AHLA's Speaking of Health Law
AHLA's Speaking of Health Law
COVID-19 GC Roundtable: One Year Later
In this special episode of AHLA’s GC Roundtable series, Sarah Swank, Counsel, Nixon Peabody LLP, reunites one year later with the three hospital general counsel from the first episode of the series—Marc Goldstone, Executive Vice President and Chief Legal Officer, Wellpath; Richard Korman, Chief Legal Officer and General Counsel, Avera Health; and David Rowan, Chief Legal Officer, Cleveland Clinic. Together, they reflect on their experiences over the past year and how the pandemic has affected their lives professionally and personally. They also share perspectives on how the pandemic has exposed the strengths and weaknesses of the U.S. health care system and lessons learned. 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.
Welcome everyone to today's podcast. We are having a reunion. Um, this is the reunion of the three participants of our very first general council round table. I'm Sarah Swank from the law firm of Nixon Peabody, and I'm so excited to have these three guests back with us today. I'm gonna have each of you introduce yourself. So let's start with Mark. Mark, can you introduce yourself?
Speaker 2:Sure. Sarah. My name is Mark Goldstone. I am Executive Vice President and Chief Legal Officer at, well, well is the country's leading provider of correctional healthcare services, and we also provide addiction therapy and neuropsych services to patients in the community.
Speaker 1:Excellent. Thank you, mark. And Rich, do you wanna introduce yourself?
Speaker 3:You bet. Sarah. Hi everybody. I'm Rich Corman and I'm Chief Legal Officer and General counsel for Avera Health. Avera Health is a Catholic healthcare system based in Sioux Falls, South Dakota. We have, uh, locations, uh, in our service area, covers, uh, the eastern part of South Dakota, Southwest Minnesota, Northwest Iowa in northeast Nebraska, and looking forward to today's conversation, uh, one year later. Thanks, Sarah.
Speaker 1:Great. And Dave?
Speaker 4:Thank you, Sarah. Happy to join today. And, uh, my fellow panelist, uh, one year later. Um, Dave Ron, I'm the Chief Le Legal Officer at the Cleveland Clinic. Our main campus is in Cleveland. And then we have, uh, uh, 13 other hospitals in Ohio, five in Florida, and some overseas operations. We manage one in Cleveland Clinic, Abu Dhabi, and we're building a hospital in London and have some operations in Canada. Look forward to the discussion, and, uh, as always, we learn from each other.
Speaker 1:Right. Um, that's, that's a very common theme that's come out of these podcasts, so I really appreciate you all joining us again. So I'm, I'm gonna start with you, mark. It's, you know what, around a year ago I sent you an email and called you and said, would you like to go on a podcast and talk about what's happening in the world? What was that like to get the call?
Speaker 2:Well, first I had to ask my teenage daughters, what's podcast? And then
Speaker 1:<laugh>, after,
Speaker 2:After they explained that to me, they said, oh, okay. It's sort of like a radio call in show for those of us on a certain age. Uh, you know, the the interesting thing is, you know, I've been involved with a H L A for a very long time. I've been in almost every leadership position you can have, and now I'm a fellow. And as David said, the key to the A H L A A experience and really growth in my view as professional, is sharing experiences and learning from each other. And this form may be more than any other I've ever been involved with, is about, um, a rising tide lifts all boats. Not I'm going to protect my clients, or I'm going to protect my standing, or I'm gonna protect my intellectual capital, but how much can I share to help us all grow? And so it was really invigorating to get that call and understand that we were gonna do more than we might otherwise be able to do during the time of, uh, emerging pandemic.
Speaker 1:Great. And Dave, how about you? Um, I said I had to kind of think about what a podcast was. I, I know people listen to sports podcasts, but I had never, I had never spoken on one or, or had facilitated one until a H l A. Uh, what did you think about being asked to be on a podcast?
Speaker 4:Well, I think I, I participated on a number of panels, uh, with, uh, fellow general counsels or other individuals, and I always find that, uh, you share stories, you learn something every time you hear that you've got some common problems, and you learn about either technology or something else. And I think that this, you've h l A and others have found that if you don't make us through a PowerPoint, that we're happy to just get on and talk. So I think, uh, they found the formula and I enjoy it.
Speaker 1:Great. Um, rich, I'm gonna ask you a little different question. So, you know, when we, when we had the podcast a year ago talking to Mark and Dave, they were in a place where they were doing a lot of, um, preparation. They were at places where they, their systems were touching a lot of places, and you were, um, you know, in a more, uh, rural setting, but also had this big telehealth, um, presence. And were looking at expanding that. Um, why has changed over that year, like sitting, if you think, if you put yourself back in a year ago and what we were talking about, what, what has changed since then?
