Heroes of Healthcare
Heroes of Healthcare

Episode · 2 weeks ago

Making a Broad Impact Through Population Health

ABOUT THIS EPISODE

To solve some of the thornier problems in healthcare—challenges like providing access, combating misinformation, and ensuring equitable outcomes—we need data.

That’s where population health comes into play. It’s a science that combines clinical care with data to improve the care of large swaths of people all at once.

Dr. Chirag Patel, Vice President Population Health at Centene, joins the show to explain the impact population health is having on a variety of areas. Plus, we chat about other hot topics in healthcare.

We discuss:

  • The practice and impact of population health
  • Making a difference in women’s health and medicaid
  • The challenge of labor shortages and access to healthcare
  • How individuals can make an impact in healthcare 

To hear this interview and more like it, follow Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

Listening on a desktop & can’t see the links? Just search for Heroes of Healthcare in your favorite podcast player.

You're listening to heroes of healthcare, the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's get into this show. Welcome to the heroes of healthcare podcast. I'm a Lavi d' Angelo and in Thrill to have Dr Sharrag Patel as our guest on today's show. Dr Petl is an internal medicine and pulmonary critical care medicine physician, as well as the VP of population health at Centene Corporation. Sentine is a publicly traded managed care company that serves as an intermediary for government sponsored and privately ensured healthcare groups. Throughout Dr Pettell's career and currently add sentine, he creates vision and strategy for population health, focusing on improving quality, affordability and healthcare access to communities across the US. He has more than eighteen years of healthcare experience and has directly led many programs that focus on improving quality outcomes for patients. He has been a featured subject matter expert on health policy, completing over three hundred multi media interviews. Is An acah Thomas Dolan scholar for two thousand and twenty two and was recently accepted to Stanford's chief Wellness Officer Program and welcome to the show, Dr Sharrag Petel. Good morning, how are you? I am doing well and and for our listeners, I've been in talks with shrug and been introduced now for several months, so I'm going to refer to him as Sharrog throughout the show. But we are so glad to finally get this on the books and to have you as a guest on heroes of healthcare. Excited and honored to be here. Really looking forward to it. Well, we are too, and for our listeners, I would love for you to just go ahead and give an introduction of WHO Sharrag Patel is and we give us a little bit of history of your path and to healthcare. Shrug Patel is a physician by trade. He is now working in population health and championing the health care for the underserved, to pour the underprivileged, the underrepresented, and my journey started long time ago and this is just part of that journey. Well, and in terms of moving into the population health space, I look forward to talking about that. But what made you decide to become a physician. Initially, was this a lifelong goal of yours since you were as young as you can remember? Absolutely, you know, when I first started as eight nine years old, I really wanted to be a veterinarian. I love turtles of snakes, and then my parents, obviously being first generation immigrants, that really probably wasn't the path of choice for them, subsequently really enjoyed taking care of people. Learning Biology and med school was a natural choice for me, but the more appropriate thing was why pulmonary critical care? I really liked working with the very ill, working with people who had not had healthcare for a long time and were really far gone removed from their health, and that was some place where I found a lot of self fulfillment and purpose and I decided to choose that road and I practice for a number of years, about twelve years, and then subsequently pivoted to the population health space. I thought my ability to impact a greater population was going to be in that space and I was drawn to it. It was a new and evolving space about ten years ago, and then, more than anything else, it was where I could impact the two things that were most important to me at that time, high risk women's care and then the totally underserved, and that's where I pivoted my career over the last ten years and in our talks leading up to...

