Episode 58:
Marathon and Not a Sprint
Rod Hochman, M.D., President and CEO, Providence St. Joseph Health
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In this episode of Fireside Chat, we sit down with Dr. Rod Hochman, President and CEO, Providence St. Joseph Health to talk about the impact of the crisis on the longer-term impact of the COVID crisis on health systems, key characteristics of a leader in a crisis, and discussion of what the federal government can do to lead change in healthcare and balance its role as a regulator while encouraging innovation.

Rod Hochman, M.D., is the president and CEO of Providence St. Joseph Health, a Catholic not-for-profit health system. PSJH has served the Western U.S. for more than 165 years and together include 119,000 caregivers who serve in 51 hospitals, nearly 1,000 clinics, and hundreds of programs and services in Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington. Under Rod’s leadership, Providence St. Joseph Health is transforming health care for the future through digital innovation, population health, mental health, genomics, whole-person care, and outreach to the poor and vulnerable. Read more

Transcription

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Rod Hochman 0:03
Giving up your power to the people that you put in place, trusting their judgment because if I don’t trust the judgment of our leaders that are in our hospitals and our clinics in a different place, you’re never going to be able to get things done.

Gary Bisbee 0:20
That was Dr. Rod Hochman, President and CEO Providence Saint Joseph Health, sharing his management philosophy which guides him in a crisis. I’m Gary Bisbee and this is Fireside Chat.

Rod is the former chairman of the Catholic Health Association and he will assume the role of Chairman of the American Hospital Association in January. He is thoughtful and detailed about how the federal government can lead changes in healthcare and balance its role as a regulator while encouraging innovation. In this wide-ranging conversation, Rod speaks about where scale matters and the continued consolidation of hospitals and health systems. He discusses changes needed in the asset intensity of health systems and outlines five factors that all health systems will face well into the future. Rod compared the value of a vaccine with a rapid, renewable, at-home test and noted that while both are needed, the test might bring greater immediate value. He opined on the efficacy and coverage required for the immunity of the population. Let’s listen.

Rod Hochman 1:21
I’d say you need at least 70% of people to be vaccinated and you need at least 70% efficacy to get enough immunity that you can slowly extinguish this virus. And the virus is going to be with us in some form, but it needs to be considerably more controllable than where it is now.

Gary Bisbee 1:41
Rod outlined the benefits of alliances between health insurers and health systems and how they will improve quality and costs as follows.

Rod Hochman 1:49
We need more partnerships. We need to really bring value-based health care together. Wherever we see that health care gets better and it gets cheaper.

Gary Bisbee 1:59
I’m delighted to welcome Dr. Rod Hochman to the microphone. Well good morning, Rod, and welcome.

Rod Hochman 2:10
Great, Gary, great to be with you, I think.

Gary Bisbee 2:12
Yeah, exactly, the times. But we’re pleased to have you back at this microphone for the second time. Let’s start by learning about what’s changed at Providence, your view of the COVID crisis, discuss the long term effects of COVID on large health systems, and wrap up with your view of leadership in a crisis.

The COVID outbreak is around now what, seven months old, but it seems like it began a lifetime ago. But looking back seven months, what’s been the major impacts from the COVID outbreak on Providence, Rod?

Rod Hochman 2:44
For us, the COVID thing started personal and I keep reminding people that January 21 was the first reported case in the United States that was cared for in our hospital in Everett, Washington who was an American citizen who had been in Wuhan and came back home and was successfully treated. And I would also point out to the rest of the country on January 21, later that month he got Remdesivir. The doctor that was caring for him was an Ebola doctor and said, “We’ve got to save this guy’s life. Remdesivir wasn’t great for Ebola. Why don’t we give it a crack on someone who has COVID?” So the rest is all history. So for us, our clock started on January 21 and it’s a lot longer than anywhere in the country and a lot of people were saying, “Oh, you know, it’s just a few foreign visitors.” And then when we had it in the nursing home in Redmond, Washington, “Oh, it’s a nursing home problem.” So we’ve gone through a lot of those iterations. So it’s been with us for a while. We got on top of it early, organized our system. The response has been, I think, fantastic in terms of what we did on the supply chain, what we did on capital, all of those issues. I think if you’re going to think about a stress test for your health system, that was the ultimate stress test.

