YouSaid · the spoken record

David Skorton

lines on the record: 23
first: 2020-05-02
most recent: 2020-05-02
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“And I said to them at the time, if you learn one thing at Cornell, learn to ask for help. And that's what I tell people right now. If you learn anything about life, learn that it's okay to ask for help, that it's a sign of great strength, not a sign of weakness to ask for help. And if I had one wish about handling stressful situations is that people would be less loath to reach out and ask for help wherever that help might come from.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Aimed at what to do in stressful times. And I shared with them an experience I had, and I'm glad to share with you and your listeners that when I was a med student, my dad became quite ill suddenly. It was very stressful, and I had some bumps in the road both academically and emotionally, and I got some help from a faculty member who actually cared and said, you know, a little counseling wouldn't hurt you. I got some counseling. It really turned things around for me. And I told that to the students at Cornell.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“I'm first turning to my family. Getting wonderful support and love for my family that's big for me. Secondly, I meditate a little bit. I pray a little bit. I'm also a failed musician, and I'm doing this recording in my modest electronic recording studio. That's very, very relaxing. I'm a voracious reader, and that helps. But most importantly, when I feel that I'm very stressed and all of these levers that I'm talking about pulling are not getting the job done, I reach out for help wherever I need to reach out for it. And if there's one thing that stops us, rough, tough individualistic Americans from getting the help we need, it's the self-imposed stigma of asking for help when we need it. One year when I was president of Cornell University, we had a series of suicides on campus, and I, with some other students, made a little video recording.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Depending on what we're talking about, it could be every day, it could be every week, could be every month. But keep gathering data. And like one would do in a research lab, comparing one's idea about what might be done, call it a hypothesis, to the data coming in. And you know, if the data on hypothesis don't match up, you don't throw away the data, you throw away the hypothesis.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“I always tend to think about things in terms of principles by which we lead and manage. Number one is first to think about the people. More than the institution per se. Think about the people themselves. What can be done to protect jobs? What can be done if furloughs have to occur to protect those who are going to be really up against it? A second is how to deal with the service that we're giving healthcare to those who are vulnerable, how to make sure that those who already are behind the eight ball, so to speak, will have a chance to survive with odds more closely akin to those with the best access to uncoverage for medical care. So that's been an important principle. A third one is communicate, communicate, communicate. It can't be said enough. And a fourth one that I think is incredibly, incredibly important is not to be rigid about a certain course of action, but to continue to gather data.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Very, very strongly that if it wasn't for vigorous social distancing and other mitigation procedures that we'd be seeing even a higher death rate, and here we are with, I believe, a staggering, staggering death rate in our country. One of the beautiful things about America is that we love to just jump in a car and go somewhere, jump on a train and go to another city, take a plane somewhere. And the virus to stay to an obvious fact knows no boundaries and can travel anywhere that a human with that virus on board can travel. So the risks are still high. I think we have to agree on criteria and stick to those criteria.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Well, it's a microcosm of what's happening throughout the country by our own volition we decided to shut down the economy. By our own volition, we decided to cancel procedures of an elective nature in hospitals. By our own volition, we decided to close classrooms, whatever kind of educational institution they are. One could argue all day long about what the right time to go back and especially what would be the indicators that it's safe to go back, whether it's a barbershop or a school of medicine. The only plea I would have to everyone is that we go slow, we agree in advance on what those criteria are, and we don't change in midstream what we think the criteria are just because we are worried about economic issues. And when I say just because we are worried, I'm not in any way belittling the crushing effect of this economic downturn. But I believe”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“And we're telling the med students, well, maybe you can't do that right now because there isn't enough PPE to go around and we want to make sure that PPE is used by frontline physicians and nurses. So the med students have themselves been pitching in in a variety of ways, doing things with telehealth. Telehealth has turned out to be an amazing, amazing thing. The big question that I'm thinking about as a former college president and as a former very active teacher in medical curricula, how do we reopen places of instruction? What kind of rules do we follow? What kind of precautions do we put in place? What kind of yardsticks do we know that it's time to move from one face to the next phase to the next phase? That conversation is going on all across the country at educational institutions, whether they're schools of medicine or whether they're colleges of engineering or whether they're research universities in general.