Part One: Restoring Trust in Healthcare

Intro (00:01):
Welcome to Health Law Talk, presented by Chehardy Sherman Williams Health Law. Broken down through expert discussion, real client issues and real life experiences, breaking barriers to understanding complex health care issues is our job.

Conrad Meyer (00:21):
And good morning. Good afternoon. Whenever you’re listening to this podcast, welcome to another edition of Health Law Talk here at Chehardy Sherman Williams. Conrad Meyer here behind the microphone, and giving you the best and greatest of healthcare compliance, discussion, regulatory, and just o overall social issues, dealing with healthcare in the in the United States. And today we have a really, really good set of guests on our show that we’re gonna talk about a multi-part series here. It’s gonna be Restoring Trust in the United States Healthcare Delivery System or the United States Healthcare. And, and I, in that context, I have two healthcare executives on the podcast show David Laird and David Bryant, who I’m gonna introduce now, who are really expertise in their field and have agreed to come on the show to talk about this important topic. I’ll take it to David Bryant. First. David Bryant, introduce yourself and tell us a little bit about your background. Sure.

David Bryant (01:18):
Well, I’m glad to be here. I’ve been looking forward to this. Yeah, I was a praying as a hospital administrator, and I’ve been at it now, and I can’t believe this for about 30 years in and out. But my formal background was in hospital administration and worked for several companies on the administrative front. And then I worked also doing mergers and acquisitions for a publicly traded hospital company as well for several years. And so, you know, it, it’s interesting just with that experience having, you know, the optics that both David Laird and I have to kind of look at what, what’s going on within, how our response was to the pandemic mainly, and what we can do good, what we did, you know, medium, what we did bad, and what are we gonna do next time. So anyway, that my, my experience is in that, is in that, that space in the executive c-suite of hospitals, typically.

Conrad Meyer (02:18):
Nice. Nice. Well, that’s very good. We’re very happy to have you on the show, and we’re looking forward to this, this wonderful, I think, timely discussion. And and then of course, I can’t forget about David Lair. David tell us a little bit about yourself and, and your background and, and, and what you what you intend to discuss today.

David Laird (02:36):
Hi, Conrad. Thanks for having me. I appreciate the opportunity to, to be with you and to talk about these issues. I have been in healthcare administration for almost 40 years. Started in healthcare administration straight outta college, and worked my way up through the executive ranks in the first two thirds of my career in hospital finance being, working my way up to chief financial officer. I was chief financial officer of three different hospitals, and then became regional chief financial officer, overseeing 10 hospitals in that role. And then ended my career with a tenure of 16 years being hospital ceo. And I retired from full-time work last year. I do a little bit of consulting. Now I’m on the board of a couple of organizations but have had my entire healthcare career in hospital executive management.

Conrad Meyer (03:36):
Well, that’s great. I I it’s obvious from both of you that y’all are both well-versed in, in hospital administration, and I could, you know, obviously that’s a, that’s a big deal. I, I, that was some of my former history when I was going through this years and years ago. And, and so I thought this was a very, very timely and good topic that we can discuss about basically I think the public’s and, and even some providers, I mean, within the provider ranks of the, of the mistrust or the you know, the, the motives right. Of, of healthcare in the United States. And so with that, I’d like to kick it off very much, you know, to either one of you. What do you see what’s going on in the healthcare delivery system in the United States and, and especially now through, through the pandemic issue? What, what, what’s been exposed? What are you guys, what are you guys seeing?

David Laird (04:27):
Well, I’ll tell you, I will kick this off with one of my favorite things, and then I’m gonna let David kind of take it away. The United States does not have a healthcare system. We have a healthcare industry, and that has served us well in some regards. But completeness and comprehensiveness and overall wellbeing of, of citizens in United States isn’t one of the primary criteria for an healthcare industry. And so, you know, during, during times of crisis, you basically don’t have one voice in the room. You’ve got all kinds of people trying to do what’s best for their organizations. And, and so I like David Bryant idea of, of taking this in the direction of restoring trust in the healthcare system as it were, because we, we essentially have never been more divided and kind of do not think that things were all done in our best interest.

