Podcast Episode 77 – Bringing Disney Magic to Healthcare Leadership – Jake Poore

Bringing Disney Magic To Healthcare Leadership
2021, Brent Lacey And The Scope Of Practice Podcast
The Scope of Practice Podcast
Transcript
[0:00] My all-time favorite Disney movie is the 1991 animated movie Beauty and the Beast
I know that may sound kind of surprising but this was the first animated movie nominated for best picture and it was just a revolution and for good reason I mean this is a beautiful
story with phenomenal animation you know and my favorite song is the classic
Be Our Guest all the castles and chanted servants sing to Belle about how their only goal is to make her feel welcome and comfortable they have complete
and total focus on one thing.

[0:33] Serving their guests I think that’s something that’s rare to find an American Business nowadays to the point that it becomes remarkable and noteworthy when we see it.
It’s not even that common in healthcare but but what if it were.
What if you had an organization that was full of people who were laser focused on providing excellent customer service so focused that it became part of the organizational DNA.

[0:55] Well today’s guest knows that it’s definitely possible and he’s going to talk all about how to bring some of that Disney Magic to healthcare leadership let’s kick it.

[1:04] This looks so good.

[1:05] Music.

[1:11] Welcome to the scope of practice podcast where we help busy Healthcare professionals learn to manage their businesses successfully in master their personal finances.
Now here’s your host dr. Brent Lacey.

[1:25] Hey y’all thanks so much for joining me for the scope of practice podcast where you can get the knowledge and resources you need to grow your leadership skills your business and your personal finances.
Welcome to episode 77 if you haven’t already subscribe to the podcast please be sure to go ahead and hit that subscribe button right now so you don’t miss out on any of the exciting episodes that are coming up.
Also don’t forget to turn on the automatic downloads on your podcast player because nothing is more frustrating than getting ready to listen to your podcast and then all of a sudden you realize
you don’t have it downloaded so make sure to hit that button that’ll get you the automatic downloads hey guys I have got a big announcement to make and I want y’all listening on the podcast to be the first to know.
I’m going to be hosting a digital Summit on November 15th through 17th this year called marriage and money MD.

[2:09] You know Medical Careers drain time and energy from Physicians and their spouses not to mention the crushing debt that most doctors are faced with when they first come out of training.
Well the marriage and money MD Summit is a free three-day online event that would give physician families the tools
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[2:34] Just go to www.marriageguy.com EMD.com to sign up it’s totally free so sign up today and even if you can’t attend Live sign up anyway and you’ll get,
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[4:15] My guest on the podcast today is Jake poor I have been super excited to share this episode with you you are really
I’m going to love this one so Jake
18 years at the Walt Disney Company in Orlando learning and teaching the Art and Science of Disney to his fellow 65,000 cast members he opened up many businesses and new opportunities for Disney including hotels theme parks nighttime entertainment their version of timeshare and he helped launch their famous Disney Institute
teaching other Business Leaders who they are and to share their business and culture secrets with the world Jake use those same blueprints to create his own company to help transform Healthcare
for the past 19 years today it’s time to bring some Disney Magic to healthcare leadership so here is my conversation with Jake
report hey y’all I am super excited to introduce my guest this week this is Jake
poor he is the president and chief experience officer of integrated loyalty systems Jake thanks so much for joining us today on the scope of practice podcast I really appreciate it.
My pleasure Brent thanks for having me.
Yeah so first of all I have to ask you have my new favorite title of anybody that I know the chief experience officer that is a phenomenal title and I’m sure that was chosen very deliberately so.
And chief experience officer so.

[5:44] Knowing what I know about you and your and your content and all of your work over the years and your book which we’ll get into in a little bit I have to believe that was a very deliberate Choice the chief experience officer so what do you do.
In that role what do you see that role is doing.
Well you know you’ve got in many Healthcare organizations the the c-suite right you’ve got the chief executive officer Chief nursing officer chief medical officer chief operations officer but who’s really looking at at it from the patient’s point of view.

[6:12] We even have the chief human resource officer who tries to get us the right people and keep them or weed out the bad ones.
But who’s really looking at it from the patient experience so I’m trying to I’m trying to create a mission of elevating The Human Side of healthcare by flipping the lens.
From the Physicians point of view the nurses point of view the front desk point of view to the patient’s point of view so about 15 years ago I was working with Cleveland Clinic and they really wanted to focus on putting the patient in the bullseye
and they created a new position called the chief experience officer and they brought in a physician named Bridget Duffy
and she really reinvented the or created the role so Cleveland Clinic and Bridget Duffy kind of led the way and
I said you know just being a president or chief
executive officer of a training consulting firm is not enough I’ve got a model that and so everything we do and everything we say we try to emulate what we’re trying to get our clients in our.
You know care team members to replicate.
So the way that you put that is that you’re trying to flip it from the doctor point of view the front desk point of view to the patient point of view so
let me ask you in your experience working with hospitals and big Healthcare organizations all around the country.

[7:28] Is that not normal it seems to me like that should be the standard that we’re looking at it from the patient’s point of view that we’re trying to serve the patients that’s who we’re here for after all but is that not what you found in general.

[7:39] No no Brent you know I spent almost two decades at the Walt Disney World company the happiest place on Earth and my last 6 years there I taught the Disney blueprints.
Um of how you recruit train on board reward and hold people accountable that show business kind of metric at Disney I’ve taught it to.
Business Leaders all over the world in 80 percent of the customers that came to Disney Institute were from Healthcare.

[8:06] When I started to actually Walk The Halls of medical institutions from physician clinics to shadowing visiting nurses and people’s homes to you know the operating rooms and the morgues and the patient floors.
I saw a huge gap that that health care is about 30 years behind Hospitality it isn’t it ironic that the word Hospitality has Hospital built in right yet we don’t do that.
So the things that we made.
That we thought were common sense at Disney are not common practice in health care and putting the customer or the patient in the bullseye is philosophically what everybody says but when you’re talking about,
you know chief operations officer we’re working about EVs and getting supplies and getting throughput and getting enough HRS working about hiring and firing and beneficence met if it’s right
chief medical officers working about keeping Physicians happy CEOs is trying to keep the place financially
afloat with the CFO we all got into this business because we want to take care of other human beings are at their worst part in their life.

