Designing for Health: Interview with Doug Turner, MBA [Podcast]

Show Notes:

 

[00:00] Intros

[00:07] Doug’s background and career journey

[07:10] UC Irvine's expansion

[09:00] Challenges with Epic implementation

[16:30] Cultural differences and expectation management

[20:47] New leadership roles and organizational growth

[22:02] Service-oriented IT approach

[26:14] Future of IT services

[37:21] Balancing family, IT, and humor

[49:12] Doug’s favorite well-designed product

[56:18] Outros

 

Transcript:

 Dr. Craig Joseph: Doug Turner. Welcome to the pod. How are you this fine day?

Doug Turner: Doing well. Better now. Being here with you.

Dr. Craig Joseph: That is sweet of you. And worth the $5 that we've paid or that we will pay. So where do we find you today?

Doug Turner: Yeah, today I am in my office at UCI Health here in Irvine, technically Orange, California, in Southern California.

Dr. Craig Joseph: And is it raining and, snowing or any of those things? Tell me what's going on.

Doug Turner: Yeah. It's, it's so bad outside. It's, probably, what, 70, 70 degrees and sunny? And I know elsewhere in the country it is not. We have it rough down here.

Dr. Craig Joseph: I'm shocked. You actually looked at maybe to figure out what the temperature was like. You don't just say it's 70 and sunny.

Doug Turner: 70 and sunny.

Dr. Craig Joseph: That's just the default answer.

Doug Turner: Yeah, it's chilling off a little bit. All right.

Dr. Craig Joseph: Well, so you're at UC Irvine Health and, what do you do there?

Doug Turner: I serve as the vice president of enterprise applications. It's division that basically means that I have responsibility for our EHR, and all of our integrated and associated third party products. Anything that's on the software side, and my peers on the technical side, our CTO has all the infrastructure, and, our CMO has our informatics and training. And I've got all the software analysts.

Dr. Craig Joseph: So how does one get that job? Tell us a little bit about, you know, where are you started from? Start at nursery school and then just move on from there.

Doug Turner: Well, in the beginning, there was my mom and my dad. No, but from, I will go back, actually. So semi far, in my life, I was a, grew up, had a very rebellious teenage career, I'll call it, but and, some something in me just wanted to fight against the man and, so that was, that was my, my teenage career. I grew up in a very, in a very faithful home. And it was interesting later in, in after towards the end of my teenage career that I found kind my own way back on my own terms and to into faith and that sort of stuff. But the reason I even share that is because it led to me, doing some missionary service, when I was a young man.

And that was a very, very transformative time period in my life. I met my wife, while we were, doing missionary service. I also met, an individual who has become a lifelong mentor of mine, who was part of part of the missionary efforts, but was, in his day job and his, and, in normal life, he was a CFO for, for a health care company. And so that started opening my mind up a little bit of, okay, I am not a health care provider for a reason. I have that's fair needle and blood phobia. And have numerous stories of passing out, at inopportune times, with that content. So however, that just, that kind of opened up the door, after doing some of that missionary service my wife and I met and got married, and we both started school and started family. And I just did a general business degree, in school. And as I went through that, health care started to fall on the list down towards the bottom, you realize that, oh, there seems to be a lot more efficiency and even money in other industries. And this sounds, particularly inefficient and bureaucratic and political.

Dr. Craig Joseph: That's all the time we have, for today. Thank you for giving us your assessment of health care. No, I'm sorry, I, I couldn't help but interrupt. Yes. So, everything was negative. And then what happened?

Doug Turner: Well, so I had my resume out on Monster.com to take this back, back to those years and, it got picked up by an Epic recruiter. And so, I started doing my research on this Epic software, and thought, well, you know, health care may not be my jam, but software that sounds okay. I'm not a super techie person. As evidenced by you had to even help me figure out how to get this mic working, but that turned into, a job at Epic. And so, we moved the family out to Wisconsin. And that's really where I got started. And for yourself and for those, those listeners that, that know that process of starting a new job at Epic day one is when you find out where you have been assigned.

I knew I was coming into the project management division, but I had no idea what application and what kind of area of health care. And you open up that onboarding folder and it said, welcome to the professional billing team. And I said, oh, thank goodness, because I could not do EHRs. And really anything clinical at that time. So that's where I got started, I got started doing Epic implementations more on the business side of applications. And one of my very first clients was an organization that was doing a lot of affiliate extensions with Epic that Epic calls Community Connect and that, as I'm a big family guy that has a very all in the family concept to it of being all on one EHR and sharing a single patient record at the heart. And I really fell in love with that with that concept. And became, one of the managers for that program at Epic for a couple of years. And then that later led to, when I left Epic, to the next jobs that moved me into I worked at Loma Linda University here in Southern California, and led some really large projects extending their software platforms, out to some of their affiliate partners, worked under their CIO for a number of years.

