Episode 16: Andrew Starr

A grounded conversation on physician leadership, community responsibility, and what it really takes to build strong healthcare systems close to home.

Transcript

SPEAKER_03 0:14

Well, hello, and welcome again to the Medical Mastery Podcast, the podcast of the Emerald Coast Medical Association. I am your Amoranthean host, Don Davis MD, and I am more than pleased to have you here again. And we get to meet with a very special guest, Andrew Starr. Andrew Starr is the president of the TMH, the Western Division of Western Market, yes. Western market of TMH. And we're going to learn all about that. We're going to learn a little bit more about you, and we're going to learn about all the things that are happening in our fair community that you are responsible for. So we are excited about this. Thank you for being here on Medical Mastery. I appreciate you having me. Thank you so much. Well, of course. Now, um, before we get on to all the things that you're doing around in this community, why don't you start off by telling me where you're from?

SPEAKER_02 0:55

Yeah, um I I'm born and raised in upstate New York near Albany. Okay. Um so uh, you know, and I went to undergrad there, went to got my graduate degrees in uh in Cincinnati, Ohio, and then uh started after grad school, started working in Cleveland, doing my uh postgraduate fellowship, and then worked for Ernst ⁇ Young and uh at in Cleveland, and then Cleveland led to Greater Philadelphia, Lehigh Valley area, and then uh was down in Houston for about a year and a half, then Rochester, New York for eight and a half, and then I have been fortunate to be here in Florida for the last six.

SPEAKER_03 1:29

Awesome. Okay, well let's let's take a step back for a second here. Okay, so undergrad career. Tell me what you majored in.

SPEAKER_02 1:35

So I was a bio undergrad with a health science minor. Okay. Um, and I and I think you know, I I always appreciated uh science, the field. Uh wasn't 100% sure medical was the way to go. I enjoyed the lab also, but um it just worked out.

SPEAKER_03 1:51

Gotcha. So so you were thinking more of a scientific bent. That was kind of where your brain works a little bit more towards deductive reasoning. Is that fair?

SPEAKER_02 1:59

Yeah, I mean I've always appreciated uh, you know, particularly in thinking about high school, biology, chemistry were always great courses that I enjoyed. I enjoyed mathematics. Um I appreciated all the things that came with that, and it seemed to align with something that would make sense for me long term.

SPEAKER_03 2:13

Yeah, so so um order, prediction, some capability of being able to understand some basic facts and then you could deduce the rest.

SPEAKER_02 2:21

Yeah, so I mean throwing statistics and data, you know, crunching is is uh things that I I've always enjoyed. Trevor Burrus, Jr. You work well with numbers and spreadsheets.

SPEAKER_03 2:29

Okay, very comfortable around that. Um so so you uh mentioned graduate school. Tell me about that. What did you where'd you go again?

SPEAKER_02 2:36

Yeah, so I went to Xavier in Cincinnati. So they had a dual master's program there, uh, an MBA and Master's in health services administration program. Honestly, the probably the other big draw for me was unlike a lot of other programs, it is mandatory you do a nine to 12 month residency or administrative fellowship. And you know, I I I think I got some really good advice early on, and I'm always grateful to the mentors I've had that, you know, at the time I was probably gonna leave graduate school at 24, 25. And I think, you know, there's a value in Book Smart, but there was also the value of experience and being that young, you don't have any. It's totally different, boy. I I think Xavier's always had that, it's one of the oldest programs in the country, and they've really always valued that. And I saw that as a major driver to me choosing that because I think that was gonna be really valuable in beginning the foundation of what hopefully was gonna be a successful career.

SPEAKER_03 3:27

Yeah, so so but you you're talking about two different worlds there when you talk about the scientific undergraduate kind of thought process. To now you're going to healthcare administration.

SPEAKER_01 3:36

Yeah.

SPEAKER_03 3:36

Now you're gonna be talking about not so much the objective as the subjective of managing, leading, understanding people, which is a wholly different perspective.

SPEAKER_02 3:46

Yeah, I I think, you know, it was I remember like it was yesterday, it had to be early on in my junior year, and my aunt, who is a healthcare consultant, um, you know, sh and she was a she was a clinician by background, said, you know, this field's gonna need people in a leadership role, um, not just at the bedside, but also behind the scenes. And so ironically, me and nine of my undergraduate friends were living across the street from the hospital in the community where I went to undergrad. I convinced the uh director of planning and CEO to take me on as a free intern. Um I liked the first semester, the second semester I liked more, um, and was thinking maybe maybe this is something I like doing. I see maybe a potential path here. But in all honesty, I I also like the lab still, and it and you know, maybe obviously taking care of patients at the bedside, maybe. So between undergrad and grad school, I took a year off. I was a dialysis tech for a year.

SPEAKER_03 4:36

Oh, excellent. Okay, all right.

SPEAKER_02 4:37

I I enjoyed that, but I think as I was going through that year of being at the bedside and taking care of patients, um, I enjoyed that, but I really felt the best path forward was actually more on the administrative route. And having the opportunity to be in a senior leadership role in a hospital or health system, it seemed to be a better fit.

SPEAKER_00 4:56

Yes.

SPEAKER_02 4:57

And uh I in my view, um, you know, and I'll just share with you, I and I don't speak obviously for people that are at the bedside and physicians, nurses, et cetera. I I think that's an all-in type of work where you have to be completely committed to the field, commit the commit committed to the education, the training. Um, the not that the management side doesn't have a lot of things that you need to be committed to too, but I I I really believe patient care has to be 100% all in if you're at the bedside and the individuals that do that, they're great at it for a reason. Um, I I I think I could have been good, but I I know the path I chose was actually probably a better fit and it's worked out well.

SPEAKER_03 5:32

Well, you know, there is some sort of um don't do medicine for the money because you're gonna be spending a lot of time. It's not that you don't get paid, you do, but but there's uh a lot of um you can miss out on events and other things like that just because you're kind of dedicated in some way towards this this thing that's you you know, you're you're fighting against death and so fight hard. Um, but at some point you'll lose that battle. And so that's something that you kind of have to come to grips with whenever you do that.

SPEAKER_02 6:00

And oh yeah, and I think, you know, yeah, you know, again, uh everybody at some point has to choose a field and and and a job that makes sense for them because I I agree, no matter what you do, it really money is a factor, but it shouldn't be the only factor. You really try to hope you would enjoy the work. You know, uh again, I I look at our physicians and our nurses that we have uh back in Tallahassee, here in Panama City Beach, and uh and every place I've worked, um, you know, they they appreciate that there's there's going to be some bad days where maybe the patient outcome isn't where it needs to be. But I think they get into the field because of what they bring, the changes in people's lives, most of which is extremely positive. I think about the great work you and your partners do. Um, you know, and and and I think that's why they pursue that. And, you know, yes, money's important, but I actually I really think it's second to I'm gonna be doing this for the next 40 years. And especially for physicians and nurses working in high acuity areas and those types of therapists and techs that do that, they deal with some real tough extremes, and that's hard. So I applaud them for doing that.

SPEAKER_03 7:02

And you know, whenever you talk to any sort of um specialist, subspecialist, their techs will make their lives so much easier. So you having done dialysis tech work, um you know, nephrologists they can write things on paper, they can put in orders for dialysis. The actual where the rubber beats the road there, you've got to have good people doing that. And also, you know, we know this being in the business, but you're gonna see a lot of very, very sick people when you do that.

SPEAKER_02 7:27

In that whole year, it was very eye-opening. I mean, I dealt with I I literally saw a patient die five feet from me. Um I had the pleasure of taking care of a patient who toward the end of my time there actually received a transplant. You went from the list to actually getting a transplant. Yes. But you see everything in between and all the dynamics that come with that. Um, and and I think in many ways that's helped me in my career as I've gone kind of the management side and behind the scenes. I it has provided some background that allows me to say, okay, at one point in a very small sample I was there. It helps me try to appreciate that the people that are really doing that 99.9% of the time, no matter which specialty they're in. I I think that's helped lay some groundwork and has actually given me some benefit when I go into these situations, these meetings, and always making choices and where we go when we invest and how we recruit. I I think that's been a positive influence, unfortunate that way.

