Leadership Edge with former Clinton, Bush and Obama Physician, Dr. Jeffrey Kuhlman
I’ve had the pleasure of chatting with Dr. Jeffrey Kuhlman, Senior Vice President Chief Quality & Safety Officer at AdventHealth. Dr. Jeffrey Kuhlman served as a Navy Physician for 30 years, with more than half of that time as Physician to the President, Director of the White House Medical unit, White House Physician and Senior Flight Surgeon for the Marine One in the years 1997 to 2013. Kuhlman is triple board-certified in Aerospace, Family, and Occupational Medicine, received his medical degree from Loma Linda University School of Medicine, an MPH from Johns Hopkins Bloomberg School of Public Health and his management certificate from Crummer Graduate School of Business Rollins College. He is the Senior Vice President Chief Quality & Safety Officer at AdventHealth.
What inspired you to embark on a career in medicine? I believe my career in health care was predestined. Growing up in a college town with a father who was a professor, I learned to value education at an early age. I was raised in a community where medical doctors were well-respected and I was fascinated by their ability to use problem-solving to improve and, in many cases, save, lives. Inspired by my neighborhood doctors’ dedication to caring for patients from the cradle to the grave, and my father’s pursuit of academics, I gravitated towards health care because it would put me in a position to change lives for the better.
When I was 19, I graduated from college and joined the United States Navy and soon attended medical school on a Navy scholarship at Loma Linda University School of Medicine. I later became triple board-certified in Aerospace, Family and Occupational Medicine and served as a Naval Flight Surgeon before becoming a White House Physician in 2001, starting my service under President George W. Bush and later as Physician to the President for President Barack Obama. Now, as Chief Quality & Safety Officer at AdventHealth, I have the honor and pleasure of leveraging those experiences to minimize dangers in health care, prioritize patient safety and improve whole-person health for all.
Can you share with our readers about the innovations that you are bringing to and/or see in the health care industry? It is going to take dramatic changes to transform health care. One way that we are leading change at AdventHealth is by transforming the way chest-pain patients are treated in the emergency room.
Up to 10 percent of emergency department visits consist of patients reporting chest pain. However, less than 1 percent of those cases need acute intervention. To better route patients to their proper care setting, our physicians teamed up to develop a written algorithm that stratifies these patients into high-, medium- and low-risk populations. To properly analyze the complete care journey, we tracked the more than 200,000 patients we studied for 30 days after discharge. It turns out, none of those patients suffered major adverse cardiac events during that tracking period. Our efforts led to a drastic reduction in unnecessary admissions, doubled the number of patients successfully moved to the outpatient setting and annually reduced health care costs by $31 million. We are now looking at ways to apply this consensus-driven algorithm method to patients with abdominal pain and fainting, which also accounts for a substantial numbers of ER visits.
President Barack Obama presents an end of tour award to Dr. Jeffery Kuhlman in the Oval Office, July 12, 2013. (Official White House Photo by Pete Souza) This photograph is provided by THE WHITE HOUSE as a courtesy and may be printed by the subject(s) in the photograph for personal use only. The photograph may not be manipulated in any way and may not otherwise be reproduced, disseminated or broadcast, without the written permission of the White House Photo Office. This photograph may not be used in any commercial or political materials, advertisements, emails, products, promotions that in any way suggests approval or endorsement of the President, the First Family, or the White House.
What was it like to be President Obama’s personal doctor? I served in the White House for 16 years. My roles included Senior Flight Surgeon for the President’s helicopter squadron, Camp David physician supervisor, White House Physician, Director of the White House Medical Unit and eventually Physician to the President for President Obama, his family and the entire executive branch. I served in the Obama Administration for the first of his two terms. In 2012 alone, I joined him and provided care on more than 100 foreign and domestic trips. As you can imagine, presidents have specific needs and unique schedule demands, which required me to be agile and team-focused. It was an honor to oversee his care.
