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Imagine this. You're at the Hyatt Regency Chicago

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immersed in insightful discussions with the health care

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industry's top leaders.

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Welcome to Becker's 12th annual CEO

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and CFO roundtable from November 11th to 14th

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2024.

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Picture yourself networking with over a 1000 executive

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level attendees,

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Feel the excitement as you engage in 4

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days of sessions featuring 400

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elite health system speakers.

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Envision yourself diving deep into critical topics like

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rural health care, digital transformation,

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health equity, and c suite diversity.

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Now imagine being inspired by our celebrity keynotes,

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pro football hall of famers Troy Aikman and

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Emmett Smith, 43rd president George w Bush, and

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author and journalist Jenna Bush Hager. Their stories

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Don't miss this unparalleled

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Get registered today. Visit beckershospitalreview.com

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and click on the events page to find

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the conference website.

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That's the beckershospitalreview.com

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events page. See you in Chicago.

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This is Chris Sosa with the Becker's Healthcare

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podcast.

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I'm thrilled to be joined by Peter Baker,

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senior vice president and administrator of Loma Linda

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University Children's Hospital. Peter, thank you for joining

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us today.

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Thank you, Chris. Pleasure to be here.

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Excellent. Could you please introduce yourself for

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our listeners who do not know who you

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are and tell us a bit about your

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background? Yeah. I'd be happy to. Well, yeah,

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I serve as the administrator and and and

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and chief executive for the children's hospital here

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at Loma Linda. We're about a 365

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bed children's hospital located in Southern California,

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serving about

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a 5th of the land mass

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of California.

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And,

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a little bit about myself,

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I am am an attorney, by background,

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and thought I wanted to go to into

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law. But, you know, as I,

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developed my own

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pathway,

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realized, you know, I really had a a

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a a desire to get into business,

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and actually found a lot of enjoyment and

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satisfaction

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in in building relationships and collaborations and really

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finding ways to kind of engage communities.

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And from that, I actually ventured into into

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health care from that out of a random

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interaction, with a health care executive.

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And,

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I've been on that path, for the last,

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15, 20 years,

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serving in various roles, mostly in business development.

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Actually, it's where I I as I mentioned,

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I I have a joy in in finding

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ways to collaborate

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and and build new services for for various

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communities,

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and and and collaborating with physicians and did

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that for

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a large portion of my career and then

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got into running hospitals, ran a, a,

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adult hospital,

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at Loma Linda University Medical Center Marietta,

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for about 6, 7 years. And then,

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during that period, I got married,

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and my wife is a pediatric

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oncology nurse.

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And, I was working at Loma Linda Children's.

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And when the role came up, they said,

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hey, Peter. You've got some family that's here,

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and I think you do a great job

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serving and end up being a great collaboration.

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So I've been fortunate to to leave the

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Children's Hospital here for the last 3 years,

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and grateful for the opportunity to serve.

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Peter, thank you so much for elaborating on

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that. I am interested a little more in

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this random interaction you have with a health

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care

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provider or person in the industry. Could you

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describe a little bit more about that? Yeah.

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I I, at the time, I was at

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a wedding, and,

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there was a CEO for,

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Adventist Health, who I ended up meeting and

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and talking with. And and

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Adventist Health is a is kind of a

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sister organization of Loma Linda.

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And they introduced me to to to hospital

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administration and,

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thought I might be a good candidate,

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to be part of their organization. Not something

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that I thought about, and had a great

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conversation about, you know, all the things that

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go into health care, and really realized, you

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know, that was that aligned with with who

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I am as a as an individual and,

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ended up being a better career path. And

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they reached out a couple weeks later and

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kinda got me plugged in, and the rest

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is kinda history from there.

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Wonderful. It sounds like you're very happy that

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you landed at Loma Linda for sure. And

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so in that context, what do you think

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are your priorities for

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not only yourself, but Loma Linda University Children's

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in general?

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Yeah. That's a great question,

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Chris.

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You know, for me, a big priority is

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just access to pediatric services.

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You know, there's some changes going on in

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our industry,

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particularly as it relates to pediatrics and OB,

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services and maternity services at at,

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in in health care.

