Dr Carl E. Lambert Jr of Rush University Medical Center: In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System
An Interview With Luke Kervin
We also need to acknowledge the importance of behavioral health. A lot of patients had increased anxiety and depression. We need to bolster behavioral health services. That might mean staffing clinics with a psychologist on staff to meet patient needs. It’s on us to help.
The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.
In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.
As a part of this series, I had the pleasure to interview Dr. Carl E. Lambert.
Dr. Lambert is a family physician with a wide range of expertise, including cancer prevention, adolescent health, diabetes and a variety of chronic health conditions. He coordinates whole-person care for his patients, understanding the intersection of each individual’s physical, mental, familial and environmental health — issues that have come to light during the pandemic. Also, with his diverse background and personal experience, he can speak to what can be improved in healthcare to support communities of color and work to advance health equity.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
I’m the oldest of three sons and grew up with hardworking, supportive parents who made me feel like I could do anything. They were always nurturing and supportive. My two younger brothers were diagnosed with autism at an early age, so a lot of my youth was going to doctors’ visits. I remember being interested in how the doctors cared about my brothers and our family, and how they used their knowledge of science, math and medicine to help us.
I learned at an early age that we need to care for people and populations that are underrepresented and knew that medicine made sense to me. In med school, I shadowed a doctor who went to my church. He had the integration of health, his faith and working as a Black male physician. I didn’t know that existed.
Can you share the most interesting story that happened to you since you began your career?
My career has taken me to places I would have never expected, especially over last year with COVID. I was offered an opportunity to do an op-ed fellowship and learn how to write. I always thought I was a better writer than a speaker — I was shy and introverted. I wrote about the minority tax and frustrations as a Black male physician where you feel isolated and have to work two to three times as hard to get the same credit. I was really feeling the strain at that time, and I let the fellowship be a vehicle to let my emotions out.
It ended up resonating with a company called First Line Heroes. I didn’t think I was a hero, but I could share what I did. I underestimated what was going on. I did the shoot for their project, and they told me it was an AT&T commercial for national TV narrated by Lebron James. They said I would be part of the Dream in Black production that shows how people serve. It included me, a firefighter, a teacher and an activist. It all came from taking a chance and not being afraid to share my personal story during that time.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
It was my first year after residency. I wanted to do faith-based continuity of care for underserved populations. I learned about motivational interviewing, where we are tasked with helping patients take their next steps, whether it’s to quit smoking or lose weight. I asked a patient if anyone had ever talked with her about her weight, and she said, “No, has anyone ever talked to you about yours?”
I explained that I did not want to offend her, but that there may be an issue from a medical perspective. I had to share why I was asking the question. I share that with my students now — before you approach sensitive topics, you should do so in the right way. I should have done that in retrospect. I told her that I would lose weight if she did too. We created goals together, and I said I’d see her in two months to share our progress. I never saw her again, but I never forgot that lesson, and I use it with every patient.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
It’s important to have an anchor. Especially this past year with COVID, but other things can rock us personally too. You need to figure out what keeps you grounded. For me, that’s my Christian faith, and for others, it may be the ability to serve. My wife and I are expecting a son in October, and that is my anchor. What is your anchor? It’s something that keeps you focused when times get hard. Not money or prestige. That’s short-lived.
Are you working on any exciting new projects now? How do you think that will help people?
A lot of my time is spent running the Rush Family Leadership Program, a specialized track in medical school. We accept three to six students a year who have a keen interest in family medicine. We teach them how to use family medicine as a vehicle for community service, leadership and how to better themselves as a scholar and advocate. The students are paired with a mentor for four years and get early exposure to clinical medicine. The goal is to encourage them to build their own patient panel under the guidance of a faculty member and allow themselves to dream and see what kind of leader they want to be.
How would you define an “excellent healthcare provider”?
I think a healthcare provider is someone you can count on. They are reliable, accessible and transparent. They have a mixture of competence and compassion. You want them to be inspirational, thoughtful, and care about you as a person. Every patient should be treated as an individual. Implicit bias can seep in, so it’s important to know their story. An excellent provider can incorporate their journey and life experiences, and then you can notice subtle changes that may affect their overall health.
Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?
I noticed a lack of resources, like community hospitals or smaller clinics having a hard time getting things like PPE. It was also hard for them to pivot to distance care, like telehealth. Some places also struggled to get compensation for that kind of care, and some primary care institutions even closed. That creates a ripple effect on populations hanging on by a thread and relying on places that have little resources to begin with.
Also, as a Black male physician, we look at the statistics of who is affected by COVID, and it’s not by accident that we see ethnic groups affected. These groups haven’t had the resources to allow them to have better health outcomes. It has spotlighted the lack of care that primary care gets. When you prevent chronic conditions, you can prevent complications. If we had a stronger primary care base and behavioral health resources, the U.S. would greatly benefit.
Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.
At Rush, we did an exemplary job of pivoting. In a crisis, you over-communicate because people worry and have questions. It was strange to see healthcare providers worried. There was a level of fear. Folks shared heart and grit — how can we help colleagues, ourselves, everyone. The key was communicating here’s what we know, here’s what we don’t, here’s what we can do. There were plans right away, how do we mitigate risk, transition to a virtual environment.
We also communicated to our students about what was going on, why they couldn’t be on rotation, and when they might be able to come back. We integrated vaccine hesitancy into the curriculum and eventually let them give vaccines. It was cool to see the whole Rush community come together and use our talents to serve however we could.
Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
We need to minimize burnout. Over 50% of a physician’s time per day is administrative tasks that could be delegated. We need funding to support staffing, so it’s not all on the physician. We’ve implemented a virtual scribing project that reduces that burden so I can spend more time with patients.
We also need to work on diversity. Black physicians comprise just 3% of the physician workforce. The numbers need to be more congruent. We need to train medical school admissions committees to be aware of any bias they may have, make sure the selection criteria are fair and look at applicants’ whole journey, not just scores.
We also need to acknowledge the importance of behavioral health. A lot of patients had increased anxiety and depression. We need to bolster behavioral health services. That might mean staffing clinics with a psychologist on staff to meet patient needs. It’s on us to help.
Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?
We underpay our primary care doctors. If we truly want to value primary care, we need to give support to doctors to do their jobs. That could be opening spots for family medicine residency to fast-track the number graduating.
How do you think we can address the issue of physician burnout?
Personally, having a virtual scribe to help with documentation and a team to help deal with requests coming through the patient portal that don’t need me to do them.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
Never be afraid to use your voice. You never know how it can resonate with people you never meet. The op-ed fellowship taught me that. I thought, who would care? But no one’s ever going to say something in the way you say it, and just by that, you’re a person of great influence. That would inspire people to get over thinking, what if no one wants to hear this. Just do it and let the chips fall as they may. It takes courage and belief in yourself.
How can our readers further follow your work online?
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
