ROOTS

ROOTS

TYLER SHIN

Founder and Managing Member

REVOLVING KITCHEN

BORN TO RIDE

(Above) Tyler Shin (right) and his sister enjoy play time with their mother in Seoul, Korea.

HAPPY COUPLE

(Top right) Shin’s parents on their wedding day. She ran restaurants, like he does today.

CLOSE SIBLINGS

(Right) Shin and his sister, who’s just 15 months his junior, on a trip to a lake when he was about 10.

as told to

SUZANNE CROW

illustration by

JAKE MEYERS

in 1992, when tyler shin was 12, his family moved from South Korea to Cedar Rapids, Iowa. Three years later, his mom was diagnosed with cancer, and his family moved to Los Angeles to seek better treatment for her. He made his way to Dallas in 2011 to become associate director at Orix. Eight years later, he left the world of finance and founded his ghost kitchen enterprise, Revolving Kitchen. Here, he shares how his mother inspired him: “My dad and mom both worked. My mom started and ran a lot of small businesses—restaurants and clothing retailers. I didn’t really get to see my parents much and grew up raised by my grandparents. I remember one night, my mom came back from her work. She was in the restaurant business at this time, so she would always come home really late. I was already up, but I pretended to sleep because I didn’t want to get in trouble. My mom came over to my sister and me. She started crying because she was feeling bad for not being at home as much as she wanted to. She was the disciplinary figure in our family. She was very tough, but it was one of her rare moments when she was a softy. My mom grew up Buddhist and instilled some of the principles and teachings in me and my sister—to be humble, don’t complain, and look inwardly for blame. I’ve never heard her complain about anything or blame anyone else for her misfortunes, regardless of how tough things were. I try (not always successfully) to be like her.”

COMMUNITY SPOTLIGHT

Capital One’s Reimagine Communities Summit

Why is the Reimagine Communities Summit important? How can it help nonprofis right now? Capital One’s Reimagine Communities Summit, now in its seventh year, brings nonprofits,corporate leaders, and public officialtogether to discuss the latest trends, explore innovative ideas, and share best practices to help move our communities forward. Each year, this dynamic event convenes the industry’s top thought leaders to share creative strategies and insights to help leaders develop actionable solutions to the challenges they face in today’s rapidly changing environment.

What are some of the biggest challenges the nonprofit ommunity is facing today? Each year, Capital One surveys nonprofitleaders and community partners to identify current issues and trends impacting the nonprofitsector. In 2021, Capital One launched the Insights Center, which strives to help changemakers create an inclusive society, build thriving communities, and develop financialtools that enrich lives. From housing to education and employment, many populations face systemic barriers to opportunity that threaten their financialhealth and well-being. Through the detailed research provided by the Insights Center, attendees of the Reimagine Communities Summit gain a deeper understanding of the key drivers for these inequities in their own communities.

How is Capital One supporting nonprofis, helping them close equity gaps and provide better access to socioeconomic opportunities within their local communities?

Capital One is on a mission to change banking for good and help people achieve financialwell-being. Through our Impact Initiative, our investment in the communities where we live and work, we are listening to, partnering with, and investing in small businesses and nonprofitsto foster fina cial well-being in our communities. The Reimagine Communities Summit furthers our impact, helping to educate, inspire, and connect leaders as they work together to findmeaningful solutions to close equity gaps in their communities.

What can attendees expect this year? Nonprofits,corporations, civic organizations, and government agencies have all faced unimaginable change from the pandemic. Many organizations have pivoted to deliver services to meet the growing needs in their communities. But, overcoming the pandemic-related challenges for funding, service delivery and operations has left little time for leaders to scale their strategic missions. Whether from a small or large organization, attendees will walk away with the knowledge and strategies needed to lead with resilience.

2022 Program Overview Join Capital One at the 7th annual Reimagine Communities Summit on Wednesday, October 19, 2022 featuring diverse innovators and experts from the public and private sectors who will leave you inspired, connected, and moved to action during times of change. Together we will spark important conversations to help grow an ecosystem of resilient corporations and nonprofitsworking to advance socioeconomic mobility across our communities. Registration for this free, one-day hybrid event will open in late August. Learn more at reimaginecommunities.com. Reimagine Communities Summit Attendee Testimonials:

“The summit addressed issues

that are hard to talk about

head-on. In addition, they

provided practical ways to have

those conversations and ways

to create an environment that

would foster action.”

— 2021 Summit Attendee

“I felt that all of the information

was valuable to nonprofit

leaders and gave a great

understanding of where Capital

One stands in supporting our

communities and nonprofis

working in those communities.”

— 2021 Summit Attendee

THE NORTH TEXAS BIOTECH BOOM

Meet DFW’s Cardiologist Power Couple

Hospital System CEO Roundtable

2022 EDITION

Even as it grapples with labor shortages, supply chain woes, an exhausted workforce, and more, there is much optimism and hope for the industry’s future.

When the Body Seeks Balance

The infrastructure is in place for North Texas to develop into a nationwide biotech powerhouse.

A disjointed healthcare industry is forging ahead because it has to. Here’s how it is facing the challenge.

we burn the calories we eat. our heart takes blood in and pumps it out in equal measure. Nearly every aspect of our physical selves seeks balance; our bodies work best when we maintain equilibrium. I am learning this the hard way as I navigate the healthcare system to get my knee fixed after I tore my ACL. I’m experiencing what happens when the body is imbalanced. The same could be said for our healthcare system. Like so many other industries, healthcare is jolted by forces outside its control. Labor shortages, supply chain issues, new COVID-19 variants, and a workforce that’s exhausted after battling a pandemic for nearly three years are creating challenges at every level of the system. Meanwhile, there is much optimism and hope for the future. Technology is allowing us to personalize medicine, and pharmaceutical companies are developing treatments for diseases faster than ever before.

D CEO’s2022 Healthcare Annuallooks at the triumphs and trials of the local health system. Inside this special edition, you’ll find a discussion with leaders of some of the largest health systems in the region who share their growth strategies and labor challenges (p. 101). You’ll also meet innovative pharmaceutical entrepreneurs who have made North Texas their home (p. 96) and get an insider’s look into the emerging biotech industry in North Texas (p. 94). In addition, we feature Drs. Shelley Hall and Rick Snyder, two of the most successful cardiologists in the state who also happen to be married to one another (p. 90). Ten years ago, we launched the only news site in the region that focuses on the business of healthcare to tell stories just like these. I hope you sign up for our daily e-newsletter and tell us what we’re missing by contacting me at will.maddox@dmagazine.com.

