[00:00:00] Stacey Richter: Episode 404 what now? Who's on the board of those big hospitals today? I speak with Dr. Suhas Gandhi.
[00:00:17] Tom Nash: American healthcare entrepreneurs and executives you want to know. Talking.
[00:00:23] Suhas Gondi: Relentlessly, Seeking value so much of this episode and this podcast as a.
[00:00:28] Stacey Richter: Whole really is about one consistent theme. How do we reset or redesign our healthcare industry, including hospital chains, mostly talking about the big consolidated ones that have a lot of money here. But how do we redesign these leviathans to be more consistent with our values as a country and the values of the doctors and other clinicians and others who work in these places and who went into the healthcare profession for a reason that had, you know, something to do with patients.
And I mean something to do with patience that doesn't involve dressing up for Halloween as a giant cardboard dollar sign.
[00:01:04] Suhas Gondi: Like some finance department guy did at.
[00:01:06] Stacey Richter: One large non profit hospital. In the spirit of shaking money out of poor patients, link in the show notes or listen to previous episodes about.
[00:01:14] Suhas Gondi: Hospitals raising prices way higher than the rates of inflation.
[00:01:19] Stacey Richter: I'll make a playlist for you if you are interested. And I promise to put the link in the show notes. Not to belabor this because we've already talked about it so very often, but.
[00:01:28] Suhas Gondi: You also have the whole thing with.
[00:01:30] Stacey Richter: Big, well funded nonprofit hospital chains going on cost cutting extravaganzas and at least in one case, basically creating their own staffing crisis. Do these activities have a familiar ring to them? Do they strike you as a page out of a playbook you may have seen elsewhere? I don't know about you, but they remind me of things that private equity or financial folks run around doing. I mean, the classic step wise for.
[00:01:58] Suhas Gondi: How to maximize the financial value of.
[00:02:00] Stacey Richter: An asset from a financial industry standpoint is to cut costs and raise prices. Piling on this kind of sounds like a B school group project thesis. What about the thing with a bunch of these big consolidated health systems with rich endowments crying crocodile tears about how much money they lost last year?
Except in a whole bunch of cases, the money they lost, some of which came from the COVID Cares Relief act.
[00:02:26] Suhas Gondi: Funds they got, by the way.
[00:02:28] Stacey Richter: But this money was lost when their risky stock market investments tanked. Those are their losses. Stock market losses from speculative investments? Are you kidding me? But hospitals are charities, right? They are nonprofits. They aren't owned by private equity. They aren't owned by an investment bank or a team of financiers. So you wouldn't expect them to be acting like they are owned by Wall Street.
[00:02:53] Suhas Gondi: But oh wait, how weird you know.
[00:02:55] Stacey Richter: Who is on the boards of some of these very well known nonprofit hospitals.
[00:03:00] Suhas Gondi: If you don't, I'm not surprised.
[00:03:02] Stacey Richter: Because in too many cases, if you ask me, you have to dig around in tax filings and other bureaucratic paperwork to unearth the names of these members.
[00:03:10] Suhas Gondi: Who have quite a large amount of.
[00:03:11] Stacey Richter: Power, it turns out, over what goes on in the hospital. But you know who is on these boards. Yeah, almost half of board members tend to have a financial background. Almost none of them are nurses. And what about doctors are physicians on these boards? Well, almost one third of hospital boards did not have a single physician member.
[00:03:31] Suhas Gondi: So there's that.
[00:03:32] Stacey Richter: Here's a quote from a Stat News article written by my guest today, sue has Gandhi, MD, and also Sanjay Kishore, MD, about a study that the two of them co authored about who is on hospital boards. Here's the quote. Our findings are cause for concern. If hospital executives are largely held accountable by finance professionals and corporate leaders instead of by clinicians and patients, might they focus more on revenue and expenses than the needs of their communities or staff?
While some argue that margin facilitates mission, the measure of a nonprofit organization is how these priorities are balanced by leaders who ultimately answer to their board. So I get there's balance. You have to be financially sustainable. But I also get that apparently tigers.
[00:04:22] Suhas Gondi: Don'T change their pinstripes.
[00:04:24] Stacey Richter: The pinstripe suit remains even when the finance tigers become the board members of a charitable organization that's supposed to be serving the surrounding community, paying its freight.
[00:04:34] Suhas Gondi: In the form of its tax exemptions.
