The Power of Collaboration: What Dr. Jay Harness Teaches Us About Winning as a Multidisciplinary Healthcare Leader

<p>I think when we interact with our colleagues at committee meetings when we interact on the national level at National cical organizations we want our colleagues to feel empowered and on an equal plane with you not a one down plane at all again that's all part of my win-win philosophy [Music] hello this is Zach with the American Journal of healthc care strategy welcome to the clinicians and Leadership podcast Series where we focus on empowering clinicians from bedside to boardroom today I am joined by a very esteemed guest with wealth of experience both in the clinical component as well as the administrative leadership component of our healthcare industry and that is Dr Jay harness Dr harness why don't you take a second to introduce yourself and just tell us a little bit about your experience well okay Zach well it's a privilege to be with you I am a University of Michigan go Blue University of Michigan educated and trained general surgeon by background who early on in my career morphed into Surgical Oncology was my initial focus in the world of endocrine surgery and then for the last 37 years of my practice was focused pretty exclusively on breast cancer I uh had the privilege over the years of rising through the ranks academically uh at not only the University of Michigan TS University and the University of California system who then became involved in the leadership of the American Association of vender surgeons uh as its president the same was true for the American Society of breast surgeons and breast surgery International so it's been really my privilege over all these years to be involved not only clinically but in a leadership role with National Surgical societies and I think that's what's bringing us here together today yeah yeah well and we could spend the entirety of this episode just talking through your resume um because you have served a variety of clinical roles you've served as as a professor you've a medical director in a variety of organizations you founded several organizations um with with all your wealth of experience I'm I'm curious what have been some of the more impactful experiences that have just developed your approach to leadership you know I got thinking about I knew about that question from you this morning I got thinking about you know it actually goes back to my Premed days at the University of Arizona I was involved in a national fraternity uh became vice president in my sophomore year in my junior year I became president of the fraternity house believe it or not and then in my senior year president of the inter fraternity Council very involved in academic uh and campus politics and I really think the The Roots were set there for my subsequent involvement As I Grew medically and with the various medical uh societies that I was involved with in the 1970s I was very instrumental and helping to found the intern residence section of the American Medical Association which is the house staff section today and you know it just sort of kept moving from there but I think the roots believe it or not actually go back to my Premed education days that's that's awesome well it's like like I said before you you have a wealth of experience in in clinical as side as well as just leadership sides of just not just our healthc care system but just in general and it it's cool to hear you recognize the benefit of um you know having served as the medical director having served on all these committees having served as consultants and professors the one of the key things that that started you on the path that you are was something that wasn't necessarily involved in healthcare in general and so just recognizing learning from every opportunity that you have in front of you that's that's that's awesome and so um like we've mentioned you youve you've served in a variety of roles and a variety of clinical roles um and administrative roles as well so I'm curious how has your clinical experience impacted your approach to the administrative and the business and the leadership side of healthcare good question I still am not sure that I've got a clear answer to that um having been involved in academic medicine for 28 years academic centers tend to be somewhat political there were the joke is there we fight over little things out in private practice which was the last uh 15 years of my experience there there the fight was simple it was just about fighting over money but what you found yourself was that you were in the middle of having to deal with multiple people on multiple levels and as a surgeon this is particularly true in the operating room you know you you may be the surgeon but you've got assistant you've got nurses you've got anesthesiologists you've got preup care postup care so you're constantly interacting with groups of people my number one Paradigm throughout my entire life and career has always been to create a win-win situation and to be able to carefully listen to what my friends and colleagues are saying so that I could at least meet them halfway if you will in negotiations interactions with with them Etc and always and by doing that what we're doing Zach is that those other people become visible they don't feel invisible and that strengthens the bonds as you try and create new things you want to do become a leader etc etc does that does that make sense to you yes yeah well in seeing seeing those people as people and seeing them not make making them visible keeping them from being invisible is is just respecting them and showing them that you value them as an individual like you said as well as and I I can't imagine how much that improves the the patient experience if every staff member views is is understood that they are respected and valued because each role that is that an individual