Key Takeaways
- Shift recruitment strategies from traditional degree requirements to work-based learning and apprenticeship models to create debt-free pipelines and fill critical roles.
In the U.S., headlines about healthcare labor shortages and escalating burnout are impossible to ignore. As systems expand and merge, the looming question remains: How do we build a sustainable, community-connected healthcare workforce that meets the demands of tomorrow—while staying rooted in the values that matter today? This challenge is more than an HR problem. It sits at the heart of healthcare quality, access, and equity.
In a recent episode of The American Journal of Healthcare Strategy Podcast, we sat down with Geoffrey Roche, MPA, EdD—Director of Workforce Development (North America) at Siemens Healthineers, recognized leader, and LinkedIn influencer—for an unflinching look at why traditional approaches to talent pipelines are breaking down, and how both legacy health systems and upstarts can rethink the entire playbook. Roche’s career bridges hospital administration, academia, and now global medtech—making him uniquely positioned to answer a question on every healthcare leader’s mind: How do we create a workforce that is ready not just for today, but for the future of American healthcare?
Why do some leaders devote their careers to healthcare workforce development, and what can we learn from their journeys? For Roche, the answer is personal and rooted in his upbringing. “I always credit my mother… without question, my mother was a huge influence on what interested me and also attracted me to want to serve in healthcare,” he shared. Roche watched his single mother—who became a nurse when he was just five—impact her local community as a labor and delivery nurse, embodying a calling to serve others.
Initially a political science major and active in local politics, Roche pivoted to healthcare after a formative internship. The move wasn’t easy: “I thought I was going the policy, political science route… and then when I did this internship it brought me back to my childhood where I saw my mother work as a nurse.” This dual lens—community-mindedness and political acumen—became the foundation for Roche’s philosophy: healthcare leadership must be about serving communities, not just organizations.
Key takeaways for executives:
Healthcare workforce leaders are often driven by deeply personal motivations.
Rooting your workforce strategy in community needs, not just system expansion, is a sustainable competitive differentiator.
How do leaders transition from policy and politics into healthcare administration, and what challenges arise? For Roche, the move was not just lateral, but a cultural leap. “Politics is always local,” Roche recounted, noting that his reputation preceded him when applying for his first hospital administration job: “I was a very active individual in that area, and in the interview, they asked me, ‘We’ve heard you campaigned against a state representative. How will you be the face of the hospital?’”
His answer—and subsequent performance—flipped skeptics into advocates. “That same individual… later presented an award to me in our community… he said to the same vice president who posed that question, ‘Boy have I been proven wrong, and look at the results he’s having.’”
Key lessons:
Politics and healthcare administration both require navigating stakeholder relationships and community perceptions.
Never underestimate the value of bridge-building: “What’s most important is to keep your eye on your patients and all those around you that you’re serving.”
What happens to workforce leaders—and the communities they serve—when systems merge or get acquired? Roche’s tenure in hospital administration ended, as for many, after a larger system acquisition: “The job that I held there was truly like going in every day and not working—it was truly a vocation… Ultimately, a larger healthcare system came in, our board made a decision to move forward with that, and I took a restructuring package.”
Roche’s refusal to betray the trust or “trade secrets” of his prior system—“As a person of integrity, if I’m going to go work somewhere, I’ve got to know they’re not just going to want to steal everything…”—highlights a core challenge: Talent and knowledge don’t transfer as neatly as contracts do. For many, acquisitions bring career uncertainty but also opportunities for reinvention.
Action points for leaders:
Protecting organizational culture and knowledge during transitions is as critical as operational integration.
Retaining talent post-acquisition often means investing in their career path, not just their current title.
What explains the chronic underinvestment in healthcare workforce development in the U.S.? Roche doesn’t mince words: “If you look at how much learning and development receive from a budgetary perspective every year—even at the largest health systems—if it reaches 2% or 3% of the budget, it’s shocking.” The result is no surprise: high turnover, retention challenges, and a workforce that feels like a cost center, not a strategic asset.
Contrast this with countries like India, where as Roche notes, “they spend way more money on employee education and employee training… because of the competitive environment.” In the U.S., however, “the investment in learning in each and every one of our colleagues will serve our organization in the best possible way forward.”
