July 2, 2021: How would you assess the state of US healthcare today? Joining Bill is Scott Becker, Partner at McGuireWoods and Publisher and Founder of Beckers Healthcare. What are the highlights of the Becker’s Podcast so far? Which US Presidents have the best grasp of healthcare issues? What are the most pressing issues facing health systems in 2021? Do new entrants like Amazon, CVS, Walmartetc pose a real threat? Who do you think is going to win the race to the hospital at home? And what do highly successful CIOs CEOs do that others don’t?
Healthcare is about serving patients. The number one priority is great quality and connectedness. [00:09:20]
The big problem we have is access. Access is a huge challenge with 330 million people and an aging population. [00:23:25]
We’ve got to figure out the labor shortage issue [00:24:50]
Hospitals are trying to figure out how to compete against the rest of the world that’s moved towards an asset light model because they are asset heavy [00:40:00]
A Look at the Healthcare Landscape with Scott Becker
Episode 420: Transcript – July 2, 2021
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.
[00:00:17]Today, we have a treat for you. We are joined by Scott Becker of Becker’s Healthcare. Founder of not only the conferences, the media assets, but also the Becker’s healthcare podcast. And he is just a wonderful individual. Easy to talk to, [00:00:30] which is why his podcast is one of the most successful podcasts in the industry. He talks to all sorts of people and we talked to him about a wide range of topics. We talked about the presidents that have come to the Becker’s healthcare conference. We talked about the leaders that he’s talked to, what makes a successful leader and what’s going on in healthcare. So we have a great visit. I think you’ll really enjoy it.
[00:00:50] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can [00:01:00] become a show sponsor as well. The first step is to send an email to [email protected]
[00:01:05] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show.
[00:01:29]This afternoon, we [00:01:30] have Scott Becker Partner at McGuire woods and Publisher and Founder of Becker’s healthcare and a lot of other things with us. Good afternoon, Scott. Welcome to the show,
[00:01:39]Scott Becker: [00:01:39] Bill thank you so much for having me, what a great pleasure to get to visit with you. Thank you so much.
[00:01:45] Bill Russell: [00:01:45] I’m really looking forward to it. It’s I feel like I’m on the show with a celebrity. I was out to dinner last night with somebody. And he goes, well, tell me what you do. I said, well, this is what I do. And whatnot. It turns out he worked for one of the healthcare companies in, in Chicago before he retired.
[00:01:59][00:02:00] He goes like who do you interview? I said, tomorrow, I’m with Scott Becker. He goes Scott Becker. Oh my gosh. It’s like, I feel like everyone knows who you are. And you do have, I think one of the most distinctive voices in all of podcasting.
[00:02:14] Scott Becker: [00:02:14] Thank you Bill. It’s. When you say celebrity, we think of a B or C list celebrity, but thank you for having me and I appreciate it. And it’s great fun. It really is. It’s you know, it’s great fun to get to visit with lots of new people to see what they’re thinking, see what’s going on and, and just a pleasure.
[00:02:28] Bill Russell: [00:02:28] Yeah. I I’ve [00:02:30] joked and maybe you feel this way too. I’ve, I’ve joked that the podcast for me is really the education of Bill Russell.
[00:02:35] I get to talk to so many phenomenal people and they just share their insights and their wisdom. And just after a while of being around it you just, you pick up so much stuff. What a great industry to be a part of. People are just so willing to share and help each other out. And so it is really fun.
[00:02:51] So you’re doing a lot of podcasting. You not only have the Becker’s healthcare podcast, you have the private, is it, is it called the private equity or [00:03:00] business podcast? What?
[00:03:01] Scott Becker: [00:03:01] Yeah. Really a private equity podcasts that we sort of, it’s more of an advanced hobby than a business but private equity and in some business generally, but those are, those just give me an opportunity to visit with some other people and see what’s going on and learn and connect. So, but yes the principle thing I do is Becker’s healthcare. I’m also a lawyer by background but my life really revolves first and foremost, Beckers Healthcare and secondary around being a lawyer, at least by background.
[00:03:25] Bill Russell: [00:03:25] Yeah. A lawyer and a degree from university of Illinois [00:03:30] in financing. You’re almost like, like me in that you’ve had multiple careers.
[00:03:34]Scott Becker: [00:03:34] Yes, we’ve had concurrent careers. So yes, university of Illinois for the MCP undergrad, Harvard law school, excuse me. And then for better, for worse. And I’ve really practiced law for the last 30 years.
[00:03:47] A long, long time ago when I was starting to practice why I started the Becker’s healthcare media business and ended up sort of doing those things concurrently and they, they were, they were very God, they were synergistic for a very long [00:04:00] time. And so we had had the fortune of building great law practice, but then also having building Becker’s healthcare started off as sort of a legal marketing type thing a hundred years ago. 30 years to be exact and turned much more into the centerpiece of my professional life. And what really happens is at some point I ended up hiring magnificent people there and they really built Becker’s healthcare into a serious franchise. And Jessica Cole, our Turo team, and some others yet would gamble.
[00:04:26] They really built it into a real media enterprise and it’s been great [00:04:30] fun but we sort of did them all concurrently and it would they sort of fed off each other and just kept on doing it. No great brilliance, but being in specific niches, in hiring great people and great fun.
[00:04:41] Bill Russell: [00:04:41] Yeah. Well last, last year was an interesting year and you guys pivoted pretty quickly. The Becker’s podcast felt to me, the healthcare podcast felt like it came out of nowhere and then it was a must listen to podcasts. I mean, you guys started producing. I don’t think it felt like 10 [00:05:00] shows a week almost.
[00:05:01] Scott Becker: [00:05:01] Well, even more than that actually. A crazy number of episodes, but what really Becker’s healthcare has always been about 50% digital, about 50% events and some portion of that being a print magazine, but the print magazine was never more than five to 10% of the enterprise. We were fortunate to already be a 50% digital type of business in podcasting ended up fitting sort of within that. And what happens is we had started doing it two and a half years ago, [00:05:30] but during the pandemic, all of a sudden the numbers of listens to podcasts and downloads and just jumped as you saw.
[00:05:37] And so we ended up doubling and tripling down on the amount of them and of course originally a lot of our business and Becker’s healthcare was these in-person meetings where you and I have met before but those were of course were off and canceled last year. So we ended up having a tremendous amount of time to do more of this and in a tremendously interesting year in terms of the healthcare information world just in terms of like, [00:06:00] obviously COVID-19 in the digital transformation in health equity issues. So many interesting issues that people wanted to talk about.
