In the eleventh podcast in this series with general counsel on the front lines of the coronavirus pandemic, Sarah Swank, Counsel, Nixon Peabody LLP, speaks with Steve Bender, Chief Legal Officer, Geisinger, and Mark Gloade, Senior Vice President and Deputy General Counsel, Northwell Health, about how the pandemic has affected their jobs and lives. The speakers examine how their work forces have adapted to the changes that have occurred since the pandemic’s onset in March 2020 and the challenges of remote working. They also discuss what they hope the next few months will bring for themselves and their organizations, including longer term trends like the increased role of telehealth, payment reform, and mental health issues. From AHLA's In-House Counsel Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
In the eleventh podcast in this series with general counsel on the front lines of the coronavirus pandemic, Sarah Swank, Counsel, Nixon Peabody LLP, speaks with Steve Bender, Chief Legal Officer, Geisinger, and Mark Gloade, Senior Vice President and Deputy General Counsel, Northwell Health, about how the pandemic has affected their jobs and lives. The speakers examine how their work forces have adapted to the changes that have occurred since the pandemic’s onset in March 2020 and the challenges of remote working. They also discuss what they hope the next few months will bring for themselves and their organizations, including longer term trends like the increased role of telehealth, payment reform, and mental health issues. From AHLA's In-House Counsel Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
Hello everybody and welcome to the A H L A General Counsel Roundtable. I'm so excited today to have two wonderful guests. I'm Sarah Swink from the law firm of Nixon Peabody in the Washington DC office. So, uh, Steve, why don't you introduce yourself to the audience?
Speaker 2:Sure, thanks Sarah. Uh, I'm Steve Bender. I consider myself just a simple country lawyer. Uh, I'm the Chief Legal Officer for, uh, Geisinger. Geisinger is a regional integrated delivery system based in central Pennsylvania and Northeastern Pennsylvania. Thanks for having me.
Speaker 1:Thanks Steve. And Mark, another simple country lawyer from Long Island
Speaker 3:<laugh>. Well, not, not so simple country lawyer. I consider myself an island boy by, um, background. But, um, I work for, um, Northwell Health, which is the largest, um, private employer in New York State. Um, we have, um, something like, you know, I, I keep losing track because frankly we, we seem to gain a couple every year, but, um, we have 21 hospitals and a few hundred, um, facilities, ambulatory facilities scattered over the five boroughs, Westchester County. Um, and, uh, it's been a terrific honor, uh, to work for this organization and terrific honor, frankly, to be here talking with y'all today.
Speaker 1:Great. Uh, I'm so, um, excited to have both of you. I think you're gonna give us a, a real breath of what's, uh, happened in Covid, what's happening in-house at your organizations, and what it's been like to be an attorney during, uh, these times, or even just a person during these times. Um, so Mark, let's start with you cuz you, because of the position, the geographical position of, of the hospitals that you serve and the communities that you serve, you had an interesting vantage point to, to the ro, to Covid. Um, we're, you know, we're coming up on a year to the lockdown in most states, and, and so, and a lot of the, the changes that we saw in our lives, um, well, reflecting on this time, what are some of the, what, what are some of the things that you saw and, and now looking back over this, over this year?
Speaker 3:Yeah, I think, um, the thing that stands out most obviously for me is just the sheer, um, I, I don't know if it's the right word, you know, if you can sort of attribute this sort of, uh, you know, uh, condition to a virus, but the, the sheer brutality, frankly, of what the virus bought to New York was for me, amazing. I think many people, um, across the country probably experienced something similar, but just sort of having people's lives upended so suddenly, so swiftly, and for many people completely, um, you know, forever, um, irrevocably, um, you know, because people were dying, people that you knew were dying. We lost a couple of our dear friends, people who represented us, um, counsel, trusted counsel as a result of the disease in the early days. And, you know, obviously because of that, these were people we trusted. We were, I would dare say we were friends. Um, and, you know, we're never going to have the opportunity to see those people again. So, from my perspective, that was frankly the most, um, impactful thing of dealing with Covid. And as, as you know, Sarah, we were, you know, as I say, the center of the center early on in, in, um, the Covid crisis. And it, it was brutal. It was absolutely brutal. And I think that's probably the best way that I can describe it.
Speaker 1:So, Steve, you, um, so you were in Washington DC before you switched jobs, and so you have an interesting vantage point because you were in, you know, the metro DC area, um, and watching that unfold, and then now you're in a, you know, you're in a different, um, organization from your vantage point. Um, what does that, what did that look like for you? Um, you know, there, there, it wasn't the same obviously as Mark at the center of the center, um, but, but what did you see and what were some things that you've been reflecting on over this year?