Got to do some really cool things there. Got to really see the inside of health care IT operation and stand up some new and innovative ways of trying to get become more agile with the software and with our projects, ways to get to some of that low hanging fruit and quick wins and ROI or return on value projects that then led later to, a move. We moved up to Washington State. Nate took the job with Providence Health, and helped run their large extension program, for a couple of years. And then I spent a couple of years in consulting doing merger and acquisition consulting. That led me to UC Irvine and doing some work with preparing for a large acquisition that they had, and then that ended up in a full-time job.

Dr. Craig Joseph: So that's amazing. You know, I think you're the first person to say you were excited to open up that folder and see professional billing first ever.

Doug Turner: Yeah.

Dr. Craig Joseph: Yeah, yeah. So, congratulations. Congratulations on that. I would ask you to explain the billing process to us, but we don't have time. So I'm going to fast forward through that.

Doug Turner: I'll simply say that what I learned getting into healthcare is that it's an incredibly inefficient bureaucratic and political, and yet somehow, now even knowing that with eyes wide open, my heart is in it and, it's hard to beat. It's hard to find a better mission than health care. And so that that just, is endears you to the industry. And now my, my aim is to try to fix what I can of the inefficiencies and help it. Help it progress.

Dr. Craig Joseph: Yeah. Well, that's a good goal. So, you know, fix what you can and try to deal with what you know, what you can't fix. You all at UC, UC Irvine are moving not to Epic from a different electronic health record, but you're moving from one Epic instance to another Epic instance, which is a little unusual. It's actually pretty unusual. Tell us about that. Or how did that come, come about?

Doug Turner: Yeah, we've, we've got some exciting stuff happening here for several years. UC Irvine has been on Epic, at our academic medical center here in orange, and all of our clinics, our 80 plus clinics, that instance of Epic, however, we are hosted by, University of California, San Diego. So. So UCSD is the owner of this platform, and we, for those that that know this model, we are essentially a large connect community connect partner of UCSD. And so, we share the instance of Epic with them. And what's happened since that time when, when they first went live with that in 2017, is a major growth phase, for UC Irvine. So, a few years ago, UC Irvine broke ground on a new hospital, a new construction project in Irvine. So that was that's going to add the second hospital into, the UCI portfolio.

And that's expected to open late next year. And then earlier this year in 2024, UCI and tenet announced that they had reached a deal to acquire four of Tenet's community hospitals here in Orange County and one in South L.A. County. So now we wake up and we are a, functioning five hospital system. All of the sudden, and with a six under construction and, just for good measure, we also have another joint venture rehab hospital under construction. So, there's hospital number seven. So, we're going from 1 to 7, kind of overnight. And that really made the decision, kind of dictated the decision for us of, should we stay on this shared Epic instance or should we move to our own Epic instance? And the question had been floating out there for, for some time. And, now with, with this much growth, it became very apparent that that we were going to need our own. UCSD has been a great partner with us and is one of the one of the really unique and cool parts of my job is that across the UC health institutions, we all have peer groups. And we get to collaborate and share things and, what each other is doing. And one group might, might pilot, a certain new module or a new, new third party.

And then the rest of us get to kind of piggyback off of that. It's a really unique, and, and fun thing that that really only comes here at the University of California. And with that, of course, with, with UCSD, we're even closer than just peers. We are we are partners, on the on the, the current platform. And so, so yeah, that's what we're doing. We're separating from our shared, UCSD instance of Epic onto our own, a new instance of Epic Foundation system right out of the gate. And we're implementing that across our legacy academic medical center and, 80 plus clinics, as well as our newly acquired, four hospitals that are coming from Cerner and Athenahealth and our new construction hospitals from the ground up.

Dr. Craig Joseph: So, I would imagine that all of your clinicians and billing folks and other folks that that have worked in the Epic system for many, many years, are going to see absolutely no changes. Once you flip the switch and they move into the new, new, environment. Is that correct?

Doug Turner: That would be incorrect. That is.

Dr. Craig Joseph: Incorrect. So, for the record, I was wrong.

Doug Turner: I'll use the cliche, but if you've seen one Epic system, you seen one Epic system, right? We had actually a choice of whether we wanted to take a copy of our existing shared, shared Epic instance or start with a with a fresh, the latest and greatest kind of Epic foundation system. And, strategically made the decision to, to start with a, with a fresh foundation system, instance and part of the, the reason it's a really unique opportunity, I've asked several, several of my peers at other organizations who have been live on Epic for years. You know, if you had a chance to re-implement Epic, what would you do differently? And while I don't get a ton of, you know, I would do it different this way or that way, I do. The number one response I get is, oh, I would love to re-implement Epic. And usually that's followed with, and we would stay as close to Epic foundation system as, as humanly possible. It would solve so many of our problems. And that's because, you know, over time, after you get live on Epic or any EHR, big platform system, the vendor development and your adoption of that just they don't keep pace together. And then customizations come in where, where you need to deviate from, from their development.