[00:06:08]We’d started this two years ago. In the first year of doing podcast. We had 143 downloads to give you a sense of scale and in one of our months, last couple of months, last month, we had 250,000 downloads. Just as an example of the difference in the amount of listenership from when I started.
[00:06:23] And it’s discouraging when you start. And 140 people listened to it the entire month. You’ve probably had several episodes, it’s a little discouraging, but [00:06:30] it’s, it’s grown a great deal. And it’s been fascinating to just hear what’s going on. It really gives you a chance as in a very quick way to understand what’s going on. We’re trying to.
[00:06:39] Bill Russell: [00:06:39] We can relate on so many different levels. So my first podcast was downloaded 28 times and it was, it was after that was downloaded. I said I’m just going to commit to doing this for a year and see where it goes, because you just, you can’t look at the numbers when you’re first starting out. And then we just rode this wave. I mean, the podcast just became huge over the last [00:07:00] three or four years, it’s been amazing
[00:07:02] Scott Becker: [00:07:02] And you’ve hit it right down the middle in This Week in Health IT which is just a fascinating area. And you’ve got this great sort of a perspective on it from your years of serving as a CIO too. So it’s sort of a fascinating, I mean, you’ve hit it just beautifully down in the middle.
[00:07:17] Bill Russell: [00:07:17] Yeah. So yeah, I went out and went to the community This Week in Health IT community, I said, Hey, I’m interviewing Scott Becker. Do you have any questions? And the questions started flooding in. So a bunch of these questions are really [00:07:30] from from people out there in the community.
[00:07:32] So this, this should be interesting. We’ll start with the easy ones. Best moments from the interviews so far from the Becker’s healthcare podcast?
[00:07:41]Scott Becker: [00:07:41] Sure. So that’s, that’s a great question. And it’s hard to, it’s I’ll give you a specific things as opposed to exact moments but and I’ll talk about some different speakers and there’s obviously some really critical leaders in the healthcare community.
[00:07:57] Whether Johnny Spiso at UCLA, [00:08:00] Gene Woods at Atrium Health, Mike Dowling at Northwell, Lloyd Dean at Commonspirit that it provided fascinating listening to hear their perspective on what’s going on and with COVID and with health equity and sofas. So those are those kinds of interviews with some of the people that are right in the middle of the game.
[00:08:19] I’ll talk again to Mark Harrison, the CEO of Intermountain tomorrow or Monday and those are fascinating perspective with just what they’re seeing. But in addition to those, [00:08:30] I get a chance to talk to people at every sort of like size and position in healthcare. Not just CEOs of the majors and some of the things that I find the most fascinating are like talk to the CEO of a smaller health system last year.
[00:08:44] And we often ask the CEOs. What are you thinking in terms of strategy? How has strategy evolved in the last couple of years? And the standard answer you’ll get from people is, well, strategy hasn’t changed that much, but we’ve made some pivots. And I think I had a CEO last week say what have you seen in terms of [00:09:00] strategy evolving?
[00:09:01] And she had the wherewithal to say well, it changed completely. We had to sort of completely throw it out the window the last year and refigure it out. And we look at what we’re doing and so forth. And I find those kinds of discussions so refreshing, just so refreshing. Like going, of course it says hit us out of nowhere.
[00:09:18] Yes. We’re still serving patients. Our number one priority is great quality and connectedness with patients and so forth but strategy, we had to evolve it and so forth. So that’s, that’s always fascinating when [00:09:30] somebody talks typically than the rest of the tribe. The other people that I find so fascinating to talk to, I find it as interesting as anybody to talk to and so many people in healthcare fit this category. They’re first generation immigrants, or second generation immigrants. Whether from India, from Africa, from wherever they might be. And I find the perspectives so fascinating because they have such a different world view than we do. And I enjoy those so much. When we talk so much about what was health care like in Nigeria?
[00:09:58] What was healthcare like in [00:10:00] India? How does it look compared to here? What do you think? How was training? talked to somebody last week. It was a woman doctor from Nigeria, her mother’s a doctor. And now her daughter is finishing medical school at Mayo clinic. So three generations of, of African-American doctors from Nigeria.
[00:10:16] Those to me are very special moments. I mean, they give you a fascinating human perspective on everything versus the here’s what’s going on. I mean, there’s other guests, Steve Klasko we’ve had on a number of times the CIO of Jefferson, I can talk to Steve Klasko all day.
[00:10:29]He’s just [00:10:30] way out in front of digital transformation. Very, very smart. Amelda DeConus who’s with Kaiser Permanente always a magnificent talk. Deep perspectives on leadership, as well as on health equity, as well as gender issues in healthcare and how women had been treated and not treated and stuff like that.
[00:10:45] Fascinating but there’s just a whole host of people I find just fascinating, but I do love as much as anything talking to doctors or leaders who’ve immigrated here, first, second generation and just have just a whole different world perspective than the rest of us. I just, I enjoy it as much as anything.
[00:11:00] [00:11:00] Bill Russell: [00:11:00] What I love about that, people ask me, it’s like or do you think you’ll go back to being a CIO or that kinda stuff? Do you know, do you really like what you’re doing? I’m like, I love what I’m doing. This is, to get to talk to these people and to hear their stories and to ask them the questions that get, get that knowledge out into the industry.
[00:11:16]It is so much fun and it is so great to, to meet those people. And it sounds like, I mean, when I hear you talk about it, you you light up as you talk about. All the people you’ve gotten to talk to. The one interview that does jump out at me is when you talk to [00:11:30] Michael Dowling, really during almost the height of the pandemic last year, and he was just sharing the burden on the frontline care workers and those kinds of things.
[00:11:40] That was I mean, that was a pretty powerful moment. And I just, I really appreciate you know, you have access to so many people within healthcare. I’m just so glad that you’re not focusing just on the celebrity CEOs, but that you are going pretty broad across the entire industry and pulling those [00:12:00] stories out.
[00:12:01] Scott Becker: [00:12:01] You’ll love it. I’m gonna make one comment. Mike, Mike is a fascinating individual. He’s also an immigrant from Ireland. I’m not, he’s an immigrant from Ireland but he’s a fascinating leader. And yet he’s got this, this huge brain. Crazy personal skills and he deeply cares about everything. I mean, and it’s this huge mix of talent, which is very smart, very motivated and deeply caring and incredible personally gifted personal skills, but incredible caring when you talk to what I find fascinating about Mike, [00:12:30] Mike himself magnificent.
