Don’t Rush Anywhere Ever (ft. Diane Sliwka)

The elephant in the room was, wait a second, we as the providers are struggling so much to just do the work that we're doing and nobody's paid attention to this. There's no way we could make a better experience for patients until somebody takes care of this problem of how difficult the work is and how much we are ourselves burning out.

Yeah, and you ultimately built a program with your team where you received the AMA Joy of Medicine Gold Award.

This gives, I think, systems of roadmap to, to know what should we be doing to make these things better. And receiving that felt like such an honor.

Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marx.

Welcome to another edition of Digital Voices. I'm with another awesome person, Dr. Diane Slivka. Diane, welcome to Digital Voices.

Thank you.

Diane, you have this incredible, uh, title of everything that you do, and just some of it, some of the highlights is like hospitalist physician, a professor, chief physician experience officer. You do a lot on the side as well as a professional and life coach, well-being-centered leadership advisor, just really cool things. So I'm really looking forward to sort of digging in a little bit and getting to know more about you and all the different things that you do. And so we basically met because I stalked you online. I was like, wow, this is like an interesting clinician leader at UCSF. And it's like, wow, I'd really like to share a little bit of Diane with my audience because I think you have a lot to offer. So that's sort of how you first met. Diane, as much as we're going to have so many super important questions, the most important one of all is what songs are on your playlist? Like, what kind of music do you like to listen to?

Oh my gosh. Okay. I consider myself an eclectic playlist kind of person. I like to collect songs from different people in my life. But if I was to highlight some of my favorites, I do have kind of a playlist that is my expansive life project playlist. And My favorite, favorite top, top band right now is Cloud Cult. Have you heard of them?

I've not, but we have a Digital Voices playlist on Spotify. We're going to add this.

You do?

Cloud Cult. Um, and a few of— let's see, I could, I could give you a couple of names of songs that are really great if you want them. One is called No Hell. One is called, um, As Beautiful as It Hurts. And then I'll say a couple more that I'm thinking of that are kind of my life-guiding songs right now. So Sara Bareilles and her song Brave, because you need a lot of bravery in the world that we live in. And then she's also co-written a song, or actually she's sung a song with Brandi Carlile called Salt and Sour and Sweet, and it is based on a poet who's recently passed away named Andrea Gibson, who just has this remarkable, remarkable body of work around life and how we could be looking at it differently. So yeah, those are a couple bands I would direct people to.

I love it because I believe those will be the first time anyone's mentioned those out of 346 episodes. So as I mentioned, we have our own playlist on Spotify. And so I listen to it like when I'm making up the scripts, I'll always put on that Spotify playlist. So this is great. What about life message and mantra? Are there sort of words that guide you, inspire you that, you know, how you live?

Uh, one, the most, the most forefront of my mind right now is one, I actually have a little Post-it to myself on my computer. It's don't rush anywhere ever. And that comes up for me a million times a day, and it's really about like, coming back to presence and slowing down. And it serves me in so many ways, I would say. I learned it from Dan Ziegmond, who is a meditation teacher, a Zen meditation teacher. And it was at the end of a weekend of meditation retreat, and he said this to us as we were leaving. He said, try not to rush out of here as you leave this 3-day meditation weekend. And then he said, and actually try not to rush anywhere ever in your life. And that has now stuck with me for 2 years and it's like a daily, daily remembrance for me to just slow down and be present.

I love that. Yeah, that's a word for me too. I need more of that in my life. I think we all do, right? We're all— it's just the way society is today. At least in the West, and it's kind of crazy. I think we have a lot to learn from other societies that don't rush everywhere, every day, all the time. All right, tell us a little bit more about who you are. Like you have the most interesting last name, Slivka. Tell us your story, like your life growing up.

