Healthcare Marketing In the Age of Limited Physician Access & Value-Based Care

Stewart Gandolf
Hi, everyone. Welcome to our podcast again today. Today, I am actually interviewing a long time friend that we've interviewed years and years ago and have interviewed over the years.

And as I was thinking about guests for this year, I thought I should go back to some of my favorites from the past.

So Dennis, thanks for joining us today. Dennis is the System Vice President of Strategy and Planning for UW Health.

Welcome, Dennis.

Dennis Jolley - UW Health (he/him)

Hi, Stuart. Thank you for having me back.

Stewart Gandolf

Yes, of course. So today, I'd like to start off just by if you could, because our listeners may not remember from the last time you and I have interviewed, plus your careers change quite a bit.

I mean, the world has changed a lot since then. So tell us about your current role at UW Health and catch us up on what you're doing these days.

Dennis Jolley - UW Health (he/him)

So I came to University of Wisconsin Health here in Madison two and a half years ago, System Vice President for Strategy and Planning.

Our strategy office has responsibility for, obviously, the strategic plan, as well as business planning, the system portfolio, and portfolio management, and then business development functions.

My area is really focused on the strategy planning portfolio side of the strategy office, so identifying the priorities for the organization, guiding the organization through the strategy process, prioritization of initiatives, and getting to work into the system portfolio and the planning necessary determine what resources will be required and how to deploy those resources.

Stewart Gandolf

So that is a, I think, very exciting and interesting job these days, right, healthcare is changing so much, so fast.

Dennis Jolley - UW Health (he/him)

It's a challenging job these days. It is exciting, but it's also challenging. A lot of academic systems, UW, is not unique in this, are overwhelmed right now, you know, with patients because of the impact of other factors in the environment, the broader environment.

So, yeah, it's an interesting place these days.

Stewart Gandolf

So I want to dive right into that in just a moment, but tell us about the help catches up on the size of UW Health and some of the, you know, do you have owned clinics, do you have, there's all academic, like a little bit more about the standard platform of providers, just so I have nowhere to start.

Dennis Jolley - UW Health (he/him)

Yeah, so we're based here in Madison, Wisconsin, affiliated with the University Wisconsin, obviously, and the academic health system here.

We are about, around a $6 billion enterprise. We have three hospitals in Madison that we own and operate. University Hospital, American Family Children's Hospital, and East Madison Hospital.

We also operate another hospital through a JOA with UnityPoint Health, the Mariner Hospital, and then we own a community-based, small community-based hospital system in Northern Illinois, just about an hour south of us, Northwestern Illinois, in Rockford, UW to be helped Northern Illinois is our division down there.

So we really have two core markets, and then we have a broad array of clinics throughout the region, mostly in Wisconsin, but not exclusively also in Northern Illinois.

Stewart Gandolf

Got it. Okay, that's about what I thought. So let's talk about some of those challenges. I think the central issue we're going to talk about today is access, and you know, I think use the word overwhelmed moment ago.

Give us a sense of some of the challenges you guys are facing today.

Dennis Jolley - UW Health (he/him)

Yeah, you know, I think it's a significant number of factors that have created the situation that we are in and the other, some other systems are in.

The coming out of the pandemic, you know, we were heading into the pandemic with a oncoming shortage of healthcare providers anyway, due to the talent cliff that we were heading with retiring baby boomers and are the fact that we had a broad system we weren't producing enough to replace all of them.

The pandemic certainly accelerated that to a certain extent by pushing some people to really retire or to leave healthcare because it was a rough time to be a healthcare provider.

And some of the challenges that were, you know, leg bear in the pandemic didn't go away. But as the pandemic kind of eased through.

And then you add on top of that the challenges the rural health systems have faced financially and with lack of providers, which has contributed their financial challenges, has really put a strain on a lot of larger systems.

Finance, the rural systems, a lot of closing. um or having to close services and those patients have to go somewhere.

Um, not all rural hospitals are an attractive, you know, acquisition for larger systems because of the cost involved. So, you know, we've had systems that are our hospitals that have closed in our region that, you know, blast this.

Well, why don't you guys just take them over? And in some cases, it's a situation of declining population, deferred maintenance, debt, whatever the combination is, you know, not all rural, rural hospitals are doing well and not all rural hospitals are necessarily an attractive acquisition for a larger system.

But those patients still need and deserve care. And so the question is how do you support those environments and those patients without them all having to come to, you know, into the larger systems?