(05:29):
So with that, I’ll I’ll pause and, and throw it David’s way. Yeah. Now, I can not segue off of that as one of the, as I was kinda thinking through just taking a look at just today and where we’ve, where we’ve gone, where we’ve, we’ve been, and David’s so corrected that it’s as divided as ever. And I wanted to look at it from, okay, if we, if we went through this again, let’s just say we had another nasty virus that we were dealing with and, you know, having to respond to it. And I think I would say the same as many providers would, is that if we looked at the communication downward from our public health system, I would say that broad term, and that would include, you know, everybody from the White House to the CDC to nh, et cetera, is if you go back in time, a couple years, I dunno how long you’re back, but starting at about four o’clock central time, you have the White House coming on with four or five experts behind them, you know, clearly hadn’t huddled on the message very well. And so, and then, you know, it morphed over to the, the press that it was a very fragmented conversation about what we were doing, what we should do, what happened, you know, all the things that the public really needed to, to know.

Conrad Meyer (06:52):
And we’re talking about the covid in March of, what, 2020, or was it

David Bryant (06:56):
2020? 2020, right. Okay. 2020. Yeah. Okay. That, that was when the, that, that was in my, in my world, that’s when was when the kinda the chaos started. Right. And so what cause of that communication, that fragmented communication, we had a lot of fear, anxiety. You didn’t, it depended on many, many factors. The, the messaging was not very consistent. Mm-Hmm. , and it wasn’t comforting at all. And so and then when it got so that it, from the very beginning, that was a little messy. And then as it got politicized, which made it way worse in terms of that messaging, cause then you were having people attached to one or the other side, and you weren’t getting at the, at the, at the problem. You know, for me, this wasn’t a political matter. This is a public health problem. And I think those of us in the industry, that’s kind of where you go, you go, let’s, let’s work on the public health issues.

(08:02):
And that involves a ton of different aspects, which is, you know, how do we respond to it? What do we identify that as disease? And what population is it? Is it affecting? It’s just a lot of the things that, you know, you would do. And it just seemed like it got for a long, longer period of time than I thought you know, just and this political football back and forth. You like this, you, you’ve got, you’re on this team, you’re on the other. And, which is kinda silly. I mean, when you look back at it, it’s kinda ridiculous. But that’s where we were. And we probably still are to a certain extent, although I think that settled down a little bit. Mm-Hmm. . So I say all that say I would really encourage, and I don’t know that, I certainly don’t have all the answers, answers, it’s a complex question. We’ve gotta get this system streamlined to where this, this communication is. We have a plan with which to communicate as a single voice and, and to the extent that we can’t keep it outta the politics. Cause that does nothing.

Conrad Meyer (09:02):
And I guess, I guess, okay, you’re referring to the Covid message that came out from the White House back in March. And, and, and of course the, the mixed messages that we were getting at the time. And, and, and sort of how do we create sort of a top down communication style? Is that what you’re referring to?

David Bryant (09:21):
That, that’s exactly it. And, and you know, again, we were in a chaotic time, and so to have all this just, I can be very, you know, idealistic about this to say, but we, we’ve gotta get we’ve gotta get a singular voice out of the public health officials that can speak to this and that can, you know, they’re not all gonna agree ever. We know that. Do, do you, I I would really like to say that I’ve got, I’ve got an interesting hot take on this. Yes. I think our system in America is based upon capitalism and mm-hmm. , we did the exact right thing, I think, with asking individual cor corporations entities to come up with their best shot for a vaccine. And of course, the mRNA vaccine technology was the newest, latest and greatest. It, it was 10 years in development, but had not been used on a wide, wide scale until this event.

(10:17):
And so it, it almost is this inherent kind of conflict that being not being able to have one central voice because you had different, different formulations of a vaccine. I still contend that the only way we can look at this is through the prism of the information we had at the time. Cause you, you work with what you know at the time and, and, you know, it’s easy to second guess years later. But working with what we knew at the time, you know, we had seven different companies trying to make a vaccine that would work. And so I liked the, the incentive that we built in to have different companies. And yet I think that hindered the government’s messaging because there wasn’t one thing. And then, and then ultimately you had this individual liberty argument of people saying, you know, the government can’t tell me what to do.

