Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 170 | May 2, 2022
Physician Coaching and Patient Experience
Joshua Washington
Organizational Psychologist
Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, we have another incredible guest, Joshua Washington, who is the President of Lee Malveaux People, Strategy & Solutions. As an organizational psychologist, Joshua has helped over 200 medical facilities with people, strategy, and performance. He’s also trained over a thousand executive leaders and developed a one-to-one physician coaching program helping doctors reach the top percentile nationally in patient experience. His passion for people development shines through his work and serves as the foundation of his success. He has a new book out called, The Mentality of Success, which he’ll tell us more about, As always, Dr. Orsini keeps his promise about two things, that you will feel inspired, and you will have learned valuable lessons to be a better and more compassionate communicator.
Joshua shares his background and journey, which is centered around communication and impacting the value of people. We learn how Joshua got started coaching doctors. Dr. Orsini and Joshua chat about the lack of money spent on teaching communication to doctors. Joshua makes a point about physicians being one of the main professions that are constantly learning and constantly growing, which is why administrators should invest more into training. We find out Joshua’s approach to communicating with physicians as well as why the communication skill set should be a culture within your physician group. Joshua details his four-step process. He explains why data is critical, getting to know each doctor on a personal level, and how long the coaching/physician relationship typically lasts. Dr. Orsini talks about the training he does, which like Joshua’s approach, has a beginning, middle, and an end. We hear about the greatest aha moments that Joshua sees in physicians’ eyes when they talk about the personal versus the practical. Dr. Orsini shares with us how many physicians he thinks are fighting to hold on to their love for medicine , and why it’s okay to ask for coaching. We hear more about Joshua’s new book, The Mentality of Success, how it’s more of a personal development book. If you enjoyed this podcast, please go ahead and hit subscribe on your favorite podcast platform. Go ahead and download this episode now!
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Joshua Washington (1s):
I would encourage any organization or administrator listening to this because I see it all the time that you spend, you talked about expensive efforts and you focus on the most expensive efforts. Nothing is more expensive than looking at your roster of doctors and only focusing on communication skill set increase for your low performers. That’s an expensive initiative because communication skill set should be a culture within your physician group. That way, you know, your high performers, your mid performers and your low performers are all looking. If that’s the same way, it happens on the medicine side. If there’s a new surgery or a new procedure that comes out, it’s not just your low performers, who we’re going to go review that procedure to be able to learn it and do it.
Joshua Washington (43s):
No, all of your high performers, your mids and your lows are going to obtain that information and communication has to be looked at the same way.
Announcer (51s):
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 36s):
Well, Welcome to another episode of Difficult Conversations Lessons I learned as an ICU physician. This is Dr. Anthony Orsini, and I’ll be your host again today. Today we have another incredible guest and this young gentleman contacted me. We hit it off really well. And it’s really fits I think, perfectly into the whole format of this podcast, Difficult Conversations, especially in healthcare. So today my guest is Joshua Washington. He’s the president of Lee Malveaux people strategy and solutions. As an organizational psychologist, Joshua has spent the last decade helping over 200 medical facilities with people, strategy and performance. He’s also trained over a thousand executive leaders and developed a one-to-one physician coaching program, helping doctors reach top percentile nationally and patient experience performance.
Dr. Anthony Orsini (2m 25s):
And for those of you who been listening to his podcast, this is a recurring theme because it is one of the hottest topics in medicine right now. With his engaging personality. As you’ll see, Joshua is able to connect with everyone he meets. His passion for people development shines through his work and serves as the foundation of his continued success. And I promise you, at the end of this short podcast, you’ll be a big fan also of Joshua because he is, soon as I met him, we became friends. We’ll talk about his book, personal development, which is coming out February 16th. And, but by the time this airs, it will already be out. So Joshua welcome. Thank you for joining us today. I know you’re very busy.
Joshua Washington (3m 3s):
Well thank you for having me, man. Like you said, we had a lot of fun. So I expect today to be a continuation.
Dr. Anthony Orsini (3m 8s):
We talked, we got to know each other and hit it off instantly. You’re a flow grown, as they say, as the term, right.
Joshua Washington (3m 15s):
Blow Grown me is that I like that.