He is blunt: “In my opinion, healthcare has grown too large, lost its identity in connection to the community… When I was at my healthcare system, academic partnership, learning and development was a cornerstone of what we saw as a strategic asset.”
Three factors holding the U.S. back:
Budget constraints and competing priorities: Workforce development rarely ranks high on annual budgets.
Loss of community anchor identity: As systems grow, their connection to local needs can erode.
Lack of non-traditional pathways: Over-reliance on college degrees ignores alternative, proven models.
Can people-focused workforce development be a viable alternative to relentless system expansion? Roche believes the answer is yes—if leadership is willing to buck prevailing trends. Referencing health systems in the Lehigh Valley, he observes, “St. Luke’s is now a standalone system, and Lehigh Valley is now part of Jefferson… St. Luke’s is marketing on being the only local healthcare system making local decisions still about you as the patients.”
He cautions that payer integration complicates the picture: “The big system moving from California has got a big payer part of it… if that payer part becomes part of their new health care systems, they’re in a much stronger position.” But local systems can—and should—leverage their community trust and agility as assets.
Leadership implications:
Rapid expansion can erode local legitimacy; sustainable growth requires community engagement.
Workforce and community development can differentiate systems, even in a consolidating market.
What’s broken about the “college first” approach, and how can work-based learning solve for the gaps? Roche is unequivocal: “We have to move to a model of really work-based learning… We can’t just tell people to go to college to serve in healthcare anymore.” Apprenticeships, youth apprenticeships, and hybrid earn-and-learn models are not just nice-to-haves—they’re essential.
On a recent trip to the UK, Roche saw this model firsthand at Siemens MRI in Oxford: “Several of our employees are apprenticeship degree employees, earning their degree on the job while they work and earn a living—they have no student loan debt, Siemens is paying them a job, and they’re getting their degree covered.”
Four steps to modernizing workforce pipelines:
Expand apprenticeships and work-based learning opportunities—not just for physicians, but imaging, lab, radiation oncology, and allied health roles.
Involve community-based organizations—particularly in underserved areas—to build real pipelines to economic mobility.
Stack credentials with new roles, like the Imaging Medical Assistant, enabling incremental progress toward licensure.
Align employers, academia, and regulators so that on-the-job training is validated and recognized, not penalized.
What’s stopping the U.S. from adopting these models at scale? In one word: regulation. Imaging, for example, requires an associate’s degree plus 1,400 clinical hours before certification—limiting how many students can enter the pipeline, especially with community colleges constrained by faculty-to-student ratios.
Roche spotlights a new approach: “ASRT, ARRT, and JRCERT recently released a white paper calling for a new role in imaging called Imaging Medical Assistant… pivotal as it allows us to stack into that associate’s degree, and it’s pre-licensure, so someone who does not have a license can work in a defined role.”
He notes, “Other countries have a defined role as an apprentice… hired into an actual role, apprenticing with a supervisor, with a core curriculum developed and validated by both employer and academic institution.” This model could address both faculty shortages and the disconnect between classroom and real-world learning.
Barriers and opportunities:
Faculty shortages: Allowing healthcare faculty to work for both hospitals and colleges can create flexible, attractive career paths.
Online and hybrid learning: Pairing online theory with hands-on clinical experience increases accessibility.
Policy innovation: The U.S. Department of Labor and leading systems are beginning to pilot these models, but scaling requires bold regulatory action.
How does a real apprenticeship program look in action? In partnership with SSM Health in St. Louis, Siemens Healthineers is piloting an imaging workforce pipeline designed to serve economically challenged communities. “We’re developing apprenticeships to get youth into these actual roles where they can earn an income and ultimately go on to get that degree… many of these young people’s parents have never held a job that can fully support a family.”
The process:
Students start exposure and paid work in high school.
They move into an associate’s degree while working, with hours applied toward clinical requirements.
Community partners support retention and wraparound needs.
The aim: reverse generational cycles of economic immobility and solve local labor shortages.
What actionable steps should healthcare leaders prioritize if they want to future-proof their workforce?
1. Prioritize People Development at the Board Level
Boards must hold executives accountable for workforce investment, not just operational performance.
2. Build Non-Traditional Pathways
Expand apprenticeships, stackable credentials, and hybrid learning models—especially for in-demand roles like imaging, lab, and nursing.