[9:10] Yet sometimes we lose that loving feeling only because our job tasks.

[9:15] Preferably or blinders on us to be so focused on transactions we forget about making connections and so.
I think there’s a huge opportunity and and I and I admittedly tell my wife all the time I’m never going to be unemployed ever.
Ever we have 4600 hospitals in this country hundreds of thousands of physician offices in dental offices and you know the majority of them 80 plus percent.
Are still operating in a 30 year old game plan do you think that that’s just a holdover from.
People coming in and just sort of continuing things the way that things have always been done or is it or is it something else.
That’s a deep question my friend I think that’s another podcast you know I think.

[9:57] Healthcare System in America was built on the Civil War battle grounds in triage tents I mean we’re still using words like triage and discharged at there’s an example 200 year-old words that patients don’t even know.

[10:09] We’re ready to triage you now we say to your wife right she looks at you you’re the medicine man right what the hell’s triage honey all that just means we’re
they’re going to assess you and prioritize you really we’re still using a French word that we use in the Crimean War with Florence Nightingale and then you say to your grandmother who’s been impatient overnight the doctor comes in looks at her congratulations,
mrs. Lacey we’re going to want you to discharge tomorrow will an elderly woman goes discharge.
That’s feminine and private we don’t talk about that right I mean come on people are willing Healthcare people are there in it for a calling not a career
right we get into this because we want to we want to make people better I joined healthcare because there’s a huge opportunity to give them the tools and the game plan in the blueprints to do that and they’re willing they’re just not able yet but yes the way we’ve always done it
is this undercurrent and we’re so busy and now with with the pandemic we’re so short-staffed
and we can’t throw enough money at it and money is not the motivators has Gallop right so how are we going to change in the middle of the worst National crisis in a hundred years.
So there lies the challenge my friend and I think a lot of the things that I bring to the table or simple common sense and if you do them consistently they become habits.

[11:29] And operational excellence
well and there’s a maxim that consistency beats intensity and so if you constantly are doing little things if every day you wake up and say what can I do that makes
something in my organization 5% better at the end of the year
it is a tremendous Improvement but it’s little changes every day and that’s the same kind of stuff that you see a Disney I’ve read a number of books from various leaders and past leaders of the Disney Corporation so I know that that’s that’s well ingrained there so how did you come to make the switch from
Disney over to health care I mean that’s that’s that’s a big transition right but I could I can only imagine that
that bringing the Disney Magic into Healthcare is something that the United States Healthcare System could desperately use.
Well I think three or four things really were the impetus for me to change my my career from Disney or entertainment industry to healthcare number one was.
A huge need my mom was a nurse of a state-run University academic Medical Center in Upstate New York
she had a nursing Union which she was out of because she was a nurse leader and she would admit to me as a high schooler you know I can’t promote the good people I can’t get rid of the bad people and she blame it on the union yet when I started working at Disney we had 24 unions.

[12:47] 17 bargaining agreements we got along with units you do not perfectly well unions do their job they protect their members
but we got along flawlessly and I think it was because Disney had an explicit intentional culture so it was Black or White and I think healthcare doesn’t
I think culture the word culture is nebulous and gray and people hide in the gray and there’s power in unions when there’s a nebulous culture because then it’s your opinion against my opinion number to my father
long-term chain-smoking director producer for CBS News got lung cancer and on a fishing trip
had a heart attack in a fishing stream with his brother was rushed to a heart hospital in Michigan where I rushed to his bedside.
And they gave him too much blood thinner before surgery the anesthesiologist didn’t know that gave him some more blood there and he bled out.

[13:37] He died of a medical mistake and then the last piece was on 9/11
how is an Eisenhower Medical Center on behalf of the Disney organization doing a cultural assessment when the second plane hit the Twin Towers I knew they were going to shut down Disney for a while and I said you know what it’s time to make a change mom needs it.
Dad needed it for safety culture and of course
Healthcare doesn’t have enough Chief experience officer so I need to go out there and create a patient experience bootcamp for Physicians and nurses
and try to create a culture of hospitality in an industry that I’m going to need I mean this is a self-fulfilling prophecy Brent so that’s why I made the transition I have never looked back 18 years at Disney now 19 years in healthcare
and I know I could leave this earth pretty much smiling because I know I’ve made an impact.

[14:26] Well that concept of creating intentional culture is important so you know I was in the military for 15 years and the military is a huge organization functionally it.
It acts in certain ways like a union and a lot of cases and when I was at the various hospitals I was that we had.
Unions of the civilian nurses in the civilian staff and that was one of the key things that always loved was lamented loudly and often by our leadership is that it was.
Yo is very hard to get rid of the bad people and very very hard to hire good people and
you know as you’re saying it that way that it’s not a union problem it’s a cultural problem I think that’s a hundred percent right I really do if you have a leadership that is
committed to improving organizational culture then you will necessarily
attract the right kinds of people and the wrong kinds of people aren’t going to thrive they’re not going to do well they’re not going to want to stay so.

[15:24] As we’re thinking about this though I can I can just hear all the people listening right now going yeah Brent Jake that sounds great but I mean
I’m already up so early in the morning I see 35 patients a day I’ve got all these notes to write I don’t have time to be holding hands and planning parties and creating
awards for people that do stuff I mean how am I supposed to have time for that but but what you’re saying is that it’s not important it’s
one of the most important things that we transform that culture so that we can create this new way of looking at things is better way of doing things which will then translate into business growth and improve patient experience and improved finances so.
How do we how do we start to do that as busy Physicians well that’s a great question I mean.
You know the physician is is the rock singer right if you go to a rock concert you’re not looking for a seating host or valet Parker you want to see the singer.
Everybody goes to a physician office they want to see The Physician or the nurse practitioner or the Midwife or the like right that’s the reason we go now
you don’t go to a car race and think about the pit crew.

