Why This CEO Says "You Can't Chart Vitals If Your Heart's Not In It" - Tory Starr

[0:16]  Welcome back to another episode here on the Heart Hustle Podcast. Our next guest says, "You can't chart vitals if your own heart's not in it." That's what he actually learned after 30 years in leadership. He said he didn't need another job. He actually needed one where it would let him serve his neighbors and die knowing that he left it all on the field. So Tori, I mean, you had a big career. Why chose this moment, this place to go all in? Man,

[0:40]  I I think I'm very fortunate that I am able, this will be the last job that I have in my career. and the fact that I was able to return to my community and actually do work that I consider to be vital for the health of the community, not just in the clinical fashion, but unless you have a really robust and comprehensive primary care delivery system in a community, nothing really works well, right? It it really is one of those foundational and fundamental elements that any community needs to have to really be successful. So, it was just a I felt really fortunate and blessed to be able to have the opportunity to come back and finish my career out doing that kind of work.

[1:34]  And you said your last job, man. So, what did that really mean to you the first day you're showing up on on on the job for Open Door? I think it's it's interesting as you progress through your career as a leader to really kind of understand where you are in your own career and also where you are in your life, right? I mean, there are seasons to um every component. And so, I'm fortunate to be at this point in time that this would be the last job that I would probably do in my career. And I've had a very wonderful career as a nurse. I think you know fundamentally I always relate back to my core and I you know got my nursing um license 40 plus years ago and have had this wonderful opportunity to you know serve and do a number of different things with that um particular career path. So, it's it's fun to be able to do a variety of things and to explore and continuous continuously learn my whole career.

[2:42]  I was going to ask you what did you do prior, but you just answered it. You said nursing. So, I can only imagine all these years in nursing. There's something you take away from there that allows you to say, you know what, I want to implement everything that was maybe done wrong here or things that I learned here and put it into the open door mission. anything that comes to mind from that you left in the nursing field you took with you and then brought it back to open door.

[3:04]  Yeah, I I would go back to being a lifelong learner. I mean, I've always had an intense curiosity and um just kind of a voracious appetite for learning. Um, and so whether it be in my particular field or career, but just in general, I think knowledge is a wonderful thing to have. Um, and that probably stems back to my childhood riding around. My dad was a salesman and we would ride with him in his car and we were always asking him questions, right? And and I think that ability to always be curious and ask questions. And one of my favorite examples that I have never forgotten, so this is this shows how old I am. When I was in junior college, we still had chalkboards.

[3:56]  Lord, I remember those so

[3:59]  chalkboards. and my professor was biology drew a circle on the chalkboard and he said everything inside the circle is the things we know and everything outside the circle is all the things we don't know and the peripheral of the circle is all the questions we can ask right so as we ask more questions and the circle on the inside grows as our knowledge grows it just turns out we can ask more questions

[4:29]  and I've always appreciated that that if you approach life that way and leadership that way, it gives you this kind of joy of exploration. And so this point in my career, I'm still learning how to be a good leader, right? I'm still learning how to take care of my community because there's always something else to learn. Oh man, I'm here looking. I had something on my desk that you would uh loved, but maybe I moved it recently. But uh man, where did I put this thing? It was a a floppy disc.

[4:58]  Mhm. I found a floppy disc and I'm like, I wonder what's in this. I brought it inside to show my wife. Um, so a couple of things that, you know, what chalkboard comes to mind. A floppy disc comes to mind. A projector. When I go now to the schools and work, they have this smartboard. I don't know how to turn it on and how to get it on the smartboard. I was like, you know, back in the days, they had those clear transparent sheets that they would just go ahead and write and they'll have to file it away. Like,

[5:21]  oh man. Nowadays, they just they technology has really taken over. They don't need to experience that. Um, another thing that just brings uh some memories here is that you mentioned just being curious and asking questions, right? Um, first of all, my child is doing that now. I have a four-year-old. She's very curious and asking a lot of questions. But that's truly every single day is a learning lesson, you know, and I always when I speak to those that are are getting into the leadership roles, I always say it's okay to ask questions because you can only do with what you know. And if you don't know, then how are you supposed to do, you know? So, be okay asking away. I tell that to my team all the way. Don't just guess because then you'll just make more work for yourself. You'll end up doing double the work and things like that. So, I love that you kind of brought those things in, man. Asking questions, being curious, learning something new every day, you know, and you going into from nursing to now you're the CEO. Is that correct of Open Door?

