Episode 63:
Optimizing Local Care
Dr. Marschall Runge, CEO Michigan Medicine and Dean, University of Michigan Medical School
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In this episode of Fireside Chat, we sit down with Dr. Marschall Runge, CEO Michigan Medicine, and Dean, University of Michigan Medical School to talk about the opportunities of being a leader and the importance of being humble. We also discussed how the COVID crisis has impacted the University of Michigan’s finances and in terms of research, delivery of medical care, and the workforce.

Marschall S. Runge, M.D., Ph.D., became dean of the Medical School on Jan. 1, 2016. He also serves the University of Michigan as executive vice president for medical affairs, a position he has held since coming to Ann Arbor in March 2015. Read more

Transcription

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Marschall Runge 0:03
I also like the opportunity to help people think about their careers, whether they’re medical students or residents or faculty members, and what might be most interesting to them. Not to help them make a decision, just to tell them about my experiences. But I would hasten to say, I think to be an effective leader, you have to have lots of humility.

Gary Bisbee 0:22
That was Dr. Marschall Runge, EVP for Medical Affairs, Dean, University of Michigan Medical School, and CEO, Michigan Medicine, speaking about the opportunities of being a leader and the importance of being humble. I’m Gary Bisbee and this is Fireside Chat. Marschall explored in-depth the three leadership hats that he wears and how Michigan Medicine which accounts for 60% or more of University of Michigan revenues is governed. He outlined the role that Michigan Medicine has played in the state of Michigan and why an affiliation agreement with Sparrow Health System has brought access to a health plan that will provide flexibility to Michigan Medicine in integrating care. Marschall reviewed the negative effect that COVID has had on the University of Michigan finances and in terms of research, delivery of medical care, and the workforce. He also looked for and found positives. Let’s listen.

Marschall Runge 1:17
On the positive side, though there were some positive, I mentioned this issue around decision making. I think had any of us said could we ever make important decisions so quickly we would have said no. But we’ve got a great leadership group that made decisions on a daily basis.

Gary Bisbee 1:32
Marschall returned to an important topic several times during the interview regarding the speed of decision making and how to sustain the pace achieved during COVID as follows.

Marschall Runge 1:42
The leader, him or herself, has to be willing to endorse rapid decision making. I think equally important, the leader cannot be under the illusion that they have the answers and all decisions should be what they think they are.

Gary Bisbee 1:56
I’m delighted to welcome Dr. Marschall Runge to the microphone. Well, good morning, Marschall, and welcome.

Marschall Runge 2:06
Thank you. It’s great to have the opportunity to speak with you today.

Gary Bisbee 2:09
Well, we’re pleased to have you at this microphone. Let’s start by learning more about you and your fascinating background, and your current roles at the University of Michigan, dig into what’s changed due to COVID, and wrap up with your views on leadership. I was mentioning to you earlier, you truly are a person of the United States. You grew up in Texas; educated in the south, Mid Atlantic, and New England; served as Professor and Dean of the Medical School at the University of North Carolina; and now lead the Health and Medical Enterprise at the University of Michigan. And we were kind of joking, I wondered what region your accent when most reflect? How do you, how do you think about that, Marschall?

Marschall Runge 2:49
Well, first, I’ll say I’ve really enjoyed my experiences all over the United States. I feel privileged to have had those. Most people say to me, it seems that I have a mild Southern or Southwestern accent. I can no longer tell, but that’s what I hear from folks that haven’t met me before.

Gary Bisbee 3:03
I think that’s right. Now your wife, you were mentioning, is a physician and has tracked along with you to all these various regions. What kind of accent does she have?

Marschall Runge 3:12
Similar, but a little bit more pronounced. She grew up in Arkansas and it’s a little bit of a more pronounced Southern accent. But I’d say we’re pretty similar.

Gary Bisbee 3:19
Well, how are you finding the Midwest?

