October 20, 2022
This is the first episode of our Executive Leadership Series, presented by Citi. This series will explore groundbreaking leaders who are envisioning tomorrow’s healthcare. Joe Moscola explores top issues and creative solutions for human resources in healthcare.
This episode was made possible by our partnership with Citi.
[00:00:00] Dr. Gary Bisbee: Good afternoon, Joe, and welcome.
[00:00:02] Joe Moscola: Thanks so much Gary. Appreciate the in.
[00:00:04] Dr. Gary Bisbee: We’re pleased to have you at this microphone. Joe, when did you start thinking about pursuing a clinical degree when you got your physician’s assistant degree.
[00:00:13] Joe Moscola: The idea of healthcare came up from two teachers, Mr. Squadrito and Mrs. Carpetera. Remember the day like it was yesterday. I was supposed to be at lacrosse. Practice was canceled cause it was raining and they we were talking about biology and science, and they said, Hey, you should check out this occupation called physician assistant. And I said have no idea what that is. Looked it up. And the rest is history.
[00:00:37] Dr. Gary Bisbee: Yeah. Very cool. So did you like it right away as soon as you began to study?
[00:00:42] Joe Moscola: I did, I just fell in love with it. fell in love with the patients, fell in love with the other healthcare workers. And I knew that’s where I was meant to be.
[00:00:50] Dr. Gary Bisbee: When did you start thinking about the MBA in pursuing more of an administrative leadership track?
[00:00:57] Joe Moscola: So I came out practiced as a physician assistant for just about six years, and I was working in cardiac surgery and my career mentor gentleman by the name of Alan Hartman, who is our. Chair of cardiothoracic surgery. He and I were in the operating room one day and again, another day that I remember very vividly we’re doing a bentilee replacement. And that’s the replacement of the aorta. And it was a very long case, but we got into many different topics of discussion. In this particular day, believe it or not, over a 12 hour case was the utopia of healthcare delivery and. We started talking about what the problems with healthcare is, how do we make an impact in people’s lives? So he challenged me to go back to school and do something about it.
[00:01:43] Dr. Gary Bisbee: But then to Northwell became the chief of staff to Michael Dowling, the ceo, Mark Lazzo, the Chief Operating Officer. That must have been a, just a fabulous experience, but what were your takeaways from that, Joe?
[00:01:56] Joe Moscola: These chief of staff roles. You just learned so much in such a consolidated period of time. I often will say I learned more in two years than I did in the 10 years prior to that. In many ways. You see how long it takes for a strategy to mature. You see how eloquent it is in terms of the artfulness, the data that it requires, and then look at other times you see how crude, if you will, it could be and really how the role of your gut plays into some of those decision making. From Mark, I absolutely learned the criticality of patience and timing. Sometimes you just gotta wait for that window of opportunity to open up. And so now to today, in my style, the way that sort of translates is I always have things that I’m working on the back burner. Maybe a little bit. The organization may not be ready for, I’m not ready for, maybe my peers and colleagues aren’t ready for it yet. But when I see that opportunity through patients, I’ll push it through the window. With Michael it was very much certainly Peter Drucker’s teaching that a culture eat strategy for breakfast. Michael Dowling, our CEO, is a cult of personality in a great way. You are drawn to him. He can translate to the highest levels of the organization at the board level to then all of our frontline.
[00:03:12] Dr. Gary Bisbee: You weren’t a specialist in HR by any stretch, but what led to that appointment as Chief People Officer Joe?
[00:03:20] Joe Moscola: This is 2014 and Michael Dowling invites me to breakfast. So we’re having breakfast, good casual conversation. Michael says to me Joe, what are you struggling with? And I said, Michael, I just can’t seem to get human resources to think differently. And he starts to laugh. To the point where I feel a little uncomfortable, and he goes let me tell you why we’re at breakfast. I’m thinking about you to take over human resources. And then I realized the joke was on me. It, it was one of those things. When I can, of transition my career it was always about making a bigger impact, a positive impact in a broader, as broader way as possible. And the more I thought about the chief people officer role, the more I felt that it really continued to lead me down that road. Because as I often would say to our team members in hr, we are never. Than in arms length from the patient. And don’t allow yourself to believe that you are more than that, because the work that we do has such a criticality and impact to the health that, to the health providers and those who are on the sort of proverbial frontline.
[00:04:20] Dr. Gary Bisbee: Joe, how many people were employed by Northwell when you took over as a CPO versus now?
[00:04:27] Joe Moscola: Yeah, so that’s 2014. So we’re about 50,000 team members. We’re about eight and a half billion. Today we’re 81,000 team members, and next year’s budget will be about 16 and a half billion. So we basically, at least from a revenue vantage point, doubled in size. It it really was one of those opportunities, especially when I think back, 2015, I believe it was the April edition of the Harvard Business Review. The cover article on Harvard Business Review was HR should be blown up. And so the notion was that I think many organizations were looking for something very different from the function and in actuality, I think that’s that. What Michael was looking for too. He wanted a more operationally, strategically integrated function in the organization.
