Realistic Optimism in Times of Uncertainty

Transcript

• 00:02Good afternoon, everyone. Welcome.
• 00:05It's wonderful to hear such
• 00:07such noise, such volume in
• 00:09the room. Welcome to the
• 00:10first
• 00:11grand rounds of our new
• 00:13academic
• 00:13year. It's wonderful to see
• 00:15so many people joining us
• 00:16here in person in the
• 00:18Cohen. And, of course, welcome
• 00:19to everyone who is joining
• 00:20us on Zoom. I'm Kieran
• 00:22O'Donnell, and I cochair our
• 00:23Grand Rounds Committee here in
• 00:25the Charles City Centre.
• 00:26And as we look ahead
• 00:28to a very exciting program
• 00:29over the next academic year,
• 00:31I think it's also an
• 00:32opportune moment to reflect and
• 00:34look back. And I'd ask
• 00:36you to join me in
• 00:38thanking doctor Andres Martin for
• 00:39his tremendous service to Grand
• 00:41Rands over the last number
• 00:43of years,
• 00:45and to Sarah Sanchez Alonzo,
• 00:47who's also rotating off the
• 00:48Grand Rands Committee. And I'd
• 00:50also like to welcome doctor
• 00:51Christine Shaw, who's kindly accepted
• 00:53our invitation to join us
• 00:54as cochair of the Grand
• 00:55Rounds Committee. And we also
• 00:58do have a spot available
• 00:59for anyone who would like
• 01:00to join us on the
• 01:02Grand Rounds Committee. Please, the
• 01:04information is available on the
• 01:06Internet.
• 01:07And if you need, reach
• 01:09out to myself, Alex,
• 01:11or Christine, and we can
• 01:12provide you with details on
• 01:13how to, self nominate.
• 01:15Now looking ahead to our
• 01:17program, we have a a
• 01:18slight change in schedule for
• 01:20our very next program, Doctor
• 01:23Bob Schultz has has had
• 01:23to cancel the two person
• 01:25matter, but our very own
• 01:26has
• 01:27very kindly agreed
• 01:29to Brian Brans next Tuesday.
• 01:31Thank you, Patrick. We will
• 01:32learn more about his exciting
• 01:34work facing the neural origins
• 01:36of cognition.
• 01:37And so please do join
• 01:38us for that.
• 01:40And so, of course, Grand
• 01:41Rounds is all about community.
• 01:43We're coming together as a
• 01:44community and coming together to
• 01:45learn together and grow together.
• 01:47And the impact that we
• 01:48have on the lives of
• 01:50children and families is really
• 01:53phenomenal. Hard to really capture
• 01:54as Linda will describe today.
• 01:57But just today, I think
• 01:58we'll keep in mind Amanda
• 02:00Detmer, who is having a
• 02:01tremendous life changing impact on
• 02:03one particular individual and their
• 02:05family as she becomes a
• 02:06living kidney donor. So join
• 02:08me in wishing Amanda
• 02:10well. And,
• 02:13as as luck would have
• 02:14it, the National Kinsey Foundation,
• 02:15we're actually in the atrium
• 02:17of the hospital today, and
• 02:19there are flyers in the
• 02:20back, that I picked up
• 02:21for anyone who'd like to
• 02:22support the National Kidney Foundation,
• 02:23which just turned seventy five
• 02:25years, and they have their
• 02:26National Kidney Walk coming up
• 02:27in October. So without any
• 02:29further ado, I'll pass you
• 02:30over to doctor Mayes for
• 02:31her first annual address of
• 02:33this year.
• 02:40Welcome, everyone.
• 02:41First off, it's just great
• 02:42to see you, and I
• 02:43hope you are enjoying the
• 02:44new chairs and the new
• 02:46carpet.
• 02:49It's really cool. Is this
• 02:52so let me get the
• 02:53slides going here or try
• 02:54to get them going.
• 02:59I'll do it this way.
• 03:02This happens every year.
• 03:09So
• 03:10we always start in the
• 03:11summer. I'm really, really pleased
• 03:13to welcome you back, to
• 03:14have you back.
• 03:15And what I'd like to
• 03:16just start, because we've we've
• 03:18got some serious matter before
• 03:19us today.
• 03:21I'd really like to start
• 03:22just having you imagine what
• 03:24are some of the words
• 03:25from the summer that you'd
• 03:26like to hold on to?
• 03:28I did actually have this
• 03:29as a poll everywhere, but
• 03:31it turned out it wouldn't
• 03:31work with Zoom.
• 03:33So so just shout out
• 03:35some of the words that
• 03:37that you would like to
• 03:38hold on to about the
• 03:39summer.
• 03:41Anybody?
• 03:42Oops.
• 03:44Hang on. Hang on. Hang
• 03:45on.
• 03:46Hang on. We gotta go.
• 03:49Joy.
• 03:50Joy. Daylight.
• 03:51Family. Family.
• 03:54Others.
• 03:56Nature?
• 03:58Fishing. Fishing.
• 04:00And throwing them back, of
• 04:01course.
• 04:03Others?
• 04:05Fun reading. Fun reading.
• 04:07Family gathering. Family gathering. Yeah.
• 04:10For sure.
• 04:11Graduation.
• 04:12Graduation. Absolutely.
• 04:14Life's transitions
• 04:15for sure. Any other? Amy
• 04:17Myers says swimming.
• 04:19Swimming.
• 04:20I actually took swimming back
• 04:22up this summer, so that's
• 04:23a great thing.
• 04:24Anything else?
• 04:28Well, some of mine, if
• 04:30this will go, my summer
• 04:32thoughts were first off that
• 04:33summer was way too short.
• 04:34Yes. Right. I spent a
• 04:37fair amount of time immersing
• 04:38myself reading and reading particularly
• 04:40in history and reading Timothy
• 04:42Snyder on freedom and on
• 04:43tyranny,
• 04:44books that I would highly
• 04:46recommend.
• 04:47I also spent some time
• 04:49deeply involved in land conservation,
• 04:51which is something that's
• 04:52very dear to me that
• 04:53I'd be glad to talk
• 04:54about, had a chance for
• 04:56a little bit of Shakespeare.
• 04:57And I'm really glad to
• 04:58announce that we have the
• 04:59jamming group of the Child
• 05:00Study Center. We have now
• 05:02had our fourth rehearsal, I
• 05:04think. So so
• 05:06people are welcome to join.
• 05:07But
• 05:08I am very aware that
• 05:10the start of this twenty
• 05:11twenty five academic year is
• 05:13very different.
• 05:15There's tremendous uncertainty
• 05:17before us
• 05:19nationally, locally.
• 05:21It's a lot of stress
• 05:22and many of us have
• 05:23a sense
• 05:24that the things that instead
• 05:26of being constructed
• 05:27are being torn down.
• 05:29And that that makes this
• 05:31opening talk,
• 05:33which I've often really wanted
• 05:34to do as a chance
• 05:35to really bring us together
• 05:37to
• 05:38yay team go, we are
• 05:39very strong, we're optimistic.