I’d say we’re in a different phase now. My people asked me about how far along we are and I said, “COVID is a marathon, not a sprint.” And they said, “Well, how many miles are we along in this?” You know, cause you how it is here. No one’s going to answer that question quickly. And I quickly did the math and I said, “It’s a little shy over eight and a half miles.” And they said, “Well, how’d you come up with that?” I said, “We’re about a third of the way through.” They said, “Only a third of the way?” And I kind of broke it down that we’re going to go through the rest of this year and we’ll probably go through the next half of next year where this is going to be just a significant part of our lives. And I think for everyone that’s a runner, you kind of know you’ve got to settle into a pace. And I think what we worry most about is just the fatigue factor on the part of our people. And it’s not just about COVID, it’s about your kids not being able to go to school and you’ve got to take care of them at home. It’s about social isolation. It’s about, on top of this, particularly for us in the West, we’ve had environmental factors that have had the worst air quality in the history of the reported world in Portland, Oregon. Those are other factors that are adding to the stress and strain of our caregivers. So that’s probably the thing that’s mostly on our mind now is, how do we get ready for the rest of the marathon race here and not just punk out because it’s still a ways to go.

Gary Bisbee 5:41
Well said and nice framework there, Rod. When we were speaking earlier, you make a terrific point about the rapid at-home testing versus a vaccine. Could you share your thoughts about that with us?

Rod Hochman 5:53
If I had a wish between two things, a viable vaccine and really cheap, readily available, rapid at-home COVID testing, I’d take that first. And as the folks that are listening to this know, and we’ve been talking with our researchers, some of the folks in our labs are coming up with a $2 at-home, reusable test kit for COVID. And if I could go out each morning and know for sure I was COVID negative that would give me more freedom than anything else. And if we had rapid COVID testing that was reliable on a general basis, it’d make us be able to go about our lives a little bit easier. So that would be my number one wish. I think the vaccine journey is going to take time. It doesn’t happen, once you have a vaccine that’s viable, you’ve got a whole sequence of events, who you vaccinate first, how you do it.

In another life, I was a rheumatologist and had a strong factor in immunology going back 30 years. I’d say you need at least 70% of people to be vaccinated and you need at least 70% efficacy to get enough immunity that you could slowly extinguish this virus. And the virus is going to be with us in some form, but it needs to be considerably more controllable than where it is now. So my first wish would be rapid testing. Presumably that we could do for influenza and COVID, but particularly for COVID, since there are so many asymptomatic carriers versus influenza. To have something that’s readily cheap and available at home would be considered beneficial to everyone’s safety and the economy and getting things moving.

Gary Bisbee 7:42
Rod, what’re the prospects of that? Have you tracked whether or not that kind of rapid at-home, reusable testing is anywhere near on the horizon?

Rod Hochman 7:50
It looks good. And people argue a little bit about what’s the false-negative rate. And I always say, don’t suffer perfection. Because probabilistically, if you do it enough times, even if it’s 70% efficacious, over time you get closer to 100% because you’re testing and retesting and all of that. So I think we suffer a little bit from having something that’s perfect, but there are tons of labs. And the question is how widespread and how available. I’d say that’s probably a 30 to the 60-day phenomenon to at least start to get that moving in the right direction. It’s been a little bit slower than we would have liked and I think we lost valuable time. Because on January 21, when this first case hit, we should have been going crazy. I’m doing rapid testing, how do we do it? And testing beyond PCR, because PCR is a little bit clumsy, cumbersome, but coulda, shoulda, woulda. So I’d say within the next couple of months we should be closer to that.

Gary Bisbee 8:50
We all hope so for sure. What’s the governance process of Providence? What’s the board thinking about? I know you talk to them all the time, but what’re the questions that they’re asking? What are they concerned about, Rod?

Rod Hochman 9:02
What we’ve done with them is to keep them up to date on COVID with the best scientific evidence and also what we’re doing as a healthcare system. And I think everyone’s done that. We do that almost weekly online with them. The great thing about the virtualized world, it actually has made it easier to communicate with them because they’re used to getting online. We were able to do that. So I think that’s been critically important. At our last board meeting, we talked a lot about that and we also talked a lot about health equity, but we’re able to bring them up to speed in terms of where we are in terms of COVID and what we’re doing. And in addition, having talked to the rating agencies that also give me an indication of what other people are thinking and be able to tell them where we’re at.

