Friday, July 15, 2016

Nirav Shah, MD, MPH, Senior VP and COO for Clinical Operations, Kaiser Permanente Southern California



Today's guest is Dr. Nirav Shah, the Senior Vice President and Chief Operating Officer for Clinical Operations for Southern California in the Kaiser Foundation Health Plan and Hospitals, in Pasadena, California. Nirav oversees the health plan and hospital quality, service, accreditation, regulatory compliance, and licensure, as well as nursing, the continuum of care, and the effective use of technology, data, and analytics to produce better patient health outcomes for $24B region serving 4.2M members.

Prior to coming to Kaiser, Nirav served as the Commissioner of Health for the State of New York, administering a $60B budget and was responsible for public health insurance programs covering 5 million New Yorkers as well as regulating the state's hospitals and nursing homes among other responsibilities.

Nirav completed an internal medicine residency at Yale, followed by a fellowship in epidemiology at Stanford. Before moving into leadership roles, he worked as a physician researcher at Bellevue Hospital in New York City and at the Geisinger Clinic in Pennsylvania.

I really enjoyed listening to Nirav's journey from physician researcher to large organization leader. Perhaps more than any other guest, Nirav talks about the importance mentors have played in his career, and how he seeks out support and guidance to help him solve his problems, while at the same time reaching out to return the favor.


Transcript: A transcript of the podcast is available here.



Podcast Outline

Time Topic
0:02:22 Upbringing in India
0:03:41 College experiences, deciding to go into medicine
0:05:06 Completing a dual M.D./M.P.H. program in chronic disease
0:06:15 Being in a Pass/Fail environment at Yale Medical School
0:07:47 Residency in Internal Medicine
0:08:30 Fellowship in Epidemiology
0:10:20 The “Physician Identity”
0:11:31 Early career at NYU Medical Center/Geisinger Health System
0:14:34 Balancing the demands of a clinical vs. research career
0:15:24 Early career mentors, privilege, and grit
0:19:00 Early interests in administrative and leadership work
0:21:13 Work as the Commissioner of the NY Department of Health (DOH)
0:25:00 The importance of having a political appointee as a Commissioner
0:27:27 The importance of building networks for future leaders
0:29:12 Role of the Commissioner of the NY DOH
0:31:30 Reforms to Medicaid at the NY DOH
0:33:30 Dealing with conflicts as the Commissioner
0:35:25 Difficulties of implementing reform
0:37:48 Relationship with Kaiser Permanente prior to and as Commissioner
0:39:25 Leadership lessons learned as the Commissioner of the NY DOH
0:40:33 Shift to working at Kaiser Permanente
0:42:55 Advantages of the Payer/Provider alignment at Kaiser
0:48:38 Size and scope of Kaiser Permanente and KP Southern California (KPSC)
0:50:22 Day-to-day life and responsibilities
0:51:36 Use of data and analytics to improve patient outcomes
0:54:43 Benefits of KPSC and hospital association
0:56:03 Relationship between corporate and regional KP organizations
0:58:15 Regional leadership team organization
0:59:15 What keeps you up at night?
1:00:40 How did prior experiences prepare you for Kaiser?
1:02:48 Common misconceptions of Kaiser
1:04:11 Are you currently practicing medicine?
1:05:23 Questions regarding leadership, personal mentors, and leadership experiences, hiring and evaluating leaders
1:10:25 Working with “inexperienced” leaders, evaluating performance
1:13:20 Importance of organizational culture
1:15:30 Advice for students in developing good mentor relationships
1:19:54 Importance of professional associations in career development

1:20:54 Advice for clinicians/students going into healthcare 


Links Discussed

Yale Medical School


Thanks to Sameer Panesar for production support.


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Friday, July 1, 2016

Brigadier General R. Scott Dingle, MEDCOM Deputy Chief of Staff, G-3/5/7



Today’s guest is Brigadier General R. Scott Dingle, the director plans, operations, and training for the US Army Medical Command, also known as the MEDCOM G-3/5/7. BG Dingle has had an extraordinary career, including attendance at some of the Army’s most respected training schools, battalion and brigade commands, and combat tours in Afghanistan and Iraq.

I really enjoyed hearing BG Dingle’s career story, but I found his lessons for leaders at the end of the interview particularly striking. He uses a clever metaphor to talking about the need for leaders to never lose their bearing, to never forget they are always in the spotlight, and to never forget they are always part of a team, because when bearings work together they can move large things. He also uses bearing as an acronym:

B - Believe in yourself and God
E - Endure through tough times
A - Accept responsibility
R - Remain unconquered
I - Identify with others who are excelling
N - Never quit
G - Give to others

This podcast is being released just in time for Independence Day weekend, and it seems appropriate to reflect on the career of a dedicated military leader and combat veteran as we remember that freedom is not free.


Transcript: A transcript of the podcast is available here.


Podcast Outline

Time Topic
0:01:49 Educational background, majoring in Sociology and English
0:03:39 Getting involved with Army ROTC
0:06:50 Experiences in ROTC
0:08:02 Commissioned as a Medical Service Corps Officer (MSCO)
0:09:05 Medical Service Corps description
0:10:12 First duty assignment as a MSCO
0:12:10 The transition from ROTC to active duty
0:15:07 Initial leadership lessons in active duty
0:16:04 Decision to stay in active duty
0:17:08 The importance of company command
0:19:56 Decision to become an operator in the Medical Service Corps
0:23:44 Being a Medical Planner
0:24:34 Attending the School of Advanced Military Studies
0:27:10 Planning and coordinating delivery of health services in Afghanistan and Iraq
0:30:05 Lessons learned from working with foreign nations
0:31:12 Healthcare operations in the Office of Army Surgeon General
0:32:52 Difference between being a company commander and a battalion commander
0:36:12 Serving as a Brigade Commander for the Army Medical Recruiting Brigade
0:38:45 What is a Medical Brigade? Serving on the 37th Medical Brigade
0:41:50 Organizing and planning healthcare delivery in the G3
0:46:50 Goals for the G-3/5/7 Organization
0:48:20 Worries in the current role
0:49:30 Common misconceptions/understanding the Army Medical Department
0:52:52 Personal leadership philosophy
0:54:50 Characteristics of a good leader
0:57:20 What do you look for in a leader?
0:58:13 Leadership advice for young leaders


Links Discussed

Morgan State University

US Army Medical Service Corps

School of Advanced Military Studies (SAMS)

Press Release About BG Dingle's assignment to the G-3/5/7

Army Medicine 2020 Campaign Plan



Thanks to Sameer Panesar for production support.


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