So, for us, it has resulted in a really significant increase in demand, and we're struggling, honestly, to meet all of that, and so a lot of our strategies have been focused on how do we create opportunities to deliver care, how do we improve access, and deliver the care to everyone who needs it?

Stewart Gandolf

That probably makes sense. I mean, the challenge in rural health care is, you know, big and looming and it's interesting, Dennis, we worked a little while with, I'm not sure if you guys cooperate with them or not, but Homeward.

Their idea was, as a new venture capital-based company, was to deliver sort of house calls through, you know, most of nurse practitioners and PAs, whether it's them or any other model.

Do you see that as a viable option moving forward with you know, companies that are just within your own system to try to bring, you know, house calls out before people get sicker?

I don't know if that's it or if its too soon.

Dennis Jolley - UW Health (he/him)

Our approach right now is everything is on the table for consideration in terms of every possible delivery method. So that's going to include virtual in-home and, you know, in-person.

And it's got to also include every type of service we need to offer. We ask ourselves, is this something we build ourselves?

Is this something we buy from someone or is this something we do in partnership with someone? And so we have to we have to consider all options because, you know, I think it's unrealistic for any system, even the big ones, to be able to just say we can do this all ourselves.

Stewart Gandolf

Yeah, there's so much out there. I mean, it's again, you're not alone with this problem and you guys are a respected institution.

It is interesting what you just said about the, I can certainly see that, not every localized hospital is a good one, right? To be able to just sort of pick up. And that brings even if you did. the administrative and the management and all those things are real, right?

Dennis Jolley - UW Health (he/him)

Yeah

Stewart Gandolf

It's real. Well, so the idea, let's, you know, some other models that, you know, that I, when I'm talking to smart people like you that come up, obviously telehealth has some promise in some ways.

And certainly, you know, when I think back about, you know, I don't know if you notice about me, Dennis, but you know, for years, I spent was on the road teaching, you know, marketing to practitioners, including people in rural areas.

Dennis Jolley - UW Health (he/him)

yeah, I remember that.

Stewart Gandolf

Yeah, so you come in for a surgery, and then you have to come back for follow up and drive for a more mile, for more hours of whatever.

So for routine stuff, I think telehealth is going to work. Not everybody's, you know, embracing it as we know, you also have a remote patient monitoring.

And you know, we talked about house calls, other models. I'm curious, going back to the telehealth and the remote monitoring, is that taking a bite out of the problem?

I mean, I think as you guys go forward I'm guessing it is helping, but it's not enough, but I'm curious what you think.

Dennis Jolley - UW Health (he/him)

It is helping and it's going to help more and more as both we get better at it as a system and as the broader health system gets better at dealing with it in terms of payment models and that sort of thing.

You know, it is a practice shift, but it's also an operational and financial shift to manage. So, for your example of, you know, you have a surgery and you need to follow up, you really have to drive that, you know, three or four hours like you said, back to see how the surgeon do it, or could you go to your primary care provider and your primary care provider has received information from the surgeon and knows what to check for or you have a virtual consult while you're in your primary care doctor with the surgeon, and your primary care doctor to say, this is what we're looking for, how is patient doing with X, Y, and Z.

And let that patient do it in their home community. There's things like that. The remote patient monitoring is certainly helpful.

It's best when it seems to be best utilized when it's tied to something like home health, you know, and it's most effective in like hospital at homes, at-home kind of situations.

But we have to get better and better at how does that information from the remote patient monitoring devices, how is it used, how is it acted upon, how does it drive care improvement?

Stewart Gandolf

Yeah, I can see the infrastructure of all this, right, how that data is going around, how do you manage it, how does that fit with everything else you do, you know, by the way, your doctors are all very, very busy.

So you're kind of like fixing the plane while it's flying, right?

Dennis Jolley - UW Health (he/him)

Absolutely. for things like, you know, hospital at home, for example, which is really a great option for some people.

But for most hospitals at home, you know, programs, the patient has to live within a certain distance, can't live beyond a certain distance from the hospital.

Because if things go south, they will need to be admitted, get into the hospital. And so, you know, there's all sorts of challenges around extending these into rural environments in particular.

Stewart Gandolf

Do you feel like, you know, it's funny, I've been the whole AI, which is the topic of every conference I go to lately.

