“I cannot express how much we appreciate the help that we have received over the last month after go live. It was not just the individuals knowledge and expertise but it was their smiles, their attitudes, and the calmness to their approach with our Physicians that made the world of difference. I only heard positive comments and remarks about the ATE support from our physicians and advanced practice providers. I cannot imagine going through this without them.”
Case in Point
By Kerry Spaedy, Lindsey Goeders and Courtney Kiss | January 16, 2019
Seminars, white papers, conferences, journals, webinars, books and magazines—these are among the methods that nonprofits of all types and sizes use to educate members. Today, many organizations are either adding or considering an innovative way to educate seasoned professionals: reverse-mentoring member programs.
Jack Welch, former CEO of General Electric, is credited with popularizing the concept of reverse mentoring. The resulting program, which took place in the late 1990s, required more than 500 top executives to pair up with younger associates with the distinct purpose of learning how to access and use the “World Wide Web.” Welch himself was matched with an employee in her 20s who taught him how to surf the web. Today, companies similar to GE, such as Hewlett Packard, Ogilvy & Mather and Cisco Systems, are continuing these programs—only now the young mentors are teaching their mentees about smartphone apps, Facebook, Twitter and LinkedIn. With rapid advances in technology widening the generation gap in virtually every business, it’s imperative for nonprofits to consider implementing their own reverse-mentoring programs for members.
Uniting Experienced Physicians, Digital Natives
As electronic health record (EHR) requirements and other digital takeovers loom over physician practices and health care systems, seasoned physicians find themselves between the proverbial rock and hard place. Transitioning their practices to a digital environment takes a lot of time and work—time they don’t have because they’re busy treating patients, and work they don’t exactly know how to do because they learned medicine and grew their practice in a hardcopy, paper world.
Conversely, an entire generation of physicians exist who have never touched paper records. They are the individuals who look at their phones each morning before even getting out of bed. They eat, breathe and live in the digital environment. Electronic media and digital operating systems are second nature to them because they were learning computer science when they were in elementary school and grew up with computers in their homes. They are digital natives.
The need for a reverse mentoring program is obvious. The combination of seasoned physicians with digital natives is a natural and necessary one: Leveraging these individuals in a reverse mentoring program could mean for many older physicians the difference between a thriving practice and a closed one. Whether a practice implements its own program, or seeks an externally administered program, the reverse-mentoring experience benefits all involved.
Some medical professional associations have introduced formal mentor and reverse-mentor programs for physicians and other health care workers, touting them as vital tools in assisting both young and seasoned physicians in learning certain skill sets that are otherwise not taught in medical school and CME courses—such as the use of mobile and web-based applications. Important skills like these are likely to become the standard as the health care environment continues to experience digital transformation. But these are skills that are not necessarily taught to seasoned physicians in a CME classroom setting, increasing the importance of one-on-one mentoring programs that allow for human connection and interaction.
Scanning the Digital Landscape
Robert Wachter, MD, author of the New York Timesscience bestseller, The Digital Doctor, laments the loss of human interaction that has taken place in many medical settings. In an interview for Disclosures, Wachter sites the radiology field as an example of how digitization has affected the health care world.
“Radiology went digital almost overnight around the year 2000,” Wachter says. “Nobody anticipated that would do anything to radiology rounds. How could they? I went back and interviewed some old-time radiologists and said, ‘Did you even muse about the possibility of it changing the nature of your relationship with the front-line clinicians?’ They all said, ‘No, not at all.’
“But the minute that radiology went digital, those rounds stopped. Nobody wanted them to stop, but we realized in retrospect that we went down for those rounds because that was the only incarnation of the film. It lived in only one place and the radiologist controlled it, and that’s what created and facilitated the geography and the communication patterns. The minute it ended, radiology rounds ended. Now we are reading reports and we are looking at our films at home or looking at them on the floor, on the computer.
“That’s all terrific. None of us want to go back to the days of only one copy of the film that can only be viewed in the radiology department. But we gave absolutely no thought to the notion that because the film is now digital, we have completely thrown a hand grenade in the middle of this vital communication for both clinical care and for mutual education.”
Wachter makes a case for reverse mentoring with his radiology example, stating that while older physicians may say “Let’s just re-create radiology rounds the way it used to be,” young physicians will challenge that sentiment by saying, “Why should we go down 10 floors to look at the film if the film is anywhere?”
Medical providers still need to provide the fundamentally important interpersonal exchange about a complex case, Wachter says. However, that doesn’t mean going back to how things were done 30 years ago.
“It may look very different. It may be a digital conversation. It may be through Skype,” Wachter says. “It’s an open playing field now, and I think the technology will be part of the solution.” He adds that health care professionals must determine what is “lost” and then consider what’s “fundamentally important” about that loss, and how to re-envision it in the current era given all the new pressures and opportunities that digital tools provide.
A reverse-mentoring program could embrace regaining what’s been lost—communication—and also use technology for maximum efficiency. Younger physicians should learn and remember the core values of practicing medicine, seeking effective communication and partnerships with their colleagues. Only then will they be able to convince the older physicians it’s worthwhile to learn new ways of doing things.
