Latest / Becker’s Healthcare Podcast / Building the Healthcare Workforce Through Education with Dr. C. Josef Ghosn

Transcript

Building the Healthcare Workforce Through Education with Dr. C. Josef Ghosn · Becker’s Healthcare Podcast

• 0:02
  - The strategic agenda facing hospital and health system
• 0:04
  - leaders right now is not a short list.
• 0:07
  - Growth in a consolidating market, sustainable margins in
• 0:09
  - a reimbursement environment that rarely moves in your
• 0:12
  - favor,
• 0:12
  - a tech investment cycle that demands both urgency
• 0:15
  - and discipline,
• 0:16
  - and a workforce story that is still being
• 0:19
  - written.
• 0:20
  - Eker's fourteenth annual CEO CFO roundtable brings together
• 0:23
  - more than 1,500 executive level attendees and nearly
• 0:27
  - 400 speakers across four days of sessions that
• 0:30
  - are designed to help c suite leaders benchmark,
• 0:32
  - pressure test, and sharpen their priorities.
• 0:35
  - Not in the abstract, but against the real
• 0:37
  - decisions they'll face heading into the next year.
• 0:39
  - It's the kind of event you leave with
• 0:40
  - a clear sense of where you stand and
• 0:42
  - what comes next.
• 0:44
  - So join us November second through the fifth
• 0:46
  - at the Hyatt Regency in Chicago, and come
• 0:49
  - ready to do the hard thinking.
• 0:50
  - Register on our events page at beckershospitalreview.com
• 0:54
  - by clicking on the events tab in the
• 0:56
  - upper right.
• 0:58
  - This is Scott Becker with the Beckers HealthCare
• 1:01
  - podcast.
• 1:02
  - We're thrilled today to be joined by a
• 1:04
  - brilliant leader who's got a fascinating
• 1:06
  - role.
• 1:07
  - We're joined today by Joseph Gosin, c Joseph
• 1:10
  - Gosin, who who serves as the president
• 1:14
  - of AdventHealth University,
• 1:16
  - a a fascinating, fascinating role and has other
• 1:18
  - roles with AdventHealth as well.
• 1:20
  - Joseph, what a fascinating career. Can you take
• 1:23
  - a moment and tell us a little about
• 1:25
  - yourself
• 1:25
  - and about what you do with AdventHealth?
• 1:29
  - Thank you, Scott. Appreciate it. It's a pleasure
• 1:31
  - to be with you.
• 1:32
  - You know, my career took many turns. I
• 1:34
  - started in education
• 1:36
  - some forty years ago,
• 1:38
  - and then I moved to, AdventHealth for the
• 1:40
  - past maybe
• 1:41
  - this is my thirty seventh year with AdventHealth.
• 1:45
  - I worked in the corporate office. I worked
• 1:47
  - in the Florida market. I worked in the
• 1:49
  - multistate market, which is the hospitals outside the
• 1:52
  - state of Florida.
• 1:53
  - I was the chief strategy officer for Florida.
• 1:56
  - I was the chief strategy officer for the
• 1:58
  - multistate division
• 1:59
  - of AdventHealth.
• 2:01
  - And about four years ago, when I have
• 2:04
  - no black hair left in my head,
• 2:06
  - this opportunity to become the university president came
• 2:09
  - up.
• 2:10
  - And I thought if I stay around young
• 2:12
  - people, I stay young.
• 2:13
  - So I came to the university almost,
• 2:16
  - three and a half years ago or so.
• 2:18
  - So today, I am at AdventHealth University,
• 2:21
  - which is part of AdventHealth. It was established
• 2:23
  - by AdventHealth
• 2:24
  - about, thirty four years ago or so.
• 2:28
  - We are a health science university. We are
• 2:30
  - not a liberal arts college.
• 2:32
  - All our majors are in the health science
• 2:34
  - area.
