Healthcare Facilities Network

AI, Labor Shortages & the Future of Healthcare Facilities

• Peter

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Healthcare is changing rapidly, and many of the forces shaping the future extend far beyond the walls of the hospital itself.

In this episode of Healthcare Facilities Network, Hamilton Espinosa, Patrick Murphy, and Peter Martin, cover a wide range of topics influencing the healthcare facilities industry today — from AI and labor shortages to recruiting the next generation of professionals, generational differences in the workforce, evolving career paths, and the growing impact of data centers on infrastructure and energy demand.

The conversation moves beyond traditional healthcare silos and explores the bigger market shifts affecting how organizations think about leadership, education, hiring, construction, and long-term planning. Along the way, the group shares perspectives on employee deficits, the value of a college education, field experience, and even why hard-plumbed bathrooms on construction sites may matter more than people realize.

Rather than focusing on a single issue, this episode offers a broader look at the trends, challenges, and conversations helping shape the future of healthcare facilities and the people working within them.

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Post-Pandemic Purpose And Trades

SPEAKER_03

Post pandemic, what I'm see what what we're seeing is just there's there's a a need and a want for people to do what they love. And if and and there's people out there that love working with their hands, there are people out there that love being outside. And so how do you cater to those folks uh to make sure they have the ability to do what what they love? And and and I guess the sort of the the stigma of not going to college is lessening. I have a couple of friends uh and their their kids did not go to college. They uh one guy wanted to be an auto mechanic. He that's he loves tinkering and working, and and that's cars are his passion. And and you know, I just I just think back to when we were in school, um he may have been ostracized, he may have been shunned, he may have been, what are you doing? Um, and and that's changed right now, which which I love.

SPEAKER_02

There's a major crisis facing healthcare facilities management. We have aging employees, aging buildings, and aging infrastructure. We've created the healthcare facilities network, a content network designed specifically to help solve for these three pressing issues in healthcare facilities management. We bring on thought leaders and experts from across healthcare facilities management, all the way from the C-suite to the technician level, because at the end of the day, we're all invested in solving the aging issue. Thanks for tuning in. Look at our videos, you will find that is a theme across our content. This is the Healthcare Facilities Network. I'm your host, Peter Martin. Happy

Guests And The Aging Workforce Problem

SPEAKER_02

to be joined today by my two guests, Hamilton Espinoza, Patrick Murphy. Today we're gonna take a little bit different of a look at the employment market, the healthcare employment market. Ham and uh Patrick will introduce themselves, but we're gonna look at it. We typically look at it from the facilities management perspective. Today we're gonna look at it from the consulting perspective, but both my two guests have deep experience in healthcare. They work in healthcare, they are healthcare, so it'll be a different look at a one of the pillars we cover here on the healthcare facilities network, the aging employee conundrum that is really uh affecting all hospitals. So before we delve into that, let's ask my guests to please introduce themselves. Hamilton, we will start with you. Good morning.

SPEAKER_03

Yes, Hamilton Espinosa. I am the national healthcare core market leader for DPR construction. Uh I've been with DPR for 28 years. Uh uh, I am I am everything healthcare at the company. So any any major pursuits, I do a lot of connecting of the dots, providing support and and assisting in whatever way I can. Thank you, Ham.

SPEAKER_01

I could kind of just say ditto. Um Patrick Murphy, I'm the uh regional president here at CREF. We are a strategic end-to-end real estate and facilities advisor. Uh I've been in healthcare probably more than half my life now. Um, if you don't include the beginning, because that I'm not I'm not including that first year. Um and I work out I work out of Boston here with Peter. Uh we do a lot of work nationally. We like to focus on hospital systems and regions that are really seeing some of the problems that Peter brings up in content on the healthcare facility just about every month. So um happy to be here, Peter, and looking forward to a fun conversation with him.

SPEAKER_02

I don't know if I'm gonna get a word in edgewise. Just a little, just really quickly, just to kind of lay the foundation. So Patrick and I work together. I'm working from home today, um, but we work together in the Boston office, and Patrick and I have worked together for 15, 16 years now with a little bit of a break in the middle when I was doing the recruiting and the education. Ham and I go way back tonight, way back a long time ago. So it's you know, you know me, Ham. I'm not a math guy. Um, I wasn't a math guy in college. So 85, that's 15, and 26, like 41 years. Yeah, we met 41 years ago. Marquette University is freshman. Ham, a guy from Lyle, Illinois, me from Cranston, Rhode Island, met on the fourth floor, McCormick. So I uh I really appreciate Ham joining us today. You know, Ham, if you had said, like maybe it'd take 1987, that you know, someday we're going to be on the internet on a YouTube channel, neither of which we would have known. And you're gonna be talking to me and another engineer about healthcare facilities, I would say you're crazy.

SPEAKER_03

Yeah, I uh honestly I'm I'm super happy they didn't have cell phones back then with video capabilities. So that's number one. Uh and and number two, uh, I think we both looked a lot younger than than we are, as I I see myself with all my gray in my beard.

SPEAKER_02

Yeah, well, gray, gray, gray new hair.

SPEAKER_03

At least you've got some hair left, Pete.

SPEAKER_02

That's true, Ham. That's true. So I I do appreciate both Hamilton and uh Patrick joining me. And I want to start first, though, Ham, with your you know experience with DPR construction. And really, you got in with DPR when you guys were just starting out. So just tremendous growth over 28 years. But talk to us a little bit about the market, the construction market today, what you're seeing in healthcare. And if you could start, I always just go back to COVID. I hate saying the word, but COVID seemed to be that C shift in everything. So, like the last what's the market like last five, six years? Where are we? What are you seeing?