Speaker 3:Oh, that's a great question, Sarah. But first thing I wanna do is touch on that, uh, first question you asked. Uh, uh, because remember where we were a year ago. Uh, you know, I was home, I was in my office. Um, our oldest son was, uh, essentially kicked outta college. He was in the dining room, and then my wife was doing all of her work in the basement. So we had to expand our capability, uh, through, um, our internet connection in order for all of us to do work at the same time in the same location. So I'm sure all of us experienced that as well. And we've learned from that, and we moved on. Um, and that's what we did here, Avera, about a year ago. Sarah, as you just indicated, you know, we are a, a large provider of telehealth services to rural areas, not only in our footprint, but um, around the country, including almost 15 to 20% of the critical access hospitals. And what we found were our clients and our, our service providers wanted to expand that even more because we wanted to bring healthcare to individuals where they are located. Um, and I didn't say home. I didn't say office. Um, located, uh, we've had some folks join us from their, their ranches out in Western South Dakota to their cars driving through rural Minnesota, uh, to their other locations. And, uh, through that process, uh, we've been working not only with our, uh, service provider partners, but also our state legislatures and trying to make, uh, them recognize that, you know, healthcare is really local. It's really individual, and it's something that we really, uh, may want to bring to those, uh, uh, patients and, uh, individuals in their locations and not necessarily having them come to us.
Speaker 1:Yeah, I've been thinking a lot about that, about, you know, for somebody who spends a lot of time with federal law, um, healthcare's really local, and also thinking about, um, transportation and the, and the real pie that we have between transportation and healthcare, and how we've seen that change. Um, so Dave, uh, I know that you were talking about a lot of innovations that were happening at the Cleveland Clinic at the time, and then a lot were in preparation, and then to a certain extent in response to the Covid Pandemic. Uh, what have you seen in those innovations and what has surprised you about those?
Speaker 4:Sure. I think that, uh, not exactly innovation, but the fact of collaboration that, that, uh, the local hospitals, uh, schools really stepped forward to do things that had not been done previously, such as joint testing, facilities, trying to help each other out in the light where competitors, so we stay within the lines. But that collaboration was very important. I think on the innovation side. Uh, we had started pre pandemic, uh, an emerging pathogens institute and hired some, uh, very knowledgeable people, uh, without knowing Covid was coming, but it was exactly that area and the fact that, uh, covid and other pathogens really can lead to, uh, cancer or heart disease and other things. So we were ramping that up and, uh, then accelerated that. And more recently, uh, working with the state of Ohio, uh, we received a Jobs Ohio grant to, uh, not only do that, but also get, uh, local hospitals and educational institutes together to collaborate. And, uh, then just yesterday we announced that we're, we've got a super computing arrangement and 10 year agreement with I B M that will include a quantum computer on our campus. And, uh, the hope that that will be something that accelerates research and is also a resource for our community. So a lot of activity, uh, and that's, let's say some, uh, other activity, I'd say innovation, kind of how you deal with patients, how you take one ventilator and make it into two, essentially. I think all institutions had to innovate. And so there's a whole range of things that hopefully will, um, prepare everyone for the next, and hopefully, well, I wish we were not, but there will be another pandemic or the next bug, so to speak.
Speaker 1:Yeah. So, so Mark, um, you know, one of the things that really struck me when you spoke was, uh, your passion about first responders and the people that were out on the front lines. Uh, has that been something that you've reflected on over this year?
Speaker 2:So, you know, one of the things I've talked about for a long time is the impact of healthcare reimbursement policy on not only the availability, but also the quality of frontline EMS caregiving in America. And we've really pushed the system to the brink. You know, I was a paramedic for a really long time, and I remember having tough days. I never had a tough year that didn't end. And so when I look back, I think to myself, gosh, if we don't do something in this country to really rationalize the way we pay for the provision of emergency medical services, we're not gonna have a system. And the system that really stood up and and served as the primary safety net in America over this past year won't be there. So not only am I as passionate, I'm more passionate about it, I've seen caregivers just say, you know what? For$16 an hour, I can work at Starbucks and I'll get healthcare benefits, and people will be nice to me, and I won't have to be faced with infectious diseases or shifts that don't end. But that's where our current reimbursement system takes a lot of the EMS providers. So, yes, I, I'm, I'm, I'm more than ever committed to seeing if there is more we can do as a country to rationalize that reimbursement to create a really strong and lasting EMS safety net.
Speaker 1:Yeah. I think one of the, there's like these moments when I, when I look back, and I think one of them was a news story, and I wanna believe it was in, um, one of the boroughs of, in New York City where they said, all I, all I can do is hear the ambulances all night. I can't sleep. I can't sleep because I just hear ambulances going all night. And then to think that each of those ambulance has a patient and the support staff and the, you know, in those that's, that there's, that's not just the siren, right? That there, there are people and healthcare connected to that, that sound, it was, it's just really, uh, something that struck me during the, the pandemic mark.
