How this Ochsner Physician Executive is Transforming Healthcare Through Technology

In another 'How I Work,' article, we feature technology evangelist and cardiologist, Dr. Richard Milani.

Oct 20, 2016 - Guest Author

Dr. Richard Milani currently serves as Chief Clinical Transformation Officer and Vice-Chairman of the Department of Cardiology for Ochsner Health System. This is how he works.

Choose one word that best describes your work style:


What is your device of choice?

My new iPhone 7. I even got the shiny black color, Matrix-style.

Favorite apps & software?

It changes every day. In the last 24 hours, I’ve been really into iBooks. I have all my books, PDFs and keynotes in there, just stored in the Cloud! It’s crazy.

How does Doximity help you in your work as a clinician?

Right now, it’s in the Colleague Connect Platform, where we’ve been able to generate information about Ochsner as a tertiary center for potential referring doctors and have them better understand what we do, in an easy-to-digest way.

What’s your secret to staying productive?

Never taking no for an answer. You find a way to make things happen that need to happen -- I guess I’m just pushy (smiles).

What do you wish you knew when you were a student?

You sort of divide medicine into two parts: science and healthcare. You can learn the science in school, but then there’s the healthcare side, which is really how it works - workflows and the business of medicine. That’s the part you learn over time, but don’t learn in school. I wish I knew more about that as a student.

Who is your mentor?

Today, there isn’t one, but I’ve had various mentors along the way. Dr. Alex Leaf, who was Chief of Medicine at Massachusetts General Hospital, stands out as a mentor in my life.

You’ve worked with Apple extensively in the past, utilizing technology to enhance patient care. How has this transformed the patient experience at Ochsner?

The transformation has been dramatic. Let’s take a step back: what healthcare needs to do is identify the issues that the population you are surrounded by face - and match those. What is the epidemic of our time? Chronic diseases. 86% of all dollars spent in the United States - 2.86 trillion dollars, is spent on chronic diseases. We do a lousy job of managing it, and we’re not doing anything different to change that. In contrast, if you were running a business, wouldn’t you look at inventory on a daily basis or sales on a daily basis? You’d be evaluating all these variables hourly or daily - you’re constantly monitoring to match supply and demand. In healthcare, we say “you have diabetes, it changes by the hour or the day, and we’ll see you in 6 months.” Then in 6 months you’ll be fine, or in 2 months you’ll be crashing. With chronic diseases, we need a different model of delivery with multiple streams of data between physician and patient.

For example, patients who have been enrolled in a digital health program in managing hypertension will work with their internal medicine doctor to measure readings wirelessly, right from their home. In addition, we have multiple “O Bars” in our primary care centers to help patients seamlessly manage their health. Now patients don’t have to call their son or daughter for technical assistance - we have a full-time technology specialist behind the bar to help if they have any issues. This way, patients have tools that empower them to stay healthy.

This week we rolled out Connected Mom, a program to promote a healthy pregnancy. Pregnancy is very scripted within health systems, usually 14 visits for the average expectant mother. At some of these visits, all that takes place is ensuring that the woman is gaining the appropriate amount of weight and her blood pressure is within normal range. Some visits would be unnecessary if everything is going well. With Connected Mom, women can go to the O Bar to receive a wireless scale and a blood pressure cuff. The program also gives women tips throughout their pregnancy, including milestones, and what to expect next. The value is that women can skip unnecessary visits, and doctors can fill that appointment slot with patients who need to be seen.

How do you decompress?

Exercise. I’ll do whatever my body will allow me to do - yoga and weights, in particular.

Do you have a favorite song?

Whatever my wife and kids are listening to.

What’s the best advice you’ve ever received?

The dean of students at my medical school told me this: it’s just as important to know what you don’t know, as it is to know what you know.

How an MD turned CDC Injury Center Director Juggles It All

In the next edition of our 'How I Work' series, we feature Dr. Debra Houry, Director of the National Center for Injury Prevention and Control (NCIPC) at the CDC

Oct 14, 2016 - Guest Author

Debra Houry, MD is the CDC's Director of the National Center for Injury Prevention and Control. This is how she works.

What words best describes your work style:

Collaborative, innovative, dedicated

What is your device of choice?

Smartphone: for better or worse, so I can keep up with emails at all hours. I also like the apps for directions, social media, and keeping my child occupied at times in the car or at restaurants with educational games and reading apps.
Laptop: I still like to use a computer for writing papers, longer emails, and working on presentations.

Favorite apps & software?

Twitter and LinkedIn for social media, One Note to keep track of to-do’s and keep notes in one place, and I can’t function without Outlook Calendar.

How does Doximity help you in your work as a clinician?