SPEAKER_03

Yeah,

Market Pressures On Reimbursement And Costs

SPEAKER_03

I you know, I I I I sort of time everything pre-pandemic and post-pandemic. And it's it's crazy to think that we're now six years later uh from from really the start of uh March of 2020, of when uh everything hit the fan back then. And and you know what's what's uh so DPR founded in 1990. Uh, like you said, Pete, I've seen a tremendous amount of changes in the company. But the the one thing that I think we do really well is we operate in in diverse core markets. And so we have an advanced technology group, um, and then the healthcare group. And what we're seeing right now is is just a huge boom in the advanced technology market, right? Um data centers are being built across the country, and money is no object. It's it's how fast can you go, how quickly can you get me up and running? Um, where where is the where can I get uh resources such as power and water to provide the cooling and power for my data centers? And and that's a little bit counter-cyclical to where we are in the healthcare core market. Um the healthcare core market right now is is, and I'll always say healthcare, the one constant is uh change, right? It's always sort of experiencing some change. There's always some some revisions going on, and and we're seeing um some shifts from the one big beautiful bill and what's happening with the Affordable Care Act. And I don't want to get political, um, so I won't, but what we're seeing is just a tremendous amount of uncertainty right now, and it's uncertainty due to a couple things. And and and one is just reimbursement rates. What's happening with reimbursement rates? The second thing that's affecting them is the rising cost of construction and labor and and and where the rising cost is in the United States, right? Everyone's buying gas, everyone's buying eggs, um, and there's just a tremendous boom in uh cost of things. Uh, and so the healthcare systems are seeing that. And so when you've got construction costs rising and reimbursement rates lowering, it puts them in a difficult position. And then we're talking, we're gonna talk about labor, and and I think the healthcare systems also have that same issue, right? What are they doing with nurses? What are they doing with clinicians? And so the thing that we're being asked um by our clients is is how can we do more with less, right? How can we be more efficient in what we're doing? And and so there's a couple things that that's going on on right now. Um prefan pre-manufacturing, manufacturing, uh, trying to get build as much as we can off-site so that we're just doing a kit of parts and installing them is helping with that. Um AI is gonna have um AI is gonna also affect where we at, right? So what are we building number one, and then how are we building it, number two, is is I think we're gonna have a watershed uh sort of moment here coming up with the with the market and and what's what's going on. So so it's it's a double, it's two two two-sided response, Pete. It's like uh data centers, mission critical, advanced manufacturing is going crazy, and there's a little bit of uncertainty in in the healthcare core market.

SPEAKER_02

Patrick, do you want to chime in there?

SPEAKER_01

Yeah, I mean, I I totally agree with Ham on that. And I think I think we kind of at CREP have a little different view because we're very hyper-focused. It's kind of a niche thing for us. But I think you made a really good, you know, you said something really interesting, Ham. You said, you know, the the the the pain or the question, the ask is how do I do more with less? Right. I wish that that was the question that we were asked, because that's the baseline that we at KREF like to start on. Because today, and I think this is where I'm going to wrap it into, the one consistency other than change is the lack of folks that are entering the hospitals to literally work in the hospitals. So by asking us as a group that comes in very early and leverages partners like you very early to start creating institutional knowledge to baseline them so they can ask the next question. So, like you're gonna, you know, RFPs, the way they were done pre-pandemic, were a lot more prescriptive, right? Because there were people there that actually knew what their priorities are. I think I've said in previous um HFN chats that like most of the time I spend my my efforts with clients trying to get to the root cause problems. And usually that lies with we just don't have the people. So we've got to really dig down. We understand we want to do more with less, but we also need to make sure that we are driving the data specifically. You mentioned, you know, the big beautiful bill. You know, we're actually working, Hamilton, with you, on a big project in a pretty um interesting community in Rhode Island that doesn't have a lot of free cash spend. And, you know, we were able to leverage information because you guys are a information machine and we kind of have a good eye for this into helping get them funding. But you know, that took a lot of work. And if you're not in, if you're not able to help early to make sure that we're actually informing the decisions after we get that question, how do we do more with less? Like you're really in a you're really in a challenging place. It's really slowing everything down. Um, so I definitely think that you know the focus from our end is to continue to try to support, supplement, or complement the staff, educate the staff on what they actually have, digitize their assets. I mean, you just talked about you know the reimbursement rates. One thing that you can't get much help on if you're not able to share on a quarterly basis your assets and how they're depreciating and the condition of them, that's now directly impacting your reimbursement rate. Like a lot of folks in a lot of hospitals that we work with are nonprofit, and they say, Well, why would I care about all this depreciation and asset information? It's like, well, you may not worry about the tax man, but you certainly need to make sure that you're watching that very, very sensitive point around reimbursement. So they're just they just don't have the folks to do it. So we love to come in and create that foundation so we can actually answer that question, how to do more with less.

Data Centers Poaching Hospital Talent

SPEAKER_02

So, what I like about your answers there, and it's very interesting, and it's why the field is never boring, is because all of these challenges, right? I mean, coming at you one after one after one. And everything you said, underlying it all, is the problem that we have with aging employees and lack of employees. And ham, you hit on data centers, which is interesting. No, it's not interesting to me, actually. It makes it makes sense. So from the many years of recruiting, obviously people will still call me and want, you know, career advice, the stuff I love to do. And one of the calls that I'm getting increasingly is directors of FM being targeted by data centers because they don't have people either. And why this is really a huge threat, and I say threat because I'm taking it from the healthcare facility perspective, is they can pay more. And they can pay a lot more. And so that's like another enemy at the gates who's coming for your employees.