[00:12:32] But when you really get the measure of a person is, whenever I get a chance to visit with any of the senior leaders, men, or women at Northwell Health it all comes back to the leadership culture that he’s built there. Lots of highly talented people that have the same vision of compassionate and energy and wanting to do caring, great things.
[00:12:50] And that’s more the measurable leader to me than that leader speaking themselves. It’s with all their other teams speaks of and how they talk and the quality of leader that he’s been [00:13:00] able to attract and keep and retain and groom. So it’s, I find that to be the biggest compliment to some of these leaders is the leaders around them and that they’ve grown with and how they speak of them and speak of the system.
[00:13:11] Bill Russell: [00:13:11] Yeah. You getting onto some of these other questions, the, cause it feels to me like you and I could probably talk for the next five hours. You’ve had a bunch of US presidents at the Becker’s conference and a bunch of celebrities, high-profile people which, which president’s current past [00:13:30] with their grasp of healthcare, really understanding the healthcare issues?
[00:13:35] Scott Becker: [00:13:35] Sure. So it’s a, it’s a great question. So I’ve got three perspectives on it. I’ve had in terms of actual presidents, president Bush and Clinton and Hillary Clinton as well. And well Hillary was not president, but, so she’s got the greatest grasp of the three of them with healthcare issues by far. She’s got the most depth of any of them on actual health care issues by far.
[00:13:57] And that’s part of how her mind works. How she approaches [00:14:00] things and so forth. She just really does. The beauty of healthcare. One of the great things about healthcare is every single one of us, aside from whether we’re involved in the healthcare industry or not, is a consumer. So in some ways you can’t really fool anybody about the healthcare system.
[00:14:17] It at least anybody that’s listening or trying to pay attention because we’re all consumers as well. So we see it from both sides, but I don’t, I don’t I do find often that the grasp of the senior most presidents, et [00:14:30] cetera, et cetera is, is fine. But plenty of people have a better grasp of some of the healthcare issue specifically than they do.
[00:14:36] It doesn’t mean that other people are better leaders than they are. I mean, George Bush, magnificent personal leader, Bill Clinton, the absolute pleasure and fasting to listen to. Hillary got the greatest depth on the healthcare issues itself, whether you agree with her where she’s had it in them or not and then there’s it whats happened on the right and left.
[00:14:54] There’s so much sloganeering. On the right it might be free market for [00:15:00] everything. And we know it’s not free market because 50% plus is paid for by Medicare, Medicaid. It’s already 50% of government market, no matter what. And on the left, it might be Medicare for all, but we know that only 14% of the population is covered by Medicare.
[00:15:13] So if you move to Medicare for all be prepared for a huge amount of unexpected consequences. And it’s not that I’m a pro-Biden and anti-Biden either way. I try to be as impartial as constantly as I can be. But the concept of incrementally changing Medicare from 65 to six or something like that [00:15:30] is to me far more appealing than completely disrupting and changing the system, and so because there’s only 14% of us are covered by Medicare. I’m not covered by Medicare yet, but I will be in not too long, but it’s a small percentage in total in total of the population. So I find that of the three is, oh, Hillary is not a president, but when it just comes to mind and excuse my senior-itis, but she is, she had the most grasp of Bill, George and her.
[00:15:54]I had the pleasure of being in Wasco with President Obama. We didn’t talk about healthcare, but he [00:16:00] also was an absolutely fascinating leader. And I had a chance to have president Obama as a student in a class that I was the TA for which is daunting because president Obama was far, far smarter than I was.
[00:16:11] And so what Barack would do is he would say in the class, when I was explaining something, he would say this is, I think what Scott means to say. And the thing about president Obama, I mean, he’s, he says I don’t agree with all his policies and like that. But he’s a absolutely wonderfully bright [00:16:30] and nice person.
[00:16:31] And so he was able to handle this with a class of like 12 people and not embarrass me, while having a brain that was just far deeper than mine. He’s just a very, very bright, bright person. And so I’ve had that experience with all three of them. I mean, obviously we would have loved to have president Trump as a speaker.
[00:16:48]The world’s become so right now, just because he’s so combative and interesting, I mean, it’s interesting, he’s entertaining. When we went to try and get him as a speaker before he was president. Before he was such a [00:17:00] lightning rod. The cost to have President Trump was so crazy before he was president that we couldn’t do it.
[00:17:05] It just didn’t make sense. Now, at some point we’d love to have him as a speaker. We try and be balanced completely. So we had him as a speaker. We’d also have president Clinton as a speaker or CCF speakers when Guntz as a the speaker. But today the world is so combustive that we couldn’t do it without people going crazy.
[00:17:25] Oh my God, you can’t have him as a speaker, you can’t have her as a speaker. We get an equal [00:17:30] amount of people upset when we have a right-wing politician or left-wing politician. And so the best that we try and do is balance it out.
[00:17:38] Bill Russell: [00:17:38] But Scott harder, I mean, so this is one of my passions in this, in this role. It we’ve got to get the conversation going again. It’s like we have to jump, start it again. Where, how do we get people to sit across from each other and just start to dialogue, just start to, I don’t know, to listen to each other, to have the conversation. What I hear you saying is let’s bring these people back into the room [00:18:00] together, regardless at any time whoever’s speaking is going to be speaking to a 50% of the audience it’s going to be. Yes, absolutely. And 50% of the audience is going to be yeah, you couldn’t be more off base, but at least let’s get the conversation.
[00:18:16] Scott Becker: [00:18:16] And we try and hit it as much as possible and then parse it down the middle. And in truth on almost all issues is, is somewhere in between and all these things. And so, so we, we try to foster that it’s become harder today just because the world has become so [00:18:30] binary.
[00:18:30] You know as you said, 50% issue. So we try and make sure if we’re doing either, we do both, but it’s constantly a fascinating, but I find talking, I mean, president Bush is about as nice a person as they come. Hillary Clinton also, you couldn’t find a more pleasant person to be around you, just, you just couldn’t. You just, it’s just not possible.
