Unlocking Strategic Creativity In Health Care With John Englehart

This episode, we are joined by John Englehart, the Senior Vice President and Chief Communications & Marketing Officer at Hospital for Special Surgery (HSS), the world’s largest academic medical center focused on musculoskeletal health. John talks about the important role strategic creativity has in their goal of achieving and advancing a standard of excellence in health care.

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Unlocking Strategic Creativity In Health Care With John Englehart

We welcome John Englehart onto the show. John is the Senior Vice President and Chief Communications and Marketing Officer at the Hospital for Special Surgery, the world’s largest academic medical center focused on musculoskeletal health.

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John, thank you so much for coming to the show.

Thank you for having me, Evan.

You’ve achieved so much in your career and had many interesting experiences. I’m excited to get into a lot of them. First off, I want to go back in time to middle school. What was middle school John like?

The middle school John was known as Enge. Enge was as I suppose I am still now awkward and nerdy in a small town in Western Massachusetts called Long Meadow, with white picket fences, old churches, the drill. Not athletic, a small social circle, and assumed that that was going to be my world forever. I have one sibling, a younger brother, and I played ice hockey and tennis.

The part of my story that my children didn’t catch is that I was bad at ice hockey, but they heard that we play ice hockey. They all went on became ice hockey players and did far better than their father ever did. I’ve enjoyed hockey more vicariously through their exports, but that’s here in Western Massachusetts.

Do you still play your racket sports?

I play and enjoy tennis but don’t get on enough.

I also got into pickleball the last couple of years.

I haven’t yet, but I’m fascinated by it for all kinds of reasons. I’m eager and impressed. If you’re playing pickleball, it’s that much cooler, so I’m going to give it a go.

From Western Mass, small-town, and then you went to Syracuse, which I feel like was probably a big jump or a shock to the system at that point. What I find so interesting is that you were the GM of the student radio show. Were you on air at all?

I was the general manager of 1 of 2 student radio stations. It was the university radio station. One is sanctioned by the Newhouse School of Public Communications, which is famously the best in the nation. There was this other station, which was a student-owned and operated commercial radio station.

That’s WJPZ, which has brought to the world lots of, self not included, remarkable and very talented radio talent on-air broadcasters and administrators. I went and started doing the overnight shifts. I thought that was interesting. I had fun and wound up doing the sales and as manager of the station. At university, I excelled at extracurricular. It was my actual major and radio was part of that.

Kenny Albert came out of that program, which is impressive, but that’s interesting hearing about middle school John was a little shy from a small town and getting on air. That must have been a big step to step out of your comfort zone in order to do that.

People are universally the same, but also universally different.

 

I am an ambivert, the expression where you’re fundamentally an introvert, but you can do the extrovert thing. I discovered the extrovert part with my first girlfriend in high school. That gave me the confidence to go out, experiment, and become a bit more social. In the course of four years at Syracuse, I became perhaps a little too social and radio was part of that, but I enjoyed it. It was fun. You could have both the solitude of being alone, but also engage with a lot of people and learn a lot.

You have the perfect voice for radio. I could imagine you signing off was amazing.

I’m not sure about that, but coming from you, I’ll take that as a compliment. Thank you, Evan.

After school, things start getting interesting. You were the MD at a PR firm owning Hong Kong and China. How does one go from Syracuse and a couple of years later, owning Hong Kong and China at a PR agency?

The key in-between part involves a rollercoaster. In the course of my time at Syracuse, I had a summer job at what is now Six Flags New England. At that time, it was Riverside Amusement Park, which is in Agawam, Massachusetts. It’s a great summer job. I had a good fortune there of getting an opportunity to work in the front office. I happened to wind up working in the marketing group and had that as a job at Syracuse throughout the whole time I was there.

