September 2, 2026: Salus Forum

Jeremy

As Howard brought up, the role of leader in this setting is to first calm themselves and then spread calm, because if they’re overly emotional or fearful there is an increasing possibility of stampedes. I don’t know if aggression leads to stampedes. I’m not sure that the animals talk to each other about how pissed off they are about the current reality, but humans do engage in this kind of thought and emotion. I don’t know if stampedes in human entities are related to strong emotions, such as fear and anger. Do those two very motivating emotions induce what is needed to begin a human stampede? I think that’s where that co-regulation piece comes in. There’s some leadership responsibility to co-regulate the population so that it doesn’t respond to what we call mob mentality.

Bill B

If we go back to what Howard’s talking about, it suggests that the discernments regarding AI are not done by individuals, but are done by collective dialogue—that is, if we go back to what Jack’s saying about the stampede. If each of us is trying to figure out what we’re going to do individually about AI, then we’re going to be stampeding about AI. It becomes a shared dialogue. I would assume within a healthcare system, it means that the doctors are talking to one another about this. They’re not just sitting there on their individual silo, scared to death of what’s going to happen with AI. It means there has to be some real conversations about it.

Jenny

Thanks for including me with regard to how this plays out in end-of-life hospice and palliative care. I actually am wondering if an example of a stampede—and this is what happens all the time with Kaiser, unfortunately, and especially in a palliative care department that is completely underfunded, which is continuous budget cuts for us. We’re very much understaffed. We are spread thin. Our volume for palliative care is just going higher and higher. All we are told is “not enough funds to support you all. Sorry”. So, I’m wondering if that’s a stampede? Is it a hard emergence? What I do know is that it’s not going so well at Kaiser. It’s contributing to low morale. It’s making me feel really like, ugh. I went into palliative care to move beyond the vulnerable conversations. And now I have to fight against a business that focuses on money. Unfortunately, this is just part of it, and I’ve accepted it over the last year as a new attending for the first time. But the thing is, it’s bleeding over, and this change is happening regardless of whether I like it or not, but then it’s going to lead to high turnover of our interdisciplinary team, which is comprised of nurses, chaplains, and social workers.

For me, when I hear these really big ideas, it’s hard for me to talk philosophically. I like to adjust it to a topic that I can grasp. So, thank you for your patience with me in connecting the two, but I’m wondering how to maneuver that, because I will continue doing palliative care wherever I go. This will always be an issue of palliative care not being considered that important, honestly, because we save money. We don’t make money. And so, how to use this thought process and be able to teach the leaders who are above me, like, hey, this style isn’t really working. Can we figure out a compromise?