AHLA's Speaking of Health Law

C-Suite Roundtable: Health Care Workforce Issues and Strategies

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Rob Gerberry, Senior Vice President and General Counsel, Summa Health, explores the role Chief Human Resources Officers play in helping health care systems navigate workforce issues and implement strategies that retain and attract workforces. Some of these issues include inflationary pressures around labor and temporary staffing costs, remote work, clinical versus non-clinical workforce standards and expectations, Board governance, and the future of the health care workforce.

Rob’s panel includes Casey Parker, Chief Human Resources Officer, Wellpath, Trevor Walker, Senior Vice President of Human Resource Strategy & Integration and HR Chief of Staff, Advocate Health, and Joe Gage, Chief Human Resources Officer, Bon Secours Mercy Health.

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Speaker 1:

This episode of ala Speaking of Health Law is brought to you by ALA members and donors like you. For more information, visit American health law.org.

Speaker 2:

Hello, everyone. I'm Rob Gerber. I'm the Chief Legal Officer at Summa Health, and also a board member of the American Health Law Association. We are excited to bring forward today, the next, in our series of C-Suite podcasts with three talented executives in the human resource space. Today we'll be hearing from Casey Parker. Casey is the Chief Human Resource Officer at Well Path in this role. She provides development implementation on well path people strategies. She's previously a labor employment lawyer at Ogletree Deacons, and she received her bachelor's from Duke and her law degree from William and Mary. Our next presenter will be Trevor Walker. Trevor is the Senior Vice President of Human Resource Strategy, innovation and HR Chiefs of Staff at Advocate Health . And lastly, Joe Gage . Joe is the Chief Human Resource Officer at Bon Secours Mercy, prior to that, served as vice president at Tenant over their human resource function, and prior to that it was with Levi and Delta over their human resource function. So thanks everybody for joining us today. We appreciate , uh, you sharing your perspective. So as we kick off our discussion today, there's been a lot of discussion recently in the healthcare space around the current state of our workforce. As we hopefully come through the pandemic, we continue to see whole systems face unprecedented inflationary pressures, particularly on their labor and temporary staffing costs. So maybe we'll start with you, Casey . Casey, how do you see this trend? Is it stabilized or how do you see it , uh, in its current state?

Speaker 3:

Sure. So for well path , at least I think we have seen some stabilization to , um, the workforce. Meaning we have been able to rely less on agency workers , um, than we did during the height of Covid . Um, which is is obviously ideal for us. You know, we would prefer to have full-time nurses, full-time clinicians working for us, rather than relying on agency workers, which can be , uh, you know, more expensive and then also maybe not as committed to working, you know, for your company. So I , I have noticed some less pressure there. I think though, what we are experiencing is more pressure on just inflation in general and , you know, our fiscal environment. So it's a little bit out of the frying pan into the fire. Um, and so navigating what is just a time where there's more pressure on cost cutting , um, and on and other things that, you know, are just challenging from an HR perspective.

Speaker 2:

So Casey is our membership learns more about Well path . Maybe if you could describe your business model and where you're at , uh, located at geographically.

Speaker 3:

Yeah, absolutely. Well, path is a healthcare company that is headquartered in Nashville, Tennessee. We provide healthcare due to vulnerable patients in challenging clinical environments. So that is gonna mean , uh, local jails , uh, state prisons. And then we have a another sector of our business that is behavioral and mental health , uh, treatment centers.

Speaker 2:

Great. Thank you. So Joe , what would be your perspective, maybe if you could share a little bit about Sacco's Mercy as well?