[6:14]  Yes. Yes.

[6:15]  Like I'm pretty sure a lot of questions had to be asked to get to that point. Do you remember some questions you you had asked yourself before taking a role as a CEO? you know, I've been in leadership for probably 30 years in my career in various ways. Um, and I think one of the greatest privileges that you can have is to actually help lead people versus manage people.

[6:42]  Yeah.

[6:42]  Right. I mean, there's a distinct difference between that and um that's a journey that I don't think ever ends, right? on how to be able to lead. And you know the lessons that you learn along that journey are that fundamentally especially in healthcare especially in community health with which I'm engaged in now is that

[7:09]  we're really a group of people that take care of other people right fundamentally. So my job as a leader is to take care of the folks within my organization so they can care for the folks that come in to receive service, right? And and so what that means is the best important thing to do is to go and talk to the people doing the work

[7:34]  and asking them how it's going and where are our opportunities to do better or what are the challenges that you're facing and also generally they will know those opportunities and those challenges. they probably have some pretty good ideas on how to overcome those. And so I think as a leader, the important thing is to go and listen to the people that are doing the work and then be the one to help remove the barriers that they find to being able to do their job. Well, I think if you hire folks that are connected to your mission, then what you really are trying to do is unleash their potential.

[8:18]  Right.

[8:19]  Correct. Yeah. So it's different than managing people depending on the kind of work that you do and I've just been fortunate to be in health care where generally people are

[8:29]  drawn to the profession because they have an underlying desire to help

[8:36]  right we fortunately way to make some money in doing it also but fundamentally people want to help. I love that you said the managing leader. Like I was fortunate to be a manager, right, general manager at 19 years old. And that's really the first time I realized I was a leader. I was leading this team. I was I, you know, we wanted to be the better store out of out all the districts. And we were, but one thing someone told me and I had to realize is um some people may not be okay with your leadership for whatever reason that is. And that's okay. You know, and I would remember I was 19 20 years old. The gentleman was 50some years old and he says, "Ephra, I love you. I think you're great and I think with the right team, you're going to be an amazing leader. I just cannot be a part of this team." And he never really told me why. But now as I I look, I'm like, who who didn't want to listen to a I'm 50ome years old and I'm listening to a 19-year-old. But he wasn't saying I wasn't a good leader. I just wasn't the leader for him. Right? And then as I continue that path and I realized people get into management and play exactly that role, a manager, but it's not you're more than a manager and I think companies don't do enough to actually pour into the leadership aspect of what that actually entails. Um, so I love that you're kind of bringing in that whole bunch of different aspects of leadership and going down your journey, man. And it looks like you got some more stuff to tell. Tell us, Tori.

[9:56]  Well, yeah. No, it's great. It's all, you know, part of of the joy of life is having, you know, dialogue with people because you learn things as you go along and it makes you remember things. Um, and and there's a distinct difference between management and leadership and my desire and interest has always led into leadership, right? And and you brought up some interesting things. We have multiple generations in the workforce right now, right? And so your your observation so one thing you have self-awareness is very important right so one of my favorite authors in leadership is a gentleman named Stephven CVY and one of his core tenants that I've always remembered he said first seek to understand then to be understood

[10:49]  love it

[10:49]  so so in in your example right like to have awareness as n at 19 is more difficult than to have awareness at 57

[11:00]  of of how what is my impact on the person right like so understanding that creates the opportunity for potentially working better together right from that standpoint so so I think I would I've always and I share that with my leadership team that that premise right like we should approach things with curiosity and and really trying to understand where the other is coming from. The simple act of doing that

[11:29]  shows respect and fundamentally all relationships to be successful have to have be have trust in them.