• 2:36
  - When we start the school in a couple
• 2:37
  - weeks from now, we will be registering a
• 2:39
  - little over 2,100
• 2:41
  - students here on campus. 2,100
• 2:44
  - in about
• 2:46
  - 26 different academic programs ranging from
• 2:49
  - associate degrees to bachelor's to master's to doctoral
• 2:53
  - degrees we have at the university here.
• 2:56
  - Amazing. And talk about the founding of AdventHealth
• 2:59
  - University and also your thirty plus years at
• 3:02
  - AdventHealth. That's remarkable.
• 3:04
  - Talk a bit about
• 3:06
  - how AdventHealth University came to be. I know
• 3:09
  - you took over leadership of several years ago.
• 3:11
  - Talk a bit about
• 3:13
  - that. Well, about,
• 3:15
  - little over three decades ago, the leadership of,
• 3:18
  - what back then used to be called Florida
• 3:20
  - Hospital,
• 3:22
  - now AdventHealth.
• 3:24
  - The CEO back then determined that we have
• 3:26
  - a need in the system and the health
• 3:28
  - system
• 3:29
  - to develop our own talent in for the
• 3:32
  - clinical personnel,
• 3:34
  - specifically started with nursing.
• 3:36
  - So a nursing school was started some thirty
• 3:39
  - five years ago,
• 3:40
  - to graduate nurses who are aligned with the
• 3:43
  - mission of AdventHealth. As you know,
• 3:46
  - the mission of AdventHealth is extending the healing
• 3:48
  - ministry of Christ.
• 3:50
  - At AdventHealth University,
• 3:52
  - we live the healing values of Christ. So
• 3:55
  - we believe that people who are able to
• 3:57
  - live the healing values of Christ are able
• 3:59
  - to
• 4:00
  - extend the healing ministry of Christ.
• 4:03
  - So the school was started to provide talent,
• 4:05
  - specifically in nursing.
• 4:07
  - And over the year,
• 4:08
  - it grew from a small nursing school,
• 4:11
  - to a school today that offers graduate programs,
• 4:14
  - masters, and doctoral programs,
• 4:17
  - ranging from nurse anesthesia to physician assistant to
• 4:20
  - occupational therapy, physical therapy.
• 4:23
  - And I don't know what else. It's 26
• 4:24
  - some different programs we have here. So today,
• 4:27
  - we continue to fulfill the mission of the,
• 4:30
  - of the founders, if you will, and that
• 4:31
  - is
• 4:32
  - to provide talent, clinical talent, clinical leadership,
• 4:36
  - to the system, to AdventHealth as a system.
• 4:40
  - Some 80% or so of our graduates,
• 4:42
  - end up working with AdventHealth.
• 4:45
  - All our clinicals are done with AdventHealth,
• 4:48
  - from nursing to physician assistant to anesthesia to
• 4:50
  - all the other clinical programs we have.
• 4:53
  - When they finish when our graduates finish from
• 4:56
  - AHU, for example, last April,
• 4:58
  - we graduated a little over 600
• 5:02
  - people in our graduating class for for this
• 5:04
  - year for '26
• 5:06
  - and about 80% of them,
• 5:08
  - are currently working with AdventHealth.
• 5:11
  - And it's a blessing that we are one
• 5:12
  - of those universities that can say that our
• 5:15
  - employment is a 100%.
• 5:17
  - You graduate from AHU. You pass your licensure
• 5:20
  - board exams,
• 5:21
  - and you are employed.
• 5:23
  - The vast majority, interestingly enough, of our
• 5:26
  - graduates usually get offers before graduation.
• 5:30
  - We have all kinds of leadership from AdventHealth
• 5:32
  - that comes and meets with our
• 5:34
  - graduates, and they, they select them to whether
• 5:37
  - they are sonography, radiography,
• 5:39
  - nuclear medicine, whatever major it is. And, usually,
• 5:42
  - they have job offers, to go there, to
• 5:45
  - work with AdventHealth.
