Key Takeaways
- Adopt schedule-based incentive programs for clinical staff to reduce reliance on costly overtime and improve patient safety.
In today’s healthcare landscape, both patients and clinicians face unprecedented challenges. From administrative complexity to staffing shortages and mounting clinician burnout, the system’s burdens often seem insurmountable. Yet, at the intersection of leadership, wellness, and community engagement, innovators are finding ways to break through the inertia. Few stories better illustrate this than that of Dr. David Wilcox, Chief Clinical Officer at MAKE Solutions Inc., a clinician, leader, and relentless advocate for patient and staff empowerment.
This feature explores Dr. Wilcox’s remarkable journey, the strategies he’s championed, and what healthcare organizations can learn about putting people—both patients and clinicians—at the center of transformation. Through real-world examples, leadership insights, and a focus on actionable change, we’ll examine how intentional collaboration and listening can improve outcomes, reduce disparities, and make the healthcare system more humane for everyone it touches.
Dr. Wilcox’s path to healthcare leadership was anything but traditional. Raised in upstate New York, his entry into the medical world was shaped not by academic curiosity, but by necessity—and personal experience with the system’s shortcomings. “I have a special needs daughter, and I had her early when I was young, about 17. I would be dragging her around to doctor’s appointments… I saw a lot of really good clinicians, but I saw a system that was really broken.”
Laid off from a manufacturing job, Wilcox used a year of unemployment benefits to train as a nurse, starting as an LPN (Licensed Practical Nurse). The immediate sense of impact—“I loved doing something where I really affected people instead of making parts”—set him on a new course, leading to further education and new roles in North Carolina’s healthcare system.
A chance assignment as a float nurse in a short-staffed emergency department revealed both his adaptability and a crucial skill: “I was able to de-escalate situations,” Wilcox recalls. This talent quickly propelled him into leadership roles, first as a night supervisor and then as Patient Placement Director, where he was tasked with fixing the very operational bottlenecks that frustrate patients and staff alike. “They were just giving me everything that was broken operationally and asking me to fix it. I thrived on it.”
Wilcox’s drive for solutions and relentless pursuit of improvement led him through a gauntlet of educational achievements (from BSN to a doctorate), stints in healthcare IT (notably at Cerner, now Oracle), and ultimately authorship—his book, How to Avoid Being a Victim of the American Healthcare System, is aimed at giving “the 17-year-old me what they should know before they ever access the healthcare system.”
If there’s a single throughline in Dr. Wilcox’s approach to healthcare leadership, it is the priority placed on listening—both to staff and to patients. This isn’t lip service; it’s the engine behind real-world change. As Wilcox puts it, “You have to listen to your patients… [and] you have to listen to your staff, right? That’s the big thing.”
This principle was never more evident than during his time managing nurse staffing amid chronic shortages. Traditional solutions—throwing money at the problem through overtime and incentives—were producing little more than staff burnout and ‘gaming’ of the system. Nurses, incentivized by extra pay, were stretching themselves dangerously thin.
Wilcox’s breakthrough came after researching how another hospital had tackled similar challenges. “I found this article on this hospital up in Albany, New York that had done something different. So I took that information and tailored this program called [the] worked hours reward program.” The basic structure was simple: nurses who fulfilled their scheduled hours received a bonus, scaling based on employment status (full-time, part-time, etc.).
The effects were immediate. “Staff were getting burned out and we didn’t have… the safest care at that point. So what happened was all these PRN staff… bumped their hours up, removed things on their own personal schedules to come to work. And 9s were like, ‘Hey, I want to pick up an extra shift so I can get the extra money.’ So it just kind of evolved into better quality outcomes for patients and much more satisfied staff because they weren’t working short anymore.”
Beyond the immediate morale and safety improvements, the program produced concrete financial results: “We saved the hospital system like two million dollars doing it this way as opposed to just throwing… cash on top of a burning fire of staff shortage.”