Dr. Anthony Orsini (3m 18s):
I see those bumper stickers everywhere here in Florida. Cause there’s not that many people that are from Florida and lived in Florida. So we’re all transplants, but I’m a true believer in building rapport. I’m sure you talk about that with your doctors when you coach them. So let’s build rapport with our audience here. Tell us a little about who Josh is. Not only for where you’re from, but some personal stuff and how you got to this point in your career, how you went through health care and all that.
Joshua Washington (3m 42s):
Yeah, yeah, absolutely. So I like to start with some of the personal stuff. I’m a husband and a father. That’s my wife and I we’re, we’re kind of, we’re still in that newlywed zone. I hear a lot of those who are experienced. They’re like you all just getting started. So I’ve been married to my wife for seven years. Our son is about one years old, so he is a pandemic baby. So that’s been a fun two years watching him go through this kind of cycle of not being able to hang out with other kids. So that’s fun. But also something that happened during that time frame was I started a business. I’ve ventured out from working with a company I was, while I worked for one of the largest healthcare companies in the country for almost 10 years with over just say an immense amount of care workers and a lot of fun, but around 2020 is when I felt impressed to get out and help more businesses.
Joshua Washington (4m 29s):
So that’s something that I’ve been doing with Lee, Malveaux people, strategy and solutions. But to your original question, how I got started in medicine is actually a very funny story because I never thought I would be in medicine. In fact, I hated going to the doctor’s office, not because of the doctor, but just because that’s not something I saw practiced a lot in my family. And so if you would’ve told me, once I graduated that I ended up in healthcare, I would have told you, you are a liar, but that’s exactly what happened. And it was really because of the things that you talk about, the relationship and really being able to connect. And I really had a connection with this particular healthcare organization. And from there, I guess the rest is just history man. I started off as a little coordinator guy and grew all the way to coaching and being a preferred coach for physicians, which I’m very proud of because that’s a prestigious group and they don’t trust everyone to come in and help them with their work.
Joshua Washington (5m 22s):
So something I’m very proud of.
Dr. Anthony Orsini (5m 25s):
We talked about that in our first conversation. I’m looking at for those of you, this is only audio, but I’m looking right behind you, right shoulder there, Josh, you got a piano. You play? I think you said something about music.
Joshua Washington (5m 35s):
Yeah. Music was my first passion. That’s what I thought I will be doing in my life. I thought it would be communication-based but through writing songs and that sort of thing, and to be honest, that’s something I still do to this day, to getaway and a passion of mine. You also see over here on my left shoulder, I keep it there, especially, probably behind me. Yeah. That little small thing that Dr. Orsini is looking at is actually my first royalty check for writing song on a major stream out. So needless to say, I like to do a lot of things, but all of it is centered around the same thing. It’s around communication and impacting people, the value of people. So that’s been a recurring theme in my life.
Dr. Anthony Orsini (6m 10s):
So you get a job in healthcare, but now healthcare is a pretty big industry. So where was your first job and how did you go from the, I’ve never been in a hospital before to getting to coaching doctors. I mean, that’s a big span right there and just 10 years,
Joshua Washington (6m 28s):
That’s a big jump. I think one thing to know is that my studies were in interpersonal and organizational communication. That’s where I started really in schooling and education. And so when I got into healthcare field, my particular area was patient experience. So I did a lot of working with the practices and managers and leaders around patient experience, which allowed me to get into the same vicinity with a lot of the doctors and see, but from an outsider’s perspective, how healthcare professionals approach this kind of particular area of patient experience. And so that’s how I got my start in healthcare.
Dr. Anthony Orsini (7m 3s):
And what made you make that transition to going out on your own? And did you start coaching doctors while you were still at the institution and then said, Hey, I can do this.
Joshua Washington (7m 12s):
Yeah, yeah. Started coaching doctors while at the institution. And to, I think everyone is surprised when doctors begin to reach out to say, Hey, I want some coaching. And that’s when I think the light went off. And it’s really, I think that was the first time in that particular institution that we were using, the patient experience scores as data to inform strategy and relationship, which I think is a huge kind of differentiator from what I’ve seen in a lot of organizations. I’ve been a pre-vis too, but using that kind of methodology of approach to say, Hey, all right, doctors are humans as well. What a thought like they’re humans as well. Let’s approach them with the same relational attitude that we want them to approach their patients.
