Dr. Kaplan, Vice Chairman of Emergency Medicine of the Ochsner Health System and Immediate Past President of the American College of Emergency Physicians, has a passion for physician well-being. He quotes the Joint Commission Resources Presentation of 2006 and states: “Leadership has been identified as the most important ingredient in transformational improvement.” He sees developing physician leadership as a tool to prevail over an epidemic of physician burnout. Further, he says that preserving the mental health of clinicians and teaching them to be leaders drives superior results for patients.
Dr. Kaplan sees the current state of physician well being in a state of decline. Traditional corporate focus is on productivity, EHR, efficiency, quality benchmarks, and the patient experience. The well being of the clinicians that drive this healthcare engine has been overlooked. Surveys of lifestyle and physician burnout indicate that within the past 5 years, burnout has increased by 25%. Over 50% of physicians now report burnout symptoms.
“As physicians, we are trained as healers” states Dr. Kaplan. He notes that physicians are not trained as leaders and physicians are not trained to understand and manage the complex healthcare systems that we operate. Dr. Kaplan further notes that the first step for a leader is to answer these questions: “What do you want to be known for?” and “What do you want your department/practice to be known for?”
So the clue to a great patient experience is not your expertise in disease diagnosis, but to create a positive environment of healthcare delivery. Specifically, great healthcare is delivered by happy employees including happy doctors. Needless to say, unhappy staff and unhappy doctors do not lead to happy patients. But the problem is more than patient happiness, as research suggests burned out physicians deliver worse clinical outcomes for patients as well.
Dr. Kaplan teaches leadership to emergency physicians through the American College of Emergency Physicians as well as to clinicians and administrators in medical practices, hospitals and health systems. Dr. Kaplan has identified a leadership and accountability foundation:
#1: Define your vision. Define your destination. “What is it that I want to be known for?” “What is it that I want my department to be known for?” When training clinical leaders, Dr. Kaplan does not stop at theory, but insists that his group identify what 1-2 things they are known for now and what 1-2 things they want to be known for in one year. He applies the same lesson to their departments. Dr. Kaplan has them identify the first steps on their path and their biggest obstacles.
He asks; “In your ER, do you encounter smiling faces?” Does the staff indicate that their goal is to provide the finest quality of clinical care in the United States? Dr. Kaplan made this goal into a wall plaque for each ER patient room. Dr. Kaplan also endorsed the use of wall plaques which endorse service goals. His team took a 40 percentile ER in New Jersey and turned it into one of the highest rated facilities in the United States for patient satisfaction.
#2 Engage your people. There are specific tools and tactics to facilitate engagement. Dr. Kaplan says: “You want your people to buy into a vision and make it their own.” Dr. Kaplan wants leaders to communicate: “I care for and about you. I care about how you feel by the time you reach the end of the day. What’s working here? What can we do better?” As a leader, you want to be stepping in and removing aggravations.
#3 Clarify your expectations. “What does it mean to be on board?” This includes both quality of care and customer experience expectations. These are actionable behaviors. You will report to duty on time. You will knock on the door and introduce yourself to everyone in the room. You will sit down at the patient bedside, etc. By clarifying your expectations, simply being cheerful is not sufficient, but being cheerful providing organized excellent care does meet expectations. Physicians who communicate better with their patients gain higher empathy ratings from their patients. Dr. Kaplan makes the point that quality requires patient engagement and trust – and patients are more likely to follow through with therapy when they have a positive trusting relationship with their care team.
Dr. Kaplan does not stop measuring healthcare quality at the door. He states: “Quality is about patient outcomes.” He draws a distinction with other businesses. He doesn’t like the term “customer service” in healthcare. He states: “We don’t want patients to be our customers, we want them to be our partners. We cannot say the healthcare team is just the clinicians. The healthcare team includes the patient and their family.”
Dr. Kaplan’s primary focus for the Ochsner Health System is improving health outcomes. He has trained clinicians nationwide in his tools through coaching and leadership retreats.
Dr. Kaplan left me with a quote at the end of the interview. He quoted Bryan MacMahon from the book The Master: “No idealistic goal can be achieved through fear. It needs to be inspired through some kind of contagious or dynamic love.”
Dr. Jay Kaplan was interviewed by Dr. Thomas Masterson, editor of Vox Salutem.
Dr. Jay Kaplan received a Doctor of Medicine degree from Harvard Medical School located in Boston, MA. He then completed a Residency and Fellowship in Family Practice at the University of California, Davis, Sacramento Medical Center. Throughout his career, Dr. Kaplan has held several leadership roles such as Chairman of the Department of Emergency Medicine and Medical Director of MICU at Saint Barnabas Medical Center, Chief of Emergency Medicine for the Saint Barnabas Health Care System, Vice President of Medical Affairs at Emergency Medical Associates, and Director of Service & Operational Excellence for CEP America. Dr. Kaplan has also operated as a faculty member while serving as Clinical Assistant Professor in Emergency Medicine at Mount Sinai School of Medicine. He is an active member of the American College of Emergency Physicians and the Society for Academic Emergency Medicine.