7 - Dr. George Palma - Neurologist - On engaging the team at all levels to problem solve

 I've got a great interview today with Dr. George Palma,  retired neurologist from a large health system in California who tells it like it is. I think you're truly going to enjoy what George has to say today. 

Let me tell you a little bit about him first. George has been instrumental in leading a lean enterprise transformation and influencing leaders to change. And you'll hear a little bit about that story during this interview today. George has also got a very unique background. He's a hospital corpsman who served in Vietnam. And, he's a former Senior Director and Healthcare consultant with IBM. 

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Transcript

0:25

Hey leaders. Welcome back to the uncommon leader podcast. I've got a great interview today with Dr. George Palma. A retired neurologist from a large health system in California who tells it like it is. I think you're truly going to enjoy what George has to say today. Let me tell you a little bit about him first. George has been instrumental. In leading a lean enterprise transformation and influencing leaders to change. And you'll hear a little bit about that story during this interview today. George has also got a very unique background. He's a hospital corpsman who served in Vietnam. And he's a former senior director and healthcare consultant with IBM. Quite a journey. In his life and he's an outdoors man, and I know that you'll have a, a good time listening to him today. So without any further ado, let's get you introduced to him.

John Gallagher 1:10

Dr. Palmer, AK George, welcome to the uncommon leader podcast. And thanks for being a guest today, I'm excited about getting to know you a little bit better, and I'm going to throw you right into the crowd. Tell him hello, and then tell us one story from your childhood that still affects you or drives you today and who you are.

George Palma 1:28

I'm not sure I can tell you a story about what drives me, but I can tell you as great story from my childhood. When my dad took me to the polo grounds, I got to see Willie Mays play and, and, and really was known for playing stickball outside of the arena polo grounds. And I got to see him hit. Spaulding, you know, red, rubber ball or pink, rubber ball with his with, with a stick ball bat. So that was one of the high points of my childhood. I was about maybe 10 or 11

John Gallagher 1:57

then. Yeah. You start saying Willie Mays, and then everybody's going to know how old you are as well, you know, as you go through that, which is kind of fun, but, but no, so baseball is one of those sports, right? I mean, I can see it now. We won't have it in video, but I can see this baseball is sitting on the, on the. Bookshelf in my office, which was my home run ball from 1981, August 6th, 1981. And then I was able to share that with my nephew, who just hit his first T-ball home run. And they gave him the ball after the game and we were able to compare baseballs. There was so much fun. So baseball can absolutely. Be one of those things that affects you, it sticks with you from a memory standpoint. And certainly we have Willie Mays is one of those guys that I would have loved to have been able to see play as well. Awesome. Well, thanks for,

George Palma 2:38

thanks for sharing dad. You know, it was a way for me and my father to communicate and get together cause he worked like two jobs all my life. And so when he had some time off, we'd go to the polo.

John Gallagher 2:50

Well, that's cool. So is that, that's kind of the regular thing. You guys, you, you would go to see the baseball when you, when with your dad. Excellent way to think about that in terms of time as well. And again, that generation, when, when people did work two or three jobs, getting that time had to be really important to you and impactful as well. Well, George, you know, I had already introduced you beforehand as to come on, but you and I also worked together for a few years. We had a chance to do a podcast similar to this in our previous work, in consulting and healthcare. But I am, I am curious I'm again, this is really about getting to know you a little bit better, and sometimes we didn't get to share this so much in that podcast, but what's what is for you. What would you consider to be your biggest success story in your career? Especially as a leader?