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In particular, our region, there's a lot of

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community hospitals that are closing their pediatric services

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and OB services. I heard of another one

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just this week that is in our region

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that's closing their

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OB services. So for me,

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you know, there's a there's a huge focus

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on

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giving the capacity

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for pediatrics,

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for have making sure we have enough OB

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OB and pediatric beds to meet the demand

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in our region,

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as as more community hospitals,

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focus more on on adult care services.

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So that's one of the key priorities,

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and really improving throughput and

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responsiveness to community hospitals so that, you know,

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they can, the the patients they need to

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come to our hospital, we we are getting

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them here very quickly. The second priority for

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me,

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is really kind of expanding new service lines.

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Behavioral health and mental health,

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is really a focus as well. More and

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more

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children,

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especially through the COVID and the and the

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pandemic,

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recognize challenges as it relates to mental health.

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They're really

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exponentially

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increased,

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need for

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inpatient and outpatient services

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for these kids.

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And especially in our market, you know, we

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just see that as the fastest growing

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inpatient need in our region. And it's really

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sad. You know?

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It's really sad to see that. Unfortunately, more

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and more kids are being affected

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by this.

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But so we feel a huge desire to

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expand it. We're building a new, what we

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call a crisis stabilization

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unit,

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which is really to support

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kids who come to our emergency and really

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just need short term, you know, medications

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or or just a quick

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treatment versus an inpatient stay.

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And so we're building that out as well

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as we're building a new 49 bed

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inpatient

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behavioral health unit as well. So

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those are some of the things we're doing

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as well as just expanding our peds, services

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to

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accommodate, you know, some of the closures and

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other things that's going on in our in

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our region.

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Peter, as you and your team ponder all

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those priorities that you just laid out, how

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how do you see the next 18 months

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or so playing out in terms of meeting

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the needs of the community and your own

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organization?

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Yeah. I know. That's a good that's a

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that's a great question.

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You know, one of the things we are

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really focused on the 8 next 18 months

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is is really access to to care in

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the outpatient setting.

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And so we're also gonna be growing that.

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I'm I'm focusing on building a new specialty

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care medical office building, about a 5 story

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building where we're kind of consolidating all of

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our specialty services is in in one place,

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as well as finding ways to kinda reach

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out all these different communities with pediatric

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services.

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Pediatric urgent cares,

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outpatient clinics

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is really gonna be something we're hoping to

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open up more services in the next 18

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months or so. So that's that's one.

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I think we're also trying to find more

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creative ways to work with our payers.

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You know, in California,

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payer dynamics

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continue to change.

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It's going from a fee for service

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world to more of an HMO

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world. And so,

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finding ways to to align incentives and and

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and support

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that capitated model is is a key focus

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of ours as well.

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And then maybe the last thing is just

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really a strong focus on advocacy.

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You know, kind of the sad part of

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pediatric,

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is is just the lack of

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physicians that are going into

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pediatric subspecialists.

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You know, across the nation,

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only about 50%

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of pediatric subspecialty

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slots are being filled.

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Unfortunately,

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you know, physicians are choosing other

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areas to go into,

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for their training than pediatrics

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and pediatric subspecialty services.

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You know, a big aspect of that is

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is reimbursement for physicians. And so really working

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with, you know, our our states and federal

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government on how do we make,

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you

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know, care, whether you're a pediatrician

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or an adult practicing physician, equal.

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And unfortunately, we're starting to see the the

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fruits of,

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unfortunately, lower reimbursement for

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for, pediatricians,

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playing out as just we just have less

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providers.

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And so we're hoping to see if we

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can advocate stronger for that, tell the story

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of, you know, the the huge need we

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have in pediatrics

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and why,

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are we need to invest in that. So

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that's that's a big focus of mine,

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and our and our teams as well.

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Peter, thank you for expounding on all that.

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I'm glad you mentioned some of the challenges

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that you're facing in pediatrics right now with

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respect to the subspecialists and not being enough

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of them. Is there anything else in the

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industry that's making you nervous right now?

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Yeah. I,

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I think just broadly

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advocating for

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pediatric

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services and and care. In in California in

278
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particular,

279
00:10:15,910 --> 00:10:17,769
you know, we've historically had challenges,

280
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with pediatric reimbursement.

