Latest / Becker’s Healthcare Podcast / Carl Bergetz on Legal Strategy, Policy, and Patient-Centered Growth at Rush

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Carl Bergetz on Legal Strategy, Policy, and Patient-Centered Growth at Rush · Becker’s Healthcare Podcast

• 0:02
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:10
  speakers to Chicago, April 13 through the sixteenth.
• 0:14
  This year's event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
• 0:20
  w Bush. For the agenda and event details,
• 0:22
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:26
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
• 0:32
  This is Laura Dierdow with the Becker's Healthcare
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  Podcast. I'm thrilled today to be joined by
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  Carl Bruguetz, chief legal officer and general counsel
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  at Rush University System for Health. Carl, it's
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  a pleasure to have you on the podcast
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  today.
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  Thanks, Laura. Good to be here. Absolutely. Now
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  I'm excited for our conversation because I know,
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  there's so much happening in the health care
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  space, and, really, things are moving at the
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  speed of light, in terms of policy updates
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  and things you have to be,
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  considering on a daily and consistent basis. So
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  I'm excited for our conversation to learn a
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  little bit more about how you're looking at
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  things at Rush and, you know, what is
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  ahead. But can we start with please introduce
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  yourself and just tell us a little bit
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  more about Rush?
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  Sure. Yeah. Like you said, I'm the general
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  counsel and chief legal officer. I'm also the
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  corporate secretary for the boards here at Rush.
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  And,
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  I've been with Rush for over a decade
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  now.
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  And
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  as I say that, I
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  feel
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  I feel like I'm showing my age. But
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  in any case, it's been a wonderful place
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  to work. It's a great organization that I
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  do feel as big as we are,
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  we are really community focused,
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  and we're an institution that is really mission
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  driven.
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  And that's what's appealing to me and a
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  lot of the people who work on my
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  team
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  is the fact that, we do have the
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  mission that we do have, and we're supporting,
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  the providers that execute on that. So and
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  that's great. And what is that mission? Well,
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  it's to provide health care services,
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  to the communities,
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  on the West Side Of Chicago and well,
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  anywhere but our main areas, West Side Of
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  Chicago, the Western Suburbs, all the way out
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  to Aurora,
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  where we have a
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  hospital out there, Rush Copley, Rush Oak Park
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  Hospital, and then our downtown campus. So two
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  community
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  hospitals
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  and a downtown academic
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  medical center. Under the same corporate roof as
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  the medical center is our university, which is
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  a graduate level only, so graduate courses for
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  medicine and nursing and allied health professionals.
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  So
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  I'm the lawyer for both aspects of that,
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  and my team is the team that works
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  on those aspects of both aspects of that.
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  So that means we're working
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  on research issues, higher education issues, and faculty
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  issues, as well as clinical
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  issues and to more typical hospital matters that
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  any GC of a hospital system is gonna
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  work on. So that diversity
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  makes it a great place. It also
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  integrates the kind of services we provide and
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  the employees we have and train here at
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  Rush, meaning people are tied into the academic
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  function as well as they are into the
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  clinical function. So,
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  and that's that's relatively rare because there's only
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  a couple other institutions
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  that I'm aware of around the country where
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  it's all under one corporate roof
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  and and that integrated and that I think
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  Mayo and University of Michigan are like that.
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  But most other places really have separate corporations
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  and separate legal teams and other types of
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  corporate services teams dealing with academics and university
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  and then clinical stuff.
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  So it's nice to have both.
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  And, we bring that to our patients. It's
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  our community, and we're tied into, just like
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  you were starting out mentioning,
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  all the various policy and political issues that
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  involve both universities and hospitals. We're dealing with
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  both of it or all of it, I
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  should say.
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  I love that. Yeah. I mean, there's so
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  much to think about when you've got all
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  sides of the school there looking at the
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  academics, the research,
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  the education aspect, as well as the clinical
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  and serving a hugely diverse population as well
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  that you do at Rush. It's just amazing,
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  to to see how you've grown and and
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  truly
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  become a system serving the people. Now when
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  you think about just the last year or
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  so, could you tell us about an initiative
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  that you led? What did you do, and
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  what were the results?