One company has made reverse mentoring its entire business strategy. MedDocLive founder Zachary Fridirici, who also is a resident physician at Loyola University Medical Center, says he envisioned the company based on his experience working at a large health care software company and his own experience in clinical medicine. The company’s concept is simple: Provide access to medical students and residents for health care providers and institutions to help guide them through the transition to EHR.
As a hospital adopts EHR software, students and residents work alongside seasoned physicians, using their understanding of medicine as they share their tech savvy.
“Reverse mentoring is a two-way street,” Fridirici says. “The experienced physicians teach the residents or medical students about what they’re doing and about the patients, and the residents or medical students teach the physicians about using the computer.”
Fridirici calls it a “perfect storm” of a “whole generation of young physicians, residents, or medical students who know nothing other than computers, and a whole older generation who are transitioning to computers.”
The reason reverse mentoring can work in the health care industry, says Christine Sinksy, MD, a general internist in Iowa and co-author of the Institute of Medicine’s 2011 report, Health IT and Patient Safety, is a relatively simple one: “Physicians are accustomed to learning from experts and understand that learning from someone who has gained proficiency is faster and more effective than learning without any guidance.”
Michael Hodgkins, MD, MPH, is a proponent of reverse-mentoring programs for health care providers, “especially if it helps physicians better manage their use of EHRs,” he says. However, he cautions, “[Reverse mentoring] strikes me as something that, if it is to be effective, would require ‘hands on’ mentoring. I think virtual programs would be difficult to arrange as it would require that the mentor actually had experience with the same EHR implemented in the same way as that used by the older physician.”
‘New Ways of Thinking, Working, Being’
The health care field is clearly not the only industry experiencing disruption from new technologies. Virtually all industries face similar challenges and, thus, are well poised to introduce reverse-mentoring programs between veteran professionals and Millennials.
Lisa Quast of Forbes.com says the keys to a successful reverse-mentoring relationship are:
- Defined expectations. Each party needs to be very clear on their expectations.
- Agreed-upon rules. Each party must be fully committed to the mentoring relationship and agree upon the rules that will be followed.
- Willingness to learn. In a reverse-mentoring relationship, both parties act in the capacity of a mentor as well as a mentee; so they must both “genuinely want to learn from and share with the other.”
- Trust. Reverse mentoring requires the trust of each party. The goal is to “push one another outside of their comfort zones and try new ways of thinking, working and being.”
- Transparency. Both parties must be open with their feelings and thoughts. They must be able to overcome differences in communication style—especially since different generations communicate differently—and be open to seeing situations from different angles.
Commitment to lifelong learning is a cornerstone of what it takes to be a physician. In our ever-changing health care environment, it’s essential that all physicians stay abreast of technological changes taking place in the industry. Mentoring programs offer symbiotic relationships in which learning is a two-way street. Younger and seasoned physicians alike can benefit from mentoring relationships, but the added value of the younger generations’ tech savviness makes reverse-mentoring programs especially timely and important to the continued success of medical practice.
Kerry Spaedy is manager of marketing for the American Society for Gastrointestinal Endoscopy, and may be reached at firstname.lastname@example.org. Lindsey Goeders is a senior policy analyst for the American Medical Association, and may be reached at Lindsey.Goeders@ama-assn.org. Courtney Kiss is marketing director of Johnson Lambert LLP, and may be reached at email@example.com.
SAMIR SHAH, MD & ZACHARY FRIDIRICI, MD
Published: “The Positive Impact Model for Physician Burnout” AMA Physician Innovation Network, American Medical Association, 26 Dec. 2018, innovationmatch.ama-assn.org/content_items/the-positive-impact-model-for-physician-burnout.
MedDocLive (MDL) is a company where the sole focus is improving physicians’ adoption, incorporation, and utilization of patient information. We are the premiere physician-to-physician, Electronic Health Record (EHR) consulting firm with a perfect track record for increasing the efficiency and efficacy for physicians in their respective EHR.
Our greatest impact, to date, is providing unparalleled EHR support at the inception of a new hospital system. From the very beginning we guide providers through their EHR in a meaningful way. Our model of provider-to-provider support gives our consultants the unique ability to translate a physician’s dynamic workflow efficiency into their EHR.
All too often we read and hear about physicians retiring after the implementation of an EHR. The new technology is often seen as an additional barrier to providing care. Even impacting patient safety. The additional time to navigate the chart, with no decrease in patient volume has negatively impacted physician well-being on the macro level. Termed “physician burn-out,” MDL is uniquely positioned to help reduce both this phenomenon and improve patient safety. MDL helps health care systems and physician groups appropriately manage their EHR implementation, training, and support. Our physician-centric model has led to our 100% success rate at over 50 go-lives around the country.
Over the past year, we have created a new, on-demand, support service for our clients. We call it PhysicianLounge. This service uses our same resources and model, but support is done remotely. This makes our deep resource pool just a click away from any hospital system or physician in need of EHR assistance. This service is cost-effective and is used for new-hire training, go-lives, and system optimization.
