Pathologists Are the Most Important Doctor You’ll Never Meet: Dr. Jennifer Hunt, Interim Dean at the University of Florida College of Medicine

Michael Carrese: Hi everybody, I'm Michael Carrese, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare.

I'm very pleased to do that today with Dr. Jennifer Hunt, the interim dean and the Folk H. Peterson Dean's Distinguished Professor at the University of Florida College of Medicine. Prior to this role, she served as chair of the college's Department of Pathology, Immunology and Laboratory Medicine and chief of the hospital medical staff at UF Health Shands Hospital and Clinics. Dr. Hunt has also held academic appointments and leadership positions at some of the most prestigious health systems in the country, including the Cleveland Clinic and Massachusetts General Hospital, which is part of the Harvard system. 

She has authored more than 160 peer -reviewed scientific publications in the subspecialties of head and neck pathology and molecular pathology, and is a fellow of the College of American Pathologists. Dr. Hunt is also active as an executive leadership coach and keynote speaker, and so we have an awful lot to dig into today with you and want to thank you for taking the time to join us.

Dr. Jennifer Hunt: It's my pleasure. I'm looking forward to a great conversation. Thank you for having me.

Michael: Sure. So we always like to start with learning more about our guests. So what first got you interested in medicine and what led you down the path, particularly to pathology?

Dr. Hunt: Well, I guess my journey is probably similar to other people's journey in many ways in that it was a number of really key leaders and mentors in my life that got me interested in my career path, both at the undergraduate medical school level and then well into my residency. 

My very first mentor in medicine lived across the street from me. I grew up my high school years in northern Idaho, middle of nowhere, sixty or seventy miles from the Canadian border -- that little tiny panhandle up there -- and across the street from me lived the one and only surgeon for a fifty mile radius. 

Michael: Wow. 

Dr. Hunt: I think it might have been more than fifty miles in some directions, and he was a wonderful mentor early on, Rich Neher. He is retired now, but he was in practice for a very long time as the only surgeon really for very, very many miles. And I was able to work with him over a couple of summers when I was either in high school and then incollege as well and I worked at his office. I was kind of a medical assistant and then occasionally he would have me go into the OR with him and actually scrub in because in Idaho at that time anyone could be the first assist, believe it or not.  I guess I was very eager and interested. This was probably into college and into medical school by then, and he taught me a lot about medicine. In fact, even in medical school and in residency sometimes I’d call him up and say “Hey Rich have you ever heard of this?” So he was my very first medical mentor and I think got me interested in medicine from a very early age. 

I always thought I'd be a surgeon because of his inspiration and that's what I knew and loved. I loved the technical side of surgery. When I was in medical school, I was pretty committed to the surgery path and I really thought I'd go into some sort of surgical subspecialty.But I went to the Women in Medicine dinner at Penn in my medical school years one year, and I was a little bit late. I commuted in by car and I was a little late and there were no more seats at the surgery table, so I sat at the pathology table and I sat next to the next important mentor in my life, that's Leslie Litsky who told me about her life, told me about her career, told me about pathology and I thought, wow, that sounds amazing.

I want to know more about that, and that's how I found pathology.

Michael: Isn't that amazing how random it can all be? And so once you got introduced generally to the field, what was it that kind of lit the fire for you?

Dr. Hunt: Well, I don't know that it got lit until I actually did it. There’s another whole story there because there was a program at Penn, and a number of other schools, where you could do a year out from medical school and do basically a year of residency in pathology and it would count for residency back then. So you were able to count it if you went into pathology as a year of residency.  I ended up doing that program mainly because I met Dr. Litzky and thought, this is really neat. I need to explore this and loved it from day one. 

So once I got in there and was looking at the microscope and enjoying the pathology cells and everything I got to look at, the fire it lit for me was the deep desire that I have to have varied experiences and different experiences all the time and every day, and if you've ever looked at pathology slides, you would realize that every single slide has something unique and different on it. And that's just the intrigue of what pathology is like. So that, I think, was what really, really did it for me.

Michael: Yeah. Well, that's totally understandable. So you further specialized in head and neck pathology, endocrine pathology, molecular genetic pathology. Talk a little bit about those areas and some highlights of your experiences in those areas.