[00:04:36] Stacey Richter: So this is what this conversation is about today. Who is on these hospital boards? How much power do these hospital boards have? What might be done to switch it up some so that we can get.
[00:04:48] Suhas Gondi: Hospitals that are reflective of our values.
[00:04:50] Stacey Richter: As a nation and what we want for ourselves and our families. Today, as aforementioned, I'm speaking with sue has Gandhi, MD, who again, along with his co author Sanjay Kishore, MD, wrote a paper on this exact topic. Link in the show notes to the paper and some great tweets and comments. Also in the show notes are some suggestions that Dr.
Gandhi makes in this podcast interview that follows to help us get a little less misaligned. My name is Stacey Richter. This podcast is sponsored by Aventria Health group. Suhas Gandhi, MD.
[00:05:22] Suhas Gondi: Welcome to Relentless Health Value.
[00:05:23] Suhas Gondi: Thanks Stacey. Happy to be here.
[00:05:25] Suhas Gondi: Maybe we just begin at the beginning. What's a hospital board? And just how much power do they tend to have in a hospital?
[00:05:34] Suhas Gondi: So the American Hospital association describes what the roles and responsibilities are for Board members of hospitals and for health systems. And briefly, they highlight a few important roles. The first is to establish the ends and the goals of the organization. They then make policies and decisions to support those ends.
And ultimately they oversee performance and ensure that management, the folks who actually lead and manage the organization, are held accountable for the results they deliver. The board members of hospitals have a varying amount of responsibility. And to your question of power based off of the hospital and which committees they sit on and what their assigned roles are.
But at a high level, it's hard to argue that the boards don't play a critical role in the management of a hospital, given also according to the federal government, actually, boards are responsible not only for strategic direction and executive compensation, but also for the quality and safety of care that's delivered in their hospitals.
It's hard to paint them all with one brush, but I think it's fair to say that they're very important players in our broader healthcare ecosystem.
[00:06:51] Stacey Richter: And how many people tend to be on this board?
[00:06:52] Suhas Gondi: I know it probably varies, but like, what are we talking about here?
[00:06:55] Suhas Gondi: The number of people on the hospital board can vary widely. It can be as few as 10 to 15 members, and it can be as many as dozens and dozens. I think one of our boards had well over 50 members.
[00:07:09] Suhas Gondi: Actually, we have this group of individuals somewhere between 10 and 50 of them, and they are responsible to establish the ends and the goals of the institution over which they serve. So what does good look like here? They make policies and they make decisions and then they oversee performance. So I'm assuming that they're setting up, as you basically said, performance goals and then measuring how well the management team does against those performance goals.
And if the management team isn't doing a great job against those performance goals, then they're responsible for hiring and firing. So, goodbye, management team. This seems like it's, as you said, it feels like a I don't know how you'd argue against it sort of statement that this is a very powerful entity within a hospital.
[00:07:56] Suhas Gondi: Absolutely. Not only are these entities powerful in the theoretical sense of what their intended role is, but actually there's empirical data supporting that hospital management teams respond to the priorities of board members. For example, prior research has shown that management teams at hospitals whose boards pay greater attention to clinical quality tend to have higher performance on quality metrics.
So it's not just in theory. It's actually the evidence supports that what board members care about, management tends to care about. And that tends to affect how the hospital performs and what it prioritizes you.
[00:08:37] Stacey Richter: Did research on these hospital boards and.
[00:08:39] Suhas Gondi: Found a really common expertise shared by.
[00:08:41] Stacey Richter: Many members of the boards.
[00:08:42] Suhas Gondi: Do you want to talk about that?
[00:08:43] Suhas Gondi: Yes, I do. We looked at the hospital boards of top ranked hospitals in the U.S. all of which were nonprofit academic medical centers. Only 15 of the 20 highest ranked hospitals actually listed their board members on their website for us to be able to access. And we classified, of the over 500 board members, we classified their professional backgrounds, meaning the industry in which they're employed or the industry which they were in before they retired.
As you said, there was one kind of overwhelming commonality amongst board members. 44% of them all came from the financial industry entities that the, that the federal government and the Bureau of Labor Statistics categorizes as within the industry of finance.
[00:09:30] Suhas Gondi: Finance. We have 44% of these boards being finance. And as we just had mentioned, these boards are critical to determine the direction of a hospital. And also these boards are responsible for quality and safety. Sounds like we're teeing up a situation where we have people with an expertise in finance who are overseeing not only what the hospital prioritizes relative to its financial situation, but also their quality and safety.
