Latest / Becker’s Healthcare Podcast / Dr. Tom Shanley on Expanding Pediatric Access and Advancing Lurie Children’s Mission

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Dr. Tom Shanley on Expanding Pediatric Access and Advancing Lurie Children’s Mission · Becker’s Healthcare Podcast

0:01
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0:31
Hello, everyone. This is Jacob Emerson with the
0:33
Becker's Healthcare podcast. I'm thrilled today to be
0:36
joined by doctor Tom Shanley, who's the president
0:39
and CEO of Lurie Children's.
0:41
Doctor Shanley, thank you so much for taking
0:43
the time to be with me on the
0:44
podcast this morning. My pleasure. Thanks for having
0:46
me, Jacob.
0:47
Absolutely. And and, Tom, before we dive into
0:49
everything we wanna talk with you about, can
0:51
you first tell us a little bit more
0:52
about yourself, your background in health care? And
0:55
and for our listeners who might not be
0:56
familiar, a little bit about, what you do
0:59
at Lurie's.
1:00
Sure.
1:01
So, well, first, in addition to now serving
1:04
as president and CEO,
1:06
my professional background is as a physician.
1:09
I'm trained as a pediatric intensive care unit
1:12
doctor,
1:13
and also did a number of
1:16
research work as well, in the area of
1:18
immunology.
1:20
So that always tried to combine
1:23
the discovery enterprise in advancing what we do
1:26
in clinical care. And so certainly
1:28
relevant in terms of opportunities to do that
1:30
with critically ill and injured kids that I
1:32
had the opportunity to care for.
1:35
Fantastic. No. I appreciate the personal background, Tom.
1:37
And can you tell us, just for anybody
1:39
who's not familiar, a little bit about Lurie
1:41
Children's,
1:42
who you serve, where you're based, and just
1:44
a little bit about your facilities.
1:46
Sure.
1:48
Well, we we're a very unique organization
1:51
in both the city and the and across
1:53
the state.
1:54
We are the only
1:57
freestanding,
1:57
comprehensive,
1:59
acute care pediatric hospital,
2:01
in the state, and
2:02
really proud of our ranking in US News
2:04
and World Report as the number one children's
2:06
hospital in the state of Illinois and, among
2:09
the leading the nation's leading children's hospitals.
2:12
We are in the process of really
2:15
evolving from a hospital, Lurie Children's Hospital, to
2:19
more of a health system. I'm sure we'll
2:20
talk a little bit more, about that.
2:22
But in doing so, really privileged care for
2:25
kids that come actually from just about every
2:27
county across the state,
2:29
as well as the Midwest Region and nationally
2:31
and internationally.
2:33
An aspect many people don't typically know about
2:36
us, perhaps, is that we're also
2:39
the top Medicaid
2:40
the pediatric Medicaid provider in the state.
2:43
Nearly 60% of our inpatient activity is covered
2:47
by Medicaid. So, you know, thinking about it
2:49
from that standpoint, we really are a bit
2:52
of a critical safety net hospital for
2:55
organizations.
2:56
In addition to that,
2:58
we have our academic partnership with Northwestern University's
3:02
Feinberg School of Medicine
3:04
that really embraces
3:05
much of our training activities
3:07
for our pediatric residents and fellowship program.
3:10
And then, of course, our research enterprise.
3:13
What we really,
3:16
ground ourselves in is our multi pillar mission,
3:19
and we describe that as care, which includes
3:21
c for clinical care, a for advocacy, r
3:24
for research, and e for education.
3:26
And so each of the areas we strive
3:28
for excellence in advancing
3:30
the health and well-being of kids we're privileged
3:32
to serve.
3:34
And, Tom, let's dive into some of the
3:36
things you just mentioned, evolving into more of
3:38
a health system,
3:40
the the Medicaid piece of what you mentioned.
3:41
We'll talk about that in just a little
3:43
bit.
3:44
But but, obviously, as you know, Lurie just
3:46
opened a new outpatient facility out in Schaumburg.
3:49
You're planning a new inpatient facility in Downers
3:51
Grove.
