Key Takeaways
- Health systems must prioritize ambulatory operations as a strategic engine for revenue diversification and population health to accommodate the industry shift toward outpatient care.
Ambulatory care is the engine room of U.S. healthcare, delivering critical services to millions outside of traditional hospital walls. In an era defined by workforce shortages, shifting reimbursement models, and unrelenting pressure on margins, few areas are more vital—or more misunderstood—than ambulatory operations. This is precisely why the latest episode of The American Journal of Healthcare Strategy podcast with Abby Berkes, MBA, Administrator of Ambulatory Operations at Lehigh Valley Health Network, matters.
Abby’s story is not only about managing a portfolio of outpatient services; it’s about what operational excellence looks like on the ground, how leaders can bridge clinical and business divides, and what it really takes to keep ambulatory services both efficient and humane. From workforce development to the nuts and bolts of process management, Abby offers practical insights for anyone serious about the future of outpatient care. If you’re leading teams, building a career in healthcare administration, or simply trying to decode what makes high-functioning ambulatory networks tick, her perspective is essential reading.
Ambulatory operations refer to all healthcare services provided outside of a hospital’s inpatient setting—essentially, outpatient care. These include everything from imaging and rehab to sleep labs and occupational medicine. As Abby explains, “Ambulatory operations is really your outpatient setting, so it’s any service that isn’t taking place on the inpatient side. You don’t have to be admitted to the hospital for it.” In U.S. healthcare, where cost pressures and patient preferences are driving a steady migration from inpatient to outpatient care, mastering ambulatory operations isn’t optional—it’s strategic.
Within Lehigh Valley Health Network, Abby’s portfolio is broad:
Occupational medicine programs and workers compensation
Sleep lab departments
Endocrinology testing centers
Durable medical equipment
Imaging, breast health, home health, and more
Why does this matter? Because these services form the connective tissue of health systems, supporting both acute care and population health. Efficient ambulatory operations can:
Reduce unnecessary hospitalizations
Enhance patient experience and access
Support revenue diversification for health systems
Enable more nimble responses to market and regulatory changes
“There’s a lot of variation there, but it’s really the outpatient departments that are supporting the larger hospital system,” Abby notes, underlining just how integrated ambulatory care is to a system’s overall health.
If you’re wondering what it takes to lead in this space, Abby’s path is instructive. She didn’t start in healthcare—she started in manufacturing and employer-side operations. As she puts it: “I started out actually on the employer side… in employer production and manufacturing. When I finished that training program, I had the opportunity to move to the clinical side.”
Key steps in Abby’s career progression:
General Operations Training: Gained management skills in process and people management.
Transition to Clinical Space: Moved into clinic operations at Concentra, learning how “operations is operations”—regardless of sector.
Hands-On Leadership: Took every project, no matter how outside her comfort zone. “I was never the person that said nope, don’t have time for that. I always took on every opportunity and my team and my mentors always knew I needed to be challenged.”
Continuous Education: Didn’t complete her MBA until later in her career, after feeling a disconnect in high-level meetings: “I felt the disconnect from a dialogue, from a process, and a thinking standpoint. I said now is the time…I felt the need where I had to [get my MBA] in order to continue to progress in my career.”
Growth through Mergers: Integrated departments during the acquisition of Coordinated Health by Lehigh Valley, managing the complexity of scaling from small to large teams during COVID-19.
The lesson for future leaders? Be relentlessly curious, say yes to new opportunities, and be willing to cross-train—clinical knowledge can be learned, but operational agility and a bias toward action are irreplaceable.
Abby’s day-to-day is a masterclass in managing complexity and change. She answers the question directly: “It’s different every day… My schedule as of 5:13 on March 5th for tomorrow, as it stands, will likely change by 8 a.m. tomorrow. As operations leaders, we have to be okay with that.”
