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The Best Ever Podcast with Scott Eblin is your insider’s guide to what it takes to lead at the highest level at work, at home, and in your community. Each week, Scott sits down with remarkable leaders for real, revealing conversations about the mindset shifts, self-management habits, and everyday routines that fuel extraordinary leadership impact. Drawing on his 25 years of experience as a top executive coach, Scott brings a coach’s lens to every episode to help you bridge the gap between intention and action.
Scott - 00:00:10:
Welcome to Best Ever, the show where we explore how effective self-management creates the foundation for positive leadership outcomes. I'm Scott Eblin, and in every episode, I sit down with notable leaders to uncover the routines, mindset shifts, and strategies that have helped them lead at the highest level, and the difference that's made for their organizations, families, and communities. Today I'm welcoming Dr. Cynthia Horner. Cynthia is the Chief Medical Officer at Amwell, a leading virtual care company delivering healthcare across the globe. In her role, Cynthia leads more than 3,000 clinicians who provide virtual care across primary care, behavioral health, women's health, and more. She's a bridge builder working across hospital systems, payers, product designers, and engineers to create virtual care solutions that are high quality, low friction, and regulatorily sound. Cynthia's career as a doctor began in family medicine, and she's practiced across the world, from her home base in Northern Virginia to Sierra Leone in Africa, where she helped organize care for orphans of war. And led an effort that eventually became Mercy hospital, which provides health care to more than 10,000 Sierra Leoneans a year, regardless of their ability to pay. She's a fierce advocate, leading with compassion, and deeply committed to improving access to care through technology and heart. Cynthia, I am so glad to have you with me for a conversation on what it means to lead for health and well-being, both for others and for yourself. So welcome to Best Ever.
Cynthia - 00:01:46:
Thanks so much, Scott. It's a delight to be here.
Scott - 00:01:48:
And it's delightful to have you here. So I have a very basic question to begin with. How old were you when you decided you wanted to be a doctor?
Cynthia - 00:01:57:
Oh my gosh, I must have been. 13 or 14.
Scott - 00:02:03:
Wow. Okay. So pretty young. Do you remember what influenced you to? You know, choose that path at age 13 or 14.
Cynthia - 00:02:12:
Yeah, you know, a couple things. I loved science. I really loved vulnerable people, honestly, and I don't think I could have put it that way when I was 13, but just I was really attracted to people in the margins and, you know, wanted to know their story. You go into a sub shop. Um, I grew up in, in, uh, Massachusetts. So you go into a sub shop and there's some guy behind the counter who's like sweating as he's chopping the meat and doing all the rest of that. I wanted to know a story there's, there just was, and what makes life easy for them? What makes life hard for them? And so I think there was a blending between those things. Um, yeah.
Scott - 00:02:58:
Wow. That's amazing. So throughout our conversation, I want to kind of, dip in and dip out of different parts of your career history, but currently, as I said in the intro, you're the Chief Medical Officer for Amwell. For those unfamiliar with the company, can you give us a quick summary of Amwell, what you do, how you do it, those kinds of facts?
Cynthia - 00:03:18:
Yeah, you bet. So Amwell is a publicly traded health technology company that delivers on what we call technology-enabled healthcare. So essentially what that means is... We support the payer health insurance and provider healthcare industry, providers being health systems, to deliver digital solutions to providing healthcare. Well, what are digital solutions? That's telehealth, whether it's my medical group. I'm president of our medical group that helps the payer market. For the provider market, for health systems, it's the technology infrastructure to take their clinicians and put them in front of hospital patients remotely. So there may be a remote hospital out in a rural area that an academic medical center provides care for or virtual nursing, a whole host. So the virtual visit piece to it, but also connecting that data infrastructure so that, Scott, your healthcare information from your primary care provider in your local community can be connected. If they're not connected through the EMR, electronic medical record of the hospital system, it can be connected with all sorts of data, whether it's data from your wearable device, whether it's an Apple Watch, Fitbit, whatever, the technology needs to pull all that together in the United States where we don't have a national health system where everything is under one umbrella.
Scott - 00:05:46:
So I said in the introduction, you began your career as a doctor in family medicine. Everything you just described is a long way from family medicine, you know, as practiced 20 or 30 years ago. What drew you to Amwell? What was it about the opportunity that was compelling?
Cynthia - 00:06:05:
I was in brick and mortar practice for roughly 20, 22 years. And at around 2016 was around the time when there was federal legislation that enabled payers to incentivize clinicians for outcomes. Really smart, data-driven care so that clinicians are really trying to help the diabetic get better and not just order more tests. Under the previous model, a fee-for-service model, the more you see a patient, the more you get paid, the more you order for them, the more you not only drive out costs, but there's a dysfunctional incentivization of healthcare providers in that. So federal legislation came around and all of a sudden clinical groups started thinking about, okay, I need to capture data. So there was a big, meaningful use became a common term and macro, those were all part of the whole ecosystem. And so a lot of health systems started investing in technology to capture data. Well, we all know that technology is only as good as how you leverage it. So I was seeing a lot of changes in both my practice, my health system, where we invested in significant amounts of technology, but you still had your highest paid professionals, your clinicians, your doctors, your nurse practitioners, doing data entry. And it was driving efficiency down, increasing provider frustration. Providers, you know, clinicians want to spend time with their patients. They want to see face-to-face. They want to have those conversations. They don't want to be spending their time putting, you know, manual data on somebody's family history into the chart. And I got frustrated and said, we need to actually change our workflows. There was not space or innovation in the place that I was at the time. And so I said, I want to go to a space that is familiar with innovation and out-of-the-box thinking and where else but technology is going to have that.
