"Nurses, Stop Undercharging!" with Molly McCarthy

[00:00:11] Hello and welcome to the Nurse Rosa's INsights podcast. I'm your host, Rosa Hart, and joining me today is such an honored guest, Molly McCarthy. Thank you so much for being with me today. It's a pleasure to be here, Rosa. Thank you for the invitation. So for anyone who happens to not know who you are, Molly McCarthy is what happens when a nurse refuses to stay in her lane and healthcare is better for it.

[00:00:40] Molly has spent her career bringing technology, clinicians, and patients to the same table to make care safer, smarter, and more human. These days, Molly advises and strategizes for health tech companies at every stage from scrappy early startups to global giants. She's also serving as a visiting professor of healthcare at Villanova University, pouring her experience into the next generation.

[00:01:08] And before that, she spent nearly a decade at Microsoft as the U.S. chief nursing officer, leading a team of clinical and technical experts who helped health systems and health plans embrace digital transformation, especially cloud and AI, way before it was cool and everybody knew what that even meant. So, yeah, you heard that. But nurses were at the table shaping how one of the biggest tech companies in the world showed up in healthcare.

[00:01:37] And that is exactly the kind of voice that I want to hear from on the Nurse Rosa's INsights podcast. So thank you for joining me again, Molly. Yeah, no, thank you. It's great to be here. Great to meet you. I know we met last, I think, fall. So it's finally good to see this happening. Right. We've done some like LinkedIn and call 10 views here and there. And we're finally like, this is the best we could do as far as face to face for now.

[00:02:05] So, but Molly, you've had a lot of adventures and going from being like a NICU nurse to working in tech and everything and now teaching and being an investor. So what challenge or issue are you working on these days that you're trying to address? Yeah, so, you know, I'm what I call dabbling at this stage of my career, meaning I kind of have my hands in a few different pots, so to speak.

[00:02:36] Since I've left Microsoft, as you mentioned, I've been doing a lot of advisory work to startups, to large companies. More recently, you know, I've talked to so many different nurses who are entrepreneurial or getting into, you know, creating their own startup.

[00:02:57] And through that, actually back up a little bit, past couple of years, I've been working with Nurse Capital as a limited partner. And Beth Brooks, who I know you've I think you've had on the show before, is a general partner and Dan Weberg and Marla Weston.

[00:03:19] And that's an organization that I really felt compelled to be part of because just pointing out the need and value of funneling or, you know, investing rally really into the nursing profession, but nursing innovation, clinician innovation.

[00:03:44] Beyond just another solution to may be a problem, but really might not be a problem. So working with Nurse Capital for the past couple of years as a limited partner, more recently also with Scrub Capital, which is really a community, a collaborative community of clinicians of many different, you know, professions, which I've really enjoyed as well.

[00:04:12] And that's fun because we get to see pitches every week and sometimes opt to invest, angel invest. So it's fun to be part of the start and really building, helping build some of these companies.

[00:04:30] Likewise, you know, I think based on my experience, I have some experience with what works, what doesn't work, you know, scaling a company, going to market, looking at the various facets of the funding. And so that's one portion of what I'm working on right now. The other one you mentioned, I'm the Halley Family Visiting Professor at Villanova. I've been there for over a year now.

[00:04:57] They asked me to stay on another year and that's been really exciting and fun to understand what the challenges are within academia and preparing nurses of the future, as well as understanding faculty, what their needs are in terms of teaching and learning and really upskilling around AI.

[00:05:19] You know, I found as I've been in academia, as I mentioned, you have, you need to look at how, what you're teaching the students and how you're teaching them in the classroom, in clinical. And when I say this, I mean around technology and interaction and communication.

[00:05:37] There's the faculty portion and then really just the strategy of these academic institutions in light of decreased federal NIH funding and other funding. So looking at other opportunities for revenue sources, I think is really important. And then the last thing that I'm working on right now is I have a podcast that I've been working on for, this is going to be my fourth season.