Speaker 4:

Sure. SCO Mercy Health is , uh, 14 states kind of , uh, Midwest down through the Carolinas. Um, we've got about 60,000 associates. I would say that , um, the labor situation is improving , uh, but not yet stable. We've returned to pre pandemic , uh, agency rate , uh, vacancy rates. Um, we've got lower turnover. In fact, the lowest we've seen in a few years. We've driven down agency use, which had spiked to historic highs, both in FTEs and in costs . But , um, I think there's still more work to do there. One of the , um, we , we saw wages have have increased, you know, one year post pandemic, they jumped nearly 8%. Um, and Rob, I think one of the untold stories is the in inelasticity in payer rates, right? Uh , Medicare and , um, commercial payer reimbursements have not kept up with, with , uh, labor inflation, which is our number one cost. So you're seeing , uh, uh, labor is a percentage of net patient revenue decline , uh, not just at SCO Mercy Health, but across the entire industry. And I think it's , um, the number one thing that has kind of turned the industry , uh, equation upside down in healthcare delivery is , um, seeing labor inflation rates at a much higher percentage than , um, than we've seen reimbursement rates. And I think long term , uh, that's, that's gonna be a significant challenge for health , for healthcare delivery in the us .

Speaker 2:

Absolutely, Joe . Completely agree. Trevor, do you wanna share a little bit about Advocate Health and , uh, your perspective?

Speaker 5:

Yeah, happy to Rob. Thanks. So Advocate Health is actually the result of Advocate Aurora Healthcare and Atrium Healthcare , two large , uh, regional healthcare systems coming together in December of last year to form Advocate Health. We currently in, in our current integrated state, we serve across six states, including Alabama, Georgia, Illinois, North Carolina, South Carolina, and Wisconsin. Combined, we now have over 150,000 teammates. Nearly 42,000 of those are RNs , um, providing care for our patients , um, serving nearly 6 million patients across our geography. So we're really excited about the opportunity that we have together to have a positive impact on the communities that we serve. And nationally on healthcare , I think that the , the opportunities, you know, as , as you mentioned, there was significant impact of and pressure related to the pandemic and the increase in the utilization of , uh, agencies. It , it really caused us to, to, to have to increase that cost and expense, which in turn increased our operating cost and expense. And I think, as Joe mentioned, the total cost of labor went up significantly in relation to our overall costs in that timeframe. As we all know, once labor costs go up, they don't typically come down again. So we've got those fixed costs built into our system. But I do think what the pressures did force us to do, in addition to having to increase the utilization of agency and increased sign on bonuses and wages in specific areas, but it forced us to look at our workforce differently. It really allowed us to analyze and understand the supply of talent that existed in our regions and our markets. It focused us to focus on the development and expansion of our workforce and our talent pipeline in ways that we hadn't previously. So while it really added some cost to the organization in the short term , it really focused our thinking in a different way around how do we not only get through this time period, but also how do we prepare for the future? I do think the utilization of agencies has gone downward, trending downward in that the expenses are going down, the cost of agency is going down. Um, so, so we're trending in the right direction. I think as both Joe and Casey mentioned, we're not anywhere near back to where we were pre pandemic, but we're , uh, we're optimistic, we're headed in the right direction, and with some foundational changes to how we work and focus on the workforce, we can be better prepared should something similar happen in the future.

Speaker 2:

So as we vision for the future, we may be relying on agency less . Do we think that we'll need to rely though more on an outsource model for certain functions, be it it, be it revenue cycle or other services? Maybe Trevor, we'll start with you on that question.

Speaker 5:

Yeah, I think, you know, as we've come together as one integrated healthcare system, we've really explored our operating model across the board and said, where should and could we outsource some of our services? We're still in the early phases of identifying that, but I think that's something that we as an organization and all organizations should constantly be doing, looking at both the cost and the quality of the service and where it is best delivered to our teammates and, and our , uh, our organization as a whole.

Speaker 2:

Joe, any thoughts on that?

Speaker 4:

Yeah, I, I actually think both outsourced and offshore models are , um, trends that we're gonna see in the future. I think we're gonna run some place that maybe other industries have run a number of years ago , um, in shared services and some of those other, other places. But I also think even in clinical services , uh, you're starting to see , uh, lots of , uh, healthcare employers start to explore , uh, offshore , uh, call centers and , um, uh, combinations of clinical service back offices that I think , uh, we'll see in the future as well. So , um, I think the, the multi-employer challenge , uh, and bringing those into one, one unified mission and one unified patient experience delivery , um, is gonna really be , uh, a trend for the future. And I think it's, it's a must have with with labor costs , you know, ranging between, you know , 45 to 55 or 60% for most, most systems of, of every dollar of revenue. Uh, it's , uh, reinventing the way that we deliver care, I think is a must have . And I think the tech , the , you know, the technology trends that are emerging now , um, are really gonna enable that to be quite effective and seamless , um, and even create some more desirable patient experience. So I don't think it necessarily means bad things for the patient. It could actually mean more access, not less.