And so, you end up needing to take on big upgrades, in the Epic land. It's called an Epic refuel project, which, often set aside millions of dollars. Just to try to catch up to their development roadmaps and make it so that the that the next smaller upgrade you take, you can actually take more of their more of that foundation system content. I think every, every Epic our organization has heard the phrase get back to foundation or they or they've heard the negative side of we can't do that because we're not foundation. But we've customized something that that now we can't adopt the new thing. So, we strategically made a decision to, to stick with that. I'm happy to, to report at least so far into our project. We're still early, but so far, we have not documented any major deviations from the Epic Foundation system. And that will undoubtedly change, over time or even over the course of the project. We'll undoubtedly run into some and, and it's also been said, and I think from a little bit of a, of a prideful stance as a, as an academic medical center, that there are times when you absolutely must deviate and customize.

And it's been said that, you know, our, our deviations, our customizations of today become Epic's foundation system tomorrow. And so, we'll just be really intentional, about those decisions that that we make. The other really cool thing about this project and the, the timing of it, not everybody has the opportunity to implement a brand new EHR or at the same time that they're going through, a big growth phase and, and acquisitions and mergers and things. Some organizations, when they, when they merge or acquire, will, you know, they'll time it out will that where they will combine on air and payroll and then, you know, they'll work on procedures and policies and, and ERP and supply chain and, and this and that. And they'll maybe try by committee to standardize their workflows. And then maybe a few years later they will go through a bigger EHR implementation. And, and finally actually codify, their standardization decisions. And we get to do that right at the beginning. And so, we think, with bringing our community hospitals into our network and into our project right from the very beginning. Our governance is designed to have everybody at the table making one decision for the whole system, and not just one side dictating to the other. Here's what here's how we do it. Here's how you must do it tomorrow. We're making those decisions together to bring ourselves together both strategically, culturally from a workflows and content standardization perspective. I think it's a really cool aspect and a really opportunistic moment for us to have this project at this time.

Dr. Craig Joseph: So, you mentioned culture. Have you noticed a difference? I mean, you must there must be a significantly different culture between the all of the hospitals because you're you've got, you know, kind of a mothership hospital and then you've got, a bunch of acquisitions are those, which come from a completely different health care system. Are there different expectations about, you know, how the system is going to work that and if so, how do you deal with those?

Doug Turner: Yeah, there's certainly different expectations. I think that's probably the number one thing on my radar every day is expectation setting, and it changes depending on the audience. I'll go into, maybe a specific area of, like data conversion. When you are converting over data from legacy platforms, you go through a process of deciding what data for how long and what converts actually into active EHR data, into your new year and what you might archive or not bring over fully. And we are coming from three different, EHRs, including the same year of our legacy Epic platform and expectation setting wise, is that that's a different that's really difficult to handle. Those, handle those messages. I would say for our legacy Epic users, the expectation is, isn't this just Epic to Epic? Like just push, push the copy Epic button and everything will be there. And, and oh, if it were that that simple and that that easy, but it is still you have to treat, what we're doing. You have to treat it like a, like a brand-new implementation of a new HR. And consider your, your, legacy as a legacy system. There are certainly some, some shortcuts. But there are some added components and data components that we will get to convert, because it is Epic to Epic, but it actually doesn't necessarily make it any easier, to do, to implement the new thing.

So the expectations setting from our academic center is, is to help them understand and the challenge to help them understand and see the implementation as, as that as a new implementation, and not to be too held on to the old implementation, including the, the legacy data, the from our community network hospitals, which is what, what our name for our, our partners that were acquired coming from Cerner and Athenahealth. It's, it's actually a little bit more straightforward. The expectation setting. It's only because the situation is a bit clearer. It's certainly this is the legacy system. This is the new target system. And here's what we can and can't move, and, and where things are going to land. And I would also add that, that there's a lot of it's interesting as we, as we're moving through our governance process and our decision making process on, on workflows and content for community health systems, I think they're actually much more able to adopt the Epic foundation system. It's a I think it's a little bit more geared, for that type of setting. But they do have a lot of, of workflows and things that are built out in their foundation system for academic medical centers. There's obviously, many, many academic medical centers that that use Epic. So, there's a lot of content in there as well. But I think we find that that will be the side that, of our organization that that will probably deviate the most, from the Epic foundation system as little as they, as they as they plan to deviate, they will probably that will probably be the side that deviates more.

Dr. Craig Joseph: So, you kind of walked into a big opportunity with it's a new position, I'm assuming. Right. Yeah. Yeah. But you didn't take over for anyone, though, did you? I think.

