Difficult Conversations about Healthcare

Thomas Dahlborg (1s):
But when I think about how we as patients are staying away from healthcare for lots of different reasons, holding off on health care for lots of different reasons, because of the brokenness. When I think about how many people have that calling like you, to make a difference and to help heal and to help people on their dying journey, when that’s the journey that they’re on. And I see how many disconnects and how many drop balls and how much harm. And almost everyone does not have the intention to harm. Everyone is here to make things better and we’re missing it and we’re missing it. And we keep going to solutions that are sexy and innovative around technology and pharma.

Thomas Dahlborg (41s):
And again, their brilliant to me are incredibly important and we forget love. That it comes down to it’s all about love. When we love we’ll take care of ourselves and we’ll take care of others regardless of the payment methodology, regardless of the tech, we’ll do the right things.

Announcer (57s):
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr. Orsini is a practicing physician and 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 42s):
Well, I am 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, whose 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. They provide such things as mental health counseling, funeral arrangements, support, grocery gift cards, professional house cleaning, professional massage therapy and support group placement.

Dr. Anthony Orsini (2m 35s):
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 mothers 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 Difficult Conversations: Lessons I Learned as an ICU Physician. This is Dr. Anthony Orsini, and I’ll be your host again this week. For those of you who are looking for Liz, Poret, my director of programming sorry to disappoint you, but you’re stuck with me again today. Today I have with me as a guest, someone, and he’s going to bless, but embodies everything that I think is right with healthcare or better said everything that should be right in healthcare With over 40 years of healthcare leadership experience, Thomas Dahlborg is a voice for relationship centered and compassionate care and servant leadership.

Dr. Anthony Orsini (3m 33s):
He is a leader in adviser and then internationally recognized speaker with a really an amazing writer with an expertise in healthcare communication, courageous vulnerability, and stopping bullying. Tom’s multiple award winning book From Heart to Head and Back Again, the journey through the healthcare system, which we’ll be spending a lot of time today, but is really an amazing book. There’s other multiple award-winning book called the big kid and basketball is also, we’ll spend a little time talking about that today and that was equally amazing. I had the privilege of reading both of them in the last two weeks Tom’s of father, husband, and a coach. He also coaches health care leaders and a coach of young men and women, Tom, believes by the end of the day, it’s all about love.

Dr. Anthony Orsini (4m 15s):
It impacts all. Tom, thanks for coming on. And it’s this really great getting to know you over the last month or so.

Thomas Dahlborg (4m 22s):
Oh, I appreciate being here and I feel the same way about you. And you’ve just inspired me with your book inspired me with your talks through the Gratitude Symposium, and I’m thrilled to share and learn with you today.

Dr. Anthony Orsini (4m 33s):
Yeah, this is going to be great. I kind of knew about you and your work. We’ve done a couple of projects together. We really first spoke about a month ago, both of us that we have a mutual friend Quint Studer, but we had a conversation that went really well back in May. And I knew that you were going to be a perfect guest for this, but I hadn’t read your book yet. I had heard about it and I read it over the last couple of weeks. Thank you for sending it to me and her it’s funny, Tom, I read the book and I said, this book is written by an author. It was beautifully written and I’m thinking, gee, my book is a nice book, but it’s written by a physician. This book is written by an author. And so you’re just a beautiful writer and I love the way your book flows. I read it actually one day cause I couldn’t put it down. So it really is.

Dr. Anthony Orsini (5m 14s):
And I’m not just blowing smoke up your in a, I really enjoyed it. I’m going to ask you to start out by talking about yourself, but the book really, it reminded me in many ways of a book that most of us know the Air That I Breathe very familiar with. I’m sure you’re familiar with that book and the similarities and differences in that book because in that book and there’s also was an old movie, I think, well, I think John Voight was in it. Where you have someone who has in the healthcare system, but then becomes a patient. And in the book with the air that I breathe, I think he realizes all the things that he was thinking wrong. But in your case, I think the, when you were a patient, it actually reinforced all the things that you kind of knew in the beginning.

Dr. Anthony Orsini (5m 57s):
And that’s where it’s amazing. So I’m going to shut up and I’m going to let you just kind of tell us about yourself. You know, I know you’ve been in healthcare for a long time, a little bit about that and just your journey. And then we’ll just go from there.

