Today's guest on Pediatric Leadership: The New Medicine Podcast is Paul Thornton, M.D., Cook Children’s Congenital Hyperinsulinism Center and Endocrine and Diabetes program and an Endowed Chair.

Why develop a center for clinical excellence for a rare disease?

Getting help for patients with rare diseases can often be a large struggle for families. Finding someone who understands and has the experience to properly diagnose and treat can lead to frustration for families. Often there is no place to go. For long standing issues, this can lead to bouncing to multiple doctors without resolution of symptoms.

For more acute issues, not having an expert available can cause significant morbidity, even mortality. Today on Pediatric Leadership: The New Medicine, we talk to one of our pediatric endocrinologists who set up a center for treating a rare disease, hyperinsulinism.

Dr. Thornton is a pediatric endocrinologist at Cook Children’s and is the founder of the Cook Children’s Hyperinsulinism Center which is one of only two centers in the country focused on hyperinsulinism. The website for the team lists endocrinologists, pediatric surgeons and many other medical specialities as well as coordination between education, social work and even Ralph Lauren, one of Cook Children’s play therapy dogs.

Questions to work through on the topic:

What is hyperinsulinism and when should a clinician expect it?

What motivated you to begin building a center for treating such a rare condition?

How did you get the institution on board? Who did you have to convince?

What were some of those first steps that got the ball rolling?

What has been the hardest step?

How can someone find out more about the center or refer a patient?

What part of your work are you most proud of?

What is the most important quality for a leader in pediatrics?

For more on this episode go to: http://bit.ly/1T7GvSA

Why develop a center for clinical excellence for a rare disease?

Innovative ideas often require a team approach. It’s difficult to make changes that truly move the needle when you consider a problem from just one perspective. Broadening the team allows physicians to consider other ideas. These new ideas might just open up possibilities that they may have never thought of.

Dr. Warren Marks is a Pediatric Neurologist with Cook Children’s in Fort Worth, Texas. He has a particular interest in movement disorders and has been involved in Cook Children’s effort to advance the use of deep brain stimulation in the pediatric population. His latest project has been the design and implementation of an innovative pediatric motion lab, which uses a multidisciplinary approach, and advanced technology to assess and develop plans for children, teens and young adults with movement disorders.

How do we break down silos for innovative design?

The practice of pediatrics is changing rapidly. New ideas for payment models and care delivery models come and go. Navigating through those changes can send a practice or health care institution on a tangent that leaves the providers and staff feeling like they don’t have a compass. It is important during these times to have someone who can help put the new changes into context and help us to remain grounded on what is most important-providing the best patient care possible. 

Dr. Frank McGehee is a pediatrician in the Cook Children's Magnolia clinic. He practices in an office that has roots in an 80-year tradition of providing excellent patient care to the children of Fort Worth. He has seen many changes in medicine, but still believes that the heart of pediatrics lies in his connection with families.

Find more information at http://bit.ly/1TYZT0q

Navigating Transitions in Leadership

There is no single criteria that makes a person eligible to lead. Education, job title and seniority can all be a start to establishing a role as a leader. But sometimes, the best leaders aren’t the highest ranking of any of the three. Today we are going to talk about leading when you are starting your career and how an early-career physician can develop leadership skills when they are not the most senior physician on their team.

How do I lead in my early career?

The world is changing quickly. The world of medicine is no different. Understanding how these changes affect you, your practice and your organization is critical to your success as a leader. At times, the amount of change can seem overwhelming. It feels at times that there is no order, only chaos. How do we survive in this environment?

What is complexity?

We talked last time about complexity and how it is changing the way that business and particularly healthcare organizations must operate if they want to be successful. In order to position ourselves for success, we must have leaders that not only accept complexity but that are agile and ready to change in complex environments.

Pediatric Leadership: The New Medicine

How to lead through complexity

Often when we think about power, we associate it with manipulation and underhanded deals. The reality is that power is not always a negative thing. We each have to use it to reach our goals every day. Understanding what power is and how and when we should use it is critical to thriving in leadership.

What is power?

The treatment of pediatric pain, particularly chronic pain, is a complex issue. Practitioners must take into account the intersection of physiologic, socio-environmental and psychological environment. Many times it is difficult for primary care and specialty pediatricians to develop and execute a plan. 

What is new in pain management?

The way you treat patients matters in many ways. It can mean the difference between having successful program or practice. More than that, it can affect how your patients recover from sickness or surgery or deal with chronic illness.  The culture of a practice depends on all the members, from the front desk to the nurses and even the custodians the patients might pass in the hallway. Everyone plays a role but the doctor can do a lot to make a break a practices ability to have a positive culture.

How can you develop and maintain a practice culture?

Taking care of patients and their families at the bedside is a rewarding experience. The connection that develops between a healthcare professional and the family can be very strong and can be a source of hope for families who are facing difficult times. There is no profession in which this is more true than nursing. At some point many pediatric leaders are faced with the decision to step away from direct patient care and to spend more time in their leadership role. Doing so can create a mix of conflicting emotions.

How does a nursing leader decide to step away from bedside patient care?

In medicine in general and pediatrics specifically, you often find yourself in positions of leadership that you didn't seek out. You were never taught how to lead outside of the exam or hospital room but you find yourself heading up a clinical team, research department or serving on a committee. Subscribe to the podcast for weekly discussions on leadership topics with a pediatric flare. Topics such as: What is a leader? How is leadership in pediatrics different? How do you break down silos for true innovation? Why and how does one develop a clinical center for a rare disease?

Pediatric Leadership: The New Medicine

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