RX_Pam Sullivan: Audio automatically transcribed by Sonix

RX_Pam Sullivan: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt:
Hey everybody, welcome back to Entrepreneur Rx! I am thrilled to be chatting with someone I haven't seen in quite a while, but our paths crossed for years and years in urgent care world, her name is Dr. Pam Sullivan, she is Chief Clinical Officer of Education and Lifestyle Operations at Landmark Health and does a ton of other things. Pam, thank you so much for taking the time to chat with me!

Pam Sullivan:
Thank you for having me, John. Excited to see you again and be a part of this!

John Shufeldt:
Thank you, this will be fun. All right, so before we jump too much and give people your background because you've got a pretty cool background and you've kind of always done stuff is outside of internal medicine, and I know that's what you're bordered in.

Pam Sullivan:
Yeah, definitely did not take the straight path to get to where I am today. So I started my career as a physical therapist and did not have the confidence to go to medical school, did not think I was smart enough or I could do it, and I was working in a clinic in Los Angeles, working with orthopedic residents, and that's when I realized I really am as smart as they do and I do have the skill set. So my sister was a medical student at the time and she convinced me to apply to medical school, so I only had a couple of prerequisite classes to take and went on to medical school, and from there I had no doubt I would be an orthopedic surgeon. But when I started doing orthopedic surgery, I recognized too that I didn't have the medical skills that I wanted to be able to take care of a whole patient. So I decided to do a residency in internal medicine and then went to apply for orthopedic surgery, but I took a one-year position in the emergency room. I loved that so much, I stayed there over 20 years, and as a part of that, or toward the end of my career in emergency medicine, I was working in a hospital where we had a new CEO, and understandably so, he wanted to get some fresh minds in there and some fresh blood, and I knew my time was pretty much up there, as upsetting as that was to me, because this is where I had dedicated my whole career, I had served on a number of boards at the hospital and love this place. So it took me a long time to recognize that he really did me a favor, and years later I went back to shake his hand and say, thank you so much for what you did for me, because I didn't recognize it at the time. But when I left that I was fortunate enough to meet Doctor Greg Daniels, who had opened up some urgent care centers and gave me the opportunity to be a medical director at one of the urgent care centers. And this company at the time also did hospitalist work and emergency room work, so I was asked to pick up some shifts in an emergency room and from there was asked to be medical director of an emergency department. So I was working two full-time jobs, being both medical director and an urgent care and medical director in the ED, and it was from there that I started to get the bug of how can I make things better? And I always put the patient first, but I never had any opportunity to make things better. And in these two roles, I had that opportunity and it just was so energizing and so wonderful. So from that point, we were purchased by Team Health where I continued my career there, but I decided it was time to go and get my MBA, and at the same time I had been elected to the board of the Urgent Care Association and again was surrounded by some brilliant minds, such as yourself, and some other business individuals and really learned so much, and I was so used to being a member of professional organizations and this was a trade organization, so I had to learn so much being there. So between that, going back and getting, you see, my physician executive MBA at the University of Tennessee, so between both of those experiences, that really gave me a lot of confidence and a lot of growth. I had to stop being medical director of the urgent care center that I was at because I couldn't do two full-time jobs in a full-time MBA. So that's when I went to straight emergency room work as medical director of a couple of different EDs. And after that, I was elected president of the board of the Urgent Care Association. So again, continued growth. And I learned so much from my colleagues on the board and it was amazing to me because again, I didn't have the confidence to think I had the skill sets to do this role, but they believed in me. And at the end of the year, when I went to each of them and thanked them and gave them handwritten notes to say, this is what I learned from you, they all came back to me and said, wow, this is amazing because we couldn't do what you did. And that's when it made me realize that I do have value and things to bring to the table, even though my experience wasn't the same as, as theirs. So that's when I spent some time looking at my next job, culture and mission were incredibly important to me, and I found Landmark and I never looked back since I found Landmark, I joined them, and they have just been a phenomenal organization.

John Shufeldt:
What year did you join Landmark?

Pam Sullivan:
I joined Landmark December of 2017, five years ago, four and a half years ago.

