Meditate Like a CEO: Real ROI from Mindful Leadership

This podcast episode delves into the intricate relationship between mindfulness meditation and its profound implications for healthcare leadership. We explore how mindfulness practices not only enhance emotional well-being but also significantly improve the quality and effectiveness of leadership within healthcare settings. Through a rigorous examination of scientific evidence, we elucidate the neurological benefits of mindfulness, demonstrating its capacity to modulate stress and foster cognitive flexibility, thereby enabling leaders to navigate the complexities of their roles with greater composure and efficacy. Furthermore, we provide practical mindfulness training techniques that can be seamlessly integrated into the daily routines of healthcare professionals, offering a pathway to both personal and organizational transformation. Ultimately, this discourse underscores the necessity of cultivating a mindful approach in healthcare leadership to enhance overall performance and well-being.

Mindfulness meditation and its application within the healthcare sector represent a profound intersection of neurological research, emotional intelligence, and leadership efficacy. The discussion begins with a thorough exploration of mindfulness, defined as a state of present-oriented consciousness, which fosters a non-judgmental awareness of one's moment-to-moment experiences. This foundational understanding serves as a springboard to investigate the transformative potential of mindfulness practices for healthcare leaders, who are often beleaguered by high levels of stress and burnout. The episode highlights compelling evidence demonstrating that mindfulness can mitigate stress, enhance cognitive flexibility, and improve emotional regulation—qualities that are indispensable for effective leadership in the ever-evolving landscape of healthcare. By integrating mindfulness into their daily routines, healthcare leaders can cultivate a more resilient mindset, ultimately translating into better organizational outcomes and improved patient care.

Through the lens of empirical studies, the podcast delves into how mindfulness training yields significant neurological benefits, such as increased white matter density and enhanced executive function. One landmark study cited illustrates that patients undergoing mindfulness-based interventions reported a greater awareness of their symptoms and a reduced identification with negative cognitive patterns—a finding that underscores the therapeutic potential of mindfulness in both clinical and leadership contexts. In practical terms, the episode outlines actionable strategies for implementing mindfulness practices within healthcare organizations, emphasizing that even modest initiatives can catalyze meaningful improvements in workplace culture and employee wellbeing. As the conversation unfolds, listeners are encouraged to reflect on their own practices and consider how mindfulness could serve as a catalyst for personal and organizational growth.

Takeaways:

• Mindfulness training serves as a pivotal mechanism for enhancing the performance of healthcare leaders by fostering emotional resilience and cognitive flexibility.
• The practice of mindfulness has been scientifically corroborated to mitigate stress levels significantly, enabling leaders to navigate high-pressure environments more effectively.
• Utilizing mindfulness techniques within healthcare organizations can yield substantial improvements in employee productivity, as evidenced by a notable increase in productive hours per week.
• Healthcare leaders must cultivate a non-judgmental awareness of their experiences to effectively integrate their internal and external realities, thereby enhancing overall leadership efficacy.
• Implementing mindfulness practices in healthcare settings has demonstrated substantial positive outcomes, such as reduced burnout among healthcare...

Episode Transcript

(00:00):
Hey everyone.
Welcome to another episode ofthe Value Based Care Advisory podcast.
This one is a very special onewhere I actually explore one of my
deepest fascinations, which ismindfulness meditation and mindfulness
practices as they relate tothe cross section of neurology, biology
and emotional well being. It'sinteresting because we'll take it

(00:22):
a step further and talk aboutmindfulness meditation practices
and outcomes as to healthcareleadership quality, healthcare leadership
effectiveness, and just enjoying.
Doing what you're doing.
I had really good reviews onthis webinar I conducted, so I decided
I would share the video with you.

(00:44):
So essentially the goal ofthis gathering here today is to really
bring in the ivory towerresearch and kind of all of the wonkiness
that goes on in psychologicaland neurological research around
the concept of mindfulness tocommercial application and particularly

(01:08):
to leaders in healthcare witha tool to really hack their performance
both personally andorganizationally. So this is, this
looks like a long agenda. Itreally isn't. So essentially, first
we're going to define whatmindfulness is and how it's not like
a religion or it's not per semeditation. We're going to look at

(01:29):
some scientific evidence thatbacks the assertion that we're making
today, which means, which isessentially mindfulness improves
several levels of performance,but particularly the neurological
aspects of the mindfulness asa training. And then we'll look at
some relevance as to how it'srelated to healthcare leadership

(01:52):
and we'll do a little guided,a little guided mindfulness training
so you could get a sense for,for what it really is. For those
of you that do not know me,which doesn't seem like to be many
today, I have a longhealthcare administrative background.

