MGMA Podcasts

Daniel Williams: 00:59

Well, hi, everyone. I'm Daniel Williams, senior editor at MGMA and host of the MGMA Podcast Network. We have a special episode for you today on New Year's Eve. It's our best of 2025. So for this episode, we found three conversations that we had that really touched on, I think, three of the biggest topic areas in health care today.

Daniel Williams: 01:25

The first one is on finding and keeping good people, staffing. The second one is on choosing tools and technology that actually help. And then third, supporting the well-being of folks who are doing the work, our clinicians and our administrative people, finding support so they don't burn out. So whether you've heard these conversations before or this is the first time, think I there's some really good information in here and something that will help you as you build your practice in 2026. So let's get started.

Daniel Williams: 02:02

First up, we have Liz Mahan from AAPPR. And in our conversation, Liz talks about staffing, building a strategic recruitment playbook, and how to focus on retention from the very start. Let's go to that highlight with Liz right now.

Liz Mahan: 02:19

I came up with this topic because it's a question I get asked a lot. Why can't you just, like, give me something that will show me how to recruit? Like, give me what I need to recruit the doctors that I need. And my answer is always, if only it were that easy. Every doctor, every practice, every organization is different.

Liz Mahan: 02:42

Recruiting is more tactical than process based. So what this presentation is going to look at is how to really identify what you need in a candidate, both clinically, interpersonally, in terms of their interest, their career their career trajectory, where they hope to see their practice growing so that we can do that that thing, that word I used at the beginning of this podcast, that recruit attention so that we can find the candidates who have the staying power to be with a practice for years and years to come and really reduce that turnover. We know retention is so important. Turnover is expensive. It impacts patient access.

Liz Mahan: 03:25

It impacts patient satisfaction. It just has so many downstream effects if somebody leaves a practice. So we're really gonna take a look at what practices, what organizations can do before they even start to meet with candidates to make sure that they have a playbook that's going to address all of the needs of the practice and really hone in on what makes the ideal candidate. Because I'll tell you the ideal candidate does exist, but rather than than kind of just throwing spaghetti at the wall and hoping it sticks, my Italian grandmother would be happy with that analogy. Yes.

Liz Mahan: 04:04

What we're gonna do is is really focus in on what we need so that we can be strategic about our search process and our interview process.

Daniel Williams: 04:13

Okay. You said something in there that was really interesting to me, and I want to make sure I understand it. You said it's this recruitment is more tactical than process oriented. Did I get that right? If I did, tell me what does that mean?

Daniel Williams: 04:30

I'm not sure. So there's not just step by step, you don't go step one, two, three, four or what do you There

Michael Blackman: 04:36

it is.

Liz Mahan: 04:37

There is. A process, though, is something everybody can follow. I can give any practice a a checklist of, you know, first you place the ad, then you look at CDs, then you do an interview.

Daniel Williams: 04:50

Right.

Liz Mahan: 04:51

That's the true. That the process is gonna generally be the same for everyone. What we're talking about is everything that happens even before you get to that process. So really being strategic about what we're looking for in a candidate, Being really very honest and realistic about where practices are individually. So where are they in terms of their culture?

Liz Mahan: 05:17

Where are they in terms of their vision for growth in the future? And then how does the ideal candidate fit into that? So I'll tease I'll give a little teaser. One example I give is is really looking at the makeup of the practice. So what providers do we have now?

Liz Mahan: 05:32

Do we have physicians that specialize in one particular area and now we're looking for a generalist or are we in a specialty practice that has a lot of subspecialists? And, you know, what we need is sort of that bread and butter provider to see all of those sort of more general cases. You know, are we looking for somebody who can lead a practice? Or are we looking for somebody earlier in the career who can really build their practice and grow into a leadership role? So really taking all of those little more nuanced things into account rather than just looking at that, you know, that that checklist that we have that says, first, I place an ad, then I interview, then I make an offer.

