Member Spotlight: Empower Clinicians and Embrace Change to Improve Retention and Satisfaction

In this episode, we welcome Blake Hendrickson, MBA, FACMPE, PhD, Assistant Professor and MHA Program Director at Austin Peay State University. Blake shares his career journey in healthcare, from urgent care to consulting to academia. He also discusses nursing retention, patient satisfaction, and strategies for improving retention through clinician empowerment and technology.

Show Notes

In this episode of the MGMA Member Spotlight Podcast, we welcome Blake Hendrickson, MBA, FACMPE, PhD. Blake is an Assistant Professor at Austin Peay State University, where he serves as the Program Director of the MHA Program.

Blake shares his career journey in healthcare, from working in urgent care to consulting to becoming a professor. He discusses his research on nursing retention and patient satisfaction and offers insights on improving retention through empowering clinicians and embracing technology.

Resources Mentioned

Connect with Blake: LinkedIn
Blake at Austin Peay: Faculty Page
FACMPE Program: Learn More

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Daniel Williams: 00:46

Unlock the full potential of your health care data with practical data solutions. Benchmarks take on new meaning when blended with key performance indicators, like expense, productivity, scheduling, and patient satisfaction data. Optimize your reporting to make better decisions with PDS analytics. Discover how at pds-online.com/mgma. Well, hi, everyone.

Daniel Williams: 01:22

I'm Daniel Williams, senior editor of MGMA and host of the MGMA Podcast Network. Today, we are happy to welcome Blake Hendrickson to the show. Blake has his PhD and an FACMPE, and he's currently assistant professor, department of health and human performance, and he's program director of the master of health care and administration program at Austin Peay State University. Blake, welcome to the show.

Blake Hendrickson: 01:52

Thanks. Glad to be here. Appreciate chatting.

Daniel Williams: 01:55

Glad to have you here. So just to get to know you a little bit better, what got you interested in health care in the first place? Tell us a little bit about that health care journey that you've experienced.

Blake Hendrickson: 02:07

So I'll make a long story short as I can. My dad was an entrepreneur, and we had sold one of the businesses that I was heavily involved in. And I got a call from the closing attorney maybe six months or a year even after and said, hey. Do you ever think about getting into health care? And I said no immediately.

Blake Hendrickson: 02:28

And he said, well, what if, an organization flew you to Florida, had four kids, gave you a place to stay for two weeks, and all you had to do is two interviews. And they gave us x amount of dollars to do that. I said, okay. I'll go. It's just two interviews.

Blake Hendrickson: 02:46

And before the second interview was over, I said, I want this job. What can I do? And it was because it was it was Adventist Health System, now AdventHealth. Two of my great mentors are the ones that happened to interview me, and they, they owned a string of this was urgent care before urgent care was cool. But they pretty much said, you can do anything you want.

Blake Hendrickson: 03:13

We just can't lose any more money. You've got, like, nine months. So I knew that on the front end. And so we were doing things in urgent care that people are now doing. We were going to cars to find out what was wrong with people before he brought them in.

Blake Hendrickson: 03:26

We did not have a waiting room to speak of. There was one, but nobody sat in there over thirty seconds. They went straight to the Treatment Room where the perception, by the way, is seven times of what you wait is according to reality. So we actually put we didn't put clock there was no clocks in there when I got there. What What we did was we put actually a clock in there with a timer that counted up so they could tell how many minutes they were there.

Blake Hendrickson: 03:54

We wanted them to know. It also brought satisfaction to them. So after so I spent nine years with them. They moved to Florida, as you probably know, where they were headquartered anyway. And then I went to work for the HCA, CHS, essence of the group of the world, did some consulting with LifePoint, joined a large consulting company.

Blake Hendrickson: 04:20

And, while I was working at CHS and doing some consulting, I came home one day, and I'd had a meeting with doctors to negotiate their contracts at 4AM. And then I had a 9PM, meeting with the practice we were trying to acquire. And I told my wife, I said, I can't do this anymore. So at age 51, I went back to get my PhD.

Daniel Williams: 04:43

Wow. Okay.

Blake Hendrickson: 04:44

And finished that while I was still working full time.

Daniel Williams: 04:47

Tell us about the PhD then. What is that in? Like, what's your dissertation, that sort of thing? Just give us an idea.

