The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
Just John – Bold innovation while building a sustainable system - John Couris, President and CEO of the Florida Health Sciences Center
Ever wondered how leaders in healthcare balance innovation with the everyday challenges of running a major health system? John Couris, President and CEO of the Florida Health Sciences Center unveils his approach to expanding Tampa General's reach while launching a venture capital fund and developing a medical district.
Join us on a journey through the intricacies of creating a supportive organizational culture where failure is not only accepted but encouraged as a stepping stone to growth. Inspired by personal tales and industry challenges, we discuss the importance of authenticity, kindness, transparency, and vulnerability as the cornerstones of a thriving workplace. Feel the energy as we uncover how this approach nurtures trust, enabling individuals to innovate fearlessly and organizations to maintain their cultural integrity through commitment and training.
We confront the healthcare industry's pressing dilemmas, from care coordination to the quest for a sustainable and affordable system. Dive into the complexities of the U.S. healthcare system, dissecting the impact of policies like the Affordable Care Act and envisioning a future where collaboration drives meaningful change. Highlights include innovative ideas like food pharmacies and the potential for government-facilitated industry innovation. This episode promises not just an engaging conversation but tangible insights into the legacy and leadership required to shape a healthier tomorrow.
Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. Today we are in the studio talking with John Kouros, president and CEO of the Florida Health Sciences Center, about world-class outcomes. Won't bankrupt the individual First. Who are we, why are we here and, more importantly, why did we name our podcast the Reverse Mullet Healthcare Podcast?
Speaker 2:Well, we want to be relevant, informative and creative, but we also want to be entertaining and have fun. So it's like a party in the front and business in the back, like a mullet, only reversed.
Speaker 3:We are your hosts and I do not have the wig on, so you can't see it in real life, Ellen.
Speaker 1:Brown, justin Politi and Dave Pavlik. We are passionate, innovative, collaborative and are committed to solving some of our industry's most pressing problems along with our clients. We have a combined 90 years of experience.
Speaker 2:A bunch of old fogies we are.
Speaker 3:Speak for yourself, although I am actually older than you. So anyway, marginally, yeah, although.
Speaker 1:I am actually older than you. So, anyway, marginally, yeah, anyway, and each episode we're going to dig into a hot health care topic and potentially dig into each other. Just don't dig into me.
Speaker 3:Be gentle please.
Speaker 1:Yeah.
Speaker 2:Yeah, not chance. We'll see about that, all right.
Speaker 3:Never, I can try at least Okay. So I'm really excited to have John back with us for a full, full episode this time Back in January, because I have to tell stories right Back in January at JP Morgan.
Speaker 1:We do only have about an hour. Yeah, it's not that long of a story.
Speaker 2:We'll do the Ellen abbreviated version, which means it's six hours long, yeah as Justin said, it takes Ellen a while to land the plane sometimes. So I'm going to land the plane quick on this one.
Speaker 3:So I was at a Centerview Partners event with some very, very impressive leaders in our industry. It was a variable who's who of C-suite and I was asking different folks. I said who do you think are the unicorns in healthcare? Who are the people in healthcare that are actually affecting real change? With all caps right, because that's our thing and your name came up three times in that room to me like and this isn't like conversation, you know going around the room and I was like, well, now I have to meet this John chorus Like, and the irony is stalker.
Speaker 1:Yeah, yeah, yeah. So the irony is you know.
Speaker 3:I'm in San Francisco for this event. I happen to live in Florida and Colorado. My daughter goes to school in Tampa and I'm thinking how have I, how have I missed this? Right, I've got it so. So then we went back to Vive and we were recording episodes and I, on the way in the plane, tagged you and said I want to talk to some unicorns and John Corris, you're on my list. And we talked and you came on the podcast and and I I just I really enjoyed hearing innovation that you're working on, um, and yeah, it was just kind of the story. And you were like, yeah, I'll come back and talk to you guys. So here we are. So I'm super pumped.
Speaker 1:I will also say that on the way here on the ride over today, I'd listened to that podcast and I remembered that when John walked in the room, first thing he said we had never met him. She just, by some stroke of luck, he was going to be available and was able to get him to come down to the studio. He walked in and he said y'all ready to have the time of your lives? We said, uh-oh, why?
Speaker 2:yes, we are.
Speaker 1:Yeah, yeah, yeah.
Speaker 2:Well, I hope you can top it today. I'll try. All right, fangirl, that's enough, so let's take a few minutes to actually introduce John. He is the president and CEO of Florida Health Sciences Center, which includes Tampa General, in partnership with the University of South Florida. Under Coruscant's leadership, tampa General's footprint has grown from 17 facilities to more than 150 care locations statewide, including six hospitals. He helped launch a venture capital fund, tgh Ventures. He is executing Tampa General's largest master facility plan, a $550 million capital commitment, by creating a growing medical and research district in downtown Tampa. He was recently appointed to a three-year term as a member of the Florida Health Care Innovation Council.
Speaker 2:Before joining Florida Health Sciences Center, he served as president and CEO of Jupiter Medical Center in Jupiter, florida. He also served in various executive leadership roles at BayCare Health and began his career at MassMGH. Roles at Baycare Health and began his career at MassMGH. So Coris is a graduate of BU and holds a Master of Science in Management from Lesley University in Cambridge, massachusetts. He holds a doctorate in business administration management sciences from the University of South Florida College of Business, where he's a research fellow. His dissertation examined the impact of the practice of authentic leadership on teams and organizations. He's a proud husband and father of two children, and his professional accolades read like a compendium of who's who in leadership, healthcare, innovation and thought leadership Another classic underachiever.
Speaker 3:Yes, and just for the record, I had to cut the accolades because it literally, I think, would have taken the entire episode to read them all.
Speaker 4:That's my staff who I still list it all out.
Speaker 2:So you were in Boston for a long time. Yes, all right Did you ever watch?
Speaker 4:see Little Joe Cook at the Cantab. No, who's Little Joe Cook?
Speaker 2:He was an institution Cantab was a Cambridge mass bar and Little Joe Cook was a blues singer and he was there for years.
Speaker 4:So a bit of an institution, yeah that's Cambridge, though that's the People's Republic of Cambridge. It's very different from the city of Boston.
Speaker 2:It is that area of Leslie, right near Harvard Square, walking distance. Did you say Harvard Square? So that's the other one. You like apples, don't you? I do? I got her number. How about them apples?
Speaker 3:What he just pulls them out Good Will Hunting. Yes, yes.