[11:38]  Correct?

[11:38]  And one of the elements of trust is that you feel like the person has good intention towards you which is that they respect you. Right? So, so just the just being curious and asking questions starts to create the environment and the atmosphere for success,

[11:57]  right?

[11:57]  You know, I wish you would have gave me these these gems earlier in life, right? Because I only assume why he said what he said and I'm going assuming the correct way, but if I were to ask the question, I'm pretty sure that's what he would have told me. But no, you are right. Asking questions, getting, you know, getting that information. And I and this is a question that's come up lately. Someone asked me and now I'm asking other leaders. Is that leadership? Is that something that is taught or something you're born with?

[12:22]  Oh, that's sort of like the nature versus nurture argument about, you know, human development. It's both,

[12:30]  right? It's both. I I think the the inherent or intuitive part is that you you have to have some kind of inner desire to do it, right? That's going to because leadership's not easy. People people think that what you are perceived in the media and print and stuff, it's not easy to be a leader, right? So, you have to have a desire internally to do that. And then you really do have to continually seek out in your career to learn more to how to do it better. And then if you're fortunate as I am, then you can start to share it with others, right? Not as the the person of wisdom, but really in a dialogue with people about here's my experience. I'm just sharing you with you my experience and you could take what you want from it. you you brought up an another important part that leadership is something that you have to develop in people. And so my responsibility is we have multiple layers. We're a pretty goodiz organization. We have 800 people that work for us. So we have multiple layers. We have 13 different clinical sites. So there's lots of people in leadership positions across the organization. All of them come with certain levels of skill and certain levels of maturity and certain levels of experience and we have to continually invest in them because they're way more important than I am. I'm the CEO. Okay. But really the people that are experiencing leadership are experiencing right at where they do the work. So, we have done a lot of work, development, investment in our frontline leaders because they're way more important than I am because they're the ones that are creating the experience for the folks doing the care. So,

[14:30]  hey, real quick, if you enjoying the podcast, we first want to say thank you and we also just want to give you a little insight of what we're up to at Francis. Some don't even realize that we're working with organizations to help them use AI to create that real human communication experiences. Whether that's actually supporting your your families, those patients or the entire community, we're actually creating tech that connects. Check it out. Francis.ai. I'm glad you recognize that, right? A lot of times as as a a leader, a CEO, we're at a desk, we're in an office, and some people, not you, because you're a great leader, forget to go back to where all started. And me, it's like I'd never forget. I mean, if I was making subs on the front line, you'll find me during lunchtime making subs. Not that I needed to, but I felt that I had to show up, right? I I I wanted to practice what we preach. I wanted them to be fast, efficient. I wanted them to show customer service. I had to show them what that looked like, not just tell them. Because as a father, Tori, I'm learning, you know, people don't listen to what you do or say. They actually watch what you do. So my kids are are learning example of that, you know. So I love that you talked about just investing. I think we're in a space now we're really investing in something different, which is technology. We spoke about it um last time we had a conversation where people are looking for especially in the healthcare. So many people were lost during the pandemic, Tom, because they were forced to do more of what they hated and less of what they loved. So now we're hearing AI transcribe is is things that people are utilizing to do more of face to face instead of 15 minutes documenting. I can take 10 more minutes of that and just look at you in your eyes and have a conversation. You know, really get to know you. Um, so what are you guys doing at Open Door to just not only invest into the individual through a leadership, but even technology to allow them to do their jobs better and do more of what they love? Is that something that you guys are into right now?

