Leading Quality
Welcome to Leading Quality, the show that dives into the real-world stories and strategies of healthcare quality improvement leaders at all levels, from Frontline Champions to C-Suite Executives. Each episode uncovers how these dedicated professionals tackle complex topics in real healthcare environments. Discussion range from QI fundamentals, to leadership, technology, AI, and beyond. If you’re passionate about elevating patient care and want practical insights that go beyond the buzzwords, this podcast is for you. Tune in for inspirational conversations, innovative frameworks, and the behind-the-scenes details you won’t hear anywhere else, and discover how you, too, can lead quality improvement from wherever you stand in healthcare.
Leading Quality
Finding Joy in Healthcare: One Physician's Journey from Burnout to Advocacy
Dr. Lawrence Yang's powerful story begins with a stark confession: "My body had to say no for me because I didn't know how to do it myself." This candid admission sets the tone for a conversation that weaves together personal vulnerability, system transformation, and the science of hope.
As a family physician who once installed a bedroom and shower in his clinic to work longer hours, Dr. Yang's burnout journey will resonate with healthcare professionals everywhere. His turning point came through an unexpected avenue—quality improvement science—which provided both methodology and community when he needed it most. "I think quality improvement science is a science of hope," he explains, revealing how structured approaches to system problems can alleviate the moral distress that accompanies witnessing poor care experiences repeatedly.
The conversation explores British Columbia's innovative Physician Quality Improvement program, which has trained nearly 800 physicians through a unique collaboration between government and clinicians. This "silent army" represents tremendous potential for healthcare transformation, demonstrating what's possible when improvement capacity is intentionally built at scale. Dr. Yang artfully distinguishes between moral injury, moral distress, and burnout, while explaining how joy in work requires leaders to facilitate safety, purpose, autonomy, community, fairness, and recognition.
Looking toward 2030, Dr. Yang envisions primary care transformation through honest quality assessment, team-based models enabling everyone to work at top-of-scope, and transparent metrics aligned with the "sextuple aim." His advice to new clinicians cuts through professional martyrdom culture with refreshing clarity: "The system will not benefit from your martyrdom. What's in your job description is to model sustainability and wellness for your patients, colleagues, and family members."
This conversation isn't just about surviving in healthcare—it's about finding the courage to bring our full selves to the work we care about, and in doing so, creating the conditions for healthcare transformation. What might be possible if we approached system change with both vulnerability and courage? Dr. Yang's journey suggests the answer could be revolutionary.
My body actually had to say no for me because I didn't know how to do it myself. Every person who goes to work is actually on a gradient towards unwellness. I think quality improvement science is a science of hope.
Jason:Welcome to Leading Quality, the podcast spotlighting the people moving healthcare forward from the front lines to the C-suite. I'm your host, Jason Meadows. Today's guest is someone whose energy and authenticity I deeply admire. Dr Lawrence Yang is a family physician in Surrey, British Columbia, and while he's held leadership roles and done incredible work in data and quality and systems change, what really stands out about Lawrence is how openly and courageously he's talked about burnout. He's taken something that so many physicians quietly struggle with and turned it into a mission, not just to survive the system but to help change it. He's been leading wellness and leadership workshops across Canada and recently brought that work to the Institute for Healthcare Improvement Annual Forum, which tells you something about how widely this message is resonating. This conversation is about joy and work, but more importantly, it's about what happens when we're brave enough to bring our full selves, even the painful parts, to the work we care about. I'm grateful to have Lawrence here to share his story. Dr Lawrence Yang, welcome to the podcast.
Lawrence:Thanks so much, jason. It's a pleasure to be here. I'm excited for your podcast and I'm excited to be here.
Jason:Well, thanks so much. I'll jump right into your origin and your background because I'm really excited here. Well, thanks so much. You know I'll jump right into your origin and your background because I'm really excited. Even though we've known each other full disclosure for a few years, with social media connection, with meeting every year at the IHI I think there's a lot we can delve into about you, and so I'd like to do that right now if I could. One thing that might be a good place to start is you've had this experience that is an increasingly common experience in Canada these days, which is having studied and worked in medicine in both the US and Canada, and I wonder how this shapes your view of primary care systems and the work that you do.