3. Partner Deeply with Academia and Community Organizations
Co-design curricula, share faculty, and align incentives so learning is continuous and practical.
4. Commit to Local Community Anchor Roles
Embrace the anchor institution framework: “It’s truly about partnership with everyone in that community.” This is your sustainable moat in a hyper-competitive market.
5. Embrace Regulatory Innovation
Advocate for flexible accreditation and licensure that recognize the value of on-the-job learning and “flipped classroom” models.
Healthcare’s future will not be won by the largest systems or the flashiest tech, but by those who invest in people, prioritize community roots, and have the courage to break from tradition. Geoffrey Roche, MPA, EdD’s story—from the son of a nurse, to political insider, to workforce innovator—shows that true leadership is both local and visionary.
“We can’t continue to substantiate this divide of choosing between college and a degree in the United States… We’ve got to move that forward,” Roche insists. The data is on his side—and time is running out for incrementalism.
If you want to build the healthcare workforce of the future, start today: invest in work-based learning, prioritize people over just expansion, and anchor your strategy in the community you serve. The payoff isn’t just operational; it’s reputational, competitive, and above all—human.
<p>hello everyone this is Cole from the American Journal of healthc care strategy joined by a very special guest today I'm sure many of you know and follow him on LinkedIn Jeffrey Jeffrey please introduce yourself yeah Cole thank you for having me Jeffrey roach have the privilege of serving as the North America director of Workforce Development at Seaman health and years [Music] it's a really interesting role and and you have so much experience on your LinkedIn I was looking you know over it you are podcast host you're getting your doctorate you have been in this healthcare industry for so many years and in touched so many people I I have to ask what got you started in this uh many years ago what motivated you to go into the health care space yes so I always say I always credit my mother right so for those that are familiar with me on LinkedIn uh you know I do obviously go by by as the son of a nurse and and there's a reason you know there's a reason for that without question my mother was a huge influence on what interested in me and also attracted me to want to serve in healthcare and you know through that when I was a college senior actually I you know did an internship in healthcare and and that was after I thought I was going the political route so to your you know when we were earlier speaking right I'm a political science major in undergrad and so I I truly thought I was going the policy political science route I had done internships on the hill did a lot of work uh you know uh in state government actually had paid jobs during high school and college and really thought that was where I was going and then when I did this internship it sort of brought me back to my childhood where I saw my mother work as a nurse um in fact my mother graduated to become a nurse when I was when I was five and so um and then she raised uh my brother and I as a single mom and what I always saw was this passion that she had to help and serve others and then growing up I always heard you know people that I was growing up with talk about oh you know my mom had your mom as a nurse we just had our other you know another child and your mom my mom was a labor and delivery nurse and so she sort of knew everyone in the community and so it was sort of a very special upbringing and then when I entered Hospital Administration uh in June of 08 obviously that was also an interesting economic time so I was blessed and fortunate to have gotten a great job to start my career I saw all truly the opportunity one has in administration and really the fact that if you have good leaders you have a good environment you can really set yourself up with great support for a phenomenal uh career and so I was really blessed to have had that opportunity so it is interesting though because you you clearly were extremely successful in in the political realm already before even graduating was it challenging to make that switch I mean what because it must have been a little scary right to switch over you know it was challenging from the perspective that keep in mind right politics is always local and so when I applied for that hospital Administration job I was a very active individual in that area and I will never forget in fact when I applied one of the questions that was posed to me in the interview was we know you've been politically active in this area in fact we've heard from one of our state representatives that you actually actively campaigned against him how will you be the face of the hospital system from a community relations standpoint and not ever put us in Jeopardy of choosing one side over the other and you know I can remember sitting there and thinking wow I'm not getting this job obviously uh there's no way I'm getting this job and and you know keep in mind you know in a job like that I mean I started as a hospital spokesperson I was responsible for all the relationships between know the chamber and elected officials and you know all aspects of sort of how do you how do you be the eyes and ears and voice of the Health Care System those things are important so it was not easy but I'll tell you that same individual who obviously had shared that experience back in my early days of me working against him uh later presented an award to me in our community on the work that I was leading at that healthc care system and about a year into my work he he said to the same vice president or I should say senior vice president who posed that question in the interview boy have I been proven wrong and not only have I been proven wrong look at the results he's having and so you know I learned that when you come into a Health Care System you're going to deal with politics just like you do when you're in politics but what's most important is to keep