Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Dr. Tom Shanley on Expanding Pediatric Access and Advancing Lurie Children’s Mission
Transcript
- 0:01This is where health care leadership comes together.
- 0:04Becker's sixteenth annual meeting brings more than 3,500
- 0:07hospital and health system executives and nearly 800
- 0:10speakers to Chicago
- 0:12April.
- 0:14This year's event includes keynote conversations with Dallas
- 0:17Cowboys legend Troy Aikman and former president George
- 0:20w Bush. For the agenda and event details,
- 0:22visit beckershospitalreview.com
- 0:25and click on the events tab in the
- 0:26upper right. We're looking forward to hosting you
- 0:29in Chicago.
- 0:31Hello, everyone. This is Jacob Emerson with the
- 0:33Becker's Healthcare podcast. I'm thrilled today to be
- 0:36joined by doctor Tom Shanley, who's the president
- 0:39and CEO of Lurie Children's.
- 0:41Doctor Shanley, thank you so much for taking
- 0:43the time to be with me on the
- 0:44podcast this morning. My pleasure. Thanks for having
- 0:46me, Jacob.
- 0:47Absolutely. And and, Tom, before we dive into
- 0:49everything we wanna talk with you about, can
- 0:51you first tell us a little bit more
- 0:52about yourself, your background in health care? And
- 0:55and for our listeners who might not be
- 0:56familiar, a little bit about, what you do
- 0:59at Lurie's.
- 1:00Sure.
- 1:01So, well, first, in addition to now serving
- 1:04as president and CEO,
- 1:06my professional background is as a physician.
- 1:09I'm trained as a pediatric intensive care unit
- 1:12doctor,
- 1:13and also did a number of
- 1:16research work as well, in the area of
- 1:18immunology.
- 1:20So that always tried to combine
- 1:23the discovery enterprise in advancing what we do
- 1:26in clinical care. And so certainly
- 1:28relevant in terms of opportunities to do that
- 1:30with critically ill and injured kids that I
- 1:32had the opportunity to care for.
- 1:35Fantastic. No. I appreciate the personal background, Tom.
- 1:37And can you tell us, just for anybody
- 1:39who's not familiar, a little bit about Lurie
- 1:41Children's,
- 1:42who you serve, where you're based, and just
- 1:44a little bit about your facilities.
- 1:46Sure.
- 1:48Well, we we're a very unique organization
- 1:51in both the city and the and across
- 1:53the state.
- 1:54We are the only
- 1:57freestanding,
- 1:57comprehensive,
- 1:59acute care pediatric hospital,
- 2:01in the state, and
- 2:02really proud of our ranking in US News
- 2:04and World Report as the number one children's
- 2:06hospital in the state of Illinois and, among
- 2:09the leading the nation's leading children's hospitals.
- 2:12We are in the process of really
- 2:15evolving from a hospital, Lurie Children's Hospital, to
- 2:19more of a health system. I'm sure we'll
- 2:20talk a little bit more, about that.
- 2:22But in doing so, really privileged care for
- 2:25kids that come actually from just about every
- 2:27county across the state,
- 2:29as well as the Midwest Region and nationally
- 2:31and internationally.
- 2:33An aspect many people don't typically know about
- 2:36us, perhaps, is that we're also
- 2:39the top Medicaid
- 2:40the pediatric Medicaid provider in the state.
- 2:43Nearly 60% of our inpatient activity is covered
- 2:47by Medicaid. So, you know, thinking about it
- 2:49from that standpoint, we really are a bit
- 2:52of a critical safety net hospital for
- 2:55organizations.
- 2:56In addition to that,
- 2:58we have our academic partnership with Northwestern University's
- 3:02Feinberg School of Medicine
- 3:04that really embraces
- 3:05much of our training activities
- 3:07for our pediatric residents and fellowship program.
- 3:10And then, of course, our research enterprise.
- 3:13What we really,
- 3:16ground ourselves in is our multi pillar mission,
- 3:19and we describe that as care, which includes
- 3:21c for clinical care, a for advocacy, r
- 3:24for research, and e for education.
- 3:26And so each of the areas we strive
- 3:28for excellence in advancing
- 3:30the health and well-being of kids we're privileged
- 3:32to serve.
- 3:34And, Tom, let's dive into some of the
- 3:36things you just mentioned, evolving into more of
- 3:38a health system,
- 3:40the the Medicaid piece of what you mentioned.