• 05:41All of that is still
• 05:42true,
• 05:43but there is a balancing
• 05:44that we need to do
• 05:46today with realism.
• 05:48And that's gonna be a
• 05:49theme throughout
• 05:50of how to balance optimism
• 05:52and realism
• 05:54in the current climate that
• 05:55we're at.
• 05:57Usually, what we try to
• 05:58do at this gathering is
• 05:59to welcome, look ahead, and
• 06:00then in January, I will
• 06:02actually give you more details
• 06:03about the actual literal state
• 06:05of the department.
• 06:06But here's where I hope
• 06:07to go today.
• 06:09Welcome new fellows.
• 06:11The theme for this year
• 06:13and for those of you
• 06:14who are new to this
• 06:15meeting, well, I can explain
• 06:16why themes.
• 06:18And this year something different.
• 06:20I asked sent out a
• 06:22survey asking you what you
• 06:23would like to hear about,
• 06:25and that is something that
• 06:27I will now continue
• 06:28in September and January.
• 06:30These talks should be what
• 06:32you want and are asking
• 06:33questions about.
• 06:35So we'll spend the majority
• 06:36of the time perhaps about
• 06:38that.
• 06:39And if we have time,
• 06:40then I'll go to the
• 06:41department goals that have been
• 06:43requested by the school,
• 06:44a few new developments, and
• 06:46then end with a reflection.
• 06:49So just briefly to welcome
• 06:51people,
• 06:51we actually have our Child
• 06:53Study Center fellows this year.
• 06:55So welcome to all of
• 06:56our new fellows. It's a
• 06:57great group, as you can
• 06:59see, from all over the
• 07:00country.
• 07:06And we actually have an
• 07:07enormous group of interns and
• 07:09practicum students also from around
• 07:11our area.
• 07:16Here are our students coming
• 07:17from the UCL master's program.
• 07:20The group continues to grow,
• 07:21and Helena continues to nurture,
• 07:24students from all over.
• 07:27And then we have an
• 07:29enormous number of postgraduate and
• 07:30postdoctoral trainees, sixty.
• 07:33Last year, we had forty
• 07:34three. So we are still
• 07:36growing.
• 07:40And here's some of the
• 07:41new faculty for FY twenty
• 07:43six so far. There's others
• 07:44still pending in the
• 07:46pool.
• 07:47But welcome to everyone. And
• 07:49I do hope I don't
• 07:50miss people. If I do,
• 07:51my apologies, but really welcome.
• 07:54And then we've had some
• 07:55lovely Here's our new staff
• 07:57that have joined.
• 07:59And Alex put her name
• 08:00down there, but I'll tell
• 08:01you more about Alex in
• 08:02a second.
• 08:03And we've had two promotions
• 08:05in twenty twenty five of
• 08:06Jesse Mayo and Kieran to
• 08:08associate professors.
• 08:14And then some transitions of
• 08:15new endowed professors
• 08:17of Carla and Dennis and
• 08:19Liza.
• 08:26And then some retirements
• 08:27of Steven and Jim
• 08:29and Shimra. We're so grateful
• 08:32for all of that you've
• 08:33given the department, Jim. Thank
• 08:34you very much.
• 08:39And then welcoming Alex Hunter,
• 08:41our new chief of staff.
• 08:43Chief of staff. Chief of
• 08:46staff.
• 08:49Those are the welcomes.
• 08:52So where I wanna go
• 08:53for this theme of twenty
• 08:54twenty five, twenty twenty six
• 08:56is to say that we've
• 08:57had a tradition
• 08:59of opening the themes in
• 09:00September.
• 09:02And prior to COVID,
• 09:04our themes were rather playful.
• 09:07They were about vacations and
• 09:08summer frames of mind and
• 09:10rejuvenation.
• 09:12After COVID, they have become
• 09:13a bit more serious
• 09:15of staying grounded,
• 09:17rejuvenating our community,
• 09:19coming together.
• 09:20And this year, I would
• 09:22love our theme to be
• 09:23about realistic optimism.
• 09:25What is realistic optimism?
• 09:28It's balancing an awareness of
• 09:30reality
• 09:32with a belief that you
• 09:33can still move ahead even
• 09:35if reality looks a little
• 09:36dark and ponderous.
• 09:38And that we have an
• 09:40agency and we have an
• 09:41action of capacity to take
• 09:43action
• 09:44even if things seem uncertain.
• 09:46And also the ability to
• 09:48manage our stress together.
• 09:51Why realistic optimism? Well, first
• 09:53off, I think it's critical
• 09:55for facing and balancing uncertainty.
• 09:57And heaven knows we have
• 09:59a lot of uncertainty in
• 10:00front of us.
• 10:02The second is there's considerable
• 10:04headwinds
• 10:05that we're facing.
• 10:07There's the changes in the
• 10:09indirect rates for federal grants.
• 10:12There's the
• 10:14endowment tax.
• 10:16There's
• 10:17NIH institutes
• 10:18changing their priorities and their
• 10:20funding.
• 10:21And there's even more additional
• 10:23headwinds
• 10:24when we think about the
• 10:26immigration policies, the potential inflation,
• 10:29the effect on the CDC,
• 10:31the changing in vaccine policies,
• 10:34all of those are headwinds
• 10:35in front of us that
• 10:37we need to be aware
• 10:39of and that are influencing
• 10:41how we think.
• 10:43At the same time, there's
• 10:44also a tremendous changing landscape
• 10:46in health care.
• 10:48Health care is beginning very
• 10:49much to even become more
• 10:51costly in this country
• 10:54and to start and start
• 10:55to use language that feels
• 10:57like it doesn't belong in
• 10:59health
• 11:00care, like profit margin,
• 11:02those sorts of language.
• 11:04Health care is a changing
• 11:05landscape.
• 11:09Why? What realistic optimism
• 11:11is not? It is not
• 11:13putting your head in the
• 11:14sand.
• 11:16It is not being tone
• 11:18deaf
• 11:19to all that's going on
• 11:20or tone deaf to people's
• 11:22stress.
• 11:23And it's not rose colored
• 11:25glasses.
• 11:27What it is, it allows
• 11:29again, managing uncertainty. It allows
• 11:31us to remain curious.
• 11:33It allows us actually to
• 11:35step outside of our bubbles,
• 11:37and it actually allows us
• 11:38to be more flexible in
• 11:40our thinking as we remain
• 11:41curious and think about how
• 11:43can we meet this challenge.
• 11:47So
• 11:48there's also a continuity across
• 11:50our themes.
• 11:52Last year it was restoring
• 11:53community or staying grounded amidst
• 11:55change. Heaven knows that is
• 11:57going on all around us.
• 11:59And this is the theme
• 12:00that I think unites us
• 12:02for this year.
• 12:03And then finally,
• 12:05there's a very much an
• 12:06importance of staying together. I
• 12:08hope realistic optimism keeps us
• 12:11together.
• 12:11And despite the challenges,
• 12:13how do we balance that
• 12:15and keep our values?
• 12:17These are the values that
• 12:18we as a department
• 12:21over the last year came
• 12:22up with to
• 12:23keep our values front and
• 12:25center.
