Licensed to Lead
43 episodes - English - Latest episode: almost 2 years ago -Join host Patty Fahy, MD as she shares the evidence for why physicians must lead healthcare and lead us out of the current healthcare system morass. Patty has twenty years of experience working with leaders in healthcare—as a member of an executive team, founder of a successful coaching and consulting firm, and as a committed physician advocate. This podcast is for you if you want expert physician leaders at the helm of U.S. healthcare systems and if you want practical advice and critical conversations about honing the leadership skills of physicians.
The Licensed to Lead Podcast offers new angles on the neuroscience of leadership, challenges a “burnout industry” that is profiting from physician burnout, and offers a no-holds-barred investigation into the business school mindset that puts profits over patients. Patty and her guests provide provocative and clear recommendations for changing the business of medicine so that it fulfills the professional obligations of medicine.
The physician identity is deeply rooted in doing the right thing for patients. It is time for the financial preoccupation that arises from a business school mindset to be subordinated to the professional obligations we have to patients. Find out more about Patty and Fahy Consulting at LicensedtoLeadPodcast.com.
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Episodes
042 - Dr. Susan Rogers Tells Senate: Don’t Hand Medicare to the Profiteers
June 07, 2022 07:30 - 51 minutes - 70.8 MBCommunity, connection, purpose: these values are almost palpable even in a virtual conversation with Dr. Susan Rogers. Dr. Rogers is an internist, educator, and activist on behalf of those who suffer when profit motives bulldoze the institutions that are meant to serve the public. A neon example of a public good which has been targeted by profiteers is traditional Medicare. As president of Physicians for a National Health Program, Dr. Rogers is fighting back against the shape-shifting strateg...
041 - Mining Mintzberg for Management Gold
May 17, 2022 07:30 - 54 minutes - 75.2 MBMcGill Business Professor Henry Mintzberg is the author of 20 books on management, creator of two revolutionary international management programs, and the recipient of a mountain of accolades and honors for his thought leadership in the business world. Mintzberg minces no words in his pointed criticism of current approaches to management training and the behavior of those in management and leadership positions. In this interview, Professor Mintzberg comments on the value of an MBA in providin...
040 - Stanford Physician Writes the Book on Wellbeing
April 26, 2022 19:24 - 46 minutes - 64.4 MBAuthor and certified lifestyle medicine physician, Iris Schrijver, MD, describes a fulfilling and fast-paced academic career at Stanford as a full professor of pathology and director of a molecular genetics research lab. A few years ago, in an unlikely turn of events, an opportunity to design a leadership project ignited her long simmering interest in wellbeing. That project culminated in a 2016 research article An Exploration of Key Issues and Potential Solutions that Impact Physician Wellb...
039 - Attorney Drops Truth Bombs about Physician Employment Contracts
April 15, 2022 12:40 - 1 hour - 83.3 MBAttorney and author Dennis Hursh helps physicians navigate their employment contracts. He describes his shock early on in his career when he saw the lopsided language in the contracts offered to his highly trained physician clients. He points out that no hospital executive would ever agree to such contractual language for themselves. A sampling of items Mr. Hursh considers “insane”: - 24 hour call shifts (and by the way, you will work the next day, too) - The employer will decide if you’re d...
038 - Physician Leaders Ask about Influence and Incentives
March 22, 2022 18:46 - 16 minutes - 15.4 MBIn response to listener questions and comments, we dive into two topics in this episode. The first is influence, especially when managing “up” or when dealing with a high profile colleague. The second topic is incentives. Podcast episode #35 featured Alfie Kohn who surprised listeners when he described the negative impact of incentives on intrinsic motivation. We discuss a model of influence from the work of Jay Conger, who wrote extensively on the topic of influence including his bestsell...
037 - Physician Ownership and Group Wisdom Prevail Through Crises
March 08, 2022 23:50 - 54 minutes - 50 MBChristopher Obetz, MD, is the CEO of an organization which started with a handful of physicians 30 years ago, and now they have over 150 physicians and APPs. The group staffs nine emergency rooms in the Minneapolis St. Paul area. One year ago, Dr. Obetz was my guest on Episode #15 (Title: Emergency Care Consultants CEO: The Incalculable Value of Physician Careers). At the time, the ECC leader and his organization were faced with a trio of crises: •The Covid pandemic and sequelae in Emergen...