- 3:41We'll talk about that in just a little
- 3:43bit.
- 3:44But but, obviously, as you know, Lurie just
- 3:46opened a new outpatient facility out in Schaumburg.
- 3:49You're planning a new inpatient facility in Downers
- 3:51Grove.
- 3:53So so talk to our audience about what's
- 3:54driving the strategy here for these suburban facilities
- 3:57and how you're really thinking about which services
- 4:00can move
- 4:01into these communities versus what needs to remain
- 4:04concentrated at the flagship hospital here in the
- 4:06city.
- 4:07Sure.
- 4:08Well, I think,
- 4:10first and foremost,
- 4:11the principal driver of the strategy is a
- 4:14focus on the kids and the access that
- 4:17they need
- 4:18for,
- 4:19excellent and high quality
- 4:21specialty
- 4:22and primary care. And
- 4:24what we,
- 4:25recognize as we look across both our market
- 4:29in Chicagoland as well as the national market,
- 4:32there's an increasing recognition that what
- 4:34we do here at Lurie Children's and many
- 4:36of our national leading peers
- 4:38do is not easy,
- 4:40to put together comprehensive
- 4:42multidisciplinary
- 4:43programs with a plethora of faculty that are
- 4:45expert at that and to have that the
- 4:48degree of patient volume to drive the experience
- 4:51that re that results in the high quality
- 4:53of care.
- 4:54And when you think about the systems that
- 4:57aren't necessarily
- 4:58laser focused just on kids,
- 5:01it's very challenging for them to provide that
- 5:03kind of service line. And so we're seeing
- 5:06across our market and others, people getting out
- 5:08of the pediatric service business.
- 5:11And that leaves a dearth of where these
- 5:13kids, particularly in the Far Northwest Region, that's
- 5:16that explains why we wanted to get more
- 5:18proximal in the Schaumburg outpatient facility,
- 5:21and then the Western Suburban Region as well.
- 5:24It it also, you know, makes strategic sense
- 5:27for us as an organization because we do
- 5:29believe that
- 5:31we have the opportunity,
- 5:33to develop sustainable clinical service programs with this
- 5:37expansion.
- 5:37And I'll talk a little bit about what
- 5:39that looks like both from the ambulatory standpoint
- 5:42in terms of casting a broader net for
- 5:44our subspecialty,
- 5:45But also as well, you asked the question
- 5:47about the differential of care, if you will,
- 5:49for example, in our in our, plan Downers
- 5:52Grove initiative.
- 5:54So as we think about,
- 5:56that particular market, first of all, we've had
- 5:59services there, for a number of years in
- 6:01our Westchester site where we provide ambulatory surgical
- 6:04care as well as some ambulatory subspecialty care.
- 6:07We were, we knew over time we were
- 6:10outpacing our capacity there, and we're looking at
- 6:12how to
- 6:13phase our next replacement strategy there. As we
- 6:16did so, we looked very closely across
- 6:18all the types of pediatric services that are
- 6:21requested by patients and families in that region
- 6:23and how they may or may not be
- 6:25adequately met and delivered. And so we recognized
- 6:28it provides us an opportunity not just to
- 6:31expand
- 6:32those services, ambulatory surgical care and ambulatory subspecialty
- 6:36access, but also provide both inpatient and emergency
- 6:40care.
- 6:41We recognize that about half of the kids
- 6:43in that region leave that region to get
- 6:45inpatient care. And so we felt that being
- 6:48able to keep kids closer to home where
- 6:50they where they play, where they learn,
- 6:53and where they study is a much makes
- 6:56much more sense for them.
- 6:57And it it enables us to not have
- 7:00to make,
- 7:01parents,
- 7:03make a differential chain
- 7:05a a choice between convenience versus
- 7:08competence and excellence. And so rather than saying
- 7:10we're gonna go
- 7:12somewhere different,
- 7:14because it's closer and don't have to come
- 7:15downtown, we wanna make sure that we're bringing
- 7:18that service capability much closer so families aren't
- 7:21sort of forced to make that decision.
