The Clinician is the Customer

The Clinician is the Customer

What if one of the most important moments in healthcare happens after a patient leaves the hospital? In this episode of PEMBA On Demand, Dr. Norman Chapin sits down with Dr. Tiffany Hanf, Regional Medical Director for Post-Acute Care at TeamHealth and current PEMBA student, to discuss one of healthcare’s most persistent and costly challenges: helping patients successfully transition from the hospital to post-acute care while reducing preventable readmissions. Dr. Hanf oversees post-acute care operations across nine western states and shares insights from her work leading skilled nursing facilities, long-term care facilities, and rehabilitation programs. At the center of the conversation is her work on an acute-to-post-acute transition program designed to improve coordination, communication, and continuity of care between hospitals and post-acute providers. She explains that one of the biggest barriers to successful transitions is the fragmentation that often exists between hospitals and post-acute facilities. Because these organizations are frequently managed by separate entities, critical information can be lost during the handoff process. Effective discharge summaries, medication coordination, and timely communication are essential to ensuring patients receive seamless care after leaving the hospital. The discussion explores how the role of physicians in post-acute care has evolved significantly over the years. Dr. Hanf explains that modern post-acute medicine requires dedicated physician leadership, advanced practice clinicians, structured rounding models, and specialty support services. The traditional model of infrequent physician visits to nursing facilities has largely been replaced by a more proactive, team-based approach focused on quality outcomes and reducing unnecessary hospitalizations. Dr. Hanf also shares lessons from a collaborative initiative with a health system seeking to address long hospital stays, discharge bottlenecks, and readmissions. Through coordinated partnerships and standardized workflows, her team has demonstrated improvements in transitions of care, reductions in readmissions, and shorter hospital lengths of stay. However, she notes that meaningful change often requires overcoming organizational silos and building trust among multiple stakeholders. A significant portion of the conversation focuses on readmissions from post-acute care settings. Dr. Hanf explains that many readmissions are driven by factors such as infections, sepsis, congestive heart failure exacerbations, falls, inadequate access to diagnostics, staffing challenges, and patient or family decisions to seek emergency care. She emphasizes that successful programs focus on identifying these drivers early and creating systems that allow patients to safely remain in the most appropriate care setting whenever possible. The episode also highlights TeamHealth’s philosophy that clinicians are the organization’s primary customer. Dr. Hanf discusses how supporting physicians and advanced practice clinicians through strong workflows, technology, communication systems, and leadership ultimately improves facility performance and patient outcomes. This clinician-first approach has become a key part of TeamHealth’s strategy for recruitment, retention, and quality improvement. Later in the conversation, Dr. Hanf reflects on her own career journey. After spending more than a decade as a hospitalist, she transitioned fully into post-acute care, drawn by the opportunity to build deeper relationships with patients while maintaining a sustainable work-life balance. She describes post-acute medicine as a unique blend of acute care complexity and long-term patient continuity. Finally, Dr. Hanf shares why she chose to pursue the Physician Executive MBA at this stage of her career. Encouraged by colleagues and mentors, she viewed the program as an opportunity for personal and professional growth. She discusses the value of learning alongside physician leaders from across the country and the impact the program has had on her leadership development. This conversation offers a practical look at the future of post-acute care, physician leadership, care coordination, and the systems-level thinking required to improve outcomes for some of healthcare’s most vulnerable patients. Key Topics Discussed * Improving transitions from acute care to post-acute care * Reducing hospital readmissions through better care coordination * Communication challenges between hospitals and nursing facilities * The evolution of physician leadership in post-acute care * The role of advanced practice clinicians in skilled nursing facilities * Building partnerships between hospitals and post-acute providers * Common drivers of post-acute readmissions * Strategies for improving CMS quality measures and facility performance * TeamHealth’s clinician-first leadership philosophy * Career transitions from hospital medicine to post-acute care * Leadership development through the PEMBA program * The future of post-acute care amid growing healthcare demands Resources * Dr. Tiffany Hanf, MD, FACP (LinkedIn) Dr. Tiffany Hanf LinkedIn Profile [https://www.linkedin.com/in/tiffany-hanf-md-facp-45358577/?utm_source=chatgpt.com] * PEMBA On-Demand Video Podcast PEMBA On-Demand YouTube Channel [https://www.youtube.com/@PEMBAON-DEMAND?utm_source=chatgpt.com] * University of Tennessee Haslam College of Business | Physician Executive MBA (PEMBA) Physician Executive MBA Program (PEMBA) [https://haslamgradprograms.utk.edu/programs/mba/physician-executive-pemba/?utm_source=chatgpt.com]