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  Well, I I think the big one I
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  have to talk about just because it's in
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  the news all the time is our work
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  in, government affairs
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  and legal
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  legal's role in interpreting
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  the political and policy
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  and legislative
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  and
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  court
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  landscape that's out there, so court opinions, because
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  so much is happening. And at the start
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  of last year,
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  we stood up a group that we've had
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  in place before. We had it back during
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  the pandemic.
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  It was a group that was an interdisciplinary
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  group that was legally led,
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  to
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  really intake all sorts of initiatives, executive orders,
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  declarations, rule changes that were happening through the
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  pandemic, interpret them, understand them, and their impact
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  on health care generally and rush specifically,
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  and try to help work with operators to
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  operationalize those.
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  We
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  restued that up because although the pandemic technically
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  ended in 2023, I mean, from a legislative
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  standpoint,
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  We kept it kind of percolating for a
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  while, but then last year, at the start
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  of last year, with the new administration starting,
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  we knew there'd be a lot of change.
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  And I don't think we anticipated it would
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  be as much change and as quickly as
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  as it has been, but, we knew there
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  would be a considerable amount. And so we
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  wanted to stand that up again.
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  And, we call it an LGA group, legal
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  and government affairs. And but it really involves
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  a lot of other groups, from comms to
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  clinical services to, of course, finance.
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  Just really
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  understanding what is happening in Washington and Springfield
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  and even locally
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  in the political
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  and policy
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  arenas and
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  interpreting how those are would affect health care
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  and higher education
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  and then trying to see how we can,
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  implement
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  anything that we needed to do to either
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  get into compliance with those things or,
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  address them one way or another,
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  from things like,
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  the proposed budget cuts, the cuts to research,
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  the executive orders, and
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  various inquiries that were going on around DEI,
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  the various changes that happened over the course
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  of that past year, the last year in
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  gender affirmed care for minors,
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  when it came to immigration issues,
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  all of it. I make I'm basically sounding
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  like everything, and it kinda was because so
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  much was driven in 2025 and continues to
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  be
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  by
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  politics and government.
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  And
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  given that health care and higher education to
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  maybe a lesser extent, but health care is
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  so heavily regulated,
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  we always know that muscle needs to be
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  in shape and staying fit and growing.
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  So we always try to work on those
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  things. And and what I should have mentioned,
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  Laura, is that government affairs also reports up
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  through the legal department.
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  So that's another function that's, under our umbrella
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  in the department.
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  And so we've always been tied together in
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  that way, which is great because
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  that which happens in the government political space
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  ends up having lee legal repercussions and therefore
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  compliance repercussions.
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  And so it just was incredibly important to
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  strengthen that muscle this past year and involve
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  other people. Like I said, it's an interdisciplinary
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  effort across our system
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  from, you know, the West Side Chicago out
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  to Aurora
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  and everywhere in between to try to make
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  sure we are understanding as best you can,
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  what's going on politically and governmentally.
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  And, that has been a really, really,
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  difficult, challenging, but also interesting,
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  thing, initiative, if you will, that that I've
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  had to lead.
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  And in the context of doing that, actually,
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  we've done a lot of communications
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  around the organization for that because like I
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  said, we have a university.
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  Lot of faculty and students who wanna know
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  and keep up to, date as to what's
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  going on, not just from the news that
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  they read, you know, on their apps or,
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  etcetera,
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  but how we are seeing it, right, as
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  an organization.
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  And And so we do a lot of
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  communication around that, some, taped audio taped,
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  offerings to,
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  leaders and and then more broadly to faculty
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  and students that's available so that we can
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  under you know, explain some of the things
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  that are going on that may be confusing
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  to people, whether it's the changes to ACA
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  and what happened with the,
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  the house res resolution,
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  the budget reconciliation act from last year. But
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  then as we continue with government shutdowns and
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  and and pauses and things like that, People
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  get, you know, understandably
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  confused and,
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  wanna learn more about it, and so we're
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  there to help provide that, that that understanding
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  as best we can. So it's all done
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  through that process, that that legal and government
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  affairs work group process.