Speaker 4:Oh, wow, wow. Just saying I'm going to bring you with me on trivia next.
Speaker 3:You would win with this one.
Speaker 1:You talk about some obscure references.
Speaker 3:Keep going, you got any more so.
Speaker 2:We could probably talk all day, you guys are in Boston, yeah. I lived in Alston, then moved to Watertown Square, waltham, and then subsequently moved further, crossed the border eventually into New Hampshire no tax land. I'm from Swampscott.
Speaker 4:Massachusetts, just to the north of the city by about 15 miles. You still have family there. My whole family is still in New England. Okay, most of it.
Speaker 2:Most of it. So we're in Salem, New Hampshire now.
Speaker 4:Yeah, I know it. I went to school high're in Salem, new Hampshire.
Speaker 2:Now but yeah, I know it, it's a school, high school in New Hampton.
Speaker 4:Yeah, In New Hampton, new Hampshire, right off.
Speaker 2:Lake.
Speaker 4:Winnipesaukee.
Speaker 2:Yep. I used to live in Lake Winnipesaukee, apogos Bay, south Down Shores.
Speaker 4:Meredith New Hampshire.
Speaker 1:Is Good Will Hunting the Beautiful Mind, a beautiful mind movie no that's different.
Speaker 3:No, but there is a good, beautiful mind aspect.
Speaker 2:with that solving equation, there is a beautiful mind aspect.
Speaker 4:But wrong movie, wrong state.
Speaker 3:He just likes to bring it up so they can make fun of me, because they make fun of me trying to make a connection and I screwed it up.
Speaker 1:I will edit that out, potentially.
Speaker 3:All right, last bit of the fun You've hiked Machu Picchu.
Speaker 4:I did. I did back in gosh when I was in high school.
Speaker 3:And not a repeat item for you.
Speaker 4:No, not a repeat item. Check that off the list. It was kind of cool, it was a lot of fun. I'm glad I did it. We went up to Wainu Picchu too. So if you've ever been to Machu Picchu, there's the Inca city and whatever the town. But there's another peak and on top of it is a temple dedicated to the moon and the sun and you can climb up that. It's not a long hike but it's a very steep hike. That's kind of a neat thing to do. It's not a long hike but it's a very steep hike. That's kind of a neat thing to do but it's a one and done.
Speaker 3:But that kind of probably was the nail in the coffin on that one like the extra steep.
Speaker 4:It was the one and done for me.
Speaker 3:But so, in good news, though, the last time we talked you were headed to London and Croatia. Yeah, it was awesome.
Speaker 4:Was it? Did it top Rome? Yeah, it was awesome.
Speaker 3:Was it? Did it top Rome?
Speaker 4:Very different. So I would highly recommend we went to Croatia, to Dubrovnik, we went to Montenegro and we went to London. I would highly recommend Croatia and Montenegro, and London is one of my favorite cities in the world. It's wonderful, but Croatia is a definite. If you haven't been, you got to go.
Speaker 3:It's high on my list. So I was. I was very. I was like, oh, we're going to see John and I get asked him about Croatia.
Speaker 4:It's like a less expensive version of Italy.
Speaker 1:So you said you loved Rome. How does, how do you compare the two? I think they're very different.
Speaker 4:Italy is such a special country and Rome is just this incredible city, as you know, um totally different, totally different, you know. I mean like croatia was former yucoslavia, right? So it's you, you know, croatia, um montenegro, they're still developing. Yeah, you know, in a crazy way, even though it's it's been a while since the 90s, they're still developing. So it's very, very different. I mean, in Rome, you feel like you're stepping back in time, right? You really feel like you're. Well, you are right, right, you walk in that.
Speaker 3:Colosseum and you're like wow.
Speaker 4:Wow, this is like the real deal, yeah, yeah very different Okay.
Speaker 3:Well, I'm going to have to. You're going to reel us in. I'm going to be the guy You're moving from the party in the front, all right.
Speaker 1:Yeah, I'm going to slide us into the business in the back part, but I'll do it in a fun way. We took failures. We're going to talk about failures again. You made headlines when you said we don't do pilots and celebrate failure. When you were speaking at the main stage on vibe, where five where we, where we met you and then we, we first met we started to scheming, we started should I say scheming? Is that the right word?
Speaker 3:I don't know, it has a negative implication, but I'm going to stick with it.
Speaker 1:We were more. We were more spitballing the idea of a failures of a failures conference.
Speaker 3:Yes, yes, so tell us your thought on that.
Speaker 4:Well, I'll tell you what after Monday, when I test drive the concept with yes, with Ellen. I will be there with you. We'll test driving together.
Speaker 4:But Ellen and I are going to test drive it together and it's going to be kind of neat because we're going to do it on a podcast, we're going to do it with podcast, we're going to do it with, I think, 100, 150, 200 people in the room and we're going to go decade by decade about, um, my failures and mistakes. So it's sort of a combination. So it's a mix between a project or two that has completely failed and why, and then what did you learn from it, or what did I learn from it. But then there's also the leadership. You know mistakes along the way. So I'm excited about doing it and if it goes well which I know it will, because Ellen is emceeing I think we should turn it into a conference.
Speaker 3:I agree.
Speaker 4:Everybody I talk to about a failure conference. Even if it's for like two days, people love it. Yeah, everybody loves the concept. Yeah, I mean going to a normal conference and hearing about all the good work that's being done around the industry is wonderful and it's important and it's seeing those conferences are significant. But literally going to a conference and only hearing about failures and mistakes I think that's where the deepest and richest learning comes from. Great, so I hope Monday will go well and it's well received.
Speaker 3:And if it is, then we need to make it happen. We're in, yeah.
Speaker 1:It's going to be great. You've got to find leaders that are willing to check their ego right the door. Come in and be humble right.
Speaker 2:That's why it's rare to find a leader that celebrates failure.
Speaker 4:Well, when I went through all my failures and was preparing earlier this week for next week, I cried myself to sleep. After the one session I had with my chief of staff and my vice president of corporate communications, jennifer Crabtree who's wonderful, we love Jennifer I was like I'm laying in bed. I'm like I should be weeping right now.
Speaker 4:You know, but I'm really actually looking forward to sharing it, cause I think when, um when people don't think they make mistakes or are unwilling to share mistakes, I think that's a huge missed opportunity. I do, and I think there's a ton to be learned, so I'm excited to share them.