[00:06:06] And that's really to highlight how nurses are going about digital transformation in many different settings. Yeah.

[00:06:45] Not just like you can be an educator or you can be a bedside nurse and you have showcased that across your career. But even like you have all this background in AI and now everybody wants to know about it. But before we were starting to record, we were talking about how you can write a curriculum or a plan of teaching AI. And then by the time, you know, that semester's over, is it irrelevant? Like have we moved on?

[00:07:14] What do we need to know about AI in the next semester that's completely new and different? Right. Yeah. No, I didn't mention I'm working on a couple book chapters. And, you know, I just was, I just received my first edits back from a book chapter within the U.S., healthcare delivery within the U.S. And it's a chapter on AI and health IT. And my concern is that it's going to publication in a year.

[00:07:42] And I want to make sure that how I'm writing it reflects the time where we are today and that the readers understand, you know, things are changing so quickly. Really, since the launch of generative AI in the fall of 2022, just the speed at which it's progressing has just been exponential. That vibe coding was a game changer, wasn't it?

[00:08:12] Mm-hmm. Yeah. So can you tell us some more about your experience with Scrub Capital and Nurse Capital? Because from what you're talking about, it sounds like you get to be a judge on Shark Tank every day, essentially. But, like, healthcare specific, is that what it feels like? I don't know. I don't, I wouldn't call myself a judge, per se. But maybe. I wouldn't call it either any doctor, right? Yeah. No.

[00:08:42] And I like to think of myself more as a coach and a mentor. And, yeah, I definitely have done judging. Mm-hmm. And I've seen a ton of pitches in my time. And I actually got to work with a group of students this past year at Villanova around a pitch that they, as freshmen, all freshmen, do a pitch, regardless of the school. And they actually. All freshmen? All freshmen. Oh, gosh.

[00:09:09] And they bubbled to the top and went on to the next level, et cetera. So that was extremely fun. Okay. But I do get to, you know, I am part of the investment committee with Nurse Capital. So we, you know, we meet and look at potential nurse-founded companies that are interested in funding or a portion of funding from the organization.

[00:09:35] And, you know, there's an intern and some internal people that do all the hard work. And then we get to kind of look through the analytics and the numbers and understand, you know, how this would potentially play out in the market.

[00:09:53] And it's been educational just in terms of really understanding kind of what nurses and clinicians, you know, what they don't know and need to know in terms of taking an idea from, you know, just an idea to full-blown potential startup. And one of the first questions I always want to know, well, two questions. How are you going to make money?

[00:10:23] And what else is, how do you compete in the market? So those are questions I ask all the time, actually, even of professors now at Villanova when they're even looking at doing research. So that's been fun to help educate those processes.

[00:10:43] And Nurse Capital has done a really great job as well as Scrub Capital in creating networks and kind of safer spaces for these clinicians to vet their ideas, to do the pitches, to get feedback. And I recently was working with Nurse Capital to get connected to the University City Center. And I also had a really great partner, Tiffany Wilson, who's the CEO there, who I've known for many years.

[00:11:07] But just they have a really great network where they bring together investors and startups and health care systems within the Philly area.

[00:11:16] So it's really fun to be able to connect the dots between not just these venture funds, but then also how can we work, you know, together in an academic setting so that we're preparing our nurses to feel comfortable working with engineers?

[00:11:40] You know, what can we do to cross-pollinate within the undergraduate arena? So, for example, like I mentioned, the freshman group, they started working with that one, the pitch. They started working with some of the biomedical engineering students as well as some of the lawyers, I'm sorry, the law students around understanding, you know, what could be patented. If you can take that out, can I say that again?

[00:12:10] Hold on just a second because I forgot to put all my stuff on Do Not Disturb. Hey, Siri, turn on Do Not Disturb. Okay. Do Not Disturb is now on. I should get all of my devices. I didn't even hear anything. Right. I had the meaning and I got all nervous. So while you're restating that, go ahead. Yeah.