Speaker 2:

So. Casey , as our boards look for workforce stability, what's ball pass thoughts , uh, around outsourcing?

Speaker 3:

Yeah. Well, you know, I think we're similar to what Trevor said, still sort of exploring the best use and, and the way to , to model that. But I do think there's a relationship between the pandemic and looking at outsourcing in that we saw a lot of requests for people to work remotely and, you know, advocating for, Hey, I can do this job entirely remotely from, you know, a few states away. And I think when you see the workforce saying that, then the necessary next question is, okay, well if this job or this group of jobs can be done remotely, what is the most cost effective way for them to be done remotely? So I do think you're gonna see employers coming out of the pandemic where they have, you know, this entire group is remote, is, is the most cost effective way for them to be remote domestic? Or is it, you know, outsourced or shored.

Speaker 2:

So Casey, that's a great segue to our next question, which is around remote work policy. We've seen during the pandemic , uh, the perspective on this evolve with companies from full remote to hybrid to a balance between the two. How are your organizations tackling the issue of establishing a culture, ensuring productivity, and making sure that you've got common standards across your workplace around remote work? Maybe we'll start with Joe.

Speaker 4:

Early in the Pan Pandemic, we began to study this and we, we developed a , uh, a policy and then a set of operating practices, which defined three types of work onsite , uh, remote , hybrid, and then remote. And we created operating procedures for each of those. And then we went through a process of defining , um, not based on employee preference, but based on the nature of work, which , um, which job profile was appropriate , uh, for each type of , uh, for each type of work that's being done. Um, and we walked in systematically through implementing that. Now over the last couple of years, we've refined , um, how we've used those , um, those standard , uh, practices around remote, hybrid, and , uh, onsite . But , um, I think each of those offers a different value proposition for the associates. And you've got, you do have to modify your practices. Um, we had to learn how to do zoom completely differently for some that are in place and some that are hybrid , um, or , you know, that are offsite. Uh, we had to learn how to gather for strategy and to pull apart for individual work. So you do , there are a whole set of related practices, I think, around how you govern your workplace that you've gotta be willing to reinvent in order to make it work. One of the main secret of success, I think, in and , um, in between our onsite and offsite , uh, workforces is that our offsite workforces saw this as an opportunity to collaborate more and to visit more , uh, with onsite associates. So rather than getting together in some corporate office somewhere, they now travel to a site where they're more face-to-face , uh, with our frontline workforces and with our caregivers. And that is , that has been tremendously freeing and engaging , uh, culturally and has , has helped break down some of that have and have not , uh, on, in onsite versus offsite work. Trevor , what's been the approach to remote work at Advocate Health ?

Speaker 5:

Yeah, so, you know, one of the benefits of coming together as we realize where we're very similar in many ways, and the approach to going to the remote work has been very similar, really in the legacy advocate Aurora organization. As soon as the pandemic hit the, the, the leading principle was, you know , remote first, think remote first, and, and those who can work from home should, and those who can't should be on site . Um, and, and so that's really been the approach and there hasn't been a swing back, if you will, to get people back into the office. As a matter of fact, we're evaluating the utilization of our office space and do we need to continue to, I think the pandemic has really demonstrated that we can work efficiently and effectively remotely. And I think, as Joe mentioned, the collaboration between functions I think has increased even more as well, because you're not confined by a specific space in a building where you tend to be homogenous and hang out with your own. You have an opportunity to reach out broadly, across virtually, and engage more in different groups. So I think that that has really been a value to the, the organization and the, the product that we've delivered. Um, you know, as you look at it, and you mentioned Rob, the , you know, performance and productivity expectations around performance and outcomes for both our clinical and nonclinical areas has not changed. You know, we still have those expectations and we measure and we track and we, we hold people accountable for delivering on what is expected. But it's, it's, it's created a different way of doing that. And I think people have really appreciated it. I think , um, if we talk to our workforce overwhelmingly, those that have moved remote , um, would prefer to stay remote. And I think I even just read an article this morning from Mackenzie that said 87% of employees given the chance would want some form of remote opportunity, whether it's full, remote or hybrid. So I do think that it's something that, that we have adopted. I think the challenge, and you mentioned it early on, is in an environment where our, our largest population, our clinical and need to be on site to deliver the care, how do we look at providing some flexibility to them that, so that they have that opportunity as well? We're beginning to look at different ways to do that, whether it's , uh, you know, for some of the , the clinical providers four days in the office and maybe a fifth day from home for charting, and another things that can be done outside of the office. But we also know, given the, the, the population of clinicians , um, more and more are wanting flexibility. You look at, you know, recent research that's suggesting even more important than compensation and career development is flexibility in scheduling and work in environments. So we're constantly looking at how do we design our work workplace so that we can build that flexibility into that for , uh, uh, a better experience for those that are looking for it.

