Leading at the Intersection of Care & Compliance

Healthcare leaders carry a unique responsibility. When systems fail, patient care suffers. When security is compromised, trust is at risk. And when change accelerates, the pressure to make the right decision only increases.

In this episode of Behind the Screens, Tyler Smith and Chris Harp sit down with Dottie Anstine, Co-CEO of North Valley Eye Care, to explore a critical question:

What does it take to protect patient trust when compliance and technology are constantly evolving?

This conversation goes beyond IT. It explores the real weight of leadership in healthcare, the importance of proactive planning, and how trusted partnerships help practices stay secure, stable, and focused on what matters most, caring for patients.

Transcript

Welcome And Meet Dottie Anstein

Jessica 0:00

You're listening to Behind the Screens, presented by the Clear IT Partner Program from Matson and Isom Technology Consulting. If you've ever wondered how confident, forward-thinking businesses make smart technology decisions while others fall behind, you're in the right place. Every episode, we pull back the curtain on the systems, tools, and leadership decisions that keep growing companies running strong so you can apply them in your own business. Now, let's get into it with your hosts, Tyler Smith and Chris Harp.

Tyler 0:34

Today, we're joined by Dottie Anstein, co-CEO and Chief Innovation Officer at North Valley Eye Care. Dottie helps lead a large eye care center built around exceptional patient care and a distinctive care model. With nearly two decades in the industry, she has led across revenue cycle, IT, operations, training, and marketing, giving her a broad leadership perspective on modern health care. Dottie, we're glad you're here.

Dottie 0:59

I'm so glad to be here. I love nothing more than talking about technology.

Chris 1:04

You lead in an industry where time is tight, stakes are real, right? What's the reason, one of the reasons that you said yes to this podcast and this episode and be on here?

Dottie 1:18

Well, I feel like leadership in the healthcare space is pretty wide. Every town, every city has a healthcare leader somewhere. And so I think it's it's good for us to talk about how those leadership and this industry intersect. And and I think it's important to dispel the myths behind leadership and the difference between leadership and management and really talking about how that all ties into all the changes that are happening now with like technology and AI. Um, because with leadership, it's something that you take into every part of what you are doing. So if I'm working on customer satisfaction, I'm gonna have those principles of leadership shine through that particular topic. Complexity in this particular industry is at an all-time high. And so I think that um bringing that into the conversation to you sounded really exciting.

The Hidden Weight Of Leadership

Chris 2:17

Aaron Powell One of the things that we've touched on in this podcast is the weight that leaders carry that people will never see, right? Uh so when you think about your role role right now, you know, what feels heavy in a good way or a hard way?

Dottie 2:32

Yeah. Um in my role now, I would say what feels heavy is making sure that my team has everything they need to succeed, but not everything, because the budget is has a max. So um just like walking that line to understand what are the true needs, uh deciphering noise from signals and being able to be nimble enough to um actually capture that in real time uh and uh wise enough to know what to set down. So that's that's that's always a struggle. But I think what I like about a leadership is the challenge. It's not the same, it's not the same day every day. Sometimes I'm like, could you could it just be like 10 years ago? That'd be great. Um but it is I think that particular flavor and change and um makes me use all of my brain and not just um be automatic or or things like that. So to me that's challenging and exciting.

Tyler 3:30

And you said something that I really identify with, which is um giving people everything they need to be successful in their role.

Dottie 3:36

Yes.

Tyler 3:37

But with constraints. But with constraints. And and I think that's one of the core challenges of leadership, which is understanding what aligns with the mission and the goal and and how you're gonna get where you're going. Right. But also in a way that you know actually fits within the the bubble, right? Um when the bubble needs to expand, when it needs to contract, you know, are the are the the questions that are the most difficult as a leader because that's not always clear. Right.

Dottie 4:04

It's it's so hard. I feel like a lot of people think leadership is a chess game. It's not, it's a poker game. Because with chess, you can go back and you can be like, oh, that was your mistake right there. And all of the pieces move in the same way every time.

unknown 4:20

Right.

Dottie 4:20

But with uh leadership, it's a poker game. You could have a great call, but a bad outcome, and you can have a terrible call, but like, ooh, I'm just super lucky. I'm a great outcome. And so that kind of uh learning can lead you down the wrong path or can help you understand um more about more about the work. So when I realized that, that it's not a chess game, it's not about wrong or right, it's about the best call that you have because most leaders don't have all the information all the time at every single step. And so you just have to make decisions blind. Sometimes uh the goal is to learn how to be a d better decision maker and and build those people around you to help you with that particular challenge.

Tyler 5:03

I love that metaphor. Sometimes you basically win with a pair of twos, and sometimes you lose with like a full house. Yeah, yeah, like, well, and leadership is knowing when to actually push your pair of twos. When to back off on your full house sometimes.

Chris 5:19

I love that metaphor, yeah.

Dottie 5:20

Yeah.

Chris 5:21

Yeah. So uh so specific to healthcare, right? That leadership kind of carries a weight like we kind of talked about. That's I feel like that's one of the things that's hard to explain unless kind of you're in it or you've lived it, right? And so for example, patient patients come in, they see the front desk, they see the exam room, the care, the quality, they don't always see what's happening underneath. Um so give me a you know, what's a behind-the-scenes challenge that patients never see, but you think leaders in all healthcare all will recognize instantly when they see it.