• 12:27So with that in mind,
• 12:29I'm gonna turn to what
• 12:30you asked to hear about.
• 12:32And here's what you asked
• 12:33to hear about.
• 12:35You asked to hear about
• 12:36the impact of changes in
• 12:38the federal government on job
• 12:40job security, how the child
• 12:41study center will manage.
• 12:43You asked to hear about
• 12:44our financial health,
• 12:46how we are actually living
• 12:48by our values in these
• 12:49challenging times,
• 12:51and how each of us
• 12:52altogether
• 12:53can contribute.
• 12:55What are the actions that
• 12:56we and you can take
• 12:58as a community
• 12:59that contribute to our financial
• 13:01sustainability
• 13:02and our sustainability
• 13:04as a department?
• 13:06That's what you asked to
• 13:07hear about.
• 13:08And I think there's three
• 13:10cross cutting themes that I'm
• 13:11gonna address.
• 13:13The first is the financial
• 13:14health of the department. I
• 13:16want to speak directly to
• 13:17that.
• 13:18The second is the impact
• 13:20of the uncertainty that's all
• 13:21around us on the morale.
• 13:25Remember I said that this
• 13:26September talk is about optimism
• 13:29and
• 13:30Everyone. Coming together, but I'm
• 13:32also aware that uncertainty has
• 13:34an effect on morale
• 13:35and then how we can
• 13:36collectively take action.
• 13:39So into finance as we
• 13:40go.
• 13:42The first is the Child
• 13:43Study Center's annual budget. Our
• 13:46annual revenue is around fifty
• 13:47eight million.
• 13:49I want you to notice
• 13:51that grants and contracts
• 13:53take up a forty six
• 13:54percent
• 13:55of our budget. So that's
• 13:57of our revenue.
• 13:59Our patient care income is
• 14:01now around seventeen percent plus
• 14:03an additional three percent from
• 14:04Yale New Haven,
• 14:06Hospital
• 14:06for the support of our
• 14:07hospital based services.
• 14:10The other important point on
• 14:11this slide is that twenty
• 14:12four percent, nearly a quarter
• 14:14of our total revenue comes
• 14:16from endowment and gifts.
• 14:19This is why we fundraise.
• 14:21This is why we work
• 14:22with our donors.
• 14:23But our revenue is fifty
• 14:25eight million.
• 14:27And you see the larger
• 14:28portion of grants.
• 14:32Our expenses
• 14:34are sixty one point three.
• 14:36So there's a little gap
• 14:37there. And I'm gonna talk
• 14:39about that gap. But you
• 14:40also see that seventy seven
• 14:42percent of these expenses are
• 14:44personnel related.
• 14:45We are not a department
• 14:47that relies on a lot
• 14:48of equipment. We rely on
• 14:50people.
• 14:51Seventy seven percent is personnel
• 14:53related.
• 14:56So and
• 14:57I'm share these slides so
• 14:59you can see the breakdown.
• 15:01But that's that's the revenue
• 15:03and the expense.
• 15:06I wanted to go over
• 15:07before I go by mission
• 15:09because I told you that
• 15:11twenty four percent is based
• 15:12on endowments and gifts.
• 15:14I wanted to give you
• 15:15a little bit better breakdown
• 15:17of the endowments. We've been
• 15:18very fortunate to have a
• 15:20lot of endowments in this
• 15:21department and a lot of
• 15:22gifts.
• 15:23Some of those, the majority
• 15:25of them actually are with
• 15:26individual faculty
• 15:28in terms of chairs or
• 15:29endowed programs.
• 15:31And there's a small amount
• 15:32that's with the department and
• 15:34is so called unrestricted
• 15:36that allows us to invest
• 15:37and do a variety of
• 15:38things.
• 15:39So if you just look
• 15:40at the first line
• 15:42between f y twenty three
• 15:44and f y twenty four,
• 15:45there is a drop in
• 15:46the in the, amount in
• 15:49that and that reflects there
• 15:50was one endowment that actually
• 15:52didn't belong in this department
• 15:53and got moved
• 15:54So that's the
• 15:56drop. But you wanna look
• 15:58at the very bottom at
• 15:59the very end last column,
• 16:00the six hundred and eleven
• 16:02thousand,
• 16:03ninety nine point five percent
• 16:05of that is restricted.
• 16:07What that means is that
• 16:08it has to be used
• 16:09for a specific purpose.
• 16:12So that leaves about thirty
• 16:14thousand
• 16:15available to the department
• 16:17for unrestricted
• 16:18use.
• 16:21For someone
• 16:23needs something bought, someone has
• 16:25a gap. That's what we
• 16:26have. That's why we fundraise.
• 16:29We fundraise for unrestricted.
• 16:31And you can see that
• 16:32under the under the,
• 16:34oversight of various faculty,
• 16:36the total amount there in
• 16:38the last column
• 16:39and that much more of
• 16:40that is unrestricted.
• 16:43So about thirty eight percent
• 16:44is restricted. The rest of
• 16:46it is unrestricted
• 16:48available to faculty for their
• 16:49use, not available for general
• 16:52department use.
• 16:53But this is why we
• 16:54again, fundraise.
• 16:58On our research mission,
• 17:00it is fully funded
• 17:01by unrestricted gifts, grants, endowments,
• 17:04and the general allocation,
• 17:06which I'll explain to you.
• 17:08There are indirect costs off
• 17:09of grants that come back
• 17:11to the department.
• 17:13The constriction in federal funding
• 17:15that's happening is very likely
• 17:16to require us to make
• 17:17changes in individual labs with
• 17:19more sharing of research
• 17:21resources that's already starting and
• 17:23something that Tom and others
• 17:25are working on.
• 17:27Our education mission,
• 17:29we receive eighty percent support
• 17:31from the hospital for our
• 17:32psychiatry fellows
• 17:34and the department provides twenty
• 17:36percent of support and that
• 17:38comes up to a little
• 17:39over two hundred thousand.
• 17:42Our psychology fellows,
• 17:44and social work fellows are
• 17:46supported by unrestricted gifts and
• 17:47endowments.
• 17:49And I give you the
• 17:50number for FY twenty five
• 17:52support for those fellows.
• 17:54Our f y twenty six
• 17:56support
• 17:56education will will increase,
• 17:59cost will increase because we've
• 18:01been trying to align,
• 18:03where people are actually teaching
• 18:05versus working in the clinic.
• 18:08But that those are those
• 18:09two lines of business.
• 18:11And then if you I
• 18:13thought you should also know
• 18:14about the administration.
• 18:17Department administration
• 18:18costs that is Ian, Christie,
• 18:20the folks working in the
• 18:21business office
• 18:23are supported
• 18:24by these grant indirects that
• 18:26come back. The administrative
• 18:27costs on grants that come
• 18:29back. And that just shows
• 18:30you the amount that we
• 18:32get back each year
• 18:33from the grants that we
• 18:35have.
• 18:36And e and any part
• 18:38that's not covered, we distribute
• 18:40across the missions.
