they'd ask you questions and you'd have to speak about these things.

Now coming from med school, we just sat and listened to our professors and memorized a bunch of stuff to pass the exam. It's kind of different. And it took a lot of getting used to. So, there's just one thing for the folks listening, there's a difference in how you approach things in medicine versus business or in a business school setting.

John: Now you made it through. So, what was your next step? Obviously, you never planned on going to residency. So, you were looking for that next thing after you graduated. So how did you make that segue? What were the first one or two things you were involved with?

Dr. Fisayo Ositelu: Yeah. I did not apply to residency at all. And a lot of people thought I was crazy and maybe still think I am crazy.

John: Does that include your parents?

Dr. Fisayo Ositelu: Yeah. Initially, they were skeptical, especially while you spent all this time when I just went through it. But after business school, I started off my career at a startup. It is now a much bigger company called NerdWallet. It's a FinTech company here in San Francisco and their whole mission is to provide the best financial advice for all of life's financial decisions. They provide you very detailed advice on financial products to bring transparency into just financial decisions.

And so, I got my start there. It was a really great opportunity because I joined early on and there were growing and I had a chance to wear many hats. In that startup, I worked with some great people. I learned a lot. And thinking about the transition from academia or medical school to the business world, that was another thing working outside of a lab or in the medical university setting to actual fast-growing, fast-based startup. It was another big transition that I had to work on surmounting.

John: Now was that something where you thought, "Well, I'll probably be here for a few years". Did you always have an idea in the back of your mind that you were going to start something yourself?

Dr. Fisayo Ositelu: Yeah. I've always had that in the back of my mind. In fact, right after school or after business school, I was working on some ideas, but it didn't quite pan out. And so, I joined NerdWallet. I always loved entrepreneurship. Stanford really exposed me to a lot of great, great entrepreneurs. Some of them were my classmates. So, for instance, DoorDash, Tony Xu was my classmate in my class. We sat together in a couple of classes, my class, my section. A lot of companies were started around the time I was at Stanford. So, between 2007 and 2013. Snapchat and just a lot of great companies that came up. And so, yeah, I always wanted to be an entrepreneur. And at that time there was a lot of excitement about tech and it just made a lot of sense.

John: How did you feel like it was going to be something in the healthcare field originally, or is that still an open option and then maybe something else? How did you actually decide to get into what you're doing now?

Dr. Fisayo Ositelu: Yeah. I always liked healthcare as a space, especially for innovation entrepreneurship, because there's just a lot of need. There's a lot of waste. There's a lot of opportunity. There's a lot of frustration, especially with doctors and physicians who are really at the front lines and really trying to affect a change in their patient's lives. And so luckily, I had some exposure to their frustrations because I had worked in FinTech. And it's going to segue into what I'm doing right now with Gentem. I could really wear many hats of understanding the FinTech world, financial technology, as well as the healthcare world, and then the intersection between FinTech and healthcare to provide value.

One big thing, one big problem we're solving is this problem of reimbursements, reimbursement to doctors and all the administrative hassle and overhead and complexity that goes into getting paid. I'm sure you know it seems to be always one new hoop to jump and one new technology and it's just a little hodgepodge of stuff. And so, that's essentially what we're trying to solve at Gentem. Really simplifying, accelerating, and just really bringing some clarity to this financial experience for doctors.

Whether they are solo practitioners, whether they are a group of doctors, whether they're surgery or just medical groups and things like that, how do we help those doctors thrive financially? How do we help them stay independent? How do we help them take away the burden of these administrative hassles? We're starting with RCM, the revenue cycle, but we have much bigger plans. So yeah, essentially at Gentem we are focused on really removing those administrative burdens and getting doctors paid what's on time and in full.

John: Okay. Well, you bring up a sore topic there, as far as billing and reimbursement, because to a physician most of us, there's definitely some barriers that are built-in, maybe inadvertently, the technology is not that good, mistakes are made. On the other hand, sometimes it seems like they just make it complicated so they don't have to pay us. So, that might only be a small part hopefully, but if you can automate something and design a system that can kind of get through all those hoops in a quicker way, then definitely will help, especially the small practice owners.

