Data Driven Leadership

The Art of Discernment in Medical Decision-Making

Guest: Hannah Anderson, University of Kentucky Physician Assistant Program

Have you ever heard the myths about data-driven leadership in the healthcare industry? That it's too hard to implement, that initiatives don't lead to meaningful results, or that reliable data is hard to come by? Hannah Anderson debunks those myths and shows how constructive discernment, leadership, and decision-making can be effective tools in your healthcare practice.

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Have you ever heard the myths about data-driven leadership in the healthcare industry? That it's too hard to implement, that initiatives don't lead to meaningful results, or that reliable data is hard to come by? Hannah Anderson debunks those myths and shows how constructive discernment, leadership, and decision-making can be effective tools in your healthcare practice.

Hannah is a passionate healthcare professional and lecturer at the University of Kentucky's Physician Assistant program. With a trauma and general surgery background, she has firsthand experience in the challenges and complexities of patient care. Her dedication to improving patient outcomes through data-driven leadership and constructive discernment has made her a sought-after voice within the medical community. As an advocate for balancing guidelines with critical thinking, Hannah believes in fostering a sense of service among healthcare providers. Her dynamic approach to teaching and commitment to empowering future medical professionals make her an invaluable asset in shaping the future of healthcare.

In this episode, you will learn how to:

  • Revolutionize data-driven patient care through the implementation of electronic medical records.
  • Strengthen patient-provider relationships by embracing patient-informed care and fostering trust.
  • Conquer fear and use setbacks as opportunities for personal and professional growth in healthcare.

In this podcast:

  • [03:10-12:15] Using data in patient care
  • [12:15-14:10] The importance of constructive discernment in healthcare
  • [14:10-16:13] Balancing patient care and keeping up with the evolving healthcare system
  • [16:13-30:03] Patient-informed care and empowerment
  • [30:03-36:16] The importance of pausing
  • [36:16-37:59] Realistic expectations of data

Our Guest

Hannah Anderson

Hannah Anderson

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Hannah Anderson, MSPAS, PA-C is a Lecturer at the University of Kentucky Physician Assistant Program, her alma mater. She previously worked in Trauma and Acute Care Surgery. Prior to PA school her background was in Community Health and Family Medicine. She is board certified through the NCCPA and is licensed by the Kentucky Board of Medical Licensure. She is passionate about training resilient, excellent healthcare providers to provide optimal patient care for their local and global community.


Jess Carter: The power of data is undeniable and unharnessed, it's nothing but chaos.

Speaker 2: The amount of data, it was crazy.

Speaker 3: Can I trust it?

Speaker 4: You will waste money.

Speaker 5: Altogether with duct tape.

Speaker 6: Doomed to failure.

Jess Carter: This season, we're solving problems in real time to reveal the art of the possible. Making data your ally, using it to lead with confidence and clarity, helping communities and people thrive. This is Data Driven Leadership, a show by Resultant. Welcome back to Data Driven Leadership. I'm your host, Jess Carter.

On today's episode, we're going to dive into data-driven patient care, and specifically what we're looking at is how we can use data in a more meaningful way to actually improve patient outcomes. To help me talk through this is Hannah Anderson, a lecturer at the University of Kentucky's Physician Assistant Program. Welcome, Hannah.

Hannah Anderson: Thank you.

Jess Carter: Now, Hannah, you have to unpack for me and remind me again, you do have alphabet soup after your name. Walk me through how are you trained, where are you trained, some of your background.

Hannah Anderson: I have of course, a bachelor's from Taylor University. Then, PA programs are master's degree programs. After college I went on to get a two and a half year master's degree program, which involves about a year and a half of didactic training. Then, our program is a year of clinical rotations but programs vary. It's masters of science and physician assistant studies. Then, the PA-C is a physician assistant certified. A lot of people wonder that, my grandmother never remembers that. Every time she sees a PA, "Now, tell me what those letters stand for?" Every time.

Jess Carter: You have some of the best stories that I've ever heard in regards to boots on the ground patient care. Part of me was like, "Could I put you on the spot to think about a scenario? I don't know, in my head I was like, it'd be cool to hear you say, "Here's a scenario I was in where you can demonstrate what you know what you think." That whole process where you're like, "If I would've just listened to the protocols, this would've happened." I don't know, do you have something you can pull out for that?

