Key Takeaways
- Cultivate 'socially complex relationships' built on deep trust and mutual long-term benefit rather than purely transactional exchanges to enhance organizational partnerships.
Clinician burnout, operational inefficiencies, and fragmented healthcare delivery pose significant threats to U.S. healthcare systems today. In a healthcare landscape strained by escalating complexities, empowering clinicians with robust leadership skills emerges as a strategic necessity. Joshua Todd, DNP-A, CRNA, MBA, Chief Nurse Anesthetist and Vice President of Operations at DPI Anesthesia, underscores the importance of cultivating "socially complex relationships" to address systemic healthcare challenges effectively. By blending clinical acumen with operational leadership, clinicians like Todd are uniquely positioned to innovate from within, enhancing patient outcomes and organizational efficiency.
Clinicians often find themselves constrained by operational inefficiencies that impede patient care and contribute to burnout. Joshua Todd explains that his journey into healthcare leadership began with a realization that many systemic issues stemmed from operational redundancies. Todd observed this clearly during his clinical practice as an ICU nurse and anesthetist:
"Your job becomes prohibitively difficult because there are so many unnecessary steps that prevent you from just caring for the patient."
Todd emphasizes that leadership education equips clinicians with tools to identify inefficiencies and advocate effectively for streamlined solutions, fostering better healthcare delivery.
Todd introduces the concept of socially complex relationships as deeply rooted partnerships built on trust, value beyond monetary transactions, and mutual long-term benefit:
"A socially complex relationship is where I'm doing something with you, and I don't believe that I could do that better with anybody else."
These relationships hinge upon intrinsic trust and collaboration, elevating them above purely transactional interactions. Todd illustrates this through an analogy of consistently choosing a trusted plumber recommended by family—a scenario highlighting that trust and reliability outweigh mere cost considerations.
To create and sustain socially complex relationships, Todd advises:
Clinicians who develop these relationships often bring forward innovative solutions proactively, further embedding trust within organizational partnerships.
Clinical experience uniquely positions healthcare leaders to recognize operational opportunities that non-clinical administrators might overlook. Todd shares how DPI Anesthesia implemented erector spinae plane blocks to significantly reduce narcotic use and improve patient recovery time:
"We cut narcotic use by over 50% intraoperatively, which not only addressed patient care but also reduced drug costs and potentially shortened hospital stays."
This clinical insight translated into substantial operational improvements—reducing costs, enhancing throughput, and indirectly increasing revenue. For healthcare organizations aiming to reduce operational redundancies and improve efficiency, Todd's example aligns with strategies discussed in Mastering Innovation in Healthcare: Practical Strategies for 2025.
One critical challenge in healthcare innovation is gaining organizational support. Todd stresses the importance of clarity and persistence:
He candidly acknowledges initial resistance, noting, "Unless it's going to give everybody a raise, you're probably not going to get immediate buy-in." However, persistence coupled with transparent communication about objectives and impacts eventually fosters acceptance and collaboration.
Leadership in healthcare, according to Todd, fundamentally involves mutual accountability. Effective healthcare leaders must model accountability and openness to feedback:
"The leader should be able to be held accountable by the employees they're managing. If they're not setting a good example, you're creating a bad culture."
Todd emphasizes the necessity for leaders to exemplify accountability, thereby cultivating a supportive, responsive organizational culture essential for navigating systemic healthcare challenges.
Empowering clinicians with leadership capabilities is crucial to overcoming systemic inefficiencies and improving patient outcomes. Clinicians should actively pursue leadership education, foster socially complex relationships within their organizations, and leverage clinical insights to innovate operationally. By maintaining transparent communication, emphasizing accountability, and staying persistent, clinicians can effectively lead change, enhancing both patient care and organizational effectiveness.