And I think anybody that listens to the show might be connecting some dots here. How many doctors are on these boards?
[00:10:06] Suhas Gondi: Yeah, that was, that was our question. As soon as we saw how prevalent the financial activity sector was, we were wondering, what about the health sector? And turns out that 16% of these board members were from the health services sector. Not even all of them were clinicians. So to answer your question, actually less than 15%, 14.6 of these board members were health professionals.
And of them, the vast majority were physicians. Actually only 0.9% were nurses. So you can see a big discrepancy in the financial activity sector, the professional and business services sector versus the health sector and healthcare professionals in particular.
[00:10:47] Suhas Gondi: And do you have any idea how these boards function? I could imagine a meeting with 10 to 15. Right. And like, do they vote and everybody on the board gets a vote, or are some people more equal than others on these boards? In other words, could there be a situation where the doctor is the boss and the finance people just weigh in on financial decisions? Like, how do they roll from the.
[00:11:08] Suhas Gondi: Best I can tell it varies a lot based on the board. There may be some situations where there's a health professional chairing the board. We didn't identify that pattern in our own research. It's difficult to say.
[00:11:23] Suhas Gondi: We have 44% being finance and 16% being health services. So Extremely underrepresented.
[00:11:32] Suhas Gondi: No, absolutely. This had us scratching our head thinking about whether the predominant background on these boards that by definition govern our hospitals and health systems might explain some of the problems that we've identified with our large nonprofit hospitals over the last few years. And I think over the course of the COVID pandemic, we saw so much tension between the administration at these hospitals and the workers and the trainees and the people on the front lines.
And in the wake of the increased emphasis on health equity, we've noticed such a broad gap between the rhetoric of these hospitals and the reality of who they serve and what drives them and who holds power. We couldn't help but wonder, could this be part of the explanation for so much of what we've observed?
[00:12:23] Stacey Richter: Yeah, I can certainly see how that would be a valid hypothesis. I mean, on this show we've done one episode after another about, frankly, certain hospitals behaving badly, just making a mockery of the no mission, no margin statement. It's just like the highest margin, the smallest mission possible. Almost really.
[00:12:44] Stacey Richter: Have hospital boards always been this way? Have there just recently been lots of finance people who have gotten themselves on hospital boards? That coincides with the trend. Do you have any insight into this?
[00:12:53] Suhas Gondi: Yeah, Stacey, it's a great question and one that many people posed in the wake of our paper. We're not aware of other data sets that have documented the professional background composition in the way that we did in prior years or in prior decades. I think it would be so interesting to look at, but it's just a really hard question to answer.
I think the question that your question raises for me is whether this overriding dominance of finance professionals and business leaders on boards, is it part of this broader trend towards the increasing corporatization and really financialization of the US Health sector, which we've seen in so many ways, not just in nonprofit hospitals, but also with the rise of private equity.
And private equity fueled consolidation and mergers in many areas of the healthcare sector, not just hospitals.
[00:13:50] Stacey Richter: Well, what really strikes me, and I'm going to ask you about PE private equity in a second, and I love how you put it, the financialization of the health care industry. But what strikes me is that these hospitals that you looked into here, their boards were all nonprofits.
[00:14:06] Suhas Gondi: That's correct.
[00:14:06] Stacey Richter: And you couldn't find the board on the website. So just that right there strikes me as a little questionable. Like these are nonprofits or charities. And these boards are clearly, as you said, it would be hard to argue that these boards don't play a critical role in the steering of this nonprofit entity.
[00:14:30] Stacey Richter: And then you cannot find the names.
[00:14:32] Stacey Richter: Of the board members on the website. Is it just a weird their website kind of sucks and they forget some important things that probably should be on there?
[00:14:42] Suhas Gondi: I was shocked to see that for five of the top 20 ranked hospitals nationwide, we couldn't find a list of board members on their websites. Board members are disclosed in other documentation filed to the IRS for tax exemption purposes. I was just as shocked as you, Stacey, that how are we unable to find this?
It got me thinking about how nonprofit hospital leaders tend to lack any measure of accountability towards the patients they serve and the communities that their hospitals are in. We have very few mechanisms to hold nonprofit hospital leaders accountable. They're not elected by the public and they're not chosen by shareholders the way they would be in a private corporation.