• 5:46
  - And over the years, interesting, Scott, we found
• 5:49
  - that
• 5:50
  - our graduates are two and a half their
• 5:53
  - tenure at AdventHealth is two and a half
• 5:54
  - times longer
• 5:56
  - than the graduates of another university.
• 5:58
  - So every university I mean, other universities obviously
• 6:01
  - offer the same majors we do. But what
• 6:04
  - is unique about AdventHealth University
• 6:06
  - is the cultural orientation
• 6:08
  - that our students here understand what it is
• 6:11
  - to work with AdventHealth,
• 6:13
  - what whole person care means for AdventHealth,
• 6:16
  - what the mission of extending the healing ministry
• 6:18
  - of Christ means at AdventHealth,
• 6:20
  - how the EMR system works, how the scheduling
• 6:23
  - system works, who are the managers are on
• 6:25
  - the units because they did
• 6:27
  - their clinical training with the system. So when
• 6:30
  - they leave the university and go work with
• 6:32
  - the hospital,
• 6:34
  - whether it is in Orlando or Tampa or
• 6:36
  - Volusia or Chicago or Denver
• 6:38
  - or any place,
• 6:39
  - of that we have facilities for AdventHealth,
• 6:43
  - they fit. There's a cultural fit, and they
• 6:45
  - stay, as I said, two and a half
• 6:47
  - times longer
• 6:48
  - than an average student from another university.
• 6:51
  - We didn't I mean, I don't wanna quantify
• 6:53
  - it in dollars and cents, but 2 and
• 6:55
  - a half times longer when you calculate the
• 6:57
  - cost of replacing,
• 6:59
  - clinical personnel
• 7:00
  - and the orientation and the onboarding,
• 7:02
  - it adds to significant
• 7:04
  - dollars
• 7:05
  - that the system saves by hiring or employing
• 7:09
  - students from AdventHealth University.
• 7:13
  - Really remarkable. In terms of getting ahead of
• 7:15
  - the pipeline issue,
• 7:17
  - what AdventHealth University has done is something that
• 7:20
  - that's the envy of so many other health
• 7:22
  - systems.
• 7:23
  - Where was the foresight? Was it the Terry
• 7:25
  - Shaw project? Was that somebody else that led
• 7:27
  - to the foresight to found AdventHealth University
• 7:31
  - with HCA Healthcare has now done something similar.
• 7:33
  - Some other places they have,
• 7:35
  - John Langel in Northeast Ohio has done something
• 7:37
  - similar. But but really getting ahead of this
• 7:40
  - a long time ago seems ahead of the
• 7:41
  - curve.
• 7:42
  - Any thoughts on that and any credit to
• 7:44
  - where that comes from?
• 7:46
  - Yeah. I mean, the credit goes to a
• 7:47
  - gentleman by the name of Tom Warner.
• 7:50
  - Tom Warner used to be the president of
• 7:52
  - the Orlando market, and later on, he became
• 7:54
  - the president and CEO of AdventHealth.
• 7:57
  - Actually, he is the one that hired Terry
• 7:59
  - Shaw. Terry Shaw came as a resident under
• 8:01
  - Tom Warner's tenure some thirty five, forty years
• 8:04
  - ago.
• 8:05
  - Tom is the one who started the,
• 8:07
  - the university. He is the one who had
• 8:09
  - the dream of starting university
• 8:12
  - here. But I have to give credit to
• 8:14
  - Terry Shaw. I became president under Terry Shaw's
• 8:17
  - tenure before David Banks took over a couple
• 8:19
  - years ago. So when Terry Shaw was president
• 8:22
  - here, he's well, he was one of the
• 8:24
  - people who asked me to,
• 8:26
  - to consider this position here. And Terry gave
• 8:28
  - us great support. I mean, in the past
• 8:31
  - three years, Scott, I think we have invested
• 8:33
  - about $70,000,000
• 8:35
  - in capital,
• 8:36
  - on this campus.