SPEAKER_03

And that's driving healthcare construction cost more, right? You would you would think that it might not, but electricians, for example, uh can go and get five to ten dollars over scale on a data center job than they can on a healthcare job, right? The data center folks, I don't know, they're printing money in the basement. I don't know, right? It's it's they they can it for them, like I mentioned earlier, it's how fast can you go? How quickly can you get me up and running? And so they're willing to pay more to get that done. And and so not only are they sucking up labor, but they're sucking up good labor. Folks that would typically be in a healthcare project are now going to data centers to get that done. And so that's number driving up costs, but then leading to that um shortage of qualified craft to work on healthcare jobs, right? So it's it's a double whammy against healthcare projects.

SPEAKER_01

And I would even add to that that we had a conversation, I don't know, this year with folks that have been in the healthcare facilities world for you know 30 years. And I even, when I started in the early 2000s in healthcare, like it was just a different time in healthcare. Like there was reasons to come into healthcare. Maybe you weren't getting $5 over scale, but you may be getting a pension. And you were definitely getting free healthcare. But all of this economic pressure over the last 20 years has left the silver bullet. Like there's no silver bullet in the chamber now to attract folks, which is adding, compounding the problem. And it's not, and you're in your ham, you're talking about the actual trades, the project folks, right? Like we're gonna find that folks that actually would usually be an electrical lead or a or an HVAC lead at a hospital, they're gonna end up leaving to go work on projects because it's you know, you've got the routine maintenance staff, but they're also skilled electricians, plumbers, carpenters, they're gonna migrate even more. So it's a compounding issue for sure.

SPEAKER_03

Yeah, that's that they're used to keeping buildings up and running. The one thing that I that I I will say that healthcare has for it, right, is just the mission, right? Of how, you know, how do we heal the community, right? How how are we um making sure that we're serving an aging pop and an aging population across the United States as well, right? Um you know, I mentioned my age earlier. A lot of us are a lot of us are getting older and we need, you know, we're gonna need more healthcare, right? And and I think what when you talk about the outlook, um, as the aging population goes, we're gonna need more beds, especially in in places where people are migrating to.

SPEAKER_02

We talk about hiring a lot, and and you hit on it, ham relative to the mission, you know, again, going back to recruiting, I could tell, you can tell in talking to people when you're talking about an opportunity. So say I was recruiting for a director role, based on the questions that they would ask me upfront and early about the role, you can normally tell if they are potentially going to be a good fit. Because if they're all about money, if they're all about work-life battle, like if there are certain tells, right? The mission has to be more important because you're not going to get as much. You're just not, but you get the personal satisfaction out of it. And is mission important to you? And that's a very tangible difference in people who work in healthcare effectively. Well, let's go to the construction market specifically. You talked about tradespeople, you talked about competition. Are you also having the the struggles of recruiting younger folks in, recruiting experienced folks in? What is that market like for DPR construction?

SPEAKER_03

Yeah, uh it's it's it's extremely competitive, uh, number one. Um, but I think there's been what I'm just gonna call a generational shift, right? Um, so Pete, you and I went to college together. Um, you know, our generation, my dad, my dad college was never an option for me. I had to go to college. My dad said, you are going to college, right? And I even think the generation after us sort of had that same mentality. Post pandemic, what I'm see what what we're seeing is just there's there's a a need and a want for people to do what they love. And if and and there's people out there that love working with their hands. There are people out there that love being outside. And so how do you cater to those folks uh to make sure they have the ability to do what what they love? And and and I guess the sort of the the stigma of not going to college is lessening, right? It's it's um uh I I I have a couple of friends uh and their their kids did not go to college. They uh one guy wanted to be an auto mechanic. He that's he loves tinkering and working, and and that's cars are his passion. And and you know, I just I just think back to when we were in school, um he may have been ostracized, he may have been shunned, he may have been, what are you doing? Um and and that's changed right now, which which I love. I you know, the the younger generation is is gone back to, you know, what what what makes me happy? And that's what I'm gonna do. And and so I think we need to embrace that, right? We need to we need to make sure that um we're not perpetuating that negative um perception of not going to school. And

Building New Pipelines Through Internships

SPEAKER_03

and so one of the things that we're doing is is we're providing internships for high school students and have them ability to come in and and look at all the different aspects of construction, right? You can uh you can be a pre-construction folk, you can be an operations person, you can be field person, right? There's there's all kinds of different things that that you can do. Um and and what what what's driving you? And and then how do we how do we make sure that we're giving you um that something and that some place to to help you with your passion.

SPEAKER_02

How has that program been received at the high school level and what locations are you doing that in?

SPEAKER_03

So we're doing it across the across the country, and it's perceived very well. I I I I do believe that uh, you know, and again, not to get political, but you know, which I forget which Bush said it, but uh, you know, kindler, gentler um um world that we're in. And and and I I think it's it's it's gone away from, as I mentioned earlier, that negative perception. Uh and so so it's received very well. Um uh we also have uh sort of this um new hire. Um it's uh the DPR Builder Development Program, where we take all of our new college hires and we put them through a rotational program where they're where they're spending one rotation in the field, one rotation uh uh in the field learning about what it takes to build a hospital or any construction project, one rotation in the self-perform work, understanding the constructibility aspect of it, and one rotation in the mechanical and electrical uh side so that they're really getting this more well-rounded um experience. And then from there they can sort of decide, hey, this is this is where I want to take my this is where I want to take my career. And and I think giving them that opportunity to look at multiple things is then they're then they're looking at, well, geez, maybe I do want to be a superintendent someday. And then how do I become that superintendent? Maybe I do want to be a field engineer, and how do they, how do they get to that? And so providing that that training and uh that knowledge and experience is huge for us. And we have a saying that uh who we build is as important to what we build. And and you're really you're really focusing on that, and you're really giving the opportunity for people to do what they're passionate about. Because you guys know, right, we've we've been working a long time. And if you're not happy, um why are we doing it? Yeah, right. Why are why are we here? We're spending a lot of time with our with our uh uh help, you know, with our Employee when I show co-workers, co-workers. Um, and if you're not happy, get out. Really find your chi, right? Find find the thing that makes you happy. And and I love that movie City Slickers, right? When Jack Callum says, one thing, right? What's the one thing? And it's different for all of us. It's different for all of us. So find the thing that drives you, find the thing that makes you happy, and go for it.

