Full episode transcript.

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Kris (00:01.635)

Welcome everyone to the No Normal Show brought to you by BPD. This is where we leave all things status quo, traditional, old school, and boring in the dust and celebrate the new, the powerful, the innovative, the future, all related to how brands can lead the way in health. I'm Chris Wickline, SVP of Strategy at BPD, and I'll be your host for today. And in this episode, I'm so stoked. We have a few new guests with us. I'm joined.

by Sarah Mars Bowie, a VP of Communications. Hi, Sarah.

Sarah Mars Bowie (00:35.158)

Hello.

Kris (00:38.236)

So excited to have you with us. This is your first time with us, right?

Sarah Mars Bowie (00:42.026)

It is. I'm very excited to be here.

Kris (00:43.447)

Yeah, very cool. We love to indoctrinate the newbies. And I also have Kate Cavernot, who also is a VP of communication and leader in our payer provider practice. And Kate, you have been on the show before. I'm pretty sure it's been a while though, right?

Kate Caverno (00:57.928)

I have. It has been a while, but it's nice to be back. Thanks, Chris.

Kris (01:03.631)

Awesome. So I'm really excited about the conversation because, know, I like this thing called the business of healthcare, which makes me a little weird in some ways. But I love what we're gonna talk about today because it's central to what we do as marketing communicators. We are here today to talk about some hot off the press information about the value attack and...

You know, some of our listeners, I'm sure many of our listeners are familiar with the value attack, but I'm sure some folks aren't. So let me give kind of just a little bit of background on what it is. So it started with a trend that we spotted in 2018. And it was, you know, the media, political circles, health plans, pharma. There was all this uptick.

in the blame for rising costs of healthcare being placed at the feet of hospitals and health systems. And you know, was really escalating and then all of a sudden COVID hit and we became heroes, know, clap and know, and bang our pans and everybody loved healthcare. But then in 2022, coming out of COVID, this whole idea of blame came back with fierce intensity.

And we couldn't leave that alone. We decided to conduct some research and in 2022, we released a white paper called the value attack and it found that indeed, payers and pharma had really effectively laid the blame for high healthcare costs on hospitals and health systems. And this narrative continued to gain steam with the media, politicians, employers and consumers. And what that paper really asserted is that, you know, our value was being called into question in really kind of unprecedented ways.

The fallout from that was really about the trust that people have in hospitals and health systems. And obviously that's kind of central to everything that we do. So we've done some new research to kind of check in on things and where they stand. We've got some amazing information we're gonna share. We can't share everything, so we're gonna hit some of the highlights. But it's really kind of around this whole idea that this false narrative is out there and it's really kind of gone unchecked.

Kris (03:23.659)

It's rooted in this idea that hospitals should not profit off of people's illnesses. It's a moral and they should be providing services at cost somehow like a charity organization. So first of all, did I set that up fairly ladies because you deal with this all the time. And then secondly, tell me a little bit about where you think the blame on health systems really comes from. What's driving that?

Kate Caverno (03:48.878)

Yeah, I think you teed it up perfectly, unfortunately. But that's a pretty good summation of where we are these days. I think we can point to COVID or the pandemic as a pretty clear turning point in the narrative, maybe, but I think it's been in the works for a long time. think, well, I know, insurance companies, pharma companies,

Kris (03:53.55)

Yeah

Kate Caverno (04:18.762)

even some policymakers have really sort of homed in on the cost of care. And unlike providers who don't have exorbitant resources to put toward that narrative and narrative development and planting seeds with different stakeholders, they do, particularly insurance companies, and it benefits them to do so, right? So we've seen

that narrative sort of build over time. you know, even I think the other thing is that communications efforts have become a little more sophisticated maybe than they used to be. And we've seen what used to be, what's wrong? Okay.

Kate Caverno (05:23.65)

Yeah, okay.

Kris (05:35.311)

Okay, so you want me to set her up again, just like.