Wilcox is unambiguous about what works when it comes to reducing health disparities: “You have to go to the people.” He points to the evolution of population health tools that allow leaders to pinpoint communities most in need. But the true test comes in the follow-through—whether organizations are willing to build trust and bring care to where people actually live.
“Setting up a farmer’s market in a place where they don’t have access to fresh food and vegetables and subsidizing it… I’ve seen that work really well,” Wilcox explains. Mobile vaccination clinics, pop-up health screenings, and other hyperlocal initiatives reflect a philosophy that prioritizes outreach over passive expectation.
For Wilcox, technology is an enabler, but it is not the solution in itself. “We now have tools that we never had years ago, such as population health tools… But if you don’t reach people where they’re at and you’re expecting them to come to you, you’re going to have a much sicker population.”
The digitization of health records, while a historic advance in patient safety and data availability, has paradoxically become one of the greatest sources of clinician frustration. “When we digitized the health record, we created a huge burden. All of a sudden docs were having to type in orders… They want to take care of patients, right?”
The situation is especially acute for nurses, whose workload is split between direct care and documentation. The result? “If you’ve got a lot of patients, you want to get in the room and get out of the room,” Wilcox observes. This robs patients of meaningful interactions and clinicians of the time to teach, build relationships, and even learn from their practice.
Yet, innovation can also offer relief. Dr. Wilcox is enthusiastic about new models such as virtual nursing, where a remote nurse manages tasks like admission assessments and patient education via HIPAA-compliant video platforms. “The beauty of it is that nurse also has time to teach the patient about their new prescriptions or their new diagnosis while the other nurse is tending to the tasks that need to be done.”
Perhaps the most promising development is the emergence of artificial intelligence (AI) as a documentation and workflow tool. “Don’t be afraid of artificial intelligence. Just make sure it’s trained correctly, and get comfortable with it.”
With tailored training for each clinical specialty, AI can prompt nurses to conduct thorough assessments, automatically generate accurate notes, and keep both clinicians and patients informed. As Wilcox explains, “The AI might say to you, ‘Was that your first attempt?’ And then you might say, ‘No, it was my second.’ So it documents everything correctly, but it’s got to be intuitive to your workflow.”
The impact isn’t just about efficiency; it’s about restoring the core value of care. “This gives the opportunity for the patient or family member to ask questions… We’ll actually see increases in HCAHPS scores because of things like this.”
If systems change is to take root, clinicians must be at the center of the process—not mere recipients of new rules, but active architects. “Over my career I have seen organizations try to make clinical improvements without involving clinicians. That never works well and clinicians feel like, oh, this is coming from the top down. We have to do it.”
Wilcox is adamant: “If you’re going to make a change—maybe you’re implementing a new electronic medical record, or maybe you’re looking at a workflow and trying to make it more efficient—if you don’t involve clinicians, it’s never going to fly. I can’t think of one instance where I’ve seen an organization not involve clinicians and it worked.”
This message extends beyond technology adoption. From workflow redesign to new care models, clinician involvement is the difference between fleeting compliance and genuine improvement.
For leaders looking for practical steps, Wilcox recommends a time-honored but often neglected practice: “Round. I remember when I was a patient placement director, people felt a connection to me.” Whether it’s updating staff about bottlenecks or simply being present, visible leadership builds trust and clarifies expectations. “You have to set realistic expectations as a clinical leader.”
At the heart of Wilcox’s work is the belief that healthcare is a partnership. Yet, most patients are ill-equipped to navigate the system’s risks and opportunities. “It’s not a matter of if you’re going to need healthcare, it’s a matter of when. You need to get knowledgeable because you can’t walk into a healthcare system thinking that everybody’s going to do the right thing.”
From surgery scheduling (“Most patients don’t know that if you’re the first case of the day, your statistics are better…”) to medication management (“If you’re going for an elective surgery, you can bag up your own medications, take them to the hospital and ask that the pharmacy use those…”), Wilcox’s advocacy is rooted in hard-won lessons.
His book and website, DrDavidHelps.com, function as knowledge hubs: “I have a healthcare resource guide which is a one-click access to things like Mark Cuban’s online pharmacy… There’s all kinds of resources up there, which would be very difficult for most lay people or, you know, patients to find, and even clinical staff.”