SPEAKER_03 8:20

Yeah, and then once you go in towards the administration side, you're now you're now a um a power rule. You're you're increasing the influence, you're a force multiplier because you're gonna be doing this at scale. And we're not just gonna be talking about one dialysis patient, you're gonna be talking about hundreds of dialysis patients as well as multi-other subspecialties and everything along the way. That's a different math that you have to think about at that point.

SPEAKER_02 8:43

It is, and it it's it, you know, it everything in life is choices, and you want to make the best choice, you hopefully um look at data and take that into mind. You involve the people that are doing the work. Um, you know, doing this for over 25 years, and I know it's something we really value in Tallahassee, we already value in Panama City Beach and will with our future hospital. We have our end users at the table for these decisions. Like when we make choices on you know, capital equipment, technology, uh where we you know put resources, we try to involve the people that are actually doing the work because ultimately, at the end of the day, they're the ones that are actually gonna have the end product. They're gonna be dealing with the capital, they're the the equipment, the supplies. Um, they're the ones taking care of patients. So I think I would hope that we have done a good job previously, and I I can guarantee you that if we'll continue with that same methodology, we really try to get the the clinicians at the table for these decisions. Making it in a making those decisions in a vacuum, just looking at a spreadsheet, the probability of that 100% working out well is unlikely. It's really, and to be honest with you, from a cultural point of view, I don't want to ru operate a hospital where the people taking care of patients aren't actually involved in the decision making.

SPEAKER_03 9:57

I I I mean, music to my ears, of course, but I do think that there is synergy there. That is absolutely where the rubber meets the road. You know, I I've said for um a while now that hospital administration is a very uh difficult task because you're trying to create a perpetual economic engine while we're worried about the things that we're worried about, which is which is upfront, patient-centered. I don't care the cost, whatever, I'm gonna do this. And and both those worlds really have to coexist if you really want to create this in in perpetuity.

SPEAKER_02 10:26

I think in the American healthcare ecosystem, let alone in any country, I I think you're 100% spot on. Because unfortunately, there is not an endless checkbook to everything. And there's not we would love to do everything. Um and unfortunately, it's just not like that. It is just an inherent reality. And I don't think we're any different from any other sector of the world. Um, no matter what business or industry you're in, they have to make choices. We our our thought process is we have to make choices. I think if we're a good organization, we're making choices that are informed. And that's why you want the end users at the table. Like obviously, I think about the world you're in. Um, you know, there are there is massive advances in technology, many products and supplies, all very close, and there's not that consumer reports, this is the A1 proven product. And we we have to be thoughtful on that, saying, where do we is do we need this, do we need that? There's two that look pretty similar. So we don't want to, we we wanna, we obviously want the most cost-efficient product, but at the same time, we don't want to have the cost-efficient product that actually doesn't do what you need to do to get the patient from point A to point B.

SPEAKER_03 11:32

And that's uh going back to you know your scientific bent, that's an iterative process. If if you fail in one way, or if you say, hey, this wasn't the outcomes that we want, let's reiterate. Let's go back through again and let's find the thing that's actually going to work for the things that we really value.

SPEAKER_02 11:47

Yeah, I mean, it's true, but I I'll tell you um the choices we make usually are not, it's rare that we're making choices that are in the small thousands. Like when I think about major equipment, um we're talking six to seven figures worth of decision making. So there's a lot of commas there. Yeah, I'm not gonna tell you we're always perfect. We're not. I mean, God knows I'm not, but you wanna have a pretty high hit percentage because the the costs are significant. And again, everybody knows the healthcare landscape is always challenged with uh costs and reimbursement. So I think our hit rate has to be reasonably to very high if we want our organization to be successful short and long term.

SPEAKER_03 12:23

Yeah. So now um taking us back a little bit, how did you find yourself here in the panhandle area? And how did you find yourself in the position that you're in now?

SPEAKER_02 12:33

Yeah, you know, honestly, uh I'm very fortunate. So uh got called by an executive search firm, uh, Tallahasse Memorial was looking for a chief health operations officer uh a little over six years ago. Um, knew a little bit about Tallahassee, uh, wasn't necessarily looking. Um learned more about the health system, had a chance to talk with people down there, including Mark O'Brien, our CEO. Started feeling like this might be a fit in terms of next step and opportunity, a health system that I think makes sense to work in. Um, you know, you go through the process and it and it kept feeling like a right place to be. Yeah. Um and at the time, obviously, you know, I was hired just for Tallahassee Memorial. Panama City Beach did not even exist. Um, and then probably within the first year, we were made aware of this opportunity out here. Um, our CEO and myself went out, had a chance to meet with the leadership team at St. Joe Company, George Gonzalez and his team. Kind of felt this was a great opportunity and a great fit. And and I think fit's really important for both sides. You know, uh building a hospital is not easy. Um, but I'll also tell you, you you want to you want a situation where it's a right fit. For Tallahassee Memorial, which was really only one hospital, for us to take on a second hospital and mind you, two hours away, different time zone, in a place where we had no real presence. Um there's significant challenges and risks that come with that, but we we felt this was a great opportunity. And again, we we started bringing our partnership with Florida State into the mix where could we do something different? You know, could this be a new campus? Could we bring out the best of everything between bringing a new hospital to the to the western end of Bay County, bringing Florida State as our partners in from an academic research side, a brand new campus? Um, and again, St. Joe Company, which has always been forward-thinking, and the amount of growth that's going on in Bay and Walton County, this is really important to the ecosystem. And we pursued it. We were fortunate enough to obviously be awarded that opportunity. And I always share with you that has grown from a smaller part of my day to obviously now it is a hundred percent of my part. All of your day and that's it. Unfortunate, though. It it is we're uh honestly, I I I've said it since day one. And this is I'm very humbled, very honored. This is a once-in-a-lifetime opportunity for for me selfishly, but I'll tell you for our organization.

SPEAKER_03 14:48

Yeah, well, uh, I I do want to kind of hunt in on the on that because I I um I don't get the opportunity to talk to uh high administrators that are achieving the things that you're doing right here. Um take me from the sea, the germinal idea there of, hey, what if we open this other thing? Because you know, it's not like you had a thousand hospitals, then you're opening one more. That's a small percentage of what you're going to be reasoning out. You're gonna be doubling your footprints immediately, and that's in many cases doubling, if not more so, the cost and other things that you're gonna have to take into account. How does that idea come about whenever you guys are in your private meetings?

SPEAKER_02 15:22

Yeah, I think we looked at it, you know, when you think about Tallahassee, we're somewhat geographically isolated. Yeah. You know, I mean, there's not a larger community around for some distance. If if you go west, it's really this community. East, for that matter, it's Jacksonville. South, we're talking Gainesville, kind of.

SPEAKER_00 15:39

Ish.

SPEAKER_02 15:39

Um, yeah, exactly. And then north, we're talking really the southern Atlanta suburbs. Um, and and you know, we're fortunate we we are the market leader right now when you think about share in terms of the the environment in Tallahassee, our immediate and our surrounding community. But we're also acutely aware that you know we there's not much more we could do there. And there was also an opportunity that we we really valued our what what what values matter to Tallahassee Memorial, um, our independence, uh, locally governed, locally serving. Um, and you know, but can we do that still as just a small or smaller entity, a one hospital entity? And where did it make sense to grow? We recognized we needed to grow. We recognized though it had to be a right fit in a right community. So actually, timing-wise, the Panama City Beach opportunity hit at the right time. And and I I really I have to give all the credit to our board and Mark O'Brien, you know, to be forward-thinking, to be bold to pursue this. Because when you look at most health systems in the country, you know, you have your flagship hospital, wherever that is. The surrounding hospital or hospitals are usually within 15 minutes, half an hour, and then you kind of keep going out like a bullseye club and spoke model. Yeah, very much so. This was a little bit different. I mean, uh we are not a half an hour away from Tallahassee. We're again two plus hours, different time zone, totally different situation where we expect the medical staff to be almost completely different than medical staff in Telehassey. So it was a different dynamic, but I think to Mark's credit, our board's credit, they saw this as a great situation where a community that wanted something similar that we wanted, similar values, uh, similar thoughts on healthcare, how healthcare should be. And we were just very fortunate that uh, you know, we were chosen, and I think it's been a great relationship literally since day one.

