Episode Transcript
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0:06
Will: Knock, knock, knock, knock.
0:11
Hi, welcome everyone to Knock-knock.
0:15
Hi, with the Glock Flecking.
0:17
I am Dr. Glock Flecking. I'm Lady Glock Flecking.
0:20
Together we are the Glock Flein, and we have an exciting show for you
0:25
today with a great guest, uh, one that you may not have ever thought would
0:30
actually come on a podcast with me.
0:32
Uh, and Dr. Christopher Longhurst, who is a Chief Medical Officer at U C S D Health.
0:39
So it was exciting. Before we get into that, um, something in my life has, has, has returned,
0:46
uh, and that is physical activity.
0:50
. I, I, so I've been, I'm fairly athletic.
0:53
Yeah. I would consider myself athletic. I played high school sports and I, I have played competitive ultimate Frisbee.
0:59
I know some people are probably laughing at that. In fact, it's, it's, I'm somewhat of a cliche being like a, a ultimate
1:06
Frisbee person who also tells jokes.
1:09
I'm like the quintessential hippie for most people.
1:12
Uh, but I played competitive ultimate Frisbee for 15 years.
1:17
Yeah, a long time. Long time. And it really, up until the pandemic hit, and then I just, like most
1:22
people stopped kind of doing things.
1:25
And it wasn't until, um, Like last month that I decided to get back out
1:32
into like a competitive sports space.
1:35
Mm-hmm. , and it came in the form of indoor soccer.
1:39
Kristin: Mm-hmm. . But it's like, it's a really cute kind of league
1:44
Will: because it's an all ages co-ed.
1:47
So it's, it's men and women and uh, and it's our, our team name.
1:53
So first of all, our team is made up of, uh, a lot of dad, moms and dads.
1:59
In fact, almost all moms and dads we're all at least 35
2:02
Kristin: years old and not just moms and dads. This is why it's cute, it's because it's the moms and dads of the children who are.
2:12
Our daughter's Will: soccer team. Yeah. Like half the team is like, yeah.
2:16
The, we're the parents of our children.
2:18
They're all on the same team. So we all, we know each other from like soccer games and practices and stuff.
2:22
We're like, Hey, let's, we like soccer, let's go, let's, let's form this indoor
2:27
soccer team and, and, and see how it goes.
2:30
Kristin: So our, you should name your team based off of the name of the
2:34
Will: children's team. Oh, the chil, our children's team is, uh, the, um, uh, jellybean Jellybean Tigers.
2:40
Tigers. The Jellybean Tigers. Uh, but our, we actually have a name for our team.
2:44
Oh, you do? What is it? Yeah, it's bedtime at eight . Perfect.
2:47
That is, that is actually our name.
2:49
Bedtime at eight. Uh, and at first I thought this was like an over 30 league.
2:56
Mm-hmm. . I was mistaken. This is an all ages league.
3:01
And the reason I know this first couple games went great.
3:05
Uh, we, we tied the first one and we lost the second one by one, one goal.
3:10
So it was, it was very close, very, you know, pretty competitive.
3:13
We had a lot of fun. And then we played the team made up of teenagers.
3:19
Oh boy. They showed up legit high school team, like a varsity high school team, . They
3:25
ran us off the field, , the, the, uh, the amount, the stamina, the energy.
3:33
It was overwhelming.
3:35
And all of us, like our goal is just to not get hurt.
3:41
. Like if we score goals, great, but if we can escape these games without seriously
3:48
injuring ourselves, that's a win.
3:51
Kristin: Isn't it depressing that you used to be.
3:55
We all did. Used to be like those teenagers, like that used to be.
3:59
Oh yeah. And in everyone's minds you're still kind of there.
4:02
Yeah. Until you get out there and actually try it.
4:04
Oh, I Will: remember like when you were, when I was like, you know, 17,
4:07
18, just I could get out of bed and immediately start sprinting,
4:11
Yeah. Like my legs would tear off my body if I tried to do that.
4:15
Now, . And, and so, and this was like a, a perfect storm of like the old people.
4:22
Mm-hmm. , you know, who still think they got it.
4:24
Mm-hmm. to a certain extent, uh, trying not to get hurt.
4:27
And then this high school varsity soccer team who, like the way they play like,
4:33
is like they will never get hurt, ever.
4:35
Like, it's impossible for them to get injured.
4:38
And so that's the way they play. And it was, it posed a very serious threat to our way of
4:44
playing, of not getting hurt. And so, uh, um, there were some, some pulled hammies , a couple, a
4:52
couple of, uh, Of rolled ankles.
4:56
I just started cramping by the end of it, , um, and, and, and this,
5:01
it was like 20 minute halves. So it was, it wasn't like, uh, you know, we'd all play for like
5:05
five minutes at a time if that. Um, and so, It was, we lost obviously . It
5:12
Kristin: was, yeah. I wonder which two Will: had less fun.
5:15
Eight. Eight to three. Oh, they were, they were having a ton of fun.
5:18
They were enjoying themselves. Maybe it'd be too easy.
5:20
Oh no. Are you kidding me? Like it always feels good to blow out old people.
5:24
Yeah. And so, uh, we lost eight to three.
5:27
I scored two goals because see, whenever I played soccer growing
5:32
up, I was a forward, so I was like, I, I scored a bunch of goals.
5:35
Yeah. Like I'm really, I like, I, I feel like I'm pretty good at scoring goals.
5:39
Sure. And I scored two goals against high schoolers.
5:42
Kristin: That's nothing to, I'm very proud of that.
5:45
Yeah. . That's Will: right. You should all be very proud of me.
5:49
Kristin: You know, I am surprised I was when it started and I have just
5:52
continued to be surprised at how early.
5:57
You start to get old, right? Yeah.
5:59
Like, I thought maybe I would start feeling old when I was a, a
6:02
teenager, I thought I'd start feeling old in like, you know, my forties.
6:06
Mm-hmm. , it starts, like, started earlier, 29, 30 for me.
6:10
It did. I was like, I mean, not, not a lot.
6:12
It goes, it's gradual. But that's when I first started noticing like, Hmm.
6:16
I'm not as surprised as I Will: once was.
6:18
Yeah. I feel like thir like, yeah. Like 31, 32 day, like all of a, a sudden you're like, uh,
6:24
you can't piss me off guard. You, you move your neck a certain way and your week is ruined.
6:28
Yeah, exactly. . Yeah. It's, it's that, that, that kind of stuff starts happening.
6:32
So enjoy your youth, everyone. That's right.
6:34
Uh, enjoy your athletic years too.
6:37
Really get the most out of those things, uh, because of eventually you're gonna
6:42
find yourself on a, on an over 35 indoor soccer team, playing against
6:47
high schoolers and feeling your age. That's right.
6:49
At least Kristin: you made it this far. I had to, I had to peek out at 15 in gymnastics.
6:54
That's gymnastics Dr Christoper Longhurst: age. That's hard in my body. Will: All right, well let's, let's get to the, our guest today.
6:59
Let's do it. How about it? Uh, so again, this is, uh, Christopher Longhurst, md, uh, he's the Chief
7:04
Medical Officer and Chief Digital Officer at uc, San Diego Health Associate
7:08
Dean and Professor of Medicine and Pediatrics at uc, SD School of Medicine.
7:14
So he is a pediatrician and a Chief medical officer,
7:17
Kristin: whereas our daughter likes to say a Will: cardiologist.
7:19
Oh, yes. Yes. She dropped that one. We have a very funny, we have two very funny daughters, uh, but our
7:25
youngest dropped the cardiologist cuz she couldn't come up with the name.
7:28
What is a type of doctor that takes care of kids?
7:31
Cardiologist. Cardiologist. I, it makes perfect sense.
7:34
I think theological probably should be called that from now on.