Marschall Runge 3:21
Yeah, I’ve loved the Midwest. I think it’s a great place to live, great people to interact with at all levels, within the university, within the medical school, and the health system. But really everyone that you run into, it’s friendly, and it’s genuine the people are very genuine. And I personally really liked the climate. Great four seasons. I like snow. I guess growing up in Texas where we never had snow, I like snow. And there’s nothing about the Midwest I haven’t enjoyed. And pretty good football although we’re looking for a victory over Ohio State this year.

Gary Bisbee 3:51
I’ve been in the Michigan Stadium and it’s quite an experience along with 100,000 other people.

Marschall Runge 3:57
Oh, it is! My first game my wife and I went to we remarked to each other, it’s a spectacle! It’s more than a football game.

Gary Bisbee 4:03
I totally agree with that. You have such a fascinating background in, we were chatting earlier because you have your BA in biology and then a Ph.D. in molecular biology from Vanderbilt. And I was wondering what came first, your interest in research or your interest in medicine?

Marschall Runge 4:20
Well, it’s my interest in research. I came to Vanderbilt from Austin, Texas. And Austin was not the high tech hub it is now. It was a much quieter small town. And I didn’t really know what kind of career I was going to enter. And I had the opportunity on two different occasions to take self-study, individual study courses in research. One was in general biology and one was in molecular biology. And in particular, I thought molecular biology was so exciting. It was just getting started. And, at the time, there was no human genome. There weren’t even restriction enzymes, which are used to do all kinds of analysis. And so I started out there and my wife was in medical school at the same time and as we talked I got fascinated with the idea of combining research in medical school and medicine. And so I went to medical school. And I have to say, I loved medical school and clinical medicine, at least as much as I had loved research. So that’s directed my career from that point.

Gary Bisbee 5:14
How and when did you become involved in leadership?

Marschall Runge 5:17
Well, the first sort of leadership role I had was when I was at Emory, in the cardiology division. And I think I was selected to be head of the fellowship program because I must have missed the meeting where they picked, or I was the only person not to step back when they said step forward, but that was great fun. But my first real leadership role was in Galveston at University of Texas Medical Branch where I went to be chief of cardiology and head of our research centers. We also really enjoyed our years in Galveston.

Gary Bisbee 5:44
Would you view yourself as an accidental leader or an intentional leader?

Marschall Runge 5:48
I would absolutely say accidental. Each step of the way it’s been something that’s come to me. Not a single time have I been out looking for new positions. I’ve looked at different new positions and sometimes it’s a different direction that I don’t think is so interesting for me or our family. So I’ve enjoyed it, I find it great opportunity and lots of challenges. If you’d asked me 25 years ago, what I thought the highest level of leadership I would ever aspire to, it might have been to be director of a cardiology division, or not that high.

Gary Bisbee 6:17
Well, it’s interesting. You’ve certainly gone well beyond that. What do you find the most rewarding about leadership, Marschall?

Marschall Runge 6:24
There are several things I like about it. The first is there are really difficult problems and I’m sure in every leadership role. And it’s an opportunity to get smart people together to try as a team to address these difficult problems. And I think that’s what I like most about it. I also like the opportunity to help people think about their careers, whether they’re medical students or residents or faculty members, and what might be most interesting to them. Not to help them make a decision, just to tell them about my experiences. But I would hasten to say, I think to be an effective leader, you have to have lots of humility because I hope that I’m betting 350 on my decisions, but I’m not sure I am. And there are lots of smart people thinking about problems. And so it’s an opportunity to really let them come up with ideas that I never would come up with on my own.

Gary Bisbee 7:14
You’re kind of addressing your leadership style. But if I asked you that question directly, how would you characterize your leadership style?

