TGIF! It is the Advent season for Christians and the end (another day) of Hanukkah for Jews. Both seasons to me, bring joy and hope. I have good Jewish friends, so I get a bit of a celebratory joy from them, especially since they reciprocally enjoy Christmas celebrations.

As readers know, I follow health care and health policy closely, along with economics and the financing/M&A markets. The years since 2020 and the start of the pandemic plus the recovery therefrom and the hangover effects to the economy have been rather depressing. We are still not quite seeing light at the end of this long tunnel in terms of capital access and cost, inflation on supplies and commodities, and labor supply improvement. Teeny gains have occurred but pre-pandemic normal is a way away.

Maybe, there is no need to return to the norms pre-COVID but to a different norm, one that is healthier. The economic conditions of programs like Medicare and Medicaid sure signal that reform is seriously needed.

This past year, I have conversed with a lot of colleagues, health care executives and executives and professionals that work in businesses that provide services to health care (bankers, suppliers, etc.). I truly can’t say I recall a time in my career (nearing four decades long) that I can remember my peer and professional friends and colleagues being so “burned out” or nearing “burn out”. Most of my peers are retiring or retired, accelerated by COVID and the events of the past three years. As a good friend (investment banker) said to me, not long ago: “When the fun is gone, so am I”. He’s retiring at the end of the year (a huge loss for his firm and the industry). A great article on burnout is here: https://www.asaecenter.org/resources/articles/an_plus/2023/2-february/one-ceos-story-of-executive-burnout

A couple of years ago, I worked through the Thanksgiving and Christmas holiday to get a good size bond issue closed. The work was tedious and included many late nights, but the deal was ultimately great and the celebration later, once closed, was truly fun. The team of lawyers, accountants, and bankers (including my good friend that is retiring) was awesome, and everyone worked together, dedicated and professional. It also turned out to be one of the last few deals done before rates accelerated. We lucked out at 3% fixed rates for a thirty-five-year period, full rights to call and refund, etc.

My point about the bond story is that like most execs, I felt alive and productive. COVID sucked the life out of me for a period, especially since nothing cool or fun could really be done. Then, once the deal was done and the celebrations were over, reality returned and so did the funk. Fast, creative, and stretching timeframes and solving problems was a jazz; the daily grind was a lullaby or maybe, a sad country song where the girl leaves, the dog does too, and the pickup truck just blew an engine.

This is what I hear from CEOs and executives today. The fun is gone from health care and the grind most days, with increasing regulation and challenging reimbursement, simply too much. Patient care is a priority BUT, it has now been overcome by piles of KPIs and financial statements to maintain bond covenants or generate a tiny EBITDA. The numbers matter but all too much stress is there too, often caused by things well beyond the CEO’s control (e.g., can’t simply clone nurses to meet labor demands).

To the title of the post – Hopeful. It is the Christmas season and as I look ahead, I am Hopeful that 2024 will be a year of rebirth and renewal. My brethren and colleagues need it. I am Hopeful that the economy will improve – signs are there. I am Hopeful that elections will produce sorely needed new blood, willing to look at the broken status quo, engage health care leaders and begin to transform Medicare and Medicaid. Finally, I am Hopeful that my friends and colleagues that are on the edge of burnout will find salvation and meaning in the true miracle that is Christmas. Nothing produces more hope than a great story of a miraculous birth. TGIF and Peace on Earth, Goodwill to All!