Blake Hendrickson: 04:53

Was in patient satisfaction. Oh, okay. And, so my my degree is in man actually, management. Mhmm. And, it took me almost the entire time they give you, but that was okay because I was working.

Blake Hendrickson: 05:13

Yeah. But I don't know. My wife would agree with that because it was pretty much seven days a week because the weekends were consumed with the PhD.

Daniel Williams: 05:21

Right. Well, that's great. Thank you for sharing that with us. Now you and I originally connected on LinkedIn. I think a lot of people in the business world make connections there.

Daniel Williams: 05:34

You've been involved, and what I found out from that is you've been involved in some research. Tell us about this research. What was involved with it? What's the time frame? Anything else?

Daniel Williams: 05:46

What give us a general overview of this study.

Blake Hendrickson: 05:51

So I haven't ever done a lot of research in my life, but being a assistant professor, you have to. Yeah. So this is but but it was interesting. It was, Tennessee MGMA was very interested in me doing this, so I did this, in in, you know, sort of an agreement with them.

Daniel Williams: 06:13

Mhmm.

Blake Hendrickson: 06:13

It was a nine month it was from September of last year, '9 months going forward. Okay.

Daniel Williams: 06:20

So

Blake Hendrickson: 06:20

and I presented it to the state organization three weeks ago, and it involved RNs, LPNs, medical assistants, CNAs, anybody who is a clinician. We had a couple of laboratory technicians, And, basically, I had sent out a few flyers to hospitals and, medical groups that I knew real well. And they put it up in their break room, and then it went wild. After the gaining the first thirty interviews, I got lots of calls. Mhmm.

Blake Hendrickson: 06:57

And what I did was I did sort of the qualitative quantitative mixed method. I would interview the person, but then look at that how it came out quantitatively. And we ended up talking to almost 500 people Mhmm. Over that time period. And, I don't know much detail you want, but one thing that we were talking about is one of the real surprises of that survey is the intent to leave, especially from RNs.

Blake Hendrickson: 07:25

Eighty one percent of the people that are in hospitals that are RNs said they intended to leave their current organization in the next eighteen months. Wow. Yeah. That's That's a good reason. A lot lower.

Daniel Williams: 07:37

Yeah. Let me follow-up then. So when you began the study, what were the topic areas or the general themes that you were knocking around there? You know, obviously, the data is gonna tell you what is what is factual, but what were you looking to uncover? What what was the topic then?

Blake Hendrickson: 07:59

So, basically, I started the interview saying, asking a couple of questions about tend to leave and things like that. But then I wanted to know what would keep you here. What would what did the employer need to provide you with for you not to consider leaving? That, I mean, you wouldn't consider it if you got a big promotion somewhere else, but, you know, you know, that you wouldn't be actively pursuing something.

Daniel Williams: 08:24

Correct. Yeah. There's a real difference there. One is I'm out on job sites looking every day or some through the networks, someone connects with you and gives you the old offer you can't refuse kind of situation. So Right.

Blake Hendrickson: 08:40

Right. That's exactly right.

Daniel Williams: 08:42

Yeah. So let's let's break that down then. So, one of the things you sent to me a while back, few weeks ago, was you mentioned the challenges of keeping nurses at an organization. Right now, we already know that there are nursing shortages, so that, puts stressors on practices in the first place. But then to keep them there, what are those challenges?

Daniel Williams: 09:06

What did you find in your research?

Blake Hendrickson: 09:09

So a a lot of them are burnout.

Daniel Williams: 09:14

Okay.

Blake Hendrickson: 09:15

That may have been one of the that was the top I I can I can list the top three? They didn't think they were being paid enough, especially with core in in their market. Too much workload that was not necessarily at the top of their licensure and burnout. Retirement was very small. That was you know, because the the survey had a lot of people 45 years old Mhmm.

Blake Hendrickson: 09:50

Which is what you usually find when you go to hospitals. Yeah. Medical groups was a little different. I mean, the average age of our responding was was higher. Same issues, though, but, easier to address, I think, in an organ in a medical organization.

Blake Hendrickson: 10:07

That's why I think the numbers were lower. The people that were not people that would not consider leaving, by the way, Daniel, and medical group organizations was way over 50%. So a lot of content employees and applaud the medical organizations for doing that.