Dottie 5:52

Oh, absolutely. I would say it is the complexity and the compliance necessary for every single patient interaction, every single touch point, every part of the journey. There is so much compliance. I actually wrote it down so I wouldn't forget. So we have the OIG, the CMS, we have uh the Federal Trade Commission, we have sometimes FBI, DOJ, if you really get in trouble. Um, and then we have the Office of Civil Rights, we have uh, I think those are the main alphabet soup uh agencies that we have to understand everything that they put out, not to mention every single payer. So every single Blue Cross, Blue Shield, United Healthcare, they all have a list of do's and don'ts. Um and so we are constantly consuming information. Um if we were to put it all out in like one PDF or one book, it would be hundreds of thousands of pages to understand to how to do that interaction right, and then not just do that one interaction, like 10,000s of those interactions correctly. So I think that um understanding the complexity behind all of it and and why things turn out this the way they do is something that all healthcare administrators understand. But patients might uh see it as not as complex uh from the beginning. It's very easy. I just walk through the door and they hand me the thing and then I go sit down in the exam room. So um understanding that part is um something I wish were more universal.

Chris 7:22

Aaron Powell Or I guess uh maybe in other areas, because we've seen it in technology too, is they may see the inconvenience of it. So they so they may see the inconvenience. Oh, can you just email me all my records? Oh, can you email this to me? It's like, no, we can't do that.

Dottie 7:36

You know, I would love to, but there's so many agencies that tell me no.

Tyler 7:42

Lobby everyone on our behalf.

Dottie 7:44

Yes, exactly. Rarely do we ever edit rules like let's take this rule away. I don't think we need this anymore. Um, and so I think it's something that just continually gets added, and understanding how to how to interpret the law and the best way to apply it to your application is is very hard. It's hard for the small one doctor practice that has three employees, and it's very hard for a larger practice that has multiple locations and 22 doctors. So I think um it's just something that is so apparent to administrators, but so not obvious to patients.

Chris 8:22

Yeah, and it all stems from those core values, the core principles that folds up to it all.

Tyler 8:28

So trying to deliver a great patient experience while complying with everything under the sun, right? That's a that's a significant challenge. Yeah. I can see that being something and as a patient coming in, um, I can appreciate because you know of what we do, right? I can appreciate how far it's come even in the last just 20 years of everything was paper-based, I feel like 10 years ago.

Dottie 8:51

We're still faxing.

unknown 8:52

Yeah.

Dottie 8:53

I I think I looked at a technology that uses AI to read incoming faxes, and I think it's just so funny that we have this, you know, this very old thing. A very old technology that we're applying the most advanced technology to uh interpret and make better. Yeah.

Tyler 9:08

That's a great example of of of compliance, right? Because the only reason fax, in my understanding, correct me if I'm wrong, the only reason fax is still around is because um somebody a very long time ago thought it was the best way to preserve privacy.

Dottie 9:24

Yes. Yeah. Absolutely.

Tyler 9:26

And even though now all fax is sent over the internet, it's it's encrypted, right? Just like any other communication between point A and point B in healthcare. And uh there's really no good reason for it to exist except it's baked into like HIPAA and just 30-year-old compliance rules or 40-year-old compliance rules.

Making Compliance A Daily Habit

Chris 9:46

What's different uh in leadership and healthcare as opposed to maybe other industries construction, agriculture, things like that?

Dottie 9:55

I think um so it's yeah, like you said, it's hard for me to compare because I don't have a good comparison to other industries. But from my perspective looking outside in, I would say that leadership in healthcare is so tied to values and what you're doing. Yeah, I we are we're selling um time with a doctor, which means the product is trust. So we have to have high trust. In high trust situations, that means you have to really live your values in every single decision that you make. When you make widgets or you make um cars or something like that, I'm sure there are a lot of values that go into it, but every single touch point with our customer has to have high trust and high um visibility. And I think that's gonna be key for uh healthcare leaders. So yeah, I think that our particular industry, healthcare, is so tied to values and the fact that we are caring for another individual. That whole dynamic of I have an expert trying to take care of people who are not experts and and um and then being paid by a third party. It's it's complex. Human relationships and and um understanding uh our own constraints and how we can best take care of patients is really, really key. And so I think that it's that trust and values mix. I also think that for healthcare, specifically my role, it's a very the administrator doctor dynamic is probably unusual to other industries. So um so we have doctors who go to school uh for years and years and years, come out of school knowing very much well how to take care of patients, how to be a doctor. Then I have the business side, the administrative side that knows how to read a PL, that knows uh management principles, management versus leadership, that knows um the all of the HR laws, billing, the revenue cycle, um all of that is foreign to doctors when they graduate. And so having this uh information um uh divide um and then working together as a team to be able to uh to move the company forward is probably unique uh compared to other situations where the leader is the knower. Like the in tech, the leader is the person who's developing the the code or knows the secret sauce to the company. So um in this case, it's very much uh uh a team sport.

Chris 12:25

Yeah, yeah, providing the service, right? Producing a product which is going to be the service. Yeah. Right. It's a it's a very interesting. I guess I never thought about that.

Dottie 12:33

Oh, it's it's such a unique dynamic compared to other industries because we're each experts in wildly different fields. Right. But we have to come together with uh mutual trust and communication and be able to um leverage the best outcomes. Yeah.

unknown 12:50

Yeah.

Chris 12:50

So you had mentioned trust, which I kind of want to dive into a little bit because I feel like trust is everything in healthcare. Um and sometimes protecting it isn't the easiest or the cheapest path, right? Most cost effective, of course. Um what's a decision that you've made uh that protected trust, even though it was inconvenient, uh expensive, and maybe even unpopular in the moment?

