The Exec: Respect Primary Element of Physician Experience

At Banner Health, leaders try to eliminate 'pebbles,' which are little things that eat away at staff members.

Including physicians in decision-making whenever possible is important for physician experience, says Bethany Bruzzi, DO, MBA, chief medical officer of Banner-University Medical Center Tucson and Banner-University Medical Center South.

Bruzzi has been CMO of both medical centers since February 2020. Her prior experience at Banner Health includes serving as a hospitalist and medical director of care coordination. Before joining Banner Health, she served as inpatient medical director and vice chair of family and community medicine at the University of Arizona.

HealthLeaders recently talked with Bruzzi about a range of issues, including her challenges as CMO, lessons learned from the coronavirus pandemic, and the main elements of physician experience. The following transcript of that conversation has been lightly edited for clarity and brevity.

HealthLeaders: What are the primary challenges of serving as CMO of Banner-University Medical Center Tucson and Banner-University Medical Center South?

Bethany Bruzzi: When you are supervising two facilities, especially ones that have different sizes and different complexities, it is a challenge to make sure that both facilities and the people within them feel like there is equally divided attention. In addition, they want to know that as a leader you are advocating for everybody and all of the needs of the different facilities. You need to be visible at both places, which is something that I continuously try to work on, so the teams feel supported at both the larger academic facility and the moderately sized community facility.

It is challenging with the business needs and trying to recognize that the individuals who have gone into healthcare have been more people-oriented. We must try to focus on improving the health of individuals in addition to the metrics that we are held to on a regular basis. I need to ensure that messages are passed down that are going to be meaningful for the bedside caregivers.

HL: How do you rise to the challenge of supervising clinical care at two facilities?

Bruzzi: In supervising two facilities, I have worked on trying to delegate to leaders at both facilities, so if I am not at one facility it is clear that there is representation of what I am trying to accomplish, and there are people the staff can go to, so they don't feel abandoned. No. 2, when I do connect with people at a particular facility, I let them know that even if I am not physically present, there are initiatives that I am working on and there are key points that are happening at the facility. So, there is a general awareness that I may not be physically at a facility, but I know what is going on, I know what the staff needs, I am going to be advocating for those needs, and I am grateful that the staff can keep the facility running in my absence.

Bethany Bruzzi, DO, MBA, chief medical officer of Banner-University Medical Center Tucson and Banner-University Medical Center South. Photo courtesy of Banner Health.

HL: You became CMO of both medical center campuses in February 2020, immediately before the onset of the coronavirus pandemic in the United States. What were your primary learnings from the pandemic experience at the medical centers?

Bruzzi: We had a lot of learnings through the pandemic. What kept us going the most and what I appreciated was being able to lean on the bedside teams. They problem solved. They were innovative. There was so much good that was created out of the teamwork as well as the ability to think fast about what we needed to do.

I also learned it was important to make decisions quickly. That is something that I feel comes naturally to me as long as I understand the details and can ask good questions. During the pandemic, I collected information, worked with bedside teams, and was able to say, "Here is a decision. We are going to make it and move forward. If we need to change something, then we will do that."

In addition, it was important for our teams to feel they were a priority and were protected. In the beginning of the pandemic with some limitations on personal protective equipment nationally, Banner Health did an excellent job of not only ensuring that PPE was available to our bedside teams but also fostering innovation and creativity. We were 3D printing. We were creating masks. We were reaching out to the community to try to come up with ideas. The physicians and the other healthcare workers knew that their safety was important.

HL: Part of your role is to improve physician experience. What are the key elements of a positive physician experience?

Bruzzi: No. 1, physicians want to feel respected. Including them in decision-making whenever possible is extremely important. No. 2, physicians went into healthcare to help people, so we must make sure that their daily work reflects why they went into practice. With all of the administrative duties and other things that come up that physicians have to deal with, the human connection with patients is what they truly desire. Physicians need to be able to sit with patients and connect with them and their families—that is what is meaningful. Promoting those opportunities on a day-to-day basis is important.

Another thing is what we call at Banner Health "the pebbles." The pebbles are little things that eat away at you. Especially when physicians are tired, we need to remove those pebbles. The electronic medical record is always a pain point, and we need to evolve how we use the electronic medical record.

HL: You have helped Banner-University Medical Center South achieve a high ranking for racial inclusivity by the Lown Institute. How has the medical center achieved this ranking?

Bruzzi: Banner-University Medical Center South has an extraordinary history. It was the county hospital. It is a half behavioral health and half medical hospital. It attracts special people to work there. Right now, we are in a space where there is a lot of light shown on diversity, equity, and inclusion. This is built within the roots of the south campus. It is in everyone's heart that every patient who comes in will be treated with respect, and we are going to treat them as if they were a part of our family. That persona of the campus has allowed us to be successful in the measures Lown Institute has been rating us on.

The special sauce of the south campus is that everyone looks at everyone equally, and they have common respect for not only each other but also all the patients who come to that campus.

HL: What role do physicians play in healthcare administration at the medical centers?

Bruzzi: At Banner Health, we have Advanced Leadership for Physicians or ALP. It is an eight-week pathway to get some experience with leadership. I went through ALP when I joined Banner Health. It is a structured way to include physicians in leadership.

We also have medical executive committees, and we have medical directors in almost every different department. That is one of my most meaningful jobs right now—I am creating a medical director council to bring our medical directors together and continue to advance their skills in administration and coaching. That is going to be critical for us moving forward.

Traditionally, physicians have taken a back seat when it comes to operational leadership. We do not learn a lot about business in medical school. We are not necessarily thinking about large-scale operations. But it has become our business to think about operations. That is something I enjoy teaching, and I hope to spark more interest as we progress.

HL: You have a clinical background in family medicine. How has this clinical background helped prepare you to serve in leadership roles such as CMO?

Bruzzi: As a family medicine physician or anyone in primary care, you are considered a jack of all trades. You know something about everything versus a specialist who knows the nitty gritty and details. The generalist mindset and ability to be able to take in information in multiple aspects of medicine is helpful. I know just enough that when I hear things, I can ask questions and learn about a topic to make informed decisions. A global thought process is ingrained when you work in primary care.

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