Stop Holding It Together: Leadership, Coaching, and the Architecture of a High-Performing Healthcare Practice

This transcript was generated automatically and may contain errors.

Melissa Gilkes-Smith: There’s a leadership pattern I see in healthcare organizations everywhere, and it doesn’t have a name, but the moment I describe it, you’ll recognize it immediately. The practice that only runs smoothly when one person is in the building, the leader who cannot take a real vacation because nothing holds without them. The team that looks functional until the moment it isn’t. And then the phone rings, and it’s always the same person who has to fix it. That’s not a staffing problem, it’s not a scheduling problem, it’s not even a culture problem. It’s a leadership architecture problem. And it’s one of the most common and most costly problems in healthcare today. I’m Melissa Jilk Smith, this is TouchPoints, Moments That Matter.

Let’s get into it. The podcast about the practical side of patient experience, operational excellence, and the moments that shape how healthcare organizations show up for the people they serve. Today’s conversation sits at the intersection of three things I care about deeply. Healthcare leadership, executive coaching, and the operational architecture that makes both sustainable. And it connects directly to something I’ve built around this show and in my focus leader program. The idea that great patient experience is downstream of great leadership. You cannot build a culture of care on a leadership culture that is running on fumes. My guest today has spent 18 years inside healthcare and dental operations, not observing from the outside, but leading from the inside.

He has worked in community health centers, academic dental institutions, and multi-site practice environments. He serves as the dental operations manager at Callum Lord Community Health Center in New York City. And through his coaching and consulting practice, he works with healthcare COOs, practice owners, and operations leaders using a proprietary framework he built from nearly two decades of real operational experience. Marcus Rembert Jr. holds an MBA in healthcare management, a master’s in executive coaching and organizational consulting from NYU, and is an ICF ACC credential coach and a Hogan Assessment Certified Practitioner. Marcus, welcome to Touch Points.

Markes Rembert Jr.: Melissa, thank you so much for having me. I’m very excited to be here and such an honor to talk with you today.

Melissa Gilkes-Smith: I’m excited to have you. So before we get into the substance, I want to hear the story in your own words. 18 years in healthcare operations, a coaching practice, a framework you built from scratch. Where does that arc begin?

Markes Rembert Jr.: Wow. So funny story. My love of dentistry and really the pain that I went through as a child. I don’t know if you remember Pat Cabbage Patch Kids. Oh gosh, yes. As a child, me and my sister were fighting, and she knocked out my baby tooth with the big cabbage patch kid head. And I went through years and years of orthodontic treatment. And when I got my braces off around junior, you know, junior high school, high school, it transformed my life, right? And I and I found myself in my confidence. And that’s when my love of dentistry really started. By education, I’m a you know biomedical engineer, um, but I learned about implants and found myself in a role in dentistry when I got out of college.

And my career started from there. I started in sales and operations, treatment plan, coordinating. And I just learned the business, I learned the craft, and it was such an amazing experience. And really, what brings me to today is, you know, the organizations that I’ve worked for have all had a common thread of really being mission-driven in environments where the patient in front of you really doesn’t have a backup option, you know, if you get the operations wrong. So it really thinks it changes how I thought about the job, right? It’s not about just keeping the trains running, but it’s about keeping the trains running for someone who has nowhere else to go. And I’ll share, I’ll take you back 18 years when I first started.

Um, I was a treatment plan coordinator, and I was sitting in the exam room, I was charting for a doctor during a periodontal exam, and he’s taking the probe and he’s measuring the pocket depths around the gums. And, you know, excuse me, uh, my language, but out of nowhere, the patient just blurts out, oh my God, what does that smell? It smells like shit. And the doctor and I, we could barely hold it together. And in that moment, it was such a comedic moment. And we were young and we didn’t know any better, and it really felt harmless. But looking back at that experience today, I have some compassion. And it’s not a joke. You know, when I when I see a patient in pain who comes in who is, you know, extremely vulnerable and saying something very involuntary and honest in front of two strangers, you know, um, my response today would be not to laugh, but to comfort that patient and let them know that like they’re in the right place and that they’re safe.