281
00:10:20,995 --> 00:10:22,855
It's been stagnated for the last

282
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12 or 13 years.

283
00:10:25,154 --> 00:10:26,595
You know, a lot of what we do

284
00:10:26,595 --> 00:10:29,095
in pediatrics, unfortunately with the high inflation,

285
00:10:29,475 --> 00:10:31,634
you know, continue to advocate for that. And

286
00:10:31,634 --> 00:10:33,335
and unfortunately that stagnation,

287
00:10:34,100 --> 00:10:36,519
as I mentioned, has caused a lot of

288
00:10:36,660 --> 00:10:39,160
hospitals to close their OB and,

289
00:10:40,420 --> 00:10:43,860
and pediatric services. And so, you know, just

290
00:10:43,860 --> 00:10:44,679
really advocacy

291
00:10:44,980 --> 00:10:46,980
around not only just the physician but the

292
00:10:46,980 --> 00:10:48,519
the hospital wide

293
00:10:48,865 --> 00:10:49,365
services,

294
00:10:49,904 --> 00:10:52,545
for for for increased reimbursement that keeps up

295
00:10:52,545 --> 00:10:55,904
with inflation is is a huge, huge focus

296
00:10:55,904 --> 00:10:58,625
of ours and and and ensuring that will

297
00:10:58,625 --> 00:10:59,125
allow

298
00:10:59,745 --> 00:11:01,860
us to just continue to broaden

299
00:11:02,480 --> 00:11:04,259
services throughout the region,

300
00:11:04,799 --> 00:11:07,700
in pediatrics. So that's a big one.

301
00:11:08,799 --> 00:11:10,179
And I think

302
00:11:10,639 --> 00:11:12,720
I touched on it. Obviously, we're opening behavioral

303
00:11:12,720 --> 00:11:14,820
health, but behavioral health for kids

304
00:11:15,514 --> 00:11:18,014
is another area where we see a lot

305
00:11:18,315 --> 00:11:18,975
of hospitals,

306
00:11:19,355 --> 00:11:20,254
health care providers,

307
00:11:20,875 --> 00:11:22,654
cutting services. You know,

308
00:11:23,195 --> 00:11:27,375
unfortunately, the pandemic has really challenged hospitals.

309
00:11:28,315 --> 00:11:29,695
And, you know, oftentimes,

310
00:11:30,190 --> 00:11:32,269
you know, as we've mentioned, behavioral health is

311
00:11:32,269 --> 00:11:34,190
one of those where you look at, you

312
00:11:34,190 --> 00:11:36,830
know, what's essential and sometimes that isn't as

313
00:11:36,830 --> 00:11:38,129
essential as some of the

314
00:11:38,509 --> 00:11:40,690
other services you're providing. And

315
00:11:41,070 --> 00:11:43,330
just making sure we have a strong

316
00:11:43,924 --> 00:11:44,504
sustainable model,

317
00:11:45,605 --> 00:11:48,004
for behavioral health because there's there's more and

318
00:11:48,004 --> 00:11:49,225
more kids who are,

319
00:11:50,084 --> 00:11:50,584
recognizing

320
00:11:51,204 --> 00:11:52,264
their need for

321
00:11:52,644 --> 00:11:54,024
for for treatment therapy,

322
00:11:54,644 --> 00:11:56,485
and there's just not enough providers to go

323
00:11:56,485 --> 00:11:56,970
around.

324
00:11:57,529 --> 00:11:59,610
You know, when you try to get if

325
00:11:59,610 --> 00:12:01,529
a child needs a psychiatrist, you try to

326
00:12:01,610 --> 00:12:03,850
they come to our emergency department, you know,

327
00:12:03,850 --> 00:12:05,789
oftentimes trying to to get them appointment,

328
00:12:06,250 --> 00:12:08,169
you know, can be a 2 month or

329
00:12:08,169 --> 00:12:08,669
longer

330
00:12:09,049 --> 00:12:10,990
challenge. And that's just not acceptable.