(11:10):
And that’s right, that’s what we have in the United States. But we had no limits that were established or kind of even a framework agreed to on if somebody chose not to get vaccinated. You know, did they have any herbs in their rights, their access to society. So it just, it’s a fascinating thing. I’m kind of more on the pro-vaccine side. I’m not, I I, I continue to think it probably saved lives. And yet a lot of people, many people in our country now think that it was a conspiracy theory and there’s, you know, all kinds of negative things that happened as a result of the vaccination strategy. I just think that’s mostly that it has, has conspiracy theorists gone wild in retrospect? But there’s, there’s vaccines that have prevented a lot of disease in the world, and I don’t think you could just wash that across and say that vaccines are, are negative and bad. So I’ll pause there for you.

Conrad Meyer (12:11):
No, no, no. And I think, I think that’s all a a good point. And let me just ask you this. Okay. So I, because we’re focusing on the dissemination of information regarding the Covid response, and, and I wanted to ask, was there, and that’s sort of exposed sort of this, this, this sort of fractured viewpoint between varying agencies and even individual providers, et cetera. But was the, you know, was, do y’all believe that that was the first time this sort of fractured viewpoint sort of exposed sort of a broken or really what you, to your point, layered that it was a industry, not really a system? Or, or had it been, you know, has this been going on for quite some time, not with respect to Covid. Right. But before that, I mean, has, has this been a broken system before that, or did it just sort of appear post covid?

David Bryant (13:03):
So I, I think we’ve had the bones of this for a while that never got resolved with universal healthcare, essentially, that we we’re pretty widely divided on whether the government should provide healthcare in the United States. And there are people who can speak more eloquently than me, but we’re the largest nation of the top 22 that doesn’t have a government provided healthcare system for, for every individual. And so we remain the kind of the outlier in that regard. And so even the fight for Medicare and Medicaid and, and all of that, you see this state’s rights issue. So it, it becomes complicated that we can’t even get agreement on how you provide healthcare and how you deliver it to the citizens. And then we layered this, you know, once in a a hundred year event on top of it, and it just, it kind of made people go into their particular points of view corner about Yeah. What the response should be. So I, I think we’ve, we’ve not resolved healthcare in the United States. We’ve actually made the camps more entrenched of whatever viewpoint you had.

Conrad Meyer (14:15):
Now, some would say, I’m sorry, go ahead. David. David Bay.

David Bryant (14:18):
No, no. Was just agreeing with that. And that, you know, this, this again goes back to this virgin territory, and we got tested, and I just don’t think we were, the structure of our, our system top to bottom was not optimal for this for the crisis that we had. And so, in the spirit of trying to be, be more prepared for next go around the open dialogue that needs to happen between providers, you know, I also felt like the, our physician patient were kind of thrown to the side. And even when the, some of the physicians were asking questions, it was like they were quick to be almost silenced and not really given a platform to keep, keep an open dialogue. And I think that really hurt us in the, in the long run too how they were kind of corralled, which really surprised me. But anyway, go ahead, Conrad.

Conrad Meyer (15:12):
Yeah, I think I, so let’s, let’s talk a little bit about that. Okay. And to respond to, to some of this, now I’m gonna play devil’s advocate here. So some would say aca, the Affordable Care Act, was the solution to universal coverage and, you know, with, with ACA and the sort of state exchanges, et cetera. And we’re not gonna get into the whole how that works. Yeah. But, but that, cuz that’s a, that’s a, that’s a very complex issue, but that was the solution to the universal coverage. And I just wanted to get your thoughts, both of you on, you know, because that’s what some would say. Some would say, wait a minute, we do have something, and we do have the charity system and we do have some things in place. How would you respond to critics who say, well, wait a minute before we take that leap, you know, ACA did, did answer that call. How would y’all respond to that?

David Bryant (16:05):
Yeah, David Laird, that might be best in your wheelhouse, but I do have some thoughts on that. Well, Conrad, Texas, I live in Texas, Austin, Texas, and it’s interesting that still 10% of Texans are not covered by health insurance. And so it, it’s a suggestion of the system to say that everybody’s got coverage now. And the fact that you can’t access mental healthcare services even through most of the ACA products, I would, I would still contend the ACA might have been a start, but it really is for people that couldn’t get coverage in a lot of other different ways. Mm-Hmm. different avenues weren’t eligible for Medicare, Medicare. So it, it still has a lot of holes in that system and it, it is not coverage in the way that most nations develop nations think of a healthcare coverage vehicle.

