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Creating a New Healthcare

Creating a New Healthcare

A podcast series for Primary Care Physician leaders who are looking for fresh perspectives, new solutions and inspiration in their journey to advance value-based care.

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Episode #109: Threading the Needle of Disruptive Transformation – with Dr. Roger Ray

Friends,Welcome to the first ‘Creating a New Healthcare’ podcast episode of 2021. The major themes we’ll explore in this episode are two sides of the same coin: the strategic, market-driven imperative for transformation in healthcare; and the financial and operational challenges of disrupting one’s own healthcare organization.  Our expert guest in this interview refers to this phenomena as the “conflicting realities” of transformation and disruption. The situation is challenging. If healthcare systems and provider groups don’t pursue transformation, it’s likely that they will find themselves increasingly less relevant in the future. Yet, at the same time, disrupting oneself is fraught with pitfalls and seemingly insurmountable challenges. Our guest this week has spent years threading this needle, earning the wisdom and the wins that demonstrate his competence and credibility. His message is simple and clear, and worth listening to. He believes that we are up to the challenge, if we grasp the mantle of high integrity, courageous, patient-centered leadership.  Dr. Roger Ray is the Chief Physician Executive with The Chartis Group - a well-known and highly respected healthcare consultancy. He has over three decades of service in a variety of leadership positions at major healthcare organizations throughout the eastern United States. Most recently, Dr. Ray served as Executive Vice President/Chief Physician Executive at Atrium Health, where he led a medical group of over 3,000 members and had operational oversight over myriad clinical services & functions. In full disclosure, I had the privilege of working with Dr. Ray for a number of years during his tenure at Atrium Health.    In this episode, we’ll cover:The 4 major strategic advancements that Dr. Ray believes every healthcare system needs to be focused on achieving.The increasing and unprecedented importance of physician leadership, and how that is a differentiating factor among healthcare systems.The specific and significant challenge of disrupting one’s healthcare system, coupled with the conflicting need to rapidly adopt technology, generate new business models and transform healthcare delivery.Why becoming expert at ‘fast-following’ and adopting best practices may be a superior strategy vs being a ‘bleeding-edge’ organization.Dr. Ray is a pragmatist and a highly strategic thinker. But, he’s also a highly principled leader. One of my favorite ‘Ray’ quotes is, “Principles matter when they’re inconvenient.” The point being that it’s much harder, much more meaningful, and far more impactful to manifest principles when they inconvenience you. One of the fundamental principles that Dr. Ray has led by include his focus on ‘patient-first’ healthcare delivery. That is, leading with the question of how any decision impacts patients - first and foremost. As an example of this principle in action - when I asked Dr. Ray what he would say if he had a few minutes with President Biden and VP Kamala Harris, he said that he would remind them that healthcare is fundamentally about “people taking care of people” - highly skilled professionals who are earnest and passionate about helping and healing others - providers and staff who sacrifice and give of themselves, and who daily deliver near-miraculous outcomes. Yes, healthcare is a business. But, if we forget what it’s fundamentally about, we will sub-optimize the endeavour and harm patients. Dr. Ray also added that he would remind the President & VP that the current disparities in American healthcare are an embarrassment to our nation. He would encourage them to use the resolution of healthcare disparities as a primary marker and absolute requirement for American healthcare improvement. I’m delighted to see that Dr. Ray is sharing his expertise and wisdom with many other leaders and organizations across the nation. American healthcare needs more leadership with principled pragmatism, and we need leadership that is willing, capable and courageous enough to thread the needle of disruptive transformation.Until next time, be safe and be well.Zeev Neuwirth, MD
January 13, 2021

