Welcome to the bio optimized summit where we explore the next level of physical and mental health you can achieve through intentional and targeted optimization.

I am your host dr AmY and today I am delighted to bring to us dr richard Hart and he is the president of Loma linda University, a post he has held since 2008 and this was, I remember actually when he became president, I was a medical student at Loma linda at the time.

M. D. PhD student actually and I had come to him in the last year as the social vice president of the university and had brought to him an idea of doing an international project where we could have all of the schools of the university rally together.

I did not know dr Hart at the time very well. So when he gave me the instructions of, well I want you to save Malamala hospital in Malawi from having to shut down.

I took him seriously and dr hart and I had a lot of fun with that project. He has actually served Loma linda University health since 1972 and has served as chair of the school of Public Health, department of Health Sciences, Director of the Center for Health Promotion, chair of the school of Medicine's department of preventive medicine and dean of the School of Public Health.

He was then Chancellor Ceo of the university and now president of Loma linda University Health which is right in the middle of the Blue zone. And as a student at Loma linda University, he started a lot of the international work that has developed than over the years, into a much wider scale on campus of the international work.

And so he also earned a public health degree from johns Hopkins University and prior to that of course was from Washington state, which is probably why we get along so well. So one of the things that we are going to talk about today is his activity as president of adventist health International, which is a management consulting organization for seventh day adventist hospitals and clinics in developing countries and with all that he has going on, he is one of the best human beings I have ever met.

I am so thankful that he has been in my life as a mentor and thank you for joining us today dr hart. Thank you amy I just need to comment that initial effort by years of malo malo malo malo has now become Loma linda's first global campus uh with uh training programs, residency program, students research activities.

A number of Loma linda graduates working out there. So your initial efforts certainly paid off and we're proud of that. We're now working on several more global campuses, one in chad and one in Haiti and eventually one in Nepal in addition to all the other hospitals that we assist around the world but uh thank you, it's been a privilege to know you as a friend for many years now and uh pretty to come on this program, thank you and with all that you have going on from not only here at Loma linda University but around the world and globally.

How do you do it all? How do you prevent burnout? How do you consistently operate on such a high level where you're actually engaged in the process? You are very much involved in the decision making. How do you avoid burnout?

What's your secret? I'm not sure. I have an easy answer to that. I mean I I have never felt burned out frankly. Uh I am a farmer at heart. So we live on seven acres up in the mountains here um that I care for solely myself. We got a couple acres of Christmas trees, we got the amas in the past year 50 some fruit trees, a big garden, big yard. So I'm always behind.

There's always something I need to do back home. Amy has failed me considerably through the years and not coming up and helping as often as she should.

This is true, but I would like to just affirm my prior efforts in scooping up lots of yama poop waiting for you for me getting outside uh and having something to put around and do, I mean every morning to go out and check the gopher traps, reset them, feed the Ama's check the sprinklers every evening to do whatever needs to be done splitting cutting wood. Uh all the difference, I mean that's that's my relaxation. We, fortunately we can hike up in the mountains uh 234 times a week and do that. And uh uh all of that gives my mind my psyche, some kick back relaxing time that that I considered invaluable, people ask me how I have time to do all that.

My answer is if I did not do all that, I would not have time to do anything else. Uh So it really is what gives the balance to life. Mhm. One of the favorite things that I have done with you are the hikes up Pisgah Peak, which is just around the corner from your house and this was something that you have consistently done several mornings for several years, several decades now and it always amazes me when we do those hikes, that your mind is processing a lot of things on those hikes and we get to the top and of course, you know you pretend to see sea world and all of the animals down down there, but that is a moment of reflection for you and I've seen how much that helps you keep your vision clear and your purpose clear.

Can you speak more to that and the value that that has had in your life and keeping your vision and purpose clear. Yeah. Where we live is right next to uh in between two ranges, but fiscal peak is one to the south of us and there's a fire road, no dirt road that goes up to the top of his six miles a little over six miles round trip up to the top and back. So I do that for sure every saturday morning and part way up at least two or three other times a week.

