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The following is a transcript of an episode of From the Front Row: Student Voices in Public Health, the University of Iowa College of Public Health’s student podcast. This episode features a conversation between host and CPH student Steve Sonnier and Emma Meador and MHA students Bridgette Boyle, Alex Burhop, Campbell Pendleton, and Matthew Carson. They discuss health care administration and preparing to meet the challenges ahead in the health care industry.

Steve Sonnier:
Hello, all, and welcome back to From the Front Row. My name is Steve Sonnier. And today, we’re chatting with some of our current second year master of health administration students about their paths into the program at the College of Public Health. Today’s guests are Bridgette Boyle, Alex Burhop, Campbell Pendleton, and Matthew Carson. Welcome to the show, everyone, and let’s get started.

Steve Sonnier:
Bridgette, can you introduce yourself and what motivated you to choose to pursue your master of healthcare administration degree?

Brigette Boyle:
Yeah. Thanks for having us on here, Steve. So as you said, my name is Bridgette Boyle. I’m a second year master of health administration student with the University of Iowa’s program. I did my undergraduate degree at the University of Illinois at Urbana-Champaign where I studied community health with a concentration in health planning and administration. So for me, I already knew that I wanted to be in health admin and the real choice was to go straight into the career or to pursue a master’s degree. I talked to a lot of advisors and decided that I wanted to continue my education. I had heard great experiences from my peers who were a few years older than me, but I decided that I wanted to learn more about healthcare. I didn’t exactly feel that I had quite mastered my knowledge yet. I don’t know that I’ll ever have mastered the field, but in the pursuit of trying to figure more out and figure out what my interests were, decided to get a master’s degree.

Steve Sonnier:
Fantastic. And Alex Burhop, can you introduce yourself and what motivated you to choose the MHA degree?

Alex Burhop:
I’d love to. I’m happy to be here. So my name is Alex Burhop, and I’m from a small town in Northwest Iowa, Storm Lake. I came to the university to pursue a degree in microbiology and I actually have very humble beginnings. I’m like Bridgette. I had no idea that this is what I wanted to do. I parked cars at the University of Iowa hospitals and clinics and valet. And through that, I met a few individuals who were already involved in the program and they kind of got me started. In conjunction with just working in different areas throughout the hospital, I really got a feel for kind of what the pulse was and how to interact with all these different facets of the hospital and became very engaged in furthering the education through the MHA program.

Steve Sonnier:
Campbell, if you want to lead off for that question as well?

Campbell Pendleton:
Yeah, absolutely. Thank you, Steve. So like you said, my name is Campbell Pendleton. So I’m originally from the Fresno area in California. So I think I’m the only one representing the West coast and the program. My degrees were in public health policy and political science. So it wasn’t really something that I picked up right off the bat, kind of like Alex. I did a two-year fellowship with the CDC. I worked in childhood lead poisoning in Phoenix, Arizona, and it was kind of through those experiences that made me realize that I wanted to be kind of closer to where the providers and the physicians taking care of patients. That kind of led me into an MHA degree.

Steve Sonnier:
And finally, Matthew Carson, if you want to introduce yourself and what motivated you to pursue your MHA degree?

Matthew Carson:
Sounds good, Steve. Thank you for having us. So my name again, is Matthew Carson. I’m from Longmont, Colorado. I went on to Concordia College in Moorhead , Minnesota to study healthcare leadership and long-term care administration. I chose to apply at the University of Iowa due to the history of the program and how it has consistently been a premier program. The emphasis on rural healthcare is very interesting to me and compliments my undergraduate work, and there’s strong alumni support with great comments from past and current students and just a very positive reputation.

Steve Sonnier:
Fantastic. That’s all excellent news for you all. How did you each decide to choose the University of Iowa MHA program? You’ve all mentioned that you’ve had different backgrounds coming into it, different experiences, but why did the University of Iowa make sense for you?