Um, and then just assure them that they’re exactly where they need to be. And, you know, that’s a really big part of, you know, why I built the CPRCAR framework the way that I did. It’s not just operational, but it’s also built on a tremendous amount of empathy, both for the patient and the chair, but also for the for the clinician and the non-clinical staff who are also human and reacting in real time with the patients. And so it’s really this ecosystem that happens. And and so, yeah.

Melissa Gilkes-Smith: I love that. It’s a it’s a very personal story too, the reason why you got into you know dental operations. I myself love my dentist. However, I am not a person that does well at the dentist. So typically, anything that has to do with anything like drilling, uh Melissa has to be sedated, or you’re gonna see a Melissa-sized hole in the side of the wall. I mean, that’s just it. So you’ve worked across some genuinely different healthcare environments, community health, academic dental institutions, multi-site practices, and now Cal and Lord, what threads run through all of them? What are the problems that keep appearing regardless of the setting?

Markes Rembert Jr.: I think the common thread always starts with leadership, you know, and and operational gaps that aren’t addressed. I’m a data-driven individual, and so I always look at the data. And so part of how my brain is wired is I’m always finding opportunities to problem solve. You know, being at Calin Lord, which is an FQHC Federal Qualified Health Center, which serves the LGBTQ community and underserved communities in New York, the standard of care there isn’t it’s just not clinical, but also about patient safety. And so that’s really kind of reframed today how I look at my operations. It’s not just about scheduling, or a scheduling error isn’t just an inefficiency in the system, but for some patients, it can really be the difference of whether they stay in care or they just disappear from the system entirely because they have nowhere else to go and then they’ve lost trust.

And so, really, there’s no neutral operations when you go into different places. You know, a private practice is extremely different from um maybe a DSO organization or an academic institution or, you know, an FQHC. They all have different operational needs and different client needs. And you really have to meet the patient where they are and adjust your operations to meet the needs of the organization. Yeah.

Melissa Gilkes-Smith: That’s one of my favorite uh phrases and statements is meeting the patient where they are. That’s what patient experience really is, is meeting them where the where they are. Um so the pivot from operational leader to coach, most people in your position would have kept climbing the operational ladder. What made you decide that the most important work you could do is not to necessarily just solve the operational problems, but coach the leaders responsible for them? Yeah.

Markes Rembert Jr.: So coaching in healthcare and dentistry can be a challenge. You know, you’re dealing with you’re dealing with professionals who have been taught that they have to have the answers. You know, one of one of my one of my favorite books is Humble Inquiry, you know, um Edgar Schein, and he talks about telling versus asking. And, you know, providers, what I find, they’re so used to tell, tell, tell. They have to know the answer. Patients are coming to them for answers. Um but what happens when that provider is burnt out or the leader is burnt out, they don’t have the the answers, and they’re just running on that willpower. You know, who is there helping the leaders, you know, when when they are under stress and having to make these decisions under tremendous pressure in the moment, you know, and oftentimes what I find is there are those underlying icebergs, you know, issues with the individual that have not been addressed, you know.

Um and so as a coach, I get to partner with those providers and really kind of have those thought-provoking and deep conversations to help them really unearth what is going on with them so that they can show up and be present for the patient, which is most important. A student that I was working with, they came to me and they said, I don’t want to see this patient anymore. They made me very upset. And and so, you know, of course, I go into coaching mode and I said, Well, what exactly is is happening, you know, with you internally, right? And then they expressed to me all their insecurities and all the things that they feel like their professionalism was being challenged, the patient wasn’t respecting what they were saying as a provider, right?

