CHEN: In 2014, when I joined the Surgical Services leadership at Baylor Scott & White Health, there were several ongoing efforts in product rationalization. It was natural for me to become involved, bringing a clinical perspective to decision making and facilitat- ing communication between supply chain and the clinicians. CHUNG: This was totally by accident. I was looking for a career change into healthcare management, especially in quality improve- ment, and I found this job that appeared to require a surgeon. I didn’t really understand supply chain when I applied, but I knew the job required skills to educate other physi- cians about cost reduction and resource management. In reality, it was only after I started my job that I really started to under- stand supply chain. LYDEN: My original involvement with cost control came back in 2003 when the Chair- man of Vascular Surgery, Kenneth Ouriel, MD, challenged me to work on reducing our cost base for devices in Vascular Surgery. I started working with Supply Chain to help reduce the cost bases for Vascular Surgery. Over the next five to six years, I eventu- ally knew everyone in Supply Chain. It was because of that relationship and unique involvement with Supply Chain that our Chief Medical Officer, Mark Harrison, MD,

CHEN UNPLUGGED Unlikely source of inspira- tion: Sunshine. Most creative thing you’ve ever done: Holding exhibi- tions of my photography. What makes you laugh: Children being silly. Best and worst advice someone ever gave you: Best — Every experience is valuable. Half of what you see, you will choose to emulate. The other half? You will choose not to incorporate into your practice. Worst — Just put your head down and do the work. That was code for “this place has so many problems, don’t even think about fixing them.” Must-have accessory: Smartphone…that’s an accessory, right? Favorite thing to do on a day off: Not answer email. Surprising fact about you: I can’t dance. Describe yourself with three words: Do the right thing (okay, that’s four words…) Favorite object you keep in your office: Ce- ramic mushroom — A reminder that sometimes people will keep you in the dark and feed you [insert expletive]. What you would tell yourself if you trav- eled back in time to when you just started in healthcare: It’s about to get a whole lot more fun!

asked me to become the Medical Director of Supply Chain and help engage physicians in our health system to do similar processes. REITER: I always had likes and dislikes as a facial plastic surgeon. But I was never picky about most equipment and supplies until I learned microsurgical reconstruction in 1992, in which flap failure is almost always techni- cal. Comfort and confidence facilitate suc- cessful microvascular surgery, so I wanted to use everything on which I learned this skill exactly as I was taught. As I was the first head & neck surgeon to do this at my center, my department’s reputation — and the future of free flap reconstruction in the head and neck at my institution — depended on my success. Our hand & general plastic surgeons were already using free flaps, so we had a lot of equipment that — as I learned — did exactly the same thing as the variants I wanted, but at less cost for reasons as disparate as list prices and contracting schema. So I quickly learned to evaluate performance and out- comes as criteria for both product selection and price negotiation. After I got my MBA a few years later, I was asked to take a formal leadership role and helped achieve better outcomes at lower cost through evidence- based supply chain management.

What’s a myth about your profession — and your colleagues — that you’d like to bust for supply chain readers? CHEN: That surgeons are obstinate and irrational. The practice of medicine is data- driven, and surgeons are extraordinarily comfortable making decisions based on data every day in their clinical activities. Many surgeons respond well to good data. CHUNG: Everyone in supply chain com- plains that physicians don’t want to change. If that were true, we’d all still be using Palm Pilots. Physicians definitely want to change for the better. We just have to figure out how to convince physicians what “better” is by finding a shared vision. LYDEN: Physicians don’t care. Physicians always will pick what is best for them and not what is best for the hospital. REITER: Docs are human, too — so we’re subject to the same emotions and concerns that affect everyone else, although we’re expected to remain aloof and dispassionate. Many changes in healthcare have affected docs adversely, from a growing body of licensed independent non-physician practi- tioners to sharply reduced reimbursement to significant loss of autonomy in many areas. A kind word and a bit of understanding will go a long way toward overcoming the most common reaction to loss of yet more that we valued in our workplace. In this context, it’s not hard to understand feelings of “Oh no!


You’re taking something else away from me?!” We may still be more fortunate than most, but we’re human.

What convinces, inspires, motivates you to be willing to cut costs, even if it means switching to a brand of product with which you may not be comfortable or favor for whatever reason? CHEN: More so than ever before, there are economic pressures to reduce cost of care delivery. Product selection in the hospital is no different than product selection at home. Just as one can be nimble and price-sensitive in purchasing laundry detergent, one can explore more cost effective options in the hospital. Of course, the non-negotiable is that patient outcomes cannot be compromised. CHUNG: During medical school, I spent three months in Kenya and two months in Papua New Guinea working at village hospitals. You quickly learn to help patients

CHUNG UNPLUGGED Unlikely source of inspira- tion: Quote from [television show] “Futurama” about humility: “When you’ve done things right, people won’t be able to tell if you’ve done anything at all.” Most creative thing you’ve ever done: Not sure if this is “creative” per se, but while I was in medical school, I auditioned to be on a beer commercial — didn’t make it, though. What makes you laugh: My kids when they tell goofy jokes. They are 8 and 9, so their jokes are mostly about bodily functions. Best and worst advice someone ever gave you: A professor once told me that to be a sur- geon you have to have thick skin. This was both the best and worst advice. You do have to have thick skin to survive the abusive environment of surgery residency, but then again, being emotion- ally closed can prevent you from getting close to your coworkers, your family and your patients. Must-have accessory: My watch… it has a life of its own and keeps me company when I’m alone. Favorite thing to do on a day off: Get on my bicycle and ride 50 miles…or bake chocolate chip cookies. Surprising fact about you: I have a tattoo and used to ride a motorcycle during my surgery residency. Describe yourself with three words: Self- reliant, thoughtful, respectful. Favorite object you keep in your office: Basket of candy — it attracts coworkers to come visit me. What you would tell yourself if you traveled back in time to when you just started in healthcare: Slow down, don’t be in such a hurry to finish school. Take time to make more friends outside of medicine.

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