From Heart To Head And Back Again: Making Healthcare Better From Both Sides Of The Slate With Tom Dahlborg – Episode 122

LFL 122 | Better Healthcare

 

It’s probably fair to say that most health leaders are genuinely concerned about making healthcare better. However, not all decisions coming from above translate well into practice from the patients’ perspective. Tom Dahlborg never realized this until he found himself on the other end of the stethoscope. When he became a patient, he saw how some of the decisions he once taught made things better didn’t make things better at all and sometimes even led to outright harm. Since then, he has become a huge advocate for patients’ welfare. In his second book, “From Heart to Head & Back Again,” he takes a walk along the memory corridors, back to the time when he was in the patient’s robe and shares how that experience impacted his view on what should be done to make the system become a better one for the patients. The task that Tom takes upon as his own is nothing short of herculean, but he believes it can be done if we go back to the core values of healthcare – which is the intrinsic motivation to care, love and be kind to one another. Listen in as he shares this powerful message with Patrick Veroneau.

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From Heart To Head And Back Again: Making Healthcare Better From Both Sides Of The Slate With Tom Dahlborg

Thank you for joining me on another episode. My guest is a repeat guest, Tom Dahlborg, a good friend of mine as well, an author, as well as the Executive Director for the Michigan Center for Clinical Systems Improvement and a huge advocate for patients. That’s what we’re going to talk about. His second book, From Heart To Head & Back Again, talks about his own journey as a patient in the healthcare system, what that looked like and how it impacted his own mission and view of what needs to be done in terms of being advocates as a patient for ourselves. Also, how to help other people in the system to make sure that we’re providing the best possible care we can for them. I hope you enjoy this episode. Let’s get into it.

Tom, thank you for being on the show. This is such an honor. This is number two for you being on the show. You were on in regards to your last book. I know we’d had a conversation in regards to this book coming out. I couldn’t wait to have an opportunity to talk to you about this, From Heart To Head & Back Again: … a Journey Through the Healthcare System and what an important time to be having that conversation. As we jump into this, I’d love to hear what was going through your mind when you first decided to go in this direction with this book?

I had been working in health care at that point about halfway through my career. I was still fairly young and thought I knew a lot and thought the things I was doing as a “health care leader” was making things better. It wasn’t until I became a patient. I got to see the other side of the slate, the other side of the picture, that it became clearer to me of what flames of good are in the healthcare system that we have to continue to fan, and also where those opportunities are. I’ll give you a specific example. At that time, I was building quality based incentive programs. Now it’s called value-based purchasing or pay for performance. I was building these programs thinking, “I’m doing the right thing. I’m helping things move in the right direction.”

Quite frankly, what I found as a patient was that these incentives didn’t work. I’ve written about this since that time of how studies have shown that you cannot incentivize someone to care. You cannot incentivize someone to love. What you do when you do incentivize people, you’re removing that intrinsic, “I want to do good. I want to help.” Creating these extrinsic drivers to do the right thing. It’s so contrary to what we want. As a patient and being married to a nurse and as a “health care leader” at that time, what I thought I knew and what reality was were two different things.

It took me a while to recognize that quiet place, process and think about, contemplate, “How can I help turn the tide? How can I undo some of the damage I helped to create to try to help others, be it the physicians, the nurses and all the folks on the front lines, the patients and families and others? How do I help recreate a system that’s going to lead to goodness for goodness sake, not caring because I got paid to care?” I started the journey and this was back in 2015 of, “I’m going to go to that place of sharing my own story,” meld that to my observations and the stakes I’ve made. Some opportunities I saw it maybe helped a little bit to try to tell a compelling story and lead to betterment within the system.

When you talk about your story, what is this? What did happen?

The bulk of the story, I was working in military healthcare at the time. I’m not a military person myself, but my family is. I wanted to honor my family and took a pathway to engage with a healthcare institution in May. During that time period, I got very sick. I was told I would never work again and to get lined for a heart transplant. I was that person that went to the pain clinic and they said, “Here’s your menu of narcotics, would you want to stop?” This was back in 2001. What’s the old saying, “By the grace of God, I did not follow a path leading to the addiction.” We think about the opioid epidemic now, a lot of this because of the broken system. I lived through that system luckily or through blessings and being married to a nurse. I didn’t fall through that full path.