And many of these hospitals enjoy such significant market power that patients can't really just take their business elsewhere as they might do in a more competitive market. And failing to publicly disclose the names of board members via accessible webpages that anybody can log in and look at, it feels like it shields hospitals from public scrutiny and further erodes their accountability to the patients and communities they serve.
[00:15:54] Stacey Richter: Well, I guess maybe huzzah. It's only 25%. But how do these board members then get appointed? I guess, like, who picks them, again.
[00:16:02] Suhas Gondi: Varies by hospital, but usually the current board members play a role in who gets selected to join the board when other board members leave or when the board is being expanded. And there may be some input that senior hospital management has in those decisions. But I think primarily it's the boards themselves.
There really aren't a whole lot of requirements for nonprofit hospital boards, in particular in terms of who should be on their boards, which is actually very different than a number of other contexts. So, for instance, at federally qualified health centers, 50% of the board members have to be patients at the hospital, which to me makes a lot of sense and might play a role in how those institutions tend to be much more embedded in their communities and much more service oriented.
And overall, just navigate that tension between mission and margin in a way that really puts patients and communities at the center.
[00:17:04] Stacey Richter: I guess it's like, again, what's our goal here? Right. So you have this board that has some amount of leverage here because they are setting what good looks like for the organization. And then you have a bunch of individuals who have never worked in healthcare setting may or may not be patients in the hospital.
I guess maybe they are. I Don't know, but may not necessarily represent the patient populations that are served. And just empirically, I think we can draw some conclusions just based on, like, what's going on in hospitals and as we just talked about. But another comparator here is just this pe the private equity phenomenon, which certainly there's been a bunch of literature that describes what tends to happen when private equity purchases a practice, physician practice.
Not necessarily a parallel here, because it's not like the board purchased anything. What do you think the parallels are that we could draw, though?
[00:18:01] Suhas Gondi: There are some parallels, but I would, I'd be cautious to go too far in extrapolating from the private equity literature to nonprofit hospitals. And that's really because the private equity model just sort of fundamentally changes the incentives of the organization. We've shown this time and again in the literature that often when healthcare organizations are acquired by private equity, they tend to cut costs, increase prices, and increase the financial performance of the organization.
When a private equity firm owns an organization or purchases a hospital, it sees that organization as, as an asset to generate monetary value for the firm and the other shareholders. Which feels to me very different than how many of us, particularly doctors like myself, think about the purpose of our organizations.
Certainly we need to keep the lights on, but the purpose of the asset. We wouldn't even think of the organization as an asset. But the purpose of the organization being to generate monetary value, I think, is not front of mind for any of us who are delivering care or for those of us who are receiving care.
Stacey Richter: And I think if you went and asked a number of patients, would you rather have your doctor's office be owned by a private equity firm or be owned by the doctors? I think many people would have a very similar answer. And to connect it back to our board's topic, I think they'd probably be a little bit more open to their primary care doctor or the surgeon who replaced their grandmother's knee last year as serving on the board and than the managing director of the local hedge fund.
[00:19:45] Stacey Richter: Well, you wouldn't make it very far in private equity, Dr. Gandhi. Just saying, you don't have the right attitude.
[00:19:51] Suhas Gondi: That's probably right. My, My former business school classmates knew that well before I published this paper.
[00:19:57] Suhas Gondi: But maybe there are some similarities that you can draw. So you just mentioned that one of the things that private equity does is it figures out how to improve financial performance, and it figures it out on the quick. You know, what you want to do is you want to raise prices and reduce costs across the sector.
I've Seen one graph after another about how hospital prices are rising greater than the inflation rate by a considerable margin. And you hear all these stories about how pre pandemic, all of this, the staff was cut to save costs. So you had said earlier you were talking about the financialization of the healthcare sector and it would seem like a very similar type of model is playing out at hospitals, maybe in a bigger, a little bit less stark or targeted kind of way, just because these organizations are larger, much more sprawling, tons more, many more people involved, maybe a little bit less control that a board may have as opposed to the actual owner of something. But it almost seems like there is a similar trend.
[00:21:01] Suhas Gondi: You make a good argument, Stacey. I think the playbook of how to maximize the financial value of a hospital or of a physician practice is not that diverse. On the revenue side, you want to see more patients and you want to see more patients with private insurance and you want to maximize the prices that you're getting paid for each service you deliver.