3:53
So so talk to our audience about what's
3:54
driving the strategy here for these suburban facilities
3:57
and how you're really thinking about which services
4:00
can move
4:01
into these communities versus what needs to remain
4:04
concentrated at the flagship hospital here in the
4:06
city.
4:07
Sure.
4:08
Well, I think,
4:10
first and foremost,
4:11
the principal driver of the strategy is a
4:14
focus on the kids and the access that
4:17
they need
4:18
for,
4:19
excellent and high quality
4:21
specialty
4:22
and primary care. And
4:24
what we,
4:25
recognize as we look across both our market
4:29
in Chicagoland as well as the national market,
4:32
there's an increasing recognition that what
4:34
we do here at Lurie Children's and many
4:36
of our national leading peers
4:38
do is not easy,
4:40
to put together comprehensive
4:42
multidisciplinary
4:43
programs with a plethora of faculty that are
4:45
expert at that and to have that the
4:48
degree of patient volume to drive the experience
4:51
that re that results in the high quality
4:53
of care.
4:54
And when you think about the systems that
4:57
aren't necessarily
4:58
laser focused just on kids,
5:01
it's very challenging for them to provide that
5:03
kind of service line. And so we're seeing
5:06
across our market and others, people getting out
5:08
of the pediatric service business.
5:11
And that leaves a dearth of where these
5:13
kids, particularly in the Far Northwest Region, that's
5:16
that explains why we wanted to get more
5:18
proximal in the Schaumburg outpatient facility,
5:21
and then the Western Suburban Region as well.
5:24
It it also, you know, makes strategic sense
5:27
for us as an organization because we do
5:29
believe that
5:31
we have the opportunity,
5:33
to develop sustainable clinical service programs with this
5:37
expansion.
5:37
And I'll talk a little bit about what
5:39
that looks like both from the ambulatory standpoint
5:42
in terms of casting a broader net for
5:44
our subspecialty,
5:45
But also as well, you asked the question
5:47
about the differential of care, if you will,
5:49
for example, in our in our, plan Downers
5:52
Grove initiative.
5:54
So as we think about,
5:56
that particular market, first of all, we've had
5:59
services there, for a number of years in
6:01
our Westchester site where we provide ambulatory surgical
6:04
care as well as some ambulatory subspecialty care.
6:07
We were, we knew over time we were
6:10
outpacing our capacity there, and we're looking at
6:12
how to
6:13
phase our next replacement strategy there. As we
6:16
did so, we looked very closely across
6:18
all the types of pediatric services that are
6:21
requested by patients and families in that region
6:23
and how they may or may not be
6:25
adequately met and delivered. And so we recognized
6:28
it provides us an opportunity not just to
6:31
expand
6:32
those services, ambulatory surgical care and ambulatory subspecialty
6:36
access, but also provide both inpatient and emergency
6:40
care.
6:41
We recognize that about half of the kids
6:43
in that region leave that region to get
6:45
inpatient care. And so we felt that being
6:48
able to keep kids closer to home where
6:50
they where they play, where they learn,
6:53
and where they study is a much makes
6:56
much more sense for them.
6:57
And it it enables us to not have
7:00
to make,
7:01
parents,
7:03
make a differential chain
7:05
a a choice between convenience versus
7:08
competence and excellence. And so rather than saying
7:10
we're gonna go
7:12
somewhere different,
7:14
because it's closer and don't have to come
7:15
downtown, we wanna make sure that we're bringing
7:18
that service capability much closer so families aren't
7:21
sort of forced to make that decision.
7:23
So excited. The other asset that will be
7:25
out there is the pediatric emergency department. And
7:29
right now we we, staff with our partnership
7:31
with Northwestern Medicine,
7:34
most of the day at Central DuPage Hospital
7:36
with pediatric emergency medicine trained physicians. That's really
7:39
the only
7:40
service that's out in that entire region that
7:43
is focused on pediatric emergency care, which is
7:46
very different and requires very different expertise than
7:49
adult emergency care. So we believe that too
7:51
is going to be an enormous,
7:54
enormous asset for this region to be able
7:56
to provide stability for kids.