(02:12):
I have to admit and prefacethis that I've had even a longer
fascination with mindfulness.And this dates back to my undergraduate
studies where I was a psychmajor and working in research labs
in positive psychology andneurocognition. So what's interesting
for me is to kind of try tolink some of these together. So to

(02:35):
link mindfulness training toperformance in healthcare leadership
and value based care settings.And how do we kind of leverage mindfulness
is a competitive advantagewhen we're doing business. And it's
interesting because, you know,survey shows that about 60% of healthcare

(02:56):
leaders report being stressed.And now honestly, that sounds like
a little low because, youknow, they all lie, these healthcare
executives. It sounds a littlelow to me, 60%, but that's more than
half right. And we know thatthe number one killer of leaders
is, is not Luigi Mangioni. Butit's stress. And so the aspect of

(03:18):
kind of modulating that stressreally makes a difference from the
leader leadership level downto the organizational level. And
of course that's not evenmentioning that half of physicians
are burnt out and all of thesupply side that we know about. I
want to focus on the leadersin this discussion. So let's first

(03:38):
define mindfulness. Somindfulness is the scientific definition
of mindfulness is a particularstate of present oriented consciousness,
okay. That's basicallycharacterized by your moment to moment
experience, your moment tomoment awareness of your subjective

(03:59):
experience. And the goal ofmindfulness training is to provide
you with the tools that youneed to basically integrate your
internal external experientialcomponents. Now what does that mean?
When we talk about internaland external experiential components,
we're talking aboutessentially internal environments

(04:19):
being your affective andcognitive states. You know, that's
kind of what you'reexperiencing as, as the self, right?
Kind of your, your affect iswhat you're feeling and it's different
from emotion. Emotion isemotion, affect is affect. And essentially
the external environment iseverything that's outside of yourself.

(04:40):
So all phenomena that'sperceived as occurring outside of
yourself, like your grantapplications or your reimbursement
rates or the health insurancecompany that's giving you a migraine,
all of those are externalcomponents. And the point of mindfulness
training is to give thepractitioner or the, you know, the
person who's training a, waspracticing mindfulness a particular

(05:01):
ability to integrate yourinternal and external experiences
together. So when you thinkabout that word integrate, we hear
that a lot in healthcareintegration, integration. So how
about we start withintegrating our own internal and
external experiences rightwhere we are, as we are. And kind

(05:23):
of won't that trickle down tothe whole hashtag integration we
talk about in healthcare? Andit's really to essentially work towards
cultivating a non judgmentalawareness of your moment to moment
experiences. So when you'reaware of your moment to moment experiences,
you might then label them aspositive or negative. So really this

(05:45):
helps you to cultivate a nonjudgmental awareness. So you're not
labeling your experience aspositive or negative, you're just
experiencing it. So this hasactually been done in healthcare
settings, healthcare corporatesettings, in bmc, Boston Medical
center as well as Aetna. Andsince we're, you know, kind of like
health insurance wonks overhere, trying to be mindful, I'm going

(06:08):
to talk about the Aetnaapplication just really briefly.
So the former CEO of Aetna,super cool guy, Mark Bertiglioni
championed, like mindfulnessand yoga and these types of things
at Aetna, believe it or not.And this was a long time ago. So
now if you're having issueswith Aetna is no longer there. So
everyone's mindless. And someof the outcomes, some of the outcomes

(06:31):
are like this. So 28%reduction in stress, an extra 62
minutes of productivity peremployee per week. So you would think
these people are taking timeto be mindful and like standing yogic
poses, that they're kind of,you know, losing time. You have to
respond to the email and youhave to get the ECM patient in and
enrolled, but they're gettingmore time. That's. That was incredible

(06:53):
to me to find 3,000 unadjustedfor inflation. So this is many years
ago. So now it's probably like5 or 6,000 if you want an added value
per employee per year. Andthat had a lot to do with, like,
lower turnover, moreproductivity, and these. The healthcare

(07:14):
costs for these employees,which is picked up by the employer,
dropped by 7%. These are justincredible ROI from, from where I'm
sitting. So kind of, what arethe underpinnings of this? What are
the neurological applications?Before I get there, let's look at
the clinical application.Right? You see a lot of things on