A persistent gap, Wilcox argues, is the lack of support for patients after discharge. “When we release patients and we discharge patients, we send them off into the wild. We don’t know where they’re going, what they’re doing… They can’t, we should, we should have places where they can call back in the hospital and say, ‘Hey, you know, I was, went to get my antibiotic, but it was… more money than I could spend on it. What can you do for me?’”
Without better systems of follow-up and open communication, vulnerable patients are left to fend for themselves, often turning to unreliable sources like “Dr. Google.”
Dr. David Wilcox’s journey from manufacturing to nursing, IT leadership, and patient advocacy illustrates a core truth: transformation in healthcare doesn’t happen from the top down. It requires a culture of listening, an openness to innovation, and an unwavering focus on people—both patients and clinicians.
As Wilcox reminds us, “Do your education. Make sure you’re safe in the hospital.” But his story is also a call to leaders: to create systems where everyone, from staff to community members, can thrive. By embracing collaboration, championing clinician involvement, and relentlessly focusing on wellness—at every level—we can chart a path toward a healthcare system that truly works for all.
<p>Nurse managers have to teach nurses to do it differently, but they get the benefit of you're not going to have a lot of nurses hanging around at the end of shift getting overtime, right? So, it's also going to increase your bottom line, which hopefully allows you to put more money into other things in the unit.</p> <p>[Music] Hello, this is Zach with the American Journal of Healthcare Strategy and you are listening to the clinicians and leadership podcast where we focus on empowering clinicians from bedside to boardroom. Today I am joined by Dr. David Wilcox. Dr. Wilcox, why don't you take a second to introduce yourself, tell us a little bit about your experience in your current role and and what you do. Okay, thanks Zach. It's a pleasure to be with you today. Um, I am a doctorate prepared nurse.</p> <p>So, I have a DNP degree. um which was a life accumulation of many degrees. And um so I'll I'll talk about my why. Why do I do healthcare? I have a special needs daughter and I had her early when I was young, about 17, and I would be dragging her around to doctor's appointments, various doctor's appointments, and I saw a lot of really good clinicians, but I saw a system that was really broken. And um I was in manufacturing.</p> <p>And when I got laid off from manufacturing, I decided I want wanted to be a nurse. I had about a year of unemployment benefits. So I became an LPN, licensed practical nurse or LVN in the state of Texas. Um and so I did that and right away I loved I loved doing something where I really affected people instead of making parts and manufacturing. And so from there I immediately got into community college to get my RN degree.</p> <p>I got my RN degree and then um my girlfriend at the time who's now my wife and I moved down to uh North Carolina from Syracuse, New York and there I was a float nurse. So I was floated a lot to the emergency department, right? Because they're always short staffed and I was able to deescalate situations. So about a year in they approached me and asked me if I would be the night supervisor and I said yes. And so I began my jump into management, right?</p> <p>Um, and so as a night supervisor, I would have patients that would hold in the ED. Um, and and the CNO came to me one day and she said, "Why is it when you're on, we don't have a lot of patients holding in the ED?" And I said, "Well, that's because I go up and talk to the charge nurses at night at like 2:00 in the morning and say, "Hey, can you stretch?</p> <p>Somebody's grandmother's in the ED and um, you know, they're in a real bad state down there." And she said, "What do you do if they say no?" So, just come down and check the patient out for me. they come down and 100% of the time they take the patient.</p> <p>So she asked me if I could do that for the whole organization and I said, "Yeah, I think so." So, um, I became the patient placement director and had the staffing office and had all these, you know, departments reporting to me and they were just giving me everything that was broken operationally and asking me to fix it. Um, which I really thrived on. I liked it a lot. Um, and so with that, I had to go back and get my four-year degree. And so I got my BSN, right?</p> <p>And then from there, I was just finishing my BSN and my buddy said to me, "Hey, Fifer University is coming up and they're going to do a cohort. Let's get our masters." And I was like, "Okay, I'm in." And from there, I started studying healthcare information technology. And by this time, I didn't have a lot of things to fix at the hospital anymore. And that's what I thrived on. And so, they were like, "Well, we'll make you over this. We'll give you the IV team.