Kate Caverno (05:50.818)

Yeah, Chris, you set it up perfectly, unfortunately. That's a pretty good summation of where we are these days. And I'm not sure that it, you you mentioned COVID and I think that is a pretty clear turning point, but I think it's been in the works a lot longer than that. Almost like this covert mission that payers and pharma companies have been on to sort of shift the...

Kris (05:54.756)

You

Kris (06:05.689)

Yeah.

Kate Caverno (06:18.52)

focus and attention away from themselves. And, you know, some of that is, it's pretty obvious that it's coming from them. But we've even seen sort of entire misdirection campaigns out there that are disguised as like a third party advocacy group. But really, if you read the fine print, it says, you know, sponsored by insert pay your name, right. And it's the those kinds of resources.

Kris (06:21.167)

Yeah.

Kris (06:37.401)

Yeah.

Kris (06:43.449)

Yeah.

Kate Caverno (06:47.764)

And the strategy behind that are things that most providers don't have time for or money for, right? we, most one are not for profit and they are mission focused and they are really just trying to serve the communities that they're in and they're not trying to line their pockets for their shareholders.

Kris (06:58.509)

Yeah.

Kate Caverno (07:15.436)

like maybe some of those for-profit health insurance companies.

Kris (07:15.47)

Yeah.

So it's mainly pharma and payers who have really been kind of really continuing to kind of assert the narrative. Tell me a little bit about what kind of attempts have been made to kind of dismantle it and what's worked and what hasn't.

Kate Caverno (07:34.326)

Yeah, unfortunately, I'm not sure that there's been a concerted effort to dismantle it. I think it's something that's really foreign to most providers. It's uncomfortable. I mentioned they're being mission driven, right? It's really uncomfortable to start talking about the headwinds that we face, the financial realities of providing care, because we, you know, we want to be here for our communities.

Kris (07:46.127)

Okay.

Kate Caverno (08:03.916)

And so it's, you know, every once in a while you'll see somebody who, a system will come out with something that's, you know, pretty strong, but it's a one-off effort versus a consistent out there beating the drum around the value that they bring and the challenges in meeting that value expectation.

Kris (08:27.289)

You know, part of me wonders if it just feels like such a message that's so above the average health system. In other words, it's so pervasive and it's bigger than the local level that somehow, know, systems feel like it's difficult to even tackle or address or not even maybe in their backyard as much.

Kate Caverno (08:47.5)

Yeah, I think that's part of it. Go ahead, Sarah.

Sarah Mars Bowie (08:48.118)

I think part of that issue, well, I think part of the issue there is that when you go into a hospital and you have a broken arm, there's no price on the wall that says broken arms are $300. There's nothing that says, you know, this specific thing is going to be this because it depends on what kind of insurance you have. Are you cash paying? Are you an indigent person? Are you on Medicare? Are you on Medicaid?

It is a very complicated narrative about what you have to pay for whatever piece of care that you're given. And I think the insurers and pharma are taking advantage of that because they have a much more set price. But if they can say, well, our prices are so high because it costs so much to care and hospitals and health systems can't point to what the actual cost is. It gives them this opportunity to say, well, you know, it's not on us. It's, on the hospitals. It's on the prop. It's on the providers.

Kris (09:43.737)

So what I kind of hear you saying, Sarah, is it just feels like it's a big issue to address. then is it that, you know, hospitals and health systems, it is difficult. It's difficult to, you know, I think Kate, you said a little bit about, well, we're uncomfortable talking about it. And Sarah, you're saying, well, it's difficult to have the conversation because there's so many layers to it. So in other words, is it just maybe that we sit back and, you know, as an industry, we, we, we, we, it's difficult to address, so we just don't.

Sarah Mars Bowie (09:57.688)

Yeah.

Kate Caverno (10:12.474)

Yeah, I think that's part of it. You know, we see a lot of systems that point to their annual report, right, and say, look, we do talk about it. It's all here. And this report that's hidden away three pages deep into our website that, you know, it's a small little link in the footer, right? And it's not something that we're proactively talking about, but it's there if you want to read it. But I'm here to tell you that nobody is...