Dottie 13:14

Yeah, um that was uh when I was reading the questions, that that one took me a minute to really think through. I would say I have twofold, two, two answers to that. Um the first answer, very applicable to who I'm speaking with, which is uh bringing IT in-house and really focusing on developing that IT side and translating that to ownership and understanding like, hey, this is really important, but you don't see it every day. Right. This is something that you don't, it's not important until it is. And when it is important, it's too late. Like the cat is out of the bag. So being able to explain the need and the necessity for something very technical that ownership doesn't feel every day is is very difficult at times to communicate when I was in the beginning of my career and just starting that IT department, bringing in a house. And so um, that was really it was not a popular decision to put all that investment and development into another another support team, but it was very key to our success and being able to grow and expand because we were able to become more nimble. And um, we're we're good. We're solid. And and I think that our our hybrid model has been really part of our secret sauce of how we can go quickly, but uh still have high quality. And I think that's that's like a unique uh unicorn. If you got that, you should keep that. Yeah, absolutely. And then the second one that's probably um more overall to the company is our commitment to access to care for everybody, regardless of ability to pay. We have decided to not let the reimbursement fee schedule dictate what patients we see and what patients we don't see, which is very challenging as a business. If I put on my CEO hat, I'm just like, wow, this is hard. And it's way more complex. It's more fee schedules, it's more patients, it's um more needs. And so uh thankfully, and the reason why I love working for Ridge Eye Care, um, the umbrella company in North Valley Eye Care, specifically in Chico, is the commitment. It's part of our mission. It always has been. How can we get access to care for everybody? How can we expand access to care? Because it's vision. We're saving vision, and that isn't shouldn't, you shouldn't have to have that choice. So do I do I go see the eye doctor or do I or do I not go see the eye doctor? And so we are trying to break down barriers to to make that true. Not popular, not easy, very expensive, um, because it there's the realities of the reimbursement fee schedule that uh doctors have to live every day. So in a system that makes it hard to take care of patients who need the care most, we are trying to do our best to provide that to all the entire North State. And it's not easy.

Tyler 16:04

And that's I just want to pause there for a second. That's special. That is that is something that's that's remarkable. And I don't know if um how many of your peers would do the same, right? That's yeah. That's a very I think that we talked about principles earlier, we talked about mission, we talked about um kind of leadership versus management. And um I love that because that basically focuses in and says, uh, what do we believe in? How do you make sure that the business stays whole and that people get paid and that you know things keep moving forward, but also uh never compromises on its core values and its core mission. So that's that's that's remarkable. Because I I I imagine that's not altogether common in the uh in the industry.

Dottie 16:47

But no, I have not seen it in other practices, and and I think that's what drew me to hear. Uh so I originally moved from Indiana to come join uh Ridge Ridge ICare in uh 2016. So I think it I wouldn't have just done that for any practice to move across the country. And so I just was really inspired, but that's always been the mission. The ownership has always been true to that, to that point, and it makes a very special atmosphere to work in. Um and having it always there and having it from top down makes it so much easier as a as a higher leader, but not the owner, to be able to use that to inspire others. It's really great.

Chris 17:28

We use uh, you know, our mission is like our North Star.

Dottie 17:32

Yes.

Chris 17:32

Right. And I think what we use in our leadership, you know, meetings or executive team meetings is is I feel like it always comes out that if a decision needs to be made or we're discussing something that maybe needs to change, it's it's it always comes back to does this align with the mission? Right? And if it does, then you're on the right track. If it doesn't, then you scrap it and you move on to the next, and the next idea, right?

Dottie 17:56

Absolutely.

Chris 17:56

Um and so you you I believe mentioned a little bit ago about um growing, an organization growing, right? And that when growth comes along, you have to set the stage for what you're doing now, and if the plan is to grow, what you're doing now has to be replicated, it has to scale, it has to grow and evolve, right? And therefore leadership needs to evolve. Um and so um, you know, as North Valley Eye Care has kind of grown, um, what leadership habits uh have you had to strengthen or intentionally let go of? The let go part is kind of the the challenging, you know, answer there, or the challenging question there, right, for you to answer. But um I feel like as leaders, you know, you take what's working and what you feel can scale and you strengthen that. And then there are some things, myself included, Tyler included, where there are things you've got to let go of this. This has got to go, right? Absolutely. Take me through some of those for for you.

Dottie 18:53

Yeah, I think uh there's a lot of research or probably writing out there about um this particular topic. And what I found is uh if we want the snarky version, it's the Peter Drucker uh quote. Uh you people are promoted to their highest level of incompetency. Yeah, yeah. So um so I think that's probably the snarkier version of it. But I think the truth underlying there is that growing and expanding is the constant understanding of what got me to this point may not get me to the next point. And understanding like what the new assignment is in every promotion. So every step or every expansion, what is the new problem? What is the new challenge? Uh, where are we, where are we going? Where's that North Star? And really understanding what got me to this role is not going to help me succeed in the next role. So, in my uh particular experience, it was uh I was the doer. Man, I did everything. I understood our RCM, I was the doer, I was the expert. Um, and I was able to really help Ridge ICare understand the technology part, understand data analytics, and move that forward. Uh stepping into the co-CEO role role required me to not, I can't be the doer anymore. There's too much to do. That would be impossible. And there's two of us. So I think understanding that I it the new role, the new idea is development. And I have to be able to develop a team and watch them succeed, watch them become the experts and watch them be able to take on more because one person is not enough. We can't, you can't scale with one person. You have to scale with a team because with a team, you be you can do more simultaneously, you get more ideas, you get more perspectives. And that is is something that I didn't learn the first, or I was learning the first year and um being in this role. And then uh a couple years in, now I'm seeing that come to fruition. So it does help uh understand uh the new expectation or the new level. And so being really honest with yourself and knowing what is it does the team needs, what does the company need, and how am I either uh a bottleneck or how am I um moving that forward is is really key.

