#001: Just Keep Swimming

The first guest in this series is Tina Simpson, JD, MSPH, Former Managing Principal of Atrómitos. Tina plays a pivotal role in advancing Atrómitos' mission. In this interview, she'll discuss the substantial challenges "regulatory lag" poses in care delivery innovations. She'll also delve into the significant influence of a critical lesson from "Finding Nemo" on her crucial professional and personal choices, always considering the importance of "just keep swimming."

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- Liz Church, Host + Producer of The Atrómitos Way

Transcript

00;00;00;00 - 00;00;12;01
Tina Simpson, JD, MSPH
Here in the States, we tend to always look for a magic bullet. And because we are always looking for some one single answer that's going to solve all of our problems. We tend to lurch between extremes.

00;00;12;04 - 00;00;31;19
Liz Church
Welcome to the Atrómitos Way podcast, with meaningful discussions on the challenges in healthcare and the solutions behind them. I am your host, Liz Church. It's our first ever episode on the podcast, and boy am I glad you're here. We all know the deal. A health care system is a complex world that no matter where you stand, whether it's a patient, provider, policy maker, or other stakeholder.

00;00;31;22 - 00;00;57;20
Liz Church
It's a complicated place to be. Each episode on the podcast will dive into the complexities of our health and social system, giving the experiences and insights of the guests that shape our lives and our communities. Why? These are change agents boldly striving to ensure that quality health care is accessible, affordable and equitable for all. But I assure you, my friends, we're not going to drag on the dreadful aspects of the systems, but highlight the good and the paths being made towards progress.

00;00;57;22 - 00;01;19;07
Liz Church
First episode. It's no surprise who's our first guest. I promise you, it's not me. But before we get started, let's set the groundwork in the ever evolving world of health care. The industry has undergone a whirlwind of transformations, making it difficult to pinpoint a single defining change or challenge. It's a landscape where everything, everywhere, happens all at once.

00;01;19;10 - 00;01;39;26
Liz Church
So where do you begin? In this interview, I am speaking with Tina Simpson, managing principal of Domino's, an expert in aiding health providers who seek to adapt to a changing market and regulatory landscape to transform care delivery. We'll dive into what it means to evolve in the health care landscape and reflect on a key lesson that influenced her professional and personal choices.

00;01;39;28 - 00;02;03;06
Liz Church
Ones that will remind you the importance to just keep swimming. Without further ado, let us begin. Now we'll be getting to the professional questions. Speak to your expertise, Tina. But first, I'd like to do some fun ones that give the audience an idea of the person that I'm speaking with today. So first question. If you could have dinner with any historical figure, who would it be and why?

00;02;03;08 - 00;02;29;04
Tina Simpson, JD, MSPH
That's a great question. Of course, there's a difference between historical figures who are fascinating and those that you want to break bread with. I think that probably the Italian writer, chemist and Auschwitz survivor Primo Levy would would be at the top of my list. He was arrested as an Italian Jew and Partizan and imported to Auschwitz in 1943 or 44, and then wrote one of the most, the first published memoirs of his experiences.

00;02;29;05 - 00;02;52;06
Tina Simpson, JD, MSPH
If this is a man, about a year after his return, he was a talented and remarkable writer, but was also notable for his generosity of spirit and resilience. Obviously, on the other side of things, I would also quite like to have dinner with the Empress Frederick of Germany. She was the eldest daughter of Queen Victoria and the mother of Kaiser Wilhelm, and a great gossip, a great gossip.

00;02;52;09 - 00;02;56;25
Tina Simpson, JD, MSPH
Judging from her letters to her mother. So I think that that would be a very entertaining dinner.

00;02;56;27 - 00;03;17;20
Liz Church
Those were two very different people. I mean, I'm a little stunned, you know, because a lot of people would say, like, I'd love to have dinner with Elvis, you know, rock stars and the like, but these are two very important people. And I think there's things behind them that just highlight things that I've noticed in your character, especially with being generous, kind, and being exciting and just for everyone's knowledge.