Speaker 2:

That's great. Casey, what's the benefit perspective at, well , Beth ?

Speaker 3:

Yeah. Well, very similar to, to Joe and, and Trevor. It's been a , a pretty constant conversation since Covid and one that, you know, we continue to have, I think what's interesting about the remote work conversation is that people feel very strongly and very differently about the topic. You'll talk to one leader at an organization who will say, I believe very strongly in in-person meetings, I need to see my team. We need to be in the office. And you can talk to a , you know, a different leader and they'll say, Nope , my , you know, my team's really productive. We can be fully remote , um, get the job done and provide people the flexibility they need. And, you know, they're both probably a little bit right, and, you know, both could probably learn from, from the other a little bit. So it's, I think it's our role as CHROs to , um, to facilitate that conversation, to hear both sides and to figure out what's the right move for, for your company. Uh, for us , uh, you know, I think the other thing, and you touched on it, Rob, is that 9,000 of our 16,000 employees are nurses that mostly need to be on site and, and need to be in person . And so how is it best to support those employees, you know, from a corporate home office perspective when they need to be in the office? And, and how do you know if we go fully remote? Is that the right message to your boots on the ground , frontline workers who don't have the ability to have that flexibility? So I think right now we're, we're striking a balance with mostly hybrid. Um, you know, Joe, I think you mentioned there's like, you gotta be in person . You can be fully remote and you can be hybrid. We have a lot in the way of hybrid, and I think that does strike a nice balance. Uh, Trevor, I think I read that same article where McKenzie showed for years and years, the driver of turnover, the number one reason someone was gonna leave their job was comp. And I think for the first time, flexibility has jumped ahead of comp. So we, in hr, we need to acknowledge that and, and realize what we're doing. Um, and so, you know , we have really gone to more of a hybrid model, which allows folks to have that flexibility, right? If we say three days a week, you can choose those three days. If you need to be home on this day for whatever reason, you can, but you're still in the office and you're still engaging and also supporting the , the frontline workers who don't have that full flexibility,

Speaker 2:

Right ? So building on that is we think about our clinical workforce and our non-clinical workforce. How do we keep , um, those different segments of our populations , uh, unified around mission when they're facing different pressures? One is that remote work. Others we may be experiencing layoffs may be in the non-clinical side, is we look to keep people bedside. We may be seeing compensation cuts on the nonclinical side, how do we keep those two segments of the workforce from and us against them mentality and really staying unified , uh, around what we're trying to execute on. Trevor, maybe I'll start with you.

