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Speaker 0: This is Scott Becker with the Becker health care podcast. It's thrilled today to be joined by 2 brilliant leaders who are sort of serving in the leadership role of the physician group of the Endeavor Health system. We're joined today by Sun K couture, who is the chief physician executive at in endeavor Health. Side by said with him Is David Ra, who's who's also heading up the physician group with him in a diet leadership form. Just for background and Deborah Health, is a combined North University Health system with the Edward Helm Elm system. Number of other hospitals have also fulton into internet umbrella, it it's been 1 of the great transformation stories and nationally in healthcare and and certainly the struggle area in health over the last decade plus. Doctor Cat has had a remarkable career than Endeavor health. You also serve stint as Ceo, 1 of the larger health systems in the country very well regarded Unity point. Health system, we're and David Ra, who I've known for probably a decade, did an incredible job of building developing leading 1 of the health... 1 of the hospitals at the North University Health System, the Endeavor Health system, the orthopedic and spine institute, which grew into just an incredibly successful Institute. I I know it personally because I've had surgery there myself as I have some of our family members, so I I'm not just a podcast or, but I'm a customer or a patient whatever you wanna call it. Sanjay, Doctor. Kat couture, you could take a moment to introduce yourself, And then, David I'll ask you do the same. Speaker 1: Thanks, Scott. Yes, Jude K couture, I'm a family medicine physician by background. I started Mike career at Edward Hospital, back in 2010, took on multiple different physician leadership roles. Over time. As you stated earlier, I transitioned over to the Ceo of Beauty Point clinic. And made my way back to Chicago and, to work with Dave to build this new medical group we're building. So thank you. Speaker 0: Thank you very, very much. And and David, take a moment if you could also, you know, introduce yourself. Speaker 2: Scott first. Always a pleasure to be with you, and appreciate the opportunity to share our journey that we're on. Dave Ra, I've been as part of the Endeavor health system. I came in through the University health some part of the health system, now for 15 years. I'm physical therapist by background, and I served in Sherman hospital, also, the Sinai health system in Chicago before coming to North shore and now Endeavor. Scott, as you mentioned I was the president of 1 of our hospitals, transforming our general community hospital in S to orthopedic spine especially hospital in Illinois and now have the privilege of working with Sung g as we pulled together for legacy medical groups. It's a single unified Endeavor Health Medical group to drive outcomes for our new health system and Endeavor Health. Thanks for having us. Speaker 0: You know, thank you very, very much. And it... Yeah, obviously, let me ask you this question, Patrick Couture And and, David, what trends are you watching can health closely right now? I mean, it's amazing for me to watch? The Shore system and denver system. Has going into this major major system. I I think you mentioned Doctor To 2 800 physicians or so full time that are in the medical group, could you help me on those numbers. And tell me what sort of trends are you watching closely currently? Speaker 1: Yeah. I I can go and start. So great question. I think just by background, the health system currently has, roughly around 2000 positions in about 800 Adp atp. So a clinical workforce for around 2800. I think our group alone does a little bit over a 1000000000 in revenue. That's just on the prop side. So I think it's just an exciting, large group with a ton of potential as we go forward. But more into the trends of what's going on. There's a lot going on in Healthcare, Scott as you as you're aware, I personally try to see what's going on in Washington to see what's happening from a policy perspective. Because you can kinda look at the pipeline as to what's gonna happen in the future, and I always say if you call the dollar, you can kinda figure out what's gonna happen in the future. So I wouldn't say I can predict the future, but seeing the the tumultuous there, and the unpredictability, and marrying that up with the actual policies being put forward will hopefully help us in the future. I also look at our payers. And so I always look at the big 5 and, you know, in current state, you know, they're not meeting shareholder demand. So that's when they start, you know, kinda of squeezing on the employers and providers and so seeing that upcoming and seen as that as a barrier for us going forward. And then just what's happening with disrupt, overall. He saw what happened with Walmart, you've seen the Bill Md Walgreens, not that we're rooting against those folks. I think anytime you disrupt you wanna see them be successful. But really what it highlights is how difficult this is with the current payment mechanisms and and the overall overview of of health care. The last thing I would say is what I'm keeping a close eye on is supply and demand from a physician perspective, and seeing trends on how we're compensating physicians as well as how we're engaging physicians I think, if I were to look nationally at the impact for positions and their overall feeling of feeling good about what they're doing, it's not great. The burnout rates are significant. And so try and to identify what are the things that we could potentially do different as we build this to engage our workforce so that it's safe seamless and personal for them as well our patients, and I think that could potentially be a differentiator for us in the future. Speaker 0: Think only ask you that question about the client demand and also the disrupt, you know, with with much acclaim, Walgreens Cvs Health, Walmart made broad pronounce, and quite frankly, built out a glut of space to try and put in health