Speaker 2:It's a, it was a disproportionate burden, likely born by the lowest reimbursed. And, and you know, in my own personal experience, probably at least respected part of the healthcare system, I don't get me wrong, our, our reimbursement system is broken in lots of ways. You know, Dave, I'm sure David would agree with me, that, gosh, we need better federal Medicare hospital reimbursement. We sort of bred out of the system, um, search capacity. You know, Medicare pays for exactly what you need when you need it, or so they think, but there's an area of thought in that reimbursement policy rubric to say, and gosh, we should pay for you to have about 10% more beds in case there's a big surge for these Medicare beneficiaries who might need care, who might be more complex, who might be more fragile. That's just not part of the system.
Speaker 1:So David is interesting because we can contrast these two, right? So here we are talking about in our healthcare system, quantum computing and AI and some of the most amazing cutting edge technology and science. And this was all, like you said, happening before the pandemic. This idea of the genome and computing and our scientific knowledge all coming together to do what is some of the best in medicine. But we also can contrast it with some of what is the most difficult parts of, of healthcare or the things that we see need to be fixed. You know, what, what are some of those sitting where you sit? What are some of the items that you've seen or things that have really struck in you between these contrasting concepts in our, in our healthcare system?
Speaker 4:Yeah, I think, uh, we would all say that we, um, had the opportunity to help people who were on the front lines. So I think that first responders, the nurses, the doctors who labored in awards, it was a privilege. Um, I think that, uh, reimbursement is, uh, always something that kinda lags. I think telemedicine, f d a, it was, it was a period of time when I think there were a lot of regulatory changes that were very productive and shortened the line for everything from developing, uh, vaccines to some new piece of equipment that was refreshing. And I hope that that is, rich was saying with regard to telemedicine, that we keep some of that regulatory advance to be able to deliver better telemedicine services. Uh, I think that clearly we saw supply chain issues that we talked about the first time around, uh, won't go through them, but we all know that that was, that was pretty amazing that in a country like ours, we had mass shortages or gloves or benal lighters. So I think there are efforts underway to try to not forget the lessons learned this time around. I'll come back to collaboration. I think that it really showed that institutions that are competitors can still be competitors for the right ways, but innovate and work together, uh, the reimbursement side is, uh, always gonna be a challenge. And I think that, uh, this pandemic did show that while we may think we have bed capacity issues, there we're certainly not capacity, um, whether capacity restraints that tested the system. So I think that the three institutions represented up here represent, uh, situations where we probably share a lot in common with regard to the kind of day-to-day problems that we had to deal with. So,
Speaker 1:Yeah, I think, uh, what I, I mean the, yeah, the supplies, the idea that, you know, you solved the pictures of, of nurses in garbage bags and knowing that you, there wasn't enough mass to do certain operations and how we had to look at the definition of what is elective procedure and, and even reflecting on, on that and, and closing down hospitals, um, it on the same side. So Rich, we have, you know, you and I have known each other a long time and, uh, we've, we've always chatted a lot about rural healthcare, right? Um, something that we both had a lot of passion around something that could potentially be not solved, but thought through with, with the expansion of telehealth. Uh, at the same time, you know, we've got broadband issues and we saw these other issues hit healthcare on reflecting on back upon the year yourself. Like, what have you thought about, like, on the things that you cared about and you knew were either good or positive in the system? What have you been thinking about?
Speaker 3:Well, I tell you, thanks sir. You know, thinking back over the past year, and I'm sure Mark and, and Dave can, uh, think about these items as well. You know, however, many months ago we shut down elective surgeries, elective procedures, in order con to conserve, um, you know, p p e not only for our folks and our employees, but also, you know, for the communities, uh, that we serve throughout, um, our service area. You know, when we did that and then we also furloughed employees, we cut salaries because obviously revenues were down significantly and we were getting ready for a surge that really never came when we thought it was going, going to come in mid-summer. Last year, our surge here in our service area in South Dakota, Minnesota, Iowa and Nebraska came during, uh, essentially Thanksgiving time, uh, where we saw a tenfold increase of inpatients all throughout our system. We went from 30 to 40 a day to over 300 a day in our hospitals, um, being cared for Covid. And that was Covid. Remember, other folks had, you know, heart attacks and strokes and, and other maladies that we had to treat as well. But during the time period in which we were conserving resources, we, we didn't really know it at that time, but we were getting ready for our surge. Um, we had the resources, uh, we had the people, and we had the locations ready to take care of the folks who came to us for care. Now, it was stressful, it was hectic, it was really at points maddening, um, because of the situations where we found ourselves and in taking care of so many folks who needed our care. But we got through it, we learned many lessons from it, and we're hoping and knocking on wood each and every day that we don't have another surge as we did late last year. Um, but the lessons learned are first and foremost, you know, be ready for what comes, um, at you. You know, save, conserve and be prepared. And through that preparation, we'll get through it and we'll take care of those individuals who come for us for their care
Speaker 1:Marker. Or Dave, do you wanna respond to what Rich said?
