Episode 1: The Need for a Balanced Perspective

It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone, and we’re left trying to figure out where to go from here.

With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell!

It’s time to navigate the new landscape of healthcare together, and hear some amazing stories along the way. Ready for a breath of fresh air?

Our Podcast Debut

Announcing the debut of the Paradigm Shift of Healthcare, our brand new podcast. Each week, the trio of Michael Roberts, Scott Zeitzer, and Jared Johnson bring you the people and ideas that are changing the way we address our health. If you’re looking for amazing stories from providers and thought leaders who are changing patient care, this is the podcast for you.

We leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health.

Show Notes – Episode 1

Michael, Scott, and Jared kick off Season 1 sharing experiences of their personal encounters with the healthcare system. One of the ways they see minds changing is in the empowerment of patients. It’s easy to demonize the big players such as providers, health systems, and insurance companies and complain about them without contributing to improvement. But it’s much more beneficial to bring our experiences and ideas to the table to create a balanced perspective.

Engage With Us

How to listen: https://shows.pippa.io/paradigm-shift-of-healthcare/howto

Archive of previous episodes: https://www.p3inbound.com/resources/podcast.php

Follow on Twitter: http://twitter.com/p3inbound

Full Transcript

Announcer: It’s time to think differently about healthcare. But how do we keep up? The days of yesterday’s medicine are long gone, and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together. And here’s some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the Paradigm Shift of Healthcare, the program where we discuss the changing mindsets in healthcare and where they’re leading us. I’m Michael Roberts, and with me are your co-hosts Scott Zeitzer, and Jared Johnson. Scott, Jared, I’m excited to take this journey with you and see where we end up each week.

Scott: Michael, thanks for getting us started. This has been a long time in the works and we’re thrilled to start sharing these conversations now with our listeners. You and I have the pleasure of speaking with providers regularly and seeing how they are changing patient care by shifting their mindsets about everything, from patient experience, to access, to emerging technologies, to digital health, to burn out, social issues, and just about everything in between. The paradigm, or the very way in which we think about healthcare is indeed shifting. For many of those providers that we speak with, this is not the medicine that they studied in school, and that has both opportunities and challenges. And I’m looking forward to discussing it.

Jared: Yeah, Scott, you know, that’s so true. We really hope, listeners, that you’ll find this program to be a breath of fresh air, because there is a lot going on isn’t there? And we hope this will be a breath of fresh air not only from the day to day, but from the battle lines that we see on Capitol Hill, away from the debates about policy and regulations that are continuing elsewhere. This is a place for ideas and conversation, not attacks and accusations. This is really about how we’re thinking differently about our health, and what that means for us as people, as human beings. So, Michael, you know, that’s a good place to kind of go with this. Maybe, Michael, why don’t you tell listeners a little bit more about what this program is all about? Let’s tell who it’s for, and then we can get into our first topic.

Michael: Absolutely. I’m really excited to get into this because the show name itself, we’re talking about the paradigm shift, but when we really start talking about what’s actually changing, there are so many different avenues, you know, Scott listed them off, but there’s so many different ways that things are actually changing in healthcare. And one of the things that I’m really excited about with this show is that it’s not just the three of us talking about what’s going on, it’s us getting the chance to interview guests, everybody from physicians, from trying to get some folks in insurance to come talk with us. Talk with people that are, you know, marketing device companies, various folks that are involved in the social media side of things, but, just a lot of different perspectives on what’s changing for providers, what’s changing for all the people that work with providers. I mean, that’s a really wide range, but trying to really dig into all the challenges, you know, that folks are facing in these spaces.

So, we’re a part of the company Mudbug Media. We’re behind the platform that’s called P3 Inbound. You know, and we work specifically with orthopedics with spine and with the neuro spaces, and we’ve been in that space for quite some time now, and have seen this starting to evolve in that side of things. And, you know, Scott, you’ve been talking with these folks for quite some time, so, can you tell us something about, I guess, first of all, how you got involved with these three different groups, and then something about how we started to see those changes played out.