...this, your passion for Population Health and serving that market is is very clear. But for the listeners who maybe don't know what population health means, can you give us an example and break that down? Absolutely, population health is the science of taking clinical care and a lot of data and melding the two to be able to take care of a large swath of people. And it can be to general population or it could be a certain subsect. It could be women, it could be a certain ethnicity of women, it could be people who live in with West Virginia who don't have appropriate clean water because of lead poisoning. It could be a variety of things and you partner definitely with govern state and local government, you partner with media, you partner with federal government to really design policies, programmed grant to really impact these inequitable health out health outcomes, and so we see that all across our country. We see in a variety of different ways and it is really really important work right now. It absolutely is, and when you and I first began our conversations. You were the VP of population health at well star, one of George's leading healthcare systems, and you have since transition into a really exciting new opportunity. Can you tell us about what made that transition happen and what made you decide to to go? This a great question, multi factoral. I had been at well star for a number of years doing population health and I wanted to grow the impact of my work and be part of a team whose moral compass was really about the underserved, the underrepresented, the elderly, and sentene is the foremost leader in that space. An opportunity came up to do that work at senteene. had some fantastic mentors who said, you know, if this is a type of work you want to do, Sentena is probably the place you're going to learn the most, have the biggest impact and is one of the more dynamic places to do this work. I've been there ninety days now and best decision I've ever made. I also think, you know, in this work you follow your moral compass and I followed my moral compass. I had the support of my friends, my peers, my spouse and I think I made the best decision for me that's great. In Ninety days and I think at this point you would know whether or not it was the right move. So congratulations on hitting that milestone. I think normally it's ninety days whenever you start to get insurance, but maybe your stuff and sooner, since you're working for a company that that provides that. Thank you. Yeah, I think I made the right decision. I also think, you know, the people that you work with in this work have to be like minded. They have to have the same agendas, the same intention, and when you're not in that space it's very obvious and evident because things don't necessarily get done. I believe in places like seen, and there's many other places like that, where everybody's like mind it. Their agenda is to help others and you get more done that way. Yes, you do. And you said you wanted to follow your moral compass. I think that also is is kind of like your gut instinct. Would you say the two or somewhat similar? Absolutely, you know, you use your gut instinct, use your moral compass, you follow your heart. You know you use some of your frontal lobe a little bit to decrease some of your impulsive notions, use all for and then you take the best step forward. And you know, life is about choice, right. You can always change your mind again if it's not the right thing for you. But it was the right thing for me. After a couple of years of the pandemic. I think I also wanted to be on the side where you help dictate and articulate policy and not just to health cure delivery side. And so this was the right move for me and it was the right for move for my family. I wanted my kids and my spouse and...

...my peers to see that I was prioritizing this work and that we're not just talking about solutions, but we're really being part of the solution itself. And so you know, when you think about all that, it's easy to get caught in an echo chamber and say, well, this is not right, this is not right, I don't like this. Well, then you got to do something about it, and that's the space on it today. That is one of those where you can see your impact and you're going to be able to start to really build that legacy for years to come. What would or how would you describe sent teens mission and purpose for Population Health so, being ninety days in and being immersed in the work, it's definitely member first. So the people we serve come first in everything we do. I think we do it at such a large scale that that can be easily lost. Were Twenty fourth largest company and Fortune five hundred, but when you really drill down to the people who work there and they're putting the members first, and I think that's really important. And then the other thing that was exciting to me is there's a new CEO, Sarah London, female, which is very exciting. Young, dynamic, really understands where healthcare is going and I think that's inspiring. It a self right. And so when you combine having a young CEO of fantastic dynamic mission and vision and then you have a company who has the history of doing great work, I think it's the futures very, very bright. I can see that. And what are some of your big goals that you're working toward right now? Being Ninety Days in, what do you think the rest of two thousand and twenty two looks like and what mark will you be able to make? Two Thousand and twenty two is going to be interesting across the country. You're starting to see Medicaid expansion in a lot of states. So that's a big part of what we do at sentine. But also long terms social services, which are for people who are medically frail, people who want to age at home in a culturally sensitive way, which is very important now, is also growing, and so developing those programs nationally and, you know, locally is very important for us. And then I think helping articulate in craft innovative health policy at a fed real estate level is going to be a big part of what I think Sentina is going to do going forward. I think it's really important to be in coauthorship of these things because that we know what works what doesn't work. And and then I think the only other thing that's really important to Scentina is diversity, equity, inclusion and health equity. Everything in which we work in has to have equitable health outcomes, and so a lot of intention, a lot of purpose, a lot of subject matter expertise put into that work and that's a very exciting piece of the work we do. What would really remarkable two thousand and twenty two like in goal look like if you could just implement one new process or your team could be responsible for one new thing. What would that be? Improving substance abuse in Indiana. I think that's you know, substance abuse is really a you know, downstream from having a lot of untreated mental illness, a lot of trauma, domestic abuse, inappropriate access to care. It's the result of a lot of things and so if we're upstream solving for some of these things and we decrease Substance Abuse Disorder and we decrease homelessness, I think that will be a great one for us. Indiana specifically, is it? Is it more wide spread in Indiana versus other markets or Indiana specifically, because that's part of the the country that your team is responsible for. So it's everywhere.

