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

0:00 Coming up on this episode of the Healthy, Wealthy, and Wise podcast. But, um, um, but, uh, with, with quality, when I was a quality improvement manager, you know, I was, I was essentially behind the scenes. You know, we would do a lot of the behind the scenes work, work with compliance, send stuff to regulators, um, work on complaints. It was a lot of behind the scenes stuff. When I then moved into a director level role, which was a center director, um, and I'll Really quick about the type of center it was. So welcome to the healthy, wealthy, and wise podcast with Dr. William T. Choctaw MD, JD, this podcast will provide you with tools and actionable information you can use to help live a more healthy, wealthy, and wise life.

0:49 It's powered 50 years of medical experience of this Yale university medical school trained surgeon, who is also a Western state law school trained attorney with. Executive experience being a former mayor of Walnut, California, as well as the current chairman of the nonprofit Servants Arms, and as president of Choctaw Medical Group, Incorporated. This is the Leadership Masterclass Edition, already in progress. Welcome ladies and gentlemen to our podcast. We are absolutely delighted. To have one of our unique leaders, um, and we indeed, uh, view this podcast as an offshoot of the leadership masterclass.

1:37 And one of the things that we try to do on a regular basis is have leaders in different levels of leadership and have them to stop by and share their words of wisdom with us. Uh, we are absolutely I'm absolutely, uh, thrilled, uh, to have, uh, Mr. Preston Choctaw. Now, you may say, wait a second, wait a second, Choctaw? And I would say, yes, you heard that right. Uh, he is indeed one of my progeny. And we will, we will have him, uh, to tell us about himself, but welcome Preston. Welcome to the Healthy, Wealthy and Wise podcast.

2:19 Well, thank you very much. Very glad to be here. Glad to be here. Give us your thoughts about leadership and what has been your experience over, uh, your, your, uh, lifespan, uh, in terms of, uh, what you think leadership is and, and how have you been involved with it? Oh, let me replay it for all the college students who are listening to you on this podcast and they say, you know, I want that management position. I want to be a director, supervisor, whatever, but I, but I don't know, you know, I hear about so much stuff going on and I don't know whether how people were viewing me. What kind of advice would you give them?

3:01 Yeah, so, um, One, I mean, it's, it's really hard. I mean, it's, it's complicated just, just because you don't know the environment that, that you're walking into. I mean, culture matters. When I mean culture, I mean the culture of, uh, of the organization. Got it, got it. You know, and that culture is usually set by, by, by, by, by leadership, by whoever the CEO or the executive director is. So, okay. So the, the culture of the organization matters, but, um, but for, you know, for like myself or for someone who's, who's African American, or someone who's a minority coming into, you know, an organizational role.

3:51 Um, one, I'd probably say that one of the biggest things is, um, results matter. So, so, um, focus on what the result is. Focus on what the expectation is. Okay. Actually, let me, let, let, let, let me actually change that, change that. So I would say, understand your expectation, understand what does the company expect out of me, even more importantly, what does, Um, if this is someone going into middle management, then it's like, what does my director or my boss expect out of me? Got it. Understand that backwards and forwards, and that can just be like, you know, having a conversation, sitting down, you know, you first get into that position, you're like, you know, You know, you know, what, what are my expectations, you know, in the first nine, 90 days, what are the, my responsibilities, et cetera, et cetera.

4:49 So that's one, um, to, um, um, focus on what you can control also, there, there'll be times when there'll be things outside of your control by however. You know, things, the things that you may not be able to impact, but there may be things that you can impact that could still result in what you're trying to accomplish. So I'll, I'll say that again, focus on what you can control, what you can do for your, what you can do yourself and not be worried about things that are external to you that you can not.

5:33 do anything about. Makes sense. Control the controllables. Yes. And then the third thing, and I'd say the most, one of the most important things is something that I've always lived my life as much as possible is, um, you know, I've always tried to have a positive outlook about everything. Got it. Everything. Everything. Positivity. Tell you positively. Positivity changes lives. I agree. Positivity will change your life as well. Yes. No bad days. Yes. Yes. I understand. It's all. It's all. All perception.