there's so many different parts of healthcare and that's one of the great and both challenging things about it is that people are coming from completely different perspectives whether you're a clinician or administrator or you know from the patient side there's so much going on so I think understanding those different perspectives creates a way more robust picture for somebody going into leadership [Music] positions hello everyone and welcome to the strategy of Health podcast from the American Journal of Healthc Care Strategy my name is Cole Lions I'm here today with Dr Katherine melman who is a physician as well as an associate professor and the director of The Institute for leadership and advocacy for the PA program at ruter University Dr mellman is in a very unique position and doing some very interesting things bridging the gap between clinical uh knowledge and administrative leadership uh Katherine thank you so much for coming on the podcast I really appreciate you taking your time today thank you so much for having me I'm excited to talk about these things really great to have you here and I wanted to just start off by asking you know you are a physician and you're now teaching in a PA program and you're teaching about leadership and advocacy can you tell us a little bit about your journey and how you kind of found yourself in this unique Niche sure it was definitely not a linear path um so I started my career in emergency medicine and I always had an interest in education teaching residence and medical students um and then my career took a bit of a turn when I moved into uh Policy and advocacy work so I did a fellowship in health policy and uh worked on Capitol Hill for a little bit and then that kind of opened my eyes to the broader Healthcare System and the importance of uh clinicians having a voice in shaping policy and leading organizations um and then I had the opportunity to transition into Academia full-time and I found myself in the PA program at recers um which has a really strong focus on leadership and advocacy and so it was kind of a perfect fit for my interests and my background and I've been there for a few years now and it's been really rewarding to work with PA students and help them develop those skills that's that's fantastic and I think it's so important because a lot of times clinicians don't get that exposure to the administrative side or the policy side until maybe much later in their careers or if they actively seek it out so bringing that into the education early on I think is really valuable um why do you you know you touched on it a little bit but why do you believe it's so critical for Pas specifically or clinicians in general to have this leadership and advocacy training yeah I think it's essential because the healthcare landscape is changing so rapidly and it's becoming more and more complex and clinicians are really at the forefront of patient care and they see the challenges that patients face every day and they understand the clinical nuances but they also need to understand the system in which they work in order to effectively advocate for their patients and to improve the care deliver very system um so having those leadership skills allows them to not just be you know providers of care but also drivers of change and to be able to navigate uh the complexities of the Health Care System whether it's dealing with insurance companies or understanding Health policy or leading teams you know interprofessional teams um all those things require leadership skills and advocacy skills so I think it empowers them to have a bigger impact beyond just the one-on-one patient encounter absolutely and I think you know we see a lot of burnout in healthcare right now and a lot of frustration and I think sometimes that stems from a feeling of powerlessness or not being able to change the things that are frustrating you so giving people those tools creates a sense of agency which I think is is really important for for well-being as well um what are some of the specific things that you cover in your curriculum or or what are some of the key takeaways that you hope your students leave with yeah so we cover a broad range of topics um we start with kind of foundational leadership skills like emotional intelligence communication uh conflict resolution negotiation um those interpersonal skills that are really critical for leading teams and also for patient care quite frankly um and then we move into more of the systems issues so we talk about health policy how policy is made how to advocate for policy change um we talk about health economics and reimbursement models because understanding the money flow is really important for understanding why things are the way they are um and then we also talk about quality improvement and patient safety how to measure outcomes how to you know Implement changes to improve care um and then we also touch on social determinance of health and Health Equity which is a a huge focus of our program um making sure that students understand the broader context of their patients lives and how to ad for more Equitable care so it's really a comprehensive curriculum that tries to equip them with a toolkit that they can use regardless of what clinical setting they end up in that sounds incredibly comprehensive I mean that sounds like almost like an MBA or an mha kind of condensed into a leadership track for clinicians which is which is amazing um how do you find the reception from the students is this something that they're eager to learn about or do they sometimes feel like why am I learning about business when I want to be learning about medicine yeah that's a great question I think initially there's sometimes a little bit of skepticism or like oh I just want to learn the medicine I want to learn you know the pharmacology and the path of physiology um but as we get into it and as they start to see the relevance to their clinical practice I think the light bulbs start to go off um especially when they go out on their clinical rotations and they see these issues playing out in real time they see the barriers that their patients face or they see the inefficiencies in the system and they come back and they say oh I remember we talked about this in leadership class and now I understand why this is happening or maybe I have some ideas about how we could fix it um so I think by the time they graduate they really see the value of it um but it is a little bit of a shift in mindset uh from the traditional medical education model yeah absolutely and I think you know creating that mindset shift is is half the battle right once you see the world through that lens you can't really unsee it and you start approach problems differently um you mentioned you know your time and policy and advocacy work do you think there is a growing trend of clinicians getting more involved in that space and is that something that you encourage your students to pursue yeah absolutely I think we're seeing more and more clinicians running for office or getting involved in advocacy organizations um and I think that's fantastic because we need those voices at the table um people who understand the clinical reality of providing care um so I definitely encourage my students to get involved whether that's at the local level you know serving on a hospital committee or getting involved in their State Professional Organization um or at the national level you know writing to their representatives or visiting Capitol Hill um I think there's so many ways to be an advocate and it doesn't always have to be running for office although that's great too um but just using your voice and your expertise to inform policy decisions is is really powerful definitely and I think you know uh another aspect of this is the interprofessional nature of it right you're a physician teaching Pas I mean how do you see that collaboration evolving and and what does that teach the students about working in these multi-disciplinary teams yeah I think that's huge um Healthcare is a team sport nobody practices in a silo anymore and so learning how to work effectively with people from different backgrounds uh different training different perspectives is is essential and so me coming in as a physician teaching PA students I think models that collaboration um and shows that you know we all have the same goal which is providing the best care for the patient um and we each bring something unique to the table and so learning how to respect those differences and leverage each other's strengths is a big part of what we teach in terms of teamwork and collaboration um and I think it's good for them to see that you know physicians and Pas can work together harmoniously and learn from each other absolutely well Catherine this has been a fantastic conversation I really appreciate you sharing your insights and the work that you're doing at Ruckers I think is uh pioneering in a lot of ways and hopefully sets a model for other programs to follow to really integrate this leadership and advocacy training into clinical education so thank you so much for your time and for everything that you're doing thank you so much Cole it was great talking with you [Music]
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