00;03;17;20 - 00;03;39;26
Liz Church
Every time Tina and I talk to each other, we end up going down a rabbit hole of things because we just love talking to each other. But these are very interesting choices to have and it's clear you are a history buff, my dear friend. As we go onward with these fun questions I've got for you, the next one, what would you say is your favorite thing to do to unwind and relax after a long day?

00;03;39;29 - 00;03;58;10
Tina Simpson, JD, MSPH
I love to cook. I'm also one of those people that needs to have music or a podcast running in the background at all times, or I just can't function. So you would find me in the kitchen listening to a history podcast or a cooking show and just chopping and dicing and that's that's how I love to unwind and relax.

00;03;58;12 - 00;04;01;15
Liz Church
Do you always listen to a history podcast or do you ever like.

00;04;01;17 - 00;04;17;17
Tina Simpson, JD, MSPH
I try to branch out. I try to my a cousin of mine shared a few years ago of like, you know, sort of market analysis and all those other very important things that one needs as an adult to be fully rounded and productive. But I just keep coming back to the same history podcasts.

00;04;17;19 - 00;04;21;13
Liz Church
You know, I actually haven't found any. So if you give me some recommendations, you know, I.

00;04;21;13 - 00;04;26;05
Tina Simpson, JD, MSPH
Have to recommend it. Yes, yes, yes. Oh please ask and you shall receive.

00;04;26;07 - 00;04;35;00
Liz Church
Oh that's exciting. All right. So then the last question that I have for you, what's the best piece of advice that you received and how has it shaped your life?

00;04;35;02 - 00;04;51;20
Tina Simpson, JD, MSPH
There's I think probably the most important piece of advice was actually from my aunt when I was considering sort of I was at a crossroads in my life, and I was debating whether I wanted to leave state government and, you know, sort of pursue my interest in public health to go back to grad school and, you know, try the great unknown.

00;04;51;20 - 00;05;14;11
Tina Simpson, JD, MSPH
And she reminded me that there's very little in life that that you can't recover from if you make a mistake. It generally with, with a few notable exceptions, is not fatal and that you can't be afraid of failure. It's important to then that indeed failure and mistakes are indispensable to growth, to success, to finding yourself and finding your place in the world.

00;05;14;11 - 00;05;35;20
Tina Simpson, JD, MSPH
So I think that that that advice of, you know, not to not to fear failure, but to embrace it as much as you can and to embrace uncertainty is probably the best advice that I've had in my life, combined with the wisdom of Dory and Finding Nemo of Just keep Swimming. So when you're in doubt, you know, just do what you can in that moment and keep breathing.

00;05;35;21 - 00;06;01;22
Tina Simpson, JD, MSPH
Keep swimming. I think that in both instances, this this has impacted me. And, you know, it's, you know, I why I'm speaking to you today from France. That was my a big goal. Life dream of mine was to live in France. So I'm here, I am in Bordeaux just keeping swimming and you know, doing the work that I love, which is, you know, working with wonderful partners who are making an impact in public health and in our communities.

00;06;01;25 - 00;06;03;26
Liz Church
I love that, although it's really nice, I love.

00;06;03;26 - 00;06;09;13
Tina Simpson, JD, MSPH
That so much. I wasn't prepared for that one. I think that's a good answer. When you can quote Dory in Finding Nemo.

00;06;09;18 - 00;06;37;11
Liz Church
Hands down I love Dory. Provide reason to use Dory. All right, not enough theatrics. So to get into the main part of the interview, you're my first guest. So now we need to get into your expertise and understanding. What is it that Tina does for our dramas? So my question for you, Tina, your role with the drama is to assist health providers in adapting to a changing market and the regulatory landscape.

00;06;37;14 - 00;06;45;21
Liz Church
Can you talk about how the health care industry has evolved in recent years, and what are the key challenges that providers face today?

00;06;45;24 - 00;07;04;21
Tina Simpson, JD, MSPH
There have been a lot of changes, so it's difficult to narrow in on any individual category or categories to say this is the biggest change. This is the biggest challenge there. It's in the past five years, ten years, whatever, because there's just so much happening at the same time in across all sectors. I'd say it's a case of everything everywhere, all at once.