- 7:23So excited. The other asset that will be
- 7:25out there is the pediatric emergency department. And
- 7:29right now we we, staff with our partnership
- 7:31with Northwestern Medicine,
- 7:34most of the day at Central DuPage Hospital
- 7:36with pediatric emergency medicine trained physicians. That's really
- 7:39the only
- 7:40service that's out in that entire region that
- 7:43is focused on pediatric emergency care, which is
- 7:46very different and requires very different expertise than
- 7:49adult emergency care. So we believe that too
- 7:51is going to be an enormous,
- 7:54enormous asset for this region to be able
- 7:56to provide stability for kids.
- 7:59I'll just touch briefly, Jacob, that you asked
- 8:01about sort of that level of care and,
- 8:05this institution,
- 8:06in Streeterville, the flagship hospital will always be
- 8:09the place where we provide that high quality,
- 8:13and high tertiary
- 8:15so called coronary care. So kids with heart
- 8:18failure that may need a cardiac transplant, kids
- 8:20with,
- 8:21cancer that may need,
- 8:23a bone marrow transplant.
- 8:25Though that type of care will always be
- 8:27anchored here at this facility because it requires
- 8:29a a unique environment and a unique workforce.
- 8:33What we will be placing out in the
- 8:34Downers Grove is a a slightly lower level
- 8:37of care capability.
- 8:39So for example, today, we we have a
- 8:42number of kids in our hospital
- 8:44impacted by
- 8:46lung viral infections where their oxygen level in
- 8:50in normal room air is not sufficient. And
- 8:52they need a little bit of oxygen to
- 8:54recover, but they don't need extensive services beyond
- 8:57that. We have kids that often come in
- 8:59with, significant vomiting and and diarrhea that might
- 9:02be dehydrated
- 9:03and can't do that on their own, but
- 9:05need intravenous fluid therapy for a period of
- 9:07time. Those are the kinds of kids that
- 9:09we anticipate,
- 9:11often leave
- 9:12that their region, to get that kind of
- 9:14inpatient care that we'll now be able to
- 9:16provide for them and keep them local for
- 9:18that aspect of it. And we've had a
- 9:20number of, you know, we we've had experience
- 9:24in managing
- 9:25how to triage that level of care. So
- 9:28I think it's something very familiar to our
- 9:30providers that we'll do safely and effectively with
- 9:33our new site.
- 9:34Understood. So these new sites, they're gonna be
- 9:36working in tandem with the flagship hospital downtown,
- 9:40but this is all really to meet the
- 9:41access demands that you are seeing and hearing,
- 9:45from patients out in in, out in the
- 9:47suburbs.
- 9:48Staying on this topic, Tom, Lurie is opening
- 9:51the Austin Hope Center on the West Side
- 9:54Of Chicago later this year.
- 9:56Can you tell us a little bit more
- 9:58about this project and
- 10:00more contextually how you think other children's hospitals
- 10:03should be thinking about meeting the needs of
- 10:05more underserved
- 10:07populations across the country?
- 10:09For sure. I think it's such an such
- 10:11an important area today, Jacob.
- 10:13The the high level summary I I would
- 10:16put on this is that, you know, two
- 10:19things kinda come to mind. One,
- 10:22too often,
- 10:23a child's ZIP code has a much higher
- 10:26impact on their health outcomes than their
- 10:29genetic code. And that's because of all what
- 10:33we describe as social influencers of health. It's
- 10:35often described as the determinants of health,
- 10:38that that conveys a deterministic
- 10:41factor from those, situations, and we believe they
- 10:44can just be influential and that we can
- 10:46help address them. And so the other component
- 10:49is that health is, not just about health
- 10:52care, but it's the broader environment. And,
- 10:55we believe that we need to be a
- 10:57component
- 10:58of the
- 10:59comprehensive
- 11:00health and well-being of kids.
- 11:03So,
- 11:03we have a number of initiatives that progress
- 11:06in that area through what we call our
- 11:09Magoon Institute for Healthy Communities.
- 11:12My privilege to to succeed, Patrick Magoon, who
- 11:16was the CEO for twenty two years here
- 11:18at Lurie Children's and, with his retirement took
- 11:21the opportunity to name,
- 11:23this area, which was such a high priority
- 11:25and focus for him that we're extremely proud
- 11:27to carry on.
- 11:28And in Austin,
- 11:31as we work through,
- 11:33an opportunity
- 11:35to enter into the neighborhood in partnership with
- 11:37the Stone,
- 11:38church,
- 11:40to develop this, it's an effort for us
- 11:42to be
- 11:43a component of a holistic approach to what
- 11:46our our real vision is, and that's to
- 11:48be a transformational
- 11:49force for health and well-being to achieve the
- 11:52healthier future for every child. And that's every
- 11:54child regardless of where they they live. We
- 11:57know that this particular area of the West
- 12:00Side Of Chicago has been under resourced for
- 12:02a number of years,
- 12:04and we have an opportunity
- 12:06to come in at what I would describe
- 12:08as the generational ground level.