SPEAKER_02

So, Ham, they might not have thought you were old the way you look, but go into City Slickers. Patrick, I know you love generations, so I'm gonna go to you next, but I just want to say one quick thing, Pat, uh, about what Ham you just said. So, and I know I may be in the minority on this one. And Patrick, I don't even know if you and I agree on this, but when I was recruiting in the recruiting world, you know, I'd work with hospitals and they're looking for a director. And they would always say, no matter the size, could be a community-based hospital, it could be critical access, could be academic medical centers, and I get it in academic medical center, but they say the director needs a degree in college. That director could have 30 years of experience being a director, and they still wouldn't look at him. 30 years of hands-on experience. They could have gone, and I'm very patent, it's the only soapbox I ever get on, and I always lost the argument. They could have gone through naval nuclear propulsion school, worked on a submarine across the world for 20 years, but no, you don't have your degree. It used to drive me crazy. It shouldn't be black and white. There is some gray. And then you'd say to the hospital, why? And they would answer, because there was never a good answer, and it's passed on. So, anyways, I'm jumping off the soapbox. I can see it if you're a director or an academic medical center, those are a little bit different, but to automatically say people with 30 years of experience doing it are not qualified because they don't have their degree is ridiculous.

SPEAKER_01

Right,

Stop Filtering Out Non-Degree Pros

SPEAKER_01

because you know, you mentioned a few things, you know, one thing that at least a trend or a narrative I'm hearing, right, is like, you know, there are a lot of folks that want to be out and doing things with their hands and being in the field, right? And most of those folks end up in technical careers, right? And oftentimes they don't go through school to get there. And, you know, with this push with artificial intelligence kind of giving folks a scare around administrative jobs and things that can be done digitally, you know, it just feels a little bit paradoxial because, you know, they're, you know, even a lot of these organizations, you know, they're they're getting leveraged with eight with AI to find the right folks and they're using a rubric, and it's like you just said, and you know, I'm jumping on your soapbox with you here, Pete, but you know, a lot of people don't get considered because of those types of things. Meanwhile, we're all seeing, you know, we're all seeing the trend that, you know, we need folks in these hospitals. Well, I'm gonna use the word hospitals, but it's probably across the board in in commercial. But we need folks in the hospitals. Um, we need people to be out there. And it was great to hear, Ham, because you you obviously you guys go through and meet a lot of younger folks, much more than we do because we're a lot smaller. But I love that idea of leveraging something that they care about, like being out in the field. You know, we have a we have a candidate we're talking to right now, and you know, I'm trying to line them all up as field engineers today, regardless if they go into a facilities director role or a project management role, because at the end of the day, if they want to be outside or they want to be in the field and they want to work with their hands, you know, it gives them a great opportunity to get in, you know, especially this, these later generations, you know, the old the younger millennials and the subsequent generations, you know, there are half of them, if there's if maybe more, you know, I don't want to stereotype it, that do want access to be able to work with your hands. It's a human condition. And this ability for us to be able to say, look, a field engineer observes, gets on site, is able to collect data. We all need that data to get digitized. Like for us, we've been really trying to centralize our approach with our farm system. I'm gonna call it that, around field engineering because at the end of the day, it's a great term. For us real engineers, it's not really an engineer engineer, but it's somebody that works technically and takes what's out in the field and makes it something you can do something with, right? I was a field engineer at Sturdy Hospital with my first job, and I spent a lot of time making sure the isolation pad was level, made sure that they installed the boilers and the chillers and things like that the right way. And I took that data and I loaded it into an Excel sheet. But we're missing that catalyst in the market right now. So just pulling all back together, Hamilton, like I love the idea of finding those folks, regardless of whether they're coming out of college, they're in college, or they went through a vocational approach and are technically leaning. I love the idea, at least for healthcare, as an entry level, to give them that field engineering opportunity because it can lead to either. You can go into projects, you can go into construction, you're in there, so you get that visceral feeling of patient safety and public health. And at the end of the day, you know, a lot of us technical folks want to see something that we did well that day. Um, I definitely think you have something there. Um so, you know, and again, I think that it doesn't matter. That goes across all generations. You know, there's folks out there that want to work with their hands, they can work in a really great industry that really needs them. You don't need to hamstring them. I didn't mean to play a word off of Hamilton there. Maybe it was Freudian, but you don't need to hamstring them into um one specific thing. You can open them up and get them into a hospital. They're they're not actually having to make crazy decisions or get the pressure that you would as a facilities director getting phone calls in the middle of the night, but you're out there doing what you learned and you're in a hospital getting exposed to an environment. So like I feel like that, and I actually looked at an article recently because I was like, boy, how's the job market looking for for folks? And I specifically put in field engineers, and they're like, in in in industries like healthcare, it's an incredible need and there's an incredible demand. Like, regardless of where you think we are economically, there's an incredible drive for that. So if we're able to filter out those folks, I think that's part of the success story that we're gonna have over the next five years in bridging this massive gap that we have.