Marschall Runge 7:23
First is inclusive, different ideas and new ideas and being receptive to those. The second though, is I am focused and goal-oriented. So I want us to reach a decision and move forward. And the last and this has become even more clear to me in the last year with COVID, is to be cognizant of timing. Some change, for example, University of Michigan Medical School underwent a multi-year process to change the curriculum, this was under my predecessor Jim Woolliscroft who was dean at the time, and that’s something that takes a long time. With COVID, like so many institutions, we had to make changes quickly in a way that had never been done. And so adapting to that different style of decision making, which was still inclusive, but was making decisions in the day that we typically would take a month to make really underscored the importance of being cognizant of time-dependent decision making.

Gary Bisbee 8:20
With your multiple hats that you’re wearing at the University of Michigan are you able to continue your research pursuits?

Marschall Runge 8:28
The most honest answer is I’m able to continue my research interests. When I came, I had a research lab and we had funding and that has continued. But during my time here, I’ve had much less direct and really no day-to-day impact on our research program. So I’ve recently asked a person who I’ve worked with for 20 years in the lab, to assume responsibility for our research program. And so I get the best of both worlds. I get to be involved and think about things, but it’s his responsibility to make sure everything’s working.

Gary Bisbee 8:55
Thinking about your career, would you make any changes in your career progression if you could have a do over?

Marschall Runge 9:03
I’ve been asked that question, Gary. And that’s a great question because I really would not. There hasn’t been a step in my career that I haven’t enjoyed, and there hasn’t been a place we’ve lived that we haven’t enjoyed as a family. I feel so fortunate to have had those opportunities. There’s not anything I would really change.

Gary Bisbee 9:21
Let’s turn to your roles at the University of Michigan. You’ve been at the University of Michigan now for nearly five years. Will you please outline your roles at the University of Michigan, Marschall?

Marschall Runge 9:33
I have three roles and they all occupy similar amounts of time. I’m Dean of the Medical School and I’m CEO of our health system, which includes all of our healthcare operations in Ann Arbor and across the state, and I’m the executive vice president for medical affairs, which mainly focuses on our interactions of the medical school and the health system with campus and our President Mark Schlissel has a weekly meeting of his executive officers and I’m one of those. And we talk about all kinds of things from how are we going to provide enough capacity and COVID testing to the climate for the undergraduates on campus. So I find those interesting. But one of his visions that I completely share is, we’re stronger if University of Michigan moves forward together. And one of the ways to accomplish that is through my interaction with the other executive officers. So in all of those roles, they’re important, and in all of them, there is no way that one person in, at least not me, could really adequately perform those roles without having outstanding people that I work within each of those roles.

Gary Bisbee 10:45
Well, in many of our universities with medical centers today, roughly half of the revenue from the university comes from the medical center. I don’t know what it is in Michigan, but it is probably somewhat similar to that, is it?

Marschall Runge 10:57
It’s over 60% now. It’s between 60 and 65% so it’s a big part of the revenue for the university.

Gary Bisbee 11:02
How do you think about allocating your time between these three roles?

Marschall Runge 11:07
Well, if I can use a bit of a cliche, I think the most important thing for me to be is to be present. And at the health system that means I need to be present and visible in the hospital and in the clinics and I do continue to do cardiology consults in the hospital. In fact, I start again on Monday. And that’s a great chance for me to see what’s going on and for also, for people to see me around. And I do executive rounding in the hospital and some in the ambulatory settings. I would say that the part of my job which takes slightly more than the other parts, is the CEO of the health system role. Such a huge operation. But we have great leadership there. In medical school, deans can spend their time on all kinds of different areas. We have an executive vice dean for academic affairs, for research and for clinical affairs, the clinical affairs person also being the president of our health system. And the four of us try to work together very closely and make sure there are no gaps. And so in research, I do get involved in decisions. To give you an example, what has happened with COVID, to research. And we’ve taken a big hit for various reasons I could talk about later. But it’s the decision, how we help our investigators, particularly our junior investigators, get back on track. And that involves organization, it also involves funding. And so those kinds of things I work very closely with our executive vice chief of research. And similarly, in academic affairs, I probably spend, if I had to guess, I’d guess 50% of my time with the health system and 30% of my time as dean, and 20% of my time is executive vice president for medical affairs.

