Episode 53:
What Are We Doing for the Community?
Andrew Wisdom, Board Chair, Ochsner Health and President, Crescent Capital Consulting
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In this episode of Fireside Chat, we sit down with Andrew Wisdom, Board Chair, Ochsner Health and President, Crescent Capital Consultants to talk about his wide-ranging governance experience. Wisdom has served on numerous non-profit boards and discussed the unique expectations and responsibilities for sitting on healthcare, higher education, and community services boards.  He shares the three key questions to be asked when considering joining a non-profit board. He also talked about the characteristics of a leader during a crisis based on his experience with Katrina, H1N1, the 2008-2009 recession, and now, COVID-19.

Andy has over two decades of experience in portfolio construction, manager selection, and performance tracking across public and private asset classes for institutions, foundations, family offices, ultra-high net worth individuals, and high net worth individuals. Andy has deep operational and venture capital experience as the current Chairman and former CEO of Turbo Squid, Inc., a digital media company he co-founded and launched in April 2000 which successfully raised Series A venture funding from Intel Capital, Eastman Kodak Ventures, and Advantage Capital Partners. Read more

Transcription

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Andrew Wisdom 0:03
My view as the board chair is that my role really is as the Chief Governance Officer. I don’t tell Warner Thomas what I think he ought to do on a day-to-day basis and I don’t concern myself with who has the contract to do the laundry. That is exclusively the management’s job. But I focus on governance, strategy, making sure that our board is fully aligned on where we think the organization out to go. And in particular, we always come back to the idea of “what are we doing for the community.”

Gary Bisbee 0:34
That was Andrew Wisdom, Board Chair Ochsner Health and President Crescent Capital Consultants, discussing how he thinks about his role as Board Chair of Ochsner Health. I’m Gary Bisbee and this is Fireside Chat. Andy has deep and wide-ranging governance experience. He has served on numerous nonprofit boards and he discusses the unique expectations and responsibilities for sitting on healthcare, higher education, and community services boards. He shares the three key questions to be asked when considering joining a nonprofit board. Andy reviewed his interesting history with the Ochsner Board and what he finds rewarding in serving on it. He dug into the responsibilities of a board chair and how he thinks about board succession. Andy spoke about the most important responsibility of a board during a crisis. Let’s listen.

Andrew Wisdom 1:26
One of the most valuable and powerful things we did as a board was communicating both to management, that our board was willing to do whatever it took to support management in doing its job, but then we also brought that message out system-wide to everyone working in the system.

Gary Bisbee 1:46
Andy wrapped up the interview by describing the characteristics of a leader during crisis based on his experience with Katrina, H1N1, the 2008/2009 recession, and now COVID-19. I’m delighted to welcome, Andy Wisdom to the microphone. Well, good afternoon, Andy and welcome.

Andrew Wisdom 1:49
Gary, thank you and pleasure to be here.

Gary Bisbee 2:10
We’re pleased to have you at this microphone. Let’s start by getting to know you and then we’ll turn to your substantial governance experience and leadership as chair of the board of Ochsner Health System. You grew up in New Orleans. Can you share a bit of your family’s deep roots all the way back to 1838, I think it was?

Andrew Wisdom 2:29
Absolutely. I grew up here. I’ve spent my entire life here. I think any evidence of that in my language or accent was hammered out by the four years I spent in college in Maine. But my family got to New Orleans in 1838. They had been briefly in Tennessee before that, Virginia before that, and had come from England before that. And so, deep roots going back a long ways and through a quirk, where my great grandfather, I am the descendant of his third wife to whom he married very late in his life. In only three short generations, it spans quite a bit of time.

Gary Bisbee 3:02
You made mention of New England. I know you went to Bates College. What in the world got you from New Orleans up to Maine for college?