Scott: Yeah, I’m actually a biomedical engineer by training. I went to Tulane University, got my undergraduate and my graduate degree down here in New Orleans. If you guys ever, whoever’s listening, ever want to come visit, we’ll be happy to feed you. But, upon graduation, I had a choice about either going to grad school and getting my doctorate, or putting my now ex-wife through med school. Don’t worry everybody, she’s remarried, I’m remarried. The kids grew up healthy and everything’s good. But I had to figure out a way to put her through school. And I did that by actually selling medical devices. I started out selling medical devices for Johnson and Johnson. It was orthopedic implants, fracture implants, that type of thing. And then moved to Howmedica which was a division of Pfizer which got sold to Stryker. When Pfizer came out with the blue pill and they were like, why are we selling total joint devices when we could sell this blue pill?

And so, the whole idea, I came at it from initially as just this young guy who was very smart about say biomechanics or bio materials talking to orthopods, and it was very much from the angle of medical device rep, orthopedic surgeon, the people in the operating rooms, and then it kind of grew as I started working closely with certain orthopod. You really genuinely start generating strong relationships with people in the hospital, with the providers.

And I will say this, I’ve been doing this for close to 30 years. I’ve never had any medical professional say to me, “I don’t want to take care of that guy. I don’t want to take care of that gal, it’s not gonna make me money.” Thank goodness for that. But they do worry. They worry about, “How do I make a living? How do I take good care of this patient? The hospital is driving me crazy. My staff is driving me crazy.” I’m talking about the surgeons. “My patients are driving me crazy. My spouse is driving me crazy.” And that’s, by the way, all of us, you know, we’re all human beings. But, as I started to work more in that area of being a sales rep, there is a guest that we’re gonna be having in one of the upcoming podcasts. Dr. Ira Kirschenbaum, who’s over at Bronx Lebanon. And he came to me complaining that he really wanted to come up with a way to describe a complex surgery for other orthopedic surgeons, and I told him that I could program it. And he thought I was basically, well, full of it, I think would be the polite way to put it. Yeah. And he did not realize that, as part of my training, I did a lot of finite element analysis, understanding biomechanics.

And so I programmed with Ira, really a precursor to medical grand rounds for the American Academy of Orthopedic Surgeons. And it went very well. I got called in to the head offices of the folks at Howmedica and I thought I was going to get yelled at, you know, like, “What are you doing doing this? Why aren’t you selling?” It wasn’t their thought at all. It was like, “Wow, that’s terrific. Can you help train our Salesforce so that they’re better at what they do?” And, at the time, my first wife was basically graduating, she’s an OB-GYN and I was starting to think about what do I want to do with the next phase of my life, and I decided to stop selling and went inside. If you’re a rep, when you “Go inside” it means you start to work at the home office. And I did.

I was essentially a liaison between the key customers and the IT department. Because, you know, it really is true. The IT guys, the coders, etc, they pretty much are introverted. You know, they’re those nerdy guys. And we currently have a group of really friendly nerdy guys and gals here at Mudbug Media. And I started out by basically being that liaison. Over time I decided to go out on my own and we formed a company that essentially worked with medical device and pharma companies. So we created very large, complex web applications. Yeah.

When that happened, I think back in ’98, I had one of the guys in marketing come to me and essentially complained about the fact that he had no way to help a lot of the orthopedic surgeons that he was currently working with to help them “market their practice.” Now, you have to remember, this is 1998. So, marketing your practice back then was putting a business card online, if you’re talking about making a website. And he was very much about doing things the right way. Obviously, a medical device company, a pharma company, cannot help market an orthopedic surgeon. That is Medicare fraud, it’s wrong, overall, you can’t do that. But he ended up just referring a few people to me. And I sat down, you know, and I talked to them about what they needed. At the time, way back then, it was more of just, “Hey, can I just get at like the fact that I’m an orthopedic surgeon, and this is my phone number, and this is where I’m at?” Yeah, that was our initial “website” that was our marketing back in ’98. I of course charged them for all that, and they were happy to pay me. Thankfully, they continued to be happy to pay us.

