Cathy Ackermann: Welcome to Sweet Tea and Strategy, a podcast by Ackerman Marketing and PR, featuring business and community leaders throughout Tennessee talking about issues and trends of importance to our state and beyond—and sharing some of their very best sweet tea recipes and tea-sipping stories. We are delighted to have as our guest today, Matt Schaefer, CEO of East Tennessee Children’s Hospital. So welcome, Matt, and thank you so much for spending this time with us and sharing your perspectives on some of the unique roles that hospitals like yours play in our country and certainly in our own community.
As the name of our podcast implies, we’re going to talk about sweet tea. And you have previously, of course, lived in Louisiana and in Texas, so unlike some of our guests who have only lived further north, you no doubt have some exposure to that most Southern of drinks, sweet tea. So if you have a favorite recipe, a favorite story, recommendations for where to get good sweet tea, we would love for you to spend a minute or two sharing it with us.
Matt Schaefer: So I grew up in Texas, as you described, Cathy. And you know, tea wasn't tea unless the water that was used to dilute the tea wasn't heated by the sun. That’s what my grandmother did. And then it became a process of dissolving the sugar in the sun as well. And you know, I think as we all know, there’s no sweet tea like Grandma’s sweet tea, and that was certainly the case for me growing up.
Cathy Ackermann: Yes, absolutely. And I think the sun method is also a really fun one that I can relate to with one of my grandmothers. I had a grandmother from Boston and one from East Tennessee, and you can guess which one did the sun tea recipe.
Matt Schaefer: Yes, I can!
Cathy Ackermann: Yes. We’re going to jump right into talking about you and your career and your goals for East Tennessee Children’s Hospital. So let’s start with you. You’ve been here in Knoxville for less than a year now. So give us a little information about your background and how you got into this particular career path. I know you’ve got an interesting background that combines engineering, management consulting, hospital administration... so just give us a brief run-through on that.
Matt Schaefer: Yeah, I'm definitely a newbie to Tennessee. What I'm not a newbie to is pediatric healthcare. And my history in pediatric healthcare started well before my life in the professional side of things, and it started through my nephew, Malachi, who was diagnosed with childhood leukemia when he was 14 months old. And at that time, certainly news like that takes everybody by surprise. And as you referenced, engineer by background, consultant thereafter really because I didn’t know what I wanted to do when I grew up... and literally found my calling through my nephew.
For five months he was treated as an inpatient at Texas Children's Hospital in Houston, ultimately lost his battle to cancer and passed when he was 19 months old. And I got to see what pediatric healthcare institutions do, even in the midst of a terrible medical outcome that no one would want for their son or their daughter. And I said, that’s what I want to do. That’s what I want to be involved with. I want to be involved with giving back in whatever way that I could. That led me to about a 10-year career at Texas Children's, where Malachi was treated, in a variety of roles. Then took me to New Orleans, a place that I never imagined I would live, and served the community there for almost three years as Chief Operating Officer of Children’s New Orleans. And was delighted to have the opportunity to follow Keith Goodwin, who was President and CEO here at East Tennessee Children’s for almost 15 years before his retirement, and take the reins here and continue on the tradition of almost 85 years of service to this region.
Cathy Ackermann: Yeah, that’s great, and we’re so happy to have you. We’re lucky to have you here in Knoxville, for sure. But what makes a pediatric hospital different, really, from an adult hospital? What are some of the unique aspects and challenges, as well as some of the unique services that a hospital like yours is able to offer children?
Matt Schaefer: You know, I wouldn’t be doing my service if I didn’t start with a catchphrase that in the children’s hospital world we use a lot: and it’s the fact that children are not little adults. They call for a different type of care. And maybe I can use just one example in that. A pediatric orthopedic specialist has to take into account where that child is in their development as they determine the correct approach to treating that injury, right? As adults, you and I don’t have to go through that type of differentiation and specialized service, but our pediatric specialists do that every day and recognize that kids aren’t little adults.