036 - Physician-Owned Surgery Center Says “Goodbye Insurance…Hello EXCELLENCE!”
February 15, 2022 07:00 - 57 minutes - 53.1 MBDr. Keith Smith cofounded the remarkably successful and wonderfully disruptive Surgery Center of Oklahoma. He and fellow anesthesiologist, Dr. Steven Lantier, left their hospital-based practices in 1997 to launch a physician-owned surgery center promising high quality care at a fair, transparent, and all-inclusive price. They had become fed up watching hospital administrators profit mightily while those who were actually caring for patients struggled. The inequitable and often outrageous bill...
035 - Incentives Serve the Powerful, Undermine Autonomy, and Gut Creativity
January 31, 2022 13:51 - 29 minutes - 26.9 MBAlfie Kohn is a prolific author and expert on the psychological and organizational effects of rewards, incentives and competition. As a longtime fan of his thinking and writing, it was a huge treat (no pun intended) for me to talk with him about the counterproductive impact of incentive systems in the workplace. In 2018, the 25th Anniversary Edition of Kohn’s superb book, Punished by Rewards—The Trouble with Gold Stars, Incentive Plans, A’s, Praise, and Other Bribes was released. In the years...
034 - Value-Based Care: The Programs, the Problems and Why Physicians Must Lead
January 21, 2022 07:05 - 1 hour - 68.3 MBMy guest is Dr. Roger Fowler, Vice President, and Chief Medical Director of Quality, Performance and Innovation with CHRISTUS Health in Irving, Texas. As an expert in population health, quality, and healthcare reform, Dr. Fowler offers a rich perspective on the historical events that underpin our current state of U.S. healthcare. His belief is that we must move away from payment systems that reward the quantity of procedures performed, and move toward those programs that reward excellent outc...
033 - Physician Autonomy: A Legal Perspective and a Blockchain Solution
December 28, 2021 07:05 - 45 minutes - 42 MBLeah Houston, MD is a serial entrepreneur, emergency medicine physician, and activist. She is the founder of: HPEC: Humanistic Physician Empowerment Community is a platform physicians can use to own and store their own digital identity and credentials. A secure, self-sovereign identity is the foundation for restoring physician autonomy. (Find out why!) EverCred: The system used by institutions to manage certification data and issue physician credentials that puts physicians in control of th...
032 - A Voice for Physician Leadership: Essential, Courageous and Magical
December 14, 2021 15:16 - 1 hour - 55.2 MBMy guest this week is national healthcare leader Dr. Jack Cochran. As CEO of the Permanente Federation, he was the top national leader for over 20,000 physicians who cared for more than 10 million people in their Kaiser Permanente medical practices. In this animated conversation, the inspiring and articulate Dr. Cochran describes his non-linear and unexpected path to executive leadership and international activism on behalf of excellent and accessible healthcare. In his early days as a pract...
031 - Jung's Physician Archetypes and the Loss of Meaning in Medicine
November 30, 2021 07:05 - 51 minutes - 47.1 MBLisa Marchiano is a Jungian psychoanalyst and cohost of the marvelous “This Jungian Life” podcast. We discuss Swiss psychiatrist Carl Jung’s work and the implications for physicians and the ailing medical profession. Lisa explains that Jung believed: “We are all on a path toward wholeness. The goal of life is to become more whole—and when that path is blocked in some way, we get symptoms.” Unlike the so-called manualized therapies (following a manual with techniques outlined for various dia...
030 - Monetization of the Physician Imagination
November 09, 2021 07:05 - 38 minutes - 52.2 MBThis episode is a continuation of my animated conversation with Professor J.-C. Spender, a nuclear engineer-turned-business school professor, author, expert on the history of business education, and former executive and business school dean. At the onset of episode #30 I asked Dr. Spender if getting an MBA degree would provide what’s needed if someone wanted to efficiently manage a healthcare organization. His response was YES. But he added “that’s a kind of modified and slightly tangled yes....