Liz Mahan: 06:16

So, you know, we're we're gonna dive more into what happens on the front end in this presentation and and talk about how that can really positively impact your recruitment process by creating that playbook.

Daniel Williams: 06:31

Right. And then as part of the playbook, do you get into the timeline and do the practices know the timeline that it's going to take, what is it eighteen months, two years? What is y'all's statistic you use as far as the timeline?

Liz Mahan: 06:48

It really varies depending on the region, depending on the specialty. It can be pretty broad. We will talk about the timeline. We will talk about how it's really important that everybody be on the same page around the timeline, that we be proactive about our timelines, that we not that we try to get away from, you know, more urgent response and more reactive response and build a pipeline in a more proactive way and really spend some time doing some medical staff planning and looking at where the practice is going, maybe where we need to look at recruiting in in the coming years and months and and getting out of the you know, reacting to sort of what's happening in terms of turnover stuff, because ultimately we want to retain. So we want to really manage that turnover and hopefully mitigate it in the long run.

Daniel Williams: 07:46

Let's talk about common challenges then. You talk to a lot of practices, you help them find these solutions using this playbook, but when they come to you, I just want to see if our listeners, you know, are nodding their head when you say whatever you're going to say, what is the common challenge that they're saying, Liz, help me with fill in the blank?

Liz Mahan: 08:09

Yeah, Liz, help me. I need an X specialist yesterday.

Liz Mahan: 08:15

You know, I didn't even put this in my presentation because we all know there's a physician shortage. All know it's getting worse. I don't think that bears repeating. What we need to start doing to address it is to try to get ahead of it and to really try to recruit to retain instead of just finding that person who can fill that immediate need. I mean, that's great.

Liz Mahan: 08:41

It's great if we find a physician that can come in and and do the job. But if the physician's not the right fit, if the physician, you know, maybe isn't a right fit for the community because they're they love fishing and hiking and you're in suburbia where where all those things are an hour drive away, how happy are they gonna be, you know, in the long run? If they have a spouse that's looking for work in a particular field that isn't available in the area and they either have a long commute or they're looking for a remote opportunity that may or may not be available. How does that work in the long run? So taking all of those things into account, again, to find that physician that's really gonna have staying power, and will be with the practice long term.

Daniel Williams: 09:30

So once again, that was Liz Mahan, Director of Professional Development and Solutions at AAPPR, talking about staffing. Next up is Julia Rosen, Senior Vice President of IT at MGMA. In our conversation, Julia talks about how practices should focus on real problems when they bring in new technology, not just chase buzzwords. She also touches on balancing tech with human care, managing legacy systems, and protecting patient data and security. Let's go to that conversation with Julia now.

Daniel Williams: 10:07

You've been at Centura. You were at Para. Now you're at MGMA, but you've communicated with lots of health care leaders on that technology side. What are the big pain points in health care right now? What are some of the pain points for those medical practices, many or who are MGMA members?

Julia Rosen: 10:26

You know, a lot of it really comes my you know, I'm I'm not I've never run a medical practice, but a lot of what I hear from, from clinicians in the field is still around the burden of documentation. You know, again, like, there's lots of great fancy tools out there, but when it comes down to it, a huge complaint of people in all aspects of the medical practice is I spend too much time on documentation and I'm documenting at night when I want to be with my family. So I think that's still a huge burden, you know, in nursing, in, you know, physicians. And again, I think that is a space where technology can really help.

Daniel Williams: 11:10

Thanks for that. So next question then. Let's talk about building sustainable tech infrastructure. Mhmm. I know nothing about tech from that, architectural side of it, when but we're talking about building that infrastructure and I'll use an example.

Daniel Williams: 11:25

Mhmm. Couple of years ago, right at the holidays, Southwest just went down, Southwest Airlines, and we learned more. My daughter was flying back to college, so we had to immediately find another flight from another airline. But what we we found out, you may know more details than I do, but the way I understood it, they built a system. Mhmm.

