The State Of Healthcare - Moving Forward

Steve Lawler (1s):
One of the challenges we have in healthcare is actually humanizing healthcare. A lot of folks kind of view us as like this big business, because we’ve got lots of bricks and mortar and lots of buildings. They hear that, you know, hospital executives are making high salaries. So I think one of our challenges to kind of improve that connection to community is humanizing the face of healthcare and moving it from being a perceived as being about big business to, you know, really what the fundamental purpose of healthcare is, which is caring for people. I think, as you pointed out, the best way to develop that new brand for the field is to develop these intimate and really mutually supportive relationships.

Announcer (49s):
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 34s):
Well, welcome to another episode of Difficult Conversations: Lessons I Learned as an ICU Physician. This is Dr. Anthony Orsini, and you guessed it I’ll be your host again this week. Today I have the privilege and the honor to have as my guest Steven Lawler. Steve has been the President of the North Carolina Healthcare Association since 2017. Prior to his current position, Steve served various roles providing health in Eastern North Carolina for over 20 years, including seven years as the President of Greenville Hospital. Prior to that he took the position as Senior Vice President Regional Group of Carolinas HealthCare System until his current role as President of the North Carolina Healthcare Association.

Dr. Anthony Orsini (2m 16s):
Well welcome Steven, really great to have you today. Thank you for taking time out of your busy schedule to talk to my audience.

Steve Lawler (2m 23s):
Great to be part of this conversation.

Dr. Anthony Orsini (2m 25s):
Know we had a really great conversation a week or two ago about the future of healthcare, and I think it’s a really important and difficult conversation to have with all the politicizing of healthcare. And so I really just want to dive into this and I don’t think there’s many more Difficult Conversations than when we talk about healthcare. So, but before we start, let’s just start off as I usually do. Just tell the audience a little bit about yourself, where you’re from and how you got to be the president of The North Carolina Healthcare Association.

Steve Lawler (2m 53s):
Well, so I grew up in North Carolina. I grew up in Eastern North Carolina, which typically is kind of a rural part of the state. So it’s east of 95. So folks that have lived in Charlotte and Raleigh, they kind of thought it was like Columbus going off the side of the earth. Both of my parents were educators. I grew up in a family that was committed to being part of some kind of a business or industry that was based on service. So grew up there, went to college at the Citadel in Charleston and then got into healthcare administration as an army officer. So spent several years doing that, taught you a lot about leadership and teams and the kind of selfless service and servant leadership got out, had an opportunity to come back to Greenville where I grew up and be part of that health system and that medical community, and did that for 22 years.

Steve Lawler (3m 45s):
I had the opportunity to do everything from running a critical access hospital, to running a thousand bed teaching hospital, built a system and then retired from there. And I’ve had the opportunity to kind of reinvent myself in two different roles. And now have the great privilege of leading the North Carolina healthcare association, which supports all 130 hospitals in the state.

Dr. Anthony Orsini (4m 10s):
Did you always know you want to do something in healthcare or did the universe just kind of take you there?

Steve Lawler (4m 15s):
And I think I always had an interest in healthcare. My mother was a public health nurse and kind of like the old school, public health nurse that had clients and people that she would go visit at their homes. And that was when population health was kind of something that they did versus a slogan. Yeah. So it had kind of the idea that something that I was interested in after first semester of college chemistry, I realized that I may be better supporting those people that are taking care of people versus getting into the science of it. So just been really fortunate. You know, I’ve had a career where my purpose was to care for people that were caring for others.

Dr. Anthony Orsini (4m 57s):
That’s great. And the North Carolina Healthcare Association, I think represents 130 members. Can you tell us a little bit more about healthcare associations in general, but mostly North Carolina Healthcare Association and really what you do there for the people of North Carolina?

Steve Lawler (5m 11s):
Well, I mean, healthcare associations really are a membership organization and with the sole purpose of supporting our membership so much like other state associations, I mean, we do that on a variety of different fronts and with the focus of providing support and services to give our membership, which includes all kinds of hospitals from state hospitals to private not-for-profits, we have for-profit systems in the state, we have governmental hospitals. So I mean, our purpose is to provide programs and services to support them. So our sharpened really is about lobbying and advocacy and development of policy.