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  That's fascinating to hear and helpful to understand
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  some of the challenges,
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  that, you know, you've seen arise and especially
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  looking at, you know, the policy changes and
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  shifts and then communicating that out to the
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  broader system and organization.
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  I can imagine, especially with, an academic system,
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  you know, there are a lot of different
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  folks and a lot of different impacts that
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  come into play here. So,
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  when you are looking at the work group
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  and the communications
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  out, I mean, I I think I'd be
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  interested in learning just a little bit more
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  about how you tailor some of those things
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  and, you know, what you feel like maybe
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  an example of one that was, you know,
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  really successful, well received,
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  from the last year that made a big
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  difference as people were operating and trying to
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  figure out how to
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  think and work differently in, an environment that's
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  always changing.
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  Yeah. I don't I don't know if I'd
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  characterize it as, you know, something that was
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  successful. I don't that that might not be
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  the word I'd use for it, but the
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  one that maybe was more prominent
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  was how to deal with
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  with immigration,
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  and customs enforcement, which ICE, which was something
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  that earlier in the year we,
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  anticipated might have an effect. And then in
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  September, you'll recall there was the,
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  the federal push here in Chicago
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  to put more ICE agents and CBP on
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  the streets. And we knew that, as a
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  consequence of that, we might see some activity.
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  And if you recall, there had been a
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  executive order during the Biden administration
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  that allowed hospitals,
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  university, schools, churches, and the like to be,
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  sort of shielded from,
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  investigations
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  by such officials.
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  And that executive order was rescinded by the
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  current administration, and
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  that meant that,
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  there could be investigations
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  and inquiries made by immigration officials into,
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  our institution, university health care. And so we
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  had to prepare for that. We had to
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  make sure that our policies were well understood
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  and trained. We had policies, obviously, that to
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  deal with law enforcement
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  one way or the other, but ICE was
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  a different thing to deal with, than we
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  had customarily
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  seen. And certainly just the size and scope
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  of it hitting Chicago when it did, we
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  knew that there would probably be more issues
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  revolving around that. And so, sure enough, we
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  had a couple encounters, both, downtown,
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  Attle Park, and in Aurora where ICE agents
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  did appear on campus.
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  But what they
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  once we got through some of the,
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  fog of it when we first heard about
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  things happening,
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  we,
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  learned that what was more or less happening
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  was ICE coming to the hospital because a
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  detainee they had was in need of health
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  care.
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  And so it was important, obviously, for us
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  to do our job number one, which is
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  to provide health care to the people.
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  And so, you know, even if they had
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  come whether it's from, you know, an FBI
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  agent or CBP
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  Chicago Police Department or any police department, any
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  law enforcement,
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  we see that a lot. And
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  they would come in, and we'd provide the
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  care. And if they were a detainee or
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  an arrested person or, let's say, a prisoner,
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  they would come in. We have a forensic
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  patient policy as we call it.
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  So we know how to operate with that.
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  With ICE, it was a little different because
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  we hadn't seen them as much before, and
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  we also weren't necessarily sure at the beginning
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  of it, like, what was the scope of
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  their jurisdiction and things like that. And we
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  worked through,
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  a lot of the issues around that, we
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  which we've seen come to light in news
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  media stories, over the past few months in
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  other locations, which is that, you know, they
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  sometimes didn't use warrants,
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  or they, used administrative warrants. And we had
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  to make sure we were educating people on
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  the need for a judicial warrant that was
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  signed by a a judge in this district,
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  and that was very specific.
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  We
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  we had this as a policy, Laura, and
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  as a protocol,
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  but it needed to be people needed to
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  be trained on it. Because when things like
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  that happen, when, law enforcement shows up, it
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  can be a little jarring to clinicians because
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  they're not accustomed necessarily seeing that. Maybe in
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  an ER, they might be, but not ICE
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  officials.
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  And they weren't accustomed to how we did
• 12:44
  business.
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  And in my experience, you know, seeing them,
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  working with them, a lot of them weren't
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  your typical law enforcement. Right? So most law
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  enforcement
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  fairly well accustomed to dealing with,
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  a detainee being brought to a hospital for
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  whatever reason or a search,
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  that needed to take place, a subpoena that
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  needed to be delivered.