[00:18:49] She’s just like when you actually meet her in person with your right-wing personal or left-wing person, no matter what you see on TV, what you hear, what you do, she’s just an absolute pleasure. And that surprised me. Cause I [00:19:00] didn’t expect that. She just is an absolute pleasure of a person. As his president. Bush. President Clinton is also a pleasure but in a different way. I mean, he’s different than the two of them, but incredibly gifted and a politician that fits a mold that you almost can have today. He was a social liberal and a financial conservative, and that world is almost lost today, even though so many people in America really fit down that profile.
[00:19:26] Bill Russell: [00:19:26] Yeah, it’s a job. We can talk about presidents for, for a long time. I mean, [00:19:30] that. The one thing I’ve heard about presidents, one of my friends, his father had to interact with each presidents over multiple years. And it was it was George Bush Sr, Bill Clinton, and then and W so he had interactions with all of them.
[00:19:47] And I said what’s the thing that stood out with you. He goes, first of all, when you meet them there’s a presence of the office. That is just as there. He said, the second thing is it didn’t matter what their politics were. They were just the most [00:20:00] engaging people you ever come across. They, they got to be President because they are engaging people. They’re warm, they’re charismatic.
[00:20:08]They know how to to have conversations with people from both sides of the aisle. And he said, that’s the thing that really strikes you. I mean, they get painted as something in the media but when you get to meet them on a personal level, that’s really not, how it’s painted in the media. It’s usually not who they are.
[00:20:23]Scott Becker: [00:20:23] But I think Bill, you fit that exactly what you’re struck by when you meet them and get to visit with them, they all have [00:20:30] crazy personal skills. I mean, incredible personal skills. They’re just incredible at it and you wouldn’t know it from seeing them on TV.
[00:20:37] But you meet Hillary in person and she’s sits with my parents. My parents are in love. They wonderful. And they tend to be, my parents tend to be Democrats themselves. I tend to be more centrist, but I just absolutely loved being with her. And president Bush you talk for three minutes with them and you have mutual friends.
[00:20:55] And he talked to him three years later and he either is great at no Trisha’s personally [00:21:00] great at it, whatever it is. You’ll feel very, very good about visiting with them. They’re very, very good at it. Present goods. And we’ve had a couple of times, and it’s just a little bit different because he’s, he also was over in a higher, he doesn’t get as down to earth as you in the same way, but it’s got this incredible, incredible following and incredibly talented personally as well.
[00:21:20] Bill Russell: [00:21:20] All right. So let’s get into healthcare How would you assess the state of US healthcare today? How are we doing. Let’s quantify it a little bit. Like, how are we doing with regard to the triple or quadruple [00:21:30] lane?
[00:21:30]Scott Becker: [00:21:30] Sure. How do you look at the US health system? The US health system is magnificent and has huge challenges. I mean, you have to take this in the context of we’re serving 330 million people. So after India and China, we’re the largest country in the world serving a lot of people. And there are lots of challenges with it. There, there are so many sort of dichotomies it’s magnificent and we have problems.
[00:21:54] It’s magnificent and we have access issues. We talk about coverage for all. [00:22:00] And most of us come to the conclusion, right, left or center that it’s something that we got to get covered for all. I’m probably sooner, rather than later, you got to figure it out. We all know it’s a lot better to do it through increasing Medicaid or Medicare than through these exchanges, it just has been shown time and time again. Congressional budget office shows it’s much cheaper to get more people on board and covered through Medicare Medicaid than it is through the exchanges. That’s not a knock and the exchanges, it was a road that president Obama wanted to go down because he felt another alternative to get there, but it closed bills that [00:22:30] have been covered through expanded Medicaid, not through the exchanges. Out of 24 million come through expanded Medicaid and it’s more efficient way to do it. Not, not perfect, lots of challenges but we all think most of us get to the spot we think we should have coverage for all. Most of us believes that insurance conapnies can deny us coverage cause we have a preexisting condition. Most people have gotten to that spot, right left center, et cetera, most ruled like a public option of some sort, just as an alternative to the health plans and many of us look at it and say, well, Be the post office, which is alternative to [00:23:00] UPS and federal express.
[00:23:01] It’d probably a good thing versus a bad thing that we have. The great challenge that nobody talks about in DC. But we do hear about it from healthcare executives all the time. And it’s not, it’s not a Poplar issue. It’s not on a right, left issue and it’s why it’s not talked about. The big looming problem we have it’s not coverage because coverage is solvable. We’re 9% away. We’re 30 million people away, something like that. It’s solvable. The great problem we have is access. Access is becoming a bigger and bigger challenge with 330 million [00:23:30] people and an aging population. So a huge aging population and lots of health care needs and increased shortages of doctors and nurses.
[00:23:39] And in DC. Well, they talk about all kinds of things that are lightning rods for their own side of the political table, right. Or left. They don’t talk about solving problems. And in the brew crowd, we’ve got a south. Yes. Technology helps a lot of course, but beyond technology, we need to figure out how to mint more doctors in an easier [00:24:00] way.
[00:24:00] We need to figure out how to get more nurses, clinicians, and so forth. How to grow more. Over the years we’ve imported a lot of doctors. We still need to do that, but we all know that that’s a net zero sum game, cause it’s not helping the rest of the world. We’ve got to figure out a way to increase the pool of doctors versus zero.
[00:24:15] We have to make medical school a little bit easier to get into and get through. We’ve got to make it easier for a doctor to become a doctor or a nurse, become a nurse clinician to be with clinicians with maintaining rigorous standards. But we’ve got to fight through the sort of the turf battles and the strengths of the medical boards and the EMA and everybody else [00:24:30] to sort of make it a little bit easier to become a doctor, a physician, a nurse or clinician.
[00:24:34] So we’re just facing looming shortage and we got to make it more attractive. You know, if you make it. til somebody is 32 to become a specialist that just makes it very hard because people know they’ve got shortage sort of professionalize. And so you’re, you’re, you basically don’t want to be a professor until 32 or so giving them X years of practice.
[00:24:50] We’ve got to figure out the shortages issue, the labor shortage issue as much as all of these political issues, which are political issues are fun because they get votes, but solving problems is [00:25:00] hard and there’s big problems to solve, but so it’s that differences system. Coverage is one thing. Access is another problem. Quality, compared to any other large country, I think is ultimately very, very good. Cost is a challenge. And I don’t know how you’re going to change that cost structure without improving the labor pool as well in this situation. But we also are very used to in our country getting what we want.
