Joey Wahler (Host): It's the subject of Healthcare Executive Magazine's cover story for its July and August 2026 issue. So, we're discussing strengthening trust in our communities. Our guest is Dr. Thomas Lee. He's Chief Medical officer for Press Ganey. This is the Healthcare Executive podcast from the American College of Healthcare Executives, providing you with insightful commentary and developments in the world of healthcare leadership.

To learn more, please visit ache.org. And a reminder, you don't need more tools. You need results. Med-Metrix helps health systems deliver solutions that turn revenue cycle management into predictable yield end-to-end or where you need it most. Find out how at med-metrix.com. Thanks so much for joining us. I'm Joey Wahler. Hi there, Doctor. Welcome.

Thomas Lee, MD: I'm delighted to be here. And Joey, please call me Tom.

Host: I will, absolutely, with your permission. And so, first then, Tom, in a nutshell, what would you say led you to healthcare as a profession and specifically to becoming an internist?

Thomas Lee, MD: Well, you know, I am a child of immigrants, and like many child of immigrants in the Baby Boom generation, we were looking for roles where we could do good work that would be secure, that did matter, but we wanted to make the world a better place. There was that optimism of the baby boomer generation. I still have it.

Host: And how about being an internist specifically? What was it about that that drew you?

Thomas Lee, MD: Well, I mean, I like doing procedures. I trained in cardiology. I did cardiac cath. But there is something special about taking care of patients over time. I do primary care in my clinical work. And when I see patients tomorrow, I have ten patients, and I've got a chance to go ten out of ten for having people walk out the door feeling, "I'm so lucky that I have that person as my doctor." being an internist allows you to do that every day, every patient.

Host: That's great to hear. So, what would you say is your role at Press Ganey and what led you to that?

Thomas Lee, MD: I was in senior management of Mass General Brigham. It was called Partners HealthCare back then for eighteen years. But then, the chance to actually try to have impact on a broader scale across the country and even beyond by helping shape the performance framework for healthcare, that was attractive to me. It wasn't like I felt like I had finished all the work that I could possibly do at Mass General and the Brigham, where I still practice, but there was a special opportunity by changing the measurement framework to actually having more impact.

Host: Now, we alluded to it at the start here in the Healthcare Executive story entitled Strengthening Trust in the Community. You're quoted as saying, "When life and the world feel unstable, healthcare organizations can make it clear that their values are stable." What did you mean by that?

Thomas Lee, MD: Well, we are living in some really challenging times. During these times, let's face it, I mean, trust is at low ebb. Trust is under attack in general in society. And for those of us in healthcare, it's kind of shocking because we know we're good people working hard for good things, but trust is not what it was. And thinking about the nature of the challenge these days, it is clear that in a wild world where everything seems unstable, we have to make it very clear that there's good reason to trust us, that even if everything else is changing, our values are not. Our colleagues, our patients can depend upon us and that is the beginning of earning their trust.

Host: Speaking of which, what does that trust mean to you, Tom, in a patient's care experience from the beginning to the end of a visit? What does that look like to a patient?

Thomas Lee, MD: There's been a lot of very thoughtful research into the nature of trust lately. A lot of it comes out of the business school world. It's more than just being trustworthy myself and being a good person. Well, Frances Frei at Harvard Business School, she has broken it down to three things. There's empathy, authenticity, and then logic. You know, empathy meaning you really are paying attention and caring about that other person. Authentic is it's the real you. It's to your core. But good intentions are not enough. You've got to have a plan. You've got to be effective, and you've got to convey that effectiveness. You've got to be transparent about all three of those things. That's how we earn the trust of patients, and that's how we earn the trust of our colleagues.

Host: Certainly makes sense. Now, you're considered an expert on social capital and its role in healthcare organizations. So, what do you mean by social capital for those uninitiated? How do you get it? And of course, how can healthcare leaders use it to improve care delivery and operations?

Thomas Lee, MD: Well, you know, it's nice of you to put it that way, Joey, because I am getting credit with being the social capital guy in healthcare because I wrote a book last year called Social Capital in Healthcare. But in truth, there's nothing original in that book. You know, everything comes from thoughtful people outside healthcare, and I've just basically been trying to help import it into healthcare.