A typical week for Abby might include:
Back-to-back internal and external meetings
Direct check-ins with teams to identify and address challenges
Reviewing volume and financial data
Client meetings, including employer occupational health site tours
Vendor meetings to evaluate new equipment or services
Collaborating across departments on integration or process improvement
Being visible on the front lines—“I have always made it a point to be front and center with those teams, knowing them by name, who they are, what they do every day and understanding that challenge.”
Why is frontline visibility so important? Abby’s approach is hands-on: “Anytime I’ve ever taken on a new role, I found it very important to sit with every member of the team… sit at the front desk for about a week, then with the billing team, then the sales team. The only way we’ll ever be able to evaluate a process… is to understand what the team is talking about.”
Key takeaways for leaders:
Stay adaptable—expect plans to change, sometimes hourly.
Build trust through presence, not just policies.
“Walk the process” yourself, not just once, but continuously.
One of the most common struggles for healthcare administrators without clinical backgrounds is building credibility with physicians and nurses. Abby is candid: “That’s some of the biggest challenges that I’ve encountered being non-clinical in the clinical space. I get very honest with the doctors that I work with—I say, ‘I’m not a doctor, I need you to explain this to me as if I’m a patient.’”
Her approach:
Acknowledge the expertise of clinical colleagues—don’t pretend to know what you don’t.
Position yourself as a practice enabler: “They need you to help run their practice so they can do the best care that they possibly can.”
Focus on operational and process challenges, not clinical decisions.
This humility builds trust and ensures operational improvements are aligned with clinical realities, not imposed from above.
Planning horizons in ambulatory care need to span from weeks to years. Abby is clear: “We always continue to look, you know, three, six, nine months, five years ahead… Healthcare is changing, it’s no secret, but we can take a look at the trends.”
Business planning involves:
Reviewing payer policy changes (especially Medicare/Medicaid) and projecting downstream effects
Preparing for acquisitions, mergers, and integration
Opening new service lines or sites based on forecasted need
Building flexibility into plans to allow for quick pivots
Abby credits her leadership team with enabling strategic foresight: “Because of those decisions, we were able to open new hospitals during COVID while other systems were shutting down. We absolutely look as far ahead as reasonably possible.”
The actionable insight: Data-driven forecasting, scenario planning, and alignment between executive and frontline teams are essential. Leaders who plan only for today’s problems are already behind.
Mentorship, Abby emphasizes, is not a luxury—it’s foundational. “I’ve been blessed with some really great mentors… Some people are naturally great at [strategic thinking], but when you have people that challenge you—and being okay with people challenging your thinking—that’s when you really become a great strategic thinker.”
How do you find the right mentors?
Interview your potential leaders as much as they interview you. Abby notes, “I think it’s very important to also interview the people that are interviewing you… You need to have a leader you can connect with, that is going to help drive you to be a better leader yourself.”
Seek out mentors who challenge, not just support, your ideas.
Don’t limit your circle to people who think like you—look for those who share your goals, but not necessarily your background.
Abby’s own network—from Mike Ryan at Concentra to Amy Nyberg at Lehigh Valley—has shaped her ability to think analytically and lead through uncertainty.
When asked about the biggest problem facing ambulatory care, Abby doesn’t hesitate: “It’s the same challenge that every other health system in the country is facing—and it’s a staffing shortage.” She references projections that the U.S. will be short 120,000 primary care physicians by 2030—a crisis not solved overnight.
How is Lehigh Valley Health Network responding?
Partnering with other health systems and clinical teams to develop creative staffing solutions
Focusing on workforce development and pipeline strategies (engaging younger generations, offering resources, and career events)
Emphasizing the mission-driven impact of healthcare careers to retain and inspire staff
“There’s a patient and their family at the center of everything that we do… We have an obligation as community leaders to do what’s right and try to engage people to want to enter the health system,” Abby asserts.
Action items for executives:
Invest in staff well-being and retention.
Collaborate across organizations for workforce solutions.
Frame healthcare careers as meaningful, resilient, and impactful—because they are.