But then also what what possibly what else could be happening here, right? And this is where empathy comes in, and which is why, you know, I focus so much on empathy in health care. You really don’t know on the other side of that. It any any relationship is co-created. You know, and so the patient is also experiencing something. You know, this particular patient was running late to the appointment, they’re under stress, they might have dental anxiety and fear being in the chair, right? And so they are already kind of in a state of not wanting to be there, right? And so right now you’re feeling that, you know, as a propeller, right? And now you’re in fight or flight mode, you know, your cortisol levels are high, and and your response is I don’t want to see this patient, right?

Instead of having compassion and empathy for the patient, asking them questions, you know, um so that you can remedy. And, you know, it was such an amazing conversation with this particular provider because they were able to go home and really reflect on what exactly was going on with them inside, you know, and why they were so quick to respond to, I don’t want to see this patient, instead of having more understanding. You know, they say it’s better to be understand than to be understood. And it was one of those moments where they were able to unpack some things about, you know, them not feeling worthy, you know, and kind of these triggers that they’ve had from kind of childhood. And I’m not saying that coaching is therapy, but what I’m saying is there there were some insights that that provider took to make them better so that they could show up in those stressful situations where they might be feeling challenged that they can, you know, really meet the occasion and be there for their patient.

Melissa Gilkes-Smith: Listening to understand, not to respond. Yeah. I try to try to use that every single day. You know, sometimes, you know, you have the response, but then you like you have to tuck it away and be like, okay, no, no, no. Take a minute. What what are they trying to tell me? This is this moment is not about me. I want to introduce um a phrase you use that I think is one of the most accurate descriptions of leadership problem that I’ve ever heard. The willpower organization. Describe it for our listeners. What does it look like? What does it feel like from the inside?

Markes Rembert Jr.: Willpower organization. Um, so if you’ve ever tried to hold a boulder boulder up by yourself, that’s the willpower organization. I do that every day. You know, when I look at organizations, I call it the willpower organization because it’s it’s running really on that personal exertion of whoever cares the most about whatever’s going on within the organization. It’s not, you know, built on the systems that hold it regardless of who’s in the room, you know? And so I always ask leaders, like, you know, what will happen if you take a two-week vacation? Right. And it’s usually that look, like, what? I could never do that. Two-week vacation? No. Or if they, if they are on vacation, do you open your laptop?

Are you answering emails? Are you responding to fires from Bermuda, you know, when your practice is in New York, right?

Melissa Gilkes-Smith: Gosh, I understand that so much.

Markes Rembert Jr.: Yes. So from the inside, it really looks like you’re in motion. Everybody’s busy, everybody’s exhausted, and everybody is quote unquote handling things. Um, but from the outside, it really looks like chaos, just wearing a mask. Um and so because a leader isn’t running the practice, they are the practice organiz, you know, um the operating system, right? And as a leader, you don’t want to be the operating system. You want to have a system where you can lead with intention.

Melissa Gilkes-Smith: So no, no longer uh no more work with a view. Let’s go on vacation. That’s what I started to call it at one time, one point. I’m like, I’m not on vacation. This is work with a view.

Markes Rembert Jr.: Work with the view. I love that. Because it works, right? Like willpower works, and and you know, high performers are they get you get positive reinforcement, you know, and and this is why it works so well. You know, being the worker, being that go-to person that everybody calls to answer the um to to solve the problems. And so you get accustomed to absorbing all the chaos. You know, you become a master really at absorbing through shared effort. But every time that you grind through a broken process and instead of fixing it, you get a short-term win. You know, but it’s not sustainable long term. And so really the framework is about building a rhythm where you can um have a sustainable practice.

So yeah, I think this the reinforcement of that really teaches the wrong lesson that the person is the fix. Um, because the better the better you are at absorbing dysfunction, the longer the dysfunction the dysfunction stays hidden. So the more that the organization quietly starts depending on your exhaustion as infrastructure, um you’re gonna get the same results over and over. So eventually something has to change.