029 - Medicine and Managerialism: A Clash of Values
October 19, 2021 09:00 - 57 minutes - 53 MBJ.-C. Spender, PhD, is an engineer-turned-business school professor, an author, an expert on the history of business education, and he’s a former business executive and business school dean. These credentials equip him to have insight into the goings-on of business schools and real expertise in the practical challenges of graduate business education. Dr. Spender has a distinct philosophical bent which surfaces in this episode (and more so in Part 2 of this interview—Episode #30). He sports...
028 - Corporate Practice of Medicine Laws: Employed Physician’s Remedy—or Nightmare?
October 05, 2021 10:00 - 49 minutes - 45.2 MBWhat is the Corporate Practice of Medicine? In this episode, Brad Adatto, a business law and healthcare attorney, takes us on a journey through the intent, implications, and risks associated with state laws that “ban” the corporate practice of medicine. He describes how these state laws arise from a variety of legal and regulatory sources, and prohibit corporations (or any “non-physicians”) from employing physicians or owning medical practices. The Corporate Practice of Medicine Doctrine ...
027 - 13 Ways PBMs Profit Mightily and Hurt People
September 23, 2021 10:00 - 39 minutes - 35.7 MBPharmacy benefit managers, or PBMs, are companies that manage prescription drug benefits for payers like insurance companies, government programs such as Medicare and Medicaid, and self-insured employers. They are the middlemen and money handlers who negotiate with pharmaceutical manufacturers to determine drug prices and drug placement on formularies. Considering the costly and far-reaching impact of their negotiations, they have been allowed an inexplicable level of unchallenged secrecy in ...
026 - Five Myths that Sabotage Physician Leadership
September 07, 2021 16:59 - 28 minutes - 19.3 MBIn today’s encore episode, I am sharing an excerpt from an earlier episode discussing myths about physician leadership and dispelling those myths with evidence. MYTH: a widely held but false belief or idea Time to bust some of the myths and stereotypes about physicians being arrogant, un-herdable cats and lone wolves who don't understand teamwork, business or finances. Stereotype… #1 Doctors are lone wolves or cowboys who can’t get along on a team #2 Physicians have a command and c...
025 - Don’t Throw Away The Physician Career
August 24, 2021 10:00 - 19 minutes - 17.9 MBFor today’s episode, I asked Dr. Barbara McAneny about her upcoming talk: Stop Blaming the Doctors! My main intention in asking Barbara to come back on the podcast (she was a guest on Episode #13) was to have her guide me through the malodorous sewer where Pharmacy Benefits Managers live. But since I had her corralled on Zoom I suggested we both give a preview of our Global Summit presentations. As an oncologist, the founder and CEO of a large, multi-specialty practice, and former AMA pres...
024 - Burnout and Moral Injury: Products of a Business School Mindset
August 10, 2021 10:00 - 21 minutes - 19.6 MBIn this encore episode, I’m touching on some of the enormous quantity of research that has been directed at physician burnout. We have clear and convincing descriptions of the causes of physician burnout. What we don’t have, is a lot of action directly tackling those causes. How is it that healthcare leadership has had a lackluster response to the crumbling careers of those whose credentials are required to open a hospital? Whether it’s the head honchos of healthcare systems, advocacy org...
023 - To Be a Physician Is To Be a Leader
July 29, 2021 18:10 - 16 minutes - 15.3 MBIn this encore episode I highlight a portion of my conversation with Dr. Patty Gabow, former CEO at Denver Health. During this 15 minute segment, Patty reacts to my question about the value of physicians’ tacit knowledge and the built-in leadership qualities physicians develop in their training. Listen in as Dr. Gabow weighs in on why physicians must lead, how values must drive healthcare strategy, and why her latest book Time’s Now for Women Healthcare Leaders is focused on doing what it t...
