Welcome to the Clinical Center Grand Rounds,
a weekly series of educational lectures for physicians and
health care professionals broadcast from the Clinical
Center at the National Institutes of Health in
Bethesda, MD.
The NIH Clinical Center is the world's largest hospital totally
dedicated to investigational research and leads the global
effort in training today's investigators and discovering
tomorrow's cures.
Learn more by visiting us online at http://clinicalcenter.nih.gov
OUR SPEAKER TODAY IS DR. SCOTT
WRIGHT.
DR. WRIGHT IS A GENERAL
INTERNIST WITH OVER 20 YEARS OF
EXPERIENCE.
HE IS THE ANNE GAINES AND G.
THOMAS MILLER PROFESSOR IN THE
DEPARTMENT OF MEDICINE AT JOHNS
HOPKINS UNIVERSITY SCHOOL OF
MEDICINE.
DR. WRIGHT SERVES AS DIRECTOR OF
DIVISION OF GENERAL INTERNAL
MEDICINE AT JOHNS HOPKINS BAY
VIEW MEDICAL CENTER, EARNING HIS
M.D. IN MONTREAL, CANADA AND
COMPLETED HIS INTERNAL MEDICINE
RESIDENCY TRAINING AT THE
MONTREAL GENERAL HOSPITAL.
HE PURSUED HIS INTERNAL MEDICINE
FELLOWSHIP FOCUSED ON MEDICAL
EDUCATION RESEARCH AT JOHNS
HOPKINS AND JOINED THE FACULTY
IN 1997.
DR. WRIGHT IS CURRENTLY THE
DEPUTY DIRECTOR FOR MEDICAL
EDUCATION RESEARCH AND SERVES AS
THE DIRECTOR OF THE MEDICAL
EDUCATION TRACK OF THE
FELLOWSHIP.
HE HAS BEEN PROVIDING
LONGITUDINAL PRIMARY CARE TO
PATIENTS IN BALTIMORE SINCE
1995, AND SERVES AS A TEACHING
ATTENDING ON THE INPATIENT
MEDICAL SERVICES.
NOTABLY, DR. WRIGHT IS ALSO THE
DIRECTOR OF THE HOPKINS MILLER
ACADEMY OF CLINICAL EXCELLENCE
WHICH IS COMMITTED TO
RECOGNIZING AND PROMOTING
EXCELLENCE IN PATIENT CARE.
THE ACADEMY'S IMPACT WITHIN
HOPKINS HAS BEEN SIGNIFICANT AND
PERHAPS BEST EXEMPLIFIED BY THE
CREATION OF A SECOND PROMOTION
PATHWAY, THE CLINICAL EXCELLENCE
TRACK, BASED ON THE ACADEMY'S
METRICS.
THE ACADEMY'S REACH ALSO
STRETCHES FAR DUE TO ITS
INITIATIVE, ONLINE COMMUNITY
THAT STIMULATES HEALTHCARE
PROFESSIONALS AND TRAINEES TO
REFLECT ON GIVING EXCEPTIONAL
CARE TO EVERY PATIENT, MOVING
THEM CLOSER TO OSLER, SOMETHING
SIR WILLIAM OSLER WOULD HAVE
VALUED.
DR. WRIGHT'S CONTRIBUTIONS TO
THE FIELD OF MEDICAL EDUCATION
THROUGH HIS OWN RESEARCH AND THE
MENTORING OF OTHERS HAVE BEEN
PUBLISHED IN LEADING JOURNALS.
IN RECOGNITION OF HIS RESEARCH
ACCOMPLISHMENTS, DR. WRIGHT WAS
ELECTED TO MEMBERSHIP IN THE
AMERICAN SOCIETY FOR CLINICAL
INVESTIGATION.
HE WAS ALSO ELECTED TO
MEMBERSHIP IN ALPHA OMEGA ALPHA
HONOR MEDICAL SOCIETY IN 2009
FOR HIS TEACHING EFFORTS.
MOREOVER, DR. WRIGHT SEES THE
ADVANCING THE PROFESSIONAL
DEVELOPMENT OF HIS PEERS
AMPLIFIES THEIR ABILITY TO
PROVIDE COMPASSIONATE AND
EXCELLENT PATIENT CARE.
WE SEEK TO EMULATE THIS SPIRIT
HERE AT THE NIH CLINICAL CENTER.
DR. WRIGHT HAS BEEN INVITED TO
VISIT THE CLINICAL CENTER LATER
THIS YEAR SO STAY TUNED FOR
FURTHER OPPORTUNITIES FOR
ENGAGEMENT.
THE TITLE OF HIS PRESENTATION IS
PROFESSIONAL DEVELOPMENT FOR
CLINICIANS AND RECOGNIZING
CLINICAL EXCELLENCE.
PLEASE JOIN ME IN WELCOMING
TODAY'S GRAND ROUNDS SPEAKER,
DR. WRIGHT.
>>THANK YOU FOR KIND
INTRODUCTION, DR. RUHL, AND FOR
INVITING ME TO BE HERE WITH YOU
TODAY.
I HAVE NO DISCLOSURES TO
MENTION.
AND WHAT I HOPE TO SHARE IN THE
NEXT 55 MINUTE OR SO IS THAT I
THINK THAT THE FULFILLMENT FOR
CLINICIANS IN ACADEMIC MEDICINE
IS COMMITMENT TO EXCELLENCE AND
CONTINUOUS GROWTH.
FOR THE OBJECTIVES, I WILL TELL
YOU MORE DETAILS ABOUT HOW WE
RECOGNIZE AND PROMOTE CLINICAL
EXCELLENCE AT MY INSTITUTION,
AND I'M GOING TO MAKE THE CASE
THAT NON-CONVENTIONAL MATERIALS
MAY BE PARTICULARLY HELPFUL IN
SUPPORTING CLINICIANS'
PROFESSIONAL GROWTH AND
DEVELOPMENT.
SO ONE QUICK STUDY TO START.
OUTSTANDING CLINICIANS ARE
CRITICAL AT ACADEMIC MEDICAL
CENTERS, I THINK WE ALL WOULD
AGREE WITH THAT, AND YUSUF SAID
IN LANCET IN 2006, WE SPEND MOST
OF THE TIME AND ARE SKILLED AT
LOOKING AFTER PATIENTS, WE WILL
LOSE THEM TO THE PRIVATE SECTOR,
FEWER CLINICAL EXCELLENT
PHYSICIANS WILL BE AVAILABLE NOR
OUR PATIENTS AND FEWER ROLE
MODELS TO TEACH THE NEXT
GENERATION OF PHYSICIANS.
SO WE DID A STUDY TO SEE WHO ARE
THE CLINICALLY EXCELLENT DOCTORS
AND LAUNCHING A PROGRAM, TO
IDENTIFY BEING IDENTIFIED AS
CLINICALLY EXCELLENT BY PIERCE
AND AS A ROLE MODEL BY
RESIDENTS.
TWO PARALLEL WEB-BASED SURVEYS.
IDENTIFY THREE TO FIVE DOM
FACULTY THAT THEY CONSIDERED TO
BE ROLE MODELS THAT THEY WANT TO
EMPLAEMULATE AND FACULTY WERE AD
TO PICK THREE TO FIVE
COLLEAGUES.
THERE WAS A MODERATELY HIGH
CORRELATION OF BEING NAMED
CLINICALLY EXCELLENT BY PIERCE
AND WERE MUCH MORE LIKELY TO BE
NAMED AS A ROLE MODEL BY THREE
OR FOUR HOST STAFF.
SO SHOWING THIS SCHEMATICALLY,
ONE CAN SEE THAT THOSE WHO ARE
CLINICALLY EXCELLENT ARE ALSO
THE ROLE MODELS AND SUPER
IMPORTANT FOR ALL ACADEMIC
INSTITUTIONS.
BECAUSE THE CLINICAL GRAND
ROUNDS -- I'LL TALK ABOUT TWO
PATIENT STORIES BRIEFLY THAT
HELPED ME LEARN A LOT IN
PROMOTING GROWTH.
SO THE FIRST WAS WHEN I WAS A
SENIOR RESIDENT NEAR THE END OF
MY RESIDENCY.
I REMEMBER GETTING THE CALL FROM
THE PHYSICIAN IN CHIEFLY OF THE
DEPARTMENT SAYING THEY WERE
DIRECTLY ADMITTING AN
88-YEAR-OLD MAN WAS WHO AN
EMERITUS PROFESSOR AND LONG TIME
DIRECTOR OF CARDIOLOGY AT MA
TBIL.
MCGILL.
HE HAD A DEVOTED FAMILY AND
CAREGIVERS AND PRESENTED WITH DI
DIFFUSE BLISTERING BULLAE, HE
WAS LWEIGHT LOSS, FAILURE TO TH,
SUSPECTED OCCULT MALIGNANCY.
THE MESSAGE FROM ABOVE, YOU'VE
BEEN SELECTED TO CARE FOR THIS
PATIENT, TAKE GREAT CARE OF HIM.
MY ATTENDING THAT MONTH I
REMEMBER WAS A BASIC SCIENTIST
NEPHROLOGIST WHO SPENT TWO WEEKS
A YEAR AT THE TIME ON CLINICAL
MEDICINE AND WAS A BRINT BRIL
YANT RESEARCHER BUT DIDN'T DO A
LOT OF PATIENT CARE.
AND I SHOW THIS PICTURE BECAUSE
DERMATOLOGY WAS INVOLVED AND
THEY WERE APPLYING LOTS OF
DIFFERENT CREAMS TOPICALLY, AND
THEY PUT -- THEY SUGGESTED HE BE
ON A PLASTIC WRAP COVERED BED SO
THAT HIS SKIN WOULDN'T STICK AND
TRY AND HELP SOME OF THE BULLAE.
SO HE HAD BIOPSIES AND TESTING,
HE WENT DOWN TO CT AND AS THEY
WERE TRANSFERRING HIM, HE
SLIPPED OFF THE PLASTIC BED AND
FELL, TRAUMA, HEAD TRAUMA, BODY
TRAUMA, CARDIAC ARREST AND HE
DIED.
THIS IS ON DAY TWO OF HIS
HOSPITALIZATION.
AND SO I GOT CALLED DOWN AND
THERE WERE FAMILY IN THE ROOM
AND MANY CARDIOLOGISTS IN THE
ROOM TALKING TO HIS WIFE AND
CHILDREN.
AND I HAD TO GO INTO THE ROOM
AND TALK TO IN THE FAMILY
MEETING.