Speaker 2:Everything Rich said resonates with me, but the thing that I take away most is that What we never thought about, and frankly, what we would never have thought to plan for, nor frankly in my personal opinion, should anybody ever think to plan for, is that you would have to compete with the government for supplies. That the government's role would not be a purely supportive one. That federal policy on assisting the healthcare system during a pandemic relied more heavily on, on political favoritism than it did on actual improvements in the system in patient care. I mean, we spent, you know, innumerable hours, all of us looking for supplies, and in some cases we thought we had supplies until the government said, no, we're going to take them, or you can't have them. Or this is for the national strategic stockpile, which then somebody in the government said, but it isn't really a national strategic stockpile. It's really a stockpile for the people we like. Uh, you know, that's an outlier. You can't plan for, you know, the economics minor. Maybe this is an externality that you just can't do anything about. We just have to hope we get better policy that our, that our politicians and our government learn from this experience and sort of hardwire better processes so that those systems, those stockpiles, those processes are really focused on one thing, helping the people who provide the healthcare, because that's what we needed.
Speaker 1:I think one of the projects that was, uh, there's a couple moments where I look back and I think these are really strange as a health attorney that I'd be working on them. One was a fashion client that said, I gotta start making masks for hospitals. And was this before the FDA guidance came out and saying, okay, we just gotta do the right thing. Like, I don't know what that's gonna look like. Cause we have no legal guidance yet. We, we eventually there was, um, but we have to do the right thing. And the other thing that was surreal was like calling people that said, I know somebody who's like making x, y, Z supplies. And I felt like I was calling all these people like a supply chain person saying, I got some masks, everybody, or I got a, a shield, or I got, it was a very weird place to be as a lawyer, but it felt very necessary. And, and I felt like that if I had that information, I had to get it out. Uh, Dave, we're listening to what Rich and, and Mark said, and I guess what I said, like, what, what are some of those, what are some of those responses? Well, how did you, you know, you say we're gonna ready, we're gonna get ready for the next one, which there's a lot of people that believe there might be like even two more in our lifetime. What, what do you, what do you say?
Speaker 4:Well, I think that, um, I think the preparation with respect to both, uh, p p E and then with regard to the science, we just have to do it. And I think we learned a lot collectively with regard to responding and cooperations. I've said, um, I think that no one can predict what's gonna be coming a year from now. Uh, but I think that some of the modern systems and developing vaccines and, and information and just some of the basic stuff that we learned that we don't have enough public health, uh, protection. We don't have enough, uh, really services. But I'm gonna focus a little bit on a few very positive, I think, uh, things that came out of this. I think that, uh, we saw that and we were not alone, but communication with very what was going on, what you could do, uh, was critically important for people to get through this. So we, uh, our c e o and others communicated the other thing that while there were problems with, with government issues, I think we saw primarily with regard to Ohio and Florida, that there was really unprecedented cooperation to, uh, among hospitals, the state, and again, I'll leave the politics out of it, but I think that, uh, we've got 50 separate systems that make decisions. And I think that, uh, we thought that the cooperation in both of our primary locations, uh, really helped. Um, and we learned that. I think the other thing is lawyers. And I know that the two general counsels joining me and you, Sarah, it was a time that you had to make decisions. We all have to make decisions rapidly, but I think it really was training for younger lawyers and some other lawyers with that. As you said, Sarah do the right thing. Yes, you gotta check the regulations, you gotta all that, but, but you had to make decisions based on judgment, which is what we all do as inside general counsel and working with our team. So I think a lot of positives came out of it. And, uh, but let's have a boring year. I mean, that would be nice,
Speaker 1:<laugh>. I think that would be very nice. Right? Um, one of the things that's happening right now as we speak today at the end of March is there's, uh, when you talk about the 50 state view, which I think there was, there was like a federal government, and then there was a 50 state view. Even just as we look at how waivers work or how governor orders work, there is this, there is this layered approach in healthcare that we all know about. That's we, the, the life we live, but we're watching now, um, some of the states open back up and we're also seeing, you know, the federal government, uh, taking certain stances. How do we, how have you been balancing in your job, you know, looking at those, or even, like you said Dave, like looking at attorneys that work for you, maybe they're younger. Um, none of us have been through this, so I can't say they've been through this or not been through this. None of us have been through this. But how do you, how do you mentor or coach, or how do you staff when you're looking at changes like that, that are happening, uh, just as we think it's maybe we're, you know, getting used to a certain level of, of maybe closures or orders, working things, a level of change, again, with, with dates opening up, uh, mark, how do you manage that from your viewpoint when you're looking across, you know, your, your, your system or, and managing those, those changes?
