Speaking the Language of Healthcare: Why Every Leader Must Master the Terms That Shape Strategy and Access

Stewart Gandolf (Healthcare Success):
Hi everyone! Today’s guest is a friend and colleague I’ve known for years. He was one of our first podcast guests back in 2010, when we were just starting this. Alan, I remember recording with you in a hallway! We’ve both come a long way since then.
Alan, help our audience get to know you—what you’re doing these days and your responsibilities—and then we’ll dive into today’s topic.

Alan Shoebridge (Providence): You bet—and yes, I looked a lot younger back then. I’m Associate Vice President of National Communications at Providence, a seven-state health system with more than 51 hospitals. I’ve spent my entire career in healthcare marketing and communications. Today, I’m firmly on the communications side, overseeing PR, crisis communications, and thought leadership for our organization.

Stewart Gandolf (Healthcare Success): Awesome. You’ve also served as president of SHSMD and done a lot of exciting things. In your role at Providence—a leading system—you see and shape some big things happening in healthcare.
When we spoke recently, you raised a topic I loved: how certain healthcare terms really matter but are often misunderstood—even by people in the industry—and how that can have big ramifications. It’s timely; about six weeks ago I refreshed a team training on healthcare terminology. We do it every 18 months because it’s easy to get lost.
Today, we’re not talking PPOs vs. HMOs; we’re going to cover terms that sound basic but have huge implications. Before we dive in, why did this topic feel important to you?

Alan Shoebridge (Providence): As you noted, this is a tough industry to figure out. There’s a lot of terminology you’ve never heard before, and most people have used healthcare but don’t know what happens behind the scenes.
When you join a health organization—or even a partner company that supports one—you’re going to hear terms and concepts that don’t make sense. A few years ago I asked: how can we help people navigate faster, cut the learning curve, and avoid having to ask potentially embarrassing questions? The goal was to help people along that journey, because our industry isn’t easy to understand without background.

Stewart Gandolf (Healthcare Success): It’s easy to “fake it till you make it” without grasping the nuances. Search is better with tools like ChatGPT and Perplexity, but people still think they know something they don’t.
Let’s start with a concept you personally didn’t fully understand at first—and that’s really important.

Alan Shoebridge (Providence): I’m a little embarrassed, but it took me five years or more to really get length of stay—often shortened to LOS. It’s how long an inpatient remains in the hospital. In healthcare we work to reduce LOS—get patients out as soon as it’s safely possible.
That’s the opposite of what many outsiders assume, especially in marketing. On social media you’ll see, “Hospitals want longer stays to make money.” The truth is the opposite: shorter, safe stays are better for patients and for hospital throughput and finances. Reducing LOS is a core objective.

Stewart Gandolf (Healthcare Success): Has that changed over time?

Alan Shoebridge (Providence): The concept hasn’t changed, but the urgency has. Since the pandemic, we’ve had backlogs: more people needing admission than we can take, plus workforce shortages. Another factor—sometimes a patient is clinically ready for discharge but has nowhere appropriate to go, like a skilled nursing facility with no available beds. That extends LOS and blocks new admissions, including needed procedures. So urgency around LOS has increased.

Stewart Gandolf (Healthcare Success): Access is such a huge issue. I remember when our kids were born—years ago—it was surprising how quickly you’re discharged. Patients often perceive longer stays as “better care,” but that’s not necessarily true.
Let’s move to payer mix—another term with big ramifications.

Alan Shoebridge (Providence): Payer mix refers to the proportion of patients covered by Medicaid, Medicare, and commercial insurance (employer-sponsored plans). You want a balanced mix. Hospital executives will tell you Medicaid may reimburse ~30 cents on the dollar and Medicare ~60 cents, while commercial payers help balance the equation.
If your mix tilts too heavily toward Medicaid and Medicare without enough commercial, you’re effectively losing money on many services. That’s why negotiations with insurers matter—payer mix directly impacts financial performance, which many in the public don’t see.

Stewart Gandolf (Healthcare Success): Right. Some hospitals are largely Medicaid by mission and community, but they may pursue more commercial volume for sustainability. That’s a different marketplace with different expectations. Quick story: years ago a charity hospital wanted to market elective spine surgery. I cautioned them to align their patient experience with commercial expectations—call handling, access, everything. We skipped that training; the first lead escalated to the CEO.
Payer mix is strategic and operational—how you staff, train, and serve. Thoughts before we move on?

Alan Shoebridge (Providence): Exactly. We aim to reflect the communities we serve. In Portland, for example, you have all three payer groups, so the experience must work for everyone. If the mix gets out of balance, you face financial implications—and you’ve also got to ensure the experience aligns with each audience’s needs.

Stewart Gandolf (Healthcare Success): That leads to “no margin, no mission.” You don’t hear it much outside the industry, but it’s critical.