Speaker 3:I'm excited. I think the other thing too is I've had such an immense respect for your philosophy on failure. Partly it's near and dear to my heart because we have an individual who was a client of ours for a number of years. Honestly, if I had to line up unicorns in rank order in healthcare but on the traditional side, there's a bunch of really innovative stuff over here that point solutions, their ideas, their disruptors, but they're not managing the day-to-day of healthcare, the underbelly of it. That's a hard place to live. It is a very difficult place to—a lot of people like to point fingers at institutions and say you're the reason. This is a system we built. We should be much more appreciative of what's happening there.
Speaker 3:This particular individual was probably the most disruptive, willing to take the most bold risks, but calculated risks. That person ended up. They're not in the industry right now because the bet that they made the partner that they chose wasn't holding up their end of the bargain and that really hit like. I had a hard time with that and I think it's important. It's like wait a minute, though that was a what? If that risk had paid off, that could have been game changing for the industry. And now we lost that person because of that one thing. So anyways.
Speaker 2:So how do we tolerate or find some level of balance between accountability and admitting mistakes? Obviously, we want to be getting people to be encouraged to take chances and risks, but we have this in our society that if I do that then I have a risk of getting fired, and so I'll kind of stay in my lane and not do that. What are your thoughts on that?
Speaker 4:Well, I think it starts with like creating a culture that sort of encourages people to take chances and to make mistakes and to celebrate failure and to do the things you need to do. So in my world it's really simple. We've got four key attributes to sort of the world we live in. We lead and treat each other with authenticity, so we are our authentic selves. We don't try to be something that we think the organization or other people want us to be. We sort of embrace who we are, even with all our idiosyncrasies, right. So authenticity creates relatability. Relatability creates trust right. In a lot of cases, we also lead and treat each other with kindness right. In a lot of cases, we also lead and treat each other with kindness right. So we spend a lot of time talking and understanding what kindness is, what empathy is, what love is, and we lead that way, we treat each other that way. As you lead people and treat people and build an environment where people are treated with kindness and love and empathy, you create psychological safety in a really significant way.
Speaker 4:The third aspect of our work and how we do it, to answer your question, is we lead and treat each other transparently. We share almost everything. The only reason I say almost is because, of course, if there are things that need to be confidential, if it's an employee issue or a team member issue, excuse me. So if it's a team member issue, if it's a patient issue, if it's a delicate strategic issue, of course we're going to keep those confidential. But most everything we do we lay it out there for team members. We hold very little back.
Speaker 4:And then finally and that builds trust that builds big time trust, because no one likes to operate in the opaque. I mean, if you've ever worked with somebody or collaborated with somebody or worked for somebody who isn't transparent, it's very distracting and limiting. And then finally, we lead with vulnerability. We show real vulnerability like I don't know something or I made a mistake right or I asked for help. That's vulnerability. When you start to do these things on a consistent, everyday basis and it becomes part of the DNA of the organization, you're able to sit in front of hundreds of people and talk about your failures. You're able to talk about your mistakes. Why? Because you know that the organization isn't going to judge you, that the organization will embrace it, celebrate it, learn from it, move on from it, grow from it. So that's how we do it. It's not supernatural, it just is very intentional, deliberate work.
Speaker 1:It's a culture you built.
Speaker 4:Yeah, it's a culture we built and, believe me, we work on it every single day.
Speaker 3:You have an acronym for it and you wrote a case study on it. Right, we did.
Speaker 4:It's called ACTIV Good, great memory. Look at you with your notes. I didn't even look at my notes. I remembered it.
Speaker 3:You were talking about it and I was like he's describing ACTIV.
Speaker 1:And I was going to ask him about that later, what does it stand for?
Speaker 3:He just gave you all the words.
Speaker 4:It stands for leading with authenticity, kindness, transparency and vulnerability, and you put those words together and it's active. It's something we train on. So every leader and every team member in the organization is trained on this. We are constantly talking about it and using it and socializing it. We hold each other accountable for it and in a rare occasion when a leader struggles with it and gets to a point where you have to make a determination are they unwilling to adhere to active or are they incapable of adhering to active, or is it a combination of both? They got to leave. I mean, we're, we're, we're really very committed to it.
Speaker 3:It's impressive and you did so. I'll just stick with this, I won't. You know, the whole point of this is to be able to have a conversation is so, but you're so passionate about it, not only do you lead that through your organization, but but you actually wrote. You wrote a peer reviewed like there is. There is a peer reviewed study on the efficacy of this approach right that you published this year.
Speaker 4:Well, actually true. So the active model came from my dissertation and my doctorate program. Yeah, so it's a very well-studied, very well-researched and there's lots of data that shows that what I'm sharing with the audience actually works. And when people say well, what does that mean? It works Well, it has improved team member engagement in our organization significantly. I mean we operate with team member engagement well above the national averages and um in team member engagement. I mean well above it. Like always, we're always in the top quartile or decile in engagement.
Speaker 4:It has created an environment of psychological safety. You cannot innovate and create if you don't feel safe in the environment. You're doing that, you can't, or you can't do it as well as if you were in an environment that fostered all of that. And then, finally, it builds trust. And then when you can have an organization that feels safe, feels protected, and you have an organization that's completely engaged and you have a team of people that trust each other, your performance is you become unstoppable. See what's interesting about our industry.
Speaker 4:I say this to my chief administrative officer, who has the strategy group reporting. To her I said you know every health system, or most health systems. Maybe there's super enlightened health systems and in in the in in our industry. But most health systems um, we think our strategies are novel and they're different and unique. They're not. They're all variations of a theme. You travel the country, you talk to all of us in the industry and we talk about the same things. We're going to build hospitals. We're going to build out an ambulatory network. We have to do more in post-acute. We have to do better with our team members. We have to recruit more physicians. We have to do more in post-acute. We have to do better with our team members. We have to recruit more physicians. We've got to build more stuff. We've got to expand our footprint. Now the configurations are different and there's slight variations to the general theme, but it's basically the same strategy across the country. What is very different from system to system? People, culture and an organization's ability to execute a plan.
Speaker 3:Absolutely Very different Very.
Speaker 4:Our secret sauce in TGH and USF is not the actual strategy, it's our people. I'm unbiased, but I'm also a realist. We have some of the best people in the industry. I'll put my team up against any team in the country and we will out-execute any team in the United.
Speaker 3:States. So I'll give a, because I have insider information right now that nobody else knows? In preparation of Monday is and see we have trust. I can see we have built trust because you didn't look at me across the table like, oh, good Lord, what is she going to say? Was I thought the learning that you had from your decade at Jupiter Medical. I feel like that really feeds into your ultimate commitment to how you lead now.