Mobile CT, AI and the Future of Lung Cancer Screening

What if the biggest problem in lung cancer is not treatment, but that patients are diagnosed too late? In this episode of PEMBA On Demand, Dr. Norman A. Chapin speaks with Dr. J. Robert Headrick, Chief of Thoracic Surgery at CHI Memorial Rees Skillern Cancer Institute, about physician leadership, innovation, and transforming how we approach lung cancer and preventive healthcare. Dr. Headrick shares how his journey evolved from traditional surgical practice into a mission-driven focus on early detection, access, and system redesign in lung cancer care. He explains that one of the biggest problems in healthcare today is not a lack of treatment options, but the fact that patients are often diagnosed too late, when symptoms finally appear. The conversation highlights how lung cancer has long been misunderstood as primarily a smoking-related disease, when in reality, many patients, including non-smokers, are affected, and outcomes improve significantly when cancer is detected early. A central focus of the episode is Dr. Headrick’s work in developing mobile CT screening programs, including a bus-based model designed to bring low-dose CT scans directly into communities. He explains that traditional healthcare delivery creates barriers such as time, access, and inconvenience, which prevent many eligible patients from getting screened. By contrast, simplifying access to a quick, minutes-long scan dramatically increases participation. Dr. Headrick shares real-world examples of how this approach is changing outcomes, including communities where people are now living with early-stage lung cancer who would not have been diagnosed otherwise. These success stories demonstrate how visibility, convenience, and trust can shift public perception and engagement with preventive care. The discussion also explores the operational and scalability challenges of this model. While mobile screening improves access, it introduces new complexities such as: * Managing large volumes of imaging data * Coordinating follow-up care * Ensuring patients return for repeat scans * Avoiding strain on radiology resources Dr. Headrick explains that these challenges are driving the need for new solutions powered by artificial intelligence, particularly in imaging interpretation and workflow efficiency. AI has the potential to significantly reduce the time required to review scans and help identify early disease patterns more quickly. A major theme of the episode is the shift from reactive healthcare to proactive care. Dr. Headrick emphasizes that relying on symptoms to guide care is fundamentally flawed, especially for conditions like lung cancer and heart disease, which often remain silent until advanced stages. He outlines a broader vision for the future of healthcare that includes: * Earlier and more accessible screening * Lower-cost, high-efficiency diagnostic tools * Integration of AI to support clinical decision-making * Empowering patients to engage in their own health earlier in life Dr. Headrick also discusses how his experience in the Physician Executive MBA (PEMBA) program helped him transition from thinking as an individual clinician to thinking at a systems level, including business planning, financial modeling, and leadership strategy. This shift enabled him to bring innovative ideas into real-world implementation. The episode concludes with a powerful perspective on healthcare economics. Dr. Headrick references projections suggesting that moving toward proactive, preventive care could significantly reduce national healthcare spending, while improving patient outcomes and quality of life. Ultimately, this conversation highlights how physician leadership, combined with innovation and system-level thinking, can reshape how care is delivered and experienced. Key Topics Discussed * The limitations of symptom-based, reactive healthcare * Why early detection is critical in lung cancer outcomes * The development of mobile CT screening programs * Barriers to preventive care, including access and patient behavior * Real-world impact of community-based screening models * Challenges in scaling screening programs across populations * The role of artificial intelligence in imaging and workflow efficiency * Shifting healthcare toward proactive, preventive models * The importance of business and leadership training for physicians * Healthcare economics and long-term cost reduction through prevention Resources Mentioned * Dr. Rob Headrick LinkedIn Profile [https://www.linkedin.com/in/rob-headrick-md-mba-6237b0aa/] * Dr. Rob Headrick Website [https://www.drheadrick.net/] * Dr. Rob Headrick ChattanoogaTrend Article [https://www.chattanoogatrend.com/dr-rob-headricks-quest-to-stop-lung-cancer/] * Dr. Rob Headrick Mountain Mirror Article [https://www.mountainmirror.com/happenings/rod-headrick-the-lung-warrior] * Society Thoracic Surgeons Lung Screening Efforts [https://www.sts.org/news/washington-scene-surgeons-strengthen-lung-cancer-screening-efforts-grassroots-level] * Local 3 News video with Dr. Headrick [https://www.local3news.com/local-news/thoracic-surgeon-baylor-school-alumnus-dr-rob-headrick-joins-students-to-tour-chi-memorials-breathe/article_4d1d8092-5b01-11ed-92ec-4b12130a7ede.html] * Dr. Headrick national news video [https://www.facebook.com/watch/?v=689001838290396] * Dr. Headrick Lung Screening Video Interview [https://video.search.yahoo.com/search/video;_ylt=AwrFOjoZGL9pCQIA9NZXNyoA;_ylu=Y29sbwNiZjEEcG9zAzEEdnRpZAMEc2VjA3Nj?type=E210US739G0&p=articles+by+dr.+rob+headrick+on+youtube&fr=mcafee&turl=https://tse3.mm.bing.net/th/id/OVP.DyKa98vYFgaRxlBFiQKh_wEsDh?pid=Api&w=296&h=156&c=7&p=0&rurl=https://www.youtube.com/watch?v=Q-rzUHi551g&tit=Dr.+Rob+Headrick+talks+to+Don+Welch+about+a+new+screening+to+detect+Lung+Cancer&pos=11&vid=5b0715c34ffb5c4e6cf0c9e7c5775d71&sigr=OhN0JHoAW4wg&sigt=0Vg86T1aGuAJ&sigi=w3iq4YJrGE0I] * PEMBA On-Demand Video Podcsts [http://tiny.utk.edu/pembaondemand] * Haslam College of Business - Physician Executive MBA [https://haslamgradprograms.utk.edu/programs/mba/physician-executive-pemba/?_gl=1*5n7yso*_gcl_au*NjIwMDEzMjgxLjE3NzQxMzIxMTM.*_ga*MTcxMjEzOTAxOC4xNzc0MTMxNzkx*_ga_QHRYV5S0YM*czE3NzQxMzIxMTMkbzEkZzEkdDE3NzQxMzIxMjMkajUwJGwwJGg5MzI1OTEzMzI].

