Who are we? Meet the Office of Well-Being team

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This special installment of Well-Being at Michigan Medicine coincides with celebrating Health Workforce Well-Being Day on March 18, 2025. As such, this episode brings together Chief Well-Being Officer Elizabeth Harry, M.D., and Jeffrey Patterson, M.H.S.A., M.P.H., the senior director for well-being operations and strategy.

The duo discusses the evolution of the Office of Well-Being from its past iteration and how it brings a broader focus on creating environments where individuals and teams thrive, emphasizing well-being and addressing upstream factors that lead to burnout.

Additionally, Dr. Harry and Patterson chat about key tenants of their work: operational well-being, culture of well-being and personal resilience. Recently, the team has grown, and new members have brought greater expertise to the organization.

Learn more about how the Office of Well-Being aids it team members and brings a culture of belonging, resilience and support.

Transcript

Dr. Elizabeth Harry:

Hello, everyone. My name is Dr. Elizabeth Harry, and this is the Well-Being at Michigan Medicine podcast. I'm excited to have Jeffrey Patterson join us today. Jeff is the new Senior Director of Operations and Strategy at the Office of Well-Being here at Michigan Medicine, and we are going to be talking about all things Office of Well-Being today. So Jeff, let's start. Why don't you tell us a little bit about yourself?

Jeffrey Patterson:

Sure, thanks. Hello, everyone. Yeah, so I'm really excited to be in this role as the senior director for Well-Being Strategy and Operations. I have been in this space for a relatively short period of time, just joining the team in November of '24. So, definitely still learning the ropes, getting acclimated. I am coming from operations and strategy roles as well in the Trinity system where I spent the last 12 years, and particularly on the medical group side. My experience most recently had been leading our academic and safety net division as well as our behavioral health division.

So in both those capacities, had the opportunity to work with providers across really our kind of most vulnerable patient populations and really also directly working with our GME programs across Southeast Michigan. So that was a great opportunity to connect with our learners and understand their experiences and how we can advance the work in those spaces as well. So it's a great opportunity now for me to shift into this space more fully and really work on well-being strategies at Michigan Medicine. It's a bit of a homecoming for me. I did my training here, both undergrad and grad school, and so I'm excited to be back.

Dr. Elizabeth Harry:

That's great. Well, we're not going to do our typical sort of interview style because Jeff and I wanted to chat together about the Office of Well-Being at a high level. So we're going to take turns asking each other questions, and I'll let you go first, Jeff. Do you have any questions?

Jeffrey Patterson:

I do, thanks. Yeah. So one thing that I think is particularly interesting is the reimagined Office of Well-Being and kind of how we've taken shape, particularly over the past year. I wonder if you could provide a brief overview of the Office of Well-Being and how it really came to be.

Dr. Elizabeth Harry:

Yeah, thanks. So the Office of Well-Being was originally called the Wellness Office and was established in 2019. The inaugural chief wellness officer was Dr. Kirk Brower, and the whole idea was really supported under Dr. Carol Bradford and the School of Medicine at that time. And amazing work was done over that time, so there were a lot of programs implemented, including the Wellness Advocate Network. There were several grants given out both to faculty and medical students. There was a faculty associate program that helped support faculty, and the student mental health program was supported and built up during that time. They also took that time to add some well-being questions to the annual engagement survey so that we could really understand how we were doing in that space. So, incredible work that was advanced from 2019 up until the time we sort of reimagined the office. And to note that all that was happening during COVID, which I think is just really incredible.

I started in November of 2023, and we really at that time decided to look at all of our portfolio and really understand what is it that we're trying to advance and how can we be most effective in advancing those things, and what is our goal? So as we were thinking through that, we started thinking through our name and really thinking about what is the difference between wellness and well-being. When we started looking it up and looking at some of the research, we really found that wellness is sort of your physical and behavioral health. And that's what we do at Michigan Medicine. We deliver excellent care to help people with their physical and behavioral health. And we also have a lot of great resources available for everyone who works at Michigan Medicine to help them with their physical health beyond the clinical care that we provide. We have the Office of Counseling and Workplace Resilience. We have MHealthy. We have great programs, our spiritual care, chaplaincy, ethics groups, lots of folks that we have available to really help people with their individual wellness.

