Racial disparities and major deficits exist in almost every child health measure. The most important one to improve, according to Dr. Jason Maxwell, is reading and literacy because of its statistical connection to adult poverty and incarceration. Dr. Maxwell, the HealthPartners chair of pediatrics and HealthPartners Como Clinic medical director, discusses getting kids and parents started early with reading, open and honest communication, and listening to patients and their families to find out what’s important to them.
Racial disparities and major deficits exist in almost every child health measure. The most important one to improve, according to Dr. Jason Maxwell, is reading and literacy because of its statistical connection to adult poverty and incarceration.
Dr. Maxwell, the HealthPartners chair of pediatrics and HealthPartners Como Clinic medical director, discusses getting kids and parents started early with reading, open and honest communication, and listening to patients and their families to find out what’s important to them.
Hosts: Kari Haley, MD, and Steven Jackson, MD
Guest: Jason Maxwell, MD
HealthPartners website: Off the Charts podcast
Got an idea? Have thoughts to share? We want to hear from you. Email us at offthecharts@healthpartners.com.
Kari Haley:
He's a rehab doctor from Chicago.
Steven Jackson:
She's an emergency medicine doctor from the Twin Cities.
Kari Haley:
Together, we're examining the health equity emergency.
Steven Jackson:
Inviting voices for change without the cue cards.
Kari Haley:
I'm Dr. Kari Haley.
Steven Jackson:
I'm Dr. Steven Jackson.
Both, together:
And this is Off the Charts.
Steven Jackson:
Welcome to our show. We're pleased to have Dr. Jason Maxwell with us today. Jason serves as a chair of pediatrics at HealthPartners, as well as the medical director at HealthPartners Como Clinic. Welcome, Jason.
Jason Maxwell:
I'm excited to be here. Thank you for having me.
Kari Haley:
Yeah. Thanks so much for being on the show. As a first, get to know you piece, tell us all that is Dr. Jason Maxwell.
Jason Maxwell:
Oh, man.
Steven Jackson:
Everything. The deepest, dirtiest, darkest, just joking.
Jason Maxwell:
I grew up impoverished. I was a biracial child in California. My family originally has Midwestern roots, so they moved here when I was young, to Minnesota. I decided I would never stay in this state. I was leaving forever, so I left back to California, came back, left to Paris, came back left to California, never to come back here again, and now I've been here since 1999.
Kari Haley:
You've got the true Minnesota passion there.
Jason Maxwell:
Who am I? Growing up, my dream was to be a dolphin trainer and I get on the boat and realize I am horrendously seasick.
Steven Jackson:
Oh, wow.
Jason Maxwell:
That's a no. And then I thought, what else do I really, really enjoy? I absolutely love kids. Every job I've ever had has been with kids. In addition, I love talking, and I love science. When I put three things together, my love of kids, my love of talking, and my love of science, the answer was clear. Become a pediatrician and move to St. Paul, Minnesota.
Steven Jackson:
Wow. I'm a rehab doctor, as you know, and there were a few specialties I knew pretty early that I probably would not do, and one was pediatrics. I think it was because I have a lot of pediatrics at home. At least I did. Now, I have teenagers and people going off to college, but nevertheless, thank you for doing what you do.
Jason Maxwell:
I'm happy to do it. I'll tell you, I have a job, I get hugs at work every day.
Steven Jackson:
Wow.
Kari Haley:
And they do give good hugs, those kids.
Jason Maxwell:
They do. Steve, you might not want hugs in your job.
Steven Jackson:
I'm a good hugger and I like hugs. I was reading your bio and I love, one of the lines says, "Dr. Jason Maxwell lives to serve the underserved; it's his passion." Tell us more about that.
Jason Maxwell:
Well, as I said, I grew up pretty impoverished. My family was on welfare. My father was in prison. A kid like that doesn't have a lot of opportunity, and I just was extremely fortunate that I had a school counselor who was kind of looking out for me. The example I use, one day, I think I was a ninth grader. I was sleeping. It was a Saturday and I got a phone call. She said, "Jason, where are you?" I said, "What are you talking about?" She said, "You got to come take this test." "What test?" "It's the PSAT. You need to take this test." She drove over on a Saturday, picked me up, and then drove me to the test. I was an hour late for it. I took the test, and then because of the scores, then they had me take the ACT, and then the SAT, and then that got me into college. If I had not had a person like that, I would never have taken the test. I didn't even know what it was. I did not know how to apply to college.