- 12:10Because one of the most important challenges we
- 12:13have in Chicago in many urban sites is
- 12:15the differential in terms of,
- 12:18longevity
- 12:19of health.
- 12:20And we have too too much of an
- 12:22adult disparity in terms of health outcomes here
- 12:24in Chicago and in other urban sites.
- 12:27You can try to address that at the
- 12:29adult level,
- 12:30but we believe that this requires a generational
- 12:33investment in kids.
- 12:35And that if we can elevate the health
- 12:36and the well-being and the education
- 12:38of kids, they can be that next generation
- 12:41of adults that continues to remain healthy and
- 12:44to remain productive and to really drive the
- 12:46future
- 12:47of our city.
- 12:49So you can't do that just with health
- 12:50care. And so this is an effort where
- 12:52we're bringing both our clinical services
- 12:55that the community has identified as needing most,
- 12:59and that's the key component of this. You
- 13:01can't go in as a system and say,
- 13:03we believe we know what you need. You
- 13:06need to go in and understand from them
- 13:08and from the community based organizations, from the
- 13:11patients and the families, and from other providers
- 13:13that are already existing in that community
- 13:16to not duplicate what they do well already,
- 13:18but to complement that. So we're very excited
- 13:21to have an integration of the primary care
- 13:23services, bring some behavioral health and social support
- 13:26structures
- 13:27along with access to subspecialty care that too
- 13:31often is not provided and results in unnecessary
- 13:34hospitalizations,
- 13:36and too often is not being taken care
- 13:38of in the community and necessitates them coming
- 13:41in to the emergency department really unnecessarily.
- 13:45So I will just say
- 13:47parenthetically to keep in mind, this is certainly
- 13:50first and foremost an investment in the kids.
- 13:52That it is going to make a tangible
- 13:54difference in them.
- 13:55But in the long run, this is also
- 13:58an investment
- 13:59in reducing the cost of care. And so
- 14:01when we think about the challenges, I'm sure
- 14:03we'll talk about the Medicaid
- 14:05funding challenges that we have coming.
- 14:07This is a way to overall reduce the
- 14:10the cost of care by significantly elevating the
- 14:13health outcomes.
- 14:14So we believe not only is this the
- 14:16right thing to do for kids, but, honestly,
- 14:17in the long term, we think it's the
- 14:19right thing to do for the state of
- 14:21Illinois in terms of the cost of care.
- 14:23Absolutely. No. It's it's incredible to hear the
- 14:25investments that you're making into this part of
- 14:27the city, and and I do wanna follow-up
- 14:30with you on on the Medicaid changes that,
- 14:32we are seeing coming down the pipeline
- 14:35under HR one,
- 14:37largely going into effect next year. But I
- 14:40know I know your organization has been,
- 14:42really preparing for this ahead of time.
- 14:45You you
- 14:47said publicly, I believe, last year that you
- 14:48were conducting a clinical program review in response
- 14:52to some of these these changes,
- 14:54under HR one, and it's nearly 60% of
- 14:58your inpatient stays are covered by the program,
- 15:00I believe.
- 15:01So, you know, we've been hearing from leaders
- 15:03all over the country, both from health systems
- 15:05to insurers, about how they're how everyone is
- 15:08prepping now,
- 15:10to get ahead of this this massive change
- 15:11for the entire system.
- 15:13Can you give us the Lurie's,
- 15:15version of that and how you're navigating this?
- 15:17Yeah. The Lurie perspective of all that.
- 15:20Well, you know, I mean, in in in
- 15:22doing so,
- 15:24you know, I I think it's important.
- 15:26Look,
- 15:27Medicaid is is a critically important program for
- 15:30the country.
- 15:31People often don't realize that half the country's
- 15:34kids are covered by Medicaid, and that's certainly
- 15:37the case here in Illinois.
- 15:39Despite that, they only they're only responsible for
- 15:42about 18, maybe 20% of the overall Medicaid
- 15:45cost. So to me, it would again, it
- 15:48makes sense to make the long term investment
- 15:51in kids is to really sustain the Medicaid
- 15:53program at least as it relates to kids.