</p> <p>We'll do this." And I was like, "I just don't want to be a maintainer." And as I studied healthcare IT, I saw a lot of broken stuff, right? So I jumped in and I I got a job with a company called Cerner, which is an electronic medical record company that was since bought out by Oracle. Um, and then from there, um, I got my doctorate degree while I was there because I just felt like I had to do it because I'm an overachiever. And from there, I decided, what am I going to do with all this knowledge?</p> <p>Like, I don't want my boss's job, you know? And so I sat down and wrote a book called How to Avoid Being a Victim of the American Health Care System, which is available on Amazon. Um, to teach the 17-year-old me what they should know before they ever access the health care system. Um, and give give back in that way cuz it it's a scary jungle out there. You know, medical errors are the third leading cause of death. Um, and patients need to be empowered.</p> <p>They need to be knowledgeable before they access it. So, I did that and I still have a career in healthcare IT, not with Oracle anymore, but with another company. Um, and so that's basically my story. Well, Dr. Dr.</p> <p>Wilcox, we're we're grateful that you are joining us today and and just excited to dive into these questions and hear your insight and and it it's just it's fascinating to to learn that your your experience with the health care system and also seeing where the health care system is broken and needs to be improved began as a father taking your p your your daughter as a patient to health appointments and seeing seeing issues and and having to navigate the health care system now.</p> <p>and and the way that that theme has allowed you just to progress in your career and that that started at a young age uh providing care for your daughter. And so um as as you mentioned, you've written a book, fantastic book, by the way, highly recommend it to to all the listeners out there. And and I'm I'm curious, we're we're going to dive into this topic of navigating the American health care system.</p> <p>And so in in your experience, what are the most significant barriers that that both patients but but also health care staff face when trying to understand and and navigate the American health care system? Well, we could probably be here for several hours. Um but I'll hit on some highlights. So most patients don't know like um let's take surgery for instance. Most patients don't know that if you're the first case of the day, your statistics are better, right?</p> <p>because the surgeon comes in, they're refreshed. Um, you're the first case and they're not tired. Um, and also, you know, they don't know what questions to ask during the surgery interview. So, you know, they they can ask, "Can I be the first case?" But they also should ask, "Are you on call the night before?" Because if they're on call the night before, then they're maybe not so refreshed when they come in.</p> <p>Um, I actually had a guy read that chapter in my book and then he had to have surgery and the doctor looked at him like he said finally said to him, "Are you a doctor?" And he said, "No, I'm just an educated patient." And uh, he said, "Well, you've done your homework." Um, you so there's things like that. The other thing that stands out to me is not a lot of people know if they're going for an elective surgery.</p> <p>They can bag up their own medications, take them to the hospital, and ask that the pharmacy use those. um pharmacy really doesn't like that much, but but you know, it saves them from getting the $50 Tylenol. Um there are so many things that people don't know about the health care system. And one thing that I really stress is if you're not knowledgeable about the American health care system, cuz it's not a matter of if you're going to need health care, it's a matter of when.</p> <p>Then you need to get knowledgeable because you can't walk into a health care system thinking that everybody's going to do the right thing. uh even though they're trying to do the right thing, there are stressors, right? There are um insurance companies who want you to see so many patients a day, there's short staffed and nurses are flying in and out of the room, right? So, not by not good by design, but it does happen. So, you really do have to be knowledgeable. In your experience, Dr.</p> <p>Wilcox, uh, what what lessons have you learned from leading efforts that improve both patient and staff engagement in in health care system and and helping both your your patients and your staff navigate the health care system? What what have been some key lessons or key takeaways that you can share with us today? Well, first of all, I think um I'll start with the staff piece of it. So, you know, the staff want to do a good job, but they're in a they're between a rock and a hard place, right?</p> <p>because the payers want to pay a certain amount and the staff just want to take care of patients. They're not opening a book to see, hey, is this cardiac calath going to be covered by the insurance company, right? They're just they're trying to do the right thing. Um I can remember at a hospital that I was at in North Carolina, there was always short staff. You they were always short staffed and so they would offer like $15 an hour for a nurse to come in and work extra.