Daniel Williams: 10:24

Mhmm. I don't know if your research looked at this, but if they're looking to leave, are they looking to leave in and then remain in the medical field? And let me follow that up. If they're gonna plan to stay, in the medical field, and burnout is the problem, is it I guess what I'm getting at is it one of those grass is greener type situations? How do you know you're not gonna be burned out in the next place if you're burned out here?

Daniel Williams: 10:56

Or are they looking yeah. Yeah.

Blake Hendrickson: 10:59

I mean think that that is a lot of it. The grass is greener, and I'm not sure not trying to say this study is totally what's gonna happen. Right. It's just I was very surprised the numbers are that high.

Daniel Williams: 11:10

Right. And it's not to make any commentary on the people looking because when you're in a burned out situation, I've certainly been there in the workplace. You and I were talking offline. You had gotten kind of, if I can paraphrase you, a little fed up at a at some previous stops along your track. And so we get there, and then you're just maybe you almost feel like anything's better than what I'm in right now, and sometimes it doesn't work out that way.

Daniel Williams: 11:36

Now if you parlay that and you you said that pay is one of the issues, and if you're getting a bump in pay, then that is at least, that ticks that particular box, but it might not tick that, burnout box. So I do wanna go back to let's stay with burnout for a minute then. If that is one of the challenges, what are you seeing to alleviate or at least lessen some of that pain of burnout right now? What are some ways we can address that?

Blake Hendrickson: 12:07

So, one of the articles that I published was also a small study of how how we can stop that. And the bottom line answer is to make sure if it's the whether it's an RN, LPN, MA, CNA, or somebody off the street who you just trained to do a few things, that they're operating at the top of what they've been trained for. Mhmm. A lot of RNs, I don't know that they really would have been burned out if they weren't asking the they thought these the EHRs were gonna be the answer to everything. And yet most of them said I think it was about 62 per 62% said that they were doing the same or more paperwork since the EHR.

Blake Hendrickson: 12:57

They need to be pulled off that and hire somebody who can do it that's doesn't it's not on our end. And, you know, we need our CEOs, and a lot of them are, and we're seeing great strides, but they've gotta be innovative. And this goes back, I mean, 20 I found the the longest study ago that I found was, like, over twenty years ago, that putting innovation in with the way that clinicians do their work was masterful and helped them retain employees. And that goes all the way. Telehealth is a big deal.

Blake Hendrickson: 13:32

Nurses can do it just as well. I know you're usually a nurse practitioner or a doctor, but that was, that was also found. And we're seeing patient care. The organizations that are doing really well with keeping people, some of the patient care is being handed off to nurses, to a certain point, of course, not, you know, not where the doctor needs to be in there. And, Daniel, the patient satisfaction is higher.

Blake Hendrickson: 14:03

And not not only that, but, you know, this is a a big trend now with government insurances that we talk about patient safety and preventive measures. The nurse is more likely to do that than the doctor according to our study. Now that's according to the nurses. I did not interview any doctors yet. I've worked with several hundred of them, so I would say it's fairly accurate to say that.

Daniel Williams: 14:27

Mhmm. I wanna get to patient satisfaction in a minute, but first, I wanted to ask you about another area that you have, conducted research in. It might have been in this paper as well. But that's managing health care in tumultuous times. What can you tell us about that?

Daniel Williams: 14:47

What has your research told you about that? Because it's, as we know, it's difficult enough in happy times, but, if you get into either, kind of the the shortage, the workforce shortage we have now, the COVID era, all these different impacts that we've had, that can make it even worse. So tell us about that.

Blake Hendrickson: 15:11

So people might laugh at that tumultuous times, and, this was an article also, because health care seems to always be at. Right. But there there were a lot of things. I think the main takeaways, and this is from a fairly long paper, but, we have to have CEOs, practice man administrators, whatever, that are well read and keep up to date with what's going on in health care. That's a must.

Blake Hendrickson: 15:43

If you let that slide over a month, you're in trouble. And some of the nurses, by the way, in that nine month study told us that they didn't think their manager was up to date at all. We did find that transformational leadership is the best compared to Laissez Faire or the others. So the leaders got to do that as well as build this is really simple to say. It's hard to do.