Thomas Dahlborg (6m 11s):
First of all, thank you for all that feedback. That means a lot, especially coming from you. Yeah. I’ve been working in healthcare for a long time when I was a kid, my mother wanted me to be a doctor. So she put me on that path and that was actually in pre-med. And I realized that wasn’t my calling. My calling was my acumens were in different spaces and, and yet I always wanted to help. And I started off as a housekeeper and a transport aid and IVA for a small community hospital and just south of Boston. And I learned so much about what healthcare should look like, what is the term or use what right. Looks like, and what’s right in health care and everything I hear you talk about, it’d be your TEDx or your book and about that humanity.

Thomas Dahlborg (6m 52s):
And about that compassion about that connection. I got to see that when I was a housekeeper and I was able to talk to patients and families and connect. And when I was at transport aid and an elderly woman would say, Tommy, please stay with me. I’m scared. I got to see how important that connection and that communication is and the system. And as I continued my journey throughout healthcare and I became a CFO and all these other roles, I never lost that. So when I decided to write the book From Heart to Head Back Again, a Journey Through the Healthcare System, I had been involved in developing pay for performance programs back when we used to call them just quality based incentive programs.

Thomas Dahlborg (7m 32s):
I was involved in all these pieces of it. And I saw so much focus on the financials and so much focus and technology and all these others areas that are incredibly important. And I was seeing less and less focused on humanity and compassion. So again, that’s why you resonate. And I really enjoy connecting with you and learning from you because you’re in that space. And so when I got sick and that was back in 2001, I was told that never work again. I wasn’t sure if I was leaving the hospital and I got to see flames of goodness in the system, other transport aides, nurses, doctors that really connected and really communicated, really cared and, and quite frankly loved. And I could see brokenness too.

Thomas Dahlborg (8m 12s):
And I got to see where in my variety of roles I contributed to, I guess, both sides of it. And it really was an ephiphany for me and a calling for me as Quint would say, Quint Studer would say a calling that I wanted to share the message and share the learnings and put that call to action out. Together we can make a huge difference together. We can bring love back into healthcare and create HealthCARING models. So I’m excited to talk more with you about that.

Dr. Anthony Orsini (8m 38s):
So it’s really interesting as I read the book. So you were CFO for the veterans association.

Thomas Dahlborg (8m 44s):
Actually I was a CFO for the national Institute for children’s health quality, which back in the day was the pediatric division of the Institute for healthcare improvement. The military spot. I was actually a COO for the military health care work I did.

Dr. Anthony Orsini (8m 59s):
Okay. So in the book you beautifully tell stories or parables that help raise your point. And there was one character while there were several, but the one character that really hit me was so give us some background. You’re going door to door, basically trying to get people’s opinion on the healthcare system, which is an amazing thing to do in the first place. Cause everybody just likes to send out a survey, but you met Linda Jones and Linda Jones was a great character. And boy it’s someone that age and that tough really told you like it was, I love that. Tell the story about Linda Jones.

Thomas Dahlborg (9m 38s):
Linda was amazing. So I, again, I was the COO for this military program and were seeking the voice of the customer. We want to figure out how we could be better. And part of that, like you said, we will go now we’re interviewing people. So I got to meet with Linda Jones was an associate of mine. And Linda was the wife of a soldier, a wife of an officer. And he was very, very ill and he was having challenges with the healthcare system. And so we got to listen and sit down and have tea and Peppa cock is and all this wonderful food that my grandmother would have. And we had this great discussions and she was incredibly smart from lots of different reasons. One just because she was smart, another, she worked at business, she got it.

Thomas Dahlborg (10m 18s):
She understood certain pieces. And I remember one piece that’s, there were really two really key pieces that drive points home for me from that discussion. One is we were talking about surveys and we were talking about veterans and we were talking about the scores we were getting from our patient surveys, from our Veteran surveys. And we were getting great scores, 95% of satisfaction and engagement and all these other pieces. And I remember she put her hand on my knee and she said, Tommy, she said, you get her. Remember soldiers like my husband, they listen, they take orders, they do what they’re told to do. They don’t complain. And oh my gosh, Tony, I was like, that just blew me away. That just absolutely blew me away.