Steve Lawler (5m 52s):
We also spend a significant amount of times providing support structures for data and policy gathering, and then shaping that data and information in a way that allows our members to best continue to improve their practice, to improve quality of care. Or it gives us a frame of reference when we are trying to shape policy or lobby. We’re now using that data and analytics to really take a deep dive and looking at equity of care and making sure that as we look at outcomes, we’re not just looking at the end and declaring victory when our numbers are below the national average, we’re really drilling down to fully understand what it means to different populations, and then using that knowledge and understanding to shape better practice and processes and shape a way that we connect with community to really improve those outcomes.

Steve Lawler (6m 47s):
And then finally, we’ve got a shared services company that creates some economies of scale and buying power. So it’s kind of like a brokerage portfolio that offers services for our members. And we’ve got one of the largest healthcare foundations in the country that does a variety of things from providing technical assistance to other community-based foundations, to being a platform for granting, for organizations that are community-based, but have partnerships with hospitals and health systems to get at those issues that are either barriers to equity or that are creating disparities in care.

Steve Lawler (7m 27s):
So, you know, it’s an incubator for good ideas. And I like to think about it as like this translational kind of research center that is focused on best ideas for practical solutions for better health within a community.

Dr. Anthony Orsini (7m 42s):
And for those people that are listening that are aren’t in healthcare, we know that is so hard to do any research or quality improvement, especially if you’re a smaller hospital without some kind of partnerships with organizations and to have all 130 of these hospitals kind of contributing and talking about their experience. And you’ve mentioned inequities, and that’s a hot topic right now. And so some of your hospitals, I’m sure in very rural areas and some of them are in the city and to be able to get those numbers and to not only look at the end, but to say, okay, what are we doing? That’s best practices is really extremely important if we’re going to get any better. And I think healthcare right now, as far as quality of care, in my opinion is going up and up and we’re getting better at what we do.

Dr. Anthony Orsini (8m 29s):
And my world is neonatology. And I remember as a medical student, which I don’t want to tell you how long ago that was 30 years or whatever that was telling me that it’s 28 weeker was the earliest survival premature baby. And now we’re saving 22 weekers. So that kind of a consortium is so important. You mentioned something earlier about helping with negotiating powers with insurance companies and costs, I went on the website, the North Carolina Healthcare Association, and I saw a little video explaining cost transparencies, which I think was the best explanation of how hospital costs occur and how we pay for healthcare in this country.

Dr. Anthony Orsini (9m 12s):
And then during the Trump organization, transparency was a big topic. So tell me how we are in a crisis right now with healthcare, with we’re trying to get better and better care, but it’s getting more and more expensive. There’s those people who have made healthcare into a political push, where do you see healthcare going with universal healthcare versus private? And what can we do to kind of make the numbers work better and still keep that quality of care?

Steve Lawler (9m 41s):
First of all, I think if I were a young man or woman that was interested in a career, I can’t think of a more exciting time to get into healthcare. And it’s a challenging time as you’re point out. I mean, healthcare is expensive and it’s driven by just these amazing discoveries and clinical advances, it’s driven by new technologies that help support that clinical advances. And it does driven by pharmaceutical prices, which are double the healthcare rate of inflation. So the fact is that we need to work together to make healthcare more affordable and less expensive. And I think that’s a fact. The idea of transparency I think is really important and something that we certainly embrace and what should go hand in hand with decisions that patients and families make in regards to where they get their care.

Steve Lawler (10m 31s):
And then I think even more importantly, what their plan of care looks like. And we talked a little earlier about the importance of conversation between patients and families and then the provider community. Well, I think that becomes even more important as we talk about kind of quality outcomes and affordability, because there is a lot of things that we can do for people. I think one of the tough questions and you’re an intensivist, so you can appreciate this, but what’s the right thing to do to maximize quality of life for individuals. So the things that we’re working on for the future of healthcare in North Carolina is we’re looking at value-based care and an alternative payment models, which actually return economic value to the place within the system of care that has the greatest potential to improve health and reduce costs.