Doug Turner: That's true. Yeah. My role is, is a net new role. We're building out, kind of our it's leadership level. And so, mine is a net new role. There's been a couple other net new leadership roles. The organization is doing this. It's not just like, not just in our IT division. But we have several, several new leaders, that we've brought in in the last several months since the acquisition, as well as integrating the leadership from our, community network hospitals. So, it's certainly a time of growth, both in terms of just sheer volume and size, but also in terms of growing our teams to, I suppose the cliche would be that, what's your number one opportunity growth? What's your number one challenge? Growth. And that's certainly, certainly true for, for us right now. But it's, it's generating a lot of opportunity. And that that makes it a really exciting time, I think, to be here, one of the big drivers that, for why I came at this time, I would much rather be here through the challenging implementation work that we're that we're taking on. And this is really the baptism by fire me and a new, brand-new role. I get to meet everybody kind of all at once, through the, through the course of the project. And that's really exciting. So that's what I in, in this new role, that's a big thing that I'm working on right now, is just establishing relationships and working on those relationships within my organization, both within our, information technology services division as well as obviously across, across the entire, operations.

Dr. Craig Joseph: One of the things you mentioned, which I thought was very interesting when we were preparing for this, for this talk, was your intention to design a service-oriented IT shop? You wanted to be service oriented. And I'm curious, what is what does that mean? And how do you do it?

Doug Turner: Yeah. Having been one of those one of those Epic kids, that grows up, at Epic, that certainly beats, a methodology and, and one way to look at the world kind of into you, and for the big implementations like we're doing now, at UCI, that methodology and that that implementation structure works and it works. Well, you kind of organize by application, in the application division, and you set up, your project management structure and your governance structure that kind of follows, follow suit. It's I think when you get it's really after the big implementation work, when you get into long term system management and kind of the forever optimization phase that you can then start to get more creative. And that's, that's one thing that I'm, I'm looking forward to. Our system right now is, is working. But what I want to look at in the future for our organization is how do you bring on bring in more agile models? How do you truly support, a business service line fully and not just, not just by one application or, but actually support it from front, front end to back end? You know, some organizations are looking at, they, they've diversified their IT structures into more of, maintenance team and a deployment team. So, there's a lot of groups out there that are experimenting and heavy fall to their structures to be able to meet the business a little bit closer to where the business is at.

And in some cases, it's really interesting. I think one of the things that I, that I'm seeing and that, that I'm certainly interested in, is I see some folks starting to turn the corner from the old mindset of absolutely no shadow it cloud. We will centralize or die in in our IT division into some more open-minded approaches. My response when I hear things like shadow, it is not to cringe and say, oh no, that's a bad that's immediately a bad thing. My response is always it. Well, is it working? I'm not necessarily convinced that centralization, just for the sake of centralization is always, always the right move. It might be in some cases, but if you could get service line level support directly to your, you know, your high criticality areas, where they get their questions answered, their maintenance done, their project shepherded and live successfully. I mean, that's the ultimate end goal, make it seem like they are part of the business. And to me, you can kind of get there either way, centralize or decentralize, or in factions. My I like to say any plan will work if you do, if you're willing to put in the work, and, and work on that plan, you'll then come to a point where you where you see if your plan is working or not.

And the, the biggest thing I think we, we have to be open to is when we see it not working. Well, is how do we pivot? Are there ways we should be structuring differently or are there ways we should be delivering differently to really meet our, our business partners, and become true business partners and not just, a reactive kind of IT shop. And that's, that's a, that's a hard thing. You know, it's very easy to fall into that, reactionary world because it usually is right where we get a ticket and that tells us what we then need to go do. Is there are there ways that we can evolve our structures so that we don't have to talk about service level agreements and targets and, and why this ticket, didn't, didn't meet it, and really get to a point where we are constantly talking about value driven, or value optimization for the business. And so that's, that's what I, what I'm interested in, I can't tell you that, that I've got a silver bullet or that anybody does, but I think there's some interesting models out there to look at.

Dr. Craig Joseph: Yeah, well, it sounds like you're, you're. If I were to summarize in one word, it's, flexibility, you know? Yeah, that one size doesn't necessarily fit all yet. We should still strive for, you know, that's kind of standardization, but understanding that customization, configuration still play an important and important role. You just have to decide when do you want to push that button? Yeah. And sometimes it's very important. You don't want to push it all the time. Otherwise, you run into the problem that your colleagues can have mentioned, which is we configured and configured and customized. And now we can't take advantage of a bunch of stuff because we'd have to back it out and move in a different direction.