Hospital at Home: Promise, Peril, and the Fine Print

What if hospital-level care could safely happen in a patient’s home instead of inside a hospital building? In this episode of PEMBA On Demand, Dr. Norman A. Chapin speaks with Dr. Mihir H. Patel about the growing hospital-at-home movement and what it means for physician leaders, health systems, and patients. Hospital at home refers to acute hospital-level care delivered in a patient’s home instead of a traditional inpatient bed, not simply remote monitoring or home health. The model has gained major momentum in recent years as health systems look for new ways to improve capacity, reduce harm, and deliver care in the right setting. Dr. Patel explains that hospital-at-home programs are designed to address three major challenges in modern healthcare: hospital capacity strain, the risks patients face inside hospitals, and the high cost of brick-and-mortar inpatient care. He walks through the types of diagnoses that often fit the model, including conditions like pneumonia, COPD exacerbations, CHF, cellulitis, UTIs, dehydration, and similar cases where patients need acute treatment but do not require ICU-level care. The conversation also explores how these programs actually work behind the scenes. Dr. Patel describes the mix of physicians, nurses, paramedics, pharmacists, case managers, and logistics teams needed to support care in the home. He and Dr. Chapin discuss how virtual visits, remote monitoring, medication delivery, and rapid-response workflows all play a role in making the model safe and scalable. A major focus of the episode is outcomes. Dr. Patel shares why mature hospital-at-home programs have shown encouraging results in patient safety, patient satisfaction, and readmissions. Public-facing hospital-at-home resources likewise describe the model as a patient-centered alternative that can improve care outcomes for appropriate adults while reducing exposure to hospital-associated complications. Dr. Chapin and Dr. Patel also discuss the business and policy side of the model, including fixed versus variable costs, reimbursement, and the importance of federal waiver support. The CMS Acute Hospital Care at Home waiver was extended for five years through 2030 in March 2026, giving health systems more certainty as they invest in infrastructure and staffing. The AMA reports that the waiver supports hospital-level home care for Medicare patients, and advocacy materials from the Advanced Care at Home Coalition show broad national participation by hospitals and health systems. The episode also highlights the role of technology. Dr. Patel explains how tablets, wireless monitoring devices, ambient AI documentation, and logistics coordination tools are becoming increasingly important in hospital-at-home workflows. He offers a practical look at how these technologies can support earlier intervention, improve efficiency, and help teams manage care across multiple patients and locations. Later in the conversation, Dr. Patel reflects on his own career path and why he chose to pursue the Physician Executive MBA at the University of Tennessee. He shares how the program helped him think beyond individual patient encounters and better understand finance, operations, workflow design, and system-level leadership. He also discusses his work in medical writing and his involvement with The Hospitalist, which is the Society of Hospital Medicine’s monthly newsmagazine. This episode is both a practical overview of hospitals at home and a thoughtful reflection on physician fulfillment. Dr. Patel closes with a powerful reminder that success is not only about titles, income, or credentials. For physicians, real success also means finding a path that supports personal well-being, family life, and meaningful patient care. Key Topics Discussed * What hospital at home really means * Why health systems are investing in this model * Common diagnoses treated through hospital-at-home programs * Capacity relief, ED boarding, and patient flow * Readmissions and continuity of care in the home * The role of remote monitoring, virtual visits, and AI * Financial and reimbursement considerations * Why rural implementation differs from urban programs * Physician burnout, flexibility, and career satisfaction * How business education helps physicians lead system change Links and Resources: * Dr. Mihir H. Patel LinkedIn: https://www.linkedin.com/in/mihir-patel-06815110a/ [https://www.linkedin.com/in/mihir-patel-06815110a/?utm_source=chatgpt.com] * Hospital at Home Users Group: https://www.hahusersgroup.org/ [https://www.hahusersgroup.org/?utm_source=chatgpt.com] * Society of Hospital Medicine: https://www.hospitalmedicine.org/ [https://www.hospitalmedicine.org/?utm_source=chatgpt.com] * The Hospitalist, SHM publication: https://www.hospitalmedicine.org/news-publications/shm-publications/ [https://www.hospitalmedicine.org/news-publications/shm-publications/?utm_source=chatgpt.com] * Advanced Care at Home Coalition FAQ: https://achcoalition.org/wp-content/uploads/2024/10/2024-10-Hospital-at-Home-FAQ_ACH-Coalition.pdf [https://achcoalition.org/wp-content/uploads/2024/10/2024-10-Hospital-at-Home-FAQ_ACH-Coalition.pdf] * AMA article on the five-year CMS waiver extension: https://www.ama-assn.org/public-health/population-health/lawmakers-extend-cms-hospital-home-waiver-five-years [https://www.ama-assn.org/public-health/population-health/lawmakers-extend-cms-hospital-home-waiver-five-years?utm_source=chatgpt.com] * Physician Executive MBA at the University of Tennessee [https://haslamgradprograms.utk.edu/programs/mba/physician-executive-pemba/] * Michael Marks MD MBA [https://www.linkedin.com/in/michael-marks-md-mba-5972a714/]