serves within a Health Care system is valuable and serves a purpose yeah absolutely it's interesting you talk about the patient experience uh obviously espec I dealt with a lot of vulnerable patients dealing in breast cancer that last 35 Plus 37 years so I would walk into the room with a newly diagnosed breast cancer patient her spouse or family members are there I'm in a white Cod hey they all know I'm a doctor I don't walk in and hi I'm Doctor harness no I walk in reach out my right hand look the patient in the eye and say hi I'm Jay I do the same thing with the family members I then sit down because I'm 6' one and a half instead of standing up and looking down on the patients I sit down immediately on the little rollar around stool have the patient up on the table I'm already delivering a message of empowerment to that patient and it's the same thing I think when we interact with our National Surgical philosophy something else Dr harness that I'm I'm curious about is I mean we've we've we've kind of briefly ran through your resume we've talked a little bit about some of your experiences you have quite extensive experience that that spans a long time you been in the medical field for for quite some time successfully and so but over the over the course of those years the medical field even now is is is changing and it has changed substantially so how do you recognize and stay on top of an everchanging field yeah well again it's the interaction with your colleagues so here's a good example over many years I ran the multidisiplinary conferences for breast cancer patients in attendance to those conferences were other medical oncologists perhaps some other surgical oncologists like myself radiation oncologist physical therapists we were constantly interacting with each other I was involved in clinical research projects so I heard about Cutting Edge research that was being done so it was being in and being in interactive with my colleagues that helped keep my uh knowledge base as high as it was and you know we all talk about reading our journals and attending CME conferences and things like that but I've been privileged to also help teach to those conferences but again it's the interaction and then one of the things I think people forget at these National and international meetings a lot of information and ideas are exchanged sort of off Podium if you will in other words it's part of our mixing and with our colleagues and I and I've seen the changes coming early I saw them at the a house of delegates coming early I've seen them at other organizations so keeping our mind open for change and then figuring out how do we adapt to those changes keeps you ahead of the game Zach I really believe that yeah well and and you you touched on this as well having having the humility to know that you you're not going to be the smartest person in the every room that you go into and so recognizing that there are other individuals who are who are doing incredible work and who are who are uh leading the front of change and Innovation and uh being able and willing to to partner with them and and see how they are doing and and what they are doing well to to better help businesses and the patient care which is which is what the medical field is all about you know it's really interesting again put a fair amount of thought into our interview today prior this morning and I and it it really hit me as I was thinking about it I grew up in a family of patent attorneys my father his two brothers and my grandfather harness were all patent attorne in fact the firm founded by my grandfather in 1921 in Detroit is still there um and so I grew up in an environment of creative thinking hey let me share with you this new invention that somebody's brought to me so I think that's Again part of my core that my ability to think openly and creatively and so as a good example when we started at the University of Michigan in the mid 80s one of the very first academic multi-discipline breast centers this was at a time a critical time in the history of breast cancer where there was a change in our approach to breast cancer the national trials from both the United States and Italy were published in the early to mid 1980s and what we what those trials demonstrated was that we didn't have to do mastectomies in every patient that you could safely do breast conservation in layman's terms lumpectomy plus radiation therapy and at a faculty meeting my focus was on the world of ocine surgery but the guy running my colleague or my chief I should say running the faculty meeting said we want to start a multi-disciplinary center where we have the surgeons the medical oncologists and the radiation oncologists all in the same clinic at the same time rotating around and seeing those patients to determine if they were candidates for breast conservation and I sat there and thought what a brilliant idea in other words my mind was open that I kind of quietly put my hand up everybody else was I don't know counting light bulbs or tying their shoelaces whatever they were doing and my chief of general surgery said all right harness it's your job to get this multi-discipline Breast Center up and going Zach I had no idea my entire life my entire career just changed right on the spot we published I think to this day one of the only textbooks on on multi-disciplinary care was called breast cancer collaborative management and so that theme of collaborative management still should go on in hospitals today particularly with Hospital administrators with other colleagues understand what their issues are what the problems are and where do we find that middle win-win ground that everybody thrives on I think that that is the perfect segue into my the next topic that wanted to discuss and you've touched on this a number of times just already but um in establishing that multi-disciplinary clinic and just