hubs they'll all call me something different, but same concept to really put in clinics in their pharmacies and so forth. And my own sense is from a supply and demand perspective, if there's just not enough doctors. So staff all those kinds of things, I mean, Walgreens made this huge deal with Village md, and 5 7000000000 dollar loss are taking on that where they tried to use that to to to fill this gap. But at the end of the day, my own central is supply demand perspective, there's just not enough doctors to fall those specs out. Any thoughts on that. Speaker 1: Yeah. I think it's a combination of a couple of things, Scott. I think you know, if you think about health care economics, Right? You know, in an industry where we don't necessarily control price when inflation happens and there's supply and demand issues and market based compensation for a workforce that isn't in demand. When you're behold to shareholders to that point, which is a good thing in some way. Right? It's it's hard to make that work. Right? And When you look at a lot of these larger organizations that have made these big investments. The question for them is, is it worth the pain? Because building a physician enterprise, is about stability, structure, safety, quality, and it's a long term game. Right? And so, you know, I don't think what They are attempting to do is wrong. I actually like some of the outputs that have come from there for us to learn from. But inherently, when it comes down to the dollars, when you don't control price, it makes it really, really hard when the things around you are not cor with it. So really well intentions. I think we can learn from them. But I think what Dave and I really think about for future of, you know, our employed medical group within a large health system is we provide stability in structure and safety, and we have the opportunity with the whole continuum of care to maybe do this differently than some of those disrupt and that's the opportunity in front of us. I think a lot of organizations are trying to do it. Dave, myself, the rest of the team here at End endeavor, we're really focusing on how do we make this the best place for physicians to work as well as for patients to receive care and and and that's the challenge. So long winded answer to, I I think they're well intention, but it's a tough market. Speaker 0: No. It really is. And and and David, let me ask you What is sort the trends you're watching closely to to go with the ones that Decker K couture is watching? Speaker 2: Yeah. Very similar trends. And when I think about us as a helps system done, our our communities dependent us for care. And the the easy convenient transactional care models that might exist in the community. It's not because our patients prefer those, it's really because they want access. And so it's our job to think about access differently and how do we meet the needs? Because not only can we provide that transactional care, but we can provide a holistic care to our patients and our communities given that we know our patients. We know their comorbidities. We know other diseases that they're managing and we can treat them more holistically. And so as we are thinking about this, more broadly, many health systems are across country collection of hospitals collection of ambulatory sites, And we're really challenging ourselves as a new health system to really think of ourselves as a truly integrated system of care that takes care of the patients seamlessly across the continuum of care. From ambulatory, office visits to... If you need to be hospitalized, post acute back to ambulatory and really holistically managing that patient from across the continuum arm and longitudinal. And then orient our health system and our assets accordingly. So organizing around clinical service lines across the continuum of care, ensuring that we have consistent, optimized and differentiated clinical service lines. That's going allow us to whether the storm of these disrupt that maybe just have a pc and a piece there, but can pull it together like we can as a truly integrated system of care. Speaker 0: Thank you very very much. And David, let me ask you this question, you move from running a specific hospital where you had just done a transformational fantastic job. Now with Doctor Cat running the entire medical group. It's a it's a big big job. What are you most excited about as you move towards the rest of this year or the next year? Speaker 2: Yeah. As a team, we are most excited about the potential of really setting the standard for how care can be delivered given all the complexity that we talked about in the u. Healthcare system. And not just providing good care, but providing exceptional care that's differentiated that is seamless and integrated and makes it easy for our patients. And as Sung ji mentioned, makes it seamless for our providers to practice in. And so we're really thinking about how do we utilize our our scale and coming together with our talent, looking to bring together our technologies and can we come up with different care paradigm together now as a single integrated medical group as part of a single integrated health system that delivers a different and better product that currently exists in the market. And so we're really challenging ourselves and thinking about this new asset that we have more broadly what can we do that others can't to be the pays car in the market? Speaker 0: Thank you very, very much. And and then doctor Cat couture, what are you most excited about and folks on this year? Speaker 1: Yeah. I... So we're obviously integrating and bringing 4 groups together, which is never easy. So it's kind of a blessing and a curse. What I would say is we're looking at it like a gift. And we're in a time period post Covid, lots of headwind where we have the opportunity to build something special. And I think the potential in itself is what keeps us going. What I'm really most excited about is the overall organization's willingness to allow the physicians to lead this. So a lot of organizations say, that's