SPEAKER_03

There's a it's another opportunity for another podcast, right? Uh

AI Prefab And Middle-To-Middle Work

SPEAKER_03

what are we doing with what are we doing with AI? And and so you mentioned you you mentioned data collection, right? And and so and if we sort of put this back on similar uh that our healthcare clients are dealing with is an aging nursing population, um, not as not as many nurses going back into the field, uh what's AI doing with clinical diagnosis, and then who's who's plugging in that data, who's checking that data. So it's another, it's another it's another podcast idea, but the data and what AI is doing from a healthcare construction standpoint is is pretty pretty cool. Okay, and and so we're seeing um uh robotics laying out floors, right? They're they're taking the plans and then they're going onto a floor and they're laying out the entire floor a lot quicker than what a human could do. Uh we're seeing AI being um with data looking at safety and looking at, you know, so it's it's it's it's a leaning, it's a leading indicator, not a lagging indicator. So they're they're figuring out what's my likelihood of fall injuries or hand injuries, and and then how do you prevent that, right? So that we're providing safer construction sites. Uh, and so there, so that's that's you know what how we're building it, and then what are we building and is changing as well, right? So you're you're seeing AGVs, automated guided vehicles that is replacing some of the human capital uh with with deliveries. And so you've got additional elevators, you've got wider corridors, you've got a place where these vehicles need to go and sit and and and recharge. And so what are we building is is also changing. I'll use another old reference, Pete, right? Big brother is watching. And and so so where where are we going that with that is is is like I mentioned earlier, is it's huge right now. And and I but I do think there's a lot of good that potentially come out of it from from what I said and just making making that how do we do more with less easier, right? And so um the speed of healthcare construction is increasing from uh from a you know, we we said prefabrication a lot, right? It's it's now sort of this this manufacturing piece, right? So where we're building wall segments or head walls, um, exterior wall panels, bathroom pods, uh corridor racks, um, off-site, and and we're just installing them in in you know, that kit of parts inside of a building. Uh, so that's that's huge, and and that's that's helping with that aging population for us as well.

SPEAKER_01

Pete, before you jump, I got a kind of an interesting one because I think it's timely. And I before we wrap this piece up, you know, this whole AI thing, where do we introduce it? I I was watching a podcast recently, and I just love the way that the guy said it. He said, AI helps not end-to-end, but middle to middle, right? And that really resent that really resonated with me for a couple different reasons. One, it it lit up light bulbs for me that the end-to-end component is still a human, it's still a human job, right? Like, and and and that means that you know, we just started talking about it, collecting the data is that beginning point, right? You can then use that data to help inform the middle to middle. And then at the end, which brings up another thing that we may have on the agenda, Pete, it might be another podcast, but transitioning to operations when a project that, you know, Hamilton's going to build a Ferrari over there, right? And it's gonna get delivered. But at the end of the day, you know, that that very complex asset now needs to get driven by whatever's living and existing and working in that hospital. So, you know, it's kind of twofold. It's A, it's very conveniently good for craft because we're very good at the bookends, but secondarily, it's really good for the youngsters that are coming in because there is, I think there's not as much fear of losing your job if your boots on the ground at that front end, collecting the data. And then you've really got to be the, you know, and for those folks that may have a lot of skills, that that endpoint, right, that's quality assurance. That's making sure that we tie it back to the human condition. Because until AI actually fully does create patient care environments, we've got to bring that, we've got to land that chip again. So for me, it feels like if you start to categorize things like that in your mind, you start to understand that there's a lot of value still out there for the entry level and for just really anybody, because it really is middle to middle, right? Even projects are middle to middle. I mean, I'll be honest, I did a lot of project management. If I was doing it with DPR, I'd be very involved in the beginning and then I'd be very involved at the end, but I knew that the machine was running in the middle. Um, so I don't know what that means, but it was just interesting.

SPEAKER_03

It's the life cycle. Well, it's the life cycle of a project, right? And yeah, and uh, you know what what uh a wise person once said to me that um you know if if a hospital is spending a dollar in running their running their project, their their organization, they're spending six cents on construction. The majority of their cost is FTEs and and utilities, right? Uh so but if you look at at our construction project, and even if you're building a big job, say that's 36 months, three years, how many years did they do a 10-year master plan and then uh a year of programming and a year of design to get it to be construction? So there's there's a huge um left-of-the-line start, and then we're there, and then there's a huge right of the line from the finish, right? Of of running that Ferrari. Uh so hospitals are 50 years, 60 years buildings. And so, how do you run and maintain and operate that that facility? And and that goes to what you were talking about earlier, Peter, is is um where's my directors? Where's my electricians? Where's my clinicians? Where's my where's my staff to just run that project for for the next 50 years and then run it efficiently, right? Run it as best as I can to serve the greater mission of of providing a place to heal.

