This week I am talking to
Bob Booth MD, Chief Care Officer at TimelyCare (@TimelyMD) a company offering a student-centered platform that is designed for digital natives of on-demand access to mental health and medical care. Bob’s path informed his role and focus starting out in education, training to be a doctor and anesthesiologist and ultimately ending back in education delivering critical support services to a population that is experiencing record levels of stress and declining brain health.
We discuss the jaw-dropping statistics of the state of the minds of our younger generation especially those in higher education where 8 out of 10 students tell us that there is a full-blown mental health crisis going on on their campus. with the brain (aka Mental) health is the number one reason why students abandon their academic goals when they quit and leave school. Importantly Bob focuses on the positive framing of these data and the importance of understanding that we cannot staff our way out of this, we could dump buckets of money into training into
increasing compensation, to try to address the supply and demand mismatch but this will not solve the problem.
Rather we must think about this differently capitalizing on work done in the UK and the NHS that remains a cornerstone of these approaches where resources are constrained how do we improve care, while I have less money to do this? The good news is it is possible with the addition of alternative approaches, enablement, and technology
Listen in to hear Bob discussing the approach to looking backward to learn and forward to innovate and create a future world that we all want to live in.
Listen live at 4:00 AM, 12:00 Noon, or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Raw Transcript
Nick van Terheyden
And today, I’m delighted to be joined by Dr. Bob booth. He is the chief care officer for timely care. Bob, thanks for joining me today.
Bob Booth
Thanks for having me, Eric. I’m looking forward to the conversation.
Nick van Terheyden
So as I do with all my guests, I always try and get a little bit of context for their history. And I gotta be frank, um, you know, as I was setting this up, I’m looking at you and you’re a physician, but you’re a gas man or underneath a test anesthesiologist, what is a GASMA doing in this space? Tell us your story.
Bob Booth
Well, I think that’s a that’s a fun way to get started. Because it doesn’t, doesn’t completely make sense. On paper, I often joke with people I overpaid for my dog, you know it when you put two or three different breeds together. Now to get a designer dog, you pay more money, but one more species away, and you’ve got a month, I think I’m actually getting pretty close to being a month. In my experience. My my background started out in higher education. I actually spent some time there between my undergraduate degree, which was in a humanities theology field, and pursuing a degree in counseling psychology, working in higher education. Now, at the time, I had no idea I was going to, to become a leader in the higher education space, I was trying to pay the bills. But I worked in Residence Life and then student affairs while pursuing a degree in counseling psychology. From that point on, I went on to medical school, and then anesthesiology. Now what’s interesting from that point is I worked for a large national anesthesia management company over the last eight years and helped work with some other academic institutions, Duke the University College of London to help develop a perioperative medicine fellowship that looked at value based care, that looked at what are we doing to improve the actual outcomes. So my experience over in the anesthesia space on the leadership side, looking at operational efficiencies, looking at growing quality, and a network, working on advancing our field, EB up perfectly for moving into higher education. So now over at the current spot that I said, as the chief care Officer of timely care, I am actively working to grow a provider network that produces high quality that delivers value from an oil based measurement standpoint, to our students. And so that’s where the intersection kind of all weaves together. But on a day to day basis, I’m not using the the the nice statistic part of my career.
Nick van Terheyden
I, you know, I’m gonna disagree with you on on your use case, in part because I think there are so many elements that contribute to what you’re doing in this educational space, but maybe not in the traditional sense. So you’re not thinking about the drugs and flow of gas and, you know, in those elements, but you do think about it critically in the same way that you know, it’s constant monitoring, understanding of that data in the processing. So I think, you know, I gotta be honest, you’re underselling that connection a little bit? And that brings me to the sort of the core of this. So what is it that you do and how did you get involved? What was the sort of pathway into being the chief care officer at timely care?