other other roles that you have served in specifically more that talking about that multi-disciplinary clinic uh that you mentioned collaboration that it requires a lot of collaboration between different individuals with different skill sets and different priorities and different perspectives yet all of those different individuals need to come together and unite around a common goal which is what's going to be best for the patient and so in your roles in in establishing those clinics how did you approach building that collaboration by personal interaction going to the medical oncologist and say hey we really need you uh going to the radiation oncologist and it was a win-win for them not not only were they discussing possible research projects they were involved with it also increased patient volume and increased uh their interaction with the patients the same thing was particularly to with social workers that we had involved in our multidisiplinary conferences because the patients had all sorts of social issues same same thing for the physical therapists particularly to look at starting to train patients to help prevent lymphodema excuse me or if they develop LMS to even get them into treatment right away the patients loved it they felt good about the team they were working with which made the team they were working with feel good about what they were doing so you see this positive feedback loop and that's that's how you build programs something else that I just think is fascinating just looking at your your career and all the accomplishments that you have had uh there's there's been a lot lot of Innovations and uh changes within the medical field since you started your career at the University of Michigan um and and in our PRI previous conversation we we've discussed some of those Innovations and uh that that were Innovations at the time and now are common medical practices and standards of care can can you talk about some of those Innovations and how you recognize which Innovations and opportunities should be pursued sued yeah again it's having an open mind so I got involved in in the uh 19 or 90s in ultrasound for surgeons well again it was a quite inadvertent one of my colleagues walked in and said hey Jay we're doing a course on ound for surgeons at the Southwest Surgical Congress I'm the vascular surgeon so I've been doing old sound for a long time I've got my trauma colleague who has been doing the fast exam with ultrasound in the emergency room we want you to lecture on ultrasound for the breast and I said oh well they knew my interest in breast surgery but I didn't know anything Zach about ound other than looking at some images so I quickly found a one of the earliest courses started by industry to teach surgeons how to do ult sound took the course asked their help in creating a a if you will gave the lecture the next thing I know one of the companies who brought equipment there were tapping me on the shoulder and said hey Dr harness we'd like you to help teach ultrasound courses out west where you're at we've got another person doing the same thing back East would you do that and I said well sure but I don't have an ultrasound machine well no problem we'll get you one and and then I was involved in the earliest days of the creation of the ameran excited breast surgeons and suddenly I found a few other breast surgeons who are interested in this the next thing you know we start doing courses at the American Society for breast surgeons on ultrasound for breast surgeons and what we found was that we were natural stenographers in other words once we got over the intimidation of the knobs on the machine and learns how the p Electric effect created images and learn how to hold the trans user and do it right we were like ducks on the water we would just take right off with that and apply that use of that technology in other areas so my second book was actually a book on ultrasound in surgical practice and the thing the rest of its history alound now used by general surgeon or by breast surgeons and general surgeons is so very very common uh so that that again that's that same process Zach of being open to new ideas learning about them getting excited about them having passion about them and then teaching our colleagues one of another way of putting this is I've always been an early adopter and one of my favorite people out there is Simon cynic and I think I shared this with you before this is Simon cic's book start with why you remember that sir and Simon talks about the Golden Circle and here's the Golden Circle and on the inner circle is the Y in other words what's the purpose or belief or the new thing we're learning the next circle out is the how how do we do that and then thirdly is the what what are we actually delivering out there and Simon talks about people who understand a why of something become the early adopters the early adopters those numbers then slowly grow until there's this tsunami effect when all of a sudden the crowd joins us at that point and says wow this is really great thank you very much but anyway I'm an early adopter I get things early and I get passionate about things well and it's it's wild to just think about all the different ways that I mean ultrasound is such common practice in standard of care now and it's fascinating to think back that hey all of our the innovations that are now the the former innovations that are now standard of care and common practice were at one point innovations that required early adopters as yourself and clinicians right recognize the value of them yeah yeah and it's and it's having an open mind to get when something's new and that it can really have applicability whether it's an organization of how we deliver care it's a new procedure it's a new whatever you've got to have an open mind and a willingness to be an early adopter so I'm I'm a little curious how