David Pate, M.D., J.D. – The MDigitalLife Interview

Posted by: in Healthcare Insights, MDigitalLife, Medical Communications, Social Media Insights & Trends on January 3, 2013

#MDigitalLife is a WCG program designed to learn from and to showcase physicians who are blazing new trails in the digital world – changing the way that medicine is practiced and better health is realized.  You can find previous posts here.

“The sum-total of medical knowledge is now so great and wide-spreading that it would be futile for one man to … assume that he has, even a good working knowledge of any large part of the world. The very necessities of the case are driving practitioners into cooperation.  The best interest of the patient is the only interest to be considered, and in order that that the sick may have the benefit of advancing knowledge, union of forces is necessary.”

– William J. Mayo, MD – Commencement Address at Chicago’s Rush Medical College in 1910 (as Quoted in Bringing the Social Media Revolution to Health Care; ed. Lee Aase)

“What’s old is new again.”  As the American healthcare system continues to evolve, William Mayo’s words are more true than ever … Healthcare is a team sport – and the contiuum of care for patients is critical.  The ability to provide that kind of holistic care is at the center of David Pate’s vision for the future of St. Luke’s Health System.

There’s no question that Dr. Pate is a communicator.  After taking the reins as St. Luke’s Health System chief executive officer in 2009, he started doing a series of roadshows for employees, physicians and St. Luke’s various boards (SLHS comprises seven hospitals and more than 100 clinics across Idaho and eastern Oregon). To meet personally with all of the groups in the system took two weeks of his exclusive time and attention – but even then, he knew that he was only reaching 10% of his audience at best.  Additionally, he saw that the health system was changing so rapidly that no number of roadshows or quarterly and annual reports would be able to keep up in a meaningful way.  He saw the need to do something different.

“When it comes to social media, I want to be clear that I don’t have all the answers. I acknowledge my mistakes and learn from them. But we believe strongly in our mission, and want to share it with everyone in our community.  There is simply no other way that I can reach so many people so quickly – social media has become a critical part of our communication strategy.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

Starting a blog is no small undertaking – especially for someone in as visible a position as Dr. Pate.  He’d heard stories about people who started blogging, but couldn’t keep it up for one reason or another.  He’d also seen business leaders who had arranged to have a “ghost-written” blog, but whose employees could see through the ruse from a mile away. So before jumping in with both feet, he wanted to make sure that he really understood both the commitment required as well as the mechanics for maintaining momentum over time. His communication team (who, by the way, are clearly critical to Dr. Pate’s process) told him that he needed to consider a few things:

  • He’d have to produce meaningful updates, and do so frequently enough to keep people’s attention.
  • The blog had to be in his voice. His staff could make suggestions and proofread, but there could be no question: Dr. Pate would be the author.
  • And the big question: Whether to make it public or private, so that only employees could read it. A public blog posed IT and other challenges that the system had not previously faced.

The decision was made to share the blog as broadly as possible, and Dr. Pate’s Prescription for Change was born.  He describes the blog’s purpose nicely on its “About Page:”

“I have been looking for more ways to reach our physicians and employees. I thought that the blog could be a way to reach people that I might otherwise miss through other communication venues.

Also, I have reviewed our employee survey results and am aware that employees want to know more about senior leadership’s vision and strategy. This is particularly important at a time when we are going through unprecedented change.

Finally, we are working to provide even greater transparency to the public. After all, the community owns us. While not everyone will agree with everything I write in this blog, I hope that everyone will appreciate this and other attempts we are making toward that end.”

Initially, Dr. Pate committed to publishing every two weeks. The volume of information he wanted to share with the St. Luke’s audience, however, quickly drove a switch to a weekly publishing schedule, and he’s maintained a pace that’s much closer to two posts per week, nearly eight per month. And there’s no question that he’s the author, though he acknowledges that he gets great inspiration and recommendations from his communications team, other SLHS employees, and members of the community. And, in keeping with Dr. Pate’s approach to communications and to live out the message of transparency he believes is critical to making meaningful change to the healthcare system, the blog is public – and has a growing national following.

One of the things that’s helped Dr. Pate to keep the blog moving is that it’s inextricably intertwined with the system’s core mission (its “Triple Aim): Better health, Better care, Lower costs.  His topics tend to gravitate toward a few key themes:

To the latter area, Dr. Pate found that people who write or post online tend to “take extreme positions and hammer them all the time.” He knew from his own experience that most people are smart enough to know that there’s more than one side to every issue – especially around a subject that’s as complex and controversial as healthcare.  As a result, Dr. Pate tries to present all positions, and really help people understand different perspectives on these issues.

“When you work at SLHS, people are going to ask you YOUR positions on healthcare issues.  As a physician, lawyer, and the leader of a health system, I believe that I have a unique perspective … and one that allows me to give – to the best of my ability – a non-biased perspective.  Then, I can introduce St. Lukes’ position and explain ‘why’ with some meaningful context.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

Over the last month, Dr. Pate and the St. Luke’s team have had an opportunity to show how impactful the blog can be.

Because Dr. Pate and the St. Luke’s board believe that the key to providing the best healthcare possible within their community means having the broadest meaningful “footprint,” they’ve been structuring to ensure that they can serve their patients across the continuum of care.  This has led to some fairly significant acquisition activity over the past few years.  In the course of acquiring a regional medical group (Saltzer Medical Group), their major competitor filed an injunction in an attempt to stop the process. St. Luke’s subsequently was featured in a New York Times piece concerning changes in healthcare delivery nationwide.  [A Hospital War Reflects a Bind for Doctors in the U.S.]

