How to Get a Second Opinion with Nancy Papesh

Unknown Speaker 0:15
white blood. This is George G. And the time is right. welcome today’s guest strong and powerful. Nancy Pappus. Nancy, are you ready to do this? Yes, I am. Let’s do this. All right, let’s go. Nancy is an MBA, an RN and a BS EN. She’s the director of clinical operations at the clinic by Cleveland Clinic. Nancy, excited to have you on, tell us a little about your personal life some more about your work and why you do what you do. Great. Thanks, George. Well, really, I’m just a small town girl born and raised on a farm in North Dakota, with a deep passion to serve and take care of others through the medical profession. From a very young age. I was really drawn to anything medical, whether nursing a baby lamb back to health, or bandaging up my little brother, I knew that this was my calling. Early in my nursing career, I was very clinically focused with experience in critical care, emergency trauma and flight nursing. That all prepared me for some of the fantastic opportunities at the Cleveland Clinic in Cleveland, Ohio, which led me to where I am today, which is I’m a wife, a mother of two. And I’m extremely fortunate to have the opportunity to work with the amazing team at the clinic by Cleveland Clinic, a joint venture between Cleveland Clinic leading world renowned health care organization and AmWell, telehealth provider, providing second opinions to individuals around the world.

Unknown Speaker 1:51
Nice. We were just talking about cold weather before we hit record, Nancy, turns out you are really really familiar with cold weather, North Dakota.

Unknown Speaker 2:00
I tell people I moved to Ohio for warmer weather. They laugh at that.

Unknown Speaker 2:06
They had to migrate south. I grew up in Duluth, Minnesota. So I’m mildly familiar with what you’ve got going on in North Dakota, you absolutely are. All right, well, perfect. So the joint venture, I think it’s it’s exciting. What are some of the problems that you’re working to to solve an address.

Unknown Speaker 2:27
So our virtual Second Opinion program is really an extraordinary service. For individuals that are dealing with a new medical diagnosis, or perhaps have been suffering with a chronic disease that are seeking to understand more about their diagnosis, and to learn what other treatment options may be available to them. Perhaps you have a newly diagnosed heart condition, and you’re looking for surgical options for a minimally invasive repair, which will faster recovery, get you back home, get you back into your life quicker.

Unknown Speaker 3:08
Or maybe you’ve received a devastating cancer diagnosis. And you really want to number one, understand if the staging of the cancer, what is the true staging of the cancer? And what are all of the solutions that might be available to you.

Unknown Speaker 3:25
We are the perfect solution for individuals to seek an outside objective second opinion from the world’s leading medical experts in their fields.

Unknown Speaker 3:37
And I imagine that this is probably a service that that has been done for quite some time. But now that we have just the the wonder of zoom calls and other technologies, it allows people probably all over the country maybe to connect. Absolutely. So how it works is we have a fantastic team of experienced nurses that connect to the with the individual, virtually in the comfort of their own home. Through the animal technology platform. Our nurses learn a little bit about what the individual is seeking a second opinion for what are their hopes, their goals, their objectives, to learn more about their disease and what they’re dealing with. From there, our team takes on the work of collecting all of the necessary medical information, identified the most and then we work to identify the most appropriate expert physician at the Cleveland Clinic to review the case. We have access to over 3500 physicians in over 500 sub specialties at Cleveland Clinic. The final step then in the process is we can neck the individual and the doctor virtually to deliver the second opinion at a time that is convenient for both

Unknown Speaker 5:00
All of this typically occurs within about 11 to 12 days.

Unknown Speaker 5:07
Well, that’s fairly amazing. That’s, that’s, that’s fast. Yeah.

Unknown Speaker 5:13
So I, there’s so many things that you I’m sure had to consider to to create this and to successfully deliver the care. I can only imagine the, the fear, and it’s terrifying to get, you know, bad news. And so you’re very, very, my I would be extremely emotional. So I’m sure that that these nurses, and certainly the physicians are needing to deal with that. And then I imagine there are compliance issues or challenges to work through when you’re sharing information

Unknown Speaker 5:51
virtually, or electronically, or just among different parties.

Unknown Speaker 5:58
Yep, our team works again, really closely, we try to work with the local care team, as well as with the facilities where the individuals are seeking care, that is a challenge for all of us. And we’re continuing to work towards identifying solutions, where we can more openly share the information, really to get it into the hands of the individual that is seeking

Unknown Speaker 6:28
to really take on and learn more about what is happening to them. Knowledge is power, the sooner that the individual can get on the right treatment path for the condition they are dealing with. It truly has such an impact on short and long term outcomes. It enhances their quality of life, and it allows individuals the opportunity to live their best life, reducing the stress our whole team.