00;07;04;24 - 00;07;26;29
Tina Simpson, JD, MSPH
And relatedly, that that leads me to the conclusion that the biggest challenge is the pace of change and that that providers have to weather and adapt to. And then I also want to pull out something. You sort of referenced an evolving marketplace and regulatory landscape. The second biggest challenge, and the biggest change is that those two things aren't evolving at the same pace.

00;07;27;01 - 00;07;47;03
Tina Simpson, JD, MSPH
We have a lagging regulatory system. A lot of our current regulations, federal policies don't really adapt well to the opportunities or to the risks of the digital age. You know, that is why, you know, we sort of have this lagging, you know, before the before of the public health emergency, sort of a lagging adoption and use of telehealth, telemedicine.

00;07;47;05 - 00;08;32;06
Tina Simpson, JD, MSPH
There are limitations in some care management applications. What you have is, you know, a regulatory system that probably doesn't reflect the realities and the risks of of current operations. If there's anything that I've learned in my career, it is that regulatory reforms are rarely nimble. So I don't know quite what the answer is to that. But I think that that is one of the biggest challenges on a systemic level is recognizing that there is this disparity between the opportunities and risks that are evolving, and then our ability as a, as a, as a governing mechanism to adapt to those to AI, to protect against unintended risks, while also embracing opportunities that, you know, technologies and

00;08;32;13 - 00;08;54;09
Tina Simpson, JD, MSPH
care delivery innovations afford. But I also want to answer the question that you said. I answered sort of. I always go big. I always go system level. But wanting to speak also about the the challenges faced by providers, I think that one of the biggest changes in the industry is the move over the past 20 years of provider consolidation, the rise of health systems.

00;08;54;11 - 00;09;12;24
Tina Simpson, JD, MSPH
There are a lot of important reasons for this. But, you know, I think that I, I'm I'm a daughter of a visit. My father's a physician. Providers used to the independence of providers was sort of a core attribute or of the culture. I remember, you know, talking with my dad at the age of ten or something about, you know, why he why he was a doctor.

00;09;12;24 - 00;09;35;09
Tina Simpson, JD, MSPH
And one of the reasons that he told me was that, you know, that he would always be able to be independent, that discretion, you know, his own personal autonomy, but then, you know, his ability to care for patients individually was very important. Today, the majority of providers, including physicians, are employees, frequently employees of a larger health system. And that is a big culture shift for the profession and one that we have to that we're adapting to.

00;09;35;14 - 00;09;55;21
Tina Simpson, JD, MSPH
And, you know, providers are being asked to do more. A big reason why there are a number of providers that have moved from private practice to employment is because it's it's really, really hard to to be all things at once. As a provider to to succeed, you need to have so many more skill sets and areas of expertise than you did 30, 40 years ago.

00;09;55;21 - 00;10;20;23
Tina Simpson, JD, MSPH
It's it's it's not enough to be just a really great clinician and to cultivate relationships, trust with your patients. A successful practice has to have so many other areas of expertise, whether that's from negotiating fair contracts with payers to wrangling billing claims, denials. You have to have an adequate data platform and the expertise to manage those workflows. It's it's just a lot.

00;10;20;25 - 00;10;37;02
Tina Simpson, JD, MSPH
I think that I just say that, you know, the healthcare landscape that I started my career in nearly 20 years ago is is profoundly different from, you know, where we're at today. And it'll probably be quite different from where we will be in, you know, even in five years.

00;10;37;04 - 00;11;02;25
Liz Church
So I see things at the patient level. And while I have a plethora of expertise in many areas, the healthcare setting is not. It's one that leaves me really confused. It's one that I throw at my hands. To you and Michel asking for help. Help explain this thing that is really big and it's a lengthy learning process. And in the world right now, it's really hard to be a patient and to be a health professional.

00;11;02;28 - 00;11;22;18
Liz Church
There's a lot of elements to that statement, but I want to just refer back and focus on when he talked about the importance of cultivating relationships. That's really hard to do now. These days as a patient, I feel really rushed when I'm going through my appointments. It's not all of them, and I need to reiterate that just in case any of my providers are listening.

