<p>hello everyone this is Cole from the American Journal of healthc care strategy and we are joined by a very special guest this evening Brogan Brogan please go ahead and introduce yourself hi Cole thanks so much for having me I appreciate it my name is broen Crockett um and just to give you a little bit about where I'm at right now I was an administrator before and now I'm currently halfway through medical school just to sum everything up real quick [Music] such an incredible journey that you've been through one of the most unique kind of rums I've ever I've ever seen after scouring LinkedIn for many many hours I've spent on LinkedIn um so it it was really incredible to come across with you and you have helped me overcome all these scheduling difficulties so I appreciate you being so flexible um I I want to kind of go back and start with where you were at way back in undergrad and what your decision was to go and get your mha so what did that look like for you at the time yeah so I've actually in order to like really tell the story I have to back up even a little bit further I've been a paramedic since 2014 I got my ENT in 2012 and I loved that that was so much fun driving the ambulance and responding and helping people I really really enjoyed it and I used it as a way to help me figure out whether or not clinical medicine was something I wanted to do do but I needed to figure out where I was going to fit in clinical medicine so I worked as a paramedic through my undergrad through graduate school and I'm currently still running on the ambulance occasionally every every now and again so I got my undergrad from the University of Utah in health promotion and education emphasis in Emergency Medical Services with a specialty in Wilderness remote rescue because I always knew I was going to go to graduate school actually and so I got something as an undergr that I enjoyed that I got to have a lot of fun with which set me up for some really unique opportunities and so because of the way that things happened and worked out I graduated my undergrad without having finished the prerequisites from medical school and I had a dear friend of mine that I worked with actually on the ambulance who was in a dual mph mha program and she reached out and said hey have you considered an mha or an mph and I hadn't really thought about it and I thought to myself if I'm going to go back to school I might as well get a degree while I'm there instead of just fulfilling more credits so I enrolled in the mha program got in at the University of Utah and enrolled in the class of 2020 and I it was kind of a new hurdle for me learning the business language and the way that healthc care administration works because I've been a clinical medicine for so long at that point so that was that was something I had to learn and overcome um but I don't regret it at all what was your reason for originally wanting to be a doctor and getting into the paramedic space yeah so actually a long long time ago I wanted to be an astronaut and there was a terrible accident that happened one of the space shuttles my mother told me no son of mine's going into space so I kind of shifted focus and I found the Natural Sciences to come easy to me and something that I really enjoyed and I had a couple of experiences that I got to help people in clinical settings or Healthcare settings that really helped kind of direct me that way including tending to like dying grandparents my mother was a nurse and so they owned Home Health hospice skilled nursing facilities so I got to be around that a lot so you know I like to think that I was indoctrinated at a young age um but yeah so I I had always kind of grown up wanting to be a physician what I was what type of physician I don't know I I hadn't figured that out yet and then when I got into my paramedic I fell in love with emergency medicine and realized that I enjoyed it and that I could do it and so I mean as of right now I'm still open to a lot of different things but that's kind of the the path I'm leaning towards nice good for you and then and so the paramedic experience and then your undergrad as well I know you know Wilderness medicine is is very adjacent I think that's one of the fellowships you can do from Em Right they have a wildness it's a small cohort I think there's like 15 people yeah I used to be into I I was I wasn't gonna do it but I I used to be into it in terms of like speculating like how cool that would be to do that because they have some really cool um cool things that I know that Fellowship does so you you went through your mha program and you did an internship of course as as part of the program but then you decided to do a fellowship as well I saw was that required or was that something that you decided to do extra so that wasn't required out of the 55 that were in my cohort only nine of us applied for administrative fellowships was your reason for choosing to do that yeah I decided you know I might as make might as well make the best of where I've put myself um I want to be the best trained leader that I can be and I saw this as an extension of my education and that I wasn't done in those two years and so I hopped into that interviewed all over and ultimately landed a administrative Fellowship wow and then how was that Fellowship experience at Banner heal did you enjoy it yeah I definitely uh had a great time and I have some really great friends uh that occasionally will checkup on me that I made during that time I learned a ton you know and it I I kind of came full circle from working as an EMT or paramedic uh in the emergency room because I'm very isolated to just the emergency room to understanding more about how the Whole Health Care system works together to take care of our patients absolutely and then and so after that experience where you're so now you have this this overview of knowledge like you're saying this full circle at what point did you know you wanted to to go back to to school get your Masters in biomedical sciences and then get your your do you know what did that process look like in your mind when did you kind of make the decision that you were going to go back yeah I had a very fortunate experience in my administrative Fellowship like I said I don't regret it at all had a great time and it's because of the administrative Fellowship that I'm at where I'm at right now and I've like updated co-workers and stuff as where as well but I was in my administrative Fellowship we had kind of ridden out the tail end of 2020 um with dealing with the covid pandemic and I was dealing with that with a SE Suite as well as like trying to manage you know our strategic plan for the organization as well and our local market and I was spending some time with our director of peroperative services her name was Cara Snyder and I owe her a huge thank you because is I spent some time with her uh for about a week learning about what per operat services and what we did we had a very busy per service I think we had 30 operating rooms that were