Dr. Fisayo Ositelu: Yeah. Yeah. And prior to starting Genten, which we started a couple of years ago, I worked briefly in private equity and I was responsible for running some revenue cycle businesses that work with large health systems. And so, I got some exposure there as well. But I still wanted to come back to the doctors, the non-acute care, the folks that are really on the front line. How do we provide an infrastructure?

So, a lot of people talk about automation. We do automation as well, but how do we bridge in that FinTech side of the house whereby for instance, we can provide access to capital, right? Instead, you have to wait weeks, months to get paid. Why not just get paid after seeing the patient? The technology is there, it's being done in other industries, why do we have to wait weeks? Why not whenever you submit a claim, have the opportunity to get the funds or the revenue associated with that visit?

And so, that's what we've done. We're innovating not only in the pure deep technology side, we are using automation and artificial intelligence to really understand the data and optimize that process, but also to start deploying capital using that data that we have. So, we understand the kinds of claims you're sending, we understand the risk behind every single claim because of how we're using the data. And then deploying capital based on that data.

So, in that respect, we have skin in the game because we're deploying our capital while on the backend, we are trying to be covered by the insurance companies. We're seen more as partners versus just your random billing company. And that's essentially what we want to do, because we were looking at this stuff more holistically. And how do we actually empower our doctors, our physicians, our healthcare providers to be able to thrive, to be able to grow, to be able to stay independent, to resist the tides of being acquired, because that's just what happens these days. And we've seen the numbers around how much private practices are dwindling down.

But we know it's not good for the system because care is actually more expensive in those hospital settings. It's way more expensive. The reimbursement is different for the same exact thing, and the quality is not always better. Some are actually mostly worse. And so, we see these things and it's imperative for us to try to really support our doctors.

John: Oh, you hit on so many things there. I just got to reflect on my own situation. My wife needs an MRI and she's been denied twice for a foot MRI that a
rheumatologist ordered. So, ultimately, I picked up the phone and I called the freestanding center, and I got her foot MRI for $350. Even at the hospital I said, I'm going to pay cash. What's it going to cost me? Well, it's going to be $1,000 plus we don't even know what the professional part is going to be. I said, okay. That's just one example.

And I think on the other side, the physician side, the other option is if you're not near retirement you really don't want to give up your practice. It's like, I'm just going to go to a cash-only practice. I just can't deal with this. And we're going to hire three people to do my billing. And I get paid only 70 cents on the dollar to begin with. And then there's a whole lag that you've mentioned. So that'll be awesome if Gentem can really help solve some of those problems.

Dr. Fisayo Ositelu: Yeah, yeah. I think you made a good point. And this is what the industry needs, even the cash-only direct primary care, just different ways to drive innovation, whether it's telehealth and all these things. Yeah, I think these are all good developments in the industry and everyone needs to be on their toes, even the payers or the insurance companies. And the more options people have, the better. It's always better the more options you have.

John: Absolutely. Okay so let's take a little detour now since you're the CEO and you're an entrepreneur and a startup expert.

Dr. Fisayo Ositelu: I don't know about an expert but...

John: You have been through it so I'm assuming there's a lot of technology in this and programming maybe and other things. And so, I'm assuming you didn't fund this yourself unless you have this big equity firm or something on the side that we don't know about. Tell us about that, the real big, tall steps. What was the process? Where did you get the idea, who did you partner with and why? And then what'd you guys do in terms of trying to get this thing off the ground, just to get it started?

Dr. Fisayo Ositelu: So, my co-founder is a buddy of mine, from college. He didn't go to the same college, but he was college buddies with my younger brother. And he was an engineer at Facebook, just living the dream and somehow, I convinced him to quit that nice job and come to Gentem for nothing. That was probably the most important step in this whole thing, finding a good co-founder, a good team aligned in vision and just willing to really stay in the trenches with you when things get bad, because they're always some rough patches. Like I said, I've worked in private equity where I was running some of these RCM companies and I'd also worked at NerdWallet.

So, a lot of the ideas came from those two places. That's the importance of really looking at whatever you do, you just have to learn and try to get the most out of it. It might not be obvious but in hindsight, you'd find that you're gaining something that could be helpful. To always try to maximize your experience and learnings from anything.