THOUGH IT WAS THE END OF MY
RESIDENCY, I WAS GETTING READY
TO STUDY FOR THE BOARDS, AT THE
END OF RESIDENCY AFTER DOING A
TON OF ICU CARE AND PATIENT CARE
THINKING THAT I REALLY KNEW A
LOT, I WAS REALLY OVERWHELMED BY
THE CLINICAL SCENARIO WITH
EVERYTHING THAT WAS GOING ON AND
BY THE EMOTION OF HAVING TO TALK
TO THIS FAMILY, AND LEARNED A
LOT, REFLECTING ON THIS PATIENT
THAT I CARED FOR, FOR A COUPLE
OF DAYS.
THE NEXT STORY THAT I'LL TELL
YOU ABOUT MORE RECENT, I WAS
ASKED FOR THE FIRST TIME IN
FEBRUARY OF 2019 TO SEE MR. S,
60-YEAR-OLD CAUCASIAN MAN FROM
BALTIMORE, EXECUTIVE, HAPPILY
MARRIED, TWO GROWN CHILDREN,
GRANDFATHER, HEALTHFUL DIET,
TRAVELED A LOT.
UP TO DATE, BENIGN NEVI, MILD
OSTEOARTHRITIS, NO REAL
MEDICINE, NO REAL RELEVANT
HISTORY EXCEPT FOR KIDNEY
STONES.
MY EXAM WAS FAIRLY UNREMARKABLE.
HE WAS ONE OF THE HEALTHIEST
PATIENTS THAT I'VE SEEN.
MOST OF MY PATIENTS HAVE A LOT
MORE CO-MORBID ILLNESS.
SO I ORDERED LABS AND WAS
SCHEDULED TO SEE HIM AGAIN IN
8 TO 12 MONTHS AND ADVISED HIM
HOW TO COMMUNICATE WITH ME IF
THERE WERE ISSUES THAT NEEDED
ADDRESSING.
THEN SHORTLY BEFORE HIS
FOLLOW-UP WITH ME HE SAW MY
COLLEAGUE, AND HE HAD PASSED
BLOODY URINE FOR SOME DAYS WITH
CLOTS IN THE MORNING, SLIGHT
DYSURIA TOO.
INTERMITTENT VAGUE RIGHT-SIDED
FLANK DISCOMFORT FOR THREE
WEEKS, NO REAL PAIN, THOUGH.
WHEN HE SAW MY COLLEAGUE, BLOOD
PRESSURE WAS OKAY, EXAM WAS
FAIRLY BENIGN, NO C VA
TENDERNESS.
THEY DID DIP URINE, THERE WAS
SOME BLOOD AND THE ACEMENTS WAS
MAYBE A STONE, MAYBE TRAUMA,
MAYBE INFECTION.
THEY FOUND MOST LIKELY A STONE.
THEY DID A BMP TO RULE OUT AKI.
THEY DEFERRED IMAGING BECAUSE HE
HAD MILD SYMPTOMS THAT WEREN'T
CHANGING AND SAID IF YOU FOLLOW
UP REGULARLY WITH DR. WRIGHT IN
A WEEK, HYDRATE AND WE'LL SEE
HOW THINGS GO.
WHEN I SAW HIM THE FOLLOWING
WEEK, I GOT MORE HISTORY,
INTERMITTENT GROSS HEMATURIA
FLEE TO FOUR TIMES PER WEEK, NO
FURTHER CLOTS.
HE SAID IF HE RUNS FURTHER THE
HEMATURIA WOULD BE MORE
PRONOUNCED.
HE HAD MILD INTERMITTENT RIGHT
FLANK DISCOMFORT, AND SUBTLE
LEFT LOWER QUADRANT SORENESS,
BOTH INTERMITTENT, NO REAL
AGGRAVATING OR ALO ALLEVIATING
FACTORS.
BLOOD PRESSURE WAS SLIGHTLY
HIGHER ON THAT DAY, BLOOD
PRESSURE WAS NORMAL, EXAM WAS
NORMAL.
SO WHEN I THOUGHT ABOUT HIM, IT
DIDN'T FIT MY ILLNESS SCRIPT FOR
KIDNEY STONES, AND I WAS
THINKING WHY WAS HE BLEEDING
MORE AFTER RUNNING?
SO THINKING ABOUT THIS, YOU KN
KNOW, -- SO THIS CONDITION THAT
I THOUGHT OF, MORE COMMON IN
MARATHONERS, 15% OF MARATHONERS,
GROSS OR MIKE SCOPIC HEMATURIA,
HIGHER PROPORTION AND MORE BLOOD
WITH GREATER EXERTION AND
RUNNING.
THE POSTULATED MECHANISMS WERE
SEVERAL.
IT'S UNCLEAR IF THOUGHT TO BE
DIRECT TRAUMA TO THE BLADDER
MOST LIKELY, THOUGH RENAL
ISCHEMIA WAS ALSO POSSIBLE.
SO I LOOKED AT THE TESTS THAT
WERE DONE A WEEK EARLIER, I
REPEATED SOME OTHER BLOOD TESTS,
CHECKED THAT HIS HEMOGLOBIN WAS
FINE AND ORDERED AN ULTRASOUND
AND SURE ENOUGH, HE HAD MODERATE
RIGHT-SIDED HYDRONEPHROSIS AND A
SOLID MASS IN THE COLLECTING
SYSTEM.
I GOT A CAT SCAN THAT SHOWED,
AGAIN, OBSTRUCTION OF THE URETER
WITH HYDRONEPHROSIS, THOUGHT TO
BE A TUMOR.
THIS IS A SCAN YOU CAN SEE ON
THE RIGHT SIDE THAT THERE'S THIS
MASS IN THE POLE OF THE KIDNEY.
HERE YOU SEE IT LATERAL VIEW.
AND THEN I GOT HIM TO SEE YOU'RE
YOLG.
UROLOGY.
THEY DID A RETROGRADE PYELOGRAM,
THIS IS WHAT THE TUMOR LOOKED
LIKE.
THEY DID BRUSHINGS AND IT TURNED
OUT TO BE HIGH GRADE UROTHELIAL
CARCINOMA.
SO THEN WE COORDINATED SURGERY
IN LATE SURGERY.
THAT HE REALLY STUCK WITH ME AND
IT TOOK 2 1/2 MONTHS UNTIL WE
GOT HIM TO SURGERY.
HE'S STILL ALIVE AND DOING
FAIRLY WELL, BUT THIS CANCER WAS
VERY SIGNIFICANT AND CONTINUES
TO BE AN ISSUE.
SO I'M GOING TO SPEAK ABOUT
BOOKS IN THIS TALK.
AND I'M A BIG -- BUT THIS BOOK
HERE CALLED SOMETIMES YOU WIN,
SOMETIMES YOU LEARN, REMINDS US
THAT LIFE IS HARD, MISTAKES AND
FAILURES ARE COMMON.
AND ALSO THAT SUCCESSFUL
INDIVIDUALS REFLECT THOUGHTFULLY
ABOUT MISTAKES AND LEARN FROM
THEM.
AND CERTAINLY WITH TWO PATIENT
STORIES THAT I TOLD YOU ABOUT,
NOT INCLUDING MISTAKES BUT
THINGS THAT DIDN'T GO GREAT AND
THE TWO STORIES THAT I THINK A
LOT ABOUT TO THIS DAY THAT HAD
TO DO BETTER AS WELL.
THIS IS A POEM THAT I THINK A
LOT TOO THAT'S SIMILAR MESSAGES.
IT READS, I WALKED A MILE WITH
PLEASURE, SHE CHATTED ALL THE
WAY BUT LEFT ME NONE THE WEISSER
FOR ALL SHE HAD TO SAY.
I WALKED A MILE WITH SORROW AND
NEVER A WORD SAID SHE BUT O, THE
THINGS I LEARNED FROM HER WHEN
SORROW WALKED WITH ME.
SO AGAIN, THE IDEA IS THAT WHEN
THINGS DON'T GO WELL, WE CAN
LEARN AND GROW A LOT.
SO NOW WE TRANSITION TO A FAMILY
THAT REALLY CHANGED HOPKINS IN A
BIG WAY.
SO MILLER, COULSON AND WORLEY
FAMILIES.
ON THE LIFT IS ANNE MILLER, AND
WE TAKE CARE OF THIS FAMILY AND
SHE HAD A BIG BIRTHDAY AND HER
TWO DAUGHTERS WERE SUCCESSFUL
AND WONDERFUL WITH THEIR MOTHER,
SAID MOM FOR YOUR BIG BIRTHDAY,
WHAT WOULD YOU LIKE US TO DO?
THEY SAID -- YOU KNOW -- SHE
SAID I HAD A MOST WONDERFUL
INTERNIST THROUGHOUT MOST OF MY
ADULT LIFE, AND I WANT TO MAKE
SURE THAT HOPKINS IS RECOGNIZING
AND VALUING AND RETAINING AND
RECRUITING AMAZING CLINICIANS,
AND SO I'D LIKE YOU TO DO
SOMETHING TO TRY AND MAKE THAT
HAPPEN.
SO THEY MADE A GIFT WHICH WAS
WITH THE IDEA TO ENSURE THAT
THERE WOULD BE EXCELLENT
CLINICIANS AT HOPKINS, AND SO
AFTER THIS GIFT WAS MADE, FOUR
OF US WERE ASKED TO THINK ABOUT
WHAT WE COULD DO AND WE THOUGHT
FOR TWO YEARS, WE DID A COUPLE
OF STUDIES INCLUDING ONE THAT I
SHOWED YOU LOOKING AT WHO ARE
THE ROLE MODELS AND WHO ARE THE
BEST CLINICIANS.
WE DID A COUPLE OF STUDIES
TRYING TO DEFINE CLINICAL
EXCELLENCE IN ACADEMIA, AND
ULTIMATELY, WE DECIDED THAT WE
WOULD LAUNCH -- TO MAKE AN
ACADEMY OF CLINICAL EXCELLENCE
WITH THE MISSION OF RECOGNIZING
AND PROMOTING EXCELLENCE IN
PATIENT CARE FOR THE BENEFIT OF
THE INDIVIDUALS AND COMMUNITIES
THAT WE SERVE.
AND WE KNEW THAT WE WANTED TO
BRING TOGETHER THE BEST
CLINICIANS AND PUT THEM IN A
ROOM TOGETHER AND THINK ABOUT
HOW TO CHANGE THE CULTURE AT
HOPKINS.
SO WE KNEW THAT SELECTING
MEMBERS WAS GOING TO BE
CRITICAL, AND SEEING THAT THE
MEMBERS HAVE DONE ALL THE WORK.
ACADEMY, I'M GOING TO BEGIN BY
TELLING YOU ABOUT HOW WE SELECT
MEMBERS.
AND WE SELECT AND INDUCT NEW
MEMBERS EVERY YEAR, ABOUT FIVE
TO 10 A YEAR, AND HIGHLY
SELECTIVE, SU SUPER HARD TO GETN
AND WE CAN TALK MORE ABOUT THAT
TOO.