Brigette Boyle:
So when I was applying for graduate schools, I was looking primarily at top 10 programs that were still within the Midwest. I’m originally from just outside of Chicago and wanted to stay within driving distance of my family. When I was applying, kind of hit the big ones in the area. Then what was really when I got to visit the campuses, that my decision was made incredibly easy. The University of Iowa’s MHA program before COVID times would allow, the night before the interviews, for candidates to meet with current students, go to dinner and get to speak with them about the program and life in Iowa city. That’s what really sold it for me. Just the feeling that I got being around each one of them and the congenial nature felt like a great culture, not only to learn, but to live in for the next two years. From that moment on, I knew I was coming to Iowa.

Steve Sonnier:
Well, those are some excellent highlights. Alex, if you want to continue on with that path, what’re similar things that resonated for you when you were choosing University of Iowa for your MHA degree?

Alex Burhop:
For me, I think it was a mix of convenience and truly who I knew and what kind of resources they offered me. My family has been an Iowa family their entire lives. Both of my brothers went to the university here and both of them went to grad school here as well. So I feel like there almost wasn’t a choice in that regard. It just happened to be convenient that it was a top 10 program to begin with. Additionally, a few of the resources I had met through the hospital had stuff set up for me here to begin with, so that kind of played in too what I had already been engaging with at the MHA program. So it just, once again, was a huge convenience to me that it all worked out so nicely.

Steve Sonnier:
Fantastic. Then Campbell, coming from the West coast out to Iowa, what was so striking about the MHA program here that would make you want to consider moving out to the Midwest side of things? I know you had mentioned you’d lived in different parts of the country, so why the Iowa MHA program?

Campbell Pendleton:
That’s a good question that I feel like I don’t get asked a whole lot. So I guess that says something about living in Iowa. But for me personally, I kind of cast a wide net. There aren’t a lot of top MHA programs in California or on the West coast in particular. So I was keeping an open mind. I really wasn’t sold until I got more of a personal appeal from our current director at the time. As alumni kept reaching out to me and telling me and trying to almost plead with me about why I should come to this program, they really sold me on everything. Once I got here, I realized that they were all right. So it’s been a fantastic decision so far.

Steve Sonnier:
That sounds incredibly fulfilling. Then Matthew, you had mentioned that you’ve had a prior background in this area too, and I imagine you’re well versed in hospital administration and healthcare administration. How did you choose the University of Iowa in particular?

Matthew Carson:
So for me, one thing to note was both of my parents are also MHA alumni of the University of Iowa. So that was how it kind of originally came onto my radar, but it wasn’t until that I visited the University of Iowa for an open house where I was welcomed with warmth and friendliness that I saw that there was a real connection through collaboration and working together rather than having students compete with one another for this master’s degree.

Steve Sonnier:
That’s a really good insight into the culture as a whole. That sounds to be the resounding thing about the MHA program is the kind of warmth and connectivity that you all were able to feel coming into the program. Kind of pivoting to now times, we know that many of the MHA students, like other students in the nation, faced an extreme challenge this summer of COVID-19 altering their internship plans. How did your guys’s internships respond to the challenge of COVID-19? And then how did you navigate this novel situation as a student in healthcare administration and health administration?

Brigette Boyle:
So for my internship, I was originally supposed to be with the Mayo Clinic at their Rochester campus. Early April, we got a call from the internship coordinator letting us know that due to safety concerns, they were no longer bringing interns on campus. It was quite an interesting time because if you remember all the way back then, we didn’t really know what the summer was going to look like. We didn’t know if anyone was going to be doing internships. Thankfully, I had stayed in really good contact. I had been an intern with Northwestern Medicine the previous two summers, and stayed in pretty close contact with my preceptors in the department that I worked in and just in conversations with them, had mentioned that my internship had fallen through and so, so fortunate that they were able to then create a position for me to come back to the department for a third summer and intern with them.

Brigette Boyle:
It was an incredible experience. It was in performance improvement. So they were working with a lot of the reactivation teams to try and get the hospital back to pre COVID levels when I had started over the summer. It was a more truncated experience than typical, so I was only there for six weeks, but what I got to see in the six weeks rivaled every internship I’ve had with them. So very thankful for that department, quite an interesting experience. I know that all of us have faced quite a few challenges in these unprecedented times as they are called, but overall, it was fantastic to be able to see how an academic medical system is handling the COVID-19 response and then planning for continued response.

