Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 122 | December 15, 2020
Achieving Excellence In Healthcare
Founder of The Studer Group
Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, It’s my incredible honor to have as my guest, Quint Studer. He is a businessman, visionary, entrepreneur, and a natural mentor to many. He’s worked with individuals at all levels of leadership and across a variety of industries to help them become better leaders and create high performing organizations. You will learn about Quint’s gift for translating complex leadership and business strategies into simple behaviors that allow long-term success and profitability. Quint is a teacher at heart and began his leadership journey teaching special needs children, He has held several leadership roles in healthcare including President of Baptist Hospital in Pensacola, Florida, leading that organization to the top 1 % of hospitals nationwide in both patient and employee satisfaction. In 2000, Quint formed the Studer Group and put patient experience on the map by connecting patient care and customer service. He has authored nine books, including The Busy Leaders Handbook and Results That Last. Both reached number five on Wall Street Journal’s bestseller list.
Quint tells us that one of the greatest gifts he’s ever had was becoming a special education teacher. He shares a story how patient experience changed his career. He makes a point to discuss the difference between stress and trauma. Quint commends Dr. Orsini for teaching doctors how to have uncomfortable conversations with patients. Dr. Orsini discusses Quint’s latest book, The Busy Leader’s Handbook. In his book, Quint talks about 2 key characteristics of a good leader: humility and self-awareness. Quint talks about one of the biggest challenges in healthcare. Dr. Orsini shares great advice to “watch the good guy.” We end with Quint sharing stories and advice about learning how to say thank you and how important it is to know how to break bad news and have difficult conversations with people today. If you enjoyed this podcast, please hit the subscribe button to find out more about what we do and how we teach communication.
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Quint Studer (1s):
One of my messages for years in healthcare is learn how to say, thank you. Learn how to look what’s right,
because I think in health care, Tony, we filter out the positives. You take the patient home that you didn’t
work, you take the employee home, that you weren’t effective with, and you miss all of the positive things
that have been done. And so, you know, were a big believer that if you start off with meetings with the wins,
you end of the day with what are you here to be grateful for? Because I think health care or any leadership is
a great, great position, but I just think we just get worn down because we play defense instead of offense,
because we find out what’s wrong instead of focusing on what’s right.
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr.
Orsini is a practicing physician and the President and CEO of the Orsini Way. As a frequent keynote speaker
and author Dr Orsini, has been training healthcare professionals and business leaders how to navigate
through the most difficult dialogues. Each week you will hear inspiring interviews with experts in their field
who tell their story and provide practical advice on how to effectively communicate. Whether you are a
doctor faced with giving a patient bad news, a business leader who wants to get the most out of his or her
team members, or someone who just wants to learn to communicate better, this is the podcast for you.
Dr. Anthony Orsini (1m 28s):
Well, I’m honored today that the Orsini Way has partnered with the Finley Project to bring you this episode of
Difficult Conversations: Lessons I learned as an ICU Physician. The Finley Project is a nonprofit organization
committed to providing care for mothers who have experienced the unimaginable, the loss of an infant. It
was created by their founder Noelle Moore who’s sweet daughter Finley died in 2013. It was at that time that
Noelle realized that there was a large gap between leaving the hospital without your baby and the time when
you get home that led her to start the Finley Project. The Finley Project is the nation’s only seven part holistic
program that helps mothers after infant loss, by supporting them physically and emotionally.
Dr. Anthony Orsini (2m 11s):
They provide such things as mental health counseling, funeral arrangements, support, grocery gift cards,
professional house cleaning, professional, and massage therapy and support group placement. The Finley
Project has helped hundreds of women across the country. And I can tell you that I have seen personally
how the Finley project has literally saved the lives of mother’s who lost their infant. If you are interested in
learning more or referring a family or donating to this amazing cause please go to the Finley Project.org. The
Finley Project believes that no family should walk out of a hospital without support. Well, welcome to another
episode of Difficult Conversations: Lessons I learned as an ICU Physician.
Dr. Anthony Orsini (2m 52s):
This is Dr. Anthony Orsini and I will be your host again this week as well. Okay. Everyone, each and every
week, I promise you, by the end of the episode, you’ll feel inspired and you will have learned a valuable
communication skills that will help you be more successful in your professional and your private life. Well get
ready because this week I have the incredible fortune and honor to interview one of the biggest experts in
the fields of leadership in health care and in business, whose name is frankly considered as synonymous
with a patient experience. And you’d be hard pressed to find anyone in health care that doesn’t know his
name. So you are tuned into this podcast will be inspired and to learn while there is so much a bolt in this
man that I can literally do 10 weeks of interviews, and you’ll still be learning something new every day.
Dr. Anthony Orsini (3m 40s):
Today I have the honor. And the pleasure to introduce to you Quint Studer. Quint is a businessman, a
visionary, and an entrepreneur, and a natural mentor to many. He has worked with individuals at all levels of
leadership and across a variety of industries to help them become better leaders and create high performing
organizations. As you will quickly realize during this interview, Quint has a gift for translating complex
leadership and business strategies, into simple behaviors that allow organizations to achieve long-term
success and profitability. He is a teacher at heart. In fact, he began his leadership journey working with
special needs children. And we’re going to talk to him about that today.
Dr. Anthony Orsini (4m 20s):
He entered the healthcare industry in 1984 as a community relations representative. He then went on to hold
leadership positions at mercy health system in Wisconsin and Holy cross hospital in Chicago, Illinois, where
their initiatives in patient care lead to their winning Hospitals Magazine’s greatest comeback award. In 1996,
he became president of Baptist Hospital in Pensacola Florida and lead that organization to the top 1% of
hospitals nationwide in patient and employee satisfaction. That’s quite a feat. In 2000, Quint formed the
Studer group to help hospitals achieve the same results as he brought to Baptist Hospital. He frankly put
patient experience on the map by connecting patient care and customer service.
Dr. Anthony Orsini (5m 4s):
Through his work at Studer group, he served as a role model for hundreds of CEOs and other administrative
leaders around the country. Studer Group became the go-to patient experience in hospital leadership
consultants. And during that time, he was honored to receive several accolades for his leadership. Quint has
authored nine books. In addition to the Busy Leaders Handbook, which reached number five on wall street
journal’s bestselling list. We want to talk about that a lot today. His book Results that Last also made the wall
street journal bestseller list and in the great employee handbook he shares insights from working with
thousands of employees during his career. Now, let me tell you every time I read one of his books, the first
thing that comes to mind is a list of friends and families that I want to purchase it for a present.