And certainly we've seen both nonprofit health systems and private equity owned healthcare organizations run that playbook and we've seen both of them also cut costs. You've seen hospitals have been large nonprofit hospitals have been criticized by nursing unions and many others for adopting dangerous staffing ratios in terms of the number of nurses per patient.
And we know that the same thing happens in private equity owned physician practices where more of the work gets farmed out to satellite practices, often without physicians present. I think you're absolutely right that the overriding role that margin plays over mission, there's very similar strategies at play to achieve that.
And begs the question of how do we reset the goals of the system again in a way that is more consistent with our values, the traditional legacy of health systems and of hospitals and how they were built to serve the poor and to take care of people at their time of need.
[00:22:26] Suhas Gondi: That's a great call to action there. How do we reset the stated purpose, the stated mission to be more aligned with our values. And considering that the boards of these hospitals. Part of the role and responsibility that you teed up at the very beginning of this conversation is in fact to establish the ends and goals of the hospitals.
This could be a tip of the spear kind of thing to do to fix up these boards so that potentially they are comprised of individuals who may be a little bit more focused on the quality and safety.
[00:22:57] Stacey Richter: What are your recommendations?
[00:22:58] Suhas Gondi: I know you were talking about, you had mentioned the FHQCs that they have a certain 50% have to be 50% of the board has to be patients who are actually patients in the FHQCs. So I could certainly see that one thing that could be done with boards is to make them a little bit more reflective of the communities that they potentially serve.
[00:23:21] Suhas Gondi: I do feel that hospital boards are an underappreciated mechanism by which we can start to redesign the system a little bit and to center the priorities that so many of us who take care of patients have and to some extent sideline what has become an overriding interest in profit. There's a number of ways to do that.
One example is the fqhcs. It's really not the only model. In fact, the Nasdaq actually looking at publicly traded corporations, they actually have rules that we should think about adopting in health care. The Nasdaq listed corporations, they have to annually disclose data about the board's gender and racial characteristics and include two, quote unquote diverse directors, meaning from underrepresented backgrounds.
This to me seems like a no brainer that we should have. The data should be publicly available and allows easy accessible public patient scrutiny of who are the people who are governing this place where I'm going to seek care? Do they to your question, Stacey, do they look anything like the communities they serve?
Rules like this, I think can not only shine a light and allow for a little bit more transparency and therefore scrutiny, which could naturally make hospitals change and consider a little bit more thoughtfully who sits on their board, but then also just hard and fast rules and regulations, like the provision to include two diverse directors that you could imagine requirements not only similar to that, but also around professional background, like the importance of having physicians and nurses and other frontline hospital staff who have played such a critical role during the pandemic but have really been sidelined from the rooms where power is exercised.
And really that's fundamentally what this is about. It's about who has power and whose voices are actually heard. Another approach to take would be Senator Elizabeth Warren has proposed for many years the Accountable Capitalism act in Congress which would require that 40% of corporate board seats are selected by employees.
And I really like that notion of having the people who the hospital employs have some say in the people who govern them. It doesn't mean every board member has to be elected by hospital employees, but at least some portion of them. It would give us a little more agency in who runs our hospital and importantly, who holds our leaders accountable for the decisions they make, how they navigate that tension between margin and mission.
[00:25:59] Stacey Richter: You basically were offering three new models here. The first one is just these are tax exempt entities. Why the community is foregoing the tax revenue is because there is. They're giving back to the community. They are accountable to the community to provide charitable services and everything that a hospital offers back to its community.
And they offer immense potential value, but they're accountable to their communities. So you would think that, again, someone that had such control and such power over what is going on in these institutions would, at a minimum be visible to that community. I had a listener write me recently who was having all kinds of trouble with their local hospital that was doing all kinds of hospitals behaving badly kinds of things.
[00:26:51] Stacey Richter: And it turned out that the board.
[00:26:53] Stacey Richter: Of the hospital was this big consolidated entity three states away in the corporate hospital location, Right? So not only are do we have a situation here where the boards themselves aren't actually reflective of the community in these consolidated entities. They are nowhere near the community. But you'd only know that, again, if this information was transparent.
And the only reason that this particular listener knew it was because they were having so much trouble with the local hospital that she and a gang of very empowered individuals went and figured this out. That's a long way of saying, number one, this has to be probably slightly more transparent. Sunshine is the best disinfectant. If we want a step one, that could potentially be it.
