The Gold Executive Leadership Track wrapped up the work of the first Gold Humanism Summit by focusing on the place of humanism among healthcare leaders.
It was a powerful event with many connections made, knowledge gathered, techniques shared, and a great deal of thought-provoking content. Among the most notable outcomes — there was a reinforced recognition of shared values and mission across settings — be they corporate, academic, or direct service.
The executive leadership track featured the work and knowledge of many of the representatives from members of the Gold Corporate Council — consisting of leaders in the healthcare business world — and Gold Partners’ Council members representing hospital and academic medical centers. The sessions also featured leaders in the community health field.
Dr. Nancy Oriol, recipient of the 2019 Pearl Birnbaum Hurwitz for Humanism in Healthcare award
Dr. Nancy Oriol, recipient of the 2019 Pearl Birnbaum Hurwitz for Humanism in Healthcare award, perhaps best summarized the purpose of the Executive Leadership Track sessions.
“The Gold Foundation clearly has been known in the medical education space, and now it is moving into care setting spaces, including important innovations in the corporate healthcare sector,” Dr. Oriol said.
“Indeed the Gold Foundation has been the change agent in the medical education space for the last 30 years with an extension in recent years into the nursing education realm,” said Pia Pyne Miller, Senior Director for Strategy and Business Development at the Gold Foundation. “It is strategically and purposefully moving across the continuum of healthcare in its next 30 years to additionally become collaborative change agents in all the places where healthcare is being delivered.”
Humanism is in the genome of Excellent Healthcare
When Tara Shewchuk, Vice President and Deputy Chief Compliance Officer at Medtronic, was speaking earlier in the conference, she spoke of Medtronic’s co-founder, Earl Bakken, who died in October 2018. It was Mr. Bakken’s example as a businessman, inventor, and human being that demonstrated “why this partnership with Gold is really important to us.”
Mr. Bakken started Medtronic in a Minnesota garage in 1949, thinking it could be a medical device repair company serving local hospitals. But then a child died after his electronic pacemaker stopped working during a power outage at the hospital. The child’s doctor came to Mr. Bakken and asked if there wasn’t some way to develop a pacemaker that would work with a battery.
So Earl Bakken, who all his life had been fascinated by electricity and technology, invented a battery-powered pacemaker pretty much on the spot.
Over the decades, Medtronic would evolve into a global medical powerhouse, but its company mission “to contribute to human welfare” did not change, Ms. Shewchuk said.
“For Earl, it was not just about technology, it was also about the human touch,” Ms. Shewchuk said. “Tech was about 20 percent of the equation, the other 80 percent was the humanistic aspect.”
The Gold Executive Leadership Track of the Gold Humanism Summit officially kicked off with a reception and award presentation by Dr. Richard I. Levin, President and CEO for the Gold Foundation and Jennifer Farrington, Senior Director, Social Investing, and Vice President, BD Foundation, for the Inaugural BD Gold Humanism in Community Health Innovator Award. The award was presented to Malvise A. Scott, Senior Vice President for Partnership and Resource Development for the National Association of Community Health Centers (NACHC). Please find more about Ms. Scott and the BD Gold award here.
Additionally, Dr. Wei Wei Lee, Associate Professor of Medicine and Assistant Dean of Students, Pritzker School of Medicine and Dr. Lolita Alkureishi, Associate Professor and Clerkship Director, Department of Pediatrics, University of Chicago offered a thought provoking keynote on strategies to build connection, while still meeting the demands of today’s Electronic Health Record (EHR).
The tension between patient-centered care and computer-centered care is perhaps nowhere more visible than in the examining room where healthcare professionals may literally turn their
backs on their patients as they work on the computer to fill out the required fields of the EHR.
The situation is frustrating for both the professional and the patient.
“No medical student ever said that they want to be a doctor so they could write a long note in an EHR” to enable appropriate billing, Dr. Lee said.