• 18:42And this is why
• 18:44there is such a worry
• 18:47about the indirect rates on
• 18:49the grants. As the indirect
• 18:50rates go down,
• 18:52there will be less freedom
• 18:53in the money coming, not
• 18:55just to our department, but
• 18:56a range of departments.
• 18:58That's why the indirect rate
• 19:01is causing such,
• 19:02concern
• 19:03across universities.
• 19:06So there's really three things
• 19:08that we will need to
• 19:09do
• 19:10for these lines of business,
• 19:12and then I'll go to
• 19:12the clinical.
• 19:14We'll need to diversify our
• 19:15funding sources. And so many
• 19:17of you are already doing
• 19:18that, not just federal, but
• 19:21but foundation, etcetera.
• 19:23If we have special use
• 19:24funds under that unrestricted
• 19:26endowment funds,
• 19:28save them,
• 19:30spend them wisely
• 19:32because we can save those
• 19:34year to year,
• 19:35save them, treat them like
• 19:37your personal bank account, save
• 19:39them carefully.
• 19:40And then most importantly,
• 19:42thinking about our values,
• 19:44we need to prioritize
• 19:46supporting junior faculty and fellows
• 19:49and be sure that we
• 19:50keep the the pipeline vital
• 19:53and well funded.
• 19:55So that's those two lines
• 19:56of business in the administrative.
• 19:59Now let me turn to
• 20:00the clinical because many of
• 20:01you were asking questions about
• 20:02that.
• 20:04So the Child Study Center's
• 20:06clinical mission at this point
• 20:08has a two point eight
• 20:09million dollars deficit in FY
• 20:11twenty five under funds flow.
• 20:13And I am going to
• 20:14explain funds
• 20:17flow. That represents a decrease
• 20:19from the last year because
• 20:20funds flow has taken some
• 20:22of those central costs or
• 20:23those space costs, etcetera, and
• 20:25moved them off.
• 20:26So that is actually our
• 20:28clinical deficit.
• 20:30That deficit, I cannot emphasize
• 20:33enough,
• 20:33is going to be covered
• 20:35and continues to be covered
• 20:36by the Yale School of
• 20:37Medicine.
• 20:38But we have agreement with
• 20:40that, And our agreement is
• 20:41we will do our best
• 20:43to reduce that deficit,
• 20:45to be budget neutral.
• 20:48So here are the three
• 20:49things that I want to
• 20:50talk about related to that.
• 20:52One is what is funds
• 20:53flow?
• 20:54It's a term we keep
• 20:55throwing around.
• 20:57What are the contributions
• 20:59to that deficit and how
• 21:00can we all come together
• 21:02to reduce it?
• 21:03And again, I want to
• 21:05I wanna actually emphasize that
• 21:08I'm very glad that you
• 21:10asked to hear about this
• 21:11because this would not have
• 21:12necessarily would have been what
• 21:14I would have led off
• 21:15with.
• 21:16So
• 21:17I want also to encourage
• 21:18questions.
• 21:19I want you to be
• 21:20fully aware
• 21:22of the financial health of
• 21:24our department.
• 21:26So first off, I'm going
• 21:27to do just a little
• 21:28bit of level setting because
• 21:30I've talked about this in
• 21:31various settings, but not with
• 21:32everyone.
• 21:35So an academic health system
• 21:37is what we are.
• 21:39And in an academic health
• 21:40system, you have a medical
• 21:42school and you have a
• 21:43hospital.
• 21:44And sometimes those two are
• 21:45the same entity.
• 21:47In our system, they are
• 21:48two separate entities
• 21:50and funds flow from one
• 21:52to the other.
• 21:54And in this new funds
• 21:55flow system,
• 21:56the hospital right over there
• 21:57across the street here
• 21:59is sending funds over to
• 22:01the School of Medicine
• 22:03to actually pay for our
• 22:04clinical services,
• 22:06to pay us for the
• 22:07clinical work that we do
• 22:10Many of you have seen
• 22:11this slide before
• 22:13That we Here is the
• 22:15Yale New Haven Health System
• 22:16with the four hospitals that
• 22:17are a part of it.
• 22:19Greenwich Bridgeport's Lawrence Memorial and
• 22:21the York Street campus,
• 22:23which has a relationship to
• 22:25the Yale University.
• 22:26The school of medicine is
• 22:27within the university. Yale
• 22:41clinical departments
• 22:42and we are closely related
• 22:44to Yale New Haven Children's
• 22:45Hospital. We are a partner
• 22:47in children's hospital.
• 22:49What we're talking about is
• 22:50funds now coming from the
• 22:52hospital
• 22:53to the Child Study Center
• 22:55or the other clinical departments,
• 22:56but most relevant
• 22:58is
• 23:01us. So this is the
• 23:02last really technical slide.
• 23:06Here are the five components
• 23:07of funds flow. First is
• 23:09that clinical payment that comes
• 23:11based on the patients we
• 23:12see. Isn't that an incredibly
• 23:14innovative idea?
• 23:16Based on the clinical work
• 23:17you do, funding comes based
• 23:20on that, and it's based
• 23:21on RVUs,
• 23:22relative value units.
• 23:24But there's a dollar per
• 23:25RVU, and it comes based
• 23:27on that.
• 23:28See more patients, more funding
• 23:30comes. It is not based
• 23:32on commercial payer. It is
• 23:34not based on Medicaid.
• 23:36All of that now is
• 23:37blind. We are simply
• 23:39paid for the work that
• 23:41we do.
• 23:43The second component is what
• 23:45we call purchase services that
• 23:47is like the hospital services,
• 23:49medical directorships.
• 23:51We don't control flow about
• 23:52that, so they're simply paid
• 23:54for by the health system.
• 23:57And then the third component
• 23:59are our clinical overhead expenses.
• 24:01There's a certain component of
• 24:03overhead that comes with funds
• 24:04flow.
• 24:06If everything goes well,
• 24:08and remember I said that
• 24:10there are headwinds in the
• 24:11way medicine and practice now,
• 24:13but if everything goes well
• 24:15and there's actually a positive
• 24:16balance,
• 24:17then there will be,
• 24:19the school will share that
• 24:21positive balance across all the
• 24:22departments
• 24:24and there will be academic
• 24:25support shared across.
• 24:27We're not to that point
• 24:29yet. We're really to the
• 24:30point of everybody trying to
• 24:32be budget neutral.
• 24:35And I'm gonna those are
• 24:36the ones that are most
• 24:37relevant to us and the
• 24:39clinical payment is much, much
• 24:41relevant to us.
• 24:43So here in summary is
• 24:45the funds flow approach.
• 24:47The funds for clinical services
• 24:49come based on, as I
• 24:50said, patients seen
• 24:52or what's called a dollar
• 24:54per RBU model
• 24:56The essential clinical services, such
• 24:58as our hospital based services,
• 25:00are a staffing or purchase
• 25:02service model
• 25:04The funds coming are not
• 25:05dependent on insurance.
