Human Development Makes a Difference In Healthcare with Stephen Beeson, founder of Practicing Excellence

[00:00:00] Hey everybody, welcome back to the Outcomes Rocket. So excited you tuned back in today. Today I have

[00:00:08] the privilege of having an amazing guest and friend back on the podcast. His name is Dr. Steve Beeson.

[00:00:16] He's the founder and CEO of Practicing Excellence. They're a nationally recognized company. He's a

[00:00:22] nationally recognized speaker, physician, and author whose life mission is to coach and develop

[00:00:28] clinicians to be their best. Dr. Beeson started his career as a family medicine physician with

[00:00:34] Sharp Re-Steely Medical Group in San Diego and throughout his career he's been dedicated to

[00:00:39] coaching, developing, and engaging clinicians to improve the clinician and patient experience.

[00:00:44] So I'm excited to have him back on. Steve, such a pleasure to welcome you.

[00:00:48] No, delighted to be back.

[00:00:50] Look, it's been too long. I know we were chatting before hitting record on the podcast today.

[00:00:56] It's been about three years, three, four years since you've been on the podcast. So

[00:01:00] just to level set with everyone, what is it that got you into the business of health care from the

[00:01:05] bedside? And tell us a little bit more about you.

[00:01:08] Yeah, no, for sure. I certainly where I am right now was not a plan. Things, doors open up,

[00:01:14] you walk through them, and then you walk through the room and all of a sudden you're in a

[00:01:18] totally different place you could not have imagined. And that was certainly the case for me.

[00:01:22] And my plan for myself was to see patients all day, every day for 35 years and call it a day.

[00:01:30] And we sacrifice a lot to become physicians. It's perpetual delayed gratification from high school,

[00:01:37] the college, to med school, to residency with a lot of sacrifice along the way.

[00:01:41] And when you get there, the intent is to utilize those skills and training and experience

[00:01:46] to see patients one at a time to advance their wellness. And I love doing that.

[00:01:52] And, but for me, probably about, I don't know, seven or eight years into my career,

[00:01:58] I had an opportunity to begin coaching clinicians in with the Sharp Restillation Medical Group.

[00:02:03] We were struggling a little bit in terms of how patients were experiencing care

[00:02:08] that we were delivering. And so I was called upon to serve as a director of an improvement

[00:02:15] effort that we call the Sharp Experience. And I had a chance to learn a lot about how we apply human

[00:02:23] development and continuous improvement and mastery in the art of medicine and patient connectivity.

[00:02:30] And found pretty remarkable things that happened to me personally, what it was like to be

[00:02:36] a better clinician for the patients that I took care of and what medicine was like

[00:02:39] to do that. And what it was like for patients to have clinicians that really listen and care and

[00:02:46] connect and partner and kind of Sherpa healthcare as opposed to collecting symptoms, generating a

[00:02:54] diagnosis and issuing treatment orders in a paternalistic fashion, which never works very well

[00:03:01] and in any area. But I really began to love the art of human development and developing

[00:03:08] clinicians to become better for their patients, better for themselves, better for their colleagues,

[00:03:12] better for their teams. And we saw a really incredible organizational results in terms of

[00:03:18] how patients were experiencing care, our ability to grow market share. But I think most

[00:03:23] importantly to me was that we were able to increase physician engagement to the 95th percentile.

[00:03:30] And we were able to drop physician turnover by about 80% by simply focusing on clinicians

[00:03:38] becoming the kind of clinicians that they thought they were going to be when they joined the profession.

[00:03:43] So I dove into the work of how do we apply human development to clinicians and care team

[00:03:49] members and leaders and even non clinical folks to be really contributory to what we

[00:03:55] want to become as an organization and also to do their work that drives great sense of

[00:04:00] meeting a purpose. And so I walked into that world and that was the experience that ultimately

[00:04:09] prompted me to found what is now practicing excellence.

[00:04:11] That's awesome. And you haven't looked back since you've been able to help

[00:04:15] many physicians and care providers with the way they deliver care or patient experience.

