← Becker’s Healthcare Podcast
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- [00:00]
A
Hi everyone, this is Brian Zimmerman with Beckers Healthcare. Thank you so much for tuning into the Beckers Healthcare podcast. Today we're going to talk about addressing the healthcare workforce crisis at scale. Joining me for today's discussion, Scott Lyles, president of the medical and veterinary segment at Kavista. Scott, thank you so much for being here.
- [00:19]
B
Absolutely, Brian, thanks for having me.
- [00:21]
A
All right, to start here, for listeners who might not be familiar with you, can you share a bit about your professional journey and the work you're doing today?
- [00:28]
B
Sure, absolutely. As you noted, I'm the president of Kovist is medical and veterinary segment. I have responsibility for our medical schools and veterinary school. Those are the Ross University School of Medicine, the American University of the Caribbean School of Medicine, and the Ross University School of Veterinary Medicine. I have a real passion about these schools and about what Covista, the nation's largest educator of healthcare professionals, does. This is not where my career started, however. I have had kind of a winding journey to land where I am and I'll preface it with the common thread. Throughout that journey has always been mission driven institutions, which these are to a T. I started out my career in development assistance in Southern Africa and Southeast Asia, moved on to consulting and then ran a number of different businesses all in mission driven industries. In particular pet health insurance, where our mission was to help folks avoid economic euthanasia. I led acams, which was the world's largest anti money laundering organization that was fighting organized crime, human trafficking, enforcing sanctions, compliance, mostly working globally with financial institutions and now leading the medical and veterinary institutions for Covista.
- [01:58]
A
Yeah, it's a fascinating journey you've had, but I do love the through line and the through line of these mission driven organizations is absolutely the connective tissue here. So absolutely great to have you on the podcast. Let's start here by sort of, I guess, talking about the workforce crisis, I mean you say that I don't think anybody who knows anything about healthcare would argue a point otherwise that there isn't some kind of crisis. But it can feel abstract when you're talking about it. So I'd love to get your take about what it actually looks like from your perspective in terms of how urgent this is.
- [02:33]
B
Y Brian, I think it's a great point and you know, we've talked about it for a long time, particularly in the United States. Healthcare crisis. Healthcare crisis. At Covista we have taken the extra step to really start to put some rigorous and consistent data around what that health crisis means. We've partnered with Gallup to develop the care capacity monitor that we publish every year to put some hard data around what this quote, crisis is and to give us some additional ability to help solve it. So let me, let me put some, some numbers around it. Right now we reckon that there are about eight and a half million job openings, shortages in healthcare providers in the United States. Eight and a half million. That is a significant, significant number. And what we hear is that almost half of, of folks who are involved today in delivering health care believe that their, their system, their hospital, their clinic has a shortage of providers. Now the numbers are really, really compelling. What is more compelling is that these are not evenly spread across the United States. These are not evenly spread. In some areas this crisis is less. And in other areas it is truly, truly acute to the point where 90% of providers say they absolutely do not have the workforce that they need in order to execute. And these areas of greatest workforce debt exist in the areas of greatest need. They exist in the areas of greatest need. The biggest ones geographically are rural areas. And we've been talking about that for a little while, but we've really put some hard numbers around that. And the second area is lower income urban areas. Those all truly, truly struggle to get the healthcare providers they need. When we talk about those providers, the shortage is not equal across the different practice areas. Nurses are the greatest numbers. Doctors in the fields of internal medicine, pediatrics, family medicine are the, are the areas of greatest need. Now why that's important, Brian, is because those practice areas, nursing, the family practice, internal medicine, pediatrics, those are the practice areas that create lifetime wellness. Those are practices that create lifetime wellness. And when you do not have those, you have more chronic disease, you have shorter lifespans and you have more need for the emergency room, which is, you know, and all of your listeners, listeners know, puts even more strain on an overtax system.
- [05:35]
A
It really shows up in the emergency room. This crisis is on full display there. Right?
- [05:40]
B
That's exactly right. That's exactly right.
- [05:43]
A
And you're the care capacity monitor that Covistus put out. You just shared some numbers that are striking and you put some numbers around some hard data around it. Clearly. And it's not all on traditional schoolings per se. This is not the only reason that this crisis exists, but it certainly hasn't is like failing to fill this gap.
- [06:01]
B
Right?
- [06:03]
A
There have been some criticisms in terms of capable candidates are sort of filtered out for various reasons. Curious to hear how you think, what role, what are the barriers? Why is that? Why have those barriers existed traditionally? And what role can International medical schools play in sort of knocking them down and filling the gap.
- [06:23]
B
Yeah, it's a great question, Brian. And let me start at the beginning where you, where you noted, you know, the beginning of the pipeline that creates a shortage in doctors, nurses, behavioral health specialists, et cetera, begins with education. It begins with education. You know, we all want our doctors, nurses, behavioral health specialists to be educated and to be professionals in their field. They simply, in our legacy education system in the United States, we. We just simply don't have enough seats. We simply don't have enough seats. There are only seats in traditional nursing schools for about half of applicants. It's the same for medical doctors. We believe that, well, well over 90% of those applicants are actually qualified to become very, very successful clinicians and practitioners in their chosen fields. And in fact, we have the data to show that, that they do. So the first step in the chain of the shortage is just simply, we don't have the system that educates enough folks who really want to dedicate their life to medicine to educate them to do so. That's where schools like ours, that's where schools like you're talking about international programs, that's where non traditional nursing schools like Chamberlain University, that today is the largest provider of nurses to the US Healthcare system. That's where they come into play. They come into play in what, candidly, is market failure on the legacy system to provide enough of what we need to supply our demographics today. And those demographics are getting worse. Yeah, the country's obviously growing, but the biggest part of our demography are folks who are aging very, very quickly and are getting to that age where they need more and more health care. You know, it's the baby boomers. They're now over 60, they're retiring at pace, and, you know, the oldest ones are turning 80 this year. So over the, over the next 20 years, we have a huge bubble of our population who is going to be going through their greatest need of health care. It's the same bubble that will mean more doctors, nurses, etc. Retiring, pulling even more people out of health care, and we simply don't have enough to serve them. That's the role that we play. And I'm very proud of our outcomes that we have at all of our schools. Medicine, nursing, behavioral health, all contribute substantially across the country.
