On this week’s episode of Money, I’m Home, Lynne is joined by Cherry Health’s Chief Medical Officer, Dr. Elizabeth Warner to discuss her new role and the upcoming Prescription Strength event.

 

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0:00:06.6 Lynne Jarman-Johnson: Money, I’m home. Welcome and I’m Lynne Jarman-Johnson with Consumers Credit Union. From finance to fitness, we have it all. And we also love to focus on health, the health of our members, the health of our community, and boy, do we have a treat for you today. Dr. Elizabeth Warner is the brand-new Chief Medical Officer for Cherry Health, one of our fabulous partners here in Michigan. Dr. Warner, thanks so much for being with us today. You’re so busy.

0:00:36.8 Elizabeth Warner (EW): Oh, it’s my pleasure. I’m new to the organization and just absorbing all of the great work that Cherry Health does and all of the varied services that we provide in six different counties and 20 different sites. So, it’s a really steep learning journey and I’m really enjoying the climb.

0:00:55.4 LJJ: What’s interesting, Dr. Warner is, you might be new to Cherry Health, but you’re not new to medicine. Let’s hear a little bit about your background. Number one, go green. I know you’re an MSU grad. [laughter]

0:01:07.4 EW: Go white. My undergraduate degree is actually a bachelor’s in arts in International Relations with a minor in French, and then I decided to become a physician, went back to undergrad for a couple of years to get all of my pre-med work and then started at Michigan State University College of Human Medicine because MSU has both the DO program and an MD program. I finished my internal medicine residency in Kalamazoo, Michigan, and started work as a primary care internist, so longitudinal relationships with adults over their lifespan for the first 12-13 years of my career. Other clinical work that I’ve done has been a little bit of hospitalist work, a little bit of work in nursing homes, and then some really rewarding work in palliative care. And then before joining Cherry Health, I was actually the medical director for a PACE program in Kalamazoo region, and that’s PACE, this program of all-inclusive care for the elderly, and got to do that all through the first two-and-a-half years of the pandemic.

0:02:11.5 LJJ: You know something. That had to have been the most eye-opening experience for you. You were right on the front-line of what was happening in elder care.

0:02:21.9 EW: Yeah, absolutely. It was humbling and terrifying and also very clarifying like, “What do we need to do to keep patients safe? What do we need to do to keep staff safe?” That was… It just, it cut away all extraneous noise [chuckle] to try to answer those two questions every day. And of course, I take that spirit with me now that I’ve joined Cherry Health.

0:02:44.5 LJJ: Something that is fascinating to me about your background, what made you change? Here, you have a French background. You’re very focused, obviously, when you were an undergrad. What was it? What said, “Oh wow, I’m changing entirely and going in a new direction?”

0:03:02.2 EW: Oh, boy. Honestly, it was an intuitive epiphany, which sounds kind of crazy, but [chuckle] the sense of, “I wonder what I can do in med school?” And I couldn’t shake that thought. Now, to be fair, I was 23 years old at the time, and I had no idea what it meant to be a doctor. I knew what it meant to enter med school. I knew what it would take to get there. And then with each step of my training… And I like school. I’m very comfortable in a formal learning environment. So, with each step of my training, I would just kind of evaluate, “Okay, who are you now? [chuckle] And what aligns with the kind of human that you want to be and the values that you want to practice?” And each step of my career has really unfolded with subconscious or conscious deliberation and alignment with my values.

 

0:03:53.4 LJJ: Well, Dr. Warner, you’re now at Cherry Health, which is just an amazing organization, and you bring with it all of your past. What are you looking for in the… Obviously, it’s been a very short period of time, but you’ve got to be looking with delight in what you can bring to the table and to our community.

 

0:04:14.5 EW: I look at it actually a lot with humility and trying to understand the great work that’s happening in all of the different service areas of Cherry Health and then to understand how I can support and develop the folks who are delivering care to our patients. When I stepped away from primary care as my main work, it was always with the intention of continuing to serve patients through the lens maybe of continuous improvement work or building a better system or just with a different altitude of how I would think about improving patient care. And so, it’s really with that same objective of saying, “Look at what great work Cherry Health does, and how can I continue to foster, contributing to the mission and then also supporting the people who are delivering that care on a day-to-day basis?”

0:05:07.9 LJJ: When you look at health care now, we have the conversation daily about the fact that you as an individual, not meaning you as Dr. Warner, but any person that’s listening, they have to really focus on how they can help the doctor-patient relationship and how to get back on track and not have fear. And Dr. Warner, how is it that you’re talking not only with your staff, but the day-to-day patients that come in or they aren’t coming in yet because they’re a little just leery? Is that still happening?

0:05:42.7 EW: I think it is, and I think one of the consequences of sheltering in place and then sort of having this hybrid world is now being deliberate about reconnecting with other human beings. Now you referenced the doctor-patient relationship, and so the medical… The clinician-patient relationship is that. It is a relationship. And how is that a meaningful and potentially therapeutic or healing connection? I think we have to re-learn or remind ourselves how to do that as humans because yes, I’m a physician, I’m also a patient. I’m a mom. I also need dentistry, [laughter] and I seek behavioral health services. So, I’m on both sides of those service relationships. And I have to be deliberate about saying, “How do I forge connections in my life?” And I hope that everyone listening can think about that and say, “Alright. I did used to have a great relationship with my, fill in the blank, my nurse midwife, my dental assistant, my dental hygienist, my counselor.” And oh, we need that. We need connection like we need air and sleep. And so, I hope that people can remind themselves of that and figure out how they can do that with least fear and with a little more hope.