Speaker 4:A hundred percent.
Speaker 3:Right. I thought that was really telling was I was the one that controlled it. I held onto it tightly and then, when I left, it all fell apart, and so I love sitting here knowing that that was, in your mind, a failure, that now, in this next decade, you've done completely differently. I just needed to practice for Monday.
Speaker 2:Maybe you could give Bill Belichick some advice.
Speaker 4:Yeah, right, right, right. No, I did. I mean the Jupiter experience, just to foreshadow a little bit of what Monday is going to be. I mean, the Jupiter experience was a mistake. I wouldn't characterize it as an out-and-out failure, because the institution did extremely well and and.
Speaker 4:But when I left, when I I was watching all sorts of things online, and when one of my board members you know because they were coming to me and saying, well, we need help with this, what do you think about this, what should we do here? And you know I love the place, so I was totally available and willing to help and guide and provide whatever information I could. But I was shocked at how quickly some things not all things, but some things just unraveled. And I actually said to one of an old board member of mine I said, well, what, what's going on? He said, well, john, and this will be like the cliffhanger he said, john, you're the leader. We were all on a path that you helped create. You're leading us down the path. And when you left the path, we all stopped walking the path and said, well, what do we? What do we do now? Yeah, like what? Okay, so what? What do we do right now like we have a plan, but john was our leader driving the plan we were following john leader and john.
Speaker 4:Right, we're following john. Maybe not the plan, maybe we didn't understand the plan, but we trusted John and I didn't think like I thought I was educating them on the plan. I probably wasn't educating them to the extent that I should have or could have. It wasn't done intentionally. I thought I was doing it, but I wasn't doing it obviously enough or the right way in that particular case. And so when I left, stuff that was just grounded in great analytics and just good plans changed and it hurt the organization, hurt the organization and my. The coaching I got from one of my board members was well, it's not anything like. His comment was oh, you did anything wrong. You just made a mistake, you didn't you? You thought these folks were coming along more than they were and they weren't Yep, yep.
Speaker 1:This has given me a new appreciation for well, I should say, my. My wife is a human resources leader at a large health system in northern Virginia and the thing that she's always the most proud of is when they get those engagement scores. And you know, I don't know if they have something like active, but certainly the pillars, the people pillars.
Speaker 3:I bet Sarah is going to learn about active whenever you see her again.
Speaker 1:I might tell her yeah, you know why not Share the wealth?
Speaker 4:Yeah, but it's given me a new appreciation for what she gets so excited about all the time.
Speaker 3:It's all about the people man, absolutely Well, so okay, so I am going to take us to the question. Really, the platform purpose, the passion purpose of this whole podcast, is to bring thought leaders like you, john, to your point. Variations in theme. But I think what we don't have a chance to do, I think we spend so much time in our lanes and in transactional conversation and in operational details that we lose the opportunity to have true non-transactional conversation about how to affect real change in all caps.
Speaker 3:And you were cited.
Speaker 3:I really liked you saying when we were prepping for this episode, you said because you know I have this passion for I want to see us reverse lifestyle disease and I'm not talking about prevention and wellness, you and I have clarified that. But I really liked your point of like hey, I'm doubling down on care coordination, my job is to help you when you are sick and I think that's a really good line to do. And and so you were quoted in a healthcare business day article recently. You were interviewed in part of a thing and you said we need to do a better job as an industry on care coordination, patient experience, access and convenience. And you went on to say we are creating a healthcare ecosystem that provides a frictionless environment for our patients, physicians and allied health professionals. Tell us your vision and if that's not your vision of real change, you can change the topic. But you know, as we push things along and it can be incremental, but you know what's that kind of push to make a difference when people complain about health care or whatever.
Speaker 4:Well, it's a great question. I mean, we're on an unsustainable trajectory in health care?
Speaker 3:Yeah, absolutely. I mean. We're on an unsustainable trajectory.
Speaker 4:Yeah, absolutely. I mean, you know, 17 to 21% of the GDP is spent on healthcare, depending on the year, and it doesn't really go lower. It's kind of stuck there and inches up. You look at quality, you look at clinical outcomes. You look at the most recent Commonwealth report, which is a wonderful report to look at because it's not a partisan report, it's sort of like just a report on health care and you look at our quality compared to the other 10 or 11 largest industrialized nations in the world. There's lots of reasons for this. We're like dead last at almost every quality indicator. Now, don't get me wrong. There's wonderful work being done around the country by really incredible and special health systems, but we're not moving the needle. Health and wellness isn't going to do it, not in our lifetimes, not in our lifetimes and maybe never. I think health and wellness is a component of care coordination, but I don't think it's the business that we're in.
Speaker 3:At least the sector of the business that I'm in. That point to me is what I always kind of go back to is and I experienced it with my mom she actually had almost died a year and a half ago at Jupiter Medical Center. So thank you for the work that you had done, because it is a really good facility.
Speaker 3:You've taken very good care of her twice. But I walked out of there realizing you go to the hospital to be kept alive, you are acutely ill, you are experiencing an acute incidence of sickness. There's something really wrong, right, and you're going to the hospital to be kept alive and to not be sick. The job of the hospital is not to make you healthy, and I think that's where we go kind of wrong as a system is. We really have not built anything for that To teach people and help people how to be healthy. We expect them to just figure it out. You know and I don't want to, I don't want to answer that right now, but my point is I agree with you that that we have built a system for what it's intended to do, which is you're really sick, we're going to help you, right, and that's what that's your job Like. That's that's what you're asked to do and you're tasked to do.
Speaker 4:That's right, and we struggle with it across the country. Yeah, so why would we get into other aspects of the business if we can't figure out the core competency of the business, if we can't figure out the main reason why we exist? All this diversification? And I'm going to be a health and wellness platform, I'm going to be an insurance company. I'm going to be vertically integrated. Well, wait, I'm going to be an insurance company. I'm going to be vertically integrated.
Speaker 4:Well, wait a minute, we don't do the core work well enough. As an industry, we don't do that work well enough. So when people say, well, what is that work, john? It's care coordination. It's coordinating care, it's eliminating friction, it's eliminating silos, it's eliminating that fragmentation that exists in the system and that drives quality down and increases cost. In any other industry where there's friction, where it's disjointed and clumsy, it adds cost and it doesn't create value for the consumer. So what do other industries do? They fix it. We struggle with that. We do. And it's not an indictment on the industry, because I'm a product of the industry. I have nothing but a ton of admiration for my colleagues that are trying to figure it out, just like I am. Just don't think as a total industry. We've embraced the concept of care coordination.