But I've heard, I haven't dug into this very deeply, that there are some pilots going around where AI really is doing a good job of diagnosing and being able to be a part of the team.

if we're thinking about extending care, and I talk about this to sort of, you know, non-healthcare friends. What's going on in health care?

It's like, well, you have MPs. PAs and you have doctor shortages and you have this and that, but do you feel like AI that it's not ready yet because of a whole bunch of issues including you know safety and you know the lack of being proven and Reimbursement and all that but can that be part of the solution for routine stuff to help identify

Dennis Jolley - UW Health (he/him)

I think it's gonna have to be I think as those algorithms get more Efficient and more reliable.

They're actually already pretty reliable and they do really help Physicians diagnose more quickly and more accurately And I think that we're gonna see huge advancements In the coming years as this continues to develop, you know, I mean right now If you think about it a physician You go get an MRI and you get a lab report and those go as separate reports into your medical record And the doctor has to look at both and kind of try it

you know, piece it together. You know, I could see a point in the not too distant future where those kind of reports and tests all come into an AI tool that looks for different patterns and then makes recommendations to a physician in terms of what a likely diagnosis would be or what a likely, you know, appropriate treatment pathway would be.

Stewart Gandolf

Yeah that's exciting because, you know, we're all still humans and everybody's busy and there are biases, right? People may miss something.

so the idea of at least, I feel much more comfortable if I'm going through this process as a patient that the doctor is still in charge, is still quarterbacking, but using the tools, then I feel actually maybe better, right?

Dennis Jolley - UW Health (he/him)

I think, I don't see this getting to the point where AI is doing the diagnosis and treatment plans independently, but I think that they can make physicians significantly more efficient.

And take workload off of the physicians where the physicians are looking at the recommendations from the AI and kind of saying Does this seem to fit with what I've seen in the patient and that moving forward from there?

Stewart Gandolf

Yeah, I mean the It's interesting because going back to pandemic when you know Health care as we know, Dennis, isn't famous for being moving fast and coordinating The but during pandemic we suddenly telehealth went from like we can't do it and all the reasons why we can't do it And all the reason why I won't to all of sudden everybody's doing telehealth in a matter of weeks Seeing millions of patients and so this side of it I'm curious there is not that singular event of a pandemic forcing change which just there is no other alternative right but with the AI and some of these other things we're talking about I feel Like the demand is going to be so overwhelming that it just has to work like we don't have to think about you know, it’s important.

Dennis Jolley - UW Health (he/him)

So we know that American healthcare is too expensive, hard to get into, and frustrating for patients. I mean, it is.

And it's unfortunate. Got to find ways to make it possible for people to access care more efficiently, and at a lower cost.

So, you know, for those patients for whom active management is necessary to identify them earlier and provide them support in an efficient way again.

And that's where all of these tools are going to become the most helpful is identifying a patient who's a rising risk before they become a total clinical train wreck.

And, you know, to better manage those costs and their health and their well-being.

Stewart Gandolf

So let's talk about that a little bit. idea of value-based care. You just said, you know, when we started looking at value-based care more broadly on the population-side population health, like how do we keep people out of the hospital?

And this is a classic area thing in rural healthcare, right? You have people that are, it's hard to get care anyway.

And not everybody is, you know, super inclined to take care of their health. So, you know, how does that change?

Like, how can you do that? What are you guys planning is working? Like, and is it, is it grassroots?

Is it email? Is it mailings? Is it just making sure your doctors are talking about this to patients when they see them?

Because that's, you know, that's a huge challenge. And I'm curious, like, what steps can you guys take to help on that?

Dennis Jolley - UW Health (he/him)

Yeah, so in our current strategy, we have three key areas. call them our strategic imperatives. And one of them is value-creating care.

And we intentionally... made the choice of not saying value-based care. And that's because value-based care is a payment model.

It's not a care model. It is not about, it's not patient-focused, it's how do I get reimbursed-focused, right? It's payment-focused.

So for us, we wanted to think of it in terms of value creation. And value-creating care is about what is the value to the patient, what is the value to the payer, and what is the value to those involved in delivering care.

Because I think if you focus solely on the payment model, it's not gonna work. What we have to do is we have to, and your question was really about how do we engage the patients, right?

So how do we identify when, you know, in terms of providing people with care that is appropriate for where they are in their life, in their life and what they need.

