A Conversation with Dr. Ben Olson, a Neurologist/Neurosurgeon and the Director of Integration and Technology at Pieper Memorial

The vetcareerservices’s Podcast

Dr. Olson provides an in-depth look into Pieper Memorial including how the hospital has grown, recent technological advances and how management strives to foster a culture where everyone is engaged and truly enjoys their work.

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Transcription

Laura: Today I am speaking with Dr. Ben Olson, who is a neurologist and neurosurgeon at Pieper Veterinary which has locations in Middletown and Madison, Connecticut. He is also the director of integration and technology at the hospital. The primary responsibility is to oversee the use of technology to help and improve clinical workflows in the hospital. Dr. Olson received his veterinary degree from Purdue University College of Veterinary Medicine. He's a member of the ACVIM and AVMA and completed both a rotating internship and a residency in neurology neurosurgery from the Animal Medical Center in New York. Dr. Olson has special interests in spinal surgery, traumatic brain injury, inflammatory brain disease, and caudal occipital malformation syndrome.

Laura: Thank you. Thank you, Ben, for joining us.

Dr. Olson: Thank you for having me here. This is great.

Laura: I'm excited to learn more about you and to learn more about Pieper.

Dr. Olson: Thank you.

Laura: So tell me, you finished your residency in 2017 and then what happened?

Dr. Olson: So, in finishing residency, I did the same thing that most second and third year residents do and start interviewing at different hospitals. And the big question is, where would we move? Would we move out of the northeast? There is a lot of great opportunities all around. But at the end of the day, there was, coming back to Pieper, it was a very clear choice for us to do. And it's been a really great experience coming back and seeing the hospital, how it's grown and then continuing to move forward from there. My first job out of residency is the only job I've had, which is the staff neurologist and director of IT at Pieper. And so both myself as a neurologist and then my wife as an internist, Dr. Sarah Winzelberg. So she also trained in AMC and then was working in Brooklyn at a specialty hospital until we decided move out of the city then.

Laura: I have not been to Middletown but I understand that it's very beautiful.

Dr. Olson: Yes, it's really grown so much because I grew up near this area as well. And it's really blossomed. It's a college town. But they've, I've seen it really go through a huge transformation where it's becoming a bit more of a smaller city that still has a small town feel. So it's been a real experience watching it change. And it's really become a great place to live and work.

Laura: From what I understand, you can live on the water. You could either live on the Connecticut River or on the banks of the of the sound, is that correct? And still be within a good distance.

Dr. Olson: Yeah. So we're right on the Connecticut River. So a lot of the doctors and staff live around that area. And then we actually I live, we're on the Long Island Sound. So you do have the ability to get kind of closer to New York, New Haven area and so be easily commutable either to Middletown, whereas that's where the main E.R. specialty hospital is. But then also to our our Madison location, Madison is one of the shoreline towns in Connecticut. And we have our urgent care and specialty medicine there too.

Laura: Ok. And you're about an hour and a half south of Boston and maybe two hours to New York City.

Dr. Olson: Yeah, around that, we're kind of smack in the middle. So I think it's good traffic hour and a half to two hours in either direction.

Laura: So when you joined Pieper, what was your biggest challenge, transitioning from academia to private practice?

Dr. Olson: I got really, really lucky on both fronts. And so coming from AMC, it's kind of this mix of private practice in an academic setting. And so I was used to a higher caseload, which I think was a huge advantage. And then I got really lucky in the sense that I came to this hospital that was just so impressive. And I think I really, they made the transition very easy, both on the neurology side with just the service being very welcoming and very similar to the type of collaborative environment I was used to at AMC. But then also the nurses and the ICU and everything like that, it really made for a very easy transition, which I, I definitely feel very lucky for one of the biggest things coming out of residency, it's always a little nerve wracking because residency never teaches you everything you need to know. One of the biggest things I found is that there's lots of ways to do things and seeing how other people practice, you see you're always continuously learning. Even after residency. And so seeing that challenge and trying to decide, what is really important, what's OK to try a different way has been, something that I think a lot of recent residents feel, just because you're going out of your safe zone from your residency program, where you have your mentors, just seeing how other people practice. But it's been an exciting and very, very good experience.

Laura: And so you joined a team of two other neurologists.

Dr. Olson: Yes. Dr. James Hammond and Dr. Jenny Perkins. They were incredibly welcoming.

Laura: So can you describe your roles at Pieper now?