Thomas Dahlborg (10m 59s):
It aligned with other things I had learned about loyalty. And you need to be in that 99% plus, and yet to have it driven home, especially as we were working with veterans and trying to take care of veterans and their families, that was just such an important point. And then the other point was, I remember she told a story about, she was trying to get her husband medication and she had just seen the doctor and she got in line and in the pharmacy, a pharmacy within the health system I worked for and she asked for coated tablets cause her husband, in addition to a lot of other issues, she had, he had issues with his gut and the pharmacist yelled at her. We created a system which led a pharmacist to be so stressed, no excuse, but so stress, he felt yelling at an elderly woman would be the right thing to do.

Thomas Dahlborg (11m 46s):
And it’s just horrific. And I remember, and I share this in the story. I was like, oh my gosh, we took the dignity from this woman. And what was so incredibly powerful for me though, is I was wrong. This woman never lost her dignity. She was sad. She was hurt, but she never lost her dignity. And she knew she was there for her husband. And she was going to make sure that she took care of him the way he always took care of her in all his men and women that reported to him.

Dr. Anthony Orsini (12m 11s):
Yeah. And there was also a point that she made about, I think our biggest complaint was that she wanted to see her doctor and every time she went, she was, I think his name was Dr. Brown, is that right? And she, every time they went there, they were thought they were seeing Dr. Brown. And it was someone else that’s important to people.

Thomas Dahlborg (12m 29s):
And that gets into that whole relationship. I use the term relationship centered care. You’re absolutely right. You’re absolutely right. That you have trust, you feel safe. You’re going to tell that additional wisdom, additional nugget of wisdom. And you talk about so well in your book and your talks are so, but that ability to connect at a human level, that is not only the right thing to do love the love sake. It’s also, it gives you more information to help and make things better. And the expectation was set that they would continue to see their doctor and we didn’t deliver. And again, you’re right. That’s another great point that we needed to fix.

Dr. Anthony Orsini (13m 4s):
Yeah. You talked about patient satisfaction scores and that you were in the 95 percentile, but that it was false. It was, you realized Linda told you, like stop even looking at that. But I think that’s true not only with veterans, but it’s just true in other people that in everyone, in that, you know, I’m big on HCAPS, I do programs as you know, to help people improve their HCAPS or patient satisfaction scores, but we really have to be careful about studying for the tests. And I think that’s what you were basically what Linda was basically saying is that, wow, we’re going to make the question so that most people are going to say yes, or we’re going to do this. So there’s a patient satisfaction, but it really comes down to, is what they want is you said is the relationship.

Dr. Anthony Orsini (13m 45s):
And that relationship can happen in a few minutes. As I talk about my Ted talk and I, when I’m reading your book, I thought to myself, thank God I didn’t read this book before I did my Ted talk. Cause he’s going to think I stole from him because there were just so many likenesses of what that connection. Tom, you talk about the EMR and I have a lot of strong opinions about that. And here’s a quote from your book. Now I have rethought my selection criteria and we’ll find a physician who connect with me, not EMR me. So tell us about how that revelation came because you’d thought EMRs were a great thing at first.

Thomas Dahlborg (14m 25s):
I did, I ran an analytics shop. I’m thinking data, more data, more data. We can find it. We can get all this great information. And yet what was happening was we were so busy filling in checking boxes, filling in slots, whatever it might be. We were forgetting human. And I believe it’s Dr. Abraham Verghese talks about the ipatient, the ipatient, a patient that’s actually in the EMR has become more important than the patient before us. And it was like, that was that revelation, a revelation for me. You. It was like, that’s it? Because I know as part of my healing journey, it was my physician. I was blessed to find who came out from behind the computer, who sat with me, who put his hand on my shoulder and my wife’s shoulder.

Thomas Dahlborg (15m 9s):
It was that connection that trust, that safety, that relationship more so than what was being inputted or outputted from any EMR that really made the difference.

Dr. Anthony Orsini (15m 20s):
Yeah. There was a major hospital here in Florida that I share with other people in the past, they built a new office building so further all their offices and the architect built it so that the computer desk was on the other end of the room from the table where the patient was sitting. The only way the doctor was able to look at the computer was it literally turn his or her back to the patient. And so you look at stuff like this. Yeah. This falls under those categories. And when you see stuff you go, what were they thinking that anybody asked a doctor or a nurse? Like, where would you like to computer? Or did some architect just decide, well, it fits nicely here because this is where the cables are.