As I went through that journey of illness, where I had to resign from my position as COO for a military healthcare organization, I was that person that initially thought, “I got this. I’m a health care leader. I know the CEO of the hospital. I know the head of the Cardiology Department.” It didn’t matter. I was incredibly sick, scared and vulnerable. Every day, I looked in the mirror and saw a lot of the brokenness I was part of. That was hitting me in the face in addition to be having three young children and my bride and thinking I was letting them down the entire time. You have all these emotions. You have this vulnerability, and it didn’t matter who I knew I was scared.

The journey is through that. Those flames of good that helped me get through and also identifying those opportunities that we need to make better because I was a health care leader and I’m married to a nurse and I couldn’t navigate. We couldn’t navigate to the best of the ability that we should’ve had or could have had. The system is that broken. There’s goodness in it. There’s also brokenness. I wanted to, again, highlight the good, use the term celebrate the good within the system and fix those opportunities.

There is goodness in healthcare and we need to celebrate that. But it is also a broken system that needs to be fixed. Click To Tweet

When you’re thinking back to yourself in the system, you’re somebody you know how to navigate, or at least you think you do. Where do you think for you the biggest challenge was in the beginning for this? Where you’re saying, “This needs to change.” It’s almost an a-ha moment for you it seems.

It was. I’d say the biggest a-ha was looking in the mirror and gone, “You don’t know what you think you now,” and having to relearn, re-see and look through. We talk about empathy, look through other’s lenses, look through the lens of that nurse in that emergency department, looked at the lens of that technologists in the X-ray department, look through the lens of the physician, look through the lens of the other patients. It was these opportunities to see differently, from other angles, from other perspectives. That was the a-ha to say, “Tom, you don’t know.” When I was full of ego and hubris and said, “I got this. We can manage this illness.” I had no clue. I’d say that was the biggest piece of it.

Add to that, when you think about Deming and the 94/6 Rule, which is all about 94% of brokenness is system related and 6% is people related or person related. As a leader, what do we typically do? We go and we blame people. We don’t look in the mirror and fixed system. What we need to do is it’s both and. It’s like, if it is a person issue, you deal with that appropriately. Sometimes it’s coaching and mentoring and sometimes it’s not. You also have to fix the system. That was the other a-ha was the level of brokenness of the system, including the financial drivers within the system that were leading and continuing to lead to that and escalate the brokenness.

You bring up an interesting point because I think of that often in regards to you might be thinking a physician doesn’t have time yet they’re being directed. They need to see so many patients within a certain time slot. It becomes very difficult. I remember hearing this back to my days when I was in that field as a pharmaceutical rep is having a physician say, “What do you do with the patient that comes in?” It’s their fifteen minutes and they’ve got two minutes left and they drop this major issue that they’re dealing with. Maybe it’s depression or anxiety that they didn’t even say anything. You have two minutes, what do you do with this? Do you say, “Time’s up, what’s next?”

It’s such a great example. The physician primary care physicians sticking with them for a while, and they’re on average obligated to generate 30 RVUs, Relative Value Units per day. For a lay person that means, an average office visit, they need 30 of those per day. If they were all average offices, so we know they’re not. That means you’re triple booked every fifteen minutes. I have on a maximum of five minutes. Don’t understand the patient prior to walking through that room. Don’t understand it and contemplating next steps post visit. Don’t connect at a human level with that patient, that family not being positioned to listen. Now, thinking about malpractice, putting that hat on for a moment, I’m now well positioned to make a mistake and to do real harm in not only am I going to harm somebody else, that’s also going to come back at me with a malpractice lawsuit.

This is the broken system that physicians are thinking about all the time consciously and subconsciously. This is going through their minds. When I talk to physicians, nurses and others, they say this is what keeps them up at night, knowing that they are going to hurt somebody because the system is not broken and trying to get through the day, try to see as many people as possible because access is also an issue. They want to try to hit on that mark and get as many people in as possible. Normally, they don’t have the time to do it all and they don’t have the system in place to do it all.

Yes, there are some bad doctors and bad nurses. Just like in every walk of life, what I’m finding is most, if not more than most wonderful people that are burning out because the broken system in that burnout leads to disengagement and leads to harm, harm to them, to patients, families and to communities. These were the things that I saw through my own journey, and a different lens that I hope this book is going to help to number one, call attention to it, and then give some practical opportunities for people to make a difference themselves.

For those that are reading that might not know there’s a term that’s used called HCAHPS. It’s like customer service surveys in healthcare. That has a financial impact on the institution because they get paid based on those.

LFL 122 | Better Healthcare

Better Healthcare: You cannot incentivize someone to care. In doing so, you’re actually removing their intrinsic motivation to care.