6:13 It's all in your head. How you decide that you want to live your life and how you see how your life is. Yes. All perception. Yes. So utilize that. So if you're concerned about going into an organization where you feel like you may not get a fair shake or You know, or you feel like, you know, people may be judging you about certain things or, or whatever. One, you can't control other people's perceptions about you. You can just control your own perception about life and your own life and everything. And, and, and what will happen though, is If you get into a position where maybe people are judging you and maybe people are seeing you in a certain way and, and maybe, you know, I mean, maybe you're in an organization where they're saying, Oh, you know, because, because this person's black, he's, he's going to think this way or he's going to do certain things.

7:17 You, you live your life and you conduct yourself in a way where that doesn't matter. What matters is. What the results that you're getting at your job, how you're working and, and, and that, um, uh, um, and that, uh, you are the person who you are. Right. Right. So it doesn't matter what, how anyone else sees you. It's more about how, what you project from yourself, right. And that, you know, and yeah, how you see yourself and how you project it out, because what's going to happen Um, uh, there will be situations where people are going to say, you know what, no matter what type of.

8:06 Crap happens to such and such, man, he's, he or she is always positive. Wow. They're still look how motivated they are. They're still working really hard. You know what he's someone, or she's someone that we want, we want him in this role. Because what happens is that becomes infectious. You're positive like that. It really spreads to everyone else about being positive. Exactly. Just the same way that negativity will spread to everybody else. Exactly. And if it's a, if it's a good organization, they want the former, they want the positivity and they want someone in there.

8:49 who will make a positive impact and influence others in that way. And that's, and, and that's also how, when you look at leadership, if leadership is radiating that positivity, that's how that culture changes. And that's how that culture becomes one of that people want to stay at and, and people want to work, work there. And people want to, To retire there. Also makes sense. Makes sense. I'm impressed that you learned so much. And it's such a, it's such a short time. I, I, I feel very good.

9:32 So no, no, go ahead. You, you, you, you were taking us on your journey. Yeah. Oh yeah. So, all right. So, so, um, all right. So what I was saying when, when, when, when I was in management, when I first went into my first management job and I had like 16 staff, um, I had no supervisors. It was a really fast paced, uh, environment. Um, and it was, it was. It was hard. I was putting out fires every single day. There was always an issue. There were people who didn't like each other. People were purposely trying to backstab each other. And I'm trying to kind of ref and corral everyone, etc, etc, etc.

10:15 Um, it was then that I, that I knew that Um, that it's one thing to be like, like, uh, like, like what I said before when I was like, oh, when I was a staff person, I looked at someone being a manager, like, oh, it's not that hard. You know, Uhhuh, . It's one thing to, you know, think that, you know, I manage projects so I can manage pe PI can manage people. Uh, and it's, it's another thing to actually manage people. So if someone wants to get into management, yes, you gotta start somewhere. But if I'm gonna hire a manager, typically, and depending on what. The team makeup is. I'm usually looking for someone who has some sort of management experience who knows that you're going to be dealing with people and then be dealing with getting those relationships to work.

10:58 So that's management. And then let's get into leadership and more about director level. And, and when I became a director, when I went into the director level, um, It was really kind of different for me because I, as a manager and the specific type of management rollout, I was in a, uh, I was a quality improvement manager, quality improvement, and mind you, we can have a whole nother call on quality. And we might do that at a later time. I mean, if you want, we can get a quality improvement process improvement. Well, you know, I can, we, we, we can get all into that, but, um, um, but, uh, with, with quality and when I was a quality improvement manager, you know, I was I was essentially behind the scenes.

11:43 You know, we would do a lot of the behind the scenes work, work with compliance, send stuff to regulators, um, work on complaints. It was a lot of behind the scenes stuff. When I then moved into a director level role, which was a center director, um, and I'll tell you really quick, About the type of center it was. So, um, uh, I had worked, I've worked for what's called a PACE, uh, program. PACE stands for Program of All Inclusive Care for the Elderly. It's a federally funded program, so it's funded through, uh, CMS, so Medi Cal and Medicare.