Dr. Anthony Orsini (16m 0s):
And so I think the EMR does have its place, but, and we’re going to talk about Dr. Omari at the end, but it does miss that personal connection. And I think what was it about your journey when you were sick? That kind of solidified that I’ve been right all along, but now I didn’t realize how right I am.

Thomas Dahlborg (16m 20s):
There were a number of things. I remember at one point, this actually isn’t in the book. My wife made sure my bride made sure I did not put it in, but I’ll share it very briefly here. I would fight with God all the time when I was sick, I was scared. I was scared. And it was really these feelings, these emotions in healthcare with so good at disease and disease, state, and diagnosis. And we forget the whole person. And I remember these fights with God. And I remember at one point I’m testing God as I was also testing myself and I lost and he won and

Dr. Anthony Orsini (16m 57s):
As usual,

Thomas Dahlborg (16m 58s):
Absolutely. And it was really this apifany that, oh my God, I’m a whole person, but not one person except for my bride, my children, my dog, I treated me as a whole person. I am now a heart attack or all these different pieces, but not Tom, the whole person, you, it was really bad. And then when I found the right doctor who really did treat me as a whole person and then helped me heal from a 360 degree perspective, that’s what made all the difference and really solidified it for me.

Dr. Anthony Orsini (17m 28s):
You’re writing your book. I think it was at the beginning, the healthcare systems profoundly broken, which is actually the beginning of my Ted talk. That’s why I said, I’m so glad I didn’t read it. We are hurting our doctors, our nurses, our families, our patients, our communities, and ourselves. What do you mean by that?

Thomas Dahlborg (17m 45s):
When I think about you and you know, all this. So when you think about the suicide rate for physicians and I’m married to an incredible nurse in what’s happening in the nursing industry and the great resignation and all this turnover. When I think about how we as patients are staying away from healthcare for lots of different reasons, holding off on healthcare for lots of different reasons, because of the brokenness. When I think about how many people have that calling like you to make a difference and to help heal and to help people on their dying journey, when that’s the journey that they’re on. And I see how many disconnects and how many drop balls and how much harm in almost everyone does not have the intention to harm.

Thomas Dahlborg (18m 26s):
Everyone is here to make things better and we’re missing it and we’re missing it. And we keep going to solutions that are sexy and innovative around technology and pharma. And again, that brilliance and they’re incredibly important. And we forget, love that it comes down to it’s all about love. Well, we’d love, we’ll take care of ourselves and we’ll take care of others regardless of the payment methodology, regardless of the tech, we’ll do the right things. And we just need to remember that and get back to it.

Dr. Anthony Orsini (18m 53s):
That’s beautifully said, you know, right now from a physician point of view, we have this. If you’re in health care and about 75% of our audience is healthcare. If you’re in healthcare, there’s a struggle right now between hospital executives, the doctors, the nurses, you know, I think the army calls this ground truth. You want to know what’s going on in the war. You’d go down to the private who’s in the trenches. There’s very little ground truth in medicine right now. There’s a bunch of hospital executives who don’t know what it’s like to take care of patient who are dictating care. There’s a lot of animosity in many instances, not always, of course not.

Dr. Anthony Orsini (19m 34s):
So, but you are a healthcare executive. You were there, you got it. And now you’re a patient and you see it. How do we fix this Tom? I guess the question that I’m coming at, how do we get together and say, let’s take care of our patients. Let’s take care of our doctors. Let’s all put our heads together and come out with a system,

Thomas Dahlborg (19m 54s):
This so many key aspects to it. And one I’ve learned from my days in quality improvement, let’s be very clear on what is the issue we’re trying to solve? What are we trying to fix? Because I see lots of fixes and I see a lot of them being band-aids that really aren’t addressing what we really need to be focusing on. Another key piece and I talk about this all the time is as leaders, the best tool we have as a mirror and look in the mirror and really figure out where we are and what is our contribution to the challenge? You know, if you think about Deming with the 94, 6 role, which is 94% of system issues are system related, 6% are people related, our purser lit, but what do we do?

Thomas Dahlborg (20m 35s):
We’re so gung ho around accountability, we’ll go after that nurse or that doctor or that person on the front lines and hold them accountable. When it’s really us leaders who will need to look in the mirror and say, wait a minute, we positioned to have that failure to have that issue before them. We need to bring love back into it. Like I said, we need to figure out, do we really believe in that mission? Do we really believe in caring for people if we do? And we truly love that we will do whatever it takes. I talked to nurses, especially doctors too, but nurses, a lot being married to a nurse and you hear that, oh yeah, we’re going to move from a med surge floor unit. We’re going to go from one nurse to four patients, to one nurse to nine patients, without any changes in the system, not moving to a team-based care model, not doing any other innovations, but just we’re going to do it.