(07:38):
the screen right now. And partof this is to stress you out so that
I could give you mindfulness.But when I was studying this in school,
I was intrigued by this, thiskind of center study that you're
seeing. So there was a study,a landmark study back in 2002. And
essentially that study lookedat the application of mindfulness

(08:01):
in the form of what's calledacceptance and Commitment Therapy
ACT with schizophrenicpatients. So now imagine trying to
implement this withschizophrenic patients. Essentially
what happened was that therewere two groups. Group number one
was essentially treatment asusual. So essentially those patients

(08:23):
that, you know would be doingwhatever it is that they're doing
at the hospital. So this was apsych hospital. And the other group
was the mindfulness group,mindfulness intervention group. Now,
what they found is that thosepatients. And this was an experimental
study, so it wasn't like acorrelation, like, you know, it might

(08:46):
be associated withmindfulness. It was like a rigorous
research method that kind ofwas able to isolate the intervention
of mindfulness and itseffects. Because you're comparing
apples to apples, right? Soone apple, one, you know, basket
of apples is kind of doing theACT training, and the other is just

(09:07):
Doing what they usually do.What happened was that these schizophrenic
patients started to reportgreater symptomology. Now that might.
You might think, oh, wow,okay, so now they're getting more
symptoms, but instead what'shappening is that they're realizing
that these experiences thatthey're having are delusion or hallucinations,

(09:29):
and they're not reality.Because, like, the main component
of a cognitive disorder, likeschizophrenia, is the inability to
distinguish reality from nonreality. And so that's why you think
the TV is talking to youdirectly, because you're having delusions
of persecution, or you think,you know, you're Louis the 29th or

(09:52):
whatever, you're havingdelusions of grandiosity. These patients
were able to report moresymptoms and report less believability
in those symptoms, which Ifound fascinating. And I'm like,
if it could work with thispopulation, imagine with, you know,
semi clinical healthcareleaders. So essentially then it made

(10:16):
me think, okay, well,healthcare leaders, we're kind of
busy. How long does this take?Do I need to hide in a mountain for
a long amount of time? Thereal estate's very high in the mountains
here in California. They catchon fire. So I might be even more
stressed. So how long does ittake for me to get this benefit that
Alex keeps talking about? So Isearched and searched and did research
and research for you, and Ifound that there are almost immediate

(10:40):
effects, immediateneurological effects of mindfulness
training. And what you'reseeing is changes in white matter
in the brain. So greaterdensity of white matter in as little
as 11 hours. So 11 cumulativehours, not all at once. Training
over four weeks. And I'll showyou images of the brain scans. There

(11:02):
were significant changes, youguys, in white matter microstructure.
So what that is is if you lookat white matter and gray matter.
So essentially gray matter,the more gray matter you have in
a particular region of yourbrain, the better you are at that
one function that that part ofthe brain performs and the kind of
pain perception. So whatyou're seeing is on your left side,
you're seeing white matterchanges on your right side. I found

(11:25):
studies that in. In as littlefour days of mindfulness training,
FMRI studies showed that thosefolks were reporting less pain perception.
Okay? And so again, it was anexperimental design. So meaning apples
are being compared to apples.And one basket of apples essentially

(11:47):
was, you know, going throughthis mindfulness training, and another
basket was not. Andessentially these were pain patients.
And so what you're seeing isin as little as four days of this
training, these folks werereporting less pain perception and
that was the only interventionthat happened. So now here there's

(12:12):
a number of different aspects,right. So I'm not. This is essentially
when I circulate this slide.And if you're very interested, you
can look at the study. But thepoint I'm making here is that this
is backed by hardcoreresearch, okay, that looks at brain
imaging and looks at thebefore and after intervention. And
here is kind of like thehighlights of some of the things

(12:33):
that were found. Soessentially increased cognitive flexibility.
You kind of need that whenyou're in a health care leadership
role because you have astrategic outlook, but you also have
to have a technical tacticalwhereabouts. Like, you know, we sit
here and plan what's going tohappen in the year. But then that
during that same planning,something blows up. The day after
the patient is doing this andthe day after that the staff is doing

(12:55):
that. Right. So you have to behave cognitive flexibility, strengthened
executive control, which isyour prefrontal cortex. We saw images
of greater density of graymatter, improved emotional regulation.
So being non reactive andbeing composed in the face of those
external circumstances Italked about earlier, all of those

