Chapters Transcript Video When every second matters: Emergency care across a growing system Look, we're a level one trauma center. We can do anything. I mean, literally anything. The other day I was reviewing a chart, a patient came in at 2:02 a.m. and, and by 2:04 a.m. we had done a thoracotomy, got into the chest. Within 2 minutes of arrival, we'd cut in this guy's chest. Within 3 minutes of arrival, we had his aorta cross clamped, 2:05 a.m. his aorta was cross clamped. I mean, the fact that we can go from 0 to 100 miles an hour in the middle of the night is like pretty cool. Hi, I'm Lindsay Carrillo, director of business development at UCI Health. Hi, I'm Doctor Sunil Verma, Associate Chief Medical Officer for ambulatory at UCI Health. I'm also a laryngologist here. Welcome to Physician Huddle by UCI Health. Today we are joined by Doctor Chris Fox, professor and chair of the Department of Emergency Medicine at UCI Health. Welcome, Doctor Fox. Well, thank you for having me. So take us through your career here at UCI Health. What brought you here and how has it evolved and what do you do now? Yeah, great question. Uh, I've been here forever, for 25 years, post-fellowship. So yeah, I would, I did my residency here. OK. I mean, if you want to back up a little more, I, I went to college at UCI. Yeah, yeah, forever. I've been here. I mean, I went to Irvine High School. It's kind of embarrassing how long I've been. Associated with the word Irvine, but no, I've been here, uh, since, since fellowship. I came back uh right after I finished my fellowship in 2001 and I've just been started as, you know. Uh, at the bottom of the totem pole and, um, and just, uh, was really into ultrasound and the emerging technology that point of care ultrasound was and that's what kinda, kinda moved my career along. It was provided a great niche in terms of, uh, research and teaching, and I started a fellowship in point of care ultrasound. I've graduated 47 fellows now and I started a curriculum for the School of Medicine in ultrasound, a longitudinal 4-year curriculum, and. And now we've had close to, I think, 10 years now of students who graduated with that 4-year curriculum. The last 5 or 6 have all graduated with their own ultrasound probes. And right now as we speak, all 440 medical students have their own personal ultrasound probe. Do you have one on you right now? Um, you know, that's a weird question you asked me, and no, we didn't rehearse that, but I did just come off my shift. And so, of course, I, I do. I always have wherever I am. This is a brand, this is a new, uh, Mind Ray product, the T Air. I was, I was demoing it today. Um, yeah, I always have some toys, some ultrasound toys with me wherever I go. It's kind of, kind of crazy because people look at this and they don't know what it is, you know, you're going through security. I was gonna say you're a joy at TSA. Yeah, like what does that, how does that work? And like, oh no, it comes on my phone. And so I turn it on and the image pops up on my phone. Next thing I know I'm doing an ultrasound of somebody in the TSA line. Of course you are crazy. Uh, but, uh, but yeah, so ultrasound is kind of where I, I got, uh, you know, my, my, uh, my niche, everything, and I was, um, so how did I go from that to becoming department chair? It's kind of a weird story. I basically Uh, was tapped to become the assistant dean of student affairs, uh, by, by, by the then associate dean of, um, The medical school and they, uh, they saw that I had some leadership potential in me which I of course did not see and they sent me to leadership school. I took 2 year, I did a 2-year leadership course at WAMC and then that led into more and more opportunities and then uh when the interim chair position came up in my department, um, again, people saw that I should apply for that and I wasn't necessarily that excited about that because I liked being a vice chair and. Sort of minding my own business and teaching ultrasound and doing research and all of the academic scholarly work that I loved so much for my whole career and traveling and teaching and uh and so, but, uh, I sort of got nudged into it and took a lot more leadership courses and um, yeah, here I am, uh, 8 years later, still in the role and uh and loving it. So that's kind of my, uh, my quick uh little story how I went from Uh, Irvine High School to Department Chair of Emergency medicine at UC Irvine. So, so you're wearing scrubs today and, uh, you have an ultrasound probe in your pocket. So you are still seeing patients and you're still, um, taking care of patients in the emergency department. Yup, yeah, I came off a shift today and yeah, I'm still, uh, still very active clinically, you know, we have, uh, I'm in charge of 4 emergency departments now and 1. Uh, urgent care. And so today I was in Orange at the, at our loved one trauma center where I've been for 25 years, and, uh, Thursday I go out to Catalina and I work a 24 hour shift out there. And then, um, and then Wednesday, uh, December 10th, the new ED opens and so in Irvine. So, uh, it's a lot, a lot going on for sure. Yeah, talk to us