Scott - 00:08:08:
Mm-hmm. Interesting. I mean, one of the things I wanted to talk about was friction, you know, friction in the system. And so you just described a good example of that. You know, the physician who didn't go to medical school to be a data entry specialist. They went to medical school to provide care. What are some of the key levers that you and your colleagues have found most effective in reducing friction and improving care for really not just the patient, but for the provider, the physician as well? Because it's a stressful job just from the jump. And then you layer on all the other demands on physicians today and healthcare providers today. It just is a lot of friction. So what are the ways that you reduce it for both? The caregiver and the cared for.
Cynthia - 00:08:59:
Yeah, and I'm glad you called out both because our healthcare system is broken. We have some of the highest costs in the world. Our mortality rates are dropping. We are not delivering on the promise to our country that we as a nation have for delivering on those good quality of life, whether it's clinicians, whether it's patients. So there is tremendous potential in technology. But as I said before, it's only as good as you can leverage it. And I daily live in a space where... I am working with well-meaning individuals who say, we want to pick up that piece of technology and actually deliver virtual care for everybody. All care is going to go virtual. And helping them understand that actually is not going to make sense for portions of the population. So I think the answer is, one, making sure that you can leverage the creative technology. And that includes AI. There is huge potential right now for AI. It's thinking about it everywhere, but there's also some risk with it. That's another podcast, I'm sure. But suffice it to say that I need to- Yeah. You know, um. But I think leveraging technology, but then I also think you have to, we all have to remember who are the users of the technology and how are we ensuring that whether it's process change that you're engaged in, whether it's technology that you're engaged in, that you're keeping the end user, and in this case, it's on both sides of that equation, provider and patient, that you're really keeping them at the forefront of your decision making. Because I've witnessed multiple times where great ideas end up creating more problems because we didn't really think about what the experience was going to be.
Scott - 00:10:58:
So customer-centered design.
Cynthia - 00:11:01:
Exactly.
Scott - 00:11:02:
Right, yeah.
Cynthia - 00:11:02:
Exactly.
Scott - 00:11:04:
What percentage of your day are you online typically? I know you speak at a lot of conferences in person, but on a typical week, if you're not traveling for a conference or whatever, what percentage of your day do you spend online?
Cynthia - 00:11:15:
I'm 100% virtual, which means there are, I do do speaking engagements, but I would say in 80% of my time, I'm not at speaking engagements and I'm not on site with clients. So of that 80%, it's eight to 10 hours a day.
Scott - 00:11:33:
Okay, so this is a question not specifically related to medicine, but I think it's a... You know, medicine is traditionally, you know, I come from a... Family where my dad was a dentist and my mom was a dental hygienist. And this was in the year when they really thought of themselves, you know, first and foremost as healthcare professionals and kind of grew up around it. It's a human connection profession. Even just here, I mean, I've had the opportunity to talk with you many times offline as well. Even here today, you convey a lot of warmth, a lot of compassion. You're very present. What have you learned about virtual communications that you think every leader needs to know in an era when we're all communicating virtually, maybe not 100% of the time? Like you are, but at least 50, 60% of the day, probably for most people listening to this is online, on Teams, on Zoom, on whatever the platform is. What are your big lessons learned about connection in a virtual environment?
Cynthia - 00:12:41:
So it's really important when you are working with a team and when you're, so I've got two sort of perspectives. One is the patient provider interaction, but that, that it's the same as when I am working, I don't do patient care anymore and I haven't for probably about two years, but I'm leading a very large team and I have had to develop the discipline or carry over the discipline from my patient interactions that I need to look at the camera and I need to, I need to see what other people are seeing. Honestly, first to say, is my lighting any good? We train all of our clinicians in what we call website manner because it's not the same. You know, what-
Scott - 00:13:22:
Website, I want to make sure I heard that correctly. Website manner as opposed to-
Cynthia - 00:13:25:
Website manner.
Scott - 00:13:26:
Very good.
Cynthia - 00:13:28:
And we have a specific soft skills course that we train our clinicians on because it's not the same as knock on the door, open the door, come in, sit down. And, you know, there's sort of the trope, if you will, of the distracted clinician that's constantly typing on their computer, even in a room. So take that into what I just did on this video call. You're not even looking at me. And if I turn off my light and you can't really see me. Patients don't have those visual cues that they have when they come into a brick and mortar space of, okay, I am at the doctor's office. So we really, you need to go above and beyond when you're on a video, whether it's clinically or whether it's in an executive position, whether it's working with your team, to make sure that the messages that are getting conveyed are the messages you want to convey. I'm attending to you. I'm listening. I'm not multitasking. And you can see me and that I'm trustworthy. You know, we have all of our doctors. It's a little over the top for a brick and mortar space, but all of our doctors have to wear white coats. All of our clinicians have to wear white coats.
Scott - 00:14:38:
Mm-hmm.
Cynthia - 00:14:39:
You're getting on with somebody who's on a video call. How do you know that they're not like your neighbor playing a doctor on TV?
Scott - 00:14:48:
My neighbor doesn't have a white coat like that. Right. Yeah, yeah, exactly. Yeah. Okay. Very good.
Cynthia - 00:14:54:
Subtle visual cues matter.
Scott - 00:14:56:
Yeah, yeah. That's really fascinating. I'm thinking about the senior vice president at some company, you know, other than outside of the health care space. I mean, so much of what you've said, I think, applies to them. Maybe not the white coat part, but everything else applies to them. How do you check for understanding in the virtual environment? I mean, because a lot of what you just talked about was the way you transmit. How do you check that you're receiving? The right message or the right data for lack of a better word.
Cynthia - 00:15:32:
It's all those kind of typical interview skills where, you know, you need to do this. You need to do this in a physical space as well. But when you're virtual, again, I like to tell our clinicians, you've lost one of your senses. You've lost all of them. You still get hearing. You still get, well, maybe two. You still get visual. We don't really use our sense of smell and taste. In meetings with people, hopefully.