Hannah Anderson: You know my background is in trauma and general surgery, so when I first graduated PA school, that's what I was doing. Obviously, in the world of trauma, at a Level 1 trauma center, the people I cared for had been admitted, so they were broken enough to really need more care than just in and out of the ER. Everyone of course, was probably in some level of pain.

When you are caring for 12 to 18, 20, some days, 25 patients a day, you have to find ways for your EMR, your electronic medical record, where you chart, where you put paperwork in for discharge, you have to find ways to streamline every process, whether it's writing a note, discharging a patient, writing a prescription, whatever it is. One of the most time-consuming things is discharging a patient and writing their prescriptions and then getting them ready for them.

One of the things that the EMR incentives would do is have these pre-written prescription amounts. I hope I don't horrify too many people by this, but this is not specific to the hospital I was in. This was an industry practice that really did make discharging my paperwork so much more efficient. If you can think of it from a quality patient care standpoint, the more streamlined discharge is and the paperwork is, the more quickly I can get to your bedside to talk to you about what we're doing today or how sick you are.

If you're declining and I run to you or the person next door is declining and I run to that room and you're waiting on discharge, you're not necessarily going to know the person next door is declining and that I'm busy there. You're going to be annoyed it's taken me so long to discharge. Efficiency is good. This is good, it improves patient care to a degree. Part of the efficiency is these prefilled prescription amounts and we had certain ones that were pre-approved.

Everyone, all of the doctors had to agree on this dose, the instructions, and the quantity. We went from, and I don't know that it's the most diplomatic thing for me to tell you the actual dosages and quantities. I think some people would be upset at me sharing that. When I first started with the trauma service, it was the same for every person discharged.

You could have a broken femur, you could have a broken wrist, you could have a broken nose, you could have had a big belly surgery or you could have had a collapsed lung, all of these things. I think in the lay world, all of that is like, "Oh my gosh, of course you need pain medicine." Well sure, but do you need two weeks worth of opioids? No. Now, will you have patients that say, "Yes, I do." Absolutely, almost every single patient was so happy to go home with more than enough pain medication.

Then, you start to see the evolution of the opioid crisis, which was not subtle. We quickly started to reevaluate how often we would use that preset prescription selection. I think just to go back to obviously that's not a national guideline, the prescription itself but it was institutionally approved by a large team of physicians. There's no fault of theirs until this point in history, we didn't have this big problem where people were selling them or abusing them.

It would be a pill bottle that you would not take most of, put it in your cabinet and forget about it until 10 years later and you had to throw it away, or take it to the pharmacy to throw away. This was a very new need that needed to be addressed and it called for a change of literally a setting in the electronic medical record. Then, within a period of probably two years, well, a few of us started to say this, "We need to change this."

There was a lot of tension over whether or not it needed to be changed. You have a lot of patient pushback of, "I don't have enough, or what if I need more?" There was a massive culture shift in seeing patients in clinic and getting phone calls, "I need more, I need more." You don't, you're scared, and we understand being scared, but also understand that after a few days of persistent opioid therapy, your risk increases dramatically.

It's even being revisited whether or not, I think it was Medscape recently, but that may be incorrect, that put out an article about even moderate operations are being considered for non-opioid appropriate procedures. You have your gallbladder out, you have a hernia repaired, I mean, those are surgeries, they're real operations, but do they really need opioids? Can we just go back to ibuprofen?

I know I've soapbox you about this before, but people so under appreciate, ibuprofen and Tylenol, it's a miracle that we have these medications. It's a miracle that you can just go to the pharmacy and buy them, and that they will help you, and that the FDA trusts you at home with these medications.

Jess Carter: I had this moment of realization with my first kiddo was it was the day after I had her. This sounds silly, but I'd never, again, I've been mostly outpatient, so I'd never experienced someone asking me my pain on a scale. You're sitting in a room and somebody's like, "Where are you on the scale of 1 to 10." At least back in 2019, I was asked. I remember being like, "It's a three."

They were like, "Are you sure? Because you look miserable, you seem like you're in a severe amount of pain." I was like, "I mean, I'm not thrilled." They were at some point it was like, "You have to say seven, we can't give you what you need unless you say seven." I was like, "How do you measure pain? This doesn't feel like a great way to be like. To me, seven is like I'm bleeding out, I'm going to die and I need morphine on a battleground somewhere."

