Rae Woods (00:02): From Advisory Board, we are bringing you a radio advisory, your weekly download on how to untangle healthcare's most pressing challenges. (00:10): My name is Rachel Woods, you can call me Rae. Look, I spend a lot of time on this podcast talking about all the problems in healthcare because, let's be honest, there are a lot. There's financial pressures and workforce challenges, there's all the vertical integration that's happening, there's the rise of disruptive therapeutics, and there's no getting around the fact that the current moment feels increasingly uncertain. But here's the thing, that complexity isn't going away. In fact, things are probably only going to get harder. That's why we're not discussing a specific challenge today. (00:51): In part one of our leadership series, I want to talk about how leaders can navigate this ambiguity no matter what challenge is in front of them. You'll hear from Matt Cornner, Advisory Board's expert on executive development, as well as three leaders who navigate complexity every single day. To start off, let's go to Matt. (01:11): Hey Matt. Welcome to Radio Advisory. Matt Cornner (01:13): Hey Rae, how are you? Rae Woods (01:15): I am doing well. I'm happy that we're here together now that I am a graduate of the Advisory Board fellowship. I feel quite proud of this. Matt Cornner (01:23): It's exciting, and it's been really exciting to see your experience going through this. Rae Woods (01:29): Yeah, you're not just my colleague, you've also been my teacher when it comes to all things leadership across the last 18 months as I've navigated our own leadership program, the fellowship. Matt Cornner (01:39): It's been a great launch. Rae Woods (01:51): You've been doing this for... I'm not going to age you here. You've been doing this for a while. Matt Cornner (01:58): A hot minute. Rae Woods (02:00): And you focus specifically on this idea of executive development through the lens of helping leaders navigate complexity. What is the biggest thing that you think organizations get wrong about leadership and what it actually takes to move an organization forward? Matt Cornner (02:18): The best way to answer this question, I would just share a quotation. This quotation comes from a gentleman named Juan Carlos Eichholz, one of the foremost sort of researchers, practitioners of adaptive leadership, and developed his work at the Harvard Kennedy School. "Leadership is difficult to put into practice because it involves challenging people instead of satisfying them, asking questions instead of giving answers, generating disequilibrium intention instead of providing comfort and safety, allowing differences to emerge instead of pretending that they don't exist, involving people instead of giving them instructions, and in some, confronting people with the problem, instead of facing the problem by yourself or simply ignoring it. All of this must be done within a strong containing vessel, one that holds people together while they're living with the complexities and losses of adaptive work." Rae Woods (03:15): I'm glad you decided to share this quote because this is the thing that changed my entire perspective on leadership. Because I had never thought to use words like challenge, question, tension, discomfort, disequilibrium. These, frankly, feel like negative terms, but why are they so important for leadership? Matt Cornner (03:38): The dirty little secret is that, consciously or unconsciously, as leaders we are socialized to meet certain expectations, and the three expectations that we highlight most frequently that leaders, implicitly or explicitly, are expected to fulfill are the expectation for direction, expectation for certainty and expectation for security. And a lot of us will have stories of great leaders that we followed who met those expectations. Fact is, when we are living in complex and disrupted moments, or eras, or reality, as we are today, you as a leader will certainly, inevitably disappoint all of those expectations. And failure to disappoint those expectations means that you're not leading, you are not doing the work that's needed in order to move an organization forward in the middle of a complex, dynamic, and disrupted time. Rae Woods (04:30): Because the goal is to move the organization forward, which to your point, often means not creating senses of comfort, for example, because that can lead to a complacent, stagnant system. Matt Cornner (04:43): That's right. Adele Scielzo (04:47): My name is Adele Scielzo, and I am the CEO of the Advisory Board. And in this role, I am ultimately responsible for the value we deliver to the market, for our growth, for our profitability, and ultimately, our value that we deliver internally within UnitedHealth Group. (05:05): The most difficult time for me was really very early in my role as CEO. I stepped into this job on April 1st of 2020, and when I accepted the role and thought about my first 180 days on the job, I really thought I was going to be implementing a new strategy for the organization and helping us craft and deliver a new set of products and capabilities to the market. And as we all know, that was the month where Covid became a reality and we started to understand the magnitude and the scope of what this meant for our country, the world, our business, given that we are in healthcare. And fast-forward to the summer of 2020, and there was the murder of George Floyd, there was the real swell for conversation and action around social justice issues. And for me, I felt like the dynamic between the employer and the workforce was really starting