What we wanted to think about is, how can we set up the conditions so people can come and thrive in the workplace? And that's really more about well-being. This is about how can we create an environment where you as a whole person can come and thrive in the workplace? And what responsibility do we as an organization have to try to address those issues? So we really wanted to focus on going upstream of burnout and looking at what the drivers of burnout are. So as part of that, we looked at the whole portfolio of work that was being done. We also looked at some best practices across the country and decided to really adopt and modify some of the Stanford model, which really focuses on organizational well-being or how we do our job, culture of well-being, how we treat one another, how our teams function, and then some personal resilience of what are the skills that each individual has to cope with those issues as we're trying to change them.

So we decided to change the name of the office to the Office of Well-being. We changed my name to the Chief Well-Being Officer from Chief Wellness Officer. And we really started getting very specific about where we were going to focus our attention and making sure that it aligned with those key priority areas and that it was really focusing upstream of the drivers of burnout in a really evidence-based way. So that was kind of how we got to where we are. And then we were fortunate enough to hire you and have you come join our team to help us really put a lot of this structure around this work and help make sure that we are as effective as possible in helping deliver this work. So with that, I wanted to ask you, as you looked at all sorts of possible places that you could take your career, why did you want to join this office, and why is this work so important to you?

Jeffrey Patterson:

Yeah, for me, I think having a career thus far in healthcare administration, we focused on well-being as one of our priorities, but it was one of several priorities. And the challenge in that being, I had a former mentor who had always stressed to me that if everything is a priority, nothing's a priority. And that really stood out to me as I was looking into this opportunity, that the majority of my career, I could even say in operations myself, I experienced some of that burnout and overload that we see across the health system and as a national trend within health care. Kudos to everybody in operations roles. It can be a grind, but incredibly rewarding as well.

But I think that experiencing that myself and understanding that I am multiple layers removed from the front lines where the care is being directly provided, that for me was a recognition that, well, if I'm experiencing it this way, our front line, our physicians, our nurses, medical assistants, receptionists, all of our ancillary support staff, those individuals probably are experiencing that to a much larger degree. I really felt that in order to fully invest in that, I needed to focus on that in its entirety. So that was really what was appealing about this office and this opportunity for me, is really being able to delve into the well-being space as my key priority, not amongst several other priorities.

Dr. Elizabeth Harry:

So as you think about our office then and you think about the impact of the work that can be done on the broader organization, where do you see the potential? Where do you see that the office can go?

Jeffrey Patterson:

Great question, Liz. I think that really ties directly into the vision that we've put forward as the Office of Well-being, which is, for all who investigate work and learn at Michigan Medicine, to build their expertise and drive our purpose to seamlessly advance health care as a team. So thinking about that vision, we've really set some key aims for the Office of Well-being, and those are the spaces of operational well-being, culture of well-being, and personal resilience.

That operational well-being, I've heard you describe many times as the pebbles in our shoes, the boulders on our backs, really looking at where are the opportunities that we have to streamline operations, to optimize how we spend our time, and ultimately increase our personal fulfillment. And then the culture of well-being is a critical component of that. How are we operating as teams? How are we approaching this as a collective opportunity to improve the well-being across the health system? Personal well-being, again, kind of being those individualized areas where we have focus and opportunity. And I'm wondering, within each of these spaces, if you wanted to touch on some of the key initiatives that we are working on as an office.

Dr. Elizabeth Harry:

Yeah, absolutely. I love that you highlighted the vision, just to go back to that for a second, because I think part of what's so important about it is that it really highlights the who. So it's everybody who's investigating, our researchers, people that spend their workday at Michigan Medicine. This means if you work at Michigan Medicine, we are here to support you. We are here to help go upstream of your day-to-day difficulties and help make it easier so that you can really lean into that professional fulfillment. And then all of our learners which is, of course, our UME, our undergraduate medical education, and our GME, so our graduate medical education.

Part of our priorities are that people have the cognitive bandwidth to build their expertise so that we're not just living day to day, we're not putting out fires constantly, but that we are a learning organization, we're an academic medical center. And that means that we have the cognitive space to continue to learn every day, to continue to have new discoveries every day, contribute to the Michigan answers, and really be able to use that opportunity to learn or to investigate or even just stay as cutting edge as we can to drive that purpose to really advance health care for all of Michigan and the world.