7:36
All right, well, let's get to it. I'm excited about this.
7:38
Yeah, he's fun. All right. Here's Chris. All right, so we got Chris Longhurst coming to us from San Diego.
7:51
Uh, and you look like you're at work.
7:53
You're wearing a, a, a white button up collar shirt with a tie, and I do not
7:59
look nearly as professional as you. So thanks for bringing some, uh, sense of professionalism to this recording.
8:05
This is great. You bet. I like to wear a tie
8:07
Dr Christoper Longhurst: every now and then, just so that my, uh, boss
8:09
stays on her feet , you know, worries that I'm out interviewing somewhere.
8:13
Did Will: you, did you, you didn't just do it for me, it's for your boss.
8:15
No, it wasn't just Dr Christoper Longhurst: for you. . We thought the Joint Commission might show up today.
8:19
Will: Oh my God. . Is that, is that a possibility?
8:23
It is Dr Christoper Longhurst: a possibility. We're we are in our
8:25
Will: window. So how does that work? So you, so they, they contact you, say, Hey, we're gonna come, uh, wait, wait.
8:31
What is the Joint Commission? Oh yeah. Good. For, for people who don't know.
8:34
Yeah. Actually, Chris, why don't you tell us who the joint commission.
8:37
Dr Christoper Longhurst: The Joy Commission is a accreditation agency that
8:41
makes sure that we are, uh, as a hospital complying with all the CMS regulations.
8:47
And so, um, that's a big deal.
8:49
We're, we're always excited when Will: they show up because if you lose your accreditation, no, because if
8:56
you lose your accreditation, Uh, the, everybody has to find a new job, right?
9:01
That's how it works. You definitely Dr Christoper Longhurst: don't wanna lose accreditation because
9:05
billing CMS is an important part of paying all of our employees
9:10
Will: So, okay, so they give you a window, like how, how long is your window?
9:14
It's like when the Kristin: plumber comes to your house and you gotta sit around all
9:17
afternoon, they show up at the very end. It's Dr Christoper Longhurst: way worse than that.
9:20
. It's horrible, Kristen. So they give you like a three month window, but you usually kind of get a
9:25
hint so that it's like here or there.
9:27
We, we got a hint that it was maybe on one of our blackout weeks cuz
9:30
we had a blackout day, you know? But, um, I canceled a trip to, uh, a family trip in November because
9:37
we thought they were coming. Oh. And uh, here it is in, uh, oh man, February and they haven't
9:42
shown up yet, so, oh my goodness. We're excited to welcome them sometime.
9:45
So, Will: so you, so you haven't do, there's like an insider, do you?
9:50
Like I have a mole at the cm. We
9:52
Dr Christoper Longhurst: wish we had a mole because then we'd know when they were coming.
9:54
But we have no mal . Will: Uh, well at least at, at least you are, you're in San Diego
10:01
and is, despite the stress of being an executive at a hospital, a big
10:06
hospital system, um, doesn't it just make your life just so much better?
10:10
Just being in San Diego?
10:13
I say that as we're in the middle of winter in Portland, Oregon, and it's
10:16
rainy and gray and awful year round.
10:19
Dr. Flanner, I'm, I'm not Dr Christoper Longhurst: gonna lie it, it doesn't suck here, but I don't
10:22
wanna really advertise it too much because we don't want anybody else here.
10:28
. Will: Fair enough, fair enough. So what I thought, what I wanted to do right now is, is give people
10:33
an idea about what, what a CMO is.
10:37
What a what Because in, in med, and I've been guilty of this obviously I, of, of
10:43
making fun of hospital administrators. Uh, and, um, somewhat mercilessly.
10:49
I think a lot of people, you're like a, a very common punching bag in the
10:52
medical system, , and so, but I feel like maybe a lot of people don't
10:57
really know exactly what it is you do.
10:59
So, uh, give us a, a quick little rundown.
11:02
Well, first of all, Dr Christoper Longhurst: um, Dr. Funny, your, your readers and listeners should know I'm a huge
11:07
fan, , and I particularly like it when you make fun impossible
11:10
administrators because it resonates. You seem to capture it really well.
11:13
But those are all the other people, not me, obviously , right?
11:16
Mm-hmm. . Yeah. So, you know, I, uh, grew up, um, as a pediatrician and, uh, that's
11:23
how I think of myself to this day. So I, I happen to serve as the chief Medical Officer and Chief Digital Officer
11:28
here at uc, San Diego Health, and there's lots of fires that we put out every
11:32
day and, and lots of great strategies we're putting in place as a team.
11:36
But, um, ultimately my identity still is as a practicing
11:40
Will: doctor. And you do still practice, you're, yeah.
11:43
I get to see Dr Christoper Longhurst: babies as part of our newborn service here
11:46
Will: at U C S T. And whenever you were going through your medical education in the early
11:52
part of your career, did you ever imagine that you would be doing
11:55
this in the administrator role?
11:59
Dr Christoper Longhurst: No, I most definitely did not. Now, I will say that, um, my father was an academic physician, an MD PhD, and he
12:07
taught me that what he loved about his career is he got to do different things.
12:10
He was in the lab some days, he was a cardiologist some days, and
12:13
he was an administrator some days. And that definitely resonated with me.
12:17
And so I stuck around in academic medicine because I knew I could wear
12:21
different hats, but I didn't think that I would be a administrator,
12:25
like a chief medical officer. In fact, I still have imposter syndrome, . And I can tell you when I
12:29
was appointed, uh, a couple of years ago, it was like the worst imposter
12:33
syndrome that I had had since intern year. Really?
12:36
Oh yeah. Big time. In what way? Well, you remember, um, will you walk into your internship and uh, suddenly,
12:43
you know, you can sign prescriptions and you have an MD after your name, but
12:46
you don't know any more than you knew. Right. You know, when you were a fourth year medical student.
12:49
In fact, potentially less if you took some time off.
12:51
Right? Right. Yeah. And so, uh, you're walking around sort of feeling the weight of the
12:55
world because your prescription error could harm another human being.
13:00
Right? And say, look everything up, double and triple, check it.
13:03
And, uh, I felt similarly. Then 20 years later, becoming a Chief medical Officer, I had served in lots of
13:08
other administrative roles as C M I, as cio, as Associate Chief Medical Officer.
13:14
Suddenly one day I was in the seat that people who I had really
13:17
admired, uh, had sat in prior to me.
13:20
And, uh, it raised the bar quite a bit and I thought, well, they
13:24
can't really be looking to me as sort of the head of physicians.
13:27
Right, Will: right. And, and you're , but they do look up to you, you're, you're, uh,
13:33
Dr Christoper Longhurst: no, no, they absolutely don't. In fact, that's how I got over it, as I realized that there's no respect.
13:38
Nobody looks at me that way at all. Kristin: Do they pity you instead for having to be
13:43
Dr Christoper Longhurst: PET physicians? You know, it's funny when I talk to people and they say things
13:46
like, thanks for your time.
13:49
I know you, you must be really busy with all the problems
13:52
Will: in the hospital. And
13:55
Dr Christoper Longhurst: I think, gosh, yeah, you're right. Will: There's a lot of
13:57
Kristin: problems. What, what is in a CMOs job description?
14:01
What are you, what all are you responsible for?
14:03
Will: Do you get all the complaints? Does it all, does it all come to you?
14:06
Are you the complaint guy? You know, um, I try
14:10
Dr Christoper Longhurst: to help. Um, they don't all come to, to me.
14:12
We also have a physician group leader and other, you know, uh, doctors
14:16
who are in our executive suite. Um, so we work together as a team.
14:20
But, uh, one of my primary roles as the chief medical officer is
14:23
overseeing all of our medical directors.