Jason Maxwell:
Nobody in my family had ever gone to college before. The vast majority had never graduated high school. We need people like that who can help foster the future generations. Daphne Steele, if you're hearing this, thank you. On that flip, now I got to pay it back. To me, I think in the end, I'm going to say Whitney Houston sang it best, "I believe the children are the future," and it's actually true. The children of today. They are our workforce of tomorrow. They are our leaders of tomorrow. We have to educate our kids. We have to nurture them because otherwise we are not going to have the workforce we need and we are not going to have the friends and family and leaders that we need. To me, it's all about payback. It's all about doing what's right. That's why I have a passion, I have a personal history with this, but in addition, I've been so fortunate over the years to work with disadvantaged populations. So many of those kids, you see the light shine off in their eyes that yes, you can.
Steven Jackson:
Wow, man.
Jason Maxwell:
It's a really powerful thing.
Steven Jackson:
That's powerful.
Jason Maxwell:
Yeah. I'll tell you, for me, it's big time.
Kari Haley:
That's amazing. Speaking of the children, any particular stories stick out in your mind of any kids that maybe was the similar path as you, or that you were able to have that influence over, that was just that, yes, mic drop success story.
Jason Maxwell:
I have two. The one, I don't want to talk about it, but I will. The one I'll talk about first that I do want to talk about is, I had a family, they were Ethiopian refugees. Again, they don't speak English. The family had never been educated and they chose me actually, because of a picture. They saw a picture of me and then their youngest girl, as she was growing up, it became very clear, very quickly, that she was quite bright. I kind of worked with them. I helped them advocate for her through the schools and very long story short, she is now, I believe, a junior at Harvard University.
Kari Haley:
Wow.
Jason Maxwell:
To me, that's that piece-
Steven Jackson:
Nice.
Kari Haley:
Wow.
Jason Maxwell:
... where one person can make meaningful impact. The second piece that I don't like to talk about is, a year or two ago, I was named a top doctor from Minnesota and I was put on Minnesota Monthly Magazine.
Steven Jackson:
It's a nice picture, by the way. Go ahead.
Kari Haley:
I google it.
Jason Maxwell:
If you know anything about me, that is not me. I did not want to do it. I was super-embarrassed about it. I didn't tell anybody about the magazine. When the magazine came out, this was the heart of COVID; it had just happened. People were on lockdown. My entire team was burned out and for the first time in months, my team... By my team, I mean, my colleagues at work, my nursing staff, my support staff, they all had smiles on their face, and they had a skip in their step, and there was something good for a change. Even more importantly, the very next day I was seeing patients and a little child came into me and they said, "Dr. Maxwell, you're my doctor." I said, "Yeah?" They said, "Look." And then, the mom told me a story that her child was at, I believe it was Cub Foods, with their child. They saw the magazine, the child became extremely excited and said, "That's my doctor."
Steven Jackson:
Wow, man.
Jason Maxwell:
And then another child said, "Oh, no it's not. That's my doctor."
Jason Maxwell:
So then, the children started fighting over it, and then they both realized that I'm both of their doctor. The reason why it's important is, I'll call this the Obama effect, but my effect is a billion times less. This shows the kids, yes, you can do it. We are so lucky, but it doesn't matter, if you grew up poor, if you grew up where your family doesn't have literacy, if you grew up where your family doesn't speak English, if you grew up and you have significant severe social issues, you still can make it. It's possible. It's not going to be easy, but it's possible. So I think kids need to see that, that there are a lot of things they can do their entire life, regardless of whatever limitations they have to start off with.
Steven Jackson:
I just want to know where your cape is because I don't see it right now.
Jason Maxwell:
There's no cape.
Steven Jackson:
Wow. When I think about a Superman figure of sorts, it's almost like, you're my hero, man. I'm like, you might be my doctor, but it's almost like, each day you wake up and go into the office, that's an opportunity in real time to make an impact that can have lasting implications, man. Is there any pressure or is there just an excitement? Tell me about that.
Jason Maxwell:
The real answer is, there's no pressure because I love what I do and I love my patients. The reason I get up every day and go to work is because I absolutely love my patients. I have the best patients on earth. I'm not the best doctor because of me. I'm the best doctor because of them.
Steven Jackson:
Wow.
Jason Maxwell:
It's so easy when you-
Steven Jackson:
It's magical [crosstalk 00:08:47].