331
00:12:11,414 --> 00:12:13,975
You know, we got a child who's in

332
00:12:13,975 --> 00:12:16,475
in a bit of an emergency. And so,

333
00:12:16,574 --> 00:12:18,954
you know, ensuring we have,

334
00:12:20,134 --> 00:12:22,794
you know, psychiatrists, therapists, psychologists

335
00:12:23,509 --> 00:12:25,429
that and and individuals who wanna go into

336
00:12:25,429 --> 00:12:27,690
that and and the ability to,

337
00:12:28,470 --> 00:12:29,610
is really a critical

338
00:12:29,990 --> 00:12:32,710
need we have, and and and advocating for

339
00:12:32,710 --> 00:12:34,870
that is is a priority for for me.

340
00:12:34,870 --> 00:12:37,325
And and hopefully, that results in less hospitalizations

341
00:12:37,625 --> 00:12:39,065
in the end. You know? I think our

342
00:12:39,065 --> 00:12:39,565
hope

343
00:12:39,945 --> 00:12:42,105
is building out that outpatient means we get

344
00:12:42,105 --> 00:12:43,085
we get less,

345
00:12:43,465 --> 00:12:45,225
who end up coming to our ED because

346
00:12:45,225 --> 00:12:46,684
there's nowhere else to turn.

347
00:12:47,625 --> 00:12:50,585
So that's a that's another concerning area we

348
00:12:50,585 --> 00:12:51,404
focus on.

349
00:12:52,679 --> 00:12:54,519
On the other side of that coin, Peter,

350
00:12:54,519 --> 00:12:56,839
what right now is making you excited that

351
00:12:56,919 --> 00:12:58,360
to just to come to work every day

352
00:12:58,360 --> 00:12:59,899
saying, yeah, we get to challenge

353
00:13:00,279 --> 00:13:02,839
ourselves in meeting this goal, and we're going

354
00:13:02,839 --> 00:13:03,659
to do it.

355
00:13:04,285 --> 00:13:05,884
I, you know, I love working for a

356
00:13:05,884 --> 00:13:08,845
children's hospital. You know, I think, for me,

357
00:13:08,845 --> 00:13:09,424
you know,

358
00:13:10,044 --> 00:13:11,504
it's a joy to come.

359
00:13:11,884 --> 00:13:13,965
You know, it's for me, working in a

360
00:13:13,965 --> 00:13:14,945
children's hospital,

361
00:13:15,404 --> 00:13:16,144
the passion,

362
00:13:16,684 --> 00:13:17,345
of the

363
00:13:18,200 --> 00:13:19,100
of the clinicians,

364
00:13:19,480 --> 00:13:22,620
the physicians, the nurses, the the clinical

365
00:13:23,320 --> 00:13:25,559
the the clinical leaders here all just have

366
00:13:25,559 --> 00:13:27,879
just a a a much higher level of

367
00:13:27,879 --> 00:13:29,100
engagement and energy,

368
00:13:29,399 --> 00:13:31,419
I find, than some of the other

369
00:13:31,924 --> 00:13:34,004
opportunities I've had to work. And that just

370
00:13:34,004 --> 00:13:35,764
brings joy to me when you're all focused

371
00:13:35,764 --> 00:13:36,664
around really,

372
00:13:37,445 --> 00:13:40,584
lifting up children, giving them the best environment

373
00:13:40,644 --> 00:13:41,464
to get well,

374
00:13:42,164 --> 00:13:45,389
and and seeing them progress. And so I

375
00:13:45,389 --> 00:13:47,070
love coming in work to work. I love

376
00:13:47,070 --> 00:13:48,509
working with the people I get to work

377
00:13:48,509 --> 00:13:50,929
with. You know, I'm excited about the future.

378
00:13:51,629 --> 00:13:53,789
Despite some of the challenges we've got, we

379
00:13:53,789 --> 00:13:56,190
are growing significantly here at Loma Linda. You

380
00:13:56,190 --> 00:13:58,110
know, we're bringing a lot more services to

381
00:13:58,110 --> 00:13:59,409
this region, this community.

382
00:14:00,065 --> 00:14:02,625
So I'm I I get really excited about

383
00:14:02,625 --> 00:14:05,044
our expansion projects and our ability to

384
00:14:05,424 --> 00:14:07,205
serve more, in our region.