We're seeing it more and more everywhere, but I think for Indiana that's something that we know that needs definite attention. It's definitely something where it's causing people to be an emergency room, which is wrong destination of care. Being in the hospital would chronic and untreated illnesses, and so for us in Indiana it's definitely high priority, but it just is high priority everywhere. You know, the opion crisis, while it's not getting as much media time as it did during the pandemic. It's still existent and maybe even amplifying and Middle America, Rural America, and so we really need to pay attention to it, particularly in those Midwestern states, those more rural states, where maybe economic hardship is hitting even a harder now with the inflation going up, and so we really need to be cognizant of those things and those trends which tie to healthcare outcomes with the truly and you mentioned getting into like they getting into the actual emergency room and like being in the hospital. But what can be done to prevent that, like at what what's the the first step in trying to make sure that it doesn't get to the healthcare facility? Access? You have to improve access for everything. We just don't have act access in the right places. We have access in a lot of other places. Like you go live in a big city like Atlanta, where we live, there may be access for certain demographics, certain income levels, certain ethnicities, but there may not be for others. And then when you take urban, suburban and rural, maybe there's a difference in access. And then the other thing is we have to design destigmatize healthcare, particularly behavioral health, mental health. Right, there's this huge swath of people who think that they can, you know, proverbly, I can make it go away, I can just will it away. Well, no, you can't will it away because they're truly as a biochemical imbalance in your brain causing depression, I mean, or bipolar disease or schizophrenia, and you do need treatment. Does it have to be medications, but you need access to your appropriate therapy. And so destigmatizing that, and we've talked about that. Right, there's a lot of work being done to do that, but it's probably not being done in enough volume and it's probably not being done in the right sectors where the most help is needed, and so I think that's a huge part of this work. Yeah, and do you think that the pandemic has helped highlight and destigmatize some of that? You know, I think it's a sea saw. I think yes, but I also think people became so detached and so insular. You know, maybe in some places I got worse. You know, there's this whole notion about anti vaxxing and, you know, a lot of alternative therapies that certain sectors of the United States were leaning towards and you know, in those sectors you saw sometimes more death from covid and so I think there's a huge polarization in even in health care, the way we have in politics, around what is considered evidence based and non stigmatized and the opposite, and I think we've got a lot of, you know, building back that bridge of scientific trust left to be done. I love like this entire theme and I think that wellness and mental health is has been a big one for the past couple of years in the United States and I'm glad that it's getting more notice. I can imagine that, since it's such a big passion of yours and it's what you do for a living, is trying to improve just the wellness of the population. What is wellness look like in your household? Oh Man, so for me it's plot on twice a day, wood the ESPN on today, quite trust me, the work and the Lafe I have, I got to do it twice a day. Who's your favorite instructor? Oh, it's olivial motto. Okay,...

