Since 2002, Dr. Collier has been at the helm of ARcare as our CEO. After his medical training, Dr. Collier returned to his hometown of Augusta in 1981 and enjoyed practicing medicine, but was excited by the chance to build “White River Rural Health” (our previous name!) into the ARcare and KentuckyCare family of clinics that you know today.
Over the years, Dr. Collier has been deeply touched by his patients, who he gets to know from birth until old age. Being involved with patients for their entire lives is a special aspect of medicine for Dr. Collier. To him, the continuity of care that ARcare and KentuckyCare provide makes them completely different from a “minute clinic” or an urgent care center.
This is because the goal of ARcare and KentuckyCare is to provide “Health for All” at any age and any stage. And this is not a phrase that Dr. Collier just throws around. It is the mission that defines every decision he makes as CEO.
When he isn’t wearing the hat of CEO or interacting with patients, Dr. Collier enjoys exercising, being outdoors, spending time with his grandchildren, and traveling around the U.S. (or abroad, as time permits!).
Transcript of the Conversation
RJ: Welcome to the iProv Made podcast, where we teach you how to build a profitable healthcare practice. How are you, Jordan?
Jordan: I’m doing well. How are you?
RJ: I’m good. You know, we’ve got a special guest, where we actually get to hear the story of how he has started his healthcare practice.
Jordan: Oh, yeah, I mean, so you guys are in for a treat. today, this isn’t our usual format. This is actually one where you recorded a while ago, it’s with Dr. Steven Collier, and Our Care. So, Our Care is a family health practice, and they have around 90 different clinics across three different states.
RJ: Well, that’s just as of today.
RJ: It seemed like every time you look up; they’re adding more and more.
Jordan: Yeah, it’s, it’s crazy. So again, a little bit different than our format. We’ve had this one in the can for a while and just tried to figure out what to do with it. And what we’ve decided is, he’s just got a great story. So, this would more follow his path, from kind of how he started the practice to where they are now. So, I know there’s some value and benefit in this. And I’m excited for you guys to hear doctor Collier your story.
RJ: And hopefully glean a little bit of information for yourself and how you can borrow, some what’s worked for him, as you also practice.
Jordan: So, let’s get to it.
RJ: Dr. Collier, thank you for being here. For the listeners who don’t know about Our Care, why don’t you just talk a little bit about Our Care and tell us a little bit about what you guys do.
Dr. Collier: Yeah, we’re actually now in three states. We started off in Arkansas. And I’ve been in practice 38 years, coming up on 38 years. We started with three clinics actually and have spread our business model and our patient care model, county to county. And so, now we’re in Northeast Arkansas. Like when I say northeast Arkansas, from here in Little Rock, I guess out further southwest, when we’ve being all the way up to past Jonesboro and I’ve been Izzard County. So, pretty big swath and Northeast Arkansas, Southwest Kentucky and North Central Mississippi. And our bread and butter are primary care, family doctors and internist. And really in the last two or three years we’ve added pediatrics, which has been very successful. I don’t know why it took me 30 something years to think of that, but there was really a need for pediatrics. So, we have some great pediatricians who are working for us and I entered our program with pediatric MDS. We got, like four Pediatrics Physicians and then we have Pediatric AP. So, our model is a little different, it’s not like traditionally you see a pediatric clinic. It’s not like that, we have pediatricians embedded in our family practice, and the practice is a little bit different. And then, so they’re working together, and so, that led us into school based clinics, of which, I like to say that we’re the experts in school based clinics, Joy Mills is our chief operating officer, every time they have a meeting on school based clinics she’s there. And so, we just were awarded a school-based clinic for Bigelow in Perry County.
Dr. Collier: So–
Jordan: As far as size and scale, how many clinics how many employees I mean, you how do you describe how large the organization is now?
Dr. Collier: Well, about 665. But if I just listed the things that we do, it’s not like you, you think I said, our focus is primary care. But that is really a small term, because we also have a educational system where we actually run schools ourselves. We actually partner with school districts, and that is like adding a whole new subdivision of Our Care, that we have. I have maybe 100 employees that are into our educational activities, and we also run the state program for HIV for the most part and Arkansas. We are really big into hypsi, because hypsi and HIV are closely related. So, we have doctors and providers who are involved in that program.
RJ: So, it sounds like you guys, not only have you grown a lot in the, you know, last decade or so, but it seems like you’ve got so much more opportunity to continue to grow, as well, just to give some listeners some scope of this, how many clinics, I know we talk clinics whenever we’re talking about your business, but almost 50 clinics, at least, over 600 employees. And I know, we’ve talked about approaching almost 100 buildings. So, if you can, you know, for a lot of our audience and me as a business owner, we think having one building with one employee, you know, offering $1 in services, a lot of stress, headache, and I can’t imagine an organization at at that kind of scale. So, I want to talk a lot about the scale and how you handled the growth, because at one point, it was a lot smaller, and it grew into that. But I want to go even a step further back on that, and just talk about early life. Tell me about what it was like growing up as Dr. Collier as even, you know, an eight-year-old?