Dr. Olson: Yes, I wear two hats. My primary role is as one of their neurologists and neurosurgeons, and I do practice that full time still. And so we do a good mix of medical neurology and then neurosurgery and all three of us do. And so I know we'll talk about my day in a little bit, but I think it's something where, it's a great mix of that. And then on top of that, I do run our integration and technology department. And what that is, is we found that we had this great IT service that we were using, but it was hard to kind of keep them in the loop with all the projects, but then also utilize them to start driving projects in the hospital. And so I came in as a way to manage both the electronic medical records, IT side of things, but then also be kind of the Go-Between between the nuts and bolts of the IT service. And then just utilize that information to help clinical workflows. And so my role is really to help everybody else work more efficiently and have an easier day. So whether that's improving the phone tree and working with call center to make sure we can triage phone calls correctly and get it to doctors quickly, whether that's helping manage the diagnostics from the E.R. service to make sure people get callbacks and that it's easy for them to manage all that information coming in. My role is really to make everybody else's life easier. From the IT side of things. And so it's been a really helpful thing for the hospital.

Laura: Does that include communication with RDVM's and clients as well as internal communication?

Dr. Olson: So we have a referral liaison who is our primary point of contact for our referral veterinarians. And so I work with her with the technology to get medical records out, to make sure that it's the easiest and most efficient way to do things. And then also any other type of outreach we can do, in terms of CE. That's one of the big things we're working on now is how to continue our approved CE credits to our referral community. Make it easy for them to access.

Laura: Ok. So in your clinical role, how many days a week are you cutting versus consulting and how many technicians do you have and what does your day look like?

Dr. Olson: The neurology service day is a little unique. And so it's different than most other services. But we start our MRI is around five or six in the morning. And this was a practice that was there long before I got to Pieper. But it's something I've really come to see the value in, but not, just everybody else listening. Not every service starts at five or six in the morning. But so we get in and we start our MRI's then and that kind of gives us a jump on the day. And then usually MRI's run till 9 or 10 in the morning in the scheduled sense. And then we can do them on emergency basis otherwise. And then I work four days a week on clinics. And so during that time, all three of us split the period between when we have surgeries when we're seeing consults. We have a rotating group of technicians that we all kind of utilize throughout the day. But we have about two technicians each. And when you look at it and divide it up that way. There's a lot of flexibility with neurology specifically because so many of our patients, for surgeries specifically are a bit on an emergency basis or on a very urgent basis. And so we find that we are good at being flexible throughout the day and splitting in. But, I'd say we're cutting every day or every other day on average between the three of us and then always seeing consults or fitting in new consults or requests from referral. We have the benefit of the hospital being essentially a seven day a week service, especially now during everything that's been going on with Covid. But so between the three of us, we actually can get really good coverage on top of the on call emergency back surgeries and stuff like that.

Laura: And what time do you round in the morning?

Dr. Olson: So after getting in, doing the MRI's we have hospital rounds at 8:00. And these are primarily for our interns. And so we have around seven to eight rotating interns every year. And this is a time for them to go over transfers from the night and maybe not go through every hospital transfer that's coming through. But to have them get really good experience at case presentation, how to know what's important, and what's not, how to interpret a case and transfer it to a specialist. And so we do that from eight to eight thirty. It's also a good time if there's not a lot of transfers to go over neat cases, pulling up MRI's or radiographs. And it's a good time for the all the specialist to come together to collaborate on cases officially. And then we try to do service runs around eight thirty to go over the inpatients and transfers and stuff like that. Make any plans for the day. And then most of us start seeing consults at nine to nine thirty. It's a pretty tight timeline, but it works very efficiently.

Laura: And so one of the questions I always love to ask surgeons or neurosurgeons is about the surgery suite. And when you're cutting and you listen to a certain type of music. Does everybody have a say? How does that work?

Dr. Olson: Huh? So I think everyone is different on this. And I so I tend to mix it up a little bit. I have my kind of generic surgery playlist that I've made throughout the years that I tend to that's just a huge mix mash of different types of music from, I've been making it since residency. And so I think that's been kind of the staple that has a mix of things like Martin Sexton, Tom Waits. Nothing that's too too high stress, I think. But then we do kind of allow the staff to make some requests and kind of help with that. And then most of the times for brain surgery we're listening to classical music, kind of sets the tone, it's nice.