Ali Love is mine, but she's a good one too, and Alex is great to Alex is intense. So I like those two and then I'll do the stretch class. And then, you know, I have two kids, fourteen and thirteen, and they're wonderful and they have their activities and making sure they're well physically, mentally and spiritually is a full time job. And I have a dog whose name is Ali. He's a cova who named after the great boxer. And and then the most important thing is, you know, the time I spend with my spouse, right, she's my teammate, she's a love of my life. Sixteen years of marriage, who coming up next week actulations. Yeah, made a sixteen years. You talk about ninety days, right. I was like, if I make it past ninety days with this thing is going to go for a long time. So and she's a psychiatrist and her specialty is high risk in women and cancer. And so there's a lot of table talk at the House on how do we make this better? And you know, I think the last couple of years have shown that, while it's one thing to be instular, it's one thing to turn around and lean into your family so you can have a stronger family unit. And we've tried to do that as best as possible, to minimize the external noise and make our family unit stronger and that's its own journey, and so that's constant work at my house. What a dynamic duo you and your wife make and I think that you probably would be just the poster couple for trying to create just about life style in a home that does have that, that mental health component. What sorts of things are you teaching your children, though, because they are going to deal with struggles and hardships, and what are you instilling in them to help prevent things from getting worse later in life? That's a great question. For of all, we try to teach them to be mindful, have mindfulness, be compassionate. I think the other thing parenting now, because teens and how social media and external pressures, my wife uses this term and I'm learning more about, is to coregulate. And so while they may be going crazy in their mind and it comes out in, you know, these verbal jabs at us, we have to coregulate to help bring calmness to them so they can make better decisions, help them think through what maybe going on or articulate their emotions or feelings, even because often they don't do that readily. And so that's a big part of what we try to teach them or we try to help them through. You know, it's hard. Like you're a fifteen year old boy, you you have academic pressure, you have peer pressure, you have pressure to look a certain way, behave a certain way, be cool a certain way and then, on top of that, you have to feel a certain way right. You know, we talked about this in prerecording about toxic MES masculinity. It's okay to cry, it's okay to feel sad or feel compassionate for something that maybe others don't and then to be able to show that feeling. And so we try to, you know, emphasize that, but it's a journey, like I'm hoping that we're building bricks that and putting bricks down and some framework and some foundation out that when they're our age, they're able to feel sad and they feel okay about it or they're feeling empathetic or compassion for certain situation, political or social, and it's okay to feel that way as opposed to repressing it. And you know, it's a journey. I keep using that, but you know, I have to often remind myself, for my wife, that today felt like a loss. But as long as we minimize loss is and stack up small ways hopefully, in the end will raise, you know, kids who...

...are good citizens of the world, but feels like a crap shoe sometimes. I admire that you're teaching your son that and instilling those values in him. And I want to circle back to women's health because I know that's a passion project for both you and your wife. But on the the male side of things and just fostering fostering that that it's okay to have thoughts and feelings. Do you think that that is also part of population health for men? Absolutely hundred percent. If you can access that part of you, you can access to part that says it's okay to take care of me first, because taking care of me first, self love and self care is going to help me take care of my family or it's going to help me take care of the people who I'm in charge of taking care of, like other elderly loved ones or whomever. And if you're not going to do that, then you can't do those other things, you can't be dutiful, and so I think it's a huge part of it and I think there's this whole stough and western notion that, oh, I'll break myself down for the benefit of others, but in the end you're hurting yourself and them because you're not taking care of yourself. And so self love and self respect. It goes for women and then and so I think in men it's really, really important and I think that instilling that at a young age and starting to teach that as a young age is is how we're going to make the bigger shift happen over time. And I'm talking about this, and I may not be the best example, like I do things often like where I'm not taking care of myself or I'm not loving myself the way I need to, and I often have my wife or my behave. Go Buy yourself something, or go take half a day off or, you know, you go decompress. I think that's really important. We don't often, it doesn't come naturally for a lot of us. That is what makes a great partner to being your accountability partner and making sure that when you're healthy, then she's healthy too, and it makes everything around you better. And you have a very big job in front of you at sent teen and the population that you're serving, they need you and they need senteen's help. You mentioned women's health. What are some of the big projects that your team is working on right now as it relates to women's health? So we're definitely work on prenatal and maternal care. That's a big one for us in Indiana. But for me personally, I think there's a ton of work that needs to be done in women's care, particularly around culturally sensitive care, you know, around ensuring that people how they want to receive their care, the receiving it, particularly in the prenatal time, and then cancer prevention. Breast Cancer Still on their rise, you during cancer are still on their rise, and then behavioral help. Depression, Major and moderate depression, is on the rise. And then, you know, there are certain aspects of the United States who are definitely trying to take away rights that women had already. Now forget about if you agree or disagree, but you're taking something away and I think there's a lot of atension on that. So that's a piece that we pay very close attention to and I think you know, overall it's also about teaching women the same thing about Selfcare, selflove, selfrespect. That way they can take care of themselves first and foremost of them they can take care of others right and so, and we have historically marginalized that piece, purposefully or not, doesn't matter. The outcome is that they've not been able to get the access and the scope of health care that they need to take care of themselves physically and mentally, and I think that's a huge piece of the work that I hope to bring to bear in the future, regardless of my role at sent team. It sounds like you're well on your way and your focus thing on those those things that matter most right now. Who are?...