Joshua Washington (7m 55s):
And so from that, the only reason why I really left the organization is because this business that I run now is named after my grandmother. So it was a personal thing. Has that not happened to my grandmother she passed in 2016. I’d still be at that organization because it was just a fantastic experience to be a part of. But because this is something that was more of a legacy move, that’s why I made the switch.
Dr. Anthony Orsini (8m 17s):
So one of the things, as you know, my background is in communication and relationship building from not only from physician point of view, but through every point of contact from the receptionist all the way to the housekeeper. But as I got into more and more of the patient experience and started to work with more and more patient experience departments, I started to realize that we were missing the boat. Press Ganey was coming in, showing the top five predictors of highly recommended that you had information from Gallop and Beryl Institute and all pointing that the top five predictors of patient experience are all communication and relationship related.
Dr. Anthony Orsini (8m 58s):
The problem is that as I, and I still see this today, and I want your opinion on this is that you see patient experience departments and hospitals that seem to go for the expensive low-lying fruit. In other words, I don’t want to take the time to teach communication and relationship to the doctors. Cause maybe I’m a little afraid of them. So let’s just redo the waiting room as if it’s okay for me to be treated rudely. As long as the carpet is nice, there’s a big screen TV and the things. Did you see that when you were there and why do you think it’s still in 2022? We’re still, I think we’re making some headway with this communication, but it’s amazing how we’re so willing to write a check out for $500,000 for a brand new waiting room.
Dr. Anthony Orsini (9m 46s):
But when it comes to training, the doctors are like, I’m not so sure about that. Why do you think that is you think that’s still happening and what do you think is,
Joshua Washington (9m 52s):
Yeah, I think that’s still happening. I think people were still trying to change the patient experience by offering a bottle of water. Right? What, while you wait, he said that’s the big to do, but I think to your point, the disconnect is relationships. I think when you look at a lot of relationships between administrators and the physicians, that partnership, oftentimes because of the lack of relationship, a lot of administrators don’t know how to approach it. I, when I first started in this, for instance, I was told by another physician that, Hey, you won’t be able to do this because you’re not a doctor. And really, I didn’t take offense to that. But really what I was hearing was you’re not someone a doctor’s going to trust. It’s a relationship thing.
Joshua Washington (10m 33s):
And oftentimes administrators won’t approach this subject because they, I think there’s often this perception that doctors are hyper egotistical and they’ll never want to accept that when the truth is doctors are one of the main professions that are constantly learning, constantly growing
Dr. Anthony Orsini (10m 50s):
Good point,
Joshua Washington (10m 51s):
The medicine changes, right? So there’s always something new. And this was solidified for me when I went out and started interviewing physicians because after I was told, you will never be able to do this. I thought, let me go ask. So I went out and asked some physicians and I’ll never forget a doctor pulled me aside and said, Hey, your expertise is in communication. Correct. So yeah, so my expertise is in medicine. So why wouldn’t I allow you to help me if that’s where I need help. And I think if a lot of those conversations would take place across the administrative and physician line, I think administrators would begin to say, you know what, we can invest into this, but we need to do it through conversations with our doctors.
Joshua Washington (11m 34s):
I bring in an expert to tell the doctor, Hey, follow these 12 steps and that’ll get us all our reimbursements. But to really understand at the physician level, what are the needs and then how can we resource those?
Dr. Anthony Orsini (11m 45s):
And it’s a personal relationship between you and the physician. We had Diane Rogers, Diane shout out to Diane Rogers was on this podcast where he was, she was the first five or 10 guests. She’s become a friend. And she is a lay person, just like you, who does Physician Coaching. If we talked about how she has to approach physicians in a certain manner. And I think you’re saying the same thing to say, listen, I’m not here to tell you how to practice medicine. I don’t know anything about medicine I’m here just to observe and point out those things that you’re doing well and maybe make some suggestions from a patient point of view. Is that how you approach it also?
Joshua Washington (12m 23s):
Yeah. And mine is really from a, just a communication perspective. I like to go in and, and really oftentimes I found physicians are so busy working the practice and all of the hundreds of responsibilities they have. Sometimes it’s just a good idea to sit down and explain the process, explain here’s some of the data points that you may not be aware of, that you’re being measured by. Here’s what your patients are looking for when they come to see you as far as a communication and personal need perspective. So my approach really is awareness driven. It’s really to, okay, let’s work together and I’m going to put on paper what you’re doing. And then I’m going to show you what the kind of best practices evidence-based approaches.