7:59
I'll just touch briefly, Jacob, that you asked
8:01
about sort of that level of care and,
8:05
this institution,
8:06
in Streeterville, the flagship hospital will always be
8:09
the place where we provide that high quality,
8:13
and high tertiary
8:15
so called coronary care. So kids with heart
8:18
failure that may need a cardiac transplant, kids
8:20
with,
8:21
cancer that may need,
8:23
a bone marrow transplant.
8:25
Though that type of care will always be
8:27
anchored here at this facility because it requires
8:29
a a unique environment and a unique workforce.
8:33
What we will be placing out in the
8:34
Downers Grove is a a slightly lower level
8:37
of care capability.
8:39
So for example, today, we we have a
8:42
number of kids in our hospital
8:44
impacted by
8:46
lung viral infections where their oxygen level in
8:50
in normal room air is not sufficient. And
8:52
they need a little bit of oxygen to
8:54
recover, but they don't need extensive services beyond
8:57
that. We have kids that often come in
8:59
with, significant vomiting and and diarrhea that might
9:02
be dehydrated
9:03
and can't do that on their own, but
9:05
need intravenous fluid therapy for a period of
9:07
time. Those are the kinds of kids that
9:09
we anticipate,
9:11
often leave
9:12
that their region, to get that kind of
9:14
inpatient care that we'll now be able to
9:16
provide for them and keep them local for
9:18
that aspect of it. And we've had a
9:20
number of, you know, we we've had experience
9:24
in managing
9:25
how to triage that level of care. So
9:28
I think it's something very familiar to our
9:30
providers that we'll do safely and effectively with
9:33
our new site.
9:34
Understood. So these new sites, they're gonna be
9:36
working in tandem with the flagship hospital downtown,
9:40
but this is all really to meet the
9:41
access demands that you are seeing and hearing,
9:45
from patients out in in, out in the
9:47
suburbs.
9:48
Staying on this topic, Tom, Lurie is opening
9:51
the Austin Hope Center on the West Side
9:54
Of Chicago later this year.
9:56
Can you tell us a little bit more
9:58
about this project and
10:00
more contextually how you think other children's hospitals
10:03
should be thinking about meeting the needs of
10:05
more underserved
10:07
populations across the country?
10:09
For sure. I think it's such an such
10:11
an important area today, Jacob.
10:13
The the high level summary I I would
10:16
put on this is that, you know, two
10:19
things kinda come to mind. One,
10:22
too often,
10:23
a child's ZIP code has a much higher
10:26
impact on their health outcomes than their
10:29
genetic code. And that's because of all what
10:33
we describe as social influencers of health. It's
10:35
often described as the determinants of health,
10:38
that that conveys a deterministic
10:41
factor from those, situations, and we believe they
10:44
can just be influential and that we can
10:46
help address them. And so the other component
10:49
is that health is, not just about health
10:52
care, but it's the broader environment. And,
10:55
we believe that we need to be a
10:57
component
10:58
of the
10:59
comprehensive
11:00
health and well-being of kids.
11:03
So,
11:03
we have a number of initiatives that progress
11:06
in that area through what we call our
11:09
Magoon Institute for Healthy Communities.
11:12
My privilege to to succeed, Patrick Magoon, who
11:16
was the CEO for twenty two years here
11:18
at Lurie Children's and, with his retirement took
11:21
the opportunity to name,
11:23
this area, which was such a high priority
11:25
and focus for him that we're extremely proud
11:27
to carry on.
11:28
And in Austin,
11:31
as we work through,
11:33
an opportunity
11:35
to enter into the neighborhood in partnership with
11:37
the Stone,
11:38
church,
11:40
to develop this, it's an effort for us
11:42
to be
11:43
a component of a holistic approach to what
11:46
our our real vision is, and that's to
11:48
be a transformational
11:49
force for health and well-being to achieve the
11:52
healthier future for every child. And that's every
11:54
child regardless of where they they live. We
11:57
know that this particular area of the West
12:00
Side Of Chicago has been under resourced for
12:02
a number of years,
12:04
and we have an opportunity
12:06
to come in at what I would describe
12:08
as the generational ground level.