What are some parts of the country or some markets that are doing really well at providing access to healthcare? Northern California, for sure. I think they have some dynamic leadership up there. I think if you look at I think Atlanta is doing better. You know, I think there's some people in Atlanta that really care. I think, you know, particularly for women's Healthcare, where plan parenthood has a huge presence, I think is very good. And then I will say this. You know, where Medicaid has expanded, you tend to see more infrastructure and more funding put into access to care for a broader based population. So Indiana, I think, is a good place you start to see Florida, you see some of the other states, Kentucky, where there's been some good funding put into place and it's where sent ten and some of the other big pairs are doing a lot of the Medicaid innovation. And can you tell the listeners as well that maybe oren't is familiar with the difference between insurance. You know, whether it be commercial or Medicare Medicaid, what Population Medicaid serves? Typically serves the population that's under the poverty line, but it can also serve people who have disabilities, people who have are transitioning between jobs or careers, who have really fallen in terms of their income and it's taking them some time, and people who have and stage renal disease often have a medicaid portion of their payment for their care. And so it could be a variety of different things and it's not just one thing and it also depends on the state right. Every state has a different take on what they're going to do from Medicaid. For someone who is utilizing Medicaid. What are some resources that set senten apart that they offer to that population? Definitely a lot of behavioral health care resources. We leverage scale we're not just in one state where thirty five plus states. I think that makes a big difference. So something that works in one state, that's the best practice, we're going to take it to other states. I think that's huge, right. Your leveraging scale of a big company, and that's very different than maybe a smaller insurance company, and I think that's very important. Also, the leverage of technology. A place like senten huge data leg huge data warehouse, a lot of outcomes data, and so we're going to definitely be minimizing our mistakes and really emphasizing the things that have historically worked. So I think that's a big part of what senten does. And I think the other thing that's important is it's a publicly traded company, right, and so there's accountability, there's transparency, and I they when you have an accountable, transparent and emission driven organization, you're going to tend to see things move quicker, move faster. Oh, you know, we have a dynamic vision. We have a new CEO. Okay, where we going? In three five years there's going to be a roadway and a path paved forward for that. Now do I don't know what that's going to look like I'm ninety days in, but you here and see certain buzzwords, you you see semblance of division and you're like, I can sign on to that. You know, you're not saying to yourself, well, that doesn't make sense. You're like, oh well, that makes total sense, and you're going to be able to see a lot, I think of a lot of groundbreaking things happen over the next three to five years and it's going to be really great that you'll have your stamp on those and be able to to provide some help to the these these people who desperately need it. Yeah, I'll say it's our stamp. You know, it's you know, trug is part of this huge team of seventy seven thousand people who do fantastic work. It's I think that's the thing that is also very important.