Conrad Meyer (17:01):
Got it. Okay. Yeah,

David Bryant (17:03):
Yeah, yeah. Yeah. And I, I, I don’t know that I have much to add to that between Medicare and Medicaid. This is probably looking at a global, you know, we, we cover, what is it, 70, 75% of the, of the people between those two programs and then, and then the balance of it or the, or the you know, commercially insured population and then the 10% that David was just referring to. So, I mean, we’ve got a, we, we’ve, we’ve got, there’s definitely holes in it. And that’s been a, that we’ve had this conversation for as long as I’ve been in the business. I think, you know, it’s how us solve that.

Conrad Meyer (17:43):
Well, and it’s the coverage versus access, right? I mean, and we can go into that and, and I think, you know, cuz this is, look, this whole topic that, that we have now, you know, we’re gonna dedicate some, some time to this on this multi-part series is so complex. It’s got so many facets, you know, so many different players that I don’t think anyone can even cover it. You know, I mean, in a single, you know, this is too complex, too many players. I think you’re right. You know, and so that’s why I wanted, this was a great topic that I have to, you know, tip my hat to both of you because I think it’s, it’s, it’s so important and something that, that I hear on a daily basis, even even from my standpoint as a healthcare attorney. So let’s, let’s kind of delve into that.

(18:27):
So when you get into coverage versus access, and I’ve been saying this since aca, you know, you got coverage, but do you really have access? And, and I think there’s a, cause those are two different points, right? Yeah. What do y’all, what do you guys see in your facilities with respect to that? Is that something that y’all can talk about? I mean, what do you think about that with respect to, and we’re going to circle back to the covid pandemic on the message, but I just wanted to talk about the coverage access. Okay. What do y’all think about that? Yeah,

David Bryant (19:01):
Yeah. Well, I mean, I’ll throw in a thought. You know, I live in Houston, massive medical center here. And you know, the, on the access side of it you know, you’ve got your public hospitals that are, in our case, bento, that you know, in, in situations you can, you know, access it there. It’s not, I’m sure it’s not ideal for, for anybody, frankly, but, you know, we’ve got, we, we’ve got, we have that somewhat covered in terms of, you know, just care rules that have been put in place that, you know, patients can’t get turned down, et cetera, et cetera, et cetera. But but so that would be my comment on the access side. And I don’t know if that’s on completely on topic or where you’re going on that, but

Conrad Meyer (19:49):
It, it, it, it doesn’t have to be, I mean, I, I mean I, I’ve always, the problem I had and, and I’ve seen it in on the legal side, right, has been you got coverage under ACA through the various exchanges, right? But then do you really have the access because you see more providers opting out of Medicaid and opting out of Medicare for these concierge practices? I mean, I don’t know if, were y’all seeing that in Texas? Was that happening in your area?

David Bryant (20:16):
Yes, absolutely. Yeah, for sure. I I can you, my specific example, without giving too much of my own information, I retired not eligible yet for Medicare mm-hmm. . And so the products that are available in the open market after I’ve been paying insurance premiums for my employer for the past 38 years, you essentially, I can get one of those products you mentioned on the ACA and then have almost no doctor that I currently see my, me or my wife providing service on any of those plans that are available in my geographic area. So there is coverage that you can get and pay for. But really access is a whole different issue. Right. And, and the point you’re making, I just would say there’s a huge disconnect and it’s why there’s not portability. A lot of people are keeping jobs that they have because of their, their benefits package, which includes insurance. And I, I think we would’ve a freeing up of a lot of employees who would change jobs, new jobs if they didn’t risk losing healthcare cause of it.

Conrad Meyer (21:28):
Right. And, and migrate. And that’s, look, that, that’s a whole, you know, we can talk about that’s a whole that’s a whole nother spinoff on, on access and coverage. That, that I think we can get to and we can make it part of the series if you’d like. But I think it was an interesting point to make because of your comment, Laird, about industry, healthcare being industry and, and, and so industry, like you mentioned, doesn’t care. Like, in other words, it’s, it’s, it’s sort of, its on its own island. Each facet of that industry is on its own island. So you’ve got facilities who are competing for their facilities or systems competing for their own systems or groups competing for their own groups. So there’s no, there’s no sort of unified, you know, goal here. Everyone’s out for themselves. And, and I mean, am I correct on that? Is that how you guys are seeing it out in your area?