[16:24]  Very much so. Um, it everything's interconnected, right? So, you know, it's like the ripple of, you know, when you toss a pebble in a pond, the ripple goes out, right? And it impacts things along the way. Um so for us we look at three main things that we are always striving for at open door and so we live in a rural committ community people always need access to health care right so so we're always trying to figure out how we can expand our access right and then we're always looking at to improve quality right we want to make sure that the service that we deliver is always the best that it could poss possibly be. And and third, and probably most importantly, we're trying to create an environment in which people like to work, right? Like we want them to go home at and at the end of the day, we want them to feel like they made a positive contribution

[17:24]  and they wake up the next morning and they go, I'd like to go do that again.

[17:28]  Simple, but it takes a lot to make that happen. Especially in healthcare today, um we don't have enough time in this particular dialogue, but um people do what they get rewarded for, right? And and right now we have a healthcare delivery system. Unfortunately, I work for a notfor-profit, right? I work for a community health center. So our

[17:54]  motivation is different than a for-profit, but the healthc care delivery system in America really is a for-profit system, which makes it very difficult for people who have gone into health care to help people achieve that with a productionbased system. So, we pay a lot of attention to what brings joy and meaning to our staff and it's not paperwork, it's not technology, it's taking care of people, right? So, so we're looking to leverage technology and you gave a great example of that so that people can spend more time taking care of people and not doing the mindn numbing and soul sucking things like documentation and paperwork and those things. So I believe that there is great promise with technology such as artificial intelligence to help people get back to doing what brings them joy in medicine, right? And take away the things that really has decreased their motivation like paperwork. So the electronic medical record came in almost 20 years ago and it was supposed to revolutionize health care so that we could communicate better across multiple different levels of care in different organizations and like most technology it advanced quicker than we knew how to manage it right

[19:33]  um and so it's taken us a while to catch up because it ended up and most people will say this to you like I don't really enjoy going in to see my provider because they're on the computer and they're always typing something in versus looking me in the eye and and talking with me, right? So, if we can remove that barrier so that that electronic requirement had created a barrier between patient and provider, AI gives us the potential to take that away, right? that the provider can be back having direct communication, eye contact with the patient like you and I are doing right now and everything is being taken care of in the background. Right? So I I believe we should always look at technology that will create the opportunity for that interaction to occur, right? And so whatever we do and and technology advances very quickly, but we often have no idea of how to do anything with it.

[20:35]  You you know, you're so right on these things. I feel like people don't go see a doctor the way that they used to because the experience is not the same, right? It's all about the experience. We go to eat, we want a good experience. We go to a Disney World, we want a good experience. And it's the same thing when we go check our for our health and how we doing. We want a good experience. And if we felt that we went somewhere and and these bills are not cheap, Tori, okay, these bills that we receive are are huge bills. And we think like, wow, you guys are charging me all that. The person doesn't even know me. The person barely gave me the information that I needed. I got to go see another doctor and then another doctor. So it it becomes so difficult. But I can imagine it's not the clinician's fault. It's just the system, just how the system has been created. But there's pieces I'm hearing. You know, I'm almost at this point talking to so many leaders in the healthcare space that I'm like, I want to go see a doctor and see what the experience is now with AI transcribe. Is it really working? Did the experience become a little bit different? I shouldn't go now, Tori. I should wait a little bit.

[21:33]  Yeah, it's it's still not quite there, but the potential is there.

[21:38]  Love it. And and you know what my job as a leader is to create the environment that people feel like they made a positive impact and they want to come back the next day, right? And so we always have to to look at that and and if we want it's more important to keep someone than to recruit somebody new,

[21:59]  right? Because and and and the system is evolving. when your parents grew up potentially they would have a provider their entire life, right? But that's not the system that we have now. And that's not necessarily bad, but what you want is consistency in the team. That the care we deliver now is much more teambased than individualbased. And another expression that I use in leadership, um, and I did not come up with this, I learned it from others. There's an expression that says, if you want to go fast, you go alone.

[22:39]  I heard it.

[22:39]  You want to go far, you go together. Right? And so,

[22:44]  and it also is if you want to do something hard, you have to do it together because a team is much more capable of overcoming something difficult than an individual.