Gary Bisbee 9:49
So do the rating agencies think about this as a shorter-term mid-term or longer-term issue?

Rod Hochman 9:55
No, I divide the world into BC, DC, AC – before COVID, during COVID, after COVID. And so that’s a construct I use, I have it up on my board. And if you look at BC, right, before COVID, it’s not like our industry was in great shape and everything was roses, right? We had a whole bunch of priorities and things that we were going to do. Then COVID hit starting this year and that changed a considerable number of those. And I think people would admit there’s also a number of things that have been beneficial about the way we’ve had to respond, whether it’s supply chain, whether it’s the virtualization of care, digitization of care, all of those types of things. Because of this pandemic, we’ve been able to change the way we do healthcare. And everyone knows the statistics on how many virtual visits they’re doing. None of that’s going to change in the AC period after COVID, that’s not going to change at all. So our whole way of the way we think about healthcare is changing considerably based on COVID. It’s going to force all of us to rethink where we’re going to be going, particularly as we head into the 2025’s and whatnot, as we go forward.

Gary Bisbee 11:15
Has it influenced the Providence CapX strategy substantially? How’s the balance sheet holding up?

Rod Hochman 11:21
We worked really hard. Everyone did their part during COVID, went and secured the funds we needed, made sure that we had lines of credit and all of those things then. We talked about it a little bit before, you know, there are five macro factors that are out there. Environment; social unrest, for that, everyone’s going to have to deal with; political change, which we’re all dealing with on a regular basis. Is this the last pandemic or what else is on the horizon? Just because we get through one pandemic doesn’t necessarily mean communicable diseases won’t affect us as we go forward. So all of these things and then we’re in a country now, before COVID, we had probably some of the best financial numbers you can have, but we’re going to probably dig out of this for five years, given things like the debt, given things like unemployment, and on and on and on. It’s going to be a five year process, which is going to affect us in healthcare as well.

And then what I did with my board is I looked at the 18 factors that healthcare has to address. And some of them are the ones that we knew about before COVID that have probably gotten worse. And one of them is that we’re too capital intense as an industry and that’s why technology runs laps around us because they don’t have the same capital intensity that we have with our, what I would say, heavy industry business, building hospitals, clinics, and whatnot. I think we’re going to have to learn that we have to be less capital intense and I’m staring out at my campus here where two seven-story office buildings are now empty. And I’m sitting in my own building with about five other people. So I think what virtualization is going to do for us is bring down our capital intensity, but that’s going to take a while to do that. But I think that’s a trend over the next few years that we’ll be seeing, and that we almost have to see.

Gary Bisbee 13:23
Providence is one of the largest couple of not-for-profit health systems in the country. How did that scale matter during the crisis, Rod?

Rod Hochman 13:33
Scale matters. We did our own supply chain across seven states. So as inept as the federal government was, and then we did all that we could to move things from Texas to California, from California to Oregon based on need. And we’re able to do that pretty efficiently. But we could only do that given our scale. And then I think the other thing our scale helped us with, we were able to virtualize everyone both on the business side and on the clinical side within seven days. And, gosh, if I was in a smaller place, I don’t know how I’d do that. And we just had the right technologists, and our friends from Microsoft and our CIO were able to do that. But I think those organizations that had scale were able to do that with more rapidity because they just have it to be able to do it. And I think people are seeing that difference and you have the ability to kind of be able to move and change things and be able to weather the storm so to say because you can move both people, supplies, and money around.

Gary Bisbee 14:41
After the 2008/2009 Great Recession, two to three years after that there was quite a surge of consolidation. Do you see something like that happening here? Some kind of timeframe like that, Rod?

Rod Hochman 14:55
Oh, absolutely. I think it’s inevitable but it’s going to be interesting to see whether things like the Federal Trade Commission and everyone else wake up to that, because we see the Attorney General of California wanting to weigh in on every hospital merger. So we’re going to just have to see. What it’ll take is once places start closing because they can’t make it, then what, right? I think from a business standpoint, I see it as inevitable. It’s the question of whether the regulators wake up to this fast enough or is it going to take. The hospitals I worry most about are our rural hospitals in this country and are, some are standalone, some are safety-net hospitals, some are smaller systems, independent hospitals. How long does this go on for? And how can they stand out there alone and do that? So it’s going to be a battle between the economic laws and principles versus the regulatory environment.