Speaker 2:So, you know, Sarah, my, my philosophy with all the folks I work with has always been that, you know, it, we're primarily navigators. Our operators tell us where they want to go, and we tell'em, here's how you can get there very, very fast, but you might crash the bus to kill everybody. Here's a middle of the road route to get there that's relatively fast and relatively safe, and then here's a completely safe way that probably doesn't meet your business goals. And so, what I can tell you is over the past year, I've never had more opportunities to say yes in more ways. And I think that that's Dave said, focusing on positives here, I've been able to both lead by example, you know, by thinking outside the box to say, guys, look, nobody's ever gonna sue us for this. And if they do, I defy a jury to, to find in, in their favor. Um, you know, or let's do this. You know, I know I, I saw that Rich's team is doing this. I think it's a great idea. Let's, let's just implement it. We need to do it because we have such a tremendous public health emergency. And so, if anything, over the past year, what it's enabled me to do is to instill in the folks that I work with, perhaps even more of that, let's get it done attitude. They still need us to be the guardians of the company's legal risk and ethics program. They still need us to take a very measured approach. They still need us to give really good and wise counsel, but we never needed to be more nimble. We never needed to think more outta the box. And we never needed to be more aligned with the fact that every decision we make ultimately impacts patient care, the ability of a patient to receive care, the ability of a caregiver to provide it. And that's sort of both transformational on the one hand and disruptive on the other. The level of change that's occurred in the past year is gonna be great for our profession as helpers, as long as we capture that and we continue that spirit.
Speaker 1:So, rich, how about you? How do, how have you, you know, stayed nimble or how have you mentored your legal department ar regarding these changes that, that were happening so rapidly? Like I, I, I remember looking up something and advising a client in the morning, and like something changed by like a few hours later. I, I mean, they were, that they were that fast. I, I don't know if the changes are that rapid right now, although the unwinding of some of these waivers and orders are creating this level of, of rapid change.
Speaker 3:Oh, those are great points. And Mark, I would just echo everything that you said. You know, back during, uh, March, April, may last year, as you said, Sarah, we could provide advice 8:00 AM in the morning, and by noon it could change, and by five o'clock it could change again. Uh, so what I was able to do with my legal team is really assign, uh, one attorney to really keep track of those regulatory changes, the waivers that were coming, um, at us, uh, not only from, uh, the, each one of the states that we operate in, but also the feds as well. And eventually the document that, uh, he worked on the last I looked at, I think the last update was a couple months ago. It's well over 120 pages long of all of the, the waivers and, and all of the, uh, individual state actions that have occurred in order for us to do what we need to do. And in the final analysis, as Dave and Markable said, we take care of people and that's what we do. Um, you know, did we, uh, you know, skirt any laws, rules, regulations? Uh, no, no. We worked within all of, um, uh, our abilities to take care of people. And so other folks on my staff as well. Then, um, I assigned to physician clinics or our clinic operations, and then also to our acute care operations so that everyone was on the same page and moving forward to, once again, that ultimate goal, and I hate to repeat it, but it is worth repeating just to take care of people as they came to us for their care needs.
Speaker 1:So rich, one of the things we talk about on this podcast, a little bit about our ourselves, I think one of the goals I, I ended up coming out of this podcast, and I think just generally was this idea of allowing to be a, a, a human and an attorney at the same time. Uh, that or, and anyone at the same time, it almost regardless of profession, that there's some something that opened up I hope that will stay. This concept of like, we are human, like we have lives outside of work and, and when we can be our, our authentic self and we can feel like we belong, we're better at our jobs, we're better at our decision making, that that actually opens up innovation and that professionalism that, that Dave and Mark and you were talking about. Um, for me there's been also like those kind of like, oh, my moments, right? Where I think on the last podcast, I, I said, you know, I I really stay at home. Like that's my choice. My kids are an in-person school. I am wildly grateful for that and I, you know, wanna keep the community safe. So this is my choice. But I, I went to the dentist the other day, like, I think it was a few weeks ago, and I like, was giddy when I was leaving because I like had human to human contact that I don't have. Like, I talk to my kids and my husband and a lot of Zoom calls where I see people on screens, but I don't actually like, see or talk to people. And it really hit me that like, level of humanity and, uh, I'm hoping that that comes out of this podcast. And, um, and we've heard all kinds of people say different things from, like, I go golfing, do I meditate now? Or I get up and run, or I used to run and now I don't. I wish I did. Um, uh, rich, what are some of the things that you've thought about, um, since that last time of your kitchen where everyone's spread around your house,<laugh> kitchen table and you and, but your, your son? What are some of the things that you've thought about personally that have helped you get through this time or that you've reflected on personally?