Lawrence:Yeah, thank you. So yeah, I did my residency at Will Cornell Medical College in Brooklyn, new York, and after that I practiced in Long Island, new York, in the urgent care setting. So during my residency I had experience of an inner city family medicine clinic. I followed and learned from preceptors and mentors who worked both in the clinic as well as in the hospital seeing their own patients who are admitted into the city hospital. I remember working with the challenges of billing different insurers and the challenges of getting funding as a clinician for the clinical work that we did. That's very different in Canada, where we have pretty much a single payer, and so, aside from that, those are really the main differences that I've noticed. I think both US and Canada suffer from a shortage of human resources right now shortage of physicians, some challenges with funding and forming adequate teams for primary care I think these are common challenges. Burnout in healthcare workers those are common challenges. So the funding is different in the systems, but a lot of the big challenges we face are very similar.
Jason:Yeah, it's such a valuable perspective and it really is humbling, isn't it, to see that both sides struggle perhaps a little differently, but with similar challenges, and I appreciate that perspective. Struggle perhaps a little differently, but with similar challenges, and I appreciate that perspective. Fast forwarding a bit, I'm curious what drew you to quality improvement rather than focusing entirely on clinical practice?
Lawrence:Well, I kind of happened upon quality improvement science accidentally. I was someone who was really devoted to running my own practice, being the owner-operator of a clinic in inner city, metro, urban, greater Vancouver, in a city called Surrey that you mentioned, surrey, british Columbia and I burnt out. I burnt out really quickly because I was managing and juggling all the business aspects, my human resources. I was my human resources department because I was managing and juggling all the business aspects. I was my human resources department. I was my leaseholder for my clinic. I was the person who was making sure there was nothing dangerous in my parking lot, while also trying to manage a full panel of over 2,000 patients with many complex challenges, including mental health challenges, addictions, chronic disease and many comorbid diseases. And the only thing I knew how to do was work harder and do more, spend more time in the clinic. I got to the place where I actually put a bedroom into my clinic. I hired a handyman to install a shower in my clinic so that I could spend more time in my clinic, because all I knew how to do was do more and, of course, I burnt out. I burnt out probably within the first three years of my career, from 2010 to 2013. And when I say I came across quality improvement by accident, what I meant is that I started to try to grow my circle. Having done training in the States and then practicing in Canada, I didn't really have all of the relationships that really make referral network awareness easier, so sometimes I really felt that I was working in a silo as a family practitioner. So as I tried to heal myself from burnout, I realized that growing my circle was a really important change idea and so I started to grow my circle, and in that circle was the CEO of my health authority.
Lawrence:In British Columbia we have about six different health authorities and at the time Fraser Health was led by a CEO named Michael Marshbank and I went up to him at one point because I was working in the hospital the hospital that I admitted my patients from my clinic to and I said my patients are having a lot of challenging experiences at the hospital. You know they're not experiencing trauma-informed care. I do my best in my clinic to provide that trauma-informed care, but when they get to the hospital it doesn't seem to exist. It's like there's no capacity for caring. And then michael said you know, this sounds like a problem. And it sounds like you really care about patient experiences, and I said, yes, I do. And then he said, well, in 2016 they started this program called physician qi, pqi, and physician qi was a project that was started by an anesthetist and a cardiologist.
Lawrence:The cardiologist has since passed away from health issues, but the anesthetist is Dr Kurt Smetcher, who I think you might have met before at IHI Forum, and what he did is he took he became aware of the Institute of Healthcare Improvements advisor program QI advisor program and he took a lot of that advisor program QI advisor program and he took a lot of that, the curriculum, and he modified it for a Canadian context and then he he brought that in and developed some mentorship and facilitation training for some, for folks like myself.