Dr. Anthony Orsini (5m 50s):
So if you want to be successful, these are books that are really on the mandatory reading list. Quint has
spoken to a variety of audiences across the United States, and it is nationally recognized expert regarding
leadership. He is often interviewed by radio and TV shows as well as magazines and newspapers across the
country. And I’m deeply humbled that he’s agreed to do this podcast. He and his wife are residents of
Pensacola Florida, they’re passionate about giving back to the community and they share their time and
resources with local and national nonprofit organizations. Well, thank you Quint this is quite an honor, and
that’s quite a lengthy introduction. How are you today?
Quint Studer (6m 28s):
I could have done the same thing and I want to thank you. You know, I’ve got your book. I keep it on my
desk. It’s all on the Delivery and I just will tell you a real quick, I love page 70. Tell me, I forget, show me, I
remember and involve me I understand. I also like your comparison with, if you’re a spikes in your program,
you hit the toughest issue in healthcare and leadership is that these difficult conversations. So thank you for
what you’re doing to make healthcare better.
Dr. Anthony Orsini (6m 55s):
Thank you so much coming from you that means a lot. And I’ve been in really forging forward with my
passion to teach communication. We’ll talk about that in a little bit. You know, at first I think is probably a
good idea. If you don’t mind, just to tell the audience, I kind of started this way all the time, who is Quint
Studer and how did you get here?
Quint Studer (7m 12s):
I got here with a winding road and I think I volunteer my time a lot in particularly in university settings,
teaching healthcare administration, sort of a, if you do have an hour and you want to have some of these
speak to your class, and I get this question quite a bit, and these are students that are great universities that,
you know, get their bachelor’s, their master’s. Mine was an interesting journey. My parents didn’t go to
college. I was lucky enough to go to college. I didn’t know what to major in. So my first two years, Tony was
like, what they call undecided major, and then 60 hours they call you in. And they say, you’ve got to pick a
major. Or courses you’re taking might not count toward graduation.
Quint Studer (7m 53s):
And I had like a four year deal. I didn’t have a four and a half or a five. I had to get out four. And so I thought
of people that had a huge impact on my life. And one of them was my high school soccer coach. And, and in
a study hall, he let me come into his classroom and work with his students, to work towards a special
education teacher. That’s what he was. So I became a special ed teacher and it, it was one of the great gift
I’ve ever had. ’cause I think what I’ve really done is taken what I have learned there into all of my jobs.
There’s no, I’m just been working on the same game plan in different fields, which is you diagnose, you start
off an assessment. You’re a physician.
Quint Studer (8m 33s):
And the challenge in leadership sometimes is we just don’t slow down to do an assessment. We read a good
book, or hear a consultant. When we rush into a treatment plan without doing an assessment, then you set a
lofty goal. Then you get everyone on the same page and then you take, and you break it down into steps,
just like you are. You know, I meet Tony so many doctors that they call me and they say, Quint, you know,
I’m now in administration. What should I do? I say, use the same skill sets you used as a physician, but
instead of a patient, you now have an organization. Frank Burn was probably the first Physician that when he
was a part of you ended up in a Madison, Wisconsin that I had this conversation with that.
Quint Studer (9m 14s):
So I did that. Then I ended up working in a behavioral medicine center, which I loved. It was 35 beds ended
up working in, in hospitals. You know, I got assigned patient satisfaction. I mean, I just happen to be the guy
who drew the short straw of that day at an administrative meetings. Our CEO, Mark Clemat was going to
divide us all up. We were sort of a new administration team and he gave our chief nurse officer quality,
clinical quality at the time. He gave our human resource person, employee engagement, employee turnover,
and he gave our CFO finance. And there’s this thing called patient sat, which was the fourth little thing.
Seeing they all had something, he turned to me and said you’re in charge of patient satisfaction.
Quint Studer (9m 58s):
And I did the same thing I had done everywhere. I did diagnosis. I was, I think the first hospital administrator
that I ever went to the press Ganey and sat on site to understand the tool and how it works. And then I came
back and started benchmarking places like Southwest airlines and other places and, and how you do it. And
then I came back and I was desperate enough that I actually started doing some of these things. And then
they sort of worked and then Tony what happened to me is I got discouraged in healthcare and I wasn’t
enjoying it like I used to because I’ve got into it. I like that. But then, you know, all we talked about at
meetings where FTEs and adjusted occupied beds and market share and should we take risk or not take
risks, should we be capitated or not be capitated?
Quint Studer (10m 44s):
And it wasn’t like a special ed or any of those things. And, and I got lost Tony and I don’t even know I got
lost. I just know it wasn’t fun anymore. And I don’t mean fun, just wasn’t feeling worthwhile. And then I’m
doing this patient sat stuff, which meant I had to go up on the units and ask a nurse’s what we should be
doing. And all of a sudden, after about six, seven months of it, I started getting the letters that people would
write to the hospital about their care started funneling to me because I’m now the patient sat guy, and some
of them were complaints. But one day I get this letter that just talks about their father dying in the hospital
and how this nurse held his father’s hand until he could get there.
Quint Studer (11m 27s):
And he said, I hope you appreciate that nurse. And because I had been gone up on units because I had
been doing behavior that was different than I have been. I rediscovered purpose worth while work on making
a difference. And that’s what changed my career. As a patient experience changed my career cause a nurse
made a huge impact. Like they do every single day.
Dr. Anthony Orsini (11m 48s):
That’s a great story. And I was when we were speaking, or I’m thinking about the issues that we have today
with physician burnout, with employee engagement in the healthcare system, and what you said, you were
going through about thinking more about FTEs than about the patient. I think today it’s worse than ever
where doctors and physicians are often forgetting why they went into medicine in the first place. So I do my
workshops about patient experience and communication I do a little thing and it’s in my book about physician
burnout. And we’ve been told for a, a a hundred years physicians that the best thing to do not to get burned
out is to just treat it like a business and not make those human connections.