Speaker 2:Yeah, it's been, it's been interesting, um, very troubling to say the least. So yeah, starting the year, uh, I was the general counsel at, uh, George Washington, uh, university's medical faculty associates. And so we were, you know, watching this unfold in, uh, in early March and, and, and really beginning the, the preparation process. Um, and then at, at some point, you know, shortly after that, I accepted the position, uh, to join Geisinger and started, uh, July 1st. And so to go from an urban setting where your positivity rate was really kind of off the chart to, uh, a rather, uh, rural community where it, it seemed far more manageable, um, was, was very interesting. And, and I share, you know, Mark's sentiments about, you know, just, just the, the entire odyssey that we've all kind of gone through, whether it's personal or professional, uh, it's been, it's certainly been a challenge joining a new organization in the, the middle of a pandemic. It, I, I've never had to, uh, you know, really take on a challenge like that. And, and, you know, we all have our own kind of, you know, bag of tricks, if you will, but<laugh>, none of us have that one. Yeah. And, and so just getting to know people and getting to learn a new organization, uh, while masked is, uh, is, is, is still challenging. So, uh, i, I, my hope is that none of us ever have, uh, any anything even remotely similar to the, this past year.
Speaker 1:Yeah. Mark, I mean, it's one of the things when you, when you and I have chatted, it's like those hallway discussions and those other kinds of conversations and ways that you can be effective, you know, as an in-house attorney and a, and a leader in your organization, like, as, as Steve said, those kind of tools, those aren't there in the same way. Mm-hmm.<affirmative>, um, at all. I mean, it's not like you can have somebody come into your office even, um, you know, unasked and sit and have a chat off the, you know, in between meetings. Uh, how have you, how have you and your organization adapted, uh, to those changes?
Speaker 3:You know, it, it was interesting because, uh, I, I think sort of the point about, um, not we, we manage in a particular way or we, uh, work in a particular way. I think we have a really, um, terrifically integrated and, um, collegial group in our office of legal affairs. And it was always, um, the, the approach, the general approach was basically open doors, um, bounce ideas. Um, I, I have, um, I, I tell people all the time, and I sincerely mean it, um, you know, there's no such thing as a stupid question. Um, living in living in ignorance is the only stupid thing. So come in, ask the question, let's have a discussion. And that to me was a really, um, significant value of, um, you know, our office of legal affairs. Um, obviously with the pandemic, all that went away very, very quickly because we just didn't have what I would call the incidental contact to sort of bounce ideas off each other and, and just have a discussion and ask about, you know, each other's kids or our families and that sort of thing. So that was, was clearly something that, that was missing and that I missed personally. Um, but I think the wonderful thing about what we did was we had always prepared, um, frankly, to work remotely because, um, living in the Northeast, as many people know, you never know when you're going to be, um, suffering under some significant amount of snow. Snowmageddon, I think was the expression, right? Right. Um, and have, and having to, um, have your people work remotely and figure out ways to get nurses to hospitals and all that good stuff. So from a, a, a, a legal affairs department perspective, what we had in place was a plan, um, that frankly we immediately leveraged to basically get everyone out of the office, get them working remotely. And I have to say, it was almost not completely, um, given sort of, you know, the different, um, capabilities of people's networks at home and that sort of thing, but it was almost seamless. And so we pivoted very quickly to get everybody out of the office, getting them working up and running and working remotely. And just having thought about it from sort of a snow perspective really helped us when we had to do it for, for the pandemic.
Speaker 1:I laugh because my kids are in person, and so, and some people say there's no such thing as a snow day anymore, but I still have them<laugh>. Um, so, uh, so Steve, um, you, um, you know, here's Mark talking about, you know, they made a plan, they pivoted, they, and it, and it worked. You walked into the middle of the plan right? In July, right?
Speaker 2:Of this
Speaker 1:Year. So what, what was that like?
Speaker 2:Uh, you know, so the, basically the, uh, the pie had been half baked at that point. So, you know, I didn't wanna be, you know, I'm the new guy. I didn't wanna be that disruptive. So we, we had actually made the decision to, uh, move everyone to a work from home status that was going to be permanent. Uh, and, and so we're, we're still working our way through that process. But, uh, I guess that's the question I have for Mark. Are are you guys planning on coming back?