Gary Bisbee 15:55
So COVID has accelerated the timeline for decision making for health systems and all health care organizations. What do you think about that?

Rod Hochman 16:03
That’s been a good thing. Because you’ve gotta wake up and move. I have a saying here at Providence. “I know if I’m standing still I will definitely get run over. If I’m moving really fast when I hit the atmosphere at the wrong angle, I won’t feel it. And I’d much rather be moving really fast and go out painlessly than just stand still and watch piece by piece everything get picked away.” And I think we’ve seen examples of that in other industries. You know, a company like Sears slowly fall apart over years. I just don’t want to see that happen to health systems and where we are. And there are a lot of forces out there. Our friends in the insurance industry haven’t stopped acquiring things. Last time I looked and Walmart wants to be a big player in healthcare and so do my friends at Amazon. So all of those threats that we had in the BC period, before COVID, are still present, but they’ve almost intensified now. So it’s either act or be acted upon.

Gary Bisbee 17:07
You’ve touched on supply chain. How do we develop a more reliable supply chain in healthcare in the US?

Rod Hochman 17:14
I think we have to designate that certain, what I would say, are almost national security items have to be manufactured and hopefully supplied within the United States. So to be brought to our knees by the proverbial PPE and not having enough gloves, masks, and gowns is a national shame. And I would rather pay more to know something was made in the US and available than to be dependent on a supply chain that’s 5,000 miles away that I can’t rely on. So I think we’re going to have to designate certain things in the supply chain for hospitals and clinics. And we’ve also seen the same thing in the medication supply route. We’ve seen it with reagents that are manufactured elsewhere, and not here. So I think we’ve got to revisit the supply chain and say, which are the things that are specifically mission-critical. And we have to have the intestinal fortitude as a country to make sure that we’re not brought to our knees a second time. And I think we’ve learned a lot about that. I think the whole supply chain rethinking is going to be an interesting phenomenon, particularly after COVID. I hope we don’t lose our memory of what happened. And carving off 3 cents on a mask that’s made somewhere else doesn’t really make sense to me.

Gary Bisbee 18:39
It doesn’t and the question is, will the payers, such as governments, employers, and consumers and the health insurers, will they fight us over that 3 cents a mask?

Rod Hochman 18:49
We hope not, right? I mean, it’s all in our own national interest to do that. I think we got to understand what’s for the good of the whole. It’s really interesting, I’m in support of capitalism at heart, but there are different forms of capitalism, right? And I do respect shareholder value. But if you look at Germany, they look at shareholder value in the common good. So they don’t let what’s good for Germany, shouldn’t be subjugated by just shareholder value. And I think we have to have that kind of discussion.

I think large companies are starting to understand that they have a greater need than just to get the stock price up for the next quarter. And that you’ve got to be a long-term investor in the United States. And if we don’t do that, we’re going to lose our world position. And I think we’ve seen some of that.

So I take a capitalist viewpoint, but there are ways to modify how we’re working in such a way that we keep the country strong and keep our healthcare industry strong and other parts of it.

Gary Bisbee 19:52
Well to follow up on a supply chain discussion, we have stockpiles. What’s the right role for GPOs, health systems, and the federal government in terms of PPE stockpiles?

Rod Hochman 20:05
I think what we have to do is, with good data systems, we have to anticipate where we need stuff and how do we circulate those stockpiles so that what happens is if we need it five years from now, they’re all not out of date. So I think we really needed to use the best tools that we have from a technology standpoint to kind of rotate where those stockpiles are. And what we saw with ventilators is a great example. It’s not that we didn’t have enough ventilators. We just had them in the wrong spots. It was more of a distribution issue than it was a supply issue. And I think with the technology that we have today, particularly data systems, we have to understand that so that we use what we have efficiently, but we also know where it is needed and how we have to move it around.

Gary Bisbee 20:53
You made the reference to the fact of empty buildings, which I think all our health systems have certain buildings that are empty. Also, you made the point about virtualization really being important. How much of this intensity of assets that we have to deal with, how much of that can be allied with more remote working and more virtualization?

Rod Hochman 21:17
I think the biggest impact is on the administrative side. Speaking with my colleagues, almost a hundred percent of our administrative arm of provider-based healthcare is at home working. And I don’t know how much of that we need to really bring back. So that’s going to be a, I think in terms of the capital intensity with buildings and leases, it’s going to be a significant factor.