functioning every day and you know we we were in a meeting she's like you know we have some free time do you want to go see some surgeries of course I do and I think I caught her off guard that an administrator would want to go watch surgeries and so I gowned up and you know changed into scrubs and we popped in and out of different surgeries and met the surgeons and I got to also study throughput of our patients through preop the O and in pacu to try and improve some processes there and while I was doing my time in peroperative Services I spent time with a surgical pathology resident and he approached me and he's like hey do you want to go watch an autopsy wow and I think I also caught him off guard I was like yeah of course I do and so we were in the morg and we're performing this autopsy and we were chatting and he's like you know why is an administrator interested in this and I told him little about my background he's like why are you selling yourself short you clearly love medicine and no doubt that you would do well as an administrator and you clearly have a desire to be here otherwise you wouldn't but why are you sealing yourself short and not trying to integrate both of those mhm and so I thought about it some more and thought about some more and was like oh my gosh I think he's right so I threw out some applications put together my application for medical school finished some PRX and ended up doing the postback program actually to get me into medical school just kind of more as a career transition thing that is incredible and good for you on choosing to go that route so you're about to go into the um you're done with well actually how does your school do it because I know usually the first two years are like didactic right and then you yeah so is it similar to in your institution yeah so in July I'll be entering clinical rotations oh y so you have both you have both the knowledge pieces down and then you already did some you know the fellowship with the administration so now you're going to be doing the actual you know clinical rotations with with medicine so that's very exciting wow um so what what was that process like doing the application was it really nerve-wracking because you know you already kind of had a secured job per se you know after the fellowship they would have probably retained you or so was it less an anxious for that or was it still as equally like you were really worried about that I was pretty anxious um I had worked really really hard and I had interviewed in at some places um when I was selecting fellowships and fellowship programs i' had interviewed at some places that no one from University of Utah had graduated or had interviewed at before and I was traveling all over the country um wow and when I just and I had landed this job this this great job with a great organization and I really like really enjoyed and learned a lot but I realized that I was giving up something that I could make a career out of um which is hard I mean like not to sell the financial compensation short by any means it was the most money I'd ever made you know only having worked as a paramedic through through school part-time and I was learning a lot I was having a great time I was able to interact with patients but to decide to give that all up was a huge decision for me to make and to be like okay I'm I'm gonna be broke I'm gonna be broke for years right and you're gonna be negative you're gonna yeah don't get me started on my student levels um but yeah so it was really nerve-wracking and then with the co pandemic going on and there was a lot of exceptions being made for exceptions to medical school and I actually never got rejected from a medical school after I applied because they failed to send me in a rejection notice um but I got an email back from the admissions counselor of the school that I'm currently at and said hey you're missing some of the prxs so I immediately called her and I I submitted all this and this all occurred within like two or three weeks this whole timeline that I'm telling you so I rushed to put together the application I was late to the application submission and she calls or I called her and we discussed you know I'm I'm short some of the prere what do you recommend and so I was doing distance ad through three different universities and finished over 30 credit science credits in like six months in order to start the program and that got me into the postback program the Masters of Science biomedical Sciences yeah yeah so it was a it was a huge leap of faith I had my orientation for the master's program on like Wednesday Thursday Friday and Saturday Sunday I took four finals uh for classes that were required for me to finish before I started the program wow so I guess that's an interesting thing as well is we talk about with Med students how it's such a long and arduous process because I mean I took some Premed I took some of the courses and and honestly that's why decided um that I'd rather do what I'm doing now for the moment is because it was just it was so I mean you know what it's like the the science courses are hard and so what is your level of energy like after doing that for so so long now right this has been a four five year journey of kind of constant learning already after completing a bachelor's and a master so this is like a long process how are you maintaining that energy uh I think it's being very cognizant of how I'm doing mentally um recognizing when I'm burnt out you know we're we're approaching we just had spring break and so I'm in the final stretch before the end of the semester and I'm tired like I recognize it I'm tired um I've been holed up in a study room for the last six months and so I take every opportunity I can to study outside I studied outside today for five hours it's been nice weather all day and so being outside is kind of what keeps me going I plan bigger activities when I can I'm friends with some of my professors and faculty so we go outside and do through hikes or go Canyon earing I went climbing this last weekend I'm hoping to go mountain biking this weekend for a few hours before I have to buckle down and take an exam on Monday morning so I I think it's being very cognizant of what's going on I also I mean I have pictures behind me I was just looking at those yeah I got married this last summer so I've been married for nine months congratulations that's awesome thank you very much I appreciate that um and it's been a blast it's been a lot of fun I'm having an incredible wife and she's very understanding very supportive and she's also in a graduate program right now she's getting an mph her is online um and she's the bread winner right now in our family and I'm support trying to do what I can to support her and her career and her aspirations while also going to medical school full-time so you know sometimes we have to just hang out on the couch at home at night after I've studied for 12 to 13 hours a day sometimes while she finishes school work because she's been at