John Shufeldt:
.... I wonder if it's a common trait among people who continue to try to improve, that we all think we're imposters. And so because of that, we're all trying to I mean, I believe I still have that today. And you clearly have that going back to physical therapy, which is no easy task to begin with, and then medical school, do you still have it? I mean, you've done incredibly well, do you still have imposter syndrome? Does it ever go away?

Pam Sullivan:
It does. I never thought it would, but it does. And this is the first time in years, I would say the last probably three years that I have not felt that way. And it took me so long to get to this point in my career. As a matter of fact, I'm doing a, leading a leadership discussion in Arizona for young physicians on imposter syndrome. And when I do some leadership courses for the American College of Physicians and post these blogs, I always do a question on imposter syndrome, and that is the one that almost everybody answers and everybody thanks me for bringing that up because they all feel it, but they think that they're alone because everybody walks into a room with the confidence, but they don't really have it. And this is the first time that I can tell you in years that I really know that I am bringing value and I can really speak positively about myself and what I have to offer, but it didn't come easy and it's taken a long time.

John Shufeldt:
And you read the book called Confidence Code?

Pam Sullivan:
No, I haven't read that one, but I will.

John Shufeldt:
Yeah, I'll send it to you, it's, it's Katty Kay and Claire Shipman, literally about this subject. Now, it's written by and for women, and I read it and they interviewed all these super high-powered women from like Hillary Clinton to the woman who headed up the IMF, I mean, real rock stars, all had imposter syndrome. So it's funny, I always wonder what the common trait is and if part of that being imposter syndrome continues to drive people to achieve excellence, it sounds like maybe, maybe that is a secret sauce, we all think we're fakes.

Pam Sullivan:
In my case, I think it did because I would not, despite what roadblocks I had, and I never thought as a woman I had roadblocks, but looking back on my career, I clearly did, and not being medicine trained, I did, without a doubt. And looking back at all of that, I always found a workaround, I always found a way to get where I wanted to be and never quit, never gave up with that. And I think that's where I learn the resilience from, but it took a long time to get the confidence to go with that.

John Shufeldt:
And that was my next question. I mean, the core and it'll lead right into the next one, the core I think for a lot of entrepreneurs and clearly you just brought it up is resilience. You just, you come up with a problem, you think, okay, you know, there's a solution to this problem, this is not an obstacle, this is just a way to prove myself, a way to be creative. Is that how you look at challenges?

Pam Sullivan:
Absolutely. I, nothing I look at now is negative. I will tell you, early in my career, if there was the slightest bump in the road or anything, I get all worked up over it, and it was such a big deal. And maybe that came from working in the emergency room, seeing people that came in with a minor complaint and you diagnosed them with a life-threatening illness, maybe it just comes from experience and getting older. I don't get worked up about anything now and when something's put in front of me, I just love it because it is a challenge and we're going to find a way, and the other thing that I've learned is I am not accountable for something 100% of my own. I always work in teams and if you work with the right teams and in the right culture, you're going to find that answer. And it's, you don't need to have the answer yourself as the leader, but you know how to rally your team to get yourself to that answer and figure out the solution to the problem.

John Shufeldt:
You, totally, you mentioned a little bit ago about culture and how culture is so important to you and your reference Landmark and in, in maybe other options for you in the future. When you say you're looking at culture, what are what are you looking for?

Pam Sullivan:
Yeah, this is, I think, believing in the mission, vision and values of a company and the company's culture are the two things that I look at now. And at Landmark, I can't tell you how brilliant all the leaders are there, but nobody walks in the room with an ego, we're all one team, one goal focused on going to the same place. And in the past, if I came up with an idea, I want to credit for that idea, Pam thought of that, that's great, look at her, I am so far from that place right now. What makes me happy now is to see the people that report to me be the ones that get credit, be the ones that do well, and I don't care who comes up with an idea because it's a start of an idea and that idea is going to grow based on all the minds in that room, and it will continue to morph and change until we get to the right solution. And it doesn't matter whose idea was, it matters that we're all focused on the same goal, on the same end point. And I think the other piece to this, and I teach these two things to all new leaders and I mentor a lot of leaders in our company, it's assume good intent, everybody means well, so if something doesn't go well, you need to find out why and have that open, honest conversation, but it's usually not because their intent is to do something wrong. They were intending to do something good, maybe they don't go about it right, but it's, the intent is almost always positive. So if you assume good intent and work through issues that just really build strong relationships. And the other thing that I always teach is to use the word because have people understand what you're thinking and why you're thinking that way. If they understand that, because behind it, they're a lot more likely to get on that bus with you.