 

I was in Cleveland Clinic years and years ago. They were recruiting me to work in the patient experience space as a leader within Cleveland Clinic. They said, “What’s your experience with HCAHPS?” I told a story about being a transport aide in a small community hospital and about connecting with this elderly person. I had gotten to know this person because I was wheeling her around the hospital for the last couple of weeks. She called me Tommy. One day I was bringing her down for her treatment for cancer and I wheeled her down there, she puts her hand on my hand. She goes, “Tommy, please don’t leave me. My family’s not here and I’m scared.” I radio up to my transport department and let them know that I need to stay with, I’ll make up a name, Mrs. Smith for the next X amount of time.

They allowed me to do that. That’s patient experience. That’s customer service. That is caring and loving within the healthcare system. I’ve told that story to the folks at Cleveland Clinic. They looked at me and they said, “What about HCAPHS and the financial ramifications of that?” I was like, “Cleveland Clinic is amazing. They’re a great organization.” The people I was talking to was so caught up in the financial drivers, associated with numbers, with metrics, they forgot the heart of what we’re trying to do here, the heart of healthcare. Hence the title of the book is bringing that heart back in and remembering that we’re to care and ideally, we’re here to love and focusing on metrics. Financial drivers to get people to care, it’s doesn’t work. What we need to focus on is positioning people so that they know they’re cared about and they’re loved so that they can then share that love and that caring with others.

Tom, think of how many times that scenario plays out now where families aren’t even allowed into hospitals. I had to go to the emergency room. I’m admitted to the emergency room since I sliced my finger in high school, but getting wheeled in there and going through an intake and Cindy, my wife being told, “You can’t stay in here, basically we’ll call you.” That was it. It was not a pressing issue that I was dealing, but I think of all those people that maybe this is it. That’s the last time you’re going to see this person and how scared the family member is, but also how scared the patient is of leaving, thinking, “I’m on my own,” which is what you said this woman said.

I share in the afterword of the book, the impact of the pandemic in the space of caring. I highlight a couple of a good friend of ours whose two family members died alone. One of them in a nursing home or a nursing facility and the other one at home. When we think about the pandemic and how we’re trying to keep people safe, when you think about quality improvement, you have to understand what your measures are? What does success look like keeping people safe, but also the unintended consequences? These undetected consequences is isolation, lack of caring, people feeling scared, the mental health and the emotional health of these people.

There’s lots of other things I won’t even go into, but we have to understand the full picture, that 360. Develop a system, a model where we can mitigate, some of the times you can’t change the badness. Sometimes it’s just is. Yet, most times it’s not. We can create systems, which allows connectivity for us to address some of those other things. There was a study some years ago that if I remember right, it was that isolation and loneliness more dangerous to anyone, to someone than smoking fifteen cigarettes a day. That’s what the study can’t found. I believe it.

This was part of my journey, when my bride had to leave me in the hospital the first time when I was admitted and again that sense of loneliness and despair. Even though they were wonderful caring people around me, nurses and so forth, in my own head, I was alone and it was devastating. I even talked about it was more devastating than the issue with my hat. We need to open our eyes and look at the intended and the unintended consequences of all these types of decisions. Those that impact the health and wellbeing, not physical, but mental, emotional and spiritual of people we need to be addressing.

In regards to the isolation, there’s so much research. One of the behaviors that I will often talk about is around creating belongingness. We know how much research there is. We are pack animals. We need each other. Thousands of years ago, we couldn’t have survived without each other. If we were voter outside of the group, that was a death sentence. I would argue that now it’s still a death sentence. It looks different now when we’re pushed outside of a group or we’re isolated because of the environment that we’re in right now is a concern for me that I see with this pandemic, the isolation that has been pushed on many. You’re wearing a 22 shirt from the military talking about how many people commit suicide every day.

Twenty-two veterans per day in America are committing suicide. That’s one of the reasons because a lot of my book is generated as based around my work with veterans. I’m not a veteran. I try to highlight often as much as I can the challenges spectrums were facing and be it, my work within the VAs and so forth, but also to let people know that, 22 veterans per day are committing suicide. I believe although I haven’t seen the intense study to support it, that number is increasing during the pandemic, not only for veterans, but for others as well.

If you are a veteran, if you’re in crisis or if you know a veteran and you know they’re in crisis or potentially, there’s a suicide prevention hotline, a Veterans Crisis Hotline, it’s 1-800-273-8255. The pandemic is escalating. These challenges that people are facing. We need to find additional ways that we can support, care and love for people during the pandemic and beyond. The Telehealth has done a lot of good things on this and yet it’s not the same. A lot of the studies because the pandemic has been going on for X number of months now is that Telehealth is missing some key very basic aspects of healthcare, such as blood pressure checks.