SPEAKER_03 17:24

Yeah. Now, was there a point where um the the analogy I'm gonna draw here is um when you get accepted into medical school, and then your first day at medical school where you realize, oh geez, I'm gonna have to do this now. Um was there a point where you went from thrilled to be, okay, we've got this spot, we're gonna do it to, oh my goodness, we're really doing this? Is it was there that transition in your mind that you could think of?

SPEAKER_02 17:45

I actually it it it wasn't a point, but it was over a course of about five days. Um so turning back the clock, we were going through our stroke accreditation, joint commission, comprehensive stroke. Yes. First time we would have ever been awarded that in Tallahassee, and that is a challenging process on top of the fact that it was, you know, we were in the middle of early stages, a little in the middle of COVID. We it had been an exhausting process getting ready for it, uh, the stress that comes with that, the review. So we wrap that up. Um, and it's somewhere around the spring break time frame. I meet my family, they were coincidentally down in Disney World. I said, I'm gonna meet you down there. Uh the next day I get a phone call, and this was a Saturday from Mark O'Brien. And Mark, if Mark's calling you on a weekend, usually you're, you know, it's abnormal. And immediately I'm thinking, uh oh. Uh-oh. So Mark actually was, I think he was in, I want to say Chicago at the time, calls me and he's like, You won't believe this. Um he's like, I got some great news for you. I'm like, okay, I know, I know we passed the accreditation, so the stroke part anxiety is over. He's like, we were awarded the opportunity. And I'm in the middle of Epcot Center. I went absolutely nuts, jumping up and down to the point that I had a couple people at security looking at me, maybe maybe you shouldn't be here.

SPEAKER_03 18:59

Goofy was coming over with handcuffs.

SPEAKER_02 19:02

People were looking at me in a non-Disney way. Um, and you know, my wife, to her credit, um, you know, kind of was in line with my my sons for for for a ride or whatever. And she kind of looked at me and she just kind of mouthed like Panama City, and I'm like, yes. Very excited. I I I probably have not been that excited career-wise in a really, really long time. But I will tell you, probably um probably when I get up on Monday morning when we get home and going back to work, it it set in that okay, this is now my project. So I mean, literally, I remember our CEO saying, if we're fortunate enough to get this, this is now yours. You knew it was gonna be math and it's for whatever reason that Monday morning it settled in that business just business just changed completely for me forever. Right.

SPEAKER_03 19:45

And now the hard part starts. Yeah. You've you've you've gotten the award now, so now you've got to do the work.

SPEAKER_02 19:50

And that's that's yeah, it's it's building a foundation from the ground up. It's a startup. Um, and you know, over those past over the past few years, we've we've had a lot of things we've had to do. Um, you know, where do we want to get started? We have to fit out, we have to look at this campus, these 87 acres, and figure out what we're gonna do with it. Um where do we get started? What makes sense? You know, I've been fortunate. Um, I've been given the opportunity to, you know, build certain parts of a hospital, like ORs, Cat Labs, even a nursing unit, but to build a hospital, brand spanking new, from the ground up, you know, that that that is a new experience.

SPEAKER_03 20:25

You know, um a buddy of mine uh was talking about um whenever we got our house, he says buying a house is easy because you only have to make one decision. Right. Building a house, you have to make a thousand decisions. Building a hospital is probably a factor of a thousand more of those decisions. I mean, how high do you want the outlets? Where do you want this the EMS to come in? Like all of those things. You've got a blank slate here, and that may not always be that helpful. You know, if you could be constrained, that's sometimes helpful.

SPEAKER_02 20:56

Yeah, I mean, I I think one of the things we talked about really early on is let's be practical and and thoughtful here. Um let's let's be humble about our approach. Let's bring in partners and leverage their skill set where their strengths are needed. Uh, we have been very fortunate. We have had a great general contractor who has built hospitals. We built, we purposely picked an architect who a majority of their work is healthcare and hospital design. Yes. You know, we we we our PMO group, um, same thing, they can help facilitate the process, healthcare driven. And we really wanted people that had worked in different environments. One of the things I was really adamant about, and maybe wasn't always the most popular, is really proud of what we're doing at Tallahassee. But this has to be different. This has to be different. You know, um things that matter to me that we talked about, um, we always have to be focused in on access, and access is a broad term. Um we need to be constantly focused on wayfinding. You know, um you go to most hospitals, including Tallahassee, by the way. Is extremely challenging. And that's that's just to navigate the parking garage. It seems like it's five nine. It's almost purposely built to be difficult. We talked about that, saying, I don't want that. I don't think our community wants that. They want it. No one comes to a healthcare campus because they have nothing else to do, or it's like it's this, or uh go to the baseball game. They're going there either to A, as a patient, hopefully not in a high anxiety, high stress mode, but they could be. And or a loved one or a friend is coming to visit them. Yes. Let's build the campus thoughtfully. And then you just you have to, you know, somewhat for a lack of better term, play the conditions. You know, we had two-thirds of that 87 acres that was workable. So you have to work around the wetlands. You have to be thoughtful on where things go. And we tried to also be very forward-thinking that, you know, we wanted to build an initial campus, but a campus also that was prepared to take on growth. Growth that would be hopefully as minimal disruption as possible, cost efficient, um, and thoughtful that the first design, if it's really well designed, the second phase or third phase doesn't ruin that first. Right. Uh so you know, it it's been a lot of good choices, but again, we have been very fortunate. We have brought in the right people, we've engaged a lot of people, we've talked to consumers in the market, we've learned from our own professionals. When you you mean you bring up things like outlets, we really have involved our our clinical staff back in Tallahassee saying, hey, we have the Mushan Tower, which was built less than 10 years ago. What have we learned since then? Yeah. What would you do differently? Would you guys like, would you not like it? Exactly. And I think that type of you know, more listening than talking approach, I think is going to serve us well when we open. I'm sure when we open, there'll always be what you could have done this, you could have done that. We've had to make choices, obviously. There is not an endless budget to this. There is not, yes. But um, I think from what I see so far and what we've designed, and obviously the hopeful end product, I I I feel good about what we're doing.

SPEAKER_03 23:48

Yeah, so um, you know, one of the things that my wife and I talk about a lot is um we really appreciate expertise. Um, and that's part of as you go through training and you've really kind of honed out your own expertise, I realize what it has taken for me to get there. And so then I totally appreciate others in the things that they do because I haven't spent that time and I know how much time it took for me to do it. And I may be slower than others, but but in order to know the things that you know or that even nephrologists know or that oncologists know. I mean, no, I'm gonna let them do their thing because that's really where they shine. And being able to kind of um get those resources together, working together is really a sign of good leadership. Trevor Burrus, Jr.

SPEAKER_02 24:24

Yeah, I mean, again, I just look at things very fundamentally. Uh you know, you are an expert in cardiology. Let's not go too far here. You're great. You are. You're and but with that with that said, if I'm going to build a cardiology footprint, whatever that's going to be, I want the physicians, I want the nurses, I want the text to say, okay, here's some guardrails that we can't work through, but we got to stay within. But within those guardrails, tell me what do you think? How would this work? What makes sense? We've tried to also be thoughtful to say, look, for many of our professionals, they've only worked in Tallahassee or they've only worked at one or two sites. This is where we bring in some of those other parties to say, hey, look, the last three or four hospitals, when we built out a cardiology suite uh or procedural suite, we have seen this. Now, what do you think? What have you? So we try to kind of blend it all together and try to make the best choices based on that.

SPEAKER_03 25:18

Yeah, and you know, there is a certain amount of you can control only so many variables, and at some point you're gonna have to deal with personnel. And I mean, sometimes doctors can be finicky. Uh, I don't think you need me to tell you that. Um, so so that that's another thing that just kind of comes in at the end of all this. However, I would say, um, did you have any design the buck is gonna stop with you in some sense. Did you have any designs that came up that you just said no from the get-go? Like we're gonna have to go back to the drawing board on this.