- 15:55And so let's let's
- 15:57let's make no mistake about it. HR one
- 16:01is a is a disaster.
- 16:03That at the same time,
- 16:06I'll I'll give the federal government
- 16:09credit for recognizing
- 16:10there are opportunities to make it better, to
- 16:13make the program better. And that's part what
- 16:15we just talked about in the Austin community.
- 16:17That's part of what we believe are opportunities
- 16:19to improve
- 16:21the the quality of the care and the
- 16:23outcomes at a lower cost for many kids
- 16:25that are covered in Medicaid. So we're all
- 16:27in on that, but to do it in
- 16:28the way that the HR one bill proposes
- 16:30to do it is, not not the way
- 16:33that we would believe to be approaching that.
- 16:36Nonetheless, that's what the future,
- 16:38at least at this point looks like we
- 16:40have coming. And so certainly, we have to
- 16:41look at what impact that that will have
- 16:44on the future.
- 16:45I will, before we jump to that, just
- 16:47parenthetically also just state the, you know, I
- 16:50wanna give our Illinois Hospital Association leadership and
- 16:53our,
- 16:54our, health and family services in the state
- 16:57of Illinois
- 16:58leadership credit for,
- 17:00the success in getting a state directed payment,
- 17:03altered,
- 17:04for the next couple years for us. That
- 17:06brings in a higher Medicaid rate for the
- 17:08time being before HR one hits. And so
- 17:10that frankly is a lifeline,
- 17:13for many of, of us, our critical access
- 17:15and safety net institutions. And so we have
- 17:18some breathing room. And that breathing room is
- 17:20to your point, giving us the time to
- 17:22understand
- 17:23what clinical programs
- 17:25we wanna continue to maintain that we know
- 17:27are high quality. We know that they're mission
- 17:29aligned. And importantly, as we look at what
- 17:32the rates are anticipated to bring, they are
- 17:34also financially,
- 17:36sustainable from that aspect of it. So
- 17:39we also are looking at opportunities in terms
- 17:42of technologies that,
- 17:44you know, the the AI,
- 17:46opportunities that allow us to be more operationally
- 17:50efficient and be able to reduce,
- 17:53the overall cost and burden of the work,
- 17:55but still being able to maintain these delivery
- 17:58services overall from that aspect of it. But,
- 18:01there's there's no doubt all of us, I
- 18:03mean, all of us that have a significant
- 18:05amount of Medicaid,
- 18:06business are going to be having to make
- 18:08these hard decisions as we look at it.
- 18:11And so
- 18:12my my bigger concern,
- 18:15as we look at what the future brings
- 18:17is to not forget where the biggest bang
- 18:20for health care investment, including Medicaid investment,
- 18:24is in the country. And that's still
- 18:26in the future generations of this country. And
- 18:29so I think as long as we we
- 18:31keep that in mind and consider how we
- 18:33might be able to adjust,
- 18:34the future of Medicaid to ensure that the
- 18:37children are covered and that they're,
- 18:39continuing to drive,
- 18:40health and well-being,
- 18:42that is the future of driving our healthy
- 18:44communities that will benefit all of us. So
- 18:46a lot of advocacy. I'm very proud that
- 18:48we're, an important voice of pediatric expertise and
- 18:52advocacy,
- 18:53both with a very favorable administration in Springfield,
- 18:56but, even with the work that we do
- 18:58at the federal level in DC.
- 19:00But these are going to be challenging times
- 19:02coming around the corner, and and, we'll continue
- 19:04to work hard on making sure that we
- 19:05continue to to meet the demands of the
- 19:07kids that we're privileged to care for.
- 19:10Certainly. Certainly. Tough decisions, challenging times ahead, but
- 19:13it is good to hear, that the state
- 19:15is supportive
- 19:16of expanded assistance,
- 19:18to to help navigate this.
- 19:21Going back to what you had said earlier,
- 19:23Tom, and just in terms of why you're
- 19:25expanding,
- 19:26in certain areas and the dearth me trying
- 19:28to meet that, dearth of, lack of care
- 19:31access you see in certain parts of Chicagoland.
- 19:34I wanna read you a stat from from
- 19:36some of our recent reporting,
- 19:38that that twenty percent of hospital pediatric units
- 19:41nationally
- 19:42have closed over the last decade.