00;11;22;20 - 00;11;45;12
Liz Church
But it's enough that I feel like I have to write everything down before my visit and treat it like a checklist, and I have to go through them as fast as I can. Sometimes I feel like I'm in a 15 minute window, and then if there's something that I have forgotten, I have to either usually a source of like phone communication, which is very rare because nowadays it's mainly through an electronic health system.

00;11;45;15 - 00;12;11;18
Liz Church
And I'm not knocking HHS like I totally get they're amazing. And how they help productivity, efficiency and workflows. But as a patient it's infuriating. And I only say that because it's days of correspondence for very small things. It can be a simple conversation, and sometimes it's weeks because I have to remind people to get back to me. If I have to remind you to give me a referral, it's pushing me back from what I need.

00;12;11;21 - 00;12;36;08
Liz Church
And it's it's hard because unless you have the time and the drive to get someone to give you answers, which is still may not be in the time that you need, there have been instances that I have heard it's been months. For some folks it is too much and being too much, it pushes people back to throw their hands up and say, I really don't have the time or the patience to deal with that, and maybe it pushes them back from going to the doctor.

00;12;36;09 - 00;12;49;00
Liz Church
They say it's not that big of a deal, I'll wait or I don't really want to go to that provider because I don't. They don't make me feel like I'm in a great place or there don't really care that much, and they don't have anywhere else to go. So they're stuck.

00;12;49;03 - 00;13;10;13
Tina Simpson, JD, MSPH
And there's that a level of what you were describing for that anonymity, you know, you becoming a number as opposed to having that, that there is a loss, you know, when it when that moving to make it so much bigger and not having that ability to connect on a 1 to 1 on one with your clinician. And I think it also contributes to a lack of patient, you know, not just patient satisfaction but provider satisfaction.

00;13;10;16 - 00;13;29;13
Tina Simpson, JD, MSPH
We have a lot of of burnout and people exiting the industry because it it can be demoralizing or dehumanizing and I certainly, you know, part of me is I recognize that, you know, at a federal level, at a policy level, there's a lot of movement there. We're trying to solve big problems, you know, trying to get people access to care.

00;13;29;13 - 00;13;53;26
Tina Simpson, JD, MSPH
But we can't lose. And, you know, so that consolidation, I think some of it is fueled by, you know, we need to be able to make it less expensive. You need to be able to to care for someone across all love point. The providers have to have a skin in the game at each level of care. But I think that at the same time, we need to also balance that with the need for you know, so that primary care relationship.

00;13;53;29 - 00;14;11;24
Liz Church
And this just reiterates that the doctor patient relationship is very important. And it's very we are seeing some changes in some industries that are actually trying to continue the cultivation of those relationships. So we don't have that loss, but it's definitely something everyone has to stay involved with, keep up with it and stay in the know that way.

00;14;11;24 - 00;14;29;25
Liz Church
Nobody gets lost through the cracks saying plain and simple. But as we move into the other side of things that we're talking about today, regulatory compliance is a complex issue on health care. So, Tina, what advice would you give health care providers who are striving to maintain compliance while navigating this complex regulatory landscape?

00;14;29;28 - 00;14;49;27
Tina Simpson, JD, MSPH
the first and most important piece of advice I would give is to to start somewhere. To start, I fully recognize that it can be complex and overwhelming, but nothing good comes from delaying or deferring or putting one's head in the sand. In fact, you know, it's we. You don't need to be perfect, but you do need to start.

00;14;49;29 - 00;15;08;19
Tina Simpson, JD, MSPH
You know, when you get in trouble is when you sort of like the willful ignorance or willful delay. If there is ever an issue, like with hit, for example, obviously I was going to come down hard on you, not so much just for, you know, the issue in of itself, but the failure to establish an adequate system to monitor, detect and respond to issues.

00;15;08;27 - 00;15;38;18
Tina Simpson, JD, MSPH
So I'd say just do it the start ignorance is no defense. And to to get help because as I was saying and we were talking about in the last discussion, you know, you providers need so many different areas of expertise. You can't be the expert in all things. So, you know, getting assistance in setting up a system that is responsive, that you can sort of that you can manage, focusing on reporting mechanisms, a governance mechanisms, that's that's very critical.