[22:57]  You there's so many leaders that are asking themselves right now and you someone that has built culture um that learns and evolves like if someone's listening to right now, what is that first move that you tell the nonprofit leader they should really start to think about? Well, I think it goes goes back to when especially in the nonprofit spaces, you're working for an organization that has a mission, right? And so your job as the leader is to make sure that you can fulfill your mission and then you work backwards from there, right? You begin with the end in mind, right? And then work backwards from there. And then I think probably the next thing is hiring the right people. You know, if you hire the right people that are in alignment with your mission and in alignment with your values, you can teach people anything. You can't teach them to be aligned with your mission. Right? So I I think it goes fundamentally we should never underestimate especially in the healthcare sector the power of people versus technology.

[24:07]  Right? There are very other industries that are very techheavy and you need the technical expertise, but I mean from a nonprofit world, you really want to have people that are aligned and your people are your most important resource. So I would say start with that in mind, right? That have the right people, have the right culture, then you can do anything that comes your way.

[24:30]  And it takes time. People I want people to know it takes a little bit of time. It's like dating. I always say find the right person is like dating. Okay? Just how we had to find the right spouse in our lives. It's the same damn way where you go look for people to go work for you. It's not going to be the first person. It might not be the second. It takes a little bit of time. Um, one cool thing that I think you're you've mentioned um the last time we spoke as well was you're taking kids inside clinics in junior high.

[24:53]  Um, what was the mindset of let's start young. Let's let's show them this opportunity at a young age.

[25:00]  Well, our experiences guide our beliefs, right? And so

[25:08]  we forget sometimes that it's not all about just being didactic in learning. It's the experiences that you have. And so

[25:16]  if you aren't growing up in a household that your parents are involved in health care, how would you get exposed to it? It's the few times. And generally the younger you are, the less you need health care,

[25:28]  right? So how would you even know what a career in healthcare is like? And if you're only seeing what's on the media or TV, that is not reality. And so it's important for people to be exposed to what the opportunities are. And so we have to create that opportunity and it starts early, right?

[25:53]  Yeah. Great. So yeah, and that's why we have tried to in in a rural community, our greatest opportunity for people to be recruited essentially is from within the community that they have to go off to maybe get the advanced training, but their connectivity to the community starts early and then people migrate back, right?

[26:16]  I love that. See, that's good leadership right there, Tori. That's a good leadership. What are some of the things you guys are offering in Open Door? For those that we've heard Open Door, open door throughout this whole conversation. Let's talk about some of the programs and services that Open Door offers. You know, you think seven locations has to be some some good stuff there that people may not even know exists.

[26:32]  Well, we're part of the community health movement. So, we're a community health center, right? And the community health center movement actually started as a social justice movement over 50 years ago. We forget, but we're gonna unfortunately rediscover here that uh there were times when tens of millions of people had no insurance in our country. And then if you don't have insurance, your access to health care is very limited. And and that's where the community health center movement came from is because we had tens of millions of people that couldn't get health care because they couldn't afford it. And with the affordable care act that happened 12 years ago, suddenly everybody had coverage and suddenly we were able to do more things. So, so community health centers started off in the social justice and now we're just we take care of over 35 million people in this country are cared for in a community health center, right? And so we've really become a major part especially in the primary care world, right? um as part of the delivery system and we take care of the folks that are often underserved compared to other parts of the health care system. So um and 50 years ago we spent a lot of time around mom and babies and now because of the demographic changes we are becoming very competent and capable um providers of senior care right just because the demographic um I did some projections on our current patient population and within five years we will have the same number of Medicare patients as we do of Medicaid patients. So which is very different than most community health centers. So for us for example we provide essentially all the services from birth to death right. So we do OB right and do family practice family medicine. Um we do behavioral health and mental health services. Um we have a pharmacy so we can provide pharmacy services to our patients. Um and then we do dental care. So the the idea behind a community health center was that you could come to us and receive almost every service that you need. So we certainly coordinate with the specialty care right from that standpoint, but the idea is that we would be the center of your medical home and that you could get everything you need here. Uh and we've done a pretty good job of that. So we actually have 13 clinical sites. We serve two counties the size of Connecticut. We see over 60,000 people a year. We do over 350,000 visits a year with folks. So, um, we've gone from being a small little free clinic in the college town to the largest provider in primary care in two counties. So, and our and our journey is similar to many other community health centers.