Speaker 3:Not if I have anything to say about it.<laugh> Okay. I'm kidding. I'm kidding. I'm kidding. No, I, I actually, um, I have to say I am one of the, um, you know, Luddites in the organization because I frankly hate working from home. I don't like it. Um, I think I like to keep a bit of a, um, disconnect between my home life and my work life, even if it means I stay in the office until 10, 11 o'clock at night. I just want to be able to go home, get in bed, have dinner, and talk to my kids. You know, I, I find it very difficult, frankly. I did the at home thing for the first few months of the pandemic. Um, and what I found was it was just, uh, frankly, around the clock completely in, uh, um, just an interminable day, just never ended. And, you know, I thought, frankly, that my kids suffered from it a little bit. I know my wife certainly suffered from it a little bit<laugh>. Um, so I'm those people. I actually like getting out of the house, coming to work, giving my wife, my kids, their space. I have my space, and that, that works really well for me. There are other people in my department, obviously who prefer, um, working from home. But, you know, I, I would, I look forward and I'm
Speaker 2:Going to, yeah, no, I, I, I hear you. I, I completely agree. You know, it, we loses the Deming line, right? It, it's like when you're working from home, it, it just work, just kind of leeches into every other facet of what you're doing. Everything. It's really hard to manage. Yeah.
Speaker 1:Well, it's, it's laugh. I laugh because people are like missing their commutes. Like, think about that for a second.
Speaker 2:<laugh>. No, it's, it's like decompression time. Yep. Yeah.
Speaker 1:Um, I'm, I'm also laughing because I, um, I'm at home and my kids go to the office. They go to school. They're actually lucky enough to be an in-person school. And so I'm at home and they go to the office. But when they go to the office, they're school, um, they're six, uh, it's actually nice. And then they were just home. And I have to laugh, I had another one of those bad zoom things, but it luckily, it actually worked out where I'm like having not a difficult conversation with a client, but we're talking about rolling out something and I'll have to send this to him cuz he'll laugh. And I'm like sitting there and we're having like this conversation, we're waiting for someone else to come. And, and, um, both my twins walk in cuz my son had lost another tooth and he just had to show me it. And he's walking in with this bloody tooth and his mouth. Oh. And I just said, you know, I mean the good thing that comes out of the working from home is that maybe we're all a little bit more human. Like, cuz I, there's nothing I could do. Like, it was just, it was what it was. Like they never do that. I, I think I've told every time on this of podcasts every time they have. So it really hasn't been that many. But, but there like, at least there, you know, this, there's this theme of like, well, maybe we'll be a little bit nicer to each other. Right. Maybe this working at home, something positive that comes out of it is like that we are humans, that we have a home. Like we, it's not so separated that we're not, it's not part of who we are. I don't know. What do you think about that?
Speaker 2:Um, yeah, it, it it's an inter you know, for, for having little kids I think is, is certainly, um, an interesting dynamic unto itself. Having older kids is a complete game changer because my wife and I thought we thought we were empty nesters and, and all of a sudden, you know, we, we, we, we were like in a certain chapter in life and now we're, we're overflow nesters. So, you know, we, you should not have your adult children back home. Like, you know, it was great to have them around the dinner table. It was sort of, initially it was like, wow, what a, what a bonus. And then after a while you're like, wait, this isn't supposed to be happen this way. So we we're, we're still reeling from that. Um, but there's, I think, hope on the horizon. And I, my daughter has gone back to college and, and my son will soon be moving back out and resuming his, uh, his job in New York City. So, uh, I think there will be some degree of, uh, of, of a returned normalcy at least. I hope so.
Speaker 3:Your fingers crossed. I look forward to it. I, I, I need, I I, I tell folks this all the time. I, I I, I'm like a pig and slop, some people will recognize, um, who listen to this exactly what that means. But if you've ever seen a pig, they seem to root around in their little world and, um, love it. I need to come to my slop in the office. So I look forward to normal
Speaker 1:<laugh>. I knew that something wasn't, I knew there was something that wasn't right when I went to the dentist, and that was like the first time I'd had like an in-depth conversation with somebody that like, wasn't in my house or on a zoom call<laugh>, like, and I was like, happy afterwards. I was like, what's wrong with me?
Speaker 2:<laugh> the dentist. The dentist is like, ma'am, it's, it's your appointment's over. It's time to go<laugh>.
Speaker 1:It's ok. Exactly. Like, wait, this is not like, it's okay. Like, you'll be okay. But, um, but yeah, just that, those types of things that you don't, you don't even notice that you're just going throughout, you know, we, we kind of adapt, you know, we, it's at some point everyone was like, oh no, we can't all be at home. And then we adapted to that and then it was like, oh no, we can't. Like, oh my gosh.