Abby’s journey and perspective offer practical takeaways for leaders across the spectrum:
Prioritize process and people equally: Effective ambulatory operations depend on both clear systems and empowered teams.
Lead from the front lines: Make yourself visible and available to staff; walk the process, ask questions, and learn directly from frontline experiences.
Adopt a flexible, data-driven approach: Forecast for multiple horizons and maintain agility to respond to changing market, regulatory, and workforce dynamics.
Seek and nurture mentorship: Proactively build relationships with leaders who challenge and inspire you—and return the favor as you advance.
Champion the mission: In the face of shortages and burnout, reconnect teams to the broader purpose and impact of their work.
“Ambulatory operations is really your outpatient setting, so it’s any service that isn’t taking place on the inpatient side. You don’t have to be admitted to the hospital for it.”
“I was never the person that said nope, don’t have time for that. I always took on every opportunity and my team and my mentors always knew I needed to be challenged.”
“I have always made it a point to be front and center with those teams, knowing them by name, who they are, what they do every day and understanding that challenge.”
“It’s the same challenge that every other health system in the country is facing—and it’s a staffing shortage.”
The real story behind ambulatory operations is one of constant evolution—where leaders like Abby Berkes, MBA, blend process excellence, adaptability, and human-centered leadership to deliver care that’s both efficient and deeply personal. For executives and future healthcare leaders, the call is clear: build your operational toolkit, nurture mentor relationships, and never lose sight of the people at the center of your work—both staff and patients. As Abby reminds us, “There’s a patient and their family at the center of everything that we do… We have an obligation as community leaders to do what’s right and try to engage people to want to enter the health system.”
Ambulatory care is changing. The leaders who will succeed are those willing to adapt, collaborate, and put people first—today, and for the long term.
<p>[Music] hello everybody this is Cole from the American Journal of healthcare strategy and we are joined by an ambulatory operations expert Abby why don't you go ahead and introduce yourself and your role yes thank you Cole I am Abby burkus and I'm the administrator of ambulatory operations at Lehi Valley Health Network um in Lehigh Valley Pennsylvania and I'm excited to join you today we're so happy for you to have us we know that you know I'm with Jefferson of course and you're with Le High Valley Health Network and there's been lots of Talks Of Us merging together so I was super excited to sit down with someone from that neck of the woods and just kind of go over their career and talk about what they do as you mentioned you're in ambulatory operations I started off in ambulatory kind of ambulatory specialty care so I'm really interested to learn about the operations side of things so can you just kind of explain to us like what is ambulatory operations yeah so ambulatory operations is really your outpatient setting so it's any service that isn't taking place on the inpatient side you don't have to be admitted to the hospital for it you know it is I think going to be a little unique depending on the health system and how it's set up and operated in terms of structure in the organization so for me specifically I oversee multiple departments smaller departments within the ambulatory setting within Lehigh Valley our structure from a leadership perspective an ambulatory includes various outpatient departments rehab Imaging breast health services our occupational medicine program um Home Health Sleep Labs things of that nature so depending on the system what falls under that might be different I am personally responsible for our occupational medicine program and workers compensation our sleep lab department our Endocrinology testing centers and our durable medical equipment so again there's a lot of variation there but it's really the outpatient departments that are supporting the larger hospital system on the inpatient side for those Services needed whether you need to get your MRI or your CT or have additional rehab outside of your impatient day but that is a lot of responsibility and it sounds quite complex with all those different you know parts of the organization that you're kind of dealing with all the time how did you get your start in this how did your education prepare you for where you are now yeah so I went to school for business and I recently just finished my M's and I went for my masters in business business administration and so I started out actually on the employer side and so I actually went through a management training program and it taught me every kind of different element of the employer space and in that world it was was employer production and Manufacturing so it was a different side of the spectrum when I finished that training program I had the opportunity to move to the clinical side and so that's where I moved to the Philadelphia Market went and started working with Concentra in the clinical space and was overseeing Clinic operations and operations is operations right you're you can be plugged and put into kind of any different space understanding that there's a service to deliver and we have to figure out the best way to deliver that service through Process Management people management and figuring out making sure that your p&l is strong so when you take it all apart into its various segments operations is just learning the product what