Will Maddox

Healthcare Editor

HEALTHCARE ANNUAL 2022

CONTENTS

90 94 96 101

HEART TO HEART

How married couple Dr. Shelley Hall and Dr. Rick Snyder became two of North Texas’ most powerful cardiologists.

BIOTECH BOOM

With a business-friendly environment and a steady supply of talented graduates, the region’s biotech industry is starting to take off.

MEET FOUR DFW PHARMAPRENEURS

From drug development to delivery of services, these innovators are disrupting the pharmaceutical market.

WEATHERING THE STORM

Hospital system leaders grapple with an industry that’s in flux while preparing for the future.

Growing with you is how we care more.

Getting what you need when and where you need it is easy, so why shouldn’t health care be the same way? That’s exactly why Texas Health is expanding across North Texas. From new hospital additions to more urgent care locations in your neighborhood to greater access to virtual care, we’re making health care more convenient and accessible for all North Texans. And we’re just getting started.

Learn what we're doing at: TexasHealth.org/BrightIdeas

ASK THE EXPERTS

Workforce Burnout

SYDNEY REECE, LPC, REGIONAL DIRECTOR OF INTEGRATION, CONNECTIONS WELLNESS GROUP

What is burnout and can it be

prevented? If so, how? In the traditional sense, burnout is described as the emotional, mental, and physical reactions one experiences when under constant stress. Individuals experiencing burnout are at risk for increased anxiety, depression, and an inability to implement effective decision-makin skills. Decreased productivity is also a symptom of continued stress in the workplace. Burnout has been seen as inescapable in careers like the stock market trade as well as in the helping profession. While working in a high-stakes environment is undoubtedly stressful, burnout is not inevitable. When we view burnout from the lens of an administrator’s responsibility to the employee, we have the power to ameliorate the victim-shaming nature of the term, empowering future generations to experience the workforce in a more meaningful way.

How should we describe burnout?

Although we have begun recognizing the importance of mental health, we have not yet shifted our vocabulary when discussing some of its preventable deterioration. In some environments, “burnout” has become a weapon used to shame employees into believing that they are incapable of managing their experiences. Replacing “burnout” with terms like “moral injury” and “compassion fatigue” should become the norm. Doing so requires those in power to act swiftly to repair relationships with their team and empowers employees to advocate for themselves rather than feel the shame of “burnout.”

What is moral injury? Moral injury is “disruption in an individual’s confidnce and expectations about one’s own or other’s motivation or capacity to behave in a just and ethical manner.” (Drescher, et.al, 2011) The symptoms of moral injury are like burnout–increased anxiety and depression, guilt, and decreased decision-making skills. Although it has been applied to treating veterans, we can use this terminology to describe what is also happening in some sectors of the workforce. A lack of supportive and ethical leadership has been emphasized as one of the main factors causing moral injury. It is the responsibility of administrators to ensure their team is not required to achieve an outcome that might necessitate violating their moral compass. Leaders should, instead, be removing barriers impeding progress and encouraging team members to advocate for themselves, their teams, and their clients.

How is compassion fatigue linked to burnout and moral injury? Compassion fatigue occurs when individuals become overwhelmed with constant exposure to the trauma of others. We saw this throughout the pandemic as physicians and nurses worked tirelessly to treat their patients. Compassion fatigue quickly set in as they experienced trauma and grief daily. However, as we failed to listen to medical professionals, we forced them experience the lasting pain of moral injury.

So now what?

We must take lessons learned in the pandemic and apply them in all workforce environments. If employers do not empower their team members, listen when they advocate for themselves, and act swiftly and purposefully, employees will experience moral injury. Leadership should ensure compassion fatigue never becomes moral injury.

SYDNEY REECE

is a licensed professional

counselor who serves as

the regional director of

integration for Connections

Wellness Group. She

earned her master’s degree

in counseling from the

University of North Texas.

She has worked in a variety

of healthcare settings,

including acute inpatient

facilities, private practice,

and outpatient facilities. She

now uses her skills to ensure

patients are treated without

the typical barriers that

clinicians are burdened with

navigating in more traditional

healthcare settings. By

eliminating these barriers,

Reece believes healthcare,

specifially mental health

care, will become more

accessible to everyone.

ASK THE EXPERTS

Pediatric Orthopedics

DANIEL J. SUCATO, M.D., M.S., AND PHILIP L. WILSON, M.D.

SCOTTISH RITE FOR CHILDREN

How early will a child show signs of having an orthopedic issue that may need medical attention?

DR. DANIEL SUCATO: Orthopedic issues can present as congenital abnormalities of the bones, meaning the bones were not completely or normally formed in utero. This can occur in the spine or the upper and lower extremities. Often these patients do not require treatment early, or sometimes ever, but they should be evaluated to see if treatment is necessary. DR. PHILIP WILSON: As a pediatric cartilage and ligament surgeon, we often see children with congenital meniscus or cartilage conditions within the knee. Sometimes these can present as early as toddler age, but more often young school-age with a loss of full extension or occasional limp.

What should I expect at our fist visit to a pediatric orthopedic specialist? DR. DANIEL SUCATO: At the initial visit, the family and patient will first meet with the povider to discuss the concerns and note any family history regarding the issue. A physical and orthopedic examination will evaluate the areas of concern. If necessary, appropriate imaging studies, such as ultrasound, plain radiograph, CT or MRI scan, will follow. Let your child know the imaging studies, if necessary, will not hurt. DR. PHILIP WILSON: We also make sure the child is directly involved in the discussion. As kids get older, the perception and magnitude may be different for parents than it is for the child. Prior to the visit, parents can help by letting them know we are just going to check their muscles–no shots.

What are common issues in

children that fall under the category of “pediatric orthopedics?” DR. DANIEL SUCATO: Pediatric orthopedics involves anything related to children’s muscles, joints or bones, so that would be conditions like clubfoot, scoliosis, developmental hip dysplasia, and even traumatic or sports injuries. We also have subspecialties in spine, upper and lower extremities, foot and ankle, sports injuries, and fractures. DR. PHILIP WILSON: Within pediatric sports medicine, conditions involving the cartilage or instability of the joint or injuries affecting th tissues around the joint are common reasons for treatment.