In the end, our goal as a company is simple. Help physicians. By helping the physician, we are indirectly impacting the health care system, and most importantly improving patient care. This, in its entirety is the MedDocLive way.
RAHIL KRISHANA, MD, MBA
At go-live, the goal of every Electronic Health Record (EHR) firm or consultant should be to make the provider feel as comfortable with the software as possible. Ultimately, comfort translates directly into charting efficiency, an improved patient experience, and patient safety.
For me, helping physicians thrive, not just survive while using their EHR is the goal. It brings me great joy to effectively relay my EHR knowledge (accumulated through grueling years of training and using an EHR) to the provider and have this incorporated into their daily workflows. I like to think the providers I assist benefit from my years of trial and error, gaining years of EHR knowledge in just a few days with the effective specialists-training-specialists (STS) model.
The providers we assist have a broad spectrum of EHR and technology exposure and aptitude. One of the most challenging and rewarding scenarios we encounter is the near-retirement provider who is not tech savvy and resisted even acknowledging the EHR conversion.
Fitting this mold is a 69-year psychiatrist I recently assisted. Being forced to learn and use Epic made retirement a more viable option by the day. On top of an already demanding job he had to face the anxiety of learning a brand-new system and re-inventing his workflows. Fortunately, his hospital adopted the STS model for training and go-live support. We built an instant rapport over our shared medicine background and started to tackle his anxieties one-by-one. Our first task was surviving morning rounds. Each day we made incremental improvements to his rounding workflow. By the end of the go-live support time frame his information gathering, note writing, and order placing workflows were seamless. Most rewarding, and something that will stay with me forever were his words on my last day, “I could not have done this without you.”
Doctors, just like this psychiatrist, are being forced (for better or worse) to reinvent their practice of medicine. Everyday hospital systems and clinics are converting to EHR’s, changing vendors, and undergoing software upgrades. Although it seems like progress, many do not realize the energy and toll it takes on practitioners to change how they approach and provide patient care. The added stress, anxiety, and demand has led many physicians around the country into early retirement. A scary phenomenon as the US is facing a potential physician shortage. Just read Spitzer’s story in the Daily Herald about the 75-year-old obstetrician at Hoffman Estates, Ill.-based St. Alexius Medical Center who delivered tens of thousands of babies is hanging up his hospital coat after refusing to take classes and learn the hospital’s new computer system.
I believe that hospitals need to leverage and engage the STS model early in their EHR conversion to de-escalate physicians confronting these cataclysmic changes. Having the right personnel to expedite physicians EHR efficiency is paramount and reduces a mountainous learning curve to just a small speed bump on the road to success.
I have seen the STS model save careers. I can only imagine that the downstream of its ripple effect through healthcare is even larger than I could imagine.
JOSEPH LEE, MD
University of Chicago Medical Center
Department of Pediatrics, PGY-3
As a trainee, I find myself pondering what life will be like when I am an attending. How will I be treated by residents, nurses and other members of the medical team? And in turn, how will I treat those that I am commissioned to lead? My experience working in the Neonatal Intensive Care Unit (NICU) as a MedDocLive (MDL) consultant through the EPIC Go Live process has provided me a glimpse of both.
Electronic medical records (EMRs) have provided both immense progresses in communication within the medical system as well as burdensome requirements for providers. In fact, some providers state that the creation and implementation of EMRs have single handedly decreased their satisfaction with the profession. With that said, it is safe to say that switching EMRs creates an atmosphere of both excitement and apprehension. That is where we, as MDL consultants, enter the scene. It in such an environment, we are commissioned to work and support providers in the transition. Further, it is in this role that I had my first taste of the type of supervising doctor I will be.
As a senior resident, I am accustomed to leading rounds as a medical provider. Further, I can be confident in my plan knowing that my attending will correct any discrepancies. As an MDL consultant, I round with the same teams, however this time, I am the last line of decision making and trouble shooting. And while the issues pertain to EPIC, the current medical record keeping climate establishes EPIC as the final decision maker as to what labs are drawn, what images are taken, and what medications are given. Thus, I serve as the gate keeper between patient illness and patient health.
From going through each order of an admission order set to pulling up chest x rays, I have sat and stood with providers in each step of the process of learning how to utilize EPIC. At times, there was joy and adulation, and others, there was stress and anger. In some cases, I have been able to solve the problem, in others I have had to admit defeat and use my resources to try and triage the problem. In both scenarios, however, I have waited and worked patiently with providers, being decisive when I have had to and taking a step back when that was in the best interest of their learning process. And through it all, I am reassured that my future as a supervising doctor is bright. I will maintain my passion for patient care, my compassion for others, and respect for all people.
I never thought that serving as an MDL provider through the EPIC Go Live process would have taught me so much about myself and my leadership abilities. Through every road bump that the providers and I have been able to hurdle together, I have learned that I can and will be a supervising doctor that is patient and kind. So I rest assured that as I continue on this arduous journey called residency, the hours and stress have not changed my core values. And for that, the patients I will serve and the medical team members I will lead will be forever grateful.