So that’s number one. Number two is, healthcare institutions have always been service-based, and in many ways mission-based. How do you keep well people well, and hopefully bring about healing to those who are ill or sick? Sometimes that mission is hard to translate. That’s not the case in a children’s hospital, because everyone can walk down the hall and they can see in the eyes of the patients—they can see their son, they can see their daughter, their niece, their nephew, their grandson, you know, the child who they know at their congregation, etc. And the mission is so incredibly clear about taking care of the next generation of adults, and in our case, the next generation who are going to be the leaders of East Tennessee going forward. I think those are two big conceptual differences between adult healthcare and pediatric healthcare.
Cathy Ackermann: The vulnerability of children, too, is just so mission-driven.
Matt Schaefer: Yeah, I'm glad you mentioned that because, you know, the truth is, as adults, often we’re sissies. And you walk around the children’s hospital and we have children who are undergoing incredibly difficult things, right? Very vulnerable. And they trust, and they’re tough, and they’re resilient, right? And they show up every day with a smile and they just want to be kids in the midst of some terrible outcomes. And that’s incredibly unique.
Cathy Ackermann: And a lot for us to learn in that as we go along.
Matt Schaefer: Yeah, no doubt about it.
Cathy Ackermann: Yes. Can you give us a couple of stories about how East Tennessee Children’s Hospital has changed or improved the whole trajectory of a particular child’s life that would ring home what you’ve just said about how they’re not little adults and how much they need the type of care that you provide?
Matt Schaefer: Yeah, absolutely. You know, I think that conceptually we all understand what healthcare looks like and what pediatric healthcare looks like, but you start to get into specific stories. There’s a patient in particular I can think of who’s been cared for here at Children’s Hospital, and a serious hematology-oncology issue, and disrupted this patient’s life in an incredible way at an important period in this patient’s life. And Children’s was here with the only team in the region that could give the holistic care that that patient needed. Not just the medical care, but the care for the family in this case. The ability to have Child Life specialists who specifically focus on how to normalize our environment—a care environment—for kids and focus on serving families. And you could replicate this patient’s story over and over and over. And for us, Kathy, 300,000-plus patient encounters a year across Children’s Hospital. And it’s just an incredible privilege to serve kids like that and be with them and their families in a time of need they never recognized they were going to have and quite honestly they never wanted, but we’re glad that they chose us to be part of that journey.
Cathy Ackermann: Right. And it’s a real awakening, a rude awakening if you will, to go through the section of the hospital where the NAS babies are and see the amazing work that’s being done there to try to help these children who are born into such a disadvantaged situation get well, have real whole lives after they get through their initial trauma. That’s a real heart-wrenching experience to see all that.
Matt Schaefer: Yeah, no doubt about it. I’m glad you brought up those children. You know, it’s a good reminder to us that some of the work that we do here at the hospital, and in fact much of it, has nothing to do with a child’s choice about what their lot in life is. You talk about the children who are born with addiction issues as newborns—that’s not that child’s burden, but yet it’s their burden to carry throughout life. And it’s our opportunity to hopefully alleviate some of that burden to allow them to be the best version of themselves they can be.
Cathy Ackermann: What are the things that you look for when you hire staff, both on the clinical side and on the administrative side? Are there special qualities that are unique, for instance, to a pediatric hospital that you really look for?
Matt Schaefer: That’s a great question. You know, I think that those who are called into healthcare in general are called to serve in one way, shape, or form. You mentioned earlier, I’ve been here almost a year, and I’ve gotten pretty bold at our new employee orientation and said things like the following: you know, if you’re here to clock in, do your job, clock out, and go home and collect a paycheck, this isn’t the place for you. Right? We are focused on serving children, we’re focused on serving families. That calls for your heart to be in it. It calls for you to be part of something that’s bigger than yourself. And I say to folks, including myself, every day: it’s not about me anymore. It’s not about our employees anymore, it’s about those 300,000 encounters that I talked about. It’s about the patient who’s here in front of us. So I think you’ve got to see a heart for service first and foremost.