[00:25:23]You want your knee replaced, you get it done pretty quickly. You want to go to the urgent care, you go in 20 minutes and that’s not the same in other countries. [00:25:30] And we like those conveniences. As citizens we like those things. And I don’t think we’d be happy without having those things.
[00:25:35]Bill Russell: [00:25:35] Is there going to be a way to change from sick care to well care to more of a health focus? I mean, I know we talk about it all the time, but are we making progress in that area?
[00:25:47] Scott Becker: [00:25:47] Are we making progress in that area? I mean, I think we know that the answer is not really, I mean, we talk about it all the time. We talk about Apps that will give people better [00:26:00] information for their own personal fitness. Obviously we’ve had good success in this country in smoking cessation. In reducing the amount of people smoking cigarettes. In terms of health and wellness and really improving health and wellness and making it so, I mean, you could be in some cities in America where every running trail, every biking trails is full, I mean, Denver is known as one of those cities. San Diego is one of those cities can we change human nature so that there’s so in terms of a bell curve, there’s [00:26:30] more of us acting like that.
[00:26:31] I don’t know. Can you make it easier to go get the checkups you need to get? To do the things you need to do to pay attention to it. Can we move more towards this model wellness? We all talk about it. We all know that a huge percent of our healthcare problems with cluster two to one way or another us as individuals not doing the things we need to do.
[00:26:52] And so can we really change that? I don’t know. I don’t know. It’s a great question. Everybody talks about so many things and [00:27:00] I’m not clear where they’re going now, when you see. Governments in a high school, junior high, elementary education get rid of gym classes. I think that just that’s that, that boggles my mind.
[00:27:12] If you want to talk about wellness, well, you got to start with as an adult, having a gym class a day as a kid having a gym class today. And as adult you got to find your own. But as a kid, you gotta have that. You have to have that just in terms of it doesn’t have to be like running, as I said, to be playing a competitive sport, but something that keeps the mind and body active is social important.
[00:27:29]Are we [00:27:30] making progress? I don’t know if we’re making progress as a society or if we will.
[00:27:33] Bill Russell: [00:27:33] Yeah, I interviewed a doctor earlier today and we were talking offline and I’m like he’s lost weight through COVID, I’ve put on weight through COVID and I said you’re a doctor, I’m going to ask you about you know what I can do to lose some weight.
[00:27:47] I said, but you’re going to tell me the same thing every other doctor has for the last 50 years, which is essentially get active and watch what you’re putting into your body in terms of eating and your diet. He goes, yeah, that’s pretty much what I’m going to tell you [00:28:00] in different ways, but that’s pretty much what I’m going to tell you.
[00:28:02]We have to get people to stop ordering big Macs, five days a week before we’re going to see any movement on diabetes and other things that are out there. And that’s. That’s it, it’s hard to say whose role that is, is that healthcare’s role or is that public health role?
[00:28:21] I mean less
[00:28:22] Scott Becker: [00:28:22] sugar or less everything but where does that come down in terms of individual responsibility versus versus th e culture of the country versus how we push [00:28:30] those things and encourage those things. I mean, the one thing I do know is that through the school systems and so forth, we ought to be having physical education and gym class, or we gotta be doing some other things as well.
[00:28:39] It just is it’s too early to give up on people. And it’s a horrible model because we know in the long run this has been written so many times, but you know, as we get older, we believe it’s so much more, that health is the number one asset that you could have. You know we take that for granted in our twenties, thirties, when we’re a kid, you get to be in your mid fifties, you just start to like realize that when [00:29:00] people have said that health is your number one asset health is the most important you could have, health is this, I’ll let you sort of give that all as lip service for a long time, then you get to your mid fifties and you’re like, absolutely health is important as you can have it. It’s actually true. So how do we sort of make that part of the country, what we’re trying to do, but you see our, our politician s don’t talk about that. They don’t, they don’t use their bully pulpit to talk about that. Not in a long time, at least. I mean, I mean, to the credit of, George Bush, Bill Clinton, they were fairly active.
[00:29:26] They tried to show themselves being fairly active. They sort of like [00:29:30] and Bill would have his, his challenges with periodic and like that, but now is famously very, very careful about his diet, but they were at least actively engaged and set that kind of role model.
[00:29:39]You want to talk about health? We all know when people talk about this constantly. He was in a house it’s outside of the hospital health system. But how to change that. When I hear systems all trying to change that it’s a laudable goal, but trying to read how they actually to it are different things and their real impact and very challenging.
[00:29:59] Bill Russell: [00:29:59] All right, [00:30:00] Scott. Well, we’ll, we’ll move through some of these questions a little quicker. Let’s start with where’s the industry move fast and where’s does the industry moves slower than you expect.
[00:30:06]Scott Becker: [00:30:06] Well, I think the industry has moved very, very fast in the acceleration of use of digital tools, digital technology, digital everything in the last year or so. I mean, you, you see, like if you went just a couple of years ago to your portal for a health system, it was very clunky. Very hard to use. You almost had to be on a mainframe to do it or a laptop, not your iPad, not your [00:30:30] phone. And I think in the last year there’s been tremendous progress, obviously. The systems that did the best at it had already invested a lot in it before.
[00:30:37] I mean, Kaiser Permanente, where had everybody else was already doing 56% of their visits virtually before the pandemic Jefferson health had put a ton of effort into this early on the systems Providence, to an extent is similar. The Morphosis had really put time and effort into digital upfront. The more, they were able to accelerate through the pandemic, [00:31:00] but a lot of other systems are catching up and catching up quite well.
[00:31:03] I mean, not perfect, but they’re put, they’re making a ton of progress. The the flip side is. Systems differ broadly in care, navigation, patient navigation, ease of access. I mean you andI think know if you want to see a specialist in our country you could be as connected as you are and it’s still was an effort to figure out how to get to the right specialist. Who’s the right specialist, how to get [00:31:30] that person out, to get on the phone with that person, how to make it work. Even if you have influence and know people, it’s very hard. So you could imagine people that don’t know people and so forth this is still incredibly difficult. And care navigation from the very most elite systems sometimes in the community systems, it’s far better than at the most elite systems. So it’s a digital acceleration digital stuff. The system, the systems are making great, great progress, cure navigation, access in how to access care in the right [00:32:00] way, the right spot, still a real evolving challenge.
[00:32:03] Bill Russell: [00:32:03] So the next question is always a fun one for me. Do new entrants pose, a real threat to the incumbents and established health systems. This is the Amazon, CVS, Walmart, Teladoc, et cetera. Are they a real threat to existing healthcare providers?