Daniel Williams: 11:48

And then they just, over a really long period of time, they just kept building onto it and building onto it and building onto it. And it was just a house of cards at a certain point that fell that way. How do you build an infrastructure works, that doesn't collapse under its own weight? What advice would you give there?

Julia Rosen: 12:08

That is a very difficult question. And and I laugh. I I think the reason it's a very difficult question is because most most health care practices are not going to be starting from scratch.

Julia Rosen: 12:20

Right? And that is a and that is a huge challenge because even if you want to migrate to a new modern system, you're still going to have whether it's on paper or in a legacy system, you're still going to have a ton of data that you have to migrate over.

Julia Rosen: 12:37

I think when you're talking about infrastructure, at least from it sounds like more on the software side of things, I think one key is how do you control and get your data to a manageable size and to manageable patterns so that you can migrate it to a new system cleanly and or don't have this huge sort of bloat of, you know, so much data that it, you know, slows down your systems or makes it hard to access things. So thinking about things like what's your retention period of data? You know, are going beyond the minimum ten years required by, you know, by government regulations, you know, thinking about things like being very careful when you're migrating systems, being very surgical about what data you really need from a clinician perspective to access in the new system versus what can be in cold storage or an archival system you just take from time to time. I think that's gonna be the big challenge in healthcare, is it's so rare that you can just start cleanly with a new modern system. You have to do this legacy data migration that's required.

Julia Rosen: 13:47

So I'm thinking really closely about how you can minimize the impacts of that migration to not overburden your system as well as to make it easier for your clinicians to find the relevant information you need easily.

Daniel Williams: 14:03

Another aspect of that is the security of the data that you have. Change health care, that breach occurred last year. It was huge. It got into, I believe, I wanna look at my stats here, a 100,000,000 individuals, you know, were impacted by that data breach. How do we protect ourselves about against the the cybersecurity threats from a medical practice perspective?

Julia Rosen: 14:30

Yeah. I think the biggest thing to think about is it's not if it's gonna happen. It's when.

Julia Rosen: 14:36

It's a very common saying in, in in cybersecurity. So really, thinking about and taking actions around, you know, in the case of ransomware, do we have immutable backups that are stored in an off-site location and do we know how to restore from those? Piece is often overlooked, right? Have we done things around practicing for a cyber attack, tabletop exercises for if there were an incident of a breach, how do we recover, how do we communicate? So I think that's really the biggest piece.

Julia Rosen: 15:15

Obviously there's lots that you can do in the vulnerability management area but the reality is cyber criminals will always be a step ahead of the technology that we have particularly, you know, when you're in a smaller organization. So I would say, you know, get a formal cybersecurity program in place. There are lots of vendors, even smaller vendors who will help you do that for a reasonable amount of money. So, you know, and then really look at your backup strategy, your incident response strategy, to make sure that, when it does happen, you're really prepared and it's very, again, surgical around, what you do and how you'll respond.

Daniel Williams: 15:55

Okay. Switching gears now. You had mentioned it to me earlier, but you're on the board of the Colorado chapter of Yep. Talk about that role, that relationship, what y'all are, achieving in in that field, in that side that you're working on.

Julia Rosen: 16:12

Yeah. I I love being on the board of HIMSS. It's such a great way to connect with other health care IT professionals in the community. So shameless plug, we have we have a lot of a lot of events coming up. We have a spring conference coming up.

Julia Rosen: 16:26

That's great a opportunity to learn about trends in health care and connect. But what I really, you know, I'm hoping to focus on for this coming year with the board is how do we engage and get more folks interested in the health care IT profession. So I think traditionally HIMSS, a lot of the focus has been around engaging executives, which is great. We're still gonna do that. But we've had talks internally within HIMSS of how do we make healthcare IT really an exciting career opportunity for people coming right out of college, early career folks, maybe transitioning from other IT disciplines into healthcare IT.

Julia Rosen: 17:05

I think that's gonna be a really exciting part of the upcoming year. And I love being in health care IT. You know, you get to be techie while also feel like you're, you know, contributing to society and to your community. And it's a great career path, I'm hoping we can get more people engaged and involved.