Scott - 00:16:04:
Yeah.
Cynthia - 00:16:05:
And you don't typically touch people when you're in meetings and certainly in a, but you do in a clinical environment. So, so you have to be able to make up for those lost senses, but you still have your two primary senses, hearing and vision. And so leverage those really significantly. And so how do you make sure that you're receiving the right information? One is in a clinical environment, I might, you know, if somebody says, I twisted my ankle, I might say, okay, well, I want to see your ankle. So can you move your camera and show me your ankle? Now, can you be my hands? Can you push on that little part that sticks out right there? That's called, you know, so can you push on that? Tell me, does that hurt? And then they say, yes, that hurts. Okay. At the end of that, of that encounter, the clinicians will do a summary and say, so what I hear you saying is, et cetera, did I get that right? What am I missing? Do you have any questions? And that's really critical. And I do that in my meetings as well. You know, there's a funny balance. It's a little easier for me, from my perspective as a clinician, as an executive, there's the balance between- Doing that in a way that engages my team and helps them know that they're heard and conveying also a sense of competence. And it's not, okay, I'm not really sure I understood. So can you tell me, you know, it's saying, you know, I think what I hear you say is X and I'd like to reframe it this way. Does that make sense to you? And is there anything else that you would want to put on the table that frames this differently? So, but I think it's that dialogue piece and just making sure that you're doing good interviewing techniques.
Scott - 00:17:51:
Yeah, I mean, the resounding phrase in my head as you describe all of that is active listening, right? I mean, you just went through, and we should put this in the show notes, you just went through a brilliant checklist of what makes a great active listener. You know, checking for understanding. Let me see if I understood this correctly. Could you repeat that back to me and maybe reframe it for me? You know, just so many things.
Cynthia - 00:18:14:
And then the summary, which I will say, particularly as a clinician, I find that that time of summarizing the takeaways, or even frankly as an executive, summarizing the takeaways, there will be somebody. And oftentimes it's the quieter person, if it's not a one-on-one clinical visit, but it's the quieter person in a meeting that will say, raise their hand and say, um, what about X? And I really want to listen to those folks because usually there's something really pithy in there. Or if I don't agree that that's relevant to this, it tells me that, okay, why did they end up over here? And then I've got to figure out what's happening in the dynamic that they're over there and the rest of the group is over here.
Scott - 00:19:03:
Yeah, yeah. How many meetings a day are you doing typically online?
Cynthia - 00:19:09:
Honestly, eight.
Scott - 00:19:12:
That's a lot, right?
Cynthia - 00:19:13:
It's a lot.
Scott - 00:19:14:
Yeah, yeah.
Cynthia - 00:19:14:
Yeah.
Scott - 00:19:15:
And so you've really got to manage the time well to do as much active engagement as you're doing, it sounds like.
Cynthia - 00:19:23:
And part of it is I'm doing that many. My team is not because I'm really particular about making sure that meetings aren't report outs. Nobody is talking about. We all have the ability to read. So really making sure that these are, that meetings are designed to. Empower the team to go out and do what's next. Either they're leveraging me to unblock something for them or to explain a strategy, to give a strategy. Here's what we're trying to achieve. Whatever it is. But because I'm in so many disparate spaces, that's why my schedule tends to be pretty tight that way.
Scott - 00:23:14:
Do they teach you leadership in medical school?
Cynthia - 00:23:17:
No, they don't actually. I learned a lot of this, Scott, in, honestly, I learned a lot of this in volunteer work, interestingly, in Sierra Leone.
Scott - 00:23:28:
Okay, so talk about, I wanted to talk about Sierra Leone, talk about... For the listeners, I gave a very quick recap about Mercy hospital in the intro. Flesh it out, please. Tell the story of Sierra Leone and your involvement in it, and then we'll bring it back to leadership lessons learned.
Cynthia - 00:23:48:
Okay. So I was a doctor. I am a doctor in a... Medium-sized suburban town in Northern Virginia, had never done any medical work in any other country overseas, big passion for, as I said, vulnerable communities, had done work in free clinics and all that, and had an opportunity to go and see the healthcare infrastructure in a country that had, at the time, the worst and highest infant and maternal mortality rates in the world, the poorest country in the world. And I thought, that is really compelling. So I went, and I went at the time with a team of people that we went in January of 2002. So the civil war had just ended, and the healthcare infrastructure, I don't think it's exaggerating to say the healthcare infrastructure throughout the country had been decimated. We went to an IDP camp, internally displaced persons camp, and brought vaccines that made their Ministry of Health nurse cry because we were able to vaccinate 300 kids against a type of pneumonia that is a routine vaccine here in the United States. And she was telling us how many people die. So fast forward, it's like, okay, this is great. We can really make a difference here. And... What does a doctor who's in a private practice in a suburban town in Northern Virginia know about doing, first of all, global health? Building healthcare infrastructure, third of all, working cross-culturally. I'd had some training on that. So it was really humbling to say, there's a lot I don't know. There's a lot that I do know, but I don't necessarily even know what these communities need. And so I need to sit and listen really carefully on what do you need? And we did some things. We tried to build some infrastructure that never took off because guess whose idea it was? Ours, not theirs. It wasn't a need that they perceived. And so, yay, we're going to help you with some inpatient care and give you some high-tech equipment that can't be sustained on the electrical grid that you have. Okay, well, that wasn't very bright. You know, you learn and there was a lot of forgiveness on their side and learned that this really needs to be a partnership. And so I think I, I was trained by some really, really bright people because we both had a goal of helping helping people get health care access in a way that was sustainable. So. Learned the heart.