The pair decided to look into how the EHR could be used as a tool to better communicate with patients, instead of just being used to document notes and orders. They created a comic inviting patients to ask questions and be engaged in decision-making about their health care.
The comic focused on an ABC strategy.
A – Ask to See the Screen
B – Become Involved
C – Call for Attention
The results of the research on the response to the comics by patients revealed important insights not just on how to better integrate technology into care but also on how intimidated many patients feel walking into a doctor’s office in the first place.
“’I didn’t know I could ask questions,’” Dr. Alkureishi said one patient answered – a response she found particularly heartbreaking and revealing.
Humanism is at the Heart of Education – and Good Business
The main sessions of the Executive Leadership Track featured speakers who captivated the audience with their stories, research, and life-long emphasis on systemic strategies to enhance communication, collaboration, and best practice care across healthcare settings and communities.
Steve Rusckowski, President, CEO, and Chair of Quest Diagnostics, and Richard Sheerr, Chairman of the Board of the Gold Foundation.
First up were Steve Rusckowski, President, CEO, and Chair of Quest Diagnostics, and Richard Sheerr, Chairman of the Board of the Gold Foundation, in the role of “Ignitor” to fan the flame and take the conversation to the next level.
The partnership between Gold and Quest could in part be traced back to a golf game between Mr. Rusckowski and Mr. Sheerr a few years back.
As the game progressed, Mr. Sheerr said he decided it was the right time to ask for a donation for Gold from Quest. Mr. Sheerr said Mr. Rusckowski’s response was “I don’t want to do that. I want to do this and this and this.”
Mr. Sheerr said Mr. Rusckowski didn’t want to just give a donation, he wanted to make Quest more humanistic in its practices.
“So you made a decision to change the corporate culture,” Mr. Sheerr said.
Mr. Rusckowski, who joined Quest from the outside in 2012, said he knew the changes he wanted to make could not just be a one-off “management program du jour.”
“Yes, we are the world’s largest lab,” Mr. Rusckowski said. “but what business we’re really in is diagnostic information services.” They needed not just to do the tests for patients, the company also needed to “find a better way to explain things.”
“Healthcare is becoming more consumer oriented every day and in my mind that’s a good thing for compassionate care,” Mr. Rusckowski said.
Next up was a “fireside chat” between Bradford Connett, President US Medical Group, Henry Schein, Inc, and Dr. Veena Lanka, Research Partner at Advisory Board, in the role of “Ignitor”.
“The Gold mission marries so well with what Henry Schein does because it has been in our DNA since 1930,” Mr. Connett said. Connett said that when Henry Schein is looking for new partners it looks first at their culture to see if it is a good match.
“Culture first, strategy second, and economics third,” said Mr. Connett. “We will get the economics right if we get the first two right.”
Mr. Connett said at Henry Schein “we go to every site we merge with…that face-to-face contact, that humanistic approach” ensures success.
Dr. Lanka asked Mr. Connett about what he is observing among his customers as healthcare professionals are ‘being asked to do more than they ever have before and they’re being asked to do it faster.”
Mr. Connett said that there is a “state of anxiety in healthcare” greater than he has ever seen. “Right now you don’t hear a lot that’s good about healthcare,” Mr. Connett said. “We can’t sustain the model as it exists today.” At the same time, Mr. Connett said, “I have not been more excited to be in healthcare than I am right now,” because the urgency of the need for change makes it more likely it will happen.
Joseph Moscola, Senior Vice President and Chief People Officer, Northwell Health.
A couple of panels focusing on medical education and technology were up next – making the link that leadership strategies should, and can, foster and sustain humanism across domains.
“How do we bring that humanism to life?” asked Joseph Moscola, Senior Vice President and Chief People Officer at Northwell Health. “Through our values.”
Mr. Moscola said that while healthcare has always embraced new technologies, they have not always been integrated in a humanistic way. Tunnel vision on the technology aspect can almost make healthcare professionals forget their patients because of all the other things they have to do.
