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HeartBeats Episode 10: Leading Through Adversity

HeartBeats: Shipley Cardiothoracic Center Podcasts

(Host) Hello, and welcome to HeartBeats. I'm Cathy Murtagh-Schaffer and I'm your host for this episode of HeartBeats. This podcast is brought to you by Shipley Cardiothoracic Center, an educational series dedicated to providing our patients and the community with information and education about our cardiothoracic surgery program, Lee Health, and matters affecting your health. Today I have the great pleasure of talking with Dr. Venkat Prasad, Lee Health's Chief Medical Officer for Population Health and Physicians Services, who has graciously taken time from his busy schedule to be with us today. Dr. Prasad, thank you so much for being here. Perhaps we can begin by having you tell us a little but about yourself and what your career trajectory has been. How did you become the Chief Medical Officer for Population Health and physician services?

(Dr, Prasad) Thank you Cathy, it's been a pleasure to be invited to share and have these conversations with you, thank you! I have been asked to take on leadership roles, been invited throughout my career. From my chief residency years in my surgical training to the primary care Chief Residency, Medical Director at the rural clinic in North Carolina to being Chief of Staff at the regional hospital and then a UNC when started working with quality improvement and I was the Associate Medical Director at the Physician's Network there, to being the Senior Medical Director at UNC Physician Network. About 4 years ago went off of those recruiting emails that you usually delete, popped up and I opened and being part of a not-for-profit public safety net mission-driven organization seemed very exciting and inviting in that stage. After 19 years in North Carolina I ended up moving as Chief Medical Officer for Lee Physician Group, as you know we are a fairly large multispecialty group of about 765 physicians and APPs, and recently increased that role to include population health and physician services. I think experience was one of the reasons why I think it has been very helpful for me in my leadership role. As a general surgeon and thoracic surgeon I have removed organs, as a primary care physician in rural Nort Carolina I delivered babies, I worked in primary care offices, I've worked in urgent care settings and I've worked in suburban offices I've volunteered in free clinics so just having that wide range of experience has been very helpful. But then, also understanding why I'm doing my leadership role, understanding the reasons and purpose behind it. Of being kind and passionate and being decisive, probably my surgical background, being selfless, and service-minded. I've always been a good listener and then having a calm even temperament has often been the feedback that I think has helped me get to where I am.

(host) Well it sounds like you and I have somewhat similar backgrounds, in my 30 years as a PA I've been in surgery and I've been in clinics, free clinics and hospitals, and rural clinics in big cities and delivered babies and done all sorts of barrier-breaking things that I never really expected to do so I understand what you say about having that broad experience background. It makes such a difference in being able to understand what's happening in the world around you as a leader.

(Dr. Prasad) and I think it reinforced that team-based work, where you work with so many different skill sets.

(Host) Dr. Prasad you and I talked briefly last week to discuss what you wanted to talk about and we came up with this concept of leading through adversity. What about that topic interest you?

(Dr. Prasad) So Cathy, leading through adversity is especially interesting in healthcare. just given how complex healthcare is and the expectation of being true to our calling. We cannon afford to betray the trust of a patient. it just speaks to the challenged and difficulties that a day, a week, a life in healthcare forces upon us and surrounds us. While we can't all aspire to be the Mother Theresa's of the world I think serving our calling in healthcare is really to accept that adversity and deal with the challenges. We use our scientific training, our creativity, and just the need to be adaptable, to be flexible. And given the changes in healthcare we are especially privileged because we are lifelong learners, and that helps us to tackle adversity head-on. I deeply feel it's a challenge that all of us in healthcare take on for our patients and it's often a fight that we take on and we fight to win.

