Saturday, October 1, 2016

Lucy C. Hodder, J.D., Director of Health Law Programs and Professor of Law


Today’s guest is Lucy Hodder, Director of Health Law Programs and Professor of Law at the University of New Hampshire School of Law, and a member of the Institute for Health Policy and Practice in the College of Health and Human Services also at the University of New Hampshire. With her dual appointment, she both helps train the next generation of attorneys in the state in the application of legal principles to health care, and works with the Institute on some of the most challenging health care problems facing the state today.

In this podcast we explore Lucy’s career, a journey that took her back and forth between public service and private practice in several states and regions of the country, including working in the office of the New Hampshire Attorney General, being a senior shareholder in the firm of Rath, Young and Pignatelli, and finally before joining the faculty at the University of New Hampshire, serving as the Legal Counsel to the Governor as well as senior health policy advisor.

I think the thing that struck me most about my interview with Lucy was her commitment to service throughout her career. From the time she was in law school to through her time in a high powered private practice, she made time to provide public service. When the governor asked her to serve as her legal counsel, Lucy’s career was in full bloom. She shares the advice she received from Tom Rath, one of the principals in her firm, and he told her: “You practice in the New Hampshire Bar, when a governor asks you to serve, you have to be hard pressed to say no… that’s what we’re here for, that’s what we do in New Hampshire… when the governor asks you to serve you should say yes.” I think that says a lot about not only Lucy and her firm, but the legal community in New Hampshire.



Transcript: A transcript of the interview is available here.


Podcast Outline
Time         Topic

0:02:30 educational background, interning with a Federal Judge
0:06:15 Georgetown Law; teaching "street law", domestic violence clinic
0:10:25 clerking for a federal judge in New Orleans (and where to eat)
0:13:50 first job in private practice at Brobeck, Phleger, & Harrison in San Francisco
0:19:17 Assistant Attorney General, Civil Bureau, New Hampshire Department of Justice
0:25:44 leaving government service to go back to private practice
0:26:54 private practice with Rath, Young & Pignatelli
0:28:27 becoming chair of the Healthcare Practice Group
0:30:22 being a successful healthcare attorney
0:31:45 what is a "shareholder", governnance of a law firm
0:34:08 developing a client base as an attorney
0:35:50 the effect of the PPACA on her practice
0:36:57 legal counsel to the Governor, back to government service
0:41:15 issues the legal counsel to the Governor advised on
0:43:54 coming to UNH, establishing the health law program
0:46:25 dual appointment with Law School and CHHS
0:48:40 teaching health law
0:49:20 working with the Institute for Health Policy and Practice
0:50:48 critical health policy issues today
0:52:02 teaching health law as part of health management education
0:53:23 leadership and influence
0:54:44 leadership without authority
0:56:30 mentorship, finding a mentor
1:01:00 organizational culture
1:02:12 professional reading on health policy
1:03:44 advice to early careerists


Links to Selected Topics Discussed



Previous interview with Director of Institute of Health Policy and Practice













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Thursday, September 15, 2016

Raymond A. Levy, Psy.D., Executive Director, The Fatherhood Project



Today's guest is Dr. Raymond A. Levy, the Executive Director of the Fatherhood Project. The Fatherhood Project is a non-profit fatherhood program in the Department of Psychiatry at Massachusetts General Hospital (MGH), Boston, MA. The mission of the program is to improve the health and well-being of children and families by empowering fathers to be knowledgeable, active, and emotionally engaged with their children.

Dr. Levy is a clinical psychologist specializing in psychoanalysis, with over thirty five years of experience in the field. In this podcast we talk about the training Dr. Levy underwent to become a psychotherapist and his career leading up to his founding of the Fatherhood Project. We then talk about the origins of the Fatherhood Project, the kinds of programming and research Dr. Levy’s team undertakes, and the challenges of running a small, mission oriented non-profit.

I think listeners will get a lot out of this interview. First, Dr. Levy does a very nice job explaining the field of psychotherapy which is very interesting. Second, his discussion of how the Fatherhood Project grew out of a research project is enlightening about the origins of great innovations.

Links to the Podcast:
Anchor: https://anchor.fm/healthleaderforge/episodes/Raymond-A--Levy--Psy-D---Executive-Director--The-Fatherhood-Project-egra79
Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge
iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Transcript: A transcript of the podcast is available here.