Scott - 00:26:52:
What's the looking back on it? I mean, how many years did you actively work? With Mercy hospital and the whole effort in Sierra Leone. How many years were you active in that?
Cynthia - 00:27:02:
About 15 years.
Scott - 00:27:03:
Yeah, a long time. It's a career. Most people don't last 15 years in one job, right? Let alone a volunteer experience. Biggest leadership. You kind of alluded to one like, you know, this high tech equipment on the electrical grid. But. Biggest leadership success, biggest leadership failure that you learned from in that whole experience. Let's hear one of each.
Cynthia - 00:27:30:
I think the biggest leadership success was getting to a point where I felt like I'm not really providing a lot of value add here. And that's not a that's not a I'm no good. It's not self-deprecating. It's the they don't need what I actually have to give anymore, which is great. We have, you know, Mercy hospital has a really stellar team of clinical leaders. They have business leaders that are setting the vision. They have financial, you know, they continue to have some financial challenges, particularly now with some of the cuts to various funding agencies.
Scott - 00:28:11:
Yeah, for sure.
Cynthia - 00:28:12:
But, but, at the end of the day, I'm really proud of the fact that we worked hard to build capacity and we didn't start with that. We started to build. Access. And that's great. It's a great vision, great mission. But fairly quickly realized that what we need to do is we need to really be building capacity for sustainability.
Scott - 00:28:33:
What does capacity mean in that context? Could you define that a little bit?
Cynthia - 00:28:39:
Yeah, thanks for asking. Education of the clinical folks to make sure that they have the education that they think they need, and that they can get it without having to fly teams of people from 6,000 miles away.
Scott - 00:28:50:
Right.
Cynthia - 00:28:51:
That they can get it, and guess what? Technology really helps that. They can get education online, and they can also get it within their own country, and they can be flown to various conferences if that's something that's useful, and all within West Africa, etc. Or London, or wherever. But building that knowledge capacity. Building the strategic analysis and planning capacity. So you asked me earlier, did you learn leadership in medical school? No, I did not. I learned how to be a doctor and doctors, I have lots of opinions on. Doctors come right out of college. And in many cases, I didn't, I was like four years out or five years out, but still most of us come right out of college. And then within four short years, you go from being the bottom of the totem pole to- I'm the doctor. And there's a lot of learning that needs to happen in those next five years of what you know, what you don't know, and who knows more than you that may be lower than you on the sort of administrative totem pole. So that's true in Sierra Leone too. That's true across all of medical education. So helping to bring that strategic planning training to the doctors and the business people that were in the community that are actually saying, we need to build a hospital. And then guess what? That's secondary. Maybe we need to actually be building some infrastructure to prevent disease out in the community. And there's some really amazing models coming out of the, you know, the global health world and saying, okay, well, what do they bring? And what are some of the, you know, should we be training doctors or should we frankly be training traditional birth assistants? And how does that relate to the, to the Ministry of Health priorities? And because, oh, by the way, if you can't get them involved, then you're probably not going to really have a sustainable program.
Scott - 00:30:52:
Yeah, so coalition building and constituency management. I mean, so many things that relate to the leadership. That was such a great answer. I hate to bring it back to the leadership failure because that would be like a buzzkill. But let's hear the leadership failure story. Then I want to circle back to some of the great points you just made.
Cynthia - 00:31:12:
Yeah. It's related to actually the greatest success.
Scott - 00:31:16:
Okay.
Cynthia - 00:31:18:
We had to learn a cross-cultural barrier or a cultural barrier. You know, and it's, I think, a truth in probably a lot of development work that when donors come and say, do you need X? It's really hard for recipients that have a vast array of needs to say no.
Scott - 00:31:45:
Mm-hmm.
Cynthia - 00:31:48:
And we did that. There is a valuable and remarkable hospital in Sierra Leone. I don't ever want to undercut that. But if I had to do this over again, I would not start with, do you think you need a hospital in this town, the second largest city in Sierra Leone? And really start with the, what are your primary problems? In healthcare. Is it access to fresh water? And while I'm a doctor and I don't want to be building wells out of, you know, I don't have that knowledge and expertise. If that's really what they need, then that's where you need to start. If what they need is traditional birth attendant training or nurse midwife training with kits and programs to connect the local villages and an ambulance, then that's what you should do. And really doing much more effective listening and getting less wrapped up in the, oh, here's a solution and here's a hammer and I sound and everything is in here.
Scott - 00:32:53:
Yeah, that's exactly what I was thinking about was what you're describing as let me understand the problem and then I can offer potentially solutions as opposed to, here's my solution. Isn't this your problem? Yeah, yeah, yeah. Solution in search of a problem. Fantastic. Thank you. Really ties back a lot to some of the points you made about this is a big emerging theme in this conversation is listening, right?
Cynthia - 00:33:19:
Yeah.
Scott - 00:33:20:
Listening again. We're back to that. And which ties back, I guess, to where did you learn leadership, right? You know, through all that experience.
Cynthia - 00:33:27:
One other little point on that. I think it was really pivotal. And I would love for your listeners to think about the work that volunteer work, anybody who's involved in volunteer work, really probe into that. Is it, I show, and this is all great volunteer work. So showing up at a soup kitchen and making breakfast once a week, that's fantastic. But if you put people that are involved in volunteer leadership, that is an unsold crucible of learning. An undervalued crucible of learning. And because you've got people that you've got that don't have to be there, don't have to be doing this stuff. And if you're trying to get engagement of these volunteers to get on board, get excited about what you're doing and do work for it, then you've got to have a clear vision. And Scott, you and I, you saw me in some of the early days where I didn't really have a clear vision. It's like, no, we're going to. We're going to help healthcare, you know, and you have to have a clear strategy and you got to make it easy for people. So, um, volunteer work in particular, if it's done well, um, can be a really remarkable learning experience, volunteer leadership, I should say.