Bob Booth
Well, I think that’s a great segue to that piece. And I will agree with you there that we have to be data driven, right? We have to look at what’s going on around us. So my pathway to timely care was moving some of those those lessons learned over in the anesthesia space, to look over in this space and ask the question, what do we need? What’s going on in the space? So we start by listening to our students to understand what our students are telling us. Our students tell us eight out of 10 students say there’s a full blown Mental Health Campus full Excuse me. Eight out to 10 students will tell us that there is a full blown mental health crisis going on on their campus. Mental health is the number one reason why students abandon their academic goals when they quit and have to leave school. This is incredibly alarming for any of us that are listening to that this is something that We have to really pay attention to. And that data is out there now coming across multiple avenues. I don’t know if you saw the February data from the CDC looking at mental health for teens, just alarming teenage girls, three out of five, have persistent sadness over the course of 2021, one out of three considered suicide, they did a great job, New York Times did a really good job of covering some of the data, if anybody wants to go back and look at that in February, they point out the boys aren’t left out here. It’s actually that for mental health, young men, it’s not actually presented the sadness as much as presented as aggression, and irritability. And then they go on to talk about some of our most vulnerable populations, and the LGBT LGBTQ group is what we really have to pay attention to, with significantly increased exposure to violence, depression, suicidal ideation, that’s the data that we’re looking at. Right? That’s the, that’s the problem to solve. And so when you talk a little bit about like, what’s my role, what happens at timely care, timely care exists to be a virtual solution, we are the leading virtual solution for student mental health and well being. And we are working to create access to care through virtual solutions to address that data that I spoke to you about so far. So we sit at that intersection, we work and partner with the University. So our partners are people who are passionate about the problem that I just described. They come to us over 250 schools, now, they come to us, and ask us to be an extension of the care that they’re already giving to their students. And so my role as the as the chief care officer, is to help lead a really talented team of people. They’re trying to address this data and trying to shift shift the trend.
Nick van Terheyden
So I’m just gonna go back. I mean, normally, I’m sort of relatively animated, but I got to be quite frank, that the level of depression I feel with those statistics, is just jaw dropping, when you consider eight out of 10. People are in that state of mind, and this is our youth, the people that should be looking out and saying, Wow, I’ve got my whole life opportunity ahead. Something terrible has happened. Before we dive into, you know, how we approach that what we can do about it. Let me ask you, you know, just for a little bit of context, has that debt? I mean, I think that number must have gotten worse in the pandemic. Was that increase or worsening, significant or was it just more of the same, but just a little bit, but more? What’s your sense of that?
Bob Booth
Yes, the CDC says, yes, that’s that was the lead and what they were saying in that, but but that’s not it’s not the cause. Yeah, I frequently will tell people there was there was a wildfire that was already raging around mental health and young people pre pandemic, the pandemic was just gasoline. So it function as an accelerant. If there’s a silver lining, it actually opened our global eyes to the issue of what’s going on. Because at one point in time, globally, we all experienced at the same time, that compression, of isolation, of fear of the unknown, of lack of resources. Just so many things that hit all of us, I think that probably opened our eyes to something that we know has been going on for a while. And that’s what the data tells us since 2011. They do this same survey 17,000 students every two years, it’s it’s gotten worse, progressively over and over again. We weren’t talking about COVID in 2011. We weren’t talking about COVID in 2019. So So what is it that’s underlying this? And I think what I’ll tell you and I’m sure you you’re probably already connecting the dots here is that we just added stress to an already vulnerable and stressed group of people.
Nick van Terheyden
Yeah, so I mean, I 100% I think the the presence of this has been around for an extensive period of time, and you’re right I mean, I’ve talked about this it’s almost it’s difficult to say but silver lining to a pandemic that we all look back and go whoa, but it true It was it did it shone a spotlight, it allowed more sort of focus and attention, which all is good. There is a little bit of a concern certainly on my part. It’s this flash in the pan, short attention span news cycle. Oh, yeah, that was that, oh, the pandemic is over. We don’t need to worry about that. But hoping that that’s not the case. Let’s talk a little bit about how we deal with this. And, you know, I’m just going to throw down some straightforward issues and concerns in this area. We already lack resources. I mean, I don’t think you’re sitting there going, Oh, well, we’ve got lots of resources to throw about this, and, you know, help start to mitigate it, that’s just not the case. How do you start to approach this when you sit in this resource poor environment?