BUT THIS IS THE IDEA, WE THOUGHT
ABOUT CREATING A CLINICAL
PORTFOLIO MUCH LIKE AN ARTIST'S
PORTFOLIO THAT SHOWS THE
CONTRIBUTION OF CLINICIANS.
AND THIS IS THE TABLE OF
CONTENTS THAT INCLUDES CLINICAL
MISSION AND VALUES, CLINICAL
SETTING THEY WORK IN AND THE
EFFORT THEY DRAW, SECTION V,
REFEREES EVALUATIONS, WE GET
INPUT FROM LEARNERS, PATIENTS,
NURSES, AND TEXT AND PEERS ABOUT
THEIR CLINICAL PERFORMANCE,
CLINICAL LEADERSHIP, QUALITY
IMPROVEMENT, PROGRAM BUILDING
AND MORE.
WHEN PEOPLE -- FACULTY HAVE TO
BE NOMINATED FIVE OR MORE TIMES
TO BE INVITED TO A PIE AND EACH
FACULTY MEMBER CAN NOMINATE ONLY
ONE PERSON SO YOU HAVE TO BE
NOMINATED REPEATEDLY TO GET
INVITED.
THEN THE PEOPLE WHO ARE
CANDIDATES BUILD THIS PORTFOLIO
THAT TAKES A LOT OF WORK AND
TIME, WE HEAR IT TAKES ABOUT 13
HOURS TO BUILD THE CLINICAL
PORTFOLIO.
WE TAKE IT AND SEND IT OUT TO
EXTERNAL EXPERTS AROUND THE
COUNTRY AND THEY SCORE THE
PORTFOLIO ON METRICS AND TABLES
THAT WE'VE DEVELOPED AND
VALIDATED.
THEN ONCE THE REVIEWS COME BACK
FROM THE EXTERNAL REVIEWERS,
THEN PHASE TWO IS AN INTERNAL
SELECTION COMMITTEE WHERE THE
MEMBERS GO OVER THE CANDIDATES
AND THE EXTERNAL REVIEWER SCORES
AND DECIDE WHO'S GOING TO BE
OFFERED MEMBERSHIP AND WHO'S NOT
THROUGH CONSENSUS.
I SHOW A PICTURE, HERE'S ONE OF
OUR -- A FEW YEARS AGO ONE OF
OUR MEETINGS WHERE WE HAVE A
DISCUSSION GOING THROUGH THE
PORTFOLIOS TO DECIDE WHICH NEW
MEMBERS TO INVITE EACH YEAR.
THIS MEETING TAKES A LONG TIME,
AND IT'S A LOT OF WORK.
THIS WAS A MAGAZINE, A 10-YEAR
ANNIVERSARY OF THE ACADEMY.
THE ACADEMY HAS NOW BEEN IN
EXISTENCE FOR ABOUT 13 OR 14
YEARS.
AND YOU KNOW, WHEN PEOPLE ARE
INDUCTED INTO THE ACADEMY, THEY
AGREE TO COMMITTING 20 HOURS OF
WORK EACH YEAR TO THE ACADEMY
THAT THEY CAN FULFILL IN
DIFFERENT WAYS, INCLUDING COMING
TO MEETINGS, AND -- BUT YOU
KNOW, WHAT IT DOES IS WE'RE
BRINGING TOGETHER THE MOST
OUTSTANDING CLINICIANS TOGETHER
AND I SAY THAT FROM EACH MEMBER,
THERE ARE RIPPLES OF INFLUENCE
OF CLINICAL EXCELLENCE, PUTTING
THEM TOGETHER ALL IN THIS
ACADEMY HAS CREATED A TSUNAMI
THAT IS HAVING AN INFLUENCE
ACROSS OUR INSTITUTION AND
BEYOND.
SO I'M GOING TO SHARE WITH YOU
SELECT ACADEMY PROGRAMS AND
INFLUENCE THAT THE ACADEMY HAS
HAD SINCE ITS LAUNCH ABOUT 14
YEARS AGO.
SO WHEN YOU THINK ABOUT DOING
RESEARCH TOGETHER, AFTER
DEFINING CLINICAL EXCELLENCE
GENERALLY, OUR MEMBERS HAVE
TAKEN THAT DEFINITION AND HAVE
TIED TO MANY OF THEIR
SPECIALTIES AND PUBLISHED THIS
IN DIFFERENT JOURNALS, SO NOW
THERE IS A PAPER DESCRIBING WHAT
CLINICAL EXCELLENCE LOOKS LIKE
IN MANY FIELDS AND MANY MORE
UNDER DEVELOP M.
DEVELOPMENT.
WE DO GRAND ROUNDS TWICE A YEAR
AT LEAST.
, MEDICINE GRAND ROUNDS BUT ALSO
OTHERS AND WE OFTEN BRING
TOGETHER CLINICIANS FROM
DIFFERENT DEPARTMENTS WHO ASSESS
A CLINICAL SCENARIO AND WHO
SHARE THINGS, SO REALLY NICE TO
HAVE DIFFERENT DEPARTMENT
FACULTY MEMBERS DISCUSSING
PATIENT STORIES AND HOW THEY DO
THINGS TOGETHER.
SO THIS IS A WONDERFUL PROGRAM.
WE DO CLINICAL EXCELLENCE
TEACHING SO WE'VE CREATED
WORKSHOPS FROM DIVISIONS AND AT
NATIONAL MEETINGS.
WE HAVE AN INTERN OATH PROGRAM,
SO FOR ALL THE INTERN CLASSES,
THIS IS A NOTRE DAME LOCKER ROOM
FOR COLLEGE FOOTBALL FANS.
BEFORE WE GO ON THE FIELD, --
CLINICAL CHAMPIONS TO REMIND
THEM TO GIVE THEIR BEST EFFORT
AND TRY TO PLAY EXCELLENTLY.
WE HAVE EVERY INTERN CLASS COME
TOGETHER AND CREATE A TOUCH
STONE WE PUT IN THEIR TEACHING
CONFERENCE ROOM THAT THEY CREATE
THEIR MINDS IN ABOUT HOW THEY
WANT TO TOGETHER AS A CLASS
COMMIT TO EXCELLENCE.
THIS IS ONE FROM ONE YEAR AND
ALL OF THESE BELIEVE ARE ALL
TAKEN FROM SOMEWHERE IN THE CITY
OF BALTIMORE.
BUT THEY'RE ALL BEAUTIFUL.
WE HAVE A COACHING PROGRAM WHERE
THERE'S ONE ON ONE MENTORING TO
HELP MOVE FACULTY ALONG THE
CONTINUE WILLIAM FROM COMPETENCE
TO EXCELLENCE.
THIS STARTED AS A PROGRAM WHERE
DEPARTMENT CHAIRS WOULD CALL THE
ACADEMY AND SAY, I HAVE THIS
FACULTY MEMBER AND THEY'RE
STRUGGLING IN THIS WAY OR THAT
WAY, CAN YOU HELP?
MORE RECENTLY IT'S TURNED INTO
AN INITIATIVE WHERE THOSE WHO
REALLY SEE THEMSELVES AS WANTING
TO GET PROMOTED AND SUCCEED AS
CLINICIANS AND FOR THAT TO BE
THEIR PRIMARY MODE OF
EXCELLENCE, NOW MANY OF THEM ARE
SAYING HEY, I'D LIKE TO BE IN
THIS COACHING PROGRAM.
ANOTHER THING WE DO IS AN ANNUAL
SYMPOSIUM WHERE WE HONOR AND
INDUCT NEW MEMBERS, WE ALSO GIVE
UPDATES ON THE PROGRAM THAT THE
ACADEMY HAS ACCOMPLISHED IN THE
LAST YEAR.
AND THIS IS BEAUTIFUL IN THAT
THOSE WHO ARE GETTING INDUCTED
IN BY PATIENTS, THEIR FAMILIES
COME, SO OFTEN AT THE EVENT WE
HAVE PARENTS, CHILDREN, OF THE
INDUCTED FACULTY MEMBER, WE HAVE
PATIENTS AS I SAID, DEPARTMENT
CHAIRS AND LEARNERS, MANY SAY
IT'S ONE OF THE NICEST GET
TOGETHERS ALL YEAR AT HOPKINS.
RAVEN FOOTBALL GAME HOLDING
SIGNS, BRINGING GIFTS.
REALLY, REALLY LOVELY.
AND AGAIN, GETTING THE RIGHT
PEOPLE IN THE ACADEMY WHO ARE
TRULY EXCELLENT, TRULY -- HELPS
OUR PROGRAM SUCCEED.
WE'VE BEEN CONSULTED IN THE
ESTABLISHMENT OF CLINICAL
EXCELLENCE ADVANCEMENT AT OTHER
INSTITUTIONS, COLUMBIA IN
NEW YORK, VA VANDERBILT AND OTHS
HAVE MODELED ACADEMIES AFTER OUR
OWN.
WE WERE THINKING ABOUT HOW WE
MIGHT HAVE AN IMPACT BEYOND
HOPKINS AND HOW WE MIGHT HAVE
DOCTORS WHO THINK ABOUT CLINICAL
EXCELLENCE SHARE THEIR WISDOM.
SO WE LAUNCHED CLOSLER, TRYING
TO MOVE US CLOSER TO OSLER.
MCGILL AND HOPKINS, FOLLOWING ME
FOR A LONG TIME.
AND THE MISSION, TO STIMULATE
HEALTHCARE PROFESSIONALS AND
TRAINEES TO REFLECT ON GIVING
EXCEPTIONAL CARE TO EVERY
PATIENT EVERY DAY.
WE HAVE A WONDERFUL EDITORIAL
TEAM THAT INCLUDES PRE-MED
STUDENTS, MED STUDENTS, FACULTY
AT OUR INSTITUTION AND OTHER
INSTITUTIONS, AND REALLY COME
TOGETHER ONCE A WEEK TO EDIT
PIECES AND TO REALLY EDIT THE
TAKEAWAYS, AND CLOSLER CONTENT
REALLY HAS TO BE FOCUSED ON
PROMOTING EXCELLENCE IN PATIENT
CARE.
WE HAVE NEW PIECES EVERY MONDAY
TO FRIDAY, GENERALLY 500 WORDS
BUT SOME ARE LONGER.
THEY'RE STAMPED FOR TIME READS,
IT WILL SAY THIS WILL TAKE YOU L
TAKE YOU 1 MINUTE TO READ.
ALL HAVE A ONE TO TWO SENTENCE
TAKEAWAY BECAUSE AGAIN MANY
PEOPLE SEE OUR TAKEAWAYS ON
INSTAGRAM OR TWITTER AND THAT'S
ALL THEY SEE, AS A BAIT TO SEE
THEM COME AND READ THE WHOLE
PIECE.