022 - Provocative Questions and Leadership Challenges
June 29, 2021 10:00 - 55 minutes - 75.9 MBIn this episode, my longtime colleague and friend Lynn Elliott joins me to take a look at the arc of the Licensed to Lead Podcast’s first season. The first three episodes launched the podcast with data dives to support my foundational beliefs about physician leadership, then we turned to interviews with physician leaders and others who shed light on the “whys” and “hows” of expert leadership, and finally wrapped up the season with my “Mother’s Day” podcasts. Lynn shares some of the email an...
021 - If You're Not Happy - You're Not Helping
June 04, 2021 09:00 - 13 minutes - 18.2 MBIn this first Licensed to Lead “Espresso Shot” podcast—designed to be short but potent— the topic is the unhealthy underbelly of “helping” professions. Cory Katuna and Patty spin-off from their Episode #20 conversation when they talked about Levels of Energy or “mindsets.” They dive into a discussion of the connection between Level Four energy (a mindset of compassion and generosity) and the implications if our “helping” is tainted by obligation and resentment. When Cory says “If you’re not h...
020 - Culture, Levels of Energy, and “Leading A Deathbed Life"
May 27, 2021 10:00 - 58 minutes - 79.6 MBCory Katuna is a professional coach, writer, graphic artist and social influencer. She joins Patty in this episode to talk about the ways her work and Patty’s work intersect, ultimately creating excellent organizational culture that truly brings out the best in each person. She takes the conversation through the seven levels of energy, a model developed by Bruce D. Schneider, founder of iPEC Coaching. Patty and Cory go back and forth with examples to illustrate this leadership mindset model...
Mother-Daughter Discussion on Physician Leadership
May 11, 2021 08:00 - 37 minutes - 51.5 MBIn the first of two special Mother’s Day podcasts, I’m in the guest chair along with my daughter, Jamie Katuna. Podcaster Keith Carlson, RN, (aka “Nurse Keith”) starts this interview by asking how we influenced and inspired each other as mom and daughter, in medicine and in leadership roles. I talk about my admiration for Jamie’s intellectual curiosity and her willingness to take risks. Nurse Keith corroborates this by describing how he discovered Jamie on her aptly-named “Speak Out Medicin...
019 - Mother-Daughter Discussion on Physician Leadership
May 11, 2021 08:00 - 37 minutes - 51.5 MBIn the first of two special Mother’s Day podcasts, I’m in the guest chair along with my daughter, Jamie Katuna. Podcaster Keith Carlson, RN, (aka “Nurse Keith”) starts this interview by asking how we influenced and inspired each other as mom and daughter, in medicine and in leadership roles. I talk about my admiration for Jamie’s intellectual curiosity and her willingness to take risks. Nurse Keith corroborates this by describing how he discovered Jamie on her aptly-named “Speak Out Medicin...
018 - Physician Leader and Author Warns the Public of a Dangerous Trend
April 27, 2021 08:05 - 58 minutes - 53.5 MBNiran Al-Agba, MD co-authored the book, Patients at Risk—The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, which unearths the confluence of events allowing poorly trained practitioners to diagnose and treat patients. Dr. Al-Agba, who has a nurse practitioner in her own practice, believes NPs and PAs can provide high quality care. In her book she states, “The NP and PA roles were created to provide complementary care with a physician carefully supervising and collabora...
017 - What is Direct Primary Care? BEAUTIFUL!
April 13, 2021 13:10 - 51 minutes - 71.3 MBJennifer McCabe Lentz, MD, and I talk about the Direct Primary Care (DPC) practice she built which transformed her professional life and home life. In 2017 she launched her DPC practice. Direct Primary Care means there is no middle-man between the physician and the patient—their relationship is direct. She takes no insurance. Her patients pay a monthly fee which covers most of the care she provides. Her patients can access her by email, text, phone, and with in-person visits—of whatever lengt...
016 - Save a Doctor – Hire a Scribe
March 30, 2021 08:00 - 52 minutes - 71.7 MBIn this episode, you’ll hear from three physicians who work with medical scribes. If you haven’t had experience with either in-person or virtual (remote) scribes, this episode will give you a pretty good picture. First, Dr. Christopher Obetz, CEO of Emergency Care Consultants (ECC) and featured guest in Episode 15, talks about launching their scribe program 15 years ago. Scribes work right alongside the physician, taking notes and doing data entry in the electronic medical record. Dr. Obet...