And part of the thing that really helped me out was the co-founder of NerdWallet. I had gotten to know him when I was there and we kept in touch. His name was Jake Gibson and he has a firm called Better Tomorrow Ventures. He was an active angel investor. And I reached out to him and shared the idea and he liked it. I feel that most people understand the friction, even as patients, they face their medical bills. And so, he could relate to that piece and this small piece. And then there's this whole other thing of eligibility, profit realizations, and all of these other things that you have to manage. He was an early backer of ours. I also was lucky too, to have some other entrepreneurs that were also very, very excited to work with me.

The lesson there is to have a good team, obviously a good team of executives and people that you work with, but also a good team of backers and finding folks that believe in what you're trying to do, to solve the problem. In the early stages, you're selling yourself. In the early stages is the team that really counts because you don't have anything, you don't have any data, you don't have any revenues or anything like that. You have some data, but you don't really have something that is as big yet.

So, it's really the team, one, and believe it or not, the idea is good, but it's not the most important thing. The exact idea is not the most important thing, because that could change. You could iterate on that, but it's really the vision. What is the future state of the world you want to see, or you are pushing towards? How you get there might be different. So, those are the milestones. A great co-founder, and also working with some really strong angel investors that were really able to open the doors for us.

John: I'm not really that familiar with this kind of startup situation, but the investors oftentimes are also bringing a lot of expertise in, in terms of maybe they know someone that solves a problem you have, or they have another solution they're working on, or maybe they spend some time actually working. I don't know how that works. It's a question I have. So, explain that a little bit.

Dr. Fisayo Ositelu: Yeah. Different investors bring different things. Some bring expertise, some just give you the money and get out of your hair which sometimes is great. In fact, it's more often than not great. Some offer expertise in sales and strategy and whatnot, or even product development.

So, in our case, we got a lot of strong FinTech investors. So, Jake Gibson, some really great, great folks and our seed investor Susa Ventures, they were investors in RobinHood for instance. They invested in RobinHood, the popular app for investing. We also worked with a series A investor, a group called Vulcan Capital, which is based out of Seattle. Great, great, great folks there as well.

John: Well, I'm going to shift gears again, and just ask you, how has it been going? You started roughly two years ago. I don't know at what stage that was. I'm looking at your website. I see you've got a head of marketing.

Dr. Fisayo Ositelu: Omar.

John: What is his official title?

Dr. Fisayo Ositelu: Head of growth marketing.

John: There's a lot of going on.

Dr. Fisayo Ositelu: Yeah.

John: So, how's it going?

Dr. Fisayo Ositelu: Yeah, it's going well. So, in 2019, when we launched the company, we did a proof of concept that year. Just really validated the idea and did some pilots. We really launched last year, which was interesting because COVID hit, but it's been going well, it's been going well. I think we are really staying true to our mission to focus on helping doctors and healthcare providers stay independent. We continue to build very great products, whether it's in automation and how we're using the data to how we deploy capital to these practices.

We're really focused now on building a holistic infrastructure whereby we can support practices at different stages of their evolution of whether or not they're starting, or they are in steady state, or they want to grow. We have different solutions for those practices. Whether they have a specific problem, wherever they are leaking in revenue, whether it's an efficiency problem, whether it's really helping up level the staff, whether it's consulting. And so, in some regards, we're really looking at these holistically so that we can help them thrive and remain independent. That's literally what our vision is. How can we help them thrive while being independent?

And yeah, we're always learning. I feel like every day we don't have all the answers. We really relish engaging with doctors. Because I am a physician, even though I didn't go through residency, I think our team, our DNA is a little bit different from just the other folks, because we have context, we have that deep empathy into what's going on. And one of our values is just having a low ego. It's literally one of our values, no ego, because that just enables us to listen and listen fully and be able to not mind rolling up our sleeves to do what needs to be done to make an impact. So, yeah, that's how things are going.

John: If I had to force you to say, who would your ideal customer be? What would be the picture of that person? Would it be a three-person group? Would it be any particular specialty? Someone who's struggling to collect more than, whatever? An AR that's at some level that's not working, what would you say?

Dr. Fisayo Ositelu: Yeah, we work with a range of practices. We do a lot of work with surgical subspecialties. We do a lot of work with vascular surgeons for instance, orthopedic surgeons. We also work with pain doctors. And lastly, we have quite a few customers in behavioral health. As you can imagine, it's a growing space, whether it's psychiatrist or therapists. It's a growing space.