Scott - 00:34:40:
So that's, that's your qualification. If done well, uh, what does well look like? Done well look like.
Cynthia - 00:34:49:
That the volunteers have a clear sense of what they're doing. They're engaged in why they're doing it. And they're actually... Accomplishing their mission. So you have to have a mission, you have to have the vision, and you have to have some metric of success. And it's not just we're working really hard and look at, it's not outputs, it's outcomes, I think.
Scott - 00:35:10:
Yeah, or not activities, it's results, right?
Cynthia - 00:35:13:
Thank you. Yeah.
Scott - 00:35:13:
Yeah. Yeah.
Cynthia - 00:35:14:
Yeah.
Scott - 00:35:15:
Um... I loved your point you made a few minutes ago about access versus capacity building and capacity building. In some ways, especially on the education thing. Aspect of it. You started in Sierra Leone in 2001. It's 2025 as we're having this conversation. Technology's changed a lot in that 24-year period. Much easier to educate people virtually, which kind of brings us back to Amwell now, right? And so what's next on the horizon, do you think? For Amwell, and then I want to ask for you. But let's focus first on Amwell. Are there... Emerging areas in virtual care that you're particularly excited about or that you feel are going to address a need that hasn't been addressed yet?
Cynthia - 00:36:03:
You bet. And there's three that I would say. In the outpatient space, bringing primary care, and full disclosure, I'm a family physician, so primary care is something that I value deeply. And oh, by the way, there's really good data that people who have a primary care provider are 30% less likely to suffer from a chronic disease and have much better satisfaction in outcomes in their chronic disease progression if they have it. So I have bias, but it's data informed. So virtual primary care, it's not for everything, but in so much as we can leverage remote patient monitoring, it becomes even more powerful. So that virtual primary care, a lot of payers are looking into how can we give access to patients who don't have a primary care provider or who are lost to the healthcare systems, healthcare world? How can we get them back into a primary care relationship? And for a hybrid care in that brick and mortar space, so your primary care provider that might be in a brick and mortar space, how can they become more efficient, which improves their outcomes, improves their satisfaction? I mean, honestly, just grueling all day long is not fun. You need variety. And so how can they reach out to you for those quick checks to say, hey, you know, I see you just got discharged from the hospital. Can I check in with you for 10 minutes real quick and in your home and kind of have you walk me around and let me just make sure that you're doing okay. Or maybe I have my nurse do that. So really empowering that hybrid care in a primary care environment. So that's one hybrid primary care that includes the virtual piece. Part number two is the inpatient space. And then in that, if you're listeners and you have not been in a larger hospital system in an inpatient room in the last, I would say, even six months to a year, you're going to be surprised at how much virtual is being done. Many hospital systems actually have cameras in the room and they have virtual nursing. And this is here today. And it doesn't mean that the nurses never enter the room. What it means is there is a nurse that's there that can be watching to make sure if a patient who shouldn't be getting out of bed starts trying to get out of bed to say, hold on, Mr. Jones, I'm going to have an aide come and help you right now. Or is there something I can help you with? Or if you've ever been in the hospital, the call bell and it's like nobody's answering my call bell. Well, guess what? If you have a virtual nurse who's working in a virtual pod, they can answer that right away and take care of probably about 60 to 70% of the issues. Discharges, admissions, all of that documentation and paperwork can be done much more efficiently. So now you take that up two levels and you get smart rooms and smart beds and smart IV poles that can be managed also virtually. Now, not everything can be done virtually. You still need somebody there. But there are certain things that, that alarms that can can go off or, when a patient, patients need to be turned if they're not mobile so that they don't get pressure sores. We can have a smart bed that, that knows how is a patient moving on their own and do they need to be turned? And if they don't, the bed turns them.
Scott - 00:39:34:
Right.
Cynthia - 00:39:35:
I could go on for probably a good half an hour. There's a whole host of really interesting things on communications and education, leveraging the TV that's in the patient's room and just making sure that they have everything that they need before they get discharged. That's more than just tune to channel three and click on that. And then the third is AI. AI is going to revolutionize healthcare. It already is. But we have to be super careful. Right now, the Colorado AI Act is putting appropriate guardrails that are for the state of Colorado today, but they're setting the bar across the healthcare industry for ensuring that we don't end up with medical decision-making-based AI that doesn't have a human in the loop that is making decisions that end up in some sort of hallucinatory, other world.
Scott - 00:40:36:
AI hallucinatory, right?
Cynthia - 00:40:38:
Thank you. Yes.
Scott - 00:40:39:
Not the patient, but the-
Cynthia - 00:40:41:
Not the patient. Yeah. Speaking ASB, but trust me, every one of the conferences that I'm going to for the last three years. Most of the keynote speakers are talking about something related to AI in healthcare. It is here. It is going to make things so much more efficient and be a really great tool. When leveraged appropriately. With a human in the loop to ensure that decisions that are being made and treatments that are being rendered are done so in a really informed way.
Scott - 00:46:08:
I definitely wanted to talk about burnout. You know, every professional, every leader in pretty much every industry suffers from some level of burnout. But I think. Almost anybody who's paying attention would agree it's probably highest consistently in the healthcare industry and providers in particular. I was thinking a lot while you were talking about AI. Well, that could be a burnout. Reducer or mitigator if it's used well. With burnout as like a reference point in this part of the conversation. What do you do about it now as a leader of the Chief Medical Officer in a large company with lots of doctors rolling up, looking to you for guidance, looking to your team for guidance? How can we address it in the short run and what's, what's it look like over the longer run? And again, I think whatever you share definitely applies to the healthcare industry, but I imagine there are going to be lessons to be drawn for other industries as well.