(Dr. Prasad) That we take on and we fight to win. Right,

(Host) Right, right. As a healthcare leader, you certainly I'm sure have had your fair share of adversity to overcome. And nationally we're still dealing with a pandemic, although hopefully there is a light at the end of the tunnel now with the vaccine. Hospitals nationwide are suffering financial losses. As a healthcare system, we seem to be engaging with patients who have increasingly complex medical situations, as well as debilitating socioeconomic situations. In fact, our 2020 community health needs assessment noted in our Lee Health community, 44% of people over age 65 have three or more chronic conditions, and the data points to many with multiple issues with social determinants of care. I'm curious as to what your approach is to devising a strategy that has to address so many complex variables

(Dr. Prasad)

Well said. Um, it is, that is part of that complexity and challenge in healthcare, you have to prioritize and you have to think of the acute and the most urgent needs much like in clinical medicine. And then also think of the long-term needs. Not all problems need the same level of attention or the resources. And as a leader, one has to consider the impact and urgency of any strategy. Delegation, developing other leaders and driving the work on social determinants of health, encouraging partnerships, considering how work overlaps and what's the commonality and what can be used to leverage for success is often helpful. Consider our work in the ACO that we had the Accountable Care Organization, and we were driving closure of care gaps, annual wellness exams, documenting disease burden, case management and quality scores, and addressing these then helped us expose gaps such as transportation, compliance, health care literacy, which were then solve for by the teams. And then of course, we had very good outcomes in our ACO. Integrating functions and deliverables to multidisciplinary teams can have a domino effect. And this advances, the health needs of our communities that you talked about, the needs assessment. For example, now we are working on integrating behavioral health in our primary care offices. We have brought all of case management services under the population health umbrella, and then our GME Graduate Medical Education, family medicine program is working on a population health curriculum that we can then roll out to educate all of our healthcare workers on what population health means and how we partner with communities and then the benefits of it. So it's that whole process of prioritizing of trying to decide the acute needs, the long-term needs, but then integrating all these overlapping areas so that you can then achieve the outcomes that you want.

(Host)

I think I like what you say as far as using teams to integrate these policies, because without that teamwork you get a one-sided unbalanced response to so many of these issues. So I understand exactly.

(Host)

I read an article that basically said we must not only prepare for success, but also adversity that success and adversity were really two sides of the same coin, where one is the other must follow. Do you agree? And if that's true, how do we prepare ourselves for both?

(Dr. Prasad)

Yes. I think that's a very interesting duality and we've, we've heard of dualities in other situations like you cannot taste the summer fruit or the warmth of summer. If you haven't gone through the winter's cold or what Thomas Edison said about, you know, creating the light bulb that when he failed a hundred times to make his light bulb, he learned that, you know, there was a hundred ways you cannot make a light bulb. Adversity really forces us to consider our why our purpose, our meaning, and it raises the collective consciousness so that we can reflect on what is right, what is important. And it goats us to give our best, to be more human, just look at all the great Wars, the famines, acts of terrorism, pandemics, and COVID certainly is a recent one. When people have come together, they have engaged, they have supported, they've healed one another. And despite what any government or country does or doesn't do, how about business review published a study called the garden book study. And it looked at, in this particular study that was done over 2006 to 2011, they looked at about 500,000 people across 469, 429, sorry, firms, where there was a positive impact on both operating financial margins, but really all of the performance measures when the purpose was defined and communicated. So during adversity, we often find the need to define that purpose of why, why are we here? What are we doing? Similarly, there was another study in the Harvard business review, August of 2018, Robert E Quinn and John Pacor. And they looked and concluded that when an authentic purpose for me, its business strategy and decision-making the perosnal good and the collective good become one and adversity again, forces us to do that thinking to get to those conclusions and in healthcare, it's easy because we have our calling, which has already been defined with patient centered care as the purpose of all that we do. Robert Kaplan notes in his book, what you are meant to do, we didn't, I spoke. And if you haven't read it, I strongly recommend, you know, your listeners should read that. And he says, following any crisis, a leader is asking people to do more, to give more at work. And you've seen that following the civil war, fallowing the great depression, the world war II, communicating with clarity about the connection to purpose and how an organization or a person is making a difference, just gives people a sense of meaning and motivates them to action. Like necessity, adversity too, is the mother of invention, or creative problem solving for our success.

(Host)

And I think that your point about having a leader who can conceptualize what the goal is in the face of adversity is critical. And then again, as you mentioned in one of your earlier answers, disseminating that information and integrating it into teams and into groups of people that can from there, pick up the purpose and move forward with that. It all kind of trickles down at some point. I read a quote that said, life happens for you, not to you. Meaning that adversity is one of the ways in which we grow, which you mentioned. There are many characters in history that have either accepted their life challenge and become better for it, or have ignored the lesson and failed because of that ignorance. There are many examples of people who have embraced adversity and found a way to change lives, and we always talk about them. But I also believe that we can learn a lot from people who have failed to learn from their challenges. And so I'd like to ask you, who do you think is an example of someone in history who failed to learn the lesson of their challenge and what can we learn from this person?