- 19:45I'm I'm sure that's not a surprising statistic
- 19:47to you, but I wonder
- 19:49what role an organization like Lurie
- 19:52should play in the broader
- 19:54pediatric care system,
- 19:56and how you're thinking about virtual care,
- 19:59partnerships like the one with Northwestern,
- 20:02labor training pipelines to
- 20:04further address some of these access gaps that
- 20:07sound like they they could worsen,
- 20:10in the region.
- 20:11Yeah.
- 20:12Well, there's a there it's important for folks
- 20:14to realize the some of some of the
- 20:17factors that have that drive that. And it
- 20:19is not surprising because it was our research
- 20:21team that published that work. So,
- 20:23we're we're
- 20:24too intimately familiar with those challenges across the
- 20:27country.
- 20:28I I think what we just talked about
- 20:30was Medicaid. Much of this really started or
- 20:33and was even
- 20:35much of it started before the pandemic, but
- 20:36was accelerated from the pandemic and a a
- 20:39very practical thing that happened during that time.
- 20:42Fortunately, kids were not impacted by COVID as
- 20:44much as adults. And because of the number
- 20:47of adults that needed inpatient beds, many of
- 20:49these systems that had small inpatient pediatric beds,
- 20:54provided them to adults and
- 20:57suddenly realized that when there's an adult in
- 20:58the bed paid for by Medicare,
- 21:00you do much better than when you have
- 21:01a kid in that bed provided by Medicaid.
- 21:03So it does get back to that differential
- 21:05of of adult versus pediatric reimbursement for care,
- 21:09even though I believe pediatric care is much
- 21:11harder than adult care.
- 21:13So that's one driver is just financially, it's
- 21:15more challenging in terms of providing that kind
- 21:18of care. The second you mentioned and alluded
- 21:20to the workforce,
- 21:21there are additional statistics that look at
- 21:25the increasing
- 21:26challenge that we're seeing of,
- 21:28medical students coming out of school and deciding
- 21:31to pursue pediatrics, and then even,
- 21:34folks that pursue pediatric training going into subspecialty
- 21:38fellowship training. Those are all on decline.
- 21:41And so we know that there's a
- 21:43a a growing dearth of subspecialists
- 21:45that are available,
- 21:46which which really creates a couple of things.
- 21:49Number one, it creates really a a a
- 21:51national competition for expertise. And then when you
- 21:54go down to a local market like Chicagoland,
- 21:56you realize it's really hard to have sufficient,
- 21:59workforce to be able to provide the kind
- 22:01of services that I've, alluded to that that
- 22:03we're privileged to be able to to provide
- 22:06because of the the special workforce that we
- 22:08have. So that certainly is a key strategy
- 22:10for us is to continuing to have one
- 22:12of the most competitive pediatric residency programs.
- 22:16We're estimated to be the third most competitive,
- 22:19meaning,
- 22:21folks really want to come, to Lurie Children's
- 22:23for their pediatric training. And I think Chicago
- 22:25as a great city is also a great
- 22:27draw for that.
- 22:29And then we're continuing to try to,
- 22:32encourage them to come out of that residency
- 22:35training program and stay in our subspecialty fellowship
- 22:38pro programming.
- 22:39So being able to sort of train your
- 22:41own and,
- 22:43populate that critically important workforce is is really
- 22:46critical there.
- 22:48Whether you can continue and and I will
- 22:50say that those strategies are ones that are
- 22:52being shared across
- 22:54really the national leading peers that we have.
- 22:57You know, it's been it's been it's been
- 22:58estimated or projected that
- 23:01these large independent children's hospitals and large urban
- 23:04areas like ourselves and and other peers are
- 23:07are going to be the few remaining
- 23:10pediatric institutions across the country that are able
- 23:13to continue to sustain
- 23:14the kinds of high level, high quality expertise
- 23:17in the subspecialty area that we're known for,
- 23:20but we're also now seeing that
- 23:23come out of the community based opportunities in
- 23:26providing care. And so we're all
- 23:29taking the opportunity and responsibility
- 23:31to lean into that access challenge.
- 23:34So we're not the first to to develop
- 23:36a community based hospital like we're doing in
- 23:38Downers Grove. You've seen Children's Hospital of Philadelphia
- 23:41do this along,
- 23:42their area. You you've seen Seattle expand with
- 23:45partnerships in the Tacoma region. We're seeing our
- 23:48other peers
- 23:49have to take a similar strategy
- 23:52and, really doing it, because of the access
- 23:56challenge that kids in their market are having.