Melissa Gilkes-Smith: And confidence creates dependence. This is such a precise and uncomfortable truth because the leaders who end up in this pattern are always the high performers, the ones who get promoted because they were excellent at the work, boo, and who are now paying for that excellence with their entire lives. What does a willpower organization cost, not just the leader, but what does it cost the team and what does it eventually cost the patient?

Markes Rembert Jr.: You know, for the leader, if you’re saying yes to everything, it it costs you your time and capacity. You know, and it’s funny because like one of one of my, you know, when I do my wheel of life, capacity is is one of my my goals, but you you pay for it in your health, in your relationships, in parts of the job that really require your full presence and not just your endurance, you you see it there. And and for the team, it costs in their development, right? Because if you’re doing everything, if you’re always swooping in, putting on that uh that cape, I call it, you know, well, I don’t call it, but I like to use the framework the um the drama triangle, right? If you’re always jumping into that drama triangle, you know, in the drama triangle, you have, you know, you have the victim, then you have the rescuer, right?

Um, and and you have the persecutor. And so I used to be a rescuer, always swooping in because I have to, I have to rescue you from your problems. I have to solve it. Now I’m, you know, engulfed in the drama, right, and not focusing on real leadership, right? Real strategy, you know. And so the team never builds really a muscle when things get hard, right? They learn that escalating to the leader is much faster than solving it themselves, which all always guarantees that the leader can actually never actually step back. And for the patient, you know, it’s the most expensive cost of all because there’s an inconsistency. You know, if the leader isn’t there, what happens with the patient experience?

You know, what you talk about in your nine pillars, right? Like, does it all fall apart when the leader decides to take a day off? You know, the the things, everything, every everybody’s yesing you when the leader is there and everything is going smoothly. So the patient who’s there that day gets a great experience. But what happens the week when the then the leader goes on vacation, right? Does everything fall apart? Um, and now you come back to fires and patient complaints and you know your net promoter scores are down, you know, and you’re wondering what happened. Um and so it it really becomes an unsafe environment for a patient. You know, when you really step back and take a look at what’s actually happening, happening, um, you can’t just provide excellent care on the days that the leader is there and then mediocre care, you know, in in the leader’s absence.

Melissa Gilkes-Smith: Training the team to make a decision, to they and the thing is is they that they know what to do. They do, they really do. And if you just give them a moment, and that’s one of the things I work with my practice managers on is that, and I I think it sometimes stems from the the open door policy, right? My my door is always open to you, right? So that means that all of the problems just constantly come to you and they’re not taking a moment sometimes just to figure them out for themselves, work it out amongst their, you know, that that that sub-team, right? It doesn’t always have to go to the leader to be that person to make the decision or you know, fix the problem between you know two team members that maybe can’t get along or can’t, you know, um communicate.

So we can also try to figure it out, you know, on our own, but the you know, allowing the team to make a decision. And I’ve always told when I was a practice manager, when I was director of operations, I said, look, you can’t come to me for everything because I I just sometimes won’t be available. And it just is what it is. And so you have to be able to make the decision and you know what to do. Just don’t burn the building down. Like, as long as you’re not lighting a literal fire, I’m good. Yes. So and you, I’m like, you know what to do. These are simple, some of these are simple decisions. Um yeah, I I I I appreciate that. You know, not not being the person that has to be dependent on all the time to swoop in, you know, supermarkets to the rescue.

Here I am.

Markes Rembert Jr.: And, you know, and I love what you’re talking about because it’s it’s really the psychological safety, you know. Um, it’s really the psychological safety and and feeling safe enough to make a mistake. You know, this is where the coaching is so valuable. If you’re a manager, often, you know, you hopefully are you utilizing coaching conversations within your leadership, you know, to help guide the conversation for your uh direct reports, for your staff, so that they can, you know, really solve their own problems. I always say, I’m gonna partner with you. I’m not, I don’t want to dictate to you how to do the work, what you should be doing, right? I want to get to you to a point where you can trust yourself.

