Episode 91

Leaders are Lifelong Learners

with John Phipps, M.D.

December 14, 2022

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John Phipps, M.D.
Chief Care Transformation Officer, Inova Health System

Dr. John Phipps is an internist and endocrinologist, currently serving as the Chief Care Transformation Officer at Inova Health System, where he is accountable for quality, safety, patient experience, care design, virtual care delivery, enterprise care management, and other areas critical to care delivery. He has 20 years in clinical practice and has spent 15 years as a health system leader and physician executive, including roles as President of one of the largest integrated medical groups and CEO of one of the largest independent specialty practices. John’s personal mission is to lead leaders towards the quadruple aim, at scale, with urgency.


Episode Highlights


Key Insights:

This episode is part of our Excellence in Leadership Series, presented by Citi. Dr. John Phipps is an expert in improving patient care.

  • Always Improving. The key to improving health systems is to identify excellent performance and make it the norm. A Care Transformation Officer leads the journey from inconsistently great to consistently great.
  • An Exhausted System. COVID stretched the limits of the system and of caregivers. In order to maintain high quality care going forward, health systems must first look after the well-being of caregivers.
  • Humility and Learning. John reminds administrators and caregivers alike: there is always more to learn. An advanced degree is merely a starting point; serious leaders continue learning throughout their career.

This episode was made possible by our partnership with Citi.

Relevant Links:

The heart of health care is really one human being coming alongside another human being in their suffering. And that hasn't changed.



Gary Bisbee, Ph.D.: [00:00:00] Well, good morning, John, and welcome.

John Phipps, M.D.: Good morning. Thanks Gary. I appreciate you having me on the show.

Gary Bisbee, Ph.D.: Well, we’re pleased to have you at this microphone. Let’s get to know you a bit better. John, what was your life like growing up?

John Phipps, M.D.: You know, went to public schools, played in the neighborhood, played sports, did the usual sort of stuff, and Yeah. And then I followed a long standing family tradition of matriculating at the University of North Carolina in Chapel Hill for for college. And then when I was in college, I lived in a house with four other people, all of whom were pretty extraordinary leaders even at chapel Hill. And I began to notice the traits that they had, which to me were, they were smart. They’re very hardworking. They were likable. I wouldn’t say that was their goal, but they were, you know, likable and they just seemed to care more than most people about the important stuff. So everything was just sort of, [00:01:00] dialed up and that was very attractive to me. And then as I went through my medical training and, you know, sort of on and on, I began to pull out that those were the threads of leadership that I really. I would say admired and tried to emulate,

Gary Bisbee, Ph.D.: when did you start thinking about medicine, John?

John Phipps, M.D.: well, my dad’s a doctor, so, you know, I was familiar at least with the idea of being a doctor from, you know, my la my earliest memories. But I don’t, I didn’t really think that’s what I wanted to do. Until I was, you know, pretty far along in college. So I wanted to do everything. I wanted to coach basketball. I wanted to be an entrepreneur. I wanted to go into investment banking. I wanted to be a sportscaster. I wanted to do everything. But ultimately I came to what I think was a pretty sober realization, which is that I was gonna work really hard at whatever it was that I did maybe harder. is [00:02:00] healthy. And therefore I wanted to do something that I thought mattered to me. And so going into medicine just made sense.

Gary Bisbee, Ph.D.: During your career as a physician, when did you spend. I’m thinking about administration and leading in that sense.

John Phipps, M.D.: Yeah I think for me when I sort of grew up as a physician leader the popular kind of path was the reluctant leader. So I cared about something enough to get involved and my colleagues liked me enough to let me sit at the head of the table. And then the next thing you know, you’re on the committee and then you’re running the committee, and then the committee becomes something more than that. And my interests were pretty broad. I was interested in. They didn’t call it population health at that time, but I was interested in the population health side, which was really just the idea that as a group of independently functioning doctors, often their little offices or whatever, we weren’t gonna [00:03:00] do as well, caring for an individual person, much less populations of people as we would if we worked together. So I was very intrigued by the idea that we. Actually be a team or you know, actual colleagues that work together for the good of patients. So that was one part of it. And you know, the business of medicine is, you know, complicated and I found myself more and more curious about that side of the house. And so, you know, then I’m on the comp committee and the finance committee and then chairing those committees. And then the next thing you know, I literally overnight turned around and went. Full-time practicing internists and endocrinologist to halftime and doing the other stuff, and then the rest is

Gary Bisbee, Ph.D.: well, let’s move through your career to your current position at INOVA, the Chief Care Transformation Officer. First of all, could you give us a brief description of INOVA, John?