Lawrence:So I was taught by Kurt's met you're in around 2016, 2017, and then I became a faculty of that program and and it was just because I struck up that conversation with my CEO at the time of my health authority and he pointed me in that direction, saying that these intrepid physicians were already, who also cared about quality quality of care, had started a program, and so I started learning in that program and I spent over maybe 200 hours in learning action projects in classroom settings, just learning the science of improvement and practicing on my own projects. And then I became a faculty member of that program and I still teach there today. So that started in 2017. And here we are in 2025. I'm eight years into this quality improvement, teaching and spreading and workshop facilitation, and it's very meaningful work. I'm really, really stoked that I'm part of it.
Jason:I mean thank you so much for sharing that. I feel like there's a lot of power in that narrative that you just shared. It sounds like you were one of the early cohorts, perhaps, of this PQI program and that it's really changed the trajectory of your career and also perhaps was part of this awakening out of the burnout that you described.
Lawrence:Absolutely yeah. So, coming out of burnout, there really aren't too many supports in British Columbia and probably other jurisdictions as well. So, quality improvement, learning in a cohort, setting along with other clinicians of different backgrounds, that in itself, that building of that circle of support, that sense of community, was actually really, really healing. And at the same time you're all aligned in shared values around excellent human experiences in healthcare as well as a hope and an optimism for improved processes and especially for resource stewardship. One of the greatest impetuses for I don't know if that's a word, but one of the things that sparked off the Physician QI program was a sense that there's waste going on in our system, that there's a lot of people doing a lot of different things but they're not following a common methodology and they're trying a lot of things but they're not following a common methodology and they're trying a lot of things but it's not really sticking. So dr Kurt Smetcher and dr Jan corner, the late physician, dr Jan quarter, they knew that there are, there was a science to improvement and they brought that to our province through the Institute of Healthcare Improvement. And, yeah, it gives you, gives one, a lot of hope.
Lawrence:A lot of times when people are burnt out, it's because of the distress of seeing poor human experiences happen over and over again.
Lawrence:And when I got into healthcare and like when you got into healthcare, we got into it because we wanted people to have great experiences.
Lawrence:We want to be proud of the experiences that were a part of delivering for our patients in our service. But when that doesn't happen over and over again, we accumulate a moral distress and in some cases it's almost akin to vicarious trauma watching other people fall through the cracks of the system. It's a traumatic experience for some of us and that accumulated distress sometimes manifests as burnout and when sometimes the most healing thing is to take action in the other way to redesign systems, to be more humanistic, to redesign systems for better health outcomes and to reduce waste in the system. Just knowing that you can do something is a very powerful healing experience, and especially when you're doing it with new friends, people who share your vision, but they have other talents, they have other clinical foci, they have other resources that they're bringing to the fore and the chance to align some of these resources just in that kind of pure mission of improving things for humans. It's a very gratifying and a healing experience.
Jason:It sounds like the unexpected experience within the educational experience of QI for you was a therapeutic one. It was one where you discovered that people who wanted to learn improvement science also fought with difficult problems, problems which they maybe found were intractable and that were bigger than them.
Lawrence:Absolutely. I think a common realization, a common finding looking retrospectively back over the past eight years, is that I would say at least 90% of those who have found themselves and devoted their their time into learning quality improvement in our program the physician quality improvement program they expressed that they have experienced symptoms of burnout in the past and so much of it was related to a sense of hopelessness in the face of very complex challenges and complex problems where they didn't really have a clear roadmap on how to make those next steps and for them, the science of improvement, the methodologies of improvement, the model for improvement, all helped to be a remedy for some of that ambiguity and hopelessness. Yeah, I think quality improvement science is a science of hope.
Jason:Wow, that might be the quote for the day. That's really powerful, and thanks for sharing that. I like to shift a little bit to the current work that you're doing and where that's taking you. You've mentioned PQI, so the Physician Quality Improvement Program based out of British Columbia, to my understanding and I could be mistaken about this, but my understanding is that this may in fact be unique as a province-wide quality improvement training program within Canada. I'm not aware of any such program in the States or in Canada. What makes this model so effective?