My life story. Okay, let's see. Let's see if I can make this brief. So I grew up in a Polish family. My name is Polish, to parents who were immigrants from Poland and came to the United States. in their 20s in search of the American dream. And their focus for me was very much to do well in school, which as a dutiful daughter I did. And eventually kind of went through my teen years and had this simultaneous understanding of I wanted to do well and be successful in life, But also kind of that rebellion of, that's not all, that's not the point. The point is not the achievement and the success. The point is something else, and it is much more alive and much more experiential. And I had this kind of philosophy that I think just started at that time of life and kind of grew up into adulthood always focusing on how could I create you know, a life that felt good for me, felt good for people around me. That's always been a central focus of my work and life, I would say. But went into college, eventually ended up in medical school. All my education was in New England. And then I think the, you know, the true adult part of my life came as I started to become an attending physician and, you When you're done with school and starting to realize, okay, like, what now? You've been on this path of kind of just achievement and getting to where you're going, and then suddenly the world is open and you're like, what do I do now? And I think I over time started to pursue, you know, things that were of interest that then grew into, oh, the world needs this.

Yeah.

And often it was just little things that I'd be like, oh, there's this thing, opportunity you say yes to. And then, you know, all of a sudden you're in like a whole new— you've opened almost like a whole new portal of work. And I would say a lot of the major bodies of work that I grew into were like that, like patient experience leadership work or running communication skills training for clinicians or the wellbeing work for clinicians in healthcare and helping with burnout and the organizational approaches to that. All of that, I think, grew out of, again, just like looking for what is interesting, what is needed, and what are people asking me to work on.

Right. And, you know, you mentioned you had immigrant parents. What's one thing, have you ever thought like, what's one thing that they really instilled in you as a result of that?

Oh gosh. I just have so much pride in them, really. I think, you know, their story was a common immigrant story, I think, of just kind of leaving everything behind, one suitcase, starting over. And very much, especially from my dad, it was kind of wanting to build a good life for myself and my sister and just the Watching how hard they worked, watching how much they sacrificed, it was both— it's both I have so much respect for what they did, and even the things that were hard on me in my life from them, you know, I have now so much compassion for why they were hard on me and why they were, you know, the way they were. But also just the bravery, the strength they had, the resilience they had. And the benefit of hard work and how much they built out of really nothing. And, you know, they weren't well-to-do, they didn't go to college, they didn't have people handing them anything, and they built so much out of, you know, just starting over basically as adults. And I think there's a little bit of that resilience and like understanding that, oh, Like, one can, you know, I believe we all have, you know, different access to opportunities, and that is a problem in our society. So I don't pretend like everything is, you know, something I can build and work towards and effort around. But there is a lot that we can do when we focus and pay attention and conserve our energy and dedicate it to something that we're trying to build. And so I think there's— Um, there's a lot of that in me. Um, yeah, maybe I'll just leave it at that for now.

Yeah, it's, it's, it's always fascinating to me and it's, it's, yeah, the fabric of who you are as a result of, of them making that, that decision. So that's pretty cool. What about a pivotal moment? I want to talk about your career here in a second, but was there a pivotal moment growing up in life, or maybe it was early career that fundamentally changed your trajectory?

Well, I mean, if you're asking about early in life, I think the most, let's see, a couple. One was my dad actually when I was probably 5 years old and I told him I wanted to be a model. 'Cause even then I like the superficiality of our culture had somehow infiltrated me. I, and he said, he basically said, I mean, he was a factory worker, you know, he was not like white collar educated.

Yeah.

And he said, Diane, I think that you are so smart. He's like, I think that you could do something with your intelligence, with your brain that will last you forever. Modeling will last you for a short amount of time. You know, your appearance is like— he basically helped me see appearance as like a fleeting thing and not the priority. And somehow that just— I still remember that. Like, I remember standing in the garage with him as a little girl and him saying that and just how much that stayed with me. And Yeah, just carrying forward. I think that I— his belief in me actually in that way, I think, uh, really has carried with me for a very long time.

Yeah, that's cool. So ultimately, yeah, you follow his advice and you head into healthcare. So what led you to become a hospitalist and then also later on, you know, more into life coaching, sort of helping other people?