do we need to deliver what does a client expect us to deliver and how is the best way to deliver that and we just continue to evolve that process and so when I moved to the clinical space it was not expected if I would have if somebody would have asked me 25 years ago where I'd be today I would have never been able to guess this but it's really understanding what we're trying to do and so as I continued to grow in the clinical space I saw the importance and the need for it and I love the operation side there's always something to potentially fix not necessarily bad it could be small and it could be major it just staying ahead of the curve of what's the your the next part to come how is there going to be new product or service is there going to be new equipment or technology so it's really staying ahead of that as I continued to get further into health care I had the opportunity to move closer to home um as I was starting to raise a family and I joined coordinated health and started to oversee their occupational medicine and Urgent Care Program which had been a lot of my career so again it was process Improvement how do we look at the service we're trying to deliver and and what are our challenges and barriers and it usually was very small minute things and it was just really educating our teams to know how to best deliver that care and so growing and learning and taking on every opportunity I was never the person that said nope don't have time for that I always took on every opportunity and my team and my mentors always knew I needed to be challenged so when they had these little projects that was completely outside of my scope I was like hey Abby how do you feel about this sure no problem let's figure it out because again if you take off the layers it's just an operational process so um I was always kind of that go-to person of ask Abby and see if she can handle it or let's talk to Abby bring her in and see what what thoughts she has um so I kind of became that go-to person and it just gave me exposure I just wanted to learn and I didn't actually finish my MBA until recently so throughout all of this this and the growth of my career I didn't have my MBA and it was always something I knew I was going to do but I finally got to a point where I felt the disconnect I was like I'm sitting in meetings and I felt the disconnect from a dialogue from a process in a thinking standpoint and I said now is the time now is when I need to do it because I felt the need where I had to in order to continue to progress in my career so there was nothing that was really planned in how my career spanned in from then until now and so as then coordinated Health was purchased by Lehigh Valley at that point I had also gained basically all of the nonorthopedic service lines and then it was integrating all the service lines into Lehigh Valley which is a very significantly larger system um we had Departments of three and four providers folding into departments of 40 and so again it allowed me to learn that system it was also In the Heat of covid uh which presented additional challenges so it's just the constant learning and wanting to engage in understand and giving yourself exposure is really kind of how I got to where I am and so I'm in this position now where we've fully integrated with Lehi Valley and really just kind of expanding departments and saying okay so now we are looking at evolving our durable medical equipment or continuing to integrate some occupational medicine programs or expanding those programs and so it just kind of came naturally and organically of how I've evolved into having some of these roles but it's really just a lot of the Departments are kind of set up and we've we've done the process we've rolled out the same things across the board for all team members and when you have your team set up for Success they know what to do and they know how to do the job so then when I'm presented with another opportunity for a department or a project I can say yeah my team is good to go I can move into this direction so I've been blessed with great mentors that have given me those opportunities to be where I'm at and I just didn't really ever say no which I don't know if that's a great thing or not excellent advice definely give me the exposure that I need it so yeah that is that is excellent It's especially for all of the the fellows out there I know we have a lot of fellows that watch to never saying no to that project I think is is excellent that's a really really good advice with everything that you've gone through and where you're at now what is your Daya day actually look like like you know what what is it like when you get in in the morning what are some things that are you like you're doing throughout the day it's a different every day you know I there's some days where I'm in back-to-back meetings there's days where you know my schedule as of 513 on March 5th for tomorrow as it stands it will likely change by 8: a.m.