And over the years that has changed. You know, way back when, back in ’98, it was actually odd if a patient came to the surgeon with information, you know, you remember? I remember back then, it would be like, you know, take the blue pill or the red pill, and, you know, and whatever we told them, whatever that surgeon said, this is, I remember a lot of surgeons tell me, whatever I told them, that’s what they would do. And now, they ask me questions. Yeah, yeah, they do, you know, because I think of it from a patient. I know you do, too. You’ve got a daughter who has had a long about.

Michael: My wife and I have learned the healthcare system very much from the other side of the equation. So, where Scott comes at it from very much partnership with providers, that sort of thing, I came to the company with a background in marketing. And so, you know, I had been working in the hospitality industry. And it’s a completely different job to market the hospitality industry than it is to market the healthcare industry. So, it’s been a chance to learn a ton about just that side of things. But then my wife and I, we have a daughter that is a chronic patient. So we’re very, very familiar with the hospitals in our area, with the providers in our area, we get the chance to know all of them that way. And it’s really interesting to have conversations with practices, with other providers when we talk about, you know, patients want to see this on your website. They want to understand this about you.

And we can say that as somebody that really gets it, as somebody that really cares, because, these are the things that my wife and I have to look for when we’re looking for a provider. You know, the bedside manner of that doctor is just as important for my wife and my daughter as is the medical knowledge and all of the, you know, experience that they bring to the equation. So, you know, between just experience here, had the chance to study healthcare more, and recently completing another degree, and being a patient, being the parent of a patient, it’s very much a toss into the deep end of healthcare.

And so this is why we wanted to get together, you know, as we were talking about different ways to talk about the company more, and to just understand like what’s going on in this space, we wanted to put together this kind of conversation series, this interview series. And that led me definitely to reach out to Jared, because Jared actually has a lot of experience in podcasting and understands this side of things as well as a career in healthcare as well. So, Jared, I’d love to hear more, you know, for you to introduce yourself to listeners and to tell us more about sort of your experience with this side of things as well.

Jared: Yeah, thanks, Michael, and Scott. I mean, great stories. I mean, we all have different experiences and different parts of healthcare. It’s such a misnomer to think of healthcare as one single dimension thing or entity, isn’t it? There are so many different parts of it, and they’re all different parts of our lives. I’d say that the couple of things that always are, you know, literally, when I wake up in the morning and I think, what am I going to think about healthcare today? You know, it’s different, like you said, than entertainment, or retail, or other things because it affects our lives. We are all patients at one point or another.

I’d like to think that I’ve approached it from different sides because of either, you know, working for medical device companies, or working for hospitals, or consulting for other healthcare entities, or just going out there and hearing. I feel like the last five years especially, I’ve done as much listening as I can. And so this isn’t all just me and my experience, although I’ve had my own experience with the healthcare system as well, Michael, and I can relate to the patient side. And, yeah, you know, I’ve got a family too, and I’ve experienced losses in my family too, you know, not to turn too serious here, but, you know, I’ve lost people in my family who I’ve wondered, you know, it felt like the healthcare system failed them.

And those things are still, you know, very much on the forefront of my mind. And I thought, “What could have been done differently?” Because, you know, in the case of my father-in-law, who I lost about five years ago this month, and it had to do with, so he passed away from prostate cancer, which is like the most, if not the most, one of the most curable, treatable forms of cancer for men, and yet it took his life and I thought, “What’s going on here? Like, where in the system is this happening?” And that was one of the triggering events for me in my life to spend more time about this.