Episode #108 – Fixing Healthcare for Everyone, with Vivian S. Lee MD

Friends & Colleagues, The focus of this episode is of immediate importance to all of us. It’s especially important right now, in the month before the inauguration of President-elect Biden & VP-elect Kamala Harris. (Of note, this interview was recorded in late August, so we were unaware of the election outcomes). The topic is ‘fixing’ healthcare and our guest today is Dr. Vivian Lee, the President of Health Platforms at Verily. Dr. Lee recently published a book entitled -The Long Fix - Solving America’s Healthcare Crisis with Strategies that work for Everyone - in which she explains the fundamental problems in healthcare and provides practical solutions. The book speaks directly to policy makers, providers, payers & patients. In this interview, we’ll hit the high points of the book and get a sense of the priority Dr. Lee assigns to certain problems. The book is remarkable and so is Dr. Lee. She is a Harvard-Radcliffe College graduate who obtained a doctorate in medical engineering from Oxford University as a Rhodes Scholar and then earned an M.D. with honors from Harvard Medical School. She has also earned an Executive MBA at NYU’s Stern School of Business. Dr. Lee is a radiologist and medical researcher who has authored over 200 peer-reviewed journals. Prior to her current role, Dr. Lee was the Dean & CEO of the University of Utah Health - one of the nation’s leading hospital and academic medical centers. During her tenure, she and her colleagues achieved numerous nationally recognized accomplishments in quality, safety, patient experience, growth and entrepreneurial commercialization. In 2019 she was ranked #11 among the ‘Most Influential People in Healthcare’ by Modern Healthcare.  She has been elected to the National Academy of Medicine. In this episode, Dr. Lee and I will touch on:A broad range of issues ranging from the mind boggling complexities of billing and payment, to the lack of price transparency, to the crippling and uncontrolled costs of medications, to the impact of healthcare costs on suppressing employee wages and retirement funds.The one issue Dr. Lee calls out as the core off-the-charts problem in the American healthcare system.Why Dr. Lee believes that it’s critically important for all citizens to understand how healthcare delivery works and what it would take to make it better. Why universal access to healthcare is not only the right thing to do from an ethical perspective, but also from a public health, productivity and economic point of view.Why Dr. Lee believes we must shift to value-based care in order for universal coverage/access to be optimally effective.I have to say that it was a privilege and a pleasure to speak with Dr. Lee.  Given her remarkable accomplishments, her brilliance, and the enormity of her current position, I was struck by how down-to-earth and humble she is. We didn’t have the opportunity to directly discuss the issue of leadership in healthcare; but an unspoken message that came across is that we need a leadership culture that Dr. Lee embodies - data-driven, humanistic, socially aware, and selfless - leadership that is, first and foremost, for the people.  Dr. Lee wrote this book for the American public - to bring some clarity to our complicated, opaque healthcare system. I applaud her for that.  Most importantly, I applaud her for the explicit intention to deliver solutions that work for everyone. Until Next Time, Be Well Zeev Neuwirth, MD 
December 3, 2020

Episode #107 – A Call to Eliminate Systemic Racism in Healthcare, with Michellene Davis Esq & Alisahah Cole MD