[00:32:19]Scott Becker: [00:32:19] Sure sure they are. Sure. I mean, what happens is the existing health systems have some real advantages, depths of care, deaths of tos, death of people, and so [00:32:30] forth. The CVS, Aetnas, the. Optum United, you have some, or those two companies are two of the sixth largest in the country right now by revenues.
[00:32:40] So CVS, Aetna and United Optum are 300 billion a year companies there. They’re literally huge and they have huge amount of resources and magnificent technology. Now, when you have a choice to take your child to CVS, Aetna CVS store, or do you take them to in our neighborhood, North street University health [00:33:00] system or Northwestern?
[00:33:01] Generally, if it’s anything more than a cold or a quick physical you’d have to do for your kids, your aim is still towards Northwestern slash north shore university health system. Just because the depth of staff that the urgent care gives you more confidence. That, whatever it is, it’s gonna be looked at seriously, take care of seriously.
[00:33:18] You take your 18 year old in and very quickly got a Mono, COVID, strep test. You sorta know what’s going on quicker with your kid and you’ve got a doctor that’s there or a PA or a nurse that’s there and you [00:33:30] feel like they’ve been well-trained they know what’s going on. And so it’s of, there’s still, there’s still built-in advantages for the health systems, but you can’t underrate the scale, the assets, the money, the technology that the Amazons, the CVS is the Optum you have. Optum’s obviously full and friend of a ton of health systems. I mean, one of the largest employers of doctors in the country they’re very powerful.
[00:33:51] They’re very good at what they do. CVS Aetna is very good at what they do, but there’s still this difference in depth, in quality that people perceive in their health system [00:34:00] versus CVS. But in the long run, the great strength that these new entrants have is they’re not encumbered by somebody, the real estate and operating cost that the health systems have.
[00:34:13] And this is this in the long run will either be a fatal flaw for health systems, or it’ll be their great advantage because I mean, we saw it during COVID. At the end of the day, we needed these health systems. I mean, we needed them. If you were going to really take care of patients during a pandemic. Mean the [00:34:30] biggest systems, the biggest contributors to take care of it’s recovered 19, where these major, major health systems in terms of actually take care of the people actually take care of people that had COVID-19 and so forth, and you needed enough mass and enough critical scale to take care of them.
[00:34:46] And the whole race, the last 10 years has been to getting rid of beds. And all of a sudden we need a bed. We found, oh my God, we need beds. We can’t get rid of bed. So, so there there’s built-in advantages of the big systems have, they’ve got to have great depth of talent. They’ve got a great [00:35:00] physician talent, nurse talent, clinician talent but there’s also a huge advantage is that at the CVSs, the Optums, the Amazons, the Walmarts. The great issue will be whether these companies put the resources in to make themselves great providers. So for example, Walmart health is baking a monument for, to grow Walmart health and. That will either be great or not great based on how deep they staff and how much you filter in care of [00:35:30] when you go to get taken care of for Walmart health.
[00:35:32] And that remains to be seen, but they have the huge advantage of they don’t have all the bricks and mortar costs that a lot of these health systems have. So we’ll, we’ll see how it plays out, but there’s certainly real interest, real concerns, more and more. When I talk to health system leaders, They’re not talking about the system down the street.
[00:35:49] They’re not talking about the physician, moving out with their cases to an ASC outpatient surgery center. Those are threats. They know those were the known threats. It’s almost like an old Don Rumsfeld thing. Then there’s the known [00:36:00] unknowns, which is, they don’t know how big a threat that the CPS, the Optums, the Amazons, the Walmarts are going to be.
[00:36:05] So it remains to be seen. But no, you can’t not take them seriously. They get such huge resources. Really the sixth. Biggest for the six biggest companies in America by revenues are Walmart, Amazon, CVS, and Optum. I mean, the people don’t understand apples right up there too, but for the six biggest are those companies. And so you can’t not take them seriously.
[00:36:28] Bill Russell: [00:36:28] Yeah. And [00:36:30] I did an interview with Rob DeMichiei former CFO for UPMC and he said, it’s, he goes, they’re not going after the specialty care or the the highly acute care, that kind of stuff. That’s not what they’re going after. They are it is going to be death by a thousand cuts to a lot of health systems, because just like we stood up ambulatory surgery centers and other things.
[00:36:53] They just start taking revenue profitable and imaging centers that just profitable revenue started getting [00:37:00] filtered out of the hospitals. And that’s what we can see the hospitals just over time. That is one of the, I think one of the greatest threats out there, but I’m going to try to be disciplined here as an interviewer instead of going back and forth because here’s a great question for, from again one of our listeners, how much of healthcare will shift to the home and at what pace do you think that’s going to happen?
[00:37:24] Scott Becker: [00:37:24] Yeah. So I don’t know. When we talk about hospital at home the skeptic skeptic in [00:37:30] me thinks of it as just a different new wave of home health. And thinks of it as hospitals are very aggressively trying to reduce their length of stay. And this is another way to really move towards that. That’s the skeptic of me that the optimist in me says. That a patient would much rather be at home for those extra couple of days of length of stay. And if there’s the right technology, the right care, they feel taken care of and they’ve got some help the better off they are.
[00:37:56] So there’s this, there’s this great mix. We certainly talked to [00:38:00] tons of health systems, whether it’s Jefferson, Adventist health in the west coast or others. That view the growth of hospital home is a huge, huge growth opportunity. Adventis talks about they’ve got 25 hospitals, 24 hospitals, they believe their biggest hospital would be their 26 hospital, which they call their hospital at home.
[00:38:19] And the beauty of it is cause you live in the technology world, right? So much of the value in the world, at least in terms of economic value is moved towards [00:38:30] asset light models. So it’s, so the asset heavy models in terms of industry, the stock market getting killed the asset light models, like the Uber’s that your BMPs, where they don’t own all the assets, they just own the technology is where the economic value has been because you’re not holding all these costs. You’re just simply the technology interweaver of all of it. So if hospitals could move themselves to being this technology asset light business where they don’t have these $5 billion campuses, and it’s [00:39:00] not so much the fiber that our cost to build a campus, it’s all the constant operating costs of having that kind of, of, of bricks and mortar and weight that will move hospitals more into this world of being able to spend money on technology and people versus bricks and mortar. So there’s a lot of incentive to do it, to move in that direction. And it, it just depends. Again, it’s like a lot of things. It depends on the health of the patient itself.