I think we need to rethink how much virtual health care we’re going to do. And do we need the clinics to be as large as they are? Where do they have to be located? So I think all of those are gonna have an effect on how we do care. Now, even on a longer range, a number of us have been all working on the hospital at home. And how do you virtualize care at home even for what would have been a hospitalized patient? But that adds a little bit longer track record out there, but that potentially might have implications for how many of these big buildings do we continue to build and how many of them and how many do we need.

Gary Bisbee 22:22
Telehealth just exploded, of course, around the country at every health system. How much of that is here to stay, Rod?

Rod Hochman 22:29
I think all of it’s here to stay. I heard someone make a good comment. Do we talk about telebanking anymore? We just talk about banking, right? I don’t think we’re going to talk about telehealth. It’s just going to be the way we do health, right? We do virtualization of a lot of it, and it’s just a better way to do it. This is here to stay and you know, more to come. It may also be one of those things that can help us, particularly in more rural areas, which we’ve known before. I think the biggest disconnect we had is no one “wanted to pay for it.” And I think now with more value-based healthcare and a number of other issues, I think it pays for itself. So I think it’s, it’s here. It’s not going to change. And it’s probably going to be the most profound influencer in the next five years.

Gary Bisbee 23:17
Will our friends on the health insurance side be willing to pay for it?

Rod Hochman 23:21
Here’s what I think. Unless this health insurance paradigm doesn’t change, that’s going to be another crisis as we go forward. I’d make the statement that we can’t perpetually get into this cycle where we’re arguing over what rates you’re going to give me for what. I don’t think that’s a successful model either for the insurers or for the providers. We need more partnerships. We need to really bring value-based health care together. Wherever we see that health care gets better and it gets cheaper. So I think with these partnerships between insurers and there has to be more of an association with the premium, has to happen. And a lot of this may be dependent on what administration we get in November and a whole bunch of other factors. But I think just from a law of physics standpoint unless the provider health community gets closer to being directly accountable for the premium and being part of that premium, we can’t exist with this model long term. It just won’t work. It won’t pencil out.

Gary Bisbee 24:30
Providence has the Oregon Health Plan which has probably about a million subscribers at this point. Any lessons from the Oregon Health Plan that we could learn from, Rod?

Rod Hochman 24:40
Well, it works, right? So it’s 30 years old and I think there are three legs to the stool, what I say. One are the doctors, one is the rest of the health system, and the other is the payer. And what PHP does is it brings all three of those closely together.

When I look at our costs for some pretty expensive healthcare groups, like public employees, they’ve been flat in Oregon for a number of years, and they’ve been flagged because they’ve got an integrated system to take care of them. So it does work. I think we’ve seen the same thing that Sentara Health Care and Inner Mountain in Pittsburgh.

Now the problem is creating these things in novo is, I think we would all agree, impossible. You can’t start from nothing and say, “Okay, I’m going to build a health plan and an integrated system.” So what we need to do is figure out can we create alliances with existing payers in such a way that we both share in upside and downside in the long term. And I think that’s what we’re going to have to see. Now we do that with the Heritage Medical Group in Southern California, they’ve had a great capitated model and it’s worked incredibly successfully and kept costs down and provided excellent healthcare. And we’re hoping that we can do some more of that potentially with other payers.

Gary Bisbee 26:04
Can we make that change broadly speaking across the health system without the federal government changing the incentive structure?

Rod Hochman 26:12
I think we need both. I think we need will at our own house systems. We’ve put out that we’re going to go 30% or 40% full cap, but I think until you get the feds to move, one of the proposals we had for the folks in government is to capitate all primary care in the United States so that your primary doctor knows exactly what they’re going to get paid at the beginning of the year. And whether they’ve got Medicare and Medicaid or commercial patients, they’ve got a panel and basically what it does is revolutionizes primary care. I want to go to my doctor and I’d like to interact with my doctor, whether it’s by phone, online, in person, what other way. And I want to pay my doctor to take care of my health, not to have a DRG based visit or CPT code. So I think that’s one of the things we’ve been trying to push on the feds because until we can get them to move, it’s hard to do that. We’ve been doing some work on a pseudo capitation System in some of our clinics where we basically put them on that kind of model and adjudicate the payments on the back end. But ultimately you need the feds to buy it and move in that direction. And I think that’s a first step that would revolutionize the way we do primary care in the United States.