do you approach I mean I Reon you know having the open mind is critical there there's a lot of opportunities out there so how do you approach distinguishing which opportunities to pursue and which ones not to pursue well I I I often I had to give a a talk recently uh uh when I was receiving a national award for my career and I I the theme of The Talk was a life beautifully orchestrated as things come along are we open to them and then pursue those Pathways and I think it's been sort of my approach to life to listen to the music of life and when that music sounds right play it if you will and and for me at least it's led to a a wonderful and beautifully orchestrated life and career some something else Dr harness that I'm I'm curious just to hear your thoughts on is um having been the early adopter for a number of different things um you you have a unique perspective on what what it takes to get those Innovations to become standards of care and common practices and that is not without some some barriers and some some hurdles and uh mountains to climb and so what are what are some common barriers to to Innovation and and how do you approach navigating those barriers yeah uh my current world is the world of exercise oncology which I was just lecturing at the American colist surgeons meeting recently and asked the audience in the small class that I was running of a 100 people or so how many of you have ever heard the term exercise psychology raise a hand not a single hand went up so I realized that they were not aware of the science that had been developed over the last 25 years by PhD researchers so the answer Zach to your question I think in our world of medicine are typically are typically two things one information and knowledge and and that requires educating people about information we may not be aware of so again 253 years of outstanding clinical trial showing the benefits of exercising cancer patients prehab during their active treatment and and long-term survivorship virtually none of that literature had crossed over to the uh allopathic osteopathic practices of Medicine in the fields of oncology but yet the other reality and devices and new procedures and whatever is frankly reimbursement and that's a long road to Hall and it takes a small little mini Army of dedicated people with lots of data to take on CMS and go after a national coverage determination to get the codes that we need so none of these uh have occurred like ultrasound as an example or nipples sming mastectomy that I've been involved with for 12 years or more these don't occur overnight but what they take is a dedicated group of people willing to believe in whatever it is we're working on and to work our way forward until we reach the conclusions we're all after again those win-win conclusions where not only the benefits are to the patience but to the industry that we're so proud to be part of well and you just you just highlight the importance of having clinicians and Leadership so you have individuals with the perspective of being able to recognize the science as well as the the the approach to receiving that reimbursement you you need individuals with both perspectives so that they can they can fight and advocate for innovations that need to be imp imped well and you have you've really nailed it with that statement because that's particularly true right now as medicine medical practices are being purchased and there's greater and greater consolidation actually the need for physician leadership is actually some of the greatest that's ever been now so that our voices are heard we are in fact the primary advocates for the patients and as medicine becomes more and more corporate we have got to be strong holding together and very vocal uh to protect not only our practices and doing what we know is right but protecting our patients and that's that is part of the reason why we are having this conversation today is to to hear from an individual like yourself who has successfully uh advocated for patients for years over the course of their career in the variety of rules that you had yeah one one when I gave this award talk recently one of my initial slides showed a guy walking down the road with arrow sticking out of his back I felt that a lot of my career people have been got their bows out and been shooting at me uh but you know what you just got to take the arrows in the back and keep on going forward so dror harness as we as we come to a close I'm I'm curious what what are some opportunities that you're pursuing right now you you've you've done a lot over the course of the the career you you mention some some new positions and roles that you're feeling I'm I'm curious what are you up to nowadays yeah well I have to maintain passion if you're familiar with the Blue Zone communities one of the key things of people living well into their 90s is not only social structure diet exercise and others but it's also having it's also having passion uh and I'm pass Al involved in exercise oncology it's really interesting in Australia they've already adopted exercise oncology programs as a standard of adjunctive care for all cancer patients because the science is so strong we're hoping to see the same thing happen here in the United States and globally and I'm having a great time as a physician helping to lead that charge and to maintain my passion not only for medicine for my patience but for life well Dr harness we we thank you for your insights and just it fascinating I I benefited greatly from getting to hear about your experience and the conversation that we had previously as well as as well as this interview today so thank you sir for for joining us today on the clinicians and Leadership podcast series and we wish you the best we're rooting for you well thank you sir and it's been my absolute privilege to be with you Zach all the best my friend take care</p>