Speaker 2:But don't you also think that, but I, I feel like Friday has lost its meaning to me at least. Oh yeah. So Friday, there's no difference between my Friday and my Saturday or my Sunday. You know, I'm, I'm still, you, you wind up working cuz you're not socialized. So you're, you're, you're really just kind of doing the same thing seven days a week,
Speaker 3:Steve. Yes. You know what we call Friday now,
Speaker 2:What's that?
Speaker 3:Two more workdays till Monday
Speaker 2:<laugh>. Exactly. Right. So, you know, here I will say one of the best things that's happened is my, my email inbox is totally manageable because I'm working way into the night Yep. And on weekends.
Speaker 3:Yep.
Speaker 1:Let's not keep that. Maybe that's not what we want going<laugh>. I don't know. We'll have to think about that. I don't. So so thinking about the future, you know, um, we're, I mean, I can't believe it's March. I mean, this is, this is amazing. It's March 5th, um, and we're headed kind of into the springtime. We were at, you know, at one point we were talking about flu and would there be flu and what was gonna happen? And now we have the, the vaccine rolling out and we're heading into spraying, you know, what are you, I mean, I keep like you have a crystal ball, but what are you thinking the next like three, six months are looking like, like how are you, what personally your, your organization, what are you thinking about? I'll start with you, Steve.
Speaker 2:Well, you know, on a personal note, I think we're all waiting for, um, what I have heard people refer to as the revenge travel, uh, to occur where people are just gonna be traveling for the sake of traveling because they couldn't before. Um, but, you know, it, it really is largely contingent upon the rollout of the vaccines and, and, and getting closer and closer to herd immunity hopefully. But work-wise, you know, we had an interesting conversation the other day, um, about when we would have our, our next in-person board meeting, and we started to plan around it to see how we could pull it off, making sure that we were able to distance each other, uh, and, and, and have a large enough room where we could all meet, making it, of course, voluntary. Uh, so no one felt compelled to, uh, to show up. But that was really one of the first times that I, I started to think down those lines. And again, having recently joined the organization, I only know, uh, my board through Zoom, uh, or whatever video conferencing service we're using. And the same goes from my team. So I'm really looking forward to connecting with everyone in person, uh, where, where we get to interact, uh, in the same room.
Speaker 1:How about you, mark?
Speaker 3:Yeah. Um, I share sort of, uh, the same hope, um, that we can actually, again, I, I need to be around people<laugh>. Um, it's just, just that important to me. And so I really look forward to, um, you know, getting, getting that, uh, everyone who will listen, anyone who will listen, I tell them, get the vaccine. A friend of mine called me this morning, um, because he was somewhat reluctant to take the vaccine and my, uh, uh, I just said, what are you crazy? Get the vaccine because I have an interest here. It's not just about you, it's also about me. You need to get to herd immunity, so get the vaccine. So I really look forward to that. Um, and, and hopefully to a return, um, to a little bit of normalcy to get on that travel crush that everyone anticipates happening. I will never complain about a crowded airport or a crowded aircraft ever again, I promise. Um, yeah. So that's what I personally, uh, look forward to from an organizational perspective. We continue to meet literally every day as an organization, um, in terms of from a senior leadership level, um, to continue to track what's happening with the virus. I know some folks have expressed, some people in our infection control group have expressed some concern about, um, a plateau, if you will, in terms of the, what we've been seeing as a trending down in terms of the number of cases. Um, so that's a little bit of a concern for them. Um, but right now the news is generally good, and I think we're also planning at some point, um, in the next three or six months to see what we can do about, um, start, you know, starting to get some folks back to work. What one of the things that Steve mentioned earlier about, um, some of this, um, transitioning to a permanent model, um, our folks frankly are also looking at that because, you know, the, the cost savings potentially in just in terms of real estate right, is something that our, the, you know, my penny pinching friends in finance are watching like hawks. So that, that may be something that happens, but, um, from my perspective, I look forward to getting back to work. And I think as an organization, um, most folks are actually looking forward to getting back to work.
Speaker 2:Yeah, I think that's a good point. You know, we are going through that now. Uh, one of the initial expenses though is making sure that everyone has the, the technology they need to work from home as well as even just the furniture they need to work from home. Yeah. Uh, not, not, not excluding, uh, good, good bandwidth and good connectivity. Yep. Um, so there are costs associated with that, but once you get through them, uh, I think it should yield a, a, a net savings. Um, but what you lose then is, is that hallway conversation and, and, and the, the connectedness that you had before. And, and that's been a, a grave concern for me. And, and I, you know, we all know, uh, people tend to forum shop, and, and, and the, the best way to deal with that as, as attorneys is to make sure that your internal communication is as, as tight as it can be. And, and so what I've encouraged my team to do, we use teams, uh, and, and instead of, uh, emailing people or, or even texting, uh, have a video call with'em, you know, in, in, in place of the hallway conversation just to make sure that we're tightly aligned and, and, you know, we can make sure that the communication, the interdepartmental communication is as tight as it can be.
