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Welcome to the Bector's Healthcare podcast. I'm Chris
Sosa, your host, and I'm thrilled to be
joined today by doctor Amy Thompson. She's a
pediatric hospitalist and the CEO of Covenant Children's
Hospital in Lubbock, Texas.
Amy, thank you for joining us today.
Thank you so much.
Amy, for those in our audience who are
maybe not familiar with you and your work,
could you please just introduce yourself and give
us a bit about your background?
Absolutely. So,
I always say I didn't wanna grow up
to be a,
hospital CEO, I wanted to be a doctor.
So that's what I did,
first. And so I
went to Texas Tech University and then followed
that with medical school and residency at the
Health Sciences Center here in Lubbock, Texas. I'm
a West Texas girl, so I grew up
in this area.
And I became a pediatric hospitalist and practiced,
in in that capacity for many years,
in my career and loved the bedside. Was,
not really looking to make a a change
from the bedside, but, in about 2013,
I actually was approached to become the chief
medical officer,
of the children's hospital here in Lubbock.
Took that opportunity and, just an an unusual
and,
set of circumstances with a previous CEO whom
I adored,
got sick. And so I had the opportunity
to stick it or stand in,
as an interim CEO. And then about a
year later became the CEO of the Covenant
Children's Hospital. And so I've remained
in that capacity until about two years ago.
I still am the CEO at the Children's
Hospital, but now also have,
responsibility for our adult, tertiary quaternary hospital here
in Luck.
So you're wearing a lot of hats these
days.
A lot of hats. Keep it all straight.
Yeah.
Amy, you're here on the podcast to talk
about several things. But one of them is
how I understand that Covenant Children's
relational health center, it's a big important part
of your efforts to treat patients' mental health.
So how has Covenant Children's strategy evolved with
respect to this area?
Yeah. This is, this is a topic that's
very, very near and dear to my heart.
And I say this this was born out
of just many years, at the bedside.
And, you know, Lubbock is not unlike other
places in in the country where we just
don't have a ton of services kind of
in that mental and behavioral health,
space.
And as a pediatric hospitalist, because we don't
have inpatient beds, here in Lubbock when I
was when I was practicing,
a lot of those patients would be would
be admitted to our hospitalist service. So I
kinda had this, you know, front row seat
to these kids that were coming in in
crisis.
And we would, you know, send them our
really our only options were to send them
to adult centers that were, you know, nearby,
not anything that was child and adolescent,
specific.
And then, you know, I certainly was having,
you know, what we all call the frequent
buyers and and that's because they they just
kept coming back. And what that speaks to
is that we just weren't able to provide
services for them that were actually causing them
to be stabilized. And so, you know, when
folks are coming back, in and out of
your hospital, the the same kid that you're
seeing that's, you know, been on your service
three times, from a, you know, from a
suicide attempt.
That's, I mean, that's just screaming to you.
We've gotta have, you know, more services and
we've gotta we've gotta have better,
you know, care for these kids. So very
much,
you know, kinda what we wanted to do
in this space was born out of that
time,
at the bedside.
I also had, I was really affected by
several people when I was a resident.
And, there was a a physician who was
a child and adolescent psychiatrist named Valerie Robinson,
who has since passed away.
But she was just very, very influential for
me, when I was in residency.
And her big thing I talked about, I'm
a West Texas girl. And so, you know,
I'm from this area.
And before she died, one of the things
that Valerie talked with me about was really
her. She was like, I know you believe
in this. I know you believe in making
services for these kids, like promise me
that you will do this. What's funny is,
she said this years before I would ever
have the opportunity as an administrator
to step into that space. And when I
talk about, you know, why I've been able
to embrace administration,
it's because you actually then have the ability
to bring to fruition, you know, some of
these dreams and things like that, that you
had,
at the bedside. And so really that journey
that for us, you know, started,
at the bedside for me was really able
to come to fruition, once I became the
chief executive at the children's hospital.
And we have a great partnership still with
Texas Tech University Health Sciences Center, with that
department of psychiatry.
Got to be good friends with,
a child and adolescent psychiatrist, doctor Sarah Wakefield,
who is part of that program.