I like reading the articles on topics relevant to my work that may not be in journals or media outlets I subscribe to or read regularly.

Want to receive specialty-specific news? Update your settings here.

What’s your secret to staying productive?

I’ve always loved the quote “well behaved women seldom make history." For me, it means you cannot be a silent bystander in life - when you see something you can do to make a difference in the world, you need to step up. Taking care of patients in underserved “safety net” emergency departments, coming up with innovative programs to prevent violence and injury, and making the world a better place for my daughter and her peers is what drives me.

Describe your journey to medicine/when you realized you wanted to be a physician.

I had a calling very early on. No one in my family was in medicine, but I volunteered in hospitals in high school and really loved science. During my undergraduate studies, I continued to volunteer in hospitals in various capacities and found that I always left inspired and wanting to learn and do more for the patients I interacted with. I pursued a joint MD/MPH degree so that I could focus on treating individual patients and have impact at the population level through prevention work. During my residency training, I realized there were so many injuries I saw that could be prevented and knew that I can balance all of this in the emergency department by working on the front line of the health care system and working with the community on injury prevention.

Who is your hero?

Several come to mind. President Carter for his work in recent years through the Carter Center to improve the health and well being of others globally; C. Everett Koop and David Satcher for some of the work they did as Surgeon General - taking on tough issues because it was the right thing to do; and my dad- who came from an immigrant family, worked his way through engineering and then law school, and has been a role model and mentor to so many. My boss, CDC Director Dr. Tom Frieden, inspires me to focus on using the data we have to compel action and to ensure that what we do has impact to improve the health of others.

What is the biggest challenge for women in medicine right now?

I think there are several issues that impact women in medicine. One is balancing work and family, and it’s certainly not just women who face this - it’s tough to do and I don’t think you can ever “balance,” but rather shift the imbalance as needed. Sometimes family needs more focus, and other times a work project may require added attention. And, although women have become more represented in leadership positions and academic rank over the past decade, there are still significant differences in the number of male and female chairs, deans, and full professors.

You’re currently the Director of the National Center for Injury Prevention and Control (NCIPC) at the CDC. What was the path like to this role, and any advice for clinicians looking to work in a similar capacity?

Over the past 15 years, I’ve balanced clinical work in the emergency department with a dual appointment in the School of Public Health. I conducted research on intimate partner violence and sexual violence prevention, taught classes in injury and violence prevention, and was president of two national organizations (Society for Academic Emergency Medicine and the Society for Advancement of Violence and Injury Research). My experiences in the emergency department treating patients after an injury and those experiencing ongoing violence, studying interventions to prevent violence, and leading diverse organizations fueled my passion for injury prevention and I wanted to have impact at the national level. I can’t say I planned the path to this role, but my various experiences gave me the balance of skills and knowledge needed for the job. I think my emergency medicine training has been really helpful for this job - I can triage what needs to be taken care of immediately vs. later, make decisions based on the data at hand and revise actions if needed when I have new information, and understand firsthand how our work impacts the patient, clinician and community. I’m lucky - I love this job, and I now get to practice medicine at the population level to help people live healthier lives through the work we are doing at CDC.

How do you decompress?

It can be as simple as reading a good book or spending some time with my family away from work. A trip to the beach where I can walk in the sand is always great when I have a few days to spend some downtime.

Do you have a favorite song?

Zac Brown Band's Homegrown and Toes. It reminds you to keep things in perspective, take things one day at a time, and be happy and thankful for what you have.

What’s the best advice you’ve ever received?

The “can you sleep at night” rule. It comes down to doing the right thing at the time based on what you know at that moment. As I’ve always said, if you’re worried that you could you have done something different for a patient when you go home and sleep, then you need to do what you believe is right for the patient now. The same is true with other types of work and interactions: if you know you did the right thing, involved others when needed, and can stand by your actions, then you can sleep at night.

Debra Houry, MD is the CDC's Director of the National Center for Injury Prevention and Control. Dr. Houry leads innovative research and science-based programs to prevent injury and violence and to reduce their consequences. She brings frontline experience of preventing injuries and violence as an emergency room physician and researcher.

Best PA Blogs of 2016

These blogs have the answers to all your future PA questions

Oct 12, 2016 - Doximity Blog

National PA Week 2016 has come to an end, and we want to leave you with a final resource for your future PA questions and needs.

Here is our list of the 10 Best PA Blogs of 2016. Each blog listed offers something different, so check out these fantastic resources and bookmark any you find useful!

My PA Training

This fantastic blog that rightfully claims itself as the “world’s best resource for PAs.” The publisher, Paul Kubin, found himself with a variety of doubts and questions when he first began his medical journey, and took to the internet for answers and advice. Now, after having gained valuable experience and becoming a PA, he created this resource so, “You don’t need to break the internet all over, like I did.”
This blog has articles on PA medicine, video interviews with PAs, PA focused forums, a directory of PA programs to help you decide where and how to apply - it really is worthy of that “world’s best resource” title.