During my senior year, I had this remote job supporting marketing and when I graduated, I left Syracuse, and I continued there. I quickly realized I didn’t want to do that. I wanted to go to New York. Somebody at my bosses at Riverside knew the right person in New York. I went there, got a job, and less than two years later, got transferred through a very big agency through Ogilvy. I had this incredible opportunity to go abroad. At the age of 24, I was sent to Hong Kong as Director of Client Service for a public relations firm for what was the third-largest public relations firm in Hong Kong. I did tons of dumb luck being in a great place at the right time.

Can you speak any other languages?

I cannot. I lived in lots of places. I tried but never did.

Where else have you lived abroad?

I had lived fifteen years altogether abroad. Ten years in Asia, the first and largest chunk was in Hong Kong. From there, I moved to Bangkok, Thailand. From there, I moved into a regional job where I was supposed to go back to Hong Kong, but I didn’t want to go backward. Everybody kindly agreed to let me live in Singapore, as long as I promised to come to Hong Kong every week, which I did. Hong Kong, Bangkok, and Singapore. From Singapore, I moved to London where I was for five years, and back to America.

Having lived in many different places abroad and coming back to the States, what unique advantages do you feel like you have from having spent time in different countries, specifically for your career?

Spending that time abroad at the beginning of a career, a lot of people do go abroad at the end of their career, when they can be insulated from the rest of the world. They go and they’re chairman of this or CEO of that. They whisk around and insulated. A lot of people that go abroad wanted to do was to come back to America for vacations.

Being young and junior, I was fascinated by the communities that I was in. I dove deep everywhere. I spent a lot longer time there than was planned. It was also very humbling going there. I have it be in your face all day every day how much you don’t know. I’m naturally curious about culture, people, and psychology.

 

All of that gave me an appreciation for the fabric of the community and bring humility and curiosity to how different people think, and work and how that can manifest in different cultures. Whether it is the difference between Malaysia and Indonesia or Rhode Island and Connecticut because there are differences everywhere and the way communities work, and the way people behave. People are universally the same, but also universally different. All of that opened, especially coming from the background that I did, where it was all unexpected.

The other piece I mentioned on a rollercoaster was also a girlfriend who has become my wife of now for many years, and whose family had lived abroad. She grew up in Europe. That opened my mind to the possibilities and also how to do it right. It was the gift of those inspirations that opened those possibilities and all of that learning.

The United States is a melting pot. Being able to live abroad, understand different cultures, how different people act, and think, to your point, even though people are universally similar, those learnings must help you so much being back in the States and how to speak to many different potential consumers at HSS.

Fundamentally, it teaches humility and curiosity. Those are two characteristics that are not always common or as strong. I say that from a point of humility, I need to do a much better job of being better at both. Those are two characteristics that are not always as strong as they could be among marketers and all day every day. It’s a reminder of the importance of humility and real curiosity.

In your pre-interview, you mentioned that if you were to teach a college course, the topic would be unlocking the potential for strategic creativity, which those two attributes align with. First off, how would you define strategic creativity?

Creativity as in creativity that solves a problem or meets a need. There’s lots of whimsical or indulgent creativity like, “This is cool. We can do this.” It is great and fabulous but there is an opportunity and a need for more creativity in problem-solving. That capability exists in more people than they realize. There are disciplines and processes that can bring that out to people.

Not only it is helpful in solving problems and advancing causes that are important to you, but also it’s personally rewarding and fulfilling. It’s a way that all of us can have a greater impact. I’m in perpetual pursuit of being better at strategic creativity, finding and exercising what’s within me. That potential exists in pretty much everybody.

We were talking about how everyone on your team is incredible, not only good people, but they’re all curious and think strategically. You mentioned that there are certain frameworks that you could do in order to bring that out of your team. Can you speak a little bit more to that? Is it a certain way you structure meetings? Is it a certain cadence of feedback? How do you bring that creativity and problem solving out of your team?

We’re on a journey to do this. There’s no part of this that we can’t, and don’t need to do a better job of. There’s no secret in any of this. A lot of this is well-trodden stuff, going back to the work of Edward De Bono.

You do it pretty well. We could learn a lot from people.