• 25:07All those things that we
• 25:08used to talk about in
• 25:09previous opening talks about space
• 25:11cost, etcetera, etcetera,
• 25:13gone,
• 25:14gone, covered by central.
• 25:17And the goal of the
• 25:18fund flow approach is that
• 25:20all departments, not just us,
• 25:21should be at least budget
• 25:23neutral
• 25:24in their clinical mission
• 25:27So how do we get
• 25:28there?
• 25:30So these are the components
• 25:32of our clinical deficit under
• 25:34funds flow,
• 25:35or in other words, what
• 25:36are the various buckets that
• 25:38we need to address to
• 25:39get to budget neutral?
• 25:41The top two are under
• 25:43our control.
• 25:44Clinical productivity, that is the
• 25:46number of people we see.
• 25:49And also,
• 25:50how do we
• 25:52our parsimonious
• 25:53and use and use our
• 25:54clinical administrative
• 25:56non billable time parsimoniously
• 25:58so that people have time
• 25:59to see patients.
• 26:01Both of those are under
• 26:02our control.
• 26:04The bottom two in purple,
• 26:06that is getting some adjustments
• 26:08to the funds flow model,
• 26:09making certain things,
• 26:10staffing model, etcetera, or thinking
• 26:12about alternative revenue sources
• 26:15are future and less
• 26:17under
• 26:18our
• 26:19control.
• 26:20Yeah. Staffing model is
• 26:22it's like the ED.
• 26:23So in the ED, you
• 26:24can't control the number of
• 26:26people you see. Some days
• 26:27it's
• 26:28it's a deluge and some
• 26:29days it's no one. So
• 26:31it's not fair then to
• 26:32have that on a dollar
• 26:33per RVU.
• 26:35You'd have to because you
• 26:36have to have people in
• 26:37the ED all the time.
• 26:39So that's what a staffing
• 26:40model is.
• 26:44So here are the key
• 26:45points that I really want
• 26:46you to hold
• 26:48for your question about the
• 26:50financial health of the department.
• 26:52School of Medicine will continue
• 26:54to support our clinical practice.
• 26:55They're not stopping to support.
• 26:57There's the agreement though that
• 26:59we do our part
• 27:00as much as we can
• 27:02to bring this deficit down.
• 27:04We need to continue our
• 27:06legislative policy work that's really
• 27:08important,
• 27:09continue to align closely with
• 27:10the Children's Hospital.
• 27:12And most importantly,
• 27:14while this sounds like a
• 27:15challenge, it is a challenge
• 27:16that I know as a
• 27:18department we can meet. We
• 27:19already are. I know we
• 27:21can. And I'm gonna say
• 27:22more about that in a
• 27:23bit.
• 27:26But is it all about
• 27:27finances?
• 27:29I know it sounds like,
• 27:31and I know it's been
• 27:32sounding like
• 27:33it's all about finances.
• 27:36No.
• 27:37It is not all about
• 27:38finances.
• 27:40Finances drive us to be
• 27:41able to do what we
• 27:42do, but it's actually about
• 27:44the people we care for.
• 27:46It's about the clinical sophistication
• 27:49that we bring.
• 27:50It's about the patients who
• 27:52come to us because they
• 27:53haven't been able to find
• 27:54help anywhere else.
• 27:57That is what we need
• 27:58to continue to balance
• 28:00a clinical excellence
• 28:01with fiscal
• 28:02responsibility.
• 28:04And I would just say
• 28:05that we have a different
• 28:07set of values.
• 28:08Those entering the mental health
• 28:10research and clinical work are
• 28:11often not as transactional
• 28:14as our colleagues that might
• 28:15be in medical business.
• 28:17They're much more about values
• 28:19and clinical care and centering
• 28:21patients.
• 28:22And we are also extraordinarily
• 28:24committed to our patients for
• 28:25very long periods of time,
• 28:27and we find it quite
• 28:28challenging
• 28:30if there's not another level
• 28:31of care
• 28:33to actually discharge them.
• 28:35We find it quite challenging
• 28:38to balance being paid with
• 28:39a responsibility
• 28:41to actually care for people.
• 28:43Our three missions have very
• 28:45different needs and thus different
• 28:47definitions of excellence, but we're
• 28:48driven by excellence for in
• 28:50all of them.
• 28:52And I would say striking
• 28:53this balance between fiscal responsibility
• 28:56and clinical excellence is not
• 28:58a simple, it's done, we've
• 28:59got it. We have to
• 29:00constantly pay attention to it.
• 29:04But I also wanna bring
• 29:06you into forecasting a future
• 29:07need.
• 29:09And these are about outpatient
• 29:11as well as inpatient services
• 29:14forecasted over the next ten
• 29:15years by the Children's Hospital,
• 29:18national organization.
• 29:21First, look on the green.
• 29:24On the green bar, you
• 29:25see that behavioral health services
• 29:27are forecasted to increase twenty
• 29:29five percent, outpatient services twenty
• 29:31five percent over the next
• 29:32ten years.
• 29:33The need. The need.
• 29:36And in the orange are
• 29:37inpatient days that are forecasted
• 29:39to increase thirty four percent
• 29:41over the next ten years.
• 29:43There's an enormous amount of
• 29:45need,
• 29:46happening. We can ask as
• 29:48academics, we should ask why,
• 29:51but that need is tremendous
• 29:53and it is going to
• 29:54increase.
• 29:55And rather than this being
• 29:57one of the, oh my
• 29:58goodness, it's coming at us,
• 30:00I would suggest that there
• 30:01are some opportunities.
• 30:04First is that it's an
• 30:05all hands on deck. If
• 30:06you if you needed any
• 30:08question about job security,
• 30:10there's gonna be a lot
• 30:11of need for mental health
• 30:12providers and clinicians,
• 30:14but we need to be
• 30:15smart
• 30:16about how we deploy our
• 30:17resources and how we train
• 30:19people.
• 30:20We need to be smart
• 30:21about optimizing access to care.
• 30:23How do we triage? How
• 30:24do we adjust models of
• 30:26care to individual needs?
• 30:28We need to be smarter
• 30:29use of technology, including AI.
• 30:32There's tremendous research opportunities in
• 30:34this to ask what works
• 30:36for whom,
• 30:37and there's opportunities also to
• 30:39advocate for sustainable reimbursement for
• 30:41behavioral health. That's what's before
• 30:44us.
• 30:45So it's a balancing of
• 30:46need and physical responsibility.
• 30:51So
• 30:53you ask what you should
• 30:54do,
• 30:55And this is a list
• 30:56that just starts.
• 30:58This is really, that's why
• 30:59there's and and many dots
• 31:01at the end.
• 31:03Bring an entrepreneurial
• 31:05spirit.
• 31:06What are the ideas that
• 31:08you might have for how
• 31:09we better deliver services that
• 31:11might also have revenue generating,
• 31:13but it's how we deliver
• 31:14good services, not just revenue
• 31:16generating.
• 31:17Network,
• 31:19link up to different people,
• 31:22participate in our cross talks
• 31:23in the faculty meeting. I
• 31:25know that sometimes those things
• 31:26seem like they go out
• 31:27into the virtual ether,
• 31:29but you'd be surprised the
• 31:31number of contacts and collaborations
• 31:32that have been emerging from
• 31:34those.