Speaker 3:Well, well, I'll say, you know, all of the points that you just made, I could second as well. You know, we have to take care of ourselves. We have to take care of our families. Um, and not only do we have, um, our home families, but also our work families as well, just to make sure that everyone is clear and focused, uh, on the job at hand, um, in our offices, but then also at our home life. You know, you have to take care of what is necessary to keep your home going, uh, so that everyone is, uh, safe and comfortable. And one thing that I found a new appreciation of was, you know, a treadmill. And believe me, getting on a treadmill every morning and just walking or running is invigorating for me. And, um, I, I found that to be a positive and I still do that to this day. I try to do that every morning and, um, just keep on walking. I don't know where I'm walking, but, you know, I'll get there eventually. Um, but one thing I did wanna mention as well is, and I don't know if Mark and Dave and, and Sarah, you have found this, you know, succession planning, um, in the office is, is extremely important. We've had several retirements, uh, not only of C-Suite folks, but um, vice presidents, directors, but also just this morning, um, just had a conversation with an attorney that we've been working with in his firm for, I don't know, 30 years or so. Uh, and he has, uh, announced his retirement. Um, he just said, you know, he's been going a thousand miles an hour and he's, and he's done this date. And, um, they have a succession plan for him. Um, and that just reminded me that, you know, we need to do that ourselves, um, for our own wellbeing, um, making sure that things are taken care of, both on, uh, uh, at our home and in the office. Um, but also, uh, what everyone expects to occur at some point in time. You know, you will retire and you will move on in your life. Um, and you need to have folks ready to take over for you when that occurs.
Speaker 1:Yeah. So, so Mark, you switched jobs<laugh>, uh, during the, the pandemic, uh, there's a couple people that have joined this podcast who did that, and, um, a lot of them were real, were actually motivated by the pandemic to make the switch. So some people may say, no, I wanna stay where I am. Some people like, like Rich said, I've, I've seen this across industry through clients, through my own firm, through even community boards that I sit on where people said, you know, I was gonna be a few years from now, but I, I think, I think it's this year, like this made me realize like, I wanna go out and, and you enjoy life in a different way without, without work. Um, why don't you tell us a little bit about Mark, what you've been thinking about in this year with the transition with your job and, and, and anything else that you heard Rich say that you wanna talk about as well?
Speaker 2:Well, I guess two things come to mind, and the first is that, you know, um, the, there's somebody who's, uh, said, you know, never let a good crisis go to waste. And I think that this crisis caused an awful lot of people to think, well, gosh, what's really important to me? Am I doing what I wanna do? Am I doing doing what I love? Am I appreciated where I am? And, and, and rich hit the nail on the head of something that I'm very passionate about? And that, that's career development and succession planning. I think it's one of the primary jobs of a chief legal officer is to let the people that they work with know, you know, their human capital, because that's our business as human capital in legal, how valuable they are and what your plan is for them, and how they can participate in that career development plan. And everywhere I've been, I've laid it out in writing and I've met with the attorneys and I said, this is what the future looks like, and you can move on this ladder faster or slower, and here are the things you can do to move faster. Here's how we'll evaluate you. It's not fair to got you later tell you, well, we really wanted you to do this, but we never told you. Here's what we're looking for. If you execute on these things, these things will come to you. Um, and, and what I found is that people who do not have that clarity use the pandemic opportunity to determine what their own personal path forward was. And there were a lot of moves made. Now, regrettably, on the one hand, there were a lot of employers who downsized and just forced those sorts of moves. And most of the folks who, who were on the wrong end of those, um, events landed on their feet. And, and I'm sure we all did whatever we could to help them, but on the other hand, there was an awful lot of forward thinking about what do I really want to do and where do I really want to be? And for me, I have twin daughters who are gonna be high school seniors next year, and I didn't wanna commute back and forth to California anymore. I wanted to be closer to home. And that was a big prime driver in my decision. But I can tell you right now, it's more important than ever. I, if you look at the Ale's career website, it's urging there are more openings than I've ever seen in one place, and the recruiters are coming out of the woodwork. Cuz as business picks up, people are not only backfilling the positions that they may have eliminated, but we're forecasting tremendous growth. And if you are not helping in that regard in your department, then your most valuable resources, the people you work with are at risk.
Speaker 1:Yeah. And so Dave, what have you been thinking about, um, with your career or reflecting on this year personally?
Speaker 4:Well, um, rich, I think we're all on a treadmill, whether we're actually on a treadmill or not, but, uh, it seems like a No, I think that, um, I I just wanna say that, uh, I think the law department consisting of the, the lawyers, the legal assistants, the assistants, uh, uh, I am very lucky to have participated in recruiting and retaining a great group of people who, I'm just gonna say, you know, through this pandemic. Um, most of them work from home, uh, got the job done, cooperated used judgment. And so, uh, my job is in one sense, uh, easy because of the, the, the talent and the judgment that they're out there. So I think that, uh, any of us want to see individuals have that career development opportunity, certainly succession planning. Um, I think what probably drives all of us is you get to be a counselor and not just, uh, working on a particular problem. I'm certain all of us have a day. You can't plan your day, you never get bored. So, uh, realizing that there's a lot of suffering out there during this year, I think that the amount of change, innovation, the teamwork, uh, is kinda exhilarating. And obviously we don't forget about the patients who didn't make it through. But I think that, uh, it's, it's was a good time to see the teamwork that developed. And I think all of us see that. Um, personally, I think we all say we're gonna exercise more or do this or that, but I think that, that by and large people reflect back and say, yeah, I want to have the work-life balance thing, but you gotta love your job. And I think that, um, that, uh, I've been, I think, very lucky to have something that is easy to, let's say, find interesting projects every day. I have come into the office about every day because a lot of the collaboration is with a small group of the leadership, which I find, uh, really you can do a little bit over a zoom call, but it's difficult. And I think that is the vaccines stakeholder, like the, that getting back to the office, but also learning that working from home is truly viable. Uh, we have started to hire some people out of state, uh, and find that the technology permits us to do it. So bottom line, you got interesting work, you're not bored and you're doing something that I think is socially rewarding, um, makes it a lot easier.