And also trust that I’m not gonna bite your head off if you make a mistake, right? Because that’s all that’s a learning opportunity and that’s a coaching conversation. You know, what do you think you could have done better, right? How else could you have handled that, right? And now you go into a rhythm and you get to practice those skills to become better.

Melissa Gilkes-Smith: And one of the hardest questions is how does the leader recognize that they’re in this pattern? Because from the inside, it often feels like dedication, like responsibility. Like that’s what strong leadership requires. Well, let’s get into the uh CPR C AR framework because this is the architecture you’ve built to solve exactly this problem that we’ve just described. Walk our listeners through what it is, what does it stand for, and what problem does each step address?

Markes Rembert Jr.: Yeah. Um, and just to kind of, I feel like what you were asking is like, how do you identify, you know, that that uh as a leader? And it’s usually for me, it’s a systemic issue. It’s my nervous system. You know, if I feel like I’m like my health is declining, I’m not, you know, being true to my values, uh, you might have, you know, a marriage that is falling apart, your relationships, or maybe your top performer is resigning, right? And you’re sitting around, what’s going on and why, right? Um and so with the CPRCAR framework, it starts with that chaos. And it’s really about naming, you know, what you’re pointing toward and naming what that chaos is. And it’s important to put a name to it. And then once you’re able to name it, we go into the pause phase.

And this is always the hardest part, but it’s the most important part to pause. You know, as leaders, we want to fix, we want to go right into the solution. What I find is that leaders want to go right into the architecture phase. Okay, I’ve I’ve named it now, let’s rebuild it. But if you’re not pausing, you you can’t lead from the inside, right? Because if you’re in the thick of things, you can’t really see what’s going on. So it’s important to just take a step back outside of the system long enough. What does that look like? That means that you have to restructure your, you know, for a day or two, right? Delegate those decisions to someone else who can make those decisions so that you as a leader can step back, right?

It’s making no decisions for for two days and being willing to do that, right? Like the anxiety. God, it allows you time to really diagnose clearly. We get through that pause phase. Now we get to the root. And I love the root phase because it really talks about excavating the values and um the patterns that are sustaining the current state, but then also really deconstructing and getting back to the root of like your own values, right? Like why you became a leader in the first place. Are you in alignment with the organizational values? You know, and and where is is maybe there’s some friction there and realigning. And once you find that, and then we get to the clarity, once you’ve re-identified, okay, what are our values here?

And where are we misaligned in that? We can go to clarity and really define, you know, what does the fix look like? Um, and being specific. What is it measurable, you know, measurably, you know, um, setting those SMART goals. And then now we go into the architecture phase, and this is where we start to rebuild. And I love this. And you know, you have to deconstruct in order to reconstruct. And so now we’re reconstructing the architecture. And that means building new systems, identifying roles, decision frameworks, um, workflows that really hold the standard, whether the the leader is there or not. And once we rebuild that, now we get into the rhythm phase where it’s just a recurring practice, you know, um, that keeps that newly built architecture alive.

Um, it’s repetition, staying in motion, the same cadence until it becomes a part of you, who you are instead of just something that you’re doing, it really becomes who you are. Um so if you skip, if you skip this phase, everything reverts back to to the original chaos. And and so, you know, a good colleague of mine, you know, we talked about like what would you tell your younger self? And I I would I always say, well, just be yourself, you know. And and he echoed what I said, but he said I would add, practice being yourself. And so I would tell any organization, this is that’s what rhythm is about. It’s about returning to yourself, but then practice it being yourself. And you so you have to practice the rhythm until it just be it until you just become.

And and so, yes, that’s a CBR, uh C AR framework.

Melissa Gilkes-Smith: And I love that it’s an architecture versus a to-do list, because with a to-do list, it’s something that you can check off and forget. But an architecture is generally something that that holds. And that’s exactly the patient experience argument for operational systems too. You cannot script your way to a consistent patient experience. You have to build the system that produces it. So, how does the CPR CAR framework intersect with team dynamics and culture? Because, in my experience, you cannot separate operational problems from people problems. They are the same problem. Yeah.