14:25
So, you know, community hospital might have a few dozen, uh, physicians with
14:30
administrative funding for medical directorship in different areas or
14:33
clinics or service lines, et cetera. And many academic medical centers, it's much larger.
14:38
So here at U C S D, we've got, uh, you know, over 150 medical directors.
14:42
That was common at Stanford where I came from as well.
14:45
And so all of those medical directors need to, um, be aligned and, uh,
14:49
marching towards goals that help to the enterprise to better care for patients.
14:54
So that's part of my role Will: that, um, that sounds really important.
14:58
Yeah, it does. It's certainly not something that, that I don't think I could ever do.
15:03
Um, and I, I'll, I'll stick to just skits.
15:06
How about that? Just dressing, it probably involves a lot of, like, organiz organization.
15:09
I am actually getting a lot of good ideas from your appearance here.
15:13
I could really kind of tailor my hospital administrator's c o character, uh, based
15:19
on, you know, this interaction right now. Um, and so, uh, I, I do wanna say that I'm, I'm glad that my depiction.
15:29
You know, peop leadership positions in a hospital, uh, did not turn you
15:33
off from, from joining us today.
15:35
So really, I, I'm curious.
15:38
he's undoing the tie. He's, he's taken off his tie . Um, uh, so, so now Joint Commission's gonna
15:45
Kristin: walk in . Yeah. Will: Yeah, I'm sure that's probably, that's probably something that a joint
15:49
commission requires is for you to
15:52
. Kristin: Wait, wait. Are, how, how far are we taking this?
15:56
? He's, he's still going now. Seems like he's, uh, maybe getting undressed in there,
16:00
so maybe we move it along. Will: Uh, so when did, when did you go through residency?
16:05
How far? So I, yeah. I, uh,
16:07
Dr Christoper Longhurst: started with the class of 2000 medical school, but
16:11
during medical school I found that I had an interest in combining my
16:14
passion for computers and information technology with healthcare delivery.
16:18
And so I took some time off and did a master's degree in health informatics.
16:22
So I, I finished medical school in 2001 and my residency training
16:26
at Stanford was from 2001 to 2004.
16:29
As you well know, those are some of the, uh, highlights of, uh, everybody's
16:33
career and definitely where memories Will: are made.
16:35
Yeah. Can you share some memories from that time in your life?
16:40
Well, will Dr Christoper Longhurst: Kristen, I'm, I'm not a great sleeper
16:44
I, I don't get to sleep easily.
16:46
I don't stay asleep easily. So, you know, adjusting to life
16:49
Will: in the call room. It's funny because you used, especially, you do kinda look like you just woke up,
16:52
but that's, that's neither here nor there. Okay. Keep going.
16:55
Adjusting to life in the call room was difficult
16:58
Dr Christoper Longhurst: and, uh, uh, especially when you're on
17:00
call every fourth night, so you're your post call every fourth day.
17:04
You know, it was a, a grind, particularly, you know, before work hour restrictions.
17:08
Mm-hmm. when you would stay sometimes post call for continuity clinic, you know, all
17:12
the way till five o'clock without sleep. So, um, I found that, uh, I had problems initially.
17:19
Um, Waking up for my pager.
17:22
Oh, no. And, uh, a couple times, I mean, the nursing staff had to come like knock
17:26
really loudly on the call room door because the pager was beeping, but I
17:30
was just sleeping right through it. Oh no.
17:32
Um, no, you know, to be honest, part of the reason I was sleeping through
17:36
it is because I found I could get to sleep easier with earplugs in.
17:39
Oh, okay. Um, and so the earplugs didn't, didn't help me hear the pager.
17:43
Sure. . Um, and so then I started putting the pager on vibrate and I
17:47
tried, you know, sticking on my pants, but roll off the scrubs,
17:52
So finally I found that, um, a formula that worked for my entire residency,
17:57
which was, I, I would go to the call room after you got, you know, it worked
18:00
for the day done and the mission's done.
18:02
Maybe you could lie down for an hour. And I put a headband on.
18:06
Oh my God. And the pager was on to vibrate on my headband.
18:10
Just right on your forehead. And it was, it was a little traumatic on my forehead.
18:14
Yeah. Like when somebody paged me and my whole head started vibrating.
18:18
Will: But I bet it woke you up. It successfully Dr Christoper Longhurst: woke me up.
18:21
I didn't miss pages and, you know, problem solved.
18:23
Will: Yeah. I, I, I swear most doctors have.
18:29
Sometimes rational in your case, but irrational fear of missing a page.
18:33
Right. But pagers, they, they're so loud.
18:35
I'm, I'm impressed that they just didn't wake you up, period.
18:38
But, but I, I felt that same kind of anxiety around like,
18:42
going to sleep when I'm on call. You know, and I'd similar to you, like I, I'd put the pager i'd, I'd bring
18:48
the stool over, like right next to my sleeping head and put the pager
18:53
like within four inches from my face.
18:56
You know, I never went so far as to put a headband on.
18:58
But, uh, , because you hear horror stories.
19:00
Like I remember a, a, a resident who had, was a few years ahead of me,
19:05
went to sleep with the pager on his belt and somehow was sleeping like on.
19:10
The button of the pager. And so it blocked pages from going through and just stuff like that just
19:17
like really freaks you out, right? Is like, oh, if, if, if no one pages me a first day intern, people will
19:24
die kind of thing, which is not quite how things work in the hospital.
19:29
But not quite Dr Christoper Longhurst: accurate. I think you Kristin: might die not that far from
19:32
Will: actress if you don't answer it. Yeah. Not that, not that you're right.
19:35
Not that far off. But yeah, it , you know, um, you're mostly gonna get in trouble with other
19:40
people, I think if you're, if you do that
19:44
So that, do you still, do you, do you, are you on, do you ever, are you, do
19:47
you take call as an administrator? Is there like an administrator on call?
19:52
? There is an Dr Christoper Longhurst: administrator of all On Call. There's also, um, medical center physician on call that help with,
19:57
uh, thorny uh, clinical issues. And so we do take call.
20:01
Um, but uh, these days it's really just cell phone
20:04
Will: based. Gotcha. You don't strap your cell phone to your head anymore.
20:07
There's no cell phone strapped to the Dr Christoper Longhurst: head, although, um, You know, might not be a bad idea.
20:14
, Will: were you a, um, uh, so aside from having difficulty waking up, did you have
20:18
any other difficult, like, situations that you encountered in your training?
20:24
Uh, lots of difficult Dr Christoper Longhurst: situations in my training.
20:27
Um, and lots of funny ones as well.
20:30
I mean, um, knowing that I was gonna become a pediatrician, I,
20:33
I thought, gosh, you know, I want to be like the patch Adams, right?
20:36
I, uh, I learned to juggle in, in college.
20:39
I learned, you know, like card tricks and tying a bow tie and balloon animals
20:43
in medical schools part of like the pediatric interest group, right?
20:46
Oh my gosh, . Yeah, none of that was helpful at all.
20:49
Never really got a cho like opportunity to bust out my juggling
20:52
Will: skills on rounds. or balloon animals?
20:56
No. There might've been one or two balloon animals.
20:59
I bet you're fun at parties though. You totally outlawed latex.
21:01
Yeah. You, you must've been a big hit with your kids', uh, uh,
21:05
birthday parties and stuff, right? Birthday party
21:08
Dr Christoper Longhurst: is probably, you know, more helpful. In fact, uh, my now wife who you guys met mm-hmm.
21:13
, uh, was a professional nanny when we met.
21:16
And I remember that, uh, people would tell her, oh, you're so lucky
21:20
you're marrying a pediatrician. He's gonna be so useful, . And my wife is like, yeah, he's, he's useless.
21:26
Like, unless the kids are sick, in which case he says, you know, I
21:29
can't be their doctor to the doctor.