about that. I mean, UC I used to have one emergency department. Now trauma for sure, so it's not like it was boring. But now we have so many more. Talk to us about like what's your vision as far as quality and consistency and like sort of delivering on that you see a health brand no matter which door you walk into. Yeah, absolutely, um. You're right to say for forever, for since my, until about a year and a half ago, we only had one, that was it. The mothership was just the ship, you know, now we call it the mothership. But I, I think when it comes to, you know, people getting acute unscheduled care 24 hours a day. There's, you know, obviously, um, it's not what anybody wants to do. Nobody wants to go to the emergency department. I certainly don't and you certainly don't. It's not like the highlight of anybody's day. It's actually probably the worst part of anybody's day or even life. And so, you wanna make that experience, um, number one, you want that experience to be extremely accurate. You want the care to be accurate, spot on, state of the art. If there's a device where you can look past the skin line at the organs you're interested in, then you'll use it. And, uh, sorry, I always keep talking about ultrasound, you gotta stop me when I keep doing that. Uh, but, uh, no, if you look at the community network that uh UCI purchased, uh, you know, the four community network hospitals. Uh, the idea is that, um, that the rising tide is going to bring all these boats up, you know, and I really think that the quality already when you walk around those hospitals, for example, we came up with, uh, instead of 40 hours a day of physician coverage, 60 hours a day of physician coverage, and frankly, uh, that, that went live in April, you know, roughly, I don't know, 7 or 8 months ago, and that made a huge difference. Uh, all the metrics turned around after that. Um, but also I would say one of the biggest effects it had is like when you, and this is something you can like measure, but when you walk around that ED, everybody's standing up a little bit straighter and the UCI, you know, merch is, uh, worn proudly everywhere and I really feel that in all the, um, you know, I read all the patient responses, positive or negative, and I just sensed that uh that's a very, it's, it's really coming around that ED now is becoming part of our brand, you know, you know, I live in Los Alamitos and I've heard that from uh friends and neighbors that when they've had to bring their loved ones into the emergency department that it feels different now than it did before and, uh, it actually, it's interesting, it's like this halo effect, so. Uh, the, their, their time in the hospital, not just in the emergency department, but as inpatients also is a lot more positive with the small change, with the very well substantial change that's been made with the emergency medicine physician staffing model. Yeah, thanks for saying that. Yeah, I love that you live in that community too. Um, I'm sure you'll be calling me, hopefully you won't, but someday you may, you know, we'll connect over that. But, um, yeah, I, I definitely feel that, you know, in talking to the, the leadership there and also the boots on the ground, you really feel there's a, there's a momentum, a spirit that's running through that place that was not there before and all the metrics show it too, for what it's worth. What is it, you know, you just mentioned that being in the, you know, going, receiving care in the emergency department is not the, what somebody desires, if you will. How has technology helped you with taking care of patients, more so from like our electronic medical record and understanding those patients that are need that continuum of care and transitioning care to outpatient? I mean, that's something you and I work alongside uh professionally, but, but, how's that changed over the years and what how much opportunity do we still have left? Yeah, uh, you know, the idea is to become one big integrated network so that we can all see everything that's going on with our patients from soup to nuts, from ambulatory to the emergency department, maybe an urgent care visit or two, something surgical, and then inpatient and then back outpatient again and being, so when I walk in the room to see a patient. I can take 3 minutes and all of a sudden I know 10,000 times more about what's going on with that patient and I feel like I almost already know them, even though we don't really know any of our patients, but I can walk in the room and I can start the conversation with, gee, you know, I couldn't help but notice, uh, looks like if, if I got this right, in the last, you know, several weeks, this is what you've been going through. Uh, yeah, doc, that's, that's, that's about it. So tell me what's bringing, what's, what's happening right now? And then they bring me up to speed. Rather than, you know, somebody from an outside system coming in and we're like starting from scratch and, you know, having to get a portion of the story, which depending on, you know, which, which may not be accurate based on their level of medical uh