Lawrence:and why don't we see it in other provinces? Do you think? I think the secret sauce to physician QI in British Columbia was really what we call the joint collaborative committees. Joint collaborative committees are committees of physicians and health ministry representatives, so government and physicians sitting together at a table and agreeing that we needed a way forward, and over 10 years ago they committed millions of dollars to paying physicians to cover their overhead from their clinical practices, while they took time out of their practices to learn the science of improvement. That is the secret sauce. Other practices to learn the science of improvement that is the secret sauce.
Lawrence:The advocacy that went into this, to allocating this public funding to this huge endeavor of creating capacity in the system for health system leadership in the form of skilled physicians who are skilled in quality improvement. That is at the crux of what made this possible. Now you mentioned it being successful. It's successful in that we have many alumni. We have probably almost 800 alumni within British Columbia, which is a fantastic number. But in terms of actual impacts in the system, we haven't effectively really measured those quintuple aim or even the sextuple aim impacts yet. But that's ongoing work right now.
Lawrence:We've been really focused in the past 10 years on building capacity, building people with the skills of a QI advisor and a clinician background, so we kind of have a latent army that's really ready to tackle some of the health system's greatest challenges. And yeah, that advocacy for this possibility of this physician activation was a key part of that. Historically, physicians have been seen as being full of counter will. It's kind of like the health ministry, the politicians, are trying to do something and physicians would often come in opposition of those because there was not a shared understanding of shared values. And this is a very rare occasion where physicians and health ministry have both agreed we need to use science when we approach health system redesign. So that's what really makes this unique.
Jason:Wow, I mean it sounds like a great problem to have that we're even having the conversation about. We haven't yet measured quintuple aim impacts of this, because it means that you've come far enough to be able to have educated this huge as you said, I think a silent army of clinicians who, you know, came into it from different backgrounds and different specialties, um, but are united in having done this. I mean, I think that's it's truly remarkable and I think a lot of people listening would be, uh, would be envious of having the problem of having the silent army that you're just trying to figure out a little more what to do with or how to measure the broader impacts of that. So I think that's really special. I wanted to shift towards something which I think has become, you know, one of the biggest focuses for you, which is your work on joy and work and your the experiences you've had with burnout that you've shared so candidly and so bravely and I really appreciate.
Jason:There was a quote that went something like this that I encountered when I was taking the school for change agents out of the NHS in England, and this is an online course. It's it's freely available. I'm not involved with them, but I was really impressed with what they did, so free plug for them. The quote went something like this there was a comic of a man looking a bit uncertain standing on a desert island and it said people aren't willing to set sail on an adventure if they don't feel secure on land. And this was intended to be a metaphor of the kind of the burnout, the joy and work, the psychological safety spectrum with QI which really can be venturing into new territory and maybe feeling a little insecure about that. I'm curious how you think about the joy and work and QI intersection.
Lawrence:Yeah, thank you. It's a little bit of a chicken or the egg thing. I think that unless a practitioner has some extra cognitive capacity that they've reserved in their lives extra cognitive capacity, extra empathic capacity unless you reserve some, it's actually very challenging to jump into quality improvement learning, because it's a new skill set, it's a new muscle, it's a new neurological muscle that you're using. I know that's not scientific, but I think you know what I mean. It's figuratively, but yeah, you kind of have to be well at a certain threshold in order to learn quality improvement effectively and to be an effective change agent. You also need to have a certain reserve of wellness. But that being said, those who do have that reserve of wellness, we have that opportunity to lead from wherever we are and to shift how we're being, such that we shift culture to be a healthier culture. The School for Change Agents really taught me things about what a change agent does. A change agent thinks in interdependent ways rather than individualistic ways. They're unreasonably optimistic that's what a change agent is but they are grounded in scientific and honest data analyses. So these are some of those things that really resonate with me when you talk about joint work. When I did the joint work training out of the IHI, and the IHI has a free white paper for anybody who's listening. You can download the white paper for joint work.
