Taking Healthcare by Storm: Industry Insights with Dr. Peter Angood

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Peter Angood, M.D., FRCS(C), FACS, MCCM, FAAPL (Hon), the current President and CEO of the American Association for Physician Leadership (AAPL).

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-GEN-102524-GK

Transcript

Welcome to Taking Healthcare by Storm, Industry Insights, the podcast that delves into the captivating intersection of innovation, science, compassion, and care.

In each episode, Quality Insights Medical Director, Dr.

Jean Storm, will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys.

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania, and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello, and welcome to another episode of Taking Healthcare by Storm.

I am Dr.

Jean Storm, the Medical Director at Quality Insights.

And today, I am thrilled to be joined with Dr.

Peter Angood, who is the CEO and president of the American Association for Physician leadership.

He has an impressive career spanning trauma surgery, patient safety, and leadership in healthcare.

Dr.

Angood has been a pivotal figure in advancing medical practice and improving patient safety outcomes.

From his role as the inaugural Chief Patient Safety Officer at the Joint Commission to advising the World Health Organization and the Agency for Healthcare Research and Quality, AHRQ, his insights are invaluable.

He's also a prolific author and speaker, sharing his expertise through two recent books, All Physicians Are leaders, which was published in 2020, and Inspiring Growth and leadership in Medical Careers, Transform Healthcare as a Physician leader in 2024.

Today, we will dive into his wealth of experience and explore the critical intersection of healthcare leadership and patient safety, which just happened to be two of my favorite things.

So I am very excited to get started with this conversation.

Dr.

Angood, thank you so much for joining us today.

Thank you, Jean, and I certainly appreciate the opportunity to be here with you.

I look forward to the conversation.

Great.

So let's just dive in.

Can you share with us your journey to becoming the CEO and president of the American Association for Physician leadership, and how your career experiences have shaped your approach to physician leadership?

Yeah, sure.

Well, first off, career development is an unpredictable thing, and careers are fascinating.

So certainly, when I was younger, I did not ever think I was going to be running a professional association.

So I say that for anyone who's listening, just to always be open minded about how your career might progress, because the opportunities show themselves, you just have to be ready for them when they happen.

So yeah, as you mentioned, I started out as a trauma surgeon, surgical critical care, came out of the Canadian system at McGill, and then pursued academia.

I was at Penn, Yale, WashU, a couple of other places, and I really enjoyed academia and did the usual sorts of things, you know, your clinical work and your research, your educational and teaching with residents and students.

But as I got into mid-career, I found myself thinking more about systems and processes and larger scale change.

And if you think about it, a trauma system is, or trauma center is a large system from pre-hospital, in-hospital, post-hospital, post-acute care, long-term rehab.

And so if those aren't working properly across that continuum, then you haven't got a great trauma center.

So that type of thinking started to be of more interest for me.

And I was very fortunate.

I was able to shift out of my clinical career and move over to the Joint Commission.

And as you said, I was the first Chief Patient Safety Officer there.

And that was kind of eye-opening for me.

It provided me the insights as to where are some of the levers and pulleys that really shift how we have to think and work in the clinical delivery system.

So yeah, accreditation is one of those levers and pulleys.

Finances is another one, obviously.

And there are a few others, but, you know, there's a larger enterprise out there that's influencing our industry much more so than we ever appreciate as frontline clinicians.

I was fortunate in that the era where I was doing that was relatively soon after the Institute of Medicine reports to Iris Hume and et cetera.

And so we were able to also do a lot of international work.

And then as well, the World Health Organization was setting up its patient safety activity at that time also.

So we got involved there.

It was fascinating work.

We did a lot of good stuff.

I was one of the pivotal characters to implement those national patient safety goals, which are still around, pretty much the same goals as what we started with.

And got some deeper insights through the sentinel events that occur out there, et cetera.

So just a wonderful experience.

And as I moved on, I then went to the National Quality Forum, which is the measurement side.

NQF endorses measurements, and I looked after a lot of their safety activities as well, including looking at the so-called never events and what should be, should not be happening in that realm.

Interestingly, I took a very brief interlude and spent a bit of time with GE Healthcare and ran their patient safety organization.

But in each of those experiences after my clinical career, I was fascinated.

It's all fine and dandy to be involved with those kinds of organizations, developing cool, good stuff, and then trying to implement them.

But I always felt there was a lack of true understanding as to what goes on in the front line.

And so as I thought about next steps, I was looking for something in the gap zone between that policy development level, if you will, and the front line.