[00:04:22] Talk to us a little bit more about practicing excellence and the type of work that you guys

[00:04:27] are dedicated to putting out there. The founding of practicing excellence came

[00:04:32] about probably in about 2012, so over 10 years ago. And what I was realizing at that time in my

[00:04:40] life because I was still in 2012, I was still managing a full-time clinical practice. I was

[00:04:45] coaching and training and developing clinicians at Sharp. And I was traveling around the country

[00:04:52] going to other organizations who were raising their hand to say, we want to develop our clinicians

[00:04:56] to achieve some of the outcomes that you've done at Sharp. That Sharp is done. There are many

[00:05:01] people that were involved in our improvement. It wasn't just me. There was many people that

[00:05:04] were contributed to that. And my life was spinning out of control. All of those are an FTE.

[00:05:10] I was managing our patients and I was coaching clinicians and I was traveling to other

[00:05:15] organizations. And what I realized in that point in my life is that developing clinicians to raise

[00:05:22] their capacity to create outcomes really works. It benefits patients, organization, it benefits them.

[00:05:30] And there was really no, there was nobody doing it. Nobody that was helping clinicians on the

[00:05:36] critical skills of patient connectivity, team collaboration, leadership effectiveness,

[00:05:41] or even taking care of themselves. And so there's a massive opportunity, a massive potential benefit,

[00:05:48] but it was super hard to do. It was super hard to scale. It was hard to synchronize. It was hard

[00:05:53] to syndicate and distribute and sustain. It was just, we were very analog doing workshops and

[00:06:00] shadowing and talks and I was just going site, and site, and site, and site, and site,

[00:06:04] writing. And that's why it took us a decade to get fit to render the results that we saw.

[00:06:09] I was thinking to myself, if human development works and skill building works to help enrich the

[00:06:17] lives of clinicians and raise their contribution and contentment, then could we come up with a

[00:06:23] technology solution that could power continuous improvement and continuous mastery? And so sitting

[00:06:31] in a Starbucks, I was thinking, and I was with a buddy of mine and we began to banter ideas

[00:06:36] about to say, could we use technology to syndicate continuous improvement and skill building?

[00:06:44] And that's, and actually when I left Starbucks, I actually went by office depot and I got this little

[00:06:52] like workbook that was, and I began to write down all my ideas for what practicing excellence

[00:06:57] was going to be. And I still have that workbook. But that was the beginning. That was the

[00:07:01] beginning of the journey. That's great. And how is the industry doing now, Steve? Like this

[00:07:05] was 10 years, a little over 10 years ago. It wasn't a thing. How are we doing now? And what's adoption

[00:07:12] looking like for these types of programs? It's a great question. I think that the healthcare industry

[00:07:19] always seems to be in crisis. It's too expensive, too inconsistent. It's burning out its people.

[00:07:25] It's providing highly variant care. It's inconsistent clinical outcomes. There's lots

[00:07:30] of care discrepancies in different populations where it's so difficult and complicated to navigate

[00:07:37] American healthcare. So American healthcare has a lot, a lot of work to do. And that's always been

[00:07:42] that sort of a steady state. But what's different now, I think is that number one, we're realizing

[00:07:50] that we can't continue to do healthcare delivery the way we're doing it right now. The standard

[00:07:57] what we call fee-for-service model is resulting in over treatment of patients and under treatment of

[00:08:02] patients and highly variant care, inappropriate care, over treatment. And it's absolutely

[00:08:08] unaffordable in terms of how American healthcare is being delivered right now. And that's been known

[00:08:14] for some time. And there's some big shifts in terms of how healthcare is being delivered and

[00:08:18] paid for that can help to bend us towards what we call value-based care, which is we reimburse

[00:08:24] systems and physicians for the health outcomes that we're able to create to advance preventative

[00:08:29] care, health preservation, patient empowerment, patient participation. All those things are

[00:08:34] big macro forces to make healthcare better. But I think the thing that we're really seeing now

[00:08:39] is the importance of the people delivering care. We have just eclipsed our highest levels of

[00:08:46] recorded burnout in the physician space. Highest levels. There was a- Even beyond COVID.

[00:08:50] Yeah. So- That's crazy, man.