Andrew Wisdom 3:07
That’s a great question. I think really two things. So my father and grandfather and great grandfather had all attended Washington Elite in Virginia. And while Virginia is certainly far away from New Orleans, to me, it really just wasn’t far enough. I’ve always loved the idea of going to a small, private college in New England. In high school, I spent my summers going to academic programs, either at prep schools, or one summer at Yale in New Haven, and I just felt completely in tune with that entire milieu. And the other, the other precipitating event, quite honestly, is my father died when I was 12. Now, had he been alive, I suspect a lot more pressure would have been brought to bear to be the fourth generation student at Washington Elite. But at that time of my life, and I have no regrets, I just have no interest in being the fourth generation of anything. I wanted to go. I love Maine. I love New England and Bates struck me as a good place to be and about as far away as I could go, short of the West Coast. It was about as far away from home. So that’s really what led me to Maine.

Gary Bisbee 4:15
Well, that makes good sense. And then you returned to Louisiana to attend Tulane Law School. Were you interested in practicing law or just learning about law?

Andrew Wisdom 4:24
It started off as the former, I thought I would end up being a lawyer. I wasn’t sure exactly what type of lawyer. I did have an inkling that I might want to use my law degree in the field of sports and sports management. But it turned out, back in my first year, I clerked at a firm and I just realized that working on depositions and motions and things like that, that I certainly didn’t want to spend my life doing that. And then, so then the value of law school for me became more about education. And I have to say, I mean of kindergarten through high school through college through law school, the academic and intellectual rigor of law school was really the finest thing I’ve ever been subjected to. It’s very hard. I’m not sure I’d go do it again. But to me has been absolutely invaluable, recalibrating the way I think, the way I write, the way I communicate. I mean really, really changing all those things for me, and I can’t imagine not having had had that education. Now, having had it and looking back over the 25 years since I graduated from law school, just a fantastic experience.

Gary Bisbee 5:28
It’s great when you do go to professional school and it just fits, which it obviously did in your case. So then you went to work on Senator Lamar Alexander’s ’96 presidential campaign. What lessons did you learn there, Andy?

Andrew Wisdom 5:42
Well, it was really one of the greatest years of my life. Lamar was a law clerk for my great uncle who was appointed by President Eisenhower to the United States Circuit Court of Appeals bench and they had been close ever since. And when I was finishing law school I was sitting down with Lamar. I said, “Lamar, what are you going to do?” He just finished as Education Secretary. And I said, “Well, what are you going to do?” He said, “Well, I’m running for president.” And I said, “Oh, that’s great. I’m finishing law school; I’d like to come work for you.” So it launched a really great year. The lessons I took out of that are, and it took a little bit of time for it to manifest, but really the power of networks. The people that I worked with for a year straight in one of those pressure cooker kind of hothouse environments are some of the finest people I’ve ever worked with. They’re all my friends to this day, and so many of them have gone on to these fabulous careers. But it was really one of those moments where I realized just being engaged and staying active and meeting people is one of the most valuable things that can happen to you. We came very close to winning the Republican nomination, but we lost a Bob Dole in New Hampshire by about 6,000 votes and ultimately that was the end of the campaign. But really, one of the most valuable years of my life for sure.

Gary Bisbee 6:59
Well, maybe you could have brought some of your fellow Bates classmates over to vote in New Hampshire. That might have done it for Senator Alexander.

Andrew Wisdom 7:08
It’s funny, I thought of it. Half of Bates College at that time came from Boston so it would have been a harder sale.

Gary Bisbee 7:14
You’ve really spent considerable time in financial services. Can you please describe Crescent Capital Consulting for us, Andy?

Andrew Wisdom 7:21
Sure. We are what I consider to be a general-purpose consulting and investment management firm. We manage approximately $1.1 billion. I would say that it’s split up about half of that is what we think of as institutional money, so foundations, endowments, things like that, and the other half would be a family office, ultra-high net worth and high net worth individuals. So we really cover that ground in terms of client base and then during our job we really cover most of the major asset classes – global equities, global fixed income, and credit, private equity from venture all the way through leveraged buyout, hedge funds, both pretty long-short, and absolute return, real assets, both private and public. And so we cover those asset classes. I would say, primarily we’re allocators. We try to figure out based on what we see in the macro environment, what allocations make the most sense, and then when the allocations are set, we go find the best managers to execute against the allocation and then we manage the managers from there.