Lawrence:Some of the really key things that leaders need to facilitate in their clinic teams, in their hospital teams, is a sense of safety physical and psychological safety. A connection to purpose, so feedback loops about how their efforts are actually resulting in improvement. A sense of autonomy, so really supporting your teams to engage in improvement of their workplaces, so QI on their workplaces. A sense of community, facilitating connections that could just be at the beginning of your meeting having people share things. They're grateful for something that really brings out that human side and speaks to the values of the people on your team. A sense of fairness, and sometimes fairness looks like people being recognized for the contributions they've put in. Sometimes fairness means, if somebody's violating the precepts of a compassionate culture, that it's addressed quickly and in a way that's respectful to everybody, something that restores justice in the team.
Lawrence:So that is really in a cap in a minute or two, what joy and work is. It's something that leaders have to facilitate and leaders need to first prioritize their own wellness in order to facilitate this type of joyful work culture. A lot of people hear the word joy and work and then they're triggered into cynicism because joy feels so far away. But I believe it was Dr Don Berwick who once said that we were all created for joy, the joy is actually our default and that there's stuff, there's a bunch of crap that's covering it up and not allowing the joy to come out. And so when I look at our system and look at the humans in our system, I look at it from an asset-based lens and I see that there's joy that's really trying to bubble up, that's trying to come out, and we have to just use some team-based quality improvement methodologies to uncover that joy. And that's how I approach joy and work.
Jason:So it sounds like you view joy and work and QI as interdependent, as synergistic, not necessarily that one depends purely on the other, that you need to have joy and work before you do QI, or vice versa. Did I get that right?
Lawrence:Yeah, has many moving parts. It's a complex, adaptive reality where each of us will have energy that that ebbs and flows, and in those days when the energy is higher, we can bring more joy and work. We can bring more joy to our colleagues, we can facilitate more connections, more fairness, more sense of purpose and and some days we can't. And so each of us has a role to grow in our own self-awareness. How we're showing up in work, because how we show up, which is how we lead, how we're being, is actually what, through the principle of emotional contagion, it's what sets the climate for all of the QI work that we're trying to do, all the health care service work that we're trying to do, all the healthcare service work that we're trying to do. So joint work is a strategy that appreciates the assets in the system and that those assets can eventually coalesce and rise up to create virtuous cycles of compassion. Less and rise up to create a virtuous cycles of compassion and instead of the vicious cycles of burnout, that we are so commonly seeing.
Jason:Now I wonder if it's worthwhile to disentangle and kind of create some space between a few terms that you've either mentioned or that are kind of implied in the discussion earlier you mentioned witnessing poor care experiences over and over, and I'm reminded of a video I actually saw of you. You posted last month. It was a talk on this exact topic, and you're kind of alluding to the idea of moral injury here. I wonder what you can tell me about the terms moral injury versus burnout, versus joy and work, where the latter term might be a lot newer or maybe even brand new to some of our listeners.
Lawrence:I believe it would be sociologists were studying the psychological burdens and trauma that existed in in citizens who had fought in wars, and I think moral injury is distinctively described as when one has taken action in a knowing way, voluntarily, which caused harm to another human, and the injury that results in oneself from having caused harm to another human. I think that's what really distinguishes moral injury from moral distress. In distress there's a distress because we have an idealized vision of what a human experience ought to be, but there are system factors which prevent that ideal future from actualizing and we watch other humans go through suffering due to these system factors. So I distinguish moral injury from moral distress in that way. I personally do. I don't know if that's a shared understanding by by any, by anyone.
Lawrence:The other term, burnout burnout is a is a syndrome where exhaustion uh is is part of it, depersonalization is part of it, where we kind of have less empathy. Depersonalization for me is is, that is where we've run out of empathy in our own empathic reserves. We haven't preserved any empathy so we don't have much else to give and and so we depersonalize our interactions. Things become more transactional. If someone complains to us, we're like not my problem bye those types of things, depersonalization, and there's also a sense of inefficacy, burnout you have a persistent sense that you're not doing a good job. Sense that you're not doing a good job. Some burnout cases also have a sense of dread when contemplating going back to work. So those are some of the distinct elements of burnout.
Lawrence:Joy in Work is an idealized summary of what has been seen as a bright spot in high-performing health systems, where leaders have intentionally taken a scientific approach to making workplaces more well, more conducive to wellness rather than conducive to distress.
