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Daniel Williams: Well, hi, everyone.

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Daniel Williams here, senior editor at
MGMA and host of the MGMA Podcast Network.

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We are back with another MGMA Weekend
Review podcast, and we are back along

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with co host Colleen Luckett, who's
an editor and writer at MGMA and We're

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going to take a look at the news today.

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So Colleen, anything you want to
share with me before we get going?

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Colleen Luckett: Um, no, I
think we could just dive in.

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I have a little, little something to
share about, um, an event I've never

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attended before, but I'll, I'll talk
about that in a little, in a little bit.

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Yeah.

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But yeah, let's just start out
with, um, just the regular old news.

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Um, so you know, what's worse
than waiting in line at the DMV.

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Prior authorizations, but good news, at
least some of them are getting the axe.

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According to Healthcare Dive, senior
reporter Rebecca Pfeiffer reported on

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March 19th, that OptumRx is eliminating
prior authorization Reauthorizations

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for about 80 drugs used to treat chronic
conditions like migraines, multiple

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sclerosis, and high cholesterol.

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So starting May 1st, this move
will cut up to 25 percent of all

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reauthorizations, about 10 percent
of prior authorizations overall.

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Prior authorizations have long been a
pain point for physicians, pharmacists,

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and patients, adding layers of paperwork
and often delaying necessary care.

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OptumRx's move follows industry
pressure to streamline the process

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and reduce administrative burden.

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While PBMs argue these requirements
control costs, critics say they hinder

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patient care and lead to harmful delays.

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This change comes amid growing scrutiny
of PBMs like OptumRx, which along

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with CVS Caremark and Express Scripts
have faced antitrust concerns and

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legislative efforts aimed at curbing
their power, with regulators circling and

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competitors touting Transparent models.

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OptumRx's latest reform could be as much
about public relations as patient care.

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For now, at least, some patients and
providers will breathe a sigh of relief,

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not to be confused with the sigh of
frustration that usually accompanies

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dealing with prior authorizations.

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Okay, Daniel, over to you.

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Daniel Williams: All right, for
our next story, let's talk about,

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drumroll please, workplace happiness.

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And why it should matter to
every practice leader out there.

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Now we've all heard the saying,
find a job you love and you'll

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never work a day in your life.

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But let's be real, that's
not how most people feel.

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Pew Research shows that job
satisfaction has been on the decline.

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since the pandemic.

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And that's a big deal because
when employees are happy, they're

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more engaged, more productive,
and more likely to stick around.

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Plus, happy employees lead to
better patient experience and

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stronger financial performance.

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So really, everyone wins.

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And that brings us to an
interesting case study.

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Out of the Harvard Business
School, Lanco Medical Group.

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This is a fast growing pharmaceutical
intermediary in Central and Latin America

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that's doing something a little different.

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They're making workplace happiness a
key part of their strategy for growth.

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The co founder, Lissette Hermida,
realized that in order to expand

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successfully, they had to keep their
employees motivated and engaged,

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especially because they're working across
multiple countries and dealing with both

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government in private sector clients.

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So what's really cool is how they
decided to measure happiness.

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They brought in a third party company to
survey employees not just about work, but

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about their overall life satisfaction.

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And the results?

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Well, they were eye opening.

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Some of the perks Lanco thought
were big wins, like free healthcare

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and company trips, weren't actually
appreciated as much as they expected.

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In fact, employees saw them as just
part of the job, not as incentives.

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They had to be, that had to be tough to
hear as a leadership team, but instead

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of getting defensive, Lanco leaned in.

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They listened, and they
adjusted their approach.

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One of their biggest insights?

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Employees wanted better
financial education.

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At first, the leadership team
questioned whether that was even their

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responsibility, but then they realized
if financial stress is affecting job

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performance, it makes sense to address it.

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So they started offering financial
literacy programs to help

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employees plan for their futures.

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And that's really the takeaway here.