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  ICE just didn't fit that description in terms
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  of how they operated and how their what
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  it seemed to be their training
• 13:11
  around those kinds of things. So it was
• 13:13
  really important to make sure that our frontline
• 13:15
  staff, especially in the emergency room, which does
• 13:17
  see a lot of a lot of dramatic
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  stuff,
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  was
• 13:21
  was understanding the policy in the process. Because
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  no matter how, you know, how well you
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  write something down until you train on it
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  and actually until you live it, it's really
• 13:30
  hard to put into action when something emergent
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  happens.
• 13:34
  And, we did it, and I think it
• 13:36
  was a good job that was handled. There
• 13:37
  were some news media stories here and there
• 13:39
  that that came out of it. But like
• 13:41
  I said, for the most part, it was
• 13:42
  a case of,
• 13:44
  officials bringing detainees in, not doing a search
• 13:46
  here, but rather detainees who needed patient care,
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  and that's what we're here for. What was
• 13:52
  again also different, Laura, about it is because
• 13:54
  of the political sensitivities.
• 13:56
  Word got out pretty quickly,
• 13:58
  and we saw in different instances people coming
• 14:01
  to the hospital either to protest or to
• 14:04
  voice their concerns or local officials
• 14:06
  contacting us about it. And,
• 14:09
  in some cases, not understanding fully what was
• 14:11
  going on. In other cases, ICE not really
• 14:13
  fully understanding how they should operate. So, you
• 14:16
  know, I I I foresee that continuing to
• 14:19
  happen in that space just because of what
• 14:21
  we're seeing in Minnesota and Minneapolis,
• 14:23
  which is unfortunate.
• 14:25
  But I think the best we can do
• 14:26
  in an institution like ours, like every health
• 14:29
  care institution could that can do, best is
• 14:32
  to get make sure your policies are are
• 14:35
  down, of course, but that you have a
• 14:37
  process because policy is one thing. It's another
• 14:39
  thing that really almost make a process instinctive
• 14:43
  and really build the muscle on it and
• 14:45
  then train on it and talk to people
• 14:46
  about it and then debrief on it. We
• 14:48
  would debrief on it to make sure we
• 14:50
  understood what were some lessons that we can
• 14:51
  learn for the next time that happens because
• 14:53
  at least as far as this administration goes,
• 14:55
  they're gonna keep trying this type, of activity.
• 14:58
  And so we wanna make sure that we're
• 14:59
  prepared for it and put ourselves in the
• 15:02
  best position possible to, deescalate, make sure that
• 15:05
  things aren't getting out of hand, and job
• 15:07
  number one, taking care of the patients that
• 15:09
  need the care.
• 15:11
  Absolutely. That's such a powerful example of having
• 15:13
  those processes and systems and then all understanding,
• 15:16
  as much as possible how to apply them
• 15:19
  and what needs to happen in order to
• 15:20
  lawfully move through these
• 15:23
  have any tensions deescalated.
• 15:25
  So I appreciate your thoughts there, and it
• 15:27
  was just a critical critical,
• 15:29
  thing to keep focused on at this moment.
• 15:31
  And, you know, looking ahead of the next
• 15:32
  year too, are there any other priorities or
• 15:34
  headwinds that you're really focused on?
• 15:37
  I think, really, Laura, it's the same as
• 15:38
  what I said before. I I there's obviously
• 15:40
  other things, you know, managing
• 15:43
  the business and, you know, is legal counsel
• 15:46
  helping to provide counsel around that
• 15:48
  in an increasingly
• 15:49
  difficult time from a standpoint of margins, you
• 15:52
  know, Medicaid, Medicare dollars being cut or at
• 15:56
  least made more difficult to obtain research dollars,
• 16:00
  different sort of frameworks of thinking about how
• 16:02
  those research dollars can be
• 16:04
  granted if they are at all.