John Shufeldt:
Totally. You know, you said something that I think so many people, well you said a lot of things that I want to chat about, but so many people fall into the trap of assuming bad intent. And as much as I know that's in my cortex, there are still times I'm like, oh, I can't believe they did that, and I'm assuming that intent. And probably rarely, if ever, actually it is a true, but I think there's this natural knee jerk reaction to when it's about you, why would they do that, you assume bad intent. That is such a, I mean, if I had nothing outside of this, I'm going to be reminded of that one, so thank you for that.

Pam Sullivan:
Absolutely.

John Shufeldt:
Okay. So it sounds like Landmark's culture is exactly the place that I'd want to work in. It is low ego, humble, doing the right thing with a team, I mean, that's a culture, how did you, how do you hire for that culture? I mean, you're going to, I suspect you're going on this entrepreneurial path, you know, you'll continue on yours. How are you going to hire for that, for that culture that you just espoused?

Pam Sullivan:
Yeah, great, great question, John. So I lead a team called the Delta Team. This is a team that travels around the country and we help not only launch our new markets, but support mature markets if they have vacancies. And basically this team does almost anything to make sure the enterprise is successful. We started with 14 members when I joined the company four and a half years ago, and we are up to over 50 team members on this team. And one of the first things we did, one of our initial off sites was we clearly have the company's mission, but this team came up with its own vision and its own values, and every year we revisit that. And we have developed a brand for the Delta team that when we were walking to a market, everybody is thrilled to have a Delta there because we're the ones that are going to make your job easier and help you meet your metrics, and we're going to be that yes team. So when we hire, we share this information and we put that expectation right there on the table. And what I will tell anyone that I hired at Landmark is two things. One, you need to believe in our mission, vision and values. And second, you can be the best, best practitioner in the world, but if this doesn't speak to you, if this doesn't, what makes you happy to come to work every day, then it's not the right fit for you, and that doesn't mean that you're not a good practitioner, this doesn't mean that you're a bad person, it just means this isn't your niche and that's okay. So I'm very open, honest, transparent, and I'm never going to sell something that landmark isn't, and Landmark isn't all roses, there's, there's some really tough parts to the job and we talk about that as well. So when somebody walks in on their first day, they know what they're getting into, they know what those expectations are. And again, we really set that brand and by treating the Delta team, by my valuing them, they will do anything back in return. And we recently looked at our turnover rates for the APPs on the team and what we saw was that we had zero regrettable turnover in four and one half years for APPs, which is really surprising, and it all comes down to culture and not micromanaging and giving people the tools that they need.

John Shufeldt:
Wow, it's so funny what the conversation you just had, I have this all the time with people. Here's where you are, here's where we are, want to be on the team. If this is what you have to espouse, believe in and and it has to work. And if it doesn't, that's okay, it's no value judgment, it just means you're just not a fit for our team.

Pam Sullivan:
Right!

John Shufeldt:
And so when you have that conversation, now it's never about the person and it's just about like, hey, you're here, we're at a different spot than you are. If we can meet up, great, if we can't, that's okay too.

Pam Sullivan:
Yeah. And the other thing that I also love to tell people is I'm here to help you, I'm here to help you find that right fit. So if it's not Landmark, call me up if you're looking at something else, let's talk through it. Because especially I will do this with male setting interview. But there's more female APPs that apply for our team, but I'm here to support them and help them and help them on their journey. And something else that I've learned throughout my career is I'm always looking to better myself, to learn, to grow. But that might not be of anyone else's ambition. There are some people that come in to be worker bees, and that's phenomenal, so having that and knowing that up front, I can help somebody be the best that they can be, reaching their goals, and it's no longer reaching my goals. It's helping them reach their goals so long as we're all working toward the same common output.

