Lessons from a Chief Wellness Officer
This week I am talking to Richard Safeer MD, Chief Medical Director Employee Health & Well-Being at Johns Hopkins Medicine. Richard is a Family Doctor who has focused his career on building culturally sound and caring organizations.
Employee health and well-being has become a top priority for organizations in the wake of the COVID-19 pandemic and the resulting Great Resignation. We discuss how leaders can create a culture that supports employee well-being.
As Richard noted the pandemic accelerated interest in employee wellbeing as healthcare systems competed for talent. Supporting wellbeing is now seen as imperative for talent acquisition and retention, and wellbeing encompasses mental, social, and biological health, without supporting employers in supporting their employees across these areas, they cannot be at their best.
We dive into the increasing burden on clinical staff with administrative tasks and lack of support roles has greatly contributed to clinician burnout. Steps like utilizing medical scribes more could provide meaningful relief.
Listen in to hear Richard talk about the range of leadership training programs that help everyone understand the day-to-day realities of employees and if you like me enjoy ‘The Undercover Boss’ this could be applied in any industry but especially in in healthcare for everyone to shadow others to build firsthand understanding of challenges.
You can find out more from his website RichardSafeer.com and his book: A Cure for the Common Company: A Well-Being Prescription for a Happier, Healthier, and More Resilient Workforce
What steps is your organization taking to support employee well-being in a substantive way? What other insights on this topic resonated with you? Share your thoughts below.
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Raw Transcript
Nick van Terheyden
And today I’m delighted to be joined by Dr. Richard Sofia. He is the chief medical director of employee health and wellbeing at Johns Hopkins Medicine. Rich, thanks for joining us.
Richard Safeer
Thanks so much for inviting me neck.
Nick van Terheyden
So as I do with all my guests, I like to get a little bit of context, you’re a physician, clearly, you’ve got an unusual career, certainly based on the title that you have. Tell us a little bit about your journey to this point in your career, and some of the key points that have contributed to where you are now, if you would, absolutely,
Richard Safeer
I was trained as a family doctor. But before going to medical school, I got my degree in nutrition. And I think that really,
Nick van Terheyden
you were the one doctor that got
Richard Safeer
it. I’ve actually met like six people in my life in my career in my cohort about 30 years ago, who studied the same Yeah, but it really influenced my trajectory. Because I realized after a year of practicing, I’m like, This is crazy 90% of the people I’m seeing if they were better skilled and how to make healthier choices and less stress, they wouldn’t need to see me. So I figured there had to be a way I could leverage my undergraduate education. And I came across some articles about what employers were doing to support the health and well being of their workforce. And I’m like, that’s where I think I need to be because I’m seeing patients for 15 minutes. And my patients are in their workplace for 2000 hours a year. So I think we got things backward, a little bit about who’s having the most impact on health and well being and, Nick, it wasn’t a straight line, I had three jobs between private practices, a family doctor, and now the Chief Medical Director of employee health, and well being at Johns Hopkins Medicine. So
Nick van Terheyden
I, it’s interesting, you bring up nutrition, because that sort of It’s a recurring theme, certainly in some of the discussions I have with other clinicians with patients. You know, it’s cited as gosh, I got a one hour lecture in the whole of medical school. And that was it kind of, you know, it’s a terrible failure. And yet, as you rightly point out, you know, all of that contribution, and you’ve now sort of morphed that into, let’s focus on the employer aspect of that, and, and how they essentially hold the attention of their employees because they have them for such a long period of time. Tell us a little bit about the journey and some of the things that you’ve discovered along the way there.
Richard Safeer
Yeah, I mean, the employer certainly sets the tone, the policies, the resources, everything about the individual’s workday. And since we spend most of our waking hours working, that this is a big deal. So Nick, I went through academics after private practice, then I ran an occupational medicine office. And then I was a medical director overseeing prevention at one of the Blue Cross Blue Shield plans. And in that role, I helped advise 1.3 million lives who are working for large employers. And so each of these pieces influenced my education and skill set to get me prepared for my role at Johns Hopkins. So I’ve seen healthcare, from a private practitioner, from an academician from a occupational health lens, and as the the side of the insurer. And so it’s a very complicated picture puzzle, let’s say that, too often is simplified by an employer to a contract with a workplace wellness vendor. And I think unfortunately, because so many employers have had unproductive experiences with these wellness companies, that many of them don’t believe that they have a chance of possibly playing a positive role in the health and well being of the workforce.