Dr. Hunt: Same thing, more mentors, more amazing mentors. So one of my dearest, most wonderful mentors at Penn was Dr. Virginia LiVolsi. She just passed away recently after training and developing and mentoring thousands of people, I would say, and she was really the first pathology mentor in the field of head and neck pathology and endocrine pathology that inspired me. And she was not easy on us. Oh, she was tough, and she was demanding and loving all at once. That combination of support and high expectations drove me to love head and neck and endocrine pathology. 

She's a world famous thyroid pathologist. I remember I did her consult service, which meant that I would look at all of the cases that came to her. I mean, these are the hardest cases in the world, and they would come to her for a second opinion. I would look at them first and then write the draft of the letter that we'd send back to the submitting pathologist, and then she would look at it and correct me liberally. After I was finished and ready to go on to my own career in pathology, she said, “You have done a fine job on my consultation service.” 

Michael: Wow, that meant a lot.

Dr. Hunt: That was, yeah, the highest compliment.

So she got me interested. Then my first job then was in head and neck pathology at the University of Pittsburgh under the mentorship there of Dr. Leon Barnes, another amazing and fantastic head and neck pathologist who also passed away sadly. These wonderful luminaries...they don't stay around long enough. There's more people to train. Fortunately, they leave behind people to carry on their mission and their life’s work. 

Michael: I'm curious about what you do to sort of pay it forward as a mentor, but tell us first about molecular genetic pathology.

Dr. Hunt: Yeah, so again, another great mentor. Dr. Debra Leonard, who was my fellowship director at Penn and got me interested in molecular pathology, taught me everything I knew, which started out as practically nothing. She really brought me a long ways in molecular pathology. She also showed me -- and so did Virginia and then Leon -- the true difference between mentorship and sponsorship. 

As I grew in my career and recognized that difference, they all showed me what it was long before I knew the word of sponsorship. The way I think about it is that they opened doors for me that I never even knew they opened. Sometimes I would say to Dr. LiVolsi, “My gosh, I got invited to write this chapter.” And she would say, “Yes, I know.” But most of the time, I don't think she even told me. I think the doors were opened by her and by Leon and by Debra Leonard without me even knowing it, and that's the real definition of sponsorship.

Michael: So, I do want to get to your work at the University of Florida, but just one more question on pathology in general. You mentioned Dr. Debra Leonard, who is somebody that coincidentally, I happened to work with for quite a long time at the University of Vermont Medical Center. She’s a wonderful scientist and leader. I remember talking to her about concerns she had that people in general don't really understand just how vital pathologists are to what happens in medicine. I think she used the phrase “the doctor's doctor.” So, I want you to have an opportunity to weigh in on that as well. What are your thoughts on that? 

Dr. Hunt: The ‘doctor's doctor’ is a phrase we like in pathology. The other way I've thought about it is, the most important doctor you'll never meet.  I mean, when you think about it, when I take my slide and I make a diagnosis of cancer, that's changing the landscape of that patient's life forever. Basically the trajectory is being set bythe words I write down on my report. And so, you know, if you think about that crucial bifurcation in the path, that happens under a pathologist's microscope. So, most important doctor you'll never meet. 

There have been some people nationally who have started patient-directed consultation practices where the patient actually can meet with the pathologist and look at the slide with the pathologist, and this is obviously much easier now with virtual and Zoom. I mean, you can Zoom with a patient if you wanted to. It's kind of neat. 

In COVID, pathology became so central that it was amazing. I mean, even my mother knew what PCR testing was and would ask me about it. “Is that a PCR test?” So we became sort of very known and important even in everyday household settings. The pathology lab became such a crucial element to the COVID response that for the first time ever I think it was really recognized and noticed how important pathology is to healthcare and the delivery of healthcare. So, I think it changed. 

Michael: Yeah. I want to return to the mentorship theme because I didn't get to ask what your approaches are to that now. You obviously have had decades of experience as a clinician and a leader and you're running a college of medicine now. How do you think about mentorship and providing that sort of guidance to people?

Dr. Hunt: So, I think of it as three helping technologies or fields, three helping ways that we can be with other individuals, and one is mentoring, which is very traditional. I do a lot of mentoring. Second is sponsoring, which is really kind of the mentorship, the next generation of mentorship. It's kind of the upper level of mentoring. And then the third is coaching. And I use all three of those approaches when I'm working with and helping to develop others - in different settings and in different environments. They are different and they're synergistic and all important when you're helping to elevate and bring up people behind you and people in front of you. All three are important together. 