Bob Booth
Well, so I’m gonna agree with you. And then I’m gonna reframe something into the positive. So we cannot staff our way out of this. There. We could dump buckets of money into training into increasing compensation, you know, all the things and we still have a supply demand mismatch. Here’s the reframe, that’s gonna force us to do something innovative. Right, that actually forces us to think about this differently. And I’m flashing back just real quick to a physician from from your side of the pond, it really impacted the way I thought about this was a man by the name of Dr. Monty Python, who, through the University College of London, who looked at constraining budgetary issues with how do we improve care, while I have less money to do this within the NHS, and that spun out of a really robust and incredible enhanced recovery after surgery program that many of us have been trying to copy for, for years. So what’s happening in the mental health space, same thing, okay, this is so bad, we have to do something different. And that’s forcing innovation. And that’s forcing us to look at things differently. So from our vantage point, and timely care that’s providing virtual care solutions to students, this is not a nine to five problem. This is a 24/7 problem. Students lead 24/7 lifestyles, 40% of our students come to us after hours, that’s times when clinics are going to be closed, right and unavailable. And yet, they’re still needing care. The students who are on campus today, they’re digital natives. They were practically born with a phone in their hand. So why wouldn’t we go to them where they already are? Why wouldn’t we go to them in a, in a manner in which they’re already connecting, to help get them connected? The next thing I think I would say there is we can’t just think of this as a sick care model. That’s what’s failed us in healthcare, right, is if we’re just waiting until pathology develops, and running after it, what’s happening at a population health level, our entire population is getting sicker and sicker. Our workforce is getting more and more burned out. Speaking of accelerate, stir and COVID liquid, it’s done to the burnout crisis with health care providers, right. But if a sick care model is a spiral, to do insolvency, there’s just it won’t work, right. And so we have to treat people when they’re subclinical, we have to provide resources to people before it gets so bad, that they’re persistently sad all year long thinking about harming themselves. And so the timely care solution for that, and the way that we’ve approached this, as we said, okay, let’s improve access to care. For students who are who are in crisis, let’s presume, you know, improve access to care for students who have acute medical care needs, but how do we widen the top of the funnel so that students can start thinking about what care looks like when they’re feeling men? When they feel like things just aren’t right? I can’t name even what’s going on. But I know something’s there. And so we’ve layered in a peer community where students can anonymously talk to each other. And this has been a drastic inertia reducing component of what it is that we do. And yet many students even find that that’s enough for them. 50% of our students who engage and we’re clearly we started this in August, we’re hundreds of 1000s in on our level of engagement on the on the peer community. Some of them did go there, and they seek support and they give support to you together and that’s it that helps them get through what they’re going through. Others from there may need other additional layers of care. And that’s why we recently launched our self care journeys. So this is digital content in bite size formats, the same way that students are already consuming information. I keep saying students, I’m consuming information this way. Show me something I can learn in 60 seconds. And I’ll watch 10 of them in a row without even realizing that learning, right. So we’ve got short bite size video components from some of our experts, psychiatrists and mental health leaders, telling students how to think about stress, allowing them to do their own self assessments about stress, and then giving them coping skills so that they can begin to start working in this way with digital content that’s available, and is not correlated to that supply demand mismatch that we talked about earlier. So that’s, that’s a handful of examples of how we’re approaching it.
Nick van Terheyden
So for those of you just joining, I’m Dr. Nick the incrementalist today I’m talking to Bob booth, he is the chief care officer at timely care, we were just talking about the devastating circumstances and the opportunity to sort of use technology to really expand access, I think, you know, the addition of that capability and the mutual support, obviously, a slightly different circumstance and that you find in traditional social circles, where it’s not so much supporters, look at me, I’m doing all this wonderful stuff, I think, you know, as partly contributed to it, but I’m wondering how you’ve managed to sort of create a solution that allows for that, but doesn’t devolve into negativity where people you know, sometimes? That’s what we’ve seen in some of these circumstances? Because I think it is, it’s that mutual support, you said, 50%. That’s a large number of people that are deriving benefit. How have you been able to manage that within the framework that you have?
Bob Booth
You I think it’s really important to look at the full picture of who the student is, who the person is. So I started by telling you some some some data points to tell you where we’re starting at the data points are, are concerning. They’re alarming. But there’s hope. And there’s optimism. And really, there’s a great deal of hope and optimism with a patient population that we really serve. And that is that there’s a lot of underlying resiliency, and our students. So yeah, oh, look at what happened after the pandemic. Yes, well, these are also students who are still in school after the pandemic. Many of our college age students right now missed the prototypical junior and senior year 11th and 12th grade experience in high school, and what did they do? They still showed up on campus. Many of our seniors right had incredibly disrupted, you know, first year and second year experience that was going on, but what are they doing, they’re still pursuing their goals. So we talk about at risk populations, and sometimes we even use the word vulnerable. Be careful. This is a really, really strong group. And so what does that mean? That means that when that group needs help, the little bit of help that we can give and giving a whole lot more out, but but sometimes it just takes little bits, little prods, little bits of encouragement, of exponential effects, right. And that’s what we’re leveraging. And that’s what gets me excited, right. That’s why I get up and come to work every day. That’s why my team is so excited within the care organization. And that’s really what drives timely care in general is that we know that the work that we do today, has legacy level impacted people saying this because when you finish school, it changes your soul, your socio economic position, right, your earning capability is your ability to interact and add value back into society. One out of 10 of all of our students that we take care of her in community colleges, oftentimes as community colleges are in rural areas where that community college is the hub. What happens when we keep a community college student who may be caring for older parents at home, maybe a single parent working other jobs? What if we can give them the support that they need to meet their goals? That actually changes an entire community. So not just the individual, not just the family, not just generational, but change of their entire community? That’s the positive. Right. That’s what gets excited. That’s, that’s what helps us continue to evolve and innovate.