SPEAKER_02

If you like this video, please like and subscribe to the network. And more importantly, share it with your colleagues in the healthcare industry. Together, we can solve the aging crisis that's impacting all of us. The reason I'm home today is because my wife and I were flying out to Milwaukee. My son graduates from Marquette this weekend, so this is May 7th. So we so heading back out to to uh to school, which I'm very excited about. But the speaker is an AI guy. And so I'm really and my son he's an old soul because he he's one of those people who's resistant to AR. He's uh he his career will be in probably public relations communication, so not on the math side, kind of more kind of what I was, you know, as far as communicating. And he sees AI as taking jobs away from those entry-level VR positions. So I'm very interested, and I told my son this. I'm like, I and he's very passionate. And I'm like, listen to what he says, but I'm interested to see what the reception is. It's that, you know, it's at Ficeurf, so you're gonna have 18,000 people there. It's a sellout. And I'm wondering how the students react to it. So that's number one. I'm very I'm interested to see how that is. And um, the second thing is, and this goes back to the program, your program, Ham with the high school students, you know, Lamar Davis, who is out in your old stomping grounds in Chicago, and Lamar is the director of facilities at Shirley Ryan Ability Lab right in the city. Um, and he was with Advocate for a long time. But I was talking to Lamar on one of the facility networks, and he made a great point. And he said, he said, you know, Pete, kids don't grow up wanting to be healthcare facility directors. They grow up playing cowboys and Indians. Nobody knows it exists. And I'm like, yeah, you're right, you know, cops and robbers. They they're doing all these other things. So the question to you are you do you know what kind of feedback like the the the kids, the high school kids going through your programs, and then the young professionals that you guys are hiring who are going through all of these little areas of DPR, finding out what they're doing, what's their feed, not around particular areas, but what's their feedback about healthcare, about their choice? What do they say? What's what feedback do you get?

SPEAKER_03

Yeah, I it I love I love that. Um I'm super interested in seeing hearing back from you, Pete, on what what this person says. And and I think some of it is is is maybe it's it's not taking jobs away, maybe it's it's making your job easier so that you can spend time doing right. So if you think about uh and I'm gonna go off here on a little bit of a chin down, I'll come back, but but if you think of a doctor, right? A doctor used to spend in his hour, used to spend five minutes with the patient, right? And then he would go back and he or she would have to type up the notes and do research on what what the diagnosis was, and and and would would spend his his or her time doing other things than spending time with the patient. And so now AI, you introduce AI and and your notes are done for you, right? You're not taking the notes, you're not going back and and transcribing what he he or she said with the patient. So that's taking time, making your time being able to spend more time with the patient. Um, clinical diagnosis is is AI in an instant is looking at what potentially is the issue, and and maybe they're narrowing it down, right? They're narrowing it down. So from from me, if you from a physician standpoint, now you have physicians doing what they what they really need to do is being in front of the patient, right? So so maybe it's it's AI is helping me do what I love easier and better. From the standpoint, uh so I I'm super, super excited about that. And and and and I told them you can't boo. It's not the NFL draft. It's not the NFL draft with Goodell, right? You can't you can't boo the guy. And and and I, you know, I I I think there's just these futurists, right? That I would always love to hear, right? And and so one of the I I went to this um uh this futurist that that was in the translational genomics field, and she said that eventually we're gonna engineer disease out, right? We're gonna engineer diabetes out, we're gonna engineer cancer out, we're gonna engineer um all diseases out of your system. Your anything that you had predisposed, whether it was MS or ALS or or whatever disease, we're gonna engineer that out, which is a I I don't think that's in our in my lifetime or our lifetime, but but that's just gonna ask you how how long did you say that takes? Yeah, well, there and and uh you and if you look at the way that that um technology is doubling, right? If you just human history, how long it took in the Middle Ages for technology to double, and then you get to uh the 17, 1800s, how long did that take? And then you get to the early 1900s, how long did that take? And now you're where where we're at, and technology is doubling uh a lot quicker than it was. I I don't know what that stat is. Um, but so who knows, right? They're they're they're uh investigating the genome and the DNA sequences and and all that stuff. That's way smarter than than I am in in this stuff. But but so then so then is health, how is healthcare changing because of that, right? And so are are now they're just meant for accidents, and then who knows, eventually we get to the Jetsons and and you know you're you're in flying cars and there's never any accidents. So so eventually, are you not gonna need hospitals? I don't know. And then eventually maybe a hospital is a one-stop shop. Um you you just go to one room that um you you you know, you you check in, it's your your pre-admissions, everything in the room. Um, you do your uh pre-op there, you get all that stuff done. The surgery is done right there, your post op is done there, your your uh post-acute care is done and and all that in in one room. And and you, you know, you no longer need to to go around to different facilities. So it it's it's fascinating just what is out there and what's in people's minds. So, but I I love I love that uh your your son has a little bit of the big brother is watching as well, right? Um yeah, yeah. And and and and that's that's the whole thing too, that I think um that we just have to be cautious with it, right? Um I uh uh I'm gonna use another uh movie quote, right? What's Genesis is Skynet, right? So the machines take in Terminator, the machines take over the world. But but I think there's just a huge opportunity, and and I and I believe that the curious folks um will help with that, will really push back and say, is this valuable or not, right? Have we gone too far? Um are we are we losing what it means to be a person, right? I and it just I know this is sort of turning into an AI podcast now, but but you know, who's who's writing who's writing papers, right, in in high school? Is AI writing your your paper or are you writing the paper? And and have we lost the ability to do some of that? So that gets me back to my high school thing.

SPEAKER_00

Um I don't know about you and if you only had it then, right?

SPEAKER_03

That was that was your second question, right?

SPEAKER_00

Pete, you know, right, exactly. Where are the high school kids? Pete, you know, I'd be curious.

SPEAKER_01

Pete, when you're when you're out there, I'd be curious, right? So, like obviously the whole Skynet thing, what happened is is people did we're no longer the common denominator, right? And you know, still on this little narrative mind that the start and the end ends with people to people, right? People create, people have the need, and then at the end, people are the consumers, right? So if one of those changes, we're in trouble. But today, that start and that end are people to people, right? When we're starting a project, the people need to be there to create the need. The people need to be the ones that are there to at least get this engine started for whatever that is, if it's a project. And then there needs to be people at the end because people are ultimately the consumers. People always use the word project closeout. I used to use it all the time. That's actually the beginning, right? So, like my thought is you know, and I'd be curious if it's the same in, you know, journalism and things like that, right? At the end. Of the day, there's an interest. People are the creators, right? We're the interest, we're the end point where we're consuming it. What we're creating in between it is an acceleration. So you're creating and consuming, right? So I I think that makes me feel a little better. I sleep a little better at night knowing that. I'd be I'd be curious if it's that widespread, because I always I usually only think of it in in work, you know, work life and and project life, but I wouldn't be surprised if it's the same thing. If it I'd be curious to hear what he says, Patrick, it is so true, right?