Jason Maxwell:
... watch these lovely children grow up and you see their strengths, you see their deficits, their opportunities. It becomes very easy to help guide those families. I'll make a plug. This is why it's so important that we have what we call a medical home for families, because the more they come in, the more you know their story. The more you know your story, the more they understand you. The more this happens, the more there's trust, and the more that there's trust, the more you can help them on their journey towards health. It is far more easy for me to do this. If I've seen the family and I know the family, and I know the siblings and the parents and the grandparents, that's a lot easier than if it's a person who just walks in off the street. To me, that's the easy part, helping kids and families develop and grow. That's the beautiful part that I love. Now, the paperwork part.
Steven Jackson:
Don't get me started.
Kari Haley:
Not to be a Debbie Downer, but I'd like to kind of delve into some of these disparities that kids have, as not a pediatrician and only seeing kids when they're either very, very sick or just needing that reassurance overnight with their parents. What kind of disparities are common for our general listeners with pediatrics? We've talked a little bit about immunizations on prior episodes, but besides the immunizations, are there other major deficits or major disparities that we see in the outpatient world?
Jason Maxwell:
I'm going to tell you, there's probably a disparity in almost every health measure that we have, and if I was going to do something, I would probably focus on one, and that is literacy and reading. That's probably the number one thing that I think we really need to focus on as a society and also as a medical group. Why is it important? I'd like to take a step back. The reason why I think this work is so important is because it affects all of us. As I said before, the children, they are the future workforce and the future leaders. We need to make sure we do right by them, but what a lot of people don't realize is how early this has to happen. I'm going to give you a couple of stats. I'm going to nerd out here a little, I apologize.
Kari Haley:
Yes.
Steven Jackson:
I like it.
Jason Maxwell:
Why does this affect everybody? Well, first of all, you may or may not know, but as of a year ago, 20% of children in the United States lived underneath the level of poverty line. That's astonishing to me. In Minnesota a couple years ago, was the first year that over half of children born in Minnesota are born on Medicaid, and Medicaid could be used as a proxy for income instability. In addition to that, we think of this as being a very homogenous state, but that's actually changing. Using HealthPartners Medical Group data, people 65 and older, about 87% of them are white. However, 14 and younger, it's only 54% of people who are white.
Steven Jackson:
Wow.
Jason Maxwell:
In addition to that, this goes without saying, half of our population are female. So when people say, "Oh, inequity, that's only for people in minority groups." Well, we're talking about half of the kids are in income instability, half of the kids belong to the Black, Indigenous, or people of color, half are female, which can be considered a disadvantaged group, not to mention the 20% that are truly under the poverty line. You start adding that up, and now we're talking about, either a plurality or, probably a complete majority of patients are now actually disadvantaged. What that means is every single person listening to this podcast is either a member of a disadvantaged community, or they love somebody who is a disadvantaged community, so we need to focus on this-
Steven Jackson:
Wow.
Jason Maxwell:
... because it affects all of us. That's my first part of my nerd. The second part is, why we had to look at this more at an earlier age. Well, the reason why we have to look at it early is, we've done a lot of research, and we found that by the time a child hits kindergarten, two out of every 10 children are behind on their reading by two years or more. In addition-
Steven Jackson:
By kindergarten.
Jason Maxwell:
By kindergarten.
Kari Haley:
By kindergarten, wow.
Jason Maxwell:
Two out of 10 are behind by a year or more. That means 40% of kindergartners are behind by at least one year. We also know that kids do not catch up. If you enter kindergarten behind, you're going to be behind in first grade, second grade, third grade, and the list goes on. Why is that important? We have data looking at fourth graders, and if you are a fourth grader, and if you are not at grade level for reading, there's a 66% chance that you will either end up on welfare or end up incarcerated. I can't even imagine that. 66% of fourth graders could end up incarcerated or on welfare.
Steven Jackson:
Wow. Fourth grade.
Jason Maxwell:
That's fourth grade.
Kari Haley:
That's when you're like, what, 9, 10 years old?
Jason Maxwell:
Exactly.
Kari Haley:
Not even a teen.