John Phipps, M.D.: Yeah, NOVA’s a really great place. So, you know, I spent most of my [00:04:00] career in North Carolina and So INOVA is a not-for private health system inside the Beltway, all in Northern Virginia. It’s a reasonable size. So about 5 billion in revenue. There’re five hospitals including a really big hospital in Fairfax. And then the usual compliment, right? So surgery centers and imaging and physician practices and all the stuff that you would expect in an. Delivery system and it’s very high performing place and you know, it’s an area where smart people want to be and so you can get great doctors and great leaders and it’s a really you know, I think it’s a really great environment to try and do provocative things in healthcare cuz all the resources are there, the intellectual horsepower is there and and there’s just, you know, there’s opportu. everywhere, so I really love it.

Gary Bisbee, Ph.D.: Right. Well share with us the role of Chief Care Transformation Officer. What are your priorities? What are your responsibilities there, John?[00:05:00]

John Phipps, M.D.: Yeah. So practically care transformation, well, care transformation officer’s a made up name. So I, I have in my umbrella, quality, safety, patient experience, care design, care model development, digital health care, and case management. Population health, all of those things. So INOVA articulates its strategy as a care mandate, which is to provide a people-centered, highly reliable, high value, seamless system of care. And although INOVA provides inconsistently great care, the journey from inconsistently great to consistently great is my job. And the priorities are. You know, right now broken down into the sort of cultural work of how do we equip 20,000 people to do their part in delivering on the mandate? And we have a very specific sort of thought about what that looks like, and then the sort of technical work, you know, how do you build systems and processes that allow you to continuously improve the care [00:06:00] delivery that you’re provid.

Gary Bisbee, Ph.D.: Just thinking about Covid and the impact on care delivery, did Covid influence the priorities that you’re now pursuing? John?

John Phipps, M.D.: So I think it was a organizationally a big, you know, shot in the arm to say, Hey, we can do hard stuff quickly and do it as a system. So that’s one thing. The second thing is covid has been exhausting for the system and for the caregivers. . And the primary thing that it has informed, I would say, me and the organization, is that if we are gonna provide PE a people-centered system of care, the people we need to care the most for are our people. So we really, and I’ve been very impressed from the c e O to the board, to the cabinet, to the folks in hr, all across the organization. They are relentlessly focused on investing in. Caregivers and team [00:07:00] members to equip them to stay and be able to do the hard work of, you know, caring for sick people. And it’s been, you know, it’s the obvious stuff and then the maybe not so obvious stuff. So some creative things as well.

Gary Bisbee, Ph.D.: . John, you’ve been around large health systems for multiple years as a leader. What are the top couple of things that you see large health systems are needing to do going forward over the next several years to transform themselves?

John Phipps, M.D.: Yeah I think that one of the things that INOVA is doing that I really like is sort of narrowing the scope to say, you know, we play a role in lots of things, but our primary role is in care delivery, and so let’s focus on. So, so saying no to a lot of things that are extracurricular and forcing the, you [00:08:00] know, the primary things to be curricular for everyone in the organization, I think is the first thing. So just, and whether that’s just operational discipline or operational excellence or how, however you define that I think that’s, I think that’s one thing for sure. And then the second thing, . You know, in healthcare, my experience is that people rationalize moving slowly because they say the stuff we’re doing impacts patients. We wanna keep patients safe. Everything needs to be informed by a randomized, double blind, placebo controlled drug. You know, all of those things. But the reality is there is opportunity to move more quickly in certain things. And so I think a willingness. Say we have enough decision to make a good decision. Let’s go ahead and do that quickly.