John Shufeldt:
Yeah. I mean, my comment is my, my job is to take care of you, your job is here to take care of the patients, and if I'm doing my job, your job should be a lot easier, and then the patient wins, which is what, what it's all about anyway. Yeah, that's, that's very cool, so what have you learned in, for your kind of entrepreneurial journey? What was the biggest aha moment for you and your entrepreneurial roles?

Pam Sullivan:
Yeah, let me think about that one for just a second. You know, we talked about that imposter syndrome and I think the biggest aha for me was learning that I do bring value, that I have a role and knowing that everybody there brings something to the table, some might be better fit for certain tasks or certain places and you've got to have the right people in the right place or pair them with the right people. But I think what I've really learned is that, A, I love to help others on their journey, I love to be kept challenged, I love to be busy, but busy and challenged, not busy and not challenged, and I don't want to get bored. I need to totally believe in what I'm doing and being able to problem-solve and see people be successful is so key for me.

John Shufeldt:
And I'm supposed to talk with Rick ... here in a couple of days, and it's going to be kind of on the future of emergency medicine. And, you know, there's going to be 7 to 10,000 too many EM docs by 2030. And he and I talked about a little bit last night, but I'm, I'm continuing to be super bullish on emergency medicine because I see all the different things we can do as EM physicians and people working in emergency departments.

Pam Sullivan:
Yeah.

John Shufeldt:
What are your thoughts on that?

Pam Sullivan:
So I've been out of emergency medicine for a number of years now, but my feeling is that there's, there's a time and a place for everything and it's got to be the right place for the right patient with the right touch points at the right time. So in the continuum of care, there's definitely a place for emergency medicine. But right now, when we're taking care of chronically frail ill patients at Landmark, there's definitely a place not for the emergency room where these things can be handled at home, or we can manage a lot more in the house with the right resources and the right teams in place, and that's what's wonderful about what we have is you teams with nurses and pharmacists, dieticians, behavioral health in addition to our providers and I'm sure I forgot some of our team members, social work, and we have a palliative pathway and we have behavioral health and, and all these different pieces that once there's an understanding of what Landmark can do, we really are in that fabric of that patient's care that only if somebody is, let's say, truly septic and it is their goal to go to the hospital, then we do it, but if it's something that can be managed in the home, we do. And I think part of the problem right now is providers are not, I won't even say providers, I would say healthcare in general is not provided with the right tools and you cannot manage a patient after hours if you don't have the proper staffing and resources to be able to do that. And with the primary care shortage these days, yeah, it's great to say that you're going to be available to your patients 24/7, but in some rural areas you can't, and you need to take a break too, and you can't be everything to everyone at all times. So I think we really need to all work together and not be in competition, even if it is a competitor, rising tide raises all ships and I honestly believe that, and we need to find a way to work together so that if you put the patient as your Northstar, we're all doing the right things at the right time and working together in a community to get there.

John Shufeldt:
I couldn't agree more. What are your thoughts on physician entrepreneurs? Here's my, here's my construct, I think that and I'm thinking emergency med and I'm biased, of course, but I think EM physicians but physicians in general are training and background resilience and creativity and problem solving skills we've had to develop over time, lead us to literally be the perfect construct, the perfect amalgam for entrepreneurs. Now, you and I both come from those constructs, so I'm probably biased, but give me your general thoughts of that belief and shoot it down if you want.

Pam Sullivan:
Yeah, no, I'm, I'm obviously with you as an MD MBA, so I totally agree with that. At first, I didn't know if there would be value in going and getting my MBA, but a lot of people came to me after I got it and said, wow, you think differently, you act differently. I didn't notice that and see it, but what others did in me, and I think it's important that you have to balance the two. So I think coming as a clinician to the table, you get things that someone in business will not and vice versa. And I'm often told that my company that as a physician I am so much more ops than other physician leaders in the company because it's the way I think now. So do I think that ED physicians or any physician in general has the wherewithal to be a good business person? Absolutely. But just like you have to get educated in medicine, you need to get educated in business and ops and build that right culture, I will say that one again.

John Shufeldt:
Yeah. I mean, I, it's funny, you and I ... are those things so similarly, I mean, I, you know, there's that old quote by Peter Drucker, strategy, culture and strategy for breakfast, I say this all the time, but, you know, I've had a few times when I've brought the right, let the wrong people in the family not to sound like the Godfather, but they can do so much damage. And so now everything we do, we hire for culture, and if you don't fit it, that's okay. But we're not going to, you know, we won't let you on the team if you don't espouse this mission, mission first sort of culture.