[00:12:30] So I think it's important for undergraduates in nursing to have the experience of working with different, you know, different groups of students, for example, engineers, biomedical engineers. And my, the students I had mentioned earlier, they were working with law students to understand what legally they can do and can't do.

[00:12:55] So really, I think expanding the ecosystem beyond, beyond just, you know, tech industry and getting clinicians to work for tech companies, which is, you know, what I've historically done.

[00:13:12] And now it's really thinking about how can we start to get tech companies and health IT solutions and how can we give that exposure to students regardless, you know, undergraduate, graduate. And also, quite frankly, how can we have industry start to invest in our schools, academics, higher education schools for nursing, for health professionals?

[00:13:37] Because they, you know, with nursing, you don't, you want to catch them when they're learning and you want to have them be prepared from a technical perspective when they come out. Even if the technology is changing, they need to have the basics around AI, around cloud. That said, the faculty, faculty do as well. Yeah. And I mean, that can be a real challenge.

[00:14:01] I mean, I know when I went to nursing school not that long ago, although my children are sure it was like when the dinosaurs roamed the earth, that we felt like our professors had not been in practice so long that a lot of what they were teaching us was not applicable anymore. And that was a long time before we were talking about AI. So, goodness, I can only imagine. Now, have you ever hosted any, like, hackathons for these collaborations?

[00:14:30] Or are you talking about more, like, ongoing projects throughout an entire semester? I mean, we've talked about a hackathon at Villanova. But I think having been involved in the Nurse Hack for Health, you know, with we started that. I know Rebecca and Sanseel had done one with Johnson & Johnson the fall of 2019. And then we went gung-ho in 2020 virtually.

[00:14:58] So it was Microsoft, Sanseel, and Johnson & Johnson. And that's been just beautiful to watch that change and morph over the years. It's a huge undertaking. But I've been involved with that, obviously, on the Microsoft side. But then I've stayed involved as a coach, as a mentor, as a judge.

[00:15:21] We haven't, you know, before I have, like, an organization, you know, bite off more than they can chew, I want them to come in to, like, don't just chase this shiny object. Understand what a hackathon is. Send a few people there. Send a team there to experience it before you commit. So I'm working with Villanova to try and, you know, encourage that to happen.

[00:15:50] But, you know, a hackathon is a great brief moment where people can really collaborate with technical people from different companies, etc. And come together and ideate over, in the hackathons case, historically with Nurse Hack for Health over, like, a weekend, etc. I know it's changed and morph. And there's prize money now.

[00:16:17] And it's gotten so much bigger and really reputable. It's going on, like, six or seven seasons now. Yeah, and I got to participate in the Nurse Hackathon at Health in Vegas. Okay. What was it? Like, right now it's 2026. So I got to participate in 2025. They had another one. No, I participated in, what year was it? Gosh, 2024.

[00:16:44] And then I observed and took pictures for 2025 because I was there as media. So I was trying to cover everything and couldn't stay for the whole thing. But it was so cool because in 2025 at Health, it was a makeathon. So people were designing things and you could use the 3D printers and things to design, to print out your prototype, to hold in your hand for your presentation at the end.

[00:17:08] And, like, the winners got help getting the patent and everything like that from these companies who were going to, like, mentor them through it. So that was really inspiring. And I think really like a juggernaut for people to see that this is even possible, right, without a huge long time commitment. Yes. But then inspire conversations that continue to go on. Right.

[00:17:35] Yeah, and I think it's important that, you know, students or nurses, really regardless of where they are in their career or schooling, be exposed to different ways of thinking, obviously design thinking. But then also, you know, I'm a big proponent of you don't really know what you don't know.