[16:34] Or the manager of the pit crew so we have not built the infrastructure the ecosystem to support the physician so they could a take care of patients but B give them the tools.
And the human resources to help manage the business that we have this thing called The Practice manager but sometimes they’re literally doing that they’re managing they’re not leading the physician leader.
Is the person we’ve come to see but they need the pit crew to help support them the infrastructure that helps them with the hiring
the onboarding the recruiting the on-the-job training the on-the-spot recognition you know the Physicians literally a jerk as another physician is told me I feel like a gerbil on a wheel just running from exam room to exam room you want to say good morning to people my staff you only say great job to the the ma
I don’t have time for that
I get that and then they’re doing notes or double entry is a lot of us are now dealing with this EHR system that is not conducive to running any kind of business you have to do it not only for your own practice because you have an old
grandfathered in EHR system but they now you have to do it again for the health system that you’re part of because no not one of us can survive on our own so I get it.

[17:49] There has to be a transformational moment where you go
you know what I can’t put all this on my shoulders I got to help Inspire not necessarily
imitate but innovate in a way where my employees.
My practice managers my other Physicians might maybe there’s a physician leader we together we create something intentional
and what I’ve learned Brent over 30 years of building cultures and changing cultures is top-down doesn’t really work anymore.
It’s definitely not going to work after covid or at this time in 2021.
Just because you say to do it I’m not going to do it and if I don’t like it I’m going to leave and you know what I’ll get a job tomorrow somewhere else so the front desk the ma.
The nurse practitioner the PA your colleagues they really can work anywhere they want in this country so the question is why do they want to stay in money ain’t it.
So you got to have a level of participation that drives authorship and that authorship will drive ownership and then they’re going to police it.
When you’re not around and quite frankly doctor
you’re not around so how can you give them Common Sense tools a Common Language and a common set of priorities where they can really be not only empowered.

[19:05] But also part of an ecosystem that’s all operating in singing from the same Hymnal you are in the u.s.
Armed Forces military treatment facilities right the nice thing about that is
they’ve really hardwired that down they had a dress code they had a look grooming Sanders I’m looking at you right now your audience can’t see you but your well-groomed your hair is cut over your ears I had to shave my mustache to work at Disney now they allow them right
change with the times but the US military system had a field guide and they were well trained and we trained not only for battle
but we train for operational excellence we have to bring that same rigor of the u.s. Navy or US Army to healthcare but not just in a rigorous way
but what’s the human side of it and that’s what I’m trying to do is bring the same amount of rigor you put in safety protocols as we do in compassion and empathy Pro.

[19:56] So let’s let’s come back to the micro in a second so let’s say that we’re a physician and we’ve got a team of.
See a few nurses and a few Mas and some and some ancillary Staff All right but let’s say that we’re part of a larger Healthcare organization or a big hospital system.
So what do we do if we’re not the person in charge of everything if we’re not in the we’re not the person in charge of supplies we’re not the trip person in charge.
Of Human Resources maybe we get some input into hiring and firing or in a lot of cases maybe not so if we’re not the ones that have.
Decision-making Authority how do we start to affect that kind of change at an organizational level so that it trickles down to affect us at a micro level.

[20:40] Well it’s a great that’s a great question so you know what comes first the chicken or the egg right do we do we wait until the entire health system like I worked with a
20 or 30 GI docs offices in the DC area called Capital digestive care right and these are
independent mom-and-pop GI practices that finally decided let’s join our forces together create one ecosystem one eh R1 hiring and firing right and yet they didn’t want to change their independent practice.
So all right you know there are three ways to do this lead follow or get out of the way right so let’s lead the way let’s innovate let’s tell our peers how to do it
so you’ve got to keep it simple you know when I worked at Disney we had a hundred thousand employees on the Disney property
right a hundred thousand foot 65,000 of them we get paychecks do and 35,000 and we’re contracted employees you thought work for us right the balloon sellers on Main Street was outsourced the photographers taking your picture over at Epcot outsourced
right but you didn’t care right the average family sends two to three years to save up money to go to Disney and a cheap place so how do you create something within one Department
that can lead the way so let me give you let me give you a simple tool that your listeners can apply tomorrow to lead by example.

[21:53] Right human clinical human if your clinician right it’s exactly what it sounds like keep it simple right before you enter that exam room start on the human.
If your mother was in that exam room Brent how would you enter the room on The Human Side before you started physical exam.

[22:09] But we’re going to talk we’re going to have a conversation it’s like hey how’s it going what’s you know what have you been doing this weekend you got any travel plans coming up stuff like that.
Perfect now you’re sweating it because you don’t want to get into too much chitty chatty because you’re already going to be here at ten o’clock at night and you’re going to miss your son’s you know baseball pitching tonight but yes
simple short ended connectors right you’re going to knock your going to wait
she says come in this not on exam room right it’s her exam room now that she’s sitting on that table she says come in you come in you make eye contact human you smile human you say good morning three humans in a row right do you know how many Physicians miss those three connections.
They walk right to the HR on the corner so what seems to be the problem.
Okay let’s reverse engineer that in a video right here’s the game film what seems to be the problem she called your
office or your call center 3 weeks ago and told him what the problem was and they heard him typing right last night she got to remind her phone call from that same call center or your front desk person to remind her to show up 30 minutes early and they said oh by the way what why do you want to see dr. lace.
And she said it again she goes she’s thinking herself gosh don’t they write this stuff down that she checks in at the front desk that morning 30 minutes early and they said oh so what brings you in today.
What do these people talk to each other then the ma comes out and says poor.
Poor or Worse Smith and three people stand upright why do we still do this Brent because we’ve always done it this way.