to change in a very visible way, which was putting pressures on me as a leader, us as an organization, that I had never really anticipated or thought about in that way before. Patricia Lewis (06:20): Hi, I'm Patricia Lewis. I'm the Chief Sustainability Officer for UnitedHealth Group. I have responsibility for our overall sustainability and ESG agenda, which includes our environmental focus, our social focus on health equity and DEI, and also work with legal on our governance strategy. Within a seven-month period of time, we went through not one, but two global crises. One obviously was the pandemic, the other was more local to us with the tragic murder of George Floyd. And during that time I was a CHRO, new to the company, and not only had to get to know the company, but also had to lead through two of the most unprecedented events in really the history of the company, and of the world largely. Margaret-Mary Wilson, M.D. (07:07): I am Margaret-Mary Wilson, and I serve as Chief medical Officer for UnitedHealth Group. And in that role I work with other leaders across the enterprise to help lead our efforts to develop a modern, sustainable, and high performing health system that is equipped to address the needs and the critical gaps that we have across the healthcare industry today. And the ultimate goal of that is to improve access to healthcare for all, to drive health equity. And a lot of that centers around ensuring quality outcomes, lowering costs, and ensuring a good experience for our providers, for payer organizations, and most especially for the people that we serve. (07:59): I can think of many moments during my career journey that have been particularly challenging. Healthcare is complex. The one though that stands out that I remember as being extremely challenging as a leader was in the early years of my experience as Chief Medical Officer for UnitedHealthcare Global when the focus was on Brazil, and we were setting out to implement an evidence-based clinical care model across our healthcare system in Brazil. (08:30): And for those who may be familiar with the Brazilian healthcare system, it's really complex terrain. It's very hospital-centric and it's very specialist-centric, and there's a lot of variation in provider practice, which at that time impacted outcomes and also drove up the cost of care. I was stepping into a country that I had never been to before. There was significant cultural differences, as you can imagine, we were so very different in a number of ways, and there was a lot of skepticism, on both parts, on their parts and on mine. It was an incredible experience in learning as a leader from everyone, also in learning how to lead from behind in an uncertain environment where there was a lot of ambiguity, and listening. And I essentially had to place my trust in the hands of team members trusting that they knew more about the work than I did. Rae Woods (09:32): Every single leader that navigated their teams through Covid-19, especially the acute moments of the pandemic, they know it was all about disequilibrium. It was all about confronting problems. But your take on leadership is that it's not about specific moments in time. In fact, I think you don't even like the word "crisis" anymore. You use "complexity". What's the difference between crisis and complexity? Matt Cornner (10:00): Well, and it's not that I don't use the word "crisis", but crisis and complexity are different. Covid-19 provided for most of us a really strong firsthand, real-world example of crisis, and global crisis at that. It is said that innovation and creativity comes at the intersection of purpose and constraint. Another way of saying that is, necessity is the mother of invention. At the intersection of purpose and constraint, we get creative. Crisis provides both crystal clear purpose and very clear constraints, and ushers forward extraordinary moments of creativity and innovation. And we saw this in spades during the Covid crisis. All of a sudden our five-year plan for digital health was accelerated to five weeks. Rae Woods (10:47): Or five days. Matt Cornner (10:48): Yeah, extraordinary innovation and creativity. When crisis starts to recede, purpose is less clear, and constraints are less clear. And we all have this deep desire for a return to stasis. And so the minute it looks like, "Wow, we can breathe again, or we can let up from that," we try to. And as a result, organizations find it more difficult to get innovative or creative during times of relative calm. Now it's still complex, which is to say our world is moving, changing, uncertain. We use the acronym VUCA, volatile, uncertain, complex, ambiguous. The world can be that and is that without being in crisis, that's harder, because we're lulled into this illusion that normalcy is possible, stasis is possible. "Can we just get back to that? We've had enough change, can we just stop please?" And so all of those expectations that are put upon leaders for, "Give me direction, give me certainty, give me security," those all come flooding back, and leaders inevitably in moments of complexity where crisis isn't nearly as clear, they become very disappointing to followers. Rae Woods (11:53): And to your point, complexity is the reality that we, frankly, always have to deal with in healthcare. I don't think there's ever going to be a time in which we are not living in complexity in this industry. Matt Cornner (12:05): That's right. And in particular the part of complexity that we overlook most frequently is around human complexity. We want to solve the technical details like you wouldn't