Episode 36 – Closing the Healthcare Mental Health Gap: How Healthcare Leaders Can Provide What the Workforce Needs with J. Corey Feist

Doctors and nurses are struggling in record numbers, but the system is working against them.

Join J. Corey Feist, Co-Founder of the Dr. Lorna Breen Heroes’ Foundation, in exploring the issues and strategies needed to bridge the gap between what healthcare workers need and what leaders think they are providing.

The COVID-19 pandemic has only highlighted the pre-existing issues of burnout, depression, anxiety, post-traumatic stress disorder (PTSD), and suicide experienced by healthcare workers. It’s time to take action and provide our healthcare workforce with the necessary support and resources.

Learn more about how to close this gap and create a supportive environment for healthcare workers.

---

Show Outline

• 03:47-How to create an environment of peace in the workplace?
• 05:48-What’s it like in the workplace with medical professionals?
• 08:04-The most important thing leaders can do
• 10:57 -The impact of employee health and well-being in business?
• 12:57-The number one driver of burnout
• 15:29-Process Improvement & Eliminate Waste
• 18:04-The three main bodies of work targeted by the Foundation
• 20:29-Engaging students, trainees & leaders on how to handle predictable stressors
• 23:39-How Dr. Lorna Breen’s Memory can motivate & guide us in work?

Quotes on the Show

“The workforce’s well being is really prioritized and we achieve a state where seeking help and mental health care is viewed as a sign of strength by those in the healthcare workplace.“

“Taking care of themselves first, not in a selfish kind of way, but in a way that truly allows them to be able to have something to offer when they go to serve other people is vitally important. And to see the light bulbs go off when we have that conversation is a reminder time and time again that whatever is wired in us wires a different way of thinking that we need to shift when we’re thinking about how we care for ourselves and each other.”

“All of these very predictable stressors, we should be absolutely training on that from day one, and then continue that training throughout. healthcare will be in a much better state if we can make that as an additional priority for healthcare.”

“The most important thing they can do is check on themselves first, and then their colleague”

Notes from the Show

At 18:04, Corey shares the Dr. Lorna Breen Heroes’ Foundation’s main body of work targeted at making a long-standing impact on this issue:

• Advising the healthcare industry to implement well-being initiatives;
• Building awareness of these issues to reduce the stigma; and
• Funding research and programs that will reduce healthcare professional burnout and improve provider well-being.

Keep Listening

---

Ready to strengthen everything you write?

Grammarly is a digital writing assistant that helps ensure everything you type is clear, effective, and mistake-free.

It offers instant writing suggestions to edit essays faster, write work emails with confidence, and even polish social media posts in a snap.

See for yourself why Grammarly is a must-have writing tool for school, work, and beyond. Try it for free today!

Connect with J. Corey Feist

• Website: https://drlornabreen.org/ 
• LinkedIn: J. Corey Feist, JD, MBA
• Youtube: Meet Corey Feist

Corey is the Co-Founder of the Dr. Lorna Breen Heroes’ Foundation, and he recently served as the Chief Executive Officer of the University of Virginia Physicians Group, the medical group practice of UVA Health comprised of 1200+ physicians and advanced practice providers.

Corey has authored numerous publications on the need to support the well-being of the healthcare workforce. He has served as an expert in multiple forums, including as a keynote speaker, panelist, and moderator, as well as provided formal testimony in the United States Congress.

Corey holds an adjunct faculty appointment at the UVA Darden School of Business. Corey is also the Chair of the Board of the Charlottesville Free Clinic. Corey holds his Master’s in Business Administration from the UVA Darden School of Business, his Juris Doctorate from Penn State Dickinson School of Law, and his Bachelor’s degree from Hamilton College.

---

Episode 36 – Full Transcript

Corey Feist 0:00
Today’s conversation with Corey is sobAarong yet also hopeful. The story is really about his sister in law Dr. Lorna Breen, Lorna always wanted to be an emergency room physician in New York City, and she made it she served on the frontlines of the COVID 19 pandemic in New York City, but tragically died by suicide in early 2020. She was a colleague of my friends at New York Presbyterian and well loved by those closest to her and out of the tragic headlines and the impact of her death on health care professionals. Corey And Jennifer, his wife and Lorna sister founded the Dr. Lorna Breen heroes foundation Jay Corey Feist is a health care executive with over 20 years of experience. He recently served as the Chief Executive Officer of the University of Virginia Physicians Group, the medical group practice of UVA health comprised of 1200 physicians and advanced practice providers. He has authored numerous publications on the need to support the well being of the healthcare workforce. He’s spoken at conferences, including the conference where we both spoke, and has served as an expert in multiple forms, including formal testimony in the United States Congress. Let’s dive right into today’s conversation with Corey I hope you will hear his story hear what he is recommending the work of the Foundation and find a way for you whether it’s in healthcare or your own industry to truly care for the people around you.