Steve Sonnier:
Excellent insight. And then Alex, if you want to contribute about your experiences?

Alex Burhop:
I would love to. So I was fortunate enough to work at a critical access hospital in rural Iowa, Washington County Hospital and Clinics. It was a very interesting kind of perspective to think about when compared to Brigette’s example because out in these rural areas, the focuses of the community and the focus of the hospital are a little bit different. They focus more on PPE and just getting everyone appropriately distanced and away from each other while still providing the care to the community versus canceling the internships altogether. So I went in with a little bit more safety precautions, but was still allowed to engage in a lot of roles in my internship.

Alex Burhop:
The most unique situation I faced was actually the addition of a new intern who is here with us today, Matthew. He’s going to talk a little bit more about his perspective and how he got into that situation. But I actually think it was very beneficial because one of the things I had not prepared for going into it was being thrust into a situation where you have a coworker that’s unexpected, and it taught me a lot about team building and how to kind of sort work and engage with each other and build upon each other’s experiences.

Steve Sonnier:
I imagine that’s a very similar situation that a lot of MHA students were going to in the internship side of things, is realizing that you might be working around people that you have connected with previously. Campbell, did you have a similar situation as well when you were going through figuring out the COVID-19 internship situation and how did your experience turn out for the summer?

Campbell Pendleton:
Yeah. Actually, I did have a similar-ish situation to Brigette. I was applying to a number of internships in California with Kaiser Permanente and right about the time we were coming down to finalists, they put on a hiring freeze because of COVID obviously. So I wouldn’t call it a backup because it was a great experience, but I was able to get an internship over the summer with UHC application services. So I kind of got to see how the kind of back end of healthcare functioned. I thought it was a great experience about something that I would never would have learned about otherwise. But also at the same time, me and my co-intern, who was also another classmate of mine, we were kind of put in charge of putting together the presentation that employees coming back to work would kind of utilize in trying to maintain safe distances and safe practices. So we were put into the fire immediately and in that regards of trying to transition everyone into COVID. So I’d say that definitely changed our internship, I would say for the better, definitely.

Steve Sonnier:
And Matthew, did you have similar challenging experiences as well, to trying to, as Alex said, adjust to a new internship lifestyle, then meeting the challenge of COVID-19 too, in your role there?

Matthew Carson:
Yes. So to start with, I was originally set to go overseas to Japan to do a side-by-side internship between two organizations of a healthcare consulting firm called [inaudible 00:12:22] and Kameda Medical Center. Once coven kind of ended those plans, I was fortunate through connections and the Iowa alumni network to be set up at Washington County Hospital and Clinics under the COO, Bridget Hill. Working alongside Alex was a wonderful experience getting to bounce ideas off of one another, but also addressing the COVID-19 challenges that the critical access facility faced and coming in with a fresh perspective and just kind of a needed perspective that they were looking for in terms of what ideas can we bring, what should be implemented to address, like Alex said, PPE and masks and shields and stuff of the sorts.

Steve Sonnier:
Brigette mentioned that we’re living in these unprecedented times, and that you all have had to be responsive to unique challenges across your field. When you’re thinking about your time here, what do you think so far has been the most valuable experience or take away from your time, whether it’s in the program currently or doing the internships over the summer?

Brigette Boyle:
I would say that my most valuable experience thus far actually came pretty early into the program. Quite a few of us participated in the University of Canvas’s first year MHA student case competition last fall, so coming up on a year now. And that was a team case that myself, and two of my colleagues, were on our team, we worked on it for quite a few weeks, went to Kansas, presented. The way that they had it set up is there were two rounds. Those who advance from the first round would advance to the finals, and then they would announce winners. My team didn’t advance past the first round. Even though we weren’t able to advance to the finalist round, it taught me a lot. One, not only about working on sustained teams. Often, especially in, in school context, we work on a group project for a few days, maybe a week, and then it ends. This was probably one of the longest team projects that I have worked on, which was an incredible experience.