the case, but the way we've structured operationally, the way we have the physician enterprise with its own P l, the way that we want physicians to lead from a governance perspective, how we're developing physician Ops dia that Dave and I are mimicking. I believe will lead us, to be a differentiated care delivery mechanism system that people wanna be a part of. And what's what's really exciting is we're getting calls from lots of physicians in the area or other areas that are hearing and feeling that excitement and what we're building and wanna be a part of it. And I think when we talked about the supply and demand issue with physicians, I think we're well on our way to building something special here that's physician led where the physicians can start owning their practices. And I think it's exciting to see the potential and We've... We've done a lot of work and we're we're we're headed there. Speaker 0: Well, it's really it's it's really amazing to watch a big effort and great systems being put together and its put together. It talked for a second, decker K to about... You've had this great career as a leader, not just a physician, but isn't leader like what advice would you give to other emerging leaders to physicians as they sort of transition or str being a physician and being a position. Will any advice you'd give to emerging leaders or anything you think of as you as you step into this this now larger and larger role? Speaker 1: Yeah. III... First of all, I always tell people will be curious. I think people should have mentors. I also believe, should be comfortable being uncomfortable as a physician leader. I think a lot of times, we wanna put physician leaders in a box and focusing in on clinical quality and safety. In those areas. I think understanding health economics, understanding operations through the continuum, will give you an opportunity to make the impacts that we say we wanna make. So my my biggest piece of advice is lean into the areas the trunk with and learn from your peers and and and don't say sorry for it. And I think keep learning, keep being curious. Never say no. And if your focus is on making impact, and there'll always be opportunity for you. If your focus is on just getting a position or a title, or working your way up the ranks, that's not gonna work because people will see right through that. Speaker 0: Thank you very, very much. I think that's right on. The more sense that you are, the more you're actually trying to make the work. If you make things work and trying do great work, good things tend to happen. If you... There's great advice on focusing 80, 90 percent on your core core job, what you're trying to do and not always be looking for the next thing. And always looking for the next rung, the far better off you are, and those opportunities will come. Yes, Should keep your eyes is open, Yes, you gotta spend 10:40 your time. Like, thinking about the future and other things, but you better do a great job on your core core job and what you're trying to do. David any advice that you would give to emerging leaders? And I've had the great pleasure of really watching what you evolve as a leader over the last decade. What advice would you give to other leaders? Speaker 2: Yes, Scott. I I would start... There's no doubt the U Us. Healthcare system is incredibly complex. I would start with doing the basics really well. It's foundational to running a strong operation and ensuring that your patient are getting the care that they need and deserve. I want you do the basics well, I I would challenge any leader to really think about what's possible. With all the chaos in the U. S. Healthcare system and the complexity, that also creates opportunities. And it's easy to get sucked into the day, day to day, fire drill and crisis at the moment. And that's important that's part of all of our jobs. But at some point, you have to zoom out and think about where can... What can this be? Where will the puck be? How can we do this different or better than others and then think right to left, build your project plan accordingly to push your teams to realize that vision. So I would say start with doing the basics well once you once you have that, really think about what's possible and leading your teams towards that direction. Speaker 0: Thank you very, very much. David, there's a. Anything else you'd like to share today. I mean you... You've seen the merger together of 2 great systems anything else that's top of mind that you're thinking about currently that you'd like to share regarding today, That Doctor Couture or or or David? Speaker 1: Yeah. I I think, for me, just making sure that, we always take care of each other. Especially in healthcare care. I think we challenge ourselves to continue to get better and push ourselves, but making sure that we continue to support each other, especially in the non for profit health care world. There's a lot of stuff going on around us, and a lot of challenges, but we're all a team trying to make our communities better and stronger. And so, connecting with like minded individuals from other areas of the country, I think is always support. So, I like to make sure that, people stay well connected and are making sure that they feel support. Speaker 2: Yeah. That that's a well said. The only thing I would add is, being in healthcare is a privilege. We get to wake up every day and make a difference in people's lives. And as chaotic as it can be it, sometimes, it truly is a privilege to be called into this profession. And I think of it that way. So, I think that perspective is healthy as folks are going through long days and long weeks to get jobs done. Speaker 0: Thank you very, very much. I want to thank the both you for joining. Excited to watch the evolution of the physician group was an amazing transformational story that North shore and Deborah Health, Edward Elm, and now all in Deborah health, it has been in the Greater Chicago area and nationally. Thank you for joining us on the Becker Healthcare podcast. Thank you very much. Speaker 2: Thank you, Scott.