George Palma 3:41

Well, my biggest, I think, and probably my first as a leader, once I was appointed as an assistant, a physician in chief was to create and lead a stroke center at our hospitals in Northern California. And it was it was an effort that required me to stretch a bit and and also to learn about how, how working with people and changing the way that they behave at work how, how it works and how it goes. As, as a background in 1996 There was a multi disciplinary study on the use of a clot dissolving drug called TPA in the treatment of acute ischemic stroke. That stroke where there's a blood clot blocking an artery. And and it was positive. It showed benefit. And, and before that, the urologists, which I am we get calls a person with a stroke in the hospital and we give advice over the phone, but there'd be little reason to rush into the hospital because there was nothing we could do. We had no effective treatment, none. So after this, I realized that, you know, things were going to change. And, and indeed they did as well. Organizations like the American heart association, American stroke association and accreditation organizations like the joint commissions, they all develop this idea that, you know, now that we have a, an effective treatment, we we need to find ways to deploy it. And the deployment was not a simple thing because before you could give this drug. Which could cause bleeding into your brain. You had to do a number of very important things and they had to be done in a short period of time. There was a window of opportunity of three hours after three hours. You could not give this this treatment safely. So it became clear that that took to my hospital, senior leaders. That we were going to need to develop a way of managing the folks coming into our emergency departments with stroke, as it turns out there was about. We had about 200 a month into the two hospitals with ischemic stroke. So the low number. So I was tasked by my boss bosses to to work with the template that had been set out by the American stroke association and to, and to Institute those at our facilities. This meant a lot of different things that I had to do that I had never done before. For example, a key to a good treatment of a patient with stroke is is the nursing care. And, and unless you work on a specific stroke unit, you don't have a lot of experience. So it came up that I had to make sure that the nurses. We're trained in what to do and how to manage problems. Now, of course, this meant that I had to sell hospital leadership on the necessity of paying for those nurses to be trained. And and, and basically it was a sales job, but it was made, it was made simple, simpler by the fact that there was a lawsuit in a, in a hospital in the San Francisco area where a person was brought into the hospital with an ischemic stroke. His wife was very smart and she said, I want him to get that clock dissolving drug, and he didn't get it. And they sued and they won. Wow. Hospitals. All of a sudden around said, let's do we had a start. We had a jumpstart on that. You

John Gallagher 7:40

absolutely had a reason for action.

George Palma 7:43

That was done. And so th the, the th the whole thing is to work with different groups, the nurses, the nurse educators, the physicians, the ones that were in the emergency room, who are the, you know, the, the, the point of the speech. ICU doctors, because people who get this drug have to be monitored in an ICU for 24 hours. And the F the regular hospital-based doctors, the hospitalists, because they take care of the patient. Afterwards, we also have to educate the neurologists. We had to also convince the doctors emergency room doctors, particular in particular that That this was an effective treatment that is worthwhile doing all of this. There was a fair amount of blow back from some of the medical societies that no, this isn't that good, and it's got to high risk and it's not going to make any difference. And so the doctors who were basically going to be administering this put a pause. So, so there was a lot of education of the physicians. And as we see in this COVID vaccine thing, sometimes it's hard to get people to change their mind, even when the science is clear.

John Gallagher 8:59

No, absolutely. I mean, I can't, I can't imagine the many different constituents that you had to deal with and oh, by the way, we still have this patient that we. Need to take care of as well. So, you know, you described kind of the, the administration and management of a challenge and you know, how, how difficult was them, was it at that time to keep them focused also on the value to the patient? Because actually you mentioned 200 a month is a lot but it's, it's 200. We see how many patients a day, every day in terms of how did you keep them focused on that?

George Palma 9:37

Yeah, that's a good question. And part of it, I think, was working with the chiefs of the various departments or the nurse executives to identify the people who actually would be useful in doing the work. You know, I needed a, a, a, an emergency room nurse educator. Well, they had, let's say four of them. So, you know, and I've never worked with them. So I talked to the, the, the, you know, the chief of nursing for, for that department. And she gave me a person who was interested in it and who had taken on projects like this before. So I went through everybody in identified every department, you know, who, the folks that I want working on this, knowing that they were for it and, and would be, would be allies.