21:31
So, pretty much, you know, completely useless.
21:34
Whereas my wife, who, um, has raised several other, um, children before we
21:38
got married, uh, you know, is very, very
21:40
Will: useful. You think, you think you're useless.
21:43
Imagine being an ophthalmologist. That's, I think that's if we, that's true.
21:48
If we're creating a list, I don't know. I don't know what's, that would be a fun thing to do.
21:52
Go through like the top five, like useless professions in like a
21:56
nonclinical, like, you know, just being at home with your family.
22:00
Kristin: I think, you know, a list of people that would be more useful Will: radiologists than you all probably be up there.
22:04
Pathology, I mean, but they understand like diseases pretty well.
22:08
Mm-hmm. . And so like, I think what you really need is, is a nurse.
22:12
Yeah. I think nurse nurses are probably like the best.
22:15
Yeah. You know, cause they got like the, the triaging skills and the
22:19
right and followed by whoever Kristin: the primary caretaker is.
22:22
Yeah. Yeah. We need, regardless of whether they have any medical
22:25
Will: training, my problem is I need too much equipment.
22:28
Like I require too much stuff to do my job.
22:32
Uh, pediatrician though, I mean, you, you really don't
22:34
have much of an excuse, Chris. You're, you're you.
22:37
You don't, you need a stethoscope and some stickers and a, and
22:40
some safety suckers, and then you should be able to do anything.
22:43
And a unicorn headband. . That's right. Do you, do you have a unicorn headband?
22:47
I, I can't remember if I gave you one. You didn't give me one,
22:50
Dr Christoper Longhurst: but I did pull it out. I've got pictures of us. Will: Oh.
22:52
Oh, that's right. Wow. Oh, that's right. It was homemade.
22:55
You, he made Jared. So I went, uh, just backstory.
22:57
I, I did, uh, the reason Chris, I know each other is, uh, because I came and gave
23:01
a talk to, uh, or both of us did together.
23:04
Yeah. Our whole family. Yeah. We Kristin: brought Will: the kids with us to the, it was all of ucs, like the whole
23:10
hospital was invited and mostly, um, the trainees and med students.
23:15
And, um, and so when I showed up, Chris had fashioned a, oh, let's be honest.
23:21
Did you do it yourself or did someone do it for you?
23:23
Yeah, no, my chief of staff because when you get on, you get
23:27
other people to do stuff for you. Uh, so, um, uh, made their own unicorn headbands, which I was very impressed by.
23:34
Dr Christoper Longhurst: Jared is like Jonathan. I mean, I can't
23:37
Will: live without him. Jared is great. I'm, I'm, I'm impressed that you actually set up your own audio and
23:42
video for this podcast yourself. I assumed I would see him in there.
23:46
Getting it all ready for you. I mean, you don't even drive your own car.
23:49
You let your car drive for you. So , so as your role of the cmo, um, I'm sure you have gotten pretty
24:00
good about managing like difficult confrontations and like, uh, um, what do
24:05
you call it, like conflict resolution?
24:08
Is that a big part of your job? I imagine it. , I would say
24:12
Dr Christoper Longhurst: it's not a small part of Will: my job. Is it? Is it the least your least favorite part of the administrator role?
24:18
Actually, I, I'd like to hear what that is. . Um,
24:22
Dr Christoper Longhurst: the conflict resolutions always come
24:25
up, you know, any leadership role. By the time things, um, get escalated to you, they're, they're
24:30
not easy problems to solve. Right? Yeah.
24:32
And, uh, it's always a trick to understand where people are coming
24:35
from, what they're looking for. Um, you know, good compromise means that nobody's happy.
24:39
Right? And, uh, they can be, um, uh, you know, coming out of a situation,
24:45
you, you can have sort of a win-win. You can't have a lose one because that's always olds loose.
24:49
Mm-hmm. . Oh, so, so lots of opportunities to help people see bigger picture.
24:56
Sometimes the answer is not, uh, no, but not now.
24:59
Um, so a variety of things, you know, have, uh, been effective.
25:04
Basically the same things you use with your patients and pediatrics.
25:07
Mm-hmm. . Or
25:09
Kristin: your children As a parent, I would think it's
25:12
just, that's exactly right. These are all just grown up children.
25:14
So a lot of the same, some Dr Christoper Longhurst: of us not so grown up
25:19
Will: I'd say. I'd say so. That's Kristin: fair. . Yeah, I mean that's what you're doing I think as a parent is just basic, you
25:25
know, this is how it works to be a human and to, to interact socially with people.
25:31
So I think there's probably a lot of overlap. There Dr Christoper Longhurst: are definitely Fridays I go home
25:34
and I think about that book. You know, everything I need to know.
25:36
I learned in kindergarten and I think, man, if we just had some posters of
25:40
those learnings, you know, around the hospital, which would be really helpful.
25:45
, Will: you should do that. Yeah, it could do a little, um, information campaign poster and you
25:49
know, everything you need to know. Just have a
25:51
Kristin: kindergarten teacher come and help with your Oh, that's a good idea with
25:55
Will: decorating your hallways. It's not a bad idea.
25:59
. Um, and so you said you work, you still work, uh, about what, a half
26:03
day a day clinical seeing patients?
26:06
Yeah, that's right. Dr Christoper Longhurst: Um, when I was at, uh, Stanford, I worked as a
26:09
pediatric hospitalist, uh, which was much more of a high acu uh, setting.
26:13
It was something I really enjoyed in the pediatric hospital medicine group there.
26:16
It's fantastic. Part of the reason that I could continue doing that sort of on a
26:20
pretty part-time basis is because it was where I had trained, right?
26:23
I remembered, uh, you know, all the nooks and crannies and I knew all
26:27
the subspecialists and, and how to get things done and who to contact.
26:31
And moving here to uc, San Diego, with a larger administrative role.
26:34
Um, first of all, I knew I wouldn't have as much time to practice clinically.
26:38
And secondly, this is an adult health system.
26:40
So the only, um, pediatrics we have are, are the babies, uh, newborn,
26:45
uh, neonatal intensive care unit. And then occasionally we get pediatric patients in our emergency
26:49
department, in our burn unit, which is the only regional burn unit.
26:53
Um, and so it was a natural transition for me to, uh, go to sink Babies.
26:57
I'll be honest with you, as a, as a resident, newborn
27:00
medicine was not my favorite. Um, stop.
27:03
Oh, really? Um, particularly before you have kids, you know, there's a lot of healthy children.
27:07
Your baby's so beautiful. And then suddenly you have kids and it's a whole different perspective.
27:13
You know what it's like to be in that bed.
27:15
Yeah. All the fears that you're bringing in, all the hopes and dreams.
27:18
And actually I've had a lot of fun doing newborn medicine, uh, uh, down here.
27:22
Um, I spent, uh, about seven and a half years moonlighting at
27:25
neonatal I c u as well, um, before I, uh, paid off all my loans.
27:30
Um, and the painter headband, you know, worked really well.
27:33
Incu setting where I was the Will: moonlighter . But um, that sounds terrifying.
27:38
. Well, I mean, just a neonatal I ICU by itself.
27:41
Yeah, that sounds like the scariest possible place in a hospital.
27:46
Um, uh, and so moonlighting, like being the only, I assume the only
27:51
physician kind of on the unit, right?
27:54
Um, at uh, I don't imagine you were getting a whole lot of sleep.
27:58
No, not a lot Dr Christoper Longhurst: of sleep. I didn't have to wear the headband that much cuz I'd just stay up.
28:02
Babysit the sick kids and go to the delivery.
28:04
So it was a lot of fun and I learned a ton. And, uh, the neonatologist came in when needed.