Alan Shoebridge (Providence): Early on I wondered what it really meant. Many nonprofit systems historically operated on a 1–3% margin. During the pandemic those margins turned negative. If you can’t at least maintain a small operating margin, you can’t serve the community for long—cash reserves only last so long. That’s why we’ve seen rural hospital closures. If you don’t make a margin, you can’t meet your mission.
The public often assumes hospitals don’t need to make money, or that “nonprofit” means “charity.” Financing is complex and not very visible to the average person. But you can’t lose money year after year and keep operating.

Stewart Gandolf (Healthcare Success): We talked a lot during COVID about the misconception that hospitals were “gouging,” when many were hemorrhaging cash. As a communications leader, can you move the needle on that understanding?

Alan Shoebridge (Providence): We try. Providence publishes a community benefit report each year and quarterly financial updates. We explain how we give back and our financial realities. It’s complicated, and most people don’t think about hospital finance until something negative happens—like a service line or facility closure—then it gets attention.

Stewart Gandolf (Healthcare Success): Sometimes it’s not a full closure—maybe OB stops accepting patients—which can be huge for a rural area.
You recently published 25 hospital terms every healthcare marketer and communicator should know. Let’s hit a couple.

Alan Shoebridge (Providence): Sure. Census is one: the number of inpatients in hospital beds on a given day. It affects bed availability, admissions, and ED flow.
Another is hospitalist—a physician who practices exclusively (or almost exclusively) in the hospital. Years ago your PCP would round on you inpatient. About 10–15 years ago, hospital medicine matured as a specialty to coordinate inpatient care more efficiently.

Stewart Gandolf (Healthcare Success): And looping back, length of stay remains a big one.

Alan Shoebridge (Providence): Yes—it’s the most misunderstood. We want patients discharged as soon as it’s safe because recovery is often better at home. That’s why you see growth in hospital-at-home services, remote monitoring, and other capabilities that support safe discharge and recovery.

Stewart Gandolf (Healthcare Success): As a patient, that’s exactly what you want—get me home.

Alan Shoebridge (Providence): Who wants to stay longer than necessary? Nobody.

Stewart Gandolf (Healthcare Success): People outside healthcare often associate hospitals with fear. Of course, great things happen there too.

Alan Shoebridge (Providence): I’ve walked into hospitals many times. There’s anxiety and hard moments, but also joy—babies being delivered, lives improved. Most patients and families don’t want to be there, so we should always ask: how do we make this easier on them?

Stewart Gandolf (Healthcare Success): A friend recently had a heart attack—it’s sobering how high the stakes are, and how grateful you are for the care team.

Alan Shoebridge (Providence): If you work in healthcare—even if you’re not based on a hospital campus—get there occasionally. Tour. Meet people. It’s one of the best ways to orient yourself. If you work for a partner company, ask to visit a facility. That immersion accelerates learning.

Stewart Gandolf (Healthcare Success): Totally agree. And if you can’t, the Cleveland Clinic empathy video is a great proxy.
You also had a couple of funny terms.

Alan Shoebridge (Providence): Two stand out. First, MOB—written as a single word in memos. I thought, “Why are we meeting at the mob?” It’s medical office building, often a standalone building on or near a hospital campus where clinics are located.
Second, elope. In hospitals it doesn’t mean two people ran off to get married. It means a patient left without authorization—they departed before being discharged. It can be serious if a patient needs ongoing care or monitoring.

Stewart Gandolf (Healthcare Success): Right—someone could deteriorate quickly after leaving.

Alan Shoebridge (Providence): Exactly. Even aside from safety, we need to ensure discharged patients know where to get follow-up care and have appropriate support getting home. Practically, we also need to know which beds are occupied. I’ve only seen “elope” used a couple of times, but the first time I was baffled.

Stewart Gandolf (Healthcare Success): There’s obviously a lot to learn. How can people get up to speed faster on the terms that matter?

Alan Shoebridge (Providence): First, ask. Don’t be shy about clarifying terms. Second, use tools—AI (ChatGPT, Gemini) and search—to get quick explanations, then validate with colleagues. Third, check out the guide I put together for common terms. And again, get closer to operations—tour hospitals and clinics. That immersion speeds the learning curve.

Stewart Gandolf (Healthcare Success): Healthcare terms can be confusing—e.g., different kinds of hospital foundations, or what an IPA is vs. a medical group. From the outside, it’s tough to parse.

Alan Shoebridge (Providence): I still learn new things all the time. There’s always new terminology. It’s lifelong learning—but AI and curiosity help accelerate it.

Stewart Gandolf (Healthcare Success): As a communications leader, beyond terminology, what else do you wish the public (and marketers) better understood?

Alan Shoebridge (Providence): In an era of misinformation, be careful with sources. Rely on trusted health systems, your physicians, and public health departments for information. It’s easy to get swept up by social media. Follow and engage with trusted sources.

Stewart Gandolf (Healthcare Success): Alan, great having you back. It’s been a while—let’s do it again soon. Thanks for your leadership in our field and for your time today.

Alan Shoebridge (Providence): Thanks—this was fun.