[00:05:12] Dr. Gary Bisbee: Has your clinical degree been particularly useful as Chief People Officer Joe?
[00:05:17] Joe Moscola: Oh yeah. Un unequivocally, so as a physician assistant where we’re there to serve. Sometimes we’re serving the, our team members who are the nurses and the social workers et cetera. Dietary, registered dietician, excuse me. And at times we’re serving the physicians. And this gives the credibility to get inside the door what you do once you’re. It’s completely up to you. But I feel like even when I think back to certain union negotiations I’ve been a part of, when I think back to strategy development, I had a certain credibility having been there on the front lines, working the 24 hour shifts back when we allowed people to do that working in the operating rooms and really, understanding what that care delivery team needs to look.
[00:06:01] Dr. Gary Bisbee: in your years before Covid as cpo, what would you say were the top one or two challenges, Joe?
[00:06:09] Joe Moscola: Yeah. Prior to Covid I had the privilege of being the chief HR officer during some. Times where many would be right to say, where was hr, where was the function? And you think back to whether that was the Me Too movement pay equity these are things that I’m proud to say that we were working on in advance of. These otherwise watershed moments across industry that we still had not gotten this notion of fairness and equity and inclusion. That said it was a good an additional wake up call for us that we needed to do more and really allowing others in. and then being transparent with our data. And again, another one of the things I think I was very thankful for was really developing a robust reliance and data strategy, workforce intelligence strategy as day one opportunity. And it wound up paying off as the years progressed. I Even if you look up through till the Covid and Black Lives Matter, et cetera I think you. Being able to be transparent, acknowledging the problem that you do or don’t have, and where you’re looking to continue to push forward. Those are the kinds of things that I think that sort and how we work together as a team within the function. And outside of the function. I think it gave us credibility when those tough topics came came.
[00:07:26] Dr. Gary Bisbee: . What stresses did Covid put on the organization?
[00:07:30] Joe Moscola: I think from my vantage point, we can create as many beds as you like. But a bed without the appropriate staff is just that, it’s just a bed. And We were fortunate in two things. One, prior to Covid years prior we had created our own staffing agency in an effort to reduce the cost of traveler agent and temp workforce, contingent workforce. And so that became a vehicle for us to Be able to recruit individuals in at a lower price point. And we all know that we saw some pretty interesting things over the course of Covid in terms of the price that organizations had to pay for contingent workforce and staff. And so we we were fortunate enough to be out there in front. So that was part one. This company that we had built, the second. You go to these conferences and you create these relationships and if some of them are such meaningful close relationships, and I think we saw it pay off through c.
[00:08:29] Dr. Gary Bisbee: So the physician burnout problem was a problem well before Covid, but was accelerated by Covid, I’m sure. What do you see going forward? How are you addressing this issue of physician burnout? Joe?
[00:08:44] Joe Moscola: Yeah, physician burnout serious issue that we knew about before covid, as you described. Then you enter Covid and you have situations where people are forced to communicate with their patients different ways. You have the toll it took on clinicians given the amount of loss that we. Both within our patients and then within our private lives. today, what we’ve done is multifaceted. One in this storing covid, we created a lavender rooms and what we call code lavenders. Lavender room is just where anyone can go to find that sort of quiet space, whether in meditation music just. A code lad can happen anywhere in the hospital. It could be called by anyone. And the notion is it’s really more of a timeout and a sort a decompression moment amongst the team. We also created what we call the Center for Traumatic Stress and Resiliency. This is an area that’s staffed 24 by seven. With behavioral health specialists, inclusive of psychologists psychiatrists, and it is there for the clinicians when they need a little bit more assistance than than needed on a daily basis. In addition, what we’ve continued to try and focus on is the notion of the importance of taking time and making sure that when the, the presenteeism we also have a number of wellness initiatives also focused on behavioral health so that clinicians know. That we’re there to support them. And then last thing, arguably maybe just as important, if not more important, is removing some of the mundane and the frustrating things that just get in their way of being able to practice medicine. That’s, we see that in as much as the the EHR and how we. Decreased the number of clicks. And so what we’re trying really hard to do is let the clinicians know that we are listening to them and we’re trying to remove the barriers that’s preventing them from proxy medicine the way they want to.
[00:10:33] Dr. Gary Bisbee: How about nurse shortages? Which obviously were. Became a prominent issue during Covid. You mentioned your nurse staffing agency, but what are you doing about the nurse shortages issue, Joe?