Kris (10:28.079)

Yeah.

Kate Caverno (10:41.027)

you know, aside from people who want to fight that message are looking for that report, right?

Sarah Mars Bowie (10:41.27)

Nobody.

Kris (10:46.691)

Yeah, yeah, and you know, it's so interesting because as health system marketing and communicators, know that, I mean, health systems are fertile ground for very rich human stories, right? It's human stories of the impact that we create one person at a time at a community level, et cetera. And, you know, we struggle to communicate that sometimes. I think that is a little bit of the irony. In some ways, it's an embarrassment of riches. We have so many stories to tell.

but we struggle to really kind of tell them. And this is a good example of that. All of the good works that we do really kind of, you we put them out there, but probably not in a way that gets enough attention or emphasis that it needs. So tell me a little bit about, we've done some new research and we have, tell me a little bit about kind of, first of all, why did we do some new research? What was going on? What did we see? Cause we saw something again that was causing us to say,

Let's dig in here. Tell me why and then give me a little bit about some of the things that we found in our work.

Sarah Mars Bowie (11:50.786)

Well, we were continuing to see the same problems, right? The same narratives are out there. And I think the thing that really spurred us is that we aren't seeing anybody fighting back. you know, on one side, in one corner, we have payers in pharma that are out there. Loudly proclaiming we're seeing many advertising campaigns. We're seeing lots of things focused on federal and state officials.

to convince them that no, it's not insurance that's the problem. It's not pharma that's the problem. It's these hospitals and their crazy prices. So seeing this out there, you know, and not seeing any fight come back, we wanted to see, well, how does the public feel about this? So, you know, when we were doing...

Kris (12:27.193)

Yeah.

Kris (12:38.031)

Yeah. So what's going on? mean, is there a lot in the legislative domain that you guys have been tracking? I know that you track things all over and I can't even keep up with it, but that you're saying, okay, there's more going on here than meets the eye.

Kate Caverno (12:39.608)

Yeah.

Sarah Mars Bowie (12:51.608)

Yes, we've definitely seen in recent years that, you know, states in particular are starting to pass legislation around lowering healthcare costs. We're seeing 31 states that have a certificate of need requirements. And those there's 24 of those that have been revised since 2021. We're seeing legislation that references pricing requirements for hospitals and these things are very real and can

impact your ability to operate and do business down the line. But one thing

Kris (13:23.895)

And all of these things are being driven out of that narrative, right? That, you know, the idea that, you know, we've got a, you know, all of a sudden our, you know, hospitals and health systems are out of control and that there need to be legislative remedies to get them back in control, essentially, right?

Sarah Mars Bowie (13:27.832)

Correct.

Sarah Mars Bowie (13:40.81)

Exactly. And, you know, why are these policymakers, you know, not only proposing and advancing this legislation, it's because they're hearing it from their constituents and their constituents are feeling a certain way about it.

Kris (13:48.302)

Yeah.

Okay.

All right, cool. Tell me a little bit about that. What are you seeing? What are you seeing in terms of what's driving them?

Sarah Mars Bowie (13:57.752)

Yeah.

Well, overall, there's a lot of national anxiety. There's a lot of concerns that reflect the growing stress over the nation's future. We're definitely seeing people mention the cost of health care and personal health concerns as big stressors. So in this research that we ran in August of 2024, 40 % of Americans felt that personal health and health care costs were major stressors for them.

Kris (14:08.079)

Mm-hmm.

Kris (14:27.427)

Yeah, I mean, you know, we see that all the time. But again, in periods of our world or time when folks are not feeling secure, you know, again, look at we see the message about what the economy, know, the impact of the economy had on, you know, on people voting and how they how they voted and, and that sort of thing. So, you know, that is, again, a great

continuing threat of a bigger issue going on in the pockets of consumers that are really kind of causing them to react, it sounds like.