Thomas Dahlborg (21m 24s):
And we checked the boxes. We just saved X amount of dollars, or we did X, Y, or Z. Now that’s not fixing the problem. We just caused more problems. We just harmed that nurse. We as harmed that patient, we just harmed that family. We harmed that community. We have to do far better. So when I hear and see, and again, I was a CFO and I was building financial models, all these new innovative value-based reimbursement and financial models. That’s beautiful. It’s one of they are important. That’s not the solution. The solution is integrity and love and losing ego and focusing on what the real problem is. And then together getting to it and using those other things, tech and pharma and everything else has tools and the solution, but not as the solution themselves

Dr. Anthony Orsini (22m 4s):
Love and good patient care is the ultimate top of the pinnacle. And all those other systems should be the, really the base and the foundation that helps them lift that up. And somehow we’ve kind of inverted that we kind of said, we need to make the financially strong. And then if it’s good for the patient, then that’s great. If not with no, it’s like it’s upside down, isn’t it.

Thomas Dahlborg (22m 26s):
And that’s exactly right. That’s exactly right. And I remember talking to this amazing physician head of a quality organization, and she said to me, we’ll do the right thing when the financials change, when the funding changes, I’m like, no, no. I can guarantee you 25 years prior, that would not have been that particular doctor’s perspective because that person had a calling. They weren’t parked. I again, go back to your book. It wasn’t burned into them. That that was where they needed to focus. It was helping others. And they’ve lost that. We’ve positioned them to lose it

Dr. Anthony Orsini (23m 2s):
And you lose it. And as I talk about many times is the talk I just gave for Quint, when we, as physicians and nurses lose that or feel that we’re not putting the patient first, that’s where the depression and the burnout and the suicides all come. And so I love your model. If you just put the love at the top and by the way, it doesn’t have to take that long. There’s a whole bunch of people out there go, oh yeah, you think I can give a doctor 45 minutes with a patient is just not going to happen, but you can connect quickly. And that’s one of the things I’ll tell you a quick story. I might’ve said it before on the podcast. So my mother-in-law is sick in Columbia Presbyterian hospital in New York city.

Dr. Anthony Orsini (23m 42s):
And she’s an ICU and it’s a large Catholic family. We take over the waiting room. Yeah. There’s 13 of us and we’re waiting for six hours to speak to the doctor and we’re getting a little angry, but it’s like, where is he? We’re not talking. I go to the nurses station. I’m trying to schmooze them as much as I can. The guy comes in, I’ll never forget this. He came in and he said, first thing he did was sit there. And he goes, I want to apologize for making any wait, was at a different hospital and the traffic was horrible. So I grabbed my motorcycle and I got right here. And all of a sudden, this is basically what I teach when it comes to relationships, be a genuine person, be a real person.

Dr. Anthony Orsini (24m 24s):
The whole atmosphere changed from I’m really angry at this doctor for waiting six hours to that is really cool. He drives a motorcycle in New York city and he just, he was brilliant, Tom, right? and he sat down. He was the nicest doctor apologized told us everything was going on. My mother-in-law, thank God she did fine. But one sentence, I rode my motorcycle here. He became our best friend. So it doesn’t have to take a long time. It’s nice when it does, but it can. So we just have to, so it’s just a great story. I want to move on to we’ll start from the beginning again.

Dr. Anthony Orsini (25m 4s):
So you’re a hospital executive, you’re working, you’re doing all these great things. You then become a patient. You see the bad things, you see the good things. And as you said, you were really down and really down on yourself and a lot of pain. And then somehow you meet someone called Dr. Omari. So tell us about Dr. Omari and why he was different. And it seems like an amazing guy. I even looked them up. I couldn’t find them on Google’s. I don’t know if it’s his real name or not.

Thomas Dahlborg (25m 29s):
I used a different name for him.

Dr. Anthony Orsini (25m 30s):
That’s why I couldn’t find the little guy. There you go. But tell us about him.