[00:10:46] Joe Moscola: Yeah, actually just this morning I had a prep call for one of the accrediting organizations a number of years ago. The vision of the health System, Dr. Kathy Gallo. Along with Michael Dowling was to create our own nursing school and advanced practice nurses. And so that’s been step one. Step two is we continue to go to the high school level not in many of the communities that. We serve and especially in the historically underrepresented communities where we’re issuing scholarships for it really engaging people in STEM careers. And then really beginning to introduce them to other areas, particularly nursing, so that they understand what that career could be and then what that means for career progression. Really allowing those opportunities during college years as well to experience what healthcare is. Just continuing to draw people in and spread that message of what it is and what it’s not.
[00:11:38] Dr. Gary Bisbee: Joe, for those of us who are not going to ever be a Chief people officer but could benefit from your thinking, your experience, what were the several top lessons that you’ve learned so far about being the chief people Officer? For sure.
[00:11:53] Joe Moscola: Yeah, couple things. One would be fairness and consistency. I think you realize pretty early on as a Chief people officer, a chief HR officer, you’re never gonna make everyone happy, particularly in an organization of 80,000. But if you are direction, your strategy, your adjudication at times is fair and consistent you can absolutely walk that line and you can elevate the culture and the engagement and experience of the organization. Northwell today is a fortune rated and it has been for the last three years, Fortune rated best place to work where number one on diversity Inc. For healthcare. And so we have many sort of accolades. Told us that we’re headed in the right direction. We don’t declare victory on any of those things. The second thing is, in the role you do have to be principled. And if your principles and your values don’t match that of the health system or the organization you work for, then you probably don’t belong in the role. Or you probably don’t belong in the organization. And look, there were a number of times, I’m not gonna say that every day was some shiny days. There were a number of times where that resiliency gets tested and you have to be willing to really walk the line far enough that you’d be willing to walk away. And I know that sounds dramatic, but when we. Talk, think about the topics that I just mentioned. Whether that’s Me Too, Black Lives Matter equity, diversity, inclusion, pay you’ve gotta be willing to to fight for these issues.
[00:13:20] Dr. Gary Bisbee: Yep. Almost two years ago, Joe, you were appointed as a executive vice president of enterprise services. Share with us. What does that role involve, Joe?
[00:13:34] Joe Moscola: So enterprise services is in essence how we were trying to rebrand corporate corporate felt like a bit of a dirty word and too much of a an imbalance of the different parts of the operation. And enterprise services was as much to one acknowledge. Our customers are the organization and our job is to serve their needs. And today it translates as human resources as real estate facilities, property management, man managing the capital dollars of which we spend about at 1.3 billion a year. Change management project. Project management. And then of course, flex staff, as I mentioned before Northwell Direct, which is our north director employer strategy and parts of the organization like that. So it very much is the shared services of the organization but really trying to somewhat subtly and not so subtly changed the culture of this side of the organiz.
[00:14:25] Dr. Gary Bisbee: So I know from our past discussions you always felt that HR in a way got a bad name because it was always viewed only as an expense to the organization. And you’ve taken some steps to actually produce some revenue producers coming out of your experience as hr. Can you share that with us, Joe?
[00:14:46] Joe Moscola: So the notion was, okay, if you’re not going to agree with how much we can save the organization from a cost mitigation standpoint and the value of engagement and all these other things that all and performance and leadership development, all the other stuff that s HR people get a little excited about. Then we’re gonna create some revenue. And Flagstaff was one of those was a step in that direction. Today, it has a for-profit arm and a not-for-profit arm. The not-for-profit arm over the last five years has cumulatively saved the organization upwards of $168 million of expense. The second thing we did was we created, as you heard me mention this, Northwell Direct, a director of employer strategy. We set out to. A company a for-profit company that hangs off of the parent of our not-for-profit that does just that they meet the employer where they are. It removes the sort of confusing nature that that is held systems and it acts to increase their engagement and improve the wellbeing of their team members while decreasing. And we’re in year three. We’re gonna, this will break even this year from the initial investments and we’re on our.
[00:15:49] Dr. Gary Bisbee: Well done Joe. This has been a super interview as expected. I’ve got one last question if I could, for those up and coming leaders in the audience. What advice. Have for them as they continue on their journey to become more and more consequential leaders.
[00:16:05] Joe Moscola: Can underestimate the value of relationships whether that’s within your organization, outside of your organization. I think you’ve heard a number of times from this from this discussion today just on where those relationships have paid off and you never know where they’re gonna. They’re going to pay off, from a career vantage point, I often will call those people your career sponsors. You make an impression on someone else without an ask, and yet one day they put your name forward because they sense the passion that you have the fire in your belly. And that relationship can potentially take you places where you never thought with. At times the beneficiary being either maybe yourself and your career, and then oftentimes and arguably more importantly to the type of work we do and the impact we have.
[00:16:49] Dr. Gary Bisbee: Joe, thanks for your time today. Keep up the great work. Give our best to Michael and Mark when you next see them. Take care.
[00:16:57] Joe Moscola: Thank you so much. Appreciate the time.
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