Mentoring is very traditional. “This is the way I did it, maybe that will help you.” Sponsoring is much more about lending your credibility as a surrogate for the person and saying, “I'm investing in you.” I think of mentoring as being like buying a few shares of stock in a person, and then sponsoring is like being a venture capitalist and throwing your whole fortune behind them in that you're throwing your reputation behind that person. You are staking your reputation. Your honor and your value is used to elevate the person that you're sponsoring.

Michael: Yeah, that's a good way to explain it.

Dr. Hunt: It helps people to understand what the sponsor is really investing in them. And then the last thing, coaching. Coaching is a totally different world. I thought coaching and mentoring were similar until I learned what coaching was, and they are very different. Coaching is really about giving a person their own resources. It's about helping them to find their own answers. It's about asking questions rather than telling. It's about helping people be their most effective self, sometimes in ways that you have never experienced, sometimes in ways that you would never dream of and never even advocate for, and yet it's the way that that person will be the most effective in their own careers. 

So, I use all three of those and I feel like it is truly part of my mission as a leader to help others be successful and effective in their own careers.

Michael: Well, as I mentioned, you do have a coaching focus and work with particularly the next generation of women leaders in health care, and I’m just wondering if you want to share a little bit about that and what are you sort of seeing in that generation that's encouraging to you or concerning to you?

Dr. Hunt: So first of all, I love the concept of coaching. I think it's one of the most effective tools that we have in terms of helping people to just be their most successful self. It's pretty underutilized in medicine. It's very, very, very common in business. I think most people who do an MBA know all about coaching and they may even have coaches assigned to the MBA students and they learn it. In business and in the executive world, I mean, every executive you ask probably would say they have a coach and it's very common and kind of accepted as the norm in terms of being your own most effective self. 

In medicine, it's been underutilized and under recognized really. There've been a couple of recent papers that show how effective it is in medicine. Coaching is getting a foothold, especially in leadership in medicine. As a Dean, I'm seeing more chair requests for recruitment packages that include coaching, and I think that shows that coaching is becoming a more mainstream tool that people can use to be an effective leader. 

I've had coaches for a long time, long before it was popular, because I was in an institution that had a coaching program, Cleveland Clinic, and it was probably one of the very first that developed that sort of coaching program. So I've been kind of fortunate to have that as part of my career development and have been enjoying bringing that to the University of Florida as part of what I bring as a leader here. 

What am I seeing in terms of developing leaders and coaching? I do tend to coach women physicians who are on the leadership trajectory. It's not an intentional choice...it's who finds me. I don't have a published or a publicized coaching program. It's really just people who find me either at the University of Florida or outside and say, “Oh wow, I would love to hear from you.” And what I find is that a lot of women physicians who are interested in leadership are hesitant to say they're interested in leadership. 

I gave a lecture in the last year or so and the title of the lecture was, Women are Competent Before They Are Confident. I find a lot of times that we have phenomenal women leaders who are hesitating and holding back and maybe not applying for those top positions that they are competent for, presumably because they somehow don't think they're ready for it. So, a lot of the coaching that I do with women leaders in particular, is around recognizing their own competence and their own skill set as much as other people recognize it. Because if you ask anybody else about them, “Oh my gosh, she's amazing, she's a phenomenal leader.” So a lot of the work that I do in coaching tends to be around that.

Michael: Well, actually, I remember reading that it's common for males -- even though they are early in their career and don't have a lot of experience -- to apply for top level positions, when the reverse is true for females who are qualified or maybe more than qualified, but are hesitating because perhaps they don't think they can check every single box in the qualifications or whatever else is holding them back. So, it's definitely a broad trend.

Dr. Hunt: Yeah, there are definitely some studies that have shown that.  I think we can learn two lessons from that. One is about one-on-one coaching that we can help develop people with. The second is about thinking about how we write job ads. If we write a job ad that has twenty-five competencies listed in it, we're going to get people who apply who think they don't have to meet them all because no one can meet them all and we're going to under-represent people who don't feel qualified and maybe are. So, we have to really rethink how we write those job ads and make sure that, you know, we put in some of the criteria but maybe not an exhaustive list of everything because we will skew the pool.