sophistication. So, definitely a way better way to communicate about the patients. I would say that's, that's definitely helping. And once we're all in the same, all on Epic together, we'll be able to see each other's patients throughout our system and that's happening, I mean, literally as we speak, um. The other thing to talk about that, um, how technology has kind of really changed how I see my patients is the ambient listening. As I'm talking to my patients now, we have software on the phone through our software called Haiku. We have this abridge software where I turn it on. I've been using it now for probably 6 or 9 months. I've seen over 500 patients with it, and I just use it again today where I walk in the room, it's, uh, I tell the patient, hey, listen, um, I've got this app on my phone that's gonna record our conversation that way I don't have to have my computer in the room. I can sit and talk to you and it's just gonna pick out the pertinent positives and, um, and it's totally in a secure platform and I've never had a patient say, no, doctor, go get your computer and start typing. Yeah, someday maybe, but, uh, but everybody's really cool about it and they understand that I could come in, sit down and look him in the eye. And as crazy as our emergency department is, and as, as you know, through all of the sea that is the US healthcare system, like, how can I connect with my patient in that one moment? How do we have that? At, you know, like that show Avatar with their tails connect, you know, whatever that is, it sounds to me too creepy, but, but actually that's how it is. It's like you need to download and talk to this patient, connect with them and sync up with them in the most like human way possible with this stranger you've never met. I mean this is as anonymous as care gets in emergency medicine, and now I have a leg up with it where I've got maybe some history in the computer and some background knowledge, and then I don't have to be sitting here with the computer tapping away. Like, uh, you know, uh, like a person just typing. It's like now I'm actually a human being having a human-human interaction and when I go back to my computer, Even though we might have talked for 10 or 15 minutes, you know, 5 to 15 minutes depending on the situation, how complicated things are, uh, I go back to my computer and we might have sidebar conversations and, you know, my ADHD is taking us over here. Today I saw a patient wearing a shirt, uh, that had the word flight on it and the logo I could tell was, um. Uh, from, from one of those, um, foil efoils, you know, and so I've been writing those. My buddy has one of those e-foils. I've been writing it a lot and I go, Yo, is that one of those, uh, e-foil? It's Do you work for that company? He's like, wow, he goes, I can't believe you recognize that. No, this is, that's so funny. No, but he goes, my best friend owns it. And I'm like, well, my best friend has one. We've been taking that thing all around the place, including the Bahamas anyway, so we went on that tangent for a while, but so when I go back to my chart, none of that is in the chart. All that's in the chart, in fact, he was the, he was the significant other in the room. All that's in the chart was the stuff with his, his, uh, his significant other and so the patient, and so it sifted through all that and it put everything, all the historical stuff is in the history section, the HPI, the present illness, that's all there. The physical exam stuff is down here. The medical decision making is over here. It's all organized, even though our conversation might not have been. And so that's what's making medicine so much more fun to practice now. I mean, it's kind of like, yeah, I've been working for 25 years and people keep asking me, you know, well, so uh how much longer? And I'm like, stop asking me that question because we have this new software out and it's like making my job so much more enjoyable, you know, so the new docs that are coming up, they're getting access to this. And I think, I think that the patients are really gonna enjoy it too because they don't have to watch someone type away while they're trying to have a conversation. You know, my first time using it was actually speaking Spanish to a patient, so this patient and I had, we've had the conversation in Spanish. The platform was able to translate it. The patient was on an advanced chemotherapeutic agent that I had not heard of, and I didn't understand, and I didn't know if it was a translation or an interpretation problem. But then when I went back to my computer after seeing the patient, it, it defined the medication for me, not to mention it obviously, then did the note in English, which was fascinating that it could just pick up that fast, and it, that wasn't it learning me, right? That was the first time I, that was patient number one for me. So it definitely has been a game changer. And, and I, to your point earlier about being able to connect with somebody in that very small moment. Having that insight into their history, even medical history, even being able to share, I know your doctor who you