To me, that's not what I was, but I felt way better when I said seven and they gave me something. I think even how we measure pain and how we learn to talk about pain, like you've said some interesting things to me in the past about, I'd never thought about the history of pain medicine, that it has been around for 100 years or 2,000 and what did that look like?

To your point about having pain meds that we can go grab in our closets upstairs or whatever, some of that is just stuff I'd never really thought through until you brought it up to me.

Hannah Anderson: Well, I think a lot of people are scared of opioids because of the opioid crisis. That's also sad to me because they have their role. It's a very short-term and acute role in many cases. It's not a, "I heard a little, I should keep taking my medicine." That's another old school medicine kind of thing. I don't know, people are going to throw me some shade that prescribed Lortab three times a day every day.

That's not a great way to train your brain to cope with pain. You have what are called endogenous opioids. Your body produces pain therapy, pain management that when you down-regulate that with exogenous opioids, when you take something that satisfies those receptors, your body's going to be less ready to make that. This is anecdotal for me, again not a researcher, but just from having dealt with, you see how people who are on opioids slowly don't tolerate pain as well.
Anyways, I think, again very anecdotal from my own personal experience, but I think what is sad is the fear on both sides that it solicits the people that are in so much pain, they need help and they're terrified to take anything because they're scared they'll get hooked. That's sad, we need to help you out, we're in the process of adjusting. There are people with chronic, horrible degenerative spine conditions, things like that.

I think this is a grace that you can actually talk to people because otherwise without this medication, you'd be in so much pain, you would be curled in fetal position all day every day. Obviously, there's a balance to be struck. And there's exactly where we come back to. It's so comforting to have guidelines. It's so comforting to be told when to say yes and no, when to have your prefilled prescription amount.

You have to at some point, take on the responsibility of being a healthcare provider and consider your patient, consider your resources. What is our prognosis? What's our timeline? There's so much to be considered, which is why in teaching PA students, we're not teaching them to read guidelines only, we're teaching them learn the guidelines and learn medicine because a computer can follow guidelines. You're not a computer, computers don't treat people.

Now, we're learning AI even has its own biases that are actually growing exponentially because we give them the bias when we create them. Anyways, we have to think, we have to discern. I think as soon as you stop being challenged by that is when maybe you're comfortable in practice but patients are not improving. I'm just listening to Dr. Fauci, it's recent podcast with the New England Journal of Medicine, and he talks about when he first started treating patients with autoimmune diseases, with chemotherapy drugs.

Everyone was going, "You got to stop. You can't do this." No one's recommending this. This is totally against everything that the guidelines say. Well, I can't remember what the exact numbers were, but he was like, "Don't these patients have basically a 93% or 95% mortality rate?" They're like, "Well, yeah." "Well, so why not take risk here?" He was in the position to do so. Obviously, there's responsibility and accountability to be acknowledged there.

I just think it's a really neat example of how he wasn't ruled by guidelines. He was thinking about the patient. He was being a provider. He was evaluating the situation, considering his resources, and making the best decision possible while informing the patient. He was very clear about, very clear conversations with patients and their family members about the whole process. Then, there's this whole other arm of patient informed care.

Jess Carter: We should dig on that, I'll put a bookmark in patient informed care. Something else I'm thinking about, what you're describing, and the reason I wanted to talk to you on this podcast is because I think what you're demonstrating too is how do you apply discernment in data-driven leadership in the medical industry? How do you understand that there's data everywhere.

You're drowning in data now. You're right, 20 years ago you weren't, you're begging for research that took 20 to 40 years to produce, and then you leveraged that for another decade or two. It's like a completely different world where you want to leverage the data, but you have to be discerning, and you have to understand. This may be, I'm probably deliberately asking a impossible question, but I am curious if you have any nuggets. How do you teach PA students that?

Hannah Anderson: Well, that's a great question. I have some colleagues that have been doing this for a really long time. Let me go and ask them and I'll come back. Gosh, well, again very specific to my opinion at this point, because I'm a very new lecturer. I think so much of it comes into who are you accepting into the program, who seems like they're ready for that challenge because it's a tremendous challenge.