Joshua Washington (13m 6s):
And then from there we’ll work that menu in together in a partnership. And I think that’s why I’ve been received well by this community because of my approaches is really to get in and customize it to the physician.
Dr. Anthony Orsini (13m 21s):
Overall I’ve found in my physician coaching and the workshops that I’ve done overall positions, first of all, we’re type a, we want to be perfect. So when you give us some advice and it’s based on sound advice, we go, Hey, I like that. I never threatened you. Do you get that all the time?
Joshua Washington (13m 40s):
And one of the ways I incorporate that is like choice options. The worst thing you can do with a type a or a really any adult is say, you have to do it this way. And so one of the ways I go in is, for instance, if we’re doing teach back kind of coaching, I say, Hey doc, I want you to try this at your next 10, you know, end of your patient interactions. And then let’s measure it. Let’s see how it goes. And then kind of let the doctor go through because you’re dealing with intelligent professionals. So they know when I try this and there’s a difference, or I get a different response. It helps them obtain the information faster. It helps them implement it faster. So options and choice, I think is a real big kind of accelerator. When we’re talking about Physician Coaching,
Dr. Anthony Orsini (14m 23s):
I get this all the time where I’ll say, how about, you know, think about maybe saying this, or do you see the perception next time? Look at the patient’s face. And they light up, I love what you said. We’re lifelong learners. We want to learn, but don’t tell us what the,
Joshua Washington (14m 39s):
Yeah, especially if you’re dealing with a doctor from New Jersey, especially when you are dealing with a doctor from New Jersey. Don’t tell him what to do.
Dr. Anthony Orsini (14m 44s):
I heard a story about, I think it was back in the Korean war. They had those mash units and that every day they were on the front lines and they’re doing surgery, et cetera. But the doctors were still required to wake up in the morning with the revelry, the trumpets, and they wake up and all that. And they just weren’t coming and they were starting to get in trouble and they were losing this and getting in trouble this and getting demoted. And at one point the United States army just said, listen, you’re not gonna have any doctors left. They ain’t coming because the doctor says, this is absolutely stupid for me to wake up at 6:00 AM to stand in line after I’ve been in surgery until 2:00 AM.
Dr. Anthony Orsini (15m 23s):
I’m not doing it. And so I think what you said is really strong is that let’s give them options because if you really want to make a doctor angry and burnt out and depressed, and we’ll get into all that in a second, tell him what to do. Tell her what to do.
Joshua Washington (15m 38s):
I send them an email with an attachment of some scores that they don’t even understand and say, you know what, all that work you’ve put in over these years, doc, to become the best doc that you want to be. You suck, okay. This, because these scores say, you suck you at the bottom percent that
Dr. Anthony Orsini (15m 53s):
Yeah. And they don’t know why
Joshua Washington (15m 55s):
That’s just as demoralizing. And I would encourage any organization or administrator listening to this because I see it all the time. You talked about expensive efforts, you focus on the most expensive efforts. Nothing is more expensive than looking at your roster of doctors and only focusing on communication skill set increased for your low performers. That’s an expensive initiative because communication skill set should be a culture within your physician group. That way your high performers, your mid performers and your low performers are all looking. Cause that’s the same way. It happens on the medicine side. If there’s a new surgery or a new procedure that comes out, it’s not just your low performance. who are going to go ahead and review that procedure to be able to learn it and do it.
Joshua Washington (16m 38s):
No, all of your high-performers you have your mids and your lows are going to obtain that information. And communication has to be looked at the same way.
Dr. Anthony Orsini (16m 45s):
You know, one of the best advice I ever got many years back was always look at the people who are good and stop looking at the people who are bad. And so what we traditionally had, especially in this patient experience is to take the doctor who wants to do well is maybe struggling in the 50th percentile, et cetera. And then they’re brought into the office and say, Hey doc, you need to improve your scores. And they don’t tell them why. And then they say, don’t be like, don’t be like
Joshua Washington (17m 17s):
Her.