saw, I know, oh, you saw Doctor Fox, he's a great guy, that actually levels, not levels the playing field, but makes it easier to speak to a patient. It takes a lot of that anxiety off from the patient and I'm sure patients, especially when they're speaking to emergency medicine physicians, there's just so much nervousness, so much stress that being able to connect as fast as you can probably, I would imagine improves the quality of the care received. Yeah, I think that's the trick is to find somebody you've never met in your entire life. And now suddenly, uh, you're, you're gonna have a very private experience with that person, a doctor-patient, uh, experience where they're about to share with you something that they may not have told anybody in the world before. And And, and while maybe the anonymity helps a little bit, you also need to have trust built in there somehow. And I mean, listen, that's, that's the trick of this job is, is trying to figure out that lane, that gear to get in with your patient where you can. You know, not disarm them, but let them calm down a little bit so that they can kind of open up because they might be holding something back that could be the critical piece to that puzzle, honestly. No, I'm excited about where technology is going. I love that translation stuff and being able to, being able to communicate with my patients in any language without the need for a third party in the room with us, but we're still kind of talking. That would be really cool. And, you know, I was in Korea. Last year and I had to, I was like cruising around all by myself and I had to figure out like how to ask a, ask somebody a question about this rail pass thing. I don't know. I forgot what it was exactly, but I had a Google Translate and I was like doing that the whole time and I got it, I got everything I needed to get and we were laughing. This person and I we were laughing and she didn't speak English and I didn't speak Korean, we're going back, but we figured it all out, you know, like that needs to be in real time at the bedside. I think that would be really cool and also. There's this app called Open Evidence that a lot of us are using now and that's another game changer. I feel like that technology, basically, you could type in a medical question into chat GPT and you're gonna get, you know, a, a weird response maybe and not necessarily the response that is accurate or, but open evidence sources actual scientific studies and goes into PubMed and sources all that data and will actually list out the articles for you. In, in justifying its answer when you ask it a clinical question. And because somebody, somebody will come to the emergency department with something that's a strange medication or uh a rare condition, uh, or a very specific type of rare condition only that, you know, it needs to be treated a certain way. And as they're talking, you know, you can type it into open evidence and all of a sudden you're like, oh, learning all about this condition and what not to do and what to do. And I think if that could get even more integrated. Into how we're seeing patients at the bedside, that and the language translation, I mean, there's a lot to go still, I think, with technology, and I'm excited for where that's going. Of course all the imaging stuff is amazing. That's your jam. I love that, yeah. So I'm hearing like a through line of just trust, you know, you wanna use the open evidence because it's a trustworthy source. Having that patient history when you walk in the room gives them an element of trust, but You know, you've also been in a position where you've had to get the other physicians to trust you. You talk about, you know, joining up with Los Alamitos and having them join your team. Like, how did you get them on board with you because this is the new sheriff in town. He's coming in. How do I know? I, you know, wanna work with him? Yep, um, this word is overused, and I'm gonna use it anyways, and, uh, and I'm gonna use it in a very specific way. The word is transparency. So, to a fault. And so what that means is for me, getting new people, these new doctors at La Salle, it's their 4th group who's come along in 10 years, they've been, you know, beaten up a little bit by the different staffing models. And here they see me come along. They think, Who's this academic guy? He doesn't know what he's doing, and I know they think that about me and they're kind of right, not to be honest. Look at these weird glasses I'm wearing a different gear model, right? Like the model that I'm sure you heard about is you have residents in there in the emergency department in Orange. So how could you know anything about Los Alamitos where we don't have residents? I said that exact statement and that's the transparency. That's what I did. I didn't really know what I was doing in terms of their community and they run things very much more. Efficiently in a lot of ways we have a lot to learn from, from a community ED, uh, and then, but we in academics, we have also, we're up on all the literature and best practices, so it's kind of two-way, you know, we're, we're