Nick van Terheyden
So you you’ve clearly focused on it. You know what I would call the younger generation, although you yourself talked about accessing, and you know, you, you’re not, I’m guessing you’re not a digital native, but you’ve inserted yourself into that that world like I have, I mean, I absorb it, but I see peers and, you know, different age groups is part of the acceptance. And that resilience that you describe, which, you know, is is gratifying to hear. And I think you’re right, it’s, you know, emphasis on the positive, is part of that is built in, because they’re digital natives. And is that something that we can transfer into other groups, because, as you pointed out earlier on, it’s not just confined here, it’s, you know, across large communities, because what you really want is to take this and expand it to a as broader population as possible, because I think everybody feels this in some fashion or another, no matter where they are, and what age they are.
Bob Booth
I completely agree, I think we’re just talking about the early adopters, right? That’s really what’s going on here, I been very fortunate in my position to get to interact with other people are doing some of the same things in our space. And, you know, we have people who are leveraging virtual care solutions for end of life and geriatric care. So we’re doing it, people are doing it, there may be some obvious things that you need to do to make sure that your technological solution is designed for who’s using it, we’ve been incredibly intentional about this, you know, it is very much that the content we deliver the training we deliver, everything is is is in college students, college students, college students, but that doesn’t mean that you can’t have different personas in mind as you design. So I like to think of them as early adopters, I also like to think that they’re, they’re pushing us courts are tipping point, to help leverage that out across other populations and other avenues.
Nick van Terheyden
So I think, you know, great, great way of sort of conceptualizing this, this is, you know, it’s refine it for different groups. And, you know, the opportunity. I’ll be frank, I mean, in a, an ideal world, we wouldn’t need this service, we would all be happy. And, you know, I don’t know if that’s even possible. I’m not sure is, you know, is happiness, a constant state? I don’t think it is, you know, and you appreciate the world if you don’t have happiness. But if you were to think about the future, and sort of, I don’t want to say get doing yourself out of a job, what what do you see as the sort of future trajectory of this going forward? And, you know, I obviously, access is important, but, you know, is the some scope to try and drive back to origins and, you know, deal with, you know, the root cause, potentially.
Bob Booth
Certainly, I think there’s, there’s two paths there. One is looking back, and one is, he’s looking forward in that. So we should never stop trying to identify what puts people at risk, what are we tolerating in society that is hurting us, that is creating this unsustainable pattern. So let’s let’s take a left eye towards the past, right eye towards the future, where do we need to go? It’s really building off that idea of not being able to staff our way out of this, it’s not being able to professional organization, our way out of this as well, too. We have to change the lexicon around how we talk about this. And we have to look at not just leveraging students and leveraging peer communities. But if we’re going to get better here, we have to help everyone become a supporter, we really got to have that mindset, that this is not just a problem for teenage girls or seniors in college, this is all of our problem to solve. And therefore we need to empower people to help each other out. That’s the society we all want to live in. Right I think we we would all do a better job if we can figure out how to make ourselves obsolete. For the for us and this space right here. I think that means leveraging every single resource she possibly have and and and creating somebody else who’s gonna go out there and do the same as well so that we have an exponential impact.
Nick van Terheyden
So I think I great way to sort of close out i’ll just supplement that with something that I’ve you know, long held a bee in my bonnet. I’ll be frank, it’s, you know, this term mental. I struggle with I’ve tried to sort of pivot to brain health, you know, a disease issue, not have much success. I wish we would. We’ve had access with other terminology and you know, push away. And the acceptance that this is no different to a cold, viral infection, you know, cancer, any of those things. It is just another condition and we really have to pivot. Unfortunately as we do each and every other week we’ve run out of time. Just remains for me to thank you for joining me on the show today. Bob, thanks for joining me.
Bob Booth
Thank you. For the time this has been a great conversation