Sarah Mars Bowie (14:55.48)

Mm-hmm.

Kate Caverno (14:57.922)

Yeah, 100%. I mean, if you think about I was at the grocery store the other day and I think eggs were $8 like that. Yeah, like that's expensive for a carton of eggs. Are you kidding me? At least where I live. So the idea that my day to day life has become more expensive. think this what's the stat these days that average American can't afford a thousand dollar emergency. Your trip to the ER is going to be a lot more.

Kris (15:05.75)

Seriously?

Kris (15:10.511)

Yeah.

Kris (15:18.766)

Yeah.

Kris (15:24.431)

I yeah.

Kate Caverno (15:28.226)

than a thousand dollars, right? So not to mention your chronic ongoing care. So if your choice is fill the tank, get to work, feed the kids, or go take care of that cough that's been lingering, right? And you're in a, you gotta make the choice. Your healthcare falls by the wayside.

Kris (15:51.811)

Yeah, yeah. Okay, so consumer stress is really fueling a lot of this. What else? What else do we see happening?

Sarah Mars Bowie (16:00.952)

Well, would say, you know, interestingly, despite the stress, hospital and family physicians have seen an increase in trust in the same survey. And that was almost 9 % since our previous survey in 2022. And so I think there's a big disconnect between like big scary healthcare, which encompasses everything from insurance to hospitals to doctors to pharmas to your local

Kate Caverno (16:01.07)

Yeah, so another finding, go ahead, sir.

Sarah Mars Bowie (16:26.072)

You know, your local pharmacy to like, everything is in that big bucket of healthcare. But when people, you are, when you ask them about this idea that's healthcare and not tangible, they don't feel great about it. But when you ask people if they like and trust the doctor or the nurse that treated them, they're going to be more positive because if they don't like the doctor or nurse that treats them, they're going to go somewhere else. They're going to find a second opinion. They're going to do what they can to go to a different hospital if they didn't like.

their experience there and they're going to vote with their feet and their dollars.

Kris (16:59.887)

Okay, so healthcare providers themselves, hospitals and physicians still maintain a strong trusted position. Is that what you're saying? Gaining, okay. All right, well that, so that's a bright spot.

Sarah Mars Bowie (17:08.3)

Gaining even. Gaining.

Yep, exactly. And, you know, I think too, that's another thing coming out of the pandemic as well. One of the positives is, you know, people look to doctors and frontline providers in a time of need. And I think in some cases that bolstered their trust. But again, that big amorphous idea that intangible of healthcare is still scary.

Kris (17:15.554)

Awesome. Okay.

Kris (17:39.107)

Yeah, yeah, so I trust my folks, but I'm still not happy about how much it costs and it scares me and that scares me. Okay, okay, cool. What else, what else have we seen?

Sarah Mars Bowie (17:44.373)

Exactly.

Kate Caverno (17:49.454)

Yeah, so another finding is that pharmaceutical and health insurance companies are still more likely to be blamed for the rising cost of care, but the accountability that folks have for insurance companies have has declined slightly. So in 2022, when we did this research, 36 % of Americans were believing that health insurance companies were of the top two sort of health care entities.

responsible for those rising costs. When we did the research again over the summer, that number dropped to 29%.

Kris (18:25.465)

So fewer people are blaming insurers for rising costs. Yeah.

Kate Caverno (18:29.932)

Right, that's a big drop. Also concerning is that hospitals saw a 2 % increase with respect to blame. So it's not as big a swing, but it's certainly not the trajectory that we want.

Kris (18:39.992)

Okay.

Kris (18:44.847)

So what's driving this? mean, what are your thoughts on what's driving this? So payers are getting off a little easier and hospitals are taking a little bit more on what's happening here.

Kate Caverno (18:57.447)

Yeah, I go back to that narrative idea.