You don't do this thing, do this work by yourself, you do it as a team and you know, everybody's carrying the water, not just you, and it's equal. And so while I might have a you know, a subject matter expertise, roll the person who's tasting the beneficiary's to tea, like the people in the community, is equally important. Right. They're the ones who are listening to the issues, listening to diseases and really putting into place care plans, and I think that maybe even more important than what I do. Well, you're a very humble leader and I think that's what makes you great in when you look over your time in the population health space, what are some things that you are most proud of that your team has accomplished? In my previous role at a well star, I look back fondly on my time there. I you know, I was in practice for a number of years in population health and, you know, design programs from scratch. You know, it's like you go into a room, it's like four or five you guys and need chalkboard it and everything. We we didn't do it with a lot of resources, and so I'm proud about the innovation. You know, we really made a lot of stuff without about anything, and I think that takes a lot of effort, mental flexibility, a lot of compromise. I think we did really well and reducing cost of care for our Medicare beneficiaries for about four or five years when I was there, and I think that was really important. It was part of the work that, you know, lead frog me into the role I'm in now, and I think you know, the other thing I'm proud of is we built a lot of relationships, not just at well star but in the community nationally, and it's those relationships that we draw upon to do the work we want to do now and then so in the future, ten years from now, if I'm in a different role, it'll be those same relationships that have built along the way who I'm going to lean and student say, Hey, help me understand this, or help me think through this, or let's do this work together, and I think that is probably make the most important thing that you can have in this work is somebody you can call to ask for help, because you don't do it by yourself, it's true. And for those of US maybe who aren't in the healthcare space and aren't able to make this impact from having, you know, big healthcare company backing them, how can just a normal individual go and make an impact and help people out there who need it? Oh, be informed. I think that's the number one be informed right. So don't don't let somebody tell you what to think. I think there's so much of that right and so much of what you see on the news. Go to a proper website, cms or you know, a proper place and learn what is actually going on so you can make your own decisions right. And I think we saw that with covid and I think we can see that with mental health, behavioral health, women's care, chronic conditions. How do you actually pick an insurance product for yourself? Like, go get informed. Right, maybe you can save twenty bucks a month. Right. Maybe for that twenty bucks you get pet insurance for your two dogs. And so there are ways to be better informed. We can do a better job as large employers. The government can do better job, but we can do a better job of taking our own accountability to become better in form about healthcare in general. And there's so many aspects of it to it right, like how do you choose? How do you choose a drug plan? How do you make sure that your dog is giving you Generic Med's when appropriate and giving you brand name when appropriate, so you're not paying too much out of pocket, you just paying the right amount, and so all of those things are incumbent on you to advocate for yourself from an informed standpoint. So you become informed and you can advocate for yourself and then you could advocate for others. You can...

...never advocate for others until you learn how to advocate for yourself, because that's just screaming and shouting from an uneducated place. And so the number one thing go get informed, learn. And you mentioned C ms and you couldn't have said that better, by the way. It's so true, and that's one of the things that I'm trying to hone in on. And I have alerts and I receive emails from various medical websites and I try to read articles that are being pushed to me every single day. But what are some websites or articles or places that we should go to get informed? You mentioned C ms, C Ms, you center from Medicare services. I think that's the number one site, right. They do a lot of work for people who have Medicare. But then Kaiser Foundation, there is a place. The Dartmouth Atlas is another place. Those three, I think, are really good. You know, evidence based, high integrity, bipartisan, okay for people who like that kind of thing, and so I think. And then the other thing is this is ask for doctor. Your doctor really will tell you, it's just you have to ask them. Doctors don't voluntarily tell you everything because they're turning patients every nine minutes. But if you stop one and say hey, explain this to me, walk me through this, I have no doubt someone will take the time to walk you through this. And I think that it's hard sometimes for people to ask for help. That's unfortunately part of our society. We just think that we're at it by ourselves and asking for help is not natural to most of us. So I think that's well said and great advice and there are people out there who are willing to help and want to help. We just have to be humble enough to just just ask. And you're asking for clarity. You're not necessary asking for help. There's nothing material. You've asked for information is depends on who you ask. Some information should be free. You're asking for information and clarity. Right so you could pick the right choice for you. We are so huge on choice. Let me choose where I want to die, let me choose how I want to get old, let me choose where I want to live, you know, or how I want to receive it. Well, if I want to choose my health care or choose the therapy. For me, being informed is kind of a natural byproduct of that. Yeah, it is. How long do you think it will take to see things start moving in the positive direction? In Indiana specifically? I think it's already moving in a positive direction in a lot of ways. I think next three to six years I think a lot of things will be changing in healthcare, even nationally in the central region of the United States, Ohio, Michigan, Wisconsin, Kentucky, Indiana, Illinois. I can see there's going to be a lot of flux and I think, I hope thinks for the better. But I also think that the pandemic has taught us that people are moving right, people work from home now and certain manufacturing industries are transitioning, and so depends on what happens economically right and so based on economist those healthcare and so we'll have to see. And I do think the next couple of years, because of inflation, there's going to be some turbulence, for sure. I think so as well. I don't think we know exactly what's to come with that, but it's going to hit hard and for a lot of different people, and unfortunately for inflation. That the communities that you're serving and those that might be on Medicaid. They're going to be some of the hardest hit. And Yeah, you know, here's the thing I'll of you that I often think about. Right, people now choose. Do I fill up my gas tank to go to work or do I have a netflix account? Right? And then eventually down the road, people getting will do I go get that a tourist at and or do I fill...