Steve Lawler (11m 25s):
So that’s kind of thinking outside the four walls of a hospital and looking at how do we make investments with relationships and partnerships throughout the community, be it primary care, the faith community, or just community partners to better engage patients in their care early on so that we are not left with a healthcare system that is only focused on sick care that only focuses what happens when that patient becomes in distress shows up at the ed. So I think it’s really about thinking about where are we making investments in the future. It’s pushing managed care companies and managed care companies have done very well claiming to be the solution for patients and families.

Steve Lawler (12m 11s):
And the fact is they do play an important role, but they play an important role as a middleman in the process. They play an important role from a finance and administration perspective, but they’re not the ones that are driving kind of what happens to that patient. So I think the future of healthcare really is about physicians and hospitals and health systems and other partners that are touching and creating value for patients kind of taking their rightful spot as the trusted advocate for patients and families and replacing the managed care companies who have worked hard through marketing and other approaches to kind of fill that gap.

Steve Lawler (12m 55s):
So I think those things are really important. Then I do think that any time a physician in a hospital can provide the total experience of care for that patient family or community, which means that not only they’re providing clinical care, but they’re also providing the full complement of support structures that typically may be available through a managed care company. Anytime we can build that ourselves and offer that to the community. I think what we’ll find are communities lead better outcomes and care will be cheaper.

Dr. Anthony Orsini (13m 28s):
Yeah. You mentioned some really key words there, trust relationship and costs. And I think they’re so related to each other. One is getting your routine care, getting your routine checkups. It always shocks me that everyone knows that if you take your car to get the oil changed every 5,000 miles, you’re less likely to break down, but we don’t do that for ourselves, right? We don’t go for a colonoscopies, but there’s a lot of data that says that most people don’t do that maybe because they don’t have the relationship with either their doctor or their community hospital and, or there’s a relationship there just because they’re local, but there’s really no trust in the system. I think one of the best things that happen in healthcare is in the last 10 years was the elevation of the patient experience.

Dr. Anthony Orsini (14m 15s):
And more than ever, the experience that a patient has, we know improves outcomes and they’re more likely to go for their health care visits. And so I think that’s one of the best things that we have done, but I think we do have to form those relationships with the community, as you said, how are we doing with that? Because I really need to teach these community hospitals better on how do you make those relationships so that people come in for their routine visits.

Steve Lawler (14m 45s):
I mean, if you look at polling data from national firms, nurses and doctors are the most trusted professionals. So I do think that understanding and leveraging individual relationships or people’s perception of groups of people is really important. And I do think that one of the challenges we have in healthcare is actually humanizing healthcare. A lot of folks kind of view us as like this big business, because we’ve got lots of bricks and mortar, lots of buildings. I mean, they hear that hospital executives are making high salaries. So I think one of our challenges to kind of improve that connection to community is humanizing the face of healthcare and moving it from being perceived as being about big business, to really what the fundamental purpose of healthcare is, which is caring for people.

Steve Lawler (15m 37s):
And I think as you pointed out, the best way to develop that new brand for the field is to develop these intimate and really mutually supportive relationships with key community partners that look like, and that have close connections with the people that we’re so privileged to take care of and having been a hospital administrator and a healthcare executive for 40 years, I can tell you that we’re great at fixing problems. We’re not great at listening. So I think the listening to these community leaders and really understand what’s the solution to the issues that are either barriers to care, what are the solutions to issues that cause readmissions to hospitals, because people may not have the right support structure when they discharge, what are the barriers from creating access?

Steve Lawler (16m 35s):
We can come up with solutions all day to the problems that we think are going to work, but really listening and developing these kinds of intimate relationships. And then being courageous enough to ask people for help, that may not be as large and complex and sophisticated as you are. Well, that’s the solution. And I’m excited to see those conversations start to happen. But again, we’re in a business of problem solving. I mean, you’re as a physician, I mean, you’re perfectly trained to diagnose and solve a problem. We’re perfectly trained to kind of say, okay, I’ve got all these resources, let’s apply them to make things better, but you know, having fumbled in that kind of communication.