Unknown Speaker 7:01
I think anyone in the medical profession wants to do what’s right for the patient, do what’s right for the individual in that space. And our team works really, really hard to make this seamless for the individual going through the experience. You know, we’ve found, nearly a quarter of the patients really do experience some modification in the diagnosis, three quarters of those patients receive additional treatment plan considerations that can be taken to take it back to their local key team to their local care team to discuss.

Unknown Speaker 7:40
I’m truly humbled on a daily basis as I listen and learn from what others are dealing with. The resilience of the human spirit is amazing. And there is honestly nothing more gratifying than connecting these individuals to the experts that are masterful at treating the diseases they are experiencing.

Unknown Speaker 8:01
And that’s our goal.

Unknown Speaker 8:03
Yeah, I think that that’s, that’s, that’s a legitimately amazing thing. So roughly speaking, a quarter of the people who who receive a second opinion, get a modification on on on potential treatment.

Unknown Speaker 8:19
Yeah, it’s a modification that may be modifying and of the diagnosis, and or a change or

Unknown Speaker 8:27
additional treatment options to consider, again, from the sub specialty experts at the Cleveland Clinic that deal with large volumes of patients that are at the stage of the illness or condition they are dealing with. There is there’s many times that they have the opportunity to educate the patient on all that is currently available. Yeah, I’m sure that

Unknown Speaker 8:55
I can’t even imagine just the ocean of information that, you know, there’s and then I imagined that me as the patient, I’m probably on the internet and I’m trying to Google and investigate all these potentially viable treatment options. But what what better than to actually be able to connect with the nurse who can then connect me to the right doctor who can connect me to the right specialist, so on and so forth. 3500 Doctors sounds like a lot.

Unknown Speaker 9:26
Yes, yep. at the Cleveland Clinic, a large healthcare organization. And again, in over 500 sub specialties that truly is taking,

Unknown Speaker 9:40
you know,

Unknown Speaker 9:42
say in the field of neurology there, they care for very specialized conditions in in the field of neurology, so that is what we’re able to do if you’re dealing with diagnosis of epilepsy, or perhaps you have a cerebral aneurysm.

Unknown Speaker 10:00
We have some specialists that work in all those different types of fields. That really that is their primary focus and where they,

Unknown Speaker 10:11
where they spend their day, every day with all of the patients that they interact with. Yeah,

Unknown Speaker 10:18
that makes sense. So the value of a second opinion, like, there’s always been immense value in that, but now that I have access to these resources, and a good percentage 25% Get some kind of a modification or different ideas and or three quarters, I think you also mentioned,

Unknown Speaker 10:38
get some different ideas on different approaches that that, that that are possible. So that’s, that’s invaluable. But there’s probably a cost to this.

Unknown Speaker 10:47
Yeah, there is. So again, we do, there is an out of pocket expense for an individual going through this experience, we do partner with certain health plans, and with employers, and it is our goal to continue to create access to this program, through those health plans and employers as we continue to grow and continue to demonstrate the value of this for people. But the cost,

Unknown Speaker 11:15
I can honestly say that individuals that want to understand

Unknown Speaker 11:22
what might exist,

Unknown Speaker 11:25
it reduces the need for travel, they can stay locally, they’re not flying to Cleveland, or flying to a center of excellence, to learn more about what’s available. There’s cost and all of that for travel stain,

Unknown Speaker 11:42
and the volume of time that you may need to spend at that organization. Again, the cost is minimal compared to what you would spend when you’re traveling to do those. Yeah, yeah. But that makes a ton of sense. And is

Unknown Speaker 11:59
makes sense also, that as you have more data and information that you can go to insurance providers or pay ORs and say, Hey, we are by getting this right, or by getting more accurate diagnoses or prescribing better treatment options, we’re going to be reducing the overall cost of the medical care. Absolutely. Absolutely. That is something that again, I think it is key to, as I mentioned, getting individuals on the right treatment path can really improve those short short and long term outcomes and reduce the downstream impact of treatment that may not be

Unknown Speaker 12:45
as up to date as what is available. In today’s we’re making such huge

Unknown Speaker 12:52
leaps and bounds in care. When I think back. I’ve been in healthcare, dare I say almost 30 years. And what I recall from my early days in the Open Heart Ward, taking care of open heart patients in North Dakota, to what we are doing today, where they’re going home within 12 hours, it’s entirely different, right? It’s so amazing.

Unknown Speaker 13:18
I can’t believe what I’ve been able to see

Unknown Speaker 13:22
in my lifetime and where it will continue to grow. And I really think that digital,

Unknown Speaker 13:29
our ability to access

Unknown Speaker 13:33
through digital means through telehealth platform is so key for us to grow and continue to create access for individuals

Unknown Speaker 13:45
across the board to the leading experts. Yeah.