And just as our careers both kind of,
you know, advanced,
it you know, we would dream about what
we wanted to do in this space.
And
then as, you know, luck would have it,
I become the CEO of the children's hospital.
She actually becomes
the chairwoman of the department of psychiatry at
Texas Tech. And so really what that did
is provide us an opportunity
to work together,
and and really bring this, you know, into
fruition.
Your next question should be why do you
call it relational health? Why why is that
the, you know, like why why is that
the thing that we're gonna call it? I
will also tell you that,
one of the other things I really learned
at the bedside
was I just didn't love that stigma that
came
with, you know, the terms mental health and
behavioral health and especially the way that the
kids just would interact with that. And one
of the big things that we wanted to
do, I did not coin that phrase.
I always said doctor Wakefield coined this phrase,
but she's told me, I think she read
it somewhere. So we didn't we didn't come
up with this name. But the reason that
we really latched onto it and liked relational
health center is, you know, mental and behavioral
health is all about your relationships. It's about
the relationship that you have with yourself. It's
about the relationship you have with the people
around you. It's also though the relationship that
you have with your environment
and, you know, specifically kids who can't control
those environments. And, you know, just learning that,
we wanna teach you skills,
that help you relate better both with yourself,
your environment,
your world, you know, and and how to
to do those things. And so I'll have
to I I can't remember the exact date,
that we opened,
but what we wanted to do is we
wanted to start in the outpatient area.
And I and I'll talk about the reason
we wanted to start in outpatient is for
that the the way that I described this
to you earlier. That when you have these
kids that keep coming back, what that tells
you is that they're not getting enough outpatient
services. They're not getting enough services to help
that stabilization,
you know, when they go from your from
your facility. And so we felt very, very
strongly,
about wanting to start with outpatient services.
And really the, you know, I I say
that the vast majority of the brain, you
know, child part of this was doctor Wakefield's.
And
one of the other things that we realized
is
the time that it took kids to get
in to see a provider was very, very
long. And so when we were trying to
solve for some of the problems
with this relational health center, we wanted to,
a, start with outpatient so that we could
provide services for kids, you know, once they
were not in that inpatient setting. And then
secondarily, we really wanted to create an atmosphere
where we could get somebody in very quickly.
And so that was kind of the the
two things that we put forward,
to want to start with that. I have
some statistics
if you're, and I'll just talk about these
are actually from
Yeah, from '24 and '25 just to give
you an idea,
what we've done. So
the first is when I look at just
outpatient,
completed visits for 2024,
we did almost 3,000,
patients that we saw in that in that
outpatient center. Now the crazy part about that
is,
that what we also have in the center,
West Texas, I don't know if you've ever
been to Lubbock, Texas, but where Lubbock, Texas
is, is we'll call it the hub city.
And it's because we live in a rural
part of our state.
They call it the hub city, like the
hub
of a wheel because a lot of things
will happen in Lubbock, Texas, but we have
a lot of rural areas,
that we serve. And so we are part
of some programs, that are actually out of
the state of Texas.
T chat, is one of those. And what
that allows us to do is that allows
us to connect
with both school systems.
And so when I say this, we are
in about a 178
school districts,
across West Texas through T CHAT. And so
in our behavioral health,
relational health, I'm sorry, center, what we have
is we have a, a space where we
do tele, in there. So we have telebase
and so we're able to do telehealth and
connect with those school districts. And when you
look at that,
our completed visits that we did with as
part of T CHAT and as part of
the school districts was over 10,000.
And that just kinda gives you
the the numbers that
in our, you know, rural area, we saw
about 3,000 of those in person in clinic,
but actually almost, you know, more than triple
that number that we were able to help,
treat and triage and or, you know, get
into our services
by that connection, with the school district.
And then I'll I'll kinda talk about where
we're headed and I'll let you ask me,
you know, any other questions that you have,
about that.
We now that we have been up for
a couple of years and we feel,
we feel like that that we have kinda
stabilized some some of those outpatient services,
the second thing that we really wanted to
do was to start,
intensive outpatient and partial day hospitalization,
programs that we had. And that's kind of
that that step that, you know, you need
something more than just a a weekly visit
or, you know, something you need some more
intensive therapy than that, but it's still not
that inpatient stay.