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Of course, local conditions are going to decide exactly what happens in a local circumstance, what the amount of coronavirus is, what the availability of PPE is at that particular site. And it's a balancing act among various variables. One is public safety in general. Another is the safety of the trainees. Another is the availability of these things that allow you to be safe like PPE and so on and so forth. We've offered guidelines to suggest that all things being equal, which of course they're not, but all things being equal, we want to make sure that we protect the health of medical students. And so depending on the situation locally, which is always need to be decided by the leaders of that local institution, we've said if possible, we thought medical students should stay away from a direct exposure to COVID, and that's happened in a lot of medical schools, but not all.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“And she's still practicing. She's still on the front lines. And so she's seeing it herself. She's listening to her colleagues around the country and bringing it back. We have the head of our scientific affairs area, Dr. Ross McKinney, who is listening to his colleagues in the research labs and bringing that back and getting the word out around the country. We have the person who's the head of our medical education area, Dr. Alison Whelan, very, very distinguished and long-standing medical education expert who's listening to all the educational innovations that have to be done when you have to empty out classrooms. So whatever area you're talking about, we're listening first to our members and others. We're compiling it, trying to make it an organized body of information and then getting it out there for people to dip into.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“So individual member institutions on their own are sharing guidelines and new insights, of course, with their own staff. They're sharing it with their colleagues who are executives or providers at other hospitals. My colleagues in the AAMC have set up clinical guidance repositories where one can go and say in a quickly updated dynamic repository, this is what is known now. This is something you might try in this or that kind of clinical condition. So it's all the things. It's person to person, dock to dock, nurse to nurse. It's within a hospital system or health system. It's within a school of medicine. It's between and among colleagues who are heading up different institutions. We actually have physicians within the association staff, one of whom, for example, is a practicing physician who's in charge of our healthcare affairs area. Her name is Dr. Janice.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“All of these are heroics, and I've seen and heard of case after case after case after case of people dusting themselves off and going back to make sure that they're there when the next life is at stake. So I'm seeing it all over the place.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“The fear, the anxiety, the fear for one's own health, the fear of bringing a very contagious lethal virus home is incredible. There's been heroism in the research labs, and that may sound weird. You tend not to think about people in research labs as heroic frontline workers. But when the day comes that we have a successful and effective antiviral treatment, when the day comes that we have a successful and effective vaccine, it'll be because of heroism of those working in a lab. Remember, exposing themselves to potentially infectious materials. And one more heroic frontline person I want to mention is the person who works in the diagnostic lab doing these PCR tests. They're exposed to potentially infectious materials. They too need the PPE that you mentioned before.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Well, this is going to sound like a bold advertisement for these places, but it's coming right from the heart. I've seen nothing but heroism from the C-suite of the hospital to the people in the ER and the intensive care unit. They have done whatever has been necessary to help not just the local situation, but the national situation, the most profound heroism has been in the front lines of actual patient care. And the emotional stress”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Procedures could again be rescheduled and where they could begin to sort of write the ship, if you will. That's what's happening all across the country. I'm particularly worried about rural areas, that even under the best of conditions, rural hospitals have a very hard time staying afloat”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“They're still very likely to have canceled many elective procedures. And they are less busy and also losing revenue. And how much revenue are they losing? Everything I know about this I know by listening to the members of AAMC, people who are actually on the ground in the front lines. And they're telling me that they're losing between $2 and $10 million a day based on having to pay to keep