believe, and then there are the human beings who are reacting to both the outside-in change as well as the change that we're authoring ourselves. Adele Scielzo (12:27): It's interesting when you talk about purpose, because there are different kinds of purposes. There is the purpose of our organization, so what is our reason for being? What is the value that we really provide to the marketplace that is helping to transform the industry that we work in? And then there's also my personal purpose as leader of the organization, and what is my role in helping to make sure that we are making good on our organizational purpose. And I constantly was trying to remind myself and hold my self accountable for taking both sets or both definitions of purpose into account literally on a daily basis when I was deciding how I was going to spend my time, what and how to communicate, who to interact with and so on and so forth. Patricia Lewis (13:18): So as the Chief People Officer for UnitedHealth Group at the time of the George Floyd murder, my purpose was to, one, address the concerns of the employees of our company who were understandably shaken by these events. They were very local, happening in Minnesota where we are headquartered, and they were looking for the company to express how the company felt about what was happening around them. And we had to provide a way for our people to be heard. So as the Chief People Officer, it was my responsibility to address the concerns of our workforce in a very visible way, which is not something that we were accustomed to doing at the time, and particularly around the issues as they were unfolding very quickly in the public eye. It was a teaching moment for our company. Because we were just beginning our diversity journey, it was important for me as a leader to leverage this moment to help the organization understand the journey that we had to go on. This was an incident that affected the workforce and demanded that we as a company address these issues within our own environments. (14:40): Listen, this work is ongoing. We have not arrived just because we were able to visibly respond. We did support the family, we supported the community, we did a lot in that environment and time, but we had so much more work to do, and we still have so much more work to do. (14:59): What did I learn through this as a leader? I would say it stretched me beyond anything that I'd ever experienced in my 35 plus years of leadership. We all were affected by the pandemic from a health perspective, and on the Floyd murder, this was painful for me as a black American who has three sons. And this type of thing could happen to any one of our children. I think this was a moment of vulnerability for me as a leader, sharing my own personal stories and helping people to understand why this was so profound for me As a black woman with three young African American sons. (15:43): It takes courage to step up and be very visible and present during these challenging times. I had the courage to be vulnerable and to share my own personal experience that I believe helped people understand how painful this was for African American people and other people in this country. And so that moment of courage and vulnerability, even though sometimes you want to shy away from those things, you need to take those opportunities because they can be super impactful and they can leave a lasting impression on people. And I believe leadership is all about courage, and courage specifically in times of uncertainty, and when you face adversity, it's critical as a leader. Rae Woods (17:41): We've said several times that comfort is not the goal, that we actually expressly want to create discomfort amid our teams. But how does that square with leader's desire, especially I think the frontline kind of manager's desire, to create a sense of safety for their teams? I feel like safety and comfort might be different things in the context that we're talking about. Matt Cornner (18:00): Well, and I think you just hit on something really important. We tend to conflate comfort and safety, and they are not the same thing at all. In fact, we do not change unless we're a little uncomfortable. I don't know about you, but I haven't seen fit to make any kind of meaningful change unless I'm a little uncomfortable and typically it is some point of discomfort. I am out of alignment with goals, or with purpose, or there's something that's not working here, some sense of misalignment that's a little bit grating on me, on us that needs to be addressed. We want for there to be a sense of safety, to the extent that I have confidence, I can show up and speak my mind regardless of my role, my position, my race, my gender, I can share of myself and everything that I am thinking about, every experience that I've had. If there's place for that, then we will all be better off, because at that point, we're able to really draw on collective creativity, rather than simply the narrow ideas of a few at the top. Rae Woods (18:58): And frankly, one of the pieces of safety that we want to create is feeling safe enough to fail, to experiment and get it wrong. Because experimentation is the opposite of comfort. The phrase that comes to mind is something that I used to say in my army days, which is complacency kills. That is a situation in which you are actually going to encounter danger. I hope that our leaders in healthcare aren't necessarily encountering danger, but complacency is a dangerous place to be when it comes to being an organization. Matt Cornner (19:30): Well, ultimately what we want is for everybody in the