And so we have started both that in
intensive outpatient, and partial day hospitalization,
and it's been very, very successful,
for us kind of providing,
those services.
We recently were actually able to get some
funds, that we made application for from the
state of Texas. I'm so, so grateful that
we were able to receive those funds. And
so I'm happy to tell you, in fact,
this morning in a meeting that I was
in, I was able to look at our
plans.
And so we now have the money that
we are going to be able to do
the second half of that unit and are
actually gonna be able to open some inpatient
beds, probably within a year,
as part of that.
So really, really excited about where this is
going and mostly
excited about the, the services that we've been
able to provide in West Texas.
Amy, thank you for sharing all of that.
I mean, it's just incredible how far
this program has come in just a couple
of years and the fact that you and
your your colleague
are able to
put all this together. And and as you
said, it's it's gotta be just a more
feeling to be able to say, okay. Here's
where we were in terms of services for
children in West Texas, and now here's where
we are.
What are some of the early returns that
you've had,
from patients in terms of how you've been
able to affect them and bring these,
mental health and relational services to them? Yep.
I think that, I one of the most
overwhelming, things that happened for me really actually
very early on. I wanted to be there
on the day that we opened the relational
health center.
And I wanted to meet the first patient
that got to come into the, you know,
to the area.
Just because it was so exciting for us,
you know, to kinda see some of this
come to fruition.
We've had a ton of feedback from kids.
The kids love,
the programs, they love the space, the space
we just lucked out with, you know, the
brilliance of architects who can go in and
just create a space that feels safe. You
know, stuff that I never think about. I'm
a doctor, I don't think about, you know,
is this actually a space where a kid
who's coming in in crisis is gonna feel
safe. And so even just a ton of
feedback that we've had just on even the
architecture,
and stuff of that space. But one of
the most influential things that happened for me,
I actually have a very good friend who
is the school superintendent,
and she has served on our boards. Actually,
right now, she's on my adult,
hospital board. And very early on in the
process,
we received a letter from a mom
who was like, I have struggled for years.
I haven't known where to go.
We haven't had any programs. Every time that
we would talk about, you know, some of
the care that we had single providers in
Lubbock who were doing a fantastic job, but
just, you know, didn't have all of the
services. The wait times were super long. And
she said, all, you know, all the time
really my,
you know, my hope was to to have
to go out of town and, you know,
to do these things. And it was one
of the most heartfelt letters that really affected
that superintendent because it was, it came from
a mom that said, I don't know who
these people are at Covenant, but I wanna
give this letter to them because I've been
struggling for years with my daughter and just
haven't known what to do. And she actually,
that the daughter that she was talking about
was part of one of our, intensive outpatient
and
programs and, like,
and I remember her talking about the day
that her daughter kinda graduated from that program
and just how their entire life had changed,
not just her daughter's life but their but
their home life. And when you hear those
kind of stories,
you know, we need more services, but those
are the kind of stories,
that that help you understand, you know, the
kind of impact that you're having.
Well, here's hoping that's that is one of
thousands and millions of three.
That
that come your way
before long.
I also wanted to ask,
you mentioned, stigma. Now this is something that
every single,
medical provider deals with in in in some
way, shape, or form. So as a hospitalist
and now a CEO, do you do you
feel that's evaporating at some point in in
some way, shape, or form? I do. And,
you know, the reason is because I think
more people are talking about it, and I
think more people are willing, you know, to
talk about it. And and I have some,
you know, everybody doesn't have to do it
this way, but I I felt very, very
strongly
that we wanted to have the relational health
center inside of the children's hospital.
And part of the reason that I was,
you know, kind of a stickler for that
piece of it,
is because I didn't want it to feel
like
this is where, you know, the sick kids
go. So when you have pneumonia, you come
to the children's hospital, but when you have,
you know, you know, behavioral or mental health,
we send you to this other building. And
it was just really important for me to
say,
we believe that relational health is part of
the health of kids. And it's the same
as when you have pneumonia, you need to
go to the hospital and get antibiotics.