the place functional and pay to have not just doctors but nurses, technicians, laboratory professionals, and many, many others available, but yet there don't have the revenue from these procedures. So yes, exactly as you stated it, choices have to be made. And right now, those hospitals are all thinking about what is the appropriate, careful way to re-enter into a world where non-emergency elective”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“So just think about, let's have two theoretical hospitals, two hypothetical hospitals. One is in COVID so-called hot zone or hotspot, maybe not too far from where you are right now. And those hospitals are overwhelmed with people who are very sick, some of the sickest people, healthcare workers have ever seen, no matter their specialty. And yet those same hospitals have, for good and understandable reasons, canceled or postponed elective procedures where a lot of their revenue comes in. And so in that setting, they're very, very busy, but they're not doing what they would usually be doing non-urgent elective procedures. So that's one. Let's take another hypothetical teaching hospital, or non-teaching hospital for that matter, in an area of the country that's been only lightly touched so far by the pandemic.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“That's exactly right. I'm a cardiologist, and deaths from heart disease have gone down quite a bit since we're doing a better job controlling hypertension, since smoking has cut down quite a bit. But the biggest factor in health are so-called social determinants of health. What your zip code is and what your neighborhood is within a zip code. And so not too far from where your apartment is, you can find the extremes of these social determinants of health.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“For Hispanic folks, but actually the pandemic didn't cause these inequities, but it sure brings them out in bold relief. And we have for a long time And not only ethnic and racial groups, but the homeless, incarcerated, a whole variety of people who are more vulnerable”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“One has to do with the financial incentives that we give for the way we do healthcare delivery. Now, this is outside the hands of the people who provide medical care physicians, nurses, and so on. It's largely outside the hands of those who are executives at hospitals and health systems. But we largely have worked in a system that's based on reimbursing people for the amount of volume of the care that they deliver. We're working toward changing it, but we still basically have a lot of areas where we're based on volume. And the other one that I thought more about than any single factor since the pandemic hit is the plight of vulnerable populations. And newscasts say, well, it's shocking that African Americans are dying in numbers beyond their representation in the population, in certain neighborhoods, in certain areas.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“Would be a great, great wasted opportunity if we didn't look back on many, many things from the middle of this pandemic. For sure we could have been better prepared as a country and as a sector. Now, as you said, there's a lot of disincentives to have extra stuff around for whatever set of reasons. But we have something called the Strategic National Stockpile, so-called SNS. And the point of that stockpile was to have materials that seemed excess at the moment, but would be called into play if there was a surge in this or that problem. And we didn't keep that up as well as we might have. In the hospital healthcare arena in general, one might say that there are some things that have been unsolved problems, not for years, Bob, but for decades, for generations, that I hope Now take more seriously.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“You know, I remember very distinctly in late February, early March, beginning to read about this a little bit in medical alerting services and little tiny bit in medical journals. And then roughly the first week of March, it dawned on me that this was something serious. The word pandemic hadn't popped into my mind yet, but outbreak was the word that I was using at the time. And the next week I decided to have all of the employees of the AAMC 700 strong work from home in Washington or close by environs. In retrospect, there were things to be known several weeks before that, but that was when I really tumbled, not so much of the fact that there was an outbreak, but that this was going to be something potentially very big and life-changing for the world, really, beyond the country.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT
“I have seen nothing but heroism from the C suite of the hospital to the people in the ER and the intensive care unit Would be a great, great wasted opportunity if we didn't look back on many, many things from the middle of this pandemic. For sure, we could have been better prepared as a country and as a sector. Are some things that have been unsolved problems not for years but for decades for generations that I hope we now take more seriously Keep gathering data, and like one would do in a research lab, comparing one's idea about what might be done, call it a hypothesis, to the data coming in. If the data on hypothesis don't match up, you don't throw away the data, you throw away the hypothesis.”
2020-05-02 · Masters of Scale · Rapid Response: On the frontlines of scale: Hospitals, w/Dr. David Skorton, AAMC · IDENTIFIED FROM THE TRANSCRIPT