...up gas in my account? Maybe I'll take my tour set every other day, and then so on and that that's kind of that down stream effect, that trickle down effect that you get and then all of a sudden somebody has a heart attack, right. And so those are like real life examples and I can see if inflation continues or we don't get the right access to care or the care, the cost of care, healthcare doesn't come down, we're going to have issues like this. We already have that issue. How does access to healthcare improves as a hard question, for sure. You know, I think there's definitely an issue with access to care. Whage is also Maldistribution in where resources are. Like, if you live in Atlanta, every third three blocks is urgent care, right, but if you go to, you know, a rural state, it's ten miles between our gent cares and even a scope of services may not be where it needs to be. In so really making it more attractive for clinicians to go to the rural states or to critical access areas, or expanding the scope of practicability for midlevels like physician assistance, nurse practitioners, midwives, Duela's, I think is really important. So getting creative in that way and then making it attractive to go into healthcare. Next it as it was, we were seeing a decrease in people wanting to go to medical school. Okay, now, because of Covid you have an increase, but they all want to become specialists. They don't want to become primary care physicians, which is where we need the access, and so I think that's a part of what we got to figure out. I don't know that there's a really hard question now. I think that was well said. And do you think either of the PTEL children are going to go into healthcare? Don't know. If they do. They choose it on their own and then I would have something to maybe offer in terms of hey, consider a primary care specialty or primary care field or psychiatry. Above and beyond maybe doing something. So, you know, specialized that you only touch one person every day, right, you know, do something. We're going to touch a lot of people's lives every day if you can. But we'll have to see. This is not for everybody. It's not, and I think that what makes what I've seen the people who are most impactful when they're in health care, they truly do care about putting others first and that is what's most you know, that's kind of what drives them and that's what makes them be excited to wake up in the morning. So hopefully we continue to to breed more of that as we spread this awareness. I hope so. I hope so. It's you know, the one thing I didn't mention is nurses. Right, there's a huge sort of nurses, just a mal distribution, and you know it's we live at a free market, and so these nurses are getting these huge sign on bonuses to go to California or to Texas well. Then you know who suffers? Rural North Carolina, rule South Carolina, where access is already low anyways. And so you know, how do we make their some parody and how we pay nurses? We should pay them very well. They do a lot of work. They should be their undervalued. Hundred percent agree. We need to really hold them in the highest esteem, but how we compensate them needs to become more equitable across the country so there's not such a huge disparity and where they are. And so how do we make that happen? Exactly, exactly what do you hope to be remembered for from a healthcare standpoint? Compassionate leader, somebody who put others first, always did the right thing with the highest integrity, and he loved his Atlanta Sports. I know you love your Atlanta Sports. Do you want to give those teams a shout out? I want to give my brays, World Series Champs, a...