015 - Emergency Care Consultants CEO: The Incalculable Value of Physician Careers
March 16, 2021 10:00 - 48 minutes - 66.9 MBIs it possible to create an outstanding organizational culture in what is often a hellhole of anguished patients, staff dissatisfaction, and high physician turnover? Emergency Medicine, with its high stress, high stakes, and ever-diminishing autonomy, has been a burnout zone for decades. Except—for almost thirty years there’s been an Emergency Medicine oasis in the Twin Cities. (Maybe it’s the wrong latitude for an “oasis” metaphor—perhaps an idyllic ice-fishing camp?) Anyway, Emergency Care ...
014 - A Warrior Spirit For The Vulnerable with Jandel Allen-Davis, MD, President & CEO
February 23, 2021 10:00 - 47 minutes - 43.4 MBDr. Jandel Allen-Davis is the CEO and President of Craig Hospital, a superb rehabilitation center for traumatic brain and spinal cord injuries. Dr. Allen-Davis, an obstetrician and gynecologist, spent 25 years caring for patients and honing her leadership skills in multiple organizational and community roles. In this episode, she describes “The Disappointment” when she was NOT selected for a CEO role, and she shares how she navigated that pain. Dr. Allen-Davis’s subsequent selection as the ...
013 - A National Leader with Tenacity and Compassion
February 09, 2021 09:00 - 1 hour - 59.7 MBFormer AMA President Barbara McAneny is a relentless patient advocate who sees the harm done by the rapacious medical industrial complex. She spells out the toxicity caused by health system consolidation, purchase of physicians’ practices, and financial exploitation of government programs intended to serve the poor. Dr. McAneny, an oncologist, comes by her in-depth knowledge through her AMA role as well as through her own experience battling a large healthcare system in order to save the mul...
012 - Physician Leader Development: What Works?
January 26, 2021 11:00 - 42 minutes - 76.9 MBAmanda Goodall, PhD, joins me in Part Two of our conversation discussing the advanced degree program for physician leaders that she founded. She talks about barriers to physician leadership development including political correctness, assumptions that physicians aren’t interested, and the daunting “re-entry” into entrenched cultures. Dr. Goodall points to a central problem with business schools: the separation of business education from any actual workplace, profession, or culture. This ec...
011 - THE RESEARCH: Physicians and the Theory of Expert Leadership
January 12, 2021 06:30 - 44 minutes - 80.9 MBAmanda Goodall, PhD, a professor and leadership expert, joins Patty in an animated conversation about her theory of expert leadership. Dr. Goodall explains how her research revealed that top scholars, not general managers, make the best university CEOs and the most effective department leaders. This phenomenon doesn’t just apply to the academic world; the same pattern holds true in sports. And important for the Licensed to Lead audience, her studies point to superior outcomes when healthcare ...
010 - AUTONOMY: with guest Bruce Katuna, MD
October 06, 2020 15:00 - 1 hour - 86.9 MBIn this conversation about the neuroscience of autonomy, I roped neurologist and neurophysiologist Bruce Katuna into joining me. It wasn’t a tough sell since he’d already joined me in holy matrimony a few decades ago. My colleague, Lynn Elliott, agreed to facilitate the conversation and help us bring to life the importance and the nature of our primitive human drive for autonomy. The headline for this podcast is the central role of autonomy in the profession of medicine. We dive into the ne...
009 - Patty Gabow, MD—How a Values-Driven CEO Transformed Denver Health
September 28, 2020 18:00 - 59 minutes - 81.4 MBIn this episode I spoke with Dr. Patty Gabow, a nephrologist and researcher who found the right match for her values at Denver Health, a city-center integrated health and hospital system. Dr. Gabow found her leadership chops early, and describes how her passion to care for the underserved fueled a twenty-year stint as CEO of the large, level-one trauma safety-net institution. Dr. Gabow describes wrangling for four years with city officials to allow the struggling hospital system to become i...