If you're a 20-something or something you're old who's healthy and doesn't need to see a doctor regularly, doesn't have significant medical concerns, how do we provide you with the care and the information that helps you identify when you do need to see a doctor and do you need a specific primary care provider that's your person or do you just need to be able to get access from your care system and know that if there's something that triggers or raising risk concern that then you will get assigned somebody to help you manage that and it may not have to be a physician.

It could be an NP, it could be a nurse, it could be a pharmacist, could be a nutritionist, could be lots of things depending on what it is you're at risk for the, so how do we help people get the preventive care, and the you know, minor acute care that they need in an efficient way that builds trust and also manage it, keeps costs down. And so it's really around value creation.

It's creating multiple care models that a patient can travel through based on their individual needs.

Stewart Gandolf

That's fascinating and it's really interesting you said nutritionists there. So you have lifelong habits that are forming in your 20s.

So even then it's a lot easier to take care of things for you avoid obesity and diabetes through life planning than elsewhere.

Dennis Jolley - UW Health (he/him)

And it's about delivering care differently than we used to. You hurt yourself playing football on the weekend or whatever.

And in the past you'd go to the fourth big surgeon. Right? Surgeons are really expensive. And most of the time you don't need surgery.

So maybe you should go see a physical therapist first for any musculoskeletal stuff, unless it's an obvious break or whatever, right? Right.

Stewart Gandolf

So, going, I'm sorry.

Dennis Jolley - UW Health (he/him)

Nope. And it's the same sort of thing when you're thinking about just even general concerns, you know, you have a rash that pops up, do you really need to see a dermatologist or can you take a picture of it and send it to your primary care provider who has a, you know, most dermatology is visual.

So, a lot of that can be done virtually, and it can be done asynchronously or, you know, live. There's a lot of different ways we can deliver care now with the technology and stuff that we have that is far more efficient than the way we've, quote unquote, always done it.

Stewart Gandolf

So, that's...

Dennis Jolley - UW Health (he/him)

And that doesn't have to be less personal. People think it's not personal. It can still be personal.

Stewart Gandolf

So, I love that resourcefulness you just mentioned... So, for example, the PTs with direct access states where people can go to a PT directly versus having to get a script.

And then here in California now, I believe it's, everybody has to be a DPT, Director of Physical Therapy, but that's something that, you advantage of the PT network out there is a way of expanding, that's resourceful.

I'm curious, how can you integrate, and I'm assuming this is a priority for you, but I don't know, the local primary care providers that are out in the countryside, do you guys have formal programs, and as you start re-imagining health care with them, you know, are you trying to engage them, and I'm assuming some of them are engaged than others.

you know, won't just keep doing the same stuff they've always done, but tell us about that.

Dennis Jolley - UW Health (he/him)

you know, we tend to work more with either larger practices or hospitals throughout the region than one of the individual physicians, but what we really try and do is, as an academic medical center, say, how can we best support your practice so that your patients don't have to leave your practice and your town and your system to receive the majority of their care?

So is that through providing provider to provider consults as needed? Is it through you know, supporting that local hospital with EICU support, you know, that sort of thing.

Sometimes we and physicians out in the old-fashioned outreach clinic kind of model still too, but only in those situations where it really makes sense both for the provider that we're sending there in the community with their needs.

Stewart Gandolf

So that makes sense. So going back to engaging patients. Some people are much more sort of self-advocating than others.

Some people would be if they knew how to. Some people don't know how. Some people don't really care. Have you found any secret sauce here?

Or is it just a lot of work? Like, how do you get people to engage, um, you know, um, or what are some of the big challenges you've seen, just in a maybe it’s just inertia or should they're used to doing things a certain way?

Dennis Jolley - UW Health (he/him)

I think the, the only secret sauce is giving lots of options and helping people to understand what those options are and why they might select them I think Kaiser actually does this really well where if you call for an appointment, they say, well, I can get you a virtual care, I can get you a virtual care, you know, depending on what you're what you're calling for, right?

But if it's an appropriate condition, they'll say, can get you a virtual care today, I can get you in with an APP next week, and I can get you in with a doctor and three in, you know, a month and a half.

And here's the price difference between them, which one do you want, right? Giving healthcare has never been good about giving patients the information.

to be more engaged and take more ownership of their health. Health care traditionally has been a, I'm the expert, I will tell you how this should be done more than, let me engage you in giving you information so that you can make a decision about how you're cared for.