Lawrence:We have so many health systems right now that, just because of how culture is designed and how workflow processes are poorly designed, it's every person who goes to work is actually on a gradient towards unwellness. That's a reality for a lot of healthcare, because of being short-staffed, because of the lack of a learning system, where the same problem impacts the worker every day and becomes an agonizing frustration that just wears on them day by day. A system that does not learn is a system that's conducive to distress. A system that has a vacuum of leadership is a system that's conducive to distress. A system that has no intentionality towards wellness for the workers is a system that's conducive to distress and joy in work is describing a system where safety, purpose, autonomy, community fairness, recognition those are intentionally focused on. That's what joy and work is and, like you said, that's not commonly discussed but it's in the literature, it's in the white paper, there are courses on it, so I encourage everybody to take them.
Jason:Yeah, and I mean thank you so much for kind of clearing that up, because those are such important terms and how we distinguish them, how we talk about them. You know I had a mentor in my palliative care journey who would always say language drives thought, and so how we use these terms really does help us to drive how we think and how we go about making change. So thanks for that. You know this kind of you mentioned courses and workshops. I mean, at the outset I mentioned that you're running these amazing workshops to promote all of these important ideas, and you've been now asked to do this all around Canada. Sounds like you're in really high demand.
Jason:One of the big focuses I want to have for this podcast this being our first episode is highlighting concrete steps that people have taken in their leadership journey. I think that's an area where, within this quality improvement world whether it's you know, you read a journal article and you can't quite tell what they did, or it's someone who's achieved success in running workshops like you have you want to get, you want to dive a little deeper and you want to kind of understand what did this person do? What's the special sauce for them? And so I'm curious how you got started with running these workshops and how have you made it grow.
Lawrence:Thanks, jason. Interesting question. No one's ever asked me this before, but as you were talking, I came up with some ideas. I want to shout out to Helen Bevan and her team at NHS Horizons for the School for Change Agents, which you already mentioned, jason. What a transformative experience, and the fact that it was free is ridiculous. So School for Change change agents was definitely a transformative experience for me. Another thing that would be accessible for anybody in Canada would be accessible, meaning you can pay for it is the QI coaching certificate out of the Institute of Healthcare Improvement. It's mostly distance learning now. It's not cheap, but I found that really effective.
Lawrence:William Edwards Deming, who is one of the great originators of quality improvement science in the manufacturing and in the health sphere, he said that a leader is a coach, not a judge, and so the QI coaching certificate teaches you coaching principles as well. It ensures that you have quality improvement methodology in your tool belt. So the QI coaching certificate teaches you coaching principles as well. It ensures that you have quality improvement methodology in your tool belt as well. So things like how to do a good aim statement, how to do a driver diagram, how to do a family of metrics, how to do project charter, how to do ethics evaluation, how to do ethics evaluation, how do you do a force field analysis, a cause and effect diagram, a tree diagram. So they combine quality improvement tools with quality improvement coaching approaches. And if you want to lead quality improvement, if you want to lead systems redesign, I think that QI coaching certificate is very very valid.
Lawrence:Yeah, yeah there's, I think, for leadership itself, just how one leads themselves. There are so many different options out there. Which one was most impactful for me? You know what Studying joy and work is a leadership? It's a leadership program. The Institute of Healthcare Improvement has its Leading for Well-Being course, which kind of incorporates some of leadership principles as well as the joy and work stuff in it. As well as the joy and work stuff in it.
Lawrence:The King's Fund out of London also has a compassionate leadership training and I found that really enlightening. You know. It validated a lot of those approaches that I would take, naturally, and so I think I might leave it at that. There's the School for Change Agents, there's QI Coaching Certificate, leading for Wellbeing and the King's Fund's Compassionate Leadership, which talk about compassionate leadership. Michael West is one of their heads of thought leadership at the King's Fund and his 40-minute keynote that he did for us in British Columbia really shaped a lot of my approach for leadership, and I mention these because they're available online. There are some experiences that I had that might be British Columbia-centric which I'm going to leave off right now.