Jason Maxwell:
The data is even worse if you look at the third grade population. If you're behind in third grade, you have a six times higher rate of dropping out of high school. If you're a person of color, it's eight times. If we don't catch this at a very early age and correct it, we are dooming these kids to a potential future filled with either unemployment, requiring public service, or maybe even incarceration. When we look at prison data, you see the exact same thing. People who are in prison, federal prison, 40% of people in federal prison dropped out of high school. 50% of people in state prisons dropped out of high school, and even more are on death row. 70% of our population in prison is unable to read. To me, there is a very strong correlation between illiteracy and poor outcomes, so we absolutely need to make sure that we correct this before kindergarten, because once it's kindergarten, it's too late.
Steven Jackson:
You had mentioned earlier the importance of building trust, because trust ultimately leads to the outcomes that we all want. Not just care providers, but the people we serve. How can we take some tools from Dr. Maxwell's toolkit regarding trust, number one, but number two, when you know how crucial it is for your patients, your young patients, to have good reading literacy by third and definitely by fourth grade, how do you emphasize that urgency, maybe to parents who may not see the urgency that you see and know?
Jason Maxwell:
Yeah, that's a good question. In terms of the trust piece, I think the very first piece of this is you actually have to care. There are some people who really don't, and if you don't care, then that's fine. You just need to understand that and move on your way, but if you can care and then if you show that to your patients, they're going to accept that. The other thing is, I totally believe personally in being open and honest with my families, and then in addition to that, listening. Obviously, when I show up to my medical appointments with my patients, I have an agenda that I have to do and I have to be very intentional to knock on the door, walk in the room, look them in the eye, and then sit down and ask them, "How's your day? How is your life? Tell me about you." And now, "What concerns do you have?"
Jason Maxwell:
Work through all their concerns and then listen to them and hear them, and only when all that is done, then I can get to my agenda. I think that's one of the hardest pieces in medicine these days, because we don't have the time to do it, but I think paradoxically speaking, oftentimes this can be done within sometimes one or two minutes. It doesn't take a lot of time. That's the first part is, connect with your patients. You've got to care and you have to listen.
Steven Jackson:
I love it. I love it. Now-
Kari Haley:
Push in part number two.
Steven Jackson:
Part two. You have a parent or parents that come in and maybe they don't see the urgency in getting their child to a point of being literate at their grade level, even beyond, and you see it, how do you get that message across without losing the audience?
Jason Maxwell:
That's a great question. I'll say a lot of this, the work is done beforehand. If you start this conversation when the child is three, we are too far. It's too late. Instead, if you start the conversation way back, then the patient understands this and the family understands this, by the time the child is three. As an example for our medical group, we start this conversation with pregnant women before they deliver their child, and this is where I think listening comes in. It's not only listening in terms of listening as a clinician, it's listening in terms of leadership. For many years in the medical community, we oftentimes would get a bunch of extremely smart people together, and we would come up with solutions and then we would give the people the solution and that's not going to work.
Jason Maxwell:
Instead, what we're finding increasingly is we need to engage all of the stakeholders. We need to all get together and have a conversation about what is important for each individual community. Once we understand what's important for them, then we can meld what's important for them with what's important for us. Once we put this all together, we can come up with a plan for success. I'll give you an example. When we rolled out developmental screening for all of our patients, a lot of our patients in certain communities felt nervous because they were worried that we were trying to label their children as diseased or autistic, and then that child would have the label for the rest of their life.
Steven Jackson:
Wow.
Jason Maxwell:
Because of that, the parents would either refuse to do the screen or they would lie because they did not want their child labeled. What we needed to do is stand back and listen and understand that concern, and then once we have that concern, then we can come back and say, "We promise you, this screen doesn't label your child as anything. This screen doesn't make a diagnosis whatsoever. This is just so we can see where your child is. We can find out all of their successes and all of their hurdles, and this will allow them to go further in life than they otherwise would have. It's all about your child." Once our community members started hearing that message, and on a side note, it's important to say, "I didn't create that message. This is the message that our community leaders made with that actual group. This is something that now resonated with the families." If we were able to come up with a communication strategy to explain to our families why it's important for them, then they're on board. It's all about, again, listening,
Kari Haley:
I'm feeling, I'm hearing the themes of the listening, the communication, the trust, the partnership.
Jason Maxwell:
It is.
Kari Haley:
And everything. Have you had opportunities to partner with other communities. I know having a recent, soon to be kindergartner, he had to go through his preschool screening when he was four or something like, 3 or 4 years old. Have you partnered with school districts or other community centers to kind of help move this work forward?
