Your research into improving management to lead to better health outcomes is intriguing. It is a strategy that crosses multiple disciplines and subspecialties of medicine and health. By addressing management and leadership to affect health delivery system operations, you are working upstream in the system and hopefully affecting multiple downstream disparities in outcomes. One of my concerns in my area of research interest is that the health system is too difficult to navigate (for multidisciplinary neurooncology care) for those with low health literacy and limited resources for transportation and home support. Your research focus to address how health systems are designed and operated would shine new light onto the role of the health system in disparities in my field of neurosurgery as well. Thank you for addressing this issue.