[00:27:33] Suhas Gondi: If I could just add the it is. I think it would be shocking for us to really shine a light on all of these boards. The most recent available data that we were able to find was an American Hospital association survey from 2018, which found that almost one third of hospital boards did not have a single physician member and almost two thirds lacked even one nurse.
To take it even a step further, that same study found that 42% of U.S. hospitals had all white board members. This is in 2018. And 70% of board members were male. Now, these are aggregate data, right? But they reflect a systemic problem in the composition of boards at US Hospitals. And I totally agree with you that shining a light would help expose a lot of what I think contributes to again, this gap in what we want our hospitals to be and how they actually behave.
Am I surprised? No, I'm not, right? Unfortunately.
[00:28:36] Stacey Richter: Yeah, exactly. Unfortunately. The second thing that you said, and maybe this is step two after just making this information transparent. But the second thing that you said, and this goes on on the nasdaq, so it's not like it's. This crazy idea is to mandate. It sounds like this is a very low bar. But to have at least some gender and ethnic Diversity.
We also could add to that to have some professional background diversity and to ensure that there are actually people who.
[00:29:04] Stacey Richter: Understand healthcare on the board of a.
[00:29:07] Suhas Gondi: Health care organization, which just, it defies logic in a way that this is an organization that is supposed to be doing health care. That's their thing. And then you have a board that is comprised of very few people who actually have that expertise. Like question mark with that. So I can certainly see that maybe setting up some standards, what an ideal board might look like relative to the distribution of expertise and experience might make sense.
And then we have number three that you had mentioned this accountable capitalism, I think you said, wherein those who work in an organization have a say and. Or it could be people who work in the hospital. But I also could see that it has some kind of accountability to again.
The community who is paying money. I mean, tax exempt means that taxpayers have to pay more because somebody else is paying less.
[00:29:59] Stacey Richter: Like what is the accountability to the community? So I also could see that could probably take a bunch of different forms there.
[00:30:05] Suhas Gondi: Absolutely. And Stacey, I should be clear that I don't think that the optimal percent of physicians on boards is 100%. I don't think the boards should only be healthcare professionals. I think people from other industries bring a lot of insight and frankly, expertise that healthcare professionals may not have to organizations with billions of dollars in revenue.
I think it makes sense have some finance and business leaders on these boards. I think what's startling to me and I think has been startling to so many of us and disconcerting is just how many there are of that phenotype relative to what we might expect ought to be better represented, which are health professionals, patients and people from again, from the communities that these hospitals serve.
[00:30:55] Stacey Richter: Well, as they say, diversity makes for the best results for teams. So as you just mentioned, you don't necessarily want the pendulum to swing too far in any particular direction. You're kind of chasing Goldilocks. It creates an imbalance in what decisions are made when one interest group is represented, has so many votes around the table.
[00:31:18] Suhas Gondi: Totally agree with you. And I think that's where that's where the concern comes from. And that's where some of these proposals might be able to diversify the hospital boards a little bit along multiple dimensions. Really what we're hoping for with that sort of diversification of boards is re centering the goal of hospitals to be around service to their patients and to their communities, which is really one of the guiding values of our profession of medicine.
One that I think has unfortunately been increasingly crowded out by profit motives and by again, the financialization of the sector.
[00:31:52] Stacey Richter: Is there anything I neglected to ask. You that you would like to mention Dr. Gandhi?
[00:31:57] Suhas Gondi: Probably the one recommendation that I didn't offer is around the IRS, which already certifies these hospitals as being nonprofit and therefore tax exempt, could easily mandate standardized public reporting of board composition and also require boards to meet certain criteria to maintain their tax exempt status. That could be sort of a simpler way to get to what we're talking about.
[00:32:20] Suhas Gondi: So for sure the IRS could do this. We're talking about billions and billions of dollars here that these tax exempt entities are not paying in taxes. So it would seem like having very minimum common denominator here to trying to straighten some lopsided behavior.
[00:32:36] Stacey Richter: Dr. Suhas Gandhi, where can people go To learn more about your work?
[00:32:41] Suhas Gondi: I share most of my academic work on Twitter. This paper generated a lot of, I think, productive and interesting discussion. I'm also on LinkedIn and happy to connect.
[00:32:51] Stacey Richter: Dr. Suhas Gandhi, thank you so much for being on Relentless Health Value today.
[00:32:54] Suhas Gondi: Thanks for having me. Stacey.
[00:32:56] Stacey Richter: Thanks so much for listening.