I think number two is, you’ve got to see beyond a heart for service—it’s not just about empathy, it’s about compassion. Meeting people where they are and having compassion to take action to help support them. And there’s a certain amount of toughness that’s involved in what we do. Some of the work that we do is hard. It’s challenging. In some ways it’s gut-wrenching. But the other side of that coin is it’s incredibly joyful. It’s incredibly empowering. It’s incredibly impactful. And I think those are characteristics that you see in most service industries, but are particularly important for what we do at Children’s.
Cathy Ackermann: Well, and the role of your team as teachers is also I think so relevant for a pediatric hospital because many times they’re teaching families how to go home with a very sick child and continue that care in their home. And so to have the patience and the empathy and the wherewithal to treat the child, but then also to educate the family in terms of after the release what needs to happen.
Matt Schaefer: Yeah, it’s a great distinction. And one of the things we talk a lot about here at Children’s is the concept of family-centered care. And it’s the concept that when you or another family in this environment brings their child to us, it is not as though we are in the driver’s seat. We have been invited in by the family to participate. And we’ve got to make sure that mom, dad, caregiver recognizes their role in that process and that we recognize their rightful role in that process. And we are just part of their life, that we are not overall drivers of what’s going on. We’ve got to equip those families with what they need when they leave us.
Cathy Ackermann: Exactly. These days most hospitals, yours included, are taking a close look at not only how but also where you administer healthcare. Talk a little bit about how things are changing in that regard in terms of satellite facilities, telehealth, and what the future holds for your institution in that regard.
Matt Schaefer: Yeah, we’ve talked about it a lot here and it’s the concept that we’re not Knoxville Children’s Hospital, we’re not Knox County Children’s Hospital, we’re East Tennessee’s Children’s Hospital. And gone are the days that we expect families to just come to the ivory center tower of the medical center, whether it’s here on Clinch Avenue or anywhere else. We’ve got to meet families where they are. There are burdens that we have traditionally placed on families that involve distance and travel time, and time off of school, and how to take care of siblings who are here with the patient that’s being treated. And we need to be in the community, rendering services that are high-quality and close to home.
That’s why we’ve taken some of the services that we have out to West Knoxville, it’s why we’ve taken it out to Sevier County, it’s why we’re going to be taking it to Blount County. It’s why we have 15 primary care locations throughout the region, reaching all the way up to Scott County in some cases, to be able to care for all the kids of this region. And you can’t do that at 2018 Clinch Avenue. You’ve got to be where the rooftops are and where families are.
Cathy Ackermannt: And of course, COVID taught us all some interesting lessons in terms of how we access healthcare and the comfort level that people now have relative to telehealth that a year ago they didn’t have at all. So do you see that continuing to advance right along in terms of the ability to connect with a physician on multiple levels?
Matt Schaefer: I do. I think you’ve heard a number of people in this realm say, including leadership across the nation, the genie’s out of the bottle as it relates to telemedicine. For years this industry, my industry, have found lots of reasons not to make it work. And the truth is, a pandemic forced us to make it work because in some cases that was the only safe way to reach a family. And you know, Kathy, we were doing tens of telemedicine visits prior to the pandemic. Now we’ll do more than 2,000 a month here at Children’s Hospital. And that has enabled us to reach patients that truthfully we would not otherwise reach. And I think it’s a modality that’s going to continue to grow, and parents are going to get used to the convenience, they’re going to get used to not having to come and park, they’re going to get used to some of the things that they don’t have to experience, yet still get great quality care.
Cathy Ackermann: What are some of the critical alignments throughout the community that you’re looking for in terms of partnering, whether they’re schools, other providers? What do you see out there when you look at that alignment of partnership opportunities for Children’s Hospital?