Do all orthopedic issues require surgery? What are other forms of treatment?

DR. DANIEL SUCATO: Most can be treated without surgery. Physical therapy can improve range of motion, strength, and flexibilit. Other treatments include bracing, casting, and anti-infla matory medications. DR. PHILIP WILSON: We always reserve surgery for use when other options are not available. In addition to what Dr. Sucato mentioned, sometimes simple reassurance to the family that the orthopedic condition is normal or will improve with age may be all that is required.

DANIEL J. SUCATO, M.D.,

M.S., is chief of staff, the

director of the Center for

Excellence in Spine and a

pediatric orthopedic surgeon

at Scottish Rite for Children.

He is a professor in the

Department of Orthopedic

Surgery at UT Southwestern

Medical Center at Dallas.

PHILIP L. WILSON, M.D.,

is an assistant chief of staff,

director of the Center for

Excellence in Sports Medicine

and a pediatric orthopedic

surgeon at Scottish Rite

for Children. Wilson also

serves as the medical

director of North Campus.

He is a professor at UT

Southwestern Medical Center

and provides orthopedic

trauma and pediatric

sports medicine coverage

at Children’s Medical

Center of Dallas.

AAFTER BLOOD TRAVELS through the body, delivering nutrients and oxygen, the low oxygen blood flows into the right atrium, which pumps the blood into the right ventricle, sending the blood into the lungs, filling them with oxygen. Next, the left atrium receives oxygenated blood and sends it into the left ventricle, which pumps it into the body to start the process over again. The left and right sides of the heart work together in equal measure—and are literally what keep us alive.

Like the two chambers of the heart, Dr. Shelley Hall and Dr. Rick Snyder are potent forces in the cardiology world, balancing complex cases with statewide and national physician leadership, all while being married to one another and raising a family. Although physician marriages aren’t all that uncommon (medical school and residency provide prime opportunities to meet one’s match), it is rare for a couple to climb the healthcare ladder as high as Snyder and Hall have done. So, how do they make it work? The expertise, energy, and discipline required to live the lives of this heart couple would sap most of us average humans, but Hall and Snyder seem to thrive when fully engaged, even if it means they are focused on giving each other a hard time.

MAKING THE ROUNDS

As Hall was getting back into her studies after taking a year offfrom medical school, she wanted to get some time with patients before she hopped back into academics. As a third-year student, she would spend the year in rotations at the hospital. She asked her school’s dean for help, and he called Snyder and asked if the returning medical student could shadow him for a couple of weeks. He obliged. Hall stood out during that period. Other students in the group had been grinding through their training without a break and were eager to get home after doing the minimum. Hall had taken a year offand wanted to get back into the swing of things, and she volunteered for extra tasks. The two didn’t start dating right away, mainly because Snyder was already in a relationship. But the reconnection was enough to start a friendship, and over the next several months, saying hello in hospital hallways turned into her reaching out from time to time to discuss medicine. Eventually, something more serious took shape, and the two began dating about a year later. Hall wasn’t interested in riding the coattails of Snyder’s medical career. The reverse was also true. “It was immediately obvious that she was going to go places from a cognitive standpoint in clinical medicine because she was upstaging my interns and senior medical students,” Snyder says. “We call them gunners.” Hall thought she would go into pediatrics, as many women did at the time. But she didn’t like her pediatrics rotation and preferred to speak with patients rather than their families. Snyder supported Hall’s pursuits, but when she decided to pursue cardiology, he wasn’t so sure

story by

WILL MADDOX

portrait by

JILL BROUSSARD

he wanted to be in a relationship with someone who worked in the same subspecialty. She said she would focus on heart transplants rather than interventional cardiology, which would have minimal overlap. When Snyder later decided to get certified in heart failure transplant, she was miffed (and Snyder never fails to remind Hall that he got a higher score on his heart failure and transplant board exam).

But their frustration on the matter, like so many things they may disagree on, is quickly swept under the rug with their ability to let things go and separate the professional from the personal. The two could not let the small stuffget in the way of what they held most dear; they both wanted to pursue their highest potential as physicians, and they both wanted to have a robust and full home life. Those dual goals would not be achieved easily, but they were up for the challenge. “Shelley has more energy than anybody else on the planet and is involved in a lot of things,” Snyder says. “She definitely wanted a career and a home life.”

PLAYING AT THE HIGHEST LEVEL

Busy doctors who are also working to raise a family require a great deal of discipline and energy, but Hall and Snyder are no regular physicians. Hall is the chief of transplant cardiology at Baylor Scott & White Health, one of the country’s largest programs. She is also the president of the Texas chapter of the American College of Cardiology and is on the national board of the organization, too.

Snyder is president of the cardiology group HeartPlace and is also president-elect of the Texas Medical Association, a role that will have him leading the country’s largest medical association, which includes more than 56,000 physicians. He has also been president of the Dallas County Medical Society and president of the medical staffat Medical City Dallas hospital. Additionally, Snyder has been involved with the Medical City heart transplant program, a competitor of the Baylor program, the couple says. He likens their ability to balance professional competitiveness and their relationship to liberal political consultant James Carville and his wife Mary Matalin, a consultant for the Republican Party. “We like to say we work for the enemy,” Snyder jokes.

Together, they sit on the board of the corporate organization that vice CEO, and the sales rep said, “This is Dr. Hall, the chief of transplant cardiology for Baylor Scott & White Health.” The CEO, making a patriarchal assumption he shouldn’t have, began approaching Dr. Snyder. Snyder attempted to back away and behind his wife, but the CEO kept coming toward him. Finally, Hall stuck out her hand and introduced herself. “It was like watching a car wreck in slow motion,” she says.

Although sexist assumptions plague many female professionals, Snyder says he often finds himself being shown up by his wife. At Medical City, a man the age of 50 was getting surgery, and his heart arrested during the operation. For 45 minutes, the team worked to resuscitate him with chest compressions; if someone survives after being in that condition for that long, they often become brain dead. Nonetheless, Snyder took on the patient, finding out that he had 99 percent blockage in his heart. The team put in four stents and a pump and got his heart working again. When they extubated him, to everyone’s surprise, he was alert and asked questions about his heart only someone in the industry would know. As they talked, Snyder learned the patient was a cardiac drug rep in town with a degree in cardiac physiology who worked with UT Southwestern physicians. Snyder mentioned that he had trained some of the physicians at UTSW and how his wife was director of heart failure and transplants at Baylor. The patient said, “Oh, you are married to Shelley Hall! I love her.”