bringing their ultrasound skills up to speed and everything that's really fun and, uh, and they're constantly showing us ways where they're way out in front of us with certain protocols in terms of efficiency, so. So, yeah, uh, it's been a really, a really fun experience and, uh, and by, by increasing the physician staffing from 40 hours a day to 60 hours a day, that's no joke. That's actually like all of a sudden their patients per hour go, go down and they're able to think and breathe and talk to each other between patients and a little bit of camaraderie goes a long way. It's not just, you know, the pure. Um, financial aspect of the job, which any private equity group can tell you there's a lot of financial upside to staffing emergency departments, um, but it's the opposite of that. It's, um, we're just putting all the money into the staffing and making this a good place to work. Well, not to mention, I mean, that's a huge trust, uh, piece that the enterprise had to have in you to be able to say, hey, I need 50% more physician time in the emergency department that has already been standing up. Uh, you're right to say that, uh, but I would say that the other way around is actually is how I felt. Every time I ran into a problem, the leaders above me, uh, I, I had a very, I had very open communication with them. So I could text them, I could talk to them at any time of day. I, I never felt that they were saying. Yo, you need to figure this out. They're saying, what can I do to help? And one of them even said to me several times, she said, Fox, just listen. Just treat it like a startup, get it, get it going, get it, don't miss it, don't miss a minute of coverage. Just get this thing off the ground, we'll figure it all out. And so, so yeah, I had to make some, you know, kind of bold decisions here and there to um. To get, to get to this point where now, we're great from a staffing standpoint, actually, we're just talking about that today. So, uh, but there were, there were some times there where we had to really bridge and do some creative things to get, to get that schedule covered. So you have a new frontier coming, which is the Irvine Hospital, and by the time that this podcast is live, it will have been opened. What insights do you have into the needs that the community of Irvine has for emergency care? Uh, I think a lot of it probably has been brought on by the fact that you, you grew an urgent care out of the ground just a year and a half ago. So what lessons have you learned and what do you anticipate for this community? Yeah, so, uh, that urgent care, 18 months ago, it opened or so, right, right around when, uh, April, yeah, uh, it was like the year before that, the La Salle happened, you know, I had no idea La Salle was about to happen a year later. So it was like, what's gonna happen this April? I'm afraid for that to come. So, um, so that urgent care opened up and, uh, Graham Stevenson is the medical director there and just did, he, you know, he's coming out of his clinical informatics fellowship and just did an outstanding job with, with staff getting everything going, all the protocols in place. And um, To this day, that stands as one of the highest patient experience clinical areas in all of UCI health. And I'm incredibly proud of that group and uh and Casey uh also who stood that place up, uh, the nurse manager there. And I think that the experience that the patients are having, I'm constantly getting text texts about it and Reading the reports that the experience that the physicians and the PAs and the NPs are having over there and the nurses, amazing. So, I'm thinking about that, the last 18 months of all of the wonderfulness that has been that urgent care and how can we keep that vibe going over at the new ED when that thing opens on Wednesday and that's the trick. Because emergency medicine is different than urgent care, it's not open, you know, the emergency departments over 24 hours. Uh, we're under, uh, MTALA, which means that, uh, you know, we, you, you, you see everybody no matter what, and, uh, and so it's a little bit different. You get ambulances coming in, really no, uh, way to control any kind of, you know, front door traffic that way. Um, it's a smallish ED. It's only 20 beds, and so we have to make sure that it's run extremely efficiently. You know, we got to get, make sure that our turnaround times and CT and labs have to be top box, you know, so we're working really closely with our partners in radiology and In the lab to make sure that happens because that can really bottleneck you down a little bit, you know, when you have like you're just waiting on stuff, but if we can get that quick, then We think the experience over there is gonna be one of a kind. I mean, just the physical plant itself, the the environment of care is next level. Uh, so, yeah, we're hoping to keep that going in the city of Irvine. When we were first looking at the new hospital 5 years ago, thinking of, you know, I was hearing about this, they're saying, don't worry, Fox, there's not gonna be an ER. And I was like, oh, cool, cool. I got so many 5 years ago. Oh, I