Gary Bisbee 12:48
Just thinking about governance, wasn’t there a board recently created perhaps an advisory board for the health system?

Marschall Runge 12:55
Yes, thanks for asking about that. That was a vision of Mark Schlissel and one that I think was a terrific idea. Everything in the University of Michigan reports to the regents. We have 8 regents that are elected, so they have vast responsibilities. They’re very interested in health care and the health system and health care education, but they don’t have very much time to spend on that. And we formed what’s called the University of Michigan Health System Board. And this is a small board. It’s comprised of six external members and two internal members. The two are elected department chairs. The external members are fantastic. They all have a connection with the University of Michigan. But we have Mike Johns who’s been a dean and a CEO for Hopkins at Emory. We have Bob Sheehy who at one time was president of United Healthcare. Kedrick Adkins who was CFO for the Mayo Clinic. Several other external members who are all just outstanding. We spend a lot of time with that group. And both at the meetings, but also aside from meetings, but we have a full day of healthcare quarterly. And then we bring them in for advice on many areas. For me, that’s a unique board that I have not been exposed to before. University of North Carolina had a health system board that was very large. And a lot of health system boards are 30, 40 people. This is a small group that’s focused on advising us. And because of their expertise, the regents also seek advice from them. So the great thing about it is we can hash out things with the health system board, and in a way, to the depth that we could not with the regents or the amount of time. And so that’s been a big help for us as we think about strategy, as we think about how we responded to COVID, how we think that employment, really all the big questions.

Gary Bisbee 14:35
Thinking about strategy, how would you describe the priorities of the health system now?

Marschall Runge 14:41
Our priorities are to make discoveries that advance health and changes care, both locally and in Michigan and more broadly. So how do we do that? Well, we have to maintain and excel in our academic missions. But we also have to have some sort of network as I’m sure has been and I can tell is acutely on the radar screen of all health system CEOs. And many have responded in different ways. We have a statewide network in which we have some owned facilities, but we have many that are either have co-ownership or are based on various kinds of collaborations. So in terms of our mission, our mission is to provide outstanding care, the best care, many people can claim that, but best class care of anywhere. So nobody in Michigan has, or in the Midwest, has to go anywhere else. And healthcare is quite uneven in the state of Michigan. People don’t think about this, but it’s about 50% urban and about 50% rural, so large rural population, and the largest urban population in Detroit is very much underserved. And so it’s an important part of our goals and our mission is to provide health care for those folks in a variety of different ways.

Gary Bisbee 15:48
You recently signed an affiliation agreement with Sparrow Health System. What was the thinking there?

Marschall Runge 15:54
Sparrow’s in Lansing, which is the state capital. We have had long time collaborations with them in pediatrics, in cancer, and in heart disease. And so our first foray is in pediatrics, where we basically have a joint venture around their prenatal ICU and their pediatric ICU. And our faculty provide most of the staffing for that. And it allows them and us to use the same criteria, the same standards for safety and quality. For us, it makes it much easier if there are patients who need their care in Ann Arbor to bring them to Ann Arbor. But it’s a good example of what our approach is and our approach is to try to optimize local care. We don’t want to and we couldn’t provide care for everybody across the state that we relate to. So our first goal is to optimize care in the community. And when there is something that’s truly high tertiary or quaternary care to bring those to Ann Arbor.

Gary Bisbee 16:49
Sparrow has a health plan. How important was that to your thinking about the affiliation?

Marschall Runge 16:56
Well, that’s interesting. They do have a health care plan, PHP, Physicians Health Providers, and that was not part of our original thinking but that turned out to be very important to Sparrow. And that, we think is going to be very valuable to us and, in fact, the end of October is the end of enrollment time for benefits at the University of Michigan. And there’s a new benefit, which is called Michigan Care, which is the third-party administrator will be PHP, but it’s fairly narrow network that involves all Michigan providers, and all related providers across the state. And it’s a different option for our people that work at the University of Michigan. This is only being offered currently to people that work at one of the university locations, either in Ann Arbor or Dearborn or Flint. But we’re excited about that. We had a very effective healthcare system called M Care that around the early 2000s was sold to Blue Cross Blue Shield. So we think we can do this.