008 - A conversation with Scott Smith, MD “A Bias for Action”
August 11, 2020 14:00 - 37 minutes - 51.7 MBThis is the first of many conversations with remarkable, consistent, and accomplished leaders in order to put a spotlight on the behaviors that contribute to their leadership effectiveness. In this episode, I talk with Scott Smith, MD, a healthcare leader, and physician. His journey wends its way from his role as chief of cardiopulmonary medicine at the Kirtland Air Force Base; through his role on the executive team at Kaiser Permanente in Colorado; to his current local, system-level and inte...
007 - Why We're Not Fixing Physician Burnout
June 29, 2020 14:55 - 52 minutes - 120 MBIn this episode I’m offering my take on why we haven’t budged the needle on physician burnout. We have clear evidence of the causes of burnout—but we don’t have effective action. Why are we so stuck? My observations fall into 4 areas: 1. Weak, bureaucratic language that fails to put a spotlight on the problem of burnout: People who have the podium, the authority, and the data are using their indoor voices— when what’s called for is a bullhorn! Why is undue restraint and bureaucratic gobbled...
006 - Physician Burnout: The Impact
June 02, 2020 05:00 - 54 minutes - 124 MBThis episode moves beyond the definition and underlying causes of burnout to focus on the impact on physicians, medical students, patients, and healthcare systems. Patty Fahy interviews a neurologist who retired in his 40’s and then five years later dusted off his medical license and launched a national company. She also interviews a medical student who provides a counterpoint to the documentary profiled in Licensed to Lead Episode #005. 1. Physicians When physicians are affected by burnout ...
005 - Robyn Symon Interview: Physician Suicide & DO NO HARM
May 05, 2020 03:03 - 1 hour - 82.6 MBRobyn Symon Interview: Physician Suicide & DO NO HARM Robyn Symon, a two-time Emmy award-winning filmmaker, joined me for the Licensed to Lead podcast on April 30, 2020. Robyn has written, directed, and produced films and television series—and she specializes in documentaries. We spoke about her acclaimed and riveting film that takes an unblinking look at the dark underbelly of medical training. Robyn is passionate about doing what she can to highlight and address the inhumanity of medical...
004 - Physician Burnout: Definition, Controversies and Etiology
April 21, 2020 01:07 - 57 minutes - 79.3 MBPhysician Burnout: Definition, Controversies and Etiology The last episode waded into the murky waters of graduate business education. Anyone listening to that podcast should have emerged with serious doubts about whether an MBA is a desirable credential for healthcare, much less for healthcare leadership. This Licensed to Lead Podcast is the first of four episodes zeroing in on physician burnout. What is it? Why is it? And how is it that the word “burnout” has become radioactive? This e...
003 - Who Are The Masters Of Healthcare?
April 06, 2020 05:00 - 56 minutes - 77.2 MBThe Licensed to Lead podcast is for physicians, physician leaders, or anyone who thinks healthcare needs a transformation. Licensed to Lead means that physicians must establish the vision, the standards, and the culture in healthcare systems so that excellent patient care is central. The first two episodes of the LTL podcast spelled out why physicians are, well, LICENSED TO LEAD. What are the underlying issues, myths and evidence about physician leaders in healthcare? In this episode, it’s ...
002 - Physician Leadership: the Myths and the Evidence
March 30, 2020 06:00 - 1 hour - 86.4 MBThe Licensed to Lead podcast is for physicians, physician leaders, or anyone who thinks healthcare needs a transformation. Licensed to Lead means that physicians must establish the vision, the standards, and the culture in healthcare systems so that excellent patient care is central. In this episode, Patty Fahy, MD, the host of Licensed to Lead describes the myths and evidence about physician leadership and why physicians are uniquely equipped to pick up the reins and lead our medical group...
001 - Physician Leadership: The Foundation
March 22, 2020 21:21 - 51 minutes - 70.6 MBThe Licensed to Lead podcast is for physicians, physician leaders, or anyone who thinks healthcare needs a transformation. Licensed to Lead means that physicians must establish the vision and the medical standards in our healthcare organizations so that excellent patient care is the central focus. Currently, unlike other traditional professions, medicine is not led by members of the profession. Physicians pay a steep price for this fact with a dramatic loss of professional autonomy, a fi...