• 16:07
  Basically, all of that translates into,
• 16:10
  and I should mention the ACA issue, which
• 16:12
  still hasn't resolved yet, whether or not those
• 16:14
  are, the the changes that are happening in
• 16:16
  that space are gonna result in more and
• 16:18
  more people, most likely it will, of being
• 16:20
  without health insurance.
• 16:22
  The more we see of that, either less
• 16:24
  fewer dollars for that or fewer people with
• 16:27
  insurance, we're kinda heading in the opposite direction
• 16:29
  than we were head heading,
• 16:31
  after 2010
• 16:32
  or so.
• 16:34
  That's unfortunate, but it is what it is.
• 16:36
  And as an organization that needs to have,
• 16:40
  the money to be able to provide care
• 16:42
  and research and other things that we do,
• 16:45
  we're after figuring out how to make do
• 16:47
  with less or how to make do in
• 16:49
  a tumultuous environment where things are uncertain. I
• 16:51
  think that's another thing, Laura, that's really difficult
• 16:54
  right now is the uncertainty.
• 16:56
  More so I mean, I always sort of
• 16:58
  view things as
• 16:59
  the default setting for me is things are
• 17:01
  kind of uncertain, and it's our job to
• 17:03
  try to create some sort of semblance of
• 17:06
  normalcy. But it's really hard to do that
• 17:08
  when, you know, we're not even sure if
• 17:10
  the funding is going to be there for
• 17:12
  certain types of programs, even something as big
• 17:14
  as Medicaid. Right?
• 17:16
  Obviously, there'd be funding for it, but what's
• 17:18
  the scope of it? So I think struggling
• 17:20
  with that and coping with that, which inherently
• 17:22
  has a lot of legal issues associated with
• 17:24
  it, is still top of mind. And then
• 17:27
  continuing forward with the, that group that that
• 17:30
  I was talking about before, the the work
• 17:32
  group, just constantly, you know, keeping the energy
• 17:35
  level there going good so that we can
• 17:37
  understand and follow in real time what's happening
• 17:41
  and make sense of it and,
• 17:43
  you know, adjust it accordingly and hopefully mitigate.
• 17:46
  Right? Mitigate where those those risks are arising
• 17:48
  or we're seeing those risks. So I see
• 17:50
  this just continuing more of 2025
• 17:52
  into 2026.
• 17:54
  And it probably just getting more and more
• 17:56
  difficult because a lot of the as you
• 17:58
  know, with the,
• 18:00
  house resolution, the budget resolution act that happened
• 18:03
  last year, a lot of the things that
• 18:05
  are gonna impact Medicaid dollars directly,
• 18:08
  aren't going to take place until after November
• 18:11
  2026. So we have to really prepare for
• 18:13
  those.
• 18:14
  We'll see what the legislature in Washington ends
• 18:16
  up doing,
• 18:18
  because there has been action by the house
• 18:20
  to kinda claw some of that stuff back
• 18:23
  or revert back to the way things were.
• 18:25
  But we have to we have to operate
• 18:27
  thinking that, oh, these things will happen. These
• 18:28
  cuts will happen. These these measures that are
• 18:31
  being taken to,
• 18:34
  control budget from their perspective are gonna result
• 18:36
  in fewer people with insurance.
• 18:38
  We have to presume they will happen, and
• 18:40
  so we have to act accordingly. So to
• 18:42
  continue to function at a high level in
• 18:44
  a very efficient way and in a nimble
• 18:46
  way,
• 18:48
  anticipating that those things are going to actually
• 18:50
  come to fruition.
• 18:51
  That's the most difficult thing, and that's what
• 18:53
  I see continuing focus,
• 18:56
  for the next year.
• 18:58
  That makes a lot of sense. And, you
• 18:59
  know, just to take all of all of
• 19:02
  that seriously, the the news coming out of
• 19:04
  the the White House and policies that you
• 19:05
  know, I think that's a really smart approach
• 19:07
  and,
• 19:08
  you know, will be helpful. And then regardless
• 19:10
  of what happens, you'll be in a strong
• 19:12
  position to continue
• 19:14
  having that foundation of stability and,
• 19:16
  ability to to serve the community as a
• 19:18
  whole. What do you think the hardest thing
• 19:20
  you'll have to do in the coming year
• 19:22
  will be?