work all day wow but we are I'm very fortunate that I married somebody that has similar interests to me as well and so she's very easy to get along with very easy to plan stuff with and she's a better rock climber than I am so oh that is so funny that's wonderful though that's and and you so you guys are are a power couple you guys are going to be transforming Healthcare what what are your plans speaking of that are you are you looking at becoming a hospital administrator and a physician so is that kind of your plan for the future you want to be involved in both leadership and the emergency medicine yeah um actually for the last probably three months or so I've been interested in dual board certification in critical care and emergency medicine so we'll see how things pan out in the next two to four years um but I am interested in up in administration I just don't want to be completely removed from the bedside I recognize that administrators have a hard job and they have a busy job but I I can't imagine a career for me where I'm not spending at least some of my time at the bedside taking care of patients absolutely and I think that makes you a better administrator so can you explain real quick what that Critical Care component looks like because I know emergency medicine is three to four years residency right yeah so in order to get into critical care you can either do Internal Medicine you could do surgery um or you can do emergency medicine and then it would be a twoyear fellowship after residency in order to sit for the board certification as well wow and so what interests you about that Critical Care component I I like the procedural stuff um I think the high Acuity medicine is really interesting and you know for the last oh 12 years I have never seen patient dispositions as an EMT or paramedic and so I Dr I spend a very brief amount of time with them drop them off the hospital and then never hear anything about them again unless I pick them up again so I'm kind of I'm more curious to see that side of things I have spent a little bit of time in icus more so as an administrator where I casually took off my badge took off my tie and took off my jacket so that the RNs didn't all scatter when I walked into the unit and I was I was really interested um and my wife is also clinical dietitian and you it's very nice because she has a clinical knowledge and so we can talk about patient cases and she floats through icus as well and I think that's something I'm I could be really interested in and when I'm tired of working in emergency medicine I can go work in the ICU and vice versa right wow excellent and then you're going to have that one of the things that I've been I know a lot of doctors are worried about is it seemed like there was this issue with em compensation and EMS kind of going down but what I'm wondering is with your with your knowledge do you feel like we're going to see a Resurgence of that because you know Walmart for example is expanding into some of these areas with their their virtual urgent care and so is Amazon and what I wonder if what's going to happen is you're actually going to see a a higher need for for freestanding EDS or or EDS in general do you feel like emergency medicine is going to continue to be a profession for a long time that's really valued and and even get a Resurgence in value yeah so I mean if right because I've been in medical school for the last two years in master's program before that we just we can talk about that side of things if you look at match rates of people going into emergency medicine we saw a downtrend with covid right we did the pandemic and we saw a lot of um Pas and nurse practitioners that were moving in and fulfilling a lot of these roles but it's because they couldn't get Physicians a lot of the older em docs were retiring and you know with IEM becoming a board certification um a lot of these docs are like I'm done I'm just gonna I'm just gonna tap out um and so you look at match rates last year on Match day there was 550 unfilled seats in EM last year I think that's what I read that's why I was kind of seeing what your thoughts were this year there was around 120 125 unfilled seats on Match Day and in I'm the president of the local or my uh school's emergency medicine Club coincidentally and so we yeah we we're one of the most popular clubs on campus we're one of the most active clubs but we also have the highest student interest in my opinion for all the organizations that are there and if we look at what's coming out through ASAP American College of Emergency Physicians or American College of osteopathic emergency physicians there has been calls for parody between dos and MD right comlex and us and to get into the same residency programs which combined back in 2020 and then I believe it was last year maybe that states started requiring that if you have an open emergency department you have to have a board certified emergency position there in order to operate you can't be staffed fully with NPS and PAs yep um and I think that was somewhere in the midwest that first started happening and I've seen similar Trends across the country or things that have popped up across the country I also belong to usap Utah College of Emergency Physicians we have our annual Summit in about a month from now actually um but I belong to American Medical Association Utah Medical Association and I've participated in a lot of these House of delegates meetings where that has come up students perception of emergency medicine um the industry as well as um emergency medicine physicians unionization and contract negotiation uh you know and when I first told my mom years and years ago that I was going to go into emergency medicine or that I was interested in emergency medicine she said why you're gonna own be owned by the hospital I said you she hasn't worked as an RN in a hospital in several years more like 20 years but I said are you aware of how emergency rooms are staffed now with Physicians it's more medical groups right and it's one of the more sought after for or has been traditionally pre-co one of the more sought-after Specialties um so I think we are definitely going to see this Resurgence as people view the lifestyle Trends start moving towards maybe unionization we are already organized with Utah Medical Association American Medical Association and American College of Emergency Physicians but they can only do so much and so I I do think that there will be Resurgence and compensation will follow and uh you know I'm I'm hoping it's not too competitive when I go for residency so I can get into a residency that I want to go to um but I I think it'll it'll become competitive again from everything that I've been seeing in the industry excellent and I mean it is good in a way to have to compete you know is to compete and we can talk for for longer another time so thank you so much though Brogan for for coming on and talking with us yeah of course thank you so much for having me it's been a pleasure of course</p>