Brigette Boyle:
But then also, it taught me that you can learn things from what would typically be called, “failures.” So though we didn’t advance to the second round, I feel like we still learn a lot about the expansion or rather lack thereof in Medicaid in the state of Kansas, as well as how to come up with solutions to complex problems. It was really great to be able to put out a product we were proud of and have all those takeaways despite not advancing. Then we also got to learn how to be gracious losers, if you will, and support our colleagues as they advanced to the final round. We actually have a winner from that case competition on with us today, and maybe he’ll be able to speak about that a little bit. But it was really cool to then have pride still in the program succeeding and your colleagues succeeding, though, you maybe didn’t.

Steve Sonnier:
That’s fully, an excellent attitude to take, and it is a comprehensive learning situation too, for yourself as well. So that’s a fantastic insight there. Alex, if you can also add on to that, thinking about what your most valuable takeaway has been thus far from the program?

Alex Burhop:
I would love to. To start, I appreciate this little shout out Brigette, but I think for diversity sake, I’m going to go with a different experience. I think that the most valuable experiences I’ve had so far have been in our data analytics course under professor, Dan Shane. He’s taught me a lot about analytics, which is a field that I thought I was strong in, and just being able to understand the difference in scope of experiences. So going into the course, I had built this really robust background in analytics to start with several computer science courses, several stats courses, a lot of internship work. Then being in his class for 16 weeks just completely undercut my foundation and showed me how little I actually knew, but I was able to take that and pile it onto the experiences I had had prior and build something even better. So just having that idea of relativity and understanding that even though your scope might seem large compared to others, it’s not. I thought that was just a really valuable lesson.

Steve Sonnier:
I think it really echoes the idea of you can always learn something from anyone and especially in this case too, your coming out and having this really renewed foundation. It’s such an important skill of data analytics. Campbell, if you want to reach out and say what your most valuable experience or takeaway has been thus far coming into our approach?

Campbell Pendleton:
Yeah, I’m going to stay in Alex’s vein and say it was a class we took, but not analytics. We had the opportunity to take a course called hospital organization and management last semester. We essentially acted as outside consultants for the UIC health system. Our project, in particular, was seeing the feasibility of whether or not a permanent hospice ward could be established in the hospital. So we were given the facts, we were given what other organizations are doing, what their capacity was and say, come up with a solution. So I think that was really getting thrown into the deep end, and it was either sink or swim. Unfortunately, a lot of our plans got to rail just because of COVID striking in the middle of semester and slowing everything down. But I think that really made me appreciate the fact that we kind of sowed the seeds of a garden that we were never going to see. So I just really appreciated that experience and it made me really thankful.

Steve Sonnier:
That’s an excellent standpoint too. There’s always something to be learned, even if it is a situation where it didn’t immediately come to fruition, as you were saying. Matthew, for you, what do you think has been your most valuable experience or takeaway from your time in the MHA program thus far?

Matthew Carson:
So for me, the thing that’s kind of stuck with me ever since the beginning was we were told to be comfortable with making mistakes. I believe that was very true as we went through many classes and courses where we were in areas that we had not touched on before, subjects that we might not have as much competence in or where we stumbled through concepts. The professors, but as well as like fellow students, they were there to support you and critique you. But for improvement, it never felt like it was harsh, like, “This person did better than this person.” It was always just a supportive network of, “We want you to get out of your comfort zone and find new areas to learn about and speak about, so that you can build up that confidence around said area.”

Steve Sonnier:
That’s a fantastic insight from all of you. I do appreciate it because it really speaks to the volumes of what you can accomplish within the MHA program here and through your connections and your insights into it. One of the things I want to touch on is what the most pressing issue is in your field that you really want to address with your education. I think everyone comes here with different ideas of how they want to handle healthcare and health administration moving forward, and I’d really be interested to see where you guys see yourself heading onwards. What do you think is the most significant issue that you’d like to address? We’ll start with Brigette.

Brigette Boyle:
I am particularly passionate about changing healthcare by changing the way we learn about it. It’s primarily the reason that I’m interested in pursuing a position in academic medicine in the future. I find that in health administration and even in public health at large, we often belabor the point of social determinants of health. I don’t mean to undermine their importance. They are incredibly important. We need to be discussing them. I feel we often don’t go a step further to talk about what causes the disparities among social determinants of health.