Matt Schaefer: You think about where we started the conversation—what makes children’s hospitals different. And I think what needs to make healthcare institutions different is that we need to be involved in more than just caring for the sick. We need to keep well people well, and in our case, that means to keep well children well and hopefully bring about healing to those who are ill. That means that we have to be engaged outside the four walls of the hospital. That means we actually have to be engaged outside of a normal pediatrician’s office with partners who are caring for the whole child in this case.
And there’s a lot of organizations in our city that are involved in the lives of kids. You talked about the school system being one of them. And it’s our job as Children’s Hospital not to just wait until people need us, but to be partnered with people who are engaged with children in a broad way to say, how do we make them and their lives as healthy as is possible through the relationships that we have in the community? And I think that’s going to be different going forward. I hope that COVID has forced us to think about that in a different way that says we’re all responsible for each other. This is our community, it matters, we’ve got to be engaged with others.
Cathy Ackermann: Anything you want to mention or predict in terms of the payment model, the reimbursement part of healthcare, and where you believe we’re headed there? And I know that that’s a whole can of worms to open up that question, but where do you think we’re going there?
Matt Schaefer: You know, it’d be interesting to see where we go. As a children’s hospital, certainly national decisions make an impact on us, but much more specifically on a day-to-day basis, statewide decisions make an impact on us. About 65% of our patients are covered by TennCare, which is the Medicaid program here in the state of Tennessee. And therefore a lot of our reimbursement comes from there. TennCare is going through a period where they’ve at least proposed an alternative model for funding that would be focused not just on episodic care, but also on driving quality care. I’m hopeful about that. I think that’s a direction that’s healthy for the state, I think it’s a direction that’s healthy for our industry.
And you know, and I think the challenge is that the over-politicization of everything drowns out what can be good solutions for kids. And as I say to our team every day, I don’t really care whether we’re on the left or right as individuals—our politics are about kids and about taking great care of kids. And I’m not sure where the model goes. What I am sure is that the history and the importance of Children’s Hospital to this community and pediatric specialized healthcare will persist regardless of what that payment model looks like. And I think it’s helpful for our team to keep our eye on that as the overriding stake in the ground, the North Star, that says things will wax and wane about what the payment model is. We have to stay focused on taking care of kids, and if we do that in a high-quality way that lends good service at the point of service, in the community where people need it, here at the hospital as demanded, there’ll always be a set of funding that will be here to help us ensure our mission.
Cathy Ackermann: What about behavioral health? That’s a big topic and I think COVID has sort of shown a spotlight on that, but I think that there were issues even before COVID in terms of our lack of ability to really plug in and understand what the behavioral needs of children are today and meet those needs. Where do you think we’re headed with all that?
Matt Schaefer: One in five kids, Kathy, before the age of 14 are faced with a mental or behavioral health challenge. That’s not just a statistic nationwide, it’s what we see play out here in our region as well. You know, if that were diabetic care, if that were cardiac care, if that were GI care, we wouldn’t be okay with it. Right? So I’d first start by saying that there is a real epidemic of behavioral health challenges, and those have been exacerbated by the pandemic. So much so that patients who are arriving here in crisis and across the country in pediatric hospitals are increasing at a rate that’s really worrisome.
You talked about partnerships a moment ago. We talked about the importance of those. This is a perfect example of a complex problem that involves schools, that involves social determinants of health, right, in communities, that involves Children’s Hospital, that involves the mental and behavioral health providers that are already in this region. And we’ve got to do better for these children. We’ve got to help them when they’re in crisis, but more than that, Kathy, we’ve got to be on the front end. We’ve got to recognize that self-esteem is important. We’ve got to recognize that undue pressure is not so healthy for kids as they’re forming in their adolescence. We’ve got to recognize that home environments sometimes create outcomes before they ever happen. And it’s a challenge for Children’s Hospital, but more than that, Kathy, it’s a challenge for our neighbors. And we’ve got to as a community decide how we can address it in a more holistic way.