And this organization, American Association for Physician leadership, is one of those.

It's right in the middle there.

We pay attention and influence what's going on in the policy level, but we also clearly impact and influence what's going on on the front line.

And I've been in the role about 12 years, and it's just been a wonderful time.

So thank you for asking.

Yeah, I really feel that there is a huge need currently for building physician leadership.

I think that this is going to be the wave of the future.

And in your book, All Physicians Are leaders, Reflections on Inspiring Change Together for Better Healthcare, you emphasize the role of physician leadership in transforming healthcare.

So what inspired you to write the book?

And what key messages do you hope physicians will take from the book?

Well, you know, at some level, all physicians are leaders.

And if we think about us as individuals, any physician, when they interact professionally, when they interact personally, when they're in their family, there's a little shift that occurs that people look at you a little bit differently.

And when you back away from that, the medical profession is still very much viewed as a leadership profession.

We're still on a little bit of a pedestal.

The society entrusts us.

They do trust us.

They share intimate details.

And so they expect us to be leaders.

And yet, as we all know, you don't get any leadership management stuff in medical school or residency programs, and you're lucky if you get exposed to it in your own early stages of career.

But at some level, all physicians are actually leaders.

Doesn't mean all physicians can become great leaders, but we have to help the physician workforce better appreciate that role and responsibility.

And yeah, so I write some essays from time to time, and as things moved along, it made sense to put the book together to try and reflect not only some of what I just described, but hopefully to give a few insights as to why physicians should pay attention to leadership and how they can.

It's not the deepest book, I would say, but it's got some pearls and some insights.

And as I continue with my writing, I'll try to provide deeper insights so that folks can figure out, well, what is it that I can truly take to my own personal and professional lives so that I can help to create the change that's so significantly needed in healthcare as an industry?

Absolutely.

And given your extensive experience in patient safety, can you elaborate what you feel are the most critical patient safety issues that are facing healthcare organizations today?

And what, maybe some simple strategies that can be implemented?

Oh, you know, if I had the answer to that, we wouldn't still be sitting here 25 years later, thinking, oh, we've got safety and quality solved.

No, we don't.

We don't.

And that's the issue, is, you know, here we are 25 years into the current era of safety and quality in healthcare, and we're still dealing with this 10 percent major error rate.

We're still dealing with efficiency problems.

We've now in the last decade or so, learnt more about errors and diagnosis.

And so, you know, safety, quality, efficiency, and now value are all very much clearly on the forefront of everyone's mind.

But the difficulty is trying to create the systems and processes that are effective enough in creating those shifts in safety, quality, efficiency, and ultimately value.

And so, you know, I could go, the national patient safety goals that I mentioned earlier, the same goals are still in place.

When you go look at the data on those individual goals, the rates of those problems are still reasonably high.

So we have not to focus in on a topic or an issue.

Yeah, wrong side surgery shouldn't happen.

We all know that, but it still does.

So it's the systems and processes that we need to continue to try and stay focused upon.

And it's not from doing it from a mandated top down way.

We do need to do better and better at engaging the frontline workforce in developing the systems and processes, providing the information and the feedback into those systems and processes, so that we can then ultimately create and improve the systems and processes to deliver better care, but also to provide a happier, healthier workforce that are trying their best to provide good quality care.

And ultimately, the patients are the ones that benefit overall.

Absolutely.

And speaking about frontline staff, the COVID pandemic significantly impacted healthcare systems worldwide.

So from your perspective, what lessons have we learned about leadership and patient safety from the pandemic, just in helping us prepare for future public health crises?

Yeah, you know, we're all going to be referencing back to the pandemic for quite some time yet.

And the reason is that it highlighted several of the issues in healthcare in a much broader daylight, if you will.

We already knew about workforce being worn out.

We already knew that systems and processes were difficult.

We already knew that supply chain was not the smoothest in healthcare systems.

We already knew that disaster management was difficult to navigate.

We already knew public health was already an important issue.

We already knew that trust wasn't fully there across all the ethnic groups in the country.

So the pandemic served us well by highlighting a lot of those different, I'm sorry, difficult and sensitive topic areas.

On the other side though, many places, delivery systems, federal, state agencies, and a variety of different companies that are in the various sectors of the industry, recognized that physicians and physician leadership was critical in terms of trying to, how do we recognize what's going on?

But more importantly, how do we then react to what's going on?

And I was impressed at how often the physicians were viewed as the ones to help lead through those crises, regardless of which environment you were in.