</p> <p>And I remember seeing um some people who work 60 hours a week, which is not really the safest thing to do, you know. Um and so I was walked up behind these two nurses up on the fifth floor um one day and I heard one nurse say to the other nurse, "Hey, I'm going to call in Saturday. Why don't you grab that $15?" So I started to understand, it was kind of a gaming of the system. So I decided I'm going to do something different. I'm going to do some research.</p> <p>And I found this um article on this hospital up in Albany, New York that had done something different. And so I took that information and tailored this program called worked hours reward program. Um I want to call it worked hours incentive program, but the CNO said we're not calling it whip. No way, David. So, so what we did with it was we just said, "If you work your if you're full-time and you work your 80 hours of pay period, then we're going to pay you $250 bonus just for showing up to work.</p> <p>If you work um a 0.9, then it's going to dip to like 175. And if you work 0.5, it's going to dip to like 125." Um, and so the why we did that was because staff were getting burned out and we didn't have we didn't have what I would call the safest care at that point. So what happened was all these um PRN staff, they said, "Well, I'm going to work the the 1.0." So they bumped their hours up. They they removed things on their own personal schedules to come to work.</p> <p>And then the 0.9 were like, "Hey, I want to pick up an extra shift so I can get the extra money." So, it just kind of evolved into um better quality outcomes for patients uh because we talked about patients before and it and much more satisfied staff because they weren't working short anymore. And if somebody called in for legitimate sickness, then they just worked with their manager to pick up a shift if they wanted to keep the money.</p> <p>Um, we saved the hospital system like $2 million doing it this way as opposed to just throwing, you know, cash on top of a burning fire of of staff shortage. So, um, yeah, that was that was kind of cool. I really like that. Um, my CNO actually took it and presented it at a conference. Um, you know, it was just very forward thinking. So, well, and I just think Dr. Dr. Wilcox, that that that speaks just the importance.</p> <p>You you mentioned that that initiative started with you listening to staff and and hearing conversation and and then doing research and and finding a hospital that had implemented a similar program and and and then taking that research and implementing that same similar program in into your own hospital. And and I think that just speaks to the importance of of content like this to allow people to share what works, what doesn't work.</p> <p>How do you navigate significant issues like like burnout and and staffing issues because those are things that that health care systems and organizations face face all the time? And so, um, Dr. Dr. Wilcox, shifting gears a little bit. Um, we we've talked just on on some barriers on on navigating the health care system and and it's a complicated health care system um to to have to navigate.</p> <p>And we're going to dive some more into how clinicians and and clinical leaders and can empower their staff to to help patients be able to now navigate that this system better.</p> <p>But before we get into that, I'm I'm curious to to hear your thoughts on just the the challenge that healthcare disparities remain and and how when trying to implement some of these patient empowerment and staff engagement uh initiatives and and make those a priority, how how your clinicians and leadership can ensure that they are in doing so are trying to reduce those health disparities and and reach vulnerable and underserved patient populations.</p> <p>So how can they navigate health disparities while while trying to make sure that that patients are empowered? So one thing that you touched on was listening, right? You have to listen to your patients. Um the other thing is we now have tools that we never had years ago such as population health tools. So we can pretty much hone in to see what zip code um what people who are less fortunate are in and you know if there's been flu outbreaks there or you know COVID or whatever.</p> <p>Um and then what we have to do as leaders and clinicians is we have to go to the people. So, setting up uh setting up a farmers market in a place where they don't have access to fresh food and vegetables and subsidizing it. I've seen that work really well.</p> <p>The other thing is, you know, setting up a spot to give flu shots or um, you know, COVID shots into an area where you have a farmers market or into an area where people that don't have a lot of means can actually access someplace where they will go and, you know, reaching out to the community and and developing those bonds with the community. Um, I think that that's very important.