Healthcare is all about caring and loving, not hitting the numbers. Click To Tweet

We’re missing out on that part and we’re missing out on the human connectivity. We’re missing out at that opportunity to develop that relationship and that trust to have the appropriate touch. When you put a hand on a shoulder, on a hand to connect at a human, bringing humanity into healthcare, keeping humanity in healthcare, we’re missing out on that. I see a lot of people talking about technology as this panacea. Technology is a tool. It’s a tool to help us, care, love and connect better. It’s not the solution in of itself. We need to keep that in mind. Too often, we think the easy button is technology. Like we’re talking about with some of these other things, there’s a lot of unintended consequences as we go down that technology path. We need to be aware and have our eyes open as we’re making these decisions.

There are a couple of things. One, going back to the conversation we had around HCAHPS and some interesting research that I will often reference where they looked at healthcare organizations and their HCAHPS scores and what they did was they transpose these, that’s the word I want to use here, with engagement scores of the institution. What they found was that the lower the engagement was within the institution, those HCAHPS scores were in line with those. There was a pretty significant gap in terms of, if your HCAHPS scores were high, then chances are, you had an organization that the employees were more engaged versus less engaged. That brings an important question to you, Tom, is that you mentioned about the majority of this might be system related, but there’s a people component. As I look at it, didn’t the people create the systems? If we have disengaged individuals, isn’t that what we need to start?

It’s a phenomenal point and you’re absolutely right. The system is made up of people. When Deming talks about system related versus individual or person related, he’s talking about processes and operations, which are created by people. Yet, we go to the place of, “I’m going to blame that nurse for being mean.” No, we create the system that led to her or his burnout that led to them being disengaged, that led to them being tired and not being able to go to the bathroom for the last twelve hours. Now they missed something. They forgot a pill. We have to fix, as I’ve said, both ends.

We have to fix the system that allows that nurse to be engaged again, that safe container. They feel whole and healthy so that they can now deliver the caring that we all need to have delivered within the health care system. It’s definitely both ends. The system is made up of people, people make broken systems, they also make good systems and we need to be aware of all of it. I’d go to the place of fixing where the fixes need to be made. Is it people? Is it system? Also go to the places of them, again, going back to your point of celebrating.

When we have that nurse, that doctor, that respiratory therapist, that transport aide that I talk about in the book and so forth, that they’re doing something well and they are living love, living caring. We want to celebrate that. We want to honor that. We want to show that, number one, it’s the right thing to do. Number two, when we start to recognize that these are the behaviors that we’re expecting, that we’re going to hold people accountable for when they’re not, but also celebrate when they are, that also changes culture. It leads to that culture change, which to your point, leads to system change as well.

I would agree with that especially around celebrating when things are going well. If you have an organization, where the only time I hear from you, Tom, is when I’m not doing something right. I’m now on a good path, I’m doing the right thing, you never seem to come around and tell me, “Patrick, thanks for making the change or this is exactly what I was hoping that I’d see from you.” That then says to me, “You noticed my effort and I want to continue this because this feels a lot better than the Tom that shows up with the stick potentially or wants to point out what I’m not doing right. I like this.” We don’t do enough of that, the celebrating. Everybody’s different. Not everybody needs the same type of recognition. That’s the important thing here though is if you’re leading somebody, it’s your responsibility to understand what is it that motivates that person in terms of how they want to be recognized. It’s not a one size fits all.

That gets back into a relationship. You need to have relationships with these people. They’re not cogs. They’re not widgets. I hear that from doctors and nurses all the time, that “I feel like a cog of a machine”. I feel like the patients are widgets. We’ve created this factory and production mentality, we hear all the time. “Did you achieve your production goals?” This is healthcare. This is life and death. This is so much beyond. Regina Herzlinger wrote a wonderful book. It’s Consumer-Driven Health Care. She’s out of Harvard that takes the analogy of the French fry at McDonald’s and poses it and puts it into healthcare. I’m like, “I get the logic. However, we’re talking about human beings here. We’re talking about life and death. We’re talking about emotions.”