Um and it's been amazing for me through the years. I may be struggling with some difficult, difficult issues and trying to make some decisions about. It's unusual for me to reach the top episcopo and not have some plan. That seems to make sense.

So somehow being outdoors hiking, watching birds, watching the flowers and bushes changed through the years uh is, is almost uh uh sav to my mind enough to where the endorphins flow and I really feel like I can work my way through various other issues how that all works biochemically. I'm not sure but I watched it now for 40 plus years and I know it works for me and I'm just delighted for that.

So it's a, it's a, it's a lifesaver for me to be able to have that kind of an opportunity. And as you work with all your different endeavors, whether here or internationally you meet a lot of people and you get a sense for who are those who are successful in their work, who are good leaders are there patterns are there trends that you have seen in others for what, what is their secret, what are, what are some consistent things that that you see other successful leaders doing that we can learn from when we first came back from Africa, from Tanzania East Africa and joined the faculty here, Jim Crawford dentist was dean of the School of Public Health.

And I'll never forget some of the advice he gave me early on is Dick. You'll get far more production out of a person by applauding their skills and what they've done than by criticizing their deficits.

Uh And so I think following that in which we recognize and support people when they do well is a far more effective way to call out the best in each of us.

Um and and make that happen. So that's been a privilege to me through the years to watch different people to particularly amy, you're a good example, but to look at young people recognize the potential, the skills they have uh and support them in their endeavors. Um and they go different directions of course, even they don't know for sure where they'll end up.

Uh But striving to uh to be meaningful is significant. Um There was a survey done, it's probably three or four years ago now um by an organization in this country called pay scales which surveys college graduates on various things and how much they are and what jobs they get and so on.

And they wanted to assess uh meaning in life for college graduates? So they asked one simple question, does your job make the world a better place? And ask a million graduates across the U. S. From 1000 different colleges and universities, does your job make the world a better place?

And I'm pleased that Loma linda University was first in the nation, at 91% of our graduates says yes, our jobs make the world a better place. So having that that purpose, that value beyond yourself, that this isn't just, you know, how do how do I make my life better? It's how do I make a difference in the world?

Is what really brings meaning to life. And now, admittedly, we have some advantages where health science place. So people who come into the health sciences tend to be those sorts of people.

Uh but I think that is part of the the value of commitment and purpose is to believe that you are making a difference. And Loma linda is a very unique educational system, health system, it is uh its model is different than the traditional model.

Does that play any influence in this, you think? Well, I think so, I mean, we have a motto that we selected for our 50th anniversary in 1955 that stuck with us to make man hold.

Uh and so that encompasses the full aspects of life. So, certainly the physical mental part of it that you would expect health professionals to be involved with, but what we now call whole person care.

So looking at the social aspects, the spiritual aspects, the family relationships, the dynamics that a person is in The environment, they live in. Uh those are all key factors in trying to to make a person whole.

Uh we've also have seven core values. Uh the universities had them for some 25 years now. We remember them by the pneumonic J. Chief Justice, compassion, humility, integrity, excellence, freedom and self control.

The medical center about 12 years ago came up with another five values, three of them common integrity, compassion, excellence and added teamwork and wholeness.

We just recently combined the two. So we now have seven core values. Once again for the entire complex here at Loma linda. We remember by the pneumonic just hum twice so justice for just hum for humility and then twice Teamwork, wholeness, integrity, compassion and excellence.

And you know I often thought well values where there's a bunch of words who really pays any attention but frankly we measure people against those. Our HR department asked you know, what are you doing in your personal work and job and so on in life to follow these values. And it does make a difference.

Uh it does really help to to provide our north star our guidance for how we seek to to run this place. And that goes for a lot of the international work as well. And I see you applying those same values to the work with H. I. So tell us a little bit about how you got started with that. I know that you went out to Tanzania after completing your medical education. How did that experience shape you and start to build build your capacity for leadership internationally?