What is AdventHealth doing to promote health and wellness in its communities? As one of the largest health systems in the U.S. with more than 80,000 team members, AdventHealth houses a tremendous amount of resources that allow us to ensure the well-being of the communities we serve. Our physicians, nurses, clinical teams and staff are all united by a mission to extend the healing ministry of Christ by providing the highest quality of care and services to help people feel whole—body, mind and spirit. Many chronic diseases and conditions such as heart disease, stroke, cancer, diabetes and obesity, are preventable. One way we are hoping to foster healthier communities proactively is through the The Feel Whole Challenge, a 21-day challenge that involves daily guidance for healthy eating, physical activity, community involvement, positive outlook, and focus on healthy environment and interpersonal relationships. The goal is to inspire people to be more positive and mindful about their lives and to be proactive with their health. We have a ton of great online resources to help participants plan out their challenges, get motivated and stay on track. You can also follow people who have been documenting their journeys on social media using the hashtag #FeelWholeChallenge.
Through my master’s in Public Health degree from Johns Hopkins University, I learned you have to help people get a job today, housing tonight and education for a better tomorrow—then let’s talk about health care. At places like AdventHealth Manchester in Clay County, Kentucky, were active in treating social determinants in the communities we service. For example, in places like Clay County, Kentucky, where residents are struggling with many issues surrounding poverty, our teams provide funding and volunteer efforts to a food pantry, clean water “kiosks” throughout the community, a homeless shelter and the construction of an outdoor youth camp. In 49 other hospital locations, we do the same work.
What changes do you hope to see in the health care industry? One alarming trend that I’ve seen in other health systems is the erosion of trust between patients and doctors. To help build that trust, we have to show and live out our values to develop meaningful and human connections. To that end, we have a common set of service standards and we have trained every one of our team members in them through what we call The Whole Care Experience.
Our core service standards guide our focus on whole-patient care by:
Taking ownership of our collective role to provide exceptional, whole-person care,
making the health care journey easy,
keeping patients safe,
and loving them.
This ensures trust is embedded in everything we do. I’m very proud of this work and I hope one day it becomes the industry standard.
Dr. Jeffrey Kuhlman in the James S. Brady Press Briefing Room, July 11, 2013. (Official White House Photo by Pete Souza) This photograph is provided by THE WHITE HOUSE as a courtesy and may be printed by the subject(s) in the photograph for personal use only. The photograph may not be manipulated in any way and may not otherwise be reproduced, disseminated or broadcast, without the written permission of the White House Photo Office. This photograph may not be used in any commercial or political materials, advertisements, emails, products, promotions that in any way suggests approval or endorsement of the President, the First Family, or the White House.
Looking back, what are the 5 things you wish you knew? AdventHealth is a very team-focused environment, so I find this hard to answer. But what I can say is that throughout the course of my career, I have relied on my military training – which involved team building, problem-solving and out-of-the-box thinking – to serve as my True North. Looking back, there are five things, the 5 Pillars of High Reliability, that every single person at AdventHealth, or anywhere for that matter, can use to transform how they care for and interact with others:
Higher-level understanding: To be able to do things right, you have to understand it. So, first and foremost doing your work well comes with being properly educated. If you want to fix an engine, you have to know how it’s done and if you want to cure someone, you have to know how it’s done.
Integrity: This means doing the right thing when no one is looking, a simple but powerful way to do your work reliably for your team and for your patients.
Formality: Following the formal procedure ensures consistency, as well as having a formal, agreed-upon language to discuss those same procedures to eliminate any confusion among the team.
Question: At AdventHealth we constantly question things to catch mistakes or improve what we do. Not only that, we question everything. Mistakes can happen because someone didn’t speak up and trust their hunch.
Back each other up: The team can achieve more than the individual. You have to back each other up by looking over one another’s shoulder, offering solutions, covering one another’s blind spots and providing unconditional support.
What is a life motto or philosophy that you live by? My motto is simple: “The purpose of life is to have a life of purpose.” Like I mentioned previously, my family taught me the power of faith and the importance of serving my fellow man. I’ve spent decades being able to do that up close. Now I can effect change on a systemic level at AdventHealth by bringing the bedside manner of a physician in the highest office to one of the nation’s greatest health care systems, and I find that very rewarding. I want to inspire people to embark on a whole-person healthy lifestyle – this includes chest pain patients, those suffering from chronic conditions or people looking to jump start their personal health through a resource such as the Feel Whole Challenge. I believe my purpose is to make a difference in the world and I look forward to doing that for years to come. Originally published on Thrive Global