Growing Up and Building Better

Green Spring Internal Medicine just turned 18 last month. Our anniversary of our start up is July 5th, right after Independence Day, which is fitting since we have worked very hard to build and sustain and grow our independent practice all of these years. I have often referred to the practice as a teenager, talking back yet still needing love and lots of attention. 

With over a decade of experience in team-based healthcare, the practice is able to function well even in my absence. I am always told that I am missed when I return from summer travels, yet the team is able to serve our patients and their families and caregivers whether I am in office or not. My long-term hope is that the practice will be able to carry on with excellence long after I retire (and I'm not planning on retiring any time soon). 

In the past year, the practice showed real signs of growing up, as we cultivated the seeds we had planted years ago. Dr. Nayak joined the practice in May, and we launched our updated practice website in October. My fellow leaders and I started meeting monthly to reflect and set goals and hold one another accountable. As the founder and executive, I have also benefitted from having a financial advisor and an executive coach alongside to help me set realistic targets and manage better in order to achieve what we have set about to accomplish. I am incredible grateful for this kind of advice and fellow leaders who share our core values.

I was challenged some months ago as we rounded the bend into new year, to distill the values of the practice into something memorizable that our staff team could grasp. This was easier said than done, as so many values are good to have. I settled for a mnemonic: TEAM GSM.

T stands for trust. Awhile back, someone shared the book _The Speed of Trust_ with us. While I didn't actually read it, not a connoisseur of business books, I have been taught that trust is a key ingredient to the healthy functioning of a team. It is most critical in the doctor-patient relationship, but it is also very important for healthcare teams. Not everyone is naturally trusting, yet repetitive experience can build that trust. I think of it the way I think of the first year with Zeke (my pandemic rescue pup). He and I would be walking down the street, and even a dog from across the street would set him off in a tizzy. He would lose his shirt, I often said, at the slightest movement in his direction. At first, we would turn around and walk in the other direction so that he would know that I was not the kind of person to lead him toward danger. Later, I would talk with him and encourage him, telling the best story we could about an approaching dog. Even though I'm sure Zeke could not understand my every word, he learned that he was going to be safe in these encounters.

E stands for excellence. I borrow from the writings of my brother-in-law, Michael Lee Stallard, when I encourage our team that a healthy workplace culture is made up of both relationship excellence and task excellence. We not only want to care for our patients with compassion and kindness but also to be technically good and diagnostically accurate. Here, I am so grateful to have an equal in Dr. Nayak. Two months ago, we put together an Excellence Box in the waiting room for our patients to highlight how they have experienced excellence from our team members or offer suggestions for how we might become better.

A is for accountability. We have held ourselves to high standards with measures of the quality of care and outcomes for our patients. We are accountable to our healthcare system, in two Medicare programs who hold us to the quality of our work and a number of other insurers with measures of their own which they expect us to meet. With such a high bar, each member of our staff plays a key role in our achievements in addition to the basics of being accountable to one another for being present physically and mentally, for following through, and for living what we believe.

M is for meaning. The value of finding meaning in what we do is so important. The past four years were so challenging in healthcare, and all of us experienced burnout of one kind or another. Besides getting the rest and relating well to one another and others, finding meaning in what we do is the best remedy. When I finally have time to really reflect, I have realized there is so much meaning for us in remaining an independent practice with all of the freedom to align all that we do with what is good for our patients and also what is overall morally good. 

G means good revenue. We are a business, after all, and if the business is not healthy revenue-wise then we cannot thrive. Yet, whatever ways we are generating revenue is tied to what is good for our patients and for society. There are a lot of ways of generating revenue in healthcare, but not all of them are good. Overdiagnosis, overtesting, overcharging and under-covering are some of the categories that contrast with what is good. We share the outcry of our many patients who struggle with woes in the healthcare system. While it is hard to work within a broken system, we also believe that is the only way we can try to change it for the better.

S stands for special care for the needs of the poor. We have taken time to identify ways certain social circumstances affect our patients, the stability of their health conditions and their outcomes. We have been able to partner with mental health coordinators through MINDOULA, social workers through Connections for Health, a clinical pharmacy team and a community health worker through Aledade, nurses through Village Health, and nutritionists through Sylvan Health. We have also contributed to charities like the Maryland Food Bank and been able to give grocery gift cards to some of our patients. Our team has also gone out to patients' homes when that is where their care needs to be. We have called this program Orbit, as we seek to revolve healthcare around our patients. 

M means making lives better. Our vision is the following: Thriving together. While we sometime struggle and often have to strive, we aim to thrive individually and as a team, as a practice and as a community. Because our health is our first wealth, it is the basic ingredient of thriving. 

TEAM GSM values. We hope to live into these values as we grow, cultivate and build the practice in order to serve patients and their families in the Baltimore Metro area and beyond. Please let us know if you know someone who would like to join our team as we are often hiring support staff and medical assistants and will be aiming to bring in more physicians in years to come.