Dr. Kiame Mahaniah, CEO, values his FQHC staff; feels for pts' life challenges; understands what he can control & can’t; & weeps for under-realized potential.
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Episode Notes
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Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here
Contents with Time-Stamped Headings
to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript)
Proem.. 2
Introducing Dr. Kiame Mahaniah 01:40. 2
Health Hats, the Podcast process and status 02:40. 2
Podcast intro 03:57. 2
Health is fragile. Falling through the cracks. 04:34. 2
The health system. Not random. 06:47. 3
Performance improvement - opportunities in the cracks 07:56. 3
CEO: care that meets people where they are 10:33. 4
CEO: setting priorities 13:08. 4
CEO: cheerleader 13:46. 5
CEO data and safety 14:47. 5
Getting stuff out of staff's way 15:29. 5
Progression to CEO 17:31. 6
Integration of behavioral and physical health 19:51. 6
Succeeding 60% of the time 23:16. 7
One-on-one visits - why? 24:40. 7
Impact of snow removal or not 25:30. 7
Sponsor 26:43. 8
Staff retention. Pay, fatigue, epidemic 27:24. 8
Long queues for services 31:00. 9
The stress you can manage 31:53. 9
Staff morale - can't help everyone who needs help 33:05. 9
Investing in training, like cops and soldiers 33:56. 9
Free market? 34:57. 10
Miss being a frontline clinician? 36:29. 10
Staying in touch with the front lines 38:24. 11
Reflection 40:02. 11
Outro 41:10. 11
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Credits
Intro and outro music by permission from Joey van Leeuwen, Drummer, Composer, Arranger
Web and Social Media Coach Kayla Nelson @lifeoflesion
The views and opinions presented in this podcast and publication are solely the responsibility of the author, Danny van Leeuwen, and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute® (PCORI®), its Board of Governors or Methodology Committee.
Sponsored by Abridge
Inspired by and grateful to Ellen Schultz, Janice John, Jamila Xible, Kerstin Meisinger, Bevin Croft, Russell Bennett, Lisa Masinter, and Michele Whitt.
Links
Lynn Community Health Center
Health Resources and Services Administration (HSRA)
Abbott and Costello's Who's on First
Related podcasts
https://health-hats.com/pod133/
https://health-hats.com/pod112/
https://health-hats.com/pod155/
https://health-hats.com/pod150/
About the Show
Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all this.
To subscribe go to https://health-hats.com/
Creative Commons Licensing
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The Show
Proem
As a student of leadership, I relish experiencing, hearing about and from good, no great, leaders. I worked for several. Sometimes I was one. What makes a good/great leader? They strategize with their team and customers, encourage, and appreciate their staff, hire for diversity of lived experience and ways of thinking about the world, and get stuff out of the way of good people doing their good work.
Introducing Dr. Kiame Mahaniah
My friend, Dr. Kiame Mahaniah, a good/great leader is CEO of the Lynn Community Health Center, a Federally Qualified Health Centers (FQHC) near me. Kiame and I meet monthly in a book club and often discuss health care, health care advocacy, and issues of health equity
FQHCs sit on the sharp point of health equity and community-centered care. Need a barometer of the health of our healthcare system? Check out your local FQHC. According to the Health Resources and Services Administration (HSRA), FQHCs are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary health care services to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans.
Health centers integrate access to pharmacy, mental health, substance use disorder, and oral health services in areas where economic, geographic, or cultural barriers limit access to affordable health care. By emphasizing coordinated care management of patients with multiple health care needs and the use of key quality improvement practices, including health information technology, health centers reduce health disparities.
Let’s meet Dr. Kiame.
Health Hats, the Podcast process and status
Please note that I started publishing a bit less frequently as I explore adding video to my menu of media options. I’ve gone from written blogs to audio podcasts, to, now, videos. The technology and workflow are more complex and I’m a novice. Please bear with me. My written edition is the transcript in the show notes. I transcribe video first for video captions, then for the printed word. I use music throughout my audio and video productions. I’m still figuring out the correct mix of apps to use for video production. You’d think I’d have audio production down by now, my audio quality has been uneven recently. Unfortunately, it took recording two interviews poorly before I realized the problem. Read the transcript or check out the video on YouTube if that helps. My apologies and my appreciation for you hanging in there with me.
Podcast intro
Welcome to Health Hats, the Podcast I'm Danny van Leeuwen a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot of our very little. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all of this.
Health is fragile. Falling through the cracks.
Health Hats: Kiame. How are you? So glad you joined us.
Kiame Mahaniah: Thank you. I'm honored to be on Health Hats.
Health Hats: Thank you. I've been looking forward to talking to you for some time. Thank you.
Health Hats: So why don't we start by telling a little about when you first realized health was fragile?
Kiame Mahaniah: I grew up in Congo. I can't remember a single time since I've had a conscious self where I didn't think that life was extremely fragile. I think growing up in a country where infectious disease is still. Infectious diseases are probably the top five reasons that people die. I had relatives who had polio. It was evident that life itself was very fragile. Still, it also was very clear from having spent my childhood in the Congo. Then my teenage years in Switzerland also showed that a lot of that fragility and vulnerability is related to the circumstances and systems surrounding you because I moved from a place where kids die of dehydration from cholera. And to a place in Switzerland where essentially nobody dies from infectious disease under 75. And so, I've always been very aware of how fragile humans are. Still, it underlies my interest in working in the health center movement because I've always been interested in okay.
Given that we're humans, whatever system we design will have cracks. And so, I'd like to have. I'd like to dedicate my life to working in those cracks, right? Like how do I reduce the size of those cracks? How do we address the depth of those cracks, and how many people are falling in those cracks? So obviously, doing it the US is way easier than doing it. In the Congo, where I grew up, it doesn't matter what society you're in. There will be cracks.
The health system. Not random.
Kiame Mahaniah: So, I've always known that life is fragile. I think it's only recently, in the last, I'd say 10 or 15 years, that I've realized just that the system isn't random. Yeah. Like that, a system punishes certain people, certain types of people, more than others. So, I think. If you're not sighted, it's a complicated system to use. If you don't read, it's tough to navigate the system. And I would say that if you don't have an infinite amount of patience, it's challenging to navigate the system as well. So, I think certain personalities are just not suited for it, and that's not that without getting into ableism, race, ethnicity, and right. It's just so like, on the face of it, we were a complicated system. And so the health center in Lynn and health centers everywhere, we specialize in selecting which groups we want to work with to make their life easier.
Performance improvement - opportunities in the cracks
Health Hats: There's so much in what you just said. My career, I spent a lot of my career in performance improvement. And when I went from being a student of individual health as a nurse and then as an administrat