</p> <p>I think that if you don't reach people where they're at and you're expecting them to come to you, you're going to have a much sicker population. Uh Dr. Wilcox, I'm I'm interested to hear your thoughts on this next question. A common complaint I hear and and that is just prevalent throughout our health care system is is burnout, but but more specifically administrative burdens that your clinicians and and frontline medical staff have to deal with.</p> <p>that is on top of having to take care of of patients and provide care for those patients. Um obviously we we can't just eliminate all of administrative tasks. Uh but in in you've you've spoken just the importance of empowering patients and helping them navigate it and empowering your staff.</p> <p>And so how can your clinicians and leadership create environments where the frontline staff, your clinicians and other medical staff have the time and ability to support patient empowerment without adding additional administrative burdens. So let's talk about something that I'm sure every clinician can relate to who's watching this. So when we digitized the health record, we created a huge burden, right?</p> <p>uh all of a sudden docs were having to type in orders and they're like I'm not a typist you know I don't do this they want to take care of patients right so we created all these burdens um in the sake of you know producing data from a medical record and being able to understand it making it safer than the doctor with a lousy handwriting who writes for a prescription that the pharmacy misinterprets and the patient gets the wrong medication those were all needed but those were very burdensome so now what we're seeing and especially after the co um epidemic, we uh or pandemic, I'm sorry.</p> <p>Um we we've seen things grow out of that like virtual nurses, right? So it very easy to set up. You get an iPad, you get a PC, whatever. Um Zoom is HIPPA compliant. I mean, you can use that. You can use Teams, which is also HIPPA compliant. And you say, "Hey, this is your nurse. This is your tech. And this is your virtual nurse." And the virtual nurse actually does the whole admission assessment which takes nurses quite a while to do.</p> <p>But the beauty of it is that nurse also has time to teach the patient about their new prescriptions or their new diagnosis while the other nurse is tending to the tasks that need to be done for patients. Um you know being boots on the ground at the hospital. Um we've seen we've seen some remarkable results with that. And then also they can go over the discharge teaching in depth because you know, let's face it, discharge at a hospital is I walk in with a bunch of paper.</p> <p>I say, "Hey, you got your new CHF diagnosis and um can you sign this form here?" And and the person's like, "I just want the get the hell out of here." Right? So there it's like total chaos. This lessens the burden on the actual nurse who's providing care at the bedside um and gives somebody who wants to do that kind of work um the ability to do it. Now let's move on to what I think is really going to be a gamecher in reducing administrative burden and that is artificial intelligence.</p> <p>And I know before I get shot some people are like no artificial intelligence bad but if you train it right it's good right? I mean everybody was afraid of email at the beginning too right? send his stuff off on the internet. But the artificial intelligence allows a doctor to go into a clinic with a little device or a phone and say, "Hey, I'm going to record our conversation um so that I catch everything.</p> <p>Is that okay?" And the patient says, "Yes." And then that note is produced for the doctor so he doesn't have that administrative burden of trying to remember at the end of the day what he did for that patient as well as the other 10 patients he saw or she saw.</p> <p>Um, so it's like those kind of tools are invaluable and I've seen some work on what we call voice for nursing out in the healthcare IT industry, which when you think about it is beautiful because normally I would go in and do an assessment on you, Zach, and I would use a cold stethoscope and I'd listen to your lungs and I', you know, listen I'd listen to your bowel sounds, uh, check you for um, edema and then I would go off somewhere maybe with a cup of coffee, maybe not, and I would chart it and you'd be like, I wonder what that nurse found, right?</p> <p>Yeah. And so, so what happens now is they hit a little device and say, um, uh, hey, Oracle, since I worked for Oracle at one point, they say, um, uh, doing my head to toe assessment, you know, and they'll say, oh, I got crackles in the left lower lobe. And the AI can speak to them and say, did you check for peripheral pitting edema in the peripheral extremities? And the nurse is like, "Well, yep.</p> <p>Got two plus fitting edema in the peripheral extremities." Giving the new nurse like the 20-year advantage, right? Because those are things that you don't learn, right, coming out of school. Um, but also the beauty of this is now the patient can say, "Well, is that why I take that water pill?" And the nurse can say, "Yeah, and you're probably going to take two of them today." So, you know, it brings them in and makes them feel a part of their care.