Well, that's a complex issue. Many people think I must have grown up in the mission field. I did not, I grew up in northern Idaho um but uh it clearly the time we spent in Tanzania and then I've traveled extensively all over the world. There's nothing I love better not the cities of the world, but the rural areas of most countries where people really live and work and what they do. Uh And recognizing that much of the world of 7.5 billion people now, much of the world still lives in pretty primitive conditions uh in developing countries. Uh And so my passion has always been trying to focus on that frankly. Where a little bit can make a whole lot more difference than in a in a western country. So speaking to that vacuum has been, has been a challenge. And within the adventist culture, why we've got about 75 mission hospitals in developing countries.

And so we've taken on that challenge of trying to help strengthen those hospitals. Many of them live on the edge of survival. Uh so being able to train people to work there, support them with better equipment, better buildings, get a donor base support and develop for them. Um that's been fun.

It's been kind of a sidelight, but it's been a hugely fun thing to have happen and to watch this grow, watch young professionals say, okay, I get it, I want to be part of that uh and go out and commit themselves to a career of doing that.

So it's a good thing amy it's it's part of the balance. Uh and if I can just say at Loma linda increasingly I find not just young people, but our leaders say if I can get involved with some project like that, it makes my life better. I feel good about what I'm doing when I can be connected with something in in in the developing or what I prefer to call the majority world, but most of the world's people live.

So it's been good for Loma linda. Very much so and not just to help out in the field and Loma linda is known for being the blue zone right where you have this pocket of people who tend to live longer.

Do you think that sense of meaning and purpose greater than themselves is part of part of that? It's not just their diet, it's not just their exercise, but it's this greater purpose?

Oh absolutely. I have no question about that. Let me just clarify, Loma linda gets credit for being the blue zone. In fact the blue zone is seventh day adventist living in California.

We did the research of Loma linda. So we get credit for it, but really applies to 30,000 people across the state of California that that actually made up that research study.

But yeah, you can control for all the other variables for a vegetarian diet. You can control for exercise, for avoiding obesity, everything else. But there's something besides that. It still has an impact.

And the researchers are not clear what all it is. Uh Does attending church make a difference? Well, they call that religiosity and they may have some difference is a social binding that comes from peer contact and so on.

Either through church or other settings make a difference. Yeah, I think it does. Uh even the issue of awareness of the world and its issues which happens more in a setting where you hear stories from abroad uh perhaps give part of the balance that that is important in life. So we're not sure what all is doing it, but it does make a difference. And uh adventist in this setting live 7 to 10 years longer. Uh And it's fun to walk around here, you can see them uh go down to Drayson Center, you see these 90 year olds doing their exercise and so on. My goodness.

You know that's that's good stuff. People say, well they don't really live longer. Just seems that way. No, they really do live longer and they keep good minds and doing that.

So it's those productive years that are important to hang on to. Mhm. Yeah, it's not just the longer age, it's their quality of life as they get older and their their mental acuity stays intact for longer. Yeah, Admit this and this sort of thing, but I'm 75. I mean I need to find the off ramp and yet I'm still in good health and and enjoy putting in a long day and making stuff happen.

So yeah, it does pay off and we won't we won't talk about your mental decline. So for other other professionals, other executives, other entrepreneurs who are trying to trying to be fully productive in their life, what type of environment overall would would you say you would recommend based on your personal experience, based on your professional experience, based on your experience internationally and seeing what works for for those who are living their best lives, what type of environment should they create for their lives?

Well, I mean as I've just said, find something that's meaningful. Uh there's nothing worse than putting in an eight hour day for some purpose that isn't have some meaning for you. So find a career, not just a job, something you can really sink your soul into and feel good about a company doesn't need to be some magnificent tower someplace, but it can be meaningful in terms of your world and what you're doing. Uh So that's important if I can just sidetrack slightly Amy we just are starting a community garden down at our northern clinic that you know, um and take an acre of land there and putting a community garden to watch community mothers largely hispanic mothers come in and say, okay, this 10 ft square plot is my garden, I'm taking care of it.

It's where I'm going to produce produce for my family that's meaningful, very meaningful, both for them and for those who, for those of us who support that makes it happen. So it can be something very small but have meaning and what you find. So that's important.

