The Future of Healthcare: A Deep Dive into PACE and Holistic Care for Seniors

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Coming up on this episode of the
Healthy, Wealthy, and Wise podcast.

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But, um, um, but, uh, with, with
quality, when I was a quality

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improvement manager, you know, I was,
I was essentially behind the scenes.

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You know, we would do a lot of
the behind the scenes work, work

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with compliance, send stuff to
regulators, um, work on complaints.

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It was a lot of behind the scenes stuff.

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When I then moved into a director
level role, which was a center

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director, um, and I'll Really quick
about the type of center it was.

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So

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welcome to the healthy, wealthy,
and wise podcast with Dr.

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William T.

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Choctaw MD, JD, this podcast will
provide you with tools and actionable

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information you can use to help live a
more healthy, wealthy, and wise life.

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It's powered 50 years of medical
experience of this Yale university

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medical school trained surgeon,
who is also a Western state law

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school trained attorney with.

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Executive experience being a former
mayor of Walnut, California, as well as

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the current chairman of the nonprofit
Servants Arms, and as president of

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Choctaw Medical Group, Incorporated.

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This is the Leadership Masterclass
Edition, already in progress.

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Welcome ladies and
gentlemen to our podcast.

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We are absolutely delighted.

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To have one of our unique leaders, um,
and we indeed, uh, view this podcast as

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an offshoot of the leadership masterclass.

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And one of the things that we try to
do on a regular basis is have leaders

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in different levels of leadership
and have them to stop by and share

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their words of wisdom with us.

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Uh, we are absolutely I'm absolutely,
uh, thrilled, uh, to have, uh, Mr.

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Preston Choctaw.

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Now, you may say, wait a
second, wait a second, Choctaw?

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And I would say, yes,
you heard that right.

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Uh, he is indeed one of my progeny.

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And we will, we will have him, uh, to tell
us about himself, but welcome Preston.

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Welcome to the Healthy,
Wealthy and Wise podcast.

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Well, thank you very much.

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Very glad to be here.

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Glad to be here.

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Give us your thoughts about leadership
and what has been your experience over,

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uh, your, your, uh, lifespan, uh, in terms
of, uh, what you think leadership is and,

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and how have you been involved with it?

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Oh, let me replay it for all the
college students who are listening to

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you on this podcast and they say, you
know, I want that management position.

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I want to be a director, supervisor,
whatever, but I, but I don't know,

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you know, I hear about so much
stuff going on and I don't know

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whether how people were viewing me.

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What kind of advice would you give them?

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Yeah, so, um, One, I mean,
it's, it's really hard.

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I mean, it's, it's complicated just, just
because you don't know the environment

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that, that you're walking into.

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I mean, culture matters.

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When I mean culture, I mean the
culture of, uh, of the organization.

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Got it, got it.

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You know, and that culture is usually set
by, by, by, by, by leadership, by whoever

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the CEO or the executive director is.

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So, okay.

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So the, the culture of the organization
matters, but, um, but for, you

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know, for like myself or for someone
who's, who's African American, or

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someone who's a minority coming into,
you know, an organizational role.

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Um, one, I'd probably say that one of the
biggest things is, um, results matter.

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So, so, um, focus on what the result is.

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Focus on what the expectation is.

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Okay.

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Actually, let me, let, let, let, let
me actually change that, change that.

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So I would say, understand your
expectation, understand what does

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the company expect out of me, even
more importantly, what does, Um, if

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this is someone going into middle
management, then it's like, what does

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my director or my boss expect out of me?

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Got it.

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Understand that backwards and forwards,
and that can just be like, you know,

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having a conversation, sitting down, you
know, you first get into that position,

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you're like, you know, You know, you know,
what, what are my expectations, you know,

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in the first nine, 90 days, what are the,
my responsibilities, et cetera, et cetera.

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So that's one, um, to, um, um, focus
on what you can control also, there,

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there'll be times when there'll be things
outside of your control by however.

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You know, things, the things that
you may not be able to impact, but

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there may be things that you can
impact that could still result in

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what you're trying to accomplish.

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So I'll, I'll say that again, focus
on what you can control, what you can

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do for your, what you can do yourself
and not be worried about things that

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are external to you that you can not.

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do anything about.

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Makes sense.

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Control the controllables.

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Yes.

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And then the third thing, and I'd say
the most, one of the most important

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things is something that I've always
lived my life as much as possible is,

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um, you know, I've always tried to have
a positive outlook about everything.

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Got it.

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Everything.