Gary Bisbee 8:23
Well as if you don’t spend enough time in financial services and governance, you’re also an entrepreneur as the current chair of Turbo Squid Digital Media Company. Can you describe Turbo Squid for our listeners?

Andrew Wisdom 8:35
Sure. So my brother and I co-founded Turbo Squid back in 2000. Prior to that, we had worked in computer animation and visual effects and along the way, we began following the internet very closely, in say 1993, prior to Netscape really busting it out into the public consciousness. And by 2000, we had decided that maybe the internet would provide a good way to marry the hardest element of computer animation and visual effects, which is essentially a service business to the internet so that we could maybe get some bigger scale and better margins and more operating leverage in the business. And what we came up with was, the way to do that would be to create a library of 3D objects. And I think the closest analogy would be stock photography. But this library is really geared towards the production of 3D animation, which, for the last 25 years or so has been all around you, whether you see it or not, but on TV and multimedia presentations, and certainly in featured films, 3D animation and 3D objects are everywhere. So it’s a library that we created. And I used to be the CEO, my brother now runs it, I chair the board. But our library is several million objects, and not only are you seeing 3D all the time, you’re seeing our objects all the time. They’re in TV commercials that you see, in movies, and things like that. So we’re the largest library of its kind in the world, which is not to say that it’s a massive business by any stretch of the imagination. But we did take it from a mere idea into a business that’ll have, let’s say, probably do $23 million in revenue this year.

Gary Bisbee 10:08
That’s awesome. Well, next podcast interview let’s spend more time on Turbo Squid. It sounds like it really is quite interesting.

Andrew Wisdom 10:17
Well, it’s funny, Gary because somehow all these things have blended together to make the executive that I am and I’m constantly drawing on lessons from all of these different environments and these different milieu about how to apply it to the future.

Gary Bisbee 10:31
It’s very exciting and you’ve got a wide-ranging and successful background for sure. Let’s turn to governance now Andy and there’s another example where you have wide-ranging governance experience. So in addition to being Chair of the Ochsner Health System Board, Trustee at Tulane University, what other boards are you sitting on?

Andrew Wisdom 10:51
So at the moment, I’m a Trustee at Dillard University, which is a historically black college in New Orleans that my family’s been involved with, really since the 40s. The Greater New Orleans Foundation, which is a civic foundation that hosts both donor-advised funds as well as engages in direct philanthropy. I was co-founder of, I’m no longer on the board, but a co-founder of a Lusher Charter School, which is a high performing charter that really came around after Katrina. And then finally, something called YouthForce NOLA, which is a youth employment training regime that goes all the way past their high school graduation. So it ultimately adds a one-year postgraduate program to tune kids up to go enter the workplace.

Gary Bisbee 11:38
So what do you find rewarding about sitting on nonprofit boards of directors?