Speaker 1:But most organizations will tell you we do care coordination, we do population health.
Speaker 4:So what I mean about care coordination. I wrote about this. It was actually published in a modern health care magazine in like a two-part series. We published it in a two-part series. The title was sort of Untying the Gordian Knot of Healthcare. Care coordination is kind of the way.
Speaker 4:And the reason I wrote the paper wasn't because I thought I had great, you know, knowledge to bestow on the industry. It's just that when we started to socialize care coordination at my health system, everybody had a little different idea of it and they were running off doing all sorts of different things and I wanted to bring everybody back and focus them. So I basically wrote, with a team of people, a manifesto that said this is care coordination, this is our rallying cry, this is our true north. So care coordination to me it's not population. Health Care coordination to me is a fundamental shift in the healthcare systems operating system. So it's like building an iOS system for healthcare, like Apple has on their phone and what I tell people all the time because Apple most of us can identify with it.
Speaker 4:I said what makes Apple great, it's its operating system, it's not the phone, it's not the tablet, it's not the computer, don't get me wrong the phone, the tablet, the computer, the earphones they're pretty cool, they're well-designed, they're well-constructed. They're earphones they're pretty cool, they're well designed, they're well constructed, they're fun, they're hip. They're all the things everybody wants, but the stickiness. The reason why people love apple apple will tell you this is their ios system. It is a closed loop system that both designers and developers and users and consumers coexist and when you're in the ecosystem it's reliable, it's safe, it's intuitive, it's friction, light or frictionless. It's not siloed and fragmented. It applies sort of a systems thinking to how they deploy it and how people either create in it or are users in it. Why can't we create an operating system like that for healthcare? That's care coordination to us at TGH and at USF, no, it sounds very.
Speaker 2:It's exactly what we've talked about in so many different instances of like. You're the type of entity that if I was a payer, I'm saying. A lot of payers have their own like idea of what care coordination should or shouldn't be, and there's a lot of overlap. But why can't I just delegate it to you? If you are doing all of this and do it on behalf of all of my members, right, we pay you for care coordination. If we all align to say this is the right direction. That's pie in the sky, I get it, but there's a lot of overlap in care coordination going on, because we're all confused in the industry right now.
Speaker 4:Providers think they're payers and payers think they're providers, and then they go. And don't get me wrong. I mean there's great business models. I mean, look at United Optum, they print money. You just look at UnitedOptim, they print money. Okay, you just look at their stock, look at what they're doing, look at the money they've accumulated. They do a great job. Now I don't think they should be in the provider piece. They're in the provider space because they want to retain first dollar coverage as much as they can in their own system. They're not trying to save the world, they're trying to build and they've built a business model that is very lucrative. That's why they're doing it. So why not pay or be a payer and get into health and wellness, get into the front end of that journey for your beneficiaries, but then help and partner with us as providers. Get into health and wellness, get into the front end of that journey for your beneficiaries, but then help and partner with us as providers. That doesn't happen in this industry.
Speaker 3:No, it's very overlapping. I think it gets back to the economics. The economics are very misaligned and very disjointed and sort of removed. You don't have a choice. Our health care dollars are invested on our behalf. I mean, I happen to have my own insurance so I can pick, but it's not like there's some grand plan. There's a limited choice of options of what's going to be covered for me. So our healthcare dollars are invested for us and they're invested into a system that's to keep me from dying, into a system that's to keep me from dying. It's not. It's not meant to keep me thriving, it's not. That's not the system we built.
Speaker 3:And so I think you know we, we need to start, we need to step up to the plate and own that. That like if I want a world-class institution to go to, if I am on death's door or I have something really wrong with me, then I want to go to TGH and know I'm going to get taken care of and then I'm going to get the best care and it's going to be coordinated. I'm going to be. You know what I'm saying. Then you're going to discharge me and say, okay, now if you want to get healthy again, that's go do it, you know what I mean.
Speaker 4:Like that's not your role or partner with people that can do it, I mean look, we have a really, really great relationship with Florida Blue Guidewell.
Speaker 3:Shout out to Lee Bowers Medicare.
Speaker 4:We love Lee, that's right Pat Garrity, who's the CEO and the president of the whole thing Excellent, great visionary, great guy. His team's wonderful. We don't always agree. There's plenty of times we fuss at each other, but we're great partners because we both kind of believe in the same thing but look at it a bit differently.
Speaker 3:You own your spaces.
Speaker 4:We own our spaces. He does have clinics and does provide care, but he does it in certain markets where it's extremely expensive and he feels like he needs to do something different. That's his prerogative, I think. Personally, I think it takes more time and it's more work, but I'd spend more time partnering with health systems and I'd spend more time partnering with folks. But he's a great partner and he's a wonderful guy. We have a wonderful relationship with Lone Blue. We collaborate on all sorts of things. They teach us the payer world. We teach them a little bit of the provider world. We sit down and we try to innovate together.
Speaker 4:A great example is Pat and his team, florida Blue. They were the first commercial payer that we had that actually paid us for hospital at home. We had commercial payer that we had that actually paid us for hospital at home. It actually started a commercial plan with us that provided us a commercial plan. I mean that's great. Those little innovations really, really matter. But again, there are a few. There's very few of those people out there. I'm telling you this is just my perspective. It's a little weird. Like I said, you've got payers wanting to be providers and providers wanting to be payers, instead of sitting down and saying there's got to be a better way.
Speaker 3:Right, I'm delivering.
Speaker 3:But see, I'll just add that I think ambulatory care is where it gets a little muddy and everybody's kind of chasing, because to me that's the area, that that's a connector, right Cause it's like, okay, I came out of the acute care setting, I'm not ready to just be at home, I've got to enter this sort of ambulatory space, right, or I'm sick, but I'm not acutely sick, right, and.
Speaker 3:And then the problem is that if the health system is just focused on the acute, but they want to be able to feed by using ambulatory their focus is on the acute then they're not going to do ambulatory well, so then the health plan says wait, I need ambulatory. You know what I mean. So then it gets this like muddy ground and the sad part is that that's actually where there's a lot of money to be made and whoever's going to own that person in terms of trying to minimize their touching into the hospital system you know what I mean. Hitting that acute care point, somebody needs to help navigate that, and that's where I think people overlap. It's like people are bumping into each other and it comes back to who's financially accountable, which is what I was saying about the economics being yeah and part of it is both sides.