</p> <p>tomorrow and as operations leaders we have to be okay with that we have to be okay with that transition and know how to make those shifts and you know having done this for as long as I have it's kind of natural and expected that that's just the organic play of your week I do have days where it doesn't change it's rare um but you know there's a lot of just meeting with my teams and understanding what challenges they're having and working through their day just checking in to see how things are going what volumes look like we just got through budget season so there was a lot of financial meetings but it's a combination of client meetings um we have vendor meetings where we're constantly looking at potential new equipment new client meetings on the employer Occupational Health side of who we're meeting with tomorrow I'm actually going to tour a major employer in our Hazelton market so it could be a site tour to visit our teams to say hi see how things are going answer their question questions but be visible and have those relationships with our front line that's the most important part I don't ever want teams to think that the decisions that are being made are from somebody that sits you know in an office somewhere that doesn't ever see what's in front of them so I have always made it a point to be front and center with those teams knowing them by name who they are what they do every day and understanding that challenge so when they say I have this issue with the system I know exactly what they're talking about I'll stand right next next to them and we'll walk through the process show me what's happening when this happens anytime I've ever taken on a new role I found it very important to sit with every member of the team so for example when I came to coordinated Health I'd been out of the he o health space for a couple of years and I sat at the front desk for about a week and then I went and sat with the billing team and then I went and sat with the sales team and I wanted to understand from point A to point B to point C what does it look like for the patient how does it look how does it feel if when this happens how does it flow because the only way we're ever be able to evaluate a process and even if it's not broken I have to understand what the team is talking about when they represent their challenges so I tried to make it a point to spend as much time with our Frontline teams as possible I can do my meetings from almost anywhere you know Co was great and that it taught everybody to kind of work remotely and differently and so I can take a meeting from anywhere I can be in the car I can sit in an office somewhere I can find an unused patient room somewhere to go take a call it's important for the Frontline teams to see us and when you build that relationship you're able to build trust number one they respect the decisions that you make whether they agree with them or not at a higher level and it builds that Rapport so you know my day-to-day could be anything from client meetings market research data analysis you know Staffing and interviewing collabor cation with our other teams we're a very large system we have a lot of Engagement with those teams so um it can be a number of those things and you know some of my favorite days are the ones that we spend all day with clients and talking to our Frontline team members my one of my earlier mentors she had scrubs in her office and she kept them there she was impatient of course and uh she you know managed some surgeons and so you know one of them would be talking about a new robot or a new piece of equipment and she just couldn't fully grasp what they were talking about until she went and just got in the room and actually saw what was going on and you know in Six Sigma I'm sure you're familiar like walk the process you know but it's not just like walk it once and then you're good it's like daily having to see what's going on yeah and the thing is is these doctors and nurses they're extremely intelligent and extremely well Tred in an area that I can't understand because my mind doesn't always work in that clinical way um and so that collaboration in person is so important oh absolutely and that's that's I think some of the biggest challenges that I've encountered being non-clinical in the clinical space and I I get very honest with the doctors that I work with they say I'm not a doctor I need you to explain this to me as if I'm a patient so that way I understand what you're talking about but it it also levels sets with them like I'm not trying to be a doctor but I need you to help me understand what's working for you and what's not because I don't speak the doctor language it's just not something I'm capable of doing and I don't want to take over those clinical decisions that's not the career path I chose I can barely take my own blood pressure with an electronic cuff let alone try to help them out clinically so you know that's that was one of the biggest things I was very humbled by a an early leader that I had of you building that relationship those positions is one of the most important things you're going to ever do and it's because they need you to help run their practice ice they don't need you to help see patients they need you to help run your practice so they can do the best care that they possibly can so you know that's it's funny that you bring that up because that was very very clear for me as well I'm I don't need to jump into this this clinical space my uh you know I was a Premed originally and I would be failing a chemistry course and I'd say well I'm just not smart enough for medicine but then when we go into business school some of my medical friends have a hard time with the business classes and so it's just the different way people you know they find the things that they're good at but shifting gears for a minute how long out are you making these plans for for the clinic is it years months 10 years five years what does that look like I mean we always continue to look you know three six nine months five years ahead you know Health Care is changing it's there's no Secret Sauce to it but we can take a look at the trends and so when we're doing business plans we make projections and we take a look at what this could potentially look like obviously business planning with Acquisitions and mergers and things like that so we always want to be aware of what's coming down the pike and understand how Medicare and Medicaid what they're doing we know