your eye on on your patience and keep your eye on on all those around you that you're serving and so I learned quickly in in a maturity factor that I no longer could play one side or the other but in fact I needed to play what was in the best interest of our Health Care system and so uh an example of that was one of the first challenges that our CEO at the time gave me was you know hey look the former president and CEO of the Healthcare System pissed off the congressman uh of this area I know you interned for that Congressman your job is to get him here and I remember thinking oh my like that's a daunting task just to get a member of Congress to a Health Care system when there's 25 other Health Care Systems in this District or more is not easy but I also know the congressman and I knew who he was and I certainly knew uh when he was you know when he was frustrated with something that wouldn't be an easy task so you know I worked on it and you know I had built those those relationships with the Deputy Chief of Staff and the chief of staff and the district director and uh I remember when I first called them and said look it's a new CEO I'm here you know we'd love to get him here uh but I I also know he's busy and keep in mind it was the economic downturn of 2008 and so this was a member of Congress who was literally the number two in the US House on financial matters uh next to Barney Frank Congressman Barney Frank many people remember Dodd Frank and so uh Congressman korski uh is his name and um I remember when I got the call a couple months later and they said hey the congressman's coming he's not going to come to talk about health care but he does want to do a press conference on the financial issues at your healthc care system and I called our CEO and she said wow you you don't give up and uh I said no I don't you gave me a challenge I'm G to take it on and so he did come ultimately uh great story of the ending is that we ended up working closely with him he introduced legislation uh that ended up becoming very impactful to US helped us to maintain uh roughly 16 to1 18 million over a period of years from a Medicare reimbursement consistently um and which was very very important for our Health Care system and ultimately the patients that we served and and so uh what I learned in that was um you know those relationships that you you built one day are always going to come back you just got to continue to build them and sustain them that is so important wow great great advice and and the applicability of that is is V you know you never want to burn Bridges you always want to keep cultivating these relationships so that makes sense why you were so successful there you were there for almost nine years right uh when you moved on though you had a bit of a shift again right you shifted this time into education and and you worked in education for a very long time after that as well uh why did you go into education yeah so like many people in hospital Administration right I was I was C certainly impacted by uh our healthcare system being a quired and I always tell people that you know those experiences certainly are not the most positive at times right uh I had been there for as as you noted almost 10 years the job that I held there was was truly like going in every day and not working it was uh truly a vocation and I was also serving the community where I grew up and I felt like every day I was giving back ultimately you know a larger Health Care system came in uh our board made a decision to to move forward with that uh prior to that our CEO who I worked very closely with who was my mentor and my coach for for for many years moved on and I knew that um you know it wasn't going to be a long-term plan uh farther into the process so you know ultimately it was it was one of those decisions that you know kind of came with with some tough love I did not really want to leave Healthcare but my options were very limited at the time as to where I lived it was either you know it was either to take a lesser role uh in the newer Health Care System environment or move to the competitor but the competitor also uh you know really was more interested in kind of what you consider in our Healthcare World Trade Secrets because I had been on the other side for so long and I also was not interested in that um you know as a person of Integrity if I'm going to go work somewhere I've got to know that they're not just going to want to steal everything uh but rather move on and so I I took a restructuring package that allowed me uh you know some period of time to really assess what I would do next and I'll tell you the main reason I thought of Academia was I had done a lot of work with Academia on the healthc care system side from the employer side around Workforce Development around new academic programs to support us and what I felt was that academics really needed someone who understood the employer side and so you know it became incumbent upon me to uh see if I could be a a good voice and someone that could help to lead some of that change into that process and I will say that in in my time certainly what I learned is I I'm not an academic I don't want to work uh in Academia uh you know permanently but the experience of working in Academia both on the faculty side but also on the Executive Administrative side has has really turned out to be very very beneficial to me a it has allowed me to understand their challenges and opportunities but it also has allowed me to be a bridge to bring employers and Academia together and not just in healthcare but I've done it in advanced manufacturing I've done it in finance I've done it in so many different areas now that I have a better appreciation for kind of the whole process I I I think back to to an article we were reading in in NBA curriculum which is um Leadership Lessons from India and it discusses how one of the reasons uh India businesses invest so much in their workplaces because of the competitive environment right 30 or 40% turnover and so compared to the US they spend way more money on employee education and employee training why do you think it