Andrew Wisdom 11:42
It’s funny, I think a lot of it just depends on the organization because they tend to draw different things. So smaller organizations give you the opportunity to really get into the details of how an organization is run because they’re small, they’re not well resourced. They really need board members with specific domain expertise to help the management team execute. And I think that is satisfying, although I think the impulse to help a staff member execute has to be tempered by the duties of a board member if by thinking about really not doing someone’s job for them, but assisting them do their job, being additive where you can, but not relieving them from the obligation of doing the work. So on the smaller side, I think that’s rewarding. In the large organizations like Ochsner or Tulane or Dillard, taking them in order. Ochsner, I think what’s been rewarding is two things. One, I joined as a director in 2004. We’ve taken it from 1 hospital to about 40 and from about $600 million in revenue to, this year, both managed and you know, on our P&L, revenue will be approaching $7 billion. And I think that it has been tremendously rewarding to be a part of that. And the other thing is, really being a part of not just a part of the culture of how we grow this system, but being a part of the culture of how we govern the system. And so my view as the board chair, is that my role really is as the Chief Governance Officer. I don’t tell Warner Thomas what I think he ought to do on a day-to-day basis and I don’t concern myself with who has the contract to do the laundry. That is exclusively management’s job. But I focus on governance, strategy, making sure that our board is fully aligned on where we think the organization ought to go. And in particular, we always come back to the idea of “what are we doing for the community,” because that is our mandate. We have taxes exempt status because we provide care to the community. And more recently, I really have been thinking about over the last three years, taking as broad a view of community as one can. Historically, I think community care was simply thought of as how many people who couldn’t pay for care that we cared for and then putting a dollar figure on it and that was the trade-off. I think in the modern world, a big institution like Ochsner, which will have around $7 billion in revenue and 40,000 employees and actually have a statewide footprint rather than just the local footprint, needs to begin to think about community much more broadly. How are we addressing as a community education? How are we addressing elements of public health and particularly public health disparities that we didn’t previously didn’t think about attacking in a direct way. And the COVID-19 crisis has really brought a good bit of that into sharp relief, the health disparities, the ways to engage the community, so I find that entire exercise to be incredibly rewarding. At Tulane, another big institution, I think the two things that I’ve found the most rewarding, keeping in mind that universities are structured differently, their boards are a little bit different, they focus oftentimes less on governance and say more on development and expertise of the trustees. It’s a slightly different dynamic and usually, you know, Tulane has about 38 people on its board so it’s a very large organization. But the two things that I found most rewarding are spending the last 10 years chairing their endowment committee and helping the investment office continue to become a more professional operation and produce some of the best returns in university endowment returns in the country. I’m very proud of that. But it’s been very rewarding to me, as well. The other thing is I co chaired the search committee to hire Mike Fitz, who is the current president of Tulane University and he has done a fantastic job. He’s put in a fantastic team and Tulane is doing as well as it’s ever done. And while I would never take credit for doing any of it, because to me there’s a clear distinction between governing and managing, it does make me feel good. I do sleep well at night knowing that Tulane is in incredibly capable hands and that I played some small role in it.

Gary Bisbee 15:52
Well on the flip side, what’s the most challenging decision you’ve had to make as a board member?

Andrew Wisdom 15:59
That’s a really good question. I would say the most challenging decision, when we hired Mike at Tulane, his transition was a lot more difficult than I think either he or I would have predicted. And I think really making the decision to stand up as tall as I could and ensure that he was given enough runway to prove whether he could be successful or not, in some sense, was the hardest decision. It certainly produced the hardest outcome. The first 18 months of his tenure were a real challenge for me personally, as well as executing my role as a board member, but I have absolutely no regrets.

Gary Bisbee 16:37
So what advice would you have for listeners who might be interested in joining a nonprofit board?

Andrew Wisdom 16:44
I would say a couple of things. One is, try to understand up front exactly what is required. And I mean that in a couple of different levels, because oftentimes the discussion says, “Hey, we’d like you to join our board” and you say, “Yes, I think I’d like that” and it doesn’t go any further than that. I would say, you want to ask questions about, how do they feel about governance? Is this, a more of a working board? Or is it a governing board? And for smaller organizations, really large organizations, what is the board’s role in development and fundraising versus governing? And to really get a clear handle on those three things upfront. Am I going to be expected to write a $20,000 check every year? I know it’s sometimes a little uncomfortable when somebody suggests that you should join their board that you might ask if there’s going to be a bill attached to it. And I take the point. It is a little bit uncomfortable, but you will never regret setting that expectation up-front. But understanding clearly those three things I think will help someone make a decision about whether to join a board.

Gary Bisbee 17:48
Well, let’s move to Ochsner Health System, which is the largest nonprofit health system in Louisiana. You indicate roughly $7 billion in revenues and you joined the board in 2004 you indicated earlier. But what was your first involvement with Ochsner? I think you were involved before you actually joined the board.