John Gallagher 10:26

No. I love that. I mean, so very important in a project that big to have an identify the influencers, especially those who, to your point, they have a passion for it. They may, they still may not be the most experienced or most knowledgeable, but they have a passion for it to put it in place or to your point, at least an interest in it. And then second. When you're talking with other leaders, trying to determine the leadership characteristic, will this person be able to influence others? Two very important points, passion, and the ability to influence and putting something that important in place. So let's, let's, let's, let's turn it to you specifically and your journey there. So what was, what was, you mentioned that the number of constituents that you had to deal with was channel. But w what else was challenging from your own leadership development standpoint during that process as well that you had to?

George Palma 11:19

Well I basically, and, and, and I basically had to learn how to accept other people's expertise. You know, I, I, I was a board certified neurologist. I had so many years of education. And if you've known any physicians besides me, you will know that we are, we like to be autonomous. We like to set the path. We like to give the orders and write down the rules. So here I am. And you know, I'm, wasn't too far off that model. So here I am with a diverse group of, of, of, of stakeholders and participants. And, and I had the, the hardest thing was to let go of what I, what I would prescribe and allow them to, to, to help me figure out the right way to do it.

John Gallagher 12:11

I mean, that's, that's not an easy thing to do, right. I mean, I, again, when I think about leadership, okay. And when we're talking about, again, moving to. Better leadership being recognized by someone often think about it. As you know, someone who's going to write your name on their list that, you know, I was, this person was a great influence in my life. Much. Like you talked about your father, there are people that have leaders in their lives that, that tell the same story about someone who had great influence. So you had the wherewithal to recognize that if you're going to implement that you needed to change it. Some of your, if you will, stripes of being so used to making all the decisions to allowing some others, I'm curious, do you have a specific example where you can see an experience that you had with someone where you had to do that and what that was.

George Palma 12:59

Well, one was we had a physical therapist who is the representative of the rehab services. And and, and, and what I wanted was a certain menu of therapeutic exercises work, et cetera. And his name was bill smart. And bill said, when, you know, we don't need to do that for everybody. What we need to do is careful assessments and, and then a wise approach to the rehabilitation. And we also need to get in there very early and start to rehabilitation within 24 hours. Instead, the quicker you start, the better off you are. So I acquiesced to him and let him, and I said, okay, you write it up. You give me a proposal on what you want, how much staffing we're going to require. And and then we'll take it from there.

John Gallagher 13:48

Absolutely. I mean, again, another, I can imagine George, I can, I can see that story again because I work with it and I know how challenging that can be. And I've worked in that space where there are healthcare is pretty easy. It's all about physicians to your point. Want to be autonomous? Go into our, you know, today's world of technology and, and the designers of interfaces. They want to do things their way as well and make that happen. So, you know, anyone who has that specific expertise wants to be recognized as the expert, when you're able to, as a leader, understand that you don't have to be the one with all the answers and that you get to ask questions that can be. Really, really powerful as you go through that, George. So, so now here's a reflective question in that, in that whole situation. So you've, you're a leader you've been given a great big project and was successful as you went through, you know, that you face challenges and you've had how many years to. Reflect on that process. If you had advice two or three pieces of advice for somebody new that was getting ready to go into a project with a large group of people, in many different leaders, with many different cultures and behavior past, what would be the advice you would give them today to, to be

George Palma 15:07

well, as you know some years after I did this my hospital did a lean transformation and I was part of that. And I said, if I had that, if I had those tools, if I had that mindset, if I had the ways of measuring, then it would have been much worse. And so, so I think having a set of, of, of norms and tools that you have at your, at your, at your fingertips is really a critical thing to have nowadays. There's no reason to just kind of muddle through on your own. There's always ways you can figure it out, a

John Gallagher 15:46

problem solving methodology. That would be very helpful. And then the second thing I heard that you said were metrics. So I could measure success and what success is going to look like, you know, how long it's going to take you to implement it how long it should take to do each of these protocols and starting to look at when we put it in place, being able to measure success in that fashion as well. What, what on the personal side that, that people's side engagement and things like that. What advice would you have for? Well,