organization to be exercising leadership in the sense that we're all walking around with a deep sense of purpose and we are noticing, we are maintaining even a sense of vigilance around the ways in which we are or are not aligned with purpose. In those moments, hanging a lantern on a misalignment between action and aspiration doesn't always make you the most popular person, but to create an organization where naming the gap between aspiration and reality is not only acceptable or tolerated but actually caused for celebration, we are purposefully leaning into the discomfort of misalignment so that we can address it. To be able to celebrate that as part of our culture requires strong safety, and a tolerance for discomfort in service and purpose. Adele Scielzo (20:21): We have really tried to engage people in experimentation through a couple of different ways. We've done some of the basics such as look at KPIs and review grids, and MBOs, and what we hold people accountable for, and have done some simple things like put experimentation on every single person's review grid in the entire organization to signal the importance of it. On rolling our goals, we've also tried to provide a framework for leaders to help them put experimentation into context. And we have three big overarching goals for the organization this year, for example. The first is to learn, the second is to iterate, and the third is to grow. And really in each of those, we are hoping that people will be reminded of and embrace the concept of experimentation. (21:16): And then the other thing that we have done, which I think in some ways may be more powerful and it may have been more effective than even those two things is we really early on in our strategy transformation work started to engage and embrace a lot of agile concepts. And so we have ground rules that we talk about at the beginning of any project, any meeting, that are meant to really reinforce a lot of the learning, the experimentation, the iteration, and include things like early, ugly, and often, to encourage staff to bring ideas in their infancy to the table for dialogue and debate. One, the earlier you bring the idea and the more you workshop it, the more perspectives that you have, the more diversity of thought and inclusion that you're able to represent. It also ensures that the folks who are generating the ideas don't become overly wedded to them before we get too far down the road. (22:16): Another one of my favorite agile concepts which we've really embraced is this notion of tough on ideas but easy on people, to really get at the value of discord and disagreement for the sake of making things better, not for the sake of tearing down people. Margaret-Mary Wilson, M.D. (22:36): It's also important to make the teams that I work with feel safe enough to fail, and safe enough to take risks. And I think I have drawn on that out of my personal journey, which as I reflect, has actually been grounded in a series of failures. As someone whose career has spanned countries, and who had to move from Africa, to the UK, to the US, in seeking out career advancement, each time I had to make that move, I felt a sense of failure, of not being able to succeed in the country where I was and having to reach out to another country in order to advance. What I did learn from that though is that each of those points of failure were actually pivotal moments in my career and propelled me even further than I would have had I not failed and taken that risk. And so my philosophy, which I encourage for myself and share with my teens, is that failure is an integral part of success. (23:51): The advice that I would give to my younger self to prepare my younger self to navigate challenges ahead, are to remember to humanize, to humanize herself and to humanize others. Humanization drives our empathy, the ability to see things through the lens of another or the other. Vulnerability, the ability to recognize that I don't hold all the answers, and more importantly no one expects me to. So there must be a humility in recognizing my gaps and knowing where to reach out to fill those gaps. The third is just as I lean into authenticity, humanization also allows us to respect the authenticity of others, and to understand them, seek to understand their nuances, their characteristics, their attributes. And therefore, as we work with people and teams, we're able to draw out the best of them because we understand their strengths. (25:02): The final lesson I would give to my younger self is, build broad shoulders. Because one of my favorite quotes is, "The reason that I have seen further is because I was able to stand on the shoulders of others." And that is an integral part of the leadership journey, because it's all in vain if we have not, as a leader, succeeded in paving the way for others. Rae Woods (25:30): Now, Matt, you've been doing leadership development for several decades. Matt Cornner (25:35): I don't know about several, maybe a few. Rae Woods (25:36): A few. Matt Cornner (25:36): Several's a lot. Rae Woods (25:43): I think I know the answer to this, but I'm going to ask you anyways. Do you have a set of principles, a clean set of answers that you can give our audience that are the principles that leaders should follow as they face complexity? Matt Cornner (25:58): I think there are a range of principles that can and must be followed in order to most effectively navigate complexity. The challenge of that is, this isn't a to-do thing. Leading amidst complexity isn't what we do, it is who we are in complexity, and who we become in complexity, how we show