Dr. Anthony Orsini (12m 32s):
It goes back to the 1912 believe it or not when Dr. Osler gave his speech to physicians who were graduating
John Hopkins and said, you can only be a good physician if you detached yourself. And so that’s exactly the
opposite because I think exactly what you said, once you started talking about the patient and you heard that
story about the nurse who held the patient’s hand, you got excited again. And I think that’s what I’m trying to
get doctors to get excited about again. Right?
Quint Studer (12m 60s):
I think you’re absolutely right. I think sometimes we hear things and because we hear it from people, me and
might respect with all good intentions, we think it’s accurate. And maybe it was at one time or maybe it
wasn’t. So here’s a couple of myths that I had to stop listening to. One of the myths was you balance your
positives and negatives. So if I compliment you, I also criticized you. I’m a one on one guy. Well, then I found
out I was completely wrong. One-on-one creates negative relationships at two to one creates neutral to
positive, to one criticism, three positive to one criticism creates positive relationships. So let’s go back to
Healthcare. We are trained you as a physician.
Quint Studer (13m 42s):
Other people are trained to notice what’s wrong. When I come to you, it’s not for a Well person checkup
probably. And in fact, I will tell you, and I like this about physicians. When I would go to my, one of my
doctors, I’d walk in, in the first thing they would say is what seems to be the problem or once a month. And
I’m glad they did that because that is why I am there. However, we have to be careful in our culture because
in our culture, it’s a little bit different. So I find that many of the things that I tried to create, where things to
play off the fence to find out what’s right. So when you look at a doctor, particularly by Dr is used to hearing
from anyone in health care or what pharmacy doesn’t call them with a compliment.
Quint Studer (14m 25s):
You, you know, the OR doesn’t call them to say, good news. Dr we’re running on time. I can’t wait to hear
what that patient is going to be ready for you. We normally only talked to the physicians when we have
something negative to say to them, and then we wonder why they get wore out. You know, I tell people when
you see a physician come down the hallway, if you say to them, can I talk to your doctor? There are already
coming up with an exit strategy to avoid that conversation because it’s not going to be positive. And some of
my greatest memories is when you start recognizing physician’s in a positive way and watch them flourish.
Quint Studer (15m 5s):
So I think healthcare has been built on a culture of what’s wrong. And I get that. We have to find out what’s
wrong, but we miss what’s right in my book, “healing physician burnout” I think I was ahead of the game. I
got a phone call from Dr. George Fort in San Antonio. He said, Quint, you’ve got to deal with burnout. She
sent me 72 pages of research. I wrote a book on it, but I think I was just not at the right time, but I had
moved from there. And I, and I go on a little bit here because I think it is so vital. Diana Handel wrote a book
recently is going to be coming out. In fact, I wrote the foreword and she is a CEO that decided that she
ended up being in post traumatic stress syndrome from her role as a CEO of a hospital and reading that
book, I came up with the new awakening.
Quint Studer (15m 51s):
That, you know, Tony, you know, we all know the pain scale. If I had come to you and I say your, a patient,
and I say on a one through 10 with a smiley face and the sad face, what are you? You are gonna say a six or
a four. I’m not gonna say to you what, you shouldn’t be a six. You should be an eight so that you have a
great pain threshold. Or I don’t say, well, you should be a two. You big wimp. I just acknowledge that your a
six, because you feel like you’re a six. Well, I think when you look at healthcare today, we’re so focused on
stress and resiliency. We might be misdiagnosing the organization because when I look at what’s happening,
we might actually be on the verge or in trauma.
Quint Studer (16m 37s):
And I think if we don’t treat it right, you know, if you treat stress and this is new stuff, so I’ve never talked
about this before on the air, because it’s just all new learnings for me. Fantastic. I got an exclusive. So what,
what happens is I was all about, I actually create, help create a stress tool kit. So that’s where I was two
months ago. And of course resiliency is. So if I treat you for stress and tell you meditate, eat right exercise,
it’s going to be healthy for you. But if you have trauma, it’s not enough. So if you look at this stress, I’m
creating a pain threshold for our organizations. And so I think if you want to be a leader, you always gotta be
looking around corners.
Quint Studer (17m 18s):
You’ve got to be figuring out what’s coming. And I think right now where health care is at, you mentioned, you
mentioned burnout, doctor suicide it’s because I think we are treating it as stress when really we’re really in
trauma. And let me quickly just to give a quick thumbnail definition, stress is usually something that, you
know, I’m stressful, but I’m going to go back to normal when it’s done. You know, you’re applying for medical
school, there’s a lot of stress, but why once you get accepted the stress changes. You have a talk, stress
changes. So there is stress we all go through it. But normally when we go through the situational stress, it
gets better. Or we go back to normal. Now the challenge is with trauma.
Quint Studer (17m 59s):
That’s a little bit different. With trauma, It can be one incidents or can be multiple. But if you look at trauma,
we know we’re not going to go back to the way it was. We feel powerless. We feel hopeless and we’re losing
trust for what’s going on in the situation. And our job is changing. Our role is changing. It’s now think of
COVID-19 you’re a physician or your role is different because now your a tele-health physician you’re using
different technology than you’ve ever used before. They’re still adjusting to electronic health record. They’re
changing your RV use. They’re changing the payment methodology.
Quint Studer (18m 40s):
You might even be asked right now to take a reduction in pay because COVID has hit the revenue streams
and you’re losing trust. And you’re feeling a little powerless and hopeless. So what are my hopes in 2021 is
to really start helping people call it what it is. I’m not saying that it’s trauma, it could be stress, but at least
we’ve got to help the organization diagnose themselves correctly. So I’m probably not the, maybe the topic
we all planned on, but I think you’re onto something when you mentioned burnout and what’s happening in
this year. So I’m very pleased that Diana Hendel who’s much smarter in this than me. He asked me, right,
the forward to her, a book on this, because I walked out of there saying there is a new light bulb that just
Quint Studer (19m 26s):
Its sort of like in patient experience, I had to move it from service excellence to If we do the right things we
will improve the clinical outcomes. ’cause when we start getting people to do difficult behavior or
uncomfortable behavior. When we connect it to the clinical outcomes with their values, your book is a perfect
example. I gave a talk two days ago on when we hit these crossroads, do we pick character or comfort?
Which way do we go? And I’d like to tell you that I always pick character, but I don’t at times I pick comfort,
but you know what you teach Tony, which has the most vital thing you teach is how to do those
uncomfortable things. But their the right things to do.