Now, that's not to discount nurses, pharmacists, all the other clinical providers, and it's not to discount the non-clinical administrators.

They're all critically important.

But that reliance on physician leadership and the guidance that physician leaders provide came through strong through the pandemic.

And so part of what we all now need to do is to leverage that understanding to now continue post-pandemic getting to the serious work of creating the change in all those areas that I mentioned a few moments ago.

Yeah, I would agree.

Physician burnout really came to the forefront during and after the pandemic and continues to be a prevalent concern in the entire healthcare industry.

So how can physician leaders effectively address and mitigate burnout among their colleagues?

It's such a difficult problem.

And what organizational changes are necessary to really support physician well-being?

Right.

I think one of the things we have to recognize as physicians, we don't have the lock as the only professional group that's got the stress, anxiety, burnout happening in it.

It's actually a society-wide set of issues that are going on out there.

Even as we know, the younger women and the younger kids out there are having the higher levels of anxiety and stress, suicidality compared to previous generations.

So there's a societal set of issues evolving here.

But the healthcare workforce, whether it's physicians, nurses and others, they seem to be feeling it more severely and acutely compared to others.

And so the physician workforce is particularly prone to this problem.

And we all know the stats.

You know, it's a third, it's a half, it's two-thirds of physicians have some level of burnout symptomatology going on.

And so yeah, we need to pay attention to it.

And we also now know it's not just about telling people to be more resilient.

It's not just about telling them to go have a yoga class or take some deep breathing exercises, etc.

It's much deeper than that.

And it does, I think, still come back to, how do we focus better on safety, quality, and efficiency?

How do we better focus on the patients and optimal delivery of care?

And while we do that, how do we better engage physicians in other clinical disciplines, but physicians in particular, in creating the processes of change in the environment they work in?

By getting involved with the processes of change, it provides that broader context for the physicians, okay, I get it.

Now I better understand why this is so complicated to create a change in a system.

But it also then gives them the opportunity to contribute to creating the change, then seeing how those suggested changes evolve in an organization, and then shift and adjust, shift and adjust.

And so that broader context of the complexity of our industry, the complexity of our delivery systems, can help offset some of that frustration that you get when you just show up to work, and you feel like you're beating your head against the wall all the time, because you can't get your patient to get their lab test properly, and you can't get the results back fast enough.

So let's engage the workforce in the processes of change.

Let's provide them with the broader context.

Let's not just tell them to work harder and go pat the dog in the meantime.

I would agree.

Engagement and empowerment are two very important things.

So with your background in academic trauma surgery and critical care medicine, what advancements in patient care are you most excited about for the future?

When I was in the earlier parts of my career, I remember a couple of times thinking, now, this stuff never changes.

This stuff never changes.

Disease is disease and I'm still making the same diagnosis, and we're still doing the same surgery.

But now that I'm older in my career, you realize decade by decade, there's a lot that changes.

And it's not just the science and the life sciences approaches to the healthcare, but it's the technology as well.

And so the pace of change is far more dramatic than it was a decade ago.

And it's on several, several levels, right?

It's, I think, you know, pharma, obvious one, genetics, unobvious one, technology and the different types of devices that are coming along for the surgical or the procedure-based specialty.

You know, the minimally invasive surgery is getting more minimally and minimally and minimally invasive.

And that's wonderful.

And then you can't have a conversation about this without mentioning generative AI.

And I think there are so many levels that that's going to impact us.

And that'll get into the robotics, that'll get into a whole variety of, I'm sorry, as yet unknown or unanticipated ways.

Yeah, the early stage stuff, it's all about, you know, how do we create better efficiency?

How do we work with the medical records?

How do we generate new ways of ambient listening and generating notes and recommendations, et cetera, et cetera.

But it also impacts all the other elements in a delivery system, finance and accounting, you know, supply chain, ordering, nursing, et cetera.

So I don't want to get preoccupied with generative AI because everybody else is.

But the overall pace of change is fast.

And it's in all elements of care delivery.

And so we as a workforce, especially as physicians, not only need to recognize that pace of change is happening, we need to be able to shift our own approaches so that we're keeping up with the pace of change as we try to deliver better care.

But it also is creating the necessity for how we define what the physicians do in the clinical delivery system, as well as how do we better define what physicians could or should do in the non-clinical sectors of the industry as well.

There's terrific opportunity out there.

There's so, so many ways.

Yes, I agree.