Doug Turner: Have to have very strong, guiding principles. You still have to have very strong change management, in place, very strong training, and, and informatics in place to keep you from going, going down the path that you don't want to go down. But it's still, I think, a worthy, a worthy thought process to then turn into something real, and try to improve our, our business. How many times has an, in it do we hear, you know, that we weren't we didn't know anything about XYZ project. And now it's landed on in our lap and we have to react, and we've got to figure out how to how to get the staff. And, you know, we've seen ebbs and flows with this of, of even at the CIO level of some, some CIOs not being at the executive table anymore. And they're no longer reporting to the CEOs. And, and in some cases, that may be the right decision for, for, particular organization. It kind of proves the point to me that, from, from an IT standpoint, it is kind of a what have you done for me lately? Business. And we have to continuously prove our value to the organization. Otherwise, that, that cost center is going to just look like a very large cost center on a large sheet of paper. And we have to bring that value. We have to communicate to that value. We have to manage the change of that value. And that's, that's where I would say that flexibility. Models come in.

How can you how can you get closer to the business and help and help drive the value in the business? Because I don't know if there's really projects that we get in in our world where we go, yeah, we really don't want to do that. Oftentimes they come in and we go, wow, we love to do that. We would love to support the business doing that. And what are we up against. So always it's, you know, time limitations resource limitations and cost limitations. So, if we can get creative and with our with again with our structures and our models, is there a future. This is maybe my dream, my, my future dream of health care. It is. Is there a future where we no longer have to talk about SLA's? And we only talk about value, and we are at the table for all the big decisions and the little ones. Not because we are duplicative, but because we add value by being there at the table.

Dr. Craig Joseph: Yeah. Well, it's at, I mean, that's a that's a great dream. And I know you're it's kind of I feel like it's something that you'll be working towards but never necessarily achieving. You know, people are going to want to know that you'll fix a problem and X number of hours or days.

Doug Turner: But and we'll and we'll evolve and, and yeah, it's there's like you said no. So, no silver bullets and no silver time silver bullet timeline either. To that it's evolving to the needs of your business and, and are there structures you can adopt and move towards that gives you greater flexibility? It's a really hard thing to do. When you have those three primary limitations always.

Dr. Craig Joseph: Was speaking of dreams and the future. Let's pivot a little bit and talk about the future of it specifically in healthcare. Are there any obviously your, your, head down in, in a big, big implementation and, and kind of, you know, building out and creating of a larger IT department. But are there any trends, that you see coming that you think are going to that you're trying to plan for now, even though you may not be able to fully execute well.

Doug Turner: For us right now? Yes, we have, a big implementation in front of us. I'm also one to, to say, let's never waste a good crisis or a good project. So, if we have the opportunity to add, you know, these are the times when you actually do have some ability to, to request the, the timelines and the resources and the funding. And so, if there are scope items that we can bring into our projects that are going to help us advance immediately upon go live. We're in that phase of our project right now, deciding a lot of those things there. There are several for us that we have chosen to move to. You know, Epic continues to develop, and they've got new modules. And so, there's several new modules that we are implementing with this implementation that we, are not live within our legacy platform. And there some of those are whole modules, and some, some of those are more functionality-driven, functionalities that we would like to be using today that we are not, for whatever historical reason.

And so, we, we're trying actively to, to jump ourselves forward, and not look at this, at this big implementation. I mean, I, having done a number of Epic implementations in my career, would not have thought that in the year 2024 or 2025, I'd be doing yet another brand new Epic implementation. But here we are, and several others are also where we're not alone. In this, it you know, it used to be the thought was all the big implementations would stop someday, and we'd all just be optimizing. And that's certainly not true. Yet, but because we have that opportunity and, like, like I mentioned, talking to my peers at other organizations, what would you do differently if you had the chance? And a lot of it is. Yeah, we'd stick to that foundation system, and we would bring in all the things we want to bring in. Everybody's been asking for. But now once you're, you know, once you're live and into maintenance mode, you got to follow all those processes and, to get things approved and, and life cycles of implementations. We decided instead on a third party and that's got a three-year contract. So, we won't even revisit the decision for, you know, two and a half years. And, and so right now for us, our, our designing is happening now, and we're trying to make it so that we aren't taking steps backwards because we have to take the time to do this big implementation, but bring the things into the implementation and build it all together that are going to catapult us forward once we're live.

And so, we're looking, you know, also with our growth, to a much larger health system with more facilities, we're looking at, you know, clinical command center type of things and, and, and patient throughput, optimization opportunities. We're looking at how we're going to, to manage, patient transfers and, and all of that. Those are going to be really transformational for our organization. And, and then at the same time, we're at that stage that many we're at many moons ago when they first got live on, on their new platforms and said, wow, isn't this great to have all our data in the same place? That's one where we're we've kind of through our acquisitions, we don't we no longer have all of our data in one place. And that will be such a nice moment, when we're all on the same platforms and have all of our data in one place and can now design further our evolution at UC Irvine, because we now have that that shared capacity.

Dr. Craig Joseph: So that that was the wrong answer. You were supposed to say big data, big data.

Doug Turner: And I.

Dr. Craig Joseph: Right. So, I'll see if we can edit that and fix your answer.

Doug Turner: That's right. Let me, let me edit that big data and I. Of course.