Well, I think that what maybe is taken lightly is the call to, I'm going to say it this way, that I realize maybe not everyone agrees with, but I think that going into medicine should be answering a call to service in your heart. I think if somebody cares for people in such a way that they want to be part of helping them get better, and that can be interpreted in a variety of ways, but I think that is what needs to be part of your foundation if you're really going to learn constructive discernment.

I think that, well, by definition, discernment I think is constructive, but I think it's hard to know if you are discerning or deciding. I think that plenty of people can decide things and it's not necessarily for the betterment of those around them. If you're discerning what is best for a patient I think a lot of knowledge, a lot of practice, and a lot of heart goes into that. I really do. Now, I'm sure there's plenty of rebuttal for me, but maybe that's my heart.

Jess Carter: Well, it sounds like you're starting at that point of who is in it for some sort of, dare I say, purpose, the sense of purpose. I do think that I'm in, we may hang out, but you're in medical, I'm in tech. For me, we're trying to debunk the same thing. We've got amazing people who are unbelievable at technology, unbelievable at science and engineering and whatever, developers that can develop robots that go to Mars.

It's incredible what they're capable of, but it is different to be exceptional at your trade and to be a good discerning leader. Where we struggle is we get people that are 15 years into their exceptional trade, and it's like, "But did we stop and ever uncover or encourage or demand that if you wanted to grow, you had to grow in discernment and leadership skills?" You had to understand how to listen and coach other people, read the room.

Some of these things that are very much soft skills, but essential to leadership. I think in a lot of ways though, they're wildly different industries there's the similar challenge. What's interesting to me is in your profession, you're pretty much training, everyone you talk to is going to be a leader. They're going to be coming through your program, they're going to make discernment decisions.

They're going to go lead and take care of people. The bar has to be pretty high, I imagine, they have to come in and demonstrate some ability or some interest or some purpose-filled desire to be coached in some of those ways, right?

Hannah Anderson: Yeah. Well, and I say all of my compassion based ideas, understanding that once we are out in the world as healthcare providers, as PAs, then you have administrative or otherwise pressure on you, whatever can handle stress the least gets squashed out first. If it's your time with the patients, if it's your ability to go research the most recent guidelines or data, whatever it is, it gets squashed.

Some people really don't have a choice but to find what they think is the best possible way, and then just do that over and over and over. I really think from a future of medicine standpoint, we have a growing problem that we have more data to take in, more ways to provide data informed care, and less opportunity to do so. The more the healthcare system evolves, the more burnout we see.

I can't tell you how many friends are ER docs who are no longer full-time because they are so burnt out and overworked. Primary care people, if you see your primary care person and you're like, "Well, they only gave me so much time." Yeah, because how many people they're seeing today? 30, 50 depends on the practice. They only have so much time to write your note. Are you frustrated that you're not getting a nice detailed, chunky note in your patient portal?
Well it's because they don't have the time. You have to choose where your time goes. I don't want throw all the healthcare providers out there listening, I don't want to sound like I'm totally disregarding the pressure and the grind that is care, it is patient care. I think one of the crises that we're facing is how do we keep up with the best, most recent, most reliable data that will optimize our care versus taking in the 10 most recent articles on tobacco cessation guidelines.

You can't read all of that. I mean, unless you don't sleep, which that is some people's answer. I mean, some people really don't sleep, but then are you a healthy person? Are you somebody that should be making medication decision? There are superheroes out there and they can do all of this and still provide excellent care. I am not one of them, most people are not that way.

Anyways, I say that because as ideal as this whole world of, "Let's get the best data to the providers and we're going to keep changing with it." As ideal as that is for most people, it isn't feasible. It's just not a realistic balance to strike. The looming question is, what is the best way to help providers stay informed, stay excellent, and manage the pace of practice?

Jess Carter: Well, that might lead us into patient informed care maybe. I literally I'm not going to propose what that is. I'm going to have you explain it, but I imagine maybe a little bit too of how do we empower patients? There's part of me too that's like, "I'm sure your dream patient is somebody that comes in and has, what was the challenge 10 years ago."

Everyone was Google searching their symptoms and walking in with a Wikipedia diagnosis and they said, "I know I have this." I'm sure that's like your favorite thing, WebMD, that's what it is, "I WebMD my symptoms and I think I have a hernia." You're like, "Okay."

