A Path Towards Better Employee Health And Well-Being With Dr. Richard Safeer

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Certain things happen in our lives that change the trajectory of our future. For Dr. Richard Safeer, that is seeing the challenges of health and nutrition to his family growing up. Now, he has dedicated his life to the field and is currently the Chief Medical Director of Employee Health and Well-being at Johns Hopkins Medicine. In this episode, he joins Tony Martignetti to share with us the pivotal moments in his life and the lessons he learned along the way. Dr. Safeer then dives deep into his foray into employee health and well-being, pushing for better workplaces that take care of its people. He gives a peek into his book, A Cure for the Common Companyand offers some few exciting resources to help us navigate our own paths to well-being. Tune in to this great conversation to learn more!


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A Path Towards Better Employee Health And Well-Being With Dr. Richard Safeer

It is my pleasure to welcome my guest, Dr. Rich Safeer. Dr. Safeer is the Chief Medical Director of Employee Health and Well-being at Johns Hopkins Medicine and the author of A Cure for the Common Company: A Well-Being Prescription for a Happier, Healthier, and More Resilient Workforce. It's a brilliant book. Dr. Safeer completed his BS in Nutrition at Cornell University before graduating from medical school at SUNY Buffalo. Dr. Safeer enjoys many outdoor activities including biking and tennis. He's hiked and camped in the Andes, Alaska, Australia, and across the United States. He lives in Columbia, Maryland, with his wife, three kids, and their dog, Kami. It is my pleasure to welcome you to the show, Rich.

Thank you, Tony. It's good to see you.

Same here. It's going to be so much fun to dig into the journey you've been on. I know there are a lot of points in your journey that have revealed who you are. I first want to congratulate you on a brilliant book. I'm looking forward to revealing more of who you are to the audience.

As someone who likes to camp, I appreciate being invited to sit by the campfire.

It was meant to happen. I wish it was at a real physical campfire.

So do I.

As we do on the show, we take people through this journey of uncovering their past through what we call flashpoints. In a few moments, we're going to take you through this journey of exploring the moments in your life that have revealed who you are, these flashpoint moments. I'm so excited and thrilled to be able to have you do that process here on the show. As you're sharing what you're called to share, we'll pause along the way and see what's showing up, and what themes or things resonate. With that, Rich, please take it away and start wherever you like.

When you're getting ready to apply for medical school and you're lucky to get an interview, you start to talk and ask around what the interview's going to be about. It appeared that a common question was, "What got you interested in medicine?" I'll tell you, it wasn't coming to me very quickly. I had to do some exploration many years ago in preparation.

Where I landed was that it wasn't just one thing. One of the earliest times that struck me was when my grandfather died in third grade. We didn't see him that often because we were growing up in Buffalo, and he was living in Brooklyn where my dad grew up. What I remembered from my grandfather was that when he came to visit, which wasn't often, there were some ashes from his cigar on the floor of the bathroom, the tile. I can picture it.

I remember asking my dad, "Why did he have to smoke?" The odor didn't resonate with me. He died when I was in third grade. Apparently, depending on how old you are, when you experience the first loss of a family member, it strikes you in different ways. This stuck with me. I can't be sure to what degree it influenced me, but I have to think that my interest in prevention and living a healthy life had something to do with that experience.

Especially at that age, it's definitely something that can have an impact. "How could that have been prevented? How could that have been changed? Will that happen to me when I get older?" I'm sure those questions ran through your head.

Nobody else in the family smoked. Not in our family, not in the people we socialize with. It was a very foreign concept to me, as was his death because I don't think I had experienced that process before.

To me, it sounds like that moment is a starting point. It starts you thinking, "What can I do to live differently?" Even as a kid, you start thinking, "I don't want to die. I don't want that to happen to anyone else in my family." You start to be almost on high alert about what the people around you doing and how you can be on the watch for that, potentially.

Probably, even if it's subconscious, I'm sure that had an impact.

What happens next?

I had a pretty good childhood. I played a lot. I got on my bike a lot outdoors. The ninth grade comes along, and I'm in high school. I've got my standard set of classes. One of which is biology. I think I'm looking forward to it. I liked school. On the first day, the teacher says, "Look to your left and look to your right. One of you is not going to be here at the end of the year." I was thinking, "Why do you have to be that way?"