Dr. Craig Joseph: Thank you. That's all you had to say is big data and AI, and that's what, that's the answer. But we're nearing the end of our time, and I wanted to give you the opportunity to do something that we have never had a guest do. And I think you're just the right person to do it. I understand that. Do you are big into dad humor. And that you might have 1 or 2 dad jokes, to bring up the up the mood because you started off, you started off in a negative way. Oh, let's be honest. Right? You started off in a negative way, by accurately describing the state of health care in the United States. And so, is there a dad joke or two that you you'd like to tell us?

Doug Turner: Well, I, I will fully own, the, the D&D title. Those for those that don't know me, personally will get big eyes at this, but my wife and I have eight kids, together. Our oldest is 16. Our youngest is almost one year. So, we have, a pretty, pretty good spread. I at one point saw a, remember she was in a magazine or where it was, but a, a picture of an of an elderly couple, who had 7 or 8 kids, and they it was them and all of their kids with their spouses. And then the sub caption on the picture said, not pictured are their 43 grandchildren, and they're 86 and counting great grandchildren. I, I, I felt like they both died from a heart attack and dropped out, jumped out of my seat excited, for that that future, that my wife and I are, are building for ourselves. I know all of my kids’ names. They're great names. Don't ask me, but they're great. I don't know if I've got a, another dad joke off the top of the head. There.

Dr. Craig Joseph: That's fine, that's fine. Listen, I'm excited that you know your children's names. I have four, and I do not know all of them at all. The all the time. And I regularly put the dog in for one of the children, so. So, you're way ahead of me.

Doug Turner: I like to joke with our, our leadership team here, that, why did we stop at seven hospitals? Couldn't we just go? Go one more? And then I can have one for each of my kids. And, and then I was on a call a couple of weeks ago, with one of our physician leaders, and we were talking about some future service lines, and he brought up a hospital at home, and he said, yeah, hospital at home becomes our eighth hospital in our system. And there it was. It's there. I got to, I got to fulfill a dream. I suppose.

Dr. Craig Joseph: Listen, I'm going to, this is a, you know, this is a service-oriented podcast. And as such, I'm going to provide a service for you and maybe for some of our listeners. And I'm going to give you a, A and health, health care adjacent dad joke for you to use. You know, maybe, maybe when it's getting a little stressful, when you're trying to, you know, follow those governance rules and you can use this. It's a knock knock joke, which instantly makes it a, a dad joke, in my opinion. Knock.

Doug Turner: Who's there?

Dr. Craig Joseph: HIPAA.

Doug Turner: HIPAA who?

Dr. Craig Joseph: I can't tell you. All right. Now there's no charge for that, Doug. Like, that's there's no that's free. That's free. Well, it's that it's health care, Jason. The kids, the kids, you know, come on. I'll give you another, another one. That's not a knock knock joke, but, a light bulb, changing joke.

Dr. Craig Joseph: So, there's many with how many, how many physicians it takes to change something along those lines. But I'd like to get even more specific. So how many psychiatrists does it take to change a light bulb?

Doug Turner: Oh, how many?

Dr. Craig Joseph: Only one. But the light bulb has to really want to change. All right. So, I, I have a lot of these and, you know, as, as, as the podcast maybe progresses, we can, we can make this a thing if, if people are listening all this way in.

Doug Turner: I think this has certainly been an area of its heart, in, in the modern day, to, to manage professional life and, and personal life and family life and, and has certainly been it's all I've ever known. Really. I had, I got married and had kids in college in my, during my undergrad time and, and so it it's all I've ever known, and I love it. But it is certainly, certainly a challenge, for all of us. That are trying to make it and still, still put in the hours at home. And many nights I get home, and I just get my itinerary for which kids I have to drive where and who I have to pick up and when. And really, all service, and credit goes to my wife for keeping our household afloat. When I talk about my family, and my wife, I will often get the response that your wife must be a saint. And I say, oh, she absolutely is. Let me tell let me tell you a story. Every time that somebody tells me that about my wife and they never met her, and pay her great compliments just upon hearing of our situation. And so, I will often text her or call her just to say, hey, somebody out there really appreciates you. And here's what they said. So, this happened one time, and I. And I got that same compliment. Your wife must be a saint, and I said, oh, she is. I'll let her know. You think so? So, I called my wife after and she picked up the phone and responded, hello? And I said, why are we whispering? And she said, I'm hiding in the closet eating chocolate, I see. Yep, that sounds about right. If I were home with that, with that rowdy bunch, I think I would be hiding in the closet eating chocolate a lot.

Dr. Craig Joseph: Yeah, that's where my podcast studio would be, actually. And I would have convinced them that I. It's all for the sound, but in fact, it's for the chocolate consumption.