SO TYPES OF PIECES ARE
EVERYTHING FROM PATIENT CARE
STORIES, CARE ARTICLES.
THIS IS WHAT THEY LOOK LIKE.
THIS IS A PIECE WRITTEN BY A
CLINICAL MEDICINE STUDENT AT
PENN.
ALWAYS A NICE PICTURE THAT MAKES
YOU FEEL GOOD AND A SHORT
TAKEAWAY.
THIS IS ONE FROM A FEW WEEKS AGO
ON ADVANCING TRANSGENDER CARE.
THIS IS ONE FROM A WHILE BACK,
WHAT WE CAN LEARN DOCTOR SEVEN
THINGS CLINICIANS CAN LEARN FROM
THERAPY DOGS.
ALWAYS WITH -- WE HAVE A
QUESTION OF THE WEEK.
HERE'S ONE, WHAT'S ONE LIFE
LESSON YOU LEARNED FROM A
PATIENT?
THE PRE-MED WORK ON OUR TEAM,
WANT TO TAKE SOME OF THE PIECES
AND CREATE A PODCAST.
WE HAVE A PODCAST THAT'S HELPING
YOUNG PEOPLE THAT ARE THINKING
ABOUT A CAREER IN MEDICINE HEAR
FROM DIFFERENT DOCTORS WHO WRITE
FOR CLOSLER ON THEIR THOUGHTS
ABOUT CLINICAL EXCELLENCE AND
THEIR PATH INTO MEDICINE.
SO IT JUST GOT LAUNCHED AND IT'S
ON SPOTIFY AND IT'S PRETTY COOL
AND FUN.
CLOCLOSLER AUTHORS, MAINLY FEMA,
PREDOMINANTLY CAUCASIAN, BUT
WE'RE WORKING ON THAT.
AND THE AUTHORS INCLUDE
PHYSICIANS, NURSE, PHARMACISTS,
PSYCHOLOGISTS, MED STUDENTS, PET
THERAPISTS, PATIENTS,
CAREGIVERS.
USERS WE'VE HAD IN THE LAST --
WE'VE HAD ABOUT 62,000 PEOPLE
COME TO OUR SITE.
THEY COME FROM -- 250,000,
MOSTLY FROM THE U.S. BUT ALSO
FROM THE TOP FIVE COUNTRIES ARE
U.K., CANADA, INDIANA AND
AUSTRALIA, FROM 62 DIFFERENT
COUNTRIES, AND YOU KNOW, WE'D
LIKE TO INVITE PEOPLE WHO SEE AN
INTERESTING PATIENT OR HEAR AN
INTERESTING TALK OR READ A GOOD
BOOK AND THINK THERE ARE
CLINICAL IMPLICATIONS CAN WRITE
FOR US, AND YOU CAN FOLLOW US ON
TWITTER, INSTAGRAM, FACEBOOK OR
EVEN TIK TOK.
AND WE'RE ON THIS MANY PLATFORMS
TRYING TO HAVE YOUNGER PEOPLE
BENEFIT FROM THE CONTENT.
SO THINK ABOUT PERHAPS WRITING
FOR US OR FOLLOWING US IF YOU
WISH TO.
SO WITH U SUCCESS OF THE ACADEM,
IT WAS INVITED TO TRY AND CREATE
A PROMOTION TRACK AT HOPKINS.
SO HOPKINS FOREVER HAD A SINGLE
PROMOTION TRACK THAT WAS MAINLY
BASED ON RESEARCH.
SO MY PATHWAY TO BEING A
PROFESSOR WAS ALL ABOUT -- I SIT
ON THE PROMOTION COMMITTEE, WAS
ALL ABOUT HOW MANY GRANTS HAVE I
SECURED, HOW MANY PAPERS HAVE I
PUBLISHED, WHAT'S MY H INDEX AT
EACH TIME AND SO ABOUT 10 YEARS
AGO, BEGIN TO DESIGN THE
CLINICAL EXCELLENCE PATHWAY TO
TRY AND RETAIN AND RECRUIT
PEOPLE WHO HAD CLINICAL
EXCELLENCE AS A MAIN CAREER
FOCUS.
THE FIRST ITERATION OF THAT, WE
PUT TOGETHER A PLAN, AND IT GOT
VOTED DOWN.
FIVE YEARS LATER, THERE WAS MORE
CONCERN ABOUT RETAINING OUR BEST
CLINICIAN, WE WERE ASKED TO
REVISIT THE TOPIC AND IT WENT
THROUGH.
AND I'M GOING TO TELL YOU ABOUT
THE ESTABLISHMENT OF A CLINICAL
EXCELLENCE PATHWAY AT HOPKINS.
SO THESE ARE SOME SLIDES THAT WE
SHOW TO OUR OWN FACULTY AND I'LL
GO THROUGH THEM QUICKLY SO YOU
CAN SEE WHAT WE DO AND HOW WE DO
IT.
SO THIS TRACK WAS DESIGNED TO
RECOGNIZE, REWARD AND ADVANCE
THE CAREERS OF FACULTY WHOSE
PRIMARY ACADEMIC FOCUS, AND
THOSE WHO SPEND AT LEAST 60% OF
THEIR TIME IN PATIENT CARE.
AND I'M GOING TO SHOW YOU THE
CRITERIA.
AND I'LL GO THROUGH THESE.
ONE BY ONE.
ONE IS CLINICAL EFFORT.
YOU KNOW, THERE'S NO EXACT
TIMELINE BUT YOU CAN'T BE
CLINICALLY EXCELLENT FOR A MONTH
AND GET PROMOTED.
SO YOU REALLY HAVE TO DO AMAZING
CLINICAL CARE FOR AT LEAST FIVE
YEARS BEFORE YOU CAN GO UP FOR
PROMOTION AFTER YOU'RE AN
ASSISTANT PROF AND THEN ANOTHER
FIVE YEARS BEFORE YOU CAN GO TO
THE NEXT LEVEL.
SO REALLY SUSTAINED CLINICAL
EXCELLENCE.
AND I'LL SHOW YOU MANY OF THE
CRITERIA CAME FROM THE PORTFOLIO
THAT WE USE FOR APPLICATION TO
OUR MILLER CLOUSON ACADEMY.
THIS IS CLINICAL CONTRIBUTIONS.
SO AGAIN, PEOPLE AT THE TIME OF
BEING -- HAVE TO GIVE THE NAMES
OF PEERS AND STAFF AND LEARNERS
AND PATIENTS WHO WOULD RATE THEM
TO BE FOR ASSOCIATE PROF AMONG
THE TOP FIVE -- TOP 25% IN THEIR
AREA, FOR PROFESSOR YOU NEED TO
BE IN THE TOP 10%.
CLINICAL LEADERSHIP, YOU HAVE TO
DO CLINICAL PROGRAM BUILDING,
YOU HAVE TO BE INVOLVED IN
FOR -- YOU HAVE TO WORK ON
CLINICAL INNOVATIONS AND
IMPROVEMENT, RECOGNIZED FOR
ASSOCIATE PROF REGIONALLY, FOR
PROFESSOR AT THE NATIONAL LEVEL.
FURTHER DEMONSTRATION OF
CLINICAL EXCELLENCE INCLUDES YOU
DRAW -- IF THAT APPLIES TO YOU,
ARE PATIENTS COMING TO YOU FROM
D.C. AND OUT OF STATE AND
FURTHER TO COME TO GET CARE FROM
YOU IF APPLICABLE.
AND THEN AGAIN, YOUR
RECOMMENDATIONS.
YOU HAVE TO BE REASONABLY
RECOGNIZED TO BE PROMOTED TO
ASSOCIATE PROF AND NATIONALLY
RECOGNIZED FOR PROFESSOR.
YOU HAVE TO BE -- IN TEACHING
AND MENTORSHIP ON THAT TRACK AND
WE COLLECT THAT DATA.
YOU HAVE TO BE ENGAGED IN
RESEARCH AND HELP RESEARCHERS
WITH THEIR MISSION, INCLUDING
ENROLLING PATIENTS, PATIENT
REGISTRY, PATIENT RECRUITMENT AT
BOTH LEVELS.
THEN DISSEMINATION.
DDISSEMINATION CRITERIA IS MUCH
LESS STRICT FOR THIS TRACK.
YOU STILL NEED TO DISSEMINATE
YOUR IDEAS AND SHOW THEY HAVE AN
IMPACT, BUT SOMETHING THAT
AREN'T CONSIDERED ON THE
TRADITIONAL PATHWAY, LIKE BLOGS
AND TWITTER AND CLOSLER AND
OTHERS, INCLUDING THE CLINICAL
GUIDELINES ARE VERY MUCH
RESPECTED AND ENCOURAGED AND
NEEDED ON THIS PATHWAY.
SO INVITED TO SPEAK, HAVE
LEADERSHIP ROLES, SO ON AND SO
FORTH.
INSTITUTIONAL CONTRIBUTIONS.
YOU KNOW, YOU NEED TO ALSO BE A
VERY GOOD CITIZEN AND HELP TO
IMPROVE THE QUALITY AND SAFETY
AND ACCESS WITHIN THE
INSTITUTION AND BEYOND.
AND WE REALLY ENCOURAGE PEOPLE
ON THIS TRACK TO TRY AND GET
INVOLVED WITH AN ORGANIZATION
THAT THEY CAN PICK EITHER BIGGER
OR SMALLER AND HAVE AN IMPACT TO
BRING WHAT WE'RE DOING AT
HOPKINS TO THESE NATIONAL
ORGANIZATIONS.
AS FOR PACKAGING AND PUTTING IT
TOGETHER, I'LL SAY A FEW WORDS.
LIKE THE TRADITIONAL TRACK, YOU
NEED A LETTER FROM YOUR
DEPARTMENT DIRECTOR, YOU NEED TO
HAVE YOUR CV IN THE APPROPRIATE
FORMAT, AN IMPACT STATEMENT
ESSENTIALLY, A VERSION OF A
LETTER THAT GOES INTO MORE
DETAIL AROUND CLINICAL
CONTRIBUTIONS.
AND THEN THE PORTFOLIO LIKE I
SAID, IT'S SORT OF A 360-DEGREE
SURVEY WHERE YOU NEED PEERS AND
STAFF AND LEARNERS AND PATIENTS
TO EVALUATE YOUR CLINICAL
PERFORMANCE, AND THEN YOU NEED
REFEREES, LETTER WRITERS, A FEW
INTERNAL, MOST EXTERNAL, THAT
WILL EVALUATE THE CANDIDATE'S
CLINICAL EXCELLENCE.
THIS JUST SAYS MORE ABOUT THE
360 REVIEW THAT WE SEND OUT
WHERE MUCH LIKE FOR THE ACADEMY,
THESE INDIVIDUALS ARE ASSESSED
AROUND 10 DOMAINS OF CLINICAL
EXCELLENCE THAT WE'D BE HAPPY TO
SHARE.