Andrew Wisdom 18:06
Yeah, that’s right. So about two years before I joined the board, I was asked to be a non-trustee member of their investment committee because they were going through a transition and wanted to embark upon a more global investment program. And so, it was known that I had some expertise along those lines. It was about five years prior to that I joined the board of a family foundation and, and we really ran that, and we still do, in fact, and I chair that foundation board today, but we ran that foundation portfolio as if it were its own mini university endowment. That in the asset allocation, hiring managers, firing managers, and while none of us was an investment professional getting paid, we ran it as if we were. Then I transitioned, took that expertise, and worked for two years on Ochsner’s investment committee and helped reorganize its portfolio. And then two years later, they asked me to become a director, trustee, and then to officially join the investment committee. And then three years after that in 2007, I became the chairman of that committee and I’ve chaired the committee ever since. And I would have to say, if you were really going to, given my day job, if you were going to really describe what I do today in that way for Ochsner, I serve as the sort of unpaid Chief Investment Officer, I guess, would be the fairest description of how I run the investment committee. We have an outside consultant, I’ve got some great committee members, and I help shape and direct the entire endeavor of investing both its pension money and its unrestricted money and do that.

Gary Bisbee 19:34
When did you become chair of the board then of the Ochsner Health System board?

Andrew Wisdom 19:40
It was in 2018. So I’m in my third year of what would be expected to be at least four years as board chair and, I’m in 2020 is my third year. So 18, 19, into 20. I’m into my third year now,

Gary Bisbee 19:56
You made the point earlier you view yourself as a Chief Governance Officer. What specific responsibilities do you have as the board chair?

Andrew Wisdom 20:05
Well, apart from leading the meetings and working on and organizing, we do a board retreat every year, I spend a good bit of time on that, on a sort of day-to-day basis, outside of just the pure governance angle, I spend a lot of time talking to Warner Thomas who is the CEO. And I think in that role, I really am kind of a sounding board for Warner. I think it should come as no surprise to anyone that they’re always a variety of issues confronting any health system at any given moment. And it’s hard, I think, on your own if you’re the CEO, to accurately judge at any given moment, what is something that should come to the board, especially if it’s an extraordinary event. And I think having a close partnership with your board chair where you can have an open and candid conversation about what things should come to the board, what things are not ready, what things might come to the board but aren’t ready yet, what things are ready, what the structure of the meetings ought to be like, how we want to address things like priorities and trying to calibrate the board in a sort of strategic way. I would say those are the most of the sort of day-to-day, though the actual running of the meeting is the smallest piece of it. It actually requires a great deal of time outside of all that and a great deal of thought and it is quite different than being a trustee in the wild, or a trustee at large, versus considering it all through the lens of being the board chair. It is a very different mentality.

Gary Bisbee 21:31
Andy, how do you think about board succession and recruiting new members to the board?

Andrew Wisdom 21:36
In a couple of different ways. So our board is a hybrid, it’s Ochsner Health came together as a result of a merger in 2002 between the hospital and the clinic foundation. So one was the nonprofit fundraising and development arm for the actual hospital, which was more or less owned by the doctors. And so our board has a very significant senior physician representation on the board and I’m just going to use round numbers. If our board has 20 members on it, nine of them will be senior positions and 11 of them would be community directors like myself. So we have a lot of that spelled out in our documents. Well over the last four or five years though, I think we realized, long before the current environment that we’re in, that like a lot of health systems, we were looking fairly homogenous, overwhelmingly male, not female, overwhelmingly white and not diverse. And so we really began four or five years ago, looking at addressing these issues and to begin thinking about diversity. So I think we’ve done a good job becoming much more diverse. So we have significantly more women on our board than we’ve ever had. We have more minority representation, whether African American, Hispanic, Asian. We really are a much more diverse group today than we were even five years ago. And so I think that’s been an important piece of work. It’s an ongoing piece of work. I’m very proud to say that we have also tried to push some of that thought across the entire organization. Warner has done a great job hiring a Diversity Inclusion Officer that is launching a series of system-wide conversations on the topics of diversity and inclusion. And I think they’re really brilliantly structured. She’s very, very capable in her job. And I think that’s going to yield great results for us long term.