[23:37] Who the heck is this person called an MA anyway why don’t we call him a medical assistant
because we do shorthand and Healthcare I’m Addie oh I’m an MD I’m a PA I’m an end be right we’re still using acronyms and patients don’t understand so this magical person who has her hands surgically attached to the
exam room door yells out people’s names in the lobby by the way that’s a HIPPA infringement
if that person is here in Behavioral Health right but we’ve always done it that way so then they bring you back and dr. Lacy walks in Social what seems to be the problem
and watch the blood and their next start to go up in the middle of their face because that’s called anger
and cortisol is being released in the bloodstream and you’re going to get a false positive on your blood pressure cuff because they don’t like you Brett
and when they don’t like you they’re not only going to give you bad patient satisfaction 8 out of 10 or just going to leave.
Just gonna go to some other chi I dot right so common sense is make that connection first so mr. poor I understand your daughter just got a scholarship to a bishop more High School what’s that all about.
Oh my gosh how did you know that well my ma said you know while she was weighing use it does it right because we had our intake sheet
the not only the ma wrote down the weight and blood pressure and so on then the nurse wrote down the blood work and so on but they wrote on the back something personal and put it on a magnet
upside down on the door so when you went to not you read the personal.

[24:57] You read the clinical then you came in and you made the human connection you entered on the human you then transition to the clinical and then you leave the room on the.

[25:07] Right very simple tool human business um how do they answer the phone what’s the name of your your practice Brent so Texas Digestive Disease Consultants.
Good morning thank you for choosing Texas digestive Consultants this is Bret how may I help you just did human business human in less than two seconds but we don’t do that.

[25:27] We don’t we don’t we go GI consultants like we skip the human and I’d like to speak with the glory in your office dead air.

[25:35] My pleasure to connect you call any Ritz-Carlton it’s a beautiful day at the Ritz-Carlton Amelia Island this Jody how may I help you why do they do that.

[25:46] Because that’s the first impression when you go to the front desk they stop drop and greet right connect on the human eye contact smile they turn their entire body.

[25:55] And Brent the other thing you have to work on as a physician is sometimes you’ve been set up to fail the exam tables over in that corner
and the EHR computers mounted on the other computer you literally are turn your back a patient you just have to ask permission so the other tool I will give you is called carrying out loud.
Carrying out loud is narrating what you’re going to do before you do it narrating what you’re doing while you’re doing it under the auspices of TMI
right and the last one is telling what the next step or person is in the process mr. poor I’m sorry healthcare’s gotten very complicated and very documented do you mind if I turn my back on you while I type your notes and ask you a few questions about your medical history who’s going to say no.

[26:34] But you ask permission before you did it.
So now that’s human now do your business right so if you’re not a clinician at the front desk human business human you look up.
If you’re on the phone and they don’t know what you got earbuds in like I do now you put two one finger up I’ll be right with you right you connected on the human have a seat I’ll be right with you come out.
Right the ma doesn’t just bark names from the front door she walks that extra 30 steps walks right up is she mr. Lacey I’m sorry dr. Lacey oh call me Brent Brent it is hi I’m Jake I’m the medical system I’m going to take you back to see dr. Poore.

[27:09] That extra 30 steps times 35 patients times 5 days a week you just walk-in the mile.

[27:16] So we call that play the extra mile so now that you understand human business human your staff will go
well I like to do it this way well I like to do it your Physicians ago well I find it’s helpful if you say this to an Oxycontin or drug seeker if you say it this way you’ll get less complaints let’s push back so now in our staff meetings
we’re sharing a very common sense tool.
How do we connect on the human how do we do our clinicals how do we exit on the human front desk em a call center PA right billing,
all the different touch points.
And now we’re creating a departmental Playbook that’s your standard operating procedure that you had in the army or navy that we don’t have.
All we have in healthcare is the disease and discomfort and diagnosing Playbook.
Where’s the human side and that’s I think that’s a simple two tools that you can use to start building it in your department share that with the rest of the organization that are going to go all right now be careful what you ask for because now they’re going to want you to teach
dr. Lacey’s got a Playbook you want to share with the rest of the system dr. Lacey oh oops well I’ll tell you though there’s there’s something to be said for being.
Being very good and producing Excellence where you are you know I call this Bloom where you’re planted one of the challenges that we found in the military is that.
You’re coming into a team or an organization that has got tremendous organizational inertia.
And so the people that are there have been there for either a couple of years or if they’re civilians maybe for 20 years but.

[28:45] The way things have always been done is deeply ingrained and it takes a lot it’s like trying to steal hurts to the Titanic right it’s a lot of it’s a lot of work to get that thing to move but what I found in my experience is that if you do well with a little.
You’ll be given more to manage and I think that that’s a really important concept for people to understand and this all sounds very simple right so the human clinical human
I love that so yesterday I had a patient that came to see me and we were we were chatting for a couple minutes at the beginning of the visit and I hadn’t seen him in a while so I was
asking about what their kids are doing and that sort of thing and we talked about her liver stuff and then you know I said so well let’s get you scheduled for your next follow-up visit and they said well we’re going on a vacation to Crete in about 2 weeks can we do it afterwards okay so in my mind.
Are you okay that’s something I want to remember and actually write those kinds of things down in my notes to remember patient is going on a vacation to Crete and so then the next time I see her in two months
the first thing I do is say hey how is Creech show me pictures I was it just a great time where did you guys stay you know is it someplace I should take my wife I mean
it’s a little thing but it’s that extra two minutes and one of the things that I think really is important for people to remember
is that as a physician patients assume your competence I’ve been I don’t think I’ve ever had a patient asked me.

[30:03] To see my diploma I’ve definitely never had that and I rarely had people ask me where I went to school.

[30:10] Sometimes it’s because they’ve already looked it up because people look up Physicians Online all the time but most of the time it’s because they frankly don’t care.
Unless it’s just a point of Interest like oh I used to live in San Antonio I saw you went to medical school in San Antonio that’s cool.
Or something some kind of personal connection but they don’t care they just assume that you’re good but what they will remember.