Michael: Oh for sure. I mean, some of these job descriptions go on for three pages and, you know, you can't imagine anyone being able to fulfill all of those qualities. 

Dr. Hunt: And no one will. 

Michael:  While we're on all this talk of leadership and coaching and all of that, you’ve had, as I mentioned, quite a bit of experience in leadership positions at some really top flight organizations.  I know this is kind of an unfair question, but can you boil it down to someleadership qualities that you've developed and that you think are particularly important for somebody in healthcare leadership to have?

Dr. Hunt: So, I can definitely boil it down a little bit to a few that I just think are kind of irrefutable. One that in today's world just can't be overemphasized is the ability to communicate in a transparent and direct way. Direct communication is so crucial and so important. And by direct communication, I don't necessarily mean blunt and I don't mean frank. I mean direct. I guess the definition of direct communication really is about saying what you mean and saying it in a way that the other person understands it, instead of leaving room for assumptions. 

I find in coaching and in real life that assumptions are going to get us into trouble over and over again, and so when we communicate in a direct way, it means that we're taking out a lot of the room for assumptions and instead just being transparent and direct and saying exactly what it is we intend. 

Some people interpret that as being blunt or frank and saying what they mean. Not exactly... because that can also get us into trouble.

Michael: So clarity kind of being an essential ingredient there.

Dr. Hunt: Absolutely. Clarity. Checking in with the person. I don't actually do this, but sometimes I threaten to do it...to ask them to read back to me what I just said. Because sometimes we say things in a way we think is direct, and then it turns out that the interpretation on the other side was completely different, so it's actually worth doing a check-in with people and making sure that what they heard is what you said. 

I had one faculty member many years ago that didn't hear compliments very well. She didn't hear them even though I would say them. I'd say, “You're amazing. You're a fantastic faculty member. Everything you're doing is spectacular.” And she couldn't hear them.  I don't know what she heard, but finally, I did resort to saying, “Could you say back to me what I just said?” And one time she said, “You said I'm doing a fine job,” I said, “No, no. I said, you're amazing and excellent and awesome.” But she couldn't hear it. So, I did make her repeat back to me.

Michael: Well, you’ve got to use your instincts in those situations. So direct communication, transparency...anything else you want to add on?

Dr. Hunt: Yeah, I think integrity in today's world has got to be one of the key leadership competencies. I'll frequently say in my meetings with my team, if we're comfortable with it being published on the front page of the newspaper, then it's probably a safe decision. If we're not, it still might be the decision we need to make, but we better be really sure and we better be able to defend it in a way that other people would logically follow our reasoning, and to me, that's about integrity. It's about holding the bar really high for yourself in terms of making decisions that are defensible and honest and truthful and grounded in compassion. 

All of the things that we kind of hold true as core values need to play out in our actions. 

There's a phrase I love in coaching. I use this a lot. “Every belief has a trail of actions.” 

Michael: Yeah, right. What's behind it. How'd you get there, right?

Dr. Hunt: Yeah, and if the actions that you have don't match your belief, you either have to re-examine whether you really had that belief or whether you're acting true to your beliefs. Either way, there's something to re-examine. So I would say those three things, transparency and communication and integrity are sort of indisputable ones. There's many, many other leadership characteristics and competencies that are incredibly valuable. To me, those three, if you don't have them, you're gonna suffer as a leader and it's gonna be a hard road.

Michael: Well said. So, let's shift now to your position at the University of Florida College of Medicine and what some of your priorities are. An overview would be great, I think, for our audience to hear and also what you think some of its particular strengths are?

Dr. Hunt: Well, University of Florida is a spectacular and amazing place and I knew this fifteen years ago. I was a visiting professor, and I walked into these buildings and I walked on campus and I thought ‘this is an incredible place and I would love to work here one day’ having no idea that would actually end up working. It was fate. It's so funny that I got a mug as a gift for being a visiting professor and I had kept it all these years and when I was getting ready to move I found that mug and it was really like…

Michael: The universe is sending you signs. 

Dr. Hunt: It was a sign for sure. It's an amazing place. The beautiful things about college of medicine here at the University of Florida...one thing is we're on the main campus, so we have this vibrant, amazing community of scientists and students and faculty and staff that's huge. I mean, our community is absolutely enormous. So, we get to collaborate with people in all sorts of different fields -- engineering and arts, and you name it. We have collaborations and we have access to pretty amazing resources here.