28:10
But, uh, you know, there were times when you were doing procedures by the book,
28:14
with the book at the bedside , literally
28:17
Kristin: by the book Dr Christoper Longhurst: Yeah. I remember, um, doing one particular procedure and the, the nurse who
28:22
was assisting and caring for the baby looked at me and said, now, Dr.
28:26
Long Nurse, um, you've done this procedure before.
28:30
Right? And I said, absolutely.
28:32
It's not gonna be a problem. . Yeah.
28:35
Kristin: You're cut out for administration, . Will: Yeah.
28:38
I, I think you always got the right answer. I've noticed here, , or at least, at least you have, it's true or not,
28:43
at least you have the answer that'll piss off the fewest amount of people.
28:46
That's right. Very diplomatic. That's, I think that's probably a key, a key part of it.
28:51
Uh, did you, uh, important question.
28:53
Uh, did you ever have to consult an ophthalmologist?
28:56
Yes, in fact, Dr Christoper Longhurst: um, we love our pediatric ophthalmologist in the neonatal
29:01
ICU cuz retinopathy, prematurity is something that can, um, cause blindness.
29:06
As Will: you know, that's also one of the scariest things in ophthalmology.
29:10
And so credit to not only pediatric ophthalmologists, but retina specialists,
29:14
I think it's different with because Kristin: the eyeball, even the adult eyeball is already very small.
29:19
So then, Neonatal sized and then yes, put it at the very back of the
29:24
eyeball and make it even smaller.
29:27
Cuz it's just the retina. Like how do you even
29:29
Will: Yeah, it's a, it's a really difficult thing.
29:32
Um, and actually as a resident, I, I didn't get, I learned about retinopathy of
29:37
prematurity, but maybe once or twice did I ever step foot in a neonatal icu cuz it's
29:42
like a, is as specialized care as you get.
29:47
In fact, I'd say probably most pediatric ophthalmologists don't
29:50
treat r O p because there's only, you know, so many places, right?
29:54
There's not a lot of community hospitals that have, you know, neonatal ICUs
29:58
that can handle that type of care. Um, but it is, it is very specialized and, um, and very challeng.
30:05
very challenging work. So I do not envy the, uh, I'm glad we have shout out to those people.
30:10
My god, that's, that's, that's tough work.
30:12
And, um, and you, I'm also, you, you, as an ophthalmologist, you
30:17
have to go to the hospital, which as we've covered in this podcast, is
30:20
not the easiest thing for us to do. So it's not the easiest thing to find
30:24
Dr Christoper Longhurst: an ophthalmologist to come to the hospital, which is part of the reason we're so grateful for our retinal specialists
30:29
to do, uh, is a requirement for every, every, uh, level three nicu and for
30:33
good reason, because it helps to prevent really bad outcomes in these babies.
30:37
And so, oh wow. Okay. Desperately, uh, needed specialty.
30:40
And it kind of reflects something that, that I love about being in
30:42
this role as well, which is that, uh, as much as everybody likes to
30:46
complain about the electronic health record and, uh, you know, the hours.
30:51
Pit and the staff and anything else they can find to complain about
30:56
Um, ultimately people have all gone to, gone into, uh, this
31:00
profession for, um, a similar reason, which is wanting to help people.
31:03
Yeah. Um, you know, there's lots of other ways to make money,
31:06
um, possibly lots more money. I'm watching this show Billions Now and like, well, if I wanted to be rich,
31:12
obviously I should have been a hedge fund, you know, uh, manager, stock
31:15
Will: Trader, or a Nanny for the Stars. That's right.
31:18
Or a Nanny to the Stars. Yeah, that's right. . Dr Christoper Longhurst: Um, you can get paid quite well if
31:23
you, uh, end up in that role. . Will: Well, I, I, it's, and I'm sure like with the pandemic, it's just
31:28
been so much more difficult having to, you know, navigate some of the issues
31:33
that healthcare workers have about their jobs, about being overworked
31:38
and feeling underpaid and undervalued.
31:40
That's probably just the pandemic's just made that so much more
31:43
difficult, um, uh, to, to, to manage.
31:47
And, uh, but having that. Underlying grounding, you know, um, motivation of patient care I think
31:56
is probably pretty helpful, right? Absolutely.
31:59
To Dr Christoper Longhurst: fall back on that, that's probably what ties us all together.
32:01
Um, but we're definitely in the sea change.
32:03
You know, uh, there were generations of physicians before you and I
32:07
will, who, uh, you know, went into the profession knowing that they
32:11
would essentially be on call 24 7.
32:13
Um, and I remember, um, uh, when I started training and there was a
32:17
transplant surgery fellow, and, uh, he literally took call every day.
32:22
And I, I saw him in the hospital once.
32:25
I was like, where do you live? And he is like, here, . And I was like, no, no, no.
32:30
I mean, are you, you close by? And he goes, well, I have some stuff in a storage locker close
32:34
Will: by. Oh my goodness. You know that that was straight outta one of my skits.
32:38
Yeah. it, it is. And
32:41
Dr Christoper Longhurst: that, that was sort of a, you know, generation of, uh, learners who, who felt there was nobility in that
32:47
complete sacrifice of one's selves. Right.
32:50
Um, in fact, that's where the term house officer comes from.
32:52
Yeah. Right. Um, but uh, you literally live, it's a new, uh, era and people recognize
32:58
the need to take care of themselves if they're gonna take care of others in
33:01
a humanistic and and empathetic way.
33:04
. And so, uh, I think we as a profession and as a society will need to struggle
33:09
with that cuz we already pay so much for healthcare in the United States.
33:13
Um, understanding, you know, well how can we rebalance things if
33:16
it's gonna take more workers to do the same amount of work, uh, that
33:19
there's not a lot of great options. Yeah, Will: agreed.
33:23
Well, let's take a little break and then we're gonna come back with, uh, Chris
33:26
Longhurst, uh, C M O at uc, SD hospital system and we're gonna play a little game.
33:32
It's gonna be fun, but probably also a little bit uncomfortable for you.
33:35
So we'll be right back with Chris.
33:41
Kristen, you know that as an ophthalmologist I don't tend to
33:43
get excited about stethoscopes. I do know that, yes.
33:46
But I have around my neck the Echo Health's 3M Litman
33:50
Core Digital Stethoscope. This thing is incredible.
33:53
It's got active background noise cancellation up to 40 times amplification.
33:58
That's pretty impressive. It. I could practically hear the individual myocytes talking to each
34:03
Kristin: other and I have one too. And mine is rainbow.
34:07
Yours as much cooler than mine. I know. I might just wear it around the house with its noise cancellation so I
34:12
don't have to hear you and the kids. Will: That's fair.
34:15
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34:18
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34:48
All right, we are back with Chris Longhurst.
34:50
All right, Chris, we, Chris Kristin: Christ, you're used to sing.
34:54
Kristen. Will: Kristen. That's right. . Chris, we are going to, uh, play a little game I came up with like last night.
35:00
Um, that's called, do we have the budget for this?
35:04
Do we have the, so what I did was I went to Twitter and I posed a
35:10
tweet, , he's already nervous.
35:12
He's already nervous about this. I, um, I said, uh, okay, you have , you have a meeting with the CMO at your
35:20
hospital, and you can give him that.
35:23
You can give that person one request and they have to fulfill that request.
35:28
All right? What is that request?
35:32
Uh, and the only caveat, I said, you can't ask for more money because I mean,
35:36
like, that's something probably everybody would, would've a and some people still
35:40
asked for that as one of their things.
35:42
Um, and so I just said, you can't ask for more money.
35:44
I got about a thousand responses Chris.
35:48
All right. A a thousand replies and quote tweets about this.
35:51
Uh, and what I'm gonna do is go through some of my favorite, some
35:55
of them, uh, some of also some of the more popular ones that I saw.