Cynthia - 00:47:21:
Yeah. So there's... I think there's sort of two directions that we can take this conversation. One is from a systematic perspective. You know, what are some, and we talked a little bit about, you know, the healthcare professionals having unprecedented, particularly in the nursing and in the direct clinician, physician, nurse practitioner, but particularly physician and nursing fields, really since COVID having significant burnout issues. And so to riff on the same theme, that's one of the things that virtual care can do. We've got a lot of clinicians that come and practice with us because they just are exhausted. And the chronic slog of see more patients in a fee-for-service model and do more work is, with less relational interaction, is exhausting. And so our ability as a company to say, hey, if you come practice with us, we can keep it really simple because the technology does a lot of this stuff for you. It captures the information. It captures the documentation. Doctors hate the documentation. And so it lets you do the stuff that you love to do. From a nursing standpoint, virtual nursing, one of the real value propositions for it is it allows nurses that are looking to leave the field. For example, did you know that the average nurse only spends five years in clinical practice before going into administration because they get burned out?
Scott - 00:48:56:
Yeah, I'm not surprised. Didn't know, but not surprised.
Cynthia - 00:48:58:
That's amazing. And so giving them the ability to say, well, your clinical skills, that five years is invaluable. So let's use you to, in a virtual capacity, to mentor new nurses that are coming in. And you can still do administration if that's the direction that you want to do, but we would love to be able to leverage those skills. So there's that, but I think also there's... One of the things with our provider group, you know, we've... We've got roughly 3,000 providers and they're all virtual. And so we need to keep them engaged. It makes sense once we've trained them and we've gotten them used to how we like to work, the clinical standards that we have and how to use our technology, et cetera. We want to keep the good ones and we really want to make sure that they're enjoying what they do. So we've got to give them value add. I mean, I've got to give them. Education where they want education. Fun peer-to-peer conversations. Because remember, they're working out of their own home office. So a space where they can talk to each other and have that sort of head in the doorway. Hey, I have the weirdest situation today. What would you think about this? Give them that sort of interpersonal engagement. And then we try to make all of our trainings gamified. And because otherwise, it's just another continuing medical education.
Scott - 00:50:24:
Yeah.
Cynthia - 00:50:26:
That's a little tedious. And, and then I think I'm going to bring this down into a much smaller realm for my team. You know, the health tech industry is like a lot of industries right now in, in a storming space.
Scott - 00:50:47:
Performing, storming, norming, performing, storming.
Cynthia - 00:50:50:
Yeah. So there's some chaos in the health tech industry. So really helping, I think, the team to say, remember, here's what we're doing. Here's what we're really succeeding on. Here's the chaos that we're experiencing, but let's frame it within the broader context. And oh, by the way, your PTO, you need to take it. And when you're off, you're off. And leverage some of those tools where we use Microsoft Outlook and Outlook will allow you to delay sending an email until 8 a.m. The next morning. And so do that so that your team gets to get a break.
Scott - 00:51:32:
Yeah, those are applicable far beyond Amwell. Right. I mean, those those practices that you just mentioned, especially in I like the acronym this year, BANI. Have you heard BANI? B-A-N-I. The brittle, anxious, nonlinear, and incomprehensible.
Cynthia - 00:51:54:
That's perfect.
Scott - 00:51:56:
Yeah. And so in a BANI operating environment, which I think we all are in. Those basics, right? Take your vacation, get off the email at night. Give yourself some space. Remember what we're here for, you know, the basics of why we're here, which leads me. I know we're about at the end of our hour here, but it leads me to. Want to hear a little bit about your own self-care practices. I mean, you are looking out for others and you're a healer, so you're always going to be looking at the others first. What about you? What are your non-negotiables physically, mentally, relationally, spiritually that? Help you show up as the compassionate person you're exhibiting yourself to be.
Cynthia - 00:52:39:
Yeah. I need downtime. I mean, everybody does, but I am really passionate about protecting my downtime. And there are a couple of, I have a group of women friends that gets together once a month. I will not, in so much as I am in town, I will move meetings to make sure that I can get together in the evenings. And we don't really have that many meetings, but if there's an emergency, I'll see what I can do to make sure that I at least show up with that late. So my friendships are really important, making sure that I am connecting with people both outside of work and inside of work. I'm sort of one of those people is I like to show up to meetings about a minute and a half to two minutes early and ask people about their kids. And if they're people I don't know, and so asking them about their kids is a little weird, I'll say, so tell me where you're from. Tell me about, oh, is it spring there? And just getting to know the people that we have to work with every day. So that social interaction is really key for me, but then I also need time to disengage. And my faith is really important to me. So making sure that my husband and I together, that our relationship is vital to me so that I attend to that relationship. Every evening we eat dinner together and we make space to sit together and eat. And then we go to church on Sunday and whether it's church or whether it's some other component of spiritual life, that's been an important part in my life and making sure that I attend to that. And it grounds me. It really does.
Scott - 00:54:31:
Yeah. Yeah. Yeah. How do you stay on top of everything you have to stay on top of mentally? I mean, you're obviously... One word would be mentally acute. And you've got a real... Just terrific range, uh, command of a range of facts. You know, there's a lot in your head. How do you stay sharp mentally?
Cynthia - 00:54:56:
So stay sharp is... And especially as I've gotten older, Scott, it's kind of depressing, but... I have to be right.
Scott - 00:55:06:
That's another whole hour of a podcast here.
Cynthia - 00:55:08:
Right.
Scott - 00:55:08:
Yeah.