Blake Hendrickson: 16:09

Build a family culture. Mhmm. And the reason I say that is is because it came up. If I read you the comments from all the nurses that I talked to, that was brought up in one way or the other. They might not have used the word family, but they felt like they could go to anybody in the organization and talk.

Blake Hendrickson: 16:25

Some of them did not had didn't even know who their CEO was or CFO or even COO. They couldn't name them because they came and went so quick. They, I think when hiring and this has been happening since really about 1980, it started. When you're hiring for leadership positions, consider physicians. We've come full circle with that.

Blake Hendrickson: 16:51

In the early days of health care, physicians mainly were the leaders. And then we got away from that, and we still are we have a long way to go. But physicians have got to be considered some of the leadership. Maybe not necessarily the tough decisions on how to do things. I mean, but you there are people, and I even found one in urgent care a long time ago that made our chief medical officer, and he sit with the board and myself and help make decisions.

Blake Hendrickson: 17:22

And we actually allowed his vote to count one and a half. So I think that's that's very critical too. A lot lot as you know, a lot of the concerns right now are AI. Mhmm. And is that am I gonna keep my job?

Blake Hendrickson: 17:35

Well, yes. You can as long as you embrace AI and what it can do for you and look for different opportunities. It's, it's it's a fact. It's not going away, so the idea is you've gotta learn to embrace that.

Daniel Williams: 17:53

Mhmm.

Blake Hendrickson: 17:53

And I think the last thing and I'm not none of these are all revelations, revelations. The to be the leader needs to be nimble. Yeah. You've gotta have an organization no matter how big that can move quickly. HCM may have trouble doing that.

Blake Hendrickson: 18:10

They they maybe they don't. I don't know. Not haven't been with them in a long time. But, you know, the organization's like a, let's say, a seven location or even a 35 practice provider practice organization can move quicker usually, especially, Daniel, if you have a physician agreeing with the CEO, saying, hey. We gotta do this.

Blake Hendrickson: 18:38

A a physician who's in senior leadership who also becomes very familiar with the finances and can see why things are going. So the best organization I worked with as far as that was concerned, the CFO and the physician CMO were close very close. They shared everything. Mhmm. And that made things run so much smoother.

Blake Hendrickson: 19:01

Like I said, I didn't have to do my job, but I had backup. And, eventually you know, but it is tough to find that right person. I think it's becoming easier. We see a lot of physicians going back to we now I think last year, we had over 350,000 physicians take leadership classes Mhmm. Compared to ten years ago, and it was about 12,000.

Blake Hendrickson: 19:24

So that's you know, know, I think physicians are starting to see that, and they're going back to school. Wow. Or at least taking online classes and things like that. In our MHA program, we have a nurse practitioner, and we're getting more applicants like that. So that that see that this is a that it's very important for their role.

Daniel Williams: 19:44

Yeah. That's great. Now one other area I wanna ask you about is that patient satisfaction. You said you had done your dissertation on that. So tell us about what you've what you've uncovered or what, the data has shown you on patient satisfaction.

Daniel Williams: 20:02

And we could even look at it through the lens of, what you've seen pre COVID to, like, today. What are we seeing? How have things changed if at all?

Blake Hendrickson: 20:13

So one one, I guess, summary question that answers your second part is the expectations are now higher. Okay. And while we hear that term, you know, under promise over deliver, which was real important pre COVID, now it's almost impossible. You have to just find those expectations and meet them. They don't expect to wait in waiting rooms.

Blake Hendrickson: 20:39

They do expect, a doctor to come in or a nurse practitioner, a PA to come into their treatment room within seven minutes. That's the goal. That is that is pretty much a standard from my my dissertation study. That's tough, but it also helps, physician increase volume. And, patient satisfaction was not the doctors that are listening, I go like this.

Blake Hendrickson: 21:06

Patient satisfaction did not necessarily equate with seeing an MD. If there was a situation where a nurse practitioner could get there quicker and there was a small cut or, you know, I told you I had a broken elbow right now, was diagnosed by a PA. Okay. And, so I I I think that's what we have to do. We have to be quick to respond, and we have to and it's becoming more and more.

Blake Hendrickson: 21:35

I were I did consulting with a survey company that sold for I don't know how much money. And, basically, as well, I had my knee replaced, and this survey company happened to be working with that group. I got my survey for the anesthesiologist, and the surgeon as I was leaving the parking lot to go home Wow. On my phone. Mhmm.