</p> <p>And of course, nursing leaders um really have to rewire nurse's brains to be able to speak that kind of stuff in front of a patient because most of the time if you've got a lot of patients, you want to get in the room and get out of the room, right? Um but this gives it this gives the opportunity for the patient or family member to ask questions and I think that we'll actually see increases in HCAP scores because of things like this. But don't be afraid of artificial intelligence.</p> <p>just make sure it's trained correctly um and get comfortable with it. Well, and that's that's fascinating to to hear you walk through a couple of those examples because in in doing so that those those nurses want to get into the room and get out of the room because they have to spend time charting and and if they don't chart effectively and efficiently, they fall behind on spending time in the room, but also there's there's liability issues and and legal issues that that can come from that.</p> <p>And so they they feel that strain. And it's fascinating to hear you mention some tools that will keep your clinical staff in the room longer, which inherently deepens and and broadens that patient provider relationship, which is empowering. If you get more time with the experts as in your clinical staff, th those patients will have more opportunities to be empowered and to understand and to help navigate the the system. And so I I I think that's fascinating.</p> <p>Something something you're curious um something that just piqued my interest is you said if it's trained correctly. You mentioned that a couple times. How how do you make sure it's trained correctly? There's various ways to train AI. So So in my what I know about it is basically um we we started AI in a clinic, right? And we started it for um family health providers, family practitioners um or you know nurse practitioners or PAs in that area.</p> <p>But if we rolled it out to somebody who was in endocrinology, we would have to train it for the terms that are spoken in end endocrinology. Right? So um there's those aspects. You kind of have to make it specific to what the venue is. Not that we didn't have people take it like in cardiology and say, "Hey, I'll just work with it because this is great." Um, but, you know, we kind of got to train it for the specialty. And that's the same way with nursing.</p> <p>You know, you can say, you can say, "Hey, hey, whatever, you know, Google, Oracle, whatever. I just placed a 16 French catheter, um, fully catheter, and I got 300 cc's of clear yellow urine." And then the AI might say to you, "Was that your first attempt?" And you might say, "No, it was my second." So, it documents everything correctly, but it's it's got to be intuitive to your workflow.</p> <p>Like I said when we started this conversation, the the electronic medical records created a burden, a huge burden for clinicians. Um, though we needed to do it, but now we're getting some tools that that this is the cool stuff, right? Let's go do this. We can get more time with our patient. I could spend more time in the room because I don't have to go out write that note. Um, and so this is the kind of stuff that clinical leaders need to be on top of.</p> <p>They need to embrace it and they need to sell it to their staff. And as I mentioned before, nurse managers have to teach nurses to do it differently, but they get the benefit of you're not going to have a lot of nurses hanging around at the end of shift getting overtime, right?</p> <p>So, it's also going to increase your bottom line, which hopefully allows you to put more money into other things in the unit than, you know, nurses who are overworked and stay in two hours later to do their documentation, right? Um, we you've touched on this a little bit, but but I want to maybe take touch on it in a in a different way, in a different light.</p> <p>Uh but but when we're when we're talking about health care systems and just the the complicated nature of the American health care system, there's a lot of clinicians that that feel powerless and and disillusioned with the system because it is so complicated and and they want to help, but they they can't help as they as to the best of their ability because of limitations and and red tape and and having to navigate that system is just something that is is very complicated.</p> <p>And so how can your how can clinicians and leadership help clinical staff see themselves as agents of change and and as people that are helping other people rather than just cogs in a system that is that is yeah how how can they how can they avoid the being cogs in a system and and how help them see themselves as agents of change. So that's a that's an excellent question because over my career I have seen organizations try to make clinical improvements without involving clinicians.