I love the part at the end of as a team, right? Because at Michigan, it's always the team, the team, the team. And what I love about that is that we know, and it is very evidence-based, that we deliver our best care as a high-functioning interdisciplinary team, and that we need all members of the team to know each other well and to be able to work well together as we know out of the team literature to be able to do these things. So there's so much baked into that vision that I think is really important to explain why we've chosen to focus on some of the areas that we've chosen to focus.

So I'm happy to give some examples in each of those areas. In the operational well-being, one of my very favorite interventions that we're thinking about right now and that we will be launching within the next month, so we're recording this mid-January, and we'll be launching ambient documentation by early February with an initial cohort of 300 clinicians, both physicians and APPs equally distributed or proportionally distributed over departments. This is an AI-generated system that is integrated into our healthcare EHR to be able to help us generate documentation. I've heard the term augmented intelligence instead of artificial intelligence, and I think that piece is so important because the point is that it helps whoever the care member is, or the provider, be able to capture the conversation and generate a draft of a note. And then, of course, there's always a human in the loop to check that note and make sure that it's accurate and make sure that it's safe. So, really excited about that one.

In the operational space, we're doing a lot of workflow evaluation. So there's a great paper in the New England Journal of Medicine for many years ago called GROSS, or Getting Rid of Stupid Stuff. And we are looking as part of our base priorities at the opportunity to implement a GROSS or a GROW, Getting Rid of Waste, stay tuned for what we'll end up calling it, but campaign to really help identify what are these pain points that don't need to be there anymore. So those are two of our really big initiatives in the operational well-being space, and there are more.

In the culture space, we're really looking at how do we function as high-functioning interdisciplinary teams. So we're partnering with the Center for Interprofessional Education, which I'm really excited about, and they're coming in and doing a couple demonstration projects, looking at our teams and how they function together and how we can really help optimize our team-based care in those spaces. We're really interested in thinking about how do we optimize communication because part of our culture is that people feel like they know what's going on. So part of that is this podcast, and we're doing that so that people can digest their information in a way that works for them.

And then another way that we're really trying to expand the culture is, we're expanding what was called Wellness Advocate Network. It will be called the Wellness Influencer Network or the WIN. This is going to be expanded to include representatives from all of our departments and all of our service line areas, both faculty and staff, researchers and learners, to make sure that it's representative of everyone that we mentioned above: all who work, investigate, and learn at Michigan Medicine. So stay tuned for calls for an opportunity to join that. And that's going to be like voices of the staff, but we're at the real focus on how we're going to advance well-being. We're going to spend a lot of time developing these folks, helping really cultivate their ability to go back into their local environment, be an influencer and advance this work.

And then the final space is the personal resilience. This is, how do we give people the skills to cope with the difficulties that we all face in health care today? There's great data around coaching. It's one of the actually most impactful things that we have in the literature to reduce burnout. So we have two coaching pilots right now that we're doing. One is a positive intelligence coaching pilot, and that we've done with some of our nurse leaders as well as with our wellness advocate group. And then we're partnering with some of the faculty from the University of Colorado on the Better Together Initiative. Many departments are either sending trainees or faculty through that.

So, very excited. Lots moving. There's lots, of course, we didn't even mention. So the team is going a million miles an hour. So as we think about that and as you've digested all this, being new to the office and learning about all the things that we're doing and learning about some of the other areas that offer great support for our team members, what have you learned about how we might help people understand how our office might be different from some of the other areas that offer a lot of support for our team members such as OCWR or MHealthy? And how are we complementary as well?

Jeffrey Patterson:

Yeah, thanks for that question. Before I get to that, I do just want to go back to something you said earlier, particularly in the operational well-being space. One of the things that we often hear from providers and staff who are on the front lines is, "It's just one more thing. You're asking me to do one more thing." What I love about some of the initiatives that we have in front of us with the ambient AI documentation, with the waste reduction efforts, is we're really talking about one less thing. It's about how can we improve the experience for our clinicians, for our staff, and ultimately for our patients by doing less, not doing more, and being able to tap into some of the technology advancements that we have available to us. These are areas where we can really advance the well-being efforts from the office and across the organization by not adding more to people's plates.