(Dr. Prasad)

Cathy, there are so many, unfortunately, unfortunately in fact, there's even a book about histories with mistakes or the greatest mistakes in history. And there are many, but the ones that come to mind, two in particular that come to mind recently, because I read after many, many years of procrastinating, Tolstoy's War and Peace, and his whole Russian war of nine to 1812, that really was a disaster. And then of course, more recently the Enron and Andersen Accounting, the collapse. And if you look at the, both those situations, just highlighted the importance of listening, of teamwork, of having integrity of selflessness and leadership, and then knowing your own true North. But there are many other examples, and I often them as a failure of a systems approach thinking. Many of us have heard about the butterfly wing theory, where when the butterfly wings flap in the Amazon, it causes tornadoes in the U S and of course, you know, it's, it's part of the chaos theory that Lawrence and MIT in the 1950s had talked about, how even small differences in initial conditions can lead to vastly different outcomes and Ray Bradbury writing science-fiction in the 1950, I think 1952 or a short story about how a time traveler steps on a butterfly and kills it. And that small thing, upset balances and knocks down a small domino's and big domino's and giant dominoes and all the way across time to cause the outcome of a presidential election in 2055. Wow. That was really bad, but he, and he wrote killing one butterfly couldn't be that important or could it?Worse, climate change, take building a highway, we have too many cars on the road, so let's just expand the highway. Well, guess what, then builders build more homes, employers bring more employment and the community now needs more roads and more roads. Zero emission cars, well, the cost of making that zero emission car increases the carbon footprint because electric batteries, you know, you consume a lot of carbon to make those. So there are a lot of these unintended consequences and I feel not considering unintended consequences, but at least being prepared for some of those is something that gets in the way of failing of not taking on the lessons from history, from your own experience, curiosity, having a high emotional intelligence and just a healthy skepticism are very essential. And you have to watch out for those dominoes.

(Host)

Yeah, for sure. For sure. Remind me not to step on any more butterflies.

I just finished reading a wonderful book called Team of Rivals by Doris Kearns Goodwin, who's a Pulitzer prize winning historian about Abraham Lincoln's tenure in the white house and how he guided the country through the civil war. And what struck me was how incredibly mindful self-aware and self-disciplined he was, and his pension for being patient while the entire world surrounding him was in chaos and panic. His emotional intelligence was remarkable to say the least. Would you talk to our listeners a little bit about emotional intelligence and why it's so important to develop that as a leader in order to overcome adversity?

(Dr. Prasad)

That too is one of my favorite books and Lincoln is one of my heroes. He's a role model. I too enjoy that book since his biggest triumph was really his sense of timing. (host) It was incredible. And speaking of emotional intelligence, he once told his secretary when he wouldn't choose to hire this person saying, I don't like his face. And the secretary said, but you can basically make a decision based on his face. He cannot help that. And Lincoln turned to his secretary and said, any man over 40 is responsible for his face. And I think what he was speaking to really is not, not the anatomical features of his face, as much as what it reflects of your character, your integrity, and what you are responsible for. So emotional intelligence really allows our very rational prefrontal areas of the brain, the new brain, the new context to really prevent and dampen the lympic old brain from hijacking. All of our, and this happens in nanoseconds, hijacking our responses, our decisions, our passions. And studies suggest that only about 36% of people are currently able to identify their emotions, their own emotions. Emotional intelligence is not just about recognizing and understanding your emotions, but then also your ability to use this awareness to manage your behavior and your relationships. Emotional intelligence is so critical to success that it accounts for 58% of performance in all types of jobs. Interestingly, every point increase in emotional intelligence leads to a $1,300 increase in annual salaries, Travis Bradberry and Jean Greaves wrote a book on Emotional Intelligence, 2.0 and found from their studies. So emotional data comes down to self-awareness and self-management, and also social awareness, and then relationship building. Emotional intelligence, equips us with how and when to implement our decisions. It provides us the grit, the resiliency, the stamina that we need since leadership is never a sprint or a title or a checkbox list, but a marathon, a commitment of purposeful drive. Emotional intelligence helps us to tap into our passion and also the passion of others, John Gardner, one of the advisors who served six us presidents and wrote a lot about self review mode, writes that passion is the key fuel that helps us overcome difficulties and work through dark times. It helps us hang in there, improve our skills, find meaning we, according to Gardner have all mastered clever devices to escape from having to deal with ourselves. And the modern world helps us by keeping us so busy, filling their lives with so many diversions, stuffing our head with information that we never have time to explore the fearful and wonderful world that live within ourselves. More often than not, we don't want to know ourselves. Don't want to depend on ourselves. Don't want to live with ourselves. By middle life Gardner says, most of us are accomplished fugitives from ourselves and in his book, Focus, Daniel Goldman writes that with emotional intelligence comes empathy sensitivity to help people are feeling in reaction to what we do or say. And it lets us navigate hidden social mind.