Dr. Anthony Orsini (17m 18s):
Instead of saying, don’t be like him. There’ll be like her. And a lot of the stuff I call it stealing, say, you know what? Here’s a guy or a girl who is in the 95th percentile for the last 10 years. Just watch her watch. When she walks into the room, watch what she does. And I don’t always say to my young doctors, all the time steal from them, steal from them, see the way she smiles, et cetera. And so I think having the coach come in, listen, I got referred a doctor in the Midwest once to coach because he was in a lot of trouble. His practice was failing. He was in trouble with the hospital. He was getting all these complaints. He kept saying, you know, they’re saying that I’m an ass.
Dr. Anthony Orsini (17m 60s):
And I talked to the guy on the phone. He, I don’t understand them. I’m the nicest man in the world. I just, I don’t get it. I don’t understand it. So I went on his website and his website was just rough. It was basically, his website was, you should hire me because everybody else is doing it wrong. And so I just took a couple of the phrases and I go, how about we soften this up? He was kind of like that. So they want to learn. So take me through your approach, Josh. So doctor calls you, or you get in touch with a group and the group says, Hey, Josh, we’re a bunch of nice doctors here. We think we’re great, but we want to be better. What happens then once they hire you.
Joshua Washington (18m 38s):
Usually it’s kind of a four-step process. We look at data. I believe data is critical, especially when you’re working with physicians who have very much data driven. So for me, it’s important to start getting some of those data points. So we started at the personal level. Actually, I want to know who am I working with? Number one, the most important question for me is, are you here by choice? Are you the physician work bid? Did you request this? Or are you bought into this? And for no other reason, then time is our greatest resource. I don’t want to waste your time because you’re not going to get any results. You’re not going to see any change if you’re not truly bought in on this. And you’re just doing it because an administrative leader partner said, Hey, you need to do this.
Joshua Washington (19m 19s):
So that’s number one, we look at readiness. Are you ready to really take this journey? And if you’re not, we can come back around, no hard feelings at all. But once that box is checked and we have the readiness piece, then we started to look into what I call the Kennedy initial consult, right? Get to know the physician kind of a 20 minute conversation. And I want to know what got you started in medicine, because if we’re going to teach you how to build relationships with your patients and I need to build a relationship with you. So that report is understanding what got you started in medicine. And I can’t tell you Dr. Orsini., some of the awesome stories that you hear from physicians, because what this also does is it helps to fight burnout. When someone stops you and says, let’s go back to the beginning and you hear the pediatric doctor who tells you about how they came in and saw their doctor.
Joshua Washington (20m 6s):
And it sparked a love of medicine. And I think that just gets us off to a great start from a momentum perspective to start at that personal level. So once I have those data points, a few different questions around why you got started, what are the three words you want a patient to leave your interaction saying, you know, about their experience with you. Then we move on to getting what I call your preferred script. Because I work at the one-to-one level. I get an exam room with the doctor and sometimes it’s in person or it’s over the computer. So we do a virtual. I just want to hear what you’re doing. There’s no judgment, no, not behind with a clipboard mark and you off, but I want to get a sense of what’s your routine, because you’d be surprised how many doctors don’t even know what their communication routine is.
Joshua Washington (20m 49s):
They just going off of either instincts or habits, but no one has ever sat down and formulated what they’re doing. And once I can formulate what you’re doing and put it in front of you and say, Hey doc, now we have this data. Now I want you to look at what the best practices are side by side. And then from there, the rest is just kind of a progressive process. We work through slowly. I break up their visit into beginning, middle, and end. And we just slowly start to integrate things over a kind of a 90 day period. From there we’ve seen great results. I have not had a physician yet that did not see a tremendous increase just within the first 30 days.
Dr. Anthony Orsini (21m 25s):
And so how long has this relationship typically that you follow them afterwards? How long does it take to turn them around?
Joshua Washington (21m 31s):
It’s all based on the physician. I’ve had some who in 30 days turn around. I have had others who they have that initial jump in 30 days, but you know, okay, we got to stick with this physician as far as follow-up is concerned. I’ve got a primary care doc I work with who comes to mind who I still talk to this doctor today. Who just checks in for kind of just maintenance. Hey, Josh, I got this tough case today. It’s a weight loss patient. I was trying to figure out how to navigate this. And so their relationship can be as long as the doctor wants, you know, cause I’m really here to serve the doc. So I don’t really close off. We will continue as long as you see need or we’ll check in, you know, for some kind of upkeep type approach.