Quint Studer (20m 7s):
But when we do those uncomfortable things, eventually we’re more comfortable because we have done the
right thing. Your book is unbelievably great for people in health care. Cause the number one issue and all the
years I’ve done in healthcare is people struggle with difficult conversations, whether it’s with a patient, a
family member, a coworker, or their boss.
Dr. Anthony Orsini (20m 28s):
Exactly. And that’s something that Difficult Conversations is something that everyone has to do. Doesn’t
matter whether it’s in your professional, your personal lives. As you know, I started off with teaching the
Difficult Conversations to physicians on how to discuss tragic news. And then as time went by, I went into the
difficult conversations and how to communicate and build rapport and form relationships. And then right
before I did the podcast, it was really the basis of the podcast was that whether you’re in business for, in
medicine it’s really the same skill set. And I have to say, as we move into your book, your latest book The
Busy Leader is Handbook. I read that book and almost every paragraph of every sentence you were
speaking about how to be a good leader.
Dr. Anthony Orsini (21m 10s):
They realize that this book, you can easily take the word Leader put in Physician and you can easily take out
the word employee when you were talking about communication and put it in the word patients or nurses
that really it’s all about the relationships. And then how are you even say it on the it “leaders must be able to
build strong relationships. They are the foundation for everything else. And that communication is the basis
for that great communication from leaders. You say sets people to do their best work, helps them improve
and grow and connects them”. So that’s the parallel, right? Do you think that’s why you went from a business
person who taught leadership to a patient experience so smoothly because it’s really the same thing.
Quint Studer (21m 53s):
It’s my background and special ed, which was the same thing. Because when you go and keep going back to
this, but again, as a special ed teacher, you assess the situation, you set lofty goals. But the other thing you
have to do is build up trust. Then you build up trust by recognizing what’s right. And I think when I first got
into Healthcare people thought I was a nut job because I was so complimentary. But you know, when you’re
teaching special ed and I was in some schools with kids with lots of different, special, multiple needs, you
will learn how to recognize certain behaviors because you want that behavior to be repeated, recognized
behavior gets repeated.
Quint Studer (22m 34s):
And sometimes you recognize people for doing things such as sitting, when the class starts, putting stuff
away. We had a girl that would get so excited about popsicles, that she had put one in her mouth without
taking off the wrapper. And the first day she took off the wrapper, you had a thought she’d won an olympic
gold medal in. So I think my training in that was very helpful because I tend to notice what’s right. And I tend
to start with what’s right. It doesn’t mean you don’t have Difficult Conversations but you still build that
emotional bank account to noticing what’s right. So when you do have to take a withdrawal, you haven’t
bankrupt the relationship.
Quint Studer (23m 15s):
And I think that’s one of the great challenges in health care. We all get so busy. We don’t make those
deposits. And then the external environment, he starts making withdrawals on us. You know, I used to say to
the employees, you know, please, I’m not the one telling Medicare to not pay us this. I’m not the one that
there are certain things that the external environment drives that we’ve got to be able to manage. So I think
that was really helpful to me. I think again, when you are a special ed teacher, you also have be good at
Difficult Conversations because you’re sometimes telling parents that their child isn’t going to be as
independent as they would make their child to be there’s diagnosis that you wish you didn’t have to provide
to a, a family With that.
Quint Studer (24m 0s):
And there’s also some consequences. So one of the stories that I always tell is I taught at the high school
level for a while and we had, sadly, we had some kids that would be taken advantage of by other people in,
in the school system. Or you might have a girl that you have to tell her not to get into the car with anybody.
She doesn’t know not to take a drink. If she doesn’t know what’s in it or not to give money to people, these
are all students and in a, you wish the society wasn’t like that, but it was so we had to be very good about
consequences and accountability too. So I’ve just been really blessed. And you know, I remember years
ago, Tony, the hospital is that won a big award and a guy came up to me and he said it tongue in cheek.
Quint Studer (24m 46s):
He said, how does a guy who was a special ed teacher end up running a hospital? And I said, well, as a
special ed teacher here is what you did. And he looked at me and said, my gosh, I wish I had a degree in
special ed. It’s really good preparation for what we do.
Dr. Anthony Orsini (24m 60s):
Yeah, you talked about the characteristics of a good leader? One of the things that you talked about really
early on in the book is a good leader, has humility. And I call that genuine in my book as a good physician is
genuine and it’s a real person. And there is a lot of parallels between that again, wouldn’t you agree?
Quint Studer (25m 18s):
Well, I think the deal that anybody has to have is clarity and self awareness. So when I think of the word
humility, I don’t want to confuse it with false pride. So for example, if somebody comes up to you, Tony and
says, wow, that was a great presentation. You did a great workshop. I feel so much more comfortable now
going out and having these difficult conversations. And you say, Oh, it’s nothing. I’m just lucky. That’s false
pride. You’re pushing away a skillset. Humility is being able to see one as they are. It’s the clarity. And I think
that’s really vital because that means you see your strengths and you see what you’re not good in.
Quint Studer (25m 60s):
Periodically because I’m in Healthcare, you know, if you’re in a health care, people come to you just thinking,
you know, no more than, you know, so that we will come to me and they’ll say, well, Quint my doctor is
referring me to the specialist out of town. And I said, well, you should thank them because obviously they
feel that you can get treatment somewhere else beyond what they can offer you right now. I said the most
dangerous thing is somebody who doesn’t know their own boundaries and their own limitations. So that’s
that humility of seeing ourself clearly in my first chapter of my book, it’s self awareness. And I think that is
the key that opens the door to everything. So how, where am I? And sometimes I think of the older we get
Tony, the more self aware we get ourselves, but early on it, we need people around us to give us feedback.
Quint Studer (26m 48s):
I do that even today. I say, Hey, don’t let me go off grid. Don’t be afraid to push me when they have to tell all
the executives to do all the time, but their teams is throw out something they know is crazy and see who on
their team challenges them, because you need people that are going to challenge you and you surround you
with that. So, yeah, I think self-awareness on being genuine, being authentic. People ask me, what’s one of
the big skills every leader has that says to be authentic, to be themselves.