Thomas Dahlborg (25m 34s):
It was absolutely incredible. So I found him because I, at one point I went back to my office again, working in the military health care. And I was saying goodbye to people because I was told I’d never again, get lined up for a heart transplant, go down and get your pain meds and all this. And I remember this nurse leader came around her desk and again, talk about positioning and communication. She got on our knees in front of me and she held both of my hands in hers. And she said something to the effect of Tommy this isn’t over. This is just a detour and you’ll be back. And then it was that same person that connected me with his Dr. Omari.

Thomas Dahlborg (26m 13s):
And he was absolutely incredible. He engaged both me and my bride from moment one. He was not behind a computer. We spoke of physical, mental, emotional, spiritual issues. We spoke of stuff I didn’t want to talk about. I, and I hadn’t talked about in front of my bride. It was incredibly hard in that. So worth it, we developed over time, relationship and trust, and I knew he loved us and that we loved him and it was compassionate empathy. And he listened and we listened. And it was just this incredibly hard, beautiful relationship that we had developed. And he was technically brilliant too because you can’t have just all the caring and the love without having the technical brilliance. He was technically brilliant too.

Thomas Dahlborg (26m 54s):
And so we would define care paths for every three days. It would basically be three days and three options. If this happens, Tom, go emergency room or immediate. If this happens, it’s going to hurt. It’s going to be scary, but that we’re expecting that. And then if this happens call me or whatever it might be, and it was in working with him and again, him getting more and more nuggets of wisdom from us, my bride and I, and hitting on all different aspects of our care. I’m back working again. And all I was able to heal. I did not need the heart transplant and everyone’s different and everyone needs different things. But for me, and with him together with my bride, we found the right path for me. And I was able to tell the story and hopefully help others.

Dr. Anthony Orsini (27m 37s):
And it’s amazing that treating the whole person like this is what doctors want to do. This is what they’re trained to do. And we have to fix the system. As you said before, let’s make the foundation that will allow them to do this. And I know he spent a lot of time with you and maybe he can’t do that with every single patient. But I always tell my, when I coach people find somebody who’s good at something and steal from them. I mean, because that’s what I’ve done, right? That, I mean, listen, I didn’t wake up and say, Hey, I got all these great things to say. I watched people. And so we can take, what’s great about Dr. Omari. And somehow just say, can we all steal from him,

Thomas Dahlborg (28m 15s):
Right, exactly. This key pieces of it. And if you think about the relationships and a care model, you’re thinking about a compassionate care model you think about a whole, so that person care model, whatever we want to call it, there are elements that he brings to it that are foundational. And by doing that, and again, balancing, it’s why he called the book heart and mind. It has to be the compassion and the love. It has to be the technical brilliance together. Then we can really make a difference together.

Dr. Anthony Orsini (28m 41s):
And I’m just looking at the book right now. You’re going to think he’s not listening, but I got the book when the air that I breathe, the name wrong. So it’s called, I’m looking at it. Now, When Breath Becomes Air as the book that I was talking about everybody. So please correct that. I’m thinking about another book that reminded me when you were telling the Dr. Omari story. There’s a book that I talk about in my book called How Doctors Think, and this is a book that many medical schools actually give out. And I don’t know if you’re familiar with it, but they’re the main story in that book is very similar to what Dr. Omari did to you. It was a story of a woman who is really suicidal because she’s been to every doctor. Nobody could help her. In those days, they were paper charts.

Dr. Anthony Orsini (29m 21s):
And to make a long story short, she walks into this doctor’s office. He takes this two feet of paperwork and puts it on his desk and says, come sit over here by the couch. Let’s talk. And she was very angry. And she says, well, why do I have to do this all over again? You have my record because I want to hear from you in the end, the story ends, where he diagnosed there, a celiac disease, cures there in no time, but the paperwork or now would be the EMR was so crazy with all these tests that we got lost in the weeds.