12:25 Uh, and they basically provide, um, uh, money to organizations to, to organizations to provide comprehensive medical, emotional, uh, so, I mean, basically wraparound comprehensive healthcare services for seniors who are 55 and older who have a, uh, a chronic illness. Okay. I know it's a mouthful, but, um, and, uh, and, uh, PACE programs, they're still relatively unknown for the most part. I mean, some people know about them in the healthcare industry, but they haven't really caught on yet, but there's a real strong possibility they're going to kind of explode.

13:11 Um, there are some large scale organizations who are trying to, you know, ramp up. Opening centers and, and promoting it a lot more and I mean, we'll see, um, uh, with the new administration, what happens with that, but, um, the pay services themselves, I have been extremely impactful for low income seniors. Got it. Because basically it's because if you have Medicare and Medi Cal, right, you got to qualify for Medi Cal. So essentially for low income seniors, but senior is, is they, they say it's 55 and older. So, you know, there may be some people who don't think that they're seniors, but that 55 us may, may, may get you there.

13:56 It gets there real fast, no? Yeah. Right, right, right. Right. Right. Um, but, um, but anyway, with, with, with PACE programs, I'll just say this briefly. Um, means we do a, a primary care provider. So you have a PCP, you have RN nursing services, you know, it's basically like an outpatient clinic. Then you have everything else under the sun. So you have transportation to, from appointments, you have a social worker on staff for you, you have a diet, dietary services, you have, Visible therapy, occupational therapy, speech therapy services, you have um, what am I missing?

14:41 Uh, did I miss anything? Let me see. Oh, um, no, so, oh, uh, home care services as well. Okay. Um, and, but even, so those are usually services within the center, but then they, Then they will usually send you out to specialty so you'll have optometry, podiatry, cardiology, pulmonology, dialysis, every service, any and every service that a senior will need PACE programs provide. Okay. And that will be at no cost to that senior because CMS is paying for everything.

15:22 Wow. Right. So that's why, and that to me, PACE is like the model. The new model of health care, which I think this country is going to move towards, because what, what they found was that, um, typically when you have your normal, uh, uh, provider, who's, or the provider of care, and then you have the payer of care, you know, the insurance plans, there's usually a conflict there. Right, because the doctor may want to prescribe something or may want a certain service for the patient, but the payer, the insurer is like, no, no, no, I don't think, I don't think that makes sense, so we're not going to pay for it, and then they're going back and forth, and then who's stuck in the middle?

16:07 Patient is the patient is. It almost sounds sort of like a Kaiser for the elderly and that's probably a bad example, but but that's the way I, I, I envision it. So, so, um, uh, yes, but you're right. Kaiser is a bad example. No, no, no, no, no, no. I'm, I'm, I'm just, I'm just saying that because, because. Kaiser is now actually moving into the pace world. So before Kaiser would provide only some services here and there. Right. But now, um, from what I've, you know, Kaiser's moving to the pace world and they're going to start opening up their own pace centers.

16:50 That makes sense. And I would assume they wouldn't be moving there if it was not something that they felt would be a benefit. Cause I mean, I'll really win. Pace is the best example of the payer provider working together because it's the same company, you know, so it's usually the best example. Yes, yes. Got it. So now you understand a little bit what PACE is. So yes. Thank you for listening to the Healthy, wealthy and Wise Podcast with Dr. William t Choctaw, MDJD. You can listen again to this and any of the previous episodes. Leave a comment or oppose questions to the doctor by going to www.thwwp.com.

17:38 That's www.thwwp.com and you've got it. It's also available wherever. You get your podcast, be sure to follow, like, share and subscribe. If you haven't already, then tune in for the next episode of the healthy, wealthy, and wise podcast with Dr. William T. Choctaw, MD, JD, a production of change makers communications, LLC.