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Becker’s Healthcare Podcast
Dr. Lindsay Mazzotti, Chief Medical Officer of Medical Education and Science at Sutter Health
00:14:22
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- [00:00]
A
Hello.
- [00:00]
B
Welcome to the Beckers Podcast. I am so excited to be joined today by Dr. Lindsay Mazzotti, Chief Medical Officer of medical education and science at Sutter Health, a large hospital system based in California. My name is Paige Twenter. I'm a reporter and assistant editor here at Becker's Healthcare. And, Dr. Mazzotti, I'd love to just turn the floor over to you and hear from you. To kick us off, can you introduce yourself and kind of share a bit about your background?
- [00:29]
A
Yeah, I'd be happy to, Paige. Thanks. I'm a hospital medicine physician by training. I'm also board certified in palliative care. And I knew early on that I loved medical education and really fell into a role of being a teacher of physicians. And also I loved to grow faculty and develop faculty. I was lucky. I did my undergrad at Stanford. I did my medical school and residency at ucsf, where I had a lot of support to grow as a clinician educator. I spent about 14 years at Kaiser Permanente in medical education roles and helping found the Kaiser Permanente Bernard J. Tyson School of Medicine. And I've been with Sutter Health in this role for about two years. I'm here because we are building medical education programs and really thinking about medical education as part of our greater strategy.
- [01:21]
B
Yeah, I know you spoke with my colleague Erica Ceru a few months ago about. Over the past few years, Sutter has made a really strong investment and, you know, focused investment in adding, it sounds like 11 residency and fellowship programs in the past few years. Can you kind of share more about Sutter's physician residency initiatives?
- [01:45]
A
Sure, absolutely. So we started before I joined Sutter. Sutter had a long tradition of medical education, both in San Francisco as well as in some outstanding family medicine programs in Santa Rosa and in Sacramento. So across Northern California, we've always had an educational system, but we had about 13 residency and fellowship programs. And as we started exploring first the changes ahead in the. In the shrinking physician workforce and the anticipated shortages by the end of this decade, we thought really differently about how we might continue to expand access to care, not just for sort of, you know, growing more care centers, but actually how to deliberately grow more physicians. And so medical education has been part of that strategy. We've now have a plan to begin 52 total residency and fellowship programs by 2035. So we're quadrupling our GME footprint. We're growing to have roughly 1,000 residents towards the end of this journey every year, residents and fellows. And that has been, I think, really critical. In terms of how we think about expanding access to care, training the next generation of doctors, particularly where access is going to be limited and is already limited, and then thinking about how we actually grow, mission aligned local physicians who want to stay and serve in the communities that we serve. So it's been fantastic. We have five new programs this year that are launching, you know, we have hundreds of new residents who joined us in July and just, you know, thousands of people looking at our programs, 100% match rate, all these, you know, kind of outstanding indicators that we're, we're moving in the right direction.
- [03:32]
B
No, I podcast listeners won't be able to see that. I give a very shocked face. When you said quadrupling, you know, residency and fellowship programs by 2035, up to 52, nearly 1,000 residents by the next 10 years, how are you planning for that infrastructure and all the resources you're going to need?
- [03:53]
A
Yeah, it's very deliberate. It's very fast moving. So I personally find that really exciting. I love the building phase and kind of imagining what's going to be somewhere and then working to strategically get there. That said, it's a lot of new programs and so each program requires, you know, applications, new faculty maybe who in departments that haven't had teaching faculty before, new program directors who are either joining us as physician leaders or who are entering into a new role as a physician leader within Sutter Health. And then the staffing that happens behind that to support the residents that I call it the care and feeding of residents. It's a, it's a daily task and journey and it's a huge commitment. And so we have to not just attend to building the programs but actually make sure that we're training them well and making sure they themselves are actually, well as they're on this journey with us.
- [04:51]
B
For other leaders at other health systems, what recommendations would you give if they're interested in also taking on this crazy task of quadrupling residency programs?
- [05:03]
A
Yeah, I think understanding that there is are resources to start graduate medical education programs. And so as you explore growth, especially in underserved areas in primary care specialties and in hospitals that haven't previously had graduate medical education programs. There are both, at least in the state of California, there's funding, grant funding through HCAI and Song Brown to actually pursue this and to support the startup phase, which is sometimes quite expensive. On top of that, you know, Medicare reimburses at least today, graduate medical education in the United States. And while it's, it's imperfect and it's different in different hospitals and settings. You can think very strategically about the resources necessary to start graduate medical education programs. And so it's a heavy lift, but it's sometimes not as fiscally resource intensive as one would imagine.
- [06:00]
B
That was surprising. Whenever you started this journey.
- [06:04]
A
It was surprising to think about it in a different way. I'll give you a great example. When you start a graduate medical education program, you have a five year window in a new hospital to build programs. You have to go very, very fast and kind of deep within one hospital in order to be able to achieve the funding, being strategic about starting things. Like there are transitional year programs that are one year programs for people going into specialties like radiology or anesthesia. And you can start those programs and then later actually convert those slots into fellowships and medical subspecialties. And so it's. You have to sort of begin with the end in mind and think deliberately about really kind of starting bigger than you might otherwise start in order to maximize the opportunities for medical education, especially in a really large medical center.