SPEAKER_02 25:45

Um we never went back to the drawing board, but I we we've always, you know, I try to be at as many meetings as possible. And I think we where we where we have to just be thoughtful, where we put in some constraints where, you know, when you involve people that are that are knowledge experts too, there's that sweet spot of I want their input, I want their forward thinkingness, what have they learned? But you also have to be thoughtful that you got to be careful of the utopian. Like, are we preparing when we're having this discussion? Are we really making the decision based on every day or the one in a million? We we can't do everything on the one in a million, you know? It just that's the unfortunate reality. Of course. And if we had endless budget, yes, one in a million we can account for, but we can't. So we try to really be thoughtful to say, where are we now? Where do you think we're gonna be five, ten years from now? And what is the majority of the patients that we're serving in this particular room or in this particular suite? What what do we need to do so that we can give all of you the best possible situation to work in and have the safest outcome, you know, um, and operate in. So I I think with that said, you have to make choices where again there's A to Z, millions of possibilities, and you have to say, okay, appreciating that, this is realistically what we can do. So within that versus this, give me your give give me your best shot.

SPEAKER_03 27:04

One of the things that I've been taken by with you is that you know you're kind of direct and forthwith, uh, forthright, and but um but still at the same time kind of um conversational with the the physicians that you deal with, or at least and and my experience with you. And I just find that reassuring just because there's there's not really smoke or anything. It's you're gonna shoot straight with people, and I I found that reassuring in dealing with you.

SPEAKER_02 27:27

I I appreciate that. Um, you know, again, uh and you know, I I think again, I've been very fortunate. I've had some great people I've worked for, uh, people that have just voluntarily been great mentors to me. So hopefully they're hopefully we're seeing the fruits of that. But uh, you know, hopefully I'll I'll continue on that pace.

SPEAKER_03 27:45

Yeah. Now um just wondering about, again, uh high agency folks that are that are working in high pressure situations, which I would I would catch you in that mix. Um, do you have some people that you can bounce ideas off? Uh, you know, there there's it's always my wife that's certainly very helpful, and I'm sure yours is as well. But I mean, do you have other people that are kind of in the biz that you can say, hey, uh how do you feel about this?

SPEAKER_02 28:06

Yeah, yeah. I mean, I and I think there's components of that, to be honest with you. I think obviously people at some people I work with, um, you know, who, and I'm very fortunate, uh, Tallahassee has some wonderful leaders that we have there, our executive team, really some really sharp individuals. Um so that that's one group. Um I think the second is you have colleagues that are out in the field uh working in a lot of different environments who I think bring in some great perspective, friends of mine that I can bounce things off of. And then the third thing, which again, I have been very fortunate on, and I hope I'm paying it forward. I've been very fortunate to have a group of people that I like to call my mentor cabinet. Uh these are individuals that have been in the field longer, are in more senior positions, have provided guidance. I picked my spots when to use them so I don't annoy them per se. Yes, of course, yeah. I I think when I've needed to reach out to them and ask them for advice, they have been very valuable. So I think it's all of those things together. And then honestly, you know, my wife's not in the field, but and she's brighter than I am. Uh it is always feeling yeah, just tell me about it. I mean, it's it's um it's always good to get sometimes some perspective from somebody that's not in the field, but you ask them a question because at the end of the day, my wife's a consumer.

SPEAKER_03 29:18

Yes.

SPEAKER_02 29:18

You know, so she'll bring in a valuable perspective. And there's other people that we're friends with that really smart individuals, different, different careers, different whatever, but they bring in a nice perspective.

SPEAKER_03 29:28

Yeah, you know, I've always really appreciated that about my my close cadre of friends as well as my wife who knows me outside of this professional context, and so can say, What are you being dumb about this? Or like, or think about this in a totally different way, can cut through a lot of the other fluff that you know some people may throw onto you just because you've got a title. My wife doesn't live with me as a cardiologist, okay? She knows exactly what so she can say, like, yeah, I don't care about any of that. Here's what you're here's what you sound like, or here's this thing, and it's really it's hallucinating and great for me.

SPEAKER_02 29:58

No, honestly, I think you you just touched on one of the things I really actually value my wife on, particularly is less about, hey, what do you think of this healthcare design? Like, she she'll bring advisement as a consumer, but I'll tell you just from a hey, this is how I handled this situation. Just because she's a different personality than I am, you know, and how people communicate, and I'll I'll be the first to tell you, we're always working on our communication skills. I am not perfect. Uh so she may, I'll review a situation with her, and she's uh it all depends which day catcher. I mean, really, she's in a she's I'd I'm not in our bad list that day. She'll say, You probably here's how I maybe would have handled it, or here's an opportunity. If I messed up earlier in the day with her, she might say, No, you are an idiot, or you handled that poorly, or something that's probably not appropriate for the video for me to say.

SPEAKER_03 30:43

Yeah, but either way, I think I think we get the gist of that. Is that uh having these people around that can give you true, honest feedback. Yep. Um, you know, uh I've I've long since said positive feedback is really great for the fields, negative feedback is really formative. That's where you really make wholesale changes that you say, oh wait, when I have the people that are really honest that says, hey, your office sucks because of blank. You know, your first is to get some umbrage and be like, wait a second. But then when you kind of cool off from that, you can say, actually, no, there's a point there. This person's trying to give me some honest stuff.

SPEAKER_02 31:13

Uh yeah, I would agree. And again, I I I think there's a lot of other things. Like, uh, you know, and I I I played sports for a long period of time, and I, and you know, uh, and like a lot of athletes, I I think they say if they've really learned a lot, you you're right. You you celebrate the championships and the victories and those milestones. But I think the most important things is how you how and how you react and what you learn from the losses or the setbacks. Um, I think in many ways, uh sometimes that makes you stronger and you become better at what you do from that. So not that you want that to happen, but it's how you handle it and what you take away from that is probably as or more important.

SPEAKER_03 31:51

Yeah, you know, and the stakes that we're playing at are pretty high. I mean, you know, you're again a force multiplier here in the healthcare world. When when we make mistakes on the front line, I mean, patients can die. And and the cardinal sin is not to learn from those. It's not to not make mistakes, mistakes will happen. It's to not learn from those and then make some changes that'll be gonna be worthwhile. And you get the chance to do that at scale here, as you are already. So uh now um, you know, we had kind of alluded to this, and I was interested to hear what is your vision for the Panama City Beach campus, and how do you see the future of your particular footprints over here? Um uh what is in your mind's eye for the future?

SPEAKER_02 32:33

Yeah, I think fundamentally, you know, the theme song that I know our team hears all the time from me, and it's not put in a big blog somewhere or anything else, but the most important thing for me is to get off to a good start. With our medical office building, you know, the theme song has really been get off to a good start. Like I'm an administrator, yes. I I want us to be busy and have volume. And unfortunately that's going really well. Great. But but I would share with you, probably as if not more importantly, I monitor like a hawk two key things with us. One, our access to our clinics, our patients being able to get in, even with us getting busier at the time frame that is acceptable. The second thing is, and probably this really should be the first thing, is I monitor our consumer scores. Um we work with a company called Qualtrics, uh, the biggest um customer service tool in in the healthcare industry, and we get measured um across the country against all sorts of similar types of environments, similar clinics, whatever the case may be. I monitor that data like a hawk. I mean, I have to be honest with you, because at the end of the day, uh, you know, I remember I work for somebody and she said people vote with their feet.

SPEAKER_00 33:39

Yeah.