Speaker 2:Well, on the payer side basically thinks that you know, wait, the health system's not necessarily focused on making sure that they're most cost efficient as possible. So we are going to start to deploy resources on our own to do something to help mitigate that right. And then all of a sudden, you have all these barriers put up that the care access that do create that friction right. So you know, prior authorizations, all those components that just are hurdles to actually implementing a good model.
Speaker 4:Yeah, you know the federal government needs to create an environment where they bring us all together to really collaborate and build a new model. The way we're doing it doesn't work. And, by the way, for those people that think, well, the solution is a one-payer system. Let the government take it over. That would be an absolute disaster.
Speaker 4:That would be a disaster, and I have strong feelings around it because it's not political, it's just look, if you look at what Obama did in Obamacare, did it help? Yeah, it probably helped, but it hasn't improved quality. It hasn't improved clinical outcomes or safety. It's increased access, but all he's done is create another pool of underinsured people. Okay, so what he's created from an economic perspective is a bigger burden on the healthcare system, because when you're a Medicaid patient, you're paid at some version of a Medicaid rate. In Obamacare, you're just underinsured.
Speaker 4:Right, you just don't have, you're not appropriately insured, and when you vilify the health systems and say, well, you're too expensive.
Speaker 3:Well, that's, somebody has to pay for that care.
Speaker 4:Yeah, but it's ridiculous because it's not the health system's fault, right, just like it's not completely big pharma's fault or the payer's fault. What our government needs to do is create an environment, hey, where you can innovate, you can collaborate, you can partner. How about being incented to do those things to build a stronger and more resilient and more highly reliable system for the people of this country? That's what our federal government should be doing. They should be facilitating this. They should be driving us towards this kind of creativity and partnership. Instead, what do we do? Our special interest groups run around and we vilify each other, I agree, and nothing gets changed.
Speaker 3:I know, and what's interesting is, you know, when you talk about Obamacare. I mean, one of the things that came out of that was CMMI, which is the Innovation Center for CMS, and they've launched 50 value-based programs and we could knock them until the cows come home and those special interest groups love to bash it right. It becomes this partisan issue of like-.
Speaker 2:Both sides, both sides bash. We want it to go away and then wait.
Speaker 3:This isn't saving anything, but to your point it's actually a learning lab for new models, and you know what. So what if it didn't save money, if it kept costs neutral? We've flip and learned from it right.
Speaker 3:And so I agree with you that it's like we have to invest in, in collaboration and and and a realignment, like I'm very relieved to hear you say like it doesn't work the way it is today, cause a lot of health system CEOs are like, well, I'm doing this or I'm doing that and it's going to get better. And it's like, no, we, we have built a system upon which volume is how you're paid and you can't fault anybody for that. Like, why would you want to step up?
Speaker 2:and I mean you know, we're given false choices too when it comes to this stuff. Right, when I say that issues are brought up and it's like well to your point, right? Well, we should just be single payer and everything like this is going to go away. No, that's not an accurate statement, or we need to like this whole concept of like. Why aren't we working together and the federal government and sending these, like everybody, to get together in a more functional system, versus putting out false choices for people and putting in their own?
Speaker 4:Be a convener, the federal government, convene us, bring us together, drive us.
Speaker 4:Instead of driving us apart, yeah, instead of driving us apart, no. But, ellen, it's a great point. Listen, under President Kathleen Pasadena's Live Healthy Act, she's created a 15-person innovations committee where we are going to take real problems. I was appointed by her for this committee. We're going to take real problems, real problems. We're going to present them to the industry and say innovate. So, venture capital, private equity entrepreneurs, health systems OEMs, original equipment manufacturers, companies, come to us with a solution to our real problem and let's let innovation drive the improvements in healthcare that we have to make across the board, I might add, from the provider side to the payer side and everything in between I'm really excited about this, you had me at healthy.
Speaker 4:Yeah, well live healthy.
Speaker 3:I understand.
Speaker 4:But what, kathleen? What the President Pasadena did is she enacted a ton of policy over the last year to improve the resiliency of the healthcare system in the state. Along with the governor and along with the speaker of the house and along with those legislative bodies, they're created a body of policy that is actually going to if implemented right and not morphed into something and picked apart and criticized, and all that if implemented right and not morphed into something, and picked apart and criticized, and all that, if implemented correctly, it will change the way care is delivered across the state and I would submit to you that if we can do it in the third largest state in the country, we can do it across the country.
Speaker 3:I agree. Yeah, I agree. You know, I'll be sending you notes on that one.
Speaker 4:You can, you can. I'll keep you updated.
Speaker 3:I'm just as excited about that as you are, except I'm not on the committee. So if you could leave a legacy on health care, in health care, right, if you could leave a legacy, I mean I think you still have a couple decades left.
Speaker 4:I have some time.
Speaker 3:Yeah, I mean I think you still have a couple of decades left. I have some time. Yeah, I've got a long road ahead of me, but what would that look like for you? What would feel like the right thing to leave?
Speaker 4:It's a great question actually. You know when it's my time, let me just set the context. So, as a leader, I believe something, a very simple concept, that the true testament of any leader anywhere, any industry anywhere, but in this case, healthcare when you're ready to leave, retire, move to the next generation gig, whatever you're doing, and you can look back and you can say you know what. I left the place that I was responsible for better than when I found it and now I'm passing the mantle. You've done your job as a leader, because leadership isn't about kingdom building and control as much as people do that stupid stuff. It's not about that. It's not about your ego, and we all have ego invested in it, and when people say, well, I don't have my ego invested in it.
Speaker 3:Oh, I know I just listened to a podcast episode with John Mackey. With you know, he's the founder of Whole Foods and it was really interesting to hear his sort of self-actualized versus ego, and I totally agree with you.
Speaker 4:Right, so they're full of you know people are full of BS when they say well, there's no ego invested in me, and we all have a little bit of ego invested in what we do. But that should not be how you measure your success, right? It should be. Am I leaving the place that I'm responsible for better than when I found it? And when I pass that mantle onto the next generation of leader, I'm passing a mantle to him or her that's better, stronger, more resilient.
Speaker 4:So my legacy is I want to leave an aspect of it. I want to leave a system and I plan on staying where I am until I am done, until I retire, because I'm very committed to what we're doing at TGH and at USF or, in a broader sense, florida Health Sciences Center, in relationship to what we're doing across the state. I want to leave a system that is driving world-class quality clinical outcomes and safety world-class quality clinical outcomes and safety. That's highly reliable, meaning that there's very little variability in our performance, that it's sustained. So, regardless of who you are, where you enter, you're getting the same care at the same level with the same outcomes, and those outcomes are world-class. And I want to do it at a lower cost and I want to be able to say that not only are we producing these great levels of quality, but we're also doing it less expensively. Oh and, by the way, we've passed that value on.