Yeah. Um, okay. Well, the first part of going into hospital medicine Well, once I think medicine was, you know, I considered such a noble profession. I think being able to learn and have knowledge that helps can help anybody. It's a respected profession. It's something that has longevity over time. You're constantly learning and you're constantly helping and able to help in a way that everybody needs. So that is just beautiful to me. Hospital medicine itself is A subset of internal medicine, which is, I would say, a broad way of looking at, you know, how we take care of patients in non-surgical ways, but more medical ways. Like people come in with problems with pneumonia or infections or all kinds of different things. And the breadth of, the breadth of medicine was one of the things that attracted me to it. Just you, You'd never, you know, a lot about a lot of things. And that always made sense to me. It didn't make sense to me to narrow myself to one small thing. In fact, that kind of seemed boring to me in a way, even though you could become deeply an expert in one thing.

Yeah, it makes total sense. And experience. So that's, that's one of my areas of passion, super into patient experience in particular. And you moved directly into that realm, both on the patient and provider experience side. So How did that evolve? Like, I'm sure it wasn't one day you had this sudden epiphany, but probably over time. Tell us how that happened.

Well, there's kind of a deep answer to this and a superficial answer to this. The deep answer to this, which is perhaps more interesting, is so we all have ways that we're psychologically wired and there's a personality test Yeah. That can help people understand their psychological wiring is called the Enneagram. I'll just put it out there. And my type would suggest that I am wired around not having pain and deprivation, which means that I actually, as a result of my growing up and things I experienced in my nature, I tend to like to create my own happiness, I tend to like to create happiness for other people, it turns out. And so I'm often looking at the world with a lens of, oh, like, what's the bright side of this? What's the cup-half-full side of this? And so I didn't learn about that until after I was actually in these roles, but once I kind of did this, like, understood this about how I was psychologically patterned, like, everything else in my work life kind of made sense. Because it's actually all organized around helping people feel better.

Yeah.

In all environments, which I think is hilarious. I just thought that was like so astounding to me once I kind of like did this test and like learned this about myself. The less deep answer to this is, you know, in healthcare, there was a need over time that suddenly became a financial mandate for hospitals to look at how patients are experiencing their care, which previous to this, You know, there were patient experience surveys, but until there's a financial mandate to, for hospitals or healthcare systems to look at this, it's kind of on the back burner. It's a little bit, you know, like less important than a lot of other things that are still important. And so once it became financially imperative, the hospitals needed people to start like looking at this and how are we going to improve? How are we gonna receive feedback from patients and respond to it and like change how the system works? And so I started, you know, I was asked initially to do that for hospital medicine and then for the whole system as that, as I, you know, in the early years, I was one of the only people who was early doing that. And in looking at the patient experience, the most impactful thing, it turns out, that clinicians can do is how they communicate with patients. There are a lot of other parts of the patient's experience that are the responsibility of a lot of team members on the healthcare team. But for physicians, so much of it is about how we communicate in order to care for patients and hear people and communicate back what they need to understand and help them make decisions. And so that began all the work in communication for me and how do I help providers be better communicators, something that we had not focused on prior to that work. But as I was in front of all these groups of clinicians trying to talk about how do we take care of patients better, how do we deal with the patient experience, the elephant in the room presentation after presentation was, wait a second, we as the providers are struggling so much to just do the work that we're doing and nobody's paid attention to this. There's no way we could— make a better experience for patients until somebody takes care of this problem of how burdensome the work is, how difficult the work is, and how much we are ourselves burning out. And that's not how they said it. They said it in different terms than that, but I was receiving that message. You know, people would just be looking at me like, you're crazy, lady. Like, we're, we can't like do any more than we're doing. We're already stretched way too thin.

Yeah.