00;15;38;24 - 00;16;02;13
Tina Simpson, JD, MSPH
I think a finally, in terms of I know that it's overwhelming because there are so many different areas of regulatory exposure, but I think the most critical one is probably and the one that is frequently neglected is, you know, sort of data management and security, everything, your whole practice, your whole everything is going to be digital. And that's going to be both, you know, that's going to be your your biggest risk exposure of risk as well.

00;16;02;13 - 00;16;09;18
Tina Simpson, JD, MSPH
So having very thoughtful data management, privacy and security protocols is is very important.

00;16;09;20 - 00;16;20;10
Liz Church
So following up on that with the data management security, what role does technology play in assisting health care providers in adapting and you know, changing regulations, improving health care delivery.

00;16;20;12 - 00;16;39;27
Tina Simpson, JD, MSPH
Well, and I don't know that I have a great answer in the context of technology as it is assisting in adapting to changing regulations, because what I see as the primary problem is, is that regulations aren't changing quickly enough to keep pace with the opportunities afforded by technological innovation. But to your question of how technology is improving care delivery, that impact is immense.

00;16;39;27 - 00;17;03;09
Tina Simpson, JD, MSPH
Technology, population health, analytics and outreach is the cornerstone of the shift towards value based care, population health. I mean, you cannot have value based contracting. You can't pay for performance, pay for quality unless you're able to benchmark quality and performance metrics and outcomes. It also represents, and this is very personally important to me as a patient, the opportunity for greater patient empowerment.

00;17;03;10 - 00;17;26;00
Tina Simpson, JD, MSPH
And I'm not just talking about applicant, you know, applications on your phone that can help individuals manage their own health. But the amount of information that is available and has to be made readily available to patients is it can be a game changer. It's absolutely critical to a patient being able to not just participate in care decisions, but to direct decisions and treatment plans.

00;17;26;00 - 00;17;51;07
Tina Simpson, JD, MSPH
I think so much of what we're seeking to accomplish in public health today, you know, can we talk about sort of health behavior as health environments? But, I mean, these are all things that, you know, the patient is the is the point, the lever point, the point of maximum impact. And I think that if we're going to move more towards this paradigm of wellness, as opposed to just sort of paying for treating sickness, patient is the center of that.

00;17;51;07 - 00;17;54;18
Tina Simpson, JD, MSPH
And the patient needs to be informed. The patient needs to be empowered in that.

00;17;54;25 - 00;18;04;08
Liz Church
Patient empowerment essential. I mean, I, I go through it every time I go to the doctor. But is there any drawbacks to achieving this patient empowerment?

00;18;04;11 - 00;18;35;19
Tina Simpson, JD, MSPH
I mean, so I think that and what comes to my mind is actually cures act a few years back when I think one of the big regulatory updates that sort of find prohibited information blocking, but it also required health systems providers, hospitals to allow APIs or access, create APIs and access for third parties like app like sometimes like Apple and Google, the big players, but also some of the, you know, any app that a patient says, I want this application, this third party to have access to my information.

00;18;35;19 - 00;19;03;27
Tina Simpson, JD, MSPH
And because for whatever reason, you know, that's there was a lot of pushback to that because of concerns around privacy and security. I mean, that is that is sort of taking a sledgehammer to the idea of to the health system's ability to be a steward for this data, arguing that, you know, patients, you know, aren't aware of the degree of rights that they're kind of signing away when they direct that information outside of the health system, but at the same.

00;19;03;27 - 00;19;34;09
Tina Simpson, JD, MSPH
So so there is a very real security privacy risk. But at the same time, I don't I think that that shouldn't be a barrier. Information is important. And the person that should be able to direct that information is the patient. If there are privacy security resets, that's time for maybe updating, you know, our privacy security regulations so that there is a universal right of privacy or security, such as they have in Europe, as opposed to the sort of covered entity model where it's only protected when it's when it's an action by a specific individual.

