Latest / Becker’s Healthcare Podcast / Building the Future Healthcare Workforce Through Innovation and Access with Dr. Ryan Gates

Transcript

Building the Future Healthcare Workforce Through Innovation and Access with Dr. Ryan Gates · Becker’s Healthcare Podcast

• 0:02
  - Every health system executive right now is being
• 0:04
  - asked to do something that has no useful
• 0:06
  - precedent,
• 0:07
  - make durable technology decisions in an environment that
• 0:10
  - looks meaningfully different every six months.
• 0:13
  - The pace isn't slowing,
• 0:14
  - the vendor landscape isn't getting simpler, and the
• 0:17
  - cost of missteps keeps rising.
• 0:19
  - Becker's eleventh annual IT and Revenue Cycle Conference,
• 0:23
  - The Future of AI and Digital Health, exists
• 0:25
  - for exactly this challenge.
• 0:27
  - Here, you'll find more than 2,500 executive level
• 0:30
  - attendees,
• 0:31
  - 600 plus speakers, and four days of sessions
• 0:34
  - built around the questions leaders are actually wrestling
• 0:36
  - with.
• 0:37
  - How to scale AI responsibly,
• 0:39
  - how to protect increasingly complex systems,
• 0:42
  - how to wring more performance out of the
• 0:44
  - revenue cycle, and how to make tech investments
• 0:46
  - that hold up over time.
• 0:48
  - Join us September fourteenth through the seventeenth at
• 0:51
  - the Hilton Chicago.
• 0:53
  - You can register on our events page at
• 0:55
  - beckershospitalreview.com
• 0:57
  - by clicking on the events tab in the
• 0:59
  - upper right.
• 1:01
  - This is Scott Becker with the Becker Healthcare
• 1:03
  - Podcast.
• 1:05
  - Thrilled today to be joined by someone who's
• 1:06
  - had a brilliant career and is a brilliant
• 1:08
  - leader.
• 1:09
  - We're joined today by Ryan Gates. Ryan's the
• 1:12
  - executive dean and senior vice president, the Levitt
• 1:15
  - School of Health at Western Governors University.
• 1:18
  - Ryan,
• 1:19
  - take a moment and and tell us a
• 1:20
  - little bit about your career and about Western
• 1:23
  - Governors University and the Levitt School of Health.
• 1:25
  - Thank you, Scott. Thank you for having me.
• 1:28
  - Yeah. So kind of an eclectic career for
• 1:30
  - me.
• 1:32
  - Early on, I started off following my my
• 1:34
  - dad's footsteps. I was a high school science
• 1:36
  - teacher and wrestling coach, in Colorado. And
• 1:39
  - couple years in, decided to go back, to
• 1:42
  - graduate school, to do a series of providential
• 1:45
  - introductions and interactions and went back and got
• 1:48
  - my doctorate degree in pharmacy,
• 1:51
  - from the University of Pacific out in California.
• 1:53
  - And, when I left public education, however, I
• 1:55
  - promised myself I would always only ever work
• 1:58
  - in academic medical centers. I just loved teaching
• 2:01
  - and mentoring, etcetera.
• 2:03
  - And so in order to do that, I
• 2:04
  - needed to do a, a postgraduate residency, which
• 2:07
  - I did at the Veterans Affairs Hospital in
• 2:09
  - San Diego,
• 2:10
  - continued on with a fellowship in, leadership in
• 2:13
  - geriatrics
• 2:14
  - and and diabetes at UCLA and USC
• 2:17
  - separate experiences.
• 2:18
  - And they got a job near back home
• 2:20
  - in Bakersfield, California,
• 2:23
  - at a county owned level two trauma center,
• 2:27
  - where,
• 2:28
  - within six months of on the job,
• 2:30
  - our residency program director and senior clinical pharmacist
• 2:33
  - retired.
• 2:35
  - All my colleagues took one big step backwards,
• 2:37
  - and I found myself the residency program director
• 2:39
  - within the first year of on the job.