PA Student Essentials

This fantastic PA resource reminds us of a virtual college student center - practically the only thing missing is a coffee shop. We love this resource because it puts a social spin on the idea of what a blog usually is. This website has a forum, events page, featured student spotlight, and active surveys to make you feel connected with other PAs across the country.
There are also articles about life before and after PA school, your didactic year, clinical year, and much more. Great resource for the PA who is looking to engage online with others.

Dose of PA

This blog is written by Paul Gonzales, a current PA student in Texas. His blog covers a wide variety of all things PA, but also serves as a kind of personal sparknotes. Most blog posts cover a few related medical topics, and include definitions, diagrams, and important facts to keep in mind pertaining to each topic. It’s a great way of merging information and entertainment that his many loyal subscribers are huge fans of.

AP the PA

This is a PA lifestyle blog, written by the blogger Aashna. Here she covers a range of topics from medical terminology and PA advice, to the general lifestyle of being a PA student. As she says, “I promised myself that I would share not only the great, eye-opening, exciting things I'll learn and experience in PA school, but also the hardships and struggles that come along with it.” This blog is a great read, and honestly conveys the intense and rewarding lifestyle of being a PA.

Lindsey the PA

Another well written blog by a PA Student - Lindsey who is studying at Albany Medical College and graduating in 2017. This blog has posts about what PA school entails, experiences with rotations, and her own personal musings. She puts an interesting spin on posts, such as this one that compares studying in PA school vs. studying for your undergraduate degree.

PA Journey

This blog breaks down posts into three categories: applying, the interview, and journal. Posts underneath ‘applying’ feature information about choosing the right program, writing your personal statement, and information about your major. Posts underneath ‘the interview’ provide you with practice interview questions, and information on what to expect in your interview and how to deal with it. Lastly, the journal section chronicles experiences of a PA student, with relatable stories and information.


This blog is titled ‘musings’ and is exactly that. Different guest writers feature with stories on recent health news, strategies, studies, and offer their own input as they present the topic. The guest writers are PAs, but also hold other titles as well, which provides a variety of different insight.

PA Wannabe

Another great blog written by a current PA, Marjorie Shanks, this website features a variety of information from surprising facts about PA school, and why you need a mentor, to podcast suggestions and personal tips on how to navigate your life as a PA.

PAs Connect

This blog differs slightly from the rest, as the majority of the posts are from guest writers and bloggers who are currently PAs and Assistant Professors. The posts range from information on “New Grad Anxiety” to stories about health news, and opinions on the current health industry.

Special Mention - MedComic

This unique website features educational and creative cartoons about the field of medicine. Created by Jorge Muniz, a PA from Orlando, Florida, the website offers a variety of comics illustrating scenes such as “Doc Vader vs. the electronic health record” as well as information cartoons detailing “Why your vocabulary affects patient outcomes.”

6 Things I Would Have Done Differently in PA School

We asked current PAs for their best pieces of advice

Oct 11, 2016 - Doximity Blog

PA School is an experience unlike any other. In honor of National PA Week, we reached out to PAs and asked them to share their best pieces of advice for those currently in PA school.

Here are our top answers from PAs who have been in your shoes:

Utilize your classmates

“Every new student of medicine - no matter how green - has unique talents and gifts. Each member of my class at UC Davis was an expert in some corner of medicine that I knew nothing about, and they were always glad to teach me if I asked. It took me a little longer to see that I was an expert in some things that others in my class didn't know much about, and that I could help them in turn.” - Paul Kubin

Try and maintain a good school/life balance

“While PA school can sometimes be overwhelming with midterms, exams, and having the constant anxiety of always studying, at the end of the day you are still a human being. You need "you time" to clear your mind, feed your brain and stay healthy mentally and physically. PA school will be always be a challenge, how you go about that challenge will make it more bearable. “ - John Dao

Be assertive

“Don't be afraid to be honest about what you want to do. Tell your professors and preceptors if there is an area you see yourself working in, and pursue it wholeheartedly. This goes for contract negotiations too. You'll never know what could happen if you don't ask.” - Savanna Perry

Remember the importance of networking

“Network with others in the profession sooner rather than later, and don’t be afraid to tell them what you are looking for. In a huge field like healthcare, much of your direction is shaped through personal connections with people you know - not like an "old boy" network, but like an "I know just the person you should speak with about that" network.” - Paul Kubin

Focus more on being a “practitioner” instead of just a “student in training”