is so low in the US what are those barriers that these institutions are are having I feel like you're the right person to ask about this yeah there's definitely a lot of barriers right I mean if you look at it from the vantage point if you just take Healthcare as a whole and look at how much learning development receive from a budgetary perspective every annual year in the fiscal year budget it's a very very low amount um even at the largest Health Care Systems in this country uh you know if it reaches 2% or 3% of the budget it's shocking and you know it's no wonder why we're dealing with retention challenges in the way that we are because to your point ultimately the investment in learning in each and every one of our colleagues will serve our organization in the best possible way forward and you know I think in many ways you will hear me say this and people will challenge me on this respectfully I often times will say in a Health Care System space this is why I've been so concerned that Health Care has grown too large a larger Health Care system has grown it's sort of lost its identity in connection to the community that it served and why that why that in my opinion is important is when I was at my Healthcare System we were we were of and part of that part of and in that Community we were what I call an anchor institution and for for individuals in healthcare I would encourage them to study the anchor institution framework because if you if you believe in Anchor institution framework you know that it's truly about partnership with everyone in that community and so in our healthare system you know academic partnership Learning and Development was a Cornerstone of what we saw as a strategic asset we felt it was not just the right thing but it was the key differentiator to our competitors and I think that this is where Healthcare has become a bit too large now I think the opportunity is really for CEOs and I'll say boards because ultimately the governing boards you know are are also making big decisions on a lot of things and holding the executive responsible need to come in and say we prioritize people in development and when we prioritize people in development that means we invest in education and so this is a space we've got to do that now here's the other element to it you heard me say I'm just returning from a global trip on apprenticeships yeah we also can't just focus on education in the traditional means we also have to focus on education in different ways and so I'm the first to say you can't just tell people to go to college to serve in healthcare anymore we've got to have work-based learning we've got to have apprenticeships we've got to have youth apprenticeships and we've got to really create a new way of creating a healthcare Workforce and I think other parts of the world have have benefited from that type of thinking and the US has just been too slow and too risk averse and so we've got to change it uh and our numbers aren't on our side and the time is also not on our side and so we've got to be bold in this work and I think you know for all my colleagues that are in healthcare you know if you're not thinking about this as a priority um you're you're truly you know off the right wavelength I I found this to be so true with my organization in that developing an internship program that actually really teaches interns valuable skills is extremely resource intensive but you get so much back from it not even in the work that they produce if they stay with your organization but in the community impact you are going to be recognized as a leader and what's so interesting is you know you said that your health system was acquired and then now we know that same health system is being acquired once again right and forming an even bigger system sometimes I I I think that it's moves and counter moves right I mean you look at some of the situations a large health system from California for example moves into the East Coast uh and they start acquiring some hospitals well then some of the health systems here feel threatened by that and they have to acquire others I think it's challenging right because don't you feel like there's a risk of if you don't rapidly expand across the state or across multiple states that you'll be then overrun by the other institution I I guess the real question that I'm asking can this people focused development you know Workforce Development Community Development make you successful enough where you don't have to expand yeah it's a really good question right and I think we we'll we'll see as time proceeds right because you know if you think about it in that exact circumstance right you know St Luke's is now a standalone Health Care system and Lehigh Valley is now part of Jefferson and if you if you know for those that have spent time in the Lehigh Valley of which obviously I have in just the last few weeks it's very clear how St Luke's is marketing upon this right we're the only local Health Care System we're the only healthare system making local decisions still about you as the patients that we serve it'll be interesting to see right this is where the US Healthcare System is really challenged because it's all about the payer side of it right and so to your exact point that big system moving from California has got a big payer part of it and if that payer part of it becomes part of their new Health Care Systems they're in a much stronger position than others the question is whether Jefferson will be in a position to to navigate that payer model even though they have some stake in a payer model will it have the same effect in the Lehigh Valley and in northeast PA we know that they're in I work for the health plan of course but uh yeah so I don't want to say anything unneutral even though I work for them but yeah we we know that internally it's like it's a big deal right we want to provide the services to as many people as we can we know that that's one of the goals that we have yeah and we we do realize as well that it seems like this this kind of totally integrated Care Network model is really important but to your point as well I you