SPEAKER_02 33:39

And, you know, we're not a hospital yet. Uh so our clinics, people really do vote for their feet. And so, yes, I may see that the volumes are going up, but as important, how are we doing? Are people having the experience they want? Because the reality is we can put up a new building and new walls, and everything's brand spanking new. Um, but if we're not doing a good job at the fundamental reason of why we're here, taking care of patients, uh, that's gonna be a very empty, brand new building and new clinic. So very pretty building, yes. So I I will tell you, that's been really the motto for us. I think that's gonna carry into the hospital. I I really do. We, you know, as a community hospital to start, you know, we're building a 180-bed shell. We'll have 60 to 80 beds live when we open up, not including a 24-bed ED. You know, as a new hospital and a startup, um I really just want us to get off to a good start. Continue what we have with the MOB, take really great care of patients, have a staff that really feel they made a good choice in choosing to work with us and want to keep working with us and want to be part of a growing solution. You know, if we do those two things really well, I'm not worried about growth for our campus. I'm really not. I I think there's enough of a population and enough of a need that will continue to grow. I mean, we're preparing this campus for arguably a 600-bed hospital someday. Um, you know, and that's ambitious and it's well down the road, but I I think it's attainable. Um, you know, uh, but I think again, you have to get off to a good start. You have to be fundamentally sound. We need to do a good job taking care of patients, taking care of our staff, having great working relationships with our physicians, make it a destination for them to work in. I I think we do those things really well. Obviously, that I think that's gonna be very critical to our success. Obviously, another factor that that you know is kind of a work in progress is where we're going with Florida State. Yes. You know, the School of Medicine, FSU Health is very exciting. It's in its infancy. And and like our plan of hopefully someday maybe being a 600-bed hospital, you know, FSU Health is in its infancy, but could it become a larger, bigger academic research health system like some of the other systems that exist in Florida here and also in the Southeast? Yeah, I don't think there's anything wrong with being that ambitious. But again, you have to crawl before you walk.

SPEAKER_00 35:53

Yes.

SPEAKER_02 35:53

You have to, you know, get those early victories. So again, I think we try to stay very sound-minded and fundamentally cognizant that we have to do those things really well up front. If we do that really well, I'm not worried about growth. But let's let's, you know, again, it's like being an expansion football team. Let's let's not talk about the Super Bowl when we haven't even had our summer practices in our first game yet. Let's get our uniforms first. Yeah, let's let's get off to a good start and we'll be okay.

SPEAKER_03 36:18

Um, yeah, one of the surrogate measures that I really like a lot for this is our patients referring their family to me. That's because that's the good feel, is that like, oh, I'm doing something right. I'm landing on somebody here. It's resonating if if you're kind of getting that word of mouth business is ultimately gonna be really great. And because, you know, there is gonna be some pomp and circumstance. It's a new hospital that's coming to town. That's gonna be a lot of flair. It's like a new restaurant that opens. A lot of people are gonna come. Are they gonna keep coming week after week?

SPEAKER_02 36:46

That's I think you hit the nail on the head. I think it's that is a very accurate way of looking at things. I mean, at the end of the day, look, uh we we other like other health systems, we market and we we try we try to do outreach. But at the end of the day, I think patients will vote with their feet and a lot of new patients will be friends or family of those patients that have come. And based on how we did with that first set of patients, we'll dictate tier two, tier three, tier four, that next wave of patients that may choose us versus going to another destination, whether that be local or unfortunately, a lot of people sometimes choose to go out of town. We don't want that. But I think you are spot on that we must do a good job with those patients and actually have them be marketing for us, saying, Yes, I had a great experience. Saw this physician at this hospital for this service, and went great. Great experience, high quality, safe, you know, everything that comes with that.

SPEAKER_03 37:40

So I think you couldn't be more accurate. And there's aesthetics involved to it as well. I found out that uh through some some business coaching, uh, shout out Mark Noon, who's one of our sponsors as well. Um, that uh, you know, I'm I'm an aesthetic. I I I like the aesthetics of things. That doesn't matter to me for some reason. I didn't choose that. That just is the way that it is. So so there's, I mean, you know, you've got to take into account a lot of different things. I typically have to take into account of if you're gonna put me in front of a patient, am I gonna keep that patient? Yeah, I can do a pretty good job of that. You've got a lot of other plates that are gonna be spinning with this.

SPEAKER_02 38:11

Yeah, but they all honestly they all un they all overlap. I mean, at the end of the day, we could be a brand new building and wonderful new aesthetics, but if the interaction uh a consumer has with one of our staff is negative, or you know, we we we are fortunate enough to work with a physician like you and the environment isn't what it needed to be, so that you can have the outcome that you want to have, that that that's gonna reflect on the experience. And there's a there's I don't want to call it a consequence, but a ripple effect to that.

SPEAKER_00 38:39

Yes.

SPEAKER_02 38:40

So I I think you're spot on. Um, but again, everything overlaps. It is mission critical uh that all of us are focused on the same driver of again, high quality, safe care, great experience. I I think if you're doing those things very well, people will come.

SPEAKER_03 38:57

The rest is gonna come, yeah. Um now uh you had alluded to this relationship that you have with Florida State University and their uh burgeoning uh medical campus facilities and program entirely. Now that's a whole different thing here. Because once you're talking about moving from uh a private hospital, private facility to an academic facility, these are different creatures entirely in their funding, in the scale, as well as the other programs that are gonna because this is gonna become a teaching hospital, one would think, as well. That is accurate. That is a totally different world, is we're gonna have trainees and other things. And and again, I'm I don't have you had experience at this, or is this something that you're carving through now?

SPEAKER_02 39:40

Yeah, but I'll be honest with you, this is where it's a team effort between Florida State and Tallahassee Memorial. You know, I you know I think the thing that's really fundamentally important to this relationship is that we both value each other's strengths. You know, Tallahassee Memorial is a hospital operator, a health system operator. We're we're good at that. That's what we do. Florida State is going to be complimented by that, and we're gonna compliment off them in the context that they are subject matter experts in medical school, nursing schools, countless other educational things. Uh they are a leading area for research. I mean, you know, with so many things they're great at there. Um, and then you think about okay, what else can we do together that we can't do as much apart? So I think this is where when you're in the infancy of this relationship, there's a lot of great things that that can happen. I think both organizations really value each other and are smart enough to let each other work together, but also appreciate that this is their strength. Like I think it would be a mistake for Tallahassee Memorial to say, you know what? I appreciate you coming with us, but we know more about research than you do. No, we don't. We we're we we have some skill in research, but FSU has experts and they have resources and countless other things. So, how can we work together on things that they want to do in healthcare and give them a platform to do it? But hey, let's let's let's bring in those experts. And at the same time, Florida State's been pretty honest. You know, they they're gonna be very much involved with our board and they want to have the same outcomes that we do, but they're not hospital operators. And they don't want they they have been pretty vocal about yes, we're gonna be involved with the leadership, but really we're not hospital operators. We're gonna have expectations, but really we want you guys to run the hospital. Um and I and I again I applaud you know, President McCullough and his team, our CEO Mark O'Brien, and and and our board. You know, both parties, uh, you know, like any two relationships that come together, it's not as simple as everybody thinks. You know, think about all the think about outside of healthcare relationships that have come together. ExxonMobil, you know, you think about you know Heinz and Kraft of right. Um these are two outstanding organizations that know it's best they work together, but it's hard, they've been in place for a long period of time. You know, it's in a much smaller scale, but you know, seemingly reasonable. TMH has been in place for a hundred years, Florida State has been in place for a very long time. So bringing the two organizations together for this new FSU health platform, yeah, I I think there's learnings that go along the way, and you know, but I think at the end of the day, fundamentally, neither side has lost sight of what the goals are, which is to improve health care in the Southeast, particularly in this great state of Florida, continue to grow opportunities in academics and research that were producing more great professionals, like physicians like you and your colleagues, more research opportunities, and to be frankly candid with you, all of those things are great, and particularly selfishly now for Panama City Beach. Research, academics, new health system, you know what that brings in? Net new jobs. And we make this community thrive. Because, you know, in an ecosystem like ours, there's so much growth going on. But if you don't have good schools and you don't have good health care, uh it you're it doesn't work. And I think, you know, again, applauding the great work of Bay County, Panama City Beach, got great government officials here, leaders doing a great job. Um, we have a strong medical community here. We want to keep it strong and make it better and grow it because that's the key, because the reality is physicians like you almost make a major league free agency. There's 150 jobs out there. We need to make sure we're trying to attract people and keep them here.