Nick van Terheyden
So, you know, I’ve got to be frank, as I listened to employers, and you know, their care and concern for employees, not not to be mean about this, but ultimately, their employees and, you know, they think about them as resources. They want the maximum productivity and, you know, there’s this balancing act with well, if I keep them healthy, then they can be more productive. But that almost feels a little bit counter to the sort of concept of wellness and health. How do you see them balancing it? I mean, are they truly, genuinely thinking about employees? And I’m sure there are. But I also feel like there are others that are not, where do you strike the balance and all of that?
Richard Safeer
Sure. And let’s just start off by acknowledging that just as there are some good doctors, and some not so good doctors, there are some more informed and enlightened leaders and some less informed and enlightened. And so I mean, the enlightened ones probably understood prior to the pandemic, that in order to have a healthy and productive workforce, there needed to be not only health in the sense of biologically healthy, but also mentally well, and socially well. Because without these different aspects of well being, we’re not at our best. And so, Nick, I would say that the pandemic really accelerated the interest and a genuine understanding about how these health care employers were going to support the health and well being of their workforce. And not only to keep them from getting COVID It really became almost an arms race of attrition. You know, we are losing employees, left and right, and how are we going to not only attract new talent, but keep the talent because all the other health care organizations around us are in the same dilemma. Workforce options are shrinking. And so I think that there has had to be healthcare employers have been forced into a position to recognize and embrace the idea of what true well being as Yeah.
Nick van Terheyden
And to be clear, I didn’t want to cast shade on everybody. I think you’re right. There’s, there’s always good and bad. And I think I always come at this with the principle of, you know, 99% of the population is trying to do the right thing. Sometimes they end up doing the wrong thing, not intentionally, or, you know, partly through the incentives, the misaligned incentives, you know, there are challenges there. And as I think about your career, and you talked about occupational health, and, you know, the genesis of that, to my understanding, if you look back in history, was the industrial revolution, we saw all of these accidents. And, you know, there was essentially the rise of occupational health, the unionization to sort of help protect rights. And that created something that I think we still point to, as you know, the source of protection. Have we moved into a different phase, and we need something more than occupational health now that needs to oversee this from the perspective of the employee? Well, I
Richard Safeer
mean, occupational health was a success for a variety of reasons, some of which you mentioned, but I would say primarily, they’ve created a culture of safety. The imperative to keep employees safe, is now common vernacular, including within the healthcare industry, how much time and energy have we spent on needle protection, I mean, it’s been a remarkable journey. The next stage, which is underway, is creating cultures of wellbeing in the workplace. It’s more than a program, a prize or a portal. It is about a culture, the shared beliefs, behaviors and attitudes of an organization that all point towards supporting employee well being.
Nick van Terheyden
So as you think about that, from a perspective of wellness, and I don’t know if this is true, but it always feels true, and you know, I’m representing my own bias here, but the clinical profession seems most at risk, or certainly through the pandemic, they they were the lightning rod for an awful lot of the stressors that took place. Yeah, we see it, I’ve seen it in my own career. It is a continuing unraveling tragedy. And I can tell you through personal experience now through the eyes of you know, new medical graduates, it has not improved if anything, it’s gotten worse for a number of reasons. Yeah. So we’re not doing a good job or you Is that just isolated and we are doing, you know, to your point of the good and the bad is the good somewhere that we can point to and say, Let’s replicate that. Well,
Richard Safeer
Nick, I hope we’re at an inflection point. And we’re seeing the lowest moment right now. Because if we’re not, our country’s in worse trouble than we want to imagine. So one of the problems, I think, with our healthcare delivery system in the United States, is that because it’s driven, as you alluded to earlier, by the need to profit in order to keep the doors open, many employers have had to scale. And they’ve essentially dumped work on nurses and doctors that could be done by lower skilled if you don’t mind me saying, employees, and it’s the burden of this additional work, which is unrelenting at times. And so it’s not just the employer who’s responsible for this, I would say state and federal government needs to play a role in the solution. So that employers can rightfully staff, their workforce, so that the burden is lessened. That is fundamental to well being. It’s not just about nutrition and not smoking and getting enough steps in your day. It’s about right sizing, the quantity and the type of work that healthcare professional professionals are undergoing. And this is a tough period, because we know that many people have left healthcare. And we can’t fill the positions fast enough. As a result, the people who remain in health care, have that burden of picking up the extra work. And so I’ll just give you one example, Nick, of where I think there could be a big difference. I know that there’s electronic medical records, great. Maybe they’re working for some people, maybe they’re not, they still need to be recorded. Why not have medical scribes take some of the load? It’s not that expensive. There are definitely some young professionals who are trying to get experience, it seems to me to be low hanging fruit.