• 2:41
  - And so
• 2:42
  - spent a decade there, at Keara Medical Center,
• 2:46
  - leading the clinical pharmacy department and and the
• 2:48
  - residency program.
• 2:50
  - So
• 2:51
  - I had a relationship with schools of pharmacy
• 2:53
  - sending their students to me as well as
• 2:55
  - my residents that were with me
• 2:57
  - throughout the year. Practice clinically, ran an internal
• 3:00
  - medicine in the morning. I was in the
• 3:02
  - internal medicine clinics in the afternoon, you know,
• 3:04
  - managing diabetes, pain, hep c, HIV, etcetera,
• 3:08
  - and then got pulled more and more into
• 3:09
  - hospital leadership roles.
• 3:11
  - Around year seven there,
• 3:15
  - a physician,
• 3:16
  - doctor Gilley, who I rounded with in the
• 3:18
  - mornings, was also
• 3:20
  - an owner of a local Medicare Advantage Plan
• 3:23
  - that, had about nearly a 20% increase in
• 3:27
  - their part b costs. And,
• 3:29
  - he said, well, you know what? I think
• 3:31
  - I got a guy at the hospital who
• 3:32
  - might be able to help us out. And
• 3:34
  - so I got a call,
• 3:36
  - and, that turned into a long relationship in
• 3:39
  - the consulting company where I helped,
• 3:41
  - this local Medicare Advantage Plan,
• 3:43
  - manage their Part b benefit and integrate,
• 3:46
  - pharmacists into the care model with their private
• 3:48
  - physician offices, etcetera.
• 3:51
  - Blue Shield of California came in, acquired that
• 3:53
  - plan,
• 3:54
  - and then, wanted to replicate what we had
• 3:56
  - accomplished there, with that on a local level
• 3:59
  - across the state of California. So I spent
• 4:01
  - several years working with large systems,
• 4:04
  - Sharp, Scripts,
• 4:06
  - White Memorial,
• 4:07
  - John Muir Health up north, etcetera, working with
• 4:10
  - at risk medical groups
• 4:12
  - and, helping them manage from their perspective,
• 4:15
  - not just the pharmacy benefit, but also, like,
• 4:17
  - chronic disease management, etcetera.
• 4:19
  - Had a lot of fun doing that.
• 4:22
  - But then, you know, life goes on and,
• 4:25
  - five children later and a wife and trying
• 4:27
  - to maintain a consulting company and a day
• 4:29
  - job was just a lot. And I got
• 4:32
  - recruited to go up north to Kuya
• 4:34
  - Delta Healthcare District called Cahuilla Health today. Spent
• 4:38
  - the last twelve years there, and in variety
• 4:40
  - of roles, but on the executive team as
• 4:42
  - the chief
• 4:43
  - ambulatory officer and chief,
• 4:45
  - population health officer.
• 4:47
  - Within six months of being on the job
• 4:49
  - there,
• 4:50
  - that
• 4:51
  - health care organization in partnership with the local
• 4:53
  - medical group formed an at risk Medicare Advantage
• 4:56
  - Plan. And so but there's this new guy
• 4:58
  - named Ryan. I think he might have some
• 4:59
  - experience in that. And so I got invited
• 5:01
  - into that and and was a vice president
• 5:04
  - of clinical integration for that local
• 5:06
  - restricted not scheme plan in addition to my
• 5:09
  - job, my responsibilities with the district
• 5:11
  - where I oversee the rural health clinics, urgent
• 5:14
  - cares, and all the specialty practices,
• 5:17
  - medical oncology, dialysis,
• 5:20
  - pulmonary, etcetera,
• 5:22
  - and to love that job.
• 5:24
  - But over time,
• 5:25
  - my my responsibilities have evolved to a point
• 5:28
  - where I'd really drifted from my original love
• 5:31
  - of education, and and,
• 5:34
  - and I was really you know,
• 5:35
  - my my world really evolved around practice acquisitions,
• 5:39
  - contract negotiations with physicians and medical groups and
• 5:41
  - health plans.