Corey Feist 1:23
Welcome to the new generation leader podcast, we’re giving you the tools you need to lead in the digital world ready to reach your true potential. This is the new generation leader podcast.

Corey Feist 1:37
So let’s go back to the beginning, the beginning of the foundation, paint that picture for the listeners of what led up to founding what you’re doing now. Sure. So we founded Dr. Winter bring heroes foundation in June of 2020. By we my wife Jennifer Jennifer Breen, Feist and me we did that on the heels of a family tragedy, which was the sudden death by suicide. I have my sister in law, Dr. Lorna Breen, who was an emergency medicine physician who was really at ground zero of the pandemic in New York City, when it really came at New York. And then the rest of the country is really a tsunami, Jennifer, I created the foundation because of the response by the healthcare community to Lorna’s death. And the volume of contacts that we received after one had died from members of the health community that weren’t just expressing condolences, but we’re talking about the environment that they worked in, and the need for it to change. Now remember, this is early days, they weren’t really addressing COVID, they were really speaking to the pre COVID status, because I had been in health care for multiple decades. And stint as the CEO of the University of Virginia’s Physician Group, which is the medical group for the physicians and advanced practice professionals at the University of Virginia in Charlottesville, I felt like I was in this unique spot to be able to understand the industry understand the real drivers who the players were. So we were in a position to help. So we had this incredible confluence of events where you had a family tragedy, and then the technical expertise to address it, really fueled by the workforce saying we really need help and really ringing a bell repeatedly for us. And so we decided that we would try to make a difference here and create to help to create an environment where the workforce feels valued and supported the workforce as well being is really prioritized and we achieve a state where seeking health and mental health care is viewed as a sign of strength by those in the healthcare workplace. I remember a few things I remember one, I vividly remember the story of Florida passing away because of the intersection of actually how you and I got connected through associations of nurses and groups who I knew who were a degree or two separated from her worked at, at her hospital. And so in a lot of those conversations, I don’t remember the exact point at the pandemic, but I had a friend who commented, another coach and leadership consultant commented, a you need to check in on people, no matter what you are, no matter what industry you’re in, no matter who you’re working with, you need to check in with people and I vividly remember introducing one of the tools and I’ll drop this in in the show notes that I talked about it often. And Jeremy actually came on the author of the Peace Index, came on a few episodes back to talk about this concept of finding peace, and how do we almost measure peace and assess peace in the workplace. And so my friend’s encouragement was, hey, when you do a workshop, check on people. And so I did this workshop with an association, a group of nurses and one particular

Corey Feist 5:00
healer, nurse on a scale of one to 100. It’s a very subjective one to 100 scale. But her number was 40 out of 100. And I thought, Okay, this is one of those red flags signs that the stress the burden that she’s carrying right now who’s listening who’s going to jump in and follow up with her. And I saw her about six months later, maybe a year later, in a different room with a different group. And we did the same assessment. And her number was double what it had been the first time. And so I knew that in that moment, that was one of those cases where, hey, we met somebody where they needed to be, what are you seeing where people are pushing that aside and not having those conversations? What’s that look like in the workplace with our medical professionals? You know, I’m hearing I’m Nick, I certainly have heard an increase in conversations around the need to take care of each other. And I would say that the echo chamber that I am closest to, is really echoing that the workforce is getting better at checking in on each other getting better at that there’s clearly a lot of work to be done here. And we’re working right now as an example, on the nationwide education and awareness campaign that came out of the Dr. Lorna Breen, health care provider Protection Act, which was the law that President Biden signed March 18 2022, named after my sister in law, and it has a number of programmatic elements, but one is this national education awareness campaign. And in that work, we’re doing all these in depth interviews with healthcare workers and healthcare leaders from across the country. And what we’re hearing in that is there’s a gap between what the workforce is saying they need and what leaders think they’re providing. So we’re trying to create a bridge and be the bridge between the workforce and leadership. So right now, there is definitely an increase in efforts across the country to speak to each other around these issues and look out for each other, I’m sure there is still a long way to go. But the doors opened and one data point to share with you. In the last year, an organization called the physicians Foundation did a survey of physicians, and 25% of the physicians in this country. No, my sister in law story. By extension, we know that one story has been deeply impactful for many who saw themselves in her story and chose a different path chose to check in on each other or themselves. So we know that it’s made an impact. But what I think we need to keep doing is we need to keep working at the local level on making these conversations, okay, and acceptable. Putting in processes and procedures, like stress, first aid, where there is a daily huddle, check in kind of like what you were talking about on your survey. But it’s color based, there are a lot of really programmatic elements and process elements that can be put in place to structurally make it just part of the routine where you’re checking in on each other. We, we have a ways to go when it comes to that. But I know we are on the right path right now. And our job is just to keep beating this drum so that folks don’t forget that the the most important thing they can do is check on themselves first, and then then their colleague and you know, that’s you get on an airplane now, again, post pandemic, and it talked about the oxygen mask principle, right, put it on yourself first and then and then someone sitting next to you. So that’s exactly what we’re, we know needs to happen. And it just needs to just not revert back to the pre pandemic phase. That’s one of those leadership principles that I don’t know where it is shared or conveyed, that we need to care for other people first, but especially in health care, or a helping kind of profession, where by very nature, what you’re doing is caring for other people. But when you get that imbalance off, I spent a lot of time talking with leaders and reminding them that taking care of themselves first, not in a selfish kind of way, but in a way that truly allows them to be able to have something to offer when they go to serve other people is vitally important. And to see the light bulbs go off when we have that conversation is a reminder time and time again, that whatever is wired in US wires a different way of thinking that we need to shift when we’re thinking about how we care for ourselves and each other. That’s funny. I’m about to bring up an example, which is how to add a little bit of a negative spotted news. You’ll check it out when I bring it up. But when I was in business school, I learned about the early days of Southwest Airlines. That’s why it’ll check out because they had a little problem recently in the news, but they’re originally stated business strategy as I’m qualifying it was our priority is to look out for our workforce. And if we take care of our workforce, we don’t even really have to worry about the customer because we know that