What we try to do a good job of is first and foremost, having a real understanding of the marketplace or the universe in which we’re working, how it works and why it works that way. What are the influences on that? All of this involves a lot of good fundamental detective work, but getting smart about that and not over-relying upon specialists.

Specialization is good, but when it comes to marketing, in many cases can create more blind spots than bright spots. Blind spots are missed opportunities. What we try to do is have a high level of insightful awareness about the domain and second is to make sure that we’re asking the right questions. Lots of communications, lots of marketing, and lots of requests that we get are for tactical executions of one form or another.

There are lots of things that you can do, but you have to start by being focused on what it is that you’re trying to make different as a result of whatever it is that you wind up doing. What impact are you trying to have? As obvious as that is, I think that is the missing piece in a lot of it. Thirdly is being open and embracing intelligent naivete when it comes to solving those problems.

There is an opportunity and a need for more creativity in problem-solving.

 

We structure our communications and processes around that. We’ve got a great team, not just in our group at HSS, but also across the organization. We’ve got 6,000 breathtakingly talented people in all corners of this organization. We’re privileged to work with a number of outside organizations. We’re inclusive. Sometimes I may be inclusive to a fault, but also we move with a lot of focus and velocities. That chemistry tends to be attractive and invigorating to the creative process.

I appreciate all of that. Something, in particular, is you’re very self-aware. I could tell what you’re good at, and where you have room for improvement. Do you think self-awareness is a learned skill?

It’s an intentional act. To that extent, it’s a learned skill and it’s a capability that everyone has, but self-awareness is hard and it’s painful. There are all kinds of reasons why we all, self-included. There are things that we suppress. If I go there, it’s going to drag me down from these other things. It is a learned skill to the extent that people can find that going through that pain, if you go through that wall, there is always more good than there is pain. Things that you wish weren’t true. If you go there, it pays dividends because going there is on the path to unlocking new possibilities for yourself and things that you’re trying to do. I do think it is a learned skill. Do you think it’s a learned skill?

I feel similarly. I thought you answered it well. I think that everyone is self-aware, but a lot of people put up barriers and it’s a process to break down those barriers as you were speaking.

Self-awareness is going to become increasingly important as a leadership skill because I think where the world, society, businesses, and all institutions are going. We’re on a journey, but there is going to be an increasingly imperative, and opportunity for genuineness. In highly turbulent change and intense environments, people can lock in for all kinds of reasons.

Some of them are good, and be less vulnerable than they might be otherwise but breaking through that and being genuine is going to become increasingly important as a leadership characteristic. Self-awareness is you can’t be genuine. If you’re not self-aware and if the people around you don’t, inherently believe and trust that you’re self-aware.

Being vulnerable with your team is important. Without trust, people aren’t surfacing problems, they’re only going to boil over. I couldn’t agree with you more. It’s a good point. Speaking of being genuine, not only is it important internally with your team, but also from putting a marketing hat on. It’s important externally with potential consumers as well.

Something that I find impressive about HSS is you have over 30,000 Instagram followers, which I didn’t look at too many healthcare Instagrams, but I feel like that’s a lot. You have many good stories from different patients. I’m curious from your perspective, how do you feel you got to a point where you had many social media followers?

HSS was strong in social before there was social. For your readers that may not be familiar, HSS is a health system that is specialized in musculoskeletal health. At the core of it is this hospital for special surgery, which has been focused on doing a few things outrageously well for many years. From a marketing perspective, this is an easy job.

This is my first job in healthcare. I’ve marketed Snickers bars, Reebok shoes, and American Express cars across the gamut. In the case of HSS, there is this unbelievable alignment of needs. Half of all adults on planet Earth experience a problem that we solve every single year. It’s a high-value problem and HSS does it. There are lots of great orthopedic providers.