• 5:43
  - I was on multiple boards and and had
• 5:46
  - to really stop doing a lot of things
• 5:48
  - that brought me joy with my family and
• 5:49
  - my kids and church family, etcetera, and
• 5:53
  - and coaching. And and, and so I wasn't
• 5:55
  - sure what to do with that, though. I
• 5:56
  - love my job, but I really was, trying
• 5:59
  - to, you you know, find
• 6:01
  - my path forward in my career. And
• 6:03
  - I wasn't looking for a job, but I
• 6:05
  - got a random call from a executive recruiting
• 6:07
  - firm,
• 6:08
  - for this position. And it intrigued me. And
• 6:11
  - I said, but what on earth? You know?
• 6:13
  - I'm not a PhD. I'm not not not
• 6:14
  - an academic.
• 6:16
  - What what makes me eligible to be the
• 6:19
  - dean of the largest school of health, right,
• 6:21
  - in The United States, or a large university
• 6:23
  - at least? And they said, well, do you
• 6:24
  - know anything about western governors? And I said,
• 6:26
  - well, I know a lot of people graduate
• 6:27
  - from there, but I really don't know a
• 6:29
  - lot about, you know, how they're offended, why,
• 6:31
  - and what's their mission is. And so, like,
• 6:32
  - well, you need to do some research. And
• 6:34
  - over four months of time of researching the
• 6:36
  - founding,
• 6:37
  - by, you know, 17 governors,
• 6:40
  - Michael Levitt and Roy Romer out of Colorado,
• 6:43
  - bipartisan,
• 6:44
  - and kinda weave the people for the people
• 6:46
  - approach,
• 6:47
  - with the mandate to keep cost low and
• 6:49
  - and,
• 6:50
  - accessible,
• 6:51
  - the high view of equity amongst, you know,
• 6:53
  - first generation college graduate communities, rural communities.
• 6:57
  - So the access piece really resonated with me
• 6:59
  - coming out of, you know, population health and
• 7:01
  - health care.
• 7:02
  - And then to see that that that mission
• 7:04
  - is over thirty years of time is it
• 7:05
  - is
• 7:06
  - deep and runs deep along the current leadership
• 7:09
  - today. And so,
• 7:11
  - yeah, after four months, my wife and I,
• 7:13
  - made the decision to to move our family
• 7:16
  - here to the beautiful city of Salt Lake,
• 7:18
  - and I joined in January. So rounding up,
• 7:21
  - month six here on the job. Well, congratulations
• 7:24
  - and fantastic. I'll ask you two questions, and
• 7:26
  - these are a little bit personal. So, you
• 7:28
  - know, if I wrestled a hundred and five
• 7:30
  - and ninety eight pounds as a freshman in
• 7:32
  - high school
• 7:33
  - and I now weigh about in the one
• 7:35
  - sixties, do I need to lose weight or
• 7:37
  - am I okay? No. It's I I love
• 7:39
  - the wrestling background. So talk for talk to
• 7:41
  - me a second about, you know
• 7:44
  - okay. Two questions.
• 7:45
  - What did you learn from Dan Gable watching
• 7:47
  - wrestling over the last thirty years? And he
• 7:49
  - was was he your favorite coach and wrestler?
• 7:52
  - And second,
• 7:53
  - what translates
• 7:54
  - coaching wrestling Yeah. To running
• 7:57
  - a a a a school of health? What
• 7:58
  - what translates over from from those issues? And
• 8:01
  - you could you could ignore my wrestling at
• 8:03
  - 98, one zero five as a freshman. Got
• 8:05
  - up to about one twenty six by senior
• 8:06
  - year and did okay, not great, But it
• 8:08
  - is I could've used better coaching from you
• 8:10
  - and your dad.
• 8:11
  - Yeah. 100%, Skye. Well, I would say it
• 8:13
  - depends on how tall you are, your BMI,
• 8:16
  - but, we'll leave that for another call.
• 8:18
  - And, yes, love Dan Gable, but Joe c,
• 8:21
  - who grew up in Bakersfield and coached at
• 8:23
  - South High School, Cal State Bakersfield, and ultimately
• 8:25
  - Oklahoma State,
• 8:26
  - is,
• 8:28
  - a big fan of Joe. He's passed away
• 8:29
  - now, and he was bitter rivals with Dan
• 8:31
  - Gable.