George Palma 16:14

I mean, I had to Sometimes I'm blunt and I had to soften my approach. Okay. Particularly, you know, like, and this kind of goes back to a point I made earlier. Medicine is a very hierarchical and the doc wants to be at the top and the unit clerk is down at the bottom. But you can't, you can't get people to you can't get people to work and do what needs to be done by maintaining all of that hierarchy. You had to completely flatten it. So I became a close. With like the nurses would they'd have a luncheon or something I'd show up and we'd talk or and it, the same thing with the educators and the, and the ER docs. So, so it became a thing where I became like a personally ambassador I had to I had to show the flag so to speak. So I realized that. You know, one of the one of the, perhaps the most important part of leadership is attending to your job and, and attention to the details of the, of your folks.

John Gallagher 17:18

No, I, I love, I love that George. I mean, you, you still, you started off that answer with softening the approach and what it led to as you talked through. It was what I heard was a humility. That, you know, there's a S flipping the org chart upside down, building relationships with everyone, such that you were serving them rather than being served at the top of the hierarchy, if you will. And I, one of the quotes that came to my mind as you went through that, that I've heard before and read a bunch of times is people don't care how much, you know, and you know, a lot until they know how much you care. And that's, I think that's a great kind of finish to that. And how you learn is that they want to know that you care about. And then if they, if, if you care about them as a leader, you have a better chance of succeeding regardless of the hierarchical structure that exists and the number of people that you work for. I think that's a great finish, George. I appreciate you sharing that story about your leadership journey. And I think my listeners are really going to enjoy hearing through that. I want to finish with you and kind of give you the last word, you know, as we go through this. And it's one of these, not just specific to that product. But it's an overall, you get a chance to talk to a lot of people while I don't know if I'll have a million listeners. I'm too worried about that. But George, I'm giving you a blank billboard and it's in the airport in Atlanta, Georgia, and a million people a day are going to see it. They're going to walk by it every day and you have a chance to get your message, your call to action out there to individuals. We are a, I believe right now, a country that has leadership skills. And we need people to have a positive influence on others so that they know what's really happening. What is your message to individuals that you would write on that billboard? So they would see it every day.

George Palma 19:04

Well, given the current climate in our country with illness, with a racial divide, with all kinds of problems I see, I see people kind of giving up. And saying that, you know, this isn't a, this isn't working anymore. My billboard would say, when you fall down dot, dot, dot, get up again. And, and it's because failure is, is, is, is going to be there regardless. And if you recognize that and you recognize that you just get up again that's way, that's the way I think the world will work.

John Gallagher 19:43

George. I love that. I appreciate those words. I appreciate you sharing your story a little bit with me and, and our listeners today. I'm sure. And I hope that you would want to do this again. We'll get a chance to, to talk about some other things as we grow on this podcast, but thank you for your time today. And I look forward to hearing from you.

George Palma 20:03

It's nice talking to you.

20:05

Well, I told you that was going to be a fun interview. Just to summarize a few of the points that I heard. One of the first things he talked about was how hard it can be to get people to change. Even when the science is clear. Secondly, you really said, you know what to understand as a leader, you don't have to have all the answers. I think that's pretty powerful. And then he had some advice for people going into a large project. And he said, things like give them the tools that they need. Give them metrics so that they know if they're winning. Flatten the hierarchy. You'd let them come in and ask questions of the leaders in the organization. Finally, if you have a leader of that project, pay attention to the team and listen to them. And lastly, and his mantra was pretty cool. Failure's going to be there. Get back up. I hope you enjoyed this episode of the uncommon leader podcast. If you get a chance. Drop us a review on iTunes, or you can go to the website at www dot, growing champions.net backslash podcast. And subscribe or see the past episodes that are on there as well. Until next time. Let's go and grow champions.