Dr. Anthony Orsini (22m 10s):
So you mentioned, I do this roadmap with over those of you read my book called program and the P is for plan and positioning. And you mentioned, and it is amazing to me that especially with Difficult Conversations, breaking bad news conflict resolution, I do a lot of videotaping. We watched the docs and I’ll say, what was your plan going in? And they’ll look at me like, What do you mean a plan? I just walked in. I just said, hi. And so I think that’s a good point that you brought out that this is kind of like a beginning, middle and an end, correct?
Joshua Washington (22m 42s):
Yeah, absolutely. And the plan oftentimes is on the medical piece, but I think one of the greatest aha moments that I see in physicians in their eyes is when we talk about the personal versus the practical need, oftentimes a physician will go into the exam room focused on the practical need because the practical need is medically based it’s they said medical need. That’s what I’m here for. There’s a lot of the thought process, but there’s also a personal need. And that personal need is the barrier to you getting to achieving and meeting that practical need. And so I think that just that concept, that paradigm shift oftentimes helps a physician understand, okay, I need to have a plan for their personal needs and their practical needs, which is what I hear.
Joshua Washington (23m 23s):
When, when you talk about just some of your experiences going into the exam room.
Dr. Anthony Orsini (23m 28s):
Yeah. I think that’s really important. And I can’t overemphasize what you said before is that overwhelmingly, you’re going to have physicians that are open to this. There’s a little barrier to get through with maybe some embarrassment. I don’t want someone to watch me. We had that in breaking bad news. When I started out teaching doctors, how to break bad news, we had some senior physicians who have been doing it for 10 or 15 years and knew they struggled with it, but they don’t want anybody to know that they’ve been doing this for 15 years and they’re still not good at it. But once you build that trust, as you said, they’re very open. They want to learn. So I think we’re moving in the right direction with patient experience.
Dr. Anthony Orsini (24m 10s):
I hope we are. So
Joshua Washington (24m 12s):
We have to, because think about this, the next generation that’s going to really occupy healthcare is like the baby boomers, the boomers are coming, you know, and the boomers are savvy and have a great interest in just overall wellness and lifestyle. And so what I believe, and this is just my based on research and experience, I believe communication is actually going to be like that free bingo spot on the cart. Patients are going to expect this. And because it’s so many boomers, there’s going to be a lot of opportunity and exposure to those who have increased the skillset. And so I would just encourage anyone. That’s practicing to understand that, yes, this is going to have to become a part of health care because it’s the generational makeup of your patient population is changing rapidly and it’s going to require, you know, that upkeeping skills, the same way technology requires us all to advance on the personal side is going to require it as well.
Dr. Anthony Orsini (25m 9s):
Yeah. My father’s generation, my mother and father’s generation. It was very common as I was growing up to hear people say, he’s got a lousy bedside manner, but he’s a great doctor. Go to him. As you are alluding to the baby boomers, especially the younger ones. That’s not going to fly. Nope. I don’t care how good of a surgeon you are. If I don’t like you and I don’t trust you, then there’s a problem. So I wish maybe together and other people can join in like Diane and all the other people doing coaching. We need to get this down to the medical school level.
Joshua Washington (25m 44s):
Oh yes.
Dr. Anthony Orsini (25m 44s):
And medical schools will tell you because they are required to teach communication. But I can tell you from training almost 7,000 residents in the past 10 years individually, and who knows how many more that I’ll say, well, you got trained in this, but yes I did. Well, how much somebody came in and gave me an hour lecture and we had a 15 minute OSKIE, a little simulation thing and I’ll go, do you find it odd that something that could affect someone’s life for 30 years, that is a major part of the success of your practice and the clinical outcomes that you only spent an hour and 15 minutes on this. And they’ll look at me and go, yeah, I always thought that was weird.
Dr. Anthony Orsini (26m 26s):
Yeah.