IMPACT STATEMENT YOU NEED TO DO,
LIKE I SAID.
SO, THAT'S THE CLINICAL
PROMOTION TRACK THAT REALLY CAME
OUT OF THE SUCCESS OF THE
ACADEMY AND THE FACT THAT WE
WERE ABLE TO SHOW WE COULD
REALLY MEASURE CLINICAL
EXCELLENCE BECAUSE THERE WAS
SKEPTICISM BEFORE THAT.
SO THIS IS A SLIDE THAT I MADE
IN 2008 WHEN WE WERE INITIALLY
THINKING ABOUT THE ACADEMY AND
WE SAID THE GOALS OF THE
ACADEMY, TWO MAIN ONES WERE TO
ADVANCE METRICS TO MEASURE
CLINICAL PERFORMANCE AT HOPKINS
AND TO CREATE A COMMUNITY OF
COLLABORATION AROUND CLINICAL
EXCELLENCE.
AND IT BRINGS PRIDE TO THE
MEMBERS AND MYSELF, THAT WE'VE
BEEN ABLE TO ACHIEVE THAT.
BECAUSE -- TWO MORE IS TO
SUPPORT THE PROFESSIONAL GROWTH
OF CLINICAL FACULTY AND ADVOCATE
FOR THEM SO THAT THEIR CLINICAL
ACHIEVEMENTS CAN BE CONSIDERED
FOR PROMOTION, CHECK, AND TO
RE-ESTABLISH PATIENT CARE IS ONE
OF THE KEYSTONES OF THE ACADEMIC
PHYSICIAN'S WORK.
SO THE GOAL IS THAT WE CREATED,
WE DREAMED OF WHEN LAUNCHING THE
ACADEMY HAVE REALLY COME TO
FRUITION.
AND WHEN I THINK BACK ON THE
ACCOMPLISHMENTS OF THE ACADEMY
IN THE LAST 14 YEARS OR SO, IT'S
REALLY SERVING TO REFOCUS
HOPKINS ON THE PRIMACY OF
PATIENT CARE, AND I THINK
THERE'S EVIDENCE THAT OUR
PATIENTS, COMMUNITIES, MEDICAL
TRAINEES AND THE FACULTY ARE
REAPING THE REWARDS OF THIS
REFOCUSING.
SO REALLY IT BEEN EXCITING, IT'S
BEEN FUN AND AS -- THE MATRIARCH
OF THE FAMILY, ANNE MILLER, SAID
I'D LIKE TO MAKE A GIFT TO
CHANGE THE CULTURE CLINICALLY AT
HOPKINS, IT REALLY SERVED AS THE
CATALYST THAT LED TO A REAL
CHANGING OF THE PLACE AND WE'VE
BEEN HERE SINCE 1994 OR
THEREABOUTS, IT FEELS DIFFERENT
NOW THAN IT DID WHEN I FIRST GOT
HERE.
SO I GET ASKED TO MEET WITH AND
MENTOR A LOT OF JUNIOR
CLINICIANS AND HELP THEM THINK
ABOUT HOW THEY FLOURISH AND HOW
THEY THRIVE HERE AT HOPKINS, AND
I'M GOING TO TELL YOU FOR THE
REMAINING 20 MINUTES AND IN Q &
A ABOUT BOOKS, AND I'M GOING TO
SHARE WITH YOU SOME BOOKS THAT I
THINK ARE FANTASTIC AND THAT
HELPED ME AND THAT HELPED OTHERS
>>Dr. Anderson: HERE WE GO
WITH THIS PART.
EIGHT BOOKS THAT DRA
MOUNTAINICALLY INFLUENCED ME AS
A CLINICIAN, AS A PERSON, AS A
LEADER, AS A MENTOR, AS A
MANAGER AND A FEW OTHERS.
SO BOOK ONE IS QUIET.
SO I AM AN INTROVERT.
INTJ.
AND I BELIEVE THAT MY DISABILITY
RELATED TO MY BIRTH HAS MADE ME
INTO A VERY BIG I.
I LIVE WITH SELF COA LITTLE BITT
KNOWING THAT, AND UNDERSTANDING
FROM THIS BOOK WHAT INTROVERTS
ARE GOOD AT WAS REALLY HELPFUL
TO ME.
I'M THOUGHTFUL AND DELIBERATE IN
MY SPEECH AND MY PRESENCE, AND I
MAKE SELECTIVE CONTRIBUTIONS
WHEN I'M IN LARGE GROUPS,
BECAUSE OF THAT WHEN I DO SHARE,
PEOPLE LISTEN.
I'M COGNIZANT WHEN I RUN
MEETINGS TO TRY AND HEAR FROM
EVERYBODY.
AND PEOPLE KNOW THAT I'M NOT
LOOKING TO STEAL THE SPOTLIGHT
FROM ANYONE, AND I THINK THAT
HELPS.
FROM THIS BOOK, I LEARNED THAT
INTROVERTS LIKE ME REALLY
CONNECT WELL ONE ON ONE IN
MANAGING AND MENTORING AND I
KNEW THAT I DID THAT BUT THIS
BOOK EXPLAINED HOW AND WHY.
AND I'M PERSISTENT AND I'M
PATIENT.
AND MY QUIET RG THAT I HAVE
ABOUT ME HELPS WHEN CHAOS
STRIKES.
AND WE ALL KNOW THAT IT STRIKES.
OSLER IS A LESS KNOWN -- SAID
LOOK WISE, SAY NOTHING AND
GRUNT.
SPEECH WAS GIVEN TO CONCEAL
THOUGHT.
BOOK TWO, GIVE AND TAKE.
GIVING AND HELPING OTHERS
TRANSLATES INTO GROWTH.
GIVING EFFECTIVELY.
I'VE BEEN THE BENEFICIARY OF
TREMENDOUS GENEROSITY THROUGHOUT
MY LIFE WITH GREAT ACADEMIC
MENTORS.
SUCH KINDNESS HAS INSPIRED ME TO
RECIPROCATE WHENEVER POSSIBLE.
IN THE BOOK, IT TALKS ABOUT IN
GENERAL SOME PEOPLE ARE GIVERS,
SOME PEOPLE ARE TAKERS.
GIVERS -- THE HAPPIEST PEOPLE
AND MOST SUCCESSFUL PEOPLE ARE
GIVERS.
VARIATION ON THE GIVE AND TAKE
IS THIS BOOK BY ROBERT
GREENLEAF, SERVANT LEADERSHIP.
AND YOU KNOW, A COUPLE OF THEMES
FROM BOTH GIVE AND TAKE AND
SERVANT LEADERSHIP THAT HAVE
HELPED MY DEVELOPMENT IS THAT
I'M REMINDED BY THESE TWO BOOKS,
MY PRIMARY GOAL IS TO BE OF
SERVICE TO OTHERS AND EMPOWER
EVERYONE ELSE TO GROW.
I'VE REALLY COME TO UNDERSTAND
THAT THERE ARE MANY DIFFERENT
WAYS THAT I CAN DEVELOP THE
POTENTIAL OF OTHERS WHICH
INCLUDE TEACHING, ROLE MODELING,
COACHING, MENTORING, MANAGING
AND MANY MORE.
BOTH VERY HELPFUL.
OUTLIERS, HE SAYS MOST OF US
HAVE COME THROUGH THE MIDDLE AND
SOME PEOPLE ARE WAY -- A FEW
STANDARD DEVIATIONS TO ONE SIDE
AND THEY'RE OUTLIERS.
HE TALKS ABOUT THAT TO GET THE
MASTERY, BECAUSE PART OF THIS
BOOK DEALS WITH ACHIEVING
MASTERY AND BEING EXCELLENT,
TALKS ABOUT THE PEOPLE NEED AT
LEAST 10,000 HOURS OF DELIBERATE
PRACTICE, AND THAT MEANS GETTING
FEEDBACK AND REFLECTING ON THE
PRACTICE WITH A REAL COACH IS
HOW ONE CAN GET TO MASTERY, AND
WHETHER THAT'S IN TENNIS OR
VIOLIN OR DOING RESEARCH.
AND THAT -- THIS BOOK TALKS
ABOUT HARD WORK, AMBITION AND
THE ABILITY MAY RESULT IN
SUCCESS WHEN PLACED IN AN
AGREEABLE CONTEXT/ENVIRONMENT.
IT MAKES ME THINK THAT WE NEED
TO CREATE AGREEABLE CONTEXTS AND
ENVIRONMENTS FOR OUR CLINICIANS
FOR THEM TO REALLY SUCCEED IN
OUR ACADEMIC CENTERS.
SO KNOW SATURDAY AND THE BEATLES
WERE NOT SO MUCH INNATE MUSICAL
PRODIGIES BUT GRINDERS WHO
THRIVED ONLY AFTER GRINDING FOR
10,000 HOURS OF PRACTICE.
AND OUTLIERS ARE THOSE WHO HAVE
BEEN GIVEN THE OPPORTUNITY BUT
HAD THE STRENGTH AND PRESENCE OF
MIND TO SEIZE THEM.
SO WHAT I THINK ABOUT WITH
OUTLIERS IS IN MY WORK AND IN
THE TEAMS THAT I LEAD AND IN MY
EFFORTS, I SET EXPECTATIONS TO
OUR TEAM THAT WE'RE NOT
ACCEPTING NEED MEDIOCRITY, WE'E
GOING TO TRY OUR BEST AND AIM
HIGH.
AS I SHOWED YOU WITH THE TWO
CLINICAL CASES EARLY ON, THERE'S
GOING TO BE FAILURES BUT WE HAVE
TO LEARN FROM THEM, AIM HIGH AND
TRY AND DO AS BECK A THE BEST T.
HAVING GROWTH AS OPPOSED TO A
FIXED MINDSET.
IT'S GREAT TO LIVE YOUR LIFE
ACCEPTING THAT YOU AND YOUR
SKILLS ARE A WORK IN PROGRESS.
AND I TELL PEOPLE ALL THE TIME,
I'M NOT GOOD ENOUGH YET AND I'M
WORKING ON GETTING BETTER IN ALL
AREAS, AND DUE TO A HUSBAND OR
FATHER OR CLINICIANS, I WANT TO
BE MUCH BETTER NEXT YEAR, NEXT
MONTH, THAN I AM TODAY, AND PART
OF GETTING BETTER IS DEVELOPING
AND FINDING A PLAN TO IMPROVE.