really worry about local communities in rural areas and how payer infighting can impact them seen this in Philly with the Keystone Temple incident right we've seen Mass confusion in our our members and even just in the public if you speak with people in North Philly especially yeah you know these individuals are not the kind of people most philadelphians aren't that can get in a car and drive 20 minutes to to go to a hospital right these people need their local hospital and that's something that I really wor worry about um to so talking about Workforce Development again though right it does make sense now looking at your resume how you were prepared to enter this role at at Seaman because you had the health care part you had the education part of things but how did you come to realize that's where you wanted to work how did that role represent itself yeah so I mean obviously just like most things right these days it's all about your network so in my circumstance you know our head of growth and Innovation at Seaman in uh education and work for Solutions who's really had a a very critical role of supporting seens on all aspects of education and Workforce you know I had gotten to know him just through my network of of educational work and uh when when he and our vice president our previous vice president who's now moved into a global role were working to think about how how would they continue to innovate and transform in this space when they created this role you know he had reached out and said hey you know I I think this may be something you want to consider and I will tell you and uh and obviously he he knows this because we had the conversation that there was a lot for me that was kind of like pause you know reflect pause reflect because I had never worked in the global med tech space right and and as a hospital person you hear a lot about the med tech space and you know for me the the part that I truly wanted to understand and evaluate as part of the process to decide whether I would come on board or not was a how serious or they really about this work and B was it truly a scalable concept and you know when I got to uh you know experience the process what it was clear to me was there was a lot of alignment on how crucial this work was and how important at the highest levels of Seamans they viewed this and you know to our earlier conversation semmons has been very Innovative in a lot of other parts of the business in the workforce this was sort of an the first kind of tranch of how health and years would approach it like other parts of the Seaman business and that piece really intrigued me right because as a global company yes my role is focused on US and Canada but I have an opportunity with amazing colleagues you know 16,000 or so in the US and and North America to make an impact in a space that could have a sustainable effect and so that really is what really attracted me to say hey you know what there's more for me to gain than there is for me to lose in this situation and ultimately there's so much for me to learn and uh you know it's been a really interesting uh you know one plus years thus far here and I'll also say I've been super impressed with all of our Executives understanding how important this issue is and really wanting to solve it in a sustainable Manner and so that piece has been really uh really refreshing to see in the healthc care space can you and I love how you're so impact focused too I I think that from what I've spoken with people is it that impact focused mindset leads to a lot higher satisfaction and I can tell that you're very motivated about your your job and satisfied with it I love that what are the sustainable approaches that you're taking if you don't mind sharing a few that maybe our audience could Implement yeah so you know you heard me talk about one right we we have to move to model of really work-based learning and so we've been super engaged you know with many Health Care Systems around the country around you know looking at this concept of apprenticeships and youth apprenticeships we have to get more youth involved and engaged in our Healthcare System much earlier than College we've got to get them in when they're in Middle School have that Journey continue through high school and then obviously uh you know the obvious question we have to ask is why in the United States in 2024 do we still require a student to decide between going to college or getting a job why can't they get a job and earn that degree on the job that's what happens in other parts of the world as I mentioned I just got back from the UK while I was in the UK I had the opportunity at our Seaman MRI facility in Oxford to meet several of our employees that are apprenticeship degree employees meaning they're earning their degree on the job while they work and earn a living they have no student loan no no debt Seamans is paying them a job and they're getting their degree covered and their academic institution is validating all of it we can't continue to substantiate you know this divide of choosing between college and a degree in the United States and so we've got to move that forward so that's one example uh certainly around apprenticeships and certainly around the apprenticeship degree the other is really around you know how do we as a nation and sort of at a national level really work to prioritize stem-based careers and so you know as you can imagine seams has been very involved in this work for a very long time but on the healthcare space where further getting involved and really making sure that when people think of healthcare they think of this type of stuff lab Imaging uh radiation oncology you know really really important roles that without it things just sit if you can't if you can't get a lab test done uh you know and get analyzed if you can't get an Imaging study done the Whole Health Care System just sits and so you know that type of stuff is super super important the other piece that's super exciting exting around this is you know Seamans being the type of company that we are we think about the whole longitudinal view of this and so you know we