People have asked me, you know, why do I care so much about healthcare? You know, why do I put out so much content? Why do I talk about it all the time? You know, that’s one reason, because I’ve experienced it myself. And the other side really is because of who I’ve been listening to. And it’s not just one side. I thrive on being able to kind of see that 30,000-foot view and see really what’s going on. Because if I stay too long in one point of view, I can miss the other things that are happening. And so I’ve seen it from the doctors’ point of view, right? I’ve seen it how the business landscape underneath them is changing, because, you know, they literally don’t know how they’re gonna necessarily make money from month to month or from year to year because regulations change, and business models change, and now its value-based care and it was fee-for-service before this, then, you know, they’re also experiencing burnouts. They’re trying to figure out why they have to do everything with an electronic health record, instead of spending more time literally making eye contact and speaking with their patient.

The piece that you said really resonated with me, this is not the medicine they grew up with, or that they studied in school. And then there’s the patients’ side. We as patients are becoming more empowered these days. We are going, Scott, we are asking those questions, and it’s not such a thing like the story.

Scott: And we should.

Jared: Yeah, exactly. Like what you were sharing there about how they’re not, so some doctors are still stuck in that. And it is just the way they are, and they come from that and that’s, they were literally told that’s wrong for a patient to even question anything. Even the concept of a second opinion, what? Like, I’m the professional here, I’m trying to help you. This is a different world, and these are some of the changing mindsets that are out there where a patient literally says, I mean, for me, you know, at one point, I wanted to keep track of my blood pressure a little more frequently than how often I went to the doctor, you know. I will go to the doctor a reasonable amount of times during the year, but I am not only asking them questions, I’m like, I’m a patient. Like, one day out of the year, two days out of the year or whatever to go get a checkup, but I’m a healthcare consumer, I’m dealing with my own health 365 24/7. So, what do I do in the meantime?

So, in my case, like I went a few years ago, and bought, it was brand new at the time, like some little health care monitoring, or some little blood pressure monitoring device. And I thought, you know, that’d be cool. Like it had the option to email the results. It was a little blood pressure cuff like they put on your shoulder like the one that you see at the drugstore, the grocery store, that you can go sit down at, that no one does anymore, is one of those, but it was Bluetooth, it hooked up to your phone and I thought, “This is pretty cool. I can do this from home.” And then, one of the options I was most excited about was this option of being able to email the results to my primary care doctor. What a concept, that’ll be fun. That would be great.

Michael: I’m sure he or she was really excited that you were consistently sending blood pressure results to them.

Jared: Well, the short version of the story is that, we didn’t even get to that point. I couldn’t even get to the point where I could find out how to send it to my doctor. And I’m like, I just gave up at some point. I’m like, I just ended up monitoring it on my own. And in my case, it was not serious at all, thank goodness. I literally just wanted to keep track of it more than like once a year, I mean, how often, it changes every day, so.

Scott: It’s interesting, because, there’s always that, life is a balance, healthcare is certainly a balance. And, from my perspective, listening to a lot of orthopods over the years, listening to friends and family who go see whether it’s an orthopod or whether it’s a primary care provider. It’s a very difficult balance. The provider, whether it is an orthopedic surgeon, a neurosurgeon, or the primary care provider, two different ends of the spectrum there. How do they spend enough time listening to the patient and understanding what they need, versus seeing all the patients that they need to see, versus making money, versus taking good care of them, all of those things are being balanced. And it’s not easy. I mean, it’s not easy for anybody.

I remember I was changing my general practitioner, my primary care provider, and one of the things you do is you get weighed. So I walked in, I was wearing a suit, and I had my computer in my bag, so a pretty heavy bag. And the young lady told me to step on a scale, and, you know, kind of checking out like whether or not they even care that I’m there. And I stepped on the scale with my computer, you know, on, and she’s like taking my weight and I’m thinking, again, you know, look, I’ve been in the business for a long time, I have some knowledge. So I said, “Are you trying to gauge my BMI, my body mass index now?” And she said, “Yes.” And I said, “Do you want to do with the computer or without the computer?” And she didn’t care.