35:58
Okay. So. We're gonna start with perhaps certainly one of the most popular, uh, requests of
36:04
the C M O, which would be free parking.
36:08
So, Chris, do we have the budget for this?
36:13
Dr Christoper Longhurst: No. . Will: What's the parking situation at u c ucsd?
36:19
Well, it's funny Dr Christoper Longhurst: you bring that up because that's one of the
36:21
most common complaints that we face, not only from our physicians,
36:26
but also from our, uh, patients.
36:28
Yeah. So, being part of the university, we do not offer freight parking.
36:32
We're not allowed to. We have a parking garage where patients have to pay for parking.
36:37
Oh, no. And, uh, we have, uh, a doctor's parking lot.
36:41
In fact, one of the most angry physicians I, I've encountered that in this role,
36:45
uh, thrown into the, uh, C-suite once bitter about the fact that he'd seen
36:51
multiple people in the doctor's parking lot without the doctor's permit.
36:55
and he wasn't wrong and we, you know, said, Hey, we'll we'll go check into this.
37:00
But that was like one of those deescalating kind of situations that
37:03
you train for and you're active shooter, you
37:06
Will: know, , that sounds like one of those things where you
37:08
say, okay, yeah, we'll look into this, but you never look into it.
37:11
I looked into it in Dr Christoper Longhurst: like in 48 minutes and uh, we actually did a
37:16
cleanup and, uh, put up some new signs and did some patrolling and Gotcha.
37:20
You know, towed all the patients that parking.
37:23
Oh good. Oh gosh. parking sucks.
37:26
You can't Will: solve that one. Parking. Yeah. That's, that's a really, that's a difficult one.
37:29
Parking is, is challenging.
37:32
Um, okay, so the next most common, this is gonna be the hardest one, I think.
37:37
Um, more nurses.
37:40
Increased staffing. Now I, in my practice, like we're, this is a constant thing, trying to
37:45
get more staffing, trying to get more. So, so Chris, do we have the budget for, so I saw some requests are
37:52
like quadruple the staff and which sounds easier said than done, I
37:57
imagine, but, uh, do we have the, do we have the budget for this, Chris?
38:02
Yes and no. Dr Christoper Longhurst: Oh, okay. So the answer on this one is that in California where we have mandated ratios
38:09
of nurses can care for no more than four patients, even in low acuity settings,
38:15
it's actually not a common concern that we get is the round of staffing.
38:18
Mm-hmm. concern we hear is a type of staffing because as you know, we've
38:23
experienced this great resignation. Mm-hmm.
38:25
and nurse staff in particular difficult to hire.
38:29
So we've partnered with local colleges, we're trying to get graduates, but
38:32
everybody wants the experienced, uh, uh, best nursing staff for their patients.
38:38
And so we're always trying to balance, you know, how do we use contractors and travel
38:43
nurses, float pool versus kind of the staff who we can employ schedule, right?
38:48
Mm-hmm. . Okay. Will: Those are, so I didn't realize that there was a, a mandated, a mandated,
38:53
uh, staffing ratio in California.
38:56
That seems like a, a, actually a good idea for other places to
39:00
incorporate because it's a patient
39:03
Kristin: safety. Yeah. How common is that, do Dr Christoper Longhurst: you think? Right. So I can't speak for other states.
39:07
Um, I can say when that passed, there was a lot of support from the
39:10
nursing unions in California, and I'm sure that that's because there had
39:13
been some abuses of staffing ratios and, and appropriate things done.
39:17
Oh, yeah. Um, but it's not always the case that, uh, you know, that
39:20
that improves safety as well. So there's some arguments on both sides.
39:23
It is what it is here in ca. and, uh, you know, keeping up with those ratios is gonna cost a predictable
39:29
amount of money when those nurses are not our employees, but travel nurses
39:35
and the like, who make a lot more, uh, that's when the budget, uh, gets busted.
39:40
Gotcha. In fact, uh, just to, to take a tangent for a minute, uh, I'm quite
39:44
worried the next couple years hospitals are gonna be a difficult position.
39:48
Did you know last year was the worst, um, year on, on record
39:52
financially for hospitals since they kept records really, and over
39:56
half of HO hospitals ran in the red. Um, and it's really, uh, at least three things driving this, right?
40:03
One of 'em is the great resignation and the cost of labor has gone up 10, 12, 13%.
40:08
Mm-hmm. . And that's really difficult to sustain.
40:11
Right. And then combine that with things like more unionization,
40:15
demanding higher wages, et cetera. Mm-hmm.
40:17
The second is the supply chain costs, right?
40:21
So just like your eggs cost more like inflation's hitting the hospitals.
40:25
So now imagine that you're paying, let's say 15% more for
40:28
supplies, 12 to 13% more for labor.
40:32
But then you're gonna negotiate with payers like say Anthem and
40:36
Blue Cross and Blue Shield, and they offer you 1% rate increases, right?
40:41
And hospitals already run on this tiny thin margin.
40:44
So how do you reconcile all that? That's really, really difficult, that it's gonna be a tough couple years.
40:49
Kristin: I think that speaks to something that is on people's minds right now.
40:53
Like I think the, the patient perspective or the, the non-medical or hospital
40:58
perspective is these procedures are so expensive and it costs me
41:03
so much money to come to the doctor or to get a surgery or, or whatnot.
41:08
And I think the perception is that that's because the doctors
41:11
are pocketing that money, right?
41:13
That, that you guys just get paid so much.
41:16
So Chris, can you speak to where does all that money go if it costs so much?
41:21
How come hospitals are in the red. Dr Christoper Longhurst: It's a great question.
41:24
And, uh, we are not pocketing money now.
41:27
Uh, it's not a poorly paid profession. I mean, you, you see the ophthalmologists sometimes walk out
41:31
with cash strapped around in their Will: chest. not supposed to talk that here.
41:35
But, but for the rest of us, um, Dr Christoper Longhurst: you know, the, the, uh, compensation is, or the
41:40
compensation procedures and surgeries and things like that, it's covering
41:44
a lot of different things, right? It's not just the physicians.
41:46
It's all the staffing, the supplies, the electricity, the
41:49
technology, everything that goes into providing care safely, right?
41:53
And in fact, um, you can provide some of the same procedures at lower
41:57
cost in outpatient settings, right?
41:59
And there's been a, a movement towards that, but it's a balance.
42:02
You can't overdo that because sometimes those procedures, while.
42:06
May have complications, and if you have a complication having one
42:09
of those procedures, you better damn well be in a setting where
42:12
you've got the support to rescue. Will: Yeah, exactly.
42:16
All right, well we got a, a number of these, so let's, let's keep going.
42:19
So I'll, some of them, you know, we're only like one or two people asking for.
42:25
Um, so this is from, um, a user, um, at Empiric game said, um, they
42:30
would ask for a second bladder scanner for a seven floor hospital.
42:35
So Chris, do we have the budget for a second bladder scanner
42:38
for a seven floor hospital? Absolutely, yes.
42:42
Okay. You can have what is a bladder scanner. So it's, uh, you gotta, you use a bladder scanner to determine how much
42:48
urine is in the bladder and whether or not you need to do a catheter.
42:53
You know, drain the bladder. Oh, okay. Because it can be dangerous to, man.
42:57
I still remember some of this stuff. Look at, look at that.
42:59
That's bladder scanner is well, bladder scanners for everyone.
43:03
. Everyone gets a bladder scanner. Okay, here we go.
43:05
Um, 24 7 childcare.
43:08
Oh, 24 7 childcare.
43:11
This came from a couple users at Gong Gas Girl asked for it.
43:14
So do we have the budget for 24 7?