[00:08:53] Even beyond COVID. Yeah. So this last year in 2023, it was 63% of clinicians are experiencing

[00:09:00] at least one symptom of burnout and burnout being cynicism, which is an awful thing to live with.

[00:09:06] It's a byproduct of just not feeling good about the life that you're leading and the work that

[00:09:11] you're doing and having this sort of sense of hopelessness in the day-to-day work,

[00:09:17] exhaustion and depersonalization. And we're seeing the same thing in the nursing industry.

[00:09:23] And we're seeing a lot of workforce instability as a result of the conditions that people are

[00:09:28] living in right now in terms of delivering care. So the thing that's really advanced that I've seen

[00:09:34] over the past 10 years is not only the realization that working in healthcare is difficult,

[00:09:39] but I think with every challenge there can be a reflection and realization that we have

[00:09:44] to take care of our people and provide conditions that they work in that allow them to show up on

[00:09:52] Monday morning to say, I love what I do. I love the impact that I'm able to make with patients.

[00:09:57] I love the teammates that I work with. I love the purpose that we serve.

[00:10:00] I appreciate how our leaders are listening and deep-burdening us and appreciating us and

[00:10:04] empowering us. And there's now a shift to take care of the healthcare workforce,

[00:10:09] which is an excellent consequence of the conditions that I think we're facing right now.

[00:10:14] There's actually the beginning of sourcing, meaning people call us and they say, hey,

[00:10:19] practicing excellence, can you help us restore the vitality of our workforce?

[00:10:23] So you're getting calls now.

[00:10:24] And yeah, we're growing despite a brutal market right now.

[00:10:29] There's been about an 80 to 90% contraction of healthcare margins compared to pre-margin,

[00:10:34] compared to 2022 in particular. It's recovered a little bit in 2023,

[00:10:39] but there's high compression in healthcare systems right now in terms of the money that they're making.

[00:10:45] But I think that the realization is if we don't have an engaged and retained

[00:10:50] clinical talent pool, then we don't have a healthcare delivery system.

[00:10:53] Yeah. I mean, that's the bottom line.

[00:10:56] That's fascinating. Ten years ago, you're out there trying to convince people they need this.

[00:11:01] Today, we know we need this and we're reaching out.

[00:11:06] As you take a look at everything that we've got going on today,

[00:11:10] Steve, what's been one of the biggest setbacks you'd say that you've seen starting the business,

[00:11:16] keeping it going?

[00:11:18] You know, I would say first of all, starting and growing a business

[00:11:24] even with a great idea and a great product and great people is super hard.

[00:11:29] It's like I've just accepted that as a reality. It's like what roadblock is going to be thrown up today?

[00:11:36] And it takes twice as long and takes twice as much money and twice as much blood, sweat, and tears

[00:11:42] to execute an outcome. So that is just the baseline operations of growing a company.

[00:11:50] And I think particularly in the healthcare sector because healthcare is just, it's a,

[00:11:56] it's complex. It's got all the workforce issues. It's got financial pressures.

[00:12:03] It's got so many different regulatory requirements and performance accountabilities.

[00:12:07] So it's just an industry under strain, not unlike education.

[00:12:15] But I think that, I think my greatest frustration with growing this company has been

[00:12:23] the deep commitment and knowledge that helping and supporting and developing your people can

[00:12:30] create such vitality in the workforce and such impact on patients. It's so

[00:12:38] clear that when we help our people to become what they aspire to be for patients and for each other,

[00:12:44] then so many good upside things can happen.

[00:12:48] So you see that in your mind and you live that experience and you've walked that journey and I

[00:12:52] walked that journey sharp. But then there's so many people that choose not to do that

[00:12:58] to say, no, we're going to start a new service line and we're going to focus on increasing our

[00:13:02] revenue and we're going to increase our RV use and that's going to be our objective

[00:13:08] priority. And so, you know, you see this pathway to creating really adaptive, culturally well

[00:13:16] effectively run, deeply collaborative, purpose driven, making an impact on the lives of patients

[00:13:22] pathway for what healthcare can be. And you see a lot of systems say it is about revenue

[00:13:29] and it is about cost and we get an optimizer margin and that's what we're doing. So go away,

[00:13:36] Steve. That's not the sort of thing that we're interested in right now.