• 31:35Join work groups to move
• 31:36this work forward.
• 31:39Offer to read proposals and
• 31:41grants, link up to potential
• 31:42donors, bring different funding opportunities
• 31:45that you might think about
• 31:46or hear about forward.
• 31:49And the last two, well,
• 31:51there's more that you will
• 31:52think about, but are really
• 31:53important.
• 31:55So many meetings that I
• 31:57am in, in the children's
• 31:58hospital, in Yale Medicine,
• 32:00I am constantly raising my
• 32:02hand and saying, have you
• 32:03thought about children's behavioral health?
• 32:06Be an ambassador.
• 32:08Speak to why children's behavioral
• 32:10health is important to the
• 32:11surgery department.
• 32:13Speak why it's important, why
• 32:14what we do impacts children
• 32:17and families over the lifetime.
• 32:19Be an ambassador
• 32:20and also bring your idea
• 32:22and questions.
• 32:23Always question what we're doing,
• 32:25why we're doing it, challenge
• 32:27it.
• 32:28Those are a variety of
• 32:29the things that you can
• 32:30do.
• 32:32So
• 32:36I really do wanna pause
• 32:38even though we had a
• 32:38bit of a slow start
• 32:40because of technology and to
• 32:41just see because that's
• 32:43that is my partial, I
• 32:45think, response
• 32:46to what you said you
• 32:47would like to have addressed.
• 32:49But are there questions? Are
• 32:51there things you want to
• 32:52bring up? And if we
• 32:53have some time left, then
• 32:54I will show you some
• 32:56news. Questions?
• 33:00I have questions. Yeah.
• 33:02Thank you for this so
• 33:03far. I really appreciated hearing
• 33:05about funds flow in a
• 33:06lot of different ways. Oops.
• 33:08Sorry. I can't
• 33:09my question
• 33:10is starts with a comment,
• 33:12and it starts with the
• 33:13comment that
• 33:15I appreciate that we're thinking
• 33:16of both clinical need as
• 33:18well as the RVU that
• 33:20corresponds
• 33:21to it. Right.
• 33:22But an identified
• 33:24gap is the education
• 33:25part because it doesn't seem
• 33:27to have an academic RVU,
• 33:30attached
• 33:32to it. And I wonder
• 33:32if we could look at
• 33:32that as an opportunity
• 33:33because I feel like
• 33:35we're moving in a direction
• 33:36of aiming for net neutral,
• 33:37and it might be at
• 33:38the expense of educating people.
• 33:40Oh, wonderful question, Pam. So
• 33:42thank you. Thank you. I
• 33:44don't want
• 33:45net neutral.
• 33:47Actually, I like the phrase
• 33:48net neutral.
• 33:49I don't want net neutral
• 33:50to be at the expense
• 33:51of anything, but I especially
• 33:52don't want it to be
• 33:53at the expense of the
• 33:54education mission.
• 33:56And as we get closer
• 33:57to net neutral, I think
• 33:59we'll be able also to
• 34:00think about how do we
• 34:01incentivize
• 34:02education? How do we support
• 34:05this or that effort that
• 34:06right now we don't actually
• 34:08do in the way you're
• 34:09talking about? So absolutely, education
• 34:11has to be central. The
• 34:13other part, if we get
• 34:14to updates,
• 34:15if we do,
• 34:17we're really trying to develop,
• 34:19with Julie Wolf's leadership, trying
• 34:21to develop a professional
• 34:23development portfolio
• 34:24of courses
• 34:25that will also not only
• 34:27be education,
• 34:28internal and external, but also
• 34:30will generate revenue.
• 34:35Other things?
• 34:40Well
• 34:41okay.
• 34:42Well then let me just
• 34:43do a few updates.
• 34:44And first off, I wanna
• 34:46just tell you that the
• 34:47the school of medicine asked
• 34:49every department to set some
• 34:50strategic goals,
• 34:52but they gave us a
• 34:53list, a shopping list to
• 34:55choose from.
• 34:56And you can't read the
• 34:57shopping list, but that's the
• 34:58shopping list.
• 35:00And let me just show
• 35:01you the goals that we
• 35:02picked for our department.
• 35:04So we picked under research,
• 35:05the submission of interdepartmental
• 35:07collaborative
• 35:08proposals points and there's already
• 35:10one going in.
• 35:12Education was developing a new
• 35:14education or professional development program.
• 35:16In the clinical operations, it
• 35:18was to increase the work
• 35:19RBUs.
• 35:21The clinical quality was a
• 35:22rating of the increase in
• 35:24our ratings that come back.
• 35:27And then in culture climate,
• 35:29the RFDAC completion. I just
• 35:30want to thank everyone that
• 35:32has done the FDAC. And
• 35:33And for those of you
• 35:34new, you will soon be
• 35:35indoctrinated into the language of
• 35:37the faculty development and assessment
• 35:39questionnaire,
• 35:40the FDAC.
• 35:41But thank everyone for doing
• 35:42it because first off, I
• 35:44really enjoy the meetings and
• 35:45I know that other of
• 35:46my colleagues who have meetings,
• 35:47they're great.
• 35:49But I know it also
• 35:50takes work. But we reached
• 35:51one hundred percent this year,
• 35:53which was absolutely great.
• 35:56And that we will be
• 35:57actively updating our specific departmental
• 36:00goals and I will bring
• 36:01those in January.
• 36:03So just a few new
• 36:05developments across our missions.
• 36:07I just wanna page here.
• 36:10First off is to tell
• 36:11you that our Child Study
• 36:12Center associates, our donors,
• 36:14are coming in November, November
• 36:16the sixth,
• 36:17and we're just now bringing
• 36:18together the program and getting
• 36:20it all arranged. So please
• 36:21stay tuned. But also thanks
• 36:23to everyone that submitted ideas
• 36:25and submitted proposals for it.
• 36:27Really grateful.
• 36:29On our research, these are
• 36:30I'm gonna try to go
• 36:31across these missions and just
• 36:33show you some of them.
• 36:35Just a bit of news.
• 36:36This is not complete. It's
• 36:38a bit of news.
• 36:39So on a few developments
• 36:41for our research mission,
• 36:44as listed here, but we
• 36:45have the we have a
• 36:46social media pilot program where
• 36:48we had a very generous
• 36:50donor,
• 36:51gave us enough money to
• 36:52award four pilot grants looking
• 36:54at the impact of social
• 36:55media.
• 36:56And those are now actively
• 36:57underway.
• 36:59One of our associates has
• 37:00offered to have an event
• 37:01on October fourteenth
• 37:03to raise additional funding and
• 37:05to introduce people to this
• 37:06topic.
• 37:07So and it's a local
• 37:09event,
• 37:09which is great.
• 37:11Tom
• 37:13and and others have done
• 37:14enormous work on this shared
• 37:16subject recruitment site, and it's
• 37:18going. But if you have
• 37:19suggestions,
• 37:20how can we can do
• 37:21it better, please, please do
• 37:22add.