Dr. Pate says that he spent over 90 minutes with the NYT reporter, helping to paint a picture of how important it is for SLHS to be able to broaden its footprint in order to meet its “Triple Aim.”  But what happened instead is that the St. Luke’s story was used as a lead-in to argue against “big corporate healthcare.”  Though none of the examples cited later in the article were related to St. Luke’s, they were made to appear to be “guilty by association.”

The report scratched the surface of the challenges being faced by health systems; that much is clear from the volume and variety of comments the article generated when posted to The Times’ website. Normally in that kind of a situation, the CEO in question couldn’t do much more than fume and fret – with no outlet to share his side of the story.  But what happened in this instance is that Dr. Pate DOES have an outlet to share the whole story – with a “built-in audience” he’s spent the last year diligently growing.  And it’s also an outlet where that audience has grown accustomed to hearing Dr. Pate objectively discuss some of the most difficult issues in healthcare.  His response, ‘ … The far more interesting story is, What if?‘, is absolutely worth a read. As are the comments – which feature physicians, patients, employees and members of the community sharing in telling the St. Luke’s story.

At this point, you might still be feeling a little bit skeptical.  After all, we’ve seen “big healthcare” misbehaving on a pretty regular basis over the last several years, right?  Just because SLHS has a great PR spokesman in Dr. Pate doesn’t necessarily mean that he’s telling the whole truth, does it?  Well, maybe not.  We usually don’t have any way to tell – we just have to take the stories we’re served, and try to ascertain the truth as best we can.  But Dr. Pate’s blogging has done something else for us … it’s given us a history.  Its shown us some things about his character and the sincerity of the St. Luke’s mission – things that have nothing to do with the Saltzer Medical Group or the New York Times.

Take a look at some of that history:

“I have been at various positions on this at different points in my career.  I worked in a large, urban, county Level I Trauma Center when I was a resident in training, and I saw many people who came into the emergency room largely because they put themselves in situations that endangered their own health, such as drug overdoses, automobile accidents due to alcohol, the end stages of alcoholism, people shot while committing crime, people with sexually transmitted diseases who knowingly took significant risks, and the like.

When I was tired and overworked, there were times I wondered why the county should have to pay all the costs of people’s poor judgment, and why I should have to be up in the middle of the night taking care of them. I’m ashamed to admit it, but it’s true.

I matured and gained life experiences. I got older and found that I didn’t take care of myself as I should have. I gained weight, and became obese, and have been fortunate not to have medical consequences. I had a family member with a drug addiction and realized it truly was a disease, rather than a character flaw. Visiting my family member in rehab, I met youths who were addicts, many of them with piercings and tattoos.

I am ashamed to say that previously I would have judged those young people negatively without even knowing them. When I really took the time to talk to them, I realized that many of them had gone through life experiences that I could not have imagined. They were incredibly smart, nice, and fun to be with, but damaged by life’s circumstances. They were overcoming incredible challenges just to sober up or get clean and to participate in their own recovery. I realized that my outlook had been poorly informed, naïve, and unfairly prejudicial.”

Dr. David Pate, excerpted from Looking at the Patient’s Part in Health – July, 2012

Or, try this one:

“Health care is a legal right for some people under certain circumstances, but it is not an across-the-board legal right for everyone. That is a matter of law.My personal morals tell me that some health care is a right, but not all health care. And ethically, I believe there are limits to the health care that people are entitled to. But in a way, all of this is the easy part. The hard part is how we pay for it for those who cannot do so, if it is indeed their right.

I realize that many will not agree with me, but I hope that this has at least added to the conversation. It is my earnest hope that the Triple Aim work we are doing here at St. Luke’s is going to succeed, so that there are fewer who are unable to exercise their rights to health care.”

Dr. David Pate, excerpted from Health Care: Right or Privilege – May, 2012

That history gives me a chance to know Dr. Pate in a way that I otherwise couldn’t have done without working side-by-side with him, or if he were a personal friend.  And I’m not afraid to say that a person who can express – candidly, objectively and compassionately – those kind of opinions, beliefs and doubts is more likely to be doing so again in the Saltzer Medical Group case.  And the publicly expressed opinions of his audience would indicate that they feel the same way – and by the way, the injuntion was subsequently denied.

Did you notice, too, that every comment expressed on the blog gets a personal response from Dr. Pate?

“Not every comment requires a reply – but I do it in any case.  It takes time and effort for people to comment, and I want them to know that if they invest that time, I’m going to give them a personal response.”

David Pate, M.D.,J.D.

CEO, St. Luke’s Health System

That kind of commitment to putting his money (and in this case, his time and attention) where his mouth is speaks volumes – and it speaks well for the people served by St. Luke’s.

Keeping up with Dr. Pate:

Dr. Pate’s Prescription for Change blog

@DrPateStLukes on Twitter

Dr. David Pate on LinkedIn

St. Luke’s Health System on Facebook

St. Luke’s Health System on YouTube

By: Greg Matthews

Greg Matthews is the the creator and Managing Director of the W2O Group's MDigitalLife - Understanding, Engaging and Activating Physicians in the Digital Age

Find me on: Twitter
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