Chris 21:14

Which I think is is having that and what we a term that we use in turn is having that next generation leadership under you. Yes. You want to you want to have the right people in place, you want to empower them, and I think that's a big step in leadership.

Tyler 21:26

The insight that I I think um I really I really like is what got you where you are is not what will get you to the next step. Right. And I feel like that is the quintessential challenge of growth in an organization, especially when you come from an operations background.

Dottie 21:45

Yes.

Tyler 21:46

And I think all three of us are in similar uh similar states here where you build your early career on being the expert, on knowing how things work, on solving problems, on overcoming challenges, on literally being the hands and the eyes and the brain. Behind the direct solution. And when you get to a certain level in any organization that's grown, like you said, you have to disconnect from the direct doing at some scale and then start to motivate and inspire others to take on whatever whatever made you successful to get to that point. And transitioning from being able to do the thing to being able to articulate how to do the thing is way more challenging than any of us expect. Is exactly what you said. Recognizing that at that point of transition, what got you here is not what will get you to the next stage, is the critical insight. Because if you continue on in your career thinking, um, you know, well, I'll just fix it myself. Right. Then you're gonna hit that ceiling. Every time. And you're not gonna be able to do that. Or you're gonna become such a bottleneck that the business can't continue to scale. Yes. Or, you know, you you end up working 110 hours a week. Yes. And then other problems happen.

Dottie 23:25

Yes. Yeah.

Tyler 23:26

But yeah, that's a key insight, I think, is how do you how do you navigate that transition from being the expert, being the doer, to being the leader? Um, and I couldn't agree more.

Jessica 23:35

This episode of Behind the Screens is brought to you by the Clear IT Partner Program from Matson and Isum Technology Consulting. If you've ever had that sinking feeling that your tech just isn't doing what it's supposed to, you're not alone. Maybe it's the constant tickets, maybe it's the security risks, or maybe you just don't know what you're paying for half the time. That's where Clear IT comes in. We built it for leaders who want to stop firefighting and start planning. With the Clear IT Partner Program, you get a dedicated team, real strategy, and systems that just work. No more waiting, no more guessing. Imagine your IT actually helping your team get more done and your business feeling more in control. That's the whole point. Wanna see how it would work for your business? Schedule a free consultation today at mitcs.com/slash hello. Now, back to the show.

Chris 24:28

Uh so when people hear compliance, they often think of paperwork and red tape. Um, but in healthcare, it's obviously much bigger than that. Um so what's um what's the most misunderstood part of compliance by by people outside of healthcare?

Dottie 24:43

I think most people think of compliance as I'm just gonna watch that video and then I'm just gonna piece right on out and check a box and I'm done. I think it it the miscon uh understanding of how to do compliance well or best practices is that it is something that is everybody's problem, not just uh the one compliance person that read the article and said, hey, we should do this. It's a team sport. Um and that also compliance is something that you just have to uh communicate over and over and over again because you have to, your staff have to live compliance. They have to know why why they do things. And I think um being able to distill down all of those regulations down to this means to you, staff member or uh middle manager, um, this means we have to do XYZ. And so I think being able to bring that to everybody, not just make it one person's problem and then um and make it so that it is lived every day is the hardest part about compliance. It's not fun, nobody wants to do it, and it is uh really feels like a like a barrier, like oh, my hands are getting tied now. Um but I think when done well, you can use it to explain the why of decisions, and that can help uh your staff be like, oh, okay, so it's compliance. It's not just that you don't like me clicking on any link that gets to my email. It is because we have to be compliant and because these are the outcomes. And I think understanding what the compliance is there for, there's a lot of good reasons to have compliance. There's a lot of like, oh yeah, I don't want the company to get ransomed. I don't want um our patients to get their data leaked out somewhere. So I think that's the the why behind compliance everybody can resonate with.

Chris 26:37

Sure, absolutely. Yeah. How do you keep that from being a morale drain on the team?

Dottie 26:41

Oh gosh. So that is that's hard. I I think my team would probably have a different answer. But I'll just give you my uh what I would love to think about how I do this. So I think that compliance has to be talked about. It can't just be one and done. Um, compliance needs its own space. So the hard part about compliance is that um it sneaks up on you. And you can't you can't have a good compliance program if you're like, oh, what should we have done? And so understanding that it has to have its own space and giving the team time, the resource of time to be able to like just focus on compliance. Um, I think has really helped us really improve our compliance game at Ridge at uh North Valley and Ridge Eye. So I think the understanding of this is not just something that, oh, backburner, just gonna keep backburning that because it's not immediately on fire. Um, I think is the best way to make it so that it is everybody's problem. And when it's everybody's problem, then it is a team sport. Now we can just say like, well, gosh, when my users sign in and they have to sign in like to all the things, like this really slows things down. And so now it's not just compliance, it's an operation issue. Um, and I think that makes the makes it, the conversation more valuable and then the outcome more valuable as well. So uh team sport and uh time.

Chris 28:09

Aaron Powell Yeah, it's the new normal, right? And this is just how it is. It's uh what we what we call in our office a non-negotiable.

Dottie 28:15

Yes.

Chris 28:16

This is the non-negotiable, it just it is what it is. Yeah.

Tyler 28:18

And you said something that um I think is important, which is understanding the why. Oh gosh. So making sure that the staff understand the why. Because if it becomes a morale issue, it's usually I feel like because there's a disconnect between the why and the what.

Dottie 28:31

Yeah.

Tyler 28:32

Um if people hear the word compliance and don't think as a synonym for risk management, that's a challenge.