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Workplace happiness isn't just
about throwing perks at employees.

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It's about understanding
what truly matters to them.

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And that's going to change over time.

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What motivates someone fresh out
of school is different from what

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a seasoned professional wants.

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Leaders who take time to ask,
listen, and adapt are the ones

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who build strong, engaged teams.

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For medical practice leaders, this
is something worth thinking about.

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And if you are offering benefits
and incentives that truly resonate

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with your team, well, That's
the question you have to ask.

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And if you're not, maybe
it's time to start asking.

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So Colleen, what's next?

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Colleen Luckett: Yeah, I was
gonna say first, um, free medical

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care would be great for me, but
what are these people thinking?

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But that's just me.

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Daniel Williams: Yes.

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Colleen Luckett: All right, well,
let's get to our MGMA stat polling.

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So this week's poll results told us
that of 455 medical group practice

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leaders, 23 percent of you plan to
switch or significantly update your

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EHR system in the next 12 months,
while 70 percent do not and 7 percent

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of you are Kind of unsure right now.

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Well, here are some key takeaways.

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So most groups making a change are
switching vendors entirely, with Epic

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being a common destination, often
as part of a merger or acquisition.

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Some practices are taking a phased
approach, having switched in

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2024 and planning further enhance
Enhancements this year among those

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sticking with their current system.

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Many recently transitioned and are
satisfied with their platform, while

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others are staying put due to cost
considerations or physician preference.

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Few respondents cited contractual
obligations as a reason for not switching,

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suggesting more flexibility in the EHR.

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EHR marketplace.

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And then I AI powered documentation
tools and new integrations are emerging

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as popular add ons for groups looking to
enhance not replace their current systems.

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And why does all this matter?

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Well, selecting the right EHR system,
as many of our listeners know, is a high

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decision, and one that can make or break
operational efficiency, revenue cycle

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management, and clinician satisfaction.

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To support leaders considering a
transition, MGMA has updated its guidance

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on crafting a strong RFP, or Request for
Proposal, that reflects the following.

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The latest regulatory requirements,
including interoperability mandates

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under the 21st Century Cures Act,
evolving technology offerings such

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as cloud based systems, AI powered
documentation, and data analytic tools,

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and the specific needs of different types
of practices, from smaller outpatient

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clinics Needing simple turnkey solutions
to large multi site systems, requiring

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robust data exchange, compliance,
and advanced reporting capabilities.

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A well structured RFP ensures
EHR vendors don't just promise

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the moon, but demonstrate how
their system meets the real.

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clinical, financial, and operational
needs of your organization.

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And on that note, Daniel, I mentioned
at the beginning of the podcast, I got

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to attend an event for the first time.

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Well, that was the HIMSS Colorado chapter
advocacy day breakfast this past Monday.

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You know, super interesting, lots of
panelists who were just really dynamic.

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Well, our stat poll reminded me of a
panel session there that highlighted

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some of the unique technology hurdles
that providers in alternative care

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settings, like behavioral health.

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senior living and community
health centers face.

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And lo and behold, one of the big things
that came up was the ongoing challenges

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with EHR systems and these alternative
care environments and how many of the

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established EHR platforms just aren't well
suited for the needs of their settings.

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So Jason Greer, one of the
panelists, he's the CEO of

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Community Health Provider Alliance.

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and Colorado Community
Managed Care Network.

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He noted how the EHR technology in
primary care is often behind the curve

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compared to the rest of the industry.

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And Stephanie Haley Andrews from
Atria Senior Living mentioned how

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they've had to really work to move
their senior living data away from

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subjective free text notes toward
more structured objective assessments.

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The panelists emphasized the
importance of EHR systems that can

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support whole person coordinated care
across the community, so integrating

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physical, mental, and social needs.

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But they said the data, the data
sharing and interoperability to

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enable that level of coordination
is still a major challenge, even

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with newer cloud based EHR options.