[00:17:56] And so just having exposure to all the different paths you can take or create, you know, create yourself, quite frankly, if you see a gap. See, and that's another thing that I really, I've had this idea brewing in me. And so I'll just put it out here to you in case it happens out in the world. Somebody steal this idea. You're welcome.

[00:18:19] I would love to see a hackathon that brings experienced nurses together with new nurses and those other disciplines you're talking about, whether it's engineering or a legal team or whatever. Because, yes, you've got like this fresh motivation of the students, but a lot of them may not have any clinical experience to pull from their ideas and know what hasn't worked that has been tried already.

[00:18:46] Whereas the experienced nurses could bring that. And we've hemorrhaged out so many experienced nurses from the bedside. I would really love to see more of them brought in for that advisory role in like a hackathon context. And I think it might give them some encouragement, too, to see some young whippersnappers to give them hope for the future. That's a great idea. I love that. Yeah. So if Illinois wants to steal that, go right ahead. I'm not in a place to throw that party.

[00:19:15] So, yeah, I mean, it is it is a huge, so to speak. Like it's, you know, it's not something you just throw together over a weekend. It's just like any endeavor. You really need to understand the cost associated, the time, and kind of what you're looking for in terms of finished product.

[00:19:40] And are you going to continue with, you know, that type of engagement? And I know the Big East has historically done some around the tournament time in March, March Madness. They've done some on activities where they bring, you know, groups from all the Big East different schools to Madison Square Garden. And they have done like poster contests and presentations.

[00:20:08] And so we've toyed with that idea as well in case anyone is interested in sponsoring that. I'll just throw that out there at the babies tournament. That would be fun. So, you know, there are lots of different ideas. But I think you need to really pick and choose just because, you know, at the end of the day, you still have to keep the lights on, so to speak.

[00:20:34] And you still have to educate the nurses and meet the goals of the institution. So you've seen a lot of people who have put their blood, sweat, and tears into ideas. And you've seen a lot of people who want to fund good ideas. Is there, I'm trying to think, should I frame this as the million dollar question for you or make this separate? So I think I'm going to make this separate as just hypothetical.

[00:21:03] Is there something you wish somebody would just build that you think would be really great and you just haven't seen anybody build it and you don't have the time to do it? That's a great question. I think it depends when I think about that question, I'm thinking big. Are you talking about something with solving a problem within academia?

[00:21:31] Are you thinking about it within industry? Industry, when I say industry, I mean like large vendor companies, big tech or health IT? Or is it something within, you know, the hospital setting? I guess I'm kind of trying to poke the bear and see if there's something rustling underneath that you just haven't had time to air out or something.

[00:21:56] I guess one of my biggest bugaboos, one of my biggest pet peeves is I want to ensure that nurses are valued and paid for what they do, regardless of where they are. Whether they're writing a book chapter, as we talked about earlier, or editing a book. Whether they're giving expertise to a company on product feedback.

[00:22:24] And especially if they're in a hospital setting, I want nurses to understand the value from an ROI perspective that they bring to that hospital. So I guess, you know, and this is not, it could be a tech problem, but it's a bigger systemic issue.

[00:22:48] I really want to see nurses some dollar value assigned to what they're doing every day in the hospital. And I want that cost and charge to be separated out from, you know, a general nursing care charge. You know, I think that, I think it's time that, you know, there are dollars assigned.

[00:23:16] And I think that going into any profession, you know, part of that education is the financial piece, the technical piece, the human piece. Yes. But one thing that I feel strongly about, like I said before, and I'm going to say it again, is that nurses need to be, there needs to be dollar amounts associated and not just a room and board charge.

[00:23:43] Yes. So this could go a couple different ways because, you know, we've had conversations on here before about the commission for nurse reimbursement and creating billing codes for nurses, which, you know, would be a great advancement in the hospital or in a clinical setting. But to your point about nurses getting paid for their expertise in other areas as well, you know, I think a lot of nurses don't know what to charge.