Speaker 5:

You know, it really comes down to, you know, how you present the purpose of the organization or the mission of the organization. One thing that I really appreciate having come to , uh, at Atrium was Gene Woods and his commitment to culture. We have culture commitments at the Legacy Atrium organization, and we're in the process of crosswalking the values from Advocate Aurora with the culture commitments at , uh, atrium. But those were foundational to how we show up together. And, and, and it was all about together. And as we've gone through this integration as together we can, together we can, together we can. So creating a culture that is not an us versus them in Advocate Aurora and Atrium, but all the way down to the front of the organization, clinical support, administrative, together, we can deliver something different and unique. And I think that culture is really what creates that unity in your workforce and that opportunity to say, okay, without you, I can't accomplish this. And , and really pointing those out. One thing that Gene Woods did an amazing job of is he called all leaders to be Chief Cultural Enabling Officers said, every leader enables the culture of our organization and needs to develop the capability and capacity to do so. So it really has been an emphasis and a focus of his and will continue to be as we move together as one organization. So I think that really keeping that forefront, looking at why we're doing the work as opposed to necessarily what the work is, is, is going to allow us to make sure we see each other together in this success.

Speaker 2:

Thank you. So Casey , how's well path tackled this issue?

Speaker 3:

Sure. So I think , um, you know, I agree with everything Trevor said. It , it is really important to drive an overall culture and an overall mission. I'll say, I think I have it easy in some ways and , and most healthcare companies do, but in particular, well path because we have such a powerful mission , um, right? So we're providing healthcare to patients that are in very vulnerable settings. In , in some cases they are receiving healthcare for the first time in their lives from one of our nurses or doctors. Um, and it is, it's really, it's hard work, but it's really inspiring work. And, and so, you know, we're kind of like, I always say like, we're like oozing mission, right? Like we have, it's just like it's everywhere. Where we're doing is, is powerful and beautiful work. And so it , it's can be easier, I think, for me than maybe other companies. Um, you know, let's say you're just like a logistics company. You're a shipping company, right? Like, what's your, what's your mission? What's your culture? Whereas here at Well Path , we, we really, we have it and we speak to it all the time. So , um, you know, bringing everyone around that mission, I, I have to say, is one of the easier jobs that I have.

Speaker 2:

Joe, can you share the perspective from Box course ?

Speaker 4:

Yeah, I think , uh, these guys have articulated it well. The , um, the mission, the mission has to be first for everyone. Um, but , um, there's also the idea, I think that same is not equal, right? Uh, for years I've been buying clothes for the kids as they go back to school, right? Um , but I've never bought 'em all the same size of jeans, right? Um, my, my, my two girls and my guy wouldn't necessarily think that was cool. Um, or even the same style for sure. So , um, uh, I think the , the key is we move forward. Um, and , uh, Rob, we can talk about this a little bit later too, but the is , um, to build a value proposition for each segment of the workforce that's right for them. And we've centered it around three ideas. Mission is right at the center of it, and then flexibility is the second one. And that means something different for an office worker than it does for a clinician. But clinicians now post pandemic definitely want flexibility. And then the third is growth, career growth , uh, personal growth, so mission, flexibility and growth. But those mixes and the specific solutions come in different proportion for different types of the workforce. Uh, they all need genes, but a lot of 'em want different things even in those , uh, even in those three things. Uh, with the mission being the unifier across all of the , um, across all of the, all of them. And then flexibility and growth dialing in, very particularly for people in ages and stages and occupations.

Speaker 2:

So as workforce has become such a critical issue for entities, they're boards that put this at the top of their list of strategic priorities. And we've seen boards and board committees really start to focus on this in a deeper way. For us at Summa Health , we've evolved from a traditional compensation committee to now that board committees the Human Resource Committee, and tackles not only executive comp, physician comp, but also is working on workforce development strategies, workforce retention strategies , um, succession planning, diversity equity, inclusion programs. How all have each of you seen your organizations adapt around the governance model? Maybe I'll start with Joe.

Speaker 4:

So , um, uh, we, we, the, the committee literally just changed its name recently from the , uh, HR Committee to the People and Culture Committee. Uh, and , um, we just finished , um, four sessions in a row where we went through different parts of a future , um, human capability plan, human capital plan , um, and the four components are pretty simple, mature, strategic pipelines. Trevor mentioned earlier, we had to take a, a long look because we, the truth is most markets , um, we're in 14 different markets and most of them don't have the workforce that we need. So we've gotta literally build the, the clinical workforce of the future. I would say if you, if you're , uh, if you've got young people that don't know what to do when they grow up, healthcare is still a great career path and most health systems will pay for it. Um, sustainable cost of labor was our second being an employer of choice is third. Um, and then realized equality , um, something beyond , um, e equal opportunity , uh, something beyond d e i , but realized equality as a, as a, as a way of being in our organization as a , as a strategic goal. So those are kind of the four strategic pillars. So we've moved way beyond there. Um, I know from my work with c h A and with, with other, on other boards like , uh, Roper , um, and with Sumin the past, those organizations too , um, are moving well beyond , um, the ceo o it's , uh, CEO's performance and , uh, even physician compensation into , uh, human capability because they realize , um, it's , uh, a must have if you're system's gonna thrive.