• 8:32
  - So,
• 8:33
  - yeah, I think, as it relates to, you
• 8:35
  - know, the transferable experience as a as a
• 8:37
  - wrestler,
• 8:38
  - the hand to hand combat, you know, it
• 8:40
  - was really needed in contract negotiations, I think,
• 8:42
  - in my health care space. But,
• 8:45
  - the grit, I think,
• 8:47
  - and that's what I love about Western Governors
• 8:49
  - and our student base. You know, we're our
• 8:51
  - mascot
• 8:52
  - mascot is the night
• 8:53
  - owl. Why? Because most of our students are
• 8:55
  - full time employed. A lot of them are
• 8:57
  - parents,
• 8:59
  - mid thirties trying to, you know, achieve economic
• 9:02
  - mobility and and growth in their career, but
• 9:04
  - the traditional path
• 9:05
  - is they can't quit their job and go
• 9:07
  - to a brick and mortar school to continue
• 9:08
  - to progress. And so they're gritty. Right? They're
• 9:11
  - doing their their coursework and competencies
• 9:14
  - nights and weekends.
• 9:16
  - And so that kinda gritty,
• 9:17
  - wrestler nature in me,
• 9:20
  - really loves that about our student base and
• 9:23
  - and and the work at hand. Like, we
• 9:25
  - work really hard,
• 9:26
  - for our students to really try to create
• 9:28
  - opportunities for pathways for success. So
• 9:31
  - I I I love that. And talk about
• 9:33
  - what is Western Governors specializing today? What is
• 9:36
  - the core the core of what Western Governors
• 9:39
  - focuses on and is great at?
• 9:42
  - Yeah. Thank you.
• 9:44
  - You know, the we have not drifted from,
• 9:47
  - our core mission as it relates to, you
• 9:49
  - know, creating pathways to opportunity.
• 9:51
  - At the end of the day, we are
• 9:52
  - laser focused on what are the workforce needs
• 9:55
  - of today and where are they headed.
• 9:57
  - We have four schools and an academy, so
• 10:00
  - technology,
• 10:01
  - business, education, and health care. Of course, I'm
• 10:04
  - over to the school of health. And so
• 10:06
  - we are laser focused on what are the
• 10:07
  - health care workforce needs in the industry,
• 10:10
  - and how can we partner with health systems.
• 10:14
  - And I have a story I can share
• 10:15
  - if you want me to about, the health
• 10:17
  - system I came from in California and how
• 10:19
  - we worked with higher education to solve workforce
• 10:21
  - needs. And those those learnings I really have
• 10:23
  - brought with me here,
• 10:25
  - to WGU
• 10:27
  - and and how we,
• 10:28
  - you know, work with industry to help solve
• 10:30
  - for those problems. At the end of the
• 10:31
  - day, we we really
• 10:33
  - demand that our, programs we create and support
• 10:38
  - result in a job in gainful employment and
• 10:40
  - economic opportunity for our graduates, full stop. We
• 10:43
  - do not intend to programs and degrees that
• 10:45
  - do not lead to gainful employment.
• 10:47
  - That's fantastic and so different than some of
• 10:49
  - the large private universities today where where people
• 10:52
  - are spending so much money go to school
• 10:53
  - and then having a hard time finding the
• 10:55
  - type of job that that will make it
• 10:57
  - make sense. You know, it's it's literally an
• 10:58
  - amazing I love that focus and that goal.
• 11:01
  - It's just very real and quite frankly, because
• 11:03
  - you were very gritty. It's really what people
• 11:05
  - need is to is to advance, to grow,
• 11:07
  - and to have
• 11:09
  - gainful income and employment on the other side
• 11:11
  - of that. I love that. And and filling
• 11:13
  - a need that the health system has.
• 11:15
  - Yeah.
• 11:16
  - Mike Levitt, remarkable, remarkable leader in person.