...shout out. They they need to figure out that pitching this year, though. My how love my hawks. They need a second superstar to put around Trey Young Geez. And then the falcons. I think there's going to be misery for a couple more years, but you know, we'll see. One day we'll make it back to the Super Bowl and we'll have a better ending. I hope so one day. And then at landing united can't forget them either. Injury plagued. What are they doing everybody. I mean, my son play soccer, so I get it, but come on man, it's we do have a lot of sports around us, though, and that is one of the great things about being in Atlanta and I've really love to see how sports teams bring people together, people from all different backgrounds just cheering on one thing and supporting the the same thing. If we could just make healthcare more like that, where everyone is just cheering, you know, for healthcare and cheering for population health back via sports scene, that would be awesome. That would be awesome. Well, tell me a little bit about your healthcare heroes. I'm excited to continue follower following your journey as you continue on with steen. But your healthcare heroes, we have to give them a shout out before we close. So in the Preiridis was going to be my favorite question. So this is the one question I actually prepare for. Wonderful. Well, you know, I'll tell you why. It's not often you get to give credit in an open forum like this and I think it's really important to call those people out because not only are they elbow to elbow with you in the work, but they've really been formative for you in your work and personally and professionally, and it's happened stance that all my heroes are women. It's it's just amazing actually, and so definitely number one my mentor. Carry O and please. She's and Kaiser Permanent, a head of the northern k off for a division, previous President of the American College of Healthcare Executives, superstar. She's helped me, personally and professionally, really think through how I want to be, where I want to be and the work I want to do. How did she become your mentor? She was at well star as a chief operating officer and you know, I think what attracted me to her as a mentor was her moral compass. You know, when you're in an environment of a lot of high achieving people, you don't always find people with the highest moral compass. Okay, even though you feel like they're wanting to do the right thing, that's not always the case. I mean healthcare still a business, right and truth of the matter, and highest compass, okay. The number two is Molly Magret, cabinet secretary for the Delaware Healthcare Service. He health care services, previous classmate of mine at Dartmouth's brilliant policy and just you know, when you know somebody who can be a wife, can be a mother, can be a policy expert and then also do school and has been a tremendous sounding board for me and how I think about things. She's been fantastic. Then sear Wesley, Dr Wesley, she is a diversity, equity inclusion champion. Forty under forty in Atlanta, also at senten. Now sentine knows how to find their talent, that's for sure. Ye, and and pull them from Atlanta. You believe it? Game recognized game. What can I tell you? So those three for sure. Then you know, somebody who's been really, really important for me is my wife from the beginning. Right. It's been a long journey, physically, emotionally, professionally,...

...raising kids, and none of this happens without her, right, without her support emotionally and her helping me think through things. And there's been lots of setbacks throughout the way and she's been there every step away to pick me up and say, okay, this is how we're going to get by this, this how we're going to move forward, this is how we're going to conduct this work. And so she's my spiritual backbone, I mean without this, without her, it doesn't work. And then, last but not least, I want to call out Lindsay landinger. She does the nerdy girl podcast, and okay, nerdy girl podcast. He she was a professor at Gartment when I was there, but she's a data scientist and she helped me really help science be cool for my daughter nine. Enough girls think about stem and she just makes it cool and that's kind of what she does and she's fantastic professor, healthcare policy expert, rising star. But decide project really for me was like, okay, you know what, you're going to be elevated into hero status. And so, you know, I've shown my daughter the videos and talked about stem and she's made it easier for me to talk to my daughter about step. And you know, you don't have to just go into Cheerley. You can be a coder. So it's been good. And Listen, being a girl dad is hard. So I'm sure it is. I'm sure, but you are giving your daughter some incredible women to look up to and hopefully emulate in the future. Your wife sounds like a remarkable woman as well and I hope that after this I'm going to get contact information for all of these heroes that you just mentioned, because I want to reach out to them and maybe even get some of them on the podcast, but at least just get introduced to them, because the way you've described them is is really amazing and I want them to make sure they hear this. All of them amazing. You know. I will tell you this, politics aside, you know the work that Alexis mguil Johnson is doing at plan parenthood. She's fighting the good fight. Yeah, I'm so glad, though, that you've had, you know, they have a platform and your get giving them the Kudos they deserve and also to a huge thank you to you, your og, for everything that you are doing to help our population, to help embrace these women, to embrace healthcare, to embrace the underserved communities receiving the care they so desperately deserve. We just appreciate all the efforts you live and breathe making, you know, healthcare a better place for all and we truly appreciate it and I can just see it and it's been awesome talking with you today. Any other questions that you wish? I would have asked her final thoughts before we wrap this up, final dust. First of all, thank you for letting me come on your podcast. It's an honor and a privilege and it's an amazing opportunity for me to forget about talking about myself but giving credit to the people who have really impacted me and who continue to do this really important work around the country, in the world, and I took that as an honor and opportunity and I want to thank you for that well. You've already done some remarkable things throughout your career and I know it's just the beginning. So I'm excited to stay in touch and continue to see what sent ten brings out and how we can help as well. And also, we need to make sure we get some rose together now that it's summertime, so we'll have we're in Atlanta. We need to go to a porch and enjoy this weather. Hundred percent. will go get some rose a die. That's not it. That's great. That sounds great. Well, again, thank you so much for being on the show and I look forward to stay in and to ch...

...and following your journey. You've been listening to heroes of healthcare. For more, subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

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