Nonfiction Observations Reflection

Reflections from the National Council Conference.

So I attended the National Council for Behavioral Health conference[1. The National Council also named me a “top tweeter“. Two people suggested that I add that to my CV.] last week with close to 7000 other people, the vast majority of whom were not my closest friends. When I reflect back over the conference, three and a half talks come to mind as noteworthy:

Mess Up Your Costing and It Will Cost You Everything. I was not the target audience for this talk. Scott Lloyd, the president of a consulting company associated with the National Council, noted that the intended audience included CEOs and CFOs. And, indeed, much of his talk focused on managing costs in a behavioral health organization so expenses don’t exceed revenue. Like many other talks at the conference, he highlighted the use of data, making it transparent to all staff, and encouraging financial leadership at organizations to explain what the data means so staff understand what they’re looking at.

What struck me most about his talk, though, was the amount of time he spent telling the audience—repeatedly—that they cannot demand their clinical staff to “do more”. He recognizes that clinical staff are already doing as much as they can. He instead urged the audience to do whatever they could to make the lives of their clinical staff easier (e.g., reduce documentation burdens). That helps organizations retain staff and promotes staff satisfaction.

It’s always nice when an administrative leader advocates for the workforce. And I got to learn more about the lens CFOs and CEOs use while at work.

Fireside Chat with the Surgeon General. I’ve already written about my impressions of the Surgeon General when he spoke to a room of about 30 people. This time, Admiral Murthy was on a stage in front of several thousand people. He told stories; he spoke about the important people in his life who have shaped his worldview; he spoke with humility about his role.

He didn’t share groundbreaking policies or ideas. He simply shared himself and his values with the audience. His wisdom and grace seems uncommon in people of his age and status.

Listening to him speak made me reflect upon what I do in my professional roles. His talk inspired me to do and be better.

Fireside Chat with CMS. I don’t understand all the regulations that come out of the Centers for Medicare and Medicaid Services (CMS), which is why I decided to hear what CMS had to say.

I was surprised when the CMS representative identified himself as the chief medical officer! Of course CMS would have a medical director, though I didn’t expect that he would speak at this non-physician conference. I was delighted to learn that Dr. Patrick Conway continues to see patients as a pediatrician. He asked for ideas and feedback from the audience and didn’t run away when his scheduled time was over. (A mob of close to 30 people, out of an audience of several hundred, came up to him afterwards to ask him more questions.) He acknowledged that the regulations that CMS imposes get in the way of innovation.

Sometimes I forget that some people who work in bureaucratic administrations want things to change, too. It’s also hard for a single person to change the direction of a bureaucracy. However, I appreciate the efforts of these single individuals because at least they’re trying. I also appreciate Dr. Conway making himself open and available to field questions from a room of people who may not have the warmest feelings towards CMS.

Social Determinants of Health. Two speakers shared the hour to discuss their respective activities. One speaker was Dr. Michael Sernyak, who spoke about his efforts in addressing “food insecurity” and nutrition in a community mental health center he oversees in New Haven, Connecticut. He shared his story about working with community partners to improve the quality and nutrition of food served in the center, which included cultivating a community garden, hiring a nutritionist, and providing explicit training to both staff and patients about the role and importance of nutrition in (behavioral) health care. He also spoke about the unintended benefits of this program: Apparently residents who live near the community garden have reported that the neighborhood is now safer.

The National Council is not a physician conference. He noted that, when his gave this exact same talk at the American Psychiatric Association conference, which is a physician conference that also has an attendance of thousands of people, only four people attended. At this conference, the room was packed: People standing at the perimeter of the room and others sitting on the floor in the aisle.

I liked both the simplicity and elegance of his vision, particularly since food affects health in more ways than one. I also appreciate that, while this intervention was simple, it was not easy.

I’m grateful that I was able to attend the conference and learn what other people are thinking and doing. I won’t lie: I also followed all the suggestions for coping with the conference and still felt cognitively impaired by the second day. Quiet and solitude are wonderful things.