• 37:24There's regular research updates, especially
• 37:27important in this rapidly evolving
• 37:29landscape.
• 37:30So pay attention to both
• 37:31the federal site
• 37:33as well as to our
• 37:34own research update site that
• 37:35Tom is maintaining.
• 37:37And finally, I just mentioned
• 37:39the points, but I really
• 37:40wanted to give a shout
• 37:41out to Darren David, who
• 37:43is working also to help
• 37:44you think about shared or
• 37:46team science,
• 37:47really how to think about
• 37:48doing it. And I'm so
• 37:50delighted that we have a
• 37:51proposal going in.
• 37:54A few developments for our
• 37:55clinical mission, we've spent a
• 37:56lot of time on it,
• 37:57but
• 37:59one thing to say is
• 38:00that we are integral to
• 38:01the new Yale New Haven
• 38:02Children's Hospital strategic plan. This
• 38:05is this is big. We've
• 38:06never actually been that integral
• 38:08to the hospital strategic plan,
• 38:10but we actually have behavioral
• 38:11health as shown by the
• 38:12red arrows now are embedded
• 38:14in multiple levels of the
• 38:15Children's Hospital strategic plan. We
• 38:18are an important very important
• 38:20player
• 38:20in that plan.
• 38:23It is actually really happening.
• 38:26The urgent crisis center that
• 38:28we have talked about now,
• 38:29I think, for two years
• 38:31is actually going to happen.
• 38:33And if the if the
• 38:34video is clined,
• 38:36I can actually show you
• 38:38a virtual walk through if
• 38:40the video is clined, but
• 38:41it doesn't look like it's
• 38:42going to be clined.
• 38:47Now let's see if this
• 38:48works.
• 38:51Nope.
• 38:52Nope. Nope.
• 38:54Let me see if that
• 38:55does it.
• 38:57Nope.
• 38:57Okay. I will send you
• 38:59the slides, and, hopefully, when
• 39:00you look at it, you'll
• 39:01see this virtual walk through
• 39:03of what the urgent care
• 39:04center I believe, Pam, you're
• 39:06proposing PIMPAC
• 39:07as the name? We're discussing
• 39:09it and there might be
• 39:10a a more group on
• 39:11I mean, I'm not Alright.
• 39:12That's fine.
• 39:13But this is great. This
• 39:14is really a a move
• 39:16forward because we'll be able
• 39:17to deliver care right in
• 39:19the ED, be able to
• 39:20start care in the ED.
• 39:22This is a dedicated
• 39:23emergency service for pediatric behavioral
• 39:26health. And it's funded jointly
• 39:28by the state and Yale
• 39:29New Haven Health.
• 39:32Our growing Westport office, they've
• 39:34been doing a tremendous amount
• 39:35of work in Westport to
• 39:37get the word out across
• 39:38social media, been giving classes
• 39:40for parents. It's all really
• 39:41great, doing great work and
• 39:44it continues to evolve.
• 39:46If you have referrals, please
• 39:48let us know.
• 39:49And then we will have
• 39:50an open house on September
• 39:52the eighteenth.
• 39:54Please, that is actually just
• 39:55a week and a half
• 39:56away. So,
• 39:58join us. Last year's open
• 39:59house was a wonderful event,
• 40:01and this is brings all
• 40:02of our missions together. It
• 40:03brings education, research, clinical work.
• 40:06So please, please join.
• 40:09A few new developments for
• 40:10our education and professional development
• 40:12mission. So one is I
• 40:14wanna talk about briefly
• 40:17a renewed partnership.
• 40:19We have for many, many
• 40:21years had a partnership with
• 40:23the Anna Freud Center in
• 40:24London.
• 40:25Indeed goes way back past
• 40:27me, way, way, way back.
• 40:29Anna Freud actually came to
• 40:31Yale,
• 40:32worked with Al Solnit and
• 40:33other colleagues at Yale on
• 40:35some very groundbreaking books on
• 40:37thinking about the best interest
• 40:38of the child.
• 40:39Anna Freud was not in
• 40:40this building, but she was
• 40:42in the Child Study Center.
• 40:44And the Anna Freud Center
• 40:45is our is our sister
• 40:47institution in London.
• 40:49They provide behavioral health care,
• 40:51but they also have a
• 40:52tremendous portfolio of professional development
• 40:54services that they provide in
• 40:56the UK
• 40:57and are very interested now
• 40:58in doing it virtually and
• 41:00doing it on both sides
• 41:01of the Atlantic with us
• 41:03and developing additional forces that
• 41:05would appeal both to US
• 41:06and UK audiences.
• 41:08So this partnership,
• 41:10I've been involved with them
• 41:11for a while,
• 41:12but under their new director,
• 41:14this is a renewed opportunity.
• 41:16And I'm very excited that
• 41:18to be able to introduce
• 41:19you in November to Eamon
• 41:20McCrory who will be here
• 41:22and is their new director.
• 41:24So this is a great
• 41:25opportunity.
• 41:27The other one is, as
• 41:28you've heard me talk about
• 41:29is I have this aspiration
• 41:31for us to be the
• 41:33nationally internationally
• 41:34recognized go to source of
• 41:35information about children's mental health.
• 41:38How do we do that?
• 41:40One is a bridge with
• 41:41the Anna Freud Center,
• 41:42but we're also putting together
• 41:44a new podcast series on
• 41:46children's mental health.
• 41:47If you're interested in doing
• 41:49an interview, being a part
• 41:51of it, please step up.
• 41:52It's a way to get
• 41:54greater visibility for the center,
• 41:56but most importantly,
• 41:58to impact how the discourse
• 42:00about children's mental health. This
• 42:02is really, really important.
• 42:04And And so we're putting
• 42:05together this podcast series to
• 42:07link science to practice,
• 42:09policy implications,
• 42:11raising awareness about children's needs.
• 42:15And then there's the education
• 42:16Scholar Fellowship. We have increasing
• 42:18numbers of our faculty joining,
• 42:20that and Julie Wolf has
• 42:22a project that's about faculty
• 42:23mentorship
• 42:24in the Child Study Center.
• 42:26But if you're interested in
• 42:27medical education,
• 42:29I would especially encourage you
• 42:30to talk to Andres, who
• 42:31is really our ambassador for
• 42:33medical education.
• 42:35It's a key important part
• 42:38of our mission.
• 42:41And then just a few
• 42:42thoughts about culture and climate,
• 42:45sustaining, adding new rounds, etcetera.
• 42:49As you know,
• 42:50we are now the department
• 42:52or the division or the
• 42:53program and collaborative excellence,
• 42:56a name that embodies
• 42:58a lot of what we've
• 42:59been doing or what Tara
• 43:00and her team have been
• 43:01doing to sustain,
• 43:02but also now launching some
• 43:04new activities,
• 43:06a community advisory collaboration
• 43:08in collaboration with the university.
• 43:11And then with Tom, working
• 43:13to establish a research committee
• 43:15that will
• 43:16create guidelines for support,
• 43:18and how to generate support
• 43:20across research programs.