Corey Feist 10:00
That’s why we hired them in. And I think about in healthcare, the impact on the workforce is rarely discussed in boardrooms and in leadership in the C suite meetings, when you’re looking at key performance indicators. When you’re looking at board reports, it’s all around the patient. It’s patient volumes, its financials driven by patient, it’s patient experience, maybe at the very bottom, there’s a turnover measure, maybe they’ve done an engagement score in the best little bit. But that’s it right now. And when you think about all of the quality initiatives that are across the country, everything that’s focused on on the patients, and including the reason why everyone gets into the business, pretty much and health care, it’s about taking care of someone else. So we do need to wreck get the workforce to realize that in order to actually do that job, you first need to do the self care piece. And that is, it is a yes. And kind of a thing. It’s not one or the other. It’s both, right. So thinking from a leadership perspective, in the seats that you’ve sat in, how do you start to build a bridge for practice leaders, administrators, or multiply this across any business? How do you start to talk and help people think about the impact of employee health and well being on the bottom line of the business? My starting point is to use something I’m not currently using in this conversation, which is my ears, it’s listening, I’ll tell you my approach, when I moved in, was promoted from Chief Operating Officer to Chief Executive Officer in an organization that I’d been in for at that point over a decade, was to go back to my key customers, my 21, clinical department chairs and ask them, what do they need us to be doing? Understanding what our core business was? What else do you need? How are we doing? And in those conversations, you get the roadmap, those conversations need to be being had by management of all level with their workforce, and they need to go something like this. Aaron, I am seeing national news that less than 50% of the healthcare workforce currently feels valued and supported by their organizations. What does it mean for you to feel valued and supported by me as a leader, and by this organization? That right there, you are going to get out of that answer 98% of the solution of how you address this, but it requires you to ask the question premium environment of trust with your team members. But I think that is critical. And then you literally take all of those interviews and what you’re learning, and you turn it into an action plan, and you report back to the workforce, what you’re doing for them and why you’re doing it and your progress on those things. And it creates this virtuous cycle of feedback, and action and results. The other thing that I think is really important to make sure that folks recognize is in this time of incredible, I’ll call it low staffing or staffing issues that are had at all levels, we need to recognize that pre pandemic, the number one driver of burnout in this country was administrative burden on the workforce number one, also recognize that from a data perspective, according to the data that I’ve seen, 50% of nurses time, and 70% of a physician’s time in this country is spent on administrative tasks. So I would proffer to all the leaders out there that maybe we don’t have a workforce shortage right now, we have clinicians, whether those be nurses, or doctors or other pharmacists, or go down the list that are spending their time on the wrong things. And we could literally double the workforce overnight without having to train another health care worker, if we focus on those kinds of very tactical, measurable, because everyone wants to measure measurable tactical initiatives that will take the pressure off, and also, by the way, address the root cause of a lot of these challenges in the first place. So conversations around Aaron, why do you how do you feel valued and supported? What does that feel like to you? And also some real tactical things around reducing administrative burden, looking at making process process initiatives that are measurable, quantifiable and tie directly to burnout? I’d say those two channels would be the absolute roadmap for leaders in this country to take this headline that’s come up recently, everybody talks about quiet quitting. And now just in the last month or so, it’s been quiet hiring and what you’re describing, you know, go back to the nursing shortage that the American Nurses Association was quoting well before the pandemic, if you could reallocate resources in that way, how much more could be accomplished? It’s fascinating. People know me well enough for like, vices quoting math. That’s scary. They gotta be big numbers. They gotta be