Speaker 2:

Casey , what's been well past experience around its governing model.

Speaker 3:

Sure. So , um, Joe, we haven't changed the name of the compensation committee, but maybe you gave me an idea. I like it. Um, we're still the compensation committee, but yes, we, we absolutely cover , um, you know, career paths and succession planning and d e i , um, it's, it's really critical to how we grow our business. And I think back to, you know, Trevor mentioning , um, that the article about, you know, turnover and how many folks are looking, you know, for, for to leave and how many folks are looking to say that , uh, flexibility is, is their number one , uh, you know, request in , in a role. We have to be really mindful about how we retain our employees cuz it's, you know, indeed can go out and ping you anytime you're sitting there and, you know, recruiters have access like they never have before. And so you have to work extra hard on, on how to retain nurses, you know , leaders, everyone in your organization. And so the compensation committee is, is looking really hard at how we do that and creating career paths, having competitive wages and, and, you know, doing everything we can to be an employer of choice is , is at the top of our list.

Speaker 2:

Trevor, how about , uh, advocate help ? How are you approaching your governing model?

Speaker 5:

Yeah, so , uh, you know, coming together, again, both legacy organizations, the boards were very interested in these topics, workforce development, succession planning, and de and I obviously are priorities for most boards right now, but, but truly as we came together, the new board is really emphasizing this not only at the committee level, but at the all overall board level. And, and , and so much so as we look at this , um, you know, we're, we're looking at all the way down to what is creating , um, you know, health equity issues, but as a part of that health equity issue, what are the economic issues that we have control over in creating jobs and opportunities for the underserved within our own organization that elevate the health of the communities that they live in and work in , but also of our workforce? I think Joe mentioned it earlier, and it's exactly right, in the states that we operate, I don't know if there's any state in the country that has the clinical workforce that is necessary to deliver the healthcare that's gonna be required. We're gonna have to grow our own. And how we go about doing that with our workforce development programs and in a way that is respectful and representative of the communities that we serve in and has leadership that is ready for those roles, the board is all in on this. They wanna know exactly where we are and what we're doing. And, and, and, and it goes, you know, it goes back to one area of , of, of , uh, the structure that we created. We created a whole new focus on community and social impact , uh, a new role that reports into the C E o and within this structure, we're creating what we call the National Center for Health Equity. And it's, it's not just focused on health equity, but it's focused on de and i and the relationship between the two. And as a , a large now national healthcare system, we feel we have the responsibility and the ability to address social determinants of healthcare with one of those, as I mentioned earlier, being economic mobility and the jobs that we create and the opportunities we provide those community members to find careers at Advocate Health , really we believe will create pathways for families to gain family sustaining wages and allow our communities to grow and, and, and be , uh, you know, vibrant and, and really have an impact in that regard. So again, it it's a real trickle down effect from saying we want to create health equity to how do we create a workforce and workforce pipelines that allow us to do both address health equity in the communities that we serve within, create jobs and opportunities within those communities, and fill our own talent pipelines with those individuals so that we are, again, it it's a full cycle of how do we create jobs and opportunities which then affect the health equity of the communities and build a talent pipeline that is so desperately needed within our own organization and across healthcare. So those are all topics that feed into that diversity, equity, and inclusion, succession planning and workforce development. And that's why the board is so , uh, focused on it at a , an , uh, a macro level and not just within the HR committees of the board.