Nonetheless, he posed a challenge. It didn't scare me. It probably increased my resolve that I was going to be one of the people who was left at the end of the year. It turned out he set the tone for his class. I don't think about this often, but as I'm talking to you, he wasn't the nicest or warmest person. Maybe that was helpful for me the other way as well. Maybe he was my first taste of working with an adult who I thought could have been nicer. There was no need for that.

That comes back in college. By the time I finished high school, I had an inkling that I wanted to be a doctor. There were no doctors in the family. I had no role models. I'm not really sure at that point in my life why I want to be a doctor. I did watch the sitcom M*A*S*H growing up, but I can't imagine that that was a flashpoint for me.

I went to college. At that time, what do you do when you're interested in going to medical school? You start studying Biology. After the first year of college, I was like, "This is boring." I'm learning about earthworms and how plants grow. I wasn't sure I could do three more years of Biology. I did start to explore some other options and landed on nutrition.

I was fortunate to be open-minded and see from the catalog. It meant me having to transfer colleges, which was not the easiest process. Most people who've transferred during college recognize that it's a little bit tough to start over in the middle. Nonetheless, I absolutely loved my Nutrition Education at Cornell. It changed me. That was probably my 2nd and 3rd flashpoints. Maybe there was another in high school too.

There's no doubt that your attention to being an achiever was set in stone pretty early on. First of all, getting into Cornell is not a simple thing to do. Getting into medicine or even pursuing biology is something that was not for the faint of heart. There was this achiever mentality that seemed to have been set in place for you.

Also, being able to have that moment in college where you start to say, "Is this what I really want?" It's a huge moment to question that. Luckily, you did because it sets you on the trajectory of where ended up. Ultimately, you could have said, "I'm going to stick it out. I'm going to tough it out because this is what I did. The decision I made, I'm going to stick with it."

You mentioned being able to question it. I was a freshman in college questioning my choice of study. I was a freshman in high school questioning the behavior of this adult. I hadn't thought of it this way before, but I do question a lot of things. That served me well. Personally, it served my employers well, and it has served our employees well. Otherwise, there's probably a propensity to go with the status quo, which isn't always necessarily the best path.

I love the insight that you got out of that. There's something about that, which is to say that some of the most successful people don't just go with the status quo. They see things differently and are willing to push up against the system a little bit. In some ways, having a challenge brought to you in high school by someone who says, "You're not going to be here," is a starting point for starting to question, "Why can't I be the one to be here?" It's almost like you've become a rebel without even knowing it.

Rebellion meant getting good grades. Isn't that crazy?

It wasn't about getting on a Harley and running wild. Tell me more about what happens next as you get into the field of nutrition. The connection points are powerful. When you think about your early childhood of seeing the challenges of how health and nutrition are all connected and impacted your family, now that you're in this field of nutrition, what happens now? What do you do from here?

I didn't get into the field of nutrition as much as I got a degree in Nutrition. I still wanted to go to medical school. It's funny because when I told my mom I was going to transfer from studying Nutrition, she said, "I thought you wanted to be a doctor." I said, "I do want to be a doctor." I told her why. She said, "Yes, but people don't study Nutrition if they want to be a doctor." I'm like, "I'm going to study Nutrition and I'm still going to apply to medical school."

I got into medical school and liked everything. As a consequence, I did not want to limit my practice. I went into family medicine, which allowed me the full scope of all the possibilities. I was pretty excited when I finished my training. It had been eleven years to go through college, medical school, and residency. I started finally practicing in a suburb where I thought I'd practice for 30 years, but I only made it about a year before I started to question my decision. I didn't feel like I was making a difference for my patients. I felt like I became a practicing doctor when HMOs were ruling the healthcare systems. That meant seeing a patient every fifteen minutes. If you were a new patient, you got a half hour.

You've been a patient, and I've been a patient. It stinks when you're the patient and your doctor feels rushed. Guess what? The doctors don't like it either. It's easy to write a prescription for medicine in fifteen minutes. What's not so easy is to help your patient understand how to make better food choices and to help your patient learn skills, like how to read a food label and how to lower their stress level so they don't reflexively grab that bag of potato chips. I was thinking, "This isn't good. It's not good for me, and it's not good for them." In this moment of enlightenment, not only was I starting to question what I was doing. I was also a little bit distraught, frankly, because I had just invested eleven years of my life.