(Host)

Very interesting. I think that emotional intelligence is not something that, as a system or any organization spends a lot of time developing in their employees, but yet so critical to outcomes and even economic prosperity in this difficult period of time. Nationally, so many leaders seem to have forgotten the concept of servant leadership, another form of emotional intelligence, I would posit, that in order to lead the mindset must be about people you are serving. Would you speak to the concept of servant leadership and why you believe it's critical to an organization?

(Dr. Prasad)

Yes. Cathy inhealthcare. It's relatively easy to see the role of leaders and the team members as servants, because we are driven to advocate for our patients, their health, their outcomes, and healing. What servant leadership at its core is to help others without regards to self. What's in it for you, right? It's that selfless service. It's giving credit to others. It's designing what is best for the organization, not just for you and to be selfless, to be facilitative, to be collaborative, and then really transformative as a leader. Not the style of leadership is so suited as in the calling of healthcare. So sudden leadership really is given all the change management, given the burden of the crisis, given the adversity we spoke to it here. It's really, it's a wonderful place for seven leadership to help all of our patients, our communities, our teams navigate all of these crisis in current times

(Host)

I would suggest, however, that servant leadership isn't something that we naturally do. And you and I take your point is well taken in that in healthcare, we have an object, our patients to develop that servant leadership, but in some of the larger corporations have less humanitarian pursuits. I think the servant leadership probably would serve them well as also, but how do you develop that in develop the emotional intelligence that surrounds servant leadership? I think that's a big question for some of our larger organizations to answer and to figure out in order to go forward into history.

(Dr. Prasad)

You're you're right. And I think the challenge there is the motive, and more and more even large corporations, Zappos, for example,Google and several other large fortune 500 companies are looking at that whole concept of servent leadership. How do you address global climate change? How do you become part of your community? I think there's a company called Barnabas, or Bombas, that donates a sock, a pair of socks for every sock that you buy. So I think organizations are beginning to see their responsibility. Their community are beginning to see that service. And as the Harvard Business Review study pointed out earlier, when an organization defines its purpose, its meaning, and then communicates that to all of its staff and when profit doesn't become the only reason for existence. And we certainly saw how integrity in some of the challenges that companies have had and have collapsed when they failed to be a role model. You can see that that service mentality really comes up when you start to define your reason for existence. And then you can get everybody motivated along with you to deliver on that promise.

(Host)

You've hit on three key words for me anyway, and that is passion, which from passion, you can develop purpose and from purpose, you develop hopefully some emotional intelligence around that and developing emotional intelligence leads you to this idea of servant leadership. And I think breaking it down like that makes sense to me.

(Host)

In an article that you and Dr. Nygaard wrote, you talked about something called compassionate accountability. Can you describe what that means please? And why it's important?