Dr. Anthony Orsini (27m 19s):
Yeah. And it’s really very important that you think of your boss as a real person who is not just your boss. It’s
also extremely important. I talk about it in my book that you think of your doctor as a real person. So I try to
teach doctors, don’t walk into the room and say, you know, what are you here for, walk into the room and sit
down and say, hi, how are you? Or if you’re really lucky, you can find some commonality with, Oh, are you
reading that book? Or I didn’t realize you’re a Tampa Bay fan. And then all of a sudden you become a real
person. And there’s this whole concept that I talked about called it’s hard to fire your best friend. Right? So if
your boss is your best friend, or do you feel that your boss is a trustworthy guy whose a real person or a
trustworthy girl, I think you’re going to give them more slack.
Dr. Anthony Orsini (28m 5s):
And that’s what makes a good leaders. Don’t you agree?
Quint Studer (28m 7s):
I think you’re going to share more. I think the reason people struggle when their physician retires or leaves or
they get referred to someone, is that idea of being vulnerable. You know, you have to have a story to start
Raphael Bueno is a doctor in Boston, who I have great respect for him as a lung cancer specialist at one of
the people who I admire greatly here, he got referred there for lung cancer. And by the time the fella got to
see Dr. Bueno, Dr. Bueno had actually look the guy up and knew something about him and talked to him and
sort of took interest in him. I think the, the issue always comes in to the fact Is are you interested or
interesting? And I think the big factors bring to the table is if I’m being interested in you, you’re going to be
Quint Studer (28m 53s):
You are going to be vulnerable. I mean, I’ve gone to mental health therapy on and off my whole life because
I’m a big believer in brain health. And I was going to a therapist named Martha Horton. And I used to tease
her. Cause I’d say on the way to her, my appointment, I’d wait till the last possible minute. Hoping she might
cancel, you know, something comes up, then I’d sit in before I would walk in, in, in case you want to cancel
the last minute, then I would sit here and say, here’s what, I’m not gonna tell Dr. Horton today. She’d come
meet me. At the time I had walked to her office. I’d already thrown out, but I wasn’t going to talk to her about.
She created that trust in that safe environment.
Quint Studer (29m 33s):
And that’s what doctors have such skill sets and doing because people have to feel safe than I can share
some embarrassing moments with you. I got a phone call from our friend maybe three months ago. And he
said, I got to tell you I’ve had suicidal thoughts. And I was so pleased he felt safe enough to tell me those
things right. And we can do something about it. So I think it’s that measure of feeling safe with yourself in a
safe environment and even what you teach Tony. And I’m a big fan of yours. When you do a workshop,
you’ve got to create the environment because you want people to practice it. You want people to
demonstrate it. Well, I’m not going to do it.
Quint Studer (30m 13s):
If I don’t feel I’m in a safe, safe environment. So one of the things that you do is you create that safe learning
lab environment for people to practice something that they feel it’s very difficult to do.
Dr. Anthony Orsini (30m 24s):
Okay. You really opened yourself up when you have to really start those show people how to communicate.
Cause its a skill. When I have been doing it for 10 years, With teaching the doctors individually, we’ve done
probably seven, 8,000 doctors by now teaching them how to communicate bad news. I have found it about
15% of the doctors that we train, no matter how young they are, knock it out of the park. They are just
natural communicators, compassionate people, 15% of them I have a real hard time and sometimes I feel
like I can’t teach them, but the other 70% are genuinely compassionate, great people who just want to learn
how to build that rapport. Get good communication. I suspect that in business it’s the same that most people
want to be good leaders and good communicators, but just need to be taught.
Dr. Anthony Orsini (31m 11s):
I guess my question for you is back to the business and where I’m trying to go back and forth and relating
business with health care and back and forth. The leader and the Physician. My question is, do you think if
you’re hiring a new manager or a new Leader I know you mentioned that in your book, how important
communication is . Do you pick the guy who could communicate or the girl who could communicate or do
you pick the smart person and the room and teach them how to communicate and be a leader? Can it be
Quint Studer (31m 36s):
It can be taught if the person who wants to be taught. Second chapter in my book, Busy Leader Handbook is
on once you’re self aware or are you coachable? Now, one of the challenges in healthcare Tony, you and I
both know is how we shortchanged training and development. We just short change people. And going back
to your research, as my research is about 34% of the leaders could probably learn this on their own it’s
natural, they’ll study it, but the rest of them need help. You don’t want to create an environment that they are
stoic people, health care people. So that they don’t want to raise their hand and say, why I need help on this
may be once in a while, I remember once again doing a training workshop years ago and a big health care
system, 75 doctors to this workshop I was doing.
Quint Studer (32m 24s):
And it was neat to see them over the day or two transform themselves from something that they thought they
could do. You know, sometimes we don’t know what we don’t know and the physicians truly are doing the
best job they can do based on what they know. And physicians that’s pretty challenging environment
because they don’t get to watch other people do it. Nobody says let’s double book physician’s in the ER
today. So they can learn from each other. Let’s watch this person. So, one of my favorite stories in the
emergency department, there was a healthcare system and they posted the patient satisfaction or a patient
experience scores by doctor.
Quint Studer (33m 3s):
And this doctor noticed that he was sort of at the bottom. No, he didn’t go to another doctor. He went to a
nurse and said, what are these guys are doing that I’m not doing. She said, well, here’s some things they do.
So I think you’ve got to almost create that training and the environment. So it’s not optional. It’s sort of
mandatory. And then when people get there, they get so much more out of it than they think you’re right,
Dr. Anthony Orsini (33m 31s):
I think a hundred percent. And when I give my workshops, you see a group of physicians or nurses or
anybody that I’m training with their arms folded in the back. And there are there because they were told they
had to be here. But I tell you, there is nothing more rewarding right then by the end of that workshop, that
person is writing stuff down and is excited. And I mean, that’s what gets me going. I love when that happens.
Cause they are like, Oh, I like that. I’m good. And I tell them, I’m going to talk to you about different things.
And I’m going to show you some communication techniques that I want you to steal from me. That’s the way
I call it a deal for me. And, but often I think what we do is we concentrate on people who are doing poorly.
And instead of concentrating on people who are doing poorly or just saying, gee, my satisfaction scores are
low or my employees aren’t listening.