Speaker 3:Yeah, absolutely.
Speaker 1:That's a really good point, Steve, because yeah, they might, you don't, you wanna talk with one voice, um, and it, if the voices are all spread out, you wanna make sure that you're still talking with one voice in the department. Yeah. So, um, so one of the things I, I wa I'm, I'm laughing cuz the, the laptop thing, I had a laptop where, um, I must have been working too much because I burnt out the letters. Oh. Like, you need to look at your keyboard right now. Okay. L and the period from time to time. And so I was like, I was like, I, I had, I ended up, you know, getting a new laptop shipped to me, but there was a time period where I didn't have one, and I was like, do I just then write all my sentences with question mark and exclamation points,<laugh> if the period doesn't work, and is that actually a good lawyer move? It might actually be a good lawyer move. Um,<laugh>, I'm not sure. Like maybe they'll listen more if you have question marks and exclamation points. Um, but, um, so another thing I've been thinking about is, is I'm trying, I am the half a half class, um, uh, not empty person, a half class full person, which is, which is the innovation. Like what, uh, and like the idea that we did, like Mark, you talked about the suffering that people have gone through and it's real, um, at all levels of, of kind of, the country has gone through a trauma and the world's gone through a trauma. And so what can we get out of this timeframe, right? Like, what can we, well, and, and some of it's, you know, everything from like the fact that, you know, the, the vaccine went through, um, you know, the FDA process and like a from like identification to, um, starting to roll out in like in a year or the fact we're looking at telehealth or other modes of, um, you know, other modes of ways to care for people or we're looking at health equity. I mean, I would just, even the other day I was talking to somebody and it, I don't know, I said something and it just felt like so obvious, but this is what, what we were not doing before, which was, you know, we make people drive to the office to get their blood pressure checked, but then like their blood pressure goes up driving to the office and waiting in the office to get their blood pressure checked. And then we put them back in the car to put the blood pressure back up. And that was like a efficient business where you could, there could be a way to not do that. And there, and we're, we're looking at that. But here, here's something that just seems so obvious now to, to all of us, but, or maybe not hope, maybe I just threw that out there and people can think about it. But, but, but you know, these, these idea of innovations like that, that we, we kind of shook things up and we knew some of the problems, but maybe it something positive will come out of it. Mark, what do you think about that and what are some things you see your organization doing?
Speaker 3:Yeah. You know, that's a really interesting question and what, you know, as much as we, um, want to return to normal, um, I think it's, it's an excellent, excellent opportunity to sort of not return to normal. What do I mean by that? Um, we've done so many things, um, in the name of responding to a crisis. Um, and the question always is, um, you know, for any, you know, any Star Wars fans out there is whether the empire strikes back, right? Um, whether you get to a point where, um, people because they are accustomed to doing things a particular way, um, sort of revert to a normal, um, so normal isn't necessarily all good. Um, and, and given what we've done from an innovation perspective with respect to the, the vaccine development, the approval process, the, the almost borderline stunning and virtually obscene expansion of tele telehealth, um, you know, do we want to return to normal or, um, you know, and does the empire strike back? Does the empire say, well, you know, under the Social Security Act, yada, yada, yada, therefore you can't do this. Or do we push our leaders and our representatives to say, no, this is something that worked really well, here are the things that didn't work well, let's try to fix those things, but why are we going back to quote unquote normal? So I think that is the one significant opportunity I think that came out of this crisis is that, you know, it's, it's one of the, you know, necessity as the mother of invention, we did a lot by way of, of moving, um, many, many things that we've been talking about for many, many years forward during the course of this crisis. And it's always going to be how committed are we, frankly, to pushing that further now that we've had the very real experience of dealing with it in the course of a crisis. So that to me is the really big question.
Speaker 1:Great.