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Everything.

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Positivity.

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Tell you positively.

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Positivity changes lives.

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I agree.

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Positivity will change your life as well.

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Yes.

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No bad days.

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Yes.

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Yes.

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I understand.

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It's all.

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It's all.

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All perception.

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It's all in your head.

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How you decide that you want to live your
life and how you see how your life is.

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Yes.

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All perception.

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Yes.

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So utilize that.

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So if you're concerned about going into an
organization where you feel like you may

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not get a fair shake or You know, or you
feel like, you know, people may be judging

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you about certain things or, or whatever.

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One, you can't control other
people's perceptions about you.

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You can just control your
own perception about life and

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your own life and everything.

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And, and, and what will happen though,
is If you get into a position where maybe

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people are judging you and maybe people
are seeing you in a certain way and, and

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maybe, you know, I mean, maybe you're in
an organization where they're saying, Oh,

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you know, because, because this person's
black, he's, he's going to think this

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way or he's going to do certain things.

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You, you live your life and
you conduct yourself in a way

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where that doesn't matter.

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What matters is.

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What the results that you're getting
at your job, how you're working and,

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and, and that, um, uh, um, and that,
uh, you are the person who you are.

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Right.

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Right.

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So it doesn't matter what,
how anyone else sees you.

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It's more about how, what
you project from yourself,

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right.

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And that, you know,

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and yeah, how you see yourself and
how you project it out, because what's

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going to happen Um, uh, there will be
situations where people are going to say,

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you know what, no matter what type of.

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Crap happens to such and such, man,
he's, he or she is always positive.

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Wow.

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They're still look how motivated they are.

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They're still working really hard.

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You know what he's someone,
or she's someone that we want,

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we want him in this role.

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Because what happens is
that becomes infectious.

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You're positive like that.

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It really spreads to everyone
else about being positive.

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Exactly.

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Just the same way that negativity
will spread to everybody else.

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Exactly.

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And if it's a, if it's a good
organization, they want the

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former, they want the positivity
and they want someone in there.

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who will make a positive impact
and influence others in that way.

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And that's, and, and that's also
how, when you look at leadership, if

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leadership is radiating that positivity,
that's how that culture changes.

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And that's how that culture becomes
one of that people want to stay at and,

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and people want to work, work there.

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And people want to, To retire there.

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Also

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makes sense.

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Makes sense.

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I'm impressed that you learned so much.

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And it's such a, it's such a short time.

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I, I, I feel very good.

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So no, no, go ahead.

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You, you, you, you were
taking us on your journey.

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Yeah.

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Oh yeah.

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So, all right.

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So,

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so, um, all right.

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So what I was saying when, when,
when, when I was in management,

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when I first went into my first
management job and I had like 16

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staff, um, I had no supervisors.

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It was a really fast
paced, uh, environment.

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Um, and it was, it was.

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It was hard.

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I was putting out fires every single day.

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There was always an issue.

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There were people who
didn't like each other.

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People were purposely trying
to backstab each other.

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And I'm trying to kind of ref and
corral everyone, etc, etc, etc.

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Um, it was then that I, that I knew
that Um, that it's one thing to be like,

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like, uh, like, like what I said before
when I was like, oh, when I was a staff

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person, I looked at someone being a
manager, like, oh, it's not that hard.

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You know, Uhhuh, . It's one thing
to, you know, think that, you

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know, I manage projects so I can
manage pe PI can manage people.

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Uh, and it's, it's another
thing to actually manage people.

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So if someone wants to
get into management, yes,

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you gotta start somewhere.

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But if I'm gonna hire a manager,
typically, and depending on what.

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The team makeup is.

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I'm usually looking for someone who has
some sort of management experience who

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knows that you're going to be dealing
with people and then be dealing with

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getting those relationships to work.

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So

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that's management.

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And then let's get into leadership
and more about director level.

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And, and when I became a director, when
I went into the director level, um,

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It was really kind of different for me
because I, as a manager and the specific

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type of management rollout, I was in a,
uh, I was a quality improvement manager,

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quality improvement, and mind you, we
can have a whole nother call on quality.

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And we might

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do that at a later time.

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I mean, if you want, we can

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get a quality improvement
process improvement.

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Well, you know, I can, we, we, we can
get all into that, but, um, um, but,

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uh, with, with quality and when I was a
quality improvement manager, you know, I

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was I was essentially behind the scenes.

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You know, we would do a lot of
the behind the scenes work, work

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with compliance, send stuff to
regulators, um, work on complaints.