(13:16):
have been demonstrated. That'swhy I have kind of at least two studies
under each of these categoriesto again further support this assertion
I'm making. So here's an imageof fmris. So essentially I. Although
you see two heads here infront of you, this is a compilation
of many, many, many brains,okay. Into one image and essentially

(13:39):
to your left. So what happenedhere is that these participants were
shown emotional images, okay.And their response to these images
was measured in the FMRI scan.So to your left. And here's your
amygdala. Everybody could liketry to reach their amygdala. If you
actually insert your finger inyour brain and go past your cerebellum,

(14:02):
it's kind of in here. Everyonecan massage your amygdala. Massage
it. Okay. So what you'reseeing here is the response to emotional
stimuli was greater. You couldsee that the left FMRI scan here
shows more yellow. It's kindof even a little bit larger in the

(14:24):
activation area. Right. You'reseeing a strong response from the
participants. Now after, andthis was, I believe, an eight week
training. After eight weektraining, the very same participants
were shown a different set ofemotional images because, you know,
the theory could be that theyalready got used to that one emotional

(14:44):
im. So then they're reactingless. So they showed other emotional
images and look at thatresponse, a more muted response A
less kind of dramatic responsebecause the yellow means more, so
red means that there's someactivation there. Now as it gets
yellow, this activation is,that's the strength of the activation.

(15:06):
You could see very composedactivation pattern. Again, this isn't
one person's brain. These arepeople who've never done mindfulness
training before. After eightweeks, look at that. This is not,
you know, this is, in theory,you can't mess with the FMRI images.
This is what we're seeing.It's literally a picture of the brain,
many, many brains into one. Sosome even might have had less activation.

(15:29):
Right. So this I found to beincredibly interesting, particularly
in kind of when you want tostay composed under pressure, right?
When you're getting rapid firequestions, when you have to do an
application for a grant fromthe state, when you have to do a
number of different things asa leader, you need to be able to.
We all want to be composedunder pressure, but by definition

(15:53):
pressure is stressful. Sowe're not always going to be composed.
So how could we make changesin our brain structure and activation
patterns to help us be alittle bit more composed? For example,
and this is just the amygdala,like the slide before this, I showed
you all the various parts ofthe brain that have been studies
that have been studied andhave been shown to make significant

(16:15):
changes. So from this slide Iwant you to take away what I've underlined.
So essentially, why ismindfulness, why does it matter in
healthcare leadership? Becauseagain, from my very own experience
doing this for many, many,many years in leadership capacity
is that especially when you'redoing value based care models and

(16:36):
kind of implementing newthings, you need to have a sharp
focus mind, you need to beable to have empathy, you need to
be resilient. Healthcareleaders must absorb a vast amount
of information very quickly.So essentially, especially if you're
operating in multi stateorganization, you need to know all
the laws and regulations andthe market dynamics. There's a lot

(16:59):
of information to want toprocess. It really is. And the decisions
are high stakes and theydemand you to be calm and demand
that you are able to connectwith the teams and your patients
on a human level. So now allof our busy leaders on the call are
going to be doing a littletraining and this training essentially

(17:22):
I'm going to break down into.So there's a number of different
types of trainings, breathwork, body scan and visualization.
These could be standalone,right? As of their own, or what you're
going to experience today is akind of compilation of these together
so you get a taste for eachtype. So what you're seeing in the

(17:45):
gray box is what you're goingto experience now. And holy Jesus,
your brain's going to likehave more gray matter after this
call. And then I have somelike, you know, implementation suggestions.
So. But before we get started,what I want to do is kind of talk
about some pointers as to howthis can affect the organization.
Now if you're, you know, eachof these could be tailored to your

(18:08):
specific environment. If youlead a large health system, for instance,
leading from the top, you canhave the CEO, like the Aetna CEO
we talked about, or a VP kindof championing the cause. If you
run a small clinic, it mightmean that, you know, the office manager
practices mindfulness a littlebit and then invites others to join
a few minutes each day. Theimportant part is to start where

(18:30):
you are and be consistent andknow that even a few champions can
spark change. Remember thatmindfulness can be integrated at
any organizational level,again, regardless of its size. And
even small scale mindfulnessefforts could lead to broader organizational
improvements in well being andperformance, which is what we're
going to do today.