Jason Maxwell:
Yes, for sure. We meet with all of the local counties and also all of the local school districts and it's a very clear message. We want to get these kids screened by age 3. By age 3 we mean the early childhood screen, which people commonly call the kindergarten screen. Again, it starts way before that. I actually start screening up my patients at age 2 months. The two-month visit, they get that first screen, and I do it every single visit. The patients feel comfortable with it because it's just part of the flow, and then this way, if you're starting to see that there's a possible concern, we can actually get screening done much earlier with the school district.
Jason Maxwell:
There are programs such as the early childhood family education. There's also early childhood special education, head start, etc. If we're seeing issues, we can get those kids in earlier and if there's no issues, then we'll screen everybody at age 3. There's massive partnerships that happen with every school district. In addition to that, all of the county departments of health and then in addition, again, it's those community support. Also, the religious organizations are fantastic for this as well.
Kari Haley:
I'm also hearing, too, just for our listeners who aren't within health care, I feel like a lot of times when I've talked to other moms and stuff, you go into your pediatrician to get your immunizations, so that's why you're going there, but it sounds like there's so much more to that visit and so many other important things that you're looking for, and you're trying to address at seeing those kids at those shorter intervals when they're so young.
Jason Maxwell:
That's exactly correct and that's where, again, the time pressure comes in. You talk about strategies for equity. One of them is standardization. We want to have nuanced discussions with all of our families. Don't get me wrong. At the same time, one of the flaws that we have run into is, if a patient goes to one clinic and gets one amount of care and they go to a different clinic and get a different level of care, that's going to cause inequality.
Steven Jackson:
Yes.
Jason Maxwell:
We have been very intentional about trying to standardize in such a way, so that a patient will come in and they will get the same level of care, regardless of which clinic they go to, regardless of what care team they see, regardless of any personal identifier, their race, their country of origin, the language they speak. It shouldn't matter. They should get that same level of care. By standardizing it, then all of the teams know what to do, and then that makes them more efficient so they can get through that visit. Now, of course, we're not going to get it all done the same day. That's why we do follow up visits, but it is really important to get this done, and again, we start it at birth.
Steven Jackson:
I think it's important for our listeners to know, especially if they have young kids or if they are with child, so to speak, pregnant, that Jason and his team and the general community, we're not here to judge, we're not here to label, we're here to prepare, to change the narrative and move the needle back towards something more positive than some of the statistics that we've heard today. I can imagine because I am a father. My kids are much older now, but at the same time, I remember being a new dad and every symptom gave me knots in my stomach.
Jason Maxwell:
Oh, yeah.
Steven Jackson:
And then to hear something like, your child isn't perfect or your child has a speech delay or different things like that. You take that to heart and then you start potentially, questioning yourself and there's just so much that goes on in that room when it comes to pediatrics, which is why I didn't go into it. I thank you, Dr. Maxwell, but how do you reconcile some of the discomfort when it comes to just the field in general? And then you add on top of that, again, the obligation to educate, even if the landscape, it's uncomfortable sometimes.
Jason Maxwell:
I'll say a couple things on that. The first one is, a lot of it is having that trust. By the time I'm having this discussion with the family, hopefully I've already seen this family for years, if not longer. When I sit down and have the conversation, they know that I love them. They know that I care for them. They know that I am doing everything on behalf of their child. That is 99% of what I need to get done right there. I think the other piece is, this is a variation of listening, is we need to really understand where our patients are, and we need to meet them where they're at and not where I might want them to be because-
Steven Jackson:
That's great.
Jason Maxwell:
It's true. Maybe I really think that the patient needs to be reading at age 4 and maybe the patients don't, or the parents don't, so then, how can I work with them and meet them where they're at, so that we can move forward, even if we're maybe not getting to the desired end point that I have and we've run into this before. We had a program that was called Read, Talk, Sing, I believe it was called. We started doing this program. It's a great thing. Read to your kids. It's a fantastic thing to read to your kids, and then we got some feedback from some of our community partners that in their culture, reading isn't necessarily as important. In part, because in some languages it's not even written. How are you going to tell a family who speaks a language that's not written that reading is important. We took that to heart.
Steven Jackson:
Wow.
Jason Maxwell:
That was a powerful message for me anyways. Instead, we changed the order and we said, "Well, let's really focus on other things. Let's focus on talk, let's focus on sing, let's focus on play, and let's put that read at the end." So now, it's still there. We still think it's important, but maybe these other things are equally valid to get our children to the literacy levels that we need. Meet our patients where they're at, listen to what they're saying, and they're going to come along for the ride.