Corey Feist 15:00
Get around, I’ll tell you it is I’ve done this work before. In my past, pre pandemic, one of my largest business units I was responsible for, had a spike in in turnover due to a relocation of an office building that folks just didn’t want to drive. And we tried the band aid approach as a short term, let’s pay overtime, let’s just let’s try to figure out how we can get the workers working harder and longer. And we tried that. And I said, timeout, we’re not doing that anymore. Let’s do process improvement initiatives where the workforce sees that value stream, if you will, as defined by the patient. In that case, this time I’m talking about is defined by the worker, we did process improvement. And the most important part of that is you can eliminate waste in that process and make things more efficient. So yes, in some cases, Aaron, you might have to and you will have to find other outlets for the administrative work. But you can make great headway and decompress the situation by eliminating first that should be the goal is eliminate first. And hospital systems in this country, as an example are just ripe to do that, with the investment they’ve all made in the last 10 to 15 years and the electronic medical record, how many of those were health systems who spent hundreds of millions of dollars implementing an electronic medical record, have gone back and done even basic optimization where you’re trying to make it more of an an efficient tool for your workforce, how many of those organizations are measuring time in the electronic medical record, you have an ability to extract it in the Executive Report, looking at which pockets of the workforce are spending more time in the electronic medical record, which pockets of the workforce are working on what’s called note bloat, where you’ve got too much content in the notes, and the benefit of electronic medical records all it’s all comparable data. And so you’ve got a roadmap and your executive summary. But there are some real tactical things here that can be done to just first eliminate. And that would be my goal. If you have to reassign, that’s also fine. But that’s not the ideal. The first is maybe you could increase the if you could increase the workforce by 25%. Just by eliminating who’s gonna be mad about that. Like that’s everyone’s in it. So that’s what I was saying before about how we’re identifying this gap between what the workforce wants and needs, and what the leadership thinks they’re providing their everybody wants an efficient health care delivery system, what I think is a gap is that leadership doesn’t necessarily recognize that the priority of the workforce is that as well. And if they could work together on making the environment more efficient, patients will benefit, clinicians will benefit other health workers will benefit. All of the metrics that hospitals are measured by will go in the direction you want them to go. But it takes hard work. It takes focus and understand it can’t be done overnight. To me, that’s the roadmap on the road ahead. From talking points and initiatives. What do you think is most important that needs to be tackled in this next season? Well, our foundation really focuses in three primary areas in raising awareness for the need to focus on well being as well as what what the causes of burnout on the occupational syndrome side and what the barriers on the mental health side are for health workers. So we need to keep on this awareness work with a focus on the cultural pieces that we were talking about today, creating an environment and a culture where the workforce not only feels valued and supported by leadership, but they also are supporting each other. So that would be number one. Number two, from an advocacy perspective, focusing on making sure that the Lorna Breen Act continues to be funded, it was originally funded with over $100 million. That money was allocated to the 240 organizations across the country, there were about 6000 hospitals. So there’s a long way to go there. But we need to make sure that we’re all advocating for future investment by the federal government, in the Lorna Breen act, current programs, and then a maturation of those programs and the work under the Lorna Brina. Also in the advocacy front, we need to really be focusing on policies that eliminate administrative burden and policies that remove barriers to mental health access that uniquely apply to health care workers, like nurses, physicians, pharmacists techs that are licensed and credentialing focused, and that I’m really talking about these questions that appear in these applications that really violate the Americans with Disabilities Act and serve as the number one driver of suicide of the healthcare workforce. So these concerns around the retribution and the ramifications rather of getting mental health treatment. So that’s the policy front. And then on the solutions front, we need to really be bringing all of that together those first two together at a local level and having organizations focus on just every organization is country focused on one operational initiative that tied back