Markes Rembert Jr.: Um, you know, this is where trust and safety comes in. Like you can’t, the architecture will only hold if the team trusts it more than they trust the leader’s heroics, right? So there needs to be a culture shift and not just a process change. And so there needs to be an unlearning, you know, you have to unlearn, you know, and then relearn and then freeze it together instead of escalating to the leader as the fastest path to resolution. Um, so the rhythm phase is really where the culture gets built or lost because it’s a recurring, a recurring cadence. That means a huddle, a review, standing check-in. Uh, that’s where the team will either see the system as actually getting maintained or just sees it as quietly being abandoned.

So that starts with leadership. You know, one of the best teams that I’ve worked with in their morning huddles, it’s always a values conversation. You know, um, every morning in the huddle, we’re reinforcing values. You know, why are we here? What worked in the new framework, right? And and really creating that dialogue as a daily part of the cadence. And that’s part of the newly built architecture is we start to talk about the values within the practice because they’re shared values. And the more that you talk about it, the more that it gets ingrained into the individual. Um and really the culture is what people believe will still be true next month. And so the CPR C AR uh framework only works if the rhythm proves the belief right.

You know, so the team has to believe in what you’re doing. And that comes through reinforcement on a daily basis.

Melissa Gilkes-Smith: So, how does that conversation look where you know you’re having a conversation with your team? Hey, I’m going to this coaching program. It is that a, you know, is that a conversation? And what does that maybe look like? I think that might, you know, for for me, I like getting feedback from my team because I want to know how I can lead them better, how I can be there for them. I um I consider myself a servant leader. I am there to take care of my team. I am there to support my team. I am there to pick my team up. Um, I am there to be high, I am pulling and I am pushing, you know, I am not there just telling them what to do and dictating and directing, um, but I am there to serve my team as their leader.

And so for me to go through a coaching program to improve myself as a leader, I would also like to have that conversation with the team to say, hey, I’d love for you to give me feedback during this time.

Markes Rembert Jr.: Yeah. Um feedback is a gift. Feedback is a gift. And, you know, if I was telling any leader this, because you you often can’t spot your own blind spots. And so you, and you, and so you really need that feedback so that you can improve and not just run on autopilot. And so it’s okay to be vulnerable, you know, and admit that, hey, I don’t have all the answers. Hey, I’m learning and developing too, right? If you’re if you are um an organization where your values lie in continuous learning and development, we’re better to start than the leader. You know, and the thing is about visibility and transparency. You know, your team will appreciate you more for it. Like, hey, okay, our leader is really doing this for us to be a better leader for us.

Right. And that’s just a testament to you showing up for your team. And so, you know, it’s it’s worth the investment. It’s worth um, you know, your team deserves it, right? If you really care about your team, then you want to be the best that you can be, right? And you want to be at your highest potential. And often what that involves is coaching. And that’s exactly what coaching is. It’s really that partnership. So, and that it’s that conversation to help you to reach your highest potential, whatever that, you know, whatever that is for you or your organization. Yeah.

Melissa Gilkes-Smith: So before coaching can actually work, what does the leader have to believe about themselves, about what they need, about what is possible? And how do you work with leaders who come in not quite ready for that feedback, maybe? Yeah.

Markes Rembert Jr.: Um coaching is not therapy. You know, the the leader has to be willing to admit, first of all, that there’s there’s a problem, that there is an operational gap. And acknowledge that. I think that that’s the first, the first step. Um really just kind of surrendering to the fact that, okay, I don’t have all the answers, and I need to to bring someone in to help me. And, you know, as a coach, you know, it’s never about the leader’s capability. I mean, I work with amazing, amazing leaders, right? I can never do what what the people that I coach do, right? And but that’s not what it’s about, right? It I I’m not there to be a subject matter expert when I’m when I put on a coaching hat, right? Um, I’m there to create a safe space for you and be a thought partner, you know, with you, um, to help co-create solutions, you know.