00;19;34;12 - 00;19;47;21
Tina Simpson, JD, MSPH
because I think that, you know, we have we have to walk the walk. If we want a patient centered health care, we need to we need to trust patients. You know, they make decisions, as I frequently do, as a patient that maybe the provider doesn't agree with.

00;19;47;25 - 00;19;49;27
Liz Church
I've done that. I've done that myself.

00;19;49;29 - 00;19;55;18
Tina Simpson, JD, MSPH
I mean, I, I am saying all of these wonderful things about, yes, trust. I mean, recognizing that I don't always.

00;19;55;18 - 00;20;13;16
Liz Church
Oh yeah. Yeah, oh yeah. We're all guilty of it. I mean, that's the thing where, you know, you have to make those wise decisions and, you know, taking those recommendations you get from your provider, checking and, you know, looking at everything with a grain of salt, understanding what you're looking at and being very wary of my friends. At the end of the day, ladies and gentlemen, being careful with your data is essential.

00;20;13;19 - 00;20;19;17
Liz Church
But as we move onward, were there any things that they wanted to say in the scope of data analytics?

00;20;19;19 - 00;20;38;10
Tina Simpson, JD, MSPH
Oh, yes. Yes. So I mean, I, I sort of got on my soapbox there about sort of, you know, the importance of data of patients having access to data and how that can be very important in terms of, you know, leveling the playing fields between providers who are up here and patients who kind of just receive it so that you're acting more and you can act collectively.

00;20;38;15 - 00;21;02;04
Tina Simpson, JD, MSPH
Data analytics, the including the use of predictive algorithms, is and is truly revolutionary and important. And, you know, use of these data analytics to stratify patients, identify areas of risks. This is one of the most important trends across the industry. It's also foundational to population health and quality improvement on a systemic level. I think that going back to our earlier conversation, there's a caution here as well.

00;21;02;04 - 00;21;29;16
Tina Simpson, JD, MSPH
Here in the States, we tend to always look for a magic bullet. And because we are always looking for some one single answer that's going to solve all of our problems, we tend to lurch between extremes. so I think, you know, when it, when it we, I feel like currently we are treating data analytics and predictive modeling as sort of like this is how we're going to solve this problem, but we can't lose sight of the individual discretion and autonomy of clinicians.

00;21;29;16 - 00;21;51;22
Tina Simpson, JD, MSPH
You know, the practice of medicine, nursing, health care in general is is probably equal parts art and science. And that's not and that's not something that can be reduced to an algorithm. Yeah. So while I applaud that shift towards population health and I'm all about some data analytics, particularly because it affords the opportunity to address systemic barriers to wellness and equity across communities.

00;21;51;22 - 00;21;54;20
Tina Simpson, JD, MSPH
While we are focusing on the aggregate, we can't lose sight of the individual.

00;21;54;22 - 00;22;07;27
Liz Church
Well, then, if you okay, if you look at it in that way too, you know, looking into the future, what do you see as the most significant challenges and opportunities in the health care industry, particularly, you know, in regulation for regulatory matters and care delivery?

00;22;07;29 - 00;22;40;03
Tina Simpson, JD, MSPH
well, you don't have to look out far into the future because we're grappling with those significant challenges already, particularly. And again, I, I keep relating back to some of the things I've already said, but the lag between, you know, sort of our regulatory framework, you know, the opportunities for innovations in care delivery. So I think that biggest challenge, one of the biggest challenges is going to be the ability of our regulatory infrastructure to respond to timely, in a timely fashion, the changing marketplace, a personal soap box for me is also the integrity of our health care system.

00;22;40;03 - 00;23;00;17
Tina Simpson, JD, MSPH
We are. United States is pretty unique among other developed countries in that the basis of our health care system is is one of the free market. It's based on free market principles. The idea that competition within a marketplace is the best basis for, you know, quality, cost, efficiency, consumer. And there are you know, there's a they're good reasons for that.

00;23;00;17 - 00;23;28;14
Tina Simpson, JD, MSPH
But the reality is that health isn't exactly a widget in the free marketplace. It's it's not just a commodity. It's it's part utility. And here in the States, we suffer from a profound lack of competition. So when not when, you talk about sort of the rise of provider consolidation that we are we're losing a lot of that, you know, the benefits of a market system where that where there is competition, where there is consumer choice, where there is the opportunity for for innovation.