43:17
Childcare? 24 7
43:20
Dr Christoper Longhurst: is difficult, but we should be supporting childcare and
43:24
in fact that's something that, uh, is a benefit for us here in the health system.
43:27
Being part of a university. There is childcare for university employees and so it's definitely not 24 7.
43:34
That would be hard to do. Um, and Will: that's something that we should be.
43:37
Kristin: Awesome. Well, and I, what's the implication there?
43:39
Like, are, are they asking, asking for free childcare because they work here or?
43:45
Will: I think everybody would love expensive, cheap, would
43:48
love affordable childcare. I think probably affordable childcare.
43:51
Kristin: So if the university employee childcare is still prohibitively
43:56
expensive, is that helpful?
43:58
Will: Yeah. I don't know. I just don't, I don't think like, and certainly have, you know,
44:03
single parents who would, who potentially would benefit from like
44:07
an overnight childcare situation. But, uh, that would be, or if you're the night shift, um, or if you're anybody
44:13
but an ophthalmologist . Um, okay.
44:15
Uh, let's see. Let's do it now. So, um, here's one.
44:19
Uh, forgive all medical debt.
44:24
at pkk.
44:27
Asked for that. Uh, so Chris, do we have the budget to forgive all medical debt?
44:33
Absolutely not. I was, I was afraid you'd say that
44:35
Dr Christoper Longhurst: for keeping medical debt is beyond the scope of the Chief Medical
44:38
Will: Officer You don't, you don't have the authority to make that decision.
44:43
No, I Dr Christoper Longhurst: do not. But that's probably good advocacy for our US Surgeon General and,
44:47
and other healthcare leaders and, uh, the federal government.
44:50
There Will: you go. There you go. So ask those people for sure.
44:54
Don't ask your local C M O, uh, because they won't be able to accomplish that.
44:58
Uh, non-dairy creamer in the doctor's lounge.
45:02
Some people had a little bit more of a, um, uh, got a, a higher
45:08
level view of, of this question. . So non-dairy creamer in the doctor's lounge.
45:14
Absolutely. Do we have the budget for that? We do.
45:16
I, you know Dr Christoper Longhurst: what knowledge, and we have the budget.
45:18
Sharon's gonna go do right Will: now, Um, alright.
45:23
I got, uh, just a few more. I really actually like this one, a nursing level family or patient liaison for
45:31
each specialty available to be contacted for up to two weeks post discharge.
45:37
I love that. I think that's a great idea.
45:40
I love that as well. Dr Christoper Longhurst: Um, we have a, uh, family and patient experience
45:45
team and uh, they actually do provide services along those lines, sort of
45:49
an Obed Smith person kind of role.
45:51
Um, can review things, provide advice, et cetera.
45:54
So, um, I think that's a really important, um, opportunity for
45:59
any health system to provide. And there's actually some regulatory requirements around it.
46:03
For example, did you know that every written complaint
46:06
requires a written response? Oh,
46:08
Will: really? No. I did not know. Kristin: Is it common for, for hospitals to have those sorts of things, or
46:15
is that just like a perk at U C S
46:18
Dr Christoper Longhurst: D? I would say that it's universal for hospitals to have those sort of things.
46:21
The, the question is what is the culture?
46:23
How is it resourced and staffed? Yeah. Is it a complaint department, you know, uh, that's reporting through legal.
46:29
That gets back to written complaints. Is it a patient and family experience department?
46:33
Um, and not to boast, but I think we've done a good job of really trying to,
46:37
you know, um, align with patients and, and be advocates for the right care.
46:41
Because truth be told, uh, we don't always provide the right care.
46:45
Right? And there's a lot of, uh, opportunities to learn from
46:47
Will: that. And what's great is that Chris is personally responding.
46:50
He's doing the right, the written Kristin: response. It stays up at night, the written complaints, right?
46:54
Handwritten. Will: So thank, thank you for that.
46:56
That, that's exactly correct. , . Um, so this next one came from, uh, uh, McLemore.
47:03
Mr. Actually, uh, several people said this.
47:06
Um, they would ask for the resignation of the CMO and the abolishing of the position
47:15
Maybe if we did that, then we'd have a little bit more money for non-dairy
47:18
creamer in the doctor's lounge. Or maybe we could have
47:21
Dr Christoper Longhurst: both, but I hear you . Um, it's funny how easy it
47:26
is to, uh, point at others and, uh, find, uh, problems instead of solutions.
47:32
But, uh, you know, it takes, uh, people in leadership roles to
47:35
help make, uh, health systems run. Yeah. And uh, from my perspective, the more physicians who have trained and come
47:42
up through, uh, the same, you know, practices, we all have that, that
47:45
are representing that the better. Right. I think
47:48
Will: it's a deeper understanding. Yeah. And that's a refrain I heard a lot with the response to this tweet
47:52
was, you know, more, more people who have taken care of patients who have
47:57
been in the system, you know, really helping people in that way, moving into
48:03
leadership roles, which I agree with. I think that's a great, uh, uh, thing to have both perspectives, right?
48:08
To have that patient care perspective.
48:11
Dr Christoper Longhurst: Um, yeah. Well we were talking earlier about kind of the sea change in medicine.
48:14
Right. You know, uh, generations have moved through.
48:17
And, uh, I remember hearing about the sea change in hospitals
48:21
from, uh, one of my former CEOs.
48:24
And, uh, he was talking about the fact when hospitals started, it was really
48:28
like the late 18 hundreds, right? Some of the first hospitals in the United States and who ran
48:31
the hospitals, doctors, right?
48:34
Yeah. And, uh, doctors owned and ran hospitals right up until the fifties and sixties.
48:39
And that's when this idea of healthcare administration again,
48:41
came about, um, concomitant with the advent of cms, uh, you know,
48:45
which was signed in the law in 1965. And, uh, by the eighties and nineties, this concept of kind of managed care
48:52
and, uh, you know, health maintenance organizations peaked, right?
48:56
Mm-hmm. . Um, but his prediction was that, uh, we would see the pendulum begin to swing
49:00
back with more and more physicians helping to lead, you know, health systems.
49:04
I, I wanna be clear, I've worked with some amazing healthcare administrators
49:07
who don't come from clinical backgrounds. Um, my CEO has a master's in public health and she's phenomenal.
49:12
One of the most empathetic, you know, um, healthcare leaders I've worked with.
49:16
I also think that having more clinicians, physicians, nurses,
49:20
and others in leadership roles will be good for healthcare as well.
49:24
Will: There you go. Uh, and then, uh, you got two more.
49:27
All right. This came from at Harlem Medic, uh, double Ply Toilet paper.
49:33
. Do we have the budget for Double Ply Toilet?
49:37
Dr Christoper Longhurst: You know, that's a phenomenal idea. We don't have the budget for it in all bathrooms, but we have the
49:42
budget in the doctor's lounge, . Will: Oh, that's it.
49:47
The rest of you? Uh, I don't know.
49:50
Use, uh, bring a towel. Kristin: Bring your own, yeah, . Bring your own double ply.
49:56
. Will: Oh, no, . Oh.
49:58
All right. And, and one more. The last one. You know, a lot of people asked for this.
50:02
This is probably the most, uh, common request, a functioning slit
50:06
lamp in the emergency department. By a lot of people.
50:10
You mean you, oh, maybe I, yeah, I don't know.
50:13
Yeah, it's, you know, I just, I saw it, uh, in my head and so I
50:17
assumed everyone else was asking for it as well, so, um, yeah.
50:21
Yeah. You Dr Christoper Longhurst: know, I think it's really critical that
50:23
every emergency department has a functioning sweat lamp and that every
50:27
newborn nursery has a functioning, transcutaneous bilirubin, uh, checking,
50:31
Will: uh, machine. You heard it here first.
50:33
All right. This is coming from, uh, a Chief Medical officer at a major health system.
