TEDxPhiladelphia runs Friday at Temple University in front of a sold-out crowd. The theme is Philadelphia as the “New Workshop of the World.” This is one of several Q&As with scheduled speakers.
“Visionary,” “ambitious,” and “disruptor” are just of few of the words that have been used to describe Dr. Stephen Klasko, the recently appointed president and CEO of Thomas Jefferson University and TJU Health System. But the list of adjectives would be incomplete without also including “plainspoken,”and even “entertaining,” both rare epithets for a hospital administrator.
A native of the Philadelphia-region, he previously served as the dean of the University of South Florida medical school where, during his nine-year tenure, he delivered on a controversial plan to turn that institution into a regional powerhouse. Before running USF Health, he was dean of Drexel University’s College of Medicine.
Klasko has blazed a distinctive path through the realm of healthcare. He worked as a professional disc jockey before going to med school. He went into private practice, delivered 2,500 babies in Allentown, then “got involved in academic medicine in a weird way,” Klasko said. He had an epiphany provoked by hearing doctors, mostly men, talk about hysterectomies in ways women never would. That prompted him to get involved with the creation of new patient-friendly medical devices.
Later, in the 1990s, he had another epiphany after noticing how often doctors complained about how difficult it was to practice the business of medicine.
“We had all these smart people whining,” Klasko said. “I thought if I can deliver a 9-pound baby through a small hole, I think I can figure this out.”
So he enrolled at Wharton, earned his MBA, and along the way investigated what makes doctors different when it comes to adapting to change. Said Klasko: “It led to some interesting theories.”
Those theories spurred him to write a “science fiction medical business book” called The Phantom Stethoscope, which is still available on Amazon, he said, “for about 1 cent.”
The Phantom Stethoscope was successful beyond Klasko’s wildest imaginings, partly due to a happy accident.
“You know about Amazon’s matching feature, the algorithm that suggests other books? Well, they matched my book with the last Harry Potter book and it sold 50,000 copies in one week. I can only imagine the bunch of pissed-off 12-year-olds who ordered it.”
Philly.com: What was the book about?
Klasko: In medical school, every med student finds out where they’re doing their residency at noon on the same day. In my book, at 11:59 a.m., right before a student is about to find out, she’s abducted by three-gendered aliens who return her to Earth years later, and re-implant the technological knowledge she needs to be a surgical resident. But they forget to implant the business, ethical, legal and social knowledge she needs. So she starts her residency with a 20-year-old view of the profession. It’s a parody of what’s wrong with medical students today.
Bottom line: The aliens feel bad, and get together with some folks from Wharton and teach her what she needs to know.
After publishing it, I thought my career was over.
What happened next?
Hard to believe, but the book became a textbook used around the country.
It’s probably the only three-gender alien book ever reviewed by the JAMA (The Journal of the American Medical Association), who said that while quirky it was ‘a must read for every board member and anyone else who wants to understand the challenges of medicine in the future’.
What will be the topic of your TED Talk? I assume it’s about health care.
My research has been about what we forget to teach in medical school and why healthcare has not evolved like other consumer industries. For example: How come you can go on Kayak and book a flight while you’re talking to me on the phone? But if you have a stomach ache you can’t make an appointment with a doctor on your iPhone. You should be able to put “stomach ache” into your iPhone and immediately get a Jefferson physician.
Think of Uber (an app-based taxi service). Uber has revolutionized what you can do in transportation as a transactional thing.
What I’ll have is a preview of what we’ll be announcing at Jefferson on April 10, a major initiative that will allow patients to access physicians from their smartphones anytime of the day through Telehealth.
You’ve hinted there’ll be even more in store for Jefferson.
During the TED Talk, I’m going to come to you as if it were March 28, 2024 - the 200th anniversary of Thomas Jefferson University. At that point, I’ll be the CEO of Stevie’s Vinyl Emporium on South Street and the former CEO of Jefferson University. I will have recently retired after leading us to unprecedented growth over 11 years and will now be running a vinyl record shop on South Street.
For decades, we talked about spiraling costs and what we could do to reign them in. But there we were in 2014 talking about the same thing. Then, from 2014 on, folks like Jefferson really changed the dynamic.
When I first started at Jefferson, someone told me there are two things you don’t want to run: academics and healthcare. He said it would be impossible to move them along. So I chose both.
Adidas once had a marketing campaign I really liked. It said “Impossible is just a big word thrown around by small men and women who find it easier to live the life they have been given rather than explore the power we have to change it.”
Impossible is not a fact, it’s an opinion. So in 2014 we decided to do the impossible and part of that impossible will be what we announced on April 10, 2014 with the unveiling of Jefferson 3.0 .
What other changes need to occur?
The first is about the way we select and educate physicians. Right now, it’s like signing them up for a cult.
We still accept students based their science grade point average, their grades in biochem and organic chemistry, and how well they perform on the multiple choice MCATs.
And somehow we’re amazed that doctors aren’t more empathetic and creative.
We’ll be changing our selection process so that it’s also based on emotional intelligence.
Not only that, we’ll change our curriculum. It used to be if I knew 19 reasons someone had a disease and you only knew 15, I’d be considered the better doctor. But now we have all that information on our iPhones - so it’s meaningless.
We’ll focus on the art of attending, sharpening the observational skills of health students by looking at art and listening to music in order to help understand what patients are telling us - not just memorizing the 19 reasons behind a disease.
We’re calling it changing the DNA of healthcare, one student at a time.
And if Telehealth is going to be a primary way of delivering health care in the future, Jefferson will be a primary place that delivers that.
In 2014, we really will become the first truly entrepreneurial medical center. How? As Yogi Berra might have said, “I can tell you about the future in one word: ‘Big Data’.” We’ll talk about how Jefferson is leveraging Big Data, integrating knowledge gained from realms of finance and sports to understand things better.
And then I’ll end it with Jefferson in 2024 getting the No. 1 ranking from U.S. News and Interplanetary Report as determined by all sorts of new rankings based on reality, as opposed to rankings based on the past.
What would the new “reality rankings” measure?
One example would be the new BUB Quotient. It stands for “Believable Understandable Bill.” Why? Because you should have enough respect for your patients that they can understand what they’re being charged for. That will be one thing that didn't exist in 2014.
That’s something we can all get behind! Before we bring this to a close, do you have a favorite TED Talk?
I have a couple. One of my favorites was a talk about how we start to really look at genomics not just as a research enterprise but as a way to look at people as individuals. Instead of giving you treatment based on 2,000 people that look like you, we can customize your care and treat you like an individual.
There are three others:
“It’s Time to Redesign Medical Data” by Thomas Goetz ties in well with my "BUB" Quotient parameter, consumer experience improvements in general, and delivering actionable data with trend analyses that could lead a patient to focus on taking charge of their wellness.
“The Next Species of Human” by Juan Enriquez. The segment most relevant to medicine in this talk starts at the 8th minute when he starts to talk about the future of genomics and stem cell research and "bionics," yup, bionics - the fusion of technology and hominids as the next stage of evolution.
And “How Schools Kill Creativity” by Sir Ken Robinson. In this talk he also talks about some of the key factors of intelligence (diverse, dynamic, distinct) and elaborates on these with great examples and stories.