[00:39:24] Certainly the more healthy patients would much prefer to be at home [00:39:30] than in the hospital. So if you’re a pneumonia patient, you’re not that sick. You’re going to be at home. If you’re recovering from surgery and you don’t record that much care, you’re going to be at home. Like my father just had a procedure. You could have been in a hospital for two days or five days. He ended up home after two days, but he has support. He’s got my mother watching him and he’s got hospital support as well but, but, so it depends a lot on the health and support systems, so forth as to how far this goes, but it’s something that everybody everybody’s very incented to [00:40:00] it because hospitals are trying to figure out how do they compete against the rest of the world that’s moved towards an asset light model where they’re an asset heavy model.
[00:40:08] Bill Russell: [00:40:08] Yeah. You talked about Adventis. Intermountain also has that that digital hospital concept in place. Mercy in St. Louis as the digital hospital concept in place. Are they positioned ahead of everybody else to be able to provide a higher level of acuity care out of the home do you think?
[00:40:28] Scott Becker: [00:40:28] I think everybody in many [00:40:30] places are trying to figure it out. I don’t know if they’re positioned to have it what they do always is there’s technology tools in their staffing issues too. The beauty of the hospital model is you have all your patients at one place. And your staffing in one place.
[00:40:45] So there’s, there’s actually a beauty of it from a staffing perspective where you’re centralizing care. Now you’re putting out all these different points of care and it depends on how much it could be done technologically versus people going from place to [00:41:00] place. I mean, what I’ve heard from some systems is what’s causing them to slow down on doing this is they still can’t staff it, how they need to staff it. Aside from getting patients comfortable with that, which more and more patients are comfortable with because patients would like to the spiel being considered depending on their own health, be cared for at home than in the hospital. But staffing issues are real, real challenge.
[00:41:22]Bill Russell: [00:41:22] You’ve interviewed a lot of people over the years. You’ve been with successful CIO, CEOs and whatnot. What do highly [00:41:30] successful CIO, CEOs do that, that others may not do obviously without naming names. So what do they do? What aspects of the things they either choose to do or don’t choose to do, make them successful?
[00:41:42] Scott Becker: [00:41:42] Well, I think, I think you tipped one thing right there. They’re very good at prioritizing. They’re very, very good at team-building and building teams and relationships. And they have to be technically good enough. They have to have proved yourself somehow or another in a system, but ultimately they’ve got to be very, very good at like [00:42:00] at, at the sort of like getting the most out of their people, like well being well liked.
[00:42:06] So I always look at this mix of skills of. Right, discipline driven and personal skills and great personal skills, great team building skills. There’s also a complexity to the world that that many of us are not capable of. I’m not capable of it. For example, there’s a big difference between running a team with 70 people than running a team with 3,500 people or 50,000 people that there’s an ability to [00:42:30] manage that kind of complexity that some people are capable of, and some people are not, I don’t view myself as personally capable of that. Others are very good at it. They see it well, they build teams well, they’re able to manage all these different thoughts at one time and able to manage priorities. And I think the other part of all this is there’s an emotional maturity and emotional intelligence that comes with leadership that is absolutely critical to be able to be very good at this. To be a very good as a leader, a CIO, a CEO, whatever it might be there, there’s an [00:43:00] emotional center ness. There there’s times where some of us could be too impulsive. It could be too excitable. It could be two different things, and those could be very good qualities.
[00:43:10] But, but there has to be a centerness to leadership as well. So there’s a number of different skillsets that seem to go with it. And I think probably tying a lot of that together is there’s a consistency of leadership. People have to know what they’re getting every day and sort of what you’ve seen this.
[00:43:26] We’ve seen this with fascinating role models. We’ve seen [00:43:30] fascinating leaders or magnificent leaders that can’t help themselves, but be change agents and change jobs every five to seven years. Then you see other magnificent CEOs that have been at the same place for a long time and just magnificent leaders and a steady hand Nancy agent at Carilion clinic has now been there for some time, sort of a magnificent, steady leader and very supportive or nurturing very much a leader of people, not just, not just excitement in the flavor of the day, but a serious leader for a serious period of time. And there’s a consistency and a [00:44:00] caring and a straightforwardness that come with being a great leader.
[00:44:03] Bill Russell: [00:44:03] Yeah. I remember having a conversation with Rod Hochman and, and I sort of joked with him. I’m like, man, you, you kicked into talking points there. And he said, Bill, he said, I’m going to have to deliver that message about 200 times in the next three months.
[00:44:18] He goes, if I vary in the way I say it or miss something or whatever, that may be the only time that that person hears that message from me and they will have half the message or they won’t have all the message. So they [00:44:30] understand the importance of communication of discipline and the message. And they’re, they understand that words are such a powerful thing as a leader, in terms of rallying people, get them excited about the mission. It’s. I think you’re right. There’s so many, so many things about, about being that leader of 30,000 people that is so different than leading a department.
[00:44:54]Scott Becker: [00:44:54] That’s right. Yeah. And Rod Hochman is a fascinating example. I mean, here’s the guy he’s been a consistently magnificent leader, an innovative [00:45:00] leader but with the message of Providence St. Joe’s throughout the system is one of compassion. Compassion, and excellence. And they’ve done a great job of both delivering on that and building that reputation that they care.
[00:45:12] And Rod is a magnificent firestarter for both being an innovator. And someone who cares and that’s got to come across, it’s gotta be true. It’s gotta be genuine, which I believe it is. And that’s gotta be consistent and constantly the message that sent in the Wednesday approaching you see some of the great faith based systems.
[00:45:30] [00:45:30] Commonspirit is right up at the top of this in terms of being viewed as sort of, we wanted to great care and we care and we actually care. We’re compassionate about what we do. We care about our people. We care about the people that we serve. Yeah, we want to be great at it too. I mean, it’s, it’s a fascinating mix of things and you just see it differently and fate in certain faith based systems than others, and you see the, the race to ex-post plus compassion and Rod Hochman is a great example of that.
[00:45:55] Bill Russell: [00:45:55] So Scott you’re doing a bunch of speaking. I saw that you were going to be speaking on digital health. The [00:46:00] money is just pouring into health tech, digital health at this point. I part of me wants you to put a crystal ball and sort of tell us what areas do you expect technology to have the greatest impact within healthcare over the next couple of years?