And so, I basically started to say, we need to look at this, we need to measure this. And, it took 2 years actually before I started— I recognized we needed to look at this problem and do something about it to get kind of the system to agree, yeah, we should study this, we should look at this. And, we finally surveyed the clinicians, the physicians. And, when we did that, I mean, it was like, Whoa. You know, all of a sudden, all of this anecdote that I was hearing here and there was a set of data quantitated. And people in leadership suddenly said, oh my goodness, like, we didn't realize how bad this was. We didn't realize what was happening. And so, I think that, like, measuring it and being able to describe that was the turning point for that body of work. And then it started small. It started as, you know, a tiny 10% of my job. And then over time, it's become my entire job at UCSF is really working on how do we build systems and culture and help improve the work so that clinicians can do their work, their best work, and take care of patients better.

Yeah. And you ultimately built a program with your team where you received the AMA Joy of Medicine Gold Award. So that's like top honor. So for those who are listening and watching, tell us a little bit about the Joy of Medicine Award.

The American Medical Association has been leading this effort to recognize health systems for implementing best practices as they are known now to help with physician burnout, clinician burnout and wellbeing. This isn't just about physicians, I should say. It is about, you know, helping the people who work in healthcare to have more professional fulfillment and less burnout. And the award is actually a very rigorous measure of all of the kinds of— you have to demonstrate basically what you have done as a system to show that you are measuring, that you are holding people accountable to the results of this kind of work, that you're working on leadership, teamwork, support. clinical work efficiency. And it's not the kind of thing where you can just check a box and say it's done. You actually have to provide supporting data and supporting documents and show that, you know, you've invested really in this work and can show the results of it. And I was actually quite impressed with the process of that. And the, I mean, honored to receive that highest award as it exists Yeah. You know, I will say that it's still a field that we are learning how to solve because the problems of burnout among clinicians and among actually even beyond clinicians, I think in healthcare administrators, leaders are also in a lot of ways struggling because of the environment, the financial environment, and in addition to the work itself being quite intense. But this gives, I think, systems a roadmap to know what should we be doing to make these things better. And receiving that felt like such an honor just because I had, at this point, I had been working on this for a decade and I thought it was good, but it's just really validating to see an external organization recognize that work.

Yeah, no doubt about that. Dan, you and UCSF have a lot to be proud of. So some people might say, well, that's UCSF, or that's Cleveland Clinic, Mayo Clinic. What if— what counsel or advice, like if there's maybe one or two things a smaller hospital, that leadership that might be listening, what are one— and they, they don't have a full-time role for someone— what's maybe one or two things that you think help move the needle? Obviously there's probably not one major thing that's going to solve everything. You probably made a lot of really healthy smaller choices, that led to the Joy of Medicine Gold Award. But what would one or two pieces of advice that you might offer?

I think the most important thing is for leadership to be listening to the frontline. And that can be done in surveys that are nationally validated surveys, or it can be done by a simple— you create your own little thing or sit in a room with a group of people and ask some questions and just Listen or collect that information and then do something with that information. And that is as simple as it is. And all of the fancy ways we do it can be replicated in very, very simple ways that are not fancy and don't cost anything except for somebody's time.

Okay, so I've alluded to this a couple of times. You do a little bit on life coaching, Some advising, the expansive life project. Tell us a little bit about that side of who you are.

Yeah, so I am transitioning into a kind of new chapter of my own career, and that is I've really taken a bit of a pivot away from how I have focused my work life in the last Yeah. —which is working at the organization and system level and culture in organizations. And I'm now really more interested in how do we work in ourselves, like on ourselves actually, and how that impacts how we show up in the world, and then how we show up in our work, and then how society is actually impacted by that.

Yeah.