Laura: Yeah. Absolutely. So tell me about Pieper as a whole. What does the business model look like?

Dr. Olson: It's evolved a lot because we've been around since 1937 when Neal Pieper started the practice. And then when my parents purchased the practice in 1982 we primarily started this as a hub and spokes model. And it's really been defined by what the community wanted. And so this was a great way to offer affordable veterinary care, kind of the spokes and then have this hub where we had more intensive care. And it was an easy evolution then to when we became kind of molded into a 24 hour E.R. specialty in 2010, because that was essentially what the pet owners and community were ready for and really interested for the care of their pets. And so that kind of evolution has been continuing in our hospital where we see the changing world of veterinary medicine and essentially try to meet those expectations and then exceed them as we move forward to continue to provide this affordable but really high quality veterinary care to everyone. And I think, we've been here for so long and it's been such a family owned organization that, that type of history is ingrained in the community. I think really it's so strong and supportive of that.

Laura: And I've always gotten the feeling from your father that you really treat everybody like your family. I've always gotten that sense.

Dr. Olson: Yeah, I think that's been a huge strength in our hospital, is that we have this long history with our employees as well. And there have been people that have grown and evolved, throughout the years into new roles for, 20 plus years. And it's really been great to see them, not only mentor people younger or newer than them, but to see them continue to grow and learn on their own as well. And I think that's always been a huge goal of Pieper for doctors, for support staff, nurses, assistants, front desk staff all around, and being able to move freely and to continue that personal growth. That's been a huge driving factor, I think, in everything we've always done.

Laura: I remember one of the first things your father told me when I first spoke with him and he described Pieper not as a teaching hospital, but a learning hospital. And it just made such an impression on me. One, he was so he's so passionate about the hospital and everybody there and what you all are doing, but also that learning is such a huge focus and to keep everybody growing.

Dr. Olson: I would think about the differentiation of teaching versus learning. And I think because teaching is not bad and we are in some ways a teaching hospital with our interns and we have a relationship with the vet tech college nearby. But it's really been the goal of not such a structured top down type of environment for teaching, but making sure that everybody is allowed to grow and to learn whether that be any parts of the staff. And I think that we're right now, we're trying to grow our mentorship program for new doctors and stuff like that, but also make sure that even if you've been here for five, 10 years, that there's opportunities to grow with technician certifications and other areas and we try to always be open and supportive to all of our staff for that.

Laura: And that is a good segway into culture, which is such a big focus this day in veterinary hospitals. How would you describe the culture as Pieper?

Dr. Olson: I think very family oriented is probably the best way to do it. It's kind of always what we've talked about. And I think that when you start talking about something and continue continuously do that, it kind of ingrains itself into your culture inherently. But we've really been working on it in the very recent past as we've grown, we want to make sure that we don't lose that family feel. And so that's been a huge benefit to our management team, where we've realized that we want to make sure that communication flows correctly and that every staff member knows not only what's expected and kind of where the company is going, but then also who they can go to for questions or concerns. And that structure is something that is relatively new in the past five years or so, because we've we found that really a huge need for it to make sure that the culture stays positive and kind of everybody feels like they are part of the team. So I think that's been kind of the biggest feel of that. We've also started pushing or getting our management team to have leadership coaching and executive coaching. I'm working with a couple different outside people. And so really helping them have the tools to succeed and help manage the people under them and make everyone else succeed also.

Laura: You made the point that the neurology service starts very early and that is not applicable to other departments. Is that up to the department then, or how are their schedules determined?

Dr. Olson: So we try to be pretty flexible with individual doctors. I think just like in residency and studying for boards, everybody learns differently. Everybody works differently. And I think everybody excels differently. And so we really tried to have some customization built in in terms of how doctors start their day, how busy it is. Is it more loaded in the front half of the day and in the back half when they want to do surgeries and then they then work with support staff management to make sure that there's adequate coverage and stuff like that. But we try to be not as strict because one of the benefits to working at a family owned private practice is you don't have that like a corporate structure that you have to adhere to. And we try to really make sure our doctors feel like they have some autonomy in their day so that they because they know how they succeed best.

Laura: Right. Exactly. And so you've mentioned this is a family owned private hospital who makes up the management team.