Gary Bisbee 17:46
It’s pretty interesting. A number of health systems had HMOs or some kind of health plan and sold them back in that same timeframe. And now, of course, they’re looking at it like, gosh, financing is an important part of delivery. So this sounds like a ready-made opportunity for Michigan to move into that space. Good for you.

Marschall Runge 18:08
Yeah, it’s great from that standpoint. And also when we think about all the ways in which we need to be more effective, better population health management, keeping people out of emergency rooms, telehealth, with your own health system, you can arrange to support those where sometimes with, whether it’s CMS or an insurance company, they may not feel like supporting any of those endeavors in a way that allows you to improve health. And I think one of the most important ways as a country that we can reduce the cost of healthcare is to put much more effort into preventive health. And that’s, that’s one of our big goals. And this will allow us with the patients that are enrolled in it to be much more creative than we could be with a traditional funder.

Gary Bisbee 18:51
Well, good luck with that. I’ll bet that’s going to end up being a really good decision. Let me ask a question if I could Marschall about COVID and at a high level, looking back eight months or so ago, what have been the major impacts from COVID on Michigan Medicine?

Marschall Runge 19:10
COVID has been very impactful for us in a number of ways. Financially, we had the same problem that many, many health systems and academic medical centers have had. Nobody knew anything about the disease. So we, like many, basically closed all of our ambulatory operations and we reduced our hospital census. I just looked this morning, it was in 94% and it usually runs around 90 to 92%. So we’re full all the time. We reduced it to about 40%. And in doing so, we accomplished our goal, which our goal was to be able to provide care for COVID patients and first-rate care. But it had a really dramatic effect on our finances. We ended up not even including some aspects with a $400 million loss for the year. So that was a big negative for us. Our research programs also had to be shut down because the state mandate was that biomedical research was not part of the very narrow group of critical functions that had to go on. So our research programs were shut down for several months and then we’re just now getting them back up to full speed. And on the positive side though, there were some positives, I mentioned this issue around decision making. I think had any of us said, could we ever make important decisions so quickly, we would have said no. We’ve got a great leadership group that made decisions on a daily basis. But we’d had a goal, probably like a lot of places, for years of increasing telehealth, but we were at about 2 or 3% of our visits were telehealth. During COVID, in many areas, it was more than 80% of our visits because we really couldn’t have visits to the clinics. And it’s settled down in the around 20% range. We think we can probably do more than that, but 20% of our new patients are seen by telehealth. We also think there’s a great opportunity for returning patients, not just in primary care, but in specialties so our surgeons and our proceduralist are doing many of their visits now by telehealth, which since we get patients from all over, it’s convenient for the patient. You don’t have to travel to Ann Arbor, they don’t have to find parking, and the cost associated with all of that many don’t have the ability to afford that. So we’re able to have a much larger approach to providing care when needed across the state with telehealth. This is a little bit of a tangent, but I do want to tell you about it. We had been doing telehealth. As you probably know the Upper Peninsula is a long way from Ann Arbor. And it’s somewhat isolated. And we had been providing backup for pediatric surgery in Marquette, which is a fine hospital, but doesn’t have a group of dedicated pediatric surgeons. And there was a huge snowstorm, so this was a couple of years ago, and we couldn’t travel and they couldn’t travel and couldn’t transport the patient. And so a surgery was done successfully, I think this was an adult surgery, was done successfully at distance by having virtual assistance from the surgeons in Ann Arbor. Really gratifying. That’s sort of the far end of the limit of telehealth, but I think we can, there’s a lot we can do with telehealth that never, well, if it had happened, it would have happened over years and years rather than over a month or two.