Gary Bisbee, Ph.D.: Let’s to the physician role and just the practice of medicine in general over the course of your. How has the physician role [00:09:00] in the delivery of medicine, how has that changed or how has that evolved? John?

John Phipps, M.D.: Yeah. So I would say, I want to first comment on how it hasn’t changed. And so I’m a romantic in the sense that I believe that even in a technology enabled digitized world of care delivery the heart of healthcare is really one human being coming alongside another human being in their suffering. And that hasn’t changed. And we need to not, and you can’t give that up. You can’t turn that over to a computer, to technology. something else. So the essence of it, I think hasn’t changed and I think it’s important. I think one of the things we need to do is make sure that we focus on preserving that really key part. We’re in the humanity business, not the hospitality business, but we spend a lot of time talking about, you know, consumers and what seems almost like a hospitality focus. So that’s one part. But the way that it has changed, of [00:10:00] course, is. You know, when I came out of training, the usual path was to run your business and be a doctor, and that’s not the path anymore. Most doctors work in large organizations, either for health systems or for some other entity that employs people. So now you can be a doctor and then be a member of another organization.

Gary Bisbee, Ph.D.: Given your experience, what you know now, if you were coming outta your fellowship program, where would you work? I mean, do you wanna work for a health system? Would you wanna work for one of the large cap c v s, Walgreens, Walmart, Optum places? What

John Phipps, M.D.: Yes, I would wanna try all of those things probably. But no, I like the health system approach. I think. , at least for me, there’s a, like-mindedness among my colleagues. You know, we really are just trying to figure out how do we take good care of the person in front of us and the [00:11:00] community around us. And I like that, you know, sort of spirit. So not focused on, you know, the bottom line and, you know, maximizing revenue and all that thing, not that. You know, you have to focus on that somewhat, but that’s not the predominance of what we talk about. We mostly talk about, you know, how do we take better care of people with diabetes or heart failure or depression or what those things are. And so I think the spirit of what’s happening in health systems is still pretty great.

Gary Bisbee, Ph.D.: Yep. Let’s go back to these large caps, the CVSs, Walgreens, Walmarts, and Opt. Now Amazon, how what they’re all doing is trying to elbow their way into primary care course. How’s that gonna change the role of physician, do you think, in a health system? How’s that gonna change the opportunities for consumers to get care?

John Phipps, M.D.: Yeah, I think there’s a period of time that’s still gonna be [00:12:00] pretty messy. But I think on the other side of that, if you imagine that we have what really is a patient directed and patient-centered record, that’s portable and mobile and that they can take from literally any place to another place and expect it. The, that the information transfer is seamless enough and accurate and timely and all of those things, you know that then I think you get patients who really do function more as consumers and can make choices based on what they prioritize, whether it’s a long-standing relationship with somebody. Convenience or access or you know, whatever those things are. And I think on the health system side, we have to just accept that we’re gonna have to partner with people from all sorts of backgrounds, including places that we haven’t been accustomed to. And I’d like to think that there is a place for us to win from a competitive perspective even on the, you [00:13:00] know, thinking of the patient as a consumer. but you know, we’re not always gonna win, right? I mean, if people are gonna choose other options for their care delivery and at a place like INOVA, you know, they’re not gonna compete against us on heart transplants, , and, you know, the really sick people. So we have to continue to be really great at that stuff.

Gary Bisbee, Ph.D.: what about private equities? Role where they’re rolling up physicians practices in, you know, various specialty areas. Is that a longstanding trend, do you think? Or is that just more of a short term trend?

John Phipps, M.D.: Yeah, I feel like I should turn around and ask that question of you, cuz I think you probably know the answer much more than I do, but I think I in some ways I don’t get the point. You know, when I was the, in a previous life, I was CEO of a large independent orthopedic group. And of course we had conversations about what would it be like for, you know, us to go the [00:14:00] private equity route. And we just didn’t see the point. The retiring physicians, the, within a few years of retirement, they saw the point cuz they were gonna get a bunch of money as part of the transaction, but for the long arc of the group it just didn’t make sense to.