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So, it's clear that EHR selection
and optimization remains a top

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priority for many practices, whether
they're looking to make a full

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vendor switch or just significantly
update, upgrade their current system.

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The need for technology that can truly
meet the unique needs of different

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care settings is an ongoing pain point
that providers are working to address.

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And hey, MGMA members, if your
organization is thinking about

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an EHR change, Make sure your
RFP doesn't just check the boxes.

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It should align with your practice's
long term strategy and avoid

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turning into an expensive regret.

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So as always, we'll drop the link
to our MGMA stat poll results

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article in the show notes.

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Check that out for more information
and how to develop a really, uh,

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really tailored RFP for your new EHR.

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system.

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And hey, do you want to have your
voice heard in future MGMA polls?

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Well, just join MGMA stat by texting
STAT STAT to 33550 or visit mgma.

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com slash MGMA.

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hyphen stat to participate in
weekly healthcare leadership

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insights sent via text.

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It's real easy.

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Okay, Daniel, back to you.

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Daniel Williams: All right.

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Next, we have a topic that
might seem a little fishy.

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Literally.

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Turns out doctors can learn
a thing or two from salmon.

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Yep.

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You heard that right.

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Not from fancy business consultants
or Ted Talks, but from the

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determined, relentless, and sometimes
downright impressive journey.

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Pacific Coast Salmon.

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Think about it.

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These fish are born in cold, rocky
river beds, swim downstream to the

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ocean, spend a few years living
their best lives, and then, well, you

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probably know the rest of the story.

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They fight their way back upstream,
dodging bears, leaping over waterfalls,

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and pushing through some serious currents.

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Just a return to where they started and
they do all this without GPS, a wellness

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app, or an overpriced cup of coffee.

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Now if that's not dedication,
I don't know what is.

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So what can doctors take away
from the life cycle of a salmon?

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A few big lessons, actually, and I
might add, this article originally

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appeared in Physician's Practice.

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It's an opinion piece there,
and so, let's get into it.

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First, remember your roots.

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Just like salmon instinctively return
to their birthplace, physicians

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should remember the mentors, the
training, and the early experiences

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that shaped their careers.

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Medicine is a tough road, but those
who came before you paved the way.

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Keeping those connections
strong can keep you grounded.

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Next, perseverance.

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If you think med school was tough,
try swimming against a raging

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current for hundreds of miles while
predators wait to snatch you up.

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Salmon don't quit, and neither do doctors.

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You push through long hours,
administrative headaches, and

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ever changing policies because
you believe in the work you do.

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That persistence is what makes great
doctors, just like it makes great salmon.

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If salmon had medical degrees, then
there's leaving your comfort zone.

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Salmon don't just stick to
their safe little rivers.

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They explore vast open waters.

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Adapting to new environments.

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Doctors, the same deal.

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Whether it's adapting, adopting new
technologies, learning a new specialty.

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or adjusting to the latest
health care regulations, success

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comes from adapting and growing.

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And then, let's not forget
deferring gratification.

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Salmon give up eating during
their long journey upstream, all

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in service of the bigger goal.

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Sound familiar?

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Whether it's residency, long
shifts, or putting patient care

00:13:09.105 --> 00:13:13.625
before personal comfort, physicians
understand what it means to delay

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rewards for a greater purpose.

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And then finally, adaptability.

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Male salmon actually change physically
as they prepare for the final stretch of

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their journey, growing hooked jaws and
sharper teeth to protect their future.

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Doctors may not grow.

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New teeth, thankfully, but they do
have to evolve constantly, whether it's

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shifting their approach to patient care
or adjusting to new health care models.

00:13:40.760 --> 00:13:44.620
The bottom line, nature has some
pretty solid wisdom to offer.

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Physicians like Salmon, navigate
complex and demanding journeys.

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And while there's no one size fits
all roadmap, staying connected to your

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purpose, pushing through challenges,
and adapting along the way are the

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keys to a meaningful career, and,
hopefully, a successful swim upstream.