Doug Turner: Yeah. I will add maybe one other, maybe a principle or a lesson that that I've, that I've learned and tried to implement in my life that I it only comes to mind because I'm trying to teach my kids, of this. It's been something that I've learned early on. Actually, when I, when I was doing missionary work, and I had the opportunity to implement it really for the first time when I was at Epic. And I've tried to continue using this. And it's a principle I call returning and reporting. And it's not rocket science. It's simply another name for self-accountability. But the idea that I came into my professional life with was I really wanted to grow my career. Of course, I had I had ambition, and I had a family at home, so I need to feed them and, that drives a lot of the ambition that I have. And, so I, I took on this, this principle. And the idea is that I never want someone else to ask me, how's that thing going? So, I own a lot of, you know, I have a lot of responsibilities in, in my, in my professional career and, and, have big projects and these things. And my goal is that operational leaders, my, my boss, that they won't have to ask me how is XYZ project going or how is that that thing going and the reason I don't want them to ask me that is because I want to be proactively returning and reporting to the right stakeholders and giving sufficient report outs that they don't have to wonder how it's going. And so, I had the opportunity when I was, when I was first at Epic to really implement this. And I even told my first boss there when we meet for our one on ones, I don't want you to ask me how it's going. I want you to just give me the first 5 to 10 minutes and let me report, on all the tasks that I.

That I've been given and all the things I'm working on. And then I want to start asking you questions of what you think the next steps would be. So, this is where the principle goes gets, gets pretty, pretty cool in my in my head it's not just that I that that someone reports and, and yeah, we were accountable. It's I can actually use this to learn how my boss thinks. And you can do this and in personal life and, and, you know, you can do it in a religious context. You can do it, in all kind of all aspects. And so, I started reporting to my, to my boss. I didn't I didn't tell her the principal, I just told her I want to report proactively and, and in my first performance evaluation, there, that was it was a one of those, I call them tiny fist pump moments. In life. You don't get very many, like huge fist pumps and double fist pump moments, but you get, you get a handful of tiny fist pump moments throughout life when things just, went, went right. And in that first performance evaluation was written. It's great. Can I never have to ask you how you're doing, how the things are going because you always proactively return and report. Now, that was a great time period. I was doing it very, very well. I wish I continued to do it, as, as well. And it takes time, and mental energy. But it's now a principle I'm teaching to my, to my kids, and trying to help them in their school work, and, and with, with all the things they have going on. It's, a principle that then you can turn into kind of a you can start growing your visioning and your strategic mind, to say, okay, now I've reported what does my boss think is the next step for me? Okay, great. Let me go do that next step and then I'll return and report yet again.

But maybe the next time I return a report, I'll go. And I think the next step would be this or option one or option two. What do you think? And I can start I can start seeing how that person thinks, whether it's a boss or a stakeholder, a leader, and eventually you could get to the point where, like I, I'm at now, I've received a big responsibility to oversee this, this very large implementation. And now I'm starting to learn my stakeholders to say, okay, what do they like, take? What do they need to know in my report outs? And am I reporting sufficiently when they ask questions and say, no, I think we would go this way. Okay, there's something for me to learn. They thought differently on that one. And why. But over time and this is, this is ultimately what happened in my early career and helped me start catapulting my own professional growth. When my boss was up for promotion and was asked who should take over your role, the very clear answer was, oh, Doug, because he thinks just like me. Yeah, right. And, and that has that has continued. Again, I, I share it only because I, I like to talk about I've taught this principle to many of my teams over time. In fact, I was at a conference, a couple of months ago, and I had a former team member come up to me and, and, and say, you know what? I just taught my whole team.

And she's progressed in her career now and hasn't has a good size team. So, I just taught them all returning and reporting. And it was one of those tiny fist pump moments. So, something to aspire to for me. I like I said, I wish I did it even better than I do. I even just try to use the language. I'll type into my emails, at the top of the email, returning and reporting, and then lay out whatever, whatever it was, almost just so that in my own mental counter, I can take credit for doing it.

Dr. Craig Joseph: Doug, we have run out of time. This has been a great talk. As you may know, we always like to ask the same question at the end of all of our podcasts, which is, is there something in your life that is so well designed that it brings you joy and happiness whenever you, you use it or interact with it? And, What? Yes. There is. What is that? Yes.

Doug Turner: I have two that come to mind. Excellent. They're both things that in recent years have become, become a new thing for me. So, yeah, it's been maybe 7 or 8 years ago now. My wife bought me for her, Father's Day gift of a Blackstone griddle grill.

Dr. Craig Joseph: Okay.