Speaker 3:Right, not just more profitably.
Speaker 4:We've passed that value on to the consumer, to the patient, to the employer, to even the payer. Now we have to make money. Payers have to make money. In my case, I'm a big private, not-for-profit academic health system. I can't provide care and can't fulfill my shared purpose if I have a padlock on my front door because I can't run profitably. So you've got to make money, yeah Right, but there's plenty of money in the system. My thesis is plenty of money in the system. It's how we use the money that needs to change.
Speaker 3:Listen, you know that you and I disagree a little bit about the lifestyle disease thing. Right, we spend trillions on it. Trillions of that healthcare dollar that should come out is on lifestyle disease. We don't need to have type 2 diabetics running around with kidney failure.
Speaker 4:No, no, I agree with you.
Speaker 3:But to me that's where there's cost to take out of the system. There's a way to do this better, right.
Speaker 4:Just because you hit something, there's costs to take out of the system and there's a way to do this better, and my hypothesis is that way is care coordination.
Speaker 3:Agreed, I agree.
Speaker 4:Right Like creating for the consumer.
Speaker 3:Well, think about it, john right. People don't know how to reverse lifestyle disease.
Speaker 4:Right, no, no, no, listen, we do differ a bit on that, but I believe that health and wellness and lifestyle issues are a part of care coordination. It's just not the centerpiece of who we are.
Speaker 3:No, because you're an acute care health system right, and so I actually agree with you because I think we need a parallel healthcare system and I think there's plenty of money to go around for that. To your point, we have trillions that we invest in healthcare and so if there's a system that people can access, where they can learn how to reverse their lifestyle disease and not just treat it like, hey, I right, there's plenty of people that want to just keep eating kfc and, and you know, drinking soda and like that's their personal responsibility with this who doesn't like the hamburger or k from mcdonald's or kfc?
Speaker 4:I love it.
Speaker 3:We're getting ready to record a hot ones, so so so I'll throw listen tamp, throw listen Tampa general.
Speaker 4:My, my academic medical center has a McDonald's in it. People will say I can't believe you have McDonald's. My attitude is well, wait a minute, you're an adult, right? Yeah, so you're telling me that you don't have enough self-control to choose whether you want to go to McDonald's or not, so I have to take it away from you. I don't believe in that. If you don't want to eat McDonald's, don't eat McDonald's. I know I might say though you're going to love this, ellen McDonald's has plenty of healthy choices on the menu. If you don't want a Big Mac or a Whopper, you can choose healthier options.
Speaker 3:Healthier Right, okay, there's a difference between healthy and healthier.
Speaker 4:You can get a salad.
Speaker 3:That salad isn't nutritionally dense, though you can get a salad at McDonald's, and if you're in New England like us. Can you get some lobster?
Speaker 4:You can get a lobster roll in the summertime. Remember growing up as a kid that was a summertime favorite at McDonald's Real lobster in a beautiful bun, toasted, delicious.
Speaker 1:I love it. I know, I know you can get a lobster roll at TGH is what I think Justin's wondering he wants a shrimp?
Speaker 2:There should be some Gulf Shrimp, yeah.
Speaker 4:You find a lobster roll yeah.
Speaker 3:And you said it right, I am not one of those, that's. The other thing is, I don't think idealism is going to get us anywhere. Right Is being an idealist in all this and trying to be a purist. It's not going to get us to your point. We have to convene, and so my thing is like hey, two things. If we're going to have a McDonald's, then let's have a bolet. Like let's just have something. So if I'm stuck in the hospital I can get something healthy.
Speaker 4:Let's make it taste good, you know what I'm saying, right.
Speaker 3:But the other it's having multiple choices. But the other thing is, you know, having some way for people that when they're ready, when they're ready to make a good choice, they have a way to figure it out. And that's where I think healthcare really does a disservice.
Speaker 2:You know, if she was admitted to the hospital, she would be at the farm trying to pick her own vegetables.
Speaker 4:Well, we some for another time, but I'd love to have you as my guest and I'll give you the personal tour of our garden. We have a huge community garden.
Speaker 4:Food pharmacy, primary care attached to the food pharmacy and huge community garden. I've heard about that. I'm very excited about this Food pharmacy Yep, Primary care attached to the food pharmacy and the community garden. We do yoga, tai chi, we have an educational pavilion, we have a sizable farm and we have a food pharmacy and a food pantry for people. So you come into our primary care office and type 2 diabetic and the doctor says you know, you're really only a type 2 diabetic because of your diet. I'm going to give you a 12-week prescription to our food pharmacy and you're not only going to be able to get food for free, vegetables and all the good stuff but we're going to teach you. We're going to teach you how to make it and how to process it Exactly. Yeah, we do do that.
Speaker 3:We do See the beauty is is that, to your point, in the way the system set up today, you're going to have a padlock on your front door if you go all in on that at this moment 100. I mean, that's the bottom line right, however, there is.
Speaker 3:You are at risk well, right, but no, no, and I'm not asking you to become a payer but if you went to pat garrity and said, all right, I got 100 people that I know are your people and they want to come to my community garden and go to my primary care position, get healthy, and my healthcare delivery is going to do that for you and I want a piece of the pie when I do it, that's different than you becoming a payer?
Speaker 4:No, no, I totally agree. So I I look at if Pat was sitting right here and he is a wonderful and, like I said earlier, his organization is great. And we don't always agree, I mean, we definitely fuss at each other, but we are completely in alignment. You're absolutely right. When people say to me are you going to become a payer? You're going to go to it. No, no, no, no.
Speaker 3:Not in my lifetime, right, and I'm not saying you should, no but do I want to partner with payers?
Speaker 4:Do I want to collaborate with them? Do I wish I had that kind of relationship with United and Aetna that I do with the Blues, Absolutely I wish I had that so do all of our clients I don't.
Speaker 4:I have a very, very good relationship with Florida Blue and it will remain very strong. But yeah, you're right, I don't believe, like a lot of health systems and they do it for their reasons and their reasons are their reasons Not a lot of health systems, and they do it for their reasons and their reasons are their reasons. I I not a criticism of it, but I don't understand. When a health system wants to become a payer, I don't get it. We don't actually care for patients appropriately. Why would we get in?