SPEAKER_03

It is it is so true. And and I think what we need to do um culturally is to provide the people with what they need, right? I mentioned it, it's the something or the someplace, right? And so if I go back to construction, and I think Peter is waiting for us to get back to that construction piece. We

Culture Mentorship And Training Programs

SPEAKER_03

came back. We got here, and and and so what what what we're finding is is, and this is this is how we draw people to want to come to the job site, and what we what what we to come to any job site, right? Is you're now providing um built-in bathrooms, right? No more porta potties. Um, you're now providing air-conditioned lunch rooms, right? No more sitting out in the sweltering heat under a lunch tent. And so, so you're really giving folks what's necessary for them to do their jobs again, easier, right? Um, you know, you're you're a lot of health, a lot of construction projects on on hospitals are, you know, expansions or renovations, and and parking is 8,000 miles away. And so how do you provide the shuttling? How do you provide the temporary um parking? What closer to the job site? Um, how do how do you provide them the tools so that they can really spend the time uh um doing what's necessary um and not not doing waste? And so so a lot of that is is just is what are you providing to the people so that they can do what they love easier? And uh, you know, I I I so I I wasn't always where I'm at now, right? I spent a lot of time after college uh on a job site, having to use a porta potty. Um the porta potty wasn't cleaned. Um and and now you go to the job site and there's these massive restroom um um hard wire hard plumbed uh facilities, so that it's a it's it's it's a nicer environment for the craft employee.

SPEAKER_02

That's a big change.

SPEAKER_03

Yeah, and and and the same thing too, right? Even in Milwaukee and Chicago and Boston, it in the summertime it gets hot. And so do you you have your lunch outside under a tent, or do you have it in in a temporary facility that is conditioned, gives you a nice respite to to uh take some time off and um get get refocused on what you're gonna do the rest of the second half of the day. So um it it's it's uh it's that improved culture to give the people what they need to do their job.

SPEAKER_01

Yeah. They can focus on what they do best, right? Yeah, what you're saying, Ham, what you're saying, Ham is it's giving them more room to create or consume, right? It's it's give, you know, we always say it like at the end of the day, we got a lot of folks that walk around um hospitals and do a lot of like regulatory inspections. You know, you can never find everything. And you want those people to be finding the critical items, the ones that are actually really directly related to patient care and public safety. And that's what makes them feel good. So if you can remove the administrative work that nobody really loves to enjoy, at least nobody that I've met in our company, you're really actually improving their quality of life, and you're also getting to what's most important for the success of your client. So I'm a big, I'm a big fan of what you said, Ham. I think it's important that we continue to create more of a an environment so people can create, right? That's what that's what that's all about.

SPEAKER_03

And part of that environment, and where I was gonna go, I don't know, five minutes ago or 10 minutes ago on on um the high school, the getting back to the high school response was training.

SPEAKER_02

We'll get you back to Bennett eventually, Hamlet.

SPEAKER_03

Yeah. Well, the the the the the training, you have to train the future generation, right? And and so uh apprenticeship, mentorship is hugely important. And and I think we've you know, you you have that craftsman or that Mason that was able to put up what they did, and and we're losing some of that. And so you have to train, you have to give the the tools that that's needed. And and part of that, uh we've we've we're now in our third year of what we call our healthcare fellowship program. And so what we're doing is finding um younger people that have a passion for healthcare construction and that are the future leaders of of our healthcare industry. And so now we've got this fellowship program. It it's it usually starts in February, ends in October. Um we we have a final capstone project uh that that we we assign to them, but but during that time, during that uh six, seven, eight months, we've got programs where they're hearing from not only us from a standpoint of how we're building construction projects, right? They're hearing from outside experts, right? So they're hearing from ICRA specialists, they're hearing from clinicians, they're hearing from designers. And so, you know, you you get into a uh a renovation project and and you have to understand what's important to the clinicians, right? And so if you're on a if you're on a bed floor, uh noise is noise is a problem, vibration is a problem, especially if you're dealing with NICU babies, right? So, so we're hearing from those clinicians and what's important for them to understand. We're hearing from the design professionals, constructibility and what we build and what's important to them, distinguishing features of of work. And so we're providing these future um leaders within our company some additional healthcare training uh to help them in their career. And then um, because we want sort of some skin of the game, we have a capstone project uh where we we organize these these folks into groups and they've got a little project that they work on, and then there's a presentation at the end of the year, and they're presenting to not only DPR folks, but but we've got an architect, we've got um an industrialist, we've got an owner panel that these guys are presenting to, and there's there's an award for for um um having the best capstone project. So it's a pretty cool program. We're in our third year. Um after the first year we did it, we you know, we're sort of is is this gonna be successful or not? But it's it's been it's been very well received. Um so I don't see us stopping this anytime soon. And and just uh the the the thing that sort of warms my heart is that the future is in good hands. Um these these folks, and and Pete, I'm sure your son is is like this, um, they're they're good people. They want they want to they want to see the world world become a better place. So that um that really warms the heart to to where the industry is going.