[00:13:39] That's tough.

[00:13:40] There's that.

[00:13:42] When you see the value and what are your thoughts on, so there's the health systems and then

[00:13:47] there's been just a large amount of unique approaches to care delivery like decentralized

[00:13:55] practices and groups that are focused on particular specialties. How are you seeing

[00:14:02] these groups be different than legacy providers?

[00:14:07] Yeah. I think that there's lots of alternative ways of delivering and receiving care now

[00:14:15] that represent a real competition to traditional healthcare, wellness centers and some homeopathic

[00:14:24] approaches and comprehensive vitality centers in addition to all the retail centers where

[00:14:30] people just want to say, I want to be able to have a clinician on my terms when I can,

[00:14:36] on my phone, right now when I need it. And traditional medicine is, well, can you come in

[00:14:42] a week from Thursday at 1.45 in the afternoon and they go, well, I have a job and I'm sick

[00:14:47] right now. So there's a rising body of care delivery systems that are not only focusing

[00:14:53] on vitality and prevention and patient involvement and less traditional ways of advancing wellness.

[00:15:01] And there's an entire cottage industry of centers that are doing amazing work on that front.

[00:15:08] And there's retail competitors that are getting a lot of private equity backing and investment,

[00:15:12] VILGEMD and just a whole host of other healthcare delivery systems that are designed

[00:15:17] around access and convenience and technology enablement, mobile care, telehealth. So we can

[00:15:24] meet the demands of today's consumer. And then you've got the plotting big healthcare systems

[00:15:29] that are doing it the way we've done it. So the big healthcare systems are trying to figure

[00:15:33] out how do we begin to innovate to compete with these other delivery systems? But I think

[00:15:37] the rise of alternative delivery systems is a byproduct of American healthcare not

[00:15:42] meeting the needs of the population and the rising sense of consumerism and what they're expecting

[00:15:48] from healthcare. Yeah, it's a real deal. And are you seeing this flow of new models

[00:15:56] gravitate toward you and practicing excellence? Do they want your services? Do they see the

[00:16:00] value of them? I think I would say almost all of our customers are big traditional

[00:16:06] healthcare systems. The band of those that have said we want to take care of our people.

[00:16:11] We want to use people development to execute our future state and we want to have a scalable

[00:16:18] people development strategy to become better for our teams as leaders and for our patients

[00:16:23] and as an organization. So we have not serviced the new innovators and most of ours are the

[00:16:29] big integrated billion dollar year healthcare systems that are looking to become better.

[00:16:34] For sure. Appreciate it. Good to understand the focus and kind of the direction and the

[00:16:39] way you see the market shaping. It's very interesting how it's all coming together.

[00:16:44] If your technology platform that educates physicians and caregivers, what's a trend or

[00:16:52] technology that you feel is going to change healthcare as we know it? I think AI is going

[00:16:56] to change everything. You guys using any LLMs or anything like that in what you do? We're

[00:17:02] not using it now but we're not directly in the delivery of our services but we're using

[00:17:07] technology solutions to enrich and enhance our content development or the ability to streamline

[00:17:15] content production and distribution. I think that some of the technology enablement that's

[00:17:20] occurring in healthcare, to give you one example is the development of what we call asynchronous care.

[00:17:26] Asynchronous care is a patient who comes in with a constellation of symptoms and they're

[00:17:33] able to interface with an AI clinical engine that is able to identify their demographics,

[00:17:42] have access to all of their clinical information and all known evidence-based care pathways and

[00:17:49] protocols. They go through a set of symptoms and questions and they will modify their questions

[00:17:56] based on how the patient is responding and the patient is interacting with an AI engine.

[00:18:01] It feels real, right? It feels like you're talking-

[00:18:03] It feels real and there are some that are even developing clinician avatars.

[00:18:07] Which is insane.

[00:18:08] They can interface and test with the patient. Yeah, so that's crazy.