Cathy Ackermann: And I do think a community-wide solution is going to be the direction that we’re going to have to move in order to make an impact with the staggering kinds of numbers that we’re seeing and percentages that we’re seeing relative to what a huge issue this really is.
Matt Schaefer: I agree.
Cathy Ackermann: Finally, what are you most excited about—number one? And number two, what concerns you the most relative to our healthcare system in the United States? If you could wave a magic wand, what would you change?
Matt Schaefer: You know, the excited amount is probably easier for me to jump at because I'm a little bit of a pessimist on the magic wand question. But let me tell you what I am excited about. What I am excited about is this organization for almost 85 years has been special to this community and region. And I think we can create another 85 years of history of serving this community by being and embracing our role as the preferred pediatric provider of care, both when it comes to the checkup for your child who’s doing just fine and the moment that no parent wants to face when you get devastating news. We’re the place for that. And that’s an exciting place to be—it allows us to embrace our opportunity and our responsibility to care for the kids of this region that will become the next host of a podcast with area leaders, that will become the next leader of a healthcare institution. And I can’t imagine something more exciting than being engaged in that.
You know, if I were to wave a magic wand, Kathy, on the other side of the coin, I think I’d wave a wand that says why have we created a model that no one likes and placed it in healthcare? And here’s the story for that. You, your listeners, myself, have all had to file a claim with our car insurance company or with our homeowners insurance company. And no matter how good your carrier is, it is a headache. It is disruptive. It is frustrating. And we’ve taken this third-party model as a country and we’ve put that in healthcare. Right? We’ve placed that in a scenario where there’s a middleman, right, or middle person who’s helping us navigate a world that’s even more frustrating and filled with more emotion. If I waved a magic wand, I’d say let’s simplify that. Let’s get the patient closer to what they need, let’s get the caregiver closer to what they need, and undo some of the unnecessary back-and-forth that happens between insurers and providers, etc. I just think we’re doing a disservice to our mission. I don’t know how to wave that magic wand. If I did, I’d be sitting on a beach somewhere. But it’s a challenge.
Cathy Ackermann: Is there anything, Matt, that we haven’t talked about this morning that really is close to your heart or that you want to express to us as we start to wrap up the discussion? This has been so informative, but anything else you’d like to talk about?
Matt Schaefer: No, I’d be remiss if I didn’t maybe anchor back to where we started with something that I think it’s important for the listeners of this podcast to know is that Children’s Hospital is special for a couple of reasons that are critical. One of it is we’ve enjoyed a history of an extremely supportive community. Supportive in terms of philanthropic efforts, but also supportive of standing behind who we are and our importance in this community and using really this community asset in a way that hopefully helps build up other community assets that exist here. So I say thank you to you and your listeners for that advocacy, both active and passive, that matters to us.
The second thing I’d be remiss if I didn’t say is we can only be who we are because we have a cadre of talented, nice, engaged physicians who bring their expertise to Knoxville, Tennessee. Who choose to say it’s not important that I’m in Philadelphia at a huge academic center, that it’s not important that I’m at Children’s of LA or Children’s of Atlanta, but I can do good here. And you look across the breadth and depth of pediatric specialized services that Children’s Hospital has—it’s actually extremely unique. And those physicians, the caregivers who say this is where I want to be and this is where I want to serve—it’s what’s made us special for the years we’ve been here and it’s what’ll continue to make us special as we move forward.
Cathy Ackermann: We so appreciate your informative comments as well as your leadership here in East Tennessee. So happy to have you in the community with your family seemingly thriving... we’re glad that you’re plugging into the community and just happy to welcome you here. We wish you the very, very best and we hope you keep drinking that sweet tea made in the sun. And thank you again, Matt, for being a part of our podcast. We appreciate it.
Matt Schaefer: Cathy, thank you very much. Have a great day.