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Colleen, keep on swimming.

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What is

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Colleen Luckett: next?

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I like that metaphor.

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All right.

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Well, we will shift to some
mental health care news.

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So mental health care in the U.

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S.

00:14:14.850 --> 00:14:18.270
right now feels a lot like
waiting for a delayed flight.

00:14:18.580 --> 00:14:21.730
It's stressful, frustrating,
and you're not even sure if

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help is ever going to arrive.

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But according to one expert,
the solution isn't just to add

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more planes to a broken system.

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It's to rethink the entire Runway.

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A recent MedCity News article by Jenna
Glover published on March 18th covers

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the state of mental health care and why
simply scaling teletherapy and existing

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models isn't enough to fix the system.

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Here's some key takeaways
from the article.

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The current mental health system is
struggling with health high costs.

00:14:51.625 --> 00:14:56.025
Long wait times and staffing shortages
making care inaccessible for many.

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Expanding a broken system
isn't the solution.

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Instead of just increasing teletherapy
or traditional care options, healthcare

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leaders need to rethink how mental health
services are structured and delivered.

00:15:08.380 --> 00:15:13.160
AI and digital tools are playing a growing
role offering real time support for

00:15:13.170 --> 00:15:17.770
individuals who may not have access to
traditional therapy, but they need to be

00:15:17.780 --> 00:15:22.620
integrated responsibility, responsibly
ensuring evidence based ethical care.

00:15:23.220 --> 00:15:25.710
Health equity remains a major challenge.

00:15:25.740 --> 00:15:29.340
Many marginalized communities
are still being left behind and

00:15:29.340 --> 00:15:33.595
solutions need to be Culturally
responsive, scalable, and accessible.

00:15:34.105 --> 00:15:36.365
For healthcare leaders,
this is a wake up call.

00:15:36.585 --> 00:15:39.755
Simply adding more therapists or
expanding telehealth options won't

00:15:39.755 --> 00:15:41.925
solve the deeper issues in the system.

00:15:42.255 --> 00:15:46.245
Instead, the industry needs to focus
on innovative, holistic approaches that

00:15:46.255 --> 00:15:51.555
blend human expertise, AI driven tools,
and new care models to meet patients

00:15:51.555 --> 00:15:55.405
where they are, especially those who
have been historically underserved.

00:15:55.785 --> 00:15:58.165
At the end of the day, mental
health care doesn't need a bigger

00:15:58.165 --> 00:15:59.825
truck, it needs a better road.

00:16:00.075 --> 00:16:03.885
And for those leading the charge
in health IT operations and patient

00:16:04.055 --> 00:16:08.285
care, the challenge is to build that
road with smarter, more effective,

00:16:08.315 --> 00:16:10.385
and more equitable solutions.

00:16:10.445 --> 00:16:14.015
And again, we will drop that link
in the show notes, so you can

00:16:14.025 --> 00:16:15.425
check it out for more information.

00:16:15.825 --> 00:16:17.725
And that does it for me today, Daniel.

00:16:18.255 --> 00:16:20.705
Daniel Williams: All right, and that
is going to do it for this episode

00:16:20.705 --> 00:16:22.945
of MGMA's Week in Review podcast.

00:16:23.395 --> 00:16:27.835
Just want to thank all of you for being
MGMA podcast listeners, and please drop

00:16:27.835 --> 00:16:31.775
us a note, and we will respond to that.

00:16:31.775 --> 00:16:34.625
We'll see what you're talking
about, what stories you have,

00:16:34.915 --> 00:16:39.105
and if you want to appear on the
podcast, let us know that as well.

00:16:39.105 --> 00:16:42.635
So until then, thank you
for being podcast listeners.

00:16:43.425 --> 00:16:43.985
Colleen Luckett: Thanks, everyone.

00:16:43.985 --> 00:16:44.665
See you next time.