Thomas Dahlborg (29m 49s):
Absolutely. I can’t remember if it was from your TEDx or Ted talk or from your book when I read that or heard you talk about that, I was like, yes, that’s right. That’s exactly right. Is it William Osler? We’ll talked about, if you want to know the diagnosis, he listened to the patient, whoever it was. It’s brilliant because that’s it, listen, listen in. What’s the saying, I want says, now don’t listen to respond, listen to understand. Which is true. I would say, listen to care. Listen to care, truly are involved in you’re engaged and you’re empathizing and you’re compassionate and you’re loving. And that will give you the wisdom and provide the vehicle for that information sharing

Dr. Anthony Orsini (30m 26s):
And immerse yourself in the patient. As a person. I hate to say this, but I just got done watching a romance movie with J-Lo. It’s called Marry Me. It’s what I with Owen Wilson too. But in that movie, there’s a saying that goes on and on over and over again. It says, if you lie in the question long enough, the answer will come to you. And I feel like when I was reading your book, I’m thinking basically, that’s what a good doctor does. We just listens lie in the patients here when he, or she has to say, the answer will come to you because you’ve already been trained. It’s all up here, but just come. So interesting thought there I’m going back the romance. Now everybody knows. I watched truthfully, I only watched football and baseball.

Dr. Anthony Orsini (31m 10s):
No, I’m just kidding. So now Tom is, now you start it. You took all this wisdom and you start Dahlborg healthcare, right? That’s your organization. Now tell us about that and what you do now.

Thomas Dahlborg (31m 20s):
So it’s, Dahlborg HealthCARING Leadership Group and it initially was Dahlborg health care. And that was like, well, wait a minute. We need to move beyond healthcare. We need to transform. We need to work towards just like you said, love at the top transforming health care to HealthCARING. And so what I do with that organization is I speak around the country. I talk about everything from bullying and healthcare, cause that lead comes from my other book and my other focus. My other passion, we talk about the different elements of creating a compassionate or relationships headed care model. I coach CXOs on moving beyond just like you said, the numbers and positioning folks to pass the test, to actually caring and making a difference in the lives of patients and their own employees.

Thomas Dahlborg (32m 3s):
It’s been an incredible run. And just recently I was working with the mercy health system and we were talking about nurse bullying and the impacts that first of all, the systems that led to it and allow it and rewarded in some cases, and then the adverse impact on people, everyone in the healthcare system, including deaths. And so we just have so much work to do. And you know, I just enjoy pondering with my bride. Like I said, she’s a nurse, she’s our chief joy officer. And she focused on the self caring aspect of health care. And with the caveat, we’re very, very careful that we don’t the physicians or the nurses or others for burning out because how often do we say, well, you need to take care of yourself.

Thomas Dahlborg (32m 44s):
Well, yes, we need to care for ourselves. But we also, as leaders need to make the system that allows them to love and care and honor their calling. So it’s a great journey.

Dr. Anthony Orsini (32m 52s):
It’s interesting about the bullying and the burnout. And I see a lot of that when I give lectures at hospitals too, but the pizza solution doesn’t work, which you’re shaking your head. Yes. This is what happens. We’re going to make you work 12 extra shifts this week. We’re going to give you a 12 patient assignment. We’re going to not let you even have time to go to the bathroom, but we’ll buy you a free pizza at five o’clock and that’s supposed to make everything okay, this and this happens that you’re shaking your head, right? Because this happens in every hospital like, oh, just real pizza.

Thomas Dahlborg (33m 20s):
Absolutely. We had one of the organizations I work for was cause burnout and the whole thing’s going on. And they say, well, Friday at nine o’clock we haven’t fish fund because none of the folks out of Seattle with the efficient, some consultants got ahold of that. And on Fridays at nine o’clock, we have fish fund and that just solved everything.

Dr. Anthony Orsini (33m 39s):
There was another story I was walking by one time doing a tour. And I pass by this bulletin board and there’s bulletin boards on burnout. And I hear two nurses eavesdropping on their conversation. They look at it, it was a chart things to do. If you’re feeling burnt out, take a yoga class, meditate, get some exercise, take a vacation. And the comment that I heard from the nurses, if I had time to do all that, it wouldn’t be burnt out in the first place. We’re kind of missing the point here, but you’re right. So it’s wonderful that your wife is doing that because you’re right. We have to take care of ourselves. Jonathan Fisher was a great guest on one of my podcasts.

Dr. Anthony Orsini (34m 19s):
And that’s what he’s all about because you don’t want a doctor or nurses half there because they’re burned out. It gets to be dangerous. So it’s something that we all need to do. And I really want to thank you for the work that you’re doing. I feel like I’ve found the cousin. So this is just awesome. And so I wanted to talk about your other book, but we don’t have time. So we’re just going to have to have you back. That’s all. So your bullying book. So Thomas, tell us at this point, where should we go from here? Are you optimistic about the health care? Are you pessimistic? Are we getting better? What’s your diagnosis here?