• 43:24There's also the health equity
• 43:25rounds that are now a
• 43:26regular part established by the
• 43:28Biola Bernard Fellows that are
• 43:30now just really an integrated
• 43:31regular part of what's happening
• 43:33and I'm just delighted and
• 43:35encourage people to to join
• 43:37in this. And this was
• 43:38one of those ground from
• 43:40the ground up activities that
• 43:42got really instantiated.
• 43:46And then,
• 43:47Darren and Tara are coming
• 43:48together
• 43:49to talk about leading with
• 43:51intention and heart in the
• 43:52academic medicine world and how
• 43:54that's changing,
• 43:56and how we can really
• 43:57continue.
• 43:58I know you've heard me
• 43:59talk about this idea of
• 44:00service leadership,
• 44:02but how can we really,
• 44:03really continue to balance
• 44:07this transactional business language that
• 44:09we must
• 44:10with the language of clinical
• 44:11excellence with attending to the
• 44:13values that we have?
• 44:17And then as always,
• 44:19I always want to end
• 44:20with a big shout out
• 44:21to Christa because Christa just
• 44:23does a tremendous amount of
• 44:25ways.
• 44:28So this is all the
• 44:29new things that Christa has
• 44:30done just internally.
• 44:33A new intranet,
• 44:34new onboarding,
• 44:36a new submission process for
• 44:38sharing news.
• 44:39It's really quite remarkable, and
• 44:41she's aligned the work with
• 44:43the Yale School of Medicine
• 44:44communication principles.
• 44:46But here's what she's also
• 44:47done externally.
• 44:49We have a new year
• 44:50in review,
• 44:51that's and now that's now
• 44:53starting to come out. An
• 44:55on a shift to quarterly
• 44:56newsletters,
• 44:58a much more consistent presence,
• 45:01with social media.
• 45:02And then we're totally overhauling
• 45:04our clinical website so that
• 45:05it is much more friendly,
• 45:07much more patient centered, all
• 45:09of those things.
• 45:14So I wanna conclude
• 45:15with personal statement
• 45:17and reflection.
• 45:20To go back to the
• 45:21theme,
• 45:23there's no doubt that these
• 45:24are tremendously challenging times before
• 45:26us. There's absolutely no doubt.
• 45:29There is a lot happening.
• 45:31There's a lot of change.
• 45:32There's a lot of uncertainty.
• 45:35I have incredible confidence
• 45:38in this department.
• 45:41Every day, I feel the
• 45:42deepest admiration for the work
• 45:44that all of you do,
• 45:46for the clinical sophistication,
• 45:48for the being with families
• 45:50at their deepest troubled need,
• 45:51for asking questions that are
• 45:53at the cutting edge, for
• 45:54actually asking questions of why
• 45:56are we doing what we're
• 45:57doing? Is there a different
• 45:58way to do it?
• 46:00For being committed to training
• 46:01the next generation.
• 46:04I am just tremendously
• 46:06encouraged by this department and
• 46:07know that we can do
• 46:09what
• 46:10we are set out to
• 46:11do.
• 46:12I would say that values,
• 46:13if we stay to our
• 46:14values, it lights our path.
• 46:17Persistent what seem like incredibly
• 46:20doggedly persistent
• 46:21tiny efforts end up making
• 46:23big changes.
• 46:25I would really encourage you
• 46:26to ask questions. Please ask
• 46:28questions. And remember, I'm gonna
• 46:29continue to ask you to
• 46:31submit what you would like
• 46:32to have heard,
• 46:34but also challenge. Why are
• 46:36you doing what you're doing?
• 46:37Is there another way to
• 46:38do it?
• 46:40I cannot
• 46:41encourage us more to be
• 46:43vocal ambassadors,
• 46:44talk about our science, talk
• 46:46about our clinical work. It
• 46:48be shamelessly
• 46:49bragging about this department,
• 46:51talk about what we do.
• 46:53And most importantly, to center
• 46:55children and families
• 46:58because that is truly the
• 46:59heart of our department
• 47:02For
• 47:03all that I've talked about,
• 47:05what is truly at the
• 47:06heart of this department
• 47:08is our care for children
• 47:09and families.
• 47:11We center them in all
• 47:12that we do.
• 47:13And I am deeply, deeply
• 47:15honored to continue as your
• 47:17chair.
• 47:18Thank you very much.
• 47:25Any
• 47:28questions?
• 47:31Anything?
• 47:33No.
• 47:36Thank you, Linda, for that
• 47:37overview.
• 47:38Just a
• 47:40just a comment on terms
• 47:41of the what you were
• 47:42talking about just
• 47:43to translate it as
• 47:45get the word out there
• 47:46or speak up. And I
• 47:47think one
• 47:48one action is also around,
• 47:51a greater effort around, connecting
• 47:53with us, the capital, the
• 47:54state capital.
• 47:55And so we for those
• 47:57of you who might be
• 47:58interested, Susie and I are
• 47:59gonna have it and others
• 48:00are gonna have an Alex
• 48:01involved with this table,
• 48:03next week. But, in October,
• 48:05we plan to have a
• 48:06meeting of folks who have
• 48:07expressed interest about learning more
• 48:09about social policy or legislation.
• 48:11So you'll be on that
• 48:13invite if you're not already,
• 48:14but stop by the table
• 48:15if you want.
• 48:16And then just an anecdote,
• 48:18on my end is Linda
• 48:19and I this was, like,
• 48:20maybe two, three years ago,
• 48:21and Yale
• 48:23News internally
• 48:24wanted to do a piece
• 48:25on social media. And I
• 48:26think we both did it
• 48:27kind of as a favor
• 48:28to them because, you know,
• 48:29it's me on news. But,
• 48:30subsequently, Krista let let us
• 48:32know that it's the most
• 48:33clicked on website. I don't
• 48:34know if that's still the
• 48:35case, Krista,
• 48:37you know, on Yale Medicine
• 48:38or Yale New Haven. So
• 48:39I think little things that
• 48:40just start to and from
• 48:41that, we get calls all
• 48:42the time now. And so
• 48:44just whatever opportunities you have.
• 48:45And I also try to
• 48:47distribute,
• 48:48opportunities to others, junior faculty,
• 48:50fellows,
• 48:51just, but those are some
• 48:53other areas to try to
• 48:53get ourselves
• 48:54out there. On the social
• 48:56media program starts to take
• 48:58off.
• 48:59Yeah.
• 49:05This is not a question
• 49:06that would intend that we're
• 49:07going to stay longer. But
• 49:09are there other things that
• 49:10you would like to hear
• 49:11more about
• 49:16Besides the new how how
• 49:18comfortable are the new chairs?
• 49:22They're very comfortable. So it's
• 49:23a great
• 49:24Sitting by turnout, I'd say
• 49:25very comfortable.
• 49:29Other other things? Other questions?
• 49:33I'm just deeply grateful to
• 49:35see all of you in
• 49:35person. There's a tremendous sort
• 49:37of vibe when there's people
• 49:38in the room. Thank you
• 49:39so much.