[30:28] Is how they made you feel they assume that you’re going to treat them they assume that you’re going to help them get better they assume they’re going to feel better 3 weeks from now but what they really remember,
is how you made them feel and that human clinical human that carrying out loud taking the next steps that’s critically important I love those very practical very simple tools and that is something that you can do anywhere and so
as Physicians if we start to do that and our patient satisfaction scores go up our no-show rate starts to go down because people actually like coming back to us.
Our referral base starts to increase because people say oh you gotta go to dr. Poore gotta go to dr. Lacy they are just fabulous people they really care about you it was a great experience.
Then you’ll start to grow and then your higher-ups will start to take notice because that is definitely happened to me
I came in my first Duty station was in Florida and when I came in I made a series of changes and we increased our throughput by 45% in the first nine months and my department chair came down one day and I was like okay
what in the world are you doing down here because you have completely revolutionized things what’s different and I walked him through all the stuff that we’re doing and like
okay why aren’t we doing that everywhere I was I don’t know ma’am that’s that’s your call not mine but it’s sometimes it’s taking these very small steps at your level doing what you can do
and then allowing people to notice and start to build that change throughout the organization.

[31:53] Absolutely absolutely so my greatest advice I can give you in 2021 for your listeners are stop telling start asking.
Give them a simple common-sense tool that they use at Chick-fil-A that they use at the Apple Store that the use it Southwest Airlines Southwest Airlines a unionized environment.
I’m a hundred thousand employees yet their stock valuation is more than all other airlines combined yet they’re the cheap airline
okay you have to ask yourself how is it that they do that they do it simple thing right one tool executed well
our greatest problems is Americans I’m not even saying this Physicians As Americans is we want to imitate not innovate.
Right what’s Disney doing what’s Cleveland Clinic doing what’s that Physician Office doing up the street right and we try to steal their play but I will give you the New England Patriots Playbook.
Okay good luck on that.
Right it’s not yours culture has to grow organically if you’re in San Antonio look out the window see that green stuff on the ground it’s called grass it needs your soil sometimes clay sand right it needs rain.

[33:01] It needs sunlight but it needs to be cutting out again and you know who I’m talking about culture is a lot like the grass outside you can buy someone else’s culture and lay it down and that’s called AstroTurf but it ain’t gonna grow so you’ve got to give your team.
Time to be authors of their own culture now we go on my website followed by my book follow my podcast whatever you want to do.

[33:26] Deal great ideas mother’s but put them in your hip pocket and see if you can get your employees to start to know so dr. Schatz cil’s the president of dignity Medical Foundation
Physician Group called Mercy Medical Group in Sacramento doctor Chateau comes up to me and says Jake I need to get my scores up
gimme gimme some tools what is what are other people doing aegyo doctor schatzel you just were in my last Workshop human clinical human human first your business second human third well can’t you
job shadow dr. cook because he scores are higher than mine and you can tell me what he’s doing it I’m not doing I said I could but why don’t you ask him your colleagues he goes over very competitive neurologist you know I don’t know if I could do that he comes back to me the next day he goes Jake guess what.

[34:07] So what.
Dr. cook told me what he’s doing that I’m not doing I go what’s that he goes he’s exiting on the human I said what does that mean he goes exactly he says he’s using your tool he walks his patients to the front desk
I said why does he do that he says because he was doing it for efficiency reasons so the ma can turn and burn and clean that room but he found out that Not only was he doing the human business human and the gun human
but patients love it and the people in the waiting area go oh my God dr. cook just gave a handshake or a hug to his Patron I don’t mind waiting now to your point.
Patients don’t know how good you are right they don’t care how much you know until they know how much you care and
Maya Angelou said it best right I’m probably not going to remember what you said this Poet Laureate I’m badly people don’t remember what you said they’re not going to remember what you did but they’ll always remember how you made them feel so this touchy-feely thing.

[34:58] Is really embedded into business and think about your practice now is a company right we as Physicians I’m not a physician but as Physicians the data says we miss 90% of empathetic opportunities
patient comes in through his back out I’ve done it right doctor says.
So what seems to be the problem well you know my mom died I had to fly to San Francisco my brother and I had to help her you know get all her things together I was lifting a box and I threw my back out.
My mom died I threw my back out.

[35:30] What is the doctor say so does the pain radiates from your hip down to your leg right.
We interrupt patients every 11 to 15 seconds Brent are you married yes.
Okay I don’t know who your spouse is so your spouse takes their car to the auto dealership mechanic comes out there’s some kind of knocking in their car.
Your spouse says there’s a knocking and the in the position or the mechanic interrupts or every 10 to 15 seconds.
Is he or she going to take the car back there we don’t change when we go to the doctor we’re still the same person who took our car to the mechanic yet the physician gets a pass for interrupting us every 15 seconds.
So sometimes efficiency is the greatest enemy of courtesy.
Because we’re so worried about those other seven patients or other people three patients in the exam room or worried about these 35 patients that we’re going to have to see today we forget to be present
and so these common-sense tools and by the way that leads to four times as much burnouts as gallop.
Amongst Physicians they’re not just leaving that practice their leaving the industry.
There were suicides all time so there’s a domino effect of metrics that are proving that we have these slow down.
We not only make a connection with the patient we enjoy our jobs better the people who work around us enjoy our jobs better and by the way the last thing I’ll say on that.
As a physician the greatest tip I can give you to get your team morale up.

[36:54] Start the day on the human don’t come through the back door and just start seeing patients park in the back
come to the back door walk to the front desk and say good morning to the front desk thank them for being there thank them for working short-handed if we are today
CDMA bring in muffins whatever you don’t always have to throw food and money in they know sincerity and authenticity when they see it start that happen.
Well in the the time that you spend building those relationships nurturing those relationships pays off huge it increases morality increases productivity so there’s real value from just the business side of things
but it just makes it a more fun place to work you’re going to spend 40 50 60 80 hours a week with these people for the rest of your life you might as well enjoy it.
So it to me I think of it like a like a marriage you have to be intentional you have to nurture it you have to spend time it’s.