It's easy to write a prescription for medicine in fifteen minutes. What's not so easy is to help your patient understand how to make better food choices.

Still paying student loans.

I was fortunate to bear with it while I started to try to figure out what I was going to do next. I saw that my patients were coming from work. After they finished the appointment, they were going back to work, or they were telling me, "You know what, I don't have time to prepare dinner. I have to pick up dinner on the way home most of the week because I got to get my kids to their soccer practice, or this and that." Everyone was rushing all over the place. They didn't have time to take care of themselves.

I'm thinking to myself, "They're working all the time. Maybe the work is the problem." That got me thinking that there was probably a path in that direction. If my patients are only spending fifteen minutes with me but they're spending almost 2,000 hours a year at work, then maybe that's the place that should be making a big difference in their health and well-being.

This is so amazing what you've brought into the space. It immediately brings to mind this concept from a book that I love, one of my favorites. It's by Dan Heath called Upstream. Instead of trying to solve a problem where it's happening, it's about going upstream and getting it solved where it starts. That's this whole thing that you're bringing into this space, which is so profound.

VCP 201 | Employee Health

Many people for millions of years probably have been thinking, "This patient's in front of me. What do I do to help them at this moment with only fifteen minutes?" If you slow down and think about what is the real cause of this, that's where you start to go upstream. You'll see, "How can I solve this problem at the beginning of where it starts?"

We're going to be friends because, at the end of each of your episodes, you asked your guests about a favorite book. I'm not going to tell you which book yet because I don't want to give the ending away, but we're going to come back to your choice of Upstream by Dan Heath. That's not my book, but you'll see what I'm talking about in a few minutes.

I don't want to steal your thunder. I want to get back to you. Here, you have this realization and you start to say, "I need to get into a different way of approaching this problem." Tell me what you did now. How did you flip the script?

My fiancée was helping me think through this. I wanted one thing, but something else came along, which was to apply for a job on a faculty at George Washington University. I got an interview. I went downtown. It wasn't appealing to me. I knew it wasn't going to be appealing to me from the description, but my fiancée said, "You should do that anyway." I did it. They ended up offering me the job. I politely declined, and we left in good standing.

Not too long after that, they had another job opening. I applied for that and got that job. It was to be on the faculty to train the family medicine residents. I always had a thing for teaching. I had done some tutoring in college. I liked presenting from an early age. Sure enough, I enjoyed that job on the faculty, yet I was still trying to figure out how I was going to get into this employer space.

I was calling different physicians. The Chief Medical Officer at Exxon was someone who I remember, but some other doctors were inside large companies. Every time, they said, "You need to go back and do another residency in occupational medicine." At that time, my wife and I both had professional school loans. We had two mortgages on our house, and we had a baby.

I'm like, "I can't now start another three years of training and not have an income." I took a leap of faith. I went and worked for an occupational medicine company, which does employment physicals, injuries, and drug screens. It's like the bread and butter of occupational health. It wasn't for a Fortune 500 company but a catchall for smaller companies that needed to outsource it. The experience was educational, informative, and helpful. It wasn't what I wanted for my final stop, but it was a necessary part of the journey.

First of all, I like that you've found a place to fit in to start and see. You didn't just stop and say, "They say I can't do this unless I go to do this path of getting residency." You found a way. That experience, although it wasn't where you wanted to end up, it was a stepping stone to the path that you wanted to go on.

Perseverance is part of my fabric. It's part of my family's fabric. It's not even a matter of persevering to arrive at the job I currently have. It's to be able to support the health and well-being of the employees at Johns Hopkins Medicine. If you take no as the answer and never go back again, you will not get very far. I wasn't having that.

If you take no as the answer and never go back again, you will not get very far.

It's also something that I hear a lot from people who are patients in their journey of discovering, "What is going on in my own diagnosis?" You have to continually push and advocate for yourself. You're almost advocating for your own diagnosis of, "What is it that is right for me? What is my path?" You're trying to make sure that anyone who's prescribing your path is saying, "That's good, but it's not true entirely. Let me see what else is possible. Let me get another opinion."