Pam Sullivan:
And it takes years if, you know, it just takes a single pebble and that creates huge ripples in a pond and it might be this teeny little thing, but it will take you forever to be able to reverse that and get people to look beyond that. So it's really hard to regain trust once you lose that culture. And I, I was guilty of being one of those negative people early in my career, but learned over time and I wish I had mentors earlier in my career because even when I reached out and asked for them, there really weren't any mentors that did what I did or that they could pair me up with, and it just didn't happen. So I learned the hard way and it took me a lot longer to get there, but it feels so good to finally be there.

John Shufeldt:
Well, I always laugh and say, you know, as a, you know, a gray haired, tall male, I had a pretty easy I mean, not that I was all that bright, but I just look the part and, you know, all my female colleagues, I still hear them come back and go, oh, my God, I just did a rectal on this guy, blah, blah, blah, blah, blah. And they asked when the doctor is coming in, they're like, really? What else do I need to do? And so I realized I had a much, much easier path than pretty much everybody.

Pam Sullivan:
Well, don't sell yourself short, John. I know how hard you've worked in your career, but it is true. I get all the time when a doctor coming in or I was never seen by the doctor or a male tech will do an EKG and they'll look to them for the reading, happens all the time.

John Shufeldt:
Yeah, yeah. It happened to me once, about two months ago. I did some long history and physical on some lady and she went, when am I going to see the doctor? And I started laughing, I'm like, Oh my God, finally, finally I have empathy! So she, I think she wondered why I was laughing so hard, but I said, you totally made my day. All right, so what, what take home advice for people? Is there's me, a whole group of people out there who say I want to grow up and be Pam, and what, what's mojo, what would you tell your younger self?

Pam Sullivan:
Listen to your heart. Don't let anything get in your way. Don't let anything stop you. You can't be bullish about it and create, burn bridges behind you. You have to be smart about it, but where there's a will, there's a way, and you can do whatever you want to do. You just have to be determined to get there. Depend on mentors, network, get involved. You're not going to do this in a bubble and it takes time to learn. My friend wrote a leadership book and I told her in her next book I want to write a chapter in it that's called Are You Climbing the Right Ladder? Because for years I wasn't. I was in a healthcare system and I was just climbing that ladder. And it wasn't until again, the CEO kind of moved me out of that position that I recognized I was totally climbing the wrong ladder. And once I got myself to the right place, I've never been happier, never look back. So you really need somebody to mentor, you help. You know, you can't just get there overnight. It takes time. It takes hard work, it takes dedication, but don't stop if that's what you want.

John Shufeldt:
You know, I've never heard anybody say that before about climbing the ladder, but that is brilliant because I, the second you said that I can have all these people who are climbing the ladder, but they don't look very happy doing it. And I wonder if they just skipped the ladder to over, they'd be, like you, all of a sudden, like, Oh my God, I'm off, interesting.

Pam Sullivan:
I feel so fortunate. I think it's taken me a lot longer to get here and then it's taken some others. But I do feel so fortunate that I got here, that I have such phenomenal people that surround me. I am still good friends with so many of my MBA classmates and we still support each other and talk to each other and there for each other. And it's just wonderful when we can all help each other take ourselves to the next level.

John Shufeldt:
Totally agree. Well, Pam, where can people find out more about you? Where can they contact you?

Pam Sullivan:
I'm on LinkedIn. You can look for me there and you can email me at my landmark email, which is PSullivan@LandmarkHealth.org. I'm happy to talk with anybody, about anything, any time I, again, I will help anyone out there that wants help, I love doing that.

John Shufeldt:
That's perfect, I am sure you are a phenomenal mentor. Thank you very much for doing this with me, it was great to reconnect with you.

Pam Sullivan:
It was as well, John, thank you!

John Shufeldt:
My pleasure. Well, that's a wrap. Thanks. Everything will be in the show notes, including ways to get a hold of Dr. Sullivan, and I look forward to seeing you next time.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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