Kari Haley:
Have there been many challenges, because not only are you taking care of that child, but as you've also mentioned, you're taking care of that family as well. Have you had challenges with, maybe you got the trust of the kid or you have the trust of the parents, you have the trust of the family, but then the other half doesn't have that trust, and how do you bridge that piece?
Jason Maxwell:
Hmm, that's a tough question. That's a PhD level question.
Steven Jackson:
Get him, Kari. Get him.
Jason Maxwell:
It will happen at certain times, and that's probably one of the most difficult things because we do not want to do, we don't want to insert ourselves between parents or grandparents. I think that's not the correct way to go. I would say it's a variation of what I'd say before. First, we need to find out, what is the concern of the other party? Because more times than not, more often than not, there is a concern that they have, it's valid, and we just have to help them bridge that gap. The nice thing is, at least when it comes to things like reading literacy, learning, school, et cetera, it doesn't tend to be as contentious as maybe, let's say, some of the vaccinations or some of the medications that we use, so that piece is a little easier.
Jason Maxwell:
In the end, I will sometimes joke with my patients again, because they know that I love them. I'll say, "Listen, I'm not getting in the way between mom and grandma. I'm not doing that, and grandma's super smart. Mom's super-smart, and here's what I believe, and here's why I believe it, and now you know as much as I do, and now that you know as much as I do, you can make the best choice for your child because in the end, that's all we can do. This is shared medical decision making. I am not the boss. I might be an expert, but I'm not the only expert."
Steven Jackson:
Yeah, that's great. Again, just like Kari said, I'm hearing themes of listening.
Jason Maxwell:
Listening.
Steven Jackson:
Building trust, which is in probably every one of our episodes.
Kari Haley:
Yes.
Steven Jackson:
Meeting our patients and families where they are, and I love what you said about how if you include them in on the decision, they'll be along for the ride. In other words, you don't have to pull people, if you just invite them and say, "Hey, this is a partnership," and it's again, going back to living our values. It's not just a plaque in our executive conference rooms, but partnership is one of our values, and I think you are the epitome of that, sir.
Kari Haley:
Yes, with your cape.
Jason Maxwell:
Oh, man.
Steven Jackson:
Oh, man. Any final thoughts for our listeners that are somewhere? Any flies on the wall, what do you want them to know?
Jason Maxwell:
Well, I'd say, we have come so far these last 20 years since I've been a clinician and especially the last four years. Obviously, George Floyd is still in a lot of our minds. The anniversary wasn't too long ago and terrible tragedy, and has really helped everyone understand how important this work is. Now, we have the buy-in from all levels everywhere from government officials to corporate entities, to everyone within HealthPartners Medical Group, to all of the doctors, all of my support team, we're all in alignment. This has really allowed us to move forward at a much faster rate than we were able to let's say the decade prior. I think a lot of my stats were doom and gloom. At the same time, when I look at the disparity data that we have today and I compare it to five years ago, it puts a smile on my face. In fact, we have one measure, I won't say what it is, but we have one measure that we have always had a disparity, and now, our Black, Indigenous, [and other] people of color are outperforming our white patients in that, and it's because we were able to focus our energy and make it happen. If we can do it with that one measure, we can do it with others.
Kari Haley:
Well, from one former wanting to be a dolphin trainer to another, who became a doctor, thank you so much for spending time with us today and giving us the nerdy stats. I think those are incredibly and really eye opening, especially too, for a lot of our listeners and for ourselves even, because if you don't know it, you don't know it, and it's amazing that you're doing all this incredible work as well to really get the kids where they should be and where they need to be.
Jason Maxwell:
It has been truly a pleasure today.
Steven Jackson:
Since you quoted Whitney Houston, did you want to sing a couple of? No? OK. Just checking.
Jason Maxwell:
I want to sing. Your audience does not want me to sing.
Steven Jackson:
Dr. Maxwell. Thank you so much for what you do.
Jason Maxwell:
Steven, thank you so much again.
Steven Jackson:
See you in the hallway. Off the Charts is a production of HealthPartners and Park Nicollet.
Kari Haley:
It is recorded by Jimmy Bellamy, with creative by Peggy Arnson, Tina Long, Tim Myers and Jeff Jondahl.
Steven Jackson:
Production services provided by Matriarch Digital Media.
Kari Haley:
Our theme music is by Ryan Ike.