Chris 28:39

Yeah, and I feel like you can use technology to help lessen some of that, right? Lessen the burden a little bit. You can leverage some technology. Some things just you can't you can't uh replace efficiency technology and vice

Using Tech To Improve Patient Care

Chris 28:54

versa. Um take me through on North Valley Eye Care. Um how do you guys utilize technology to improve specifically patient care?

Dottie 29:01

We are using technology in, I would I'm gonna break this out into two answers. So administrative technology and then medical care technology. So we have, let's start with medical care that's very patient uh focused. And I think the idea there is that we have a strong passion for innovation and technology. We have um we're integrating new technologies that are on the forefront of care to understand um how we can bring solutions to our patients that just they wouldn't have otherwise. With any particular problem or care, you have to understand the problem. So we we die we have great diagnostics. And then applying that the solution is having great treatment. And so if you just stick your hand head in the sand and just say, well, that's just how we've always done it, um, you could be missing out on a lot of value that you can bring to the patients. And so um having that technology, but also putting it through our rigorous vetting or verifying is key. Because just because it's new technology doesn't mean it's uh effective, right? So uh we're always uh looking at ways we can make sure that we're making the right choices for our patients and bringing in the right technology. Um on the flip side, on our administrative side, we have uh brought in technology to help streamline uh workflows. We have an HRIS system that uh handles onboarding. So now onboarding now is not a very manual process, it's almost automatic, which helps set up our staff for success. All those HR compliance uh forms and documents are all signed right before like day one. And so um bringing in that technology has helped that department, bringing in technology into our IT department and having uh uh very uh well orchestrated and structured networking systems to make it easy for our teams then to pivot. So when we went into pivot to having global partners and staff um offshores, we're able to easily make that pivot because we already had that infrastructure set up with our Meraki networking equipment uh with site-to-site VPM. And it was great. And so being able to um have solutions ready uh is is really key. So it's it is preparing for that next step before you even need it. Yeah. Absolutely. Technology has really helped us.

unknown 31:18

Yeah.

Chris 31:19

Uh within technology um on the AI side. Yeah. Right. I know you I know you love AI. I know you're you're being into it. I cannot. If you don't know, the door's there.

unknown 31:32

You can go.

Chris 31:34

Um so what do you see as some of the opportunities um and risks to adopting some of the AA tools specifically in healthcare?

Dottie 31:41

Yeah. So um I would wager, if I were a betting person, that no human individual is like, I'm gonna grow up and I'm going to send paperwork to insurance, and that's what I want to do for my life, right? I want to click boxes and I want to just have that continual workflow be the rest of my life for 20, 15 years, right? So I think AI is gonna help us as human beings, not just healthcare in general, remove ourselves from the toil and the drudgery of work and help us focus on what actually makes an impact. Now, I would say that you know, filling out prior authorization forms, getting uh going through that red tape is impactful. I mean, the patients do get their prescriptions then or the insurance then knows that they are going to come see us and then the claim gets paid. Everybody's happy about that, but that is more something that can be automated and doesn't require a human soul to go through week after week to do that, right? So I think AI is going to help us um find out, okay, if we don't have to worry about that, we can automate it in some fashion with a gentic AI. What can what can we do? We have this human now. Um, can they look at all of the things that aren't uh easily uh figured out, like all the edge cases. So the edge cases that we could never get to or understand why does that insurance do that when when we do this? Or um even looking to see the the trends, we are able to focus on what is more impactful to the business, what is more impactful to patients. Um being able to, for example, we uh uh just last week we started our our first endeavor into kiosk check-in. And it's such a very uh interesting launch because I I can tell our patients really care about our staff, which I love. And I think that's great. And I think the the goal for us is to show them like, hey, this actually makes that front desk person's job so much easier because they can uh we can collect all that paperwork that you the those forms you have to fill out and and um somebody has to go in and type those in and and get all that updated. Um but having this kiosk check-in system means that that they can just focus on you. And so um being able to focus on that human connection, that relationship, it'd be great. We would love to see our patients walk in and then it's a calm environment. People aren't like, hold on, I need to take care of this. Can you bring it on hold? And um and being able to focus on the people coming in would be the best patient experience. Uh if our front desk staff didn't have all of that work to do, a scanning and filling and things, um, we might be able then to have the better opportunity to be, hey, can I clean your glasses for you? Can I get you a drink? There's a coffee bar over here to make that particular interaction more comfortable. If they aren't inundated with all of the things that are happening to them all at once, then they have the m- the time to be able to focus, oh, I remember you, I saw you last week or last month, and they might be able to remember names and be able to make that connection. And so I think that uh a lot of times uh people think that uh technology is going to be a replacement of humans, and I don't never, never could there always has to be a human in the loop. But I think what it can do is take the drudgery of life or the toil of life away and help us focus on what's more important and impactful.

Chris 35:03

Yeah, we say uh use it to elevate, not eliminate.

Dottie 35:05

Yes.

Chris 35:06

And um exactly what you said is when you you obviously hire the right people, you hire, you know, you have the right people in in in um in your in your business. So they're obviously hired for a reason. Repurpose them to higher value things. Yeah. Right? Like higher value things, and and I've I've been asked by so many people, especially being in the technology industry, of like, how long is it until AI replaces us? You know, how long is it? And I said, I if anything, I think it's what it's gonna do is it's gonna do the opposite. It's gonna not force people, but it's gonna help people have conversations because it should free up the internet the interrupt-driven, you know, patient coming in, checking in. And that's not that it's interrupt uh a negative interruption by any means. You guys all wanna talk and work with your patients and have conversations with them, but in a higher value capacity. Yes. Not in a, yep, here are the forms.

Dottie 36:04

Sign here. Yep, yeah, build this out. Yeah.