The COVID-19 pandemic has shone a new light on the deep-rooted disparities and inequities that are built into the fabric of our American healthcare system. Triggered in part by the pandemic, as well as a number of deeply disturbing episodes of racist police brutality, and the Black Lives Matter movement, we’re experiencing a national re-awakening of concern regarding systemic and institutional racism in our society.Our two distinguished guests in this interview, Dr. Alisahah Cole and Michellene Davis, are nationally recognized leaders in the movement to eliminate healthcare disparities. Michellene Davis, Esq. is currently the Executive Vice President and Chief Corporate Affairs Officer at RWJBarnabas Health, the largest academic healthcare system in New Jersey. She is an attorney and has held positions at the senior most tier of government, including as State Treasurer, Chief Policy Counsel to a Governor, and CEO of a state lottery. Dr. Alisahah Cole is currently the System Vice President of Population Health & Policy at CommonSpirit Health, one of the largest integrated healthcare systems in the United States. She is a Family Medicine physician and has held multiple leadership positions including as Chief Community Impact Officer and Academic Chair, implementing novel approaches to improve health equity in vulnerable populations.This interview was recorded last month as a panel discussion during a virtual conference on patient experience. The topic was originally intended to be a discussion on the Social Determinants of Health (SDOH). But we felt that it would be culturally tone-deaf and socially irresponsible to discuss the SDOH without recognizing systemic and institutional racism as a root cause of the inequities and disparities in health care delivery and health outcomes.With that in mind, this panel discussion includes:A passionate discussion on this most recent ‘awakening of awareness’ about the systemic & institutional racism in our society - including the impact of the COVID-19 pandemic.The manifestations of systemic, institutional & interpersonal racism in healthcare.Practical, real-life recommendations regarding a systematic, data-driven approach to identify, understand & eliminate racism in healthcare.In addition to bringing their experience as clinicians and executives, Michellene and Alisahah also share their lived experience as professional Black women. The stories they share are honest, courageous, and at times, unsettling. For example, Michellene shares that, unlike her white colleagues, she does not have the luxury of putting racism aside, even for a moment. Alisahah shares that, as the mother of two teenage Black boys, she worries for their lives, literally, each time they leave home to venture outside.  This conversation challenges the very core of our humanity - in our communities, our corporations, our social institutions and our government. One lesson this interview taught me is that the issue of ‘social determinants of health’ needs to be reframed in terms of eliminating the racial disparities and inequities in healthcare and in our broader society. Another is that good intention is not enough - we need to take sustained systemic action.There are so many lessons embedded in this podcast. Lessons about listening and building trust. Lessons about the unhealthful effects of racism on Americans of color. Lessons about the need to fundamentally reorient, redesign, reorganize and appropriately resource healthcare delivery so that it meets the needs of vulnerable populations. And lessons about the need to expand healthcare delivery beyond traditional medical boundaries - to apply a racial equity lens to how we reframe our education system, our criminal justice system, our housing and urban development system, our transportation system, our social services systems, our labor system, and our public health system.This was the most important interview I've conducted to date. I say that with Martin Luther King’s words ringing in my ears. Words that, sadly enough, have as much relevance today as they did when he delivered them over five decades ago, during a 1966 speech before the 2nd National Convention of the Medical Committee for Human Rights.  Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death. I see no alternative to direct action and creative nonviolence to raise the conscience of the nation.Martin Luther KingUntil Next Time, Be Well Zeev 
November 19, 2020

Episode #106: The 2020 Presidential Election 'Oval Office' Episode

Dear Friends & Colleagues,Welcome to episode #106 of Creating a New Healthcare. This week has been a historic one for our country. As votes continue to be counted at the time of this writing, I want to turn our attention to what will undoubtedly be a key component of POTUS’ work over the next four years - our national healthcare policy agenda.This is the first time we’ve posted during a presidential election. But, it is not the first time we’ve tackled the POTUS question as it relates to healthcare. For those of you who have been listening to the podcast series this year, you’ll immediately recognize the question I’ve asked every guest this season. In this episode, it’s time for me to tackle this question. It’s Thursday, Jan 21, 2021 - the day after inauguration of the President of the United States; and you find yourself in the oval office, sitting on the opposite couch from the POTUS and VPOTUS. (As an important aside, you are socially distanced; and you are all wearing masks.) POTUS has asked for your opinion - your thoughts, suggestions & recommendations on what this administration should be focusing on in regard to HC policy & policy deployment over the next 4 years. What are you going to say to them?Listen to the podcast to discover the 5 Policy Principles I recommend to POTUS and the specific recommendations toward a solution for each. I hope you’ll listen with a discerning ear and let me know how you would answer this question. Finally - I have a request of you. I need your help.If you find value in this podcast series, please share it with as many colleagues as you can think to. I have heard from so many of you how valuable these episodes are to you; and if that’s the case, then it’s critically important that you spread the word about Creating a New Healthcare.Until Next Time, Be WellZeev Neuwirth, MD 
November 6, 2020