Dr. Collier: Well, you know, I was born in Searcy, Arkansas because we didn’t have a hospital in Augusta which it’s just a smaller town. And you know, I was strictly raised there at Augusta and here Luwak actually, but my grandparents were here. And so, I just went to one school, I always knew I want to be a doctor. Sometimes I think I’d want to specialize and thinking what am I doing as a family practice doctor. And then
I started out, when I when I came back to practice there, after leaving and going to medical school here in Little Rock and then did a residency in Palm bluff of going back there. So, let’s say that for seven years, I just was a straight doctor, I did not even want to be bothered with administrative duties or business duties, and just really didn’t want to participate in those activities. And, I don’t know, after about 10 or 15 years of practice in delivering babies and, ER work and things like that, you know, I agreed to be medical director.
RJ: Which medical director?
Dr. Collier: As you know, it was just kind of like a chief of staff, helping the doctors, recruiting the doctors, credentialing the doctors.
Jordan: Did you know at that time, like getting into your mindset, have you been practicing for 10 to 15 years as a physician? Did you know the medical director was the step like a toward business?
Dr. Collier: Yeah, I did. I think I was on the medical board, and I had a phase of my life probably 10 or 15 years that I was seeing myself more as medical director. And also, it led to appointment to the medical board, and I served an eight-year term. And so, that gave me a lot of insight into what was going on with the rest of the state.
RJ: So, was there a shift in mindset from, I just want to be practicing to, hey now I want to move into administration, was it because you saw that you could kind of have a larger reach and do more–?
Dr. Collier: Yeah, good that way.
RJ: Okay, kind of–
Dr. Collier: That’s exactly what happened. It was, you know, I was appointed to the medical board by President Clinton, then did that for eight years, and then I did two or four years on the insurance board, appointed by Governor Yeardley and sitting there listening in those meetings, to all of those cases and controversies. Then I thought, well, maybe there’s something besides just the straight practice of medicine all the time. And so, that kind of shifted me over to say that, I might start a business, treat it like a business. Because, traditionally, doctors aren’t businesspeople, I’ve never even thought like that. If I didn’t make money, that was the administrator’s fault it wouldn’t–
RJ: Yeah, you just went to school to practice medicine, not to run a business or find an HR director or any of this other. So, what was that period like? How did you learn the things that you needed to learn to run a business as opposed to just practicing?
Dr. Collier: Well, you know, that did come a lot from my background.
Dr. Collier: I had been introduced to some family businesses, and then I made a more intentional effort to become qualified. And so, I started taking some courses. They had a, it was a 98’ish or was it 99, they had a program through Southern Cal, where you would get an executive certification. And I took that whole thing and graduated, I think in 2000. So, about a half point in my career, and anyway, I came back after I graduated, and our CEO at that time had a, they just told me he wasn’t feeling good. Anyway, I did some blood work on him in the clinic, I was still a doctor, and it was leukemia. And so, I hadn’t thought, even at that point, I hadn’t thought about being an administrative officer. And anyway, it was a malignant attack of leukemia and I think he might have been diagnosed in Christmas and he passed away in March.
RJ: Oh geez.
Dr. Collier: So, I really kind of took over his spot, but it was more of a medical twist and an expansion twist. And this was other diseases.
Jordan: And it was still White River Roller Health Care?
Dr. Collier: Yeah.
Jordan: And you guys had three clinics at that point?
Dr. Collier: We started out with three.
Dr. Collier: Yes and then, that’s where we came up with the philosophy of how to expand a program like this and with the model, and that model was several things expand contiguously even though the best market when the one that we started in, we knew that, we just didn’t know where it]s lightest, even like now we don’t really know, we just know we’re going county to county. And so then, we just did it in counties, we did Woodruff County, Prairie County, Monroe County, Jackson County, Walk County, Cleburne County, Craighead County, and then Lone Oak County was really a big one, then Wagner at Pulaski and we’re going back to Perry now, I don’t know, you don’t want to get in the weeds, but we have a clinic at Perry, at Perry Vale. And it stretched us, and we weren’t able to stay with it, because it was so far, we thought so far at that time. And so, we had to close that clinic, and we weren’t meeting some of the indicators. You know, within the feds, it will give you so much time to clean up things and at that time Perry County was really rule and now it’s really, it’s doing better, and we’re going back to Perry County.