I love my French fries. If they’re good, my emotions change in a positive way. Don’t get me wrong. However, in all seriousness, we’re talking about people that are on the edge of losing their careers, life, family, and losing all they own. It’s far more than a French fry. We need to truly get to that place of focusing on relationship, understanding and creating the systems that allow people to be on it the way they want to be on it. To ensure that the organization is all about the caring, loving and delivering of great evidence-based health care, not production, not hitting HCAHPS numbers, not these other pieces. It’s about the outcome of a kid and loved on this person. I was going to say got better, but sometimes as we know, people are on the dying journey as well. We also want them to be on it throughout that journey. We want to be there with them for that piece of it. It’s far beyond just the metrics and the numbers.

LFL 122 | Better Healthcare

From Heart to Head & Back Again: … a Journey Through the Healthcare System

We’re not going to solve the administrative side of this, but what would be interesting for me to hear is if you’re in the system, what would you recommend for them? I’m somebody that’s part of the system. “How can I make this better for myself? What things can I do to help advocate for the change from the receiving end of this?”

I’m going to answer this differently. My aunt read my book and she said, “Tommy, what the book did for me is it brought more awareness to me that I want to be grateful for all those people that work in the healthcare system for when they are caring about me when they are taking care of me. I don’t think I was doing that in the past. I want to make sure that I’m doing that.” As you and I were talking about Patrick celebrate, yes, we want to celebrate within the system. Should we rely on patients and families to celebrate the people in the healthcare system?

No. However, if I’m a patient and a family member, and I can go to that place of gratitude for somebody who cared about me, it makes a huge difference. I hear from nurses and others all the time that when that patient or that family said, “You were there and you held my mom’s hand until she passed. That means a lot to us. I’ll never forget.” That changes lives. That instills that caring in that person to want to continue to do that. That’s a big piece is that lens in that place of gratitude as a patient. Another piece is, understand that you’re not going to understand. Find the experts. I was lucky. I was married to a nurse who was an expert. My bride, she was going through crises as well, emotional crisis and everything else. We were going through this together.

You need to be able to identify other experts, patient navigators, family members, who know the system, whatever it might be and lean into them as well. Make sure that you’re truly aware as you’re making decisions. This expert influence is incredibly helpful on what those decisions should be and could be and what the ramifications are. I had an unnecessary invasive procedure because here I am, again, health care leader married to a nurse, I didn’t know the odds. I was scared. My doctor said, “This is the right thing to do because I said it.”

I was at that place at that point with, “I’m going to do it because my doctor told me I should do it.” You still have to advocate for yourself. If you can’t emotionally or otherwise have that expert, that trusted person that you can lean on, that can say, “Here’s what it means. Here’s what the risks of going through with that. Here’s what the benefits are of going through with that. Now let’s figure out what’s best for you,” and so that’s key as well.

You bring up such an important point there in terms of advocating for yourself, having people that understand the system on some level to be able to bounce things off of. I’ve heard of even people, especially if they’re dealing with life-threatening illnesses, is having somebody go to their appointments with them. If I’m sitting there and listening to the doctor, I’m listening for different things than the patient might be listening to. I might be so wrapped up in concern of this, that I’m not picking up the other pieces. Having somebody else there is important.

That’s how you can manifest or that’s how you can put into action. Those experts bring them with you or consult with them before and after, because it’s helped with them before you make any specific decisions, especially life jeopardizing decisions. Several years into my career, I should’ve known that. When you’re in the midst of it, you’re not in that place emotionally and otherwise, at least I wasn’t. We would have benefited from somebody like that. Someone who sat in that room that was dispassionate, that loved me and cared about me, but was dispassionate it’s about the facts and about the evidence.

Along those lines, was there ever any thought for you of, “I’m going to get a second opinion?”

We went through a number of different doctors. It was the 7th or 8th opinion, for lack of a better term, that saved my life. It was going down that path of being open to. I was tired. I was beat up. My career was over. I may die. My family is going to be left destitute. My wife was a nurse so that is an exaggeration, but still how I felt from an ego, a humor perspective, I was letting everybody down. I was done. I was pretty much given up at that point. This has been going on for a long, long time. This amazing nurse that I had worked with, she got down on a knee in front of me at one point while I was sitting in a chair and she held my hands and she said, “Tommy, this is a detour. We’re going to get you through this.”

The cheapest and easiest way to start change is to love and be kind to one another. Click To Tweet

She wasn’t doing it because she was financially incentivized to do it. She was sharing her heart with me because she cared. She loved. Not just me, but she’d loved people. That was the person that she is to this day. It was her who connected me with that next provider probably 7th or 8th that showed me a different way to practice medicine, care, to take healthcare, and create healthcare. It was that, in that container that my wife, myself in that position and others became part of that led me to being able to work again, write a book and tell a story and hopefully help others.

