cgallagher [at] jhdgroup.com
City, State: Dallas, TX
HCAD Class Year: Master's in Health Care Administration 2002, B.S., from Trinity University in Biochemistry and Molecular Biology 2000
I am a director of the JHD Group (John “Hank” Duffy—firm founder), in Dallas, which provides management consulting for physician groups, hospitals and health systems. I’ve been with the firm nine years with the past four focused on firm growth and development as well as directing projects and personnel in physician practice optimization and improving infrastructure design. Many of our shorter term management consulting projects and “blitzes” lead to longer engagements that involve project management and turnaround services to enhance operational, financial, clinical and revenue departments. Lastly, we provide practice management for large physician groups (independently owned or employed by a health system) who select us to run their operations. We do this by aligning our deliverables to our client’s goals and becoming a partner with our client with risk based incentive metrics.
What I love about where I work is that we don’t view ourselves as consultants but rather as partners with ‘skin in the game’. Based on the type of project and clients, if we don’t hit our metrics and deliverables, we don’t get incentivized. It’s a collaborative environment and one in which our group and physician practices must align for it to be a successful partnership. Plus, by running physician groups smoothly, we give the doctors time to be doctors and focus on clinical care while we handle running the business. After all, physicians went to medical school to deliver care, not to run a business. In the past, when they graduated medical school, they were expected to hang a “shingle” and do business. In today’s health care landscape, that is very difficult to do and we’re here to help them accomplish that.
I studied pre-med as an undergraduate and biochemistry and molecular biology were my official majors. It was when I was taking my MCATs junior year that I made a big decision. We broke for lunch during the test and I sat back to take stock of what I wanted to do with my life. I had the distinct feeling that I could not want to go into medicine and look at patients with a dollar sign over their head.
Some of my close friends and fraternity brothers who had gone through Trinity’s Health Care Administration program convinced me that there are other health care career options. I could still be in the health care arena but with no clinical delivery or big worries about the business outcomes of running my own practice. I wanted a career that provided financial stability for my family and when I thought about all of the loans necessary to get all the way through medical school along with the personal sacrifices of time away from family it was heavy on my heart and my decision was made.
Yes and no! I came into the Trinity Health Care Administration program knowing it was excellent at pointing students toward hospitals, especially with the benefit of the residency experience, but I knew I wanted to consult and see everything that was possible because I thrive on new challenges. So, I relied on the class background for theory and structure while knowing that the bottom line drives how systems are run. It really helped me focus on learning which continues even now.
Well, first of all, the education was superior. The program gave me the background to substantiate my opinions with credibility. Having the Trinity name is helpful but the knowledge coupled with the intangibles of networking is invaluable. That credibility factor is key because otherwise, consultants are apt to be viewed as 'suits' trying to sell something. My residency at CB Medical Management Professionals in Plano (now part of Zotec Partners LLC) was also very helpful and uniquely prepared me for what I'm now doing.
I think becoming a director in my current firm at such a young age is an accomplishment but it's really the teamwork with my colleagues of which I'm most proud. We work with physicians on an average 50-55 hours per week and those doctors have varying degrees of enthusiasm. Our team is so cohesive and successful that we routinely see clients succeed as a result of our efforts and seeing clients benefit from that work we've performed as a unit is very gratifying. One example was turning around a group of physicians anticipating a huge annual loss. JHD had that practice turning a large profit in 18 months without cutting any of their staff.
You have to make yourself happy before you can make anyone else happy so my order of priorities is: self, family, clients and firms. If you're happy, your family is happy! This really works for me. Plus, I've built a work team to be supportive of each other. Do we vent? Sure but we always have each other's backs. The real motivation is having a great family structure. My wife and kids are everything to me. Having their support means I'm good all the way across the board.
The two biggest changes I have seen are:
Well, the times are a changing but you sure don't turn a battleship on a dime. All the way down to an individual's physical level of health, things are already shifting from volume to value and it's happening very, very quickly.
At this point, 20% of the patients are driving 80% of the cost and we just have to continue to keep quality in the equation. The systems are there but we have to align everything that needs to be done. The uninsured already use emergency rooms as their first solution, not having access to primary care so the costs are going through the roof. That has to be addressed.
Secondly, health care will become much more integrated on three levels: doctors delivering care, nursing delivering service and front desk and tech providing assistance in a true "care team" model. In addition to these three groups working together, there will be much more physician integration around the "Continuum of Care" - the primary care doctor working with all specialists - to manage patients through active, seamless care so that physicians will work on problems such as obesity that share comorbidity factors like heart disease, diabetes and hip and joint replacements. That continuum of care will include doctors all the way to long-term care to hospice, making sure that patients and their families are clear and comfortable with things such as DNRs, meaning that once they're in hospice, they won't be transported back to ICUs: pretty much womb to tomb.
Learn everything you can, be a sponge and do not be afraid to ask questions multiple levels deep because generally others around you are wondering the same thing. Always have an opinion. You will get great background from the classroom and book time that will build your base but you must be prepared to use that base.
I'd say to realize that it is a career progression and you're now on the path. It will take time but it is so worth it at the end - if you're willing to put in that time. Learn everything you can from everyone and don't take everything as absolute fact. 95% of it will be factual but it's up to you to substantiate it through your own research and experience.
Did I make the right decision? Yes. I have absolutely no regrets.
The driving force in my case is a book, The Pyramid Principle. It's not a health care book and I think it's indicative of my belief that you learn by looking outside your industry. It helps you prioritize and organize as well as to write what you want to say very effectively. There are always going to be proposals, presentations and ongoing interactions. How we talk to and interact with others requires clarity and concision so I'd recommend that book to anyone. Also, The Secrets of Consulting offers advice on how not to be seen as a salesman or empty suit. It's like I tell many clients - we are not 'the Bobs' from the movie Office Space. We're really here to help you!
I love to spend time with my family: my wife Valerie, with whom I've been married to eight years this January and our twins Hudson and Addison who are turning five.
As a family, we love to travel and take the kids to different, fun places. In the summertime, we're in the backyard swimming pool or going out to dinner and a movie with friends. We used to be avid scuba divers, but these days, since I'm gone three or four days out of the week for work, we simply like being together as a family.