I kept networking and volunteered one day for a program called Take Your Legislator to Work Day. Basically, in Annapolis, they have this hall that different professionals could go in. They had tables and you could do whatever. If the legislator or their aids came through and they were interested, you could talk with them.

I was set up with another doctor next to me and my table was nutrition, specifically cholesterol because I had my experience or my education. There was a lull. The doc next to me said, "CareFirst BlueCross BlueShield is looking for a doctor to lead their prevention effort." I never thought of working for a health insurance company. That's not what people go into when they go to medical school.

It's probably the last thing most doctors think of, but I applied and wanted to explore it. They offered me a job. Fortunately, it was about prevention and how to keep people healthy. It was not the job of, "Do you approve or deny this claim?" It was not that, thank goodness. It was a great learning opportunity. I learned a lot of things, like how the pull payments, a part of healthcare, work and how large employers interact with health insurance companies.

In fact, I was out in front of 100 or more large employers over the years I was at BlueCross BlueShield, advising them on strategies to help keep their workforce healthy, so that they had fewer claims and it cost less to insure them. After a while, the value of that education for me ran out, and I still wanted to be a doctor in a large organization.

These stepping stones keep on adding value. You're learning more and adding to your arsenal to create what you ultimately ended up with. These little breadcrumbs are leading us up to the work you're doing now.

It's true. As I'm telling you this, it seems like it never came easy. It's like I had to claw through this to get where I am. I continued networking when I was at BlueCross BlueShield and speaking with a leader at Hopkins. I found out that there would be an opening. It was a position with their own self-insured health plan, which honestly having just done seven years at BlueCross BlueShield, I wasn't that excited about.

I went for an interview and explored it. During the interview process, I came to realize, through my questioning, they did not have a robust strategy to support the health and well-being of their workforce. I knew that if I got into the organization, I could build them something better. I was fortunate that I got the offer, and I accepted. I essentially took the job that they were paying me for, and I took a second job that was unpaid. That was to build an employee health strategy until the point where they valued it enough to make it a job and I was able to have a little bit more sane schedule.

I love this realization that's like, "This is the job, but this is what I also was doing that created a different and even more value than the job itself was planned to be." Tell me what happens now. What is the next big moment where you started to lean into the work you're doing now?

To get some traction at Hopkins, it takes quite a stir because you got all these people there. Some of them are testifying on Capitol Hill or they're being recognized. Anyway, you'll have to read chapter one to know the first foray into this employee health and well-being strategy. The biggest pivot at the beginning of my career at Hopkins was to get a meeting with the president of the health system.

VCP 201 | Employee Health

He asked that I come and explain what I was doing because he had heard a little bit of a buzz. I went and explained the strategy. Ultimately, I asked him to build some employee health and well-being measurements into the annual strategic objectives and to make it part of the business plan, all these other important pieces like patient quality and finance. He agreed. That was a huge win for the institution because now, we had buy-in from the leader, and then ultimately, accountability across the leadership.

How did this translate into this concept of, "We've got this realization, now the book?"

We have to fast forward ten years. The pandemic set in. Things were crazy in the country and at Hopkins. After working sixteen-hour days for several months and after that first wave calmed down, I was able to work fewer hours and have more time to reflect. Part of the reflection was this. I had been keeping a journal at Hopkins about what we were accomplishing. I also knew that the number of years I had left to work was narrowing. I thought that it was probably time to share some concepts that are often not communicated in employee health and well-being.

Most people think of employee health and well-being as workplace wellness like, "Let's have lunch and learn, and let's fill out a health assessment." There's a lot more to it. I had learned a lot along the way and thought I had something to share with the community. I sat down and wrote a book. I was fortunate to find an agent to represent me. Wiley was interested. Now, it's out and you can read the story.

Here you are, you probably never thought of writing a book, and you make it seem so easy, but of course, it's not.

I didn't think of writing the book until late into my career. It wasn't easy. In fact, as much as I feel like I took science and math pretty easily, English wasn't always the easiest thing for me. I had a group of friends that I knew from elementary school. We were in most if not all the same classes in elementary and middle school. When we got to high school in ninth grade, I wasn't in the same English class as them. After a few days, I got the nerve up to go to my teacher after class and say, "Can I be in this other class?" My friends were in the Advanced English class. She said, "I'm sorry, but your writing's not good enough." That stuck with me.