David Bryant (22:21):
That’s exactly it. That’s what spot on to do. Yep.

Conrad Meyer (22:25):
Yeah. And, and, and to, yeah, I mean, yeah, go ahead.

David Bryant (22:29):
Well, I mean, it’s as competitive as it’s ever been really, is that, you know, all you have to do is pick up a, any newspaper Houston’s is crazy competitive. And we’ve got big massive systems here but it’s very, very competitive. And that wanna, you know, wanna wanna be number one. And so, and which probably serves the consumer, the pace is pretty good. But, you know, it’s, it’s, it is an industry that is competitive for the best people to not only in management, but on the floors. So yeah, it’s, it’s, it’s a it, it’s definitely an industry and it’s, it’s difficult to, that’s always been a diff you know, to distinguish when you’re dealing with human lives and patient care and patient’s rights and, and then, you know, stockholder concerns and et cetera, et cetera. It’s always been kinda a you’ve always had to straddle that line. And I think we’ve done a pretty good job with that. But I, it, it still is kind automatically a little bit wonky.

Conrad Meyer (23:35):
Yeah. And, and, and that goes to, so when you’re having your competing interest, right, you wanna be the number one yeah. As you, as you stated. So that to me, I mean, that, that’s, you know, does, does that put, you know, and I guess here’s a, here’s a good quote. Lemme see how y’all like this profits over patients. I mean, if I say that term profits over patients, does that, yeah. You know, in your mind sort of, you know, even if you don’t wanna publicly say it, I mean, does that sort of ring a bell? Like, man, I can’t tell you the, you know, the opinions I have on that, but, but I’m saying, does that sort of feel like, is, are providers in, you know, and you don’t, if you’re not comfortable answering this, that’s fine, but does, does profits over patients seem to be where most people view our healthcare system? What do y’all think

David Bryant (24:24):
This is, Larry, I’ll come. Yeah, yeah, I’ll come in. I think profits over patients absolutely is the thing that we have to overcome. And whether that’s mm-hmm. Guard rails by regulations, regulatory kind of issues, or even some within the industry. So I’ll say that the best providers in healthcare, physicians, hospitals, health systems, and even insurance companies are those that take the long view and are in indeed interested in, in distinguishing themselves in the marketplace on their quality, their outcomes. And so I would say I, I’m proud to say every organization I ever worked for was trying to differentiate itself positively on quality and outcomes. And so if you do that, the long term is that you continue to positively set yourself apart and, and hopefully attract customers, patients to you. The short term implication of that is whether it be a, an insurer or hospital or anybody else. Yeah. The, the financial viability and profits is the word you’ve used. Is it, it’s a topic that’s impossible to ignore. And I’ll, I’ll throw one thing, not to get us off on a side conversation, but think about the early days.

Conrad Meyer (25:46):
It’s kinda hard not to, no, it’s kinda hard not to in this kind of conversation. It’s so, it’s so far. It is, it is very wide here. But go ahead, I’m sorry.

David Bryant (25:53):
Well, no, that’s right. In the early days of the pandemic mm-hmm. , you essentially market forces people started retiring, getting outta the industry, didn’t wanna come back to work. You think about nurses who were on the front lines, whether that’s an emergency department, surgery department. Think about all of those, those fear issues that those frontline caregivers had in those early days of a pandemic. Mm-Hmm. . Cause most of us thought if we got, if we got the virus, we might die. There was that level of fear. And so the issue becomes, you know, what is safe staffing and how do you ensure that if you don’t have 20% of your workforce, which was a very real number for most hospitals, do you then limit the services you provide? What do you do? It has all kinds of real practical implications for how you then run a service.

(26:51):
You, you could have paid, you know, tripled the wages and still not had all of the labor that you would’ve, you know, liked to have had back in those those days. So I’m circling back to around the point does, does profit or, you know, in a lot of cases just financial viability play a role and, and most, most of the time a central role in the provision of healthcare. I would say it does in our system, the way we provide it. So I’ll pause there and let David Bryant. Yeah. You know, I’m thinking, and I think this is some good perspective to have some guys really on the front line like David later, that were having to keep a hospital open. I believe there was some pressure, particularly at his facility at the time on, you know, postponing elective surgeries and, you know, all kinds of challenges.