[29:30]  That is cool, man. I mean, the growth is real. How long you been with the organization, Ali?

[29:34]  Uh, six years. When you started, how many locations did you guys have?

[29:38]  Same. The same. We're in a pretty consistently stable environment being in a rural area. People forget how big California is. We're way up in the northwestern corner of California. We call it behind the redwood curtain, behind the redwood trees up here. So,

[29:55]  well, I love it, Tori. Tori, we're actually coming to an end here, man. So, where can people find uh where's the website that people can find more information on Open Door? Um, if people can connect with you on LinkedIn, are you on LinkedIn? Do they also know that information? Just any socials that people can go and check out?

[30:09]  Sure. Yeah. I mean, we have the classic uh social media. So, we have a web page, we have a Facebook page, we have an Instagram page. Um, there's more than one open door in the country. So, we're the one in northwestern part of California. Uh, I am on um LinkedIn from that standpoint. So, we're easily found if you want to look. There is uh other open doors throughout the country, but we're the one in California.

[30:36]  Probably the one they should care about, right? I'm just joking.

[30:39]  All community health centers are important.

[30:42]  Just joking. No, I leave you with this blind question, Tori. Of course, I had to cater it to you as well. If you could write one prescription for America that has nothing to do with medicine, what would it be? I think we need to get back to realizing that we're all in this together and we should stop fighting with each other and learn how the joy of working together is there.

[31:10]  That is so crazy. You're the second person I spoke to today that said that like you know we just have to help each other and it is true. So many times we're divided. even organizations sometimes that could really come together to be very powerful are still divided because of just how

[31:26]  we see the world how the world has really taught us to be in a sense um so I love that you said doing it together you know

[31:32]  I would do one other prescription

[31:35]  go ahead go ahead what is it

[31:37]  I would say don't pick up your phone for at least an hour after you wake up and put your phone down at least an hour before you go Go to sleep.

[31:48]  Damn, Tori, you're talking to me. Okay, sorry. I'm going to put my

[31:54]  Your world will be a better place if you do that. I can guarantee.

[31:58]  I hear that. I'm trying. I'mma try. I'm definitely I'm trying. When you grow up with this in your hand, it's like I can't let it go. Uh Terry, what is your blind question to the next leader?

[32:07]  Excuse me.

[32:08]  What is your blind question to the next leader? You have a blind question you want to give to someone else?

[32:12]  Oh, um

[32:15]  if not, it's all right. I just thought maybe you wanted to pass along.

[32:18]  No, I think it's interesting. I've been fortunate. I didn't have a career path, but I just kind of always kept open and when you keep your eyes open and you're open to potential, lots of opportunities will come your way.

[32:36]  Love it, brother. Well, Tori, it's been a pleasure, man. I can't believe how time just really flies. This is why we got to just do more of just conversating, right? Like there's so much to provide in a conversation and and I love it because sometimes I have conversation with friends and I'm like if only this was a podcast because there would be so many things that we talk about that people need to hear and I love that you were just so open authentically yourself today and allowed people to understand the healthcare world just a little bit more but also all the insights if you've grown I mean you've had and dropped today after 30 40 plus years just in the healthcare space and still loving it right still loving it still having a passion for it. So thank you so much Tori for the conversation guys if you guys want to hear more conversation like this. So just continue to share the stories really being able to make impact because a lot of the times change starts with someone hearing a story. So hopefully this actually resonated with you. You guys make sure you guys do tag someone in the comments. Uh make sure you guys do share and also just check out Tori on LinkedIn. Man, this dude's doing some phenomenal things. But Tori, we thank you. My name is Erain. This is Tori. We'll catch you guys in the next episode. Lers. Bye.