Podcast Outline
time topic
0:02:07 educational background and early experience
0:07:29 what is psychotherapy?
0:08:53 what does success look like in psychotherapy?
0:10:23 the psychodynamic approach - getting beyond our adaptations
0:14:25 early career, getting established as a provider
0:18:02 achieving competence as a provider, the ongoing process of supervision
0:22:12 peer supervision
0:24:13 psychiatry vs. psychology
0:26:53 finding the right tool for the right problem
0:27:59 appointments at medical schools, teaching at affiliated hospitals
0:29:35 changing affiliation to Massachusetts General
0:30:31 inpatient vs. outpatient care
0:31:37 common misperceptions about psychotherapy
0:33:00 the origins of The Fatherhood Project
0:37:25 the Harvard study of adult development
0:38:27 adding programming to The Fatherhood Project
0:40:13 the evolution of the Project
0:41:24 the role of Executive Director
0:42:30 the significance of publishing in academic journals and presenting at academic conferences
0:45:38 The Fatherhood Project programs
0:52:03 evaluating the effectiveness of programs
0:52:51 the link between psychotherapy to parenting
0:55:20 what makes a good father?
0:57:50 the Fatherhood Project as an organization
0:59:25 financing the organization
1:00:35 advice to people who want to start organizations like the Fatherhood Project
1:02:03 the most significant challenges of running the organization
1:05:15 what should early careerists in healthcare admin know about mental health?

Links to Selected Topics Discussed

The Fatherhood Project

Father's Day and the Evolving Role of a Dad - short article by Dr. Levy

William James College (Formerly the Massachusetts School of Professional Psychology)

Massachusetts General Department of Psychiatry

Harvard Medical School Department of Psychiatry



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Thursday, September 1, 2016

Luanne S. Rogers, President & CEO, The Courville Communities


Today’s guest is Luanne Rogers, the President and CEO of The Courville Communities, a long term care system in southern New Hampshire. The Courville Communities include two nursing homes, assisted living communities, and retirement apartments. The Courville Communities is a private, family owned organization, something that is becoming less common as corporations have come to dominate the competitive landscape.

In this podcast, Luanne talks about her thirty-year journey through a field that has gone through many changes. Her career began as a nursing assistant in Chicago, Illinois, working to put herself through college and has included working for privately owned facilities as well as national chains. I really enjoyed my conversation with Luanne. Her passion and commitment to the field is remarkable. 


Transcript: A transcript of the podcast is available here.

Links to Selected Topics Discussed

The Courville Communities

Kindred Healthcare

Loyola University

Genesis Healthcare




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Monday, August 15, 2016

John R. Fernandez, President and Chief Executive Officer, MEEI



Today’s guest is John Fernandez, the President and CEO of the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts. Mass Eye and Ear is one of the world’s leading specialty hospitals dedicated to ophthalmology and otolaryngology care, or as John says, they take care of everything from the neck up except the brain, but maybe the brain too sometimes. 

In this podcast John talks about his journey to leading this world class organization, including his progress into the executive ranks at another world class Boston organization, the Brigham and Women’s Hospital. Throughout the interview, John talks about his management approach, which focuses on the fundamentals: plan, execute, follow up. While this sounds like a fairly simple formula, I think anyone who has tried it knows that simple isn’t always easy. John tempers his management approach with a focus on kindness, which was something heartening to hear from a senior executive. 

One of the things that is clearly important to John is work life balance. We talked about work-life balance both before and during the interview, and one of the pieces of advice he gives to early careerists is to get your personal life sorted out first, and then figure out what you want from work, which was interesting advice. John has a series of questions that he gives people to help guide them through that process. You can find a reproduction of the slides he shared with me with the questions here.


Links to the Podcast:
  
Transcript: A transcript of the podcast is available here.