• 8:38
  - We just finished in the next two weeks.
• 8:40
  - I hope they will give us the keys
• 8:42
  - to a brand new simulation center,
• 8:44
  - 45,000
• 8:45
  - square feet of simulation that we will be,
• 8:48
  - starting classes in this building, starting September 1
• 8:53
  - coming few weeks.
• 8:54
  - But this is also, I mean, it is
• 8:56
  - a testament of the support of the, corporate
• 8:59
  - people at AdventHealth.
• 9:00
  - And in this specific situation, specifically for Terry
• 9:03
  - Shaw, for really allocating funds for the university
• 9:07
  - to be able to expand its physical plant,
• 9:10
  - expand its simulation
• 9:12
  - ability for teaching, and be able to accept
• 9:15
  - more students in the different areas of clinical.
• 9:18
  - So Tom Werner, I would say he is
• 9:20
  - the one who started the place
• 9:22
  - more than three decades ago. And I think
• 9:25
  - the the last three years or so, Terry
• 9:27
  - Shaw is the one who gave it the
• 9:28
  - boost to boost us into the next, decade
• 9:31
  - or two.
• 9:33
  - No. It's it's fantastic leadership and foresight. Really
• 9:37
  - remarkable.
• 9:39
  - Talk talk for a second about where does
• 9:41
  - AdventHealth University go go from here? You've got
• 9:44
  - 27, 28 different programs.
• 9:46
  - Are there areas that you looked to, we
• 9:49
  - have to double down on this, we have
• 9:51
  - to expand that. Where is sort of the
• 9:53
  - that that how do you think of the
• 9:55
  - next steps and and what AdventHealth University needs
• 9:59
  - to do?
• 10:00
  - Sure. You know, three years ago when or
• 10:02
  - three and a half years ago when I
• 10:03
  - started, we had roughly about 1,600
• 10:06
  - students.
• 10:08
  - And today, three and a half years later,
• 10:10
  - we will register, as I said, over 2,000
• 10:12
  - students.
• 10:13
  - So we've had we had significant growth over
• 10:16
  - the past few years.
• 10:17
  - The challenge in health care education and and
• 10:20
  - universities
• 10:21
  - like us,
• 10:22
  - there are three challenges for growth. One is
• 10:24
  - the space to be able to have adequate
• 10:27
  - classrooms and equipment and so on.
• 10:29
  - And the second one is to find a
• 10:31
  - clinical placement for our students because,
• 10:34
  - after they do the didactics, they have to
• 10:35
  - find clinical space to do the the actual
• 10:38
  - training in their clinical profession.
• 10:41
  - And the third one is finding faculty,
• 10:44
  - to be able to grow the programs. The
• 10:46
  - first two issues, the space and the clinical,
• 10:48
  - we are able to manage.
• 10:50
  - We have enough hospitals in the system to
• 10:52
  - find clinical placement for our students,
• 10:55
  - and we have enough capital in the system
• 10:57
  - to support the expansion and creating more classrooms
• 11:00
  - and mannequins and simulation, things of that nature.
• 11:03
  - The challenge is the last one, the third,
• 11:06
  - challenge that is finding faculty.
• 11:08
  - Faculty in this field is difficult to find
• 11:11
  - because the competition
• 11:13
  - is not other universities.
• 11:15
  - It is not that I'm not competing against,
• 11:18
  - other universities to find faculty. The competition becomes
• 11:21
  - against health systems,
• 11:22
  - large health systems, AdventHealth included.
• 11:25
  - Because they are the ones that hire those
• 11:27
  - high talented people, whether it's an anesthesia
• 11:30
  - or nursing or imaging, radiography, whatever it is.
• 11:35
  - So finding the right teachers,
• 11:37
  - that we are able to hire employee at
• 11:40
  - the university becomes very challenging.