Despite leading the team that saved the man’s life, Snyder found himself playing second fiddle. “I found out two things about this guy: No. 1, he was neurologically intact, and No. 2, I took a guy who was 99 percent dead, and now he is essentially Lazarus and still alive. And my wife still shows me up.”

THE POLITICS OF THE PROFESSION

Both Snyder and Hall are cardiologists and physician representatives, and their house is no stranger to political fundraisers. They have spent ample time in Washington D.C., and Austin speaking with legislators about laws impacting physicians. Snyder has long been focused on impacting legislation and says that they can impact more patients in legislator chambers than in operating rooms. “I was very satisfied,” he told D Magazine at the time. “I was feeling good about the city. I was feeling good about my family, that were being protected.”

One particularly proud moment was working with Dallas County when he was president of the county’s medical society during the West Nile outbreak in Dallas. After making a passionate speech about the benefits and risks of spraying Dallas County to kill the infected mosquitos, Judge Clay Jenkins called a press conference later that day to announce the spraying. Snyder was thrust forward to explain the move to the various city councils in Dallas County and on radio and television shows. “As a physician, we treat one patient at a time, but as an advocate, we can impact the whole country all at once,” he says.

Hall’s approach has been different. She isn’t a huge fan of politics or the political process and has focused more on the scientific and research side of medicine, but she is starting to lean into her leadership roles and see her ability to have an outsized impact. On a recent trip to D.C. with Snyder, the two were making the rounds to legislators. Hall felt intimidated, and Snyder reminded her others were likely more intimidated by her than vice versa.

“I’m happy to support him when I agree with him, but I’m not afraid to disagree with him.”

DR. SHELLEY HALL

runs HeartPlace, which often proves entertaining for the rest of the members sitting around the table. “I’m happy to support him when I agree with him, but I’m not afraid to disagree with him,” Hall says. “Our group always loves it when we have different views, and they can sit back and eat popcorn and watch the show.”

Being married and in the same field is not without awkward moments. The couple once booked individual trips to the same hotel for the same conference without knowing it until just days before they left. At another conference, the couple was introduced to a major medical de-

In the first meeting, Snyder did the talking. In the next one, he introduced his wife to give her perspective. By the third conversation, she interrupted him and jumped in to help advocate for her fellow cardiologists. The two are focused on changing the law to increase organ donation by making Texans opt-out of being on the organ donation registry at the DMV rather than opt-in. “I don’t like politics, but I understand the importance of them,” Hall says.

FULL HEARTS, CAN’T LOSE

On top of their high-profile physician and leadership roles, the two have raised five children, now ages 38, 35, 27, 26, and 24. As the kids were growing up, it wasn’t easy, and sacrifices had to be made. But the two sharp minds kept things organized with shared Apple calendars and a dry-erase board where each kid had their own color. That way, the couple could divvy things up to ensure that kids would get to recitals and sports activities. “Both of us can go at Mach speed in the world of texting,” Snyder says.

They would trade offtaking the kids to school, as their work often began early. They had a nanny for support but avoided live-in help, as they were afraid they would depend on it too much and risk becoming too uninvolved in their kids’ lives. They also had to make sure only one parent was on call each weekend. Still, it was rare for the family to have dinner together between all the activities and working schedules, but, when each child turned 10 and every birthday after, a special weekend with just mom and dad anywhere in the continental United States headlined the year’s activities. Even with five children, a cardiology practice, and advocacy work, they made time to manage hockey and soccer teams, lead Scouts and Indian Guide groups, and participate in other activities. “I look back on it and think, ‘How did we ever do it?’” Hall says. “We took a divide-and-conquer mentality.”

It has only been over the last 10 years that Hall and Snyder have rediscovered their social life, taking trips to Cancun, where Snyder and Hall soak up the ambiance. “We had very little room for anything else,” Hall says. “It was work and kids, work and kids, for 20 years nonstop.” It might be easy for a couple as busy as Hall and Snyder to wonder if they spent enough time with their kids. Lingering questions about work-life balance haunt many parents. But the children put those fears to rest when Hall brought up the subject after they were grown. “I asked, ‘Do you regret that I wasn’t the room mom or the carpool mom or things like that?’ To be honest, they said no. They said I was a role model as a strong working mother.”

Making it work required a strong sense of each other’s strengths and weaknesses, implicit trust, and an ability to communicate and prioritize efficiently and consistently. Spending their days taking care of hearts and saving lives and their offtime raising children and representing colleagues in the highest halls of government would seem to be a heavy burden. Still, Hall and Snyder seem to take on everything with a balance of focus and humor.

When they both sat for an interview, I spoke with Snyder for a few minutes before Hall joined us, and I joked that it would be good to have her fact-check what he had told me so far. Her first words to me were said with a wink: “He lies.”

TWO HEARTS IN SYNC

Dr. Rick Snyder and Dr. Shelley Hall have taken similar career pathways and achieved great heights in their profession, all while raising fie children. Couples don’t do that successfully without knowing each other well. We decided to put them to the test by asking them identical questions in separate interviews.

What was your firt impression of your spouse?

SNYDER: “That she was a quiet, introverted, nerdy medical student who was simultaneously way overthe-top confident and an outspoken academic ‘gunner.’ Her history and physicals were also written in perfect penmanship and were seven to 10 pages long (compared to the typical two or three). Her attitude, work ethic, and enthusiasm were refreshing and attractive.” HALL: “Uh oh; he is a player!”

Who is the better heart doctor?

SNYDER: “Dangerous question. For advanced heart failure, transplant, and mechanical circulatory support, no question, Shelley. For general, preventative, and interventional cardiology, me.” HALL: “Critical care, me. Preventative health, him.”

When did you know you wanted to marry the other?

SNYDER: “During one of our getaway weekends. It was just the two of us at my family’s lake house in Cedar Creek during the summer of 1992.” HALL: “When I had to choose between moving back to New England for fellowship or staying in Dallas.”

What have you learned about medicine from your spouse?

SNYDER: “I have learned much from her about the pathophysiology of advanced heart failure and physiology of mechanical circulatory support.” HALL: “How not to put a central line in! (It’s an inside joke.)”