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It was a lot of behind the scenes stuff.

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When I then moved into a director level
role, which was a center director,

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um, and I'll tell you really quick,
About the type of center it was.

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So, um, uh, I had worked, I've worked
for what's called a PACE, uh, program.

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PACE stands for Program of All
Inclusive Care for the Elderly.

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It's a federally funded program,
so it's funded through, uh,

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CMS, so Medi Cal and Medicare.

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Uh, and they basically provide,
um, uh, money to organizations

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to, to organizations to provide
comprehensive medical, emotional,

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uh, so, I mean, basically wraparound
comprehensive healthcare services

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for seniors who are 55 and older
who have a, uh, a chronic illness.

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Okay.

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I know it's a mouthful, but, um, and,
uh, and, uh, PACE programs, they're still

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relatively unknown for the most part.

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I mean, some people know about them
in the healthcare industry, but they

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haven't really caught on yet, but
there's a real strong possibility

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they're going to kind of explode.

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Um, there are some large
scale organizations who are

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trying to, you know, ramp up.

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Opening centers and, and promoting it
a lot more and I mean, we'll see, um,

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uh, with the new administration, what
happens with that, but, um, the pay

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services themselves, I have been extremely
impactful for low income seniors.

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Got it.

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Because basically it's because if you
have Medicare and Medi Cal, right,

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you got to qualify for Medi Cal.

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So essentially for low income
seniors, but senior is, is they,

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they say it's 55 and older.

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So, you know, there may be some people
who don't think that they're seniors, but

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that 55 us may, may, may get you there.

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It gets there real fast, no?

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Yeah.

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Right, right, right.

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Right.

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Right.

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Um, but, um, but anyway, with, with, with
PACE programs, I'll just say this briefly.

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Um, means we do a, a
primary care provider.

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So you have a PCP, you have RN
nursing services, you know, it's

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basically like an outpatient clinic.

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Then you have everything
else under the sun.

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So you have transportation to, from
appointments, you have a social worker on

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staff for you, you have a diet, dietary
services, you have, Visible therapy,

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occupational therapy, speech therapy
services, you have um, what am I missing?

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Uh, did I miss anything?

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Let me see.

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Oh, um, no, so, oh, uh,
home care services as well.

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Okay.

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Um, and, but even, so those are
usually services within the center,

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but then they, Then they will usually
send you out to specialty so you'll

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have optometry, podiatry, cardiology,
pulmonology, dialysis, every service,

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any and every service that a senior
will need PACE programs provide.

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Okay.

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And that will be at no cost to that senior
because CMS is paying for everything.

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Wow.

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Right.

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So that's why, and that to
me, PACE is like the model.

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The new model of health care, which
I think this country is going to move

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towards, because what, what they found
was that, um, typically when you have your

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normal, uh, uh, provider, who's, or the
provider of care, and then you have the

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payer of care, you know, the insurance
plans, there's usually a conflict there.

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Right, because the doctor may want
to prescribe something or may want a

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certain service for the patient, but the
payer, the insurer is like, no, no, no,

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I don't think, I don't think that makes
sense, so we're not going to pay for it,

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and then they're going back and forth,
and then who's stuck in the middle?

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Patient is the

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patient is.

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It almost sounds sort of like a
Kaiser for the elderly and that's

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probably a bad example, but but
that's the way I, I, I envision it.

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So, so, um, uh, yes, but you're right.

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Kaiser is a bad example.

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No, no, no, no, no, no.

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I'm, I'm, I'm just, I'm just
saying that because, because.

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Kaiser is now actually
moving into the pace world.

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So before Kaiser would provide
only some services here and there.

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Right.

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But now, um, from what I've, you
know, Kaiser's moving to the pace

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world and they're going to start
opening up their own pace centers.

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That makes sense.

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And I would assume they wouldn't be
moving there if it was not something

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that they felt would be a benefit.

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Cause I mean, I'll really win.

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Pace is the best example of the
payer provider working together

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because it's the same company,
you know, so it's usually the

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best

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example.

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Yes, yes.

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Got it.

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So now you understand a
little bit what PACE is.

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So yes.

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Thank you for listening to the Healthy,
wealthy and Wise Podcast with Dr.

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00:17:23,030 --> 00:17:25,579
William t Choctaw, MDJD.

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00:17:30,130 --> 00:17:37,990
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00:17:38,350 --> 00:17:43,660
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00:17:44,350 --> 00:17:45,490
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00:17:56,820 --> 00:17:57,370
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