Jason:Yeah, fair enough, and thanks for sharing that. I mean, that's that is a rich list of resources. I'm curious when you're now being asked to to go across the country and run workshops and you're being asked to the IHI to to run workshops, what kind of feedback are you getting from people? There must be people having some really transformative moments and I'm curious what stories you're hearing.
Lawrence:Yeah, and I want to be clear here, I put an abstract in along with some colleagues Christina Krauss, who's the CEO of Health Quality BC, which is our health ministry's quality arm, and also Dr Hussain Kanji, who's a leader in the intensive care and ECMO space. The three of us partnered and put in an abstract. We weren't necessarily recruited to present at these workshops but, yeah, we did a three hour workshop and, you're right, we did get I believe it was a transformative experiences. Within those three hours. We were able to give people time to really reflect on self.
Lawrence:How are people managing their own empathy? Were they preserving their empathy so that they had enough to apply in the places that mattered to them? And that's often self, self-empathy, self-compassion, family, family compassion, friends compassion, workplace, team compassion, and then you can go to community and systems leadership. We really gave time for people to, in those three hours, to grow an awareness of some of their inner narratives that might be driving them to overextending themselves, which is conducive to burnout and distress, and to reflect on some of the narratives that they might choose instead so that they can have a more sustainable work life. And so we really went from self to team leadership to systems leadership in those three hours.
Lawrence:And yeah, the feedback is fantastic. I've posted it onto my LinkedIn and you can find me at Lawrence Yang on LinkedIn and I've posted some of the feedback survey reports on there. I like to do that because it's kind of like a closed loop. You come to my sessions and then you wonder what other people thought survey reports on there. I like to do that because it's kind of like a closed loop. You come to my sessions and then you wonder what other people thought about the session and they just look at my LinkedIn and it's free. You can see the feedback loop of how it went.
Jason:And that's feedback for me.
Lawrence:But it's also feedback for anybody else who's interested.
Jason:You're running PDSA cycles all the time, even with your own workshops.
Lawrence:That's right, and you had mentioned, you had asked me earlier what are those key leadership things that I learned. I think social media is really how I've gotten my voice out there. I think it's a part of how you and I, jason, have connected. But it's also how I've connected a little bit with Helen Bevan, a little bit with Amar Shah you know these quality improvement leaders around the world and Doug Eby out of NUCCA, a system of care. So social media has been, I've used it. Social media can be a lot of things. It can be a lot of bad and negative things, but when in the hands of people who really just care about community, it can be very powerful, as you know, and so, as a leader right now in healthcare spaces, where advocacy and the necessity of leaning into politics really matters, the use of social media effectively, I think, is a key skill for change agents.
Jason:Yeah, well, if anyone uses it well, well, and people should check out your socials, which we'll we'll kind of include at the end. But if, if, if you use it well, and you certainly do, that's you know, I've seen the power that you, that you've kind of extracted from that and I'm curious, you know, as we think forward, we've talked a little bit about about your work in work in physician quality improvement, pqi, in British Columbia, and we've talked about the workshops that you run. What does five years from now, if we think 2030, in Canadian primary care? You can limit that to British Columbia or to the whole country, if you like. What's different? Because we finally, quote unquote, got QI right.
Lawrence:We've all drank the Kool-Aid the QI Kool-Aid yeah. My hope is that family doctors really lean into both vulnerability and courageousness, and what that means is that we become honest with the level of quality that we're delivering our patients and the level of quality that we're allowing ourselves to experience in the course of giving care. Why I say that is that if we're honest about how we're delivering quality and we're honest about how we're experiencing life at work, change will become a necessity. We will have to move out of our comfort zones of potentially lower quality and high volume practices to team-based care.
Lawrence:I think team-based care is the only way that we can get to the quality that we need to sustainably. We can no longer work in silos just a physician, maybe two physicians and two MOAs. We need to have co-located skilled team members that we can delegate to who are doing our counseling, who are doing our social work, who are doing so that we can all work at the top of our scopes. Because there's just not enough physicians in Canada to deliver the care that needs to be done, because Canadian physicians are doing things they don't need to be doing, that are not at the top of their scope. That slows them down. We need to figure out a way where physician owners can actually, in a reasonable financial arrangement, have co-located skilled workers, skilled team members, to deliver care.