• 19:23
  I think it's, I think part of it
• 19:25
  is going to be,
• 19:27
  you know, the what I said before, continuing
• 19:29
  to make sense of it and communicate it
• 19:31
  and create a sense of, I don't wanna
• 19:33
  say calm, but understanding amongst
• 19:37
  faculty, students,
• 19:39
  that's a challenge. And it's, you know, making
• 19:41
  sense of what's going on
• 19:43
  is tough, and that's gonna continue to take
• 19:45
  place. But I think I'm I'm repeating myself
• 19:47
  now because I think the last thing I
• 19:49
  said about the fact that the financial
• 19:51
  impacts
• 19:52
  of a lot of those changes are gonna
• 19:54
  start hitting more and more, especially later in
• 19:56
  the year, is going to be the biggest
• 19:58
  challenge. And that's I do I am concerned
• 20:01
  about it. I think I think everybody in
• 20:03
  health care should be concerned about it. I
• 20:04
  certainly, everybody in the, health care delivery of
• 20:07
  services space should be concerned about it. And,
• 20:11
  you
• 20:12
  know, we can mitigate and plan as best
• 20:14
  we can, although it's difficult to plan in
• 20:15
  such a very
• 20:18
  uncertain framework and environment.
• 20:20
  And the other thing is to, you know,
• 20:22
  work on
• 20:23
  our own advocacy,
• 20:25
  you know, with through associations
• 20:27
  and,
• 20:28
  through groups
• 20:30
  to try to make legislators
• 20:32
  and the administration
• 20:34
  and even locally, you know, our state and
• 20:36
  local officials understand what it is we're going
• 20:38
  through
• 20:39
  and how hard it is. It's it is
• 20:41
  very hard. It's hard for a lot of
• 20:42
  people out there these days. This is not
• 20:45
  a pleasant time.
• 20:47
  But for health care in particular, there's some
• 20:49
  very specific
• 20:50
  risks and issues and problems
• 20:52
  that are happening. Some of them are happening
• 20:55
  anyway, but they're actually being exacerbated by what's
• 20:57
  going on in Washington. We hope that, you
• 20:59
  know, more rational and cooler heads will prevail
• 21:01
  in the coming year, but it's that's not
• 21:03
  gonna happen on its own. It's only gonna
• 21:04
  happen by us paying attention to it,
• 21:07
  doing what we can internally to,
• 21:09
  interpret and make sense of it and mitigate,
• 21:12
  and then work on
• 21:14
  trying to have legislative initiatives and,
• 21:17
  change the discussion as best we can towards
• 21:19
  something that's friendlier for hospitals and health care.
• 21:23
  So well said. And, you know, in putting
• 21:25
  everything
• 21:26
  into that right framework so that that you
• 21:28
  can have,
• 21:30
  the mindset to move forward is so hard.
• 21:32
  And like you said, keeping folks calm and
• 21:34
  having that understanding, I know a lot of
• 21:36
  that comes from,
• 21:38
  the reassurance that there are those plans in
• 21:40
  place, no matter what happens, but it can
• 21:42
  still be
• 21:43
  a huge, huge undertaking,
• 21:45
  to create that message and that feeling. I
• 21:47
  think before we wrapped up here, I wanted
• 21:50
  to ask,
• 21:51
  where do you see some opportunities for additional
• 21:53
  growth as well given the headwinds that we've
• 21:55
  talked about given the current environment and uncertainties?
• 21:58
  How do you think about growth, and and
• 22:00
  what does that look like for you at
• 22:01
  Rush?
• 22:02
  I think, you know, it is as it
• 22:04
  was before, and I think it's gonna accelerate.
• 22:06
  I think it's it's getting care closer to
• 22:08
  patients
• 22:09
  through so while as important as the hospital
• 22:12
  is for higher acuity matters,
• 22:14
  more and more needs to be brought closer
• 22:16
  to patients. So I think,
• 22:18
  that needs to happen. And as as much
• 22:20
  as we're living in this digital world,
• 22:23
  you know, being physically present, health care is
• 22:26
  one of those industries that you need in
• 22:28
  person personnel. You need in person services
• 22:31
  to be provided.