- [09:13]
A
Yeah, and to your point earlier, just the math doesn't work, like, at all. It's not even close. But I want to get to some of something you said too, or sort of like some of these students who aren't being or aren't entering the pipeline in traditional education, but they are capable. They also come from different backgrounds that are probably not as well represented in the industry as they could be. And there's probably some value there that's just not being tapped into. Can you talk a little bit about how, how Kvista, other organizations like yours are intentionally recruiting from different backgrounds, different candidate pools and how are you also because sometimes some of the challenges there I can imagine is those folks don't have the right support systems in place to get them over the finish line. So then how are you helping these folks get over the finish line?
- [10:05]
B
Yeah, so those are two great questions. And let me start with some of the the data that exemplifies the ends. First, our schools over index in future doctors who will be the first person in their family to go to college. It's the same with nurses. And what's important about that is we know from hard data that doctors, nurses, behavioral health specialists who look like the communities they serve deliver ultimately deliver better outcomes. And that's great. So that's the, that's the end. That's the end of the story. Getting there. There's a couple of really, really important points. The first one is we talked about the shortage of seats in the legacy system, but we know that that's where, that's where it starts. We also, in addition to taking students who look a little bit different than the typical applicant class, we also who might not have done as well on some of their entrance exams, who might not have had a straight path through pre med, they made changes in their career path as they went throughout their educational journey. We specialize in that non traditional student that just looks a little bit different. We have, to your point, developed a system that is now decades proven of being able to turn those applicants, future students and ultimately doctors, nurses, behavioral medicine professionals into high, high performing doctors and medical professionals, they all take the same exams. Whether you go to an Ivy League institution or whether you go to an international institution. If you want to practice in the United States, you take the same exams. Our students take the self same exams. And what we see is the segment of students that attend our schools actually perform better on the same exam than that same segment who goes to a legacy program. Same student, same exam, better outcome. And we see that in the hard, hard data. Now why is that? That starts to address your following question which is what do you provide that's a little bit different. Ultimately, we start very early on providing additional support for our students throughout their entire journey we set up our programs very, very intentionally to do that. We have early identification mechanisms where people might need a little bit of extra help. At our medical schools that I have responsibility for. We have set up what in the traditional system would be called postbac programs, which is preparatory programs for medical school. Our programs are tailor made for the students who come in and they show about a 2x matriculation rate over the average postbac program in the United States. We know what our students need, we prep them. Right. And we do it throughout their journey with us, and they ultimately have better outcomes. Now, you know, I'm not trying to say you get everything. The trade off that we make is we spend a lot more time on education and less time on research. We still do research, but if we compare it to legacy programs, our mix of, in class, our budgets for teaching as a percentage of what we do are much, much higher than legacy programs who spend a lot more on research. And so that's the real trade off in how we make that, make that happen. It's a dedication to education and a dedication to those students. Yeah.
- [14:08]
A
And it also sounds like just a. A dedication to actually really addressing the problem. And no one thing is going to solve this crisis, but truly, like organizations like yours, like Kavista, are going to have to play a role. Do you have hope too, that sort of. Maybe the silver lining behind this crisis is that people will wake up in traditional spaces or leadership everywhere will kind of understand like, hey, we got to do medical education a little bit different.
- [14:38]
B
What I would love to see, and I'll speak mostly from the, from the, the MD side, from, from the doctors, is I would love to see us have a holistic view as a medical system said there is a role for everybody. And ultimately the key that we should be shooting for is to have enough of the right doctors in the right communities to where we can improve our overall systemic health outcomes. That should be the goal. Mm. And it should be a systemic solution where we look at the right avenues for the right outcomes. I don't think we do that today. And I think there's a real opportunity for us to change, to change that mindset.
- [15:25]
A
Yeah, let's go. I'll put even more, I guess, specific parameters around it where it's like, let's say, let's fast forward 10 years and we're having this conversation and maybe your hope there has sort of come true in some ways. What does that look like and what has needed to change for that, for that to have happened, for that reality to become reality.
- [15:44]
B
You know, I think probably the number one thing is that folks will look at all of the schools and the entirety of healthcare education and understand that it all contributes to the same end. I'm not sure that that happens today. I think there is still a view of it being competitive and that there's a fixed pie and if there's a school in Barbados that that takes away from opportunities for a school in Illinois, and that's just simply not the case.
- [16:15]
A
It's a scarcity mindset.
- [16:16]
B
The scarcity mindset. That's exactly right. That's just simply, simply not the case. We're in a situation where our pie is so woefully small that in order to do what we really need to do for our population, we have the opportunity to grow that significantly. That's what I would hope that all of the folks who are involved in really driving forward the medical health care system would understand.
- [16:44]
A
No. Well, Scott, I think it's a. It's a wonderful point, and it's been a pleasure having this conversation with you, truly. Thank you for coming on the podcast.
- [16:52]
B
Thank you, Brian. Appreciate the opportunity.
- [16:54]
A
We also want to thank our podcast sponsor, KVista. You can turn to more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.