Chris 36:06

Yeah.

Tyler 36:07

No, the word I I I liked uh that you used was impact, right? Make freeing up people to focus on creating uh a higher impact for your patients.

Dottie 36:17

Yeah.

Tyler 36:18

And that's it. At the end of the day, like all technology is here to help with that, right? You have that mission. You're there to help people see and or see better or see more clearly or whatever that is. But the the focusing on the impact, I think, is is a a really important point because that's what all good technology helps us do. And whatever industry we're in, if we can get our staff, our employees, our partners, whoever, to focus more and more and more on making a more significant impact, then uh then that reframes the business around the goal. Right. And then the technology, including AI, including these tools that are moving so fast that they're scary, but they're also exciting to some extent, uh terrifying, it's like a roller coaster. Terrified, but you're on it, but you get in line, didn't you? Uh but you you get there and uh if you can, in a leadership role, continually reinforce why, the why. And if if the tools are here and it's a great lens to judge tools as well, because if the tool isn't amplifying the impact, if it isn't helping you do things, if you're actually now spending more time on the tool than the work, then it's probably the wrong tool.

Dottie 37:32

Yeah.

Tyler 37:32

Yeah. But yeah, impact I think is the exact right word for this technology because you if you can frame it that way, then you can you can create value judgments because all these tools have cost, all these tools have to be implemented, they all have to pass compliance, right? There's all there's lots of layers to get them implemented. But uh the impact lens is exactly the right one because it's is it going to help us do what we do better? If not, let's not waste time.

Dottie 37:58

Yeah. I think the overall uh fear around AI could be attributed to the fact that things are changing. So um and fast. And so, yes, we are definitely going to use AI or technology to help streamline efficiencies, but that means that the person who is what they were doing now is changing. And so the understanding that the change is not always bad and understanding the change can be an opportunity is I think the the key driver there. And I so I I do recognize that. I do recognize that people are like, oh man, my job might be outsourced now by AI. It might not be outsourced, it might change, it might change fundamentally. Um, but I think that's always happening, whether it's AI or something else. I think we're we're always moving forward as a as a human race.

What Real Partnership Looks Like

Chris 38:48

Let's discuss partnership in healthcare. Okay. Um, so you know, especially in healthcare, the the word partner carries real weight, right? There's a difference between a vendor and a partner, in our opinion. Um so what makes a partner feel like part of the team kind of without crossing those lines or without blurring those lines?

Dottie 39:07

Yeah, I would say communication and uh expectations. So you really have to a partner is somebody who you communicate with a lot. A vendor is somebody who's like, hey, thanks for installing that. I'll I'll never talk to you again. Um the uh the partner is somebody who you're communicating with often, um, and the expectations are set there to help each other out as far as as being able to work together. So the best partner vendor relationships are ones where the expectations are very clear and everybody understands how we can be successful together. And I think that a lot of times it's easy for a partner-vendor relationship to just be transactional. And um, the best way to leverage that is to think of how how can this help both parties? Because uh because that there, at the end of the day, we have to work together in order to get all of the outcomes that we want. And if we compete or butt heads or or don't listen to each other, I think that that impedes all of the those good outcomes. So uh partnerships are really, really important in healthcare. Um, whether it's a vendor, whether it's uh uh an insurance contract, or whether it's uh partnerships in the community with other physicians and doctors, I think it's it's really key to understand how to do those.

Chris 40:30

Yeah, we use a term a word internally, uh alignment.

Dottie 40:33

Oh, yeah.

Chris 40:34

You have to ensure that you're aligned.

Dottie 40:36

Yeah, yeah.

Tyler 40:36

And part of alignment is expectation management.

Dottie 40:39

Yeah, right?

Tyler 40:39

Like making sure that it's clear, trying to have some kind of a plan. Yeah. Um being on the same page, right? Yeah. And having uh a really good understanding of what each partner kind of needs to get out of the partnership to make it work.

Chris 40:53

And I think trust is at the core of that. Right. And so it takes a really long time to build trust in partnerships. Um but it can be lost real quick, right? Um so tell us about a time a partner earned or lost trust. You know, what was it that was kind of that deciding factor of of of maybe uh ending the partnership?

Dottie 41:14

Yeah, I would say I've had partnerships uh with vendors go really well when they are um when they think about the the problem as a whole, when they listen to hear what the problem is before trying to prescribe the solution. Um and that is is goes both ways. So if I if if I've blabbed on for an hour about my problem, I you know I need to stop and listen to what the solution is and really focus and give that time and respect. So I think the best partnerships are ones where you have clear communication, you understand what's happening, and you can focus on the outcome together and how you you both can can reach that together. I think the uh harder partnerships, the ones that fail, are ones where communication is broken down. Trust, like you said, has no longer there. Um it's very, very clear what what the uh other side, either side is is going for. And I think it's really important to understand at the end of the day, we're all just running a business. We're all doing what we can to help our business out. And I think if you have the mindset of it's me against them, or if I if I win, you lose, and if you win, I lose, that is something that can really be detrimental to overall success. So understanding that expectation at the beginning, are you a partner, or is this transactional? Are we like, do what are our needs? Because I think even in the same space, like some people might have more need for an IT vendor rather than an IT partner. Uh some people might need a partner. And so I think what was what was very clear, specifically with Mountain Isum, we needed a partner when we started to bring IT in-house, and that was very, very clear that that you guys were there to help provide that and um and be able to be communicative. And I think that was uh one of the best uh partnerships that we've had with Ridge Eye Care as far as uh managed service and organization. Um I think the the key with uh some partnerships that haven't gone well is just understanding um why things are a barrier. Just tell me why. Like what this is what I'm seeing. Can you explain why? And um if there's not that explanation of why, then that that does kind of erode the trust. Right. Yeah.

