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After his mother’s journey with breast cancer, Scott Rissmiller discovered the deep desire to make an impact in others’ lives as a physician-leader.
Witnessing his mother’s experience with cancer inspired Scott Rissmiller, MD, chief physician executive at Atrium Health-a Charlotte, North Carolina-based healthcare network that includes more than 40 hospitals and 900 care locations-to become a physician.
His mother’s journey with breast cancer included chemotherapy, surgeries, and recurrences of the disease. Rissmiller’s mother also inspired him to pursue a career in medicine because of her role as a neonatal nurse.
“She really had a passion for it,” he says. His mother passed away due to cancer when Rissmiller was 21 years old.
“When we knew that it was terminal, [I noticed] how her physician would spend time with my mom in her hospital room. Not even talking about medical things. It was just about sitting there and answering her questions. That was probably the most impactful thing that influenced my decision to go into healthcare,” he says.
Guided by life experience
The fact that her physician was completely present with his mother made an impression on Rissmiller.
“I saw the incredible impact that her physician had on not just her medical condition but on her emotional condition,” he says. “Even after she had received bad news, a quick call from her physician could keep her moving forward.”
That’s the type of physician Rissmiller wanted to be.
Also informing his career path were the financial challenges his family endured after Rissmiller’s father lost his job. It was during his high-school years that the family had to sell their house and move into an apartment.
“I also saw my mom having to spend much more emotional energy on how were we going to pay the bills than on getting better,” says Rissmiller. He laments that the healthcare system is still not set up to care for patients and their family members during through their journey through that system.
Committed to transforming patient care
Awareness of those difficulties drives Rissmiller to pursue evidence-based approaches to care.
For example, he led Atrium Health’s efforts to transform the use of blood transfusions. In 2016 (the latest year for which results are available), the health system transfused 104 units per 1,000 patient encounters; that’s down from 221 units per 1,000 patient encounters, according to a spokesperson. Cost savings in 2016 as a result of these efforts were $773,000.
According to a recent JAMA Internal Medicine article, blood transfusion is one of the top overused procedures in U.S. hospitals. According to a 2018 report from ConsumerReports, a unit of blood costs between $200 and $300, in addition to storage and processing costs and hospital fees. Cardiac overload (severe shortness of breath due to overloading the heart with fluid), infections, and lung injury are risks associated with blood transfusions.
Engaging physicians in reviewing the research and “believing in it” is vital. Just as important, according to Rissmiller, is getting physicians to “own” the initiative. That means physicians across the health system drive the initiative, instead of it being a “top-down approach.”
Focused on connecting with patients
In his role as physician-leader at Atrium Health, Rissmiller is responsible for the surgical, primary-care, adult acute-care divisions, in addition to the health system’s behavioral health service line.
It’s his personal relationships with patients-just being present “with a patient who’s really afraid”-that “keep me going from a clinical standpoint,” says Rissmiller.
But encouraging employees to share that level of compassion and empathy can be challenging, especially in a large health system that includes hundreds of care locations.
“Just treating the disease is not enough. You need to engage the patient emotionally and find out about their life outside the hospital.”
He cites one example of a terminally-ill patient’s care team. The patient’s daughter was getting married, and he really wanted to see the wedding; still, the patient’s care team knew he wouldn’t make it to the wedding day.
To support the patient and his family, the nurses on his care team raced out to buy a cake and helped create a wedding ceremony in the patient’s hospital room. “That father was able to see his daughter get married from his bed. It was just an amazing event,” says Rissmiller, adding that the celebration came together spontaneously. He credits Eugene Woods, Atrium Health’s president and CEO, with encouraging all employees to “connect to purpose, which I absolutely love.”
Being mindful about asking what’s going on in the home-such as for the patient with diabetes whose medications must be refrigerated and who can’t afford electricity-is tough, admits Rissmiller. While some physicians have these skills on an innate level, he says these skills can be taught.
Atrium Health offers role-playing-based training where a colleague will act as a patient and the doctor will interact with them and demonstrate their approach to care. The physician then receives real-time feedback and coaching on practical ways to develop a meaningful relationship with the patient. For example, that can include sitting at the bedside and really making eye contact, he adds.
Embracing music and family time
When he’s not coaching physicians on his team or catching up with a patient, Rissmiller steals precious moments to strum on his guitar in his office. It’s been a “passion” since his teen years, and today he counts it as a great stress reliever. While Rissmiller considers Stevie Ray Vaughn his “all-time favorite guitarist,” he’s also a fan of B.B. King and Jimi Hendrix.
But if he can get a few days away from the office, his favorite way to spend time is with his wife and teenage children. He met his wife, a sports medicine physician at Atrium Health, during their residencies.
“We love to ocean fish,” says Rissmiller, and their favorite place to go fishing is Oak Island, one of North Carolina’s Barrier Islands. “It’s the only time I can get the kids off their cell phones,” he jokes.
Aine Cryts is a writer based in Boston.