“PA school can be viewed by many as an accelerated version of medical school with rotations ranging anywhere from 4-6 weeks. Quite frankly, this isn't enough time to master your skill set. So when you make that transition from didactics to clinicals, mentally prepare yourself to fully engage in that "practitioner" mindset no matter how difficult that speciality may be, because you will not have this opportunity to when you’re done with school.” - John Dao

Spend some time to reflect and appreciate

“Stop every now and then and take stock of where you are. School only lasts for two or three years, so savor this time when your biggest responsibility is to your own learning. Soon your biggest responsibility will be to your patients, which is wonderful too, but in a much different way.” - Paul Kubin

Keep these helpful hints in mind as you navigate your way through the challenging and rewarding experience of PA school.

Share your own advice and thoughts below!

Paul Kubin, MS, MFT, PA-C is a primary and urgent care physician assistant who writes and speaks passionately about physician assistant careers. He is the founder of a well-known and visited PA blog, MyPATraining. He lives, practices, and coaches pre-PAs in Sacramento, California.

Savanna Perry is a member of the Society of Dermatology Physician Assistants, Georgia Dermatology Physician Assistants, American Academy of Physician Assistants, and the Georgia Association of Physician Assistants. She hosts a website called The PA Platform.

John Dao is a Family Medicine PA in San Jose, CA. He graduated from Touro University Mare Island in 2015.

How I Work: How This Surgical PA-Turned-Olympian Finds Balance

In our third rendition of our PA-themed 'How I Work,' we feature Olympic gymnast and PA Houry Gebeshian

Oct 11, 2016 - Guest Author

Houry Gebeshian is a Surgical PA at Cleveland Clinic Fairview Hospital in Cleveland, OH. This is how she works.

Choose one word that best describes your work style:


What is your device of choice?


Favorite apps & software?

Gmail app

How does Doximity help you in your work as a clinician?

Doximity is a good way to network with other healthcare providers as well as stay up to date on recent medical issues.

As a PA and Olympian, time management must be very important. What’s your secret to staying productive?

Life is a balance and nothing is unmanageable. People are capable of accomplishing more than they think. If there is a will, there is a way. After taking 3 years off of the sport, I had 2 years to get ready for the 2016 Olympic Games. I was 20 pounds overweight, I hadn’t set foot in a gym in 3 years, I didn’t have a job, and I was in an unfamiliar city.

I was essentially on my own to make this dream a reality. Even though it seemed overwhelming, I sat down and made a plan. I wrote out all of my training plans, routines, diet ideas, strength and conditioning, job search directions, and eventually my work schedule; everything that would get me from being a nobody to an Olympian. Through hard work and planning, anything is possible.

My advice is to write out your goals and then make a schedule for how you are going to accomplish those goals. Then all you have to do is follow your plan. There will always be set backs, but focus on the bigger picture of what your original goal was. Think positively and you will be able to balance it all.

What do you wish you knew when you were a student?

I wish I knew that I didn’t have to know everything when I was a student. I was so worried that I wouldn’t be prepared when I got out into the workforce but realistically, no one is ever fully prepared. As a medical provider, you are always learning because medicine is always changing and evolving. As a physician assistant, we are expected to be like sponges, learn as we go, and use everything we learned in school as a stepping stone into our careers.

Who is your mentor?

My gymnastics mentor is 1996 Olympic gold medalist, Dominique Moceanu. She was my childhood idol, however has transitioned into a mentor during my recent years.

My physician assistant mentor is my boss, Jim Nahrstedt. Not only has he taught me everything to be a successful PA, but he has also supported my Olympic dream since the first day I met him, which was the day of my interview for the position I have now in obstetric surgery.

What’s the first thing you do when you wake up?

Grumble that I have to get up and exercise, but once I am up and going, I'm happy that I did it.

What’s the last thing you do before you go to sleep?

Make sure my alarm is set for the morning.

How do you decompress?

By exercising. All of my worries and frustrations from the day would just dissolve once I started my routine in the gymnastics gym.

I can’t live without...

Some type of challenge that needs accomplishing.

What are you currently reading?

“When Breath Becomes Air” by Paul Kalanithi.

Do you have a favorite song?

I don’t really have a favorite song, but my favorite artist is Micheal Jackson. All of his songs are my favorite.

What’s the best advice you’ve ever received?

The best advice I ever received was to work hard because my hard work will eventually pay off, even if I don’t see it immediately.

Houry Gebeshian is a Surgical PA on the labor and delivery floor at Cleveland Clinic Fairview Hospital in Cleveland, OH, and received her PA training from Wake Forest University School of Medicine. Most recently, she was the first female gymnast to represent the Republic of Armenia at the 2016 Olympic Games in Rio.