</p> <p>Um that never works well and clinicians feel like oh this is coming from the top down we have to do it. So the big thing that clinical leaders need to do is they need to incorporate um clinicians into clinical decisions. It seems like a no-brainer, right? A lot of times it's the finance people, you know, it's like other people are are making these decisions.</p> <p>So, I would strongly suggest that if you're going to make a change, maybe you're implementing a new electronic medical record or maybe you're looking at a workflow um and trying to make it more efficient, that if you don't involve clinicians, it's never going to fly. I can't think of one instance where I've seen an organization not involve clinicians and it worked. Um it's, you know, it's just like a no-brainer. But so clinical staff want to be involved, right?</p> <p>I mean, I wanted to be involved in um you know, making steps better for the staff that I did at that hospital in North Carolina. um but they want to be involved, but if as clinical leaders we don't tap into that invaluable resource and get them involved um then we're setting ourselves up for failure. Dr. Wilcox, we're grateful for your time today and and just before I let you go, I I have one last question.</p> <p>Um what advice would you give to to clinical leaders, clinicians in leadership who want to champion patient and staff empowerment but aren't quite sure where to start? Sure. So the first thing I would say is round. Um I I remember when I was a patient placement director, people felt a connection to me.</p> <p>So if I said I went into the um into the PACU and I said, "Look at things are going to be slow going up on the ortho floor today." Um and they were so I got them prepared for what was going to happen. I think that you have to listen to your staff, right? That's the big thing. Um, and then you have to set realistic expectations as a clinical leader.</p> <p>Um, and so another thing that I think we have a big gap in as far as patients go is when we release patients and we discharge patients, we send them off into the wild. We don't know where they're going, what they're doing. Um, we might have a street address or whatever. But when they have questions, it's very hard for them to get answers. So they go, where do they go? Dr. Google, right? Let me get there. And that's a terrible thing to do.</p> <p>Um, so you know, they can't we should we should have places where they can call back in the hospital and say, "Hey, you know, I was went to get my antibiotic, but it was like much more money than I could spend on it." And um, so, you know, what can you do for me? Well, we write you a prescription for something that's generic. And those kind of things are a big gap. Um, you don't see a lot of people paying attention to that. they want to get them in, get them out, and be done with it.</p> <p>And they don't really get reimbursed for it either. So, that's the other piece of it. Um, but those are the kind of things that that I would suggest ways we could improve the patient experience and ways we can improve um and be successful in getting across clinical changes that we need to get across. involve your clinical staff and have an avenue for your patients to go or call after they get out of the hospital when they have questions.</p> <p>And I just I love the emphasis on on listening listening to your staff, listening to your patients. And the the other thing that I would add uh to that just if if you're a clinician in leadership or or a healthcare leader out there that doesn't know where to start on how to do this, there's a there's a great book on Amazon called How to Avoid Being a Victim of the American Healthcare System. um by Dr.</p> <p>David Wilcox that that offers a lot of unique insights and um it just practical tips on on how to be empowered and as a result better empower others. Yep. And you can find me also at drdavidhelps.com. drdavidthehelps.com. Um I have a healthcare resource guide which is a one-click access to things like Mark Cuban's um online pharmacy. Um, I have even insurance, even companies that will take your hospital bill, look it over, and if they can't save you any money, they don't charge you anything.</p> <p>And if they do, they they take a third of what they save you. There's all kinds of resources up there. Um, which would be very difficult for most lay people or, you know, patients to find and even clinical staff, but it's available there. And if you sign up for my newsletter, I'll send it to you. drdavids.com. Well, Dr. Uh, Will Cox, we're we're grateful for your time today.</p> <p>Great grateful for you coming on to the Clinicians and Leadership podcast and and sharing your insights and and your expertise on on how we can we can better help patients and staff navigate and understand the health care system as a whole. So, we're grateful for you and we wish you the best. Thank you, Zach. I appreciate it. I enjoyed talking with you today. And remember everybody who's listening, do your education.</p>
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