12:10
Because one of the most important challenges we
12:13
have in Chicago in many urban sites is
12:15
the differential in terms of,
12:18
longevity
12:19
of health.
12:20
And we have too too much of an
12:22
adult disparity in terms of health outcomes here
12:24
in Chicago and in other urban sites.
12:27
You can try to address that at the
12:29
adult level,
12:30
but we believe that this requires a generational
12:33
investment in kids.
12:35
And that if we can elevate the health
12:36
and the well-being and the education
12:38
of kids, they can be that next generation
12:41
of adults that continues to remain healthy and
12:44
to remain productive and to really drive the
12:46
future
12:47
of our city.
12:49
So you can't do that just with health
12:50
care. And so this is an effort where
12:52
we're bringing both our clinical services
12:55
that the community has identified as needing most,
12:59
and that's the key component of this. You
13:01
can't go in as a system and say,
13:03
we believe we know what you need. You
13:06
need to go in and understand from them
13:08
and from the community based organizations, from the
13:11
patients and the families, and from other providers
13:13
that are already existing in that community
13:16
to not duplicate what they do well already,
13:18
but to complement that. So we're very excited
13:21
to have an integration of the primary care
13:23
services, bring some behavioral health and social support
13:26
structures
13:27
along with access to subspecialty care that too
13:31
often is not provided and results in unnecessary
13:34
hospitalizations,
13:36
and too often is not being taken care
13:38
of in the community and necessitates them coming
13:41
in to the emergency department really unnecessarily.
13:45
So I will just say
13:47
parenthetically to keep in mind, this is certainly
13:50
first and foremost an investment in the kids.
13:52
That it is going to make a tangible
13:54
difference in them.
13:55
But in the long run, this is also
13:58
an investment
13:59
in reducing the cost of care. And so
14:01
when we think about the challenges, I'm sure
14:03
we'll talk about the Medicaid
14:05
funding challenges that we have coming.
14:07
This is a way to overall reduce the
14:10
the cost of care by significantly elevating the
14:13
health outcomes.
14:14
So we believe not only is this the
14:16
right thing to do for kids, but, honestly,
14:17
in the long term, we think it's the
14:19
right thing to do for the state of
14:21
Illinois in terms of the cost of care.
14:23
Absolutely. No. It's it's incredible to hear the
14:25
investments that you're making into this part of
14:27
the city, and and I do wanna follow-up
14:30
with you on on the Medicaid changes that,
14:32
we are seeing coming down the pipeline
14:35
under HR one,
14:37
largely going into effect next year. But I
14:40
know I know your organization has been,
14:42
really preparing for this ahead of time.
14:45
You you
14:47
said publicly, I believe, last year that you
14:48
were conducting a clinical program review in response
14:52
to some of these these changes,
14:54
under HR one, and it's nearly 60% of
14:58
your inpatient stays are covered by the program,
15:00
I believe.
15:01
So, you know, we've been hearing from leaders
15:03
all over the country, both from health systems
15:05
to insurers, about how they're how everyone is
15:08
prepping now,
15:10
to get ahead of this this massive change
15:11
for the entire system.
15:13
Can you give us the Lurie's,
15:15
version of that and how you're navigating this?
15:17
Yeah. The Lurie perspective of all that.
15:20
Well, you know, I mean, in in in
15:22
doing so,
15:24
you know, I I think it's important.
15:26
Look,
15:27
Medicaid is is a critically important program for
15:30
the country.
15:31
People often don't realize that half the country's
15:34
kids are covered by Medicaid, and that's certainly
15:37
the case here in Illinois.
15:39
Despite that, they only they're only responsible for
15:42
about 18, maybe 20% of the overall Medicaid
15:45
cost. So to me, it would again, it
15:48
makes sense to make the long term investment
15:51
in kids is to really sustain the Medicaid
15:53
program at least as it relates to kids.
15:55
And so let's let's
15:57
let's make no mistake about it. HR one
16:01
is a is a disaster.