Shifting, I guess, to an opposite subject from AI and technology, I've read that you're involved in outdoor-oriented organizations, such as the wilderness Medical Society and the American Alpine Club.

I'm really interested in hearing how your outdoor experiences inform your approach to leadership and decision-making in the healthcare industry, if at all.

Yeah, you know, we all need something else in our lives, separate from our professional identity.

And I think, you know, the younger generations are doing us all a favor by pushing into better work-life balance, work requirements, and the pursuit of other non-professional approaches for a broader, more healthy, holistic lifestyle.

And everybody will find their own formula that works.

You know, in the physician workforce, there's a good percentage of physicians are highly creative, whether they're artists or writers or whatever.

But there's a whole variety of other ways that you can find these ways of enriching yourself as a human being.

And it's really, you know, at the end of the day, it's growing your soul so that you're just a better, holistic person for yourself, for your family, for your friends and for your coworkers.

So for me, I find that pursuit towards nature as refreshing as possible.

And I've done that all through my career.

Yeah, I spent time doing this so-called endurance sports, marathons, triathlons, all those things.

But I've also spent a lot of time just doing the simple things like hiking, mountain biking, just being out there in nature.

And I do that probably three, four times a week.

And when I get longer breaks, I'll make sure I'm out there in nature a little bit longer because it rebalances me.

And it helps me freshen up my own perspective of myself.

And I know when I'm happier and healthier with myself, then I'm happier and healthier with others.

And it impacts what I'm trying to do in leadership and what I'm trying to do in terms of our own workforce and our organization.

Because this association of AAPL is impacting others in such significant ways.

So I've got to be happy and healthy.

The workforce has got to be happy and healthy because they're the ones trying to help other physicians become happier and healthier in their lives.

And I think that is such simple, basic, but just very good advice for anyone in leadership and healthcare in general.

So last question, looking ahead, what trends do you foresee in physician leadership and healthcare management?

And what advice would you offer to emerging physician leaders who are seeking to make a positive impact in the future of healthcare?

I think there are a lot.

And I know that they would love to hear your advice.

Yeah, I'm privileged.

I do continue to mentor a few medical students, and I am continued to be impressed and reassured just with those interactions, but also the data that I see as well.

The types of folks going into medicine are still very much altruistic, idealistic.

They want to help create a better health for people.

They like helping people.

They're interested in the science of medicine, and they want to create change in a whole variety of ways.

Unfortunately, the medical education system is far slower moving than the clinical delivery systems.

And so there's a discrepancy between how fast education evolves and how fast the delivery systems evolve.

So, there's a lot of students and trainees out there who aren't getting any leadership or management.

And yet, on a grassroots level, they, as students and residents, know and oftentimes want some of this leadership and management.

And so the advice is, yes, you want it, but you're going to have to seek it out.

And it can be simple experiential type of learning, get involved with a committee or some type of change initiative, or it can be educational and seek out some additional opportunities to learn.

Our own association has got a whole wide variety of opportunities for trainees, but any early career person.

We have stuff from early career stage all the way up to late career stage stuff.

So a group like ours is a wonderful resource.

But it's more about seeking out that experiential and educational opportunity to then foster your insights, learn about yourself, what your true aptitude is for the leadership, and then figure out how to grow a path that provides you the opportunity to grow your leadership potential, to help influence others, and then to help create the change that is really needed in healthcare.

So at this point in time, Jean, that patient-physician relationship is still the dominant driver in healthcare.

And yes, there are other important clinical disciplines in the industry, but that patient-physician relationship is the dominant driver.

And so we as physicians in our leadership roles need to leverage the importance of that relationship.

And the industry more and more is looking for physicians to be the leaders to drive the change.

And I think the receptivity of non-clinical administrators, healthcare delivery systems, or physicians to be CEOs, physicians to be leaders of other types is the strongest it's ever been.

So the opportunity is here.

Let's take it.

Absolutely.

Such wonderful advice.

Dr.

Peter Angood, thank you so much for joining us today.

I know you are busy, and I appreciate you sharing your insights with us so much today.

We will certainly link the American Association for Physician leadership in the podcast for any physician who is looking for information on leadership.

And there's so many wonderful resources available there.

But again, thank you so much for joining us today.

Thank you for the opportunity.

I very much enjoyed chatting with you.

Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director, Dr.

Jean Storm.

We hope that you enjoyed this episode.

If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.

We would love to hear from you.

So until next time, stay curious, stay compassionate and keep taking healthcare by storm.