Gary Bisbee, Ph.D.: Let’s talk for a moment about the increasing technology available to. You all that practice medicine, digital technology, pharmaceutical technology, is that exciting as a physician to see all this new opportunities for you, or is it overwhelming? How do you think about that as a physician?

John Phipps, M.D.: Yeah. I think it’s exciting and overwhelming. And for me, I think it’s been also frustrating because I feel like we need to be able to get tools and information in front of provider slash decision makers in real time or efficiently, and we’re not very good at that. So Best Practice Alert is a real-time decision [00:15:00] support tool that works, but it’s not very elegant. And so the idea. You know, you can have this accessory brain there to help you sort through all this, you know, structured and unstructured information that you receive and all kinds of ways to help you make better decisions. I mean, we’re just not there yet, but it will happen. So that part I think is really exciting. And then I love the idea that we consider personalizing care to the biology psychology. Genome, social conditions, all of the aspects that are unique to an individual. And then say, based on all of these unique aspects, you know, how do we deliver care in a way that’s optimal for that person? And I feel like we’re, you know, very early at even gathering some of that information. Some of it we don’t even gather at all, but all of it represents, I think, huge opportunity.

Gary Bisbee, Ph.D.: How are medical schools going about? Preparing physicians for [00:16:00] this kind of rate of change or are they, is that something you pick up in your residency and fellowship program?

John Phipps, M.D.: Yeah, I think, I mean, you know, the technology in training is different now. So, I mean, e every aspect of training is infused with technology, so I think that part is different. I think the idea that you work in a team and that you play different roles on the team is something that they’re really focusing on, which we never focused on. So, and now, you know what, one of the things we talked about is not only what is my role as a leader of a team, but teaming, cuz the teams change every day sometimes, right? The people around me caring for a given patient aren’t the same people. As yesterday, so how do you quickly learn how to work as a team? You know, how do you leverage the technology? I think all of those things are things that were completely absent of my training and are embedded in all aspects of training. Of training. [00:17:00] Now.

Gary Bisbee, Ph.D.: Well, John, it’s been a great interview. I’ve got two kind of wrap up questions if I could. One is for young people that come to you and say, Dr. Phipps, I’m really interested in medicine. What advice do you give them?

John Phipps, M.D.: Yeah I encourage people that are interested that it’s an amazing. universe of opportunity and that there isn’t one path that you have to take. There are a million things that you can do in anywhere, whether it’s the medical school route or any, you know, almost any route that ends up in the universe of care delivery. So I’m discouraged and disappointed when I hear that people are telling their children or younger generation, oh, don’t go into medicine. I don’t, honestly, I don’t understand that at all. I still think it’s. Noble profession. I think it’s a calling. At least to me, the work that I do is important. And it’s focused mainly on other people and, you know, to build a [00:18:00] life and a career from that mindset and to have the opportunity to do that and make a good living and, you know, I can’t imagine why people wouldn’t wanna do that. I mean, they’re frus, I’m sure. There are frustrations in every industry, so there are frustrations in healthcare, but I mean, you know that I, that to me is hardly a reason not to do it.

Gary Bisbee, Ph.D.: second question, which you’ve really answered, but let me ask it directly. For those not only physicians, but any healthcare leader let’s just say in a health system that come to you and say, Hey, Dr. Phipps, I’m thinking I’d really like to do more in the way of leadership. What advice and counsel do you provide them, John?

John Phipps, M.D.: Be humble enough to know. , you can learn about anything like. There’s so much stuff you can learn about. You can learn how to be effective in a meeting. You can learn leadership, you can learn how to work in a team. I mean, you know, just because [00:19:00] you have an advanced degree and a career behind you, it doesn’t mean that you know how to do everything, even things that may seem basic. And so take the time to learn, you know, how to do those things better. And I, and that’s time well spent in my.

Gary Bisbee, Ph.D.: Yeah. That’s great advice. We appreciate your experience. We appreciate your wisdom that you shared with us today, and many thanks for being here. Terrific interview John.

John Phipps, M.D.: thanks so much for having me. I always love talking to you.

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