So part of that developed through my own midlife kind of journey, the hero's journey of going through what happens when you're approaching age 50, and experiencing that for myself. And then I actually landed on a beautiful, inspiring woman named Martha Beck who has written some beautiful books, and one of them was Yeah. Is called The Way of Integrity, and that book totally flipped me actually to just recognizing— I think one of the principles in that book is around— actually her main principle, her whole guiding principle around her work I think is understanding that there is a true self, essential self that we have, and then a social self that we have, and that when those 2 things are very distant from each other, the way we live, because we're in conflict in ourselves, and that conflict in ourselves creates all kinds of deterioration in our well-being, and then that, you know, impacts everything around us, and then I think that's how we end up in societal problems. So, you know, I think that's a long way to say that part of my helping people to address this is through coaching and working with people in groups or one-on-one in helping them figure out for themselves where are they not aligned with their true selves and how is that impacting them, and do they want to do that or do they want to start living from a place of more true self? And then part of it is bigger than that, and I think I have this passion now around helping people in midlife transition But the Expansive Life Project, the principles behind it are broader than midlife. My focus happens to be in this midlife transition phase because I have most credibility in it right now because I've just been in it. I'm still in it. But I'm interested now in beyond healthcare, actually how we just show up in our lives and helping people feel better in their lives in general in this phase of life.

Yeah, I, I, it's critically important. And like you're saying, not many people get, go there, get there. It takes a little bit of work to get that alignment, get your identity, uh, because there is like all this friction and it shows up in the workplace and all aspects of life. So, uh, I completely endorse what you're doing and we'll put it in the show notes a little bit on how to get ahold of you in terms of the Expansive Life Project. Oh man, there's so much more to, to talk about. Um, but I, I do want to learn a little bit about— tell us about your role at UCSF. What is it like daily as a Chief Physician Experience Officer? Like, I imagine there's not a set day, but like, give us a, give us a sense of some of the things that, that you're responsible for.

Um, yeah, so one of the things is I oversee the measurement of how our clinicians are doing in the work environment. So a lot of my work is centered around getting that data, interpreting that data, reporting it to leadership, and helping leadership understand how do we then do something with that in the organization. And that happens at the highest levels of leadership, like with executives or chairs of departments, but it also is through lots of groups of people who are trying to do great leadership. And so, you know, I might be meeting with a group that works on diversity, equity, and inclusion, or I might be working with— going to talk to a division, like, of rheumatology and just giving them kind of a talk or a discussion, or I might be going into a department and holding a listening session to get more rich information because they want to actually impact their data better. So, things like that. I spend a lot of time meeting with people and talking to people. I would say there's a huge role for just hearing and listening to what people's struggles are, and then trying to use that to inform, okay, how can we be actually helping people? And some of what helps people is being heard and knowing that someone is taking that information and doing something with it. Well-being and the work of well-being is almost everything in the work environment. So, in some ways, in my role, I do get pulled into a lot of different committees and things because I am the face, I think. I represent this principle of we actually need to balance finances and quality and safety and patient experience with what is happening for our people. And that's a priority. And so, I view my role as being the face of that and representing that. And raising my hand and being like, hey, did we think about this when we did this thing? And over time, what's happened is, you know, we've built structures such that I don't have to be in the room for people to think of that. And that's the coolest thing, I think. But yeah, still worth always the person in the room to raise their hand and be representing that voice.

Dan, this is You're a pretty amazing individual. They're super lucky to have you because you're super practical and just very open, different ideas, great communicator. I loved our conversation. We talked about a lot of things, didn't get to half the things that we wanted to, but that means that we'll just have to have you back. But we talked about everything from music, and we've got some new music to add, Cloud Cult specifically, we're going to add. And then you gave us some other songs. We'll put those again in the show notes. And then, you know, really importantly, and it comes through in your style, Is don't rush. You know, slow down, enjoy the moment, enjoy life. We learned a lot about your family, and they were immigrants from from Poland. That instilled a lot of resiliency in you and a great work ethic, and just influence overall of your mom and dad in your life. And then we talked a lot about patient experience and the importance of that, and also on your personal development, right? Almost saying you the better you are inside and aligned with who you really are, I think the more effective you are or the more you enjoy life, those sort of things. So spot on. We'll put all that information in the show notes. What did I miss, or is there anything you want to double down on? Diane, I'll give you the last word.

Oh, we could talk for hours. Um, but no, I think you captured it beautifully. Um, thank you. I'm just honored to have been here. Appreciate it.

Awesome person. Can't wait to see you in person someday. Thank you so much for being on.

Thanks.

Thank you for listening to Digital Voices We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.