Dr. Anthony Orsini (34m 15s):
Why don’t you just sit back and watch that doctor who’s having really good patient satisfaction scores. And
even without me and without you, you’ll probably say she does something a little different here. She sits
down and she talks about it. And I think that’s one of the things that I try to teach my kids now that they are
all almost adults is watch the guy who is good.
Quint Studer (34m 35s):
All right, well, you’ll hit something Tony. And this has been researched. Now the Heath brothers and their
book “switch change when change is hard” they say the same things, they don’t use medicine. They use
other examples. So they say that there’s been a study after study on a child who drops out of high school,
but they find the child that doesn’t drop out of high school that lives in poverty that is moving around from
foster home to foster home. And just trying to figure out what is different in that child. So I’m a huge believer
in what you said. And I fell into this by accident. So I am at Holy cross hospital. Our patient satisfaction is
crummy across the board, which was beautiful because then we could all blame the patient, the place where
consistently crummy and then all of a sudden, dang it.
Quint Studer (35m 24s):
If one nursing unit doesn’t pop way up. Now we start sitting here with our smart intelligence executive brain’s
we say those are the same patients that are in all the other units are probably the same payer mix, the same
shared rooms, the same community, the you know, the same intercom they’re hearing the same. gheel’s on
the cart. That’s to know. I see, because these are all the excuses we had for us not being Good. So the
challenge is Tony, because people don’t see other people do it. If you ask that person, what are you doing
differently? They are going to say nothing. I’m just doing what everybody else was doing.
Quint Studer (36m 6s):
And they think they are. So I released a fellow named Don Dean who worked for me. And he was like part of
our measurement team. He was in radiology. And I said, Don, Michelle doesn’t think he is doing anything
different, but something’s got to be different because those patients are so much feeling better about the
care than any place else. Go up there and I want you to just observe her for the next five days. And I know
you will probably be a pain to her. She’ll say nothing, but just watch everything she does. So about the third
day, he said, Michelle, I noticed that one of the first things you do in the morning, is you go visit every single
patient on a unit.
Quint Studer (36m 46s):
And she said, it isn’t everybody doing that? We said no, nobody is doing that. Well pretty soon. And
everyone was doing it and now we’ve got better at it. You know, you’d find recognition to come out reward
that I absolutely a a hundred percent agree with you. I had an ER in Texas, they put a camera up. They were
really clear about not doing the patient, but they then took all the physicians. And they basically, and I think
you’ll really, this is what you’re talking about. And then they created sort of a, like you would an athletic If
analyze the video. And what they did is they study the doctors that had the best patient experience.
Quint Studer (37m 25s):
That’s what they did. And then they took the physician in that didn’t have as good. And they showed the
physician, their video. And then they showed that video, the doctor with the best patient experience, within a
matter of months, everybody had a great patient experience. Because once they could just see, ahh, they
said, I don’t know, they offer a blanket. I don’t, they talk about it. I want to do everything I can to reduce your
pain. They narrate the care better than me. Doctors are smart people and what they saw it done. And they
were doing the best they could, but remember physicians and all health care people have a disadvantage
cause they don’t get to see the other people, the best practices where, you know, again, I own a minor
league baseball team.
Quint Studer (38m 11s):
The player’s watch the other people bat . That they watch other people’s pitch. They are constantly
observing what their peers are doing. And Healthcare the last time he got to see a peer or do anything. It
was your residency.
Dr. Anthony Orsini (38m 24s):
Yes. That’s a great point. So yeah. And so watch here at some of the take home messages, I have two
quickt more questions for you. I take our message to be positive reward. You mentioned about one to one
positive and negatives, but it actually should be three to five. In the previous episode that I did really have
the pleasure of interviewing Dr. Helen Reese. Who’s one of the big names for empathy and, and she brings
that up all so that when you’re bringing up children, that’s the same ratio, three to one, five to one positives,
Quint Studer (38m 54s):
Workplace. You’ve at least got to get three and outside of the workplace at home, you gotta hit five now. So
I’m sure if you can get five everywhere, I always teach people in health care where sometimes so unused to
hearing what’s right. We even get nervous when we hear what’s right. You know, what’s happening? I tell
people, Oh, it was my, when you start being more positive, you better tell people why you’re doing it. Are
there going to think somebody had changed your medication and they are going to be a little bit nervous
Dr. Anthony Orsini (39m 20s):
And the other thing that was really cool that you mentioned to me is that it is amazing. No matter how old
you are, how much do you like positive feedback? When I do my program from the book, it’s all in the
Delivery. When we go in and we do the workshops, we do communication training for everyone, the doctors,
the nurses, the final phase of that program is called. See something, say something. And we have little
stickers, tiny little stickers that go on your chest and little stickers that go on in your badge holder. And we
say to everyone who takes the class, the workshop that if you see something good, anytime you see a good
interaction, it doesn’t matter if you’re the housekeeper who sees an interaction with the director of medicine
or a director, a medicine that see’s a good interaction with the housekeeper, give them a sticker.
Dr. Anthony Orsini (40m 5s):
And at first people said to me, you know, directors, chief medical officers, directors of the NICU directors of
the programs, get these stickers and get this big smile on their face. They put it on their lab coat and some
of them even put it on their doors outside of their office. And there was a 60 year old man or a 60 year old
women. So everybody needs a little positive feedback.
Quint Studer (40m 30s):
I think too in healthcare sometimes we’d sort of joke about these things. We almost make fun of them at first.
Then you say the affect. Two little stories that I just love. We have this thing at the Hospital I was at Baptist
where you can give a wild card. So when somebody does something good, you right out and you give them
a wild card and it was cute. It was nice. You know, it, it was wonderful, but I underestimated the impact of
these wildcards. So I’m going up to see Dr. Troy tippett. He is a neurosurgeon and he’s a really spectacular
physician. And you know, I go out again in here, he’s got a wild card that somebody gave him a nursing
assistant had written him a wild card handed a to him.
Quint Studer (41m 12s):
And he had it next to his diploma from medical school, this wildcard. And it hit me how much of the impact
that it had. The other story is sometimes even when it’s not sincere at first, it has an impact and that we
joked and even insincere recognition works in health care time. So my story was, is this again, working a
hospital, there was a nurse. And she was very frustrated because she had always wanted her own children.