Steve Lawler (17m 19s):
And thankfully, I had a minister that was kind enough to point out where I was missing the boat and helped me kind of connect in a more meaningful way to get stuff done. I think that’s a critical aspect for making progress in the future.

Dr. Anthony Orsini (17m 34s):
Tell me about that conversation. So the minister sit you down and say, Steve, we’re getting this all wrong. How’d that go?

Steve Lawler (17m 40s):
The CEO of a thousand bed teaching hospital. Let me, once a month, I had like this techie medical lunch. So I got all the faith community members together and we break bread and it was fantastic. I thought it was fantastic. It was marvelous. And I give them updates on everything that we’re doing and what’s new about the medical center and here’s all the things we’re doing to fix all the community woes. And after about three or four months of this, one of the most influential African-American pastors sat me down and said, Hey, Steve, but he said, you have a second. So after everyone left, we sat down and we’re drinking our iced tea. And he said, this is a complete waste of time and you’re not getting anything done. I was like shocked. And he said, we appreciate your effort to get us together.

Steve Lawler (18m 22s):
And by the way, it’s a great lunch. He said, but you’re missing the point. We’re not here to listen to you tell us how to solve our problems. We’re here because we want a relationship. We want you to listen to us so we can help you understand what the barriers are. And then we can help give you the fill in the blank answer is to get this right for our community. So I was just grateful that we thought enough of me to sit me down and tell me I was getting it wrong.

Dr. Anthony Orsini (18m 50s):
I love that. That’s a great story. It’s all about relationships. And to me, it, you know what we do at the Orsini Way, we train doctors on how to form relationships with patients. And then that just moves up in my mind. This is a, an upside down pyramid. So we always say a patient can have a relationship with a person it’s hard that you can have an abstract relationship with a community or a hospital, but there has to be this upside down pyramid where the patient feels a strong, trusting relationship with their family doc who’s on the ground, who they have a relationship with. And then when their family doctor says, this is the test that I think you should have, they go for that test. And that’s been shown over and over again, that if you trust your doctor, you’re going to do it.

Dr. Anthony Orsini (19m 33s):
And then when the family doctor says, I need to bring it into the hospital and this is what you should have it done. And so we just get wider and wider. And, but without that, one-on-one community doctor. And I think, and I’d like you to comment on this. I think part of the problem is the community doctors don’t have enough time because of the restraints put on them to sit and really talk to their patients, or maybe the community doctor going to the local church and saying, this is why you need to have your colonoscopy. That’s what I’d like you to comment on the, really the restraints on that community doctor to really take the time for those relationships.

Steve Lawler (20m 8s):
Yeah. So I think that’s a great comment. So I think, I mean for no better term, it’s about how we value time and how we assign some kind of financial support or payment for that time. So I do think moving to some kind of universal payment or some global payment, or even a capitated rate where we’re clinically integrated networks are responsible for a population and they’re paid for that population. I think that creates the kind of dynamic that allows that community physician, that primary care physician to invest more time in conversation and understanding. So they can customize that plan for patients because right now, I mean their time is so fashioned toward productivity, that it doesn’t incent that, and I think once you become responsible for the health of a community, you’re investing your time differently, you’re using your healthcare team differently.

Steve Lawler (21m 11s):
I mean, right now, most primary care physicians have a patient panel between two and 3000. I think that’s kind of how they view when I used to be a practice manager. I think that was our target. So what would happen if your practice at 10,000 people and you had advanced level practitioners that were taking care of those things that are reasonable for a nurse practitioner or a PA, or either even a health educator and the physician’s time was really dedicated to helping customize those plans for people that really needed care. So I do think when we look at value based care or alternative payment models, part of the long-term goal is to use talented people at the point that they’re most effective and the way we can get our primary care physicians to really understand how to customize care plans that are easy for people to follow and that enable individual patients to get it right.