got so many things in my mind. I have 18 faculty to worry about. Yeah, my one, my one trauma center. Oh, glad there's not. And then all of a sudden like, oh well, the city of Irvine is really demanding to put that we, they, they, they're telling us we need another ED. So, OK, all right, cool. Now I was excited. Oh, OK, this will be fun. Again, not knowing that we were gonna have these other, uh, EDs come online, but that's cool too. Uh, really exciting. I think the way forward is just, um, you know, we hired, I interviewed 26 emergency physicians and hired 7. So far, uh, I still have two open spots. I'm deciding still what to do there, but, um, I had, you know, I don't wanna, you know, the pick of the litter. I had the best of the best from around the country. These people are coming from around the country to staff that ED, uh, almost all from the community, other, they're all like mid-career emergency physicians. I've done a lot of due diligence and, uh, and we've been working with them the last few days in training all this week actually. I gave my kind of state of the department address to them Monday yesterday at noon and uh looking around the room and all the faces that that made it that we hired, the energy in the room is, is, is really good. On Saturday we're having, uh, we're having a little barbecue at my house uh with the new team in my backyard to kind of celebrate the, uh, the new group, uh, and C-suite's coming again so they'll get to meet them. So that's uh that's kind of how I'm building the culture if you will just like they know me they know how transparent everything is they're excited about that they're um excited to be part of the brand new facility and they understand that that and I talk a lot about the experience with the urgent care bringing it back to that and about the type of the patients that we saw, the experience that everybody's having 360 degrees over there and that we need to keep that vibe going in at the emergency department. Wow, that's pretty cool to just basically build it from the ground up, build the team you want. It's kind of a dream for any leader. Yeah, yeah, well, I have a partner, uh, the medical director there is Ryan Gibney, Doctor Gibney, and, uh, he, uh, he's, I've known him since he's a med student. Um, I think, uh, one of my birthday parties, he, he, uh, you know, we, we did karaoke together, you know, we're good, we're good, uh, we're good colleagues together. And um you know he used to run the uh Sharky's bar. He was the manager at Sharky's for 10 years before he became a doctor. And so, so like most doctors, I think that's in Newport Beach. Yeah, no, I mean that's like those are leadership skills there when you're managing like late night drunk people, it's, you know, so it's those skills translate pretty well into mercy medicine sometimes so and into leadership, frankly and um. And yeah, so Ryan Gibney is a great, uh, he, he's, he's perfect for that role over there. He knows the community really well and, and what he's, but he lives like 3 miles from the site too, so it's perfect. What's, uh, what's so much opportunity, but what, what, what are the challenges you have? What keeps you up at night or? You know, you're a very positive person, but there has to be something you think about that needs to be improved that just can't at the yup. Well, my optimism does drive my team crazy sometimes and they, they, because you can be perceived as like you're not in touch with reality when you're when you're overly optimistic. Optimism gets you in trouble, can get you in trouble financially too. Um, and so I'm always, uh, I've got good financial people around me all the time, you know, keeping me out of trouble and definitely letting me know when something's not feasible and I don't. Uh, I don't let my optimism drive the finances, uh, too much, and so I think that's one way to, to always kind of show insight about your own, whether it's optimism or pessimism. I think it's important to, to show insight there and know when to flex that skill. Um, there is one very negative thing that, uh, that does keep me up at night that my optimism has not fixed at all, and that is something called boarding. And boarding is uh a phenomenon that's happening around the country and emerging around the world actually. Uh, my colleagues and I was just in Budapest and they were all talking about their boarding problems there. Made me feel better but also kind of stepped on my optimism a little bit. If no country can solve this, but basically boarding is where a patient is too sick to be discharged. So about 25% of our patients get admitted to the hospital who come in through our front door, whether it's by ambulance or by foot traffic. And when they need to be admitted, they can't go home, they need further care, inpatient care, um, the emergency physician makes that call and unfortunately, there aren't beds for them to go up to. In orange, at least we have, we don't have those beds. And so even though we have 72 licensed emergency medicine treatment spaces, you know, 72 beds in our ED. 50 of those are boarding patients who are there for 