Gary Bisbee 22:15
Well you wrote a piece to the Michigan Medicine community in late July, seems like forever since COVID, but you talked about at that time, the pace of change of decision making, you spoke about remote working and telehealth, and you just commented on the pace of change of decision making, but do you think that we will see this increased pace of change continue in our health systems generally? Or do you think it’ll slip back to the way it was?

Marschall Runge 22:45
I don’t know in general, but I can speak to the University of Michigan and Michigan Medicine. Decision making was very, I would put it on one end of the spectrum in terms of being slow because it was so inclusive, that the phrase is sometimes used of 1000 points of note and rather than 1000 points of light. And that was the case here unless there was entire consensus, it was hard to move forward. During COVID, I think we were at the opposite end of the spectrum. And there wasn’t much time to get meaningful input. And so I think we will settle somewhere in the middle but closer to faster decision making because people have gotten used to that. But we have to be very cognizant of, there’s lots of good thought, and there are things that you can’t possibly recognize by yourself. We were told that we had to reduce our operating budget by $400 million for the coming year for fiscal year ’21, which we started July 1 and we had two weeks to do it. And two weeks with a very small group, there were seven of us that worked on it. It’s just impossible to get it right. And when I talked to departments, Zoom, you know, as much as Zoom can be overwhelming, it’s also very helpful in talking to groups of people. So I’ve now been talking to all our different clinical and basic science departments. And as I talk to them, and they start mentioning things that definitely weren’t a good idea in retrospect. I have to tell them, that’s true. And I don’t know that we could have gotten in right to cut out $400 million if we’d had two years. But there’s no way we could have done it in two weeks. And I use that really as an example of how we do need to get input. We can’t just make snap decisions. And I don’t know how it works really in other health systems. But for us, we both benefit from and we need that level of inclusion and thought in decision making.

Gary Bisbee 24:27
You also wrote in late July about remote working. Looking at that now several months later, will remote working become a workforce and facility planning asset for Michigan Medicine?

Marschall Runge 24:39
Yes, I don’t know where it’ll shake out. We had been trying to promote remote working for several years without much of an impact. And it didn’t have much of an impact because people weren’t sure they could get their work done from home and supervisors in many areas just didn’t like it that the person was sitting next to them or down the hall. We found that that could work very well. And it doesn’t work for everything, but it works for a lot of things. We’ll have to try to figure out what the right balance is. One of the challenges, I think, with the last eight months has been social isolation. And remote working contributes to that. Although we’ve really decreased the density of people in all of our office areas. We have to factor that in. One little caveat that’s been interesting is, we have had terrible parking problems for employees, for patients, you hear all these horror stories about people spending an hour or more going to two or three different lots trying to find a parking place. So remote working has completely changed that dynamic and we don’t have any problems with parking anymore. That’s not the reason to do remote work, it’s not to fix our parking problems. But I think in many areas, people have felt more effective working from home. I think it’ll be a mix and I don’t know exactly where it’s gonna end up for us. But we’ll have much more remote working, again, it’s kind of like telehealth, than we would have ever envisioned was possible before.

Gary Bisbee 25:59
Let’s turn to academic medicine if we could, Marschall. Academic medicine in the US has been lauded for the quality of research and innovation in clinical practice through the years, you worry a little bit just to telegraph my bias. But can the current rate of progress be sustained in this increasingly financially constrained environment?