00;23;28;15 - 00;23;47;19
Tina Simpson, JD, MSPH
I think that we're we're in a we're in a time right now where there is so much consolidation that is impacting choice and quality. I guess I'd also add by saying we need to do we're always looking to do, to add on to a system where we look for additive solutions. There's this great article whose names I'm forgetting at the moment, but it was.

00;23;47;19 - 00;24;04;08
Tina Simpson, JD, MSPH
The bottom line was that we need to do simple things better. Sometimes the solution is taking away complexity as opposed to just adding on more on top of something. We've got a very top heavy system. So I think, you know, looking to reduce complexity is is going to be critical.

00;24;04;11 - 00;24;17;18
Liz Church
It is it is insanely critical. But there's there's this thing that I see when I think of these type of issues that, wow, there are too many cooks in the kitchen. You guys all have different ideas. Not all of them are terrible. Some are great, some are brilliant. But then we have a problem where they clash with each other.

00;24;17;20 - 00;24;32;22
Liz Church
And when you have this, you do have a system that's breaking down because people are not figuring out what works best and it's not working very well. And in the United States, we have this. I mean, I don't know what the right word is, but we have this notion that we have to get it done fast. We have to do it right.

00;24;32;28 - 00;24;52;11
Liz Church
But just enough that way we can get it done. And it's this is from my perspective, again as a patient, because we see so many issues where there's this problem that pops up and it's like, well, we got to come back to it later, okay. We've delayed this problem so long now that it's we're not taking the time to stop and think.

00;24;52;11 - 00;25;05;07
Liz Church
And it seems like time is becoming a secondary thing, taking that time to stop and think about this. How is this system doing? How does it impact people? I'm hoping this makes sense.

00;25;05;12 - 00;25;34;17
Tina Simpson, JD, MSPH
That that does make sense. And I think it ties to like in this project in the States, everything is so fragmented. So you have so many cooks in the kitchen, everyone with their own little silo of this, of what their role is. So we have we we have a challenge of pulling it all together so that there is sort of that this is this is one of the reasons why I think that some have seen sort of provide a consolidation as a good thing is because you you do want to have someone who has skin in the game, who is responsible for all the pulling the silos together.

00;25;34;17 - 00;26;01;03
Tina Simpson, JD, MSPH
But I think you're you're correct in that we need to change the way we're working together, collaborating together. The nature of work in general in our digital age has changed so fundamentally. The skill of being able to pull together different perspectives and to share information and to not drop the ball and keep it moving is is the 21st century skill set that we're, I think, health care we really need a little primer on that sometimes.

00;26;01;05 - 00;26;04;12
Liz Church
Sometimes. I mean, I think a lot of industries can be said for that.

00;26;04;12 - 00;26;07;22
Tina Simpson, JD, MSPH
But let's just say it's it's particularly important in health care.

00;26;07;25 - 00;26;19;12
Liz Church
Well, speaking of the importance, you know, for health care professionals that are interested in entering the field of health care consulting, what skills and knowledge areas do you believe are essential for success based on your own journey?

00;26;19;19 - 00;26;40;15
Tina Simpson, JD, MSPH
I'd say adaptability, the ability to take lessons and skills learned in one sphere and then apply them creatively to another. We were just talking about how inherit health care generally, but like in this 21st century, there's a new way of working across disciplines where no no one is focusing on one widget. It you have to have you have to understand how other disciplines intersect.

00;26;40;15 - 00;27;03;01
Tina Simpson, JD, MSPH
You have to work with a lot more areas of expertise. You know, the doctors have to be able to speak to the engineers. The engineers have to understand where a where the physician is coming from and how, you know, we were working in that. We're living in a very complex system. So the ability to simplify and work across different sectors is very important.

00;27;03;04 - 00;27;21;27
Tina Simpson, JD, MSPH
There's a great book, Principles of Adaptive Leadership, which I think, you know, encapsulates this with within all of this complexity, being able, you know, effective leadership is, is, is responsive and identifies, you know, what identifies where there are those adaptive challenges that a system has to respond to.