Early in my career when I published my first journal article in a professional medical journal, I was thinking about her. Similarly, I thought about her often as I was writing this book, and I really worked at this. I worked at it on a lot of different levels, but mostly I wanted to make sure it was an enjoyable book to read. It wasn't just about a how-to. It is a book that I want the reader to enjoy reading because I'm a reader, too, and I don't want to be bored with what I'm reading.

Revenge is sweet, isn't it?

In one way, you might think it's revenge. On the other way, I thanked her in the acknowledgment section of the book. Who knows? Perhaps it took that to motivate me. I view it more as a motivator. I don't think she was trying to be mean about it. She was giving me genuine feedback that she had.

It sounds like there were a lot of those moments along your journey that are like that. There's the bittersweetness of the moments in your life, from having your grandfather passed away at a young age for being a smoker or however you want to frame that to having that propel you into this space of wanting to do something in a positive way. It's having that criticism along the way that says, "You won't be here" but then you say, "I'm going to do it." It's almost like you thrive on that. You say, "I can't and I will." I'm glad you did because the work you're doing is what we need most nowadays. It's how we can show up differently in our workplaces and create a different path to being healthier in the workplace.

I didn't realize it at the time, but I was the only student in medical school who got a degree in Nutrition. When I started this path to lead an employee health and well-being strategy, at that time, it was just occupational medicine. It was much more hardcore like workplace injuries and environmental exposures you're getting exposed to. It wasn't about helping employees have a healthier day. I feel fortunate that I wasn't satisfied with where I was and that there was a better path.

I have so many questions I'd love to ask, but I want to respect your time and make sure we get you out on time. I have one question that I ask everyone on the show. I'm going to move right to our final question. What are 1 or 2 books that had an impact on you, and why?

VCP 201 | Employee Health

I'm going to give you two. One of them is related to what you shared earlier. I became interested in behavioral economics early in my career because it can impact our choices during the workday. There are several behavioral economics books that I enjoy. In honor of one of your favorite books by Dan Heath, I'm going to give a shoutout to a book that Chip Heath wrote called Switch. It's for anyone who's interested in knowing more about why we make decisions.

The second book I'm going to choose is a book called Connected by James Fowler and Nicholas Christakis. It is about the science of how we are influenced by the people around us, our friends, the friends of our friends, and the friends of our friends' friends. The same goes with family, not just our immediate family, but other relatives. It had a profound impact on my thinking about what genuinely influences our health and well-being in the workplace, which is our coworkers and our manager. Both of those strategies are in the book, as well as the behavioral economics that I took away from that part of my education.

I vaguely remember Connected. Now, I want to go back and reread it because it seems to fit perfectly with your research and the work that you've done in the sense of everyone around you has this impact on you. That's something that people have to recognize. I love the way you described it. It's well done. Switch is a brilliant book. I love how you brought that into the space. That's awesome.

Thank you. I would agree with you, Tony. Most people don't realize that they're being influenced by the people around them. If we can be aware of that, we stand a much better chance of adjusting and making sure that we have the best opportunity to take the health and well-being path that we want. It's not being put upon us by others.

Most people don't realize that they're being influenced by those around them. If we can be aware of that, we stand a much better chance of adjusting and making sure that we have the best opportunity to take the health and well-being path that we want.

I feel like I want to do a continuation of this episode because we didn't even get to touch on all the hiking and adventure stuff you do, too, which is a whole other chapter. I'm a kindred spirit when it comes to that stuff. I have to thank you so much for all the brilliant insights and stories. I feel like we've been on an amazing journey together. Thank you.

Thank you, Tony, for bringing it out of me.

Before I let you go, I want to make sure that people know where they can find you. Obviously, they need to go pick up your book. It's absolutely a brilliant book. I have it here. I want to make sure people know where to reach out if they want to learn more about you.

The book is A Cure for the Common Company. I do have a website, RichardSafeer.com. You can also find me on LinkedIn. There's a website called CreatingAWellbeingCulture.com.

Thank you again. Thanks to the audience for coming on this journey with us. I know you're leaving feeling connected to this idea of how we can do better and how we can create a better and more well organization in the places we are. Thank you so much.

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