• 11:43
  - Our advantage is our affiliation with Edent Health.
• 11:46
  - So we're able to share teachers where you
• 11:49
  - have, for example, take in nursing. We have
• 11:51
  - a number of people, a number of faculty,
• 11:53
  - if you will, that are full time employed
• 11:55
  - by Edent Health.
• 11:57
  - But they do teach a class or two
• 11:58
  - with the university in the area of nursing,
• 12:01
  - so we borrow from each other in order
• 12:03
  - to support the curriculum and be able to
• 12:05
  - grow.
• 12:06
  - The the next step of growth for AdventHealth
• 12:09
  - University
• 12:10
  - is going to be determined by the health
• 12:12
  - system needs.
• 12:14
  - We do not grow without understanding what the
• 12:16
  - market demands are. I want to make sure
• 12:19
  - that when our students graduate,
• 12:22
  - even before they graduate, I wanna make sure
• 12:25
  - they have job offers. I don't want anybody
• 12:27
  - to be going and looking for work. I
• 12:29
  - want people to be lining at my doors
• 12:30
  - here
• 12:31
  - during graduation, during pinning ceremonies or white coat,
• 12:36
  - ceremonies,
• 12:38
  - plucking our graduates. So we have to be
• 12:40
  - very well attuned
• 12:42
  - with the demand for health care. What does
• 12:44
  - the system need?
• 12:46
  - Whether it's AdventHealth or other health care systems.
• 12:49
  - So example,
• 12:50
  - today, the demand for, what we call APPs,
• 12:54
  - advanced practice providers or practitioners,
• 12:57
  - is very
• 12:58
  - high. And that is areas in nurse practitioners,
• 13:01
  - midwives, CRNAs, physician assistants, and others.
• 13:05
  - And all of these are graduate programs. They're
• 13:07
  - not undergraduate programs, and they're very expensive to
• 13:10
  - operate. But that's where the demand is. So
• 13:12
  - that's where we are heading into increasing our,
• 13:16
  - ability to offer more or to be able
• 13:18
  - to accept more students into these programs.
• 13:21
  - I'll give you an example.
• 13:23
  - This month, we are interviewing, not I, but
• 13:25
  - the department is interviewing for
• 13:28
  - the new incoming class for, the doctor of
• 13:31
  - nurse anesthesia practice students.
• 13:34
  - We can accept 30 students.
• 13:36
  - Three zero.
• 13:38
  - I think they're interviewing around 300.
• 13:41
  - So we're gonna have 300 interviews to choose
• 13:43
  - 30.
• 13:45
  - This means I can accept I can accept
• 13:48
  - 60. I can accept a 100, and still
• 13:50
  - there's market.
• 13:51
  - But today, I don't have the capability to
• 13:54
  - increase the number of people I get in.
• 13:56
  - It even gets worse when we talk about
• 13:59
  - areas like physician assistant.
• 14:01
  - Physician assistant for this year that we are
• 14:04
  - starting,
• 14:05
  - also we accepted thirty, three zero.
• 14:08
  - We had 1,000
• 14:09
  - applicants.
• 14:11
  - So to go from 1,000 to 30 became
• 14:13
  - a draconian effort for the faculty to make
• 14:16
  - sure they are choosing the right 30
• 14:18
  - because I always tell them 30 in, 30
• 14:21
  - out. I don't wanna lose a couple along
• 14:23
  - the way, the three year education that they
• 14:25
  - do here because we wasted lots of investment
• 14:27
  - if we don't graduate the full 30. So
• 14:29
  - they have to make sure
• 14:31
  - that they are choosing the right 30 that
• 14:33
  - are very likely to graduate.
• 14:35
  - So I can make the thirty, sixty. I
• 14:37
  - can make them a 100 or 200.
• 14:39
  - Next phase of our growth is gonna be
• 14:41
  - in expanding the areas of education that we
• 14:44
  - offer where demand in the health care system
• 14:47
  - is very high, and the advanced practice,
• 14:50
  - providers or practitioners
• 14:52
  - will be
• 14:53
  - a very good area to expand in.