Who would play your spouse on a TV medical drama?

SNYDER: “A young Dana Delany” HALL: “George Clooney”

What do you most admire about the other?

SNYDER: “Shelley is the most caring and giving person. She always volunteers to lend a hand in an emergency. I have seen it if we come upon an auto accident or whenever a pilot asks if a doctor is on board. Professionally, she can empathize and relate to a patient’s fears and concerns about their condition like no one I have seen.” HALL: “His passion and dedication for something he believes in. Like a dog with a bone, he will work for it and defend it.”

What would the other describe as an ideal date?

SNYDER: “A musical in New York or the Broadway Dallas, followed by dinner at a fun restaurant.” HALL: “Hanging out in our media room, watching shows together.”

If not a heart doctor, what would your spouse be?

SNYDER: “An FBI agent or a CSItype detective.” HALL: “Tough one. Either a businessman or the President’s Chief of Staff.”

DFW’S BIOTECH BOOM

With a steady supply of talented graduates and a business-friendly environment, the region’s biotech industry is starting to take off.

story by WILL MADDOX

BBUSINESS AND POLITICAL LEaders gathered on a windy day in March for the ribbon cutting of BioLabs’ Dallas location at the Biotech + Hub at Pegasus Park in the Design District. Philanthropist Lyda Hill, Mayor Eric Johnson, and U.S. Representative Eddie Bernice Johnson were all in attendance. It isn’t every day that a local business gets that kind of attention, but BioLabs’ arrival in Dallas was about more than just adding some lab space to a trendy new development. It was a sign of what the region is becoming.

BioLabs is an international, membership-based network of shared lab and office space that help launch biotech companies. The Dallas location is BioLabs’ first in the U.S. that isn’t on the East or West Coast, where this type of innovation usually originates. The company is part of what is the beginning of a biotech district that includes the medical center and UT Southwestern Medical School. “Pegasus Park has created a central hub or a landing place for the life sciences to come and congregate within that one building,” says Jorge Varela, vice president of innovation at the Dallas Regional Chamber.

BioLabs is a 37,000-square-foot facility with several private labs and dozens of benches with enough room for 30 to 35 startups. The company’s site director at Pegasus Park, Gabby Everett, says BioLabs expected to be about 15 percent full in the first year. But in just two months, the space was already 30 percent occupied, a level that usually takes three to four years. It isn’t just the name and reputation bringing members into the space. The opportunities for collaboration, discussion, and socialization are ample, with a café on site, ping pong tables, and a brewery across the street. “It has that Silicon Valley feel to it with a comfortable vibe,” Everett says.

The gravitational pull of BioLabs is luring other organizations to Pegasus Park, too. UT Southwestern, McKesson, Health Wildcatters, and several nonprofits have secured space, creating synergy for startups and convenience for VC funding. “In the past, investors may have nailed down one or two reasons for coming to Dallas,” says Dr. Hubert Zajicek, co-founder and CEO of Health Wildcatters. “Now, they are trying to find other purpose-driven entities or organizations to visit, and this makes things easier because of the spotlight.”

Dallas recently ranked No. 6 nationally in a report on emerging biotech markets produced by real estate giant CBRE. Individuals involved in life science research as a career grew by 79 percent between 2001 and 2020, compared to 8 percent for all industries. The number of U.S. graduates in biological and biomedical sciences is twice what it was 15 years ago. These occupations have the second-lowest unemployment rate of any industry, meaning the battle for talent is fierce.

Dallas-Fort Worth is well positioned to meet the challenge. In addition to the region’s relatively low cost of living, business-friendly environment, and blistering growth, its educational institutions are supplying the talent companies are looking for. Last year, area universities produced 1,935 bachelor’s degrees, 378 master’s degrees, and 108 doctorate degrees in biological and medical sciences, according to the Dallas Regional Chamber.

The area’s logistics infrastructure supports the industry, too. DFW Airport is only the second in the country that has been named a Center of Excellence for Independent Validators by the International Air Transport Association, which means it meets the standards for safe handling of pharmaceutical and life science products. “When you’re flying a vial with maybe four or five ounces across the world from Mumbai to DFW, you need to know has it hasn’t been shaken too much,” Varela says. “It could be worth $250,000.”

Through infrastructure investments and a push for growth, Fort Worth has developed its own biotech scene, with accelerator TechFW leading the charge and partnering with UNT’s Health Science Center in Fort Worth and Texas A&M’s growing research and innovation presence in the city. Fort Worth’s labor supply is boosted by HSC and TCU’s School of Medicine, and it has a growing funding presence with venture capital firm Cowtown Angels, which has supported the startup biotech industry in the city.

But players in the space say it isn’t wise for the region to rest on its laurels. It will take continuing focus, investment, and recruiting to help the region move from an emerging biotech hub to a national powerhouse. “Past success is significant and important, but it isn’t enough to be evidence of an unstoppable tidal wave,” Zajicek says. “If you learn anything from ecosystems, it’s about the redeployment of capital. People make money or entrepreneurs have an exit, and then they reinvest the earnings.”

ON THE SHOULDERS OF GIANTS

DFW’s success has been built on the backs of local biotech success stories.

CARIS LIFE SCIENCES

The Irving-based company has raised more than $1 billion in the past several years to support its precision medicine initiatives and focus on cancer.

ALCON

Founded in Fort Worth in 1947, Alcon is the global leader in eye care, offering surgical and eyecare products that have impacted 260 million people in 140 countries. It has a market cap of $38.06 billion.

ONCONANO MEDICINE

This Southlake-based diagnostic startup has seen significant success in fundraising as it works to create products that use a pH biomarker to diagnose and treat cancer.

LANTERN PHARMA

This Dallas-based clinical-stage biotech company focuses on the cancer drug development process. It went public in 2020 and raised $69 million by the end of 2021.

story by

WILL MADDOX

photograpby by

DAN SAELINGER

From drug development to clinical trial infrastructure and delivery of services, these innovators are disrupting the region’s pharmaceutical market.