Joshua Washington (26m 27s):
Yeah. It’s and this gets even crazier, but all of this direct contract stuff, this happening and patients are being almost like, Hey, go see this preferred doctor. It’s one of those things where communication is a direct line to patient loyalty. And that is going to be one of the sustaining factors for patients be able to keep their patients and be able to have their patients, prefer them over the patient, down the road, who they getting the stipend for. You know, they’re getting their transportation paid for to go see the difference is going to be no, I have a connection with this doctor because they can meet my personal need because they are great communicators.
Dr. Anthony Orsini (27m 2s):
And one of the important points, I think I’ve said this before, is if for no other reason, when a nurse or a doctor feels like they’re communicating well with all their patients, they have a relationship. You said it before it reduces their burnout because they enjoy their job. They’re reminded, as you also said that this is why they went into medicine in the first place. There’s less turnover and dramatically. The data dramatically reduces medical errors and malpractice lawsuits dramatically. I talk about in my book, my family Dr. Anthony Merk, 50 years, practicing OB GYN and family practice never sued.
Dr. Anthony Orsini (27m 43s):
The odds of that If you look at statistics is less than 2% of happening. And the guy was just an okay doctor. Wasn’t the greatest doctor ever, but he could cut off the wrong finger on you Josh, you wouldn’t sue him because he was just a great guy. And he was your friend. And I hope that we’re moving in that direction. I really do.
Joshua Washington (28m 1s):
Well, let me ask you a question real quick. Cause you’ve been in his thing. You are a vested and experienced. How many doctors do you think today? Cause you brought up something that I think is really important about the burnout piece. How many do you think are literally fighting to hold on to their love for medicine to stay in it?
Dr. Anthony Orsini (28m 20s):
You look at the data depending on who you read it somewhere between 40 to 60% of doctors right now are feeling some type of burnout. We had Wendy Dean on, Wendy Dean is a doctor who redefined physician burnout as moral injury, which basically I think she’s got a very good point that it’s not that we’re working too hard. It’s that we’re not being satisfied with our job, that we are being forced to see patients back to what you said before. Looking for that relationship, reminding of why we went into medicine in the first place. When you have people telling you how many patients you have to see, and that’s what I get a lot is you don’t know, I got to see 27 patients and I go, yeah, but when you’re in that room, nobody’s telling you what to say.
Dr. Anthony Orsini (29m 4s):
There’s no administrator, there’s no insurance company. And if I teach you how to build that relationship, and as you say, have a plan and a beginning, middle, and end, it won’t take you that much longer. Probably be less time. So that’s your time. There’s a whole world went out there like Dike Drummond was another episode. He calls it. There’s a world went out there, but when he shut the door, this is your time to enjoy medicine. So let’s learn how to do it. And for those people who want the bit, we all want to, and we just need coaching. It’s not embarrassing to need coaching. Everybody needs coaching.
Joshua Washington (29m 38s):
Yeah. And I asked you that question for a reason because the majority of my work often takes place with the administrator. It often takes place getting the administrator to balance that focus of outcome-based results. You know, patient experience, scores, engagement, scores, financial results, and really getting back to the process piece. Because if you think about it, there is so much pressure on the physician because the physician, especially if you deal in a lot with medical practices, like I do, the physician is expected to be a leader in the medical practice. Even if there’s an office manager, the physicians voice carries more and see patients and connect with not only the patients but their staff members.
Joshua Washington (30m 17s):
So in many ways, physicians are expected to be relational experts and you have all that pressure and pressure to perform pressure, to meet the administrators’ goals and partnership. And it can be overwhelming. And I think that’s something that we have to keep in mind. That’s why I always say data should be used to inform strategy, not to throw more stress on the physician. If we can get to that point, then communication and patient experience conversations become a lot less combative and it becomes just a working mechanism within the overall organizational structure.
Dr. Anthony Orsini (30m 52s):
That’s a great point. So Josh, tell me about your book. Now, it’s coming out February 16th, it’ll be available on your website. And I think you said Amazon, this is probably going to go live or drop as they say, probably in March. So it’ll already be out. So tell us about the book, the title and what drove you to write it.
Joshua Washington (31m 11s):
Yeah. The book is called The Mentality of Success. It is a personal development book and it’s part of the reason why I branched out to start my own business. I wanted to focus on kind of two verticals. So I do a lot in healthcare organization, but I also work a lot with young professionals and this book was written and I think it’s a very timely piece because it was written to bring back our attention to our own personal value in success. It can be a pressure trigger for a lot of young professionals who are looking to reach some imaginary line of success. When the truth is we are all created with success already in it. Every great thing that has been invented and built on this earth has come from a human being, which means the success was not in the thing.