[00:24:11] Right. So, and they think about their hourly wage at the hospital as a baseline. Well, if you're making $35, $45 an hour as a nurse in the hospital, that's different than a consulting fee for a company, which it might be more appropriate just ballparking it to charge $250 or more dollars an hour. Like if you're a legal nurse consultant or if you're doing an authorship project or that, right?

[00:24:41] So, do you know of some good resources that nurses could look for to see their market value in those other areas? Well, I am not a bean counter, but I mean, I'm sure you could do a search around that.

[00:25:03] But I know, for example, when I started consulting with a company a few years ago, I said, this is my rate. And I would encourage everyone to always go higher because it's, you're also, you have to consider taxes, et cetera. Because that's all going to be taken out, right? Eventually.

[00:25:27] But they did, they went back and did like a, you know, a research with some, I don't know, I want to say JP Morgan or something, some financial company. I don't recall that. That was so many, like five years ago. So we did adjust for inflation. So yeah, at this point. Right. So, I mean, I do think, you know, it depends what level you are. It depends what you're consulting on.

[00:25:57] But nothing should ever, knowledge shouldn't be given away for free. Yeah. It should be worth your time, especially if it's taking your time away from other things. Right. Yeah. And it's not just about time either. I think we're, nurses are very much used to trading time for money as opposed to trading expertise for money. And so that's a really different calculation. So I'm really glad that you brought that up.

[00:26:27] Now, that does bring me to the billion dollar question. So, Molly, if you were given a grant for one billion dollars to meet a need you see in health care, how would you like to see it used strategically to have the most sustainable impact? Well, I hear some game show time ticker music playing down.

[00:26:54] So I think there's like a certain number of seconds when you get caught. So I forget what I put in the screening question. But, you know, that you asked me prior to this. But, you know, I think, gosh, there's, you know, one of the things that I've seen that I wasn't even aware of are the different foundations that provide scholarships for students.

[00:27:21] So I've had more exposure to that in the past year, just understanding, for example, like the Bedford Foundation, which, you know, gives so much to second degree students or undergraduate students.

[00:27:35] But I think one is funding, you know, funding people who are in need to have the education, to have the bachelors or to become an advanced practice nurse in some way, shape or form and commitment afterwards to the profession. And I think also, though, conversely, the students, but we also need to invest in our faculty.

[00:28:06] We need to think about different models for education. I think that one of the things that I've loved is that I'm a visiting professor. So I come in and as you said earlier, I don't stay in my lane and I'm sure I caused some issues. I told the dean, I was like, we need to move faster.

[00:28:27] But I do think having, you know, especially in this day and age, having someone come in, like doing a guest lecture series, doing visiting professorships, etc., bringing in industry to academia, just so there's more connections on the front end when we're doing the education so that when nurses come out, they feel prepared, you know.

[00:28:54] And they, you know, after two years, they, a lot of them have an itch. I had an itch to like go out and do more, but have more of a pathway back to either education becoming, for example, a CRNA or an NP. So, I mean, right now I'm hot on education because I feel like it's been pinched.

[00:29:17] And if we don't invest in the future, both from a faculty and student perspective, you know, we're going to compromise, you know, the output into whatever care setting. And the other thing that I kind of along the lines of that question earlier is I probably hire like an accountant and project manager to help me oversee and a statistician because that's not my forte.

[00:29:46] But I think there needs to be a component in undergraduate education around understanding like financial and technical, just like a 101, so that the nurses understand from a systems perspective how it looks and not in, you know, not in a graduate level, but really within that undergraduate level.

[00:30:15] So I'm going to put my money towards education. Yeah. Well, and I love that idea. And, you know, any ideas do you have as far as how to adequately reimburse nursing instructors so that they can afford to be educators? Because a lot of them have to take a pay cut from leaving clinical work in order to be educators. And wouldn't you say?