Gary Bisbee 23:30
Well, you mentioned your board retreat, an annual retreat. Was it in person or virtual this year?

Andrew Wisdom 23:37
This year, we did a bit of both. In the past, what we’ve done is taken three days to go off campus somewhere, and it has been incredibly helpful. Just being away from your normal environment, I think, allows you to drown out your other concerns and really focus on what you’re talking about at the series of meetings. But because of COVID-19 we weren’t able to do that this year. So what we did was a bit of a hybrid. So we had a large space that we could put everybody in at an appropriately socially distanced way. But then we also had some directors and staff zoom in. So we had both going simultaneously.

Gary Bisbee 24:11
How does a virtual meeting work, do you think? Is it as effective as in person?

Andrew Wisdom 24:17
You know, it’s funny. I think there’s sort of mixed feelings about it and different schools of thought emerging. I felt like we were very effective with that hybrid approach. I would say to anybody listening, if you’re about to do something similar, do make sure that your audio-visual setup is working. When you’re using zoom, for instance, there are these bizarre little feedback loops that happen. So it can be hard. On the first day, we did have a few challenges where people who were remote we’re having a hard time hearing the people in the room and so on and so forth. Ultimately, it all got ironed out. And I would say overall, I felt like we were focused and we were productive and we got a lot done.

Gary Bisbee 24:55
So what were the major strategic initiatives that you reviewed at the retreat?

Andrew Wisdom 24:59
Some really good ones. So we’ve really been a pioneer, I’d say, over the last five years in digital health. And I think COVID-19 has made things like telehealth now a part of the common vernacular in this country. I mean, I don’t think anybody knew what telehealth was other than practitioners six months ago. But digital health, we have an innovation lab inside of Ochsner, that has done a lot of work on how to use digital health as a means to both address health disparities on the one hand, but also getting people in compliance with their various regimes. So whether you’re hypertensive, whether you have diabetes, there are a variety of digital strategies that can be brought to bear. We’ve begun thinking about our patients as customers and sort of thinking about patient acquisition, customer acquisition. There’s a lot to be learned from digital and online practitioners that are outside of healthcare. So that was one full day we spent on digital. And if digital is executed correctly, I think if you really just reduce it all down to its element. Digital represents the ability to pick up margin. So in a world where we should probably expect to be constrained in our margins moving forward, picking up sources of margin becomes that much more important. And digital health really represents an opportunity to pick up margin and protect yourself against a downward pressure from government payers and things of that nature. So a full day on that. We did another full day really on the meaning scale in the business. So this is a conversation that we engaged in 10 years ago. And I think going from 1 hospital to 40 sort of shows that we have taken it to heart, but scale is always going to be there. We’ve seen single hospitals grow into statewide systems. We’re now seeing more regional systems and we’re seeing super-regional systems and so spent a day thinking about, and we thought of it in really in this context, we’re seeing national scale in pairs and we’re seeing more national scale in sort of lower acuity providers, so think CVS, Walmart is going to start to get into the clinic business, that ambulatory business that represents a good bit of margin. And in some cases, the national scale for payers and providers are coming together. Meanwhile, I think in health, the most we’ve seen as sort of regional and super-regional aggregations of systems. And so it seems to us just as a theoretical construct that the center of gravity, the gravitational forces, could be suggesting that even larger scale needs to be brought to bear an environment like this. I don’t think it’s a settled question at all. But we tend to think out 5 and 10 years out in time and think about where we need to be and what we need to be thinking about. So we spend an entire day on that. And then, third day, we really just look inward and we think about our capital budgeting and really capital budgets as an expression of priority. Less about what’s happening in the next 5 years and more about what’s happening the next 5 months.