• 11:20
  - Talk to us a little bit about over
• 11:21
  - the next six, twelve months, as you get
• 11:23
  - going here, as you start to lead, and
• 11:25
  - you've been here for several months now,
• 11:27
  - what are you most focused on and excited
• 11:29
  - about?
• 11:30
  - Well, we have a very aggressive,
• 11:33
  - growth plans because there's huge sectors of health
• 11:36
  - care, within health care that are are unmet
• 11:39
  - as it relates to workforce needs. I will
• 11:41
  - say that, we have several,
• 11:43
  - priorities. I think one
• 11:46
  - is our partnership
• 11:47
  - first approach
• 11:48
  - from from the student perspective, school perspective on
• 11:51
  - licensed program like like nursing,
• 11:53
  - like any therapy, social work, psychology, etcetera.
• 11:57
  - The last mile of training is that those
• 11:59
  - clinical hours that are needed for those hands
• 12:02
  - on experiences,
• 12:03
  - for the students to graduate and sit for
• 12:05
  - their license reports.
• 12:07
  - That is the choke point of any program,
• 12:09
  - but it's also the biggest pressure point for
• 12:11
  - health systems.
• 12:12
  - You know, 47% of our rural hospitals have
• 12:14
  - negative contribution margins. They operate very lean. And
• 12:17
  - so for them to take on students on
• 12:19
  - a very already burdened staff and nurses that
• 12:22
  - are maxed out on their patient ratios, etcetera,
• 12:25
  - it's a very,
• 12:28
  - it's a very difficult position for for schools
• 12:31
  - who are trying to enroll students but depend
• 12:32
  - upon the health systems, and health systems,
• 12:34
  - you know, have constraints. And so,
• 12:37
  - and yet that's kind of a a a
• 12:38
  - vicious cycle because those are the health system
• 12:41
  - that typically need the staff. Right? They need
• 12:43
  - our graduates to join them, and yet we
• 12:45
  - need them to help us get them across
• 12:46
  - the finish line on the training. So part
• 12:49
  - of that part of what excites me in
• 12:50
  - this space is
• 12:52
  - the integration and the maturing of virtual reality.
• 12:57
  - Having been a preceptor for ten years, you
• 12:59
  - know, I have a herd of white coats
• 13:00
  - of students following me around,
• 13:02
  - trying to get a good experience. Say they're
• 13:04
  - with me for four weeks in infectious disease
• 13:06
  - rotation. Well, it's the most assertive students that
• 13:09
  - are at the front of the line answering
• 13:10
  - all the questions,
• 13:12
  - wanting to get all the experiences, putting hands
• 13:13
  - on patients, and the more docile, shy, insecure
• 13:16
  - students who are in the back try not
• 13:17
  - to make eye contact,
• 13:19
  - you know, and just kinda survive it without
• 13:21
  - looking silly in front of their friends, etcetera.
• 13:23
  - You know, the the students who are assertive,
• 13:24
  - they get a great experience. But there's even
• 13:26
  - then,
• 13:28
  - their experience is dictated on what patient walks
• 13:30
  - in the door. They can go through an
• 13:32
  - entire month and not see an HIV patient
• 13:33
  - or a hep c patient or a patient
• 13:35
  - with, you know, osteomyelitis
• 13:36
  - in a bone. And so virtual reality
• 13:38
  - gives us an opportunity to make sure that
• 13:41
  - every single student
• 13:42
  - gets confronted with
• 13:44
  - a patient case scenario
• 13:46
  - that they need to have. They need to
• 13:48
  - interact with. They need to make decisions on.
• 13:49
  - They need to get things wrong so they
• 13:51
  - know how to grow, mature, and and and
• 13:53
  - learn.
• 13:54
  - And so and and boards of nursing and
• 13:56
  - other, accrediting boards are more and more recognizing
• 13:59
  - the value of virtual learning experiences,
• 14:03
  - not in a full replacement, but as an
• 14:05
  - augmentation to in person learning.