SPEAKER_03 43:10

Yeah, and you know, um there's there is that free agency aspect, but there's also the aspect of this is our home. And that, you know, we're all gonna be on the other side of the equation in terms of healthcare at some point. We want to make this as robust and talented as possible. And it's exciting just to be a denison of this community to have one academic center that's going to be here. It's gonna be doing R01 grants and and research and things that are, and to have that substrate and patient um backing in order to be able to do that. I mean, that's exciting. That makes things, you know, things are happening at a higher level. And, you know, what do we end up with a level one trauma center or something along those lines? Yeah, those are things that we can start to kind of get and make this really the the home that we think it could be.

SPEAKER_02 43:53

I think it can be. I mean, uh again, it's hard not to get excited and ambitious about this. If we get off to a good start, do well. I'm not worried about growing higher acuity services. We can continue to expand our academic and research platform so that it is not beyond the bounds of reality, like we were talking about earlier, that you know, right now we want to take care of Bay and Walton County and then some of the immediate surrounding counties. But if we do what I think we can do, this can be a regional destination. I mean, that the thing that everybody worries about is can I keep health care local? And the reality is I think based on who you asked, sometimes this could be a challenge for this area. Um, but the reality is I think if we do what we, if we can do what we we think we can do, we can increase the probability that people do not have to leave this area. Now look, we even at Tallahassee Memorial, we don't do transplants, we don't do burns. Really proud of almost everything. I'm really proud of everything we do, but there's a couple things we don't do. Yes. And it makes sense that those patients, unfortunately, when they have that situation, should go to a destination that has that. I'm not saying on opening day, we're going to be doing Trump or have a burn unit. That that probably is a scenario that could be 15 years down the road or maybe never.

SPEAKER_00 45:02

Sure.

SPEAKER_02 45:03

But as we get going, if we do really well, we'll expand services, we'll increase the probability that healthcare can stay local. We can be a destination, not just for those initial communities that I talked about, but now we start thinking in a more ambitious way that communities that are not even part of our what would be our secondary or tertiary market, those patients that might have been going to Atlanta or Nashville or Dallas or New Orleans or New York are now coming here. That is that is the lofty goal you hope for. But again, you gotta get off to a good start. Yeah, start with the baby steps first.

SPEAKER_03 45:33

Now, um, how is construction going right now?

SPEAKER_02 45:35

It's going great. Honestly, I mean it's uh you know, you know, taking uh an area that we really we just got going on the hospital project in November of 24, and you know, you have uh 50 plus acres of trees and dirt, and you're a mile and a half from the water. Or is it take a couple weeks? Yeah, it it it you you the amount of work you need to do up front just to get the land where it needs to be is pretty significant. But you know, here we are now, we're in March of uh 2026. The exterior of the of the hospital, for all intent and purpose, is pretty much done. Um a high majority of our energy plant, uh which is obviously mission critical to our ability to be successful during good days and inclement weather, uh, is toward the end of completion. So what you'll see is us begin to shift our focus uh from exterior to interior. Uh so that's pretty exciting, but you know, we still have a ways to go looking at early 28 uh at this point to to open up. Um and you again, I I wish it could be done faster, but uh we can't divide the laws of physics and uh and uh reality, but I think we're making great headway.

SPEAKER_03 46:41

You know, I think there's um uh one of the sayings that I've I've tried to incorporate into my life is I'm working for the hard dopamine. I'm working for the things, the projects that take a lot of time. Not not the quick fix, not the quick uh I'll go skydiving or something. No, I mean the long-term projects. And this is what it is. This is an incredibly long-term project, and it's huge in scale and scope. Um, and so those are the hard things. And so when that comes to fruition, that's the really good feels.

SPEAKER_02 47:08

Yeah, I mean, uh, we again uh you this you start developing a family environment with everybody on the project, um, and and everybody understands how important this is. Uh, because to your point, um, we're not just building this thing, we're gonna be patients of this thing. Yeah, so it does hit home with a lot of our our our crews, uh, our teams that are there. Um, but I will share with you, I I won't lie, it'll be a very emotional day when we open. It'll be one of excitement and potentially even uh tear-jerking to the amount of work and effort that has already gone into this and will go into it. Um but the hard work really even you know, I don't want to minimize it now, but the hard work really starts when we open.

SPEAKER_03 47:45

That's right. That's right. And so this is yet another thing of just you almost don't want to know what you have ahead of you until you kind of get to that point and then you're getting through it. That's that's the thing. Yeah, keeping them to that point.

SPEAKER_02 47:55

You know, I mean, you know, it's the construction is one side, recruitment of many, many professionals is a whole nother thing. And then getting close to operating and then opening the door, it it's there's a lot of to-do still that need to happen.

SPEAKER_03 48:10

Yeah. Um, and I should I should take this opportunity to shout out to Dr. Littles uh for uh her work over at the FSU Medical School being the DM there and the interaction that she has.

SPEAKER_02 48:19

Yeah, she is a one of the Alma Littles. If you don't like Alma Littles, you don't like anybody. She is passionate, she is caring, um, and uh uh someone that is uh uh uh like you has been committed to patient care for a long period of time. We're we're fortunate to have her as part of this process. She's a friend. I think she does a great job.

SPEAKER_03 48:37

Well, and is doing it at scale, is doing it at the FMA as well. So she's really hitting all kind of different territories in her. So I don't know how she wears all the hats that she does.

SPEAKER_02 48:44

But I don't know how she does it too. She's a rock star and she's always smiling. I'm always sure.

SPEAKER_03 48:48

I've never seen her not smile. So I I don't maybe drugs are involved. You know what? Fit that out, Chris, okay? So we don't get that on there. Now, um, well, look, this is wonderful insight into a lot of stuff. I'm gonna kind of cover a couple of other things here just that because uh again, you know, you're perhaps a different level of guest that we typically have here, and just just different specialty here. So I I want to ask you, um, what is the biggest issue facing your particular specialty? And I would say that in terms of uh hospital administrator, president of large hospital facility here. What is the biggest issue facing you in the near future?

SPEAKER_02 49:21

I don't think there's just just one thing. I would tell you the natural first thing that comes to mind is obviously the the balance of cost and reimbursement. Um the reality is from everything from products to more importantly human beings that do this work, um, you know, it's it's a competitive environment and an environment where you have to obviously you you have costs that continue to go up because that's what comes with the the the turf. The balance to that is obviously like every hospital, every healthcare practice, uh obviously reimbursement is is going to be important. Um, you know, you you have to make sure those are in balance, and if they're not, you have to obviously make choices. Um but like anything, um, you know, eventually, you know, we hope to see continued work with um, you know, things that are going on in Washington, working with payers. Hopefully that will continue to work favorably. Um and we're no different than any other group, by the way. This is not a telehasm moral FSU health issue. This is a name that name the practice or hospital, that's an issue. I would tell you the second thing I think that probably we think about is again, um, it is not lost on you, obviously, and your colleagues. Uh there is a as much as we'd like it to be, there's still a shortage of physicians, uh, regardless of discipline, any discipline. Um, and I think when you think about the state of Florida and this area, which is realizing significant growth, we're gonna need more and more physicians to take care of people. So we need to continue to make this area a destination for physicians to come to and as important stay. So I think you know that falls on me and my leadership role to make sure it is an environment that physicians want to work in that meets their professional and personal desires. We need to make sure that's important, that they feel engaged. Um, and I think, but I also think that goes beyond uh a physician, nurses, pharmacists, techs, therapists. You know, it is a you know hospitals, there are a large ecosystem. It's a community, oh yes, yes, and there's many faces beyond the billboard that play a part in that. So I I will tell you the development of human capital, for lack of better term, is gonna be really important to our ability to be successful, our partners in the community that are already running hospitals, their ability to be successful, clinics, and and this is again, it is not a Bay County issue. It is not a Northwest Florida issue. It is a global health system, United States problem.

SPEAKER_03 51:38

Well, you know, we found it in our own practice. You know, you you invest a lot in the training and employee that's coming in. And so when that doesn't work out, well, that's that's a large investment, it's an opportunity cost that you've lost there. Um and so when you're doing that at a scale that's a hundred, a thousand X from that, that's a totally different. I mean, you know, those those those opportunity costs add up.