Gary Bisbee 27:31
Well, that’s for sure. I think there are roughly 80 million people now on Medicaid and CHIP coverage. And that’d be a great place to start, Rod. That’s about a third of the population.

Rod Hochman 27:42
People ask me how do you solve the healthcare crisis in the United States? I’d say if you started and said, “If every American was guaranteed really good primary care that was comprehensive, preventive, cost-effective, all of that, we’d go a long way to solving some of the other problems that we have with the health system. It’s a great place to start, and it’s probably not as hard to implement and, you know, primary care is not the most expensive part of our healthcare system. So that’s what we’ve been pushing for.

Gary Bisbee 28:09
Well, I think you’re right. And really the COVID crisis should show us that healthcare and public health is part of the national security.

Rod Hochman 28:19
Exactly, Gary. I think if anything COVID has underlined that exclamation point. And I think we’ve all learned that, that we’ve really got to get on top of that. We’ve got to get there long before someone ends up in the emergency room or the ICU. And because if you look at the biggest difference between the United States and its western countries that do healthcare around the globe, the biggest deficit we have is really on the front end of care. It’s primary care, preventive medicine that we probably do the worst job in. It’s probably one that’s not as expensive to fix, but it’ll have great implications for the rest of healthcare.

Gary Bisbee 28:56
Across the country, roughly 55% of our health system revenues come from governments, most of them federal governments at this point. And many people would say with the growing baby boomer population and all the COVID activities that could be 65 or 70% by the end of the decade. What challenges or opportunities does that present? Our health systems?

Rod Hochman 29:21
Wow! You have another hour, right?

Gary Bisbee 29:24
Or two days.

Rod Hochman 29:25
It’s trying to get the feds to really understand how healthcare actually works. And I think the biggest frustration, and I think I could get all of my colleagues listening to this to nod. I think what we’ve been frustrated with, so first Hillary Clinton’s plan was made up in a vacuum and didn’t really involve people that actually took care of patients. Under President Obama, we took the first big step, but it was more of a health insurance plan than it was a healthcare plan, right? So it really involved getting people insured. But we need to take the next step and really think about health care and how it gets done. And our only hope is that we can get enough smart people to work with the federal government to understand that and how that has to happen. But the books out on that one.

One of the things that we do really well in the United States is innovation. But we do innovation at local levels and states and everything else. So whatever we do with the regulatory environment, it can’t stifle innovation. People have got to be able to see. And what I’ve always said, the models for the federal government and healthcare should be what they did with the auto industry. They said, “Okay, you’ve gotta get to 23 miles per gallon for your whole fleet. You figure it out.” Now that created a lot of great innovation in the auto industry. Now it also, there was some cheating, right? You know, we have people that gamed the system. But overall it allowed different manufacturers really to innovate around the models that they use. I think we need the same thing in healthcare. We’ve got some great innovators all around the country. We can’t overregulate them to death so that they can’t figure out what to do. I think everyone agrees that healthcare needs to be more affordable. I think everyone agrees that we’ve got to get a better handle on prevention and if I look at health care, we’ve got to take, do a better job at the beginning of life and we’ve got to do a better job at the end of life. That’s where a lot of our costs are, whether it’s in the NICU or whether it’s in the process of leaving this earth. We just gotta do a better job with how we manage clinically those situations and then we’ve got it in the middle range there, we’ve got to do a better job of preventing a lot of the chronic disease that we have. And it’s gotta be through better health practices and we’ve gotta be paid for health, not just the health care side of it. So those are general principles and we’ve just got to get the folks in the government to understand that.

Gary Bisbee 31:55
Well as the former chair of the Catholic Health Association and now soon to be chair of the American Hospital Association, how do we get more groundswell of support among our health systems to spend time educating our legislators and the agency decision-makers?

Rod Hochman 32:12
There’s really a power in a lot of these health systems getting together with a common voice. And that happened with the workaround Civica RX and generics, but I don’t think we’ve come close to unleashing some of that influence when we’ve all gotten together and thought through a problem. And then I think that’s what we’re trying to convince through the AHA and through the Health Management Academy and through the CHA. We’ve got to get that collective voice more focused on these issues.

And we may not always agree completely amongst ourselves, but boy, I trust my colleagues in healthcare much more than I do some of the politicians.