Speaker 2:Well, yeah, if you, I think if you believe the axiom that necessity is the mother, or maybe it should be father of invention either way, mother or father, the parent of
Speaker 1:Event, I'm gonna say, I'm gonna say parrot. Let's say
Speaker 2:<laugh>. I didn't wanna offend the fathers, just, you know, um, but, um, it, it could also be of the careful of what you wish for scenario, right? Mm-hmm.<affirmative>, um, because we all work in a space where we tend to see, or the, the, the worrisome side of, of, of the initiatives that we embark upon. And, and right away when we start thinking about telehealth, we're all gonna jump to privacy. Mm-hmm.<affirmative> and, and, and, and, and in those concerns. And it's great that from a regulatory perspective, they have relaxed some of the standards in terms of state law, licensing, et cetera. Mm-hmm.<affirmative>. But the reality is there are gonna need to be some controls and we don't really see them, uh, in, in place at the moment. The other concern, I I, I, you know, focus on, uh, the, the, the mental health challenges in terms of delivery of care and services that we have throughout the country. And I see telehealth as being a great opportunity to kind of bend that curve. But again, you're now you're talking about even heightened privacy concerns, right? So, uh, you know, I know that we're, we're all challenged with, with those in initiatives. I don't necessarily have all the answers, but I think we have to be thoughtful in the way that we approach it. Great.
Speaker 1:And just, just the idea that, that the new stark exceptions and a na kickback safe harbor around cybersecurity was included purposely, I think. Mm-hmm.<affirmative> says a lot, doesn't it? Um mm-hmm. Oh yeah. About where, where the government is, where the government's concerned enough that they're, they would be okay with an arrangement that's not the 1585 split of a eh H R. Right? Right. That they are really like, worried about it. Um, uh, it's interesting cuz I, I, I just, you know, you reflect on healthcare again and like think how dependent is healthcare on transportation, right? And, and as a barrier to access. And I, I remember when the, uh, the OIG advisory opinion started coming out around transportation. I also remember being in-house before they were there and seeing the transportation issues even in a, an urban area or a rural area. I mean, it's just, it's, they can be barriers. Um, you know, just think about people leaving the ER and they just have no way to get anywhere. It doesn't even matter if like,
Speaker 2:Or just even getting your vaccine if, I mean, getting, getting to a, a vaccination location.
Speaker 3:Absolutely. Absolutely. That, that is sort of a, that, that is the example that I was going to bring up because if it's not really apparent in the context of how the vaccine is rolled out, um, and you know, sort of the drive up locations and the implications of that for people who don't have that, that capability, you know, uh, it, it's been an issue in healthcare for so long and we're just seeing it sort of, you know, completely large in the context of this vaccine rollout.
Speaker 1:Yeah. I hope, I mean, I, I hope that it, it, like I said, these examples of it's a health inequity. Like you shouldn't have to be able to, you know, have that not, you were saying like the haves and the have nots in transportation or just our own infrastructure in the United States. Like it might, you can't always get here from there. They would say, like in some cities it's like the last mile, like there is public transportation, for example, but you have to walk a mile on both sides of it. Yeah. Like, and that's not reasonable for a, a lot of people. Yeah. Um, the other thing I was, um, thinking about, uh, as well, I guess it's, um, is, is this idea of, um, population health and payment reform and, you know, our, and, and how this pandemic will look at that. You know, at some point we had, you know, ACOs and we still have them out there. We had this transformation that was happening and it seemed to like, I don't not say slow down, but there was clearly like the idea of these, uh, the government looking at the sprint rules, which is where that cybersecurity exception in safe harbor come from. This idea of care coordination and making sure people don't fall through the cracks in our healthcare care system. But now here we set, and we do have these lessons. A lot of us knew what we knew these, what these issues were. It's just, they're so highlighted by this pandemic. Do you, what do you think about the future of those types of initiatives? Um, like where we sit right now on March 5th? I don't, you don't have to go into too far in the future, but, um, on March 5th, where do you think we are now? How about Steve, what do you think?
Speaker 2:Yeah, I can, you know, give the Geisinger perspective, which is, you know, this is sort of our strength. Uh, I, I, I'm so, so proud to join an organization that they, they really placed this at the, at the top of the totem pole. And we have this initiative of making better health easier. And, and maybe that's one of the, the hallmarks, uh, o of an integrated delivery system because we really have the ability to, to shift to a, a, a value-based kind of a protocol. And we've had a lot of success in, in, in making sure that people have access to high quality care and that it's not, we're, we're not focused on volume. We're, we're focused on value. And, and so for us, uh, we see nothing but opportunity in front of us and, and, and grow and grow. And our growth strategy is sort of aligned with that. Um, so that, that shift from leaving DC and, and coming to, uh, to Geisinger has been just an eye-opening experience for me.
Speaker 1:How about you, mark?