Sarah Mars Bowie (18:57.472)

I'd say it's a direct result. Yeah. Of what's out there. What's, you know, what, what's being pushed by the insurers and pharma. and you know, it's that kind of messaging is effective. And again, because when you go in with your broken arm, you don't know if you're going to be paying $200 or $2,000. It makes it easy for them to exploit that. and there's definitely this, you know, growing perception.

among consumers that hospitals prioritize profits over patient health. And in fact, in our survey, 36 % of Americans believe that the number one priority hospitals care about most is profits. And we know this is untrue. And we know that the mission of hospitals across this country is first to their patients and second to their communities that they serve. But it's not trickling down and the other narrative is taking over. So it's a really, really dangerous narrative.

for the longevity of hospitals around this country.

Kris (19:57.261)

Yeah, I mean, that is scary because mean, trust is the basis of the relationship that we have with our patients, right? So, you know.

Kate Caverno (20:04.654)

100%, but that is the connection, that's the value attack, right? Like we can't continue to provide the services that value that everyone is accustomed to, feels like we deserve, and I don't disagree with, but the reality is that that has to be tied to sustainable rates. It has to be tied to the financial realities that systems are facing.

Kris (20:08.761)

Yeah.

Sarah Mars Bowie (20:10.306)

Mm-hmm.

Kris (20:37.167)

So there's, I mean, there's a lot of other findings that you had, right? Is there anything else that really stood out or were those, know, I mean, to me, the pinnacle of this is the idea that 36 % of Americans think that...

the number one priority that hospitals care about most is profits. I mean, that's staggering. 36%, y'all, that's bad news.

Kate Caverno (21:00.268)

Yeah.

It's not great, that's for sure. I mean, it doesn't, if you think about the stories that you see in the news, the conversations that employers have with payers when it comes time to picking their plans, right? That's the conversation that they're having. They're saying, hey, you know what? Health System X.

Sarah Mars Bowie (21:03.586)

Mm-hmm.

Kate Caverno (21:28.626)

is charging us more this year and so we have to increase your premium. And they, the payers have strong relationships with employers. Most systems that we work with, I'll say don't, right? It's just not something that they have time to prioritize. It takes a lot of resources. It takes a lot of follow-up. But it's really valuable and really worthwhile to do because when it comes time,

for the payer to have that conversation with the employer, the employer is going to be armed with, wait a minute. I know that my provider does X, Y, and Z for me that is really tangible, helps keep my employees at work longer, all those value adds that make sticking with us worthwhile.

Kris (22:11.236)

Yeah.

Kris (22:21.507)

Yeah, I think it's really interesting to me that, you know, I mean, most hospitals have are very active in their communities. They're very active in circles where, you know, employers are also active. The fact that there's not a lot of relationships, I think, has always been surprising to me. And, you know, it, you know, as you're explaining it, it's pretty clear to see that when the narrative comes down.

it's really kind of, we're not giving the folks in our market anything to fight back with. We're not giving them any reason to think differently. That we're not the reason for their rising premiums and the cut that they're taking to, you know, to their profits or their inability to kind of grow their employee base, whatever the case may be, but we're basically not doing anything to combat that.

Kate Caverno (23:10.626)

And let's not be naive about it. We can't just gloss over the fact that it costs more to provide care. So costs are rising, right? But there are so many variables with respect to supply chain and labor. And we try to talk about that in our work with payer negotiations. But honestly, the amount of educating folks around this topic

Sarah Mars Bowie (23:19.628)

Mm-hmm.

Kate Caverno (23:40.226)

is not light. Let's let's say it that way. So starting sooner, getting involved in having the conversation, starting to have those conversations sooner than later allows the, well I'll say it this way, sort of allows you to dip your toe in the water, right? You don't have to have all of the answers all at once, but making a concerted consistent effort to

Kris (23:44.59)

Yeah.

Kate Caverno (24:07.842)

to marry the conversation around finances and value together in a way that's authentic for your organization, in a way that is approachable for your audiences, because let's be honest, this stuff can be pretty dense, is a little bit art with the science to it, right? It has to be, like I said, approachable. And so getting...