Hannah Anderson: The nice thing is, as a provider, if you Google something, you really don't get the answers you need. You need to know the specific way to search or to a Google Scholar review. I think what's comforting about that is that if a patient had enough knowledge that they could search for a similar thing, they're going to get vague enough results that they still have to call their provider. From a safety standpoint you're like, "You should not be trying to do this at home."

Jess Carter: Even if you can't figure it out, you need a diagnosis or support. You still have to call us.

Hannah Anderson: Yeah, so call. Patient informed care I think is excellent. I think there's, trying to think of what show it was. It was on Parks and Rec when or no, it wasn't. I'm sorry. It was on the office, and it's when Pam has her baby and the nurse comes in to check on her and she says something like, "Oh no, don't give her a pacifier in the nursery. I don't want her having nipple confusion. I read all about that." The nurse says, "Good."

Jess Carter: The side eye to the camera.

Hannah Anderson: I think the problem with that is usually that it takes away trust from the provider. If somebody says like, "I have an idea of what this is or what I'm experiencing." Would you think if the trust is still there, then it's a very constructive thing. I think if you have, which often you do have patients coming in that don't trust you and they feel like they have to defend themselves, but it's still part of that vicious cycle.

They have to defend their time in your office because they know you're stressed and you're going to be brief, and you're going to assume things to make care easier. It's not because the person coming in to see you doesn't care usually, it's because they have 10 other patients actively in the office waiting for them or stuff like that. There is hope in the medical system.

I think a tension-filled moment right now where patients feel vulnerable but overwhelmed with information and possibilities. Providers are overwhelmed with information, but want to stick with what they know which is safe.

Jess Carter: Well, I feel like as a parent, I feel like I text you whenever I take my kids anywhere because there's this concern of do I need to advocate for anything? Is this just a normal visit and it's fine and my kid has strep again, or my kid just has a cold or there's something normal going on. Is there any little tiny thing that if I paid attention to it and voiced it, someone would be like, "Wait a minute, what?"

There's this desire of, for my own care, I might go two years before I check into, "Sometimes when I stretch my back, I feel a tweak. What's going on there?" When it's my kids, I'm like, "Hold on." They can't adequately advocate for themselves and discern exactly what's a nine on a scale of pain or something. I think that amplifies it for me too of like, "I got to advocate. It's not just like I trust, there's a little bit of trust but verify going on."

Hannah Anderson: I mean, feel that. The healthcare providers talk about that everybody goes through this, I mean, they say healthcare providers are the worst patients, or nurses are the worst patients because you come in, you've already decided what you have. Well, one day I'll forget, but for now, I don't forget that I had a sore throat one time, and my background is trauma.

I'll say that in general surgery, but I feel like I'm pretty sharp on most topics still. Everybody has this little blind spot every once in a while, especially when it's for yourself. I had a sore throat and I went in to be seen and I was like, "Well, I have a virus or I have strep, that's it." The doctor I saw looked at my throat and said, "Well, you have a tonsil ulcer." Which those happen, they just happen, I totally forgot they exist. I was so embarrassed.

I was so embarrassed, I was like, "I should have known that that was what was going on." I just had convinced myself that I had strep throat and I needed to make sure I wasn't going to give it to our kids or spread it at work, or I had virus and I just needed to make sure. No, it tonsil ulcer. I felt so silly. There are those kinds of moments where anytime I'm worried that I need to give the provider all of this information about me or my child.

I've tried to practice reminding myself that non-healthcare provider patients come in every day, all day, and they get excellent care throughout the world. I trust that. I mean, obviously not excellent everywhere but it's possible. Is it possible that I would have something that gets missed and I'd be one of those bad stories, of course, but it's very unlikely. I get in the car and drive every day, and I don't freak out that I'm going to have a car accident.

I can go to the doctor and trust that I'll probably get good care. It's really hard to take that step back because you do, you go through the spiral of, "Well, maybe that's relevant, but maybe it's not, but I should tell them anyways and let them decide." It's this fear cascade. It could be worst case scenario, what if it is worst case scenario? Well, the only thing I can do is overreact just in case. Well, just in case, and the brain is really good at fear.

