The Experience Mindset in Healthcare: What Dr. Thomas Howell Says Really Drives Experience

If you’ve ever tried to “roll out” patient experience improvements by handing clinicians a dashboard and asking them to do better, this episode of NRC Health’s The Experience Shift will feel like a much-needed reset.  

In a candid conversation with hosts Jennifer Baron and Brian Wynne, Dr. Thomas Howell, a practicing OB/GYN, former Medical Director at Mayo Clinic Health System, and now NRC Health Physician Advisor, made a clear case that the future of healthcare transformation depends less on chasing scores and more on rebuilding relationships, meaning, and smart workflows.  

Below are the most compelling highlights and what healthcare leaders can take away from the conversation right now. 

Early in the episode, Dr. Howell shared what has kept him engaged in medicine for decades. “Really, what drives my satisfaction was the connection you make with people and the relationship you develop,” he said. 

He painted a vivid picture of what clinicians actually carry home at the end of the day. “I don’t go to bed and say, that was a great surgery, and they had this complication—I handled that so well,” he said. 

Instead, he emphasized, the most meaningful moments are rooted in outcomes that patients feel and relationships that they trust. “The thing that drives you is when people come back two weeks after their surgery and you see how they’re doing,” he said. 

Metrics Don’t Motivate Clinicians 

In one of the episode’s most direct statements, Dr. Howell challenged a common assumption that more data automatically produces better experience. 

“Data is not the answer, the data is a tool,” he said. 

He went on to explain why scorecards and performance comparisons often fall flat with physicians: reporting can feel accusatory, and statistically, individual-level measurement can be noisy. 

“When you show up, especially with physicians, and say, ‘Here’s your report, do better’—that doesn’t resonate,” he said. 

So what does work? Start with values, then use data to support progress against what clinicians care about. 

“Ask, what do you care about?” Dr. Howell suggested. “What are your values around patient care? What does the data tell us about how that’s going in the patient’s perception, and then how do we measure how your progress has been on things that you care about?”  

This reframe, Dr. Howell noted, matters for leaders who are trying to move from compliance to commitment. When clinicians see experience work aligning with their professional identity, it stops being “another initiative” and becomes part of practice.

Healthcare executives often ask the same question: What’s the ROI of patient experience? Dr. Howell acknowledged the pressure that underlies this consideration, but he also pointed out that the impact is broader than what shows up in a single financial line. 

“There’s tons of data that says the ROI exists, and it’s very powerful,” he said. “It’s just not easily measured on an accounting sheet.”  

But Dr. Howell’s most resonant argument here wasn’t about reimbursement, but about why healthcare professionals choose this field in the first place, and what keeps them from burning out. 

“You care about this because this is why you’re in healthcare,” he said. “That’s what makes your job cool, and why you say, ‘I get to go to work on Monday,’ not, ‘I have to go to work on Monday.’”  

Continuous Improvement Beats Target-Chasing 

If you want clinician buy-in, Dr. Howell suggested eliminating a major source of cynicism: unrealistic percentile targets. 

“We moved away from artificial target-setting to an idea of continuous improvement,” he shared. “The goal is not to be at the 90th percentile, but to be better today than we were yesterday.”  

This is an operational strategy. When goals feel attainable and context-aware, teams can focus on meaningful changes rather than defending why they missed an arbitrary benchmark. 

One of the sharpest leadership lessons in the episode was also the simplest: Don’t request feedback if you won’t act on it. 

“Don’t ask the question if you don’t want to answer and you’re not going to do anything with it,” Dr. Howell said. “That’s the biggest path towards disengagement—I don’t trust what you say, because I see what you do.” 

For healthcare leaders, this was a crucial reminder: engagement isn’t built through surveys or town halls alone. It’s built through follow-through. 

Burnout, Meaning, and the Intrinsic Motivation Problem 

The conversation also dug into a sobering point: early-career physicians reporting lower meaning at work than we’d expect. 

“The youngest physicians had the worst score on a question of ‘My work is meaningful,’” Dr. Howell shared. “What really drives people professionally is the ability to be competent, the ability to have some autonomy—then what I do has meaning.”  

He also described the cultural shifts that have chipped away at connection among clinicians—small changes that add up over time. “Most people eat lunch at their desk,” he said. “That removes those connections and those mentoring opportunities, and we need to figure ways to get back to that.”  

If your organization is investing in workforce stability and retention, this is a powerful lens: experience work is also the pathway back to clinician purpose. 

When asked how he hopes healthcare will transform, Dr. Howell quoted a line that set the tone for the urgency ahead: “The pace of change in healthcare today is as slow as it’s ever going to be.”  

His own aspiration, as he described it, is straightforward: make the quadruple aim real, pursue better outcomes and access, secure a better experience for patients and providers, and set a more reasonable cost structure. And he ended with a call for experimentation, learning, and refusing to settle. 

“The enemy of excellence isn’t failure, it’s acceptance of mediocrity,” he said. “We’re going to have to try stuff. If it doesn’t work, we learn something.” 

Experience Is a Leadership Strategy 

This episode was a strong reminder that patient experience, clinician engagement, workflow transformation, and organizational performance are not separate conversations, but one greater conversation about building healthcare systems where relationships are protected and supported by smarter design. 

Or, as Dr. Howell put it, “The first rule is, take care of the patient—and the second rule is, take care of the patient.”  

Listen to the full episode of The Experience Shift for additional insights, or catch it on YouTube.