SPEAKER_02 51:56

Aaron Powell They do. And and I think, you know, because of those two things that we talked about and exactly to your point, the margin of error in our business is extremely slim. Um it it just it just is, which is, you know, in many ways makes us better as leaders, but in many ways, you know, it's extremely challenging. And it's not to say that other market sectors don't have challenges and issues and that they don't have much of a forgiveness uh factor. But uh I will share with you, I think in healthcare what the way margins are for a lot of hospital systems, uh many of which are still not positive. Um yeah, I I I think we have to hit not on seven out of ten, we have to hit on about 98 out of 10. Or about 100 rather.

SPEAKER_03 52:38

Yeah, you know, I am uh some of this is frustrating for me because, you know, when I when I look at things like um the tallest building in every single city is gonna be an insurance building. And so so noting that margin and that they kind of marionate a lot of these things, it's very frustrating. But but you're right to start to think about dealing with the system that we're dealing with and having to optimize that in the best way possible. Could we change it from the ground up? Well, that's gonna be pretty difficult and it's gonna involve a lot of governmental agencies, and maybe we'll get there. It's one of my goals in life. But until we get there, we've got to work with the hand that we're dealt and try and make the best of it to make an economic engine to help as many people as possible.

SPEAKER_02 53:17

I I think you have to play, you know, for a lack of it's like playing golf, you have to play the conditions, you know, um, and you have to maximize the opportunity that you've been dealt with. Um, you can try obviously advocate for change and hope things will happen. Um, and you and again, I I think there's two things you can do in life. You you can option A is you can complain about it and cry about it. That really doesn't make it any better. I think certainly there's nothing wrong with lobbying or advocating for your opinion or for what we think is right. But the second part about that is okay, what are we gonna do about it? Like what can we do in our respective roles to based on those conditions? How can we maximize the situation, maximize the opportunity? And uh, I think any healthcare leader, any healthcare professional, I think is gonna be challenged with that uh for many years to come. And even the people on the other side of it, the insurance companies, the government, I think they're all challenged by this. Yeah just because it's such a large, large subject matter. Yeah, yeah.

SPEAKER_03 54:10

So it'll be interesting how it pans out. Well, I hope my daughters listened to the last thing that you just said because that was uh pretty good. Um now, can you tell me about um how do you think of AI and how do you think of its integration into your current practice and what it you what you think it's gonna be like in the near future?

SPEAKER_02 54:26

Yeah, I I think you know the reality is AI has advanced very quickly in the past few years as going from something that is in discovery mode to now almost in acceptance mode. I think there's a lot of benefits that come with AI when I think about um efficiency. Um because we're all the reality is we all have certain denominators for anybody, and sometimes time is an issue. I I think about, you know, I think about you as a physician. In a dream world, you would never sleep, you'd work 24-7 and take care of patients. That's not realistic. And unfortunately, um, you know, I would love to have a thousand more of you. That's not a realistic answer. So, how can we efficiently use your time so we're maximizing you so that you can as safely and as high quality but see as many patients as you can. Um so I think there's room for AI, and I think there's going to be even more advances in that. Um we use a platform called Epic, which most hospitals are using now. Um, and there's advances being developed by then with AI that will be beneficial in so many ways, clinically, fiscally, operationally. I do think that because, like all advances in technology, they move at quite quite fast pace. We need to be thoughtful though, and be able to put a little bit of reins on it to say, before we do this, let's make sure it is effective, it's useful, and probably most important because we're in a different type of business. We deal with patients. Yes. It has to be safe. Yes. Um, so I I think there this is the AI is the cat's already out of the bag, AI is going to be part of the world. I think we just need to be thoughtful on its implementation, where it should be used. Um, you know, at the end of the day, all the AI in the world, they're not the ones doing the procedures you are. Um we need to make sure that you know you are in a position that you feel comfortable with AI, that it's a value add, not a risk point, not one other thing you need to be worried about when I again I don't pretend to do what you do, but appreciating what you do, you are dealing with life and death. You are dealing with uh the most extreme of situations. So let's not give you one more negative distraction. Let's give you one other thing that's gonna help you get the outcome that you want, which is obviously a safe and healthy patient, or get them on that road. So I I I think I think we'll see where AI goes, but I think it's gonna be part of our world and if how where that expands and where there could be some guardrails, I think there's more to come on that.

SPEAKER_03 56:55

Yeah, I think that's well said. Um you know, I think there's a lot of ways that um AI can benefit us. And I think there's maybe a relatively simplistic way, is gonna be look, there's something, you know, speaking from the physician side to the administration side, there's something that many hate, which is the EHRs never really panned out to be the things that we wanted them to be. It was sold as a this is gonna make your life more efficient. It really wasn't. Okay. It it perhaps made billing easier in a lot of different ways, but it was it was home to a lot of frustration. At the end of the day, we think, you know, in some sense it's taking nursing certainly and sometimes us away from the bedside, which is where we think that we ultimately belong. I truly see AI as this could be a quick way that it could help. If I can just say, give this patient lysentapril 10 milligrams, and it's sent off, and I don't have to put it anywhere in a computer system, yeah. I can see more, I've got more satisfaction with my job, I don't have to worry about that or typing it into a that would be fantastic, and I see a lot of uh benefit towards that end.

SPEAKER_02 57:54

I think you can have sent it any better because at the end of the day, again, I I talk a lot about the word about fundamentals. It's a it's it's something I really believe in. Like, you know, and I think about what are the fundamentals for people that are at the bedside taking care of patients. You know, it's that eye to eye, I'm taking care of you, I'm able to diagnose you. That really doesn't get replaced necessarily with AI. Maybe it's complimented, it's helped out, but that never goes away. I think to your point, where there's kind of those things that are part of the healthcare continuum when you're taking care of a patient, um, but they're almost secondary in nature in the context, like the acknowledging you gave, or hey, you've already diagnosed this patient that they need to go on lysenterle, okay, versus you typing in a computer or writing a script, you're now moving on to the next thing, but you're you leveraging AI that it has made you faster. And that that task gets compounded throughout the day. If that is gonna make you more efficient, give you the same positive outcome, it's safe. Yeah, I think we want to pursue those things. It's gonna be a better situation for everybody. But again, we're in the early stages of this. I don't pretend to be an expert either, but I I I think I think a lot will be developed and a lot will be evaluated over the next few years.

SPEAKER_03 59:06

Yeah, I I I think it's certainly it's gonna be a boon in a lot of different ways. Um, I do recall one patient that had um said to me, and and I didn't really even recall this, he said, I remember you coming to my bedside and you putting your hand on my shoulder and saying, We're gonna take care of this, and then we'll just move from there. And he said, That was the most meaningful thing. It was the touch. And so that's something that it may take a little bit for AI to get there to that touch point.

SPEAKER_02 59:32

I don't think AI will ever be able to do that. At the end of the day, I I always think of myself, if I was in that bed.

SPEAKER_00 59:37

Yeah.

SPEAKER_02 59:38

The analogy you gave is about as perfect as you can get. There is never gonna be an AI that is gonna do that human-to-human interaction where at the most vulnerable point in maybe most people's lives, they have a physician like you who's saying, Hey, I got you. Or we're we're gonna let me walk you through this. Or we're the you're giving them hopefully a happy answer, but even if it's not a happy answer, it's an honest answer. I don't think there's ever a way AI will ever, ever, ever replace that. You know, it's uh it just won't be.

SPEAKER_03 1:00:09

Well, we will see. Um now let me ask you this. Uh what do you do for fun?

SPEAKER_02 1:00:13

Boy, I'll tell you. Uh uh, do you get any time for fun now?

SPEAKER_03 1:00:17

Is it a little here and there?

SPEAKER_02 1:00:18

It'll go here and there. I mean, honestly, I'm probably torn between um I'm a terrible golfer. I love to play, but I am terrible. I'm terrible. If you see me on the course, you want to be sensitive to where you're standing. Be very cautious. Yes. Yes. If you're in the fairway or you're on the green, you see. No pup there. Yeah. Trees, woods, houses, no, you don't want to be there. Um away from that, uh, I have two high school students. Um, so they are very much involved in sports all, you know, all seasons and even over the summer. So usually at something along those lines. And then obviously the third part, uh, you know, spending time just away from all of that with my wife, my boys. I have two dogs. Awesome. You know, they're uh so you know, I I think those are the important things. Um I would say that's where the time is away from work.