IN ORDER TO IMPROVE AND GROW,
ONE NEEDS TO TAKE GOOD CARE OF
ONE SELF SO THAT YOU'RE POISED
TO GROW, AND ALONG THOSE LINES,
YOU KNOW, I REMIND MY STUDENTS
AND RESIDENTS AND OTHERS, MY
CHILDREN, TO EAT HEALTHY, TO TRY
AND SLEEP ENOUGH, TO EXERCISE,
AND TAKE CARE OF YOURSELF.
THIS IS AN OLD PICTURE OF OUR
YOUNGEST, PROBABLY 10 YEARS AGO,
OUR YOUNGEST AND OUR DOG.
THIS DOG IS -- I SAY IT'S OUR
THERAPY DOG, UNCONDITIONAL LOVE.
I TRY AND SPEND MUCH TIME WITH
HER EVERY DAY TO RECHARGE MY
BATTERY AND TO GAIN -- JUST GAIN
POSITIVE VIBES FROM LUCY, OUR
DOG.
AND I ALSO MEDITATE.
SO HEADSPACE AND CALM ARE TWO
SITES THAT WHEN I CAN, I TRY AND
DEVOTE 10 MINUTES A DAY TO
MEDITATION THAT ALSO HELPS ME A
LOT.
SO I THINK IMPORTANT FOR MY
GROWTH ARE MEDITATION, SPENDING
TIME WITH MY DOG, AND TAKING
CARE OF MYSELF.
BOOK NUMBER FIVE, CREATIVITY,
INC. BY ED CATMULL, WHO TALKED
ABOUT WHAT HE DID AT PIXAR AND
DISNEY ANIMATIONS.
IN THE BOOK, HE TALKS ABOUT
THREE THINGS THAT HE THINKS
ARENESS SAIR ARENECESSARY FOR EE
VALUE OF CANDOR, AN ENVIRONMENT
WHERE PEOPLE CAN SAY IT LIKE IT
IS, NOT BEING BLUNT OR UNKIND
BUT SAYING I THINK THIS PICTURE
DOESN'T LOOK RIGHT OR -- SO THE
VALUE OF CANDOR WAS A BIG
MESSAGE IN THIS REALLY GREAT
BOOK.
ANOTHER IS THE IMPORTANCE OF THE
INTERSECTION OF PEOPLE AND
IDEAS, AND REALLY TRYING TO GET
GREAT PEOPLE ON YOUR TEAM AND
THEN MAKE SURE YOU HEAR FROM ALL
OF THEM.
SO AGAIN, COME BACK TO MY
INTERSECTION BOOK, I WANT TO
MAKE SURE I HEAR FROM EVERYONE,
BECAUSE THE PERSON WHO'S QUIET
OR WHO MIGHT BE RELUCTANT TO
SPEAK, THEY MAY HAVE THE BEST
IDEA AND YOU KNOW, SO HAVING
GREAT PEOPLE, WORKING WITH GREAT
PEOPLE AND THEN MAKING SURE THAT
YOU HEAR FROM THEM BECAUSE THEY
MAY HAVE THE BEST IDEAS.
AND THEN CREATE A CULTURE OF
FEARLESSNESS.
EMBRACE FAILURE.
FAIL FAST AND RECOVER.
AND AS I SHOWED YOU EARLIER AND
IT'S GOING TO COME UP AGAIN, I
THINK IF YOU TRY LOTS OF BIG
THINGS, YOU'RE GOING TO FAIL A
LOT, BUT FAIL FAST AND RECOVER
AND LEARN FROM IT IS A KEY
MESSAGE IN THIS BOOK.
REALLY GREAT BOOK, I RECOMMEND
HIGHLY.
FAILURES ARE NECESSARY ON THE
ROAD TO SUCCESS, SO EMBRACE
THEM.
BOOK SIX, THE POWER OF NOW BY
ECKHART TOLLE, BORN IN GERMANY,
LIVES IN VANCOUVER, CANADA.
AND THE BOOK SAYS YOU'VE GOT TO
DO GREAT THINGS AND TO BE HAPPY,
AND TO FLOURISH, YOU NEED TO BE
PRESENT AND FULLY ENGAGED.
AND A QUOTE FROM THE BOOK, MOST
HUMANS ARE NEVER FULLY PRESENT
IN THE NOW, BECAUSE
UNCONSCIOUSLY THEY BELIEVE THAT
THE NEXT MOMENT MUST BE MORE
IMPORTANT THAN THIS ONE.
BUT THEN YOU MISS YOUR WHOLE
LIFE, WHICH IS NEVER NOT NOW.
AND THAT'S A REVELATION FOR SOME
PEOPLE: TO REALIZE THAT YOUR
LIFE IS ONLY EVER NOW.
AND I HAVE A PICTURE OF A CLOCK.
IT'S ALWAYS NOW.
SO IF YOU CAN -- I TELL MENTEES
AND MY CHILDREN, YOU CAN FOCUS
ON BEING THE BEST YOU RIGHT NOW
AND JUST REPEAT THAT, THINGS
WILL GO WELL.
THIS IS A POEM THAT WE'RE GOING
TO SKIP BECAUSE IT'S A LITTLE
BIT LONG, BUT IT'S A GREAT POEM
IF YOU WANT TO LOOK AT THE
WOODCARVER, WHICH TALKS ABOUT
HOW THIS PERSON GETS REALLY
PRESENT AND THEN IS ABLE TO
CREATE A MASTERPIECE.
BANDS.
SO HOW DO YOU REMEMBER TO DO ALL
THIS?
SO THIS IS A COMPANY CALLED LE
CLAY, MAKE GOOD THINGS HAPPEN.
YOU'RE SUPPOSED TO TURN IT OVER
ONCE OR TWICE DURING THE DAY.
I HAVE OTHER BANDS WITH OTHER
MESSAGES.
SOMETIMES I GIVE THEM OUT TO A
TEAM WHEN THEY NEED TO WORK ON
SOMETHING.
PRETTY NEAT.
BUT IT'S A REMINDER BECAUSE WE
GET CAUGHT UP IN WHIRLWINDS OF
THINGS AND THEN WE FORGET WHAT
WE REALLY CARE ABOUT AND WHAT
WE'RE TRYING TO DO, SO I LIKE
THESE BANDS.
VISUAL INTELLIGENCE, YOU KNOW,
REMINDS US TO BE MORE OBSERVANT
AND BE MORE PERCEPTIVE IN OUR
LIVES.
LESSONS FROM THIS BOOK IS THAT
WE'RE ALL MISSING SO MUCH THAT'S
RIGHT UNDER OUR NOSE BECAUSE
WE'RE CAUGHT UP IN A ROLE AND
WE'RE TOO FOCUSED.
HEIGHTENED OBSERVATION SKILLS IS
CRITICAL FOR COMMUNICATING
EFFECTIVELY, EMPATHIZING WITH
OTHERS, MAKING INFORMED
DECISIONS AND FOR OUR GROWTH.
I'M GOING TO FLASH AN IMAGE
HERE, MOST OF YOU ARE LOOKING AT
IT AND DON'T SEE ANYTHING
SPECIFIC.
I KNOW.
A COUPLE OF YOU ARE LOOKING AT
IT AND SEEING SOMETHING CLEARLY.
BUT MOST OF YOU ARE LOOKING AT
THIS AND TURNING YOUR HEAD AND
GOING CLOSER AND FURTHER AND
SAYING, I DON'T SEE ANYTHING
THERE.
AND YOU'RE LOOKING AT SOMETHING,
AND THEN IF I ENCIRCLE IT,
YOU'LL SEE THAT THIS IS THE BODY
AND THE HEAD OF A COW.
AND NOW I'M GOING TO SHOW TO YOU
AGAIN, YOU CAN'T NOT SEE IT.
NOW YOU CLEARLY SEE, HEY,
THERE'S A COW THERE THAT YOU SEE
CLEARLY, BUT YOU COULDN'T SEE IT
BEFORE WHEN IT WAS RIGHT IN
FRONT OF YOU.
I HEAR THIS FROM THE MESSAGE
FROM THIS BOOK IS THAT WE'RE ALL
MISSING TONS OF THINGS THAT ARE
RIGHT UNDER OUR NOSE THAT WE'RE
MISSING.
SO TO LEARN FROM ROLE MODELS,
AND I'VE DONE SOME RESEARCH ON
ROLE MODELS AND LEARNING FROM
ROLE MODELS AND HOW ROLE MODELS
INFLUENCE CAREER CHOICE, HANG
WITH REALLY GOOD PEOPLE, AND PAY
CLOSE ATTENTION TO WHAT THEY DO.
HOW DID THEY WORK WITH THEIR
TEAMS?
HOW DID THEY INTRODUCE
THEMSELVES TO PATIENTS?
HOW DID THEY END VISITS?
HOW DID THEY COMMUNICATE, HOW
DID THEY LEAD MEETINGS?
WE CAN ALL LEARN TO GROW, SO
MUCH WE'RE MISSING BECAUSE WE'RE
NOT SEEING THE COW THAT'S IN
FRONT OF US BECAUSE -- THAT WAS
A CHECK THAT IN OTHER
CIRCUMSTANCES, WE'RE MISSING
THINGS THAT ARE UNDER OUR NOSE.
BOOK NUMBER SEVEN TO TELL YOU
ABOUT IS THE 7 HABITS OF HIGHLY
EFFECTIVELY PEOPLE, A CL CLASSII
STEVEN COVEY.
HABIT 3 IS BEGIN WITH THE END IN
MIND.
DON'T SPEND YOUR LIFE JUST
WORKING AIMLESSLY, TACKLING
WHATEVER JOB IS AT HAND, EVERY
TASK BEFORE YOU.
BUT IT'S GREAT TO HAVE A VISION
FOR THE FUTURE AND TO ALIGN YOUR
ACTIONS AND GOALS ACCORDINGLY TO
MAKE IT INTO REALITY.
SO MY TAKEAWAY FROM THIS, GET
MORE CLEAR ABOUT YOURSELF, WHAT
DO YOU WANT TO ACCOMPLISH, AND
TO ESTABLISH A LEARNING PLAN FOR
THE NEXT SIX MONTHS, A LEARNING
PLAN FOR THE NEXT YEAR, A
LEARNING PLAN FOR THIS ROTATION.
I JUST DID ALL MY ANNUAL REVIEWS
OF MY FACULTY, AND THE SECOND TO
LAST AGENDA ITEM IS WHAT'S YOUR
LEARNING PLAN FOR THE NEXT YEAR?
AND THEY HAVE TO TELL ME HOW
THEY'RE GOING TO -- WHAT THEIR
PLAN IS AND I ALWAYS ADD AT
LEAST TWO BOOKS THAT THEY NEED
TO READ BASED ON WHAT THEY'RE
DOING.
I DID A LITTLE STUDY WITH BRAND
NEW INTERNS WHO JUST GRADUATED
MEDICAL SCHOOL BEGINNING WITH
THE END IN MIND.