[37:48] People talk about quality time but quality time is born from quantity time.
So building some of that time into your schedule and say okay I’m going to have 10 minutes in the morning I’m going to have 10 minutes in the afternoon where there are no patients scheduled
and I’m going to use that time just walk around and go okay how’s everybody doing that you know just chat with somebody make a make a personal connection I think that’s great so how do we
start to assess where our culture is let’s say we’re coming in to a new job and we’re full of vim and vigor and we’re all excited we’re like I’m gonna I’m gonna set the world on fire I’m in a square every round hole
but you’re coming in and you’re in an existing organization in existing culture how do we start to assess where that culture is.

[38:29] And give ourselves a baseline from which to start to grow because you can’t go to where you’re going to go unless you know where you’re starting from and then you have to build on that so how do we assess where our culture is right now.
It’s a it’s a really great question let me give you an example Bill Bragg who’s a surgeon at Mercy Medical Group we created this video and I’d be glad to give you the link to the video for your listeners.
It’s called a pre-employment video.

[38:54] It’s a five minute video that clearly states who we are what we stand for and what we won’t stand for Missouri after watching this five-minute video If you think you fit our culture please proceed with the application process Bill Bragg.
He’s already interviewed at Stanford UC Davis UCLA and Sutter and Kaiser so this is his sixth
job application to work in Sacramento he comes across as video and he says I want to work here because those personal values my personal values fit your organizational values and I said all right we’re going to revise this video and you’re going to say that.
In this video so.

[39:33] That’s a culture that says we’re not perfect but we’re going to be intentional about what we stand for what we want stamp if you take that video for a moment watch it.
Right and then say all right my next job interview what questions could I ask in the interview that says.
What are you doing organization or practice to be clear about what you stand for what you won’t stand for
how do you do team Rapport and how do you reward and recognize each other how do you deal with service recovery and upset patients angry patients vulgar language what’s our dress code.

[40:09] We don’t do that in the interview we interview to get the job.
We don’t interview to work there so to assess a culture I mean there’s some things I do when I do a cultural assessment in a hospital takes me five days takes five of my executives.
But we do the employee experience The Physician experience the patient experience and the leadership.

[40:27] All four of those have got to come together in a Venn diagram is our ecosystem but one fun thing that I like to do Brent I’ll tell your your listeners I like to walk through a hospital and do a secret shop and I’m in jeans and a t-shirt.

[40:39] A walk to the hospital walk through 100 employees and see if I can read their name tag the average name tag 60% of the name tags are flipped over.
Or hidden by long hair or covered by a coat or on a belt or stuck in the cleavage name tag.
Simple thing first impression that next things I do is I take a GoPro cam I put it right next to a trash can on the floor and I put a piece of trash usually an empty Styrofoam cup.

[41:05] Next to that trash can 3 feet away and I count how many employees walk over around or kick the trash.
Before they pick up the trash I called it a pride assessment if you’re proud to work here you would wear your name proudly over your heart.

[41:17] You would pick up trash and the last thing we do is we walk by a hundred employees and do eye contact and smile so I’m trying to make eye contact and smile with everybody going in the hall and I count how many of them and it’s sadly about 30%.
So those three things give you a quick indication what it’s like to work here what’s it like to be a patient or visitor here and in a small practice you could even do you can even do something else I do which is I strapped a GoPro cam on a wheelchair and I just wheel it around.
It’s amazing what you see from the eyes of the patient now from a cultural assessment in the job interview I would also ask them how do we reward success.
Many organizations physician-led organizations have one metric and it’s called relative value units the more patients you see the sticker they are the more money you make
well if that’s our only metric for success we’re going to be out of business we’re going to be fast and efficient and nobody’s going to like us and nobody’s going to come back and that’s a bucket with a lot of holes in it we’re going to constantly put new patients in it and they’re going to constantly leave.

[42:16] So that’ll give you some ideas on how you do that.

[42:19] Those are really practical I love the trash one especially that’s that’s a that’s a great one and it’s simple stuff like that right it’s the little things that all Translate
into something larger it’s all tiny pieces it’s a microcosm of the greater organizational culture.
So okay so those are some great ideas for how we start to assess I just want to give you one funny thing so one of the things I do with that that video of the trash pickup.

[42:46] Is I don’t understand anybody’s face I always show kneecaps down to shoot so if you know what she was people wear and I’d play it in Auditorium for all the employees to see during a retreat right and I played a video and I said now just so you know
in three months time six months time then I’m going to do the video again
so the next the only people’s paste you see in the people who pick it up so what’s funny is when I put trash down the next time people are actually looking around for the camera
and they’re holding the trash at the air they’re doing little backhanded dunks into the trash can and that’s fun.

[43:19] Because that says somebody might be watching somebody in the parking lot in the Landscaping picking up cigarette butts but now that’s not just Big Brother watching it just becomes part of who we are you go anywhere at Disney and I’m not
happy to say this but I terminated three very smart very educated leaders at Disney who just would not stoop.
To pick up trash that was our culture because that was the number one key driver of people going to Disney World the place is clean
and if that’s the number one key driver that you take in your family to Disney World by God we got to get a hundred thousand employees to comply with that so it’s not just a nice to do it’s become part of our business makeup
I think that is absolutely fantastic so I’ll tell you a story about the first time that I went to Walt Disney World my
wife and I went to her friend’s wedding on Cocoa Beach we stayed in Orlando for a couple of days extra after that and went to Universal and went to Disney World and a couple of the other Disney locations and
we were outside of the Jungle Cruise Aladdin area
I was I think Adventureland and we’re in a little we’re just killing time while we’re waiting for our fast pass to be available and for us to be able to walk in and so we’re just killing time in a shop just kind of wandering around.