SPEAKER_03 1:01:02

Yeah, yeah. And it's so refreshing and so necessary. So even the high agency amongst us uh need that time too to refresh and kind of keep their wheels going in the right direction.

SPEAKER_02 1:01:12

So absolutely. I mean, I there there is a burnout factor for all fields, I especially am sensitive to those in the healthcare field, especially again, starting with physicians, yeah. That uh I think is tangible and real. And I think we just need to be aware of that. That, you know, again, giving the physician he or she as much of a toolkit so they can be successful, but also again, be able to turn it on and turn it off. Uh same thing with all of the clinical personnel. I think that's really important.

SPEAKER_03 1:01:39

That's that's refreshing to hear from the physician standpoint. I can tell you that. Um, you ready for some rapid fire questions? Sure. Okay, here we go. Uh it doesn't necessarily have to be rapid fire, by the way. That's okay. Who's the smartest person in history?

SPEAKER_02 1:01:52

My wife hates that question, too. There's never just one. I mean, obviously you think about um probably in the last 25, 30, 25, 30 years, you think about the the Bill Gates and this, you know, the Steve Jobs of the world. Obviously, you think about, you know, before that, the Einsteins, the the people of the Industrial Revolution in the 50s and the 60s, some of the work they were doing. And then obviously you go further back in time, early inventors, things along those lines. Um, you know, I I I don't think there's ever just one thing.

SPEAKER_03 1:02:21

No, I do I do like and I do want to double-click on that for just one second and say that, you know, um the Steve Jobs, um, the Bill Gates, their genius was not in their products that they made, because in many times it they weren't necessarily products that they made. It was in their marketing and really in their vision and how they had seen things and how they could lead people into getting things and and perhaps squeezing the most out of them and getting the most um orange juice out of them.

SPEAKER_02 1:02:51

That's true to some extent. Yeah, I think you know, you think about where they've taken their companies, yes, but at the same time, you gotta remember that these are still guys that were in a garage developing a computer. Oh, yeah. Um, and you think about what that meant to this world now. Um, you know, I again to just your question, inventors that I would you know held in high regard, how have they changed the landscape of life forever? That that's the people that are in that very small window. Like, I mean, again, you these are the it's a very elite uh group of individuals uh which I will never be a part of.

SPEAKER_03 1:03:23

You you know, um my wife actually brought up for the her answer to this question, um, was uh Ronkin, Rainkin, uh the uh first x-ray um who who who thought of maybe we can see inside the body. And now, you know, if you start to do an echocardiogram on somebody that lived down the road, um I I'm watching the heart work in real time. This is magic. This is crazy, and I can not only see it working in real time, but I can use this to diagnose things that we're seeing from outside the body and then know how to treat that and make that better. I couldn't agree more.

SPEAKER_02 1:03:54

Yeah, that's another great example of someone that single-handedly changed the landscape of healthcare.

SPEAKER_03 1:03:59

Yeah, yeah, indeed. Um, if we can live to be a thousand years old, should we do it?

SPEAKER_02 1:04:05

Uh I I I probably wouldn't because I think just watching family members as they have gotten older, you get you know, I I can imagine in a world where maybe we're getting to live longer in nineties and a hundreds, I don't know if we want to, are we going to be able to function at a thousand years old? As an individual, I don't know if we will be able to.

SPEAKER_03 1:04:24

That's and and you can make this question what you want. So that's pending. If we could get maybe we're living actively with joyspan, I don't know.

SPEAKER_02 1:04:33

Uh the I you know, I probably would still say no. I think like everything in life, there is a beginning and an end. Um you know, if there's someday a miracle world where we could live to a thousand and live healthy and younger for a longer period of time, I'd let's put this way, I'd at least be anxious and learn anxious and learning more, but I wouldn't say necessarily I'd change my mind.

SPEAKER_03 1:04:52

Let's say uh just look up Yamanaka factors. They're coming online soon. Doing phase one trials now. All right. Uh would you rather have it too cold or too hot at night? Um I'd rather it be uh too cold. That's the right answer. All right. Now um what is one thing you would tell yourself at the beginning of your career if you could go back and talk to yourself then? Uh talk less, listen more. Very well said. What is one current medical treatment or therapy that we do now that we are gonna shudder that we do that we used to do 15 years from now?

SPEAKER_02 1:05:25

Great question. Um I I think I don't know if that'll ever a hundred percent be knocked knocked out, but that you can see already the world changing. Like I think about um, you know, in a small sample, uh you know, bariatric surgery lat landscape's changing with some of the pharmacology that's out there and and the advances. Now it's early to say, and I don't want to say bariatric surgery is going to be eliminated. I don't think it will will be, but it's certainly just in just thinking about here now, it has already changed the landscape of things.

SPEAKER_03 1:05:56

Absolutely. What a wonderful answer. Um what books are you reading? Right now.

SPEAKER_02 1:06:00

You know, uh I just got done with another I'm a big fan of the the Roosevelts and Presidents and Key Leaders. So I just got done with uh Teddy Roosevelt uh biography. I actually want to read another one. Um I kind of bounced between um presidents and key leaders and uh and also coaches that I look up to. Like uh just got done reading Bill uh Bill Belichick book, and I I just enjoy that. How he wasn't a first ballot Hall of Famer. I mean what what on earth is? I gotta be honest. I'm a Giants fan, but I have to be honest, even that one, I'm like, how that just doesn't make sense. That's possible. Uh yeah, I'm not sure why that happened. Uh that that will be another wonderful mystery of life because there's no one more deserving as a first-time Hall of Famer than outside of probably Tom Brady than him. Yeah, I think it's pretty clear.

SPEAKER_03 1:06:45

Um our uh financial fiduciary, shout out Ron Coleman. Um he uh sent us uh River of Doubt, which is uh uh a book about um Teddy Roosevelt that I haven't quite gotten to yet. And so, but looks great. It's great.

SPEAKER_02 1:06:57

I uh he's he's one of the more amazing. He's a character, isn't he? Like he's a very good thing. He's one of the more amazing American presidents, uh honestly. Uh you know, yeah, it it is really appreciated. And um uh the uh Steve Evans, uh uh IBM executive who's based out of Talhasse, retired, great guy, mentor of mine. Uh, you know, the he's a big fan of the uh Man in the arena. So if anyone is aware of that, that is a great thing to look at. I I I look I frequently will read that to remind myself of what what leadership is and what's involved with that.

SPEAKER_03 1:07:30

Yeah. Um, you know, also Teddy Roosevelt had this um conservative persona, but also a wild environmental strength. I mean, like what would really kind of cover the game, it's at extremes of both ends, and so really kind of undefinable almost. Yeah, it's just unique snowflake characteristic that is amazing. So um and then finally, what is the best song of all time?

SPEAKER_02 1:07:52

Great one. Um if I had to pick one, I would probably say um uh Eric Clapton's Unplugged Layla.

SPEAKER_03 1:08:04

Beautiful choice.

SPEAKER_02 1:08:05

That's uh that's that's one of the better ones, but boy, picking one, I know it's hard, right? You know, because I I mean I wouldn't say one, I'd probably have to narrow it down to ten because Interstate Love Song by Stone Temple Pilots is one of the best songs of all time. Um but again, music is a very choice of what people like and don't like. So I I probably couldn't say one, but the the initially off the top of my head, those are two good ones. That's a great choice.

SPEAKER_03 1:08:27

Um well um, Andrew, thank you so much for being here today. Thank you for your vision for our community here. Um the the scale with which you're approaching this is really it's heartening. Um, and I think it's it's really great that you're bringing another option here for our community, uh for our physicians, and for all of us here. So thank you very much for your vision and your leadership.

SPEAKER_02 1:08:47

Oh, thank you. I appreciate the opportunity to be here. Um, and again, we're very honored and humbled with this opportunity and uh looking forward to the future.

SPEAKER_03 1:08:55

Indeed. And I want to thank you for helping us make medicine better together. Thanks.