Gary Bisbee 27:56
Good review. Thank you. Obviously, very active meeting, very active board. Why don’t we turn to COVID crisis, which you’ve brought up several times, and of course, you’ve lived through Hurricane Katrina, the 2008/2009 recession? How does the COVID-19 crisis compare?

Andrew Wisdom 28:14
Those are the first analogies that I drew and it’s a little bit like all of them wrapped into one. A distinguishing feature was, you know, Katrina really just happened to us. And so, in that instance, this whole region was able to rely on the generosity and thoughtfulness of the rest of the country who was more or less unaffected. In the financial crisis, 08/09, from a financial perspective, it happened to everybody. That was its own sort of crazy time in terms of what happened, in terms of assets and balance sheets and investment portfolios and things like that. Very, very stressful in its own right. COVID melds the two in a way that I would have never predicted possible and then the funny thing is, is that it’s happening to everyone simultaneously. Whereas New Orleans could have thought about the generosity of the rest of the country to help it in its time of need, a major distinguishing feature of the COVID 19 pandemic is that it’s happening to everyone simultaneously. There is no one else that can help you out. Everyone is in the same boat. So that has really raised the degree of difficulty, if you ask me, in terms of how we approach it.

Gary Bisbee 29:22
When you first became aware that there was a COVID crisis, what were your first thoughts?

Andrew Wisdom 29:28
I started reading about it, like everybody in the beginning of January, you know, into December, beginning of January. And my first thoughts were, I sure hope it won’t come here, just like MERS and just like SARS, I hope this is just another dud of a respiratory virus that never quite does the thing that everyone’s predicted. And that changed fairly rapidly in a very quick succession. And interestingly, my mother and her partner who was 92 years old, lived in a senior facility in New Orleans, that became the very first hotspot in New Orleans. And tragically, he did not survive. He was 92. And I, you know, look at 92, I think one is certainly fragile, if nothing else. My mother has survived. But that was really the first moment where I thought, “Okay, this is really happening. And once it starts embedding in these communities, it will be very hard to stop the spread. So then what does that mean?” And by that time, we started seeing the case showing up in the hospital. And the Ochsner team began, not only running the numbers for our system in terms of capacity, but modeling different are/not values, different spread values, and then mapping that against our capacity. And then we reached out to every other health system because I think we have better control of our data and forecasting than anybody else. So we started aggregating everyone’s data. By the middle of March, it was clear that at the current rate of replication at that time that the entire region would be exhausted. Its resources would be exhausted by the first week of April. That was where it really sunk into me that this is not just a new world for Ochsner. It could be a new world in a variety of different ways. And this is pretty scary.

Gary Bisbee 30:10
What’s the board’s responsibility during a crisis like COVID?

Andrew Wisdom 31:15
That’s such a good question because there’s no one answer to that. But I think one of the most valuable and powerful things we did as a board was communicate both to management that our board was willing to do whatever it took to support management in doing its job. But that we also brought that message out system-wide, to everyone working in the system, to make it absolutely crystal clear that there is literally nothing this board will not do to protect you, to make sure that you have what you need to do your job. We’re going to do what we can to protect your job and I’m very pleased to say that we have not laid off anyone through this entire crisis. But just to reinforce, and then to finally say how much we appreciate the absolutely herculean tasks that they were all performing on a daily basis. And in that sense, it felt very much like Katrina, because there were a lot of that same messaging. People were really just performing courageous and heroic acts day in and day out during Katrina, as they have in COVID. But to really make sure that we as a board let every constituent group inside of the system know, we’ve got your back. We’re going to do everything we can to protect you. We are deeply, deeply appreciative of your heroic sacrifice in this very difficult time. There’s no playbook for that Gary, but I do think that is what seemed natural to me.

Gary Bisbee 32:38
How and how often did Warner communicate with the board?