[44:30] And I saw that a couple of items had fallen on the ground you know a couple of the the Souvenirs of I don’t know rubber snake or a teddy bear or something I just picked him up and just set them on the table I wasn’t really thinking about it just you know okay hey there’s something on the ground pick him up
one of the staff came over and said thank you so much I mean like they came over and put their hand on my shoulder and said hey we really appreciate you taking the extra time to to put those back and make this a nice place and he pulls out this button
it says Walt Disney honorary Citizen and I was like I was like what is this he said
this is something that we’re empowered to give people when they’ve made
real contributions to our team so we want this is a way for us to say thank you and we really appreciate it and.
I didn’t think too much of it I was like okay that’s kind of that’s a little hokey whatever and then
my wife and I put it on there like a cool check it out we’re on our way citizens whatever that means and so later later we’re standing in line for one of the rides one of the employees that was at one of the rides saw it and they looked in like
how did you get one of those it was this it was like it was like I was wearing the Holy Grail or something and I was like oh my gosh this is some price thing that the organization has has instilled that’s.

[45:45] I can only imagine that people would just love to have a culture that is so loved and so celebrated by all of their employees that not only are they super excited to work there
they’re super excited to celebrate other people who embody I’ve and embody those values that is amazing how do you
how do you train for that I mean that’s do you have to hire for that or can that be trained in an organization that already exists.

[46:15] The answer to both of those is yes okay when you move from a culture of ambiguity to a culture of intention you’re not going to get every physician to work there.
They’re going to opt out somebody’s gonna say I have to be nice to know I’ve been doing this 30 years honey I’m here to save their but not kiss their butt right
good you we don’t want you here probably the best quote I ever learned in Disney business school right my MBA from Disney University is unexpressed expectations
can sometimes lead to unexpected resentments think about that for a moment when you don’t express
your expectation let you and I are going to be roommates I’ve been in college two years before your freshman you come in we share a dorm or room together and I say hey who ate my yogurt.

[47:00] That would be me we don’t do that here you didn’t tell me that hey whose underwear is over that by the washing machine that would be mine we don’t do that here so that’s resentments.
There was no new employee orientation in our dorm right and we do that we throw physicians at it oh you got a degree you’ve got two years experience here’s your keys here’s your password will start seeing patients.
Wait a minute who are we.
What do we stand for here how do we how do we connect with each other how do we connect with patient how do we write each other up that example that you used is a culture That incrementally Grew over time and two pieces I would say
right one is a flywheel called on the spot recognition encouraging employees to do human business human in a way that stays within the guardrails of our mission vision and values
when you do it well I’m going to write you up.
Write you up in a good way right that’s on the spot recognition oh my gosh Brent you’re walking out to patients to how do you do that well I got Glory at the front desk to write that what people wear and he’s got brown hair he’s white and he’s got this check or turn on I knew that was dr. Lacey.
And I called him Brent because last time he was here he told me that and I wrote it in the charm my gosh it’s fantastic now we’re going to use you.
As a model in our newly newsletter you’re going to do an in service for 15 minutes at our next staff meeting and now that becomes a play in our Playbook now that play can be an interview question.
In our next recruiting for a physician for front desk install so now the other piece is service recovery.

[48:29] Had a lady come in she had her son had a bee sting she had to take time off of work bring them into our office of Dermatology
what did you do well we prescribed an EpiPen for him gave him some land some epinephrine doctor did prescribe them to go to Walgreens to get a pen and go back to school great.

[48:48] Doctor went home at 3:30 4 o’clock the lady came back with her son says she can’t win the nurse says we have to sign this paperwork oh my gosh she was really angry was a 45-minute drive
she’s upset she can’t go back to work the kid had a test that day in science it.
3:30 but the doctors gone home what did you do I jumped through hoops I went down the hall talk to the physician and Family Medicine got him to sign the paperwork
but that’s not service your company that’s right so I gave her a $25 gas card she drove an extra 45 minutes that’s a lot of money okay so you gave her a Shell gas card.

[49:18] Now we have two Monday Morning Quarterback so Monday morning literally we come in and say how do we keep that from happening again.
Some smart front desk person goes listen my old practice I used to work in dermatology down in San Diego
we had a play for that we actually called the local school districts in three County areas we asked them for their paperwork anytime we prescribe medicine and we have them in a folder called epipens and every time you prescribe a happy time we said what School District Korean we pull it out
my God now I’m writing you up for on the spot recognition and that’s that infrastructure that’s that ecosystem that now at Disney
is helping us incrementally grow one inch at a time.
Most organizations want to grow leaps 1000 inches Disney grows one inch at a time through on the spot recognition of service recovery so as an employee I get written up I get encouraged to include you and experience so if your birthday.
You just got married you just got engaged you’re having a reunions whatever those moments in time I’ve you know Brent I’m going to give you a great example I’m at a hospital system in Allentown PA big hospital system.

[50:22] I doing Secret shopping on the security team at the front desk I’m in jeans and a t-shirt I run from my car from the parking lot to the front desk and I say this to the security office
hey my sister just had a baby can you tell me where the mother baby Flores he goes driver’s license I know.

[50:41] What he goes That’s a secure floor I’ll need your driver’s license okay what would any human being saying to any other human being.
Brent if you said hey my sister just had a baby.

[50:53] Congratulations is boy or girl what’s her name what’s his name okay that’s basic level he skipped because he skipped right he skipped the human he went right the business right.
Number two if Disney ran your front desk rent.
What else might they have behind the desk to celebrate that moment by the way which happens a lot in a baby hospital right.
What would we get the security officer whose contracted as a way to help celebrate this new uncle
so I don’t know give them I don’t even know what would you give them.
I don’t know what candy cigar a button that says proud Uncle it’s a boy it’s a girl some nominal not expensive things to say okay but let’s rewind right here let me push the rear I’m good.
Let’s Play It Again hey my sister just had a baby can you tell me where the mother baby floor is all congratulations what did she have.
She had a little girl oh what’s your name Elena Grace
Grace that’s a beautiful yeah she’s named after my Grandma Grace who passed away a couple years ago ah what a beautiful name well you want your sister and your new baby Elena Grace your new nice to be safe don’t you.
Absolutely well only special people get a VIP pass for that floor and to get that VIP pass I’m going to need your driver’s license I’ll just stop for a moment right.

[52:12] We connected on the human we still did the business what hospital do you want to go back to Brent.