But social capital, you know, we all have it in our regular lives, our relationships with other people, the trust we have in some people and they have in us, teamwork, reliability. We all love those things, but the idea of building it, like the same way we build financial capital, not blowing it off when we're hemorrhaging social capital. That is really what I'm pushing for. So, the idea of building teamwork, trust, high reliability, the currencies of social capital with the same intensity and discipline that we build financial capital. To do that, that means every single patient, you know, looking in their eyes, forming a connection, and then using that connection to do good things—that kind of discipline, that's what I'm pushing for.

Host: Gotcha. So, switching gears just a bit, Press Ganey together with Vizient are releasing a study linking patient experience data with clinical outcomes at the individual patient level across multiple health systems. So to preview that, how might those results change how leaders think about building trust with patients that you were alluding to earlier?

Thomas Lee, MD: Well, you know, this analysis where we integrated patient experience and the administrative data Vizient has for like five major systems was so cool. And it did show, frankly, what common sense would tell you, was that if we establish better relationships with patients where they trust us more, they work with us better. So, length of stay is actually shorter. Returns to the emergency department and readmissions are shorter. It is common sense.

But the coolest thing there, Joey, is that communication was a good thing. If patients rated communication from their doctors and nurses better, their readmission rate was lower, their length of stay was shorter, particularly on the surgical service. But here's the nuance I love the most. Communication is two ways. You know, there's output and input. So, the clarity of my explanations as a doctor, that's a good thing. If the patients felt I was more clear. But did I seem to be listening? That was two to three times as important than the clarity of my explanations in terms of predicting shorter length of stay and lower readmissions.

When I saw these data, I said to the analyst, I said, "Does this mean I'm doing a better job when my mouth is shut than when my mouth is open?" And she said, "It kind of looks that way." I think what this tells us is that the relationship is what matters. It's not just conveying the facts. It is building trust with people.

And when we show respect, when we show that we're listening to them, it leads to good things. It's like that Maya Angelou quote, which actually wasn't said by her, but everyone attributes it to her, I think, which is that, you know, people won't remember what you said, but they will remember how you made them feel. That's like an important insight for people taking care of patients, and I think it's an important insight for all of us who are having any human interactions.

Host: Absolutely. Very well said there. So speaking of data, what measures or metrics can leaders use to show they're making good progress in building this trust and improving that patient experience?

Thomas Lee, MD: Well, you know, I think the things to look at for both your how patients feel about their care, how employees feel, how providers, you know, doctors, nurses, advanced practice, practitioners, I think the key things to look at are, you know, are things like for the currencies of social capital. Like, do people feel respected or not? Do people feel like the teamwork is good? Do they feel like there's a safety culture that is excellent?

All of our analyses of Press Ganey data are consistent with, we call it the Anna Karenina principle. You know, happy families are all alike, unhappy families are all unhappy in their own ways. Virtually every employee, every patient who is happy, who feel trust in their organization, they feel they're treated with respect, the teamwork is good, and that there's a culture of safety. Those three things, if you don't have one of them, you're in a hole that is hard to dig your way out of. It's an all-hands-on-deck issue.

Host: From a leadership perspective, where do you see the biggest gap between what frontline staff need in high-pressure moments and what executives think they're providing them?

Thomas Lee, MD: Alignment. You know, vertical social capital. Trust that people have at the front lines, that information they have, which is important, will make their way to the top, make its way to the top, and that the people at the top have values that resonate with theirs as they make the difficult decisions that must be made.

That is a very important type of bridging social capital. There's horizontal bridging, and then there's vertical bridging. That vertical bridging in a time of crisis becomes very important because difficult decisions have to be made. And if you trust that they're being made by people who have the information, and you trust that their values are resonant with yours, then you can live with those decisions. If you don't have that kind of trust, you get half-hearted adherence to the decision. So when big organizations are getting bigger and more complex, working on alignment is critical because a lot of leaders, they know they're good people, and they think, "They must know I'm good. They should trust what we're doing." And that doesn't necessarily play out that way.

Host: And speaking of leadership, when you look across organizations, where do you think trust between staff and leadership or with patients, where does that tend to break down first?

Thomas Lee, MD: When we get bigger as organizations, it's a threat to trust. John Kouris, who's the CEO of Tampa General, he and I wrote an article together that talked about the middleman trap, the wholesaler trap, which is big organizations can start to think like wholesalers. They're in between the producers and the customers, and their main focus is volume and price. It's so easy to fall into that trap. And when people aren't seeing you, they don't know that you're trying to do the right things. So, avoiding the wholesaler trap was what I really urge people to be wary of as we get bigger.