Podcast Outline

0:02:19 Education the College of Wooster
0:04:41 starting out in management consulting
0:08:11 University of Pennsylvania, Masters in Government Administration
0:11:02 starting in healthcare at Boston City Hospital
0:15:50 learning healthcare, discovering management problems
0:18:27 watching the "craziness of healthcare", up close
0:19:50 planning and following up - the secret of management
0:20:40 The One Minute Manager - giving feedback
0:22:04 Are leaders made or born?
0:24:43 Management is difficult - not everyone is cut out for it
0:27:17 about Brigham and Women's Hospital, "a young organization"
0:29:45 "The Pike" - how physical plant affects culture
0:31:07 Dr. Michael Zinner, new Chief of Surgery and new opportunity
0:34:10 becoming Vice President for Surgical Services, Brigham and Women's
0:35:37 relationship between the administrative and clinical leadership
0:44:14 leadning up to VP - honing people skills, planning skills, space planning
0:45:56 the responsibilities of being a Vice President at Brigham and Woman's
0:50:53 expanding VP portfolio - 2100 FTEs and $300M budget - changes to leadership
0:57:34 the importance of not appearing too busy - special projects
1:00:17 Massachusetts Eye and Ear Infirmary - background
1:02:17 what is a "specialty hospital"?
1:03:27 basic research vs. clinical trials
1:04:20 how do patients come to be seen at MEEI?
1:06:52 Affiliate of Partners Healthcare
1:08:41 Governance and the Role of the MEEI Board
1:14:47 a day in the life of the CEO
1:15:40 assembling the right team as CEO - it's about fit
1:18:18 organizational culture
1:20:01 leadership philosophy - plan and execute, how can we be kind
1:21:34 advice to early careerists



Links to Selected Topics Discussed

Massachusetts Eye and Ear Infirmary

The One Minute Manager

Partners Healthcare

Brigham and Women's Hospital

Boston Medical Center

University of Pennsylvania, Government Administration

College of Wooster



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Monday, August 1, 2016

Katie Fullam Harris, SVP of Government Relations and Accountable Care Strategy, MaineHealth


Today's guest is Katie Fullam Harris, the Senior Vice President of Government Relations and Accountable Care Strategy for MaineHealth, in Portland, Maine. Katie oversees the development, implementation and coordination of state and federal advocacy on behalf of the MaineHealth System, and also leads the development and implementation of strategy that supports improved access and value for health care consumers and purchasers and the alignment of incentives for providers in the MaineHealth System. Prior to coming to MaineHealth, Katie worked in a variety of not-for-profit, government, and for-profit institutions.

In this podcast, Katie and I discuss her career journey, then transition to talk about what it’s like to manage government relations and health policy for the largest integrated health system in the state of Maine, and the challenges of trying to move a large system towards paying for value. We conclude with a discussion about influence and leadership.


We cover a lot of ground in this interview, especially around the recent evolution of health policy. I think early careerists in particular will get a sense of the importance of integrating proactive government relations in a large healthcare organization.



Transcript: A transcript of the podcast is available here.

Podcast Outline

0:02:05 Educational background
0:02:54 Government relations, Planned Parenthood of Northern New England
0:07:30 Maine Department of Mental Health, Mental Retardation, and Substance Abuse Services
0:13:07 Director of Development, Sweetser
0:15:53 Program Director, Maine Development Foundation
0:18:57 Director of Government Relations, Anthem Blue Cross and Blue Shielf of Maine
0:25:27 MaineHealth overview
0:27:55 impact of Maine's geography and demographics
0:30:15 efforts toward population health
0:31:32 primary care and case management program for underinsured
0:32:24 Government Relations at MaineHealth
0:34:20 Employer Relations at MaineHealth
0:36:55 promoted to Senior Vice President - developing risk-based contracts
0:44:07 "accountable care movement"
0:46:03 Effect of the ACA on MaineHealth
0:52:30 a day in the life of Katie Fullam Harris
0:53:38 working with the MaineHealth affiliates
0:58:13 importance of bringing government relations in early
1:00:02 concerns about the future
1:01:19 leadership philosophy
1:02:01 characteristics of a good leader
1:03:16 organizational culture
1:04:59 career mentors and what they do
1:09:37 where do early careerists go wrong?
1:12:18 most frequent advice to early careerists?
1:13:28 read anything by Atul Gawande
1:14:16 opportunities in health administration


Links to Selected Topics Discussed

MaineHealth

MaineHealth Strategic Plan

Planned Parenthood of Northern New England

Sweetser

Maine Development Foundation

Anthem Blue Cross and Blue Shield of Maine

Atul Gawande


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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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