This week we are talking about how value-based care transformation is related to the “Hero’s Journey” monomyth that was initially described by Joseph Campbell, an intellectual known for his work in comparative mythology and religion. Campbell studied religions, all of the greatest literary achievements, mythologies, folklores, and fairytales and discovered that they all involve a hero who goes on an adventure, is victorious in a decisive crisis, and comes home changed or transformed. Leaders in healthcare transformation are on a Hero’s Journey, not unlike Jesus, Buddha, Krishna, Apollonius of Tyana, Odysseus, Superman, Luke Skywalker, and Harry Potter! We all have one thing in common — we follow our bliss in becoming captivated by population health and health equity and then reach for the stars!
Joining us this week in the Race to Value is the one and only Dr. Zubin Damania. Dr. Damania (aka “ZDoggMD”) is a physician Leader, internet personality, and healthcare influencer with 2.5M Facebook followers and 75M YouTube views. In this special podcast episode (a recording from the closing keynote at the Advancing Health Value Summit), Zubin discusses the transition to Health 3.0 through the monomyth of the Hero’s Journey. In this podcast, we pay special attention to the issues of burnout and moral injury in the healthcare workforce and how we forge a new way for delivering care that is compassionate, relationship-based, and technology-enabled. Can our nation’s healthcare industry successfully make the transition from Health 2.0 to Health 3.0 in this Hero’s Journey? Will health leaders heed the call for adventure and come back home completely transformed? Meet Dr. Damania, your mentor in this journey to provide you (the Hero) with guidance and inspiration to dispel your doubts and fears, while also giving you strength and courage to begin the quest.
03:00 Introduction to ZDoggMD (and how Eric first met him at a 6-day silent mediation retreat!)
05:00 “We are all trying to forge a new way of being in the world when it comes to health care.”
05:20 COVID-19, system fragility, and workforce burnout
06:20 An opportunity for optimism and the two sides of “hero’s work here”
07:30 The Hero’s Journey in healthcare (Health 1.0 à Health 2.0 à Health 3.0)
08:20 Zubin explains “Health 1.0” as a way physicians practiced holistic medicine based on relationship and intuition
10:15 Physician paternalism in Health 1.0 began the Hero’s Journey (just like Luke Skywalker on Tattooine deciding to forge a new path forward)
11:00 The excessive utilization, care variation, and escalating costs of Health 1.0
12:00 The dominator physician hierarchy of Health 1.0 and how that relegated nurses to a lower status
13:30 The origins of “Health 2.0” – a technology-enabled, data-driven business model
15:30 Right-brain (holistic care) vs. Left-brain (reductionist care) that led to a clash in medicine between 1.0 and 2.0
16:30 The shadow side of Health 2.0 (reductionist de-humanization, commodification, and de-personalization) due to the dominator administrator hierarchy
17:30 “Burnout is like renal failure. You are being dialyzed due to chronic moral injury.”
18:00 What is moral injury and how does it apply to healthcare?
19:00 The suffering created by Health 2.0 and how looking inward can help the workforce find equanimity (Awakening)
20:00 The negative feedback loop caused by a flawed system and how that contributes to moral injury
20:20 The Empire of 2.0: How de-personalized EHR systems defeat healthcare heroes by turning them into data entry clerks
22:00 How Zubin reached the apex of 2.0 due to pressures to practice medicine on an assembly line
23:30 Health 1.0 is the old shore, Health 2.0 is the boat we’re in, Health 3.0 is the shore we’re trying to get to.
25:00 The Elephant and the Rider: Human behavior from the emotional side (Elephant) versus the analytical, rational side (Rider)
27:00 “The Rider is not the master of human decision-making in a society based on tribalism.”
28:30 How understanding the moral matrix of “the elephant” leads to more informed and compassionate decisions
30:00 The dichotomy between rider and elephant explain the difference between Health 1.0 and 2.0!
31:20 Referencing the book, “Switch: How to Change Things When Change is Hard” in understanding the path to true transformation
32:00 “The new shore of Health 3.0 is the transformative integration of Elephant, Rider, and Path.”
32:30 The promise of “Health 3.0” – a transcendent physician-led model that integrates relationship-based care and technology
35:00 The path to Health 3.0 is paved by capitation that aligns financial incentives with outcomes
37:00 Lessons learned from Turntable Health: Zubin explains how relationship-driven, preventative, team-based primary care exemplifies Health 3.0
38:30 How does mindfulness and meditation relate to Health 3.0?
40:00 How “Understanding the Elephant” relates to patient behavior change and SDOH interventions
42:30 Capability requires the autonomy to make decisions. (Reference: athenahealth studyshowing that workforce capability leads to high performing organizations)
43:30 Transforming the path (e.g. payment models, dominator hierarchies) leads to capability
44:00 How Health 3.0 leads to antifragility in healthcare
45:30 Zubin explains the “sacred connection” and why we need to get technology out of the way to empower human relationships in healthcare
47:00 Why AI will only replace mechanical processes but never replace humanity in medicine
49:30 The wisdom of Warren Buffet in how to beat inflation by investing in yourself (and why we need to invest in our healthcare workforce)
52:00 The transformation of the caterpillar to the butterfly as a corollary to the Health 3.0 movement
57:00 “The Hero’s Journey gives purpose to suffering.”
59:00 “The deepest altruism is to turn inwards and transform yourself on this Hero’s Journey.”
60:00 Recognition of the moral imperative for value-based care through Alt-Middle awareness and moral intuition
64:00 How an Alt-Middle perspective can elevate one from “hive mind” groupthink
66:00 The recent homicide conviction of Nurse RaDonda Vaught due to a medication error
68:00 How can you have trust and autonomy in a system when it is dishonest with itself?
69:30 The mental health issues of the healthcare workforce (how it is created by a flawed system and why that creates adverse patient outcomes)
71:00 Referencing the book House of God by Dr. Samuel Shem in exposing physician suicide
72:00 The need for healthcare leaders to support the communalization of pain
73:00 The difference between affective empathy and compassion
74:00 Compassion — an unconditional and infinite expression of love – as a solution to moral injury
76:00 Join the ZPac Supporter Tribe to meet other hero’s in the Health 3.0 Movement!