Host: The word kindness, not always a term executives use in operational discussions, as you know. So how do you translate kindness into something leaders can actually design and scale? And what impact have you seen on team performance and patient outcomes where that's concerned?

Thomas Lee, MD: Well, you know, I think there are two very important aspects of this issue we raised about kindness. And one of which is that in the era of AI, it's very clear that we humans have to focus on what we bring to the party, what we can do that AI cannot do. And I think it's becoming increasingly clear that we humans have to focus on being better humans, both individually and collectively. So, kindness, it ought to be the default.

You know, I wrote an article with Amy Edmondson and Nicki Macklin in Harvard Business Review last year about kindness. And she started it when she said, Amy, when she said she hated the phrase random acts of kindness, because it shouldn't be random. It should be the way we are all the time.

That's the way we should see ourselves. But there's another dimension to it, which is that kindness is not the same thing as niceness. When you really care about someone, you support them, you do what's in their interest. And sometimes supporting them means giving them tough love. I mean, everyone who's got children, pretty much all of us, have done that at times. We've done some things that were kind to them, but it didn't feel particularly nice. Giving people feedback on how they could be better, that is kindness. To not give them that feedback is unkind, even if it may feel nice in the moment.

So, I would say that in the era that we're in, the AI era, the complex culture era, we have to be better humans, make kindness the way we always are, but that kindness should include tough love.

Host: Very well put. Very important distinction that you make there. A couple of other questions for you. If healthcare leaders joining us could take away just one thing from this conversation and how they can strengthen trust with their patients and in their communities, what would it be? How do you start?

Thomas Lee, MD: I know obviously I'm tuned into the social capital issue, and I'm using the phrase to capture a lot of things important to me. But I think it is the right phrase. It is the right thing. Your relationships with your colleagues, your relationships with your patients, your relationships with your family and friend, they really, really matter. AI is great. But it's going to be a bit of a commodity. We're all going to have AI. It's all going to be great. What'll really distinguish us is our social capital, how we work together, how we relate to each other, how we relate to our technology, that kind of dimension of our work. That'll be what is our big competitive differentiator. So, focusing on social capital. That's the basket I'm putting my biggest eggs in right now

Host: And in summary here, how would you say the work you do at Press Ganey informs your role as an internist? What have you learned that you've applied to patient care, which as you've said, is still so important to you?

Thomas Lee, MD: I love seeing patients. And frankly, I think I'm doing a better job than I ever have before, even though medicine is more challenging all the time because of progress. But now, with the support of AI, I can look patients in the eye and have my interactions with them, and I'm not worrying about forgetting stuff anymore because the Ambient AI scribe is putting it right there in front of me all the time.

I think every single session I have, there's an instance where if I didn't have the AI doing that note, I would have forgotten something important, even though I think I'm doing a pretty good job. The way we can use the tools in front of us to do a better job, and I can, like, ask, you know, large language models right during the patient visit questions that I might have been embarrassed to ask a colleague, is making me better than I've ever been.

Those same kind of tools with patients are also relevant to our lives as managers. And I do think that, you know, our ability to have the information, to ask for help and get help, and hardwire those processes are greater than they've ever been. So as difficult as our challenges are, I would say this is the best of times. You know, this is the golden age. Our ability to understand more of what's going on and respond to it is greater than it's ever been. So, it's hard, but I wouldn't trade our time for any other.

Host: Wow. Well, on that very optimistic, uplifting note, we want to remind people that, again, ACHE members can read more about this topic in Healthcare Executives Magazine's July and August issue cover story entitled Strengthening Trust in the Community. Folks, we trust that you're now more familiar with community trust.

Dr. Lee, keep up all your great work. And, a reminder to folks, he says random acts of kindness should not be random at all. Certainly a thought for the day to keep in mind. Keep up all your great work. Congratulations on all your achievements, and thanks so much again.

Thomas Lee, MD: My pleasure, Joey

Host: For more information, please do visit healthcareexecutive.org. If you found this podcast helpful, please do share it on your social media. And thanks so much again for being part of the Healthcare Executive podcast from the American College of Healthcare Executives.