are very committed from an environmental perspective on on you know reducing carbon footprint that element kind of goes through the whole thread and so all of our work even in Workforce Development has a sustainability factor to it and so we're really getting to the heart in the work we do with our Healthcare Systems around the social determinance of Health looking at how do you lift up communities in their region around career and economic Mobility so I'll give you an example in St Louis with SSM Health you know we've publicly announced work there to develop apprenticeships and if you think about what's really unique about that is we have together decided to go into one of the most uh challenged economically parts of the city and partner with community-based organizations to create a process where we can get these youth into these actual roles that will be paid where they can do a job earn an income and ultimately then go on and get that degree because again we we don't have the apprenticeship degree yet in the US and so we've got that hurdle but they're going to earn an income and these are young people that's parents have never necessarily even held a job or if they've held a job it's not a job that allows them to fully sustain and support the family and so you know we're trying to reverse that system challenge that's existing there so that we can try to move that Community forward and we're trying to do that type of stuff and so you know that that work is not just to your point about impact it's also about changing lives and I think it's it's very Noble when you have a health care System you know in an organization like Seamans that want to go deep into the heart of those communities to want to do that and I can't say enough about our our leaders uh to be to be that caring and concerned about that especially as a global uh organization I have so many you know questions about this I'll probably have to have you you back on again sometime to to answer all of them but one of the ones that I really want to talk about is is how you know these hospitals are at such a great place uh a great advantage in a lot of ways because they have universities most usually attached to them um they have programs for residency and fellowships administrative fellowships administrative internships can you just give me an example of that one you're talking about in in St Lou you said it was St Louis right what does it actually look like what degree are they trying to get what skills are they you know just so that we can have some more details on what that looks like yeah so in the St Louis example with SSM Health we're actually really working to create sort of an Imaging Workforce Pipeline and so that would require obviously that that today under uh regulation and under licensure they have to get an associates degree first um certainly you could get a bachelor's in imaging as well but that's four years versus the 2-year and then you you know you have to get that associates degree you have to do your 1,400 in-person clinical hours and then you sit for the national uh level certification exam in whatever modality you choose now that's where we have inherent challenges because you know realistically postco we've lost about 30% of the Imaging Workforce Nationwide and um if you look at the data around our community colleges is you know more than half of them report being full and fully enrolled but what's true there is they're not really fully enrolled they only have a certain number of students that they can take because of Faculty student ratio and so the challenge we have is we have such a demand but we don't you know we have such a supply and demand Gap significant challenge here and when you talk to the community colleges the hurdle is you know under accreditation they can only do a certain number of students to faculty that they have and so in that circumstance obviously we're focused on getting them into the Health Care System earlier so they get exposure get interested and then obviously they have to go on for their degree but if you hear what I was talking about earlier we've got to shift to a work-based learning model we cannot continue uh the model that we have in uh in today or we will never sustainably fix our Healthcare Workforce and there are other Healthcare Systems doing this around the country uh U health in Madison Wisconsin is doing some amazing work work with apprenticeships in nursing they launched the first nursing apprenticeship um they're doing work in other parts of apprenticeships really creating these sticky relationships that are going to ultimately have those students retain and grow their careers at UW Health there are other systems looking at doing this Memorial Herman is doing some of this work uh and looking at nursing apprenticeships among others we're doing work with MC in uh South Carolina around Imaging youth apprenticeships and so you know we've got to continue to move this model to this more work-based learning because ultimately you know when when you're earning an income and you're learning on the job why should that make a difference uh whether you're doing that in the classroom or you're doing it on the job and uh those of us that have worked in healthcare know Healthcare is the optimal space for learning because you're not only going to learn you're going to learn on the best technology you're going to learn in the most challenging environment you're going to learn with other professionals and and I love faculty and all but a lot of times faculty have not necessarily been around all of that in more recent time either just because the environment that we have in the US and so that's the model we've got to move to it's so much easier in the business side of things to do that right because there's not this regulation requirement I mean a lot of my co-workers here are getting their bachelor's degree while working full-time I you know my one of my co-workers has four kids she has to support her family that's what has to do and so if it wasn't for that online option through Jefferson she wouldn't be able to get her bachelors's and then you know her