Stewart Gandolf

That makes sense. And that's, that's overdue, but awesome. can see how that would work really well. The, another question I would have going back to something else, said a few minutes ago, like bringing other options, for example, seeing the PT, you know, you have the patients to educate them, but the doctors also, you know, especially if they're in a practice, they've been doing a certain thing a certain way for a long time.

Even if they want to cooperate, there's habits, right? So right in this review store is doing this happens and I do that.

And if they don't even think about it. Because it is so natural. So as you guys think about the future, are there ways of just continually educating doctors at scale, whether they're in your network or out to help just reinforce some of these new ideas?

Because I could see it's like even if they want to participate, the raw human, it's like easy just to do this thing we've always done.

Dennis Jolley - UW Health (he/him)

Yeah, and physicians are incredibly busy too, but physicians want to be practicing at the top of their license. They want healthcare providers generally want to be more at the top of their license.

They want to be efficient. They don't want to be seeing patients. They don't need to see. A surgeon doesn't, you know, an orthopedic surgeon doesn't want to see 10 patients who don't need his services and then say, well, you know, all you need is physical therapy or all you need is that, you know, they don't they don't want to do that.

They do it but that's what they've done in the past. But if you give them a way that says,

we're going to take that off your plate. I can't think of a time when I've had a physician say no, I don't want I want to keep doing it the way I have when you give them a really genuinely useful option.

Stewart Gandolf

This is such an insightful call because I'm just thinking back to all the doctors I've worked with in the past and the idea that okay this is what you're really you know especially today when they're kind of I'm an administrator I don't want to be a administrator right even clinically right to be able to say okay you know I'm a surgeon I remember once I was just a specific doctor and he's like no I'm a surgeon I do surgery you know you didn't want to do this other stuff and so or you know a classic case of you know I remember high maintenance emotionally patients and the doctor admitting to me like I don't want those patients and it's like okay instead of trying to not a bad fit for both sides get you know psychological care or whatever.

However, to be part of the equation, that makes sense.

Dennis Jolley - UW Health (he/him)

That's another great example because behavioral health, mental health is an area that we have a problem with in the United States.

We don't have providers, there's incredible demand. What we did here is we have embedded behavioral health, mental health providers within all of our primary care settings.

If you come in for any kind of primary care appointment, virtual or in-person, we do a quick screening. If you get a certain score, the provider you're talking with, whether it's an NP or a physician, can probe and say, you seem to be experiencing a lot of anxiety, is that something you like some help with?

We can get them connected with primary care, with behavioral health, mental health, in that same visit to initiate an intervention, a short-term intervention because a lot of people just need

you know, help getting over a hump or then in some cases, you know, the mental health provider identifies a more significant issue.

But that kind of thing also takes a load, you know, yes, we're asking them to initiate conversation, but it does actually take a load off of the primary care provider to know that that resource is available right there.

Stewart Gandolf

That's great. You know, and I would assume you have your community is a fair number of Medicare patients, a fair number of Medicaid, mandula-eligible, anything specific you've learned about, you know, to service those populations well and, you know, and is the house that evolving?

Dennis Jolley - UW Health (he/him)

You know, for the Medicare or Medicaid?

Stewart Gandolf

Sorry, I always said both, really, it's like medically take one at a time to make it easy

Dennis Jolley - UW Health (he/him)

For the medicare population, you know, the growth in medicare advantage plans, which are likely.

going to expand even more here in the coming years, I think. It's really about proactive management and ensuring that you get them in, you know, comprehensive annual wellness exams, that sort of thing, and making sure that, you know, that you're able to connect them with a team of people.

And again, this is about educating the patient that you don't always have to see Dr. Jones because Dr. Jones has all these people in Dr. Jone office who work with him to support you. So maybe what you need is a regular check-in with the pharmacist, maybe what you need is a regular check-in with the nutritionist, maybe what you need is a regular check-in from home health, you know, or, you know, that sort of thing.

We've also expanded our primary care at home model for those patients for whom leaving the home is challenging, to make it possible so that they can receive primary care visits in the home, and that's pretty important for that population as well.

Medicaid, it's really around accessing and ensuring that they're getting the care because most of the individuals on Medicaid, there's a reason for being on Medicaid and needing those services and so identifying how we can best reach out to them.

It's a challenge, I don't have a single answer to that question, but certainly getting them to engage with you in that just annual kind of check in check up is key because that's that makes the flows that everything else flows from.

Stewart Gandolf

So we've talked today about a lot of things. The and access is the key issue of course for the things you're facing.