up in complexity. Are we able to hold the fact that we're going to be disappointing to other people? Can we hold the fact that we're going to do some things that not everyone's going to understand because they don't have the same context we do, and they will be disappointed? Can we hold that? Can we handle that? Are we willing to be objects of contempt and disappointment in order to do the right purposeful thing in any given moment? Rae Woods (26:43): So you're not going to give me the perfect five to-do items because perhaps what you're saying is that they don't actually exist. But I wonder if there are some questions that leaders can ask themselves as they navigate the environment and the path forward. What are some questions that you want leaders to ask themselves? Matt Cornner (27:03): The central question that all leaders must ask themselves 100 times a day is, "What is my purpose in this moment, in this conversation, in this meeting, in this initiative? What is my purpose here?" Lots of different ways of orienting around this question. If it is within a team environment, "What are we trying to build here together? What are we trying to create?" And as a critical orienting principle, this becomes really important When we talk about things like adaptive leadership, what is our direction? If it's not our plan, which will be inevitably disrupted, what are we orienting to? How do we shift our plan? What's informing on what basis we shift our plan? And the thing is, it can't just be held by one leader at the top of an organization. "I know what our purpose is, I'm going to drive it through the organization, through force of personality and charisma," doesn't work. The world is moving too quickly, so we need an entire enterprise to have the leadership capacity to be in alignment with purpose accordingly. Rae Woods (28:01): And what's so interesting about that is I think it is slightly different from personal purpose. I think in an ideal world, your personal purpose and your organizational purpose is perfectly aligned, but I'm not sure that that's always the case. And to your point, you have to bring others along in that journey. So how do you create a clear and shared sense of purpose for others? Matt Cornner (28:24): I think that's just it. There's a lot to be said for movement building, like, "What are we trying to build here together?" And if you go to organizations where there's a deep, ubiquitous, internalized sense of purpose, these are not leaders or even frontline team members that are waiting around for a direction. They have a deep internalized sense of what we're trying to build, they have the agency autonomy, empowerment to exercise their leadership or action relative to that. And so the leader's role is perhaps to have a strong vision, but it's not to hold it alone, or to even hold it tightly within an executive team. Leaders must be in the business not of giving direction, but of mobilizing others to purpose. Rae Woods (29:08): And I think it's very clear when you go to an organization and every person can articulate that purpose. I'm thinking about the conversation that you and I had with our friends from Whitman-Walker, and how clearly every single person can articulate their purpose as, "We see you." And that's not just something that Naseema, their CEO, could share, but it's something that the member taking calls at the front desk would say as well. Matt Cornner (29:33): Who do I need to be in this moment? How do I need to show up? What are the actions that I must decide to undertake in this moment to be in alignment with that clear shared purpose in this organization? Adele Scielzo (29:48): I get others to understand that purpose by trying to constantly remind ourselves about what our purpose is. So whether that is kicking off every meeting with a reminder of what we're trying to accomplish as an organization, what value we aspire to deliver, what's the purpose of the conversation, the meeting, the project that we are undertaking in this moment, and how does that relate back to the purpose of our organization, and our reason for being? Margaret-Mary Wilson, M.D. (30:23): One of the many superpowers in navigating complexity is leaning into one's authenticity, and also leaning into one's humility, but still being ready to take responsibility as a leader. I found it difficult at times to maintain my authenticity, particularly in moments of crisis and in moments where, as a team and also as a leader, we had shifted away from our common purpose and were more focused on performance and hitting objective targets. During moments like that, I found I was at risk of leaning into overdrive. And instead of being myself, I now flexed into driving and working with the teams towards performance. What was helpful at times like that to remind myself how authenticity could really play into this is to recenter back on purpose, both professionally and personally, and essentially, pretty simply, remember why we were all there. And we were all there because we had a collective mission to make things better for the people that we serve. And at the end of that lens is always a person. Rae Woods (31:52): We're talking about how leading through complexity almost is this never-ending challenge. And I just want to call out the elephant in the room of how freaking hard that is. It is hard for ourselves as leaders. It is also hard on our team to say, "No, I know that comfort feels good, I know that stasis might be something that would allow you to take a breath, but again, that is a dangerous place for our organization to be, and it's my job as a leader