[00:46:17] Scott Becker: [00:46:17] So it is very, very hard for me to tell. I get the chance through what I do to talk to both lots of healthcare IT entrepreneurs [00:46:30] plus people that have founded them in others. And the reality is I’d be lying to say, I have a crystal ball. I’d say that many times it is dizzying to me, the pace and trying to figure out what’s going to work and what’s not going to work.
[00:46:43] And so I don’t have great clarity on it. What I do see is this, I sort of look at companies and divide them into five phases. There’s the idea, which in some ways is meaningless because everybody’s got an idea and I don’t mean that [00:47:00] to be negative because in reality, big ideas make a big difference, but there’s an idea.
[00:47:05] And then there’s somebody actually taking the idea to product actually works actually a product it’s actually a software service, such a technology that could be used. And that’s sort of a big, giant step. It’s a big funnel from idea. To get into the spot of actually having a product, then there’s actually having revenues. Can you actually turn it into revenue? Somebody actually want to buy it. Somebody just want to use your product. Is there really a need for, to somebody who would really want to use it? Then we look at next, is there [00:47:30] profits in it? Could they actually turn into profits? And then, then the big, big challenge and the big differentiator between so many of these companies is, is something it could be scaled or not. And how are they going to scale it? That’s a big unknown for a lot of these. So, so we, you could place bets on this alongside other very knowledgeable investors, but it’s, it’s very hard to tell. And so we’ll money keep on pouring the digital health and digital technology to it.
[00:47:58] Absolutely. It’s [00:48:00] asset light. It’s viewed as the gold mine, some of these things will pop become used by every system. Others won’t. But it’s absolutely, money is going to keep pouring into it. When you talk to people, the digital health world it, everybody’s raising funds and digital health, everybody in their brothers, raising funds with digital health.
[00:48:17] And if you ask somebody and I never know this as an investor, never know this, they’ll say, I always think it’s the ninth inning. And somebody will tell me no, it’s a second. And there’s a huge amount of opportunity, [00:48:30] and I never know if I knew I’d be far, far wealthier than I am, but I never know.
[00:48:35] And I’m very very, nervous by nature. Just my nature as an investor and as a person. But tell, I’ll tell you, when you talk to them, now we’re in the second or third meeting this is just going to explode. And so where to go. And that may be very well be the case, but in terms of deciding, is it going to be in predictive analytics?
[00:48:49] Is it going to be in a different type of EMR? That’s cloud-based that’s sort of a takes away the sort of entrenched newness of Epic and Cerner and so forth. I don’t [00:49:00] know. Or is it all easy answers that are software as a service? This could be so deep and embedded in these things. That that’s going to be used by so many that it’s going to be a winner.
[00:49:10] I don’t know. There’s just an explosion of you, and I know, like if you look at podcasting, at one point there were three podcasts. Now there’s a thousand new podcasts today. If you look at digital technology, the people that have a much better sense of it, I’ve talked to venture capital investors very often as part of our private [00:49:30] equity podcast.
[00:49:31] And it’s fascinating to me. So to sort of see the ecosystem, that’s built, built around all these things and obviously seven wire ventures. Yeah hugely successful. They were one of the funders of Lavango and Glen Tulman. And we Shapiro out speaking a decent amount and brilliant, brilliant people and they they just raised another fund they’ve, they’ve publicized it.
[00:49:50] They just raised another fund and everybody hopes it’s an invest in that fund. And I’m not that they’ll have the next Lavango in that fund, but who knows? So I don’t know. I mean [00:50:00] but for COVID telehealth, Teladoc, all these things was taking off and doing great. But it was the last year was steroids for the match those things that made it made Sammy Sosa, mark, McGuire’s out of a lot of those things just because also there’s this huge need for towels in a way that there wasn’t before.
[00:50:20] So I, I don’t know what any, Morgan’s very hard for me to protect. I’m not good at predicting yet, but there will surely be certainly lots of lots more winners.
[00:50:30] [00:50:30] Bill Russell: [00:50:30] Yeah, absolutely. Are you a Cubs fan?
[00:50:32]Scott Becker: [00:50:32] I’m more of Cubs fan than I’m a white Sox fan but I like both, but I grew up more as a Cubs fan. I knew I’m not an anti Sox person, but I knew that I was not a deep dyed in the wool Sox fan, even though my grandfather was when the Sox won the world series in 2005, 2006, it didn’t really register me. Remember where I was. I wasn’t that excited. Whereas when the Cubs won and I was at the game and was, and was quite excited so right. I liked the socks. I’ve always liked the [00:51:00] socks. Well, I’m more rof a Cubs fan.
[00:51:02] Bill Russell: [00:51:02] Well, I am a, I’m a Cardinals fan. So let, let’s try to remain friends. I think you just took the lead. I think you’re a half game up. Maybe even, maybe even a full, full gameup.
[00:51:11] Scott Becker: [00:51:11] No, my brother-in-law is a Cardinals fan and is good as pertinent is as they come. So we, we we can be friends and love Cardinals fans as well.
[00:51:19] Bill Russell: [00:51:19] Well, you would laugh. I moved to Naples, Florida. I have a Cardinal slag little flag out in the front of our house. And I have a neighbor right across the street who has Cubs flag and a neighbor, two houses down [00:51:30] that has a Cubs flag in front of their house. So maple seems to attract people from from Chicago and in the Midwest. So I’ve actually bought some extra Cardiunals flags. I’m going to steal their Cubs flags and put Cardinals flags.
[00:51:43] After I get to know them a little better. Before I start doing that kind of stuff. Hey, Hey Scott. Thanks. Thanks for so many things. Thanks for your contributions to the industry. Really appreciate it. And thanks for coming on the show. It’s always great to have this conversation. I look forward to catching up with you, hopefully in person next time. That [00:52:00] would be, that’d be fantastic.
[00:52:01]Scott Becker: [00:52:01] We hope so we don’t think we’re very far away from in-person meetings yet. Bill, you’ve built a dynamic reputation industry for a very long time, just magnificent. So what a great pleasure to get to visit with you today. And thank you very much. Hopefully I didn’t offend anybody or embarrass myself, but a pleasure to visit with you. Thank you so much.
[00:52:16] Bill Russell: [00:52:16] Thank you. What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to [00:52:30] this show. It’s conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. [00:53:00] Thanks for listening. That’s all for now.