That was the funny thing. She was like, “Yeah, it doesn’t matter.” So, balance I think is going to be something you’ll be hearing from a lot of different people. And that’s why I like the idea that, hey, we’re gonna go talk to some surgeons, we’re gonna go talk to some primary care providers.

The insurance companies aren’t evil. I know it’s easy to make them out to be evil. They’re not, they’re trying to figure out a way, yes, to make money, so is everybody, right? But they’re also trying to figure out a way to take good care of their customers who happen to be patients. So you’re gonna be hearing that balance, whether it’s from the hospital administrator, the insurance person, the orthopod, the patient. Everybody needs something, and how you get there I think will be the fascinating thing.

Michael: It’s interesting talking about the patient side of things, you know, again, going back to just the experience that we’ve had as a family. When we found out, you know, that our daughter was diagnosed with something that we’ve never heard of before. It’s not that uncommon, but we hadn’t heard of it, because we’re just never paid attention to that side of things. So, we’re a young family, we have a daughter that has a condition, and we go online and start researching things. Well, you know, my wife centers very heavily around engaging with people, not just consuming information, right? Not just looking at what WebMD has to say about the thing, or what some article will list out, but what are other people experiencing with this.

And this is an interesting challenge that healthcare has to figure out how to engage with so that they can get the right information out there. There’s not too much misinformation going on, which is so very possible in this era. But we go online to see other families that are dealing with the same condition. And we’re connecting in a way with other families from all around the world than we can with our doctor, than we can with our healthcare system. And so we’ve got this kind of support network built in. And I can’t tell you how many relationships we’ve built over the years, with families like ours, with families that are going through similar kinds of scenarios. So, there’s very much the provider side of things, but patients are shifting, and patients are adapting in just tons of new ways. And some extremely positively. Like, absolutely, some of these things are really, I don’t know what we would have done as a family if we hadn’t found those communities, they were really instrumental and are figuring out a way to cope with it all.

Scott: You know, I can’t tell you how many times that we, as a company, you know, have been on the phone with a potential customer that is looking to market their practice. And one of the first things I talk to them about is like, you got to basically look, the thing that I talk to them about and why we came up with the goofy name of P3 was, it was patients, pathologies, and procedures. And I would kind of calm the surgeon down and say, “Which ones do you want?” I’ll tell you right now that, as an orthopedic surgeon, most orthopedic surgeons could probably fix what’s called a Colles fracture, it’s a wrist fracture, at the end of their first year of training. It’s a pretty simple thing to fix. I couldn’t do it, but I’m sure the orthopod could do it quite easily. They also don’t make any money doing it, and that’s okay. If anybody walked into the office of any of these orthropods and said, “I broke my wrist,” they would fix it. That being said, if they trained in say total joint replacement, they’d like to see more patients who need total joint replacement.

And so when we talk to them along the lines of like, hey, when a patient needs, say, a total knee, they’re scared, you know. They’ve never had surgery before. What can I expect? And I remember like, it’s very eye opening, because the surgeon, it’s what they do every day. Like, to them, doing a total joint or a scope, like a simple meniscal repair, hey, that’s their bread and butter, that’s what they do every day, they don’t think too much about it. And, you know, you and I spend a lot of time talking to them going, hey, they really don’t care too much about the surgery itself. They care about what’s gonna happen before the surgery. Sure, what’s the surgery about? And then, just as important and most importantly, what happens afterwards?

And we talk a lot about setting expectations. When you found out that your daughter, you know, had this condition, yes, you want to reach out and talk to people on Facebook and other social communities, you want to go to the website of the provider you’re thinking of choosing and saying, “Are you talking to me about this? Are you setting expectations about what you do, how well trained you are? How often you do this? What you expect when I’m there?” I can’t tell you how many office staff have thanked us because they’re not answering the same questions over and over, right? Because it’s the same questions. You know, “Hey, I’m going to have surgery. Where do I go? What floor?” You know, that kind of stuff. “How quickly can I get back to walking?”