Dr. Elizabeth Harry:

Yeah, I love that so much. There's a study I like to quote that came out a couple years ago that said, "If in primary care, someone did just evidence-based care for an average panel size with a little bit of urgent care, it would take 26 hours a day." Of course we don't have 26 hours a day, and even 24 would be unreasonable because we need to sleep and eat and maybe see our family and nurture relationships. So there really is more to do than there is time to do it in. So thinking about how we streamline I think is really a huge priority.

Jeffrey Patterson:

To your question then about some of the partnering offices or departments within the organization focus on well-being, this is where we have great opportunity to create synergies across the network. So as we think about the Office of Well-being and its position relative to the Office of Counseling and Workforce Resilience and MHealthy, what are the distinctions and how are we collaborating? So as you mentioned earlier, Office of Well-being is really meant to be kind of that upstream approach, that mitigation opportunity for the stressors that are impacting our organization on the system level that's causing the healthcare workforce to feel burnout or stress.

The Office of Counseling and Workforce Resilience is really positioned to then address the treatment from those stressors. So counseling and consultation for individuals and groups experiencing mental and emotional health concerns. And then ultimately, MHealthy is really also from a prevention perspective, promoting holistic well-being, but on the individual level through resources, programs, and policies that again can help us advance this work. So there's really a lot of opportunity for us to build upon the foundation that we've set as an office and working in collaboration with these groups to be able to advance our efforts.

Dr. Elizabeth Harry:

As you share that opportunity for collaboration, I often say we have an embarrassment of riches at Michigan Medicine because we have so much support available to people and many other supports that we're not even listing here. So really important to name that obviously there's Ombuds Offices and there's the Office of Clinical Affairs. HR does incredible work in this space. There's so much opportunity for people to get support. So the one plug I would really put here is, if you are struggling, if you're feeling like you're having a hard time, please reach out to our Office of Counseling and Workplace Resilience. They will help triage and get you to the right place for the support that you need, because we really do have that support.

Part of our goal has been then, well, let's really expand the office to be able to be as effective as we can in this very focused niche that we are carving out so that we can really help reduce the drivers of burnout. Can you talk to me a little bit about the expansion and how we've been thinking about expanding the office and maybe some of our new members?

Jeffrey Patterson:

Absolutely. This is a really exciting time for us as an office as we've gone through some transitions, certainly with yours and my onboarding from a leadership perspective, and really then building the foundation of the team has been a really great opportunity for us. So a couple of the individuals that I want to highlight, Kiana Daniels is a new member of our team just in the last few months. She actually has a combined role with the Office of Health Equity and Inclusion. So again, from a partnership opportunity, there's really great opportunities to create synergy and collaborate more closely. Kiana is coming to us as a project manager. She's really focused on our culture of well-being space in particular.

So in this work, she's really going to help develop and shepherd initiatives such as the expansion of our Well-Being Influencer Network that we touched on, as well as providing some oversight and coordination for these podcasts moving forward. She's coming to us from the National Kidney Foundation where she led several key initiatives such as their Project ECHO program and development of worldwide international podcasts for kidney health professionals. So we're in good hands there. She actually also is a Zumba fitness instructor on the side, so she's living that personal well-being mission for us as well.

In addition to Kiana, we have Carolyn Winslow, who is our new director for research and analytics. Carolyn is an industrial organizational psychologist specializing in employee well-being. She brings a wealth of knowledge to our team, particularly around employee survey design and analysis, program and policy evaluation, and applied organizational research methods. She's really positioning our team and organization to expand upon our foundation of evidence-based practices, and we're very excited to have her as well.

These individuals are joining our team already established, one of whom is Shelagh Saénz, our senior project manager, and really jack of all trades. She has helped us take our strategic concept to operational advancement, and she's really been a stabilizing force for the office through our transition and expansion efforts. Julie Evans is another project manager on the team. She's really taken the reins on advancing some of the evidence-based practices in the personal resilience space. And Debbra Galanti, our executive assistant, who keeps our heads above water really and has such a deep knowledge of the organization. She's really helped many of our newcomers, myself included, to navigate effectively and develop key relationships. So we've really taken shape quite a bit over the last year, really looking forward to the contributions we'll advance collectively through the office.

Liz, I wanted to go back to the research piece of that specifically, and we'd love for you to expand on why this is so critical to the mission and vision of our office, and how you see our efforts really being grounded in data moving forward.