commercial payers tend to follow suit but you know part of how we have done so well as a network was our leadership is continuously looking that far out you know and making really smart business decisions about how things progress and you know one of the big Testaments is I remember one of the first leadership partner meetings that we had with um Dr Nester is he was talking about what's going to be happening with Medicare and Medicaid three to five years from now this was a couple years ago and you see it now play out and we're like yes we've talked about this we knew this was going to happen and here's what we did to prepare and so I I feel very grateful that we have a really strong leadership team that makes those decisions and looks that far ahead and and then we follow suit at the practice level and so you know we were because of those decisions we were able to open new hospitals during covid while other systems were shutting down and doing things we were able to open them and so we absolutely look as far ahead as reasonably possible you know it it just kind of depends on what's trending for those service lines at that time and you know those things get derailed we know that but when you already have the the overarching plan it's e easier to go in and shift and say okay this happened here's where we need to shift and adjust um instead of saying okay well this happen now what right we're already prepared mentally and have those plans kind of mapped out in a generalized area to know this is what we expect and here's a potential impact how did you learn how to do that how did you learn how to think strategically like that I've been blessed with some really great mentors I have to be honest I one of my first mentors a gentleman by the name of Mike Ryan who hired me at kentra was always very strategic and taught me how to evaluate financials we learn how to do math in elementary school my kids are learning it now um 2 plus 2 equals four but it's what's behind the numbers what drives every single one of those elements and so he kind of taught me how to evaluate in a different scale and Then followed up with you know current mentor and leader of mine at Lehigh Valley Amy nyberg very analytical and dynamic and and they teach you how to look at things differently knowing what to look at having great analytics and data teams to ask those questions to and know who to go to and what questions to ask or be very vulnerable and say walk me through how to do this but you have to find mentors that will help guide you and understand it it's not you can learn some of this stuff by doing but a lot of it is a process of understanding and and walking through it with leaders that have been very successful ahead of you you know we use a lot of different data analytics for what happens in the market we can see our our volumes and we can see some dashboards from nationally ranked organizations that publish data it's usually a year behind but we use that to they say okay so here's how it's trending this is what we can expect we look at population data we look at all of those different things for me on the employer side we look at the shift in employment what does that look like in this region in this region we're we're grateful because it's a very large growth region in the country for industry because of we have land and we have some very major highways that intersect so and it's cheaper than New York and New Jersey and the surrounding states so we look at all of those things and put it you know kind of throw it up and say okay how does this connect and then so we say okay so here's how it's been trending and what happened during those years to create that Trend what do we expect to see but you really have to have some great mentors to teach you how to do it some people are naturally great at it um but I think when you have people that challenge you and being okay with people challenging your thinking that's when you really become a great strategic thinker because we are all built differently our experiences have created the questions and the path that we take and so we have to As Leaders also be vulnerable to say I don't have all the answers all the time and I need to be okay with people questioning my thinking because it's actually making me a better leader how did you find these mentors I mean it sounds like they've had a huge impact on you how did you how did you discover them I think it's very important to also interview the people that are interviewing you you know I have always felt connected where I've had jobs where I've interviewed hundreds of different places and I think it's very important that when you interview you need to come out of that feeling as good about it as the interviewee did for you and if you don't pick those people you need to have somebody that you can kind of ping and pong with that you know you're going to be able to have that open and organic relationship that they know what drives you as a leader and they are able to provide that for you and they're looking for some of the same things and I you know I think that that has what has gu gotten me to where I am I actually met Amy prior to even joining coordinated Health she was on a panel speaker at Lehi University on a discussion around the cost of waiting for healthcare and how she described certain things at coordinated Health at the time I was like I need to know her I need to meet her and a year and a half later I was like actually in an interview room with her and I was like I don't know if you met CU I I of course introduced myself afterwards and I was like I don't know if you remember me but I was I saw this talk I was so engaged by you and I'm so excited to be here but it's finding those people