And adoption is wonderful, but you always wanted her own children and she could not conceive. And she
was in a busy ER in a inner city hospital and people are coming and either pregnant or maybe not taken care
Quint Studer (41m 55s):
And prenatal care may be very young. Pregnant may be sometimes beyond with two or three kids. So she
would get very judgmental. And this nurse manager got complaints about her treatment and it wasn’t just
them. It was, she treated people differently depending on different characteristics in it. She was very
judgmental. So the nurse manager brought her in and told her she’d have to be nice to everyone. And she
says, I know that’s hard on you. I don’t care. You know, she started made a joke. She said, I’ll give you a
smiley face teeth of plastic. He can put it in your mouth to look like you’re happy.
Quint Studer (42m 35s):
She said I don’t care if you’re a sincere and not sincere, or you have got to treat people better, no matter
what. So that next day she came in and almost went overboard. Well, hello, how are you going to get you
this? Let me do this for you. And then she would say, what’s the patient’s, that’s not me. It’s the patients. So
at the end of the day, the nurse manager called her in and said, well, how did the day go with, you know,
treating everybody night? And she said, today didn’t count because everybody was nice to me. So all of a
sudden it clicked on her at the message is you started to get what you reap. And I think the fact that you
talked about reward and recognition at first, these wild cards are sort of a joke or who, wow, Oh, here’s
something, Whoa, wow, you’re doing a good job.
Quint Studer (43m 24s):
But then all of a sudden it clicked up when I was again, president of Baptist people got little light bulbs so
that they made us better. So they got all these little light bulbs, right? Ideas and something. They look like
military people with all these little light bulbs. So USA today came to do a story on us. So what they were
walking around the hallways, they saw some of the staff with these light bulbs. And they said, tell me what
that is for it. Do you know, the staff member could go by every single light bulb and tell me why they have
that light bulb. And I think sometimes maybe we’re not comfortable with recognition. Cause in Healthcare,
you know, we are not used to getting it. And one of the things I used to always talk about and health care,
sometimes Tony, it’s even hard to compliment somebody.
Quint Studer (44m 8s):
You tell somebody, they do a good job. They start arguing with you. I could do better. I can do it better. And I
shared again, in one of my therapy stories, I went to Catholic social services years ago, Amy Storme was my
therapist. And she said, Quint, I’m going to give you some feedback. I went there because I was depressed.
And she said, you know, and I get some positive feedback. You rejected that you deflect. If you tell me why
it’s not true. And she said, I think one of the reasons you feel bad about yourself as you filter out the positive,
one of my messages for years in Healthcare is learn how to say, thank you. Learn how to look what’s right.
Because I think in health care, Tony, we filter out the positive. You take the patient home that you did help.
Dr. Anthony Orsini (44m 50s):
You take the employee at home you weren’t effective with. And you miss all of the positive things that have
been done. And so, you know, were a big believer that if we start off meetings with the wins, you end of the
day with what are you here to be grateful for? Because I think health care or any leadership is a great
position, but I just think we just get worn down. ’cause we play defense instead of offense, because we find
out what’s wrong instead of focusing on what’s right. And you’re one of those right. People in healthcare. I
mean, you know, you’re taken care of the most difficult topics in health care. I mean its easy to teach
rounding its easy to use key words at key times, its easy to talk about making a phone call.
Quint Studer (45m 30s):
It doesn’t mean it’s simple, but it’s easier than what you teach. You teach the most difficult thing. And
Healthcare my first grandchild was stillborn birth. Oh I’m sorry. My daughter-in-law was a full term maybe a
week before she was due. Her placenta released. And she didn’t know at the time that was going to be an
issue. She went to the hospital, she delivered a baby, they named her Ella and she was still born. Now when
she got to the ER, she sort of had that feeling something was wrong because of the blood, but she still has
held out hope that her baby was alive.
Quint Studer (46m 9s):
And somebody had to sit down with her and my son-in-law and tell him that the baby had died. Hard right?
Excellence of course of the book story at the end is Brian’s story was about my nephew who has killed at 19
in a car wreck. And somebody had to tell my sister-in-law and brother-in-law that your, you know, your son is
dead. I’m so sorry. But what I learned amazes me is how people have the skillset to do it in a way. So when
you, four years later, I go to speak at that hospital that Brian died on me and I call him his parents and tell
them I’m going to speak at Christ hospital in Chicago and immediately my sister-in-law Cathy said, tell them,
Quint Studer (46m 49s):
They were so kind to us. So what you teach Tony is just how to do the most difficult thing in Healthcare and
they have to break bad news and have difficult conversations. So I want a thank you for the impact that you
make and thousands of thousands of lives.
Dr. Anthony Orsini (47m 4s):
Oh thank you. And it’s something that is so important. I don’t think most people know how important it is,
how you break bad news can affect somebody for up to 30 years of you don’t do it correctly. There’s not a
person in the world, a doctor, a nurse, a police officer at a first responder who wants to be bad at it. But we
are just never taught on how to do that. And when things don’t go well, we tend to get upset, but I’m going to
tell you what it brings me really. It makes me feel good is when and now it’s been 14 years, but I get letters
and Christmas cards from the mothers and fathers who’ve lost her baby that was in my care or a premature
baby had died for a variety of reasons.
Dr. Anthony Orsini (47m 48s):
And and I got a Christmas card from them 14 years later. If that doesn’t make you proud and be happy that
you went into medicine, then I don’t know what will because many people would to see that as I failed, but in
the end I was there for the family and they appreciate it. And it’s something that I think we just need the team
more and I’m trying Quint I mean, I’m trying to train every doctor out there on how to do that and build the
relationships and we’re doing it one at a time. Sometimes we’d do it in big groups, but I feel that is even
more important than what I’m doing as a physician, but it’s at least equally important.
Dr. Anthony Orsini (48m 27s):
And I thank you for your compliments, that’s really very nice of you to say.
Quint Studer (48m 30s):
I think I will tell you have to look at the physicians and yes, most physicians what they major in and it wasn’t
a sociology or psychology behavioral medicine per say it was usually science, biology, chemistry. If you take
the Myers-Briggs and you get most physicians, about 90% of them are going to be an I, which means they
like to think internally before externally. And that means some things are not going to be as natural to them.