Dr. Deborah German, Founding Dean of the University of Central Florida College of Medicine, started her talk with a description of how she begins her orientation with new medical students with perhaps the oldest of technologies: the chalkboard.
Dr. Deborah German, Founding Dean of the University of Central Florida College of Medicine
She asks students to list the qualities the best doctors have.
Invariably, the students come up with words like “compassionate” and “humble” – “don’t those sound like humanism words?” she asked.
Dr. German at the chalkboard also reminds the students that they will have to serve as her “spellcheck” because she is not working on a computer. She said she does this so that from the beginning her students can see that “medicine is a team sport” and everyone, from the dean of the medical school to the most junior member of the team, needs to be ready to do what is necessary to provide the highest quality care.
After Dr. German’s and Mr. Moscola’s discussion, Dr. Wayne Riley said he was inspired to go find a chalkboard from the bowels of SUNY Downstate Health Science University in Brooklyn, where he is President.
Dr. Wayne Riley, President, SUNY, Downstate Health Sciences University, and Dr. Larry Smith Physician-in-Chief, Northwell Health and Dean of the Donald and Barbara Zucker School of Medicine at Hofstra University.
Dr. Riley then shared the stage with Dr. Lawrence G. Smith, Physician-in-Chief, Northwell Health and Dean of the Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell, in a conversation about how to infuse humanism into academic medicine.
The conversation quickly evolved into discussion of how we choose our future doctors in the first place.
“I have a concern about the way we pick medical students,” Dr. Riley said. “Do we overemphasize MCAT scores and having research?… We’re not allowing students to have humanistic experiences.”
Dr. Smith added he was also concerned that once they’re in medical school – and after that when they become doctors – the pressures of the job are not healthy.
Adding to this is that the informal support that used to be standard has gone the way of the chalk board.
“All of that collegiality has been lost somewhere,” Dr. Riley said. “Long gone are the doctor’s… dining rooms…they’re probably filled with computer terminals now,” added Dr. Smith.
But as with so many other things, the answers to these challenges may be humanistic ones.
“When we know a loved one who is sick, we go to the guy or gal that we know with the most humanistic qualities,” Dr. Riley said.
Dr. Kyu Rhee, Vice President and Chief Health Officer at IBM Corporation and IBM Watson Health
Dr. Kyu Rhee, Vice President and Chief Health Officer, IBM Corporation and IBM Watson Health, gave the afternoon keynote talk about “Values-Based” Care, with Dr. Levin serving as “Ignitor”.
The conversation quickly focused on the impact of cutting edge technology like artificial intelligence (AI) in healthcare. For Dr. Rhee, technology and patient-centered care go hand in hand as long as technology is evolved with the patient and humanism in mind.
Dr. Rhee acknowledged that there is the fear that using AI means computers will call the shots and replace humans. Instead he said that “the people will still be in charge” but “healthcare professionals who don’t use AI will be replaced by those who do.”
This can be a force for humanism, Dr. Rhee said, because using AI for the things it can do better than people can – like analyzing massive amounts of data quickly– lets people “focus on what they do best…the human side.” Infusing healthcare – including the technology side – with humanism is crucial at all levels. Dr. Rhee said he also believes that AI can be an ally in “ways to establish greater social justice for all people.”
“The hope is AI plus human beings will be less biased,” Dr. Rhee said, “and more appropriate than just humans.”
Ryan Rumbarger, CVS Health, and Dr. George Thibault, Immediate Past President of the Josiah Macy Jr Foundation; Daniel D. Federman Professor of Medicine and Medical Education at Harvard Medical School, Emeritus
Ryan Rumbarger, Senior Vice President, Retail Operations, CVS Health, the Gold Corporate Council’s newest member held a discussion on “infusing humanism into your healthcare ecosystem” with Ignitor Dr. George Thibault, Daniel D. Federman Professor of Medicine and Medical Education at Harvard Medical School, Emeritus.
In recent years, CVS has built on its strong community presence as retail pharmacies by adding the provision of healthcare, such as through their MinuteClinics.