Leadership Odyssey: Bridging Medicine and Business with Michael Marks

What if the skills that make a great physician aren’t enough to lead healthcare, and the real transformation begins when medicine and business finally learn to speak the same language? This recast episode of Pemba on Demand: Leadership Odyssey Bridging Medicine and Business revisits a compelling conversation with host Dr. Norman A. Chapin and Dr. Michael Marks, Senior Medical Director at Relievant Medsystems, Inc. Dr. Marks reflects on his professional journey from orthopedic spine surgeon to healthcare executive in the medical device industry. He shares how his experience in the Physician Executive MBA program at the University of Tennessee shaped his leadership approach, supported complex orthopedic group mergers, and prepared him for roles in hospital administration and industry leadership. The episode explores the evolving identity of physician leaders and highlights the importance of education, mentorship, collaboration, and adaptability when navigating the intersection of medicine and business. Dr. Marks also discusses the human side of leadership, including maintaining empathy in patient care, facing personal health challenges, and advocating for patients within complex insurance and reimbursement systems. SHOW HIGHLIGHTS * Transitioning from clinical practice to executive leadership roles * The value of the Physician Executive MBA program for physicians * Managing healthcare mergers and navigating cultural integration * Empathy and communication as essential leadership skills * The role of mentorship in career development and growth * Staying connected to clinical care during personal health challenges * Advocating for patients amid insurance and coverage barriers * Understanding healthcare spending and its impact on Medicare and Medicaid * The importance of continuous learning in a changing healthcare landscape * Collaboration and shared purpose as foundations of effective leadership Links and Resources: * Physician Executive MBA at the University of Tennessee [https://haslamgradprograms.utk.edu/programs/mba/physician-executive-pemba/] * Michael Marks MD MBA [https://www.linkedin.com/in/michael-marks-md-mba-5972a714/]