Speaker 2:

That's great. And maybe building on that, so your boards are looking for you all to manage not only these current issues that we've discussed today , but to do that future visioning around what is the workforce for the future three, five years out as you hear things ranging from virtual nursing to changing standards around your bedside clinical workforce to, as Joe mentioned earlier, offshoring, just what are some of the things you're telling your board about that workforce of the future and where you need to start now as you look at that planning? And maybe we'll start with you, Joe.

Speaker 4:

Uh, it's gonna be, it's very diverse. Like even now, 35, 40% of the people that we hire are , um, are , uh, multiracial, multi-ethnic. Like it's a very diverse workforce. It's multi-employer, it's multinational. Uh, and I don't mean just eth ethnically, I I mean even in even it's delivery , um, uh, I mentioned flexible hours. I think that's gonna become a standard way of operating just like it is in many other industries. And I think that's gonna provide a lot of satisfaction for clinicians that, that historically has been lacking in our industry career growth. I think we are one of the only places where you can come start with in an entry level unskilled job and work your way all the way up to the top of the house. There are very few other companies now that, that actually offer that type of, or industries that offer that type of , uh, opportunity and potential. But we still do , um, I think for, for , uh, you know, those listening with legal ears , um, joint ventures, corporate structures , uh, compensation models, joint employer unionization, I think are all gonna be fought legal topics that are gonna be really challenged as we, as we blend together this , uh, very complex workforce to Dr try to deliver , uh, healthcare and the healthcare of the future.

Speaker 2:

Casey, your thoughts on the future workforce?

Speaker 3:

Yeah, I mean, I'll, I'll echo a few things that Joe said. I do think the future absolutely is increased flexibility for nurses. Um, and I think that probably means even more in the way of growth and telehealth. Um, you know, and I think , um, I personally utilize telehealth. I , you know, I think may sort of selling it as it being the norm. It's not a, it's not a reduction in your service, it's not less service, it's just a new way of, of getting service from a nurse or a doctor. Um , I think companies expanding into that will be able to provide flexibility for their staff. Um, but I also, you know, I'm , I'm an optimist, so I'm gonna say I , you know, I'm optimistic about the future of the healthcare workforce. Everything I read about AI says if there's one job that you want to pursue, that's not gonna be taken over by ai, it's nursing and healthcare. So I think even though we had a hundred thousand nurses leave the industry in Covid, we're hearing more and more people be interested in getting into that line of work. They know it's gonna be steady, we're gonna need it. Trevor, to your point, there's not a single state out there that says, we have more nurses than we need. Right? Everyone, you talk to anyone, they say, you know, we, we could hire a hundred tomorrow. So I think you're gonna see more people entering that and , um, and, you know, more people understanding that it is a really great , uh, career to pursue.

Speaker 2:

Great. Trevor, your thoughts?

Speaker 5:

Yeah, I think your question was what does the workforce of the future look like? Well, it doesn't exist today. So I think that what we've gotta do is we've gotta create it . And I , I think it's aligned with what both Joe and Casey have suggested. Um, we have to create the workforce of the future. And one of the ways that we're adopting a mindset around that is we've gotta do that. And I love Joe's comment. Healthcare is one of the only industries where you can recruit from the outside in and the inside up within the organization . You can enter in a nonclinical entry level position, and you can grow a career to the point that you're a , a , a , a , a bedside clinician of any sort and type. And, and our responsibility is to develop those pathways to provide visibility to those pathways so that it's appealing , um, to individuals as they come into the organization and then invest in that development. Um, for them , I think a lot of it is in partnerships with other organizations to create, you know, pathways and opportunities. One thing we're really looking at is apprenticeship programs, registered apprenticeship programs , uh, you know, working with , uh, you know, any, any partner that can really help us prepare that workforce of tomorrow , um, in , in, in all of the areas that are required. And again , uh, and Casey alluded to this, the AI impact on healthcare I think is just hugely , uh, it's huge, just the potential. And I had a conversation earlier today with someone and we were talking about, you know, it's not a threat to healthcare. It's an enhancement to how we deliver healthcare and the outcomes that we're going to get as a result of it are going to improve quality is gonna improve, throughput's gonna improve, all of it is gonna improve because of this technology that is gonna allow us to look at how we work in a different way. I think as we do look at the workforce, I think, and, and I think of my , so I've got three 20 year , 20 ish, 20 year old kids. And what they're looking for is that flexibility, flexibility in their schedules, flexibility in the work that they do. As much as we can create flexibility in the work environment for our, our workforce , um, I think we'll be able to attract them and , and, and engage them in a way that , uh, you know, they wouldn't, if we weren't creating that flexibility, they'd just come and punch a timecard and, and , uh, pass through and as , as they live their lives kind of thing. But I like kc , I'm very excited and optimistic because I think the opportunities are so great. Um, within healthcare, you can come in and you can, what other industry can you come in? And you can be a , you can be an attorney, you can be in supply chain, you can be in hr, you can be a clinician. Um, all of these opportunities exist to contribute to a mission, which really is unique and different than any other industry. So I'm excited. I think there's challenges and there's headwinds that we're gonna have to overcome, but I definitely think that the future is bright.