HSS, because of the specialization for so long, does it well. Long before I showed up and before there was social media or Instagram, what was happening here is people were having unusually good and consistently good outcomes. The way that HSS works is not about the TV ads, billboards, or Instagram followers. Those are all amplifiers on word of mouth. Word of mouth has been driving HSS since it was founded in a physician’s home during the civil war to treat soldiers and children.

Now, technology and culture are helping to amplify that, but it is fundamentally, the experience that people have through care here. You mentioned patient stories. Patient stories are everywhere. That a relatively small place like HSS has more patient stories on its website than any other hospital on planet Earth is astounding.

If you add them all up at Mayo Clinic, which is the most unbelievable institution. You add up all the different patient stories that are close to 200. There are more than 3,100 stories. That’s not because we’ve asked people. It’s because it’s part of the experience that people have. When you feel that you’ve discovered something that is special, valuable, and not obvious to others, you share it because you want to help other people.

 

People are doing what they’re doing. The way that they’re behaving and engaging on Instagram or in any of the other ways that they have an opportunity to educate. The HSS patients are proud of what they have done and accomplished together with their clinical providers. Also, they want to help other people who are earlier on their own path to figuring out what they can do to learn from their experience.

It is an act of altruism and whether those 30,000 Instagram followers or more than 1 million unique visitors to the website, every single month. This is a small place. That is astounding. People who are discovering something and they’re sharing it. They are doing it at a peer-to-peer level because that’s been the seismic shift in trust, where they’re not trusting claims from on high, but rather what are other people experiencing.

HSS is the gold standard. It’s incredible and not surprising that you have many incredible advocates. It’s one thing to have many advocates and had enough promoter scores. It’s another thing to enable them to effectively share their stories with others. As a marketing department, how do you enable these people that have had such incredible experiences to refer other people and share their stories with other people?

You used the keyword and the first is recognizing opportunities for enablement. In healthcare, for all kinds of obvious reasons, it’s common for providers to ask patients to review them. You give us stars, comments, or whatever. HSS could do that but in the course of the detective work that we talked about earlier, we discovered the importance of story sharing to the patient’s recovery process, that’s where this revelation of an opportunity for enablement.

There’s an appetite to do something that is good for the patient, institution, clinicians, and all of the other members of the HSS community. How can we make it easier for people to do what they want to do already? That’s where we created this forum on the HSS website, which looks and behaves a lot like Facebook or social media. It’s very visual. It’s fun and easy to look through. You can search stories based on not only your doctor or condition but also your favorite activity.

If I’m into lacrosse sites, I can look up people that are lacrosse players. The opportunity for people to customize their experience, but then to make it easier for people to share their experience. It’s all online. There are appropriately rigorous controls around confidentiality in healthcare for their consent processes. All of which are built into the process.

If you go in and online, you can share your story and in five minutes, you can go. As people are sitting there, they’re waiting for an appointment, they’re at home reflecting on their experience, or whenever they’re feeling with at the time and place of their choosing, they can do something that they find. We researched this and tested it in different ways. We’ve evolved it over the past several years that we’ve been doing this to make it a great experience.

That’s consistent with the great experience that they’ve had clinically and makes it rewarding to them emotionally. It’s a service that they provide to other people and they feel good about it. It’s like a sprinkler system. I’m proud of having, A) Discovered HSS, B) Gotten into HSS, and C) Achieve the outcome that I’ve got. I’m going to go and tell my story. They also make it easier for me to share my story on my social media. It’s a flywheel, sprinkler system and it goes.

There’s an important distinction between promotion and marketing. Promotion is about self-interest and marketing is about, in the case of healthcare, helping people make better decisions. This, as a service patient story sharing, is among a lot of different things that we do to make it easier for consumers to make their own decision about what to do about their medical needs or questions.

A challenge that I’ve heard specifically in healthcare marketing is no matter how well you’re doing in your campaigns, driving awareness, driving consideration, and even driving patient volume, there’s always feedback from specific surgeons saying, “What are you doing for me?” Is that a pain point that you experience?