Steve Lawler (22m 8s):
I mean, it’s kind of like coaching individuals. Some people you can give them the plan, they’re out the door and they’re doing great. Other people just need some additional support and rehearsals to kind of go through it over and over again before they get it right. So for those of us who have had the privilege of like coaching our kids in sports, which is kind of like a thankless job, because every other parent thinks they’re smarter than you are. And they’re quick to tell you, but you know, you’ve got kids with different levels of ability. So patients are very much the same way. Some get it immediately, they’re out the door, others just need some additional support. So wouldn’t it be great if those primary care physicians had the time to provide that additional support and coaching,

Dr. Anthony Orsini (22m 54s):
Just give it a Ted talk that dropped last week about personalizing medicine. And I think that’s one of the things that is one of the biggest struggles with medicine right now with electronic medical records and all the documentation and all the billing I’ve had doctors come to me and say, just don’t understand. I have really a good doctor. I do practice really well, but my practice is not thriving. I’m not getting those two or 3000 and mostly it’s not their abilities as a physician or a scientist. It’s just, we need to train them a little bit more on, on how to form that relationship with a patient when they walk into the room. But how do you find that commonality? How do you become as my mother would say, the best friends walk in and Dr.

Dr. Anthony Orsini (23m 36s):
Lawler Is my best friend. And by really see them not just as a doctor, but as a person, et cetera. And so making that personalization of medicine from the doctor, and then it goes right up to the community hospital is really so important, but I don’t think we give enough protected time for that kind of, and I hate this term, but it’s still being used soft training for physicians and for health, it it’s software. It’s not soft training, it’s actually required.

Steve Lawler (24m 4s):
Well, I’m going to be interested to see having the CEO of a big teaching hospital that was a partner with a medical school. And we had 400 residents and fellows. I’m going to be interested to see how our next generation of physicians and these are young people that are extraordinarily skilled in social media and communicating that way and how they transition into a profession that really is based on like personal conversations and personal connections. So they’re going to be taking care of people that have never texted before and use an ATM machine for God’s sake. That’s going to be a new skillset that we’re going to be asking folks in medical school and residency to grasp and understand pretty quickly.

Steve Lawler (24m 53s):
And I mean, how do you deal with conflict with a group of people that like text each other while you were mean to me and versus kind of have these like really tough conversations. So I’m going to be really excited and interested to see how we, how we help prepare those young men or women, because it is going to be different.

Dr. Anthony Orsini (25m 11s):
It’s a great point right now. This is a generation that’s growing up with instant information and whatever disease your doctor mentions that they can look it up. And so the doctor patient relationship is less informational. And 20 years ago, the doctor would explain everything that’s going on. And that was their main goal of that conversation. And now I’m teaching the young people that your main goal is not necessarily information. You do have to provide that, but it’s really relationship. And so one of the exercises we do is I take a doctor and I’ll say, okay, I want you to speak to somebody here and tell them the diagnosis and then explain what it is.

Dr. Anthony Orsini (25m 53s):
Okay. And I want you to watch their eyes. Now tell them what it is first. And then say, we call that and I’ll write it down for you. And what happens, Steve is it’s nine out of 10 times. If I give you a diagnosis, hyperemesis, gravidarum the patient looks up and starts to figure out what, how to spell it.

Steve Lawler (26m 14s):
It’s like a really complicated name. Exactly. Right?

Dr. Anthony Orsini (26m 17s):
So whatever it is, it could be ulcerative colitis. But what they’re doing is almost universally, especially the young people. They’re trying to remember how to spell it because as soon as they get home, they’re going to Google it. That’s just the fact you and I never did that when we were younger. So by you telling them, these are simple things that we teach, this is what it is. This is what we call it. And I’ll write it down for you. As soon as we’re getting ready to leave, what happens? Your attention snaps right back on me. And now we’re listening. And so little things like that. Yeah. I mean just little things that we can do to teach, because right now you’re right. I have three kids. My youngest one is 21. My oldest one is 28 and they totally text.