Marschall Runge 26:21
I think the correct answer is it must be sustained, but it can’t be sustained in the same way. And there’s a quote from Mark Laret that I’d run across, Mark is president of UCSF Health and this was while he was chair of the AAMC. He wrote, “AMCs must embrace profound, meaningful changes to time-honored, treasured, and now increasingly ineffective, non-affordable ways of carrying out our mission.” And I think that just hits the nail on the head. We need to carry out our missions, but we need to figure out new ways to do it because the ways that we do it are ineffective and are already unaffordable and that will just get worse. I think it’s possible, I think we must continue with all of our missions. One area of great importance to us at Michigan Medicine is that we do continue our missions in top-line research, top line of education, and top-line clinical care. It would be easy to say, well, we need to cut back on research or education because we need to spend that money in network expansion or capital costs. And we have decided as a group, and as a university, that we’re not going to do that. So we have to find other ways to be more efficient. We can be more efficient in our healthcare delivery, but we can certainly be more efficient in the way we fund education and research here, as I suspect is the case for most academic medical centers. Neither research nor education can break even on its own. And so those depend on the success of the clinical programs to support them. And that has enabled us, as conversations, they’re not easy conversations, but to help everyone understand how important our clinical missions are, but we can’t sacrifice our other missions for those clinical missions.

Gary Bisbee 27:59
It works us to the point of the current reimbursement system. You really quickly get to the point that we should change or refine the current reimbursement system to reflect what we need to do on the research front. How do you think about that, Marschall?

Marschall Runge 28:17
I do think we need to reform that. There are two big steps forward, at least here, in trying to reform it. One is just change. It’s not the way we’ve always done it, but we’ve learned that what used to require inpatient care can be taken care of in ambulatory settings. Ambulatory care can be taken care of at home and telehealth can fill a lot of patches. So we could do it, but we have to change culture. But also current reimbursement won’t enable us to do so because I think all funding groups whether it’s the government or private insurance are looking at ways to reduce costs. And so we also have to reduce costs, but we have to find areas in which we can support our missions. And I think that’s always been a tug of war and I think we’ll continue to be.

Gary Bisbee 28:57
Marschall, this has been an absolutely terrific interview. I have a couple of questions about leadership I’d like to ask. What are the most important characteristics of a leader during a crisis would you say?

Marschall Runge 29:09
I think that one is the leader, him or herself, has to be willing to endorse rapid decision making. I think equally important, the leader cannot be under the illusion that they have the answers and all decisions to be what they think they are. It involves a change and I think if you can work with other leaders and reach a place where everyone understands that this meeting does not lead to another meeting, that at the end of this meeting, we’re going to have a decision on any of a number of key topics. Trying to bring that forward I think is the most important thing for a leader. And to respect that everything is done by somebody and we need to continue to be an employer of choice and a healthcare system of choice because we can’t do any of this without having great health care providers in all areas.

Gary Bisbee 29:58
So on a more personal basis, how has the COVID crisis changed you as a leader and a family member?

Marschall Runge 30:05
I, like many people in my role, have been a person who felt like basically, I couldn’t be fatigued. And I understood burnout. And I understood the consequences on many people in medicine, and it’s endemic now. But it really got worse during COVID, I think. And my personal anecdote is, every morning I would come into my office, because I spent a little bit of time in the hospital many days, not every day, I’d come into my office and I’d greet the security guard who, we had security guards all over the hospital to make sure, we were early adaptors of face masks and screening, which I think helped, we had very little COVID transmission in the healthcare system. So I’d spend a moment or two talking to the security guard, got to know him quite well. And so I felt like I was doing okay about three months into it, but I had not taken a single day off. And so my wife more or less insisted that I come to visit in North Carolina where she was helping take care of grandchildren whose parents both worked. And I did that. And I came back and the security guard said to me, “Hey, what happened? I haven’t seen you a few days, but you’ve gotten the bounce back in your step.” And it really hit me that I was feeling the same thing everybody else was feeling. I was trying to shunt it aside. So it helped me understand the importance of balance for everyone. Importance of having a social structure and that they really can’t be replaced. I embraced those things, but I didn’t really understand it to myself I’d have to say. But I do now.

Gary Bisbee 31:37
Well, that’s a great way to wrap the interview. Marschall, thanks again for your time. You’re doing an absolutely terrific job at the University of Michigan. They are lucky to have you and thanks for being with us.

Marschall Runge 31:48
Well, thank you, Gary, and I’ll look forward to talking again.

Gary Bisbee 31:51
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.