00;27;21;29 - 00;27;40;09
Liz Church
I mean, from the tagline that we're using when we're talking about the podcast is it's a complex world. And so in order to stay on top of it, you have to adapt. It's not a perfect answer. It's the number one thing that you have to be able to do. You're taking what you've learned and applying it to other things, but you're also being able to educate others in that way as well.

00;27;40;09 - 00;27;58;00
Liz Church
And I say that from my perspective with what you've helped me learn with Medicaid, it's a big thing. I'm still conquering it, but we're getting there, and that's what we do with our clients. We're able to educate them and given those tools that they need so they can adapt and they don't feel burdened and they can take on these things head on fearlessly.

00;27;58;03 - 00;28;16;08
Liz Church
So as we close out this lovely conversation, we've gotten to know Tina. Her aspirations. We've gotten to know the health care industry and the challenges of what she sees, what everyone is facing right now. So, Tina, I got one last little question for you. What's one piece of advice or call to action you'd like to leave the listeners with?

00;28;16;08 - 00;28;25;26
Liz Church
How can each of us, regardless of our role or background, contribute to meaningful change in health care without being deterred by the obstacles ahead?

00;28;25;28 - 00;29;03;18
Tina Simpson, JD, MSPH
And that's a great question. I think that we have approaching approaching the problems with curiosity, you know, because there are a lot of obstacles. We are we have created a very fragmented system that's not always rational. And the problems can be overwhelming and repetitive at times. But there's always a reason why something is the way it is. So approaching it with, you know, some with curiosity and trying to sort of trying to get to that root analysis of it and resolve how you might be able to overcome that is, I think, that curiosity and a willingness to to listen can help combat that feeling deterred by the obstacles ahead.

00;29;03;18 - 00;29;09;28
Tina Simpson, JD, MSPH
So so staying staying curious is pretty critical for me at least. And in staying positive.

00;29;10;01 - 00;29;17;19
Liz Church
You know, I agree with that because if you're aggressive taking on a challenge, you're not really able to solve that problem with a level head. And you just to, you know, make it worse.

00;29;17;19 - 00;29;42;28
Tina Simpson, JD, MSPH
Yeah. Yeah. And I will I you know, you know some some days are harder than others because, you know, we do keep coming. There are significant barriers that I mean, we're talking about sort of a system level challenges. It's hard to feel empowered in when you're working in that kind of system where just by one of scale. But I think that what the change does happen, it happens on an individual level.

00;29;42;28 - 00;29;47;27
Tina Simpson, JD, MSPH
So being the change that you want to see in the world is possible and necessary.

00;29;47;29 - 00;29;56;14
Liz Church
Yes, possible and necessary. Look at that. Tina, you made a tagline for your own episode. Ladies and gentlemen. It's possible and necessary.

00;29;56;21 - 00;29;59;08
Tina Simpson, JD, MSPH
Here in the United States. Possible and necessary.

00;29;59;12 - 00;30;19;01
Liz Church
But you know what else is also possible? And that necessary. Tina, you're the first person I've interviewed for the podcast. Holy smokes. But thank you, Tina. Thank you for being here and taking the time with me this morning. We got through the first episode, and you had the lovely pleasure of being the first one to introduce yourself to all of our listeners.

00;30;19;03 - 00;30;22;17
Tina Simpson, JD, MSPH
It's my great pleasure. Thank you. Liz.

00;30;22;19 - 00;31;07;11
Liz Church
The Atrómitos Way is produced by me, Liz Church. Editorial assistance for this episode was by my fantastic team at Atrómitos. I would like to express our heartfelt appreciation to our guests who shared their expertise, stories, and insights with us on the podcast—finally, a big thank you to our listeners. Your support and engagement have meant the world to us at Atrómitos.  

We are a boutique consulting firm with the imperative mission of creating healthier, more resilient, more equitable communities. I encourage you to connect with us. Let’s continue these conversations and work together towards positive change. 

You can listen to all of our previous episodes on our website,  

atromitosconsulting.com/atromitos-way.  

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We’ll see you next time.