SPEAKER_02

So you guys have programs that target the high school level that target your younger professionals who are just entering the field, and then that target the fellowship uh is that your existing employees who have already worked? What's what's the audience for the fellowship? How many years?

SPEAKER_03

So we want and we're looking at four to six years, right? Okay, of experience, and and uh we don't care if you're a superintendent or pre-construction or a project manager, whatever. It's just you have that passion for healthcare construction, right? So there is a four to six years requirement, a passion towards towards healthcare construction, um, and and you know, um wanting to wanting to stay in healthcare and and build that that next generation of healthcare leader.

SPEAKER_02

Awesome. So we're coming up to the close of our hour, and I knew it would kind of go by very fast. My guest Hamilton Espinoza from DPR Construction, Patrick Murphy from Craft. You know, uh I think the biggest upset in addition to Larry Bird only winning three NBA titles, the biggest upset from this um podcast is that ham, you and Patrick did not start talking about your background there. We can do a podcast on golf, so but we can't go that way yet because we don't have a lot of time left. Patrick, I know you're gonna say something.

SPEAKER_01

No, I'm good. I feel good. I feel I feel like I you know me, but I'm good.

SPEAKER_03

But I guess yeah, no, no, I just I just love the free flowingness of of this podcast, right? We hit a bunch of topics, and and this is Monolani on the big island. I'm not there right now. Um, it's a wonderful golf course. Uh if you get a chance, go play it.

SPEAKER_01

Well, I was gonna say, did you hit it beyond the green or you are you teeing off there? I'm just trying to figure out where you are on the whole.

SPEAKER_03

I I took this picture, and if you zoom in, my ball is like 10 feet from the pin, and I made the birdie putt. It's a par three. So that's a claim to fame.

SPEAKER_02

I like that. Very nice. So last question, we try to be solutions oriented if we can.

Solutions And Closing Calls To Action

SPEAKER_02

If you guys had to um offer an opinion as to how to help um close this employee shortage to bring more people in, and you've touched on a lot of them, but what what piece of advice would you give? Just wide open. What would your solution be? What advice would you provide to to um other to help close that gap, to in to to attract more people into this field so that we're I I because I worry, you know this, Patrick, we talk about this a lot. You look five to ten years, the people leading the hospitals, if we don't do something, we could be in trouble, more trouble than I think people sometimes assume.

SPEAKER_03

I think it's it's it's really about culturally giving the person what they want and not and not being judgmental about what they want, right? Um and so having that open flexibility to to in and we've all heard it, you can be anything you want to be. Um as long and and and giving that person the tools, the right tools, the right environment, uh, the right training, the right mentorship, the right apprenticeship to be able to do that, right? Um and and I and I do I do see uh us being better at that and us continuing to to get better at that.

SPEAKER_01

Yeah, you know, you just hit it, Ham. I mean, you you know, even though we kind of went without an agenda today, we did kind of lay out the way I would answer that, right? It's remembering that there's people out there and take away the filter. There are people out there that like to work with their hands, they like to be out in the field, right? Whatever that field might be, draw them in, give them an opportunity to succeed, make their condition one that they can create. And then most, I mean, this is the piece I was going to end on, but you already hit it all in one fatal swoop ham. But find a mentor, right? Yeah, and that mentor may not be in that existing hospital all the time. I mean, we have a program that we can bring in folks that were in hospitals for 40 years, and and you know, they're they're on a, you know, a lot of folks are are retiring now, whether they want to retire or not. Some of them, because of the pressures of the economy, are getting forced into earlier retirement. They go home, they realize that five days a week at home may not be actually what the their wife wanted them to be, and they've still got a lot left to give. There's a lot of folks, like, let's not let these boomers off the hook. I don't mean to be general generationalist here, but they're they're there and they're that mentor piece that I think really will lock these folks in and that visceral emotion of helping people get healthier will stick because I was typecast into it like you were Ham. I mean, first job I ever had in construction was a hospital, and I haven't left since. I'm like Costanza, but that's why, right?

SPEAKER_03

Yeah, that into that intellectual property uh that exists in that uh more experienced person. I'm not gonna say older, but that more experienced person that exists here is huge. And and how do you how do you get that um to just additional training for the younger generations?

SPEAKER_02

Yeah, yeah, and that's you guys are doing it. That's one of the things that we're working on as well.

SPEAKER_01

You know what that does though, Pete, too? If you have that built in, that allows the one of the questions we had that we didn't answer, like, how do these organizations find people? Well, cast a wider net with more lures. If you have that person to help guide and put rails on it, now it's just all right, I want to work with my hands, I want to be in the field, and they don't necessarily need to have their CHFM or they don't need to have to understand 100% how to do an ILSM or an ICRA or a PICRA permit. They're going to be given an opportunity to learn it in the field.

SPEAKER_02

Yeah. Yeah, I think for too long, and we've talked about this healthcare organizations, they're too black and white with what they're looking for, and it doesn't match the reality. They need to expand beyond and see what the possibilities are. I didn't want to ask that last question because you guys did. You you talked about so much, but I wanted you to pick one thing, and you did. So, Hamilton Espinoza, National Healthcare Market Leader, DPR Construction, Patrick Murphy, president for CREF. Thank you for your time today. I appreciate it.

SPEAKER_03

Oh, thank you. This was a lot of fun. Really appreciate it.

SPEAKER_02

Always a pleasure, Hamilton, and thank you, Peter. Thank you, gentlemen, and as always, thank you for watching the Healthcare Facilities Network. We will be back with a future episode. Thanks for watching. Have a great day. If you want to be a guest on a future episode of the Healthcare Facilities Network, go to healthcarefacilities network.com and let us know who you are and what you want to talk about. Because together, we can solve this critical aging issue.