Andrew Wisdom 32:42
Warner and I talked about that a good bit and my default is in those acute moments and those crisis moments, more communication is better than less. And so what I decided to do with Warner’s full agreement and even the full agreement of the board, so it wasn’t like I just dictated that this would be the pacing, but every Tuesday and every Friday, we convened a board call at 1pm. And Ochsner was doing all the statistics, and the replications statistics and our capacity both locally for us at Ochsner and citywide. And looking at the curves of when we may or may not run out of resources and so on and so forth. So they track it every single day, actually, they were doing it twice a day. But every Tuesday and every Friday we all hopped on a call, we went over the information that we had and just tried to stay as on top of it as we possibly could. And I think we did that for probably three months or so. And then we began scaling it back to just once a week and having a once a week update on where things are, because you could see that the spike really happened in March, but it sort of peaked locally in the beginning of April and really began to come down. And it looked like at least sort of temporarily the virus was, I would use the word under control very advisedly because I’m not sure this thing is subject to being controlled in some definitive way, at least not yet. But it began to look a lot less acute. So our capacity started looking good. Rather than about to be overrun, we thought, you know what, certainly on a metropolitan area basis, we should be okay. We will have enough ventilators, we will have enough ICU, we have enough med surge beds that even we can handle the overflow. So when the ICU is full, we can use those beds as well. So we begin to get a little bit of a handle on it and I have to say it really shifted a lot of my thinking. I now almost exclusively view this pandemic through the lens of, “What is your local hospital system capacity? What is your positivity rate? What is your hospitalization rate? What does your capacity look like?” Because there are going to be people that contract COVID-19, particularly young, healthy people, probably not going to develop any problems. But when you have vulnerable populations you want to make sure that you have enough capacity to get those folks the care they need if and when they get sick. So I’ve now really just zeroed in on “What is our capacity? What is our census? How many extra beds do we have? What are we seeing?” And Ochsner through EPIC and the digital health techniques that we use, we’re able to track outbreaks of COVID zip code by zip code and neighborhood by neighborhood. So we really can get out in front of where these things are happening locally. And I think that all feeds back into the planning of how do we deal with capacity. In the early phase, we did a lot of ramping up on TPE, getting suppliers ready and it was one of these crazy, you know, almost like the operation that saving sailors at Dunkirk, you know, like all hands on deck, we were getting hand sanitizer from local microbreweries that certainly weren’t selling any beer. But they realized they could start churning out hand sanitizer in industrial capacity levels. We started buying hand sanitizer from breweries and distilleries locally, clothing shops that were no longer selling clothes started making masks and gowns. It was this really incredible sort of all hands on deck approach to just sort of supply chain issues. Managing that overtime. So how’s your supply chain? How is your hospital capacity? How many people do you have in these beds and so on and so forth. That’s really, it’s really evolved into that and really staying on top of those levels. And if we see those levels spike, then it’s a real cause for concern. If we’re at a sort of steady-state, then we feel much better about the enterprise.

Gary Bisbee 36:19
Andy, this has been a terrific interview. We appreciate your time. I’ve got one last question if I could, which involves leadership in a crisis. Generally speaking, what do you think the characteristics of a leader are during a crisis?

Andrew Wisdom 36:36
I can only tell you the way I approach it, and whether these stand up to some type of objective criteria of any value, I couldn’t say. But I think that transparency and candor and empathy go a long way towards leading through a crisis. At the same time, I think it’s important to not be paralyzed by risk. Risks exist and risks are out there and even bad things happen. Try not to be paralyzed by it. Keep working through it. Just keep working through the problem. But I think empathy, transparency, communication to all of your constituent members, I think those are, to me, the lessons I’ve taken out of this and that those are probably the most important.

Gary Bisbee 37:19
This is a terrific place to land. Thank you again, Andy, for the marvelous interview today. Much appreciated.

Andrew Wisdom 37:26
Thank you, Gary, I appreciate it.

Gary Bisbee 37:28
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