Dr. Anthony Orsini (27m 0s):
And this is the way they communicate. And I work with them all the time, just because that’s what I do. But many of these kids can’t communicate. And sometimes we’re having a conversation. My youngest one will just start going on his phone. And I used to get really angry with them. I’m like, TJ, his name is like, what are you doing? Like I’m speaking to you. And Lauren, my wife says, she’s looking it up. So, so that’s what that generation is doing. So if I say, give my son advice, even from his father, he’s looking it up as we speak to see if I’m right. Yeah,

Steve Lawler (27m 33s):
No. If you asked your kids, I mean, I’ve done this, Hey, when’s the last time you taught, I’ve got two kids in there. They’re amazing. And thank God they took after their mother, but when’s the last time you talked to your brother and they don’t talk on the phone. There is like communicating back and forth in a different way. So there’s a lot we can learn from this younger generation. And I can tell you anytime we had an issue with our electronic medical record, I had a, an advisory group of residents. I just like turned them loose on that. Here’s a problem that like some of the older faculty are dealing with. And I mean, they come up with a solution in like a matter of hours on how to make something easier. So that’s pretty exciting, I think. But I do think getting to our earlier point in our conversation, making it all personal, even though we’ve got all these amazing tools and technology, it’s really about relationships.

Steve Lawler (28m 24s):
And it’s about just having that personal connection. That’s the currency. I mean, relationships are the currency we use to get anything done.

Dr. Anthony Orsini (28m 32s):
And it ties into everything that we do both in our personal and professional life. But as far as medicine, if you have a relationship with your doctor, you’re less likely to file for malpractice lawsuit to be out of a relationship with your doctor. You’re more likely to listen and take your medication and you’ll have better outcomes. One of the things that I’m hoping that we’re going in the right direction and the patient experience is pointing us that way is let’s teach our healthcare professionals how to have those relationships. And then we’ll go on. So one more question, before I get to the final question. So if you take out your little crystal ball, now you’ve been in healthcare for all these years, 10 years from now, what do you think will be?

Steve Lawler (29m 9s):
So I think 10 years from now, I think we’ll be more clinically integrated and that doesn’t necessarily mean it’s like a balance sheet exercise where people are taking over other people. I think it means that we’ve been smart enough and wise enough to figure out if we’re all responsible for the health of a geography or health of a state, or even the health of a region, figuring out how to leverage the best ideas and the best locations, and kind of bringing that into a package to make it easier for patients and communities to receive the best care at the right location, right time and navigate that care.

Steve Lawler (29m 51s):
So I think we’ll see that. And I think that’s pretty exciting. I think we’ll see those clinically integrated networks move to provide coverage options for people in geographies. I think that that makes a lot of sense and I think it creates some efficiencies for the system. I think we’ll see more advances and movement towards kind of hospital at home and kind of using technologies where patients and families have more control over where they’re getting care and then being closer partners and how that care is managed and delivered. And then finally, I think we’ll, we’ll continue to see improvements in quality and patient outcomes and patient safety and tied to that.

Steve Lawler (30m 38s):
I think we’ll see advances and equity and reducing disparities because I do think that by following the same game plan that we followed after Don Berwick’s hundred thousand lives campaign kickoff, where we took this very focused and systematic approach to reducing patient harm, I mean, following that same game plan for equity and disparities, we’re going to see significant progress over the next 10 years. So I’d like to think that at least in North Carolina and I’m sure other states would say the same that our health outcomes and kind of rankings as a state on how healthy we are, are going to improve.

Steve Lawler (31m 24s):
And when we focus on that, it’s kind of like the rising tide it’s going to lift all boats. And then finally, I just like to see our hospitals and health systems continue to build on that level of trust and confidence that we have coming out of the pandemic. That’s something that has been a good thing where people realize where this like amazing force for good. Sometimes we’re not at our very best talking about that, but I think we’ve proven that over the past 18 months. So I think building on that really is important. And part of that, I think ties back to humanizing Healthcare.