Speaker 2:

Great . Well, thank you . I wanna thank each of you, Casey , Joe , and Trevor, for sharing your perspectives today on these really critical issues, not only for our organizations, but for the future of the health system. The way we've traditionally ended these C-Suite podcasts is to go around the horn and ask though what you want from your legal partners. As we look at our membership, how can they best support you, support your organizations and their work? And you all have a , a benefit of seeing across the enterprise as chief human resource officers , um, really what's the best way a legal partner , uh, can work with their team . So maybe we'll start with Joe. Uh, how do you feel those legal partners can best support your organization?

Speaker 4:

Uh, creative solutions. Sometimes , uh, we'll bring , uh, a new way of thinking or a new idea , um, and we don't actually know how to put it into the best corporate structure or the best legal form, or to navigate around a , a legal structure that was built for an entirely different way of working. And , uh, we need help finding creative options to be able to satisfy the current legal environment and at the same time move forward with a , uh, with a better way of delivering healthcare. So , uh, creativity , uh, creativity and keeping us out of , uh, out of orange is , uh, a good start.

Speaker 2:

That's great. Uh, Trevor, what would you look for in a strong legal partner?

Speaker 5:

I love that keeping us out of orange <laugh> . That that's always what we look for in a good legal partner. How can we push the limits and really be creative and innovative, but not end up in an orange jumpsuit? So I , I think I'd echo what Joe has mentioned. You know, we want someone who can come to the, to the conversation with us and think divergently and think possibilities and what can we really create tomorrow that isn't been done today. Um, and, and keep us <laugh> , I guess it is, keep us out of the jumpsuits, the orange jumpsuits by keeping us with line of what is regulatory and, and legally required. Um, but, but really be willing to kind of explore the possibilities and , and what really can be with us as we look forward.

Speaker 2:

Great. And Casey , other than the orange jumpsuit, you wanna share as far as what you look for in a legal partner or two practice ?

Speaker 3:

Well , yeah. Well, you know, I'll, I have to give a plug to our legal team. We have an awesome legal team, so really lucky and , and I rely on them quite a bit. Um, but I think , uh, in addition to keeping us out of orange, I would say it's always great when , um, a legal team is, is proactive in their sort of advice. I mean , a lot of times when you call your attorneys, your , they have to be reactive, right? It's like, this happened, this happened, and they say, oh, well you , you shouldn't have done this, and you definitely shouldn't have put that in writing, right? And so they're reacting and trying to kind of k kind of , uh, redirect. But when there is a lull and when there is their time, it's great when legal gets ahead of things and helps you look at policies, look at the way you're doing things, you know, you know, you're embarking on , um, a project, a cost cutting measure, and they get ahead of it and say, Hey, well before you do this, let's look at this and this and this. That's always great. Um, so I , I would say just being really proactive in, in legal advice and guidance is very appreciated.

Speaker 2:

Excellent. Well , thank you again, Joe Casey, Trevor, we really appreciate your perspective on behalf of the American Health Association. Thanks for joining us.

Speaker 1:

Thank you for listening. If you enjoyed this episode, be sure to subscribe to a H L A speaking of health law, wherever you get your podcasts. To learn more about a h and the educational resources available to the health law community, visit American health law.org.