It’s a pain point, but it’s also super helpful. My group and I were here because of them, and I’ve worked as a service provider. This is my first job as a client and my first job in healthcare. I’ve had the privilege of working at the highest levels with amazing corporations all over the world, teams, and groups. This is the first time where I’ve had the privilege of working with such a high concentration of people, who by objective definition is the best in the world at what they do. Time and opportunity are precious for them.

The responsibility that I have and that my team and I share is to earn their confidence that we are as good at what we do as they are at what they do. That is a push me, pull you process. They’re not experts in marketing, but it’s easy for everybody to be an expert in marketing. There are lots of good, well-intentioned questions, critical feedback, flaming arrows, and bullets that are coming from a place, but you got to always be thought, “Where is this coming from?” Begin with empathy.

Somebody is angry with me. Here is a surgeon, a doctor, or whatever who feels that I’m not doing a good job of supporting them and their needs. That comes with the territory. Understanding, first and foremost, where it’s coming from, and being open to the possibility. They may have a good point about what are they speaking.

All patients are consumers, but consumers are what they are before they make the decision to become a patient.

 

How best to address this? It might be addressing it by bringing them a better understanding. Patients are not always representative of consumers. All patients are consumers, but consumers are what they are before they make the decision to become a patient. What happens in that decision? Bringing that understanding and working with the surgeons, the doctors, and the other members of the clinical staff. We learn and we help them get better, which isn’t about being popular.

There are lots of times, what I hope they feel is when they feel that we have a discussion where they might not be satisfied with what we’re doing or even with the outcome of that discussion. My hope is that they walk away and say, “That didn’t achieve the change or the outcome that I was hoping for. I might not like what we’re doing, but I do think that they know what they’re talking about.” That’s what are we trying to do.

I’m excited by the fact that you all are growing. Not only your physical footprint but digitally as well. The question I have is, your brand awareness and reputation are strong, I assume, worldwide, but specifically in the Northeast where you’ve historically operated for the last many years. As you enter new markets, what are different tactics that you’re thinking about deploying to connect to those local communities as you’re opening physical locations there?

There are layers to that. I won’t be boring about it, but it begins with the high ground territory of academics and specialization. We’re an academic medical center. Academics and teaching are the bedrock for us. We provide continuing medical education to tens of thousands of specialists who are all over the world. We have a continuing medical education platform.

There are medical specialists who are getting their continuing medical education online from HSS in 140 countries. It begins with specialists having an appreciation for the fact that quality varies and quality matters in musculoskeletal care. That’s everywhere. That’s all over the world. When we go into new markets and as we look for whether it’s for physical presence or digital presence, it begins with that premise that we’re on a path and an opportunity to better quality of care.

If the clinical people have that awareness, they’re eager to get more of their patients into HSS for things that they don’t do themselves. We do a lot of complex care that other orthopedists don’t do. We also do a lot of revision work. We see way too many patients the second time and that’s part of what’s driving our expansion.

There is demand everywhere. Patients have for a long time been coming to HSS from all 50 states. There is demand everywhere. It’s a matter of how do you scale the quality of care and the reliability of outcomes that we’re able to do? How can you scale that? That has been a model that we’ve been learning our way into. There’s an enormous demand. There’s demand from employers and payers.

What we can solve is a valuable problem. You can go into markets where consumers haven’t heard of HSS, but that’s turning over that card. If you go to Cleveland, people will say, “All these orthopedists who are around here, I know them. I’ve never heard of these guys. Who are these carpetbaggers from New York?”

Let’s turn the lights on. Turning the lights on is, “These are all of your neighbors in Cleveland that come to HSS. Hear from them. We’re not an outsider. We’ve been serving your community for a long time.” I don’t mean to single out Cleveland. There are some fine medical centers there but people from all over the country have been coming here for a long time.

As we expand, whether it’s digitally or physically, first and foremost, it’s about making increasing convenience for people that are coming from there anyway. If we can make it easier for the person from Bozeman, Montana, you don’t have to come to HSS for every visit. Now you can do some digitally or at our regional location that might be closer to you. You only have to travel further distances in isolated instances. A super valuable problem expansion is about doing our best to keep up with demand. The demand is colossal, but how do you do that without compromising an inch on the quality of care?