Dr. Elizabeth Harry:

Yeah, absolutely. I think that the research part is so important because there is a really ever-growing field of literature around organizational well-being and a lot that started outside of health care many, many years ago. This is not a new concept. Burnout is an occupational hazard that has been studied for quite some time, bringing it into health care has happened in the past decade or so, and the literature body is growing. But the approach to really focusing on reducing workload, reducing administrative burden, and addressing cultural drivers while equipping people with the skills to approach those things is very robust. There's robust literature looking at coaching programs and their impact on reducing burnout. There's also robust literature around work overload, and whether you define it as task load or perception of work overload and that being correlated with burnout. So we're really trying to follow that literature and continue to build that literature with Carolyn's help to think about how do we make it easier for people to do their job?

Health care is hard, and it's hard enough as it is helping people deal with some of the most challenging times in their lives. That emotional aspect, that cognitive aspect is where we want everyone to be able to focus their attention. And anything that is an unnecessary administrative burden takes us away from that. It takes us away from the ability to connect with our patients, to be as present as we can, to focus on the literature, to focus on the problem at hand, and make sure that we are bringing our full cognitive capacities to really help our patients.

So our goal is to eliminate as much waste and redundancy as possible, and really partnering with organizations such as the National Academy of Medicine that has synthesized and collated a lot of this data. We're actually a change-maker organization for them now and reporting out quarterly on what we're doing and advancing there. As well as the AMA who has synthesized a lot of this data and made really incredible toolkits. They even have a toolkit on GROSS, or Getting Rid of Stupid Stuff, and really walk you through how to do this.

So we're really approaching this in an evidence-based manner and trying to partner with many national groups that are trying to advance this work to make sure that we are giving people the opportunity to practice the highest quality of medicine and really meet that professional fulfillment or that sense of meaning and purpose.

So we've talked about the what, we've talked about the evidence supporting it. We've talked somewhat about the who. We've talked about who we have on our team now and how we've grown. And I'm curious how you envision and things that we've chatted about as an office, our growth and expansion over the next couple years, and how is this going to support the overall vision of Michigan Medicine and really the drive to reduce burnout and enhance professional fulfillment across Michigan Medicine?

Jeffrey Patterson:

Yeah, I think that having the right players doing the work and interacting with folks across the organization is really going to be a continued aim for us as an office. So as we think about expansion for the health system, we really start by expansion of our team. So while we touched on some of the new members of our team, we're also in the process of recruiting for some additional roles as well. One of those being our nurse lead. The nurse lead is really going to allow us the opportunity to best communicate and support with our nurse colleagues across the organization and, again, advance some of the well-being initiatives that we have to move forward.

We're also moving forward with a research and analytics expert that we'll be bringing into the team, and that's really somebody who's going to position us to provide the data and support all of the individual units and departments across the organization with the information they need to advance our well-being strategies. And then we have faculty and staff leads. This is really a key opportunity for us within the next six months in particular to really fill these positions. And this is an opportunity for folks to come in and engage with the team in a way that helps really design, promote, and implement the well-being strategies that we have, again, across the organizational and cultural well-being spaces as well as our personal resilience initiatives.

In thinking about the advanced initiatives that we have in front of us, we also have to acknowledge some of the challenges that we have. In doing so, it's really imperative for us to consider that the work needs to be integrated into the fabric of everything we do. For well-being really to take shape within the organization, we need to think about this from a comprehensive lens. So it's all teams, all processes really engaged and involved and helping move the work forward. So while we're building our complement within the team, the partnerships outside of the team are going to continue to be incredibly relevant and necessary as we continue to look at burnout strategies, strategies to decrease burnout, and improve professional fulfillment.

Dr. Elizabeth Harry:

I love that. I think it's just such an important point because, as we know, this isn't a problem unique to Michigan Medicine. This is a problem across the country. Health systems across the country are trying to address this. And in order to meaningfully make a difference, it really does, to your point, need to be integrated into how we do things. We don't naturally as humans think about where can we remove. It's sort of that holiday thing of, or I think Jovita said it really nicely on the recent town hall of, sometimes you think of one in, one out, and we are joking, maybe it should be one in, two out that you sort of do when you're trying to purge your house. A lot of times we add policies and procedures or we add things, but we don't often have the mindset of, how do we make this easier? How do we reduce administrative burden? How do we make it easier to get the job done?