I think also finding balance. Uh you know, I'm I'm a compulsive character, likes to make sure everything gets done and done on time and everything else, but learning to say, okay, you know, this can wait till tomorrow, you know that this there's other things. I mean i it is rare that I stay up late trying to solve something. I mean I go to bed uh and I may wake up early and get going at it again, but you know, just just finding the balance in life, Finding time to to get outside. Um Let me let me criticize my own place a bit are Drayson Center, Our gym is great, but frankly there's no substitute for being outside in my view uh and and being walking among nature and and uh and smelling the smells and seeing the sights. Like there's some good research evidence now that the pheromones coming from trees may actually be an antidepressant, that it's good for us to get out and smell and and and be part of, so finding meaning, finding balance. I think those are important regardless of the particular career path you are pursuing.

And tell us about the SAn Bernardino campus and the Gateway College, how tell us the background, the context for that and what what you've been able to do with that? Well, medical students everywhere and certainly here at Loma linda are humanitarians, that's why they go into medicine.

So years ago, now, 60 years ago, a group of medical students here at Loma linda started an evening clinic. Uh they called Social Action Corps uh to take care of two groups of people primarily at that time.

Uh the hippies who were coming into California with their brightly colored Volkswagens and the migrant farm workers that were here that had no health care.

So we started evening pre evening clinics and those carried on through the years, gradually growing bigger and bigger and bigger. We finally took over in 1995 was given a large clinic building at Norton Air Force base when it converted to civilian use that filled up became bigger and bigger and finally says we need someplace even bigger.

So about five years ago, now longline invested uh $68 million San Bernardino. It was a gutsy move. This was a city was bankrupt second largest bankrupt city in the country and we built a clinic in downtown San Bernardino say we want to put our stake in this, saying we believe there's something valuable that can be done here.

And as we started planning the clinic, he says, you know, another part of health care of development communities, not just providing good health, but it's also providing jobs.

And so the idea that came out of that if you have a clinic clinic is also a laboratory, a training ground. So we put the SAn Manuel Gateway College on the third floor of that building, so we take high school kids that don't have a career path in my, in my mind, give them job entry skills, 6 to 12 months training programs for pharmacy tech, dialysis, tech, surgery, tech, community health workers and so on and launch their careers, which is life changing for themselves and their families.

And then in the clinic below that we're now seeing over well over 100,000 patients a year providing health care for those who have insurance and those who don't and you know, we can, we can sit there and be proud of what we've done for SAN Bernardino.

I would argue it's even more important what we've done for Loma linda, the opportunities that has given our faculty, our students, our doctors to engage with the community to understand and confront human need at a very real level is very powerful. So having a setting where I've got all the way from Loma linda sub specialists, residents being trained in their specialty medicine care professional students in medicine, dentistry, pharmacy, nursing and so on.

And high school students all training in the same space is incredibly powerful learning experience. And as I like to remind them this education doesn't come just from the docks down this goes from high school kids up.

This is what it's like living in, where we live in the burg. This is what it's like caring for grandma. This is why there's no point in ordering Cipro or an expensive lab test because you can't afford it understand our situation.

So it's been an incredibly meaningful program and very beneficial to Loma linda. It's also been under your leadership that the marietta hospital and campus opened up.

Right. Talk to us about that. Well there was a great need down there in in southern riverside county. Uh and so a group of physicians came to us and asked to partner with us in developing a hospital in marietta. So about halfway between riverside and escondido. Um and so we've done that and that hospital has, has been a blessing. Uh it's changed a number of ways from where we originally started, but now it is full and busting at the seams.

I was seeing the numbers a couple of days ago, we have 100 and 11 beds. They had 100 and 56 patients in marietta. The covid epidemic has really hit them hard. So they've been caring for those having to convert er rooms, two patient rooms and uh everything else to take care of, all the needs that are there. So we're proud of mary and it's been a huge, hugely advantage to Loma linda to be involved. We've just started a new residency program there now and family medicine as of july. So it'll also become a training ground for Loma linda graduates. So one thing that I did not tell you that I was gonna ask you, so I'm gonna, I'm gonna throw you a curve ball here.