(27:45):
You’ve got a nervous staff you just did, and they were trying to do the best for themselves and yet come to work every day and, you know, help get us through this. But yeah, what happened back in the c-suites during that time was not easy. And although I wasn’t technically in the hospital management during the pandemic much, but it was the challenge to kind of keep the, keep the floodwaters at bay when there were just so many challenges. And one of which was the, you know, stuff, going back to the original topic that we were talking about, was the messaging that was coming out to the general public. Cause if you look at it the way, there was a long period of time where you, you thought everybody was exposed to this, including children and everything else we know better now.

(28:34):
It was focused on, on a pretty, fairly specific, a few outliers, obviously specific population. And so having to manage all of that and not knowing the, the you know, what, what was the next surprise out of the actual virus really, really created some, you know, took some, some good patience and ma and making some good decisions, you know, with your entity to kinda keep everybody safe and happy. But anyway, that’s, that’s, that’s what went on in a lot of the C-suites, was just trying to figure out this, that, and the other. And, and really, you didn’t know what the government was gonna come out with. I mean and this is a whole other topic that we may have to have separately too. And David la and I talked about this, and when they threw the mandate card out there right, that created another, you know, kind of a mess. And, you know, trying to see where that was gonna go. I guess that kinda settled down now. But, you know, that was a good example of, you know, what are we gonna do if nurse so-and-so doesn’t wanna get a, a vaccine? You know, how are we gonna deal with this? And now, and the systems dealt with that differently. Some were very, very harsh, some were very lax on it and didn’t, didn’t, didn’t make it a real, real onerous thing. Yeah, I saw,

Conrad Meyer (29:59):
Saw, I saw that that hospital in Texas, it was in your area where they fired, what, 600 nurses, or I mean, some, some astronomical number because they refused to get the vaccine. You know,

David Bryant (30:10):
Yeah. There, that was, it

Conrad Meyer (30:13):
Was, it was, what,

David Bryant (30:14):
What’s that? Well, yeah, Conrad, that was, that was in the city that I live in. Oh. And you know, that, that became a, a, a kind of a secondary issue of your company’s rights versus an individual rights. And I’ll just come in on this as well. I think a, a company does have the right to determine the criteria for working at that system. People may not like it. And, and this is where this individual liberty argument kind of came in of, of what Trumps want, but mm-hmm. in our capitalistic society, I think we, we give employers certain rights. And a TB test is one of those, you, you have to be screened for TB if you work in most acute care hospitals in, in the United States. And people just have, have taken, have had that understanding and basically gone along with it.

(31:07):
But then all of a sudden now you had covid kind of have people question what the rights of those employers were. Mm-Hmm. . So I, while I may not like it, and, and my organization had a, a kind of a softer approach to that mandate. I absolutely respect the rights of employers to determine that if you wanna work at that organization, because they thought that was what was best to keep patients safe who came into their care. And, you know, again, the side road, you saw what happened in New York with the nursing home. Patients were active, patients were sent back into nursing homes, and one of the highest death rates in the United States. And so I, I, I do think there was a real implication with lives having people not being protected yet by the vaccine. So I kind of would wrap this up in saying the, the point of saying this individual liberty question, not having a health insurance system health coverage system, really, it just became this swirling mess.

(32:20):
And you had to find kind of a home base of your argument where you, on individual liberty trumped everything, where you, the government had the right to tell you, now you injected, well, companies now have a say in do don’t, they could just get out. They could opt out, they could not be employed. They could, they could not have, you know, some things that were accessible only to other people, but it just became this mess. So there, it, by definition, you couldn’t have one central voice from the government. Cause they, the choice of individuals remained throughout that whole process.