• 14:57
  - Fantastic. And and you also
• 15:00
  - teach physicians, or is that in the future
• 15:02
  - of Evan Health University?
• 15:05
  - Or is that all the other roles?
• 15:07
  - No. We today, we do almost everything in
• 15:10
  - the medical field except the medical degree, the
• 15:12
  - MD.
• 15:13
  - So MD is not in our portfolio today.
• 15:16
  - I can't speak for the future,
• 15:19
  - but it is an area that we look
• 15:21
  - into occasionally to determine if this is something
• 15:24
  - we should go in. So I don't think
• 15:26
  - I can tell you today we are starting
• 15:28
  - something in the MD area or the DO
• 15:30
  - area, allopathic or osteopathic,
• 15:32
  - but we know there is demand.
• 15:35
  - But that's a different beast. It it's something
• 15:37
  - that we need to fully understand
• 15:39
  - and understand the implications of having a medical
• 15:42
  - school in addition to the health sciences, the
• 15:44
  - allied health sciences that we have today. So
• 15:46
  - I don't think I wanna talk about medical
• 15:48
  - schools today.
• 15:50
  - No. Thank you so much. One other question.
• 15:52
  - It seems like over the last several years,
• 15:55
  - there's been a tremendous
• 15:56
  - acceleration
• 15:57
  - in the training of nurses in our country,
• 16:00
  - and that that has gone really well in
• 16:02
  - terms of filling that gap.
• 16:04
  - It it it seemed like just a few
• 16:05
  - years ago, that was an impossible gap to
• 16:07
  - fill. And, obviously, there's still so much need,
• 16:10
  - but it seems like there's been great acceleration
• 16:12
  - back to turning out almost 200,000 nurses a
• 16:14
  - year. About 30,000 a year come here from
• 16:17
  - other countries, and we're so fortunate to have
• 16:19
  - them.
• 16:20
  - How did that happen? How did that
• 16:22
  - accelerate so well when people thought that couldn't
• 16:25
  - be done? Any any thoughts there?
• 16:27
  - Well, you know, we have found medication for
• 16:30
  - everything.
• 16:31
  - If you have high cholesterol, we have Crestor.
• 16:34
  - If you have blood pressure, we have medication
• 16:36
  - for that.
• 16:37
  - But we haven't found a pill for aging
• 16:39
  - yet.
• 16:40
  - And and that's the problem we have. We
• 16:42
  - are aging. All of us in America are
• 16:44
  - aging, and and I don't have to tell
• 16:46
  - you. I speak for myself only. After 50,
• 16:48
  - it's downhill when it comes to a person's
• 16:51
  - health.
• 16:53
  - So that aging of the population, it created
• 16:56
  - significant increase in demand for the different health
• 16:59
  - professions, nursing included, nursing being
• 17:01
  - the most acute, if you will.
• 17:04
  - So the past number of years, we have
• 17:06
  - expanded our offerings, not I and AdventHealth University,
• 17:09
  - but everybody across the country
• 17:11
  - expanded their, their offerings in the nursing area.
• 17:14
  - Take an example at AHU.
• 17:16
  - Three years ago, we used to educate about
• 17:18
  - 300.
• 17:19
  - Today, we educate about 600.
• 17:22
  - So we have doubled our intake of
• 17:26
  - training nurses in our university over the past
• 17:28
  - three and a half years.
• 17:31
  - And so we graduate, let's say, 300 some
• 17:34
  - nurses each year.
• 17:35
  - And we send them to work in AdventHealth.
• 17:37
  - And AdventHealth
• 17:39
  - in Orlando alone requires about 3,000 a year.
• 17:43
  - So 500 is not the majority even. Right?
• 17:46
  - So they have to depend on other nursing
• 17:48
  - schools to give additional graduates to come work
• 17:52
  - at the at the hospitals.