(Dr. Prasad)

It is, it is very important. We all hold ourselves accountable. We understand that actions have consequences and personally, professionally, this is reality, but that accountability should really be framed in the context of each situation, each person. So that conversations and decisions are made with respect, with compassion and with mutual understanding. So everyone can grow and learn from such interactions. Maya Angelou said, a leader sees greatness in other people, you got to be much of a leader if all you see is yourself. And in holding yourself and others accountable, you have to be able to see the other people as human beings, as people who have their role, have their reasons for actions, with understanding and the contextual information becomes compassionate accountability then perhaps the person could be successful somewhere else with some other team, with some other resources or in other situations, and drive that accountability conversation to be a good learning experience and not an insulting personal attack . Using objective data to support and trend performance or behavior and healthy listening conversations can be helpful when dealing with people or teams. And this allows sometimes the person or the team to reach the same conclusions that you might and agree about his or her fit or his or her role and the failing performance at the same time as you do, or even earlier, and then make decisions that are very respectful. Chip and Dan Heath wrote a book called Switch about change management, and they often talk about what looks like a people problem ends up being a situation problem. And no matter what your role is, you've got some control over the situation, or it could be a system problem or a process problem. And then we can all own and change that. Compassionate accountability to me really speaks to the fairness. And then it speaks to that precept of do unto others what you would have them do unto you,

(Host)

Compassionate accountability, I just recently started a graduate course in actually diplomacy. And of course, as you enter into school, they all want you to be very well aware of when you're doing scholastic type writing , plagiarism, isn't going to be tolerated. And while I agree that taking other people's work is dishonest by all means, I know that there are students who come into the systems who have not been brought up in how to site works and how to do the process of writing and they get caught plagiarizing, not intentionally, of course. And so I think your idea of compassionate accountability, let's teach people so they don't get into trouble. Let's listen to what they have to say about how they got into that spot to begin with, offer corrective action and a second chance. I'm a big believer in second chances for sure. And I, I don't know why, but that's what you said just kind of spurred that thought about this whole essay I had to write about plagiarism. So, Dr. Presant while leaders should and must hold themselves up to a higher level of integrity, which we've been talking about, transparency and lifelong learning, they are after all is said and done human beings, subject to error just like the rest of humanity. How does a leader develop decisiveness knowing that you never have a complete understanding of how really cold the water is until you jump in. In other words, how does a leader avoid the problem of paralysis through analysis?

(Dr. Prasad)

Making tough decisions is really the hallmark of an effective leader. And many leaders struggle with the fear that they'll make a mistake and making a position, and they'll either embarrass themselves or harm other people, worried about the consequences. Colin Powell had a good rule of thumb when facing such situations. And he said, when you have a tough decision, you should have no less than 40% of the information and no more than 70%. And he felt that if you make a decision with less than 40% of the information, you're really shooting from the hip and you'll end up making mistakes. Intuition is what allows us to make tough decisions, but many of us ignore our gut. And then we want certainty and Ben Franklin told us there no certainties in life except death and taxes. And so if you focus on doing the right thing at all times, consume data with healthy skepticism, understand and build your knowledge and key skills. You will grow comfortable making decisions with less than a hundred percent of the information you are seeking, or that certainty. Think about timing. We talked about president Lincoln's sense of timing about the negative consequences of not doing something. And it is always wise to remember what Theodore Roosevelt said in any moment of decision, the best thing you can do is the right thing. The next best thing is the wrong thing. And the worst thing you can do is to do nothing.

(Host)

I'm a big believer in the power of gratitude as a grounding process. And I make it a habit as I drive to work every day to go over all the things I am most grateful for. One of those things is my 30 year career as a PA, which has included incredible adventures in patient care and the occasional witnessing of history in the making. It has also included moments that have remained with me to this day. For instance, I will never forget the conversation I had with a mom about her four year old daughter's inoperable brain tumor, or the time a woman collapsed to her knees while hugging me sobbing as she described her gang rape. To me, these are moments that are etched into my soul. I'm sure as a physician, you've had your moments as well. How do you remain positive as a healthcare provider when you're constantly exposed to the real life horrors of the patients you serve.

(Dr. Prasad)

And these are for all of us moments, memories, events that move us. Absolutely. They, they cause pain. They cause hurt. And while in healthcare physicians, ABPs nurses, other team members are to some extent, trained to deal with situations in an objective manner. A career in healthcare always will lead you to have these hurtful, painful moments that you have to cope with. You have to deal with and I think you have to remember that life is unfair, that rain falls on the just, and, but remember that you are the captain of your journey and ultimately justice will prevail to quote Robert Kaplan "Think of what you can do. Think of the impact. You can have the legacy, you will leave behind, do something, write something, teach, learn. Don't be a victim and believe in your own power to heal, to cure, to help, to listen and to support think best practices, share your secret sauces for success. Invest in continuous quality improvement strive to be better every day and be courageous."