Conrad Meyer (33:05):
And, and, and that goes back to, to, to both of your comments about the one individual voice, right? Because you, I think all of us saw that there were people trying to get out, I guess, different voices, if you will, right? On different platforms that were basically censored. They were taken off. If you didn’t, if you didn’t talk, you know, the the talk or walk the walk, or if you weren’t speaking government language that they felt acceptable, suddenly you were just disappeared. You were taken off John. Right. And I think you know, more of that, whether, you know, some people would call it conspiracy, whatever, it doesn’t matter. I think, you know, the point of, you know, being able to voice your opinion, whether you like it or not is one of the founding principles of the country. And so, you know, you, you, I agree with you in our constitution, right? So, so I agree with, you know, how do we manage that? You know, who, who’s, you know, should people be left to their own accord, to judged for themselves, who to believe and who not to believe? And, you know, how do you manage that? That’s a, thats a big mess. That’s a tough one. Real tough.

David Bryant (34:10):
Yeah, that’s a tough one. Real, very tough. And, you know, that, that, that was one of the things too that concerned me a little bit and as we went through this, is even our physicians weren’t really allowed to ask a lot of questions. I don’t even, I don’t think I know a lot of different doctors that have different opinions on all this kinda stuff. But, you know, even asking a very basic question is particularly if it, if it surrounded the vaccines, man, that was really, you were really holding yourself out there and you’re kind of brave. It’s a lot different now,

Conrad Meyer (34:45):
I think. I think so.

David Bryant (34:46):
So our doctors, yeah. And, you know, now, which was different it was a kind of a change from when I was originally in the business a long time ago is we have some employed doctors now that I think that there was some autonomy that they may have lost. Maybe it’d be different. Maybe it would, and I don’t know. But I know there were systems here in Houston that were pretty heavy handed on, you’re gonna do this and we’re gonna also control your formulary of the drugs that you can prescribe, which Phi was a little overreaching. So th these are a part of the look back questions that, was this a good idea? Or what was it not? And you know, what, what’s gonna, what’s gonna work? And and the conversation that we’re having now is an important one to really objectively take a look at, you know, the moves that we make next time. So,

Conrad Meyer (35:38):
And I, and I think also too, some of the things, I think communication, right? Coverage, access, yeah. Right. Outcomes, measurements, and quality as as, as sort of the primers for reimbursement reimbursement itself. Yeah. The players in the game, meaning not just providers, but we’re talking about payers, dme, biomed, pharmacy, all of the industry players, right? And and so when you get all that stuff, I think, I think we can really have a lot of different topics for conversation that could open, you know, at least give people more information as to sort of your background and what you’re seeing out there with respect to these topics. If, you know, if we continue down this road on this, on this, this multi-part series, which I think is very, very important, I think it’s great that you guys have decided to come on here to do this, you know?

David Bryant (36:34):
Well, I think, I think it’s clearly a very complex, you know, topic that we’ll we’ll be on. But again, I think it’s a vital subject to, to, to be, to be tackled. So I’m glad to be on to, to expound on the earlier point, I said I think we did the best we could, oftentimes with the information that we had mm-hmm. at the time. And now in retrospect, there are probably many things that we would do different. And I think maybe covering some of those aspects in in the future discussions would provide some value as well. Cause I agree with your point about, even though people mistrusted the government and sometimes had this strong distrust of the government messaging, I think we did a very poor job in retrospect for communicating a central message, including, you know, the highest levels of, of our elected leaders. If there would’ve been a little bit more of a consistent message, I think we would’ve had a better chance of getting some consensus about our approach to what we were going to do.

Conrad Meyer (37:43):
Very good. I I, and I agree with that. I don’t agree with that, Greg. So I’m gonna wrap this up, gentlemen. I think, I think we’ve sort of laid the groundwork for really what what could be some really interesting episodes down the road on these various topics. So I would like to, to thank you David Bryant, David Laird, both of you, for coming on the show today and sharing your expec expertise with the with the audience. And I think we’ve, we’ve sort of hit sort of the nail on the head in terms of, wow, what, what could we enlighten our listener base with respect to, you know, reinvigorating trust in our healthcare industry or healthcare system. Right.

David Bryant (38:23):
Right. He, I think it’s a, it’ll be a very interesting journey.

Conrad Meyer (38:28):
Well, fantastic. Well, everybody, y’all sit tight. We are gonna end this episode now on Health Law Talk here at Chehardy Sherman Williams. This is Conrad. We thank you for listening and look forward to our next episode. Y’all have a good day. Take care now.

Intro (38:43):
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