One of the things that I think of, if you’re saying you got to number seven, that there was something inside of you, that’s saying this isn’t right. You were listening to that on some level, bringing in other people, “The expert is saying this, but it doesn’t feel right.” I wonder how many people don’t do that because they’re afraid. They don’t think they’re going to be listened to whatever that might be. They don’t have that opportunity to find what’s going to work for them.

Some of those physicians were recommended by my cardiologist. Some of them were, “Let’s look at it through a different way.” My cardiologist is very good. “Let’s look at it through different lens. Let’s connect to these other specialists that can figure out. Is there anything else that’s driving this, is there any other opportunity?” On top of that, it was also that probably stubbornness in me that said, “No, I’m not going to grow up with my family or my team.” Even with all that I’m even saying, “I wasn’t going to give up.” I gave up. There was a point in time where I said, “I can’t do this anymore.” I remember I was in the bathroom and I’m on the ground. I’m in tears saying, “I can’t go on.”

Thank God for my bride, at that point, that helped me get past that and the rest of the journey. As we said, cry a number of times as a healthcare leader married to a clinician and my sister’s a nurse as well. To throw out my family, I can’t imagine folks that speak a different language. I can imagine it more because I talk and I hear these stories, but it was so hard for us from all different perspectives. We owe it to all people throughout the country, the world to have access, to have the right information, to have someone who cares and support stuff, to have that expert opinion, to have the mechanisms, the systems in place where people are engaged. Creating betterments and creating opportunities for people to get better or to go down that dying journey in a peaceful way, we owe it to them.

The system is that broken. Not that I knew at all by any means, although I thought I did, if we couldn’t manage it, I can’t imagine people again, as I described the elderly and others trying to manage it. It’s impossible. We created such complexity that it’s leading to more and more harm. When you think about the harm we do in healthcare, when you think about the lives lost to the pandemic, lives lost to diabetes and heart disease and so forth, medical errors is way up there on that list too because we’ve created a broken system that leads to harm and we need to do much better.

I’m going to put you on the spot here, Tom, you’ve got one copy of this book that you can give out. Who would it go to?

Part of me wants to answer it with, “I want that patient, that person to read this book so they are well positioned to understand. That’s part of where I would be coming from,” but if I had to go, it’s one answer. I would want the Dr. Fauci of the world, the folks that are out there at the highest level, to brilliance and doing lots and lots of good things to also read it from another perspective. It’s those people that can drive policy change and can drive many of the other changes that we need here. I would answer it that way.

I should have given you two books because there are two different ways it can go. I can see both of those being so important. There are so many good professionals out there, practitioners that are caught up in the system that there’s an opportunity missed in terms of a patient feeling as though this person is interested in what’s going on with me, as opposed to, “I’m number 23 out of 30 that are going to come through this other day.”

LFL 122 | Better Healthcare

Better Healthcare: We have created a broken system that leads to harm and we need to do so much better.

 

I have a chapter in the book called The Heart Attack. I remember I was going to a visit for one of my appointments and my name isn’t necessarily easy to say. I said who I was. The person at the front desk, a very nice person. She’d gone through it. She couldn’t find my name. She finally found it. She goes, “You’re one of the heart attacks.” That’s what I became. I became my diagnosis. I was no longer Tom or Tommy or Mr. Dahlborg or any of that. I was a heart attack. It’s not an operation, unfortunately. How often do we hear, “I have three diabetics I need to see before the end of the day or whatever it might be?” We need to change that. We need to bring that humanity back into the equation. We have long ways to go. There are incredible people that I highlight in the book as well, doing amazing things, everyone from the front lines through the entire system, to CEOs of healthcare organizations, doing it the right way. We need the fan their flames as well so they don’t burn out.

Tom, this has been a pleasure as always having this conversation with you. It’s such an important topic right now as this pandemic goes on. It seems like even fewer resources to do a larger body of work in terms of helping people. Thank you for your commitment to that through this book.

I appreciate that, Patrick. The last point you made, there are lots of systems to be changed and we can love now. It doesn’t cost any money. If we can connect, if we can love, we can care and we can start that and every one of us could do so. It’s the cheapest, easiest way to start the change is to start to love and be kind to one another.

I would completely agree. Wishing you all the best in that.

Thank you, Patrick, for having me on again. You have a phenomenal show and a phenomenal platform and what you do with cables, changes organizations and positions, people to make a difference and kudos to you.

Thank you for that.

Thanks, Patrick.

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