I had a hernia operation a few years back, guy that I know very well, and he did the surgery. And I wake up the next day and he’s got a little pain pump connected to me that’s going down to where the incision is, and there’s a little blood in the tubing.

And I called him up, and I said, “There’s blood in my tubing.” And he laughed to me, and he said, “Dude, you just had surgery, of course there’s blood in your tubing.” And my response to him was like, “Well, that would have been nice to set that expectation, and then you wouldn’t have to talk to me.” And he laughed, and he goes, “Good point.” You know. So, I really do think the patients are coming with more information. I think that’s a good thing. And the surgeons and the providers who are embracing that, and learning to speak better, and set expectations better, are getting better outcomes. It’s a win for everybody. It’s a win-win. I say that to Michael a lot. It’s a win-win.

So, that’s the kind of stuff where it’s always about a search for that win-win. That’s what this whole changing paradigm is about, is that, there’s nobody that we’re gonna talk to that doesn’t want to find a way for it to work, you know. They really do want it to work. It’s how can we get it to work, so that everybody is taken care of. And that’s the win for everybody.

Jared: I really like that thought, Scott. And I think, what I keep hearing about as we’re looking at the stories that we will be telling in this podcast, I hear words you keep coming back to balance, which I love. I think that’s important. Without it, we get focused, and we’re gonna be just thinking in a narrow-minded way like so many people are out there. How do you fix healthcare? It’s complicated, so let’s use some balance in our perspective. I’m also hearing empathy, Michael, when you’re talking about coming at things, you know, healthcare means something very different now as a patient and as a healthcare consumer than it did at different points in your life. So I’m hearing empathy, that’s something that we’ll be focusing on as well. And then just perspective itself. I think these different points of view are important to kind of put all these pieces together.

And I think, when I keep coming back to the theme of paradigm shifts of what’s going on and the changing mindsets involved with healthcare, that’s why I’m really excited to be able to be involved in telling these stories on this program, because we’re going to hear from different points of view, we’re gonna hear some balance, and we’re going to feel that empathy, and those are keys that just, they are missing. When I talked about this being a breath of fresh air from the other conversations that are happening out there. Yeah, it’s a lot easier to be really upset about something and not consider other points of view. I would say, you know, as we head into this with open minds, we hope our listeners that you do as well, and you’re gonna hear these stories, you’re going to be interested in in what comes next, and where these shifting and changing mindsets are taking us. And so, maybe, Michael, that’s a way to kind of put a bow on all this, but those are just my thoughts for what they’re worth.

Michael: Absolutely. Absolutely. Yeah, I’ve been really excited as I’ve been getting further and further into this industry, just learning more about the conversations that are going on. You’re right, there are a lot of people that are angry and frustrated with where things are, but seeing how many people really are moving towards this, “Hey, let’s make things better. Let’s actually put our minds together and come up with some real solutions instead of just being so frustrated about it.”

Scott: Yeah, I agree. And I’m actually really, I’m psyched to be part of the conversation. I’m very interested in hearing those other points of view, you know, honestly. I don’t think there’s anybody in a corner kind of, I’m thinking of Mr. Burns, you know, from the Simpsons who kind of moves his fingers together going, “How can I take advantage of everybody?” I think everybody’s trying to figure out a way to take good care of the patient in a cost effective, intelligent manner. And balance is a good, balance, perspective, these are all good words that you’re going to be hearing from everybody that we talk to. I’m excited about it.

Michael: That’s awesome. Thank you, guys, both so much. “Paradigm Shift of Healthcare” is brought to you by P3 Inbound. You can subscribe on iTunes, Google Play, and anywhere you listen to podcasts. You can find our full archive of episodes at https://www.p3inbound.com/resources/podcast.php. And you can even recommend a guest or topic on Twitter @p3inbound. Thanks so much.

Announcer: Thanks again for tuning in to the Paradigm Shift of Healthcare. This program is brought to you by P3 Inbound, marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.

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