16:03
That at the same time,
16:06
I'll I'll give the federal government
16:09
credit for recognizing
16:10
there are opportunities to make it better, to
16:13
make the program better. And that's part what
16:15
we just talked about in the Austin community.
16:17
That's part of what we believe are opportunities
16:19
to improve
16:21
the the quality of the care and the
16:23
outcomes at a lower cost for many kids
16:25
that are covered in Medicaid. So we're all
16:27
in on that, but to do it in
16:28
the way that the HR one bill proposes
16:30
to do it is, not not the way
16:33
that we would believe to be approaching that.
16:36
Nonetheless, that's what the future,
16:38
at least at this point looks like we
16:40
have coming. And so certainly, we have to
16:41
look at what impact that that will have
16:44
on the future.
16:45
I will, before we jump to that, just
16:47
parenthetically also just state the, you know, I
16:50
wanna give our Illinois Hospital Association leadership and
16:53
our,
16:54
our, health and family services in the state
16:57
of Illinois
16:58
leadership credit for,
17:00
the success in getting a state directed payment,
17:03
altered,
17:04
for the next couple years for us. That
17:06
brings in a higher Medicaid rate for the
17:08
time being before HR one hits. And so
17:10
that frankly is a lifeline,
17:13
for many of, of us, our critical access
17:15
and safety net institutions. And so we have
17:18
some breathing room. And that breathing room is
17:20
to your point, giving us the time to
17:22
understand
17:23
what clinical programs
17:25
we wanna continue to maintain that we know
17:27
are high quality. We know that they're mission
17:29
aligned. And importantly, as we look at what
17:32
the rates are anticipated to bring, they are
17:34
also financially,
17:36
sustainable from that aspect of it. So
17:39
we also are looking at opportunities in terms
17:42
of technologies that,
17:44
you know, the the AI,
17:46
opportunities that allow us to be more operationally
17:50
efficient and be able to reduce,
17:53
the overall cost and burden of the work,
17:55
but still being able to maintain these delivery
17:58
services overall from that aspect of it. But,
18:01
there's there's no doubt all of us, I
18:03
mean, all of us that have a significant
18:05
amount of Medicaid,
18:06
business are going to be having to make
18:08
these hard decisions as we look at it.
18:11
And so
18:12
my my bigger concern,
18:15
as we look at what the future brings
18:17
is to not forget where the biggest bang
18:20
for health care investment, including Medicaid investment,
18:24
is in the country. And that's still
18:26
in the future generations of this country. And
18:29
so I think as long as we we
18:31
keep that in mind and consider how we
18:33
might be able to adjust,
18:34
the future of Medicaid to ensure that the
18:37
children are covered and that they're,
18:39
continuing to drive,
18:40
health and well-being,
18:42
that is the future of driving our healthy
18:44
communities that will benefit all of us. So
18:46
a lot of advocacy. I'm very proud that
18:48
we're, an important voice of pediatric expertise and
18:52
advocacy,
18:53
both with a very favorable administration in Springfield,
18:56
but, even with the work that we do
18:58
at the federal level in DC.
19:00
But these are going to be challenging times
19:02
coming around the corner, and and, we'll continue
19:04
to work hard on making sure that we
19:05
continue to to meet the demands of the
19:07
kids that we're privileged to care for.
19:10
Certainly. Certainly. Tough decisions, challenging times ahead, but
19:13
it is good to hear, that the state
19:15
is supportive
19:16
of expanded assistance,
19:18
to to help navigate this.
19:21
Going back to what you had said earlier,
19:23
Tom, and just in terms of why you're
19:25
expanding,
19:26
in certain areas and the dearth me trying
19:28
to meet that, dearth of, lack of care
19:31
access you see in certain parts of Chicagoland.
19:34
I wanna read you a stat from from
19:36
some of our recent reporting,
19:38
that that twenty percent of hospital pediatric units
19:41
nationally
19:42
have closed over the last decade.