Joshua Washington (31m 56s):
The success was in the person. And I think sometimes that idea gets confused. And so this book was really written for the young professional, with suicide rates, kind of, you know, now due to the pandemic, they’re accelerating even more. I think this book is something that’s really timely for the depression, the anxiety that the suicidal thoughts to bring us all back to purpose and say, your life matters, your value matters. And not only does it matter, but someone needs the value that’s within you. And so the motivation to write this book really sparked once my son was born and I just looked out at the future in his future and wanted to write some words and some pages that he could always look back to and read and listen and hear his dad’s voice.
Joshua Washington (32m 37s):
And I hope it is the same for anyone else. Again, young professional, who would pick it up and say, you know what? This book inspired me to go out and pour out my value on the world.
Dr. Anthony Orsini (32m 46s):
I love that. So this is not a healthcare book. This is a personal book. The point of the book. I, it sounds like it’s something that I agree with wholeheartedly is we don’t want to go through life studying for the test and you get that going back to the health care, or you have us news and world report. You have leapfrog, you have HCAPS. And when you bring these results to somebody and say, okay, here, you’re going to get two points. If you do this, you can get one point. That’s going to fall flat on its face, right? Yeah. But bring it to them and say, do this because there’s excellence in you. And because you want to do it because it’s the right thing. And this is how you were raised.
Dr. Anthony Orsini (33m 26s):
You get better results. You know, the numbers will follow and we have to stop, you know, learn math because you need to know math. They’ll learn math because you have to take the SATs. It’s a big difference on how you look at things.
Joshua Washington (33m 40s):
Yeah. The numbers follow relationship because the relationship ignites the intrinsic motivation. There is a far as a small, small amount of doctors who are in this thing for the wrong reasons. The overwhelming majority of doctors are in this with the right part and want to succeed. And I think when we can push the numbers aside and say, okay, let’s bring this back to you as a person who wants to treat your patient the best that you can. It makes it a lot more receptive. And it ignites those intrinsic motivators that sustained performance, because you don’t want someone to just increase performance because you sent them a bunch of red numbers. Right. But they increased performance because it means something to them. Intrinsically.
Dr. Anthony Orsini (34m 19s):
I love that. Perfect. That’s a perfect way to end here, Josh. So I’m so glad that our paths of our lives crossed and that you contacted me. I think this is going to be a really informative episode. It fits perfectly within, as I said before in our podcast platform and our theme, and I think you really seem very knowledgeable and you’ve had success, you’ve shown success, and I wish you all the success in the future with your book, what’s the best way for everyone to get in touch with you if they need your services.
Joshua Washington (34m 49s):
Yeah. A lot of times it’s LinkedIn has been just a great portal for connection. So you can reach out on LinkedIn, it’s Joshua, Washington, or Lee, Malveaux people, strategy and solutions. You can find me there, or actually my email as well, Joshua at Lee malveaux.com. Any of those three ways that’s connect. And if I can help in any way, I will definitely do so.
Dr. Anthony Orsini (35m 9s):
And we’ll put that all in the show notes. So if you’re a, as I say, if you’re driving, you don’t need to pull over or just go to the show notes and click on it. If you enjoy this podcast. Thank you again in please go ahead and hit, subscribe or follow on your favorite podcast platform. Go ahead and download some previous episodes that we mentioned already. If you’d like to get in touch with me, you can reach me at the Orsini Way.com or Dr. Orsini Way.Com. Again, Josh, thank you so much. This was a great time and I can’t wait for my audience to hear.
Joshua Washington (35m 42s):
Likewise, thank you for having me.
Announcer (35m 44s):
If you enjoyed this podcast, please hit the subscribe button to leave a comment and review. To contact Dr. Orsini and his team, or to suggest guests for future podcasts, visit us at theorsiniway.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.
Show Notes
Host:
Dr. Anthony Orsini
Guest:
Joshua Washington
For More Information:
Difficult Conversations I Learned as an ICU Physician Podcast Episodes
Resources Mentioned:
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