385
00:14:07,585 --> 00:14:09,904
And maybe the third thing I'm I I'm

386
00:14:09,904 --> 00:14:10,404
incredibly,

387
00:14:11,184 --> 00:14:13,205
impressed and excited about is new,

388
00:14:13,899 --> 00:14:16,940
therapies that are being offered as particularly gene

389
00:14:16,940 --> 00:14:17,440
therapies,

390
00:14:18,059 --> 00:14:19,040
you know, illnesses.

391
00:14:19,500 --> 00:14:22,240
One of which that affects our community significantly

392
00:14:22,460 --> 00:14:24,160
is sickle cell and these,

393
00:14:24,540 --> 00:14:25,120
you know,

394
00:14:25,865 --> 00:14:28,845
poor children, you know, have this blood disorder

395
00:14:28,904 --> 00:14:31,084
that unfortunately is debilitating.

396
00:14:31,464 --> 00:14:34,184
And there's new gene therapies that are just

397
00:14:34,184 --> 00:14:36,605
hitting the market market that essentially,

398
00:14:37,704 --> 00:14:38,204
allows

399
00:14:39,009 --> 00:14:39,509
the

400
00:14:40,129 --> 00:14:42,629
child to have, you know, infusions

401
00:14:43,089 --> 00:14:43,829
that essentially,

402
00:14:44,850 --> 00:14:48,389
change their blood DNA and sickle cell to

403
00:14:48,690 --> 00:14:51,345
treat it and cure it. And so that

404
00:14:51,504 --> 00:14:53,824
new therapy, while quite expensive, is coming on

405
00:14:53,824 --> 00:14:55,125
the market. And these

406
00:14:55,504 --> 00:14:58,225
individuals and these these children and these, that

407
00:14:58,225 --> 00:15:00,704
have been affected by it, are gonna how

408
00:15:00,704 --> 00:15:02,144
a lot of them are gonna be cured.

409
00:15:02,144 --> 00:15:04,160
So it's exciting to see that. We have

410
00:15:04,160 --> 00:15:05,460
the same thing with leukemia.

411
00:15:05,840 --> 00:15:08,000
Some of these gene therapies, in our in

412
00:15:08,000 --> 00:15:11,040
our situation, we started offering one that's called

413
00:15:11,040 --> 00:15:14,100
CAR T therapy where children with leukemia,

414
00:15:15,040 --> 00:15:16,820
you know, get their blood drawn.

415
00:15:17,200 --> 00:15:18,580
It goes back to a lab,

416
00:15:19,404 --> 00:15:21,424
and it gets reengineered

417
00:15:21,804 --> 00:15:22,945
to have the the,

418
00:15:23,884 --> 00:15:25,585
blood cells go and target,

419
00:15:26,285 --> 00:15:27,024
the leukemia

420
00:15:27,404 --> 00:15:28,144
blood cells,

421
00:15:28,845 --> 00:15:30,870
and destroy them so that the child is

422
00:15:30,870 --> 00:15:33,190
is cured. And then get and then that

423
00:15:33,190 --> 00:15:35,929
blood gets reinfused in them, and they're cured.

424
00:15:36,470 --> 00:15:38,870
And so these gene therapies are a game

425
00:15:38,870 --> 00:15:41,669
changer. You know, I dream of the day

426
00:15:41,669 --> 00:15:43,269
we may have we we would be able

427
00:15:43,269 --> 00:15:46,034
to close our our pediatric cancer unit, but

428
00:15:46,115 --> 00:15:48,595
it's really exciting and inspiring to see this

429
00:15:48,595 --> 00:15:51,154
and to see these these ailments that have

430
00:15:51,154 --> 00:15:52,454
affected children,

431
00:15:52,995 --> 00:15:55,334
have the potential to be going away. So

432
00:15:55,394 --> 00:15:56,595
those are some of the things that really

433
00:15:56,595 --> 00:15:57,414
excite me.

434
00:15:58,309 --> 00:16:00,070
Certainly, everyone will welcome a day when all

435
00:16:00,070 --> 00:16:02,629
the children's cancer centers could be closed, and,

436
00:16:02,629 --> 00:16:04,709
hopefully, that day is closer than we think.