Jess Carter: Well, if you're leading me into this totally different topic, but it's something interesting that I was curious about too. Part of me is also there's a lot of emotion involved in the medical field and it's not just in the patients. I don't know if I sat here and asked you, when's the time you got it wrong? When's the time that you used data tried to discern? Then I was like, "I don't even know if you could tell me, Hannah, because there's probably somebody could sue you or something."

There's some of that where it's like there's probably people who are, the medical community is not necessarily a place where it's easy and safe to fail is my point. You call it practice because it is practice, it's not perfection, but there's not a lot of room for, "You didn't do great in your practice, just get better, try again next time is not exactly the environment we're in." That probably amplifies some stress and some, I don't know, key factors where humans don't tend to perform at their best when they don't feel like there's any wiggle room buffer safety net. I don't know, it's interesting to me.

Hannah Anderson: Yeah, there is no wiggle room. You don't go, "Oops." No patient wants to hear their provider go, "Oops."

Jess Carter: You want to feel like they're trusting them and there's not a lot of room for error if they get something wrong, you're like, "I don't know that you're hanging out with that doctor for the next 20 years."

Hannah Anderson: I'm trying to think of, I can remember one time that did not cause any problems with the patient.

Jess Carter: You're taking me on, you're taking the question on. I love this.

Hannah Anderson: I am, I'm taking you on because I think it's important but it still ties into fear. I remember one time talking through a patient asked something about they wanted to see their rib fractures, and I'm all about, if you've had imaging, that's your body, you should be able to see what's going on. So often, people would just accept what they were told as diagnoses or they'd be so broken that by the time they cut come out of anesthesia and they're waking up a few days later or weeks later, they don't know all of their injuries.

It was an important process at some point to sit down with the patient and say, "These are all your diagnoses." Often the follow-up was, "Well, I didn't know that. Can I see that? Where is that?" I pull up images and talk through them. This was when I was a very early PA and I had pulled up, I think it was probably a CT scan or something, and I was explaining their rib fractures to them and I had totally flipped the orientation of the images.

I was telling them that their fractures were over here on the right or left. I was telling them that they were over on the right and then it might have been the attending that came in, or one of the fellows that came in while I was talking to them and corrected me that, "No, no, no." Before they came in, I remember the patient getting this look on their face like, "What?" The fellow walks in and corrects me. "No, those are on the left side." I was so humiliated and the patient said, "That makes sense, that's where I hurt. I was pretty confused that they were on the other side."

I was so humiliated and I didn't make that mistake again. From a providers' standpoint, the negative feelings are really fear that everyone will just think you're incompetent then. If you make that mistake, what are the mistakes are you going to make? Oh, gosh that's a fear spiral. At some point, we have to learn to mitigate our fear, look at what we know and do the best we can with compassion and excellence.

I think that when it comes down to it, you have to regroup somehow and go, "What do I know? What are my resources? What am I looking at? What am I looking at can be all of the things. Who is the patient? Where are they coming from? What's wrong? It sounds simple when you just describe it that way but it's not. It's also not specific to medicine, I mean in life we have to learn to do that. I don't even know if I want to call it trust that everybody has to move forward with trust.
I think it's just learning not to listen to fear. Just don't be ruled by fear because everybody has different things they might trust in, but try to be not ruled by fear.

Jess Carter: I think the emotional description of fear for me that I've really, I just think most people can relate to is that spiral. You start spiraling out of control. You have a thousand thoughts, you can't let go of them. You either can't go to sleep or you wake up in the middle of the night thinking about it or you can't let go of it. You're in a meeting and you can't focus because you're focused on the other thing that you can't let go of.

To me, and maybe that's where I'm curious about when did you learn, and this is a little bit abstract here as we wrap up, but when did you learn how to stop the spiraling? Are these some of the processes and tools that were given to you where it's like, "It's not productive anymore to keep, it's actually accomplishing nothing to keep spiraling." How do you get yourself out of those moments?

Hannah Anderson: Well, I do think being a healthcare provider was a huge part of that because you can't stop and you can't be ruled by it because the next person you're going to see they need you. They need all of you fully present, fully engaged. You can't really have a day. You can't go, "Sorry, I know you're hemorrhaging in your belly, but I'm really stressed out about the encounter I just had. You're going to need to take a minute."