Chris 43:32

So we talked a little bit about AI, um, you know, decisions around AI. Some people can view those as a technical decision, um, but they're also leadership decisions, right? Uh they're also partnership decisions, too. So um right now, specifically, we've kind of talked about there's a lot of noise around AI, right? And some of it's hype, but some of it's legitimate innovation.

Dottie 43:54

Yeah.

Chris 43:55

Um, and uh so in the healthcare side of things, where do you Think AI could genuinely reduce friction for patients or staff, right? Not the value side of it, but that friction point, right? I think you alluded a little bit to like kind of the check-in process and things like that.

Dottie 44:11

Yeah. Yeah. I think it's access to care. There are only 22 doctors that have to serve a mass population for our patients. So if AI can open that access to care by um doing an AI call center, we have tens of thousands of missed calls. I'm going to be honest. I feel like there's there's an opportunity, missed opportunity there for us to take care of that patient population with a solution that doesn't have to sleep, that doesn't need overtime, the solution that is replicable, the same to over and over and over again, uh, can be can handle conflict without being uh personally drained by that, I think is is something that could be something we could look into, could be something that is really going to have value to our patients because when you call, it's more interactive. It's not the press one to talk to a front desk, press two, you know, it's not a robot, it's not a recorded message, it is something where the patient can interact with. Um getting that information and and and um to our patients timely is also really, really important to us. It really is important for us to get the right message to the right patient at the right time. And I think that can be overwhelming to a staff uh pool that's like, I'm just doing the best I can. I've got all these patients, I don't have time necessarily to go back and text all these patients or or um uh to spend that extra 10 minutes because we have a full schedule, because access to care, there's just the demand is there. So having uh AI solutions to help us with patient education and patient communication is going to be key because that that as a patient, you want to know all the things that are going to happen. I want to know what is this procedure, can I know more about it? I want to know what I should expect, you know, where do I go? Do I go here? Do I go to the surgery center? Um, and I think our AI solutions will be able to do that intelligently with a gentic AI, where versus being able to hard code the old school like if-then statements, we would be coding that for forever. We'd never get to the end of that.

Tyler 46:19

And people would just be hitting, mashing the zero button. Yeah, exactly. Exactly.

Dottie 46:24

So we need something more uh sophisticated, more human to help us take care of the mass amount of patients and uh and their needs. And I think that AI is a really good solution. Again, not to replace people, but to augment people so that if a patient really does have that nervousness, they can get right to a the right person rather than having to like hunt and peck with a phone tree or um get to the wrong department. And so I think that's that's really key for us.

Tyler 46:52

Aaron Powell I like I like what you said around the the value portion of it, right? Like um creating space where right now, based on the constraints that exist, like a normal working day. Yes, I feel like everyone expects 24 by seven access to health care, but no one wants to pay for 24 by seven access to healthcare. Because it's not just three times more expensive, but it's probably like 10x.

Dottie 47:15

Yes.

Tyler 47:15

Um creating those opportunities where you get somebody who's calling in at maybe nine o'clock at night.

Dottie 47:21

Yes.

Tyler 47:21

And uh and and being able to articulate maybe what is a simple question that has a straightforward answer, that without a tool like Agentic AI in play, they're just gonna have to try to go find it on the website or try to wait until 8 a.m. and then flood the inbound calls at 801 or 701 or whenever you open. Um Do I need to go to urgent care?

Dottie 47:43

Do I not need to go to urgent care? Yeah, no, I think.

Tyler 47:51

Yeah, that's that's a a great place for for AI tools to live, I feel like, is can can you ha can you ask a natural language question just with your voice to something that can answer it very straightforward in a trustworthy way that's been trained by experts?

Dottie 48:05

Yes. Perfect.

Tyler 48:06

Yeah.

Dottie 48:06

Um and then can that AI open the door then to to bring the human in the loop? So um uh and the can can it do it consistently every time with re with repeatable outcomes is really interesting for me as a leader because I think every person deserves, every patient deserves to have that great experience. And I want to make sure we have that that consistency in our product. So uh AI is is scary, but also the opportunities there are really interesting.

How To Start With AI Safely

Chris 48:36

Yeah. What I dislike is when leveraging AI and the automation, but passing it off as a person.

Dottie 48:45

Oh no.

Chris 48:45

You know, like with such that that I think is just an absolute no-go.

Dottie 48:49

That's a total fail.

Chris 48:50

Yeah, we just we started by saying the word trust. Yeah, yeah, exactly. But I get I get I get emails all the time or whatever, like, oh hey, you know, this is Danny from such and such technical support. And I'm like, no, it's not. You just said thank you for your email, or I hope this email finds you well. You are not a person, Danny.

Dottie 49:07

Yeah.

Chris 49:08

So I think uh, you know, a lot of other practices um, you know, maybe in the area or maybe in the in the world are kind of asking the same question now. Um, but you know, do we do we lean in on AI? Do we wait? Do we ignore it? Um so if a peer practice asked you, you know, like, should we be paying paying attention to AI right now, what would you, what would your response to that be?