Nick van Terheyden
So for those of you just joining, I’m Dr. Nick the incrementalist today I’m talking to Dr. Richard Sofia, he is the Chief Medical Director, employee health and well, being at Johns Hopkins Medicine, we were just talking about the continuing decline in the work circumstance, you brought up something, you know, part of my history, and certainly some of the things that I brought to bear on the healthcare system. You know, medical scribes, and interestingly, they’re, I was surprised to discover this, but they are part of the rite of passage, in many cases for medical students who go through that, as part of their clinical experience that they’re asked to obtain, as you know, the package when they apply for medical school proves to be actually a very helpful skill set, because that means that they’re they’re very familiar with the systems. And you know, so far, so actually not not a bad circumstance. And, you know, certainly providing that support to the clinicians to take them away from the administrative tasks. We’ve introduced a lot of technology into the healthcare setting. And I would say most of it has not produced better flow, better working circumstance. It certainly improved medicine in many respects, certainly the information has, but it hasn’t improved the experience. And you talk about this sort of inflection point, there’s a part of me that thinks that maybe the inflection point is the change in the technology, particularly with some of the improved artificial intelligence that we’re seeing that is maybe taking some of that burden away, and allowing for automation of those tasks. Do you think that’s going to help? Or is that just layering more art more technology on? Well,
Richard Safeer
I mean, we want to be careful that we don’t take away the roles and responsibilities that clinicians enjoy, and then we take the joy out of their work. I mean, that’s the last thing we want to do. I think we need to be more mindful about the tasks that don’t require a medical degree or a nursing degree, and make sure that healthcare professional professionals are working up to There degree. So I am not opposed to artificial intelligence. And in fact, Nick is you know, and many of your readers now, healthcare has deployed artificial intelligence for a long time before chat GPT came to play. But I don’t think that that’s where we’re going to get the biggest bang for our wellbeing buck.
Nick van Terheyden
So, as you think about this, you’ve obviously, you know, you’ve been persistent in sort of trying to address this problem creating a happier, healthier, more resilient workforce. That’s something that we all sort of strive for. The question I have is, What have you seen that successful? What are the things that work to allow, you know, the joy of medicine, which I know as a campaign, I’m sure it probably still exists at Johns Hopkins, you know, I would have called it an oxymoron. I’ve got to be frank. And I think that’s a terrible thing to say. But it should be because that’s why I went into medicine. I’m certain it’s the one reason you went into it. But we sucked it out. Right? How do you get it back?
Richard Safeer
Yeah. So first of all, I’ll say that I’m going to give some ideas, Nick. But the few ideas I will give you are really short of a comprehensive roadmap, which I’d like to share with you at some point. But just a few ideas. Nick, when when we become physicians, and nurses become nurses and presidents of hospitals become presidents of hospitals, very few people are given training in their orientation, and how to lead with wellbeing, how to support the well being of those they lead is just not even a discussion. So how can we possibly expect leaders of physician groups, leaders of hospitals, leaders of health systems, to know what their role is, and I think in my 25 years in this space, this has been the biggest gap. This is why I wrote a cure for the common company. Because I wanted to help leaders of organizations, regardless of industry, as well as human resource professionals know what they can do. Because Nick, folks like myself, and my team, we can’t do this alone. And so we have five different training programs at Johns Hopkins Medicine for leaders at all different levels. Some of them are 10 minutes, some of them are ours, some of them are voluntary, and some of them are mandatory. Some are in person, and some are remote virtual. And this is purposeful neck, because different types of leaders have different needs. We and leaders are busy, we know that. And yet, if we don’t help train leaders to know their role, they will be running on the proverbial treadmill. Because every time another employee leaves the organization, it just increases the load for the people who remain. So at some point, we have to slow down and invest so that we can reap the dividends of that happier, healthier and more resilient workforce. So we’re not dealing with the turnovers that I would say is the you know, obviously came to me first when you ask the question, I got some other ideas, but I’ll pause there.
Nick van Terheyden
So I know I think it reminds me a little bit of medicine. And, you know, I imagine you probably had a similar experience of see one do one teach one? Which one?