The students are top-notch. We get some of the top students in the southeast. We get students from all over the world. So the education here really can't be beat at the undergraduate and the graduate levels. We’re usually ranked top five in the in the country for public institutions and we just have really everything you could ever want. Now we're considered one of the “new ivys” and it's true. I'm constantly impressed by this institution. 

At the College of Medicine level, we have a lot of strengths. We are a top program in transplant....liver, kidney, heart, lung. We have unbelievable transplant results, and the program is very, very strong. It's really ranked top in the country in a number of different areas. We have top rankings in neuroscience in terms of funding, in terms of productivity. Neurosurgery is top ranked in the country. So we have some key programs that are really jewels in the crown of the University of Florida. Then we have so many that are just amazing that I haven't even mentioned, can't even count the number of strong programs we have. So to me, we have it all at the University of Florida.

We also have two campuses. We have two academic medical centers in very different settings. We have the campus here in Gainesville, which is much more rural, but draws from a huge catchment area; and then we have an academic campus in Jacksonville, which is a very big city focus and a safety net hospital in an underserved urban community. So, we have both aspects, and now we have community hospitals in our network, too, so we are able to provide educational venues that cover all of the practice of medicine. That also opens up possibilities for doing community-based research, for doing clinical trials enrollment across lots of different venues and settings. So, there's not anything we don't have. That sounds like I'm bragging, but there's not anything we don't have. We have it all, and it's an embarrassment of riches. There's nothing that you look at and say, “Wow, I wish we had this.” It's a pretty spectacular place. 

I knew that this was a great place, and when I got here, it's been just even above any of my dreams. It’s better than anything I could have imagined.

Michael: Wow, that's wonderful. I'm curious about the curricular side of things because so much seems to be in flux there. COVID kicked off a lot of changes in how people were approaching things, obviously, with a lot more use of online learning and digital technology and AI and everything else. So, talk a little bit about how your curriculum is set up now to deal with that and what's on your mind in terms of preparing students for this world, particularly with AI? Obviously, it's going to become part of their daily lives as providers.

Dr. Hunt: Yeah. One of the really great strengths of UF at the institutional level, but also at the College of Medicine is actually in artificial intelligence. We have either the biggest or it's one of the biggest supercomputers on any campus in the country, the HiPerGator, and it's an amazing resource. What it does is it allows our faculty and our physicians and researchers to do a lot of AI work in medicine and actually in healthcare. So we have a pretty strong program in quality and patient safety that's based on AI and a lot of the innovative work that's happening in quality and patient safety is generated from AI analysis through this computer resource, which is unparalleled. I mean, it's just right here, accessible even to our students. Our undergrads can access this supercomputer. Pretty neat things happening.

So, we have a lot of science happening around AI and a lot of innovation in clinical care, all the way from a virtual ICU -- like a whole ICU in the metaverse -- down to revenue cycle AI. I mean, pretty neat stuff across the whole spectrum of healthcare. 

What you asked though is about how we're educating on it. We do have a curriculum for our undergrads and our medical students on AI in healthcare and so they're able to go through a curriculum. Actually, the faculty can go through it too. It's an open access curriculum for medical people to go through. We're also starting to launch a couple of master degree programs and I suspect a lot of our medical students will consider doing it as a combined degree in AI and healthcare. I think it's going to be very attractive for our undergrad medical students to think about a combined degree program. So, lots of opportunities to be educated and also to do research and to do clinically relevant research in AI and healthcare.

Michael: Are you still practicing?

Dr. Hunt: I wish I could turn my computer around and you could see my microscope sitting right here. I am practicing pathology, still doing head and neck pathology. I do a little less now because my schedule is not as friendly as it used to be, but I still do it.

Michael: Sure, sure. I ask only because I'm curious about how AI has impacted you, if at all.

Dr. Hunt: So in pathology, you would think it would have a lot of applications. The applications have so far been relatively narrow, and they are there and starting to be implemented in certain areas. For example, interpreting pap smears has some AI work behind it in order to make it more streamlined and efficient to find the cells that are abnormal on a smear that has millions of cells, and so that's a really nice application of AI that's coming into practice. But surprisingly not a lot of applications in real life, everyday practice. It’s probably because, frankly, most of pathology can be done on a microscope with a glass slide. Even molecular pathology has not replaced that good old fashioned microscope.