And I think that’s why you’ve got to make it safe for them to be vulnerable, safe for them to say they don’t
know because they were sort of a program to know because they picked the major that they are really good
Quint Studer (49m 13s):
They’ve always been very successful. So I was talking to a person, a Harvard medical school, student
science major and the whole BIP or biology or chemistry. And I said, isn’t it amazing that most of your
training’s going to be scientific at your job’s going to be all about relationships.
Dr. Anthony Orsini (49m 30s):
Yeah. I love that a a a hundred percent. You’re exactly right.
Quint Studer (49m 34s):
And so I think the fact that you create a safe environment for clinicians or every one on how to have these
conversations, how to say they’re tough. And I know we are going way, way long, but you know, I love
doctors and I think doctors knew I liked them. And I think that makes a big difference. You can’t fake it
because their diagnosticians. One of the biggest impact I had from a physician who was my first week in
administrator on call, you know, that’s When in the old days, you got a beeper in you. Your role comes in to
the administrator on call. So it was a Saturday morning and be in a administrator and call. You have to walk
around the Hospital. My big skill was learning to say to the house supervisor, what do you think we should
Quint Studer (50m 15s):
And then I’ll tell you. So I had heard that a person I sort of knew not well, but knew of them. She’s mid
forties. Her husband had a severe stroke, couple of teenage children. I knew she was in the hospital and I
turn the corner and there she is with her kids and Dr. Ram Rao, who’s an internal medicine physician. And
he was sitting there with the family, going over the decisions that they have to make. The decision was when
you look at it, do we keep him alive per se, artificially, or let him die naturally.
Quint Studer (50m 55s):
And I watched him walk through the family with this and they made the decision to let sort of nature take its
course. There wasn’t any real other option, but you know, there is always another option, but they have
tools, all sorts of things, Andy. And then you said to them, now I am available. Here’s my number here’s my
beeper. This is beeper day. If you changed your mind or need to talk about it, I want you to call me. Now, I
think he knew that they probably wouldn’t call him. But the sense of understanding and comfort was really
quite remarkable. And I’m sitting there and I’m thinking I’ve never had to tell somebody that, and I’ve never,
you know, Dr.
Quint Studer (51m 37s):
Steve base and a good friend of mine tells about the fact when he’s telling a patient, a woman in her
husband that she’s got terminal cancer. She’s the same age as his wife and the kids are the same age. I
think physicians have to do some of the most difficult things of anybody. And what do physicians really want?
You know, treat me with respect to have things go on in time. They don’t have a lot of demands. So I’ve
always been a, a, a big fan of physicians. And that’s why I think in this environment, providing them the
support with training, because they’re not going to ask for it. I don’t think if the chief medical officer says,
Hey, raise your hand.
Quint Studer (52m 18s):
If you want some additional training on how to help be more effective talking to your patients, nobody is
going to raise their hand. Nope. Once you provide the training and the education, they’re so grateful for it. So
I think what you do is just a difference maker in Healthcare. And I’m very honored you have asked me to be
on your podcast.
Dr. Anthony Orsini (52m 37s):
Well, thank you Quint and what you have done for a patient experience really can not be underestimated.
You really made patient experience what it is today. We have a long way to go. There’s still, and I don’t have
time for the question, but we, we do know that most hospital executives place, patient experience in their top
three priorities and Yet many of them have not yet invested in patient experience, but thanks to you. It is now
put on the map
Quint Studer (53m 5s):
In 1999. It wasn’t even in the top 10, nor was employee engagement, I think two. And when you tie it in a
clinical outcomes, which I tried to do all the time, that’s where that all of a sudden it clicks just like an
employee engagement. You know, when the research came out and said, there’s a correlation between
employee turnover and your mortality, rate? So it’s no longer we’re lowering turnover at a lower, longer
turnover. We’re lowering turnover to save lives. So it’s really exciting for me to see there is an association
like the Beryl Institute that didn’t even exist. There’s a, job’s called patient experience. Chief patient
experience officer that didn’t exist. CEO is even having in their incentive comp that’s when you know, it’s real
when it’s, so we have a long way to go, but man have we’ve come a long way also.
Dr. Anthony Orsini (53m 54s):
And a lot of that has to do with you. You mentioned the Beryl Institute. Jason Wolf I interviewed just a couple
of weeks ago. His interview will probably drop early December, maybe right before yours. So Quint, this has
been amazing. I sent in the beginning of this introduction that we could probably do 10 of these. And I think
the audience now believes me because you have so much to offer what you’ve done for Healthcare or what
you’ve done for leadership and business is just amazing. When you agreed to come on in this podcast, I was
just elated. So thank you so much for coming. Thank you for spending your time. I’m going to put all the
references in our show notes about what’s the best way for someone to get in touch with you. And I’ll put that
in the show notes for those of you who are driving.
Quint Studer (54m 34s):
Sure. It’s my email is Quint@quintstuderstuder.com. I have one time, somebody sent me a note and I
responded right away. And the person’s husband said, yes, it’s not him. He has someone that does that for
him. So then she wrote me in another one and I confirm it really, it was me. So, you know, I pray every
morning just to be useful to people. So when people reach out and allow me to be useful, I feel I’m blessed
or a good friend of mine. And I went to thank him one day and he said, the one thing you and I will never
agree on us, who should be thinking who so, Tony, thank you. And anybody who reaches out, I’d be very
grateful to do whatever I can do to help them.
Quint Studer (55m 16s):
And I guarantee I’ll end up getting more from them than I’ll ever give them. Right.
Dr. Anthony Orsini (55m 20s):
Thank you. Quint this has been an amazing, if you like this podcast, please go ahead and hit subscribe and
download all of the previous episodes that we referred to during this podcast. If you want to know more
about the Orsini Way or about the book, you can go to the Orsini way.com. Thank you again, and thank you
again. Quint and I can’t. Thank you enough. It’s been great. So grateful. All right. Take care of well, before
we leave, I want to thank you for listening to this episode of Difficult Conversations Lessons I learned as an
ICU Physician. I want to thank the Finley projects for being in such an amazing organization, please.
Everyone who’s listening to this episode, go ahead. Visit the Finley project.org. See the amazing things that
are doing. I’ve seen this organization literally saved the lives of mothers who lost infants.
Dr. Anthony Orsini (56m 5s):
So to find out more, go to the Finley project.org. Thank you. And I will see you again on Tuesday.
Announcer (56m 11s):
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