Episode #106: The 2020 Presidential Election ‘Oval Office’ Episode

Friends & Colleagues,Welcome to episode #106 of Creating a New Healthcare. This week has been a historic one for our country. As votes continue to be counted at the time of this writing, I want to turn our attention to what will undoubtedly be a key component of POTUS’ work over the next four years - our national healthcare policy agenda.This is the first time we’ve posted during a presidential election. But, it is not the first time we’ve tackled the POTUS question as it relates to healthcare. For those of you who have been listening to the podcast series this year, you’ll immediately recognize the question I’ve asked every guest this season. In this episode, it’s time for me to tackle this question. It’s Thursday, Jan 21, 2021 - the day after inauguration of the President of the United States; and you find yourself in the oval office, sitting on the opposite couch from the POTUS and VPOTUS. (As an important aside, you are socially distanced; and you are all wearing masks.) POTUS has asked for your opinion - your thoughts, suggestions & recommendations on what this administration should be focusing on in regard to HC policy & policy deployment over the next 4 years. What are you going to say to them?Listen to the podcast to discover the 5 Policy Principles I recommend to POTUS and the specific recommendations toward a solution for each. I hope you’ll listen with a discerning ear and let me know how you would answer this question. Finally - I have a request of you. I need your help.If you find value in this podcast series, please share it with as many colleagues as you can think to. I have heard from so many of you how valuable these episodes are to you; and if that’s the case, then it’s critically important that you spread the word about Creating a New Healthcare.Until Next Time, Be Well.Zeev Neuwirth, MD 
November 6, 2020

Episode #105: The Need to Overhaul US Healthcare Payment, with Dr. Ezekiel Emanuel

Welcome to episode #105, Season 4 of Creating a New Healthcare. Today we welcome one of the most prolific and influential healthcare policy experts of our era. Professor Ezekial Emanuel is the Vice Provost for Global Initiatives and Co-Director of the Healthcare Transformation Institute at the University of Pennsylvania. He is also a Special Advisor to the Director General of the World Health Organization. Dr. Emanuel was the founding chair of the Department of Bioethics at the National Institutes of Health. From January 2009 to January 2011 he served as a Special Advisor on Health Policy to the Director of the Office of Management and Budget, and the National Economic Council. He is also a breast oncologist, having earned his MD at Harvard Medical School, completed a residency in Internal Medicine at the Beth Israel Hospital in Boston, and then completed an oncology fellowship at the Dana Farber Cancer Institute, where he was also appointed as faculty. Dr. Emanuel has written and edited 14 books and over 300 articles, and is the world’s most cited bioethicist. He is a frequent contributor to the Atlantic, the New York Times, the Wall Street Journal, and the Washington Post, and regularly appears on television and radio.In this episode, we’ll touch on the following:The fragility of the US employer-based healthcare payment system and how the COVID-19 pandemic is nudging us to a universal payment system.The differences between a universal payment program and a single payer system.An illustration of a capitated primary care trial demonstrating the advantages to providers and patients.What the US can learn from other advanced nations in terms of primary care access and healthcare payment reform.The multi-pronged solutions that Dr. Emanuel recommends to address the insidious institutional racism and the inequities that are embedded in US healthcare deliveryI believe it was H.L. Mencken who said that there are often simple solutions to complex problems, and those simple solutions are typically wrong. Dr. Emanuel does not offer simple solutions to the complex problems in our healthcare system. Instead, he offers thoughtful, studied, and ethical solutions that directly and realistically address the fundamental flaws in our healthcare system. These are serious flaws that leave tens of millions of Americans with no or sub-optimal health insurance, limit access to preventive primary and specialty healthcare for tens of millions of Americans, and create perverse and unethical incentives for providers and health systems that greatly inhibit them from delivering the type of healthcare they would like to offer.Dr. Emanuel is one of the most cited healthcare policy scholars and advisors of our era, as well as one of the most prolific researchers and authors. He is one of the finest healthcare educators and thought-leaders our country has ever produced. It is well worth our time to listen to and study the critically important lessons he is teaching us.Until next time,Be safe and be well.Zeev Neuwirth, MD 
October 22, 2020

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Creating a New Healthcare

A podcast series for Primary Care Physician leaders who are looking for fresh perspectives, new solutions and inspiration in their journey to advance value-based care.
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Host

Zeev Neuwirth, MD

Zeev Neuwirth, MD

Dr. Zeev Neuwirth is the author of “Reframing Healthcare: A Roadmap For Creating Disruptive Change” and produces and hosts the popular podcast series, “Creating a New Healthcare.” He is currently serving as Atrium Health’s Senior Medical Director of Population Health.

Through his book, podcast series, speaking engagements, and executive leadership, Dr. Neuwirth is reorienting the way individuals and organizations think about healthcare, to catalyze movement towards an affordable, accessible, effective and safe healthcare system. His ultimate goal is to humanize healthcare for those who serve within the system, and especially for those who are served by the system.

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