[00:30:41] Yeah, I think I'm just going to be bold and say I think academia is really antiquated in terms of how they compensate faculty. And I don't necessarily, I'm not a huge fan of tenure, if I can just say that, because I think that you need to, what is it, play to, pay to play. I really believe that you got to stay fresh.

[00:31:10] I always tell the faculty, I'm like, get outside the four walls of Villanova. Go to health. Go to HIMSS. Go someplace where you are uncomfortable and you are not in your lane. Because change isn't going to happen by you doing the same thing, you being exposed to the same people. And I do believe that, you know, my son was saying my best professor was a visiting professor.

[00:31:38] And I think they bring in that real world experience that goes beyond, here's the theory of, you know, care planning and et cetera, et cetera, which is all important. But I do feel like academia, faculty need to be, we need to look at a different way of compensation that really changes behavior. Yeah.

[00:32:06] And I don't necessarily have an answer for that, but I have, I have broached that subject a few times. And, you know, people don't like that, but it's, it's an industry that is right for disruption and it needs to be, it needs the ability to be more dynamic and changing. Or they could also provide childcare on site for instructors and students. Right.

[00:32:35] But a lot of places probably are now, I hope. But I wrote a post on LinkedIn the other day about how I was able to work my way through nursing school without taking out student loans for my tuition because it's cheaper than, it's gone up since then. But I did have to take out a loan to pay for the childcare that I would have not have been able to afford and therefore would not have been able to attend school otherwise for.

[00:33:01] And so, you know, childcare is such a big, important factor in this and with nursing being such a female dominated profession, I think that's a huge factor. So if you're not going to raise wages, at least provide some childcare on site. Right. That would be super helpful in case anybody wants to invest in that. Yeah. That's a great idea. While we're brainstorming. I mean, that's a, that's a nationwide problem. For sure. Yeah. Childcare in general. So. Yeah. Well, awesome.

[00:33:30] I mean, I can think of a lot of different ideas with the billion, but let's just start there for today. Hey, got to start somewhere. That's a great foundation. So. Yeah. Yeah. Well, thank you so much for sharing your wisdom with us today, Molly. Is there anything else you would like to invite our listeners to investigate? Um, let me think. Um, I remember.

[00:33:58] Well, we were talking right before we started recording and you were telling me about how you met Mark Cuban and he in the Starbucks. And that just reminded me of saying that someone said to me once, and I can't remember, to be honest, where, where it was, but is you can't get what you don't ask for. Um, and take a risk.

[00:34:26] Um, don't stay in your lane. Um, and, you know, uh, it's just been a pleasure talking to you and hopefully your listeners will get some insights out of this. And I'm looking forward to connecting with you in person, I guess, at probably at health. Probably. I will be there. The media pass has been approved. So. Oh, good. Hotel is booked because it's formula one week this year. Did you see that?

[00:34:56] No. Oh, my God. So we're talking about the conference health spelled HLTH. It's in Vegas in November. And no, they're not paying me to say this. I just absolutely am obsessed with this conference. And Petunia, their unicorn mascot, who I need a selfie with every year. But, um, uh, like I said, we have great nurse hackathons there for one thing. I get to go as a podcaster and, um, interview amazing thought leaders while we're there.

[00:35:23] But this year it is happening on formula one week. So if you want to go book your hotel and flights now, because it's not going to get cheaper. Yeah, that's good to know. Thank you. Exactly. Cause I want to see you there. So I need to have a room. Awesome. And if people want to reach out to you, um, would LinkedIn be the best way? LinkedIn's great. Yeah. Just reach out to me on LinkedIn. That's the best way to get in touch with me. Yeah.

[00:35:52] And you've got some great content around your podcast there. So I'll have a link to that in the show notes. And then for our listeners, if you've enjoyed this episode of the Nurse Rosa's Insights podcast, please be sure to like and subscribe wherever you're listening. Or if you're watching on YouTube, you can connect with me on social media at Nurse Rosa Speaks. And I'll see you in the next episode. Bye.