Jess Carter: In my world, it's the equivalent of when people ask you in interviews, what do you do? How do you handle stress? People are like, "I go on a run." I'm like, "It turns out you can't go on a run in the middle of a failed prod go live or deployment. It's not like I'm stressed, let me go on a quick jog. I'll be back in an hour." That doesn't work.

Hannah Anderson: Well, just to get a little bit crunchy granola on you but I know you're here for it. I think if you're not able to go inward and find some stability, then you're toast. I mean, good luck.

Jess Carter: That is my favorite thing that anyone has said on the podcast yet, because somehow just while discussing how to get over fear spirals, induce a major fear in me of like, "If you can't, you're toast."

Hannah Anderson: I know, just don't call me to do your motivational speeches. You're toast.

Jess Carter: You're not probably wrong.

Hannah Anderson: It's got to be a better way to say that.

Jess Carter: It's so funny.

Hannah Anderson: Well, I've got to find a more constructive way to share with people that I think we are so fast, whether you're in traffic, in medicine, in your workday, in your personal relationships, you move so fast that if you don't pause, the spiral is not stoppable. I don't mean that you will end up dead in five minutes obviously, but I just mean that fear might dictate what you do.

I think it's pretty easy to say and hard to practice that if you aren't aware of the beginning of that spiral, then you have a hard time putting the stick in the wheel and going, "I am okay. I am breathing, I am present. This is my purpose here right now." Then, move forward with that purpose.

Jess Carter: You're right, no, no, no. I think Hannah, I actually think it was hilarious and astute because there is a reality where it's like, "Hey guys, on earth, no one else is going to be enough for you to calm you down in the moments of fear." You have to be an adult and figure out how do you know need breathing techniques? Do you need to close your eyes for a minute and just stop with the stimuli visually? Pause for a minute.

For me, everything felt like it was overwhelming at work and work was my identity for a long time. And it took me a minute I was like, "I either need a therapist or a coach, maybe both." I got on the phone with a coach and she was like, "Can you just find 30 seconds?" Before, to your point, I was making decisions all the time, I wasn't discerning. She's like, "If you can just create 30 seconds where you think you're ready to make a decision, but you pause just for 30 seconds and really contemplate why you're making that decision, what data you have available, kind of stuff you've walked through, and then make it.

You're probably not going to change your mind. It was like I had to practice realizing that when I got in the car, I didn't have to be efficient my whole life every minute, I could pause. Actually, in reflecting, in processing for five minutes, I'd always get in the car and make a call because I'm trying to be efficient on my drive. Actually, if you stop and reflect on some things, you might have better ideas than the ones you have right now.

In five minutes you can make a better decision because you taught yourself the skill of not hours of pausing, not hours of mindfulness, minutes and seconds of pausing. I can't believe what a difference has made in my abilities to just and the number of people that come to me when they didn't before probably because I reacted to everything versus now I'm seen as somebody who can make you pause too and get somewhere better than where you are. I didn't have those capabilities two years ago. Some of that's just through practice.

Hannah Anderson: Everybody has 30 seconds, everybody has a minute. I think what's important is you're not doing something else. I think from a leadership standpoint, if you are not managing your spiral, the people under you won't either. I think from a patient care standpoint, that's easy to say. Patients know when a provider is on edge and snippy and trying to get out of the room or not paying attention.

I think we've all been in an office where somebody came in and never sat down and then left the room within three minutes. From a patient advocacy standpoint, that is when I say, "Well, hang on, you can speak up. You are a human being with a voice." You were allowed to say, "No, I need the doctor back in here. I have more questions." I remember working with a doctor once who said, and this is not an uncommon practice that I've been in the room once I never go back in.

They can ask as many questions as they want through the nurse but I will not go back in. I would be curious what the rest of your relationships in your life look like. If that is how you treat people, then I think the evidence will speak for itself. A little different kind of data, it's like subjective data being collected in the moment. Anyways, I guess to pull together the tangent that I led us on, I think that I used to be really cynical about the idea that anybody can be a leader.
I mean, that was a very juvenile thought and it was a pretty cocky thought, not anybody can be a leader, I know what a leader is. How many people was I leading? Nobody. They were going, "You got a bad attitude, we don't want to go where you're going." I think there are a lot of titles that really come with talent and skills and strategy, but treating human beings in your life is leading someone somewhere.