Unknown Speaker 13:50
So you mentioned that from the time that that it takes around 11 to 12 days. And I think that that’s extraordinary. And obviously, I’m sure that you’re working to minimize that number and to reduce it and to reduce it introduce it.

Unknown Speaker 14:08
How when when when the program started? Well, I guess how long has the program been in existence? We, we the have been in existence for about two and a half years.

Unknown Speaker 14:25
Really heading into almost our third year. And, you know, when we started, we had,

Unknown Speaker 14:33
you know, our turnaround times have always been an area of focus, to continue to again, reduce those and get the information in the hands of the individual. I can tell you,

Unknown Speaker 14:46
you know if records are available digitally and we can get all the necessary consents from both parties. We have turned opinions around in under 24 hours. It’s quite amazing. And as we continue to build out those paths

Unknown Speaker 15:00
Ways to share medical information that’s going to be key to making that much more easy. And then it can, things that can delay is if we are seeking multiple medical records from multiple facilities, obviously, that can take a little bit longer. And so those are some of the challenges that we have. But our team, our care team, of nurses and care coordinators, work day in and day out to focus on getting in the necessary information to turn the opinions around as quickly as possible. Yeah, that makes sense. And do you see a time where you have too many people using this service?

Unknown Speaker 15:44
I can’t imagine that at this point in time. I think that

Unknown Speaker 15:51
the access

Unknown Speaker 15:54
and this story stories, and I have done this, I have lived a long life in healthcare, and I’ve seen a lot in my time and experience and

Unknown Speaker 16:09
what individuals, the stories that come forward, just life changing for individuals, truly life changing, I would want this to be available to as many people as possible.

Unknown Speaker 16:24
Yeah.

Unknown Speaker 16:26
Yeah, that that’s really makes sense. And through technology, it’s probably it’s probably going to happen.

Unknown Speaker 16:32
Yes, that’s the goal. We hope that we can make this happen. Yeah. What is a as as you look at, at, at,

Unknown Speaker 16:44
at the healthcare landscape? What do you wish that that that more people knew just consumers of, of health care? That me as as a healthy person?

Unknown Speaker 16:56
Who’s Who’s Who’s Who’s in my 40s, but it doesn’t matter? What what you wish that the more people did?

Unknown Speaker 17:04
I think seek care take control of their health.

Unknown Speaker 17:12
Knowledge is power, right? So understanding, staying ahead of things. Obviously, staying as healthy as possible, both physically and mentally is so important.

Unknown Speaker 17:26
Diet Exercise, I can’t say enough about mindfulness and meditation. What that does, those are key to individuals living one’s best life, whether they’re fighting to stay healthy, or they’re fighting a disease, right.

Unknown Speaker 17:43
So I, I think that it’s so important to just take control of your health care, seek health care, understand if you have underlying conditions, and, and work to stay ahead of those, and

Unknown Speaker 18:03
understand what is possible for you. I think that we live in such a fast paced world, we forget to take care of ourselves. And this is really, really key. That is I would just wish that because when I when you see the flip side of people waiting too long, I think we saw this in the pandemic, right, individuals stopped getting preventative care, they stopped seeing their physicians,

Unknown Speaker 18:30
and doing their regular follow up. And then on the backside, they have dealt with diet, a disease that’s grown. And now we’re at a different stage in the illness and our options are less. And so I would just say seek care. Knowledge is power, consider getting a second opinion to validate that and understand all treatments that are available to you. There is little harm in learning more. Yeah.

Unknown Speaker 19:02
Well, that’s it. Thank you so much for coming on. Where can people learn more about you? And how can they engage with the clinic by Cleveland Clinic? Absolutely. Head to our website address, which is clinic by Cleveland clinic.com. Here, you can learn more about the program, you can hit the get started button, or if you’re ready, if you’re not quite ready to start, but you want to learn more. You can submit questions to our patient liaison team. We’re here we’re happy to talk with individuals. If they’re thinking about it again clinic by Cleveland clinic.com.

Unknown Speaker 19:39
Well, if you enjoyed as much as I did short answer your appreciation and share today’s show with a friend who also appreciates good ideas, go to clinic, buy Cleveland clinic.com and check out the gray resources. Click the Get Started button if you are in fact ready to get started or you’re also able to submit questions and start a dialogue as well. Thanks good Nancy.

Unknown Speaker 20:00
Thank you George really appreciate it take care and until it’s done holidays safe travels you too oh thank you until next time remember do your part by doing your best

Transcribed by https://otter.ai