But one of the things that strikes me is like how you're right like in your position, you are the one who ultimately has to make some big decisions, some of them very risky. What's that process like for you?

How do you actually make these kinds of decisions? Well you're right and there's always some tough decisions that are not slam dunks uh that they are, they're risky ones building a new hospital here at Loma linda was one of them uh and so on.

Hi function best by being able to put out ideas to a group of people, uh get listening to their feedback and and try different different groups of people coming back to the same group multiple times and just listening to the dialogue, listening to what goes forward and then finally, yes, I will have to make a decision, but uh I covet input and ideas from others in that decision making process because it often uncovers things that I hadn't thought about.

I mentioned our values and just trying to re re coalesce around seven values. Uh we put all those out as we're going along to all the faculty and got back a lot of different things. Things you'd never think of just by yourself, but different word changes, different meetings and so on.

So so I find real value in being able to to dialogue with others as we're moving towards the decision, even though ultimately why you've got to weigh all the pros and cons say, okay, here's what we're gonna do.

And then let's talk about the criticism piece. Because anybody in a leadership position who is responsible for making those decisions is going to be met with criticism.

How do you deal with that? How do you um take that as feedback and yet not let it bring you down and cause the burnout? Well, you're right. I mean there's always gonna be people who don't agree with what you've done and have plenty of criticisms and and I appreciate hearing from that. I mean I get a lot of letters back from different people. Why did you do this?

Why did you do that? And let me tell you how terrible Loma linda is not a lot, but I get some um and that that feedback is valuable. Uh you know through the years I developed the ability to, to shrug my shoulder and said, well okay, uh you're welcome to your opinion but you're dead wrong and I'm gonna ignore it or that's something I need to take seriously and see if we can correct it. Uh many times if I get a patient complaint, I will share that with a particular part of our system that that failed that patient and say what can we do better? Uh often it's a pretty minor thing but is there something we can do to make this better? Um, so yeah, no, I'm, I'm used to taking shots and get pretty thick skin.

Uh I get home at night and share some with my wife and she's sure she's got the answer to this. I said, wait a minute. There's another side to every issue. So just be patient.

Let's understand the other side. Before we try to make some decision on something. Um and that's, that's an important thing to recognize the balance of uh of issues that are there.

So we deal with it and you work and you hike and you and you do yard work and farm work. Hmm. Good. Well to wrap things up, what would be another life lesson that you would feel would be important for those who are wanting to live well do well, what other life lesson would you feel would be an important one that you have learned in your life that you would want to pass on and share?

Well my wife has some Cherokee blood distance in her past that she's proud of. Uh, came across the Cherokee saying the other day, don't let yesterday use up too much of today.

Uh, and I think it's important to recognize where there's times when I have made mistakes, certainly made mistakes, bad mistakes in terms of relationships in terms of so things and so on. Uh, but you've got to move on uh, and and make that happen. Um, and so I, I would encourage people not to be bogged down by past issues, but take each new day is a fresh day.

I heard another thing recently says the future is already here. It's just not very evenly distributed. Um, and you know, we've got to keep that in mind, things are gonna happen, Things are coming. Uh, and uh yeah, so courage. We're in a crazy world right now.

I mean, none of us can predict everything. You know, as I listened to Joe biden's speech last night at the Democratic convention. Uh, you've got covid, you've got financial crisis, you've got racial crises, You got climate change, you get all these different issues that could be overwhelming any one of them by themselves. And yet in that whole combination of stuff why and my personal belief, God still cares for us as individuals.

Uh, and still is concerned for our own personal health and safety and wellness. Um, and so with that confidence, why we move each day at a time and stay out of the overwhelm. Mm hmm. Mhm. Good.

Thank you. Thank you Dr hart for being willing to take this time. I know your schedule is very busy, so I really appreciated you taking the time to share with us today.

Thank you Amy. Always good to see you come up and visit definitely. And thank you for joining us on the bio optimized summit together, let's find that next level of health and aliveness.

Richard Hart, MD

Building a Life of Peak Performance