Cynthia - 00:55:10:
I have to eat right. I have to exercise and I have to sleep. I mean, it's-
Scott - 00:55:13:
Oh, my back. That's the name of that podcast. Yeah. Anyway, go ahead.
Cynthia - 00:55:20:
But no, I am not sharp if I'm not sleeping right. And so I'm not sharp when I have, you know, I have to be much more careful about, um, you know, how I'm, how I'm eating and sleeping and, um, and just, you know, and when I say exercise for me, that's getting outside and just walking, you know, honestly. Um, so like moving cause this chair knows me too well.
Scott - 00:55:51:
It's custom fit to you at this point. Yeah, exactly. That's really good.
Cynthia - 00:55:57:
But I will also say, staying on top of facts, and this was something that I learned from you on your Next Level Leader course and book. It was a big transition for me having to go from being a subject matter expert. And doctors aren't subject matter experts. I don't know what they are. To saying, I don't know everything. And I don't need to. And how nice is it for me to actually let my team be the subject matter expert? And that was an epiphany for me to say, oh, I need to be quiet and let them speak up. Because I might not have the most accurate answer on a process that we have.
Scott - 00:56:43:
Was that an easy transition for you or a harder transition to let go of being the subject matter expert?
Cynthia - 00:56:52:
A little bit of both, honestly.
Scott - 00:56:53:
Okay, say a little bit of each. Tell me a story about each. Harder and easier.
Cynthia - 00:56:59:
I got to where I am by being really clinically astute and being the clinical expert in the room. Even with other clinicians. And that felt really good. I know my stuff. I know what the right way to do something is when it's clinical and clinical processes in the programs that we have. I was the expert in that. And now I'm in a different space. I'm not really the expert on how we execute certain programs. I might know what makes clinical sense, but I don't have all the details on exactly what the provider workflow is. And I was in a couple of meetings where I said, well, actually, here's how we do this. And God bless one of my team members. They're like, well, actually, It's a little different from that now. It took, I think, two episodes of that before. I remembered the lesson that I had learned and said, oh, that's the, I'm not doing what I'm supposed to be doing. I'm not letting my team be that. And, um, and as a result, I'm creating some chaos confusion. I'm looking kind of like an idiot. So, um, so I think that's it, it, it was easy to let go of because for me, I tied it, I was able to tie it to the, you know, I can be gracious. I can let my team have that, that wonderful experience of being that person. That's where they need to be. That's not my job anymore. So.
Scott - 00:58:30:
Yeah, that's fantastic. I remember it reminds me of a guy I coached years ago, 20 years ago, probably, who was an expert in cybersecurity back when cybersecurity was a relatively new field. You know, it was like the emerging thing. He was great in many ways, but his thing that he needed to overcome was swooping in and solving his team's problems for them, the technical problems. And they were driving him nuts because they'd been working on it for months. And he'd come and say, well, this is what we should do. And it was like, dude, we don't need that.
Cynthia - 00:59:02:
Yeah.
Scott - 00:59:03:
So he worked on that and worked on that. And I walked in about five months after we started. And he said, you know what? I realized that I've only got about five years left to be an expert in cyber. I said, why is that? He says, well, because... I need to be, as a senior vice president, I need to be speaking for the company at conferences, Cynthia Horner. You know, I need to be, you know, I need to be doing this, I need to be doing that. And I don't have, this field is moving so fast, I don't have time to keep up with it. And So the thing is, he, like you... You're never going to lose the ability to ask good questions. I mean, I would imagine you're pretty much world champion of asking good questions based on this conversation, right? So I think a lesson that applies broadly. I want to be sensitive to the time. So two last questions and we'll wrap up. You've made a lot of big changes in your life, professionally at least, you know, from... You've made a lot of big changes in your life, professionally at least, you know, from family practice to Sierra Leone to Amwell and being the Chief Medical Officer for 3,000 clinicians. What's next for you? What might be next for you, do you think? What's the next big thing?
Cynthia - 01:00:15:
I like big hairball challenges. And I don't know what the next big hairball is, but I'm not done with the one I'm working on today, which is our healthcare delivery system.
Scott - 01:00:30:
Well, you might be working on that for a while. Yeah.
Cynthia - 01:00:33:
I know.
Scott - 01:00:34:
Pick a bigger hairball.
Cynthia - 01:00:36:
Right.
Scott - 01:00:37:
Yeah. Yeah. You kind of reminded me, Cynthia, of when you when you ask a governor if he wants to run or she wants to run for president. Well, you know, I'm just focusing on the job I have right now. I'm not saying you're running for president.
Cynthia - 01:00:53:
No, no.
Scott - 01:00:56:
So my last question, I like to ask every guest on Best Ever just for fun and find it interesting, interesting answers. What's been in your ears lately? In other words, are there podcast books or other resources that are currently inspiring you or shaping your thinking?
Cynthia - 01:01:11:
I'm really interested right now in how the, the intersection of actually, you know what Scott, I don't have a good answer to that.
Scott - 01:01:22:
Okay.
Cynthia - 01:01:25:
I'm just going to come clean.
Scott - 01:01:26:
Do you want to say about that? What's the intersection that was in your mind?
Cynthia - 01:01:29:
Yeah. So I'm really interested right now in the intersection between how we're such a data driven, I'm in a data driven field. I'll put it that way. And outcomes are everything right now. And yet there's, there's this whole experience piece where we're leaving people behind. Um, and we're leaving, we're leaving, whether it's, um, it's that interpersonal relationship piece. And so, um. Where I... Where I find whether it's articles or podcasts or, um, uh, books that are leading me in the, how can you stay authentic in, um, in driving these very data-specific, data-focused outcomes, and yet still retain the humanity in it.
Scott - 01:02:24:
Keep it human, yeah.