Dottie 49:30

I would say uh start learning. This is we're all going back to school. We are all it is not something you can ignore, but it's something you can't just be like, right now, this second, I'm gonna implement it. You have to be very cautious with all of the regulations we talked about in the beginning. You want to make sure that you aren't putting the cart before the horse. Um so at this point it's in the game, it is really understanding what's out there. Get like talking to a lot of people, talking to your vendor, talking to your peers to understand what is signal, what is noise, uh, what is hype, what is what is not hype, and talking to a lot of vendors that are in that space so you can understand how each vendor is synthesizing and talking about it. Um, one of my goals in my industry is to be a leader in technology and AI and education and making sure people understand that that it's it's important for us to keep looking, just like our surgeons are keep looking for that extra that new technology or that new device or thing that can help them solve the the disease state. As administrators, we need to keep looking for those things that that are can be out there to help us. So absolutely, we need to be really uh really educated and go back to school and start learning how to incorporate this and how to verify it. Just like when the internet came out. You have to use it, but you have to use it wisely.

Chris 50:55

Yeah, to verify, right? Yeah, exactly.

Data First Principles And Priorities

Chris 50:58

AI is you know it's as much about planning it as it is using it, right? Um so good leaders don't react to problems, they anticipate them.

Dottie 51:07

Yes.

Chris 51:08

Right? And so uh what tells you that it's time to invest in technology or processes before it actually becomes a problem?

Dottie 51:16

Oh, I like data-driven decisions. Uh so that's data in all kinds of forms. So that's going to be analytical data. Uh, we've implemented dashboards through Power BI. Um, we've uh uh securely moved our data to an online warehouse with Snowflake, and we are able to see more insights than we ever saw before. Speaking to your whole idea of changing from paper to digital, this is this is it, we're living it, and then being able to use AI to interact with that data. But then the also the subjective qualitative data. I feel uh talking to your team, understanding, really listening as a leader, what is the problem? And then first principles as a leader. Just five whys. Why? Why, why? To really get down to the root of the problem and really understand is this a uh a big ubiquitous problem, is this a systems problem? Is this a is this a person-people problem? Is this a technical problem? And I think that that's going to be really key in understanding um how to leverage the technology.

Tyler 52:20

Yeah, that's that's a really important point from my perspective too, is understanding how like getting down to the root causes and the first principles is really important because there's a temptation, especially as this technology is moving so quickly, yeah, to just literally throw tech at it. Yes. Just literally say, well, we have a problem. I'll bet AI will work. Let's do that.

Dottie 52:39

Yeah.

Tyler 52:39

And and then turns out, uh, like you said, maybe it's a people problem. Yeah. Maybe it's a training issue. You literally just need two or three people in key roles to understand edge cases more completely. And uh maybe AI can help with that. Yeah. But uh like I feel like every lesson we've learned with technology in the last 50 years at least has been if you understand the problem more completely, you will be more successful in the implementation of technology to automate or solve the pieces that can be solved by technology.

Dottie 53:12

Right.

Tyler 53:13

And uh yeah, that's that's that's super important. Uh the the temptation is strong, especially now because it's moving so fast and the promises are so strong. There will never be a substitute, if you like, uh in small business, mid-sized business enterprise for that matter, for understanding the problem thoroughly and then being thoughtful about solutions that may involve technology.

Dottie 53:34

Yes.

Tyler 53:35

But technology is not step one. Right.

Dottie 53:38

Absolutely. It's just a tool in a toolbox.

Tyler 53:41

Yes. And an ever larger toolbox. Yeah.

Dottie 53:44

But still a toolbox. Yeah.

Chris 53:46

So as a leader in healthcare, how do you decide on what truly deserves attention and what can wait? How do you prioritize that?

Dottie 53:53

Uh we patients first. So if it affects our patient outcomes, that's number one. Um and then our framework is patients first, administrative burden or costs and savings there and efficiencies. And then the last one is revenue. And you know, is this is this impeding revenue? Is it is it helping revenue and things like that? So always start with patients and then work with my staff, and then uh the business will will follow.

Chris 54:20

So I'm gonna drop a heavy question on you here. Um you've you've been in this industry. Uh so you've been in the industry for a while now. Uh you've seen kind of cycles like change and growth. Um, if you could go give yourself one piece of advice 10 years ago, what would that be?

Dottie 54:39

Um other than invest in certain companies. I think I think it would be to stay cu always stay curious, don't lose that, and um don't be afraid of people because people I have learned going through my my career that um that it's really important to network and talk and understand uh anyone, vendors, your uh fellow employees, uh upwards management, lower management. I think it's really key to just keep those conversations going. Because you learn so much more. I think uh in the beginning, I just wanted to keep my head down, just be a good employee, and just gonna get through the day. Um and I think uh older, more mature Dottie is very, very much realizing, oh, people are the key to unlocking all kinds of uh innovation, uh creativity, and passion. And I think those are the things that that really get us up every day. It's not like, oh, I'm gonna go do some fancy clicks on my computer. I'm gonna do this cool thing on my phone. It is it's the connection, and that that is really, really key and important, uh, which can be lost in uh more of a technical realm. Yeah. So just stay curious.

Tyler 55:54

The more AI comes around, comes around, comes around, I've started thinking of, okay, you know what, we need authentic intelligence from time to time. And that comes from other people, right?

Dottie 56:03

It does.

Tyler 56:04

And being inspired by having conversations with other people, um being honest with sharing your challenges with others that you work with, and looking for different perspectives is what makes humans great, right? Because the tools, the AI, the the command prompts often will just kind of be an echo chamber and it'll say, oh yeah, that's a really you're right, that is a really hard problem. Um and you're right to think this, and you're right to think that, and you're right to think that. And uh I totally agree with you. Having someone to talk to and being unafraid to network um is something that's really important because you will run into those people who say, I really respectfully disagree. Yes. And that's how you grow. Thanks for listening to Behind the Screens.

Final Takeaways And Next Steps

Tyler 56:47

If you're ready to take the guesswork out of technology and lead with greater clarity, we'd love to help you build a plan that works. Visit mitcs.comslash hello to take the next step. And we'll see you next time.