19:45
I'm I'm sure that's not a surprising statistic
19:47
to you, but I wonder
19:49
what role an organization like Lurie
19:52
should play in the broader
19:54
pediatric care system,
19:56
and how you're thinking about virtual care,
19:59
partnerships like the one with Northwestern,
20:02
labor training pipelines to
20:04
further address some of these access gaps that
20:07
sound like they they could worsen,
20:10
in the region.
20:11
Yeah.
20:12
Well, there's a there it's important for folks
20:14
to realize the some of some of the
20:17
factors that have that drive that. And it
20:19
is not surprising because it was our research
20:21
team that published that work. So,
20:23
we're we're
20:24
too intimately familiar with those challenges across the
20:27
country.
20:28
I I think what we just talked about
20:30
was Medicaid. Much of this really started or
20:33
and was even
20:35
much of it started before the pandemic, but
20:36
was accelerated from the pandemic and a a
20:39
very practical thing that happened during that time.
20:42
Fortunately, kids were not impacted by COVID as
20:44
much as adults. And because of the number
20:47
of adults that needed inpatient beds, many of
20:49
these systems that had small inpatient pediatric beds,
20:54
provided them to adults and
20:57
suddenly realized that when there's an adult in
20:58
the bed paid for by Medicare,
21:00
you do much better than when you have
21:01
a kid in that bed provided by Medicaid.
21:03
So it does get back to that differential
21:05
of of adult versus pediatric reimbursement for care,
21:09
even though I believe pediatric care is much
21:11
harder than adult care.
21:13
So that's one driver is just financially, it's
21:15
more challenging in terms of providing that kind
21:18
of care. The second you mentioned and alluded
21:20
to the workforce,
21:21
there are additional statistics that look at
21:25
the increasing
21:26
challenge that we're seeing of,
21:28
medical students coming out of school and deciding
21:31
to pursue pediatrics, and then even,
21:34
folks that pursue pediatric training going into subspecialty
21:38
fellowship training. Those are all on decline.
21:41
And so we know that there's a
21:43
a a growing dearth of subspecialists
21:45
that are available,
21:46
which which really creates a couple of things.
21:49
Number one, it creates really a a a
21:51
national competition for expertise. And then when you
21:54
go down to a local market like Chicagoland,
21:56
you realize it's really hard to have sufficient,
21:59
workforce to be able to provide the kind
22:01
of services that I've, alluded to that that
22:03
we're privileged to be able to to provide
22:06
because of the the special workforce that we
22:08
have. So that certainly is a key strategy
22:10
for us is to continuing to have one
22:12
of the most competitive pediatric residency programs.
22:16
We're estimated to be the third most competitive,
22:19
meaning,
22:21
folks really want to come, to Lurie Children's
22:23
for their pediatric training. And I think Chicago
22:25
as a great city is also a great
22:27
draw for that.
22:29
And then we're continuing to try to,
22:32
encourage them to come out of that residency
22:35
training program and stay in our subspecialty fellowship
22:38
pro programming.
22:39
So being able to sort of train your
22:41
own and,
22:43
populate that critically important workforce is is really
22:46
critical there.
22:48
Whether you can continue and and I will
22:50
say that those strategies are ones that are
22:52
being shared across
22:54
really the national leading peers that we have.
22:57
You know, it's been it's been it's been
22:58
estimated or projected that
23:01
these large independent children's hospitals and large urban
23:04
areas like ourselves and and other peers are
23:07
are going to be the few remaining
23:10
pediatric institutions across the country that are able
23:13
to continue to sustain
23:14
the kinds of high level, high quality expertise
23:17
in the subspecialty area that we're known for,
23:20
but we're also now seeing that
23:23
come out of the community based opportunities in
23:26
providing care. And so we're all
23:29
taking the opportunity and responsibility
23:31
to lean into that access challenge.
23:34
So we're not the first to to develop
23:36
a community based hospital like we're doing in
23:38
Downers Grove. You've seen Children's Hospital of Philadelphia
23:41
do this along,
23:42
their area. You you've seen Seattle expand with
23:45
partnerships in the Tacoma region. We're seeing our
23:48
other peers
23:49
have to take a similar strategy
23:52
and, really doing it, because of the access
23:56
challenge that kids in their market are having.