(Host)

And I think your, your comment about trained to be objective absolutely vital, but also in that objectivity, we still remain human beings and we still feel the pain of others. And that to me is actually one of the blessings of healthcare. I want to be able to empathize with my patients. I want to be able to know that I can understand where their pain is coming from

(Dr. Prasad)

And Cathy you're right. That empathy, which is at the heart of it, emotional intelligence, one of the skills that are so important and if you look across, not just, but other industries where people burn out, one of the first things they lose is that empathy, the depersonalization that manifests itself is because of that loss of empathy, because you've just given up being a human being. And so you're absolutely right.

(Host)

Hedonic adaptation, I just love those two words, but it's a fancy term that essentially means you get used to living in a frantic rut and it begins to feel normal, but eventually this adaptation bears a huge burden on the psyche. I think many healthcare workers are feeling like this right now in the couple of articles that I have read by you. I see words such as authenticity, empathy, integrity, compassion, inspiring engagement. These are words that describe the joy of being a healer. How does a leader help return healthcare workers back to the joy and passion that these words reflect?

(Dr. Prasad)

And for me, Cathy, all of those really resonate because I chose to be in healthcare. I chose to be a doctor and that fills my cup gives me purpose, gives me meaning there was an article I read several years ago about finding happiness. It wasn't the scientific American July, August of 2015 and they found on based on research that some of the key elements that healthcare workers too can use to feel that joy that you described. One was the richness of routine. We are sometimes really dismissive of routine, but there's a richness in having some mundane regularities of life that can give us a sense of meaning, make us feel normal, maintaining a tidy office, keeping a daily schedule, having weekly dinners with friends, which of course we have all postponed because of COVID driving the same route every day. Yep. The three other aspects that are important to being happy. And that is significance, purpose and coherence. Life is very meaningful when it feels important when it seems to have a point and when it makes sense, so spend wisely on finding your reason, your meaning, your purpose, so that you can have that significance in your, in your activities spend wisely on experiences, not good. As people have said the activities, such as dining travel concepts, those experiences, family, friends, relationships, conversations, all have meaning. Whereas just spending on goods really high that doesn't last. Planned with abandoned because, and this is especially important, Cathy, during these COVID times when planning and anticipation of those experiential trips travels, purchases or vacations can really dissolve in more happiness, delaying gratification for a special date or occasion. And that again helps you be happy as you anticipate and postpone that and surprise, surprise Tylenol over the counter. Tylenol can really relieve the pain if you're making a difficult decision, scientific American research, and make a deliberate time and attempt to plan your time around activities that you think you will enjoy. Epicurus tells us do not spoil what you have by desiring what you have not remember that what you now have was once among the things you only hope for. So that attitude of being grateful or being in the moment or being mindful of the present, not worrying about the past, not worrying about the future and having a grounding. You spoke about that sense of grounding sense of purpose, I think is really the key to finding joy.

(Host)

I think, um, what I understand you to say is that by planning and looking forward to events or places you may go or to people, you may see, it offers us hope for the future. And the other thing that I take from what you're saying is that if you live congruently with what your purpose is for me, my, what I want to do is I want to live. I want to love, and I want to matter. Those are the three things that drive my life for me. And because I have that already, I can, I can write it out and say, this is exactly what my purpose is. I can choose to do things that are congruent with those efforts. So I think I absolutely agree with what you're saying. It's, it's important

(Dr. Prasad)

At a stylus important, Kathy, and you're one of the few who actually have your mission, vision values for your own life. Not many people think of, yeah. They think of mission, vision values as something organizations do companies do, but individuals can do that too. And having that clear, having that written down, uh, there are many who will write it down and store it by their, uh, computers, uh, to remind them during, during times of adversity during times of doubt. Uh, so I'm glad you already have your mission, vision, and values.

(Host)

I also noticed in your articles that we share some of the same admiration of leaders of the past and you and I both are fans of Abraham Lincoln and Nelson Mandela. I think my other choices would be Gandhi and Martin Luther King. And I have to say that I feel Martin Luther King's ability to use words with such passion behind them has always been my literary ideal to embolden people yet to continue to preach love. And kindness is an art. And as you said to me, as we were talking about the topics for this podcast, words matter, I think the last political administration for this country opened up a Pandora's box when it came to the use of language, giving people permission to speak from a very self-indulgent entitled and the now base can healthcare help to reverse this trend. And if so, how ?

