Interview with Dr. Toby Cosgrove — former Chief Executive Officer of the Cleveland Clinic

Dr. Toby Cosgrove is one of the great leaders and innovators in American medicine. 

On this episode of The Moving Healthcare Forward Podcast, I am thrilled to speak with the former President and Chief Executive Officer of the Cleveland Clinic, a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Together, Dr. Cosgrove and I talk about innovation through the COVID-19 pandemic, the role that technology can have in reducing burnout, advancements in telehealth, and so much more.

Addressing Burnout and Inspiring Teamwork 

In healthcare, we’re experiencing a documented shortage of frontline workers and caregivers and what seems like record stress and burnout. (At VNAHG, we’re working to build the workforce of tomorrow, tackling this shortage head-on.)

As much as 50% of the individuals in healthcare are burned out, Dr. Cosgrove shares, because they’ve just been working at an almost unhuman task. The acute shortage means that we need to train 200,000 nurses a year to meet demand. 

To address this burnout, we need to ensure the work healthcare workers are doing is important and is relevant to their training. We also need to embrace technology, Dr. Cosgrove says, which can reduce the workload in healthcare, such as administrative costs. At VNAHG, we’ve been working to integrate a new technology — documentation through voice recognition to speed up some of our nurses’ and aides’ visits. I am optimistic that we can be more sophisticated and efficient. 

I appreciate that Dr. Cosgrove also helps complicate the narrative that the worker shortage is solely based on stress in the field. We also have to recognize how much new healthcare information there is, he explains. “The total amount of knowledge in healthcare doubles every 73 days,” Dr. Cosgrove shares, “so in order to surround all this information, you’re going to have to fragment it and have a lot of people who are individuals, who can bring that sort of expertise to the table and be part of the team.” 

Teamwork has become absolutely essential to getting great healthcare, Dr. Cosgrove says. The pandemic emphasized the importance of healthcare workers willing to cross the borders between specialties and collaborate under duress.

The Promise of Telehealth

Those who work in healthcare likely know that it has historically taken a long time to move healthcare forward. When a new therapy is proven, Dr. Cosgrove says, it takes 13 years before it’s the standard of care in the United States. “That’s a very slow pace of innovation,” he shares.

Dr. Cosgrove tells a story of one of his initial experiences with telehealth. His daughter got a rash on her face, and he took a picture of it and sent it to a dermatologist who could immediately assess that it was poison ivy. He realized that this technology saved half a day in the emergency room in getting diagnosed.

It took the pandemic for us to more fully embrace this technology.

Why Home Healthcare is the Future

Twelve  years ago, my practice had been an area of geriatric medicine in home care. I’d do these visits with my laptop, charting an epoch. Sometimes, when I’d send a referral in or a recommendation, the phone would ring before I even left my patient’s home. But now, fast forward 12 years, we still have people faxing things back and forth during some of those visits. 

Many patients are happier being at home than they are in a hospital bed, Dr. Cosgrove shares. Now more than ever, we need our technology to meet the moment, so that home healthcare is accessible but also innovative. 

In our home care world, one of the things we’re proud of is that we’ve been focused on wound ostomy continence nurse specialists. We prioritize bringing in nurses who have this specialized expertise, because we know that they can better serve patients. 

Listen to our episode with Dr. Toby Cosgrove, former Chief Executive Officer of the Cleveland Clinic, on Apple Podcasts here, or on Spotify here.  


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