Michael: Yeah. So, we’ve gotten to the point in the interview where I get to ask you one of my favorite questions, which is can you provide us some direction? Osmosis, as you may know, is an education company and we love to have our guests tell us about something that they're particularly concerned about or interested in, where they think there's a gap in knowledge, a myth, or something that needs to be cleared up or something that should be better understood. And you would say, “Osmosis, you know, it'd be great if you could make a video about that or a course about that.”  What would that be for you?

Dr. Hunt: I have a really important one and I would be so grateful if you filled it. What I have found over and over again is that physicians coming into practice have no idea about the process of credentialing and privileging and medical staff and what it means and all of the accreditation standards around clinical practice. It's a real gap. I mean, they'll get the credentialing packet for the first time going into practice and have absolutely no idea why we're asking things, what we're asking, how to find the documents, and it becomes this big labor because they have to go through the whole packet and fill all this out without really understanding what credentialing and privileging is, and how it interfaces with the hospital and the medical staff. 

Almost all physicians will be credentialed somewhere unless you're really purely doing outpatient private practice and not admitting to a hospital. Everybody else who has any interface with a hospital will go through credentialing and privileging and there's just a huge knowledge gap for our graduating residents around what it even means. That would be really useful to graduating residents.

Michael: You have the distinction of joining a very exclusive group of people who, in 500 shows, have suggested something to us that we have not heard before. 

Dr. Hunt: Yay! 

Michael:  So, that’s one of them and it's a wonderful idea. And of course, there’s so much cover in medical school that some things are going to be missed along the way, but that's a really good one.

So, I'm sorry to say we're getting to the end of our time, so I'll have to wrap it up with this question, which is just give us your go-to advice to the many students that you advise about how to approach their career in healthcare at this particular time which is obviously a very challenging time. What would you tell folks?

Dr. Hunt: Well, one of my favorite lectures I've ever given around leadership development is something I call GPS Leadership development, and here's the concept. Back when I was a kid -- as somebody said to me recently, I trained in the 1900s -- back when I was a kid in the 1900s...

Michael: Eons ago. 

Dr. Hunt: ...when we would go on a road trip we would have a map, like a real physical map and you had to make sure it folded up right. It was this big thing that spread out over the dashboard and before you left home you would map out your course and you would kind of draw it on there, notice where you're going to turn, what highways you were going to look for and then somebody would be the navigator and somebody would be the driver. “Turn right, turn right, that's the road we're supposed to turn right on.” And it was a very structured path. You planned it out and you stuck to it. If you missed a turn, you actually did a U-turn and backtracked, you found your road again, and you stuck with the plan. 

Today we have GPS and I am completely and totally dependent on it. I cannot get anywhere without it. I plug in my destination and I assume I'm gonna arrive. I follow the directions and sometimes I miss and it just reroutes me and I'm totally okay with that. I arrived at that place somehow, not knowing what the path was gonna be.

So, I like to think of leadership development and career development as benefitting more from GPS than it did the old fashioned map. If you don't plan out and structure your entire path, you're going to learn and grow in ways that you could never predict, and they're wonderful ways. So, you allow the path to evolve as long as you have that destination in mind and you know directionally where you're headed. You can allow the path to evolve and you can reprogram and you can recalculate and you can go on tangents and you can meander a little bit. You're directionally correct, but you're learning and growing in so many fantastic ways. 

So, my advice to people who want to plan out their career and their leadership path is to just plan a vague destination and then allow the path to unfold before you because it will be amazing and you'll have incredible journeys.

Michael: Well, that is not only wonderful advice, but it's a wonderful way to help people picture it and depict it. I'm old enough to remember the maps. It wasn't so easy, was it?

Dr. Hunt: Nope, and you could never get it folded back up again

Michael: No, nobody knew how to do that! Well, listen, this has been a delight, Dr. Hunt. I'm so glad that you could spend time with us today and we wish you all the best there at the University of Florida.

Dr. Hunt: Thank you, I appreciate it.

Michael: And with that, I’m Michael Carrese. Thank you for joining us, and as always, remember to do your part to raise the line and strengthen the healthcare system. We’re all in this together.