There is so much consolidation happening in healthcare and HSS is one of the last couple remaining independent healthcare providers. As you’re expanding, why do it as a standalone entity instead of through consolidation?

Our strategy is based on the integrity of the quality of care. There is no one way of doing that. There are lots of opportunities and we are partnering. We’ve learned our way into some successful models for collaboration. We’re doing different models in places like Stanford, Connecticut, West Palm Beach, Florida, and outside Cartagena in Columbia. It’s different model of collaboration. We’re testing and learning. That’s also collaborations that we’re bringing into the digital domain.

It’s not about doing it alone. We can’t fulfill our mission alone. What you’re going to see in the coming years is the more visible emergence of an HSS ecosystem of providers and collaborators that are unified in the purpose of achieving these extraordinary outcomes with extraordinary reliability. It’s a little bit of saying, “If NASA wants to fly more, why don’t they consolidate with an airline.”

 

Somebody once observed and commented, “HSS is to other hospitals that do orthopedics, as NASA is to airlines.” It’s the same thing. How can NASA do what it needs to do? Do NASA and SpaceX someday? At this point, in orthopedics, there is no SpaceX. I like to think the HSS was the SpaceX. We’re able to move faster.

Mayo Clinic is every year number two in the nation for orthopedics according to US News. That’s based mostly on data but by order of magnitude, you look up the US News ranking for orthopedics and you see lots of great providers. What you will see in orthopedics that you will not see in other categories is the magnitude of the delta between number one twelve years in a row. We don’t take anything for granted. HSS scored a perfect 100 out of 100 and was number two in the nation. The mighty Mayo Clinic is breathtaking. Mayo Clinic scores in the low 80s.

You have HSS scoring a perfect 100 and number 2 in the nation. Mayo Clinic, which is fabulous, scoring a B minus. When I say NASA to airlines, that is not hyperbole. That is the truth. There is so much in that US News score, as you will see, there is an enormous amount of data. That’s not a popularity contest. How can you scale that level of performance? HSS isn’t under the commercial pressures of some other institutions that might like to merge. We’re focused on a long-term view on achieving and advancing a standard of excellence that is a category of one. Our mission is a sense of purpose of owing that to the world and being the beacon that people can count on to provide that.

John, I am pumped that you all are expanding because more people deserve access to your incredible care. My dad alone has gotten three surgeries from HSS and there is no revision. You have been interesting and fascinating. I could ask you questions for hours, but I know you are busy. I want to thank you so much for coming to the show. I think that our readers are going to get out of this episode. I’m excited to see what you and your team can continue doing and learn more about the expansion. I wish you all the best.

Thank you very much. I appreciate you making the time and if anybody’s stuck around, I appreciate them reading. Thank you to everybody, whether Evan or readers, for advancing this conversation around the importance of community, sharing, and learning from each other. I’ve learned so much from your previous guests. Thank you for the service that you are providing to all of us.

Thank you for reading this episode. As a recap, we discuss the benefits of working abroad, how the excellence of HSS expands outside of the OR, and how to elicit strategic creativity from your team. Thank you for tuning in. See you next time.

 

 Important Links

• Hospital for Special Surgery
• WJPZ
• Instagram — Hospital for Special Surgery
• Mayo Clinic

About John Englehart

John Englehart is Senior Vice President, Chief Communications & Marketing Officer at Hospital for Special Surgery (HSS), the world’s largest academic medical center focused on musculoskeletal health. Prior to joining HSS in 2014, his experience spanned brand and business building across many categories and many places, including living and working in Asia (10 years) and Europe (five years) as well as his native U.S. (1,000 years). A common thread from beginning through today is on understanding, exploring and cultivating affinity among communities of many types and sizes — in the changing landscape of media, relationships and trust.