career would be in a so it's challenging because not to say that we don't need business people but we really need these Imaging people all right I mean there's a lot of business crats out there um and and so it creates this diversity issue as well where only the people who can afford to take two years or four years off uh and then the Community College case right they have to pay for their own housing a lot of times um and so that's just not working but I I do want to probe a little bit more and I appreciate your your time when when we're talking about an ideal scenario where the regulations are changed right let's say we could change the regulations in any way you know based on what you've seen overseas what does it actually look like for the the intern of The Apprentice in imaging are they working in imaging with one of the more experienced workers and then also doing their their cour workor yeah so the way it works you know in other countries and then I'll also talk a little bit about you know sort of a new new role that's being envisioned in imaging uh as well so you know asrt which is the professional Society of Imaging arrt which is the licensing uh board in imaging and Jer which is the higher ed creditor of Imaging programs recently released a white paper and that white paper calls for a new role in imaging called Imaging medical assistant that new role is pivotal as it allows us to stack into that associates degree that'll be very transformational uh certainly important because it's also pre-licensure so allows somebody who does not have a license to work in a defined role in a hospital system uh they could do basically everything except for do the actual scam they can't hit the button because you've got to be licensed to do that but they can certainly room the patient they can certainly help with all those aspects they can certainly observe uh the scan with the technologist that's actually doing it and they can certainly do other aspects blood draws they can take blood pressure just like a medical assistant would do but specifically specialize in imaging so there's new curriculum that's being developed for that new role and certainly I applaud everyone that's been a part of that work because we have to have a stackable role now to how other countries do this right I mean so in the UK and in Germany uh and other parts of the world you know look you this this is a defined role so they get hired into an actual role as an apprentice they have a they have a a person that they're apprenticing with whether that's their direct supervisor or another member of the team they um have a Core Curriculum that's developed either with the academic institution or by the employer with the academic institution or by the academic institution with the employer whichever way works best and then they both validate that and so the academic institution will send faculty on site um to validate it in terms of hours validate it in terms of competencies you know look at things from a growth pattern to see how they're learning and growing just like you would in the classroom you know ultimately it's just it's the idea of a flipped classroom uh if you really think about it experiential learning has historically shown to be more you know much more effective in this model it's just it's having the willingness and desire to think very very different the other piece that's super intri intriguing about it is we have significant faculty shortages in healthcare programs around the country and so if you can have a model where maybe the health care faculty are actually also employed by the Health Care system and their faculty we can move to a model where because guess what we colleges lose people all the time because they realize you can make more in Hospital systems and so if we can have a model where we flip it and we again have that great approach we may also fix those things and so you know it's not going to be an easy change in the US because historically we've been we've been more place-based in these types of programs to your point but the other piece is some of these students are doing online learning to your point as well they're doing those online learning aspects and so you can arrange it so they do their online in areas where they can and they do their Hands-On in the areas where they can't do the online it's a great model and I will tell you every single one of the students that I've spoken to that are in this across across the diff you know various different employers and such in the country I visited the NHS while I was there last week as well talked with a bunch of nurses and other clinicians that are in this exact same model at the NHS in England they're all and they're all ages keep in mind too that's the beauty of this too what what it's doing is it's transforming not just them but their lives and it's it's allowing the Health Care system to create this stickiness that allows retention to improve and they're creating a Workforce that's more sustainable and uh you know look I I think um the time is fresh and we've got to move on this and you know I was blessed to be a part of a really group uh really engaged group uh and the US Department of Labor was along with us uh as well as others that that really also want to see that something like this have an opportunity to advance forward and uh I think the time we've got to move on it really incredible points I really hope that some of the people watching start to get their wheels turning on this a bit and and see the the massive space for opportunity I know that I'm personally very excited about some of the things that you've been saying for for my own organization to see how we can Implement these kinds of things and just become maybe a better advocate in the space but um really really incredible points and I see why you're you're in that role that you're in now you're very skilled at this topic so I couldn't be more appreciative for you coming on Jeffrey really really do appreciate it and I hope we can have you on again in the future absolutely thank you as well of course</p>
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