WE HAD THEM WRITE THEIR
RETIREMENT SPEECHES OR THEIR
RETIREMENT INTRODUCTIONS WHEN
THEY'VE JUST BECOME DOCTORS.
AND IMPACTFUL IN THAT I HAD THEM
SIT DOWN, THEY JUST BECAME
DOCTORS AND THEY'RE WRITING
ABOUT WHAT THEY HOPE TO
ACCOMPLISH AND THINKING ABOUT
THAT, SO THAT'S BEEN A NEAT
LITTLE STUDY THAT WE CONTINUE TO
DO FOR NOW OVER 20 YEARS.
SO THIS END, I HAVE GOVERNING
VALUES, I HAVE MY PHONE AND MY
WALLET, I GET TO A MEETING, I
LOOK AT THEM -- MY
UNDERSTANDING, I LISTEN, I
UNDERSTAND, I CARE, I DON'T
ACCEPT DISCRIMINATION, I DREAM
BIG, I SWING FOR THE FENCE.
NUMBER 20, I LOOK FOR
OPPORTUNITIES TO PRAISE OTHERS
PUBLICLY.
I NEVER CRITICIZE OR SAY
ANYTHING THAT MIGHT EMBARRASS
ANYONE.
SO I HAVE THESE GOMPI GOVERNINGS
AND WHEN OPPORTUNITIES COME UP
THAT DON'T ALIGN WITH MY
GOVERNING VALUES, I DON'T DO
THEM AND I SAY NO.
THIS BOOK IS ABOUT DESIGN
THINKING, AND IT'S BEEN A
REAL -- SOMETHING THAT I'VE BEEN
THINKING A LOT ABOUT.
I THINK THAT ACADEMIC MEDICINE
AND MEDICAL EDUCATION, THE AREA
THAT I STUDY, IS IN NEED OF A
SERIOUS INFUSION OF DESIGN
THINKING.
AND DESIGN THINKING IS A
DIFFERENT APPROACH TO PROBLEM
SOLVING WHERE YOU BEGIN BY
UNDERSTANDING THE USER'S NEEDS
AND DEVELOPING INSIGHTS TO SOLVE
THOSE NEEDS.
THE MINDSET AND A PROCESS.
THE PREMISE IS ONLY THROUGH
CONTACT, OBSERVATION AND EMPATHY
WITH END USERS CAN YOU TRULY
DESIGN SOLUTIONS TO FIT THEIR
NEEDS, ENVIRONMENTS AND LIVES.
AND THIS IS VERY DIFFERENT FROM
WHAT I HAD BEEN DOING, WHAT MANY
OF US DO.
HERE'S A PROBLEM, LET'S GET INTO
A ROOM AND BRAINSTORM SOLUTIONS,
OR WE HAVE THIS TECHNOLOGY, WHAT
CAN WE USE IT FOR?
OR OTHER PEOPLE ARE DOING.
EX, HOW CAN WE DO X A LITTLE
FASTER OR BETTER?
AND I THINK THAT -- I'VE BEEN
THINKING ABOUT DESIGN THINKING
WHEN I ENCOUNTER A PROBLEM AND
NEED TO DEVELOP AND DEPLOY A
SOLUTION, AND BOTH FOR NEW
ISSUES AND ALSO THINGS THAT
YOU'RE DOING THAT AREN'T HAVING
THE DESIRED EFFECT.
THERE'S SIX STEPS IN THIS BOOK
THAT THEY GO OVER TO TRY YOU AND
AND UNDERSTAND, YOU OBSERVE, YOU
SYNTHESIZE -- MY SIX TAKEAWAYS
FROM THE BOOK I STARTED TO DO A
LOT MORE IS DRAWING A LOT.
THIS LITTLE BOOK SHOWS HOW WE
CAN ALL DRAW ON THE BACK OF A
NAPKIN.
GO FOR IT CREATIVELY, DON'T BE
AFRAID TO FAIL.
THAT CAME UP IN SEVERAL BOOKS.
CO-CREATE WITH OTHERS, A DIVERSE
TEAM.
AVOID ASSUMPTIONS, ASK A LOT OF
QUESTIONS.
THIS BOOK BY THE PRESIDENT OF
UVA, HE WAS FORMERLY THE HEAD OF
EDUCATION AT HARVARD, WAIT,
WHAT?
TALKS ABOUT QUESTIONS WE NEED TO
BE ASKING MORE.
SO WAIT, WHAT GETS AT SLOWING
DOWN AND REALLY TRYING TO
UNDERSTAND THE OTHER PERSON.
WE NEED TO SAY I WONDER A LOT
MORE.
I WONDER IF OR I WONDER WHY IS A
WAY TO STAY CURIOUS AND ENGAGED,
AND COULDN'T WE AT LEAST AGREE
OR COULDN'T WE AT LEAST GET
STARTED WHEN WE'RE STUCK.
OTHER QUESTIONS, HOW MIGHT WE
FOCUS ON THE POSITIVE?
HOW MIGHT WE CUT OUT THE BAD?
HOW CAN WE GO COMPLETELY IN AN
OPPOSITE DIRECTION?
HOW MAY WE IDENTIFY AN UNTAPPED
RESOURCE, LOOK FOR ANALOGS?
WHAT WOULD A AMAZON OR APPLE DOF
THEY WERE IN THIS SITUATION?
WE'RE NEARING THE END.
OTHER TYPES OF BOOKS I READ A
LOT THAT HAVE HELPED ME TOO ARE
BIOGRAPHIES.
SO BOOKS LIKE LYNDON JOHNSON,
THESE ARE THE THREE BUYI BIOGRA,
LYNDON JOHNSON, ELON MUSK AND
BILL GATES.
IS THAT BILL GATES?
NO, IT'S STEVE JOBS.
PARDON ME.
AND HOW THEY APPROACH PROBLEMS,
VERY, VERY HELPFUL TO READ
THOSE.
I READ A FAIR BIT OF FICTION AS
WELL.
THIS FIRST BOOK, THE ART OF
FIELDING I READ YEARS AGO BUT IT
GAVE ME INSIGHT INTO PATIENTS
WHO WERE BACK AT THE TILE
STRUGGLING WITH COMING OUT ABOUT
THEIR SEXUALITY, ALL THE LIGHT
WE CANNOT SEE GIVES ME INSIGHT
INTO A PATIENT OF MINE WHO HAS
VISUAL IMPAIRMENT.
THIS BOOK, QUE C UCKOO'S CALLINS
ALSO A SERIES THAT'S REALLY
GOOD, ABOUT DIFFICULTIES
ASSOCIATED WITH LIVING AS AN
AMPUTEE, HELPING TO CARE FOR
PATIENTS WHO ARE AMPUTEES.
SO CONCLUDING THOUGHTS ABOUT
READING.
TOO MANY HEALTHCARE
PROFESSIONALS DO NOT READ
NON-MEDICAL BOOKS, AND IT'S
LIMITING THEIR GROWTH AND THEIR
CHANCE TO REALIZE EXCELLENCE.
SO MY SUGGESTION AROUND READING
IS BUY A BOOK TODAY.
ONLINE, IT'S EASY.
TRY AND LISTEN TO A BOOK.
I LISTEN TO LOTS OF MY BOOKS ON
MY COMPUTE FROM THE ANNAPOLIS
AREA UP TO BALTIMORE, SO I'M
ALWAYS ACTIVELY LIST INTO A BOOK
AND READING A BOOK.
I'M ALWAYS IN THE PID MIDDLE OF
A BOOK.
IF I'M NOT IN THE MIDDLE OF A
BOOK I FEEL LIKE I'M MISSING
SOMETHING SO I'M ALWAYS IN THE
MIDDLE OF A COUPLE OF BOOKS.
I'M A MEMBER OF THREE DIFFERENT
BOOK CLUBS AND HELPS WITH
GROWTH.
IF YOU WANT ME TO -- I HAVE A
BOOK -- LIST OF BOOKS, I'VE
MENTIONED EIGHT OR 10 TODAY, BUT
IF YOU EMAIL ME AND SAY PLEASE
SEND ME YOUR BOOK LIST, I WILL
SEND YOU MY BOOK LIST OF BOOKS
THAT I THINK ARE GREAT.
AND USE READING AS ONE OF THE
CRITERIA WHEN YOU'RE HIRING.
EVERYONE THAT I HIRE, I SAY WHAT
HAVE YOU READ LATE LEA, WHAT'S A
BOOK THAT'S INSPIRED YOU OR
MOTIVATED YOU?
AND PEOPLE THAT READ ARE REAL
REALLY -- ARE MORE OPEN-MINDED
AND MORE COMMITTED TO GROWTH, I
THINK.
SO READ MORE.
AND THEN TO SUMMARY -- TO END
RIGHT ON TIME, 1 1255ISH, SO IN
SUMMARY, CLINICIANS ARE VITAL TO
THE SUCCESS OF ACADEMIC MEDICAL
CENTERS' TRIPARTITE MISSION.
SO WE NEED TO CHERISH AND VALUE
AND A HELP OUR CLINICIANS GROW
AND THRIVE AND FLOURISH.
AND FOR CLINICIANS, THEY NEED TO
BE CONTINUALLY GROWING.
SO AGAIN, YOU KNOW, WE NEED TO
MENTOR A CLINICIAN, BUT
CLINICIANS ALSO NEED TO -- IT'S
ON THEM AND ON US TO CONTINUE TO
GROW CLINICALLY, TO GROW TO
BECOME BETTER AND BETTER
CLINICIANS AND TO ALSO TO GROW
PERSONALLY.
SO I THINK THAT'S MY LAST SLIDE,
RUNNING THROUGH A NUMBER OF
SLIDES, AND I'LL BE HAPPY TO
STAY ON TO ANSWER ANY QUESTIONS
ABOUT MILLER COULSON ACADEMY,
OUR PROMOTION TRACK AT HOPKINS
OR ANYTHING ELSE YOU WANT TO ASK
ME.
SO THANK YOU AGAIN FOR INVITING
ME AND I LOOK FORWARD TO COMING
DOWN INTO D.C. TO BE THERE IN
PERSON.
INITIALLY THIS WAS SET UP AS
VIRTUAL SO I SCHEDULED PATIENTS
FROM 8:00 TO 11:00 TODAY, AND
COULDN'T GET THERE, BUT I KNOW
THEY COULD HAVE BEEN ONLINE NOW
BUT THANK YOU FOR HAVING ME AND
I LOOK FORWARD TO COLLABORATING
WITH YOU MORE IN THE FUTURE.
>>THANK YOU SO MUCH,
DR. WRIGHT.
AND WE APPRECIATE YOUR KEEPING
YOUR PATIENTS A PRIORITY AS
WELL.
SO WE'VE HAD A NUMBER OF
QUESTIONS THAT HAVE COME IN.