Speaker 4:well, that's a whole nother business when we can't even do the core business the way it needs to be done? Let's go master that.
Speaker 3:Right or figure out a combo.
Speaker 2:Well, there's a lot of me too-ism going on where you hear stuff and like, oh geez, they're successful. Why don't we have our own health plan?
Speaker 3:That's a great point, I flew around the country helping people start Medicare. Advantage plans because you know they went to some leadership institute meeting and everybody talked about it and then everybody needed to have their health plan.
Speaker 4:You know how hard it is to run one of those things. It is really hard we have that's.
Speaker 3:John that has been the core of our business for many years, is like helping. And, to your point, the system is not set up for those models of care to succeed and do well in that, and it's a. It's a, so you have. And culturally it's misaligned so you have to realign culturally to be like.
Speaker 4:So anyways, we could like I know we've got, you know we got to move on, but you know what it brings us back to this conversation. Care coordination no it brings, it brings us, you bring. If we should have that drinking, you know like if you?
Speaker 3:ever watch us, if you hear this word take this word take a drink.
Speaker 4:It should be care coordination over my head, no, but you know not that we're condoning over drinking because we're not. We're not. It's a healthcare podcast. Right, we are not Drink responsibly. But what it brings us back to is the concept of where the federal government could play a really significant and thoughtful role. How about being a convener? How about bringing all the elements and the parts and pieces of the industry together to sit down and to really collaborate and rebuild and retool a system? Now, what my critics will say is you're being completely naive and you don't understand the industry the way we think you should. I totally disagree. I know this industry better than most and absolutely as good as some.
Speaker 4:Right, I mean I, I, I know the industry, not perfect at it by any stretch, which you'll find out on Monday, but with each decade.
Speaker 3:you've got better. With each decade I'm getting better. It's like wine, but truthfully, I've gotten better With each decade. I'm getting better. You're getting close to perfection.
Speaker 4:It's like wine, but truthfully, I mean, people would say, john, you're being naive and you don't quite understand how complex this is. No, I know exactly how complex it is and I'm not being naive. What I'm asking people to do is think differently. It's sort of like the reverse mullet Think differently, behave differently, not for the sake of it, but the country is depending on it. If you don't have a healthy and well society, you don't have a strong country, you don't have a strong economy, you don't have anything. And I think there's an opportunity where you get payers and providers and all different aspects of the industry in a room with venture capital, private equity, entrepreneurs, real innovators, and you sit down and say what does a system look like in a free market, capitalistic society?
Speaker 3:What does it look like that meets people where they are?
Speaker 4:That meets people where they are and that is sustainable, exactly Right, and that's reproducible and that's highly reliable. The answer is there, it's no question about it. The lens that we're looking through to see the industry needs to change.
Speaker 3:So I have to come up, so you have to help me before the 18th of September, so we have a very quick time frame here. I am now dating this podcast, right? Yeah, that's all right.
Speaker 3:But I will be up at a Hill Day and it's all about innovation and I need to have an elevator pitch on what we just talked about today. I have to like re-listen to this elevator pitch on what we just talked about today. I have to like re-listen to this because that's what I will say. At a bipartisan level, there is a desire societally to impact this. A hundred percent, and so there's a lot of momentum in different places. But I really appreciate that point around convening. That's what we're missing.
Speaker 2:Your words helped paint a picture in this white space behind me of what things could look like.
Speaker 1:So it's very inspiring. The thing is and I'm bringing us in for a landing because we need to, I know, because we have, because we could talk.
Speaker 2:It wasn't my fault that we didn't land the plane yet.
Speaker 1:It wasn't my fault no, we usually well, we usually close with this question that you essentially just answered right, which is you have a by the world, a coca moment, or when pigs fly? I think you're convening I don't want to put words in your mouth, but I think you answered that question when pigs fly buy the world a coca I don't know John looks like he's got to finish.
Speaker 4:No, I think you're right, but I think it's very doable, and you said something, ellen, that's important. It's not a partisan issue, it's not. It should not be politicized. The health and wellness of the people of this country should not be politicized.
Speaker 2:Whether you're a.
Speaker 4:Democrat, republican, an independent or however you identify.
Speaker 4:When it comes to the health and wellness of the people that we are responsible for in this great nation, we should be coming together and collaborating and innovating and building a new model, and not for the sake of building a new model, but because we need to build a new model, because we are on a unsustainable trajectory with healthcare costs and quality. And for the real cynicalist thing, the budget can't be balanced unless you deal with the Centers for Medicare and Medicaid federally. Yeah Right, it can't be no, and so we have to think differently.
Speaker 3:Well, the trust fund is going to go. I mean the trust fund is going to be bankrupt.
Speaker 4:And my biggest fear is, somebody will come in and do it for us if we don't do it ourselves.
Speaker 3:Oh, you're 100% right.
Speaker 4:And we will not like what they do to us, we will not like it.
Speaker 4:I don't know what it would be. I could venture to guess, but we're not going to like it. So right now is our time. It's not 10 years from now, it's now, and so we got to get after it. So what is my when pigs fly, kind of thing, but I do think this is achievable is when you're up in the hill. It's how do you build something and how do you build a process and a collaborative? We're like-minded. People from different parts of the industry come together to build the new model of healthcare.
Speaker 1:Carter will love this so it's a, so it's a by the world the Coke a moment.
Speaker 3:More so than pigs fly.
Speaker 1:Pigs will probably never fly. Yeah, they probably will never fly.
Speaker 3:Pigs flew a couple weeks ago, when they did in the Simpsons too. Well they also flew a couple weeks ago when Epic announced that people were going to be able to get their own health data into apps as they wanted. So there are pig flying moments, but anyways all right.
Speaker 1:Thank you so much for being here. Thanks again, John. Thanks for having me. This is super fun. I know it's rough on a Friday afternoon.
Speaker 4:No, no, it's been great, thank you.
Speaker 2:We appreciate it. Thanks again.
Speaker 3:Well, I'm Ellen Brown.
Speaker 2:I'm Justin.
Speaker 1:Politi and I'm Dave Pavlik. We are the partners at. As you can tell, we can talk about this stuff all day. Drop us a line. We might even go down rabbit holes that are not at all listed.
Speaker 3:Yes, exactly, but we are your best chance for real change.
Speaker 1:We are your best chance for real change.
Speaker 2:Check us out at ep2healthcom. Thank you.
Speaker 4:You guys are great you.