Dr. Olson: So a management team, we have two hospital directors, one for primary care and one for ER specialty. And then two medical directors kind of divided up in the same way. And then they're part of the leadership team with myself and Tesser, who is our CEO. And so that's the primary team. And then there's a management team below that, which includes marketing as well as support staff management. And a couple other like HR and then finance. And then it spreads down kind of below that, almost like a Christmas tree, it gets wider and wider. And that's where then you have specific department leads and then supervisors. And that way everybody knows kind of the structure of everything and how they're supposed to get information and then also who they can go to for help. But I do think that because we're kind of a boots on the ground organization where everyone is in the facility, in the hospital, it's not so strict that you can't go, move one or two up the ladder in terms of that, to go to that supervisor if you have a real big concern or if you need some advice on something. And I think that's a huge benefit to the company because information flows a lot better that way. And I think everybody feels more comfortable with the decisions that are made.

Laura: Yeah, absolutely. I mean, communications is key. And if it's right down the hall, it makes it so much easier.

Dr. Olson: It does.

Laura: So if Piper's hiring a new specialist, a new emergency doctor or a new technicians, are there certain qualities that you all look for?

Dr. Olson: Absolutely and I think one of the most important thing that I found, and that's important to not only the business sense, but also to the other doctors in the hospital is a collaborative environment. And that's been, I think, hands down the most important aspect we've found in the doctors that really thrive in this environment , it's fast paced, there's a lot of work to do, which is great. But at the same time, we all succeed so much better if we interact in a way that is collaborative. We have the same kind of goal in mind for the patient, for the client. So I think that's finding a doctor that wants to work in an environment where you can easily go to another specialty and ask their opinion or ask them to look at a case and that goes for all the ER specialties, also with general practice, it's really as a whole that family mentality is really ingrained into that doctor interaction, too. And I think that's really important for the type of doctor that would want to work at Pieper on top of just being a great problem solver and hardworking, all the other things. I think it's pretty, pretty common in a lot of the hospitals. I think that's probably the biggest one.

Laura: Over the past year Pieper bought a C-arm. Any other big things that have happened at Pieper since 2017?

Dr. Olson: There's been a lot of changes. So the C-arm and definitely getting Floro running both with orthopedics also internal medicine. That's been a great addition. We upgraded our CT to a 64 slice rate in 2017 right before I got there. So utilizing that in a trauma sense then also for other surgical and IM cases has been really helpful. We've vastly expanded our ICU in critical care with the addition of two critical assets. And so now we have mechanical ventilation and then wireless telemetry. So you have your ECG wirelessly monitored, which has been incredibly helpful. And then the biggest IT side of things is we moved to a cloud based EMR system and electronic medical record. I'm sorry. Electronic treatment sheets. And that's been a huge benefit both in efficiency in the hospital, less paper, more digital, but then also allowing doctors to do a lot of their work on their time, either from home and stuff like that. So I think that's been a huge change over the past year and a half. And then in terms of services to the public, we've expanded our urgent care both in the big facility in Middletown and then also at one of our satellites in Madison. And the urgent care model has been helpful to kind of take a little bit of pressure off the ER and let them work with more critical cases. And then for the less critical kind of just convenience type appointments that we still want to provide a service for urgent care seems to be a great way to decrease wait times and to kind of make them kind of move to a different area of the hospital, which has been great.

Laura: That's a great concept. I'm not sure how common that is in the specialty side of things. Do you know?

Dr. Olson: I think it's becoming more and more common. I know definitely in cities that type of either subscription mentality or just very on the client's schedule when they want to come in to deal with the problem. It's becoming a lot more popular. I think the benefit of having it adjoined to an ER specialty is that sometimes it's not actually an urgent matter, but it's an emergency. And it can be hard to differentiate that. And so if you're in the big hospital, that's easy. You just move to the emergency department. If you're in our Madison location, we actually have an ambulance that we transport animals and that has oxygen and everything else in it. And that's a free charge to our clients. And so that's how we've helped make sure that we have a great urgent care facility that's kind of in a quieter area in Madison. But at the same time, we're not compromising any care, in the moment something needs to get shipped off we can do it on the drop of a hat.

Laura: Gosh, that must be such a huge comfort to your clients when their pet is in distress. For me, that would be huge.

Dr. Olson: Yeah, it's one of those things where I wasn't sure how much it would be used. And it's been a really positive thing that we can offer. And clients really appreciate that. It's similar to human medicine where we have this ambulance that's parked right outside the urgent care facility. And so if something needs to happen, going up to the 24 hour emergency is very easy to do.

Laura: And so what kind of community outreach is Pieper involved in?

