Episode Overview
Podcast: Becker’s Healthcare Podcast
Guest: Dr. Dennis Disch, MD, MMM, FACC, Vice President, Hospital-Based Specialties, Advocate Health
Host: Grace Linkeller
Date: January 2, 2026
Theme: Leadership and innovation strategies in hospital-based specialty care at Advocate Health, with a focus on operational efficiency, talent retention, collaboration across specialties, and transformative initiatives in emergency department management.
Guest Introduction & Background ([00:32]–[02:49])
- Dr. Dennis Disch is the Vice President over the Hospital-Based Specialty service line at Advocate Health, the third largest nonprofit health system in the U.S.
- Advocate Health is organized into three divisions: North Carolina/Georgia (combined), Illinois, and Wisconsin.
- Dr. Disch oversees five core hospital-based specialties for the Illinois and Wisconsin divisions:
- Specialties: Anesthesia, Radiology, Hospital Medicine, Critical Care Medicine, Emergency Medicine
- Emphasizes collaboration across these specialties and integration with operational leaders from all 27 hospitals in the region.
- Previous roles include leadership in the cardiovascular service line at Advocate and at Corwell Health in Michigan (including Chief Medical Officer and Chief Operating Officer positions).
Quote [01:36]:
“We really think that class collaboration fosters moving hospital based care forward in sort of a synergistic way.” — Dr. Disch
Growth Strategies in Hospital-Based Specialties ([02:49]–[04:59])
- Unlike outpatient or procedural specialties, growth in hospital-based specialties is not about increasing market share.
- Focuses include:
- Creating inpatient capacity by improving operational efficiency, enabling accommodation of more acute and elective patients.
- Enhancing patient flow and safety throughout the hospital admission process.
- Recruitment and retention of top providers—1800 physicians and APPs (Advanced Practice Providers) are employed across the five service lines.
- Wellness and well-being programs to reduce burnout and maintain high retention.
Quote [03:43]:
“We really have to constantly be focused on recruiting and retaining top talent… we’re constantly in recruitment mode.” — Dr. Disch
Key Initiatives: ED Boarding & Interdepartmental Collaboration ([04:59]–[08:45])
A. ED Boarding Crisis & Solutions
- Major Cross-Service Project: The "ED Boarding Project"
- Background: ED boarding—when patients are kept in the emergency department while awaiting inpatient beds—is a major operational pain point, particularly at large urban teaching hospitals in Chicago and Milwaukee.
- Key Actions:
- Early inter-specialty collaboration, involving critical care, emergency medicine, hospital medicine, and radiology from the start of a patient’s ED visit.
- Leveraging virtual health, teletriage, and AI technologies to streamline triage, diagnosis, and disposition.
- Challenging traditional, sequential patient workflows (e.g., waiting for all test results before moving patients to appropriate care areas).
Systemic Bottlenecks
- Identified that patients moved to a hospital bed from the ED can get bumped down the imaging queue, causing hesitancy in moving them out of the ED, which exacerbates boarding.
Quote [06:39]:
“One contributor to the ED boarding issue is that there’s a hesitancy to move the patient out of the emergency department to the floor, because as soon as they do that, they tend to go from the top of the imaging cue to the bottom...” — Dr. Disch
B. Innovative Programs
- Hospital at Home: Initiated as a solution for appropriate patients who would traditionally wait in the ED for an inpatient bed—now can be transitioned directly into home-based hospital care.
- Program originated in Charlotte and is expanding across Illinois and Wisconsin.
Key Benefits from Initiatives
- Quicker diagnosis and disposition
- Multidisciplinary decision-making engaged earlier
- Reduced ED boarding time for patients
- Potential admission avoidance in some cases
Advice for Healthcare Executives: Proactive Leadership & Workforce Wellness ([08:45]–[11:41])
- Honest Collaboration with Independent Physician Groups:
- Financial pressures are acute for both health systems and independent specialty groups.
- Emphasizes early, honest discussions about sustainability, partnerships, or possible employment models to avoid disruptive care gaps (especially evident in anesthesia).
- Being proactive minimizes organizational risks and maintains continuous patient care quality.
Quote [09:16]:
“We have to be willing to have earlier, more honest, ongoing conversations with our very valued independent physician groups...We would rather be prospective and thoughtful about that ahead of time rather than have to react to a situation once it falls apart.” — Dr. Disch
- Supporting Physician and APP Wellbeing:
- Advocate’s “Best Place to Care” program has significantly improved engagement and alignment scores.
- Participation in the AMA’s Joy in Medicine program.
- Focus on strong engagement helps ensure the health system remains an attractive place to work, supporting care for both patients and communities.
Notable Quotes & Memorable Moments
- [01:36] “We really think that class collaboration fosters moving hospital based care forward in sort of a synergistic way.” — Dr. Disch
- [03:43] “We really have to constantly be focused on recruiting and retaining top talent… we’re constantly in recruitment mode.” — Dr. Disch
- [06:39] “One contributor to the ED boarding issue is that there’s a hesitancy to move the patient out of the emergency department to the floor, because as soon as they do that, they tend to go from the top of the imaging cue to the bottom…” — Dr. Disch
- [09:16] “We have to be willing to have earlier, more honest, ongoing conversations with our very valued independent physician groups...We would rather be prospective and thoughtful about that ahead of time rather than have to react to a situation once it falls apart.” — Dr. Disch
Timestamps for Key Segments
- [00:32] Guest introduction and background
- [02:49] Growth strategy for hospital-based specialties
- [04:59] Current exciting initiative: ED Boarding Project
- [08:45] Advice for healthcare executives on organizational success
- [11:41] Conclusion
Summary
This episode offers a concise but insightful exploration of how scale, collaboration, proactive leadership, and digital innovation are shaping hospital-based specialty care at Advocate Health. Dr. Dennis Disch shares actionable strategies for enhancing hospital capacity, tackling emergency department bottlenecks, and fostering workforce well-being, all underpinned by his deep experience in both clinical and administrative leadership. The episode provides both practical advice and food for thought for healthcare leaders facing operational and financial headwinds.