Speaker 1:Yeah. I, one thing I would like to hit on something again that I think you said, Dave, about, you know, your international footprint and, and Mark has known me long enough to know this is something that I've always tried to figure out in my growth and development and interest of this idea of international, like what, like this, that, that I felt the synergy of, we're all connected. And right now when we look at the vaccine and the variants and the distribution of the vaccine and the movement of the variants and this idea of a, a vaccine card to travel and, um, you know, it's, it's really even hit me harder, how, how connected we all are, this pandemic has shown. That's something to me personally that I, i again, very passionate about, but I, I see it so, so clearly now and that, that, that, that might be part of our solution or our planning. It's not just to look to our 50 states and ourselves, but maybe to look past our borders. Uh, does anyone else wanna talk about that or have you been, has it been something that's been on your mind?
Speaker 3:Okay, well, just real quick, no, as both Mark and and Dave have said, you know, rely on your teams, um, and your teams are not just those in your office, but your teams over the years. You know, one thing about gray hair, uh, you acquire not only gray hair, but colleagues around the country through A H L A, rely on those individuals because more than likely the issue, the matter, the opportunity that you're, um, handling at that point has been talked about or dealt with somewhere else in the country. So rely on that network.
Speaker 1:Anyone else?
Speaker 2:Yes, Sarah. The, the, the one thing I synthesize from all of that, you know, and, and, and a lot of what Dave said his home is that this is a job that can be done remotely by high performers. People who are not great performers have a tough time meeting, at least my own personal expectations. But if you lay that onto what Rich just said, which is sometimes geography matters, sometimes you have somebody who's working remotely in a different part of the country or just a different part of the state. So as you know, we are seeing something where we're getting a great result that might be good over here. Communication's imperfect at best, the dissemination of information is imperfect at best. We are trying to remedy that with, with podcasts like this, but it's not just, well, people like telecommuting so will do it. It's not just, oh, we will save money on office, overhead will do it. There is an intrinsic benefit, I think, to having that remote distribution, better viewpoints, better diversity, better experience. I've always tapped into the A H L A network, but now that I have experience with having employees who are more remote, I I'm noticing that we're developing our own intrinsic network to give, bring that disparate information to the benefit of all of us. And I think that's a really powerful tool. People tend to forget when you, you're an old school person thinking we could never work remotely. You know, I saw in the paper today that Citibank CEOs said, the days of everybody coming into the office every day are over, but we will never get to a point where nobody ever comes into the office. So there's a middle ground there, there's there to me, there's uh, you know, an important place for that socialization and, and those connections you make in the office. But there's a real value above and beyond just cost savings and employee satisfaction to having a distributed legal workforce.
Speaker 1:Well, if you guys can bear with me, I'm gonna surprise you for a second and I'm wondering if you'll play a little game with me. I play it with my kids. I have twins as like Mark and, uh, they're a lot younger, but we play this game called high, low, haha. The high is the best part, the low is the lowest part, and the last is the funniest part. And we try to talk, do this at dinnertime or at at bedtime to, to, to frame our day. So, um, so if I could, if you could do this with me, I like, I think it would be a great way to, to talk about this year. So if you could think of the highest part of your year, the best part, the lowest part of your year, and the funniest part of the year, um, I would, I would love to hear it. Um, I can say, I'll, I'll go first so you, I can give you guys a chance to think on your feet. Um, but the highest part of the day for the highest part of the year for me was, was really feeling like I was making a difference to get information out and that maybe that was actually changing or saving lives out there and, and working on innovative projects, that was my high, my low was trying to decide whether my kids were gonna go into in-person school or not. That was a personal low for me. And I think my funniest part was my kid walking in with scissors while I was being Zoom taped and like trying to figure out how to tell him while still looking at the Zoom thing, um, that I I, that I needed him to walk away. And, uh, that was, it just makes me laugh. Um, how about, how about, how about Mark? I'll start with you.