437
00:16:04,709 --> 00:16:06,470
I mean, I'm glad you mentioned the therapies.

438
00:16:06,470 --> 00:16:08,789
I was just talking to Dan Fields over

439
00:16:08,789 --> 00:16:10,470
at CHOP, and he mentioned those as well.

440
00:16:10,470 --> 00:16:11,929
It's just really exciting

441
00:16:12,389 --> 00:16:14,875
what physicians and scientists were able to do

442
00:16:14,875 --> 00:16:15,695
on that front.

443
00:16:16,075 --> 00:16:18,475
Yeah. It's it's incredible. I mean, it's really

444
00:16:18,475 --> 00:16:20,975
incredible. I mean, it's an exciting time,

445
00:16:21,995 --> 00:16:23,115
to be able to be a part of

446
00:16:23,115 --> 00:16:23,914
this. You know?

447
00:16:24,634 --> 00:16:25,134
So,

448
00:16:25,595 --> 00:16:28,049
yeah, it's it's it's gonna make a big

449
00:16:28,049 --> 00:16:29,909
difference on in in kids.

450
00:16:30,690 --> 00:16:31,990
So we're we're thrilled.

451
00:16:32,929 --> 00:16:35,909
Lastly, Peter, is there anything else regarding pediatrics

452
00:16:36,049 --> 00:16:37,889
that you would like to see a brighter

453
00:16:37,889 --> 00:16:38,870
spotlight on?

454
00:16:39,794 --> 00:16:40,294
Yeah.

455
00:16:41,875 --> 00:16:43,335
I think just continuing

456
00:16:43,875 --> 00:16:45,794
to advocate. You know? I think I've talked

457
00:16:45,875 --> 00:16:47,654
touched on this. You know? But

458
00:16:48,035 --> 00:16:48,754
really just,

459
00:16:49,715 --> 00:16:52,375
keeping forefront, you know, concerns around,

460
00:16:52,720 --> 00:16:55,220
you know, just reduction of of these services

461
00:16:55,279 --> 00:16:57,200
in in in the communities. And I I

462
00:16:57,200 --> 00:16:59,039
think I've talked a little about it, but

463
00:16:59,039 --> 00:17:01,039
it it it's certainly something that keeps me

464
00:17:01,039 --> 00:17:01,539
concerned

465
00:17:02,159 --> 00:17:04,240
at night is, you know, making sure our

466
00:17:04,240 --> 00:17:05,700
kids have access to care.

467
00:17:06,559 --> 00:17:07,059
And

468
00:17:07,464 --> 00:17:08,984
hopefully as we kind of go through this,

469
00:17:08,984 --> 00:17:11,565
I'm I'm seeing some movement in California where,

470
00:17:11,625 --> 00:17:13,384
you know, it sounds like they're looking to

471
00:17:13,384 --> 00:17:16,024
to move some of their reimbursement to that

472
00:17:16,024 --> 00:17:17,565
has historically been underfunded

473
00:17:18,184 --> 00:17:18,684
towards

474
00:17:18,984 --> 00:17:21,884
centers that have OB services and maternity services,

475
00:17:22,690 --> 00:17:23,830
as well as pediatrics

476
00:17:24,210 --> 00:17:26,049
to offer more funding so that we can

477
00:17:26,049 --> 00:17:27,990
have access more access to care.

478
00:17:28,289 --> 00:17:29,970
So I think that just continues to be

479
00:17:29,970 --> 00:17:31,809
a a big focus of ours and and

480
00:17:31,809 --> 00:17:32,769
advocacy. So

481
00:17:34,465 --> 00:17:36,065
Peter, thank you for being so generous with

482
00:17:36,065 --> 00:17:38,305
your time and insights today. We absolutely cannot

483
00:17:38,305 --> 00:17:40,065
wait to share them with our audience, and

484
00:17:40,065 --> 00:17:41,505
we look forward to connecting with you again

485
00:17:41,505 --> 00:17:42,005
soon.

486
00:17:42,625 --> 00:17:44,565
Hey. Thanks, Chris. Great to be here.