23 days sometimes and so that boarding is what keeps me up at night to answer your question because basically what's happened is that creates a pretty rough experience for everybody else who's trying to get access to us, you know, I mean, look, we're a Level One trauma center. We can do anything. I mean, literally anything. The other day I was reviewing a chart. A patient came in at 2:02 a.m. and, and by 2:04 a.m. we had done a thoracotomy, got into the chest. Within 2 minutes of arrival we'd cut in this guy's chest. Within 3 minutes of arrival, we had his aorta cross clamped, 2:05 a.m. his aorta was cross clamped. I mean, the fact that we can go from 0 to 100 miles an hour in the middle of the night is like pretty cool, you know. And so we can, we, I'm so proud of that and the accurate care that we can provide, that doesn't keep me up at all, that I sleep like a baby. But knowing that there's patients in my waiting room who can't get back to access a horizontal space, a bed, that eats away at me and. As much as my optimism is trying to clear that up, it's an unresolved conflict that I have. I think that once the community network is all on the same. Uh, version of Epic. That we'll be able to have the patients translocate between the different sites. So while there's no beds in orange for the more straightforward cases like pneumonia and pyelonephritis, cellulitis, they could go to a really comfortable space at one of our community network hospitals so that we can provide access to all of the super sick critical patients, complex patients that really need our level of expertise. That to me is like the. The, the perfect situation, right care, right place, right time. No, it's gonna be nice to go truly from a hospital to a health system, and that's what you're speaking of. And to be one day it won't be the community network hospitals. It'll really just be UCI Los Alamitos, UCI Fountain Valley, UCI Irvine, yeah. So that's our opportunity and This next step is a big bridge for us, but, uh, I think also just having phenomenal leaders like yourself that recognize that care is gonna be different at each of our, each of our locations and not trying to make, you know, put one model of care everywhere, that's, that's really important and something a lot of us other clinicians are learning about, with. Yeah, absolutely. Yeah, I just want to also take this moment just to point out just this kind of like take a beat. And think about this moment in time. And based on kind of what you just said, which is, you know, we're kind of all going through this funnel right now. We're like swirling through this big funnel and it's like the community network. It's epic reimagined, it's the Irvine Hospital opening up. All of this is like rotating together and happening at the same time and we're going to go down through this and we're all like feeling it. I mean, every second of my day is accounted for between now and like. Christmas and so we're all, all of us, I'm sure are feeling this. And as soon as we get through the other side of that funnel, you know, I think that we're gonna be able to take this 6th hospital and then now a 7th hospital system that's coming online with that rehab. I think that uh we're gonna be able to really shift gears from like survival, putting out all these fires mode now into thriving mode and really Beautify each site and bring and continue this crazy momentum that UCI is currently experiencing. I've never, I've been here forever. I've never experienced this kind of momentum. I tell you, when I, when I, um, I know when I interviewed, it was just the brand new hospital was here, Douglas Hospital, and they were showing it off to me and look at these beautiful operating rooms, and never in my mind could I have thought 15 years later, this is what it would be like. Yeah, I've never seen those rooms too going. First of all, those are really cool operating rooms back. I remember seeing that and go, wow, if I was a med student now, like this would be a really fun place to, you know, spend time, spend my career. But, uh, but yeah, and here we are growing out of it, you know, yeah, which is great. So a great organization to be part of. Really is, really is. And everybody I hire keeps saying that to me. So yeah, it's cool. Great. Well, thank you so much for spending your time. We know you're super busy, especially right now. Um, I appreciate you coming out. It's my pleasure. It's actually, it's an honor to take a, take a minute and think about what's happening. And until we have something like this, you don't, you're just nose the grindstone. You just one email after another, 11 interview after another, you know, but this was nice to take a little beat. And think about everything that's happening. Cool. Thank you so much. This has been Physician Huddle by UCI Health. Thank you. This was an episode of the Physician Huddle podcast by UCI Health, produced by Brett Shaheehan, Angelica Yagubi, and Victor Ting. For more episodes, information on clinical trials at UCI Health, or to refer a patient, review the show notes or visit clinical connection. UCIhealth.org. Created by
