Consulting
I love to wrap my arms around a large set of data to dig into the heart of the issue. The goal is to generate new insights and practical next steps that resolve issues, create buy-in, and build a path forward. I am an original thinker with a raft of creative solutions, grown out of decades of experience in the exam room and the board room. Leverage my brand of unique insights to explore the next idea that will transform your organization.
The Task: How to buff up Medical Home quality numbers
As the new director of Legacy Health’s “Medical Home” program, I was tasked with teaching Primary Care providers how to do their work better. I knew better than to struggle through this first assignment alone and on the hotseat, because leadership is not just about implementing my own ideas. So I mined the wisdom of the best performers by interviewing the top 25 highest-rated PCPs about how they achieved their excellent numbers.
I collated all of their winning techniques into a 60-slide “Medical Home Best Practice” onboarding presentation for new Legacy Primary Care providers, reinforced by a series of bite-sized articles explaining various aspects of Medical Home and how to hack them for best performance. Providers grew happier and more efficient as the most effective techniques disseminated through the ranks. Wrapping my arms around a complex body of clinical information quickly and “writing a manual” clarifies any situation and helps providers achieve their best.
The Task: Challenging preconceived skepticism to a new workflow
Could physician assistants or nurse practitioners safely run the Medical Intensive Care unit at Legacy Mount Hood Medical Center alone overnight? Believing that a trained provider who was physically on-site trumped a doctor taking phone calls from home, my answer as hospital CMO was yes - but not everyone agreed. To get authentic buy-in and implement the new program, I went back to the original stakeholders, sought input and listened thoughtfully to feedback. I brought together a problem-solving team which dived into misaligned incentives, credentialing problems, and the need for a new training program for the APPs. With this new consensus, we increased the number of critical-illness-trained providers overnight in the hospital, a major safety win for patients and staff alike.
Previewing Clinical Teams of the Future: this experience yielded an invaluable glimpse into the future of healthcare, which by necessity will rely more on APPs to augment scarce physician resources.
Stepping into the role of Hospital Chief Medical Officer at Legacy Mount Hood Medical Center, I discovered the floors were jammed with patients who had completed their inpatient medical care but lacked a safe discharge plan to home or a facility.
Legacy Health had developed a best practice bundle to reduce length of inpatient stay, but how to marshal diverse stakeholders to implement it? Working closely with the Chief Nursing Officer and inpatient medical director, I coaxed doctors to join “multidisciplinary rounds” with nurses and care managers, and encouraged them to write discharge orders earlier in the day (like checking out of a hotel by 11 a.m). I pitched families directly to transfer ER patients to other Legacy hospitals before admission, sometimes obtaining consent myself when their attending physicians were too busy. I wrote a “myth vs. fact” guide to overcome physician and nurse objections to a sticky spot: the “take-back” program accepting our own patients back from a specialty hospital for further recovery.
But even the best modalities don't succeed without authentic leadership conversations. I personally served as the “escalation pathway” for difficult discharge delays. Diplomacy, soft skills, and judicious application of “Lean thinking” secured buy-in, and the discharge machine began to hum. Average inpatient length of stay dropped close to the goal of 4 days, more patients were served, and finances improved.
The Task: Bring physicians, staff, and families together to discharge inpatients faster and more efficiently


Coaching
Sometimes it is so hard to see the solutions to our own problems. That’s because we are not designed to do everything alone. I have benefited so much from my own coaches and consultants, and I love to play that role for others. I offer not just a listening ear, but a source of new perspectives and practical solutions, along with the toolbox to implement them. After 20+ years of clinical work and leading physicians and staff in organizations of all sizes, there are few situations I haven’t encountered myself or coached others through. Let’s discuss what you need to take the next steps to love your practice and thrive as a healthcare professional.
The Ask: Make medical education practical and appealing
Faced with a shortage of primary care providers while working as Medical Director at Legacy Health, I volunteered to start a Primary Care interest group for Internal Medicine residents in our educational programs. All the book learning in the world can’t capture the vivid highs and inevitable lows of a dynamic primary care practice. And I remembered how the theory of my residency training seemed to pale in the face of the challenges I experienced in my first clinic positions.
So I put together a curriculum based on real-world street smarts using my own and colleagues’ experience as PCPs. I distilled this into a series of informal, conversational lessons to help our new doctors hit the ground running…all the tips no one tells you in school and you have to learn the hard way! Now a new generation of IM graduates is entering clinics better prepared to serve their patients and thrive in their practices over the long term.
The Ask: Turn an ordinary Urgent Care visit into a quick and delightful patient experience
A naturopathic doctor working for ZOOM+Care, an innovative Urgent Care medical start-up, had the medical know-how to perform the required 15-minute visits, but her patient reviews weren’t stellar – bedside manner was too serious, not “Zoom-y.” As the medical director, I coached her through barriers and pain points around the proper customer-oriented mindset.
After shadowing and giving feedback, I had her observe me doing a visit. I put in my all, employing my best empathy, rapid-decision-making, and tricks to elicit patient buy-in. At the end, the ND said ruefully, “That was a great visit….but it took 18 minutes.” Ouch! I couldn’t quite pull off the perfect visit I was trying to teach! It was an unforgettable moment of humility on my professional journey. Now I understand that rigid 15 minute-visits without ever running late is a tough standard, and I feel proud of taking an extra 3 minutes to produce a great outcome. The ND did use my techniques after all to level up her "Zoominess," and I learned more about what constitutes sustainable and beneficial healthcare.


Let's talk about the help you need
Don't hire a non-clinician consultant who can't see things from a providers' point of view - I speak "doctor," "administrator," "patient," and other healthcare "languages." And don't struggle alone! A 30-minute call with Novella Insights can revolutionize your career, team, practice, or organization.