And when you have
suicidal ideation and depression and those things,
we want you to feel the same about
that and not to feel the stigma, to
understand
it's just something that we can help you
with. And we do have not just medicines,
but we have therapies and we have you
know, these different kind of things. And so
I think that that is is starting to
disappear because I think more and more people
are talking about it. And look, I'll be
honest enough to tell you, I am a,
53, just turned 53,
this week. So,
and look, I'm a person who has dealt
with,
with these issues in my life. I've had
depression,
in my life. My husband and I, were
fortunate,
and and were able to raise his brother.
His brother came to live with us when
when he was 14,
and he came to live with us because
of a suicide,
in their family. And so what I always
say is,
part of the reason that you want to
destroy the stigma is I always say these
are not the people out there that are
dealing with the issues. Like this is us,
this is our kids, this is our brothers,
this is and this is me.
It's not just, you know, these people out
there that are dealing with these issues, it's
us. And,
I've just become very, very comfortable
sitting in the space of,
you know, this this is our family and
these are the issues that we have had,
and these are all the things that we've
done to to try to, you know, work
through those. And so I think the more
that we have conversations like this where we
just call those things out and we're willing
to talk about that it's not just out
there, it's in our families.
I think that that's the stuff that continues
to just tear those walls down.
That makes a ton of sense, Amy. Thank
you so much for sharing, your personal insights
and
experiences with that with mental health.
Next, I wanna give you a chance to
discuss some of the other
programs and innovations that are happening.
Yeah. Absolutely.
So I know you you have a transportation
program, kite flight. That's a big deal there.
So between that and and other projects, what
would you like to put on our audiences
like that? Yeah. Let's talk kite flight. This
is also one of my one of my
favorite, you know, things.
This is not necessarily innovative. You know? There's
a lot of of folks. I will say
it was innovative for West Texas because you
know, of where we're at. And I always
talk about one story that I share,
when I was at the bedside is, you
know, there was a rural community, it's a
couple hours from us. They had called me
about a kid that had a simple, we
call it a cellulitis, It's a skin infection.
And appropriately,
you know, unfortunately, right after they called me
to to transport,
this kid, there was a woman who came
in that was having a heart attack in
the same community. Well, they've got one ambulance,
and so they made the appropriate decision,
sent the woman, you know, in the ambulance
having, a heart attack. But then by the
time the kid got to me, it had
been about nine and a half hours. And
so from the time, you know, that they
originally called to when we were able to
free up EMS and get that kid here,
the kid was, something that we call Sears,
which is a systemic inflammatory response. And I
say he was on his way to sepsis
because, you know, it just took so long
in transport.
And I have numerous,
you know, cases like that over my career.
And so one of the things that we
knew that we had to do was,
to step into that transport
space. So in in 2018,
we started, we started just with, an ambulance
and we we've always done, neonatal
transport. We've always used, local, you know, services,
here.
But again, you're kind of in this queue
of having to wait, you know, for when
when those helicopters and and those things are
free.
So in 2018,
we started a more comprehensive,
transport program that include both neonatal and pediatric,
transport. We started training that transport team.
About a year
later, we were able to get a helicopter
and so we actually have, a helicopter. We
lease it. People are always like, how did
you have enough money to buy a helicopter
in, you know, in,
in healthcare these days? And the answer is
we lease it from somebody who knows how
to take care of it. It's but it
is a Covenant Children's,
helicopter.
I've just had great, great, response from the
community. We had some folks that helped us
build a hangar.
So now what I have now is I
have,
I have both a a neonatal team, that
I have both nurses and, you know, respiratory
therapists, EMTs that are part of that team.
I have a pediatric team, who does, you
know, kids that are outside of that neonatal
period. But then what we have started,
most recently is what we call high Rob,
which is a high risk OB
transport service. And so I use some of
our women's personnel. So we also now have
the ability to transport moms.
And we, when you look at the growth
that we have had, as part of that
program,
it went from a few 100, the very
first year that we did this,
to over 900,
in this year. So it's just been an
exponential growth. And what we're seeing is, is
just our ability to get to kids quicker.
And even doing things like the hanger allows
us to take off directly from the hospital.