Thomas Dahlborg (34m 53s):
We have a long road ahead. There’s a many mountains to climb. However I have found, like you just said, and I believe that you have a huge part of, there are flames of good throughout the healthcare system. They’re great caring nurses and doctors and transport aids and housekeepers. And there are brilliant and caring CEOs and COOs. We need to capture that positive energy. We need to bring that forth. I am optimistic. We have huge challenges. I don’t look through rose colored glasses by any means. Hence my gratitude talk was not looking through a rose colored glasses at all, but rather with heart, with love, with brilliance, with skills, we can make a difference as long as we keep, like you said about before us, and we’ll make it happen

Dr. Anthony Orsini (35m 37s):
Going to let you leave without getting the dreaded last question from This podcast and that’s in your entire life. What’s the most difficult conversation you’ve had to have and give us some advice on how you’ve navigated through that conversation

Thomas Dahlborg (35m 50s):
I had. So this will probably be maybe it’s a segue to rejoining you and talking to you about bullying. A most difficult conversation out of ahead was a couple of years ago. I’d already been where I wrote a book on the bullying and we’re talking about bullying. And a lot of it has to do with my son. And a couple of years ago, my son who had been bullied from when he was four years old and born with neurological challenges and bullied by predominantly by adults. And we helped them in many ways and try to help them. We made tons of mistakes. Well, two years ago, he came to my wife and I, and he said, mom, dad, I need to let you know that when I was in fourth grade, I put a belt around my neck and it was the most challenging discussion. It was the most challenging thing to hear.

Thomas Dahlborg (36m 30s):
When you go to a thousand different places, including how did I screw up? How do I miss? How did I, and thank God this didn’t happen. And what can we do to make things better? And so we’ve been using that as additional fuel to really help children and help parents and help coaches and others really ensure that other children did not go to that place. So thank God my son was not successful. And now to this day, he’s helping others. So that was definitely the most challenging.

Dr. Anthony Orsini (36m 56s):
Thank you for sharing that. I know that’s difficult every time you talk about that, we appreciate that before we close, I’m actually going to put you on the spot here and it gets you to commit to coming back again, that talking about the book and Difficult Conversations about bullying. And so you can’t say no on air. So I’m going to, I’m going to ask you now, would you be willing to come back and talk about your first book and the bullying and cause that’s something that really, really is important and sports. I mean, sports is such an important part of your life. You know, I know you’re a huge Phil Simms fan. I’m just kidding. That’s just me as I sit here, but I want to talk about all that and how you became a Dallas cowboy fan from Massachusetts and all that. So would you be willing to come back on?

Thomas Dahlborg (37m 37s):
Yeah, absolutely. I would love it. Absolutely not. But I appreciate the opportunity to come back. Join you, learn from you and share with your audience too.

Dr. Anthony Orsini (37m 44s):
Thank you so much for being on. I really, really appreciate this. If what’s the best way of people getting in touch with you.

Thomas Dahlborg (37m 50s):
My email is Tom @Dahlborghlg.com.

Dr. Anthony Orsini (37m 54s):
Yeah, we’ll put that all on the show notes. Thank you so much. If you enjoyed this podcast, please go ahead and hit, download or follow. We appreciate all the subscribers we can get. If you need to get in touch with me or anybody at the Orsini Way, just go ahead and email us at info@Orsini Way.com. Tom. Thank you so much. Appreciate everything. And thank you. This has been an amazing podcast. I can’t wait for my audience to hear it.

Thomas Dahlborg (38m 16s):
Thank you so much.

Dr. Anthony Orsini (38m 18s):
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 don’t want to thank the Finley project for being such an amazing organization, please, everyone who’s listening to this episode, go ahead, visit the Finley project.org. See the things they’re doing. I’ve seen this organization literally saved the lives of mothers who lost infants. So the find out more go to the Finley project.org. Thank you. And I will see you again on Tuesday.

Announcer (38m 48s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. To contact Dr. Orsini and his team, or to suggest guests for future podcast visit us at the Orsini Way.com. The comments and opinions of the interviewer and guests on this podcast are their own and do not necessarily reflect the opinions and beliefs of their present and past employers or institutions.