Kris (24:24.889)

Yeah.

Kate Caverno (24:37.806)

comfortable with having those conversations on an ongoing basis so that it's not a, crap, we have a negotiation coming up, we better start talking to people. It's a, we've been talking about it. Let me go tell them now that it's time for action, right? Because we're at that inflection point. Yeah.

Kris (24:54.613)

So it's...

It's really about a plan. It's about having a plan. It's about dedicating the time and resources to a plan, working the plan. What's interesting though is this also hits kind of, it hits marketing communicators in a hospital, but it also hits others, right? You know, who do you have that deals with brokers and, you know, employee or employers? And what does that outreach look like? And how do we work together to kind of put that message out there? It needs to be a concertive effort. But what I'm hearing you say is it all starts with a plan. You got to start somewhere.

Kate Caverno (25:26.797)

Yeah.

Kris (25:26.916)

and you have to start with kind of pieces of what is your story and then, you know, how do we make sure that we were deploying it?

Kate Caverno (25:30.126)

100 %

100%. And I love the way you started this conversation by calling it the business of healthcare. That's what this is, right? I think there's this, there's a sense that healthcare is a public good, right? That the hospital has to be there. They have to be, the ER at least has to be open 24 seven. What if I need them? But there's an unwillingness to pay for that, right? And so,

Kris (25:38.991)

Yeah.

Kate Caverno (26:03.416)

we have to sort of shift that mentality that yes, we're not for profit, yes, we're here for our mission and to serve our patients, but it is the business of healthcare. Insurance companies are there to make money. And that's not our primary goal, but it is a factor and it has to, that part of the equation has to be, it's simple math, right? If our expenditures,

don't outweigh our income, right? We're in trouble.

Kris (26:37.903)

So where else do we go? I mean, what else do we do? You said get a plan in place, get your story together. What else? What else can we do?

Sarah Mars Bowie (26:47.554)

Well, I think, you know, if I were to boil it down to three things, really, you need to define, define what you stand for. And, you know, speak loudly with what that is, you know, tell your stories in a clear and compelling manner that cut through and use the bit of like the natural virtue you have to your advantage, which is that doctors and hospitals are still trusted and people rely on them, you know, every single day. So let's take that and run with it.

but let's also explain things to people in a way that makes sense. you know, as soon as somebody says Medicare reimbursements and payouts and blah, like my eyes just, they glaze over. Let's figure out how we can, you know, be transparent with people that, Hey, we aren't getting paid enough from Medicare or Medicaid. Hey, you know, we're negotiating with our payers right now and they don't want to pay us as much as it costs to deliver this care.

Kris (27:29.561)

Yeah.

Sarah Mars Bowie (27:45.462)

So, you know, we're already on the back foot here. So we need to figure out how to tell those compelling stories and be honest, transparent about that. The second thing is, is we have to be more strategic and aggressive. Again, going back to what Kate said, you have to have a plan and part of that plan needs to be, you know, show clearly that impact in your communities, but also push back when there is a negative story or some untrue storyline that's out there and correct that record. We need to ensure that there's

Allies who will also go to bat for us, know, is it a pay, you know, is it one of those local employers? Is it patient advocacy groups? right. Is it academics who study this? You know, have you engaged your state and local politicians recently? You know, and not just for a I want, but for a proactive, here's what I'm doing. Here's how we're helping. and really be again, transparent about the cost drivers and hospitals and do so without shame. It is a reality for many industries that costs are going up.

It is just a fact of doing business. So I don't understand why there's so much shame around the cost of what it takes to deliver the care. And then I'd say lastly, promote that value there is in hospitals. know, there's a lot of innovation that we bring to communities. There's jobs that we create in many of the communities in which we're in. We are the number one employer. So tell that economic development story. Tell those jobs that you're supporting. Tell those, you know, additional ancillary businesses that are supported by your hospital being there.

Kris (28:52.505)

Yeah.