SO THE FIRST QUESTION IS, IT
TOOK SOME TIME FOR YOU TO GET
YOUR PROGRAM OFF THE GROUND.
WHAT SPECIFIC STEPS DID IT TAKE
TO CONVINCE LEADERSHIP THAT
THERE WAS VALUE IN VALUING
CLINICIANS?
>>IT DOES.
SO ALL -- ALL NEW IDEAS AND NEW
PROGRAMS TAKE TIME TO GROW AND
FLEWISH, AND I THIFLOURISH, ANDE
LUCKY AND WE REALLY HAD A
COMMITMENT FROM THE DEAN AND
DEPARTMENT CHAIRS TO CHANGE THE
CULTURE, SO THAT CLINICIANS
WOULD BE SEEN AS EQUAL AND
VALUABLE AND IMPORTANT NUMBERS
OF OUR COMMUNITY, AND SO I THINK
SHOWING THEM THAT IT'S POSSIBLE
AND SHOWING THEM THAT WE WERE
HAVING SOME EARLY GAINES AND WE
WERE HAVING SOME SUCCESSES AND
THERE WERE LOTS OF PEOPLE WHO
WERE INTERESTED IN JOINING US
AND WORKING WITH US, I THINK
SEEING THE AMOUNT AND THE
NUMBERS OF PEOPLE WHO WERE
ENGAGED AND THE PEOPLE WHO WERE
BEHIND US, I THINK HELP TO ALLOW
LEADERS TO BE PATIENT WITH US
AND TO GIVE US TIME TO DEVELOP
AND TO MAKE PROGRESS.
>>GREAT.
SO IT SOUNDS LIKE HAVING SOME
EARLY SUCCESSES AND SHOWING A
GROUNDSWELL OF SUPPORT WERE
IMPORTANT FACTORS FOR YOU.
>>YES.
WELL SAID, DR. RUHL.
THANK YOU.
>>SO AN ADDITIONAL QUESTION WE
HAVE IS, MORE DETAILS ABOUT THE
ACADEMY IN PARTICULAR AND THE
ROLE THAT YOU'VE DESCRIBED A
WHOLE MENU OF MECHANISMS THAT
YOU'VE USED TO KIND OF IMPART
CULTURE CHANGE AND REALLY IMPACT
THE CAREERS OF CLINICIANS AT
HOPKINS.
SO IF YOU COULD JUST TELL US A
LITTLE -- DRILL DOWN A LITTLE
BIT MORE INTO THE ACADEMY IN
PARTICULAR.
>>SO THE ACADEMY IS REALLY --
WHEN PEOPLE GET INTO THE
ACADEMY, THEY'RE OVERJOYED, AND
I REMEMBER ONE ACADEMY MEMBER
WHO GOT IN AND SAID THIS IS MY
ACADEMY AWARD, THIS IS -- I KNOW
I'M NOT GOING TO GET TO
PROFESSOR, THAT WAS BACK BEFORE
THE DAY OF -- THIS IS -- THIS IS
THE HIGHLIGHT OF MY CAREER, AND
YOU KNOW, HER FAMILY WAS THERE
AND HER CHILDREN WERE THERE,
WONDERFUL.
SO I THINK THAT THE ACADEMY,
THOUGH, IT'S A WORKING ACADEMY.
SO WE HAVE 90 MEMBERS AND THEY
KNOW THAT THEY ARE -- THEY HAVE
TO GIVE US 20 HOURS A YEAR TO
HELP DO WORK.
SO WHILE HIM WHO'S HELPED ME
WITH LOTS OF THINGS AND KIM
WILLIAMS IS MANAGER OF THE
ACADEMY, AND WHILE SHE AND I
SPEND TIME THINKING ABOUT THE
ACADEMY WEEKLY IF NOT DAILY.
THE OTHERS ARE ENGAGED MEMBERS,
ZOO -- SO I WOULD SAY OUR
ACADEMY MEMBERS COMMIT TO
ROLLING UP THEIR SLEEVES,
GETTING THEIR HANDS DIRTY AND
TRYING TO WORK ON PROGRAMS, OUR
COACHING PROGRAM AND OUR GRAND
ROUNDS, ARE FANTASTIC, AND
PEOPLE SEE THAT, SO I THINK
THAT'S THE BIGGEST THING, I
THINK THAT WHILE -- SO MANY
PEOPLE THINK OH, YOU GET INTO
THE ACADEMY AND IT'S AN HONOR.
AND IT IS, BUT WE TELL PEOPLE
WHEN THEY APPLY, DON'T APPLY
UNLESS YOU'RE WILLING TO DEVOTE
20 HOURS OF YOUR TIME IN A YEAR
TO COME UP WITH IDEAS, WORK ON
PROJECTS AND HELP US TO ADVANCE
THE ACADEMY.
AND I THINK THAT'S BEEN THE
BIGGEST THING.
OTHER THINGS, TEACHING
ACADEMIES, CLINICAL ACADEMIES
ELSEWHERE, IT'S AN HONOR, YOU
GET IT, YOU PUT IT IN YOUR CV
AND THEN YOU'RE NOT ENGAGED, I
THINK SOME OF THOSE HAVE FAILED.
BUT BUT I THINK THE BIGGEST
THING IS ENGAIBLGM ENGAGEMENT.
AT THE START OF A YEAR, WE SAY
TO AWR ACADEMY MEMBERS, WHAT'S A
BIG NEW INITIATIVE WE'RE GOING
TO LAUNCH THIS YEAR, AND HOW ARE
WE GOING TO DO IT.
WE FORM THINGS AND WE GET THINGS
DONE.
SO THE COACHING PROGRAM,
CLOSLER, I THINK THAT'S REALLY
LED TO THE SUCCESS OF THE
ACADEMY.
>>THAT'S GREAT.
IT REALLY UNDERSCORES THE NEED
FOR BOOTS ON THE GROUND AND A
LOT OF LITTLE TASKS TO MOVE BIG
PROJECTS.
ONE COMMENT THAT CAME IN FROM A
STAFF CLINICIAN IS, DR. WRIGHT,
THANK YOU FOR THIS INSPIRING
TALK.
IT IS ALWAYS GOOD TO REMIND
OURSELVES THAT IN ORDER TO TAKE
CARE OF OTHERS, WE NEED TO TAKE
CARE OF OURSELVES.
VERY INSPIRING.
>>THANK YOU.
I APPRECIATE THE COMMENT.
AND I THINK IT'S SO TRUE.
AND WE DON'T REMIND OURSELVES OF
THAT ENOUGH, AND I REALLY FIRMLY
BELIEVE IN THAT, AND I TRY AND
LIVE THAT, AND IT'S SUPER, SUPER
IMPORTANT, ONLY IF WE TAKE CARE
OF OURSELVES CAN WE SUCCEED
WITH -- IN RELATIONSHIP WITH
OTHERS.
SO GLAD THAT THAT WAS NOTICED,
AND SO TRUE.
>>ONE ADDITIONAL QUESTION IS,
WITHIN YOUR PROGRAM, EITHER THE
ACADEMY OR YOUR OTHER EFFORTS TO
FOCUS ON CLINICAL EXCELLENCE,
HOW HAVE YOU MEASURED COMMUNITY
IMPACT?
>>SO YOU KNOW, HOPKINS HAS
OTHER PEOPLE BEYOND ME WHO
MEASURE JOY OF WORK, EMPLOYEE
SATISFACTION, AND THINGS LIKE
THAT.
AND TO BE HONEST, WITH COVID IN
THE LAST FOUR YEARS AND WITH
SOME ISOLATION AND WITH SOME
EXTRA WORK AND EXTRA PRESSURE,
I'LL TELL YOU THAT OUR
INSTITUTION, YOU KNOW, MORALE
HAD BEEN LOW, AND IT'S
DIFFICULT, AND I THINK THAT --
SO I THINK THAT WE -- WHILE I'M
CONVINCED THAT OUR ACADEMY, OUR
PROGRAMS HAVE HAD A BIG
INFLUENCE ON THE CLINICAL
CULTURE AT HOPKINS, YOU KNOW,
THOSE WHO ARE IN CHARGE OF
MEASURING MORALE AND OVERALL
SATISFACTION DO IT AND IT'S
STILL A BIT OF A TOUGH TIME, AND
THERE'S STILL A WAY TO GO.
WE HAVE A CHIEF WELLNESS OFFICER
THAT IS WORKING ON THINGS AND
WORKS WITH THE ACADEMY, TO MAKE
THINGS MORE FUN.
OUR LAST GRAND ROUNDS LAST WEEK
WAS JOY AND FUN IN THE CLINICAL
ENVIRONMENT, AND WE HAD SIX
ACADEMY MEMBERS WHO TOLD STORE
HE OOOS OF JOY AND FUN, AND SOME
WERE PEDIATRIC ICU DOCS WHO WERE
CARING FOR VERY, VERY SICK
CHILDREN, AND OTHERS.
SO IT WAS LOTS OF INTENSIVISTS,
ONCOLOGISTS WERE TELLING
STORIES, AND SO I THINK THAT WE
NEED TO ALL DO BETTER EVERYWHERE
TO TRY AND MAKE WORK A BIT LESS
SERIOUS, A BIT MORE FUN, DAY TO
DAY JOY, CERTAINLY THERE'S LOTS
OF -- THERE'S ENOUGH TO GO
AROUND IN MEDICINE, BUT IT ALSO
HAS TO BE ENJOYABLE, AND I THINK
THAT INSTITUTIONS ARE STARTING
TO HAVE WELLNESS OFFICERS AND
PEOPLE ARE THINKING ABOUT HOW
CAN WE PROMOTE WELLNESS, LIMIT
BURNOUT, HOW CAN WE MAKE THINGS
MORE FUN SO THAT WE CAN DO THIS
FOR A LONG TIME.
SO SOMETHING THAT WE'RE THINKING
ABOUT, WE LIKE TO THINK WE HAVE
A POSITIVE IMPACT ON WELLNESS
AMONG CLINICIANS IN PARTICULAR,
BUT DON'T HAVE GREAT DATA AND
SOMETHING WE'RE THINKING ABOUT.
>>WELL, THANK YOU, YOUR LAST
COMMENTS REALLY FOCUSED, I
THINK, BACK ON THE NOW, AND
THAT'S AN IMPORTANT MESSAGE, SO
THANK YOU FOR COMING TODAY.
JUST A REMINDER THAT PEOPLE CAN
PUT IN THE CME ACTIVITY CODE,
AND THAT THIS WILL BE --
RECORDING WILL BE AVAILABLE ON
THE VIDEOCAST WEBSITE.
SO WE LOOK FORWARD TO HOSTING
YOU HERE IN PERSON IN NOT TOO
LONG.
>>THANK YOU.