Daniel Williams: 17:26

So once again, that was Julia Rosen, senior vice president of IT at MGMA. So in our final segment we're going to highlight today, it's a conversation we had this year with Dr. Michael Blackman. He's chief medical officer at Greenway Health. Now, Dr.

Daniel Williams: 17:44

Blackman talks about a very important topic, how we can use automation and workflow tools to lessen the burden of administrative burden, pajama time, and even quite possibly burnout. In this conversation, Doctor. Blackman focuses on approaches that might ease those pressures that often lead to burnout in medical practices. So let's go to that conversation with Dr. Blackman now.

Michael Blackman: 18:11

We talked about burnout for a long time. Yeah. And we people have done different things and different approaches. Say, how can you eliminate burnout? You often hear about you know, people call it different things, but pajama time.

Michael Blackman: 18:24

People taking work home home with them in the evening. Certainly, when I was in full time practice, I don't think we called it pajama time then, but I certainly did. Didn't call it that, but certainly brought stuff home.

Daniel Williams: 18:36

Sure.

Michael Blackman: 18:37

You know, you know, after I put my kids to bed, you can often find me sitting on the couch calling patients, and patients often be surprised they get a call from me at, you know, eight or 09:00 at night. But that's when I had the time to do it, and it was important to catch up with them. You know, AI and and people use the term very broadly, it can mean a lot of different things. Right. But I think it it comes down to what are the available tools that can really help.

Michael Blackman: 19:04

So think about it as as an assistant. It's not a replacement, but an assistant. And there are some some things that can, you know, replace in some, you know, some tasks. Some tasks, it's, you know, it's an additional speed. You know, I use AI tools a lot myself for doing different things.

Michael Blackman: 19:24

You know, even for something as simple as if I'm thinking about creating a presentation. You know, I could sit and write an initial draft. It might take me a while. I can equally take, you know, AI and say, hey. What are the seven things or 10 things you would talk about on this topic?

Daniel Williams: 19:39

Right.

Michael Blackman: 19:40

And then edit it from there. I think the point of it being an assistant is critical, know, especially if we get to other pieces like using AI for clinical decision support. Notice I said the support and not decision making. This still requires, you know, human oversight and paying attention to what you're looking at. You know?

Michael Blackman: 20:01

AI can still hallucinate in certain situations, so you gotta make sure what's what's being presented is real and makes sense.

Daniel Williams: 20:08

You make great points there, and we've talked about that before on this show. And, obviously, anyone who's interacted with, the different AI tools that are out there, they'll be humming along, and then all of a sudden, there's something just, as you said, the hallucination, the just getting things completely wrong. Or if you are looking at, as you were saying, making a presentation, it's not the right tone. You know? It's not really hitting the way you wanna address it.

Daniel Williams: 20:38

So I think what's so important, and this is the point we make a lot here, at least in this day and age, we're not replacing jobs per se, but what we're doing is really giving us, whether it's you, me, physicians, clinicians, anybody else out there, some really important tools, and then we have to use our wisdom, our knowledge, our education base. And it sounds like you've really dealt with that as well.

Michael Blackman: 21:04

Yeah. You know, it often comes up. People say, well, is it gonna replace people? It's gonna cause people to do different things. And I don't know where this quote originated.

Michael Blackman: 21:14

It it's not mine, but I'm gonna share it. You know, people talk, oh, will AI replace doctors? And the short answer to that is no. But likely doctors who use AI may replace those who don't.

Daniel Williams: 21:28

I love that quote. I mean, not not for what it means for people's job, but that that's the reality that we're in. And I think the people who really are making that adoption to using the tools and using them wisely are gonna be ahead of the ones who aren't. I mean, that's just the clear way to say it. So let's talk about a very specific AI tool.

Daniel Williams: 21:49

That's the one that Greenway is working with. It's Greenway Clinical Assist. Talk about that because in the name itself, it's not Greenway Clinical Replace. It's Greenway Clinical Assist. Talk about a little bit about what you see in its usage as a tool in the way that you're seeing administrators and practice leaders using it.