Speaker 3:Yeah. If you, um, I think as an organization, we are absolutely cognizant. I don't think I've been in a meeting in the last year with our C E O or our C O O where this, um, issue has not been, um, a center, uh, a central focus of one part or another of the discussion. And I think, you know, to be perfectly honest with you, in the interest of full disclosure, I think everybody recognizes that here in, in the Northeast, um, at least in the New York City area, there's still too much of the sort of old FIFA service model that, um, that that fo that we rely upon, frankly. And I think there is a recognition that healthcare has to, uh, a stress has to move in a different direction so that we can frankly, um, you know, at the end of the day, what we're in this business for, improve people's lives without frankly, um, making it so cost prohibitive on many, many levels. Um, so I think it's been a focus. We, we have expanded on our expanding some of our programs to be cognizant not just of frankly the healthcare aspects of it, but, um, of every aspect of the, um, of our patients' lives. You know, focusing some programs on food issues, on food security issues, focusing on other barriers to health. Um, you know, something as simple as, um, where does one have the opportunity to get healthy if they're worried about getting evicted and focusing some of our programs and our efforts on that. So it's sort of pivoting from sort of the traditional fee for service model to one where we look at the patient more holistically, frankly, um, because I think there is an ever increasing recognition that that's the only way that you are really going to have a meaningful impact on people's health, um, health condition in the long term.
Speaker 1:I think, you know, it's, I think you're still right about that. It's interesting cuz I, this is my own personal opinion, but as somebody who worked on some of the first ACOs and really felt very passionate about this idea of like, care transformation and, and even some of my first quotes were about caring for like, the individual, it just seems like we didn't get far enough given the timeframe that we, like, I can think about those first ones we did and how, how much time has gone, and I think you're right, mark, like we look about and we talk, use these words like social determinants of health and food insecurity. And there's, this is again, my own personal opinion, but at some point it's like somebody's starving. Like they don't know where they're gonna get their next meal. Their kids might be getting their food at home or may have it being delivered now because, and like if you're trying to survive, how can you work? How, I mean, it's hard enough for us to like, if you to remember to take like, for example, your blood pressure or your medication mm-hmm.<affirmative>. Um, and then we ask of people who are, who are in survival mode. And I think given that where we're looking at the percentage of people that are gonna have food insecurities or like, Steve, what you said are mental health issues are gonna be Yeah. Um, I mean there's, there's some outrageously huge percentages of, of what they think the mental health crisis will be. There are doctors out there who are getting out and speaking about it, like, this is the next pandemic as this mental health pandemic or this food insecurity pandemic.
Speaker 2:Yeah. As I think about it, you know, look, we can land on Mars, right? We should be able to solve these issues.
Speaker 3:<laugh> Well said<laugh>.
Speaker 1:Thank you. That's good. Like, yeah, let's just, I mean, it's right. And part of it's like, it's so simple. Like, let's stop talking about it. Let's do it.
Speaker 2:Well, I I did make, I made the comment to my dad who's a scientist, and he said, the reason we can land on Mars is because it was initiated by scientists, not politicians.<laugh>.
Speaker 1:Very interesting. Yeah. I love that. Um, so, you know, well, let's get back to like, so we, we talked a little bit about, like, on some of those podcasts, like the things that people do personally to try to get through this time. I mean, mark, you're talking about being a pig in the slop and you don't have your slop and you know, people have talked everything from like, I meditate under trees now to, like, I go for walks, I play soccer, I make sure I eat dinner with my family every day. What are some of the, what are some of the things that you have found that have brought you, like, kind of these, like, I kind of got, I think about back over'em, like these kind of moments of joy that I had, like these little, these little times that I make sure I, I grab during these times just for myself. Right. Um, what are some of the, what are some of the things that you've done to, to do that? I'll start with you, mark.
Speaker 3:Oh, I, I started painting<laugh>.
Speaker 1:That's amazing. What kind of painting do you do?
Speaker 3:Um, you, um, mostly landscapes. Um, you know, but it's just something to, that's completely different than what I would ordinarily do. I am not good for the record, you know, this, this, this is more therapeutic clearly than an artistic and endeavor.<laugh>, let's be clear about that. But I started painting because Okay. Um, you know, I I I don't want all the carbs from bread. My friends were telling me that they started doing breads and other friend was experimenting with dumplings. Okay. You know, I don't need to eat anymore. Thank you very much. So painting and, and that's where I landed. So, and, and you know, the wonderful thing is that, um, it it, it just gives you an opportunity to concentrate on something else and frankly not think about anything else. Um, that's the beauty of it, I've found. It's, it's quite meditative. So that, that's what I started doing.
Speaker 1:How about you, Steve?