“CVS is a very unusual organization,” said Dr. Thibault, who is also the Immediate Past President of the Josiah Macy Jr. Foundation.
“Our vision is to be the front door of healthcare,” said Mr. Rumbarger, who is Senior Vice President for Retail Operations at CVS Health. And to be that front door they need humanistic practices.
Dr. Thibault asked Mr. Rumbarger how CVS balanced taking care of people with its for-profit motives. “We also hear from our customers we are a bit too transactional,” Mr. Rumbarger said. So CVS now has the goal of “changing those transactions to interactions… You can’t be the front door of health care and be transactional.”
In surveys and interviews with employees, Mr. Rumbarger said the company has learned “we haven’t done as good a job at listening to our colleague customers as we have our customers who come in the stores.”
Mr. Rumbarger said employees were saying, “Help me manage my time. There is so much flying at us…help us understand…empower us.”
Mr. Rumbarger said the partnership and strategic collaborations with the Gold Foundation seem “like a natural fit” for CVS Health.
“It’s a multitude of different people in a multitude of different settings all working toward the same purpose,” Mr. Rumbarger said. “The word humanism is not in our mission statement, but the word ‘people’ is.”
The final session of the Gold Executive Leadership Track, sponsored by BD, was devoted to the social determinants of health and the efforts of community health centers and clinics to address them.
Community health centers were started as part of the War on Poverty of the 1960s and early 1970s.
“They talked about something other than pills and needles,” said Ms. Malvise A. Scott, recipient of the BD Gold Humanism in Community Health Innovator Award. “What we call social determinants of health are in the DNA of health centers.”
Social determinants of health are the things beyond medicine, often more powerful than medicine, that determine our health and quality of living – things like access to education, family support, social justice, and income level.
Serving the sixth poorest congressional district in the country means the Roanoke Chowan Community Health Center in North Carolina helps its patients navigate “a lot of problems around poverty and structural racism,” said Kim Schwartz, CEO of the Center.
“Transportation is our Number 1 barrier,” Ms. Schwartz said.
Transportation is not such a barrier for people living in urban Boston if for no other reason than proximity to health care, said Dr. Nancy Oriol, 2019 Gold Foundation Pearl Birnbaum Hurwitz award winner and an anesthesiologist and Harvard Medical School professor who served in the role of “Ignitor.”
But people can still be geographically close and still be a world away. In the 1990s Dr. Oriol’s patients made her see that people were shut out of health care “right down the street from the hospital that performed miracles.”
The greatest barriers in the city of Boston were the lack of “trust, knowledge, and the feeling that you were entitled to care,” said Dr. Oriol, who Co-Founded and pioneered mobile healthcare delivery with The Family Van in Boston. “I knew the answer was not in our hospital.”
After Hurricane Katrina struck New Orleans in 2005, Direct Relief saw that the medicine and medical supplies they distributed globally might be needed as much right at home in the US.
With Malvise A. Scott and NACHC, the organization was able to “direct these resources through community health centers,” said Damon Taugher, Vice President for Global Programs at Direct Relief.
“If you want to scale the concept of humanism, you want to scale the work of community health centers,” Taugher said.
In 2012, Direct Relief, BD, and NACHC joined forces to get resources to community health centers after Hurricane Sandy. This collaboration has become an enduring commitment to tackle the long-term issue of social determinants of health.
The Roanoke Chowan Community Health Center has been a beneficiary of this partnership, Schwartz said. The center not only received a significant amount of money for its programs but gained other important resources and relationships as well.
“They are showing us how we can work together,” Schwartz said. “Social change moves at the speed of relationship.”
In closing the Executive Leadership Track – and the overall summit as well – Dr. Levin knighted the participants as Gold Ambassadors for making healthcare human. And he harkened back to the beginning of the summit, led by members of the Gold Humanism Honor Society.
“We learned from our younger colleagues, students, and residents that the future is in remarkably good hands.”