23:58
And so we take that as an important
24:00
responsibility to do so.
24:02
I I think
24:03
the other unique piece
24:06
about ourselves
24:07
in the Chicagoland market, and and this does
24:09
extend to other peers,
24:11
is you you can't have a static system,
24:14
a static health system. You have to advance
24:17
it. And I think what we're so proud
24:19
of is the extraordinary growth of our research
24:21
enterprise. When I got here ten years ago,
24:23
you know, we probably had around $20,000,000
24:26
of research expenditures.
24:27
We're now well over $140,000,000
24:30
of research expenditures. And what what does that
24:31
mean? It only means that we have a
24:33
research enterprise
24:34
that is advancing what we understand about diseases.
24:37
It's, it's identifying new therapeutic ways to take
24:40
care of kids. It's It's developing new treatment
24:43
strategies,
24:44
and it's and it's informing us what the
24:46
next questions are. So to your point, our
24:48
research enterprise
24:49
being able to tell us, hey, places are
24:51
closing around the country. We better step in
24:53
and do it. So I think that important
24:55
essentiality
24:56
of our discovery enterprise that complements and advances
24:59
what we do on the clinical side is
25:02
it's just our mission focus. And, again, I
25:04
think it's our responsibility
25:07
as the only laser focused children's hospital in
25:09
Chicago and across Illinois
25:11
to continue to drive that mission.
25:14
Well, Tom, we've covered a lot of ground
25:15
today.
25:17
Anything else we're missing that you wanna make
25:18
sure we mention to our audience or any
25:21
final bits of advice you wanna offer all
25:23
your colleagues listening in from around the country?
25:26
No. You know, I mean, I I I
25:28
think the one thing I would reflect on
25:30
is is,
25:31
how how challenging it is today.
25:34
We've talked about the the reimbursement pressures with
25:36
Medicaid and what's coming down the pipe
25:39
in the pediatric world.
25:41
And and and each, you know, the adult
25:42
world has its own aspects of it, but
25:44
we have challenges in terms of where how
25:46
people are recognizing the important critical importance of
25:50
vaccination strategies, for example. Right?
25:53
We're
25:54
we're looking at the ability to provide
25:57
appropriate drugs and access to those both for
26:00
kids and adults. So the pressures on the
26:02
three forty b program,
26:04
There's just enormous challenges that we have and
26:06
I I think what I've always encouraged our
26:08
folks to do is to make sure
26:11
that despite the challenges, we stayed anchored on
26:13
our mission. And that as things continue to
26:16
be challenged and things continue to evolve, you
26:19
you can put your head down and and
26:20
be defeated by them.
26:22
But, frankly, I think that's not the that's
26:25
not the position we take, and we have
26:27
to just take the opportunities and looking at
26:29
how we devise strategies, how we devise operations,
26:32
and frankly, how we educate and advocate for
26:35
changes,
26:36
to those policies that are impacting negatively
26:39
the well-being of our kids and therefore the
26:41
future of our city and the future of
26:43
our country.
26:44
So I think as long as folks remain
26:47
so anchored and committed to what we come
26:49
to work every day to do and improving
26:51
the health and well-being of the of the
26:52
patients that we're privileged to care for, whether
26:54
it's adult or kids,
26:56
I think we will continue to thrive,
26:59
and continue to drive the best health outcomes
27:01
and therefore the best communities,
27:04
that we have for our great city and
27:05
our great state.
27:07
It's a great message,
27:08
to close us out with. Doctor Shanley, I
27:11
wanna thank you for taking the time to
27:13
sit down with us and and for sharing
27:15
all about the leader the stuff that's going
27:17
on under your leadership at Lurie Children's with
27:20
our audience. We really appreciate it. I appreciate
27:22
the opportunity, Jacob. Thanks again for having me.
27:25
Absolutely. Anytime. And to our audience, if you'd
27:27
like to listen to more podcasts from Becker's
27:30
HealthCare, you can visit beckershospitalreview.com.