• 22:32
  And so you need to be as close
• 22:33
  as you can to patients for that. I
• 22:35
  think another thing that,
• 22:37
  you know, is coming up is the challenge
• 22:39
  of,
• 22:40
  what to make sense of when it comes
• 22:41
  to AI.
• 22:43
  I I kinda I guess Laura would be
• 22:44
  remiss if we didn't have a podcast where
• 22:46
  I didn't mention those two letters. But in
• 22:48
  in reality, we do see a lot of
• 22:50
  people approaching us and other institutions looking towards
• 22:53
  AI for some measure of solution in health
• 22:55
  care just like it is in a lot
• 22:57
  of other industries.
• 22:58
  And making sense of that, understanding the risks
• 23:00
  better, I think we're all just kind of
• 23:02
  figuring it out.
• 23:04
  And,
• 23:05
  that,
• 23:06
  that is something that we'll have to pay
• 23:07
  attention to. But it also presents an opportunity
• 23:10
  for growth. So to tie into your growth
• 23:11
  question,
• 23:12
  meaning,
• 23:13
  can we do more with the same that
• 23:15
  we have? So using the people we have
• 23:16
  or less. You know, can we do more?
• 23:18
  Can we reach more patients?
• 23:19
  Can we do more for them with technological
• 23:22
  tools? It's possible. I'm very leery
• 23:25
  of AI. I am a, a
• 23:28
  skeptic, if not worse. But I also understand
• 23:31
  that it is, it it it is best
• 23:33
  form like most technology. It can be used
• 23:35
  to help grow and help create efficiencies.
• 23:39
  And I would like to see where it
• 23:40
  can be done where it can be used
• 23:41
  to do that.
• 23:43
  But, basically, it's that. It's getting closer to
• 23:45
  patients. It's getting closer to them in person.
• 23:48
  And then from a more digital standpoint or
• 23:50
  a technological standpoint, figuring out these new tools
• 23:53
  that are being offered
• 23:55
  and making sure we understand them better and
• 23:57
  what their implications are for increasing,
• 24:00
  maybe not growth per se, but, you know,
• 24:02
  if creating efficiencies and creating better ways of
• 24:04
  connecting with patients and doing more for them.
• 24:07
  But always staying pretty,
• 24:09
  you know, cautious on it when it comes
• 24:11
  to that because, at the end of the
• 24:12
  day, health care is a human endeavor.
• 24:15
  It it I think patients want it to
• 24:17
  be,
• 24:18
  not surprising. I know I do. I have
• 24:20
  a human being, whether it's, in the form
• 24:22
  of a nurse or a doctor,
• 24:25
  helping us out. The care should be delivered
• 24:27
  by patients excuse me, by people for patients,
• 24:30
  and we need to be focused on that.
• 24:32
  And so as impressive as some technologies can
• 24:35
  be, and we've seen them before,
• 24:38
  we are going to be dealing with humans,
• 24:40
  and we need humans to take care of
• 24:41
  humans. And so that's what's gonna be important.
• 24:45
  Absolutely. A 100%. Carl, thank you so much
• 24:47
  for joining us on the podcast today. We
• 24:48
  covered a lot of ground looking at different
• 24:51
  policies, procedures,
• 24:53
  you
• 24:54
  know, best practices as well as now technology
• 24:56
  and AI in in workforce shifts. So I
• 24:59
  I appreciate your time, and it's been such
• 25:01
  a great conversation. I I'm also looking forward
• 25:03
  to seeing you in person at our annual
• 25:05
  meeting. I know you'll be speaking on a
• 25:06
  panel, and, we'll definitely be able to touch
• 25:09
  on some of these themes, dig a little
• 25:11
  bit deeper, and, overall, have the opportunity to
• 25:13
  connect further at that point. So looking forward
• 25:15
  to it and seeing you there.
• 25:17
  Laura, it was great to to to work
• 25:19
  with you today, talk with you today, and
• 25:20
  I look forward to seeing you at the
• 25:22
  meeting as well.