Sarah Mars Bowie (29:15.128)

We hit on a little bit at the beginning, these annual reports that we know everybody does, these impact and sustainability reports, and we know that they're buried in a PDF on some tertiary webpage. Let's make sure they don't just go to that webpage and die. Let's take those stories, make sure they're being told. Let's really show the value that we bring to the communities that we serve and the patients that we serve.

Kris (29:26.959)

Mm-hmm.

Kris (29:38.733)

Yeah. Yeah.

Kate Caverno (29:40.398)

Yeah, I think all of that's spot on, Sarah. And the one piece that I think has to sort of transcend or overlap all of that is, we call it intestinal fortitude. Resolve. It's really easy to be around a board table, conference room, and have internal alignment until you get a piece of criticism.

Sarah Mars Bowie (29:54.22)

Yeah

Kris (29:54.703)

Yeah.

Kate Caverno (30:08.908)

Right? Whether that's a patient saying, I saw that article that you put out there and I don't agree with you. or, or pushback from policy makers or, you know, a stiff negotiation where the payer doesn't seem to be, Conceding the valid points that you've made, that resolve knowing that you have the high ground. You're, you're the people providing the care.

Kris (30:34.617)

Yeah.

Kate Caverno (30:38.126)

and not to exploit that position or to use it in any sort of malicious way, but to stand on some really strong facts, pull those facts together, the stats together around your value, and don't shy away from it. It's okay. And I think I go back to, it feels foreign.

Kris (30:59.524)

Yeah.

Kate Caverno (31:04.322)

We don't like to beat our chests about how great we are. We're here for our patients. But there's also, I think, this idea that we don't want to make anyone mad or we don't want the payers to be angry with us. We're already the target.

Kris (31:24.655)

What do we have to lose? Yeah, essentially.

Kate Caverno (31:25.454)

So what are we afraid of? Yeah, right. It's going to continue. I use this sort of weird metaphor where if you've ever sat at the beach and let the water wash over your feet and the sand sort of starts to sink your feet in a little bit. And at first, you know, if you let it sink in an inch or two, you can pretty easily pull your feet back up and no big deal. But if you don't do anything sooner than later, you're buried up to your knees.

Sarah Mars Bowie (31:29.176)

Yeah.

Kris (31:42.659)

Yeah.

Kris (31:55.172)

Yeah.

Kate Caverno (31:55.294)

and pulling your feet out is really challenging. That's where we are. We haven't said anything for so long that we're buried up to our knees. And now pulling out of that is challenging. So it's gonna take one step at a time. It's gonna feel uncomfortable. But the more we wiggle, right, and move our feet, the looser the sand around our legs becomes, and we can pull out. And it's okay.

Kris (31:58.275)

Yeah.

Kris (32:18.169)

Yeah.

Kris (32:24.419)

I think that's a great, you know, that's a really great metaphor, you know, that it's about that getting started. And it's, you know, I mean, it's really kind of what we've found in now these two rounds of research around the value attack is just this idea that it's not getting better. And if we don't do something about it, it's going to really continue to challenge our ability to effectively operate. So I think with that, think in that beautiful metaphor, let's wrap it up. I thank you, Kate and Sarah for so much for being here. And of course, for all of you listening.

healthcare marketers, it's essential that you take specific steps to kind of reshape the narrative around your value. And we are here to help you in that. know, Kate and Sarah just teased a couple of findings. There's plenty more. So visit our website at bpdhealthcare.com. Go to frontslashinsights, frontslashguides to download our latest value attack and let us know how we can help.

And as always, if there's something you want us to cover on the NoNormal show, shoot us an email at nonormal at BPD Healthcare. And, you know, we would really appreciate if you also share the show with your friends and colleagues and give us a review and rating on iTunes and Spotify. That would definitely be appreciated. until next time, don't ever be satisfied with the NoNormal. Do not be satisfied with value attack and push that NoNormal y'all and we'll talk to you next week. Thank you.