that you connect with it's really important and I know people aren't always blessed to be in those positions to say you know they might need a job and and that's great and sometimes you have to take those positions but I think it's also very important to make sure that when you're in a leadership role you need to have a leader that you cannect con with that is going to help drive you to be a better leader yourself because I do definitely think that there's something to be said for hiring strong leaders and hiring people that are smarter than you because you learn from them and so I think that it's very important to surround yourself by people not necessarily likeminded but goal focused in similar mindset as you to be able to help drive you because not everything about operations is glamorous and we need to have those people that bring it out us and say we're going through this for a reason you know there's there's a lot of different things that impact our day and when you have leaders that help you find the positive in those that's what makes you a great leader and ultimately helps to drive you to become better and have better results for your team I agree I've I've been very fortunate with the leaders that I've had and you know they really and it all the way up the chain you know their leader is responsible for my leader success and soest if you know kind of having that community of leadership that's strong has been really beneficial that I think that's another reason why I'm excited for us to join as Jefferson with leh high Valle Health Network if it all goes through it's just because I've met quite a few leaders including yourself and it just seems like an excellent you know Community with being able to access a whole another network of mentors will be really really exciting so yeah absolutely I'll leave you with one final question and it's what do you think kind of the biggest problem in Ambulatory Care is right now now and how are you working to overcome it I think it's the same challenge that every other health system in the country is facing and it's a staffing shortage you know I was actually you know looking up for a paper that I wrote towards the end of my MBA and it was this alarming statistic that they projected to be short 120,000 primary care physicians by the year 2030 and that's a scary thought because it's not like we can engage somebody tomorrow to become a physician by then it's that's only six years away and so I think we continue to have to work and partner with our the other Hospital systems and teams and clinical teams by us to come up with Creative Solutions to be able to still provide care we still have a very unhealthy environment that we live in and the population is a very unhealthy one it's great that people are continuing to live longer but that just means it's a bigger population as well to serve and so I think that we have to continue to collaborate and come up with Creative Solutions to want to engage people to want to join Healthcare there was a lot of people we saw the mass Exodus of Co of people saying you know that's not a path I really want to enter I don't want to have to go through that um but now that we've kind of come out of it and people see that there's still really strong Health Care Systems and so much work to be done and there's so much value in knowing that you've impacted somebody's life and I think that's why you know all of us as leaders in the healthcare SP face that's why we still show up and do it every day there's a patient and their family at the center of everything that we do and so no matter how hard the decision or challenging the day there's people at the center of everything and those are people in our community so we have an obligation as Community leaders to do what's right and try to engage people to want to enter the health system and so you know I think that we've all been saying we need to make our country healthier for a very long long time and I don't know that we've really had success no matter how many apps or gym memberships or New Year's resolutions they have but I think that we have an obligation to help people understand how great it is still to be in healthcare despite those challenges because every organization while it may not be covid has those challenges and so it's really helping people understand that you can still make a huge impact it's so many different levels and we need those clinical teams to take care of of our nation that's so true and and you're right the pipeline you know right now it's six years away medical school is four years residency is two to three so the decisions we're making now you know impact us for the future and we gotta be serious about it and take it seriously and just do the best we can and try to encourage people you know we we at the journal we go to these career events and try to encourage young nurses and things like that and try to give them as many resources as we can I know Lehigh Valley is really big in that as well so I really appreciate you coming on as well and sharing your insights for uh either the younger people getting into strategy or some of the more experienced ones who are kind of interested in it so thank you so much for your time and I'm sure we're GNA be hopefully talking a lot more as the Jefferson merges and and whatnot so thank you so much yeah well thank you for taking the time and you know I I think it's great that you're doing this and you know bringing some awareness to what's out there and opportunities and you know I'm really excited and I'm sure we'll be talking soon and you know if there's anything you need let me know great we'll be uh definitely in touch for sure</p>
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