I just so agree with what you said, because I think we've hit this tipping point where it is hard for people to do the job, and that's not unique to us. There's nothing specific about Michigan Medicine in that. That is where we are in health care. Yet I'm so hopeful that with so many of the advances that we have, both technologically and culturally, that we really are in a position to make some incredible improvements in the way we deliver health care to really reduce that burden. So it's this process of acknowledging where we are and also being really hopeful about the future, which brings me to a question for you. What makes you most excited about the future of our office?

Jeffrey Patterson:

Well, I think, again, being relatively new to the organization, one of the things that's always exciting and challenging in the early going is just the relationship building. But I think, ultimately, when we zoom out and look at this from the 30,000-foot view, it's people and culture that drive change. With my background in operations, I think folks in my type of roles were fairly adept on understanding and applying the X's and O's of healthcare operations. But when it truly comes to understanding and appreciating how the work moves forward and how we really advance as a system, the X's and O's have a little bit less relevance if we don't have a healthy engaged workforce applying those X's and O's. So I'm really excited about the team, the culture that we're building as a foundation for the Office of Well-being, and really, again, establishing those relationships across the organization.

Dr. Elizabeth Harry:

Yeah. I mean, you're absolutely right. I know that when we had Charlie Reuland on, he commented about that too, that the system is really a collection of people. And I love that piece too because it means that if we each do our little part, if we each think about "Am I noticing some waste or administrative burden in my workflow that I can help remove? Is there a way that I can help enhance the culture? Am I bringing my best self to work today? How can I make somebody else's day a little bit brighter?" and we all take that on, that really is how we will make a large impact. So I couldn't agree more.

Jeffrey Patterson:

I would say too that as much as we talk about the opportunities, it can be almost more valuable to talk about how things are going well, where are the spaces where we are really succeeding from a well-being perspective. Again, kind of a plug to reach out to us and share those success stories and that feedback because that becomes really valuable not only as we consider our challenges, but looking at the direction that we're heading as a group. It's important to magnify the areas where we are really applying well-being strategies effectively today, and how do we expand upon those.

Dr. Elizabeth Harry:

Yeah, I love that. It's sort of that bright spot methodology and finding those folks that are doing it well. And we absolutely have those. We've met recently with several early adopters that are really excited to get on this sort of GROSS or GROW train and are even thinking about how they can implement that already in their section. So we're really excited about that.

I think the thing that I'm most excited about or inspired about is the time and history that we're in. I know there's a lot of ways in which this time feels very uncertain, and we're facing technology in some ways that we don't necessarily fully understand and the implications of it. But I also think the possibilities are really exciting in terms of what might be possible to help us really focus in on the most important pieces of delivering care, which is why every single one of us are here. Whether we are delivering care or researching the newest breakthrough or educating our learners of tomorrow, or being a learner and a healthcare provider or a researcher of tomorrow, we're all here to make that point of contact between us and the patient, the best experience it can be, and for both parties involved. I think that there's so many exciting possibilities that are right across the horizon that are going to be able to help support us. So I'm just really excited about that. So Jeff, as we wrap up, is there anything else you'd like to share with our listeners today?

Jeffrey Patterson:

I'm just excited to be partnering with you, Liz. I think that for us to really be at our collective best, we need to lay the groundwork to produce at our collective best. And I think we as an office are really well positioned to help the organization to achieve that. So it's an inspiring time, and I'm really excited to be a part of it.

Dr. Elizabeth Harry:

Well, I'm so excited you've joined the office. I'm very excited about where the office is and where I think we can go, and all of the support that we've really gotten from Michigan Medicine to continue to advance and grow this work. To your point, we need every single member of Michigan Medicine really participating and helping advance this work. So if faculty, staff, or students or learners are interested in getting involved or learning more, what would you say?

Jeffrey Patterson:

Yeah, I think we've mentioned our expansion of our Well-Being Influencer Network. We're going to have some communication coming out shortly about that. So I would ask folks to stay tuned. But we would definitely love to have participation from a broader net of folks across the organization. Generally too, just certainly can reach out to us individually, but we also have our [email protected] email address. So if there are general inquiries or, again, stories, thoughts to share, please do so.

Dr. Elizabeth Harry:

Please share those best practices. We're really excited to hear those success stories as well.

Thank you for listening to another Well-Being at Michigan Medicine episode, and thank you, Jeff, for joining us. And until next time, I'm your host, Elizabeth Harry.