Are there any services that you still want to do more of? Are there any services that you don't have enough access or you have access that you feel like can really help or is that just such a second priority you guys aren't thinking about these days?

Dennis Jolley - UW Health (he/him)

No, we are. mean, certainly, as an academic medical center, we're continuing to push the boundaries and trying to think about what's the next.

What's next? And we are certainly leaders in a number of areas, you know, for us oncology and solid organ transplant, neurosciences, you know, there are a number of areas like that that we continue to lead in and that we have a responsibility to really provide, you know, the higher level services for the entire region.

And so we continue to push in those areas and we just, you know, continue to advance the field. Let's say some of the, you know, quote unquote, ancillary areas or our physicians don't like it when we use that term, but, you know,

imaging, advancing imaging and pathology, like I said, those are kind of integrating how we're thinking about new next-generation therapeutics.

The biologics, cell therapies, gene therapies, those sorts of things are certainly critical as well. So we're not dialing back because of the access crash.

We actually think some of those things are going to be critical to how we provide access in the future.

Stewart Gandolf

Makes sense. So a couple of questions more before we wrap up. I'm curious, just from the marketing standpoint, because this is a different kind of a situation you've been in the past, right?

So broadly speaking, you to share everything about your marketing plan, but like how does a system like yours, you know, market to patients, market to doctors, and how does that evolve in changing over time?

Dennis Jolley - UW Health (he/him)

Yeah, ironically, I just had my monthly check-in with our Chief Marketing Officer just immediately before this call. And, you know, for us, it's all around that personalization.

You know, it's about using technology like a CRM to extend the personalization of the care that we're trying to provide and translating that into the information the patient receives.

It's not, you know, we used to 15, 20 years ago, you'd, you know, do a newsletter or magazine or something that just everybody got the same thing.

And now we don't do that. really target the messaging around ways that, you know, have to promote prevention, self-care, and helping patients know when they should engage with us based on their own profile.

Stewart Gandolf

Outstanding. Anything we should have talked about today, this is a lot. This has been, this is fun and insightful as I knew it would be.

Anything you think we should be talking about that, know, maybe about where health care is and where you guys are going from a strategic level?

Dennis Jolley - UW Health (he/him)

You know, I think it's going to be a very interesting decade ahead of us in health care. We've got to get access affordability Both kind of under control at a systemic level, and I mean don't mean you to be health system I mean you know national system.

I think each system each, you know each of us is trying to new things and Continuing to learn and share through you know venues like this and others Is really important because we have to continue to get better at this It's necessary for the health of the country and the individual patients and the health of our systems.

Stewart Gandolf

So it's interesting that you've had another insight.

love which is you know, I think Reimbursement drives this so much that sometimes we don't I see it. How it's being thought of from a reimbursement viewpoint.

And the, you know, health care has had its challenges and certainly recently, but, you know, for the last, you know, X number of years, increasing sort of the, I guess, the pressure.

And one thing that I've always talked about for years is that, you know, nobody would design the system that we have today from scratch like this, right?

Nobody would just say, let's do this. Let's go whiteboard how it's all going to work.

Dennis Jolley - UW Health (he/him)

Yeah. It's the most rubed Goldberg of all systems in an air country, you know.

Stewart Gandolf

So yeah. So how do you, you know, it's really difficult because you have, nobody likes it, but then everybody has an interest for the way it is, right?

So it's, it's really difficult to make substantive change. But I feel like the pressure is so much that we'll just have to figure it out.

Dennis Jolley - UW Health (he/him)

Yeah. Exactly.

Exactly. And there are, there are really good, there are some really, really good bright spots out there too. There's a lot of challenges, but there are a lot of really good people in health care across this country and good organizations who are trying new things and who are making really good progress in improving care and improving efficiency.

And that's why I think sharing those lessons learned so that people can try it in their community and see what works you know because every community is a little bit different, but a lot of people are pretty probably applicable.

Stewart Gandolf

Great Dennis, great job today as I expected. It's been really fun reconnecting.

Dennis Jolley - UW Health (he/him)

Yeah, I had a really great time talking with you.

Stewart Gandolf

I invite you any time you have some news you want to share that you think is helpful to you know the broader audience.

You're always welcome back so think of us as you know one more microphone to get the word out. Thank you again, I appreciate it.

Dennis Jolley - UW Health (he/him) Thank you. Thank you. Great to talk to you