And man, when you're taking care of a
kid, that needs ICU status,
cutting off four minutes,
you know, of transport time is huge. And
so every, you know, time that we're able
to cut down, that time. I'm gonna give
an example in in West Texas. Unfortunately,
you know, that health care across The United
States has really taken a hit kind of
post that post COVID, you know, time has
been really, really hard. And as we see
more and more hospitals struggling,
unfortunately, in West Texas, a lot of them
have stopped doing OB services. And so that's
part of the reason we wanted to start
this high risk, you know, OB. And just
to give a flavor for that, across West
Texas,
one month ago, we transported 19 moms,
from our region that were in hospitals that
didn't really have access to,
you know, either either any OB services or
certainly, you know, not high risk OB services.
You know? And of that, 12 of those
kids ended up in our NICU.
And so, like, it it's just it's really
filling a void in West Texas, in terms
of the ability to go to get people.
I always say Lubbock only has about 300,000,
people in it, but we serve an area,
that is about the size of the state
of South Carolina when you look at at
the land mass.
And so having this transport team for us
and starting that program has really been a
differentiator for us just in the ability to
go get both kids and and women as
part of that. So super proud of what
we've been able to do in that space.
Yeah. One every other day more or less.
Yeah. That's crazy.
Yeah. But I'm just glad that they're able
that you're able to provide that now whereas
before it was,
not possible.
Lastly, Amy, I simply wanna ask you,
like to give our guests a chance to
Yeah. To discuss other things that might be
on their mind. So simply
what aspect of health care, whether it's related
to pediatrics or not, do you think deserves
a brighter spotlight? And how do you and
Covenant Children's fit into that? Yeah. So, you
know, we were actually discussing this. I thought
that was the hardest question that you that
you posed to me was, you know, what's
the other aspect of health care that you
think? There are always plenty of them. Right?
Yeah. There's always plenty of them. And you
know what, after talking with, some folks that
were in my office, about it this morning,
what I decided that I'm gonna say on
this is actually I'm not gonna talk about
a program or, you know, a service that
we're doing.
I lived through COVID. I both was at
the bedside during COVID and,
also was a hospital administrator during COVID. I've
seen the after effects of,
not just, you know, COVID, but also I
call that that post COVID world.
It it's our caregivers.
We call all of our employees caregivers because
we believe that,
everybody that works at Covenant Health, takes care
whether you are touching the patient or not.
If you're in the billing office, you still,
you know, have,
part of that care. And, look, this is
the hardest
environment
I've ever seen in health care in these
last, you know, really twelve years. And, you
know, I when people say, how did you,
you know, live through COVID? Listen. I'm not
trying to minimize COVID. COVID was was one
of the hardest things we ever dealt with,
but I'm not sure that what we're experiencing
right now in that post COVID era is
any easier, just because, you know, there's diminishing,
you know,
returns, there's, you know, inflation is high. And
I just think we've just never had as
much stress
as we have right now for our caregivers.
And so when I think about, you know,
what what deserves a brighter spotlight, it's the
people that actually each and every day are
standing at the bedside and or working,
in our hospitals.
And and I just think we have to
continue to have that conversation
about how we honor,
the people,
that are doing this work day in and
day out and, and make sure that we're
not burning them out, especially in this very
hard kind of post COVID environment. So I
I think that that we've gotta figure out
a way that we can,
you know,
pay people what they need to be paid,
but also celebrate people in the way that
they need. And then we have a long
way to go in this even at covenant.
It's something that's important to us. And so
I wanna continue,
just to grow in that because I know
how important that is for our caregivers.
Amy, I think that's the perfect place to
end. Thank you for covering all this ground
that you did today. I know I learned
a ton. I know our audience will feel
the same. Thank you so much for sharing
your insights, and I look forward to the
next time our paths cross. Awesome. It was
so nice to meet you. Thank you so
much for having me. Thanks, Amy.
At athenahealth,
we know your ambulatory practice wants healthier,
a healthier business, healthier care teams, and healthier
patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters most?
That's where athenahealth can help. Our AI native
all in one solutions reduce administrative burdens, streamline
billing and payments, and deliver critical insights when
clinicians need it most. That means fewer clicks,
more time for patients, and stronger bottom
lines. Practicing medicine is complex, but running a
practice can be that much simpler with athenahealth.
See how simpler is healthier at athenahealth.com.