Brigette Boyle:
So for example, we know that housing insecurity leads to adverse health outcomes. I find that we don’t often talk about what has led to housing insecurity among disparate population. So we don’t discuss red lining’s impact on that or different mortgage approval rates. I would really like to use my knowledge and my degree to work in an organization that tries to bring those conversations to the forefront that brings all community stakeholders to the table to say, “We need to unpack this problem further.” I feel sometimes we think that, “We’ve unlocked the secret,” “Figuring out that social determinants of health have caused all of these issues. But if we don’t take it a step further and say, “Well, what has caused the social determinants of health?” I worry that some of our implementations and solutions won’t quite address the root of the problem. So I guess I would say the most pressing issue would be making sure we have all stakeholders at the table, all members of the community informing our education and our implementations.

Steve Sonnier:
I think it’s a very good point to touch on the upstream factors. It really is such a critical piece all along the situation of trying to figure out how do you address a problem holistically. Alex, if you want to touch on what you think the most pressing issue in your field is that you want to address through your education/

Alex Burhop:
One of the things that I’m extremely interested in is addressing rural health disparities. As someone who grew up in a small town, actually on a farm, I’ve seen a lot of my family friends and even my parents go through issues and accessing care, whether that be traveling great distances for specialists or even hitting closer to home without access to mental care or primary care shortages.

Alex Burhop:
So I made it my mission when I decided to join the MHA program to really get involved in these facets of rural care. I understand a lot about provider workflow and I’ve been able to kind of integrate that into some of the prior work I’ve done, but I’m really invested in balancing the ability of rural communities and rural hospitals to bring in some of these providers that are incentivized to go to larger systems and bringing in some of these specialists as well.

Alex Burhop:
There’s a variety of challenges that providers, physicians and APPs face when going into rural communities versus urban areas, and there’s a lot of issues that the hospitals themselves face in attracting these providers. So I’m just very interested in attacking those disparities and allowing these rural communities to bring in providers to serve their community.

Steve Sonnier:
I think it’s a very admirable goal to go forth and do that because we know it’s a tremendous burden, our rural communities trying to access, like you’re saying, primary care, mental health care, especially in states like Iowa where you have those workforce shortages. So it will be a really necessary area to champion going forward. Campbell, if you want to touch on what you think the most pressing issue is in your field that you want to address through your education briefly?

Campbell Pendleton:
Coming from the field of public health, much of my job was in education. We were telling people about what the health dangers were, what the risks were because in regards to lead poisoning, there really aren’t any symptoms. You just have to be aware and get tested. So I feel like with a lot of the preventable diseases that we are seeing today, people are able to see them in real time and we can prevent them. We just need to work on that step. I think that’s going to be a big part of our healthcare system moving forward, given that a lot of our health systems are moving towards capitation models. They’re going to take on all these risks, so they’re going to have to invest in preventative healthcare.

Steve Sonnier:
I think that’s a very crucial point as well, to the idea of preventative health care and preventive measures necessarily. It really echoes back to Brigettes’s point of you want to tackle these upstream issues so they don’t add costs later on or costs negative outcomes and negative outcomes for all of our healthcare systems. Matthew, if you want to touch on what you think the most pressing issue is at your field that you want to address with your education?

Matthew Carson:
So for me, it has to be going back to my undergrad education of healthcare leadership and long-term care administration. With the rising population of elderly individuals increasing over the next couple of decades, it’s the access to this post-acute care and long-term care and connecting the gap between what can hospitals and organizations do with these facilities to help better address the ongoing disparities by race, income and education across the country that we will be seeing.

Steve Sonnier:
I appreciate your guys’ variety of perspectives too. It’s nice you can pull through the common threads and see similar motivating factors in similar pressing issues, but overall, just such a wide breadth of interests. So I really want to thank you guys for touching on those really different points. When it comes to the field of healthcare and health administration, this is the last question I want to touch on for today in a quick lightning round, but what is one thing that you thought you knew, but were later wrong about?