SULAGNA BHATTACHARYA

Nanoscope Therapeutics

SUCHISMITA ACHARYA

AyuVis

B

BY THE TIME MOST PEOPLE HEAR ABOUT

a pharmaceutical advancement, chances are that the scientists have been waging war against a specific disease or condition for years, if not decades. According to industry group PhRMA, it takes 10 to 15 years on average to develop a new medicine from the moment of discovery through the regulatory process. The process is expensive, too. Estimates range from just under $1 billion dollars to $2.6 billion to get a drug out of the lab and into the pharmacy.

In addition to the biology and chemistry aspects of development, there is an entire industry to support the infrastructure needed to get these life-changing advancements to market. Over the past couple of decades, North Texas has become a leader in the life sciences and drug development industry, attracting the types of companies that create a pharmaceutical powerhouse and the talent to fuel ongoing growth.

North Texas is home to McKesson, one of the largest pharmaceutical distribution companies in the world. In addition, it has recently attracted the first non-coastal location of BioLabs, an international network of shared lab and office space. There are many other companies in the space that operate under the radar, quietly making a difference for patients and a name for the region as one that supports and develops life-changing medicines. Here are four of them.

STAGE 1: IN THE LAB NANOSCOPE THERAPEUTICS

Co-founded in 2009 by Sulagna Bhattacharya and Samarendra Mohanty, Nanoscope Therapeutics has developed several biomedical innovations that include diagnostic and therapeutic treatments. Most of the company’s innovations have centered around bringing sight to the blind. Bhattacharya grew up with a family connection to degenerative retinal disease and was inspired to pursue the science behind inherited retinal degeneration, a group of visually debilitating diseases that can lead to blindness that affect millions of people around the world.

These diseases are especially painful because the patients know exactly what they are missing. “They’re not born blind. They have seen the world and are gradually losing their vision,” Bhattacharya says. “They’re losing their world. So, when they go through this journey, it’s a very traumatic journey for the patient as well as their family.”

The Bedford-based clinical-stage company has numerous gene therapies in the works at various points in the developmental process, and investors are beginning to take notice. The company has raised more than $25 million through various private funding and non-dilutive funding efforts. It has also received orphan drug designation from the FDA for a treatment that will allow it to continue to develop medicines that affect fewer people.

Bhattacharya knows the power of medicine, as she lost both her parents to Covid-19. She is fueled by much more than just making a profit and is hopeful that their treatments will hit the market in the next two to three years. “We have seen the impact in the patients, so I’m optimistic,” Bhattacharya says. “It will bring so many patients relief in their life.”

AYUVIS

When premature babies are born more than two months early, they often injure their fragile lungs and develop bronchopulmonary dysplasia, a breathing disorder where the lungs don’t develop properly. The disease can be mild or severe but can cause breathing difficulty into the teen years, and the children spend a lot of time in the hospital and need extensive care. Fort Worth-based AyuVis aims to change the way these babies are treated.

Standard treatment can include oxygen therapy and sending infants home with complicated breathing equipment. However, the medications can cause side effects and merely treat the symptoms rather than the cause of BPD. “It’s tough on the families because they’re transforming the home into some sort of an ICU,” says Dr. David Riley, a neonatologist at Cook Children’s and also the chief medical officer at AyuVis.

The company is designing immunotherapy drugs that control inflammation and infection and can attack the root cause of BPD and potentially other conditions. Other immunotherapy drugs suppress the body’s immune response, but research has shown that AyuVis’ respiratory treatments do not reduce the immune response.

The venture’s name comes from a combination of Ayurveda, traditional Indian medicine that means life science and knowledge and Vision, representing the founder Suchismita Acharya’s ability to plan ahead. Eight years in and with $6.6 million raised, the company is looking forward to its first clinical trial and bringing some solace to families dealing with a premature child struggling to breathe. “It took quite a bit of time, but it’s a very interesting journey,” Acharya says. “We have a goal to help these pre-term babies to grow with healthy lungs so that they can have their quality of life.”

STAGE 2: CLINICAL TRIALS REVELES

Once a drug is ready to be tested on humans, clinical trials must occur to ensure the medicine is safe and effective. Trials can be costly, inconvenient for potential subjects, and time-consuming for all parties involved. Often, a clinical trial is the last ray of hope for a patient suffering from a debilitating or fatal illness, so providing greater access to these medicines is even more essential.

In addition, the Covid-19 pandemic has put a damper on clinical trial participation, and local researchers are reporting difficulties in recruiting patients for research and trial purposes. Finally, clinical trials have not reflected the diversity of the population that will eventually benefit from them. A U.S. Food and Drug Administration report on drug trials between 2015 and 2019 showed that trial participants were 7 percent Black and 13 percent Hispanic. According to the census, the U.S. is 13 percent Black and 18 percent Hispanic. That lack of representation could have medical impacts, as a diverse population may react differently to the medicine being tested.

R’Kes Starling’s company, Reveles, looks to change all of that by allowing patients to undergo a clinical trial in their own homes. Using telehealth, electronic consent, in-home nursing support, and home health, Reveles manages trials so that patients can go through the entire process without worrying about transportation and other barriers that keep patients from participating. Reveles is ahead of the curve; EY predicts that by 2024, 50 percent of all clinical trials will be hybrid or remote.

Starling launched the Southlake-based business in 2020 after several years with McKesson and is currently in a pre-seed round of raising money. As of this spring, the company onboarded 12 customers, with eight more on the way. As a Black entrepreneur, he knows that decentralizing and digitizing the process will allow for a more diverse trial population.

Location isn’t the only advantage Reveles provides to patients and trial sponsors. Having trial participants interact with a nurse in their home rather than a clinical investigator has proved helpful. “Patients will be more open to the provider as opposed to the investigator; it’s a common phenomenon,” Starling says. “Our role is to capture all that information and get it back to the principal investigator and the sponsor.”

STAGE 3: DELIVERY & SERVICES COURMED

CourMed launched before the pandemic as a healthcare delivery service, crowd-sourcing drivers to offer next-day delivery of pharmaceutical and healthcare products. Partnering with pharmacies to cover the cost of delivery, the business quickly grew, as consumers prioritized convenience and the gig economy grew.

During the pandemic, CourMed shifted into the vaccine distribution market. The company organized healthcare providers and helped connect them to patients needing a Covid-19 vaccine, and CourMed connected patients with a pharmacy that may have gained a new customer.

Partnerships with McKesson, Microsoft, and Google helped CourMed grow quickly, and the business has continued to evolve. Today, it focuses on delivering healthcare services to patients in their homes rather than products. The company helps source everything from optometrists to dentists willing to make house calls.