• 14:08
  - And so some states allow up to 49%
• 14:10
  - of clinical learning to be done virtually through
• 14:12
  - simulation,
• 14:13
  - which really helps us open up access. There
• 14:16
  - are some hospitals, for instance, in rural communities
• 14:18
  - that they don't have a psychiatric hospital, but
• 14:21
  - that's a required rotation
• 14:23
  - or a required experience at least. So can
• 14:25
  - we bolt on virtual reality trainings that fulfill,
• 14:28
  - the spirit and letter of the laws that
• 14:30
  - relates to what their their clinical experiences are
• 14:32
  - needed, but then now expand access
• 14:35
  - to rotations and get that last mile training
• 14:37
  - done to help serve our workforce needs. And
• 14:39
  - so that that's really exciting for me. That's
• 14:42
  - an emerging technology that we're
• 14:44
  - investing in heavily.
• 14:46
  - That that that that's so important, though, because
• 14:48
  - you mentioned that limiting step that last mile.
• 14:51
  - For medical students, it's residencies.
• 14:53
  - For nurses, it's been rotations and getting that
• 14:56
  - clinical time. And just it it's it's quite
• 14:58
  - frankly incredible what the nation has done. And
• 15:01
  - so it's been starting to fill that gap
• 15:04
  - in nursing training. We're we're backed up to
• 15:06
  - educating about 200,000 nurses a year, which is
• 15:09
  - incredible compared to several years ago. Whereas on
• 15:11
  - the physician side, we're still way behind the
• 15:14
  - eight ball. We're still only starting 22,000 a
• 15:16
  - year, but but the same choke point you
• 15:18
  - talked about, which is getting enough clinical on-site
• 15:21
  - practice for nurses and now solving that some
• 15:23
  - through virtual, it it is such a great
• 15:26
  - move in the right direction because you you
• 15:29
  - I mean, you nail what people talk about
• 15:30
  - as a choke point the last several years,
• 15:31
  - and it's amazing how how much that's evolved
• 15:34
  - in just a few years and how much
• 15:36
  - you folks are solving that problem.
• 15:38
  - Ryan, you've had this tremendous leadership and practical
• 15:41
  - career.
• 15:42
  - Talk a little bit about
• 15:44
  - what advice would you give to emerging leaders?
• 15:48
  - Stay connected. Stay curious. You know, I always
• 15:51
  - say,
• 15:52
  - don't let school get in the way of
• 15:53
  - your education type of mentality.
• 15:56
  - When I was in pharmacy school, etcetera, very
• 15:58
  - deeply involved with the associations,
• 16:01
  - attending conferences, really networking,
• 16:04
  - outside the four walls of of the school,
• 16:07
  - and then I I carried that with me
• 16:08
  - in my professional practice. And so, really, obviously,
• 16:12
  - your your chief responsibilities are your are your
• 16:14
  - job and core responsibilities. But
• 16:16
  - you need to create margin in your professional
• 16:18
  - life
• 16:19
  - to stay engaged in in your profession
• 16:22
  - and to stay engaged with your associations
• 16:24
  - and and to network to prevent
• 16:27
  - yourself becoming myopic
• 16:30
  - and no longer exposed to what's happening in
• 16:32
  - trends and and best practices
• 16:34
  - in the industry. So stay curious, stay connected,
• 16:38
  - stay involved, and be intentional with your time.
• 16:42
  - Ryan, what a pleasure as we could not
• 16:44
  - agree more with the concept of being intentional
• 16:46
  - and staying curious, staying connected.
• 16:49
  - You know, your core job and these other
• 16:51
  - things you're talking about, I think is fantastic.
• 16:53
  - I will tell you as a midwestern kid,
• 16:55
  - there was no one like,
• 16:57
  - Dan Gable, but but but it is what
• 17:00
  - it is. No. I'm just kidding. It's it's
• 17:01
  - just fantastic.
• 17:03
  - No. I Ryan, what a pleasure to visit
• 17:05
  - with you. Congratulations,
• 17:06
  - and and what an amazing job that the
• 17:08
  - Levitt School of Health and Western Governors does.
• 17:10
  - Thank you so much for joining us today.
• 17:12
  - Thank you,
• 17:13
  - Scott.
• 17:16
  - Appreciate it.