Um, and and so it, you know, it does require uh some trust building. Um, but you know, you have to be willing to put in the work too as a leader, right? And to get honest with with yourself about what’s really going on, you know, and and how do you really show up, you know, when when the stakes are high. And also be be honest about, well, how do how are you being perceived, you know, within your practice? When when the you know, when you’re faced with challenges going on in your in your practice, you know, how are you operating? Are you at your best? You know, are you hotheaded? Are you yelling at your staff? Are you like losing it in those moments, right? And how do you, what do you need to do to regulate yourself?

Um, and and so this is where the coaching comes in to help you kind of really identify those deraillers, that dark side that may come out right in those moments. And and how do you how do you suppress those things so that you can show up your best self?

Melissa Gilkes-Smith: And for the leader that is in the middle of that right now, that’s who’s feeling burned out, who’s listening to this on a commute or a late night after everybody else has left the building, the one who’s holding it all together, starting to wonder how much longer they can hold it together. What do you want them to know?

Markes Rembert Jr.: Um, you know, there’s there’s never a perfect, there’s no such thing as a perfect organization. You know, what I would want that leader to know is that you don’t have to solve every problem. You don’t have to solve every problem. You know, start with one thing. And it it it it always starts with the one thing. Think about your operations. You could have on a Sunday night, you’re losing sleep, you should be with your family, but you’re thinking about the job and what fires are you gonna walk into the next day? Who am I? What’s the one decision, the one upstream decision that you can make that’s gonna alleviate downstream and put a lot of those fires out? Right. And that’s where you start. And so thinking about all the chaos, you step back, okay, if I do this, it’s gonna have an impact on X, Y, and Z.

It may not solve everything, but what’s the first, where’s your starting point? Um, and and so that’s what I would say to a leader. Figure out what is the starting point? What upstream decisions are you making now that are gonna affect the downstream? And then and then go from there. You know, because Rome wasn’t built in a day. You know, CPRCAR, it’s an ongoing rhythmic system of of feedback. You know, any any good any good um change management system, it requires constant feedback loops. Because there are always going to be kinks in the armor. And so you you go back, you evaluate, you do those qualitative assessments, you talk to your people, you get that feedback. Where can we refine this and that?

And it’s a continuous um process of building and working. And, you know, things are changing so fast. You know, and so it could be you have to just you have to build an architecture where, you know, thinking about AI and what AI system do I use, and where do I put this? And is it even applicable in my business and where to put it, right? Um, this is why you build the architecture so that you can just input things into it. And if it doesn’t work, you could take it out. And it doesn’t cause the whole system to fall apart.

Melissa Gilkes-Smith: This has been a great conversation, Marcus. I appreciate everything we’ve been talking about, what you built, the the CPR C AR framework, the coaching practice, the 18 years of operational excellence uh and experience behind all of it. And it comes from the genuine belief that healthcare leaders deserve better than the pattern most of them are living in. And here’s what I want our listeners to carry away. Patient experience is downstream of leader experience. The culture of care that I build everything around on this show, accountability, compassion, empathy, collaboration cannot be delivered by a leader who is running on empty, holding everything together through willpower, and operating without a framework.

You cannot pour from an empty vessel, and you cannot build a culture of care from a leadership posture of survival. Your challenge this week is simple, but it requires honesty. Identify one system in your organization that only works because you are personally holding it together. Write down what would happen if you were out for two weeks. That gap is your coaching agenda. Marcus, thank you for your time, your candor, and for doing the work of making healthcare leadership better. I’m really glad you are here.

Markes Rembert Jr.: Thank you so much, Melissa.

Melissa Gilkes-Smith: Every interaction is a moment that matters. I’m Melissa Jilk Smith, and this is TouchPoints. If this conversation moved you, subscribe wherever you listen and connect with me on LinkedIn. I’ll see you at the next Touchpoint.