0:07:10.1 LJJ: You bring hope every day, Cherry Health across the State of Michigan. Dr. Warner, I know there’s a big event coming up that also brings a fresh light to health care and quality care. It’s called Prescription Strength. It’s May 9th. Consumers will be there in force. We love our partnership and our team. What is it that you’re looking at as this is your first Prescription Strength that you’re attending? What’s your thoughts about the fun that happens with events? And hey, we’re going to be back face-to-face.

0:07:42.8 EW: Yes, the whole team is so excited that we’re going to be able to come back together live. It’s a very concise and festive event, so in that one hour between 12:00 and 1:00 at the Watermark Country Club, we’re going to be coming together, eating together, sharing a short program and hopefully inspiring folks to support the beautiful mission of Cherry Health. I joined Cherry Health because of its strong mission-driven focus, and I really expect that Prescription Strength will be a big celebration event.

0:08:14.8 LJJ: You know as you are hitting the ground running, can you give us an example of mission in action?

0:08:20.5 EW: Well, we can talk about what Prescription Strength is focusing on this year, thinking about and focusing on adverse childhood experiences. The acronym is ACE, A-C-E. The more these ACEs that stack up in a young person’s life has very dramatic behavioral health and health consequences for the rest of their lives, including reduction of life expectancy by up to 20 years. So, when we think about adverse childhood experiences, if we can understand those upfront, then we can try to soften their impact. We can try to give families and kids different resources, different coping strategies to be able to go through the world differently or with a softening of the risk that these adverse childhood experiences can play out in someone’s life.

0:09:12.7 EW: What we can see here at Cherry Health is the Pediatric Department identified this as a significant opportunity and was formally trained by the Children Advocacy Center of Kent County to participate and understand, “What are adverse childhood experiences? How would we screen for them? How would we gather this data, and most importantly, then how would we support the patients and families once we know that maybe they have an elevated ACE score?”

0:09:43.2 LJJ: It sounds like this is like a scoring system. What are some of the adverse issues that are happening that you’re scoring?

0:09:51.2 EW: There’s actually 17 questions in 10 different domains, but the three big categories are: Childhood abuse, and that could be emotional, physical or sexual; neglect, which could be emotional or physical; and household challenges, and that would include things like, if a mother was treated violently and a child witnessed that, substance misuse, mental illness, separation and divorce, or the incarceration of household members. And the numbers are astounding that all of the folks in the original study had one ACE, but 16% of folks have four of those categories that I just referenced.

0:10:34.0 LJJ: Isn’t this where Cherry Health really shines? Where you begin to partner with community organizations to find out, “Okay, how can we now help?” It’s beyond health care too, isn’t it?

0:10:47.3 EW: It is. It’s both/and. If we know the ACE score, we can start to deploy all the resources that we have internally. So, if there’s barriers to dental care. They’ve never been to a dentist before or maybe they were struck in the face as a child and they’re afraid to have somebody going to their mouth. We can navigate that just through the services that Cherry Health provides, but helping somebody feel safe swallowing a pill, which might have some trigger from back when they were a young child are all things that we can do in-house. And then to your point, the ways that we collaborate with the community, the ways that we can access other community resources would be an additional extension of that.

0:11:30.3 LJJ: And I think you bring up the greatest point. You don’t know until you’re truly face-to-face and asking the questions and finding out, digging deep and helping families.

0:11:41.5 EW: I think what I’d really love to leave your listeners with is this sense of having a spirit of trauma-informed care as we think about caring for all of our fellow human beings. If we enter the space of serving patients with a trauma-informed lens, we will assume that folks have experienced trauma. We have this tool that will help us quantify it and navigate it. And then we shift from asking a question like, “What’s wrong with you? Why did you do that? What were you thinking? What’s the problem with taking your meds?” And we can shift that into a trauma-informed lens of, “What happened to you? What contributed to you not wanting or taking your meds or fill the blank with the barrier?” And that sense of curiosity and assumption that something might have happened to you that would perfectly explain why you’re behaving the way you’re behaving. And if I can align with that and understand that, then I can be part of your healing.

0:12:58.9 LJJ: Absolute compassion.

0:13:00.5 EW: Yeah. Parked with curiosity and empathy to say like, “I’m not helping that person. That person is me [laughter] or could be me.”

0:13:11.3 LJJ: Well, Dr. Warner first off, welcome to Cherry Health. We are so glad you took the time to talk with us today and our listeners about not only Prescription Health, but ACE and all your background is just fascinating.

0:13:25.9 EW: Oh, well, thank you. I just hope that folks can join us at Prescription Strength on May 9th, and it was a pleasure talking with you.

0:13:33.5 LJJ: Thank you, Dr. Warner. Hey, thank you for listening.

0:13:35.2 EW: Thank you.

0:13:36.7 LJJ: If you have any questions or you would like to attend Prescription Strength and/or donate, it’s [email protected]. We also will have information in our website, consumerscu.org, that gives you information on how to get tickets and/or how to donate. We would love to have you participate. Also volunteer with Cherry Health, such great opportunities. Thanks again, Dr. Warner.

0:14:02.3 EW: Truly a pleasure.

0:14:03.7 LJJ: And Hey, Jake Esselink, thank you for your production skills. We sure do appreciate it. Again, if you have a topic that you’d like to share with us, please send it our way. I am Lynne Jarman-Johnson with Consumers Credit Union. Money, I’m Home.

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