For us, like I said, our ideal customers today are folks that are working really hard, getting revenue, but they know something is not quite right. They know that there is some frustration with really optimizing their revenue and feeling like they are doing the right thing. And so, for us, we come in there and really help them identify the leakage money left on the table, plug those, and then really amplify them for growth.

So oftentimes even like 15% - 20% bumps in revenue, which is where we benchmark in terms of our incremental benefit working with these groups. That can mean a lot of things. That can mean investing for instance, like a TMS chair, for those doing transcranial magnetic stimulation, as some of our customers. It could mean just more investing in marketing or growing to a new practice, opening a new center, which we've done for a couple of our customers.

So, those things really count. It could mean giving your staff a bonus. These things really count. And so, it really depends on where they are as folks that mostly know that there's a problem and they know that things could be better. And so, once we give them our value proposition, we have great, great folks, professionals, certified coders and billers that have decades of experience in some cases. They know that we have the technology and they also know that we have the capital. So, we have the capital, we have the people, we have the process and the technology. And then bringing all those things to bear is what really makes this a really revolutionary way of helping these practices thrive.

John: Now, just one other final question on Gentem itself and where you are. Healthcare is kind of local. A lot of insurance carriers, people we're dealing with are local and there're rules and regs at each state. So, is this currently more of a California thing, a regional thing? How does that work for Gentem?

Dr. Fisayo Ositelu: Yeah. Believe it or not, we're nationwide. So, we have customers all over the country from California to Florida, to Massachusetts to Texas, all over the country. I think the key thing is really understanding the payer policies and understanding, as you mentioned, things can be different with each state and each region, while you just have to have the ability to do that at scale and nationwide to build a big company. And for us, we're venture backed. So, the way we think about the business, it has to be big and we're not just building a mom-and-pop type operation.

John: Right. Well, I just want to make sure if someone's listening and they're in New York or they're in Texas, and they're like, "Oh, I don't know if this applies to me because they're in Silicon Valley". You're saying, basically you put the contracts from the payers and what have you, all that can be done, it doesn't really matter where you're located.

Dr. Fisayo Ositelu: Exactly.

John: So, let me see. We're going to run out of time. But tell us, the easiest way to get a hold of you and learn more is just to go to gentem.com is that right?

Dr. Fisayo Ositelu: Definitely go to gentem.com if you are interested in learning more about our company, our startup. And if you want to see a demo of what we built, we would love to show you. You can also reach me personally on LinkedIn. I'm pretty active there. Fisayo Ositelu on LinkedIn and Twitter as well. I'm pretty active. I try to check those channels, but mostly LinkedIn. We'll be happy to chat about Gentem, career advice and any way that I can be helpful. I know I learned a lot from mentors and people that really helped me out when I was coming up as well. And I still am.

John: Oh, before we let the listeners go and let you go. Any advice for someone who is thinking, "I think I could do something like this". Maybe they have a little business background, maybe they need to go get the MBA first. But if someone really had an idea that they thought "Well, I could have an impact on healthcare" whether it's payments or delivery or whatever it might be, what would you advise them to do to get started?

Dr. Fisayo Ositelu: Well, you don't need to get an MBA. I'll tell you that. But one thing that really helped us out or help me out is you're going to get a lot of "noes", unless you're lucky. But we got a lot of "noes". The key thing there is to have the ability to transmute these "noes" into fuel that energize you. It's sort of a weird thing, but we use the "noes" as a way to energize us even more. Obviously, you have to listen to the feedback and be close to feedback, but the noes can be brutal in this game. But the key is to find a way to transmute those noes to fuel that power your vision. And it's not as easy as it sounds, but once you can do that, your whole perspective changes as regarding this entrepreneurship or trying out a new endeavor, a new venture. And it's almost like a superpower, if you can get it right.

John: If you have the right mindset, you can probably do almost anything I suppose.

Dr. Fisayo Ositelu: Right. Go for no.

John: Go for no. All right. Well, I appreciate that. And I will put links in the show notes to everything there, the website and the LinkedIn and all that. And I guess with that, I want to thank you for spending the time describing your story to us and giving us some good advice and encouragement.

Dr. Fisayo Ositelu: Thank you, John. I enjoyed the time as well.

John: All right. Well, you take care, Fisayo. I will talk to you again soon hopefully. Bye-bye.

Dr. Fisayo Ositelu: Thank you. Bye-bye.
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