Doug Turner: It's just it's a flat top grill. It's like a, you know, a hibachi style restaurant type of grill. It's the biggest size they make. Which with a family of ten, that's what we need. And I did not do much cooking before this. I did the typical, you know, Saturday morning, Sunday morning, dad breakfasts of burnt pancakes and bacon. But I have found that I love to cook and almost more than love to cook. I love to serve the food. I love to make a big meal and serve it and watch people eat it. There's something in the service of it. And the Blackstone Griddle has, has opened that that side of my, of my life, to me, and the design is, is pretty straightforward. It's just a flat top grill, with a propane tank. Not much to it. There's several other, brands and flavors out there I love. Any time I get to, I get to cook on it. Because you can do all the things. You can do the meats, but you can also do things like fried rice and all the things that would fall through the grate on a, on a on a regular grill. I mention mostly because of the, the life change that it's, that it brought into my life. The other one is a more recent one, but also dealing with food consumption. You've seen the Santa Claus movie. Tim Allen.

Dr. Craig Joseph: It's, I believe it's a federal law that everyone.

Doug Turner: I think so, yeah. Right. We watch it every Christmas with the kids, and they, they get a kick out of it. And there's a, there is a, a scene where the elf makes a hot chocolate for Tim Allen, Santa Claus character. And those that know will probably even be able to, to quote the scene of extra chocolate. Not too hot, shaken, not stirred. I have been trying to figure out how to make the perfect cup of hot chocolate for a long time. Last winter I was in the kitchen and I'm over the pan and I'm. And I'm whisking and I'm stirring. And I shared with a coworker, my dilemma in having never accomplished my goal. And she, shared with me that she had an amazing new product. And it's by a company called Hotel Chocolate, I think. Is chocolate or chocolate for the fancy. And they created what they have called a “velvetizer”.

Dr. Craig Joseph: Oh.

Doug Turner: The I would go as far as to say they are the kings of, they're on the forefront of velvetization.

Dr. Craig Joseph: Yeah.

Doug Turner: This it's essentially it looks like an electric kettle. It's, it's actually not, overly complicated, but it is a joy to use. And, when, my previous, organization, when this coworker told me about this, it was right around the time we had just had our last, our last kid and my previous organization sent me one as a as a as a gift. Kind of and I immediately got it out, and you can buy their chocolate, or you can get your own. I have way too many kids to buy expensive chocolate. So, we go to the store and get, you know, extra dark chocolate. And we, in fact, two of my kids and I, as soon as we got it, we went to the store, and we bought all the different kinds of milk and creams and different flavors of chocolate bars and milk chocolate and dark chocolate. And we went kind of mad scientists, on this. And we have found in the last year of using it, for us what is the perfect ratio of cream, the perfect kind of milk and the right amount of, of chocolate and blend of, of dark chocolate to make it just right for every individual in the family. And it is I, I just love it. It froths it for you. It thickens it heats it up. It takes about two and a half to three minutes to make a make a cup. I always go over the max line because I need to make a lot more at once and do it five times to feed, to feed the whole family. But I've gotten this thing out to, you know, the way to, to, a woman's heart is through dark chocolate. And, so when my, when my wife has her friends over, I'll throw the apron on and, get the velvetizer out, and with them all up, the best cup of. They don't even call it hot chocolate. They call it drinking chocolate because they want to be fancy. Oh. And serve that up and I don't have to say anything. I don't have to engage in conversation. I can just hand, hand that, hand that over, and I win hearts and minds.

Dr. Craig Joseph: I feel like you should. We should get you in front of the United Nations. Because I feel.

Doug Turner: Like you can. It could bring peace. World peace to the world.

Dr. Craig Joseph: Yeah. Well, that's amazing. And that certainly qualifies as a well-designed machine. The velvet visor. And also, you used the word velvetization, I think, which is one of the best words I've ever heard. I don't know what it means, but, I mean, it just.

Doug Turner: It just makes you feel good.

Dr. Craig Joseph: It does like. Right. Yeah. Like, we need to max out the velvetization today. Right. And on this call, or something. Yeah. I'm start using it and people ask what it means. I'll just kind of put back on them or what do you think it means? And then that will be the right answer.

Doug Turner: I wish I had a podcast voice that was very velvety. Right. So, some people are just blessed that way.

Dr. Craig Joseph: Now, you and I talk like normal people. That's unfortunate. Doug, thank you so much, for enlightening us. And, and making us smarter and, and also, I think starting us on the path to world peace and harmony with all through, hot chocolate or, drinking chocolate.

Doug Turner: Drinking chocolate.

Dr. Craig Joseph: Drinking chocolate. Yeah. I appreciate it. And I look forward to, seeing all the success that you have it at UC Irvine Health. And, and I'm so glad that you got that eighth hospital, that virtual hospital, that hospital at home to complete,

Doug Turner: Completes the set.

Dr. Craig Joseph: Yeah. And so now you just have to figure out what hospital goes with what child, and then and then you're there.

Doug Turner: Yeah. Well, they are so close.

Dr. Craig Joseph: We'll have to do a follow up once that happens and get and get back. So, anyway, once again, thank you for your time and really appreciate it.

Doug Turner: It's been a pleasure. Thanks, Craig.