Founder Derrick Miles has even been a beneficiary of the services. After working out one day, he found that his ear was clogged, and there was nothing he could do about it. He avoided a hectic trip to the emergency room when a provider came to the house to unclog his ear. Not only was it more convenient, but it was also cheaper than a visit to the ER, he says.

At its heart, McKinney’s CourMed is a technology platform built to connect customers with services. Miles has expanded the business to connect concierge physicians to patients, leveraging the CourMed customer base to raise the concierge physician’s practice. “Customers don’t want to leave and want to get all those services at home. They don’t want to leave and go to the dentist or the doctor,” Miles says. “With the ability to get all the services, they get their time back.”

R’KES STARLING

Reveles

DERRICK MILES

CourMed

WEATHERING THE STORM

Hospital system leaders grapple with an industry that’s in flux while preparing for the future.

story by WILL MADDOX

IN THE PAST COUPLE OF YEARS, North Texas healthcare executives have faced multiple generational challenges, dealing with everything from COVID-19 to physician and nurse shortages that have led to a fierce war for talent D CEO’s healthcare news site recently brought together three of the region's most influential leaders to disuss the changing nature of healthcare and how it impacts hospital systems. Participating were Chris Durovich, president and CEO of Children’s Health; Peter McCanna, CEO of Baylor Scott & White Health; and Dr. Sanjay Shetty, president of Steward Health Care System. The conversation touched on the future of the pandemic, how providers can embrace value-based care, and what a hospital system may look like in the future. Here’s a recap of the discussion.

WHAT ARE THE CURRENT ECONOMICS OF THE LABOR MARKET IN YOUR HEALTH SYSTEM, AND HOW ARE YOU ATTRACTING AND RETAINING TALENT?

CHRIS DUROVICH: “We’ve been able to weather that storm because we’re in affil tion with 50 different colleges and universities, so we have talent coming into the pipeline through internships, externships, clinical rotations, and the like. We also got in front of the storm cloud by implementing raise programs to retain people, particularly in the clinical space. For example, in our most portable workforce—the ladies and gentlemen who work in housekeeping, food services, or plant operations—we implemented a living wage program six years ago. The mechanics were in place to allow us to immediately scale that up so that we can retain these valuable individuals, as they are an important part of our patient care team. On the nursing side, we have nurses in 100 different depatments at Children’s, and 60 of them went through retraining and offered more than 1,500 shifts. That’s a lot of person power to put back into the system with a very incremental expense.”

PETER MCCANNA: “Labor is a very serious public health problem. A lot of industries are facing workforce shortages. But during the surges of the pandemic, particularly the last Omicron surge, it wasn’t the number of physical beds that was restricting assets; it system. We have more than 12,000 nurses, and this workforce shortage affets all allied health professionals. So, it’s a severe problem. It’s acute, and we believe it’s a long-term problem. We are addressing it in a disciplined fashion. Our program is the four Rs: recruit, retrain, retain, and reduce agency (using staffing encies to fill positions). Bfore the pandemic, we had essentially zero contract agency nurses. At the peak of the January Omicron surge, we had 1,500, at rates of $150 to $200 an hour. These are massive investments. It is the most significant near-term and long term problem facing hospital systems, but it’s something that we can fix. e need to attract young people to the profession because it’s a profession of purpose, it’s going through a lot of change, and it is an exciting place to work.” on survival—on equipment, PPE, and keeping our people safe—that we got away from some of our core tenets of culture. That’s something we’ve been reinvesting in with programs that focus on making sure everyone remembers why they work in the facilities they do, why they love to serve the community, and why their roles are so important. When we started to look at why people were leaving the workforce entirely or leaving us, wages were a part of it. But there was more to it. Often, it was due to their direct supervisors. All the turnover that had happened in our workforce meant that people were now supervisors who had never been trained to be leaders. Our culture program started at the bottom, but we’ve now expanded all the way up to the level of the chief nursing officer to ask ‘What do you know about being

“We’ve gotten smart about how we invest in accountable care through data and analytics.”

DR. SANJAY SHETTY, Steward Healthcare System

was the number of available medical professionals to train and treat patients. We were at the point with Omicron where we began to see lines forming outside the emergency department. At some point, you can’t treat people because you do not have the capacity to treat them. We have 50,000 employees statewide in our

DR. SANJAY SHETTY: “All of us saw through the pandemic that the rising contract labor prices changed the dynamic of the entire workforce. Suddenly, the stickiness to an institution changes when nurses can travel across the country and make enough to pay off a motgage in six months. During the pandemic, we were so focused a leader? What do you know about employee engagement and retention? How can we make you better at that part of your job?’ It is paying dividends with respect to retention. From a recruitment standpoint, we’ve expanded our international recruiting, and we’re thinking about new pipelines we can open. We’re opening two

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nursing schools—one in Florida and one in Arizona.’”

WHAT CAN YOU SHARE ABOUT WHAT YOUR SYSTEM HAS LEARNED IN THE PAST TWO YEARS?

MCCANNA: “The pandemic forced us into a different managerial operating style. We moved from mission control to what we call mission command, meaning we are clear about what the goal is but allow the commanders in the field to innoate and achieve those goals. There are fabulous things that are going to pay dividends down the road as we go through the modernization of healthcare. We have learned how rapidly we’re able to apply virtual care in our environment. We’ve just scratched the surface of virtualization in healthcare. We’re in the firt inning but have an optimistic future where everything that is done short of a procedure will be done through a virtual channel and, on top of that, a home channel.”

WHY HAS STEWARD EMBRACED VALUEBASED CARE, AND WHAT CHALLENGES HAS IT ENCOUNTERED ALONG THE WAY?

SHETTY: “We started in 2010 from a set of six community hospitals, then owned by the Boston Archdiocese, so we embraced accountable care because it was a survival mechanism. We’ve taken on value-based contracts in the commercial space, and we’ve aligned ourselves with a large network of physicians who believe in the model and are also incentivized to believe in the model. We’ve gotten smart about how we invest in accountable care through data and analytics, making sure that every dollar we’re putting toward the program is going to reduce total medical expense and yield a better quality score. The country is a very diverse place, and what works in Massachusetts and Florida is probably several years ahead of where we are right now in Texas, which is a market that is much more fee-for-service based. We expect to see that continue to evolve as we engage with payers.”