Brigette Boyle:
Coming from my undergraduate degree, I obviously knew that I wanted to be part of the health administration world, but I think what I was deeply wrong about was how interrelated it is with public health. To be quite transparent, I took a class. It was a public health focus course and my understanding is that public health was seat belts and sidewalks, and it had nothing to do with my career. It was just something that I had to get through. In that course, and then throughout my graduate education, even the MHA program being housed in the College of Public Health speaks to just how interconnected they are. You can’t do health administration without approaching it from a public health lens. So it’s rather vague, but I think something that I was deeply wrong about and have since become quite passionate about is promoting public health as a means to be a successful healthcare administrator.

Steve Sonnier:
Alex, if you want to take that shot too, as well, and say one thing that you thought you knew, but were later wrong about?

Alex Burhop:
One thing that I think it’s brought up a lot, especially in my interactions with both people who are in different programs in the College of Public Health, as well as people in general, it’s just kind of the air that people who have graduated from the program or in the program walk around with. They’re always dressed up, they have a different dress code, they just act differently. So I thought going into the program, I kind of had what the archetype or embodiment of an MHA student was. I thought I knew that. I thought I had it pegged. And then getting in and interacting with my fellow cohort members, including those here today, has really taught me that I was wrong and that you really need to get to know people before you peg them.

Alex Burhop:
I’ve actually been able to expand that lesson on other people, as well who have similar ideas. I think it’s easy to put individuals in all fields in a box, whether they be physicians or administrators or nurses, and the truth is that everybody’s their own individual and that they have their own missions that they want to pursue in those areas. Being able to relate to them and get to know them, I think is very important for health care going forward.

Steve Sonnier:
I think we talk about that a lot. It’s the idea of not wanting to get into the echo chamber concept, but also the whole idea of breaking down silos comes up. We have this interdisciplinary collaboration, like Brigette mentioned, being housed in the College of Public Health speaks to this idea of, “We want to be able to approach people from all walks of life in our context of things.” For Campbell, what do you think in your scheme of things, is one thing that you thought you knew, but were later wrong about?

Campbell Pendleton:
Yeah. No, that’s a good question. I guess I would say that when I first, coming from a more of an outsider’s perspective, I thought I understood where health policy was made. And boy, was I wrong about that? I think learning about all the different levels, all the different stakeholders, everyone who’s engaged in every level of healthcare has really kind of opened my eyes to how many different just partners you’re going to have to work with over the course of your employment and over the course of your career. So I guess that was something that really got illuminated right off the bat for me.

Steve Sonnier:
That’s fantastic. I’m glad to hear more of that interdisciplinary collaboration echoed here. Matthew, if you want to take the last question, it’s what is one thing that you thought you knew, but were later wrong about the field of healthcare and health administration?

Matthew Carson:
For me, going into the program, I thought mergers of healthcare systems were more likely to decrease costs, improve quality and improve overall delivery of services efficiently. But current studies have shown me otherwise, that most of the mergers have not been able to reduce costs for consumers. There isn’t a statistical improvement in quality and overall efficiency in many of these mergers and systems has not yet improved.

Steve Sonnier:
Thank you for that very specific insight. I want to thank you all for coming on today and giving us your perspective into the issues at hand. Thank you so much for coming on and chatting with us today here at From the Front Row.

Brigette Boyle:
Thanks for having us, Steve.

Campbell Pendleton:
Yeah. I really appreciate the opportunity to speak with you today. Thanks, Steve.

Matthew Carson:
Thank you, Steve.

Alex Burhop:
It’s our pleasure to be here today, Steve. Thanks for having us.

Steve Sonnier:
That was this week’s episode of From the Front Row. Many thanks to our guests for coming on today. You can find our team’s work on iTunes, Spotify and SoundCloud. This episode was produced by the College of Public Health. You can find us on Facebook as the University of Iowa College of Public Health. If you enjoyed this podcast, please share this episode with your colleagues. This episode was hosted, written, edited and produced by Steve Sonnier. If you have any questions or recommendations for our team, we can be reached at grad-ambassador@uiowa.edu. Thanks for tuning in, and we wish you a great rest of your week.