Cynthia - 01:02:25:
Yeah, that's really where I'm focused. Now, what I don't have for you is what's the interesting book that I can point people to.
Scott - 01:02:33:
Maybe that's the book you should write. You know, because...
Cynthia - 01:02:39:
You just answered the last question for me too.
Scott - 01:02:44:
Maybe I did, because that's really the theme of this whole conversation, Cynthia, is that juxtaposition or the intersection between taking great advantage of the technology and the data that's available, but still keeping it human and not losing sight of either. Either end of that spectrum, right? And it seems to me you're uniquely positioned. You're already a thought leader in that space, right? And so if not you, who? Somebody should write that book. It should be you.
Cynthia - 01:03:19:
Hmm. Well, now you've given me a lot to think about.
Scott - 01:03:24:
Okay, well, you have for me and for the listeners. And what a brilliant transition. See, have we ever met before? Yeah, actually, we have.
Cynthia - 01:03:32:
Actually.
Scott - 01:03:33:
We've known each other for a long time, just truth be known. But that was a brilliant segue. So thank you for that brilliant segue and brilliant close. It's been delightful to talk with you in this context, Cynthia. I really appreciate the conversation. You've shared a ton, which I'm going to kind of try to recap after you leave in a coachable moment for the listeners. But I've got so many notes to sort through on that. It's going to be hard to boil it down to one or two. But thank you so much. Great to see you.
Cynthia - 01:04:00:
Well, thank you. And really great to see you, too.
Scott - 01:04:10:
So I'm struck by so many things in that conversation with Cynthia Horner as we come to the coachable moments part of Best Ever. You know, she and I, at the very end of the conversation, when I asked her what's in your ears and she sort of struggled for an answer and she was about ready to bail on me, I think. And said, you know, I'm sorry. I just don't have anything for you. But she had said, I'm looking at the intersection. And I asked like, what's the intersection? She said, well, it's the intersection between... Everything that technology and data can do, and we have so much of each. And remembering the human experience. I'm paraphrasing, but that was essentially the essence of what she said. I said to her, I said, that's really the whole theme of the conversation. If you can't find the book, you should write that book because there's nobody better qualified to write that book than you. But that does lead me to the coachable moment. About that intersection between the technology and the data and keeping it human. That's not just true in the healthcare industry. Every industry has reams of data, more data than we can comprehend at this point. And every industry has its unique technology opportunities. She mentioned AI and healthcare. Every industry has AI. Opportunities. And it's so easy, so easy to get. Caught up. In the latest and greatest iteration of ChatGPT or what we can do with this technology or that technology or what can we do with this data set to lose sight of the humans. And Cynthia is the Chief Medical Officer of a medical technology company. That's how she describes him well. Never has lost sight of the humans. And there's a few things that she talked about that I think break it down that any leader in any field can think about in terms of how you manage yourself. To show up at your best, not just as a leader, but as a human. A big one kind of goes with the relational domain of routines. But also the outcomes part of routines too, because relationships drive results in the long run in the business setting. Is active listening. You know, she, at the very beginning of the conversation, talked when I was asking her about how do you manage this virtual environment that you're in 100% of the time? You know, just make it work. And she had an amazing... List of ideas which i would encourage you to go back and listen to we'll try to summarize it in the show notes for you And I said to her, I said, you just went through the classic checklist of active listening skills. And that is so clearly embedded in her being, you know, that it just comes naturally to her. And so some of us are like her where it's naturally embedded, but all of us have the opportunity to either practice it. Day in and day out, or practice it with the intention of getting better at it. Active listening. I've got a long way to go before I'm as good as Cynthia is at active listening. And my job is to ask questions for a living, basically, you know, in coaching and now as a podcast host. But active listening, I would really encourage you to consider how that applies and how that can be leveraged for the good. In your neck of the woods, as Al Roker would say. The other thing, you know, that applied to a couple of stories she told. Her story is about Sierra Leone. And we talked about, wouldn't you like to have this nice piece of high-tech equipment for the hospital? Well, maybe we would. Our electrical grid in Sierra Leone will support that. So, you know, would you like this solution? I'm searching for a problem. As opposed to taking the active listening approach of... Talk to me about your everyday life. Talk to me about your problems. Talk to me about what would make it better. And then really listening and considering what you have to offer. Whether it's an idea or a solution or a technology or a resource or whatever it might be. Now we can tailor that solution to the unique problem. Rather than to say, you know, here's my solution. And she used the classic analogy of hammers and nails. Active listening can help you avoid that. And so, you know, when I think about Cynthia and the coachable moments, and I think about the domains of routines that I always talk about, physical, mental, relational, and spiritual, she covers all of them extraordinarily well. But I think the one that... She's a role model in is the relational aspect. And I've said for years, if you're only going to do one thing in the relational space, it's listen. Active listening is the key to strong relationships. I think Cynthia also has proven through her career that it's the key to keeping it human. It's the key to delivering results at Amwell and Sierra Leone in terms of the health outcomes there. It all ties back to the listening. So, Coachable Moment from Cynthia Horner, as summarized by your host of Best Ever, Scott Eblin. If you found today's conversation valuable, be sure to follow Best Ever on your favorite podcast platform and leave us a review and a comment on this episode. I want to know what's landing with you and your engagement really helps others discover the show. And if you're looking for more on how self-management fuels lasting leadership impact, connect with me through eblingroup.com. I've learned it takes a village to make a podcast. Thanks to executive producer, Cee Cee Huffman and editor Mark Meyer, both of Wavestream Media. And thanks to my other team members, Lindsey Russell, Mary Motes, Sophia Shum, and Diane Eblin. Best Ever is a production of the Eblin Group. Thanks for listening to Best Ever. And until next time, keep taking those small steps that lead to your Best Ever outcomes.