(Dr. Prasad)

Cathy language and communication is what separates us from animals. And there was a lover of dogs. I must say, animals can communicate and bond with them.

(Host)

I agree,

(Dr. Prasad)

But words can hurt just as silences can, and we have two ears and one toung so that we should listen twice as much as we talk. And we know that in healthcare, we talked about compassionate accountability earlier, where listening that skill, where you listen to the patient's history, you listen, and he often will give you the diagnosis. If you can only listen. We also know from studies that patients get interrupted, usually within 30 seconds to one minute in these days, I think that's where healthcare can listen better and make that a habit and words like sorts can harm. They have drastic consequences. I like swords. They should remain in the scabbard because once you say something, it cant be taken back. And then transfers power to the other person. So we need to move away from the rumors, move away from false information, which again, we have a lot in healthcare. We have to do our due diligence. As we advocate treatments, advocate, trials, advocate, courses of action, or healthy behaviors for our patients. We have to stop bickering on social media. We have to choose on listening, choose on having meaningful conversations with our neighbors, our friends, and not to be judgmental there. Again, we learn sometimes non-compliance can be because of multiple social determinants of health. We talked about transportation as a reason for no shows. So just being judgmental about a patient's no show or non-compliance can be deleterious. And we in health care can pave the path for that kind of honest listening and conversations. We can be kind, you can be forgiving, we can speak mindfully. And I feel we should all be big fans of brevity.

(Host)

My final question, one of my favorite quotes from George Bernard Shaw, who was an Irish playwright, as well as a political activist is this is the true joy of life being used up for a purpose recognized by yourself as a mighty one, being a force of nature instead of a feverish selfish clod of ailments and grievances complaining that the world will not devote itself to making you happy. I love the idea of being remembered as a force of nature. So my question for you, Dr. Prisaad is how would you like to be remembered?

(Dr. Prasad)

Thank you for sharing that. Cathy, I had a smile on my face, uh, because, uh, this again speaks to taking accountability. As we talked abou that nobody, nobody owes you happiness, that happiness is yours to define and to get, that you cannot complain. Cathy, Robert Burns said that the only purpose of life is a life of purpose and many, many years ago, when I first came across that condition, I made it mine. and I hope to your question, I would like to be remembered as somebody who lived a life purpose of service lifted with meaning the compassion was gentle and kind and amount of science and logic.

(Host)

And I think that's probably exactly how you will be remembered. This has been a wonderful conversation as we close. Do you have anything additional that you'd like to add Dr. Prasad?

(Dr. Prasad)

Cathy, We all have our demons and dark sides. With emotional intelligence, servant leadership, kindness, we must all work on these demons, so our lives can have meaning and purpose. That the world we leave behind is the better because of us. I would like to end with what Albert Camus said in his book, The Plague and he refers to the weaknesses within all of us and how we can avoid manifesting them should avoid manifesting. And I quote "that each of us has the plague within him. No one, no one on earth is free from it. And I know too that we must keep endless watch on ourselves less than a careless moment. We breathe in somebody's space and fasten the infection on him. What's natural is the microbe. All the rest, hell integrity, purity is a product of the human offer vigilance. That must never falter. The good man. The man who infects hardly anyone is a man who has the fewest lapses of attention. And it needs tremendous willpower, a never ending tension of the mind to avoid such lapses". Thank you, Cathy, not only for inviting me today, this has been a delightful conversation, but also for showing your leadership in developing the series of podcasts, I do wish you and your listeners to be safe, to be well taking care of yourselves and the communities as we navigate our way out of this fandom. It and also wish all of your podcasts, every success. Thank you.

(Host)

Thank you, Dr. Prasad. This has been just wonderful for my listeners. I'm Cathy Murtaugh-Schaffer, and this has been heartbeats Shipley Cardiothoracic Centers, podcast, dedicated to bringing research innovation and education to our patients and the community. I hope you all have a good night.

Lee Health's Chief Medical Officer of Population and Physician Services, Dr. Vanket Prasad, joins our host, Cathy Murtagh-Schaffer to discuss leadership in the face of adversity.

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