Michael Blackman: 22:12

So our vision for Greenway Clinical Assist is just that. It's an assistant that helps you, you know, across the board as you work your way through any variety of tasks within the practice. The place that it's starting is assisting with documentation. So at its core, it starts with being a ambient documentation solution. So as you're having a conversation with the patient, the system listens to the conversation and then writes a note based on that conversation, leaving in, you know, the the pertinent medical parts and stripping out other pieces that it doesn't deem are pertinent.

Michael Blackman: 22:48

Now going back to the comment I made before, you still need to read your note. Right. You know? So you read it. You say, okay.

Michael Blackman: 22:57

Yep. That makes sense. Or wait. It didn't it left out something I think is important, and you can then just tell it to put it back in. It's really very, very simple in that regard.

Michael Blackman: 23:06

But what it does do at its core, though, is it turns documentation from being what has traditionally been an after event. Do all the work and now write down everything you did to being a byproduct of the work you're already doing. So that in itself saves time. And at least, you know, what we've seen with this, you know, both in the literature and in direct conversations with its providers is it also creates, in a lot of cases, a more accurate note. Obviously, in the course of a medical visit, you're talking to the patient, thinking about things, and the patient may say something you miss.

Michael Blackman: 23:46

It's just part of a conversation. Well, I've had conversations with physicians and others when they say, well, wait a minute. This showed up in the note. I don't remember that coming up. We go back.

Michael Blackman: 24:00

We look at the transcript, and sure enough, it's there. And they feel like, wow. I I missed that. You know, I missed that comment. So I think that's important.

Michael Blackman: 24:11

One one provider in particular said to me, he said, I'm getting to spend more focus on my patient. It's taking me less time, and it's generating a better note. Truthfully, I take any one of those three outcomes, let alone all three.

Daniel Williams: 24:25

I would too. I wish I spent twenty five years as a reporter, like, jotting down notes or recording it and having to go back and transcribe it myself. I'd spend the whole afternoon just typing up the interview, and now you can just get the audio, drop it into one of the different platforms, whatever it might be. And then in a minute or five minutes or so, you have the transcription. Now you can really use your

Michael Blackman: 24:50

Yeah.

Daniel Williams: 24:51

Analytical skills to, decipher what's right, what's wrong in there. So I do wanna follow-up with you one more question about the, product itself. How does it work in practice? Is it within embedded in an app, or what what is where is it located, and how is it used?

Michael Blackman: 25:11

Yeah. So the way really, it's embedded in an app. Walk in, start start the app, and then just ignore it. Okay. Have a have a conversation.

Michael Blackman: 25:22

It'll be usual conversation, usual interaction with the patient. And then when you're done, you simply hit the stop button. It generates the note. You have a chance to review it, and then you press another button and off it goes right into right into the electronic health record. Now I think, you know, one of the things that is different about this a little bit is that this may sound sort of obvious, but it could only record things in the note that that system hears.

Michael Blackman: 25:53

So, you know, the way what one chooses to vocalize during the course of the visit has to change a little bit if you want that to show up in your note. You know, for example, you know, typically, as you're doing the physical exam, you'll you don't necessarily vocalize all of those findings. Right. You would just eventually write them down. But if you want the system to capture it, you'd have to say things like, you know, what was your heart exam?

Michael Blackman: 26:17

What was your lung exam? What are your other findings? Now, personally, I think there's some benefit from that just to conveying that information to the patient. But it's it's a, you know, necessary step if you wanted to do that. If you don't want to and you wanna put it in later, that's totally up to the user.

Daniel Williams: 26:36

So once again, that was Dr. Michael Blackman from Greenway Health talking about using tools to lessen burnout. So I just want to thank you all for spending this day with us, your New Year's Eve. Hope you have a wonderful New Year's Eve. Stay safe out there, and Happy New Year.