Lawrence:And we have to become more courageous about sharing some of the metrics that reflect the sextuple aim in our work.
Lawrence:When I say sextuple aim, I mean health outcomes, patient experiences, health provider experiences. I mean resource stewardship how are we stewarding the resources? I mean advancing equity and I mean planetary health health. So developing metrics and dashboards around around these, these important aims in quality improvement and making sure that, even though I my main job that I was trained for is just delivering care, that I'm doing it in a way that produces lasting, positive impacts on the community rather than just throughput, and a lot of that lies in the hands of system leaders system leaders, who have to be courageous enough to make big changes based on and in a data-informed way, rather than based on. I think this is what we should do. I think this is like there is, there's a methodology to how change can happen in a data informed way. So that's my hope for 2030 that we move closer to data transparency in how public funds are spent in the course of delivering health care and that we really value the human experiences and, like I said, the sex double aim in there.
Jason:Yeah, yeah, I mean, well said, I've got nothing really to add there. That's perfect. I wanted to close by asking you how you personally talking about joy and work, how you personally protect your own joy and work these days, and if there was something that you could embed as a mindset shift in every new clinician, what would that be?
Lawrence:I think the concept of sustainability has been a huge thing right, and sustainability means something different from each person. What really resonates with me, like my experience, my lived experience, was that I had a very low awareness of how much time I needed to devote to recovery after working really hard clinically, after working really hard clinically, and so I had that almost invincibility, or I thought that I had the ability to endlessly give and give and give, and I was not aware, I didn't know how to say no and set my own boundaries, until actually my body actually said no to me. I developed autoimmune flares, psoriatic arthritis and some pain symptoms from that inflammation, emphysitis and dactylitis. So my body actually had to say no for me because I didn't know how to do it myself. And I think that's that might be a common experience for a minority of physicians, where they they just never were trained or given an intentional plan to preserve themselves going forward. So if, when you talk about about new clinicians, definitely reserve time for at least one hobby in your life, at least have one hobby. Definitely prioritize your family. If your family is your priority, definitely reserve time time for your own maintenance of your own body.
Lawrence:The system will not benefit from your martyrdom. I think that's a big message. Being a martyr for the system is not in your job description. So what is in your job description is to model sustainability and wellness for your patients and for your colleagues and for your family members. Modeling sustainability and modeling wellness is a great aim for your life. We're still in that position where the money is enough in health care. You're not going to be as rich as some tech entrepreneurs who got really lucky. No, that won't happen. You might not be a real estate mogul, but the money is enough in healthcare if you live in a moderate way, and I think that, as you definitely do the financial planning that you're going to do. But, yeah, I think the focus on really getting clear on what your values are, ensuring that you're allocating time and energy to those things that you really value and often that's yourself and your family first and really protecting and prioritizing that, and then leaning into your clinical services and your leadership.
Jason:It sounds like the wellness version of pay yourself first.
Lawrence:I like that. Yeah, pay yourself first, yeah, I like that.
Jason:That's really powerful and I appreciate you sharing that. Lawrence, I didn't ask permission at the outset to call you Lawrence, but we've known each other for a while and I really do appreciate you coming on and talking with me today and sharing this story. If people want to know more about you, your socials and the work that you're doing, where should they go?
Lawrence:You can find me on LinkedIn under Lawrence Yang. You can also find me on X under Gateway Medic. My clinic was called Gateway Medical Center because it was next to the Gateway Skytrain Station in British Columbia. So Gateway Medic on X and I think that's probably it. That's the best ways to find me.
Jason:That's great. Well, we'll link to those in the show notes. Again, appreciate your time so much, lawrence, and it was great to see you. Thank you.
Lawrence:Thank you so much for having me, jason, honored to be a guest on your first episode.
Jason:Thank you very much. Bye now, thank you.