[00:18:12] What happens is the patient talks with this AI driven clinical engine and this thing is able

[00:18:19] to collect a history, create a differential diagnosis which is a list of possibilities

[00:18:24] and from a vast resource of clinical information is able to make a clinical recommendation

[00:18:33] and present that to the physician. There's asynchronous connection between a clinician

[00:18:40] overlooking and reviewing the note and when the patient actually interfaces. It's called

[00:18:45] asynchronous care. The physician can look at the note and say, agree, initiate plan

[00:18:52] or can modify it or can prompt the patient to come in if the patient needs to be seen.

[00:18:56] But the point being is that utilizing technology to expand our ability to have access and to really

[00:19:02] begin to reduce the variance of care that we deliver because we as people, as humans,

[00:19:07] we have a high degree of variance in terms of our own personal ways of doing things.

[00:19:12] Our own biases are the life experiences but these AI clinical engines are able to

[00:19:19] better access evidence-based care and reduce the variance and also radically improve access

[00:19:27] because a typical clinician encounter you go in to see a physician for a problem is a 15-minute

[00:19:32] endeavor and these AI interfaces that are asynchronous are about three minutes and they

[00:19:37] can occur 24 seven, 365. The access is unparalleled. And it may need better.

[00:19:43] Yeah, it's a new world out there and certainly got to stay ahead of it

[00:19:47] because you don't want to get left behind. So certainly appreciate you sharing some of what's

[00:19:53] top of mind for you in that technology advancement department. I love connecting with you, Steve,

[00:19:58] your focus on bringing people up and giving them what they need so they could be fulfilled

[00:20:03] and engaged. What closing thought would you leave our listeners with today and where can

[00:20:08] they reach out to you and follow you for ways to work with you? Some of the things

[00:20:12] that I want people to think about who may be listening to this in or out of healthcare

[00:20:16] is that there's really compelling evidence and there's strong precedent that there's actions

[00:20:21] that we can take within healthcare to make healthcare better. Better for patients,

[00:20:26] better for care teams, better for communities. I happen to believe and have a belief system

[00:20:31] that developing our people to live out a compelling future state that's deeply connecting

[00:20:37] for patients and highly collaborative for healthcare system cultures and really effectively

[00:20:42] led the pathway to those future state manifestations of deeply connected, highly

[00:20:49] collaborative, well-led healthcare organization. The pathway to that is through human development

[00:20:54] and developing the skills to allow that to happen. And we love taking that journey with people

[00:20:59] to say, we're going to help our people store and to be the kind of care team members where

[00:21:06] they're super proud of kind of the work that they're doing. And they look back at the

[00:21:09] end of the day and they go, man, I can kill that today. I love what we're doing for our patients

[00:21:14] and I love how we're helping each other and lifting each other up. And yeah, it's still hard,

[00:21:18] but yeah, it's just good. And getting that cultural reality to manifest in this burden

[00:21:25] industry is life purpose thing for me personally. And practicing excellence just happens to be

[00:21:31] the catalyst to allow those things to manifest. So I think if people are interested in taking

[00:21:36] that journey about how do we apply human development strategy to make an amazing healthcare system

[00:21:42] that revitalizes teams and really engages patients, we love taking that journey with you.

[00:21:48] And so probably the best way to get a hold of me is probably just through our website,

[00:21:54] which is just practicing excellence.com. And then you can peruse our, we've got 15

[00:22:00] case studies and we have published results because it's all about if you say you're

[00:22:04] about offering something in healthcare, the next question should be, does it work?

[00:22:10] And prove that it works because we don't have the resources to spend time, money or effort on things

[00:22:16] that are not proven. I love it. Well, Steve, I appreciate you sharing that resource with us.

[00:22:22] Folks, we'll leave everything in the show notes so you could take a look,

[00:22:25] learn about the work that Dr. Steve Beeson and his team are doing at practicing excellence,

[00:22:31] check them out. At the end of the day, it's about taking action on the stuff that you do,

[00:22:35] that you hear here, that you hear here, that you hear on the podcast,

[00:22:40] to take your organization to the next level. So Steve, thank you so much for being with us

[00:22:44] today. We bet so. Give it the great work. Awesome. All right.