Dr. Anthony Orsini (32m 4s):
So one of the few things that did come out of COVID I agree is this healthcare heroes campaign that came out from COVID showing how hard doctors and nurses really are working and work for your health. And I do think that it did form more trust with the healthcare system prior to that because of either political or media reasons, we were starting to paint positions in hospitals, as a, as you said early on is people in organizations who are just looking to make loads and loads of money by the Jaguar. But then we saw nurses on the floor, sleeping in the hallway during COVID and caring for patients. And I think that humanized it, so I’m pretty optimistic about where medicine is going.

Dr. Anthony Orsini (32m 46s):
And I think we are definitely getting better with the quality we’re getting better with safety, but the only caution is that we have to make sure that we are keeping the personalization, especially with, I mean, we’re using electronic medical records to maximize billing and to maximize safety. But I had one doctor say to me last month, you know, I feel like I’m treating the computer and I’m not treating the patient. And so as long as we’re careful about that, I think I agree things are going in the right direction. So Steve, I’m not sure if I warned you about this question when we spoke or now this is the last question I ask every guest before we leave. What in your 20 plus years experience in healthcare or in your personal life, what do you think is the most difficult conversation you have had to have type of conversation?

Dr. Anthony Orsini (33m 30s):
And please give the audience some advice on how to navigate through that type of conversation.

Steve Lawler (33m 34s):
I would say the most difficult conversation I’ve had is been with my aging parents for all of the wonderful things we have in healthcare. It’s hard to navigate and for helping an aging population develop a plan for themselves for the future for that was a really hard conversation. When we sat down with our folks and said, let’s talk about kind of, how do we create the conditions for you to meet the objectives that you both have? So it was a really, I mean, I think these are probably conversations that are going on all over the country. And part of it is the difficulty. And you’ve seen this and having critical conversations with families about a critically ill grandfather in the hospital that is not going to be able to leave that hospital and do all the wonderful things that individual loved doing.

Steve Lawler (34m 29s):
So for my folks. So it was really sitting down and saying, what’s important to you in this kind of last chapter of your life and it was being together. So I’m happy about that. And they’ve been married for 60 something years and I said, wow, in order to do that, if you want to be together, you’re going to have to change. And some of the things that you, hold dear, we’re going to have to work with you to change so you can meet your objective. And that was a tough conversation because it required some decision-making and support. They didn’t necessarily want if they were orchestrating the plan by themselves. And it taught me a lot about just, you know, how to kind of in a very respectful and caring way, have a conversation that leads people to where they want to be, and then work backward from there to make it work for them.

Dr. Anthony Orsini (35m 23s):
I think that’s great advice. And the way to navigate those is to let them make the decision on their own kind of lead them where you want to go. But I think all too often, we, we tend to dictate these difficult conversations like mom and dad, this is what has to happen. This is what you need to do. And I think it works best if they can make that decision on their own. Wouldn’t you agree?

Steve Lawler (35m 43s):
I would completely agree.

Dr. Anthony Orsini (35m 45s):
Well, that’s great advice, Steve. Thank you so much for taking the time. You’re crazy busy. I know. And thank you so much for your time for what you do for promoting health care and thank you for my audience, because I think they really learned a lot from you today and it was a great conversation. Thanks.

Steve Lawler (36m 1s):
I really appreciate you doing this because I mean, it’s a great venue for people to be up to date and grew up regards to what’s going on, but also kind of lifts the shroud of secrecy sometimes in regards to what actually takes place versus what people think.

Dr. Anthony Orsini (36m 16s):
That’s, what we hope to do, Steve, the best way for someone to get in touch with you. If they’re listening to this,

Steve Lawler (36m 20s):
It’s like an email me at Steve Lawler at NCHA.org.

Dr. Anthony Orsini (36m 25s):
And we’ll put that in the show notes to be enjoyed this conversation. If you joined this episode, please go ahead and hit follow on your favorite podcast. It’d be like, get in touch with me I’m available at the Orsini Way.com Steve. Again, thank you so much.

Steve Lawler (36m 38s):
Take care. Thank you.

Announcer (36m 40s):
If you enjoyed this contest, please hit the subscribe button and leave a comment and review your 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.