Speaker 2:You know, I would say I have learned to fail miserably,<laugh> managing all, all of it. Um, before the pandemic, I, I was a very disciplined person. I woke up at five and I worked out and, and I was sort of like, you know, and I was so very goal oriented. And since the pandemic I still wake up at five and I still work out, but my heart is not in it. And, and I, you know, as I'm doing it, I'm kind of almost going through the motions, thinking to myself, what do you, you're wasting your time. There's a pandemic. So yeah, hopefully when this thing ends and, and the weather breaks, uh, I'll be able to rededicate myself to it. But for the time being, I, it almost feels like I'm just kind of hanging on. Yeah,
Speaker 3:Yeah. Yeah. You know, Steve, what I tell people all the time, um, is just hanging on is what I call the recipe for a successful day, right? Yeah. As, as long as you're hanging in there
Speaker 2:<laugh>. Exactly right. Exactly right.
Speaker 1:<laugh>. Yeah. I think, um, yeah, I, I haven't figured out the right balance of things either, Steve, that's like the perfect thing that I can do. But, um, painting sounds lovely. Uh, I'll<laugh> I'll have to think, oh, maybe I'll put I'll think about that. I'll contemplate that. Yeah. Um, especially if I don't have to be good. Um, exactly,
Speaker 3:Exactly.<laugh>,
Speaker 2:I'm, I'm afraid if I suggested I want to take a painting, my, my one will say, okay, start with this room.
Speaker 1:Exactly. Oh
Speaker 3:My God. Yeah. Which is why I'm painting mine this spring. Right. So it's the way it works.
Speaker 1:That's great. Um, so you, with that, why don't you, why don't you, um, let me know with the audience know something you'd like to leave, leave them with. What's something, um, I'll start with, I'll start with you, Steve. What would you like to leave the, the audience with?
Speaker 2:You know, that's a great question. I, I think, uh, it's something I alluded to or actually stated earlier, whi, which is, uh, the, the remote, uh, nature of our work these days has really placed, uh, uh, a significant premium on our interdepartmental communications. And there's never been a more important time that we are, we, we try to connect with each other, um, but not necessarily just for the human interaction of it, but also to make sure that we, we circle the ra the wagons, because I think we'd all agree that, you know, your, your in-house legal department is frequently put upon and challenged and, and so, uh, it's very easy for, uh, your internal clients to kind of poke holes in, in the, um, uniformity of, of the, of the, of the work that we do. And, and so when we're, we're scattered to our, our houses, uh, it becomes even more easy for, for that occur to, for that to occur. And so my suggestion really is to find ways, uh, to, to connect with each other, share information and, and to be able to, you know, advance the cause, uh, and, and to really u unite behind the, the common work that we're doing, uh, in a way that is, uh, as effective as it was when we were all in the same office.
Speaker 1:Wow. Yeah, I think that's a great, I mean, that's almost a great sentiment that for any workplace and actually maybe even life right now. I think that's wonderful. Um, mark, how about you? What would you like to leave the audience with?
Speaker 3:I, I think, um, Steve's statement was, was terrific because that also, if I can echo some of it, that really is the challenge now because, uh, as I said before, we were such, um, a collegial group that we've, and I can give people some practical tips. We've done. Um, we have a regular Friday happy hour now, um, where we, people get on a Zoom, they can come with beverage or without, um, whether it's an adult beverage or, you know, pop, you know, it doesn't matter. And folks get on a call and they say, hello, if you can attend, you can attend. If you can't, you can't, no pressure. Get on a call, talk to people, try to maintain that connectedness and not just, frankly, for the benefit of the work. Um, I think it indirectly benefits the work. If you can just talk to your colleagues, see them every once in a while, have a couple of meetings schedule, um, um, you know, at least every other week where you connect just for the sake of connecting. Um, simply because you're not in the office, does it mean that you should lose touch with each other? And I think if I can leave, um, the audience with any sort of cl message, that's the one that I suggest, um, that they take away from it.
Speaker 1:Oh, great. I appreciate Steve and Mark, you, you joining us today, and I appreciate the audience, um, listening in. And I really like the idea of leaving with the, the theme of, uh, connection, both personal and professional. So I'll put an exclamation point on that. Um, thank you all, um, for, for joining us. Yes. With my lap on top, my broken profile.
Speaker 2:Yeah. You just say, is it worn out? It might be worn out.
Speaker 1:<laugh> might be worn out. A lot of escalation points going on,<laugh>. But<laugh>, thank you everyone for joining us and we have more to come. Thank you all for joining us. Bye.
Speaker 3:Thank you for your time. Thank bye. Alrighty, byebye.