Strategic Conversations

WHAT IF THE SAME NEGOTIATION SKILLS USED TO SAVE HOSTAGES COULD HELP PHYSICIANS LEAD BETTER TEAMS, REDUCE BURNOUT, AND TRANSFORM HEALTHCARE FROM THE INSIDE OUT? In this episode of PEMBA On Demand, host Dr. Norman A. Chapin sits down with Camilo R. Gomez, MD, MBA, and former FBI lead hostage negotiator Christopher Voss to explore how elite negotiation strategies can reshape leadership in healthcare. Drawing from their new book Strategic Conversations, the conversation bridges the worlds of medicine and high stakes negotiation. Dr. Gomez and Christopher Voss explain how principles like tactical empathy, calibrated questions, ethical ambition, and disciplined curiosity can improve physician leadership, strengthen care teams, reduce burnout, and create better outcomes for patients and organizations alike. This episode challenges traditional command and control leadership models and offers physicians a practical framework for navigating conflict, complexity, and change with clarity and confidence. KEY TOPICS COVERED * Applying FBI hostage negotiation principles to healthcare leadership * Tactical empathy as a leadership and communication tool * Moving from authority based leadership to influence based leadership * Reducing burnout through better conversations and alignment * Ethical ambition and its role in modern medical leadership * Improving collaboration across care teams and organizations * Navigating high pressure conversations with patients and colleagues * Building trust and psychological safety in clinical environments * Creating sustainable win win outcomes in healthcare systems GUEST'S BIO: Dr. Camilo R. Gomez, MD, MBA Dr. Camilo R. Gomez is a physician, author, and healthcare executive with a focus on leadership, ethics, and system level improvement. He brings deep experience at the intersection of medicine, strategy, and communication, helping clinicians navigate complex professional environments with clarity and purpose. Christopher Voss Christopher Voss is a former FBI lead international hostage negotiator and the founder of Black Swan Group. He is the bestselling author of Never Split the Difference and a globally recognized expert in negotiation, communication, and decision making under pressure. LINKS & RESOURCES * Dr. Camilo R. Gomez on LinkedIn https://www.linkedin.com/in/neuroranger/ [https://www.linkedin.com/in/neuroranger/] * Christopher Voss on LinkedIn https://www.linkedin.com/in/christophervoss/ [https://www.linkedin.com/in/christophervoss/] Organizations * Black Swan Group https://www.blackswanltd.com/ [https://www.blackswanltd.com/] Books Mentioned * Strategic Conversations by Camilo R. Gomez and Christopher Voss https://www.amazon.com/Strategic-Conversations-Successbooks-Publishing/dp/B0DWH4R21H [https://www.amazon.com/Strategic-Conversations-Successbooks-Publishing/dp/B0DWH4R21H] * Never Split the Difference by Christopher Voss https://www.amazon.com/Never-Split-Difference-Negotiating-Depended/dp/0062407805 [https://www.amazon.com/Never-Split-Difference-Negotiating-Depended/dp/0062407805] * Empathy and Understanding in Business by Christopher Voss https://www.amazon.com/Empathy-Understanding-Business-Chris-Voss/dp/B0CNF6J4G8 [https://www.amazon.com/Empathy-Understanding-Business-Chris-Voss/dp/B0CNF6J4G8] * Empathic Reasoning for Extraordinary Results by Christopher Voss https://www.amazon.com/Empathic-Reasoning-Extraordinary-Results-Critical-ebook/dp/B0DZ1Y2GW2 [https://www.amazon.com/Empathic-Reasoning-Extraordinary-Results-Critical-ebook/dp/B0DZ1Y2GW2] * Downgrading American Healthcare by Camilo R. Gomez https://www.amazon.com/Downgrading-American-Healthcare-Camilo-Gomez-ebook/dp/B009FM9P6E [https://www.amazon.com/Downgrading-American-Healthcare-Camilo-Gomez-ebook/dp/B009FM9P6E] * Medical Rules of Engagement by Camilo R. Gomez https://www.amazon.com/Medical-Rules-Engagement-Educators-Blueprint-ebook/dp/B0F6BTGCZQ [https://www.amazon.com/Medical-Rules-Engagement-Educators-Blueprint-ebook/dp/B0F6BTGCZQ] PEMBA ON DEMAND * Dr. Norman A. Chapin on LinkedIn https://www.linkedin.com/in/nchapinmd/ [https://www.linkedin.com/in/nchapinmd/] * PEMBA On Demand Podcast on Apple Podcasts https://podcasts.apple.com/us/podcast/pemba-on-demand/id1732311647 [https://podcasts.apple.com/us/podcast/pemba-on-demand/id1732311647] * PEMBA On Demand YouTube https://www.youtube.com/@PEMBAON-DEMAND [https://www.youtube.com/@PEMBAON-DEMAND]