Richard Safeer
Yeah, that’s one. That’s one thing, but I was thinking, you know, when you’re going through training, you know, you’re you got this big pecking order, right? And there’s no questioning the the top of the pecking order the packing the you know, the head Packer doesn’t project him or herself is really caring about what you think that’s a problem. That’s a culture problem. And it doesn’t mean that we can’t get the work done if the leader shows some care. But here we are, we’ve lost some of the human part that most employees whether you’re a nurse doctor, an IT worker, or food service worker, we all have some basic human needs. And one of the is to be respected and be on the receiving end of some caring every now and then.
Nick van Terheyden
Yeah, it it sort of brings me back to one of the things that we did in medical school that I don’t know has been repeated, but it was the most humbling experience I had as a medical student. I had to be a patient for a day. Yeah. And I spent a day on a gurney in chairs being moved from ward to radiology, and there is nothing more just demeaning, quite frankly, than lying on a bed that’s being wheeled through a corridor. Yes. With all this activity going on. Yeah. And nobody paying any attention to you. And you feeling like, essentially, I can’t describe it any other more eloquently than a piece of me. Yeah. And it changed my perspective. On the experience I tried to deliver. I don’t see it as much. And I feel like everybody in healthcare needs to go through that. Not just clinical, but all the way through the top. And I’ve seen that I’ve seen that with presidents and CEOs. Yeah, but it’s rare. Well,
Richard Safeer
that’s, I think that is a great exercise, if we’re trying to better understand the employee experience, I’m sorry, the patient experience. But what I would also add neck, is wouldn’t it be great if leaders took their turn at being an undercover boss, and that they assumed the role of different types of employees and their organization. Now, the pandemic created a great and hopefully unique and one time only opportunity for this. I know this, you know, this is what we did at Johns Hopkins Medicine. We had employees who had COVID, they needed to stay home that accentuated our challenge for staffing. And so different people pitched in in different ways. Nick, I took a turn with patient transport. I took a turn and food services, I took a turn for environmental services. And so did the other people on my team, and so did other people who had administrative roles. And this is what I learned in occupational medicine. When I was running an occupational medicine office for almost four years. You need to walk in the shoes of the employees to truly know, their health and well being needs. And I don’t think that’s done enough.
Nick van Terheyden
You know, it really resonates with me, because when I was a medical student, I did that I worked in the portering. Department, I worked in the security department, I worked on a switchboard. You know, and it served me so well when I was practicing, because I had just wonderful relationships. Yeah, as well as true understanding. But I hadn’t thought about it in those terms. I do use the sort of terminology walk a day in the shoes. And I think it reflects the other way. I think that’s important too, to understand. You know, we’re close to time. If you would tell us where can people learn more about this?
Richard Safeer
Nick, I have created a Richard severe.com website. That includes my blogs, some videos, and other resources. And one day, Nick, I’ll also have a link to this podcast. So I hope you’ll visit me there or on LinkedIn. And I certainly hope that people will check out the book a cure for the common company.
Nick van Terheyden
So I will definitely put that in the materials that go out with the podcast and the associated blog posts will link to that. As we close out, you know, what I’m struck by is, you know, we saw this inflection point, I think with the pandemic, it as you described it, it accelerated things were certainly on the move. It’s sort of pushed people over the edge. It’s interesting, you talked about that. And your pandemic experience in doing all of those things hadn’t even occurred to me, but I did I was there too, in in some other areas. And what can we learn and continue to persist into the future, so that we can deliver that on an ongoing basis? Because I feel like there’s a little bit of this. Oh, that was yesterday. We’re moving on to the new problem.
Richard Safeer
Yeah, right. Short term memory. Well, you know, the organizations that have that short term memory are not going to do well. They will continue to struggle with talent acquisition and talent retention. And those organizations that learn from the pandemic that their most valuable resource is their workforce, they will thrive because they will treat the workforce with the care that we deserve. And it will reap rewards for everyone, including the organization itself.
Nick van Terheyden
So overall, I think we have this tremendous opportunity of the sea also great challenges. I think as you describe Richard, you know your website as a resource. Both the book as well as all of the resources that are built on there, Richard Sofia, sa F e r.com. Unfortunately, as we do each and every week, we’ve run out of time. So just remains for me to thank you for joining me on the show and sharing some of your experience. Rich, thanks for joining me.
Richard Safeer
Thanks so much, Nick. I enjoyed our conversation. Hopefully we’ll do this again.