Blake Hendrickson: 22:01

That's a key too. Some people do not wanna pay for the phone part of the survey, and yet the response rate is about 600% higher. So and, you know, Medicare and HCAHPS don't do that, and they should. I'm just sleeping at that. Yeah.

Blake Hendrickson: 22:21

They're a little behind. I don't know. They may always have it. I don't know if they'll catch up.

Daniel Williams: 22:26

Yeah. Well, let's for our final, line of questioning, I know you've had a relationship with MGMA. I'm always interested in that. How did that begin? Tell us about that relationship with with the organization.

Blake Hendrickson: 22:40

Yeah. So I was taken to lunch by, the president of the Tennessee MGMA at that time over twenty five years ago, Tom Stearns. And he said, hey. You need to get into this.

Daniel Williams: 22:52

Okay.

Blake Hendrickson: 22:52

So I did. I mean, he was he was a well he's he is still a well known leader in health care. He's retired, but I and I I went ahead and got my certified pretty quickly within Mhmm. After I passed a couple of year mark. I dry did not go for the fellowship for seven more years.

Blake Hendrickson: 23:18

I And we had grown from five urgent carriers to 27, and that was my excuse is that I was too busy. But it was not as hard as people think it is, if you do the work. I'm a grader now for MGMA. Mhmm.

Daniel Williams: 23:35

You

Blake Hendrickson: 23:35

know? And that fellowship situation has changed a lot. So, you know, when I got it, you had a little questioning. You felt like you were in the concentration camp with the spotlight on you and seven people on one side of the table and you on the other. But that's not there anymore.

Blake Hendrickson: 23:50

And there are several graders that grade your business plan or what you submit for fellowship. And, I'll tell you what the Daniel, I can tell you the quality of the work from about seven years ago when I started grading to now is incredible. So MGMA has done a great job of making that not an easier task at all Mhmm. But a more thoughtful and a better education. So

Daniel Williams: 24:19

Well, that'll be good news to, Nikki Klaus and the team that, handles that. So

Blake Hendrickson: 24:25

Yeah. That's always good. Nikki's great.

Daniel Williams: 24:28

Yeah. She really is. She does a great job with the with the program. Alright. Well, a final question then before we sign off.

Daniel Williams: 24:35

What would you like to share with us to, what we could do better about developing health care leaders? I know you've mentioned some things already about culture and or leadership and continuing education. Any final thoughts you wanna share with us?

Blake Hendrickson: 24:49

So if I'm a CEO or a practice administrator, I would search for ways to help and, you know, it depends on the physician, whether you give them advanced articles or small ones or maybe then education opportunities, to keep them in the loop. Start communicating with them about, hey. We sure wanna make sure you stay with us and that you're happy here, so we would like to send you some leadership, you you know, some ways to acquire leadership skills. Probably wouldn't say it that way because they they many of them think they already have those, but ways to refine leadership skills for the future. So communication, again, was one of the reasons that nurses intend to leave.

Blake Hendrickson: 25:33

They don't have it. And the ones that love the places they're at, communication was huge. And, again, that's, you know, a 50 o 50 year old cliche. Communication is key. But probably now more than ever as we see the trend of physicians becoming leaders and and other things in health care, AI, things like that.

Blake Hendrickson: 25:57

Yeah. So there's there's a lot to figure out there, Daniel, and it's our job to answer it.

Daniel Williams: 26:02

Mhmm. Well, Blake, I just wanna thank you for joining us today. It's great that we connected on LinkedIn and can keep in touch with each other moving forward. So, thanks for joining us on the podcast today.

Blake Hendrickson: 26:16

Well, thank you very much. I appreciate you reaching out.

Daniel Williams: 26:19

Alright. Well, that is gonna do it for this episode of MGMA's Insights podcast. Thanks again to Blake Hendrickson for sharing his thoughts on health care. In our episode show notes, I'm gonna provide some direct links to points of interest discussed today. And thanks again for listening and being a part of the MGMA podcast network.

Daniel Williams: 26:43

Join us at the leaders conference, hosted by MGMA, powered by you, where top minds gather to accelerate the success of ambulatory care and medical practices. Join us in Nashville, October Twenty Second through the twenty fifth. Register today at mgma.com/leaders.