[52:18] Right now I’m an uncle but I’m also married I might have a baby someday or my wife will right
might we encourage her not to go to the other hospital we were going to go to drive a little further pay a little more common sense dictates in business were willing to drive further,
wait longer.
Pay more for any business that treats us as a VIP and not just a very important person like in most business a very individual person.

[52:45] Right and what they did for you is they singled you out as an individual and then they built mechanisms that said when you see that button make them cut the line
treat them special call them out now my daughter’s an introvert 9 years old
her birthday she wants to go to Disney she gets the birthday pin it says happy birthday Elena after the 50th hundredth person said happy birthday she goes down I can’t take this anymore I don’t want the attention right so Disneys not for everyone,
right
it’s not not everybody wants to wait in line not everybody wants to treat you special not everybody likes Disney entertainment Southwest Airlines does not for everybody but what you can’t argue with is the intentionality of their organizational Playbook.

[53:27] Start to look at Chick-fil-A Apple Stores you know the Apple Store I was there the other day brand I took my iPhone in it was not those African kind of wonky and I got there early I’m always like you probably military I’m always before they open I want to be there
and I saw them doing a team mating in front of their front desk about 30 employees and it was a stand-up meeting and they ended the stand-up meeting with clapping.
I thought that was interesting they ended clapping and they started clapping and they walked to the front door and somebody opened the door and as 30 of us walked in they gave us a standing ovation little thing
big impact
right can we start our practice with a standing ovation right no I go to your practice between 12 and 1 and they bring this blinds down behind a glass with a hole in it and it says no food or drink yet I can hear them chatting.

[54:15] Talking about other patients and eating their lunch behind the glass we have to understand about what we stand for in the other thing
is what we call organizational graffiti those things that detract or distract away from the ideal patient experience and we’ve got to make sure we do both that is awesome well I would
just love to have another five hours just sit here and no doubt about this stuff with you but if people want to continue this conversation if people want to learn more from you if you want to hear more about what iOS does or wants to get more of your content or see more of your stuff you got great stuff on your website I know you got a lot of great content so how can people connect to you and ILS and how can people continue the conversation well listen
I have the abundance mentality I want to give away my stuff so every day on LinkedIn and Twitter I’m sharing these tools I’m a lifelong learner so I don’t profess to know it all but I’m constantly collecting best practices and Lessons Learned so if you want that just follow me on social media doesn’t cost you a penny for I don’t know 20
25 30 bucks you can buy my book 99 lessons learned from Disney to improve the patient experience so I give you a lesson from Disney
and how I applied it to healthcare so you get lots of examples unfortunately most of those are Hospital examples so I know you can adapt and adopt that to your practice number three.
Is I took that book last year and I built a lesson plan for it so for every chapter of the 99 lessons I built you a lesson plan you can sit down with your team every week every month.

[55:40] And talk about how we can adapt that to our practice number four
I took all ninety nine chapters last summer since if we are locked down and I created 99 videos that go with that so now you got 99 lessons online.

[55:53] And number five if you really are exhausted and you want to really keep engage I invite you to come to the Grand Floridian next January 24th through the 26th.
I’m actually going to do a small intensive Retreat for any leader in healthcare that wants to sit in a conference room.
Learn about the Disney proach and how have adapted and Healthcare go out into the parks for the Resort’s see it in action and then we’ll go to a local hospital
where we built it so you can literally kick the tires feel it see it and then we’ll come back to the classroom say so what that’s a multibillion-dollar entertainment Empire that’s a huge hospitals.
Part of a huge Health System what does that mean to my small physician practice and you’ll be able to leave with the blueprint you need to build a world-class service culture.
And patient experience so there’s a bunch of ways you can stay connected
I love it that’s great that’s going to be awesome well well Jake thank you so much for coming to us today and encourage everyone definitely go to his website and I’ll make sure to have the links to all that in the show notes follow my only on LinkedIn
get the book 99 lessons learned from Disney to improve the patient experience all great stuff and if if any of that stuff is is even half as good as the conversation we just had
it is going to be life-changing for so many people so I really encourage people to go check it out Jake thank you so much again for joining us today on the scope of practice podcast I really appreciate you coming on,
Brent thank you for what you do I think these conversations are vital in.

[57:18] Keep the conversation going thank you so much I love Jake’s attitude about business and especially
about Healthcare business you know one of the reasons that I like to bring non-physicians on the show for you is that I think that there’s a lot that we can learn about business from people who are not Physicians if we want to learn to be excellent at something we need to study the people who are already excellent.

[57:43] I hope that these conversations keep giving you that knowledge and those resources to help you become the healthcare leader that you want to be and that American needs you to be.
Well it’s growing your business or growing as a leader is an important goal for you than I have an amazing free resource to give you it’s called
five critical tools for physician leaders this guide has five incredible resources included to help you find ways to celebrate your team members
build a mission statement that actually makes an impact create a one liner that will help you Market your business more effectively have a set of leadership books that will help you grow even more and attend a challenge to improve your clinics efficiency and customer experience it’s totally free to download just go to www.scopemonth.com / physician leader tools or
click the link in the podcast description to get.

[58:32] Don’t forget also sign up for the marriage and money MD Summit which will take place on November 15th 16th and 17th this year
it’s completely free to attend and so you should definitely sign up today the website is www.marriageguy.com money MD.com
or just click the links in the podcast description you can also upgrade to an all-access VIP pass for just $99 up until the day of the conference starting.
So go ahead and sign up for the free event today and you can always upgrade later but go ahead and sign up today at www.marriageguy.com EMD.com.
Thanks so much for joining me on the scope of practice podcast today you can also find all those resources in the show notes at www.scopemonth.com / episode 77.
That’s www.thekingofrandom.com episode 77 or just click the links in the podcast.
Thanks so much for joining me and I’ll see you next time.
Thanks for listening to the scope of practice podcast at www.visaplace.com.

[59:36] The doctors the story has changed visit Doctor podcast network.com Locum story for unbiased information about Locum tenens and see if it should be your next shot.

[59:46] And remember Locum tenens tends to Trend as a God send men to burnt out.