50:39
Every emergency department needs to have a slit lamp and whatever it is that he said.
50:44
That's the second thing. . . All right.
50:48
Thank you so much, Chris. So we're gonna, uh, come back here in just a second with, um, our, uh, a couple
50:53
of fans stories before we let you go. Okay.
50:55
Be right back. Sounds great. Okay.
51:01
Let's take a look at some of our favorite medical stories that were
51:04
sent in by you, the listeners. We still have Chris Longhurst here.
51:07
He is gonna listen to these stories with us.
51:10
All right. So we have, um, uh, this is an anonymous story.
51:13
As a pre-med student in undergrad, I worked.
51:16
Urgent care clinic as a medical assistant, one particular patient encounter will
51:20
always stand out amongst the rest. As I began triaging this patient who was complaining of a sore throat, she
51:26
asked if she could get a covid test as well, not thinking much of it.
51:29
I asked her if she had any known sick contacts.
51:31
Recently the patient replied that she hadn't been around anyone sick,
51:35
but she was concerned she may have contracted Covid 19 from her pet hamster.
51:41
Apparently the hamster had seemingly died, so she administered C P R with
51:46
mouth to mouth rescue breaths to it.
51:50
Miraculously, she told me that she was able to successfully resuscitate
51:54
her pet hamster, but it died anyway.
51:57
Shortly after she was at least comforted to learn that she could not contract
52:01
covid from her beloved pet boy.
52:03
Did our scribe get a thrill out of typing up that H P I?
52:07
I, this is incredibly impressive to me.
52:10
See, like, can you, ima like CPR on a, on a hamster, successfully
52:15
resuscitate a hamster. I, whoever sent that in, I, I'm, I am, I'm just very impressed.
52:21
By that, if you're listening to this, you should write a book about, um, or at
52:26
least a guide on hamster resuscitation.
52:28
In my opinion, that's quite Dr Christoper Longhurst: a story. Isn't that great?
52:31
Although it's possible, the hamster died of attention nemothorax after the resuscitation
52:34
, Will: it's, Hey, you know what? At least the hamster got a few more minutes.
52:39
Um, so there you go. I like that.
52:41
That's great. All right, Alex. Uh, this is a story from, um, uh, user Alex.
52:46
Uh, I have a medical story from my intern year.
52:49
On my first overnight shift, my resident went to take a nap and
52:52
left me the phone being nervous.
52:55
When I got a phone call for an admission, I quickly write down patient information
52:59
and ran to wake up my resident.
53:01
Unfortunately for me, my resident was sleeping on the futon in
53:05
our conference room, which had a glass door that was closed.
53:08
I didn't see the door and ran into it hard enough to split open
53:12
the skin just above my eyebrow.
53:15
I grabbed some tissues and thought I was able to stop the bleeding
53:19
before we went to see the patient. But after we got back to the workroom, I saw blood had actually
53:23
been dripping down my head. Oh no. Probably the entire time I had to go back to the ED for stitches
53:30
and only have a small scar. . I like that this the, there's an assumption here that the, that we have to
53:38
make as the listener, uh, that the patient noticed blood dripping down their doctor's
53:43
head and did not say a word about it.
53:49
Oh, man, that's great. We all have stories.
53:51
I, I, I love like trainee story, like stuff like that.
53:54
I feel like it only happens to like, people in training.
53:57
It's, it's great. We all have stuff like, not like that, but, you know.
54:00
Anyway. All right. Thank you for those stories.
54:03
Send us yours. Knock, knock [email protected].
54:07
Chris, thank you so much for joining us.
54:09
Uh, it's, it's really, I, I love chatting with you and I love hearing your
54:13
perspective on all things administration.
54:16
Kristin: Thanks for giving us some of your time on Jared's busy day.
54:18
Yeah, Will: you Dr Christoper Longhurst: bet. And thank you guys for, uh, everything that you do.
54:22
It's really, uh, making a difference. Now, do Will: you have something that you want to promotes?
54:25
Anything going on in U C S D? I understand there's a, um, you've got a, a new Center for
54:31
Health Innovation, is that right? Dr Christoper Longhurst: Yes, we do.
54:33
In fact, uh, we're just preparing to announce, um, a large gift for
54:37
Center for Digital Health Innovation. Which is really going to be taking advantage of these new technologies
54:42
to transform the way we deliver care. So, um, besides you on Twitter, a lot of the other chat has been about chat, G P T
54:50
and all the amazing responses it can have.
54:53
Let's think about in a meaningful way, how.
54:56
AI and other types of technologies can help support
55:00
the delivery of better patient Kristin: care. Is Jonathan gonna be replaced by chat?
55:04
Will: G p t? Uh, I think Jonathan might be the author of Chad gp.
55:08
He might be chat. He might, he is Chad gp.
55:10
G T p. Nope, it's possible four.
55:13
Dr Christoper Longhurst: Jonathan got into medical school, . Will: Well that is, and that is health innovation.ucsd.edu.
55:20
If you wanna check that out. And Chris, we can find you on Twitter.
55:23
You are Follow this guy. He is, he is.
55:26
Great. Um, Chris Longhurst, I'm not sure what your handle is, but Yeah, I think you're
55:29
the only Chris Longhurst out there. So ca longhurst ca longhurst, that's what it is.
55:34
All right. Well, thanks again for being here and we'll let you go back
55:37
to your very important busy job. Take care.
55:45
Oh, it was so much fun talking to Chris. Yeah, he's a blast.
55:49
Yeah, it's, you know, it's, uh, I appreciate people who can
55:54
kind of laugh at themselves. Mm-hmm. , and I mean, I'm pretty like merciless to, to like CEOs and stuff and people in
56:00
these, in, you know, leadership positions, uh, you know, uh, in my, in my content
56:06
and making skits and I, I appreciate that someone like him can see the truth
56:13
in it and still laugh at themselves.
56:15
And so, um, but it was really cool to hear his perspective on
56:19
a lot of the common issues that people are having in healthcare.
56:24
Kristin: Yeah. And you can tell that he, like, he cares.
56:26
Right. I think that's what makes a good healthcare administrator is that
56:29
empathy and, and being able to take different perspectives.
56:32
And I think where, where it can go wrong is when you don't have that and.
56:37
Will: I still think he could, you know, he could probably forgive all medical debt.
56:41
I, Kristin: I don't, oh, I was gonna say, he could probably spring through the two play . I mean,
56:46
Will: at least the two-ply. Yeah. And then we'll talk about forgiving all the medical debt.
56:50
All right. Um, so, uh, yeah, thanks for, uh, thanks to Chris and, uh,
56:56
thank you for the stories. Uh, and if you have any other stories to share, please let us know.
57:01
All right. We wanna, uh, hear what you thought about the episode.
57:04
Uh, do you want us to bring on more hospital administrators?
57:07
Do you like hearing, uh, their perspective on things?
57:10
Do you know other people that we should have on?
57:12
Let us know. All right. Hit us up in the comments. Uh, there's other ways to hit us up as well.
57:16
Uh, you can email us, knock knock high human content.com.
57:20
You can visit us on our social media platforms, YouTube, TikTok, Twitter.
57:25
Uh, you're on Instagram kind of.
57:27
Kristin: Yeah. I'm, I'm trying. Get a little more active, have a great Instagram plans for, for the
57:32
Instagram, but it's, I can only Will: handle so many social media platforms.
57:36
I know it gets to be a lot. Uh, and, um, let's see.
57:39
You can also hang out with us and our human podcast, human Everything, human
57:44
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57:50
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Uh, thank you all and thanks for listening.
1:00:04
We're your host, will and Kristen Flannery, also
1:00:06
known as the Glock Flecking. Special thanks to our guest, Dr.
1:00:09
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