- [07:01]
B
It's a heavy lift.
- [07:02]
A
It's a heavy lift.
- [07:03]
B
It's not a two and a half pound dumbbell.
- [07:05]
A
It is not.
- [07:09]
B
I want to make sure we have enough time to, you know, talk about your other priorities. Outside of obviously this really incredible work with gme, what other priorities would you say are top of mind for the rest of 2025 for Sutter Health?
- [07:24]
A
I think, you know, we're really focused on expanding access. So we've talked about the physician workforce. We're also looking at opening more care centers. We've talked about sort of that next generation and building local pipelines. We want to make sure that we're creating great learning environments where our learners are thriving, where also our physicians are thriving. And that's been really an incredible partnership that I've seen since I've started at Sutter Health is the relationship between Sutter Health and the physicians that are working within our hospitals and our ambulatory centers. And then there's just a huge focus right now, obviously on the patient experience. And so we want to make sure that we're providing seamless, digital, personalized care. And we want to make sure that we're teaching our residents and fellows and our medical students within our walls how to practice medicine in this ever changing environment, including AI, including virtual care. It's a really different system than it was when I trained and it's going to be different tomorrow and it's going to be different in 10 years. So I think that's A really critical piece to the journey right now of being a learning health system. I'll also say, personally speaking, we've been doing a lot of work in undergraduate medical education, which is thinking about going earlier, going upstream to think about medical students. So we have nine schools that we have affiliations with and we have a really exciting deepened partnership with Charles R. Drew University, which is based in Los Angeles and is the first historically black medical school west of the Mississippi. And so we've been committed to helping their students pursue research and scholarship and then their clinical training with us. So that's been a really exciting journey for us. It's a great time to be at Sutter Health.
- [09:17]
B
Yeah, your mention of the patient experience, I really want to tap more into that with just higher acuity, higher patient volumes across the board, and even further projections of, you know, more patients, even higher acute cases, and a smaller pool of physicians who can care for them. You said, you know, in five years from now, kind of that training, education needed is going to be different. What are you already kind of planting seeds for?
- [09:50]
A
That's a great question. I think we want to be focused on making care easier. We want care to be easier for our patients to access. So whether that means on demand video visits, two way texting, you know, really utilizing technology so that, you know, even personally, year over year, I'm seeing it so much easier to, to get help in the care that I'm seeking for my family, for myself. And we want that to be accessible and just kind of, you know, in your pocket. So that's really critical. I think also, you know, on the flip side of that, physicians are really busy and in the era of new technology, work never stops. And that's a great thing. But it also means we have to be really careful to set up infrastructures where our physicians are doing their, their best work and their most critical work and having support, whether through nursing or through advanced practice clinicians, so that things that can be managed by other team members and really relieve the physicians of that type of work. And so technology plays into that. It's amazing. And then also I think I would add, when you are a physician and you're caring for large numbers of patients, especially in primary care, you're thinking about things on a population health level being able to pull information from digital technology, wearables, to understand what people are doing in real time and intervene and intervene in a digital way. That's all possible now in a way that it really wasn't even possible five years ago. So tons of exciting work and then making sure that our current doctors and our incoming physicians are all training on how to do this effectively, efficiently, and in a way that really serves our patients and communities.
- [11:42]
B
You mentioned before also you felt like whenever you joined Better Health, you saw a really strong relationship between the organization and the current physicians. Right. And that support, I just always go to the advice piece for maybe other, you know, for listeners who are struggling for that. Any kind of recommendations for them to find that foundation?
- [12:02]
A
Yes, I think that's been very deliberate. Our CEO, Warner Thomas, has been very committed to ongoing communication. And so that means bringing people together on a regular cadence and listening and also providing information and updates and communicating strategy. And so it can be very easy, especially in a large health system like this, I think, for people to retreat into their silos, whether it's their hospital or their office or their specialty and department. And so as you're spreading messages and strategic imperatives and really trying to over communicate, I think that's been a key success of Sutter Health in the last few years because of Warner. And in that sometimes I think the business of medicine can stay on the side of the business of medicine and the physicians can stay on the physician care delivery, on the care of patients and their specialty. That bridging that is very critical. Making sure that as a business in healthcare, that you have physicians at the table is crucial. I've been really excited to see that at Sutter Health because we have new service lines we're expanding and better connecting services like cancer care and heart and vascular care, orthopedics, neuroscience. In each of those service lines and those settings, there's partnership between physician leaders and administrative leaders. I personally am, as a physician leader in education, have an administrative partner. And so we work in tandem in these dyad partnerships. And I think those also are key.
- [13:41]
B
We only have a few minutes left, and I want to give you as much time as possible. What have we not touched on yet that you'd really want to highlight?
- [13:50]
A
I think we covered everything. I wanted to just say education is part of our strategy for both growth and for patient experience. And we're thinking proactively about our future physician workforce and the skills and experiences that are needed for tomorrow's doctors. We're really committed to raising that next generation of physicians.
- [14:10]
B
Wonderful. And we're excited to do that. And thank you so much, Dr. Mazzotti, for joining us today. I really appreciate it.
- [14:17]
A
You bet. It's been a pleasure. Thank you.