Gary Bisbee 32:53
We all wish you well when you become the chair of the AHA. We certainly need you there, Rod, so.

Rod Hochman 32:59]
It’ll be great. I’m looking forward to the input from our colleagues on the phone and whatnot in terms of what we do. And it’s sure an interesting time to take over that chairpersonship, right?

Gary Bisbee 33:12 
Yeah, I mean you’ve spent a lot of time in Washington now. I guess that’ll be what, mostly virtual for awhile?

Rod Hochman 33:17
Well, you know, the good thing is well I’m at my home, I live in Seattle, so I’m always in Washington. It’s just 3,000 miles away, right?

Gary Bisbee 33:27
Let’s turn to leadership for a second, Rod. This has just been a terrific interview as expected. The interviews with you always are. But what’s the most important characteristics of a leader during a crisis?

Rod Hochman 33:38
I’m staring at a book that I have on the corner of my desk by Stanley McChrystal, you know the Leaders Myth and Reality. And it’s all about giving up your power to the people that you’ve put in place, trusting their judgment. Because if I don’t trust the judgment of our leaders that are in our hospitals and in our clinics in a different place, you’re never going to be able to get things done. Because people have asked me how do you manage a 7 state, 120,000 people, $25 billion organization? Well, you manage it because you’ve brought in great leaders and great people. And guess what? You’ve actually listened to what they tell you. And that’s the secret to this. And, you know, what’s been interesting in this virtual environment, you know, you can actually sneak into the back of a room now as a CEO and listen to your people as they’re working on problems together. So a lot of times I’ll just get in the middle and I listen to some of our young people, doctors, nurses, executives, solving problems. I go, this is fantastic because they’re so smart. And I think I’ve gotten a better appreciation for who we have out there and what we’re doing. But I think great leaders listen to their people, put great other leaders out there, and get out of their way and let them do what they need to do and you’ll have a successful organization.

Gary Bisbee 35:00
Let’s wrap up with one more personal question. How’s the COVID crisis changed you as a leader and as a family member, Rod?

Rod Hochman 35:10
I will go on the record. I gave a talk four years ago to about 900 people. It was our all systems conversation. And I said I was worried about two viruses, the first being cyber viruses, and everyone kind of got that. And the second being RNA viruses and people looked at me and squinched up and I tried to explain to them about SARS and MERS and about how RNA viruses work. And I still stand by that. And I think we’re living in a world that is affected by things that cross borders and everything else and we can’t think just in our own little world anymore. So that’s, I would say globally, that’s how that’s affected me, this accountability for a large world.

And then the second part of it is, I’m finally, some of you can relate to this out there, gonna be a grandfather and gosh, I mean, it took my daughters about 5 or 10 years too late on this, but it’s happening. But I think it also gives you a sense of what are you leaving for the next generation? And I think we have an accountability to do a better job about how we’re managing what we have, our resources, and how we do it. And I think there’s nothing like having a grandchild or someone who’s next in the lineage to help you think through them.

Gary Bisbee 36:29
Boy and isn’t that the truth and give our congratulations and best wishes to Lindsey and Steve. Lindsey, of course, was an international class rower and we’ve had Lindsey as a guest at one of our Fireside Chats. I was lucky enough to interview her. So all good for the Hochman family.

Rod Hochman 36:46
Yeah, she is. And she’s already checking out on ultrasound what the arms and legs look like, you know. Her and her husband were both rowers so they’ve already got that in the works.

Gary Bisbee 36:59
Rod, this has been an absolutely terrific interview. It’s a pleasure to be with you today. Many thanks.

Rod Hochman 37:05
Thanks Gary.

Gary Bisbee 37:08
Fireside Chat with Gary Bisbee is a Health Management Academy Podcast produced by Think Medium. Please subscribe to Fireside Chat on Apple Podcasts or wherever you’re listening right now. Be sure to rate and review Fireside Chat so we can continue to explore key issues with innovative and dynamic healthcare leaders. In addition to subscribing and rating, we’ve found that podcasts are known through word of mouth and we appreciate your spreading the word to friends or those who might be interested. Fireside Chat is brought to you from our nation’s capital in Washington DC, where we explore the strategies of leading health systems through conversations with CEOs and other interesting leaders. For questions and suggestions about Fireside Chat contact me through our website firesidechatpodcast.com or gary@thinkmedium.com. Thanks for listening.