• 17:54
  - But everybody is expanding their nursing programs.
• 17:57
  - A few years ago, well, not more than
• 17:59
  - a few years ago, about 10 ago or
• 18:01
  - so,
• 18:02
  - the nursing degrees offered in most universities
• 18:04
  - were associate degree of nursing. You get ASN,
• 18:07
  - you become an RN, you go work.
• 18:09
  - Some fifteen years ago or so in the
• 18:11
  - infinite wisdom of health care administrators,
• 18:14
  - including myself back then when I was in
• 18:16
  - the hospital,
• 18:17
  - we said we don't want ASNs. We want
• 18:19
  - BSNs.
• 18:20
  - Bachelor degree of science in nursing, not an
• 18:22
  - associate degree. So most universities, including AHU, shifted
• 18:26
  - from an ASN to BSN.
• 18:29
  - Well, now we have it's like a circle.
• 18:31
  - You know? We go back. We learn. We
• 18:33
  - don't we never learned. We came back to
• 18:35
  - the point today where we say, no. We
• 18:37
  - want to reestablish the ASN
• 18:39
  - because we need quickly nurses to graduate and
• 18:42
  - and go join the, the workforce.
• 18:44
  - So now at AHU, we have both. We
• 18:46
  - have the ASN and the BSN,
• 18:49
  - two separate programs, two accreting bodies, two faculties,
• 18:52
  - two different faculty sets dealing with them,
• 18:55
  - two different accreting bodies, I said that, in
• 18:58
  - order to meet the needs of the system.
• 19:00
  - So we did that. Other universities are doing
• 19:02
  - that. So the gap started to narrow, but
• 19:05
  - it will not disappear.
• 19:07
  - There is always need and the need not
• 19:09
  - just for nurses, for other professions.
• 19:12
  - I mean, the other day, I I heard,
• 19:14
  - from our colleagues, my colleagues in Volusia County
• 19:17
  - here in Florida,
• 19:18
  - that they have openings for 29
• 19:20
  - nurse anesthetists.
• 19:22
  - Well, I don't know where we're gonna find
• 19:24
  - 29
• 19:24
  - nurse anesthetists
• 19:26
  - to fill those positions in six months' time
• 19:28
  - frame
• 19:29
  - when it takes me three years to graduate
• 19:31
  - 30.
• 19:32
  - So the the the shortage in in the
• 19:35
  - in the providers for health care is across
• 19:37
  - the continuum.
• 19:38
  - Nursing is probably the most acute, but we
• 19:41
  - don't hear much about sonographers. We don't hear
• 19:43
  - much about nuclear medicine
• 19:45
  - or nurse nurse anesthesia
• 19:47
  - or other
• 19:48
  - areas in the clinical field.
• 19:51
  - The acute shortages are everywhere, and the aging
• 19:54
  - of the population,
• 19:56
  - maybe not the increase because we're not growing
• 19:58
  - as fast in population, but the aging of
• 20:01
  - the population
• 20:02
  - is increasing utilization
• 20:04
  - to the point that it's becoming
• 20:08
  - the pressure is real on health care systems
• 20:10
  - across the country.
• 20:12
  - A 100%.
• 20:13
  - I I I have to tell you,
• 20:16
  - it is remarkable, Joseph,
• 20:18
  - what you folks are doing at AdventHealth University
• 20:20
  - and quite frankly what AdventHealth does nationally.
• 20:23
  - It's really remarkable.
• 20:25
  - I I I wanna thank you for taking
• 20:27
  - the time to join us today on the
• 20:28
  - Beckers Healthcare Podcast and shed more light on
• 20:31
  - what AdventHealth University does. It might be one
• 20:34
  - of health care's best kept secrets, but remarkable
• 20:36
  - what you're doing. So thank you for joining
• 20:38
  - us. Thank you. It's my pleasure.