Dr. Olson: We've had a strong community outreach for a long time both focused on rescues and fostering programs throughout Connecticut, as well as with the state police dogs and helping them with managing their care and then also with the education side of things being the clinical part of that tech program at one of the community colleges. And so I think that type of outreach, one helps the community, but also keeps us involved and gives us better insight into what's important and what people are looking for. We've also, in the past two years started what's called the Pieper Foundation, and that's a program for a community that is essentially a fund that you can donate to for that can be used for pets that have a good prognosis, but for financial reasons are having trouble getting that care. And so that fund, as is something that all the doctors have access to. And it's something that we can use that's really been helpful, especially in this time, to help give good care to pets when people maybe think if they can't afford exactly right then and there.

Laura: It's a discretionary fund. Is there a board of directors or employees that determines where and how the money goes.

Dr. Olson: So we do have a board that is kind of overseeing the fund. But at the same time, a lot of these we find are they kind of need to happen on an emergency basis or a somewhat emergency basis it doesn't always it always happens at like a Friday at nine o'clock at night. So there is a lot of lead way with the specialists. And as if the doctor feels like this really fits the fund there's not a lot of red tape, which is really nice. And we found that there hasn't been a problem with it being overused. I think people, with due respect it and have followed the protocols that have set up. So there's an overseeing board. But I think the easier we make something like this to use that, the more help we can give to pets.

Laura: And I would think it would just be so rewarding and encouraging for your doctors and your technicians and your staff to know that you've got that because everybody cares and this animal might not be able to get the care needed, can get it. And that's why we're in this, right?

Dr. Olson: Absolutely. Even though the doctors are the client facing side of this, a lot of times the staff have such a connection and are so involved in the success of every clinical case that goes through, that it is important that they see that, that we're able to support them and they they see these cases get better and there's not a financial hurdle to go over. So I think to show that we're we want to be able to provide that care for other pets, too, I think is a huge thing.

Laura: Absolutely. I would have to agree. I know for me it would be just a huge benefit and just make me feel so good about working at Pieper.

Dr. Olson: Exactly. And it's something where that we also I think that people in this area it's nice to donate to something like that where you know that your dollars are going to be used to help your neighbor or to help somebody in the surrounding town when they're in need that they see the benefit to that. We do try to showcase some of those cases to the public to just show them what their funds are being used for.

Laura: Ben, what's on the horizon for Pieper?

Dr. Olson: So we're continuously growing. I think that we have kind of these short term goals, which a lot of this right now is looking inward and helping grow with the leadership training, executive coaching of our management team. And then also really continuing to grow the mentorship program for doctors that we hire. And then on the other side of that is especially right now, is improving the client experience as we move to more digital interactions. And I think especially with the social distancing, trying to see how that's going to evolve over the next couple of months to even beyond that and how we can continue to provide exceptional care both for patients, but then also for the clients that are a lot of times going through quite a stressful experience. And so we, as the world is changing, we want to make sure that we're ahead and really directing it to make sure we can make the right choices, to get the best experience for everyone. And then I think longer term than that, it's continuing to find ways to provide what our community wants for their pets. And I think listening to what their their goals are and how to help them give the best care for their pets, is really what our goal has always been to provide that high quality, affordable care. And so I think that we've always continuously tried to find new areas that fulfill those needs and really listen to the voices around us.

Laura: So as far as services that you can offer and outreach avenues like that. Yeah.

Dr. Olson: And then on the digital side, increasing our patient portal usage is just making life easier for our clients. If only to see what medications they are prescribed or to interact with their doctors easier. We've started doing a lot more telemedicine. And so anything we can do to make that experience easier for clients, but also help our staff have the tools to provide that high quality care is really the goal and always has been.

Laura: Well, thank you, Ben. This has been wonderful. I did not realize that Pieper was founded in nineteen thirty seven. That was a fascinating fact to me.

Dr. Olson: Thank you. This has been really fun.

Laura: Yeah. And I hope, just knowing your parents and having met you and just sounds like it's going to be a great, great future.

Dr. Olson: Yeah. We have, um, we have big plans and we're excited for what's coming up, so, definitely.

Laura: Well, thank you. Thank you for speaking with me. And I'm excited to hear more.

Dr. Olson: Great.

Laura: OK. Thank you, Ben.

Dr. Olson: Thank you.

Laura: Bye.

Dr. Olson: Bye.