Speaker 2:Well, you know, to me the high part was all about patient care. When I was at my former employer, we discharged a patient from one of the hospitals who was one of the earliest covid patients, and he'd been in the unit for, you know, a hundred plus days. And, and, and that was really just a spectacular moment for me. Um, you know, as a former caregiver, there's nothing better than when you have a great patient care outcome. And then the low point, um, almost at the same location was, uh, the death of a couple of EMS providers who really just went above and beyond to care for covid patients and ultimately succumbed to covid themselves. Um, and, and, and, you know, I I, and the system will never recover from that. Um, the haha was, I invariably found that my daughter's cat liked Zoom more than I did. And although I did not have a cat,<laugh> had a cat on more than one zoom qual. Um, and it did not go unnoticed.
Speaker 1:<laugh>. Um, how about you Rich? What's your high low Haha,
Speaker 3:I will say, I just echo the high would be, uh, the teamwork. Um, as I'm sure Mark and Dave and others around the country set up their own incident commands and we were a part of that, and the singular focus was taking care of people. The low, um, is just, uh, conversely, uh, you know, just, uh, the unfortunate deaths of, of individuals, uh, throughout the, uh, states that we're in, uh, those small rural areas. Uh, when one person dies, it just affects the entire community. And not only for that day, but for, you know, possibly, uh, a generation to come. And then the haha was, well, a couple ahas at that incident command. Uh, we tried to do something different every Friday, either, I don't know, a hat day, uh, jacket day, you know, something to see what, uh, individuals would wear to make things a little, uh, uh, a little more lighter, let's say. Um, but then also a, as mark indicated as as well, my try at social media and trying to tweet and Facebook and other things has not gone very well. So, um, you know, we'll see if that comes about even more. But right now the jury is out
Speaker 1:And Dave, how about you
Speaker 4:Can't top any of'em on the list, but the high is undoubtedly when you kind of work through a problem as a team and, uh, deliver something that really affects patient care, whether it's some regulatory issue again, or figuring out a new way to say yes. And I, we've all said as general counsel, getting to saying yes in the right kind of way was, was, uh, exhilarating at times. The law is undoubtedly, I mean, I could, as you say, patient care issues. I think that some of the disparities, um, uh, in healthcare access, certainly I think the, the issues with regard to race were very troubling this year. The haha moment. I think that probably, uh, it all goes around zoom moments and some of'em, which I could talk about, but some of'em I shouldn't talk about. But I think we all had those, those episodes. I, I know all the dogs that my, the fellow lawyers, their names and a like, but there are a few things I'm just gonna say for my book, which will be coming out, uh, shortly and then we'll go from there. So
Speaker 1:I see one of the stories you told I that you will not, will not be on this podcast, I did tell my kids, and that might actually be my funniest moment of the, was telling my kids that Joe<laugh> because, and you guys all have to guess what it is cuz it's kid appropriate. Um, but uh, it, they loved it. So thank you for that cuz that is actually one of my favorite moments was laughing with them over your Zoom joke, um, and explaining that to them. So, um, I also appreciate you bringing up the concept of race. I think one of, uh, if I really had to reflect on my national saddest moment that wasn't personal, like was uh, was texting one of my friends in like March or April about what I thought some of the numbers that were coming out around race and saying, this is gonna be a problem and we already knew it was and it's gonna get bad, and then it did. And I think that was really, that was really sad to me to watch that actually be true about our healthcare system. So, um, so each of you, is there anything you'd like to leave our audience with? Something that you'd like to leave them with? Um, I'll start with you Dave, since you were just speaking.
Speaker 4:Well, I think that we've shown that, um, there's lots of tragedy, but we did get through this and I think, uh, we're all better, more knowledgeable, so, uh, this too will pass as a phrase that I think you have to have when you've got adversity.
Speaker 1:Great. And you rich,
Speaker 3:I would just echo what, uh, Dave said, uh, first of all, you know, and also thank H l a Sarah and, and David and Mark for, uh, for this podcast, very enjoyable. Um, keep taking care of yourselves and, um, get vaccinated when your turn is up. And, um, maybe next year we can look back on this and, and know that, uh, COVID may something that's in the rear view mirror. Thank you.
Speaker 1:Great, thanks. And Mark,
Speaker 2:I'll I'll say the same thing I said last year, which is, you know, we are in the business of taking care of people. Go find somebody whose job it is to lay hands on people to support the people who lay hands on people or doctor a nurse, paramedic and emt, uh, a housekeeper, a food service person. And just thank them while they've been through because each and every one of them has gone above and beyond in conditions that we never thought would've occurred and, and, and have given of themselves in ways that we never thought was possible. So I I just wanna remind everybody that, you know, the work we do supports them, but the work they do is indispensable. So thank you to all of them.
Speaker 1:Oh, I'm gonna thank the audience and thank you three for coming back. Uh, it's a wild year. Um, I would've never thought that we would, uh, be doing this podcast a year ago and here we are a year later. But I really appreciate your insights and uh, I will tell you, just so you three know that I did, you know, heard people say like I'm listening to this has helped me either personally, professionally, and so I really do appreciate you joining us today.
Speaker 4:It was a pleasure. Thank you All
Speaker 3:Pleasure. Thank you.