TAKE A TRIP 10 OR 15 YEARS INTO THE FUTURE. HOW WILL HEALTHCARE SYSTEMS BE DIFFERENT FROM WHAT WE EXPERIENCE TODAY? how to do, which is going to be prevalent in the use of the genome. That, in turn, engenders a whole lot of machine learning and a whole bunch of artificial intellience. Notwithstanding examples in the past five years of Ebola, COVID, and monkeypox, I also think we’re going to see a resurgence of infectious disease, and that’s going to force us to rethink the lines between healthcare and public health. Each of us in our respective organizations is living with this every day. Finally, I think we’re going to see the home continue to play a more important part in care, and this is also going to impact our staffing. oday, we think about clinical care teams of nurses and respiratory therapists and patient care techs and the like. I envision a time in the future when those job descriptions will change.” MCCANNA: “Healthcare healthcare–you can’t access us. If you were in retail, that would be a cardinal sin. So, we want to be accessible through multiple channels and give you care when, where, and how you want it. And it will be personalized to you. We can take information about you, maybe we even have your DNA profile, and we will hit that up against 300 million records and find a cohot that looks a lot like you and use pattern recognition to give you a diagnosis and to issue a treatment plan that we believe will work. Physicians will still have a big role, but it will be augmented by AI. It’s a very exciting future because the tools are uniquely different than thy were just five or 10 years ao to achieve this.” SHETTY: “One positive of the pandemic is that it forced agility, innovation, and a willingness to experiment with things that no one was willing

“Physicians will still have a big role, but it will be augmented by AI.”

PETER MCCANNA, Baylor Scott & White Health

DUROVICH: “We now have mapped the human genome, which is only going to accelerate what we understand, what we know causes what, and ultimately, how we work through how best to diagnose and treat within that dimension of using the genome. We’re going to continue to have the conversation about what we know how to do, but also the ethics of what we know accounts for $1 for every $5 spent in our economy. I think we’re going to see an evolution in healthcare that will look and feel a lot like what you expect from service providers in the other areas of your life—an ecosystem that gives you an array of choices, ease of navigation, and is accessible. What service business issues 50 percent back orders on any given day? That’s what we do in to experiment with before. Telehealth is a great example of that. We went from 2 percent usage to as high as 70 percent. It’s back down now, but not to where it was. People are more used to doing things virtually, and hospitals are going to provide a smaller and smaller sliver of care. In thinking about our hospitals in the future, they are going to have more and more ICUs, with more care

moving out of the clinic and into the home. As mentioned, it’s already starting. For those embracing accountable care models, they are thinking about a more efficient y to do this. For things that we would never have thought could be possible, the pandemic has forced us to say, ‘Wait, maybe we should give it a try.’ If you aren’t going to let me do inpatient surgery, can we try it as an outpatient? That is going to be huge. So what do we do with these big assets of hospitals? We’ve got to think about how we redesign and deploy them for other purposes and serve a narrow niche. I think the future also involves more directly engaging with the consumer. We have engagement with employers, with school districts, and with municipalities because they’re recognizing the value of having a local partner. We need to recognize the power of serving their needs in a much more direct and meaningful way.”

HOW HAS THE PANDEMIC IMPACTED PEDIATRIC VACCINATIONS?

DUROVICH: “There are roughly 20 million kids in the United States under the age of 5. Getting them vaccinated is the most fail-safe way we can continue to protect people. The Kaiser Family Foundation found that fewer than 20 percent of parents of children younger than 5 are indicating they will get their children vaccinated. That’s not a good statistic. Other vaccination rates are down more than 3 percent, so we have an infectious disease issue that may creep back into our lives. If you combine that with increases in measles, chickenpox, and hepatitis, it underscores the importance of timely vaccinations.”

CAN YOU GIVE US A LOOK INTO WHAT THE GROWTH STRATEGY LOOKS LIKE FOR YOUR SYSTEMS?

MCCANNA: “We believe in building out the ecosystem both up and downstream from the hospital to give you what you need. We can’t do that all by ourselves. We’ve got to develop partnerships. We have a long history with United Surgical Partners International and its ambulatory surgery centers, so we’re used to doing this as a health system. We’ve also announced a hospital-at-home partnership with Contessa Health, which is considered by generation, have much less loyalty than you might think. We believe if we are providing them with what they want, where they want it, when they want it, we can increase loyalty. And when we increase loyalty, revenue will grow.” SHETTY: “We’ve been on this growth journey for a number of years, and going forward, it will probably look similar to what we’ve done in the past, which is looking for communities that have a set of hospitals with a paired set of physicians and an affil te network that matches our model. We also divested a portion of our Medicare ACO business. It was described as a divestiture, but it’s probably closer to a partnership with CareMax. We could do this ourselves, but we could partner with someone who’s already good at it and has that access to capital to accelerate our journey. What we’re going to the future is going, and we want to accelerate our journey to pathways where we’re being incentivized to deliver high- quality, lower-cost care.” DUROVICH: “Rough estimates say that there will be 150,000 more children in North Texas five years from now than there are today. What we have endeavored to do is to provide multiple points of interaction. We have our flagship, we have our hospital in Plano, we are part of the Redbird mall development, and we are in the process of opening another facility in Prosper. Through partnerships with two providers, Haven Healthcare and Perimeter Healthcare, we’ve gone from 12 psychiatric beds to 55 beds available. We’ve also moved into the technology space as an independent provider. We have a tele-school relationship with 250 school nurses and tele-mental health

“Rough estimates say that there will be 150,000 more children in North Texas five years from now.”

CHRIS DUROVICH, Children’s Health

the national leader in hospitalat-home, to provide that option to patients who need it. We’d like to think no one ever requests medical records for our patients because they stay in our system, but when I looked at a competitor’s system, it was about 50/50. Patients in healthcare today, particularly if you break it down see is some hospital growth but especially continued growth on the accountable care side. The Medicare model of a sole focus on seniors is something that’s going to be replicated with Medicaid and eventually the commercial and employer space, where each of those populations can have specific needs. We believe that’s where relationship with almost 300 school nurses. We’ve been able to train our team to deliver care virtually, and we have used apps to continue to engage on a business-to-consumer basis. Our opportunity is to use all of those outlets to reach children and, more important, their parents. The future is extraordinarily exciting.”