Corey Feist 20:00
to wellbeing, whether that be on electronic medical record optimization, team based care, pick an initiative, measure it, report it to your boards, tie compensation of your leadership to it. That’s my roadmap for the next year, frankly, probably a little bit beyond that, too. But that’s our roadmap. And I think we just need to stay focused in those in those domains. And we will continue to make progress, we have made great progress, we will continue to make great progress, we have a long way to go here. Last comment I would make on this is we can’t forget to engage the student and trainee level, those are our next generation of leaders, that’s where the culture will really have a chance to truly start fresh. And so let’s not forget about our trainees and the impact on our nursing students or medical students or other professional students, as well as those who are in residency are up the sleeves training, I teach a leadership course at the Bonocore College of Nursing here in Richmond, and I have a Bachelor of Nursing students, new class, we’re a few weeks into this semester. And the conversation, I recognize from my own career, the lack of this leadership development, emotional intelligence, self awareness that isn’t part of many education processes. And so I always used to say, Nobody teaches this in school, which I have to stop saying now because I am teaching a class. And I know a few others are. But it’s fascinating to me, when I ask them questions, have them reflect on their own personal story, journey and experience, how seldom they’ve ever been on that reflective journey. And there is a lot of weight, there are a lot of stories, a lot of life that they’ve lived before they even get to nursing school. And so being able to harness that, leverage that and give them I hope tools to navigate communication, stress crisis, all throughout their career, I can only hope they’ll be able to carry those tools with them. So you know, Aaron, thank you for your leadership and creating space. One thing that never ceases to amaze me is how few tools nursing students and other health professional students are given on how to in a healthy way process, even what they’ve seen what they will see, what are the outlets for it that are appropriate, it’s 100%, predictable that in a nurse’s career, he or she will see, I’ll call it tech, this is a technical medical legal term, bad things, things that are you know, traumatic, that would create a high degree of stress anxiety. And for the vast majority of health professional trainees, that’s not a topic that’s really covered, and it’s just skip it over. They’ll just stuff it down. And it’s going to come out somewhere. So we might as well start early. And then often by training on what’s the best way to manage this stress and what to do with it. It does not solve the operational issues that cause a lot of the stress, but from the exposure to trauma, and the death, the dying, the bad outcomes, the near misses the potential for being involved in lawsuits, all of these very predictable stressors. We should be absolutely training on that from day one, and then continue that training throughout. I think healthcare will be in a much better state if we can make that as an additional priority for healthcare. I wholeheartedly agree with you there. We’ve talked a lot about the tactical approaches. But I want to wrap on this question, what memory of Lorna do you and your wife carry with you most to motivate and guide you in this work? That’s a hard one to encapsulate in one statement. I can’t tell you what, Jennifer thanks. But for me, I know that my sister in law cared as deeply and talk to us all the time, about how she cared as deeply about the well being of her colleagues as she did. As she did her patients. This was her passion. So she just exuded everything that there is about your just prototypical healthcare professional who just cared so deeply about it, it was just everything about her essence exuded it, she was constantly looking for ways to improve it, to published on it even and so really that just her essence and her prioritization of her care team members, as humans as people, that’s a motivator for me, and I’m honored to be carrying this forward in her name, and really want our healthcare community to know that even though this is named after Lorna, and even though it’s got the word doctor in that title, we are an organization that is focused on the well being of all health professionals. And we did this because of their reacting to her passing. It wasn’t because we were looking for something to do. And so this is an organization that is for the healthcare workforce, now and in the future, and we’re just really feel fortunate to be able to name it after

Corey Feist 25:00
Want to and really have her be our inspiration? And we do miss her dearly? Yes, it sounds like she was a force to be reckoned with. And I can only imagine how much not only you her family, but her co workers, and probably anyone who passed through a hospital who laid in a bed that she cared for has that same sense as well. So, Corey, thanks so much for joining me today for this conversation. It’s an important one. And based on all of the ways that I’m connecting to and working within healthcare, healthcare is going to continue to be a topic that we talk about on this podcast, and every day as well. So thanks for sharing a bit behind the work of the Foundation and the work that you’re doing.

Aaron Lee
What’s the best way for people to connect with you and engage with the foundation if they’re intrigued and want to get involved?

Corey Feist
Yeah, thanks so much, Aaron for asking. And thanks for creating the space today on this podcast, I think now more than ever, we’ve got to look out for each other as us to kind of started this. So our Foundation website is Dr. Lorna breen.org. There’s all sorts of information there as well as ways to contact us directly. Another great way to do it is to follow us on social media. We’re on all the social media channels pretty much. And I will just tell you that my children who are adolescents are convinced that no one’s ever going to take it seriously unless we get about 2 million social media followers and we’re only in the 1000s. So helps anybody’s listening. Follow us to get my kids off my back a little bit on this work.