- 23:58And so we take that as an important
- 24:00responsibility to do so.
- 24:02I I think
- 24:03the other unique piece
- 24:06about ourselves
- 24:07in the Chicagoland market, and and this does
- 24:09extend to other peers,
- 24:11is you you can't have a static system,
- 24:14a static health system. You have to advance
- 24:17it. And I think what we're so proud
- 24:19of is the extraordinary growth of our research
- 24:21enterprise. When I got here ten years ago,
- 24:23you know, we probably had around $20,000,000
- 24:26of research expenditures.
- 24:27We're now well over $140,000,000
- 24:30of research expenditures. And what what does that
- 24:31mean? It only means that we have a
- 24:33research enterprise
- 24:34that is advancing what we understand about diseases.
- 24:37It's, it's identifying new therapeutic ways to take
- 24:40care of kids. It's It's developing new treatment
- 24:43strategies,
- 24:44and it's and it's informing us what the
- 24:46next questions are. So to your point, our
- 24:48research enterprise
- 24:49being able to tell us, hey, places are
- 24:51closing around the country. We better step in
- 24:53and do it. So I think that important
- 24:55essentiality
- 24:56of our discovery enterprise that complements and advances
- 24:59what we do on the clinical side is
- 25:02it's just our mission focus. And, again, I
- 25:04think it's our responsibility
- 25:07as the only laser focused children's hospital in
- 25:09Chicago and across Illinois
- 25:11to continue to drive that mission.
- 25:14Well, Tom, we've covered a lot of ground
- 25:15today.
- 25:17Anything else we're missing that you wanna make
- 25:18sure we mention to our audience or any
- 25:21final bits of advice you wanna offer all
- 25:23your colleagues listening in from around the country?
- 25:26No. You know, I mean, I I I
- 25:28think the one thing I would reflect on
- 25:30is is,
- 25:31how how challenging it is today.
- 25:34We've talked about the the reimbursement pressures with
- 25:36Medicaid and what's coming down the pipe
- 25:39in the pediatric world.
- 25:41And and and each, you know, the adult
- 25:42world has its own aspects of it, but
- 25:44we have challenges in terms of where how
- 25:46people are recognizing the important critical importance of
- 25:50vaccination strategies, for example. Right?
- 25:53We're
- 25:54we're looking at the ability to provide
- 25:57appropriate drugs and access to those both for
- 26:00kids and adults. So the pressures on the
- 26:02three forty b program,
- 26:04There's just enormous challenges that we have and
- 26:06I I think what I've always encouraged our
- 26:08folks to do is to make sure
- 26:11that despite the challenges, we stayed anchored on
- 26:13our mission. And that as things continue to
- 26:16be challenged and things continue to evolve, you
- 26:19you can put your head down and and
- 26:20be defeated by them.
- 26:22But, frankly, I think that's not the that's
- 26:25not the position we take, and we have
- 26:27to just take the opportunities and looking at
- 26:29how we devise strategies, how we devise operations,
- 26:32and frankly, how we educate and advocate for
- 26:35changes,
- 26:36to those policies that are impacting negatively
- 26:39the well-being of our kids and therefore the
- 26:41future of our city and the future of
- 26:43our country.
- 26:44So I think as long as folks remain
- 26:47so anchored and committed to what we come
- 26:49to work every day to do and improving
- 26:51the health and well-being of the of the
- 26:52patients that we're privileged to care for, whether
- 26:54it's adult or kids,
- 26:56I think we will continue to thrive,
- 26:59and continue to drive the best health outcomes
- 27:01and therefore the best communities,
- 27:04that we have for our great city and
- 27:05our great state.
- 27:07It's a great message,
- 27:08to close us out with. Doctor Shanley, I
- 27:11wanna thank you for taking the time to
- 27:13sit down with us and and for sharing
- 27:15all about the leader the stuff that's going
- 27:17on under your leadership at Lurie Children's with
- 27:20our audience. We really appreciate it. I appreciate
- 27:22the opportunity, Jacob. Thanks again for having me.
- 27:25Absolutely. Anytime. And to our audience, if you'd
- 27:27like to listen to more podcasts from Becker's
- 27:30HealthCare, you can visit beckershospitalreview.com.