to turn up the heat and keep pushing you forward." But I have to say that is so hard. So what is your advice to keeping the momentum going, keeping our foot on the gas to push forward when frankly it would feel good just to stop and take a breath? Matt Cornner (32:45): Just coast for a little while. Rae Woods (32:47): Yeah. Matt Cornner (32:47): This gets to something we talked a little bit earlier around the capacity of leaders to notice, and navigate, and hold the human complexity associated with change and transformation. We can be implementing a change that is undeniably good for the organization, for the community, for even our workforce. And there is inevitably loss for someone associated with that change. And the leader's job when we talk about, who do I need to be? Who do I need to become in order to hold paradox? Paradox, in this case, this is good, it's also bad for some, or feels bad for some, and complexity, multiple things can be true, priorities will be in tension with one another, there aren't clear black and white, "This is important, this is unimportant." There are a lot of things that are important. How do we hold all of them and be able to hold an entire enterprise in navigating both the complexities between competing priorities, but also the human reactions associated with, "The thing that I believe matters most isn't the thing that we're going to center or prioritize in this organization right now?" (33:51): And we see this a lot in big enterprise initiatives like mergers and acquisitions, for instance. So many of the stories of successful leadership occur when we have to make decisions that we know are good, but that will inevitably produce really clear tangible loss, like when you are consolidating either clinical services, back office services, reduce cost, improve efficiency, improve quality, improve patient customer experience, and there is loss. In some respects, the leader's role, and this is sometimes a really difficult reality for leaders, particularly those leaders who have ascended in their careers through subject matter expertise and technical skill, that the role of leader is more pastoral than technical. How do we bring people along? How do we mobilize others to purpose? How do we account for loss and fear of loss, and hold people through the inevitable grief that comes along with loss and fear of loss associated with change? Mobilizing others to something big and holding them in grief, this is not mostly the MBA curriculum that people are familiar with. Rae Woods (34:57): Matt, I think your example of mergers and acquisitions is such a good one. In fact, you and I might be thinking about the same story. In next week's episode of Radio Advisory, we're actually going to be going deep on an organization called Ballad Health, which is a new organization, came together in 2018, just five years ago. And they faced some pretty difficult changes as they navigated coming together as one organization, including some of the difficult trade-offs of closing a couple of facilities, and downgrading a couple of facilities. So for those that want to hear more about that story, make sure you're tuning into next week's episode of Radio Advisory. Matt Cornner (35:38): Absolutely. And by the way, the leader that you will be talking to is also an alumni of the Advisory Board Fellowship, and you'll hear a lot of the principles that we spend a lot of time practicing in fellowship. Rae Woods (35:49): Well, Matt, we've talked a lot about what leadership is and what it is not, and we've heard from a couple of leaders actively navigating complexity in their role. I want to give you the final word here. What's the biggest risk to successful leadership? Matt Cornner (36:08): The biggest risk to successful leadership is the tendency to solve very human challenges with very technical solutions. We want things to be measurable, and finite, and definable, and replicable, and the fact is, what we're navigating is very, very human and very, very complex. And the work that we must do as leaders in order to create a space capable of holding all of that human complexity, including grief, and loss, and so forth, doesn't feel comfortable. And the way that our organizations will typically avoid that work is, we'll call it soft. We'll call it soft, we'll call it not the real work, we'll beg ourselves to get on with the real work, when in fact, the thing that we call soft is in fact the very hardest thing that we will do as leaders, and that is to engage people at a human level, give them space to reveal what is hard, what is challenging, what is confusing, what feels uncertain, and to be able to use that discomfort in a productive way. Rae Woods (37:11): As always, Matt, thank you for coming on Radio Advisory. Matt Cornner (37:14): Always a pleasure, Rae. Thank you. Rae Woods (37:21): Look, I wish there was a perfect checklist that I could give to every leader in healthcare that would help them navigate through complexity, but such a checklist will never exist. That's why it is so important to learn from each other. And remember, Advisory Board is also here to help. (37:47): If you like Radio Advisory, please share it with your networks. Subscribe wherever you get your podcasts, and leave a rating and a review. Radio Advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Katy Anderson, Kristin Meyers, Vandana Ram, Micha'le Simmons, Jenny Heipp, and Matt Cornner. This episode was edited by Dan Tayag, with technical support by Chris Phelps and Joe Shrum. Additional support was provided by Carson Sisk and Leanne Elston. (38:22): Thanks for listening.