I definitely always under appreciated how much just being a healthcare provider was being a leader. If at minimum you're teaching someone that they're a valuable person, you're sitting down to look at them in the eyes and say, "What's wrong?" That's tremendously important. Then, hopefully you're trying to keep up on the data and do that well.

Jess Carter: I really, really appreciate some of these reflections because I think there's also, there's something scary that happens, I hope not in healthcare, but in my world, and you said something different than this, but it reminded me of this too, is what the other plague that befalls leaders, I think at least in tech and consulting, because I've observed it firsthand or in my clients or our own company, whatever is if you don't know how to look in word or else, sometimes your team tries to do it for you.

Now, you have people where if I was to apply it to your world, instead of worrying about the patient, you're worried about your boss and that's not what anyone needs. That's where I think even in a leadership role, you got to learn how to take care of yourself because if you don't, you're at risk of, yes, leadership is lonely. Yes, leadership is super lonely and I don't want to minimize that because I think it's really lonely.

I also think to know the difference between the stuff you can delegate and make sure you're not delegating leadership and you're not creating dependency on the people beneath you to be enough in your own role, that is more energy they're wasting on you versus stuff they could be doing in my world for a client, in your world for a patient, and let's make all of our energy spent on those people.

Anyway, well, you have scratched every itch I've wanted to ask you in order to force you onto this podcast and talk to me. Are there other tangents you want to go on or things that you want to discuss?

Hannah Anderson: I do. I do want to speak to the fact that I've learned in education, the data driven side of the world is going, how can we be unique? How can we be different or inspect things that have not been investigated or challenge what has already been found? That isn't the world that most of society wants to live in. That's terrifying, that's unsettling to not have reliable peer-reviewed published data.

I think there's the input and the output and hopefully, I know I don't know anything about the business world really, but I hope that I've not squashed hope in the reliability of data outside of research, outside of the world of develop research development I should say.

Jess Carter: It's realistic. It would be a bit naive for people who are in data in tech all the time to assume somehow that the world in data is different and operates perfectly somewhere else. The reality and it is scary sometimes to be like when I start getting into government technology and consulting, I remember thinking, "Surely, it doesn't work like this." Then you're like, "It turns out it's just real human beings with real technology stacks."

Real challenges and real data about real human beings in the first place who all do things differently and behave differently. It turns out insights are really hard to come by. There's always caveats because we're trying to model after human beings and we're trying to solve for conditions that human beings have. In those worlds, it's actually very similar. I think being realistic about those things is important.

Hannah Anderson: When I recently had someone say to me that when he finished, he's a longtime surgeon who was licensed maybe almost 50 years ago, and he said that well, he was well into his career 30 or more years ago, the half life of medical knowledge was approximately seven years. Then he said he saw maybe a year ago that the half-life of knowledge is something like 30 some odd days.

He gave me specific numbers, but I'm not going to pretend to obviously remember them exactly. Seven years to 30 days, I mean textbooks don't really, they don't have a hope in the world like that. Nobody's going to have information that lasts long enough to publish them if that's the rate that we keep growing in. I mean, that's not totally true, the bones in the body don't change things like that.

Jess Carter: Thank God the bones in the body are not changing every 30 days.

Hannah Anderson: Oh my gosh.

Jess Carter: I just wrapped up talking with Hannah Anderson about data-driven patient care. What I think is really cool about this conversation is it touches on three different perspectives: a patient, a provider, and then I think just in general leadership. How do you scale leadership? How do you train somebody on discerning what needs to be done and not just being cocky enough to make a decision?

She was really honest and open and reflective about some of the real challenges to the leadership component that is completely transferrable to any industry. I loved this conversation and really appreciated Hannah's honesty and her openness and willingness to be somebody who educates, advocates, and is honest about ways that the healthcare industry and patient care are going to continue to need to evolve to meet the needs of patients everywhere.

If you have specific topics that you want to hear about more, please rate and review the podcast and let us know how we can work to incorporate those into future episodes. Thank you for listening. I'm your host Jess Carter, and don't forget to follow the Data Driven Leadership wherever you get your podcasts. Rate and review letting us know how these data topics are transforming your business. We can't wait for you to join us on our next episode.

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