RJ: I want to rewind just a little bit, because I think a lot of our audience is, where you were when you first stepped into the CEO role? That is they’ve got something, you know, the three clinics, they’ve got the want to grow, and they feel like they’ve got the education to grow. And so, going back to you are now fresh CEO, you’ve just really gotten your business degree, or, really been intentional about the education side of it. Did you come back and try to remember what was happening? Did you set core values out? Did you set a vision out? Or did you just say, hey, I found a good real estate deal here. We’re going to open up a clinic here, what was going on in your head? And how did you even get everybody on board, whenever?
Dr. Collier: Well, that’s a really good question where you know, some of this when you look back, we were really lucky that we made it, because we have open clinics or operations and didn’t get everything we needed to get lined out. And we had to take a step back, which I don’t say that as a defeat. You know, we’d come out there and get out there on the field and man, it sounded good. And then maybe some of the things didn’t go over, as well as you thought, maybe the doctor didn’t stay with it, maybe you didn’t see near as many patients. anything like that can happen and you have to take a step back. But so therefore, we came up with a lot of little one mono-laterals, that we expand out a strength contiguously. So, like, right now we’re doing Jacksonville, and Benton County, and there has always been somebody or a group of citizens who come to us and say, well, we want you to come here. Now, you might have some that don’t, but they’re the minority, you’ll have somebody pushing your computer, so we’re very responsive to the community. And then we’ll tell them when they come and say, hey, we’d like for you to just be here, in this town. Sure enough, we had that happen in Vilonia, like, we had a tornado there three years ago, and just there was a lot of damage and they didn’t have a strong medical community. Well, we know that Conway Regional was ramping up and Baptists was going to build a new hospital. But we just barely had a doctor, I think there might have been one doctor, and Vilonia, well, Vilonia is a growing town, plus, they came through Mayor Firestone, came through with a rebuilding plan. And so, Mayor Firestone and I got together some way and he said, hey, we’d love to have a clinic and he took the petition around to the businesses and other medical people and they said, well, sure Vilonia, wouldn’t even lock, it was competition, as they wanted to say. So, there was somebody to come out of the woodwork, and all we know is that there was a tornado with some destruction.
RJ: And that there is an opportunity to help a community.
Jordan: You mentioned something really powerful that I don’t want to gloss over at all, which is what you called one of these one liner. You said expand out of strength. Can you kind of explain the philosophy behind that statement?
Dr. Collier: Yeah, expand out a strength can either be financial resources or people resources. And so, we’re like, we already have a doctor now, for Ben is a doctor who’s been working for us for years. He came out of a force math, because they don’t want that drive lives and Ben, and I used to joke you know, how do you ever get a place like Ben, then I’ll be glad to work there. But that’s a strength of recruiting a doctor, because sometimes, like Mississippi, we are have yet to recruit a full-time doctor. So, that’s a little weakness there, but we had some financial resources where we could go ahead and justify expansion because of the money, we had available.
RJ: Got you. So, whenever you’re making those types of decisions, you’re looking at those two, do we have the personnel, or does it make financial sense right now? And those are the two main aspects that you’re looking at whenever you’re talking about expanding strength.
Dr. Collier: That’s Right.
RJ: Okay. Yeah. You also said another thing, which is, you know, you opened some clinics that weren’t 100% successful, but we don’t look at those things as failures. I think one of the common things we see with these businesses that have grown is they take their lumps and they keep on moving, they don’t just sit there and dwell on the problem, they move forward.
Jordan: And I saw the same thing whenever he said, we’ve got this physician who would like to be, like Ben, and a lot of times that’s seen as a fear. You know, a lot of people look at that and say, oh, no, we’re going to lose this guy. And, you see these things, that some people would see as problems or fears. And you turn it into a positive and say, look, I’ve got a guy who wants to be there, this could give us an opportunity in the future. I don’t know how impactful; you know that he’s been on the growth in the organization. But I’m saying, I see it over and over in these guys that sit in this chair and talk about how they grew their organization. They don’t get afraid by failure, and they look at problems not as problems but as opportunities to grow the organization.
Dr. Collier: Yes, that’s right. And then where people see, you know, to be really honest. Where people see us our care, Mississippi care, Kentucky care, where they see us in that market. You know, the doctor world, you know, you got your specialist up there, which they’re really responsive to referrals, though our care spins off
a tremendous number of referrals, but we’re not in the specialty business. So, that interface between hospitals and Our Care, we think is very important.
Dr. Collier: And we do everything we can to convince our hospital partners of that, because they might not think it’s near as important as we do. And so, if we have a glitch in our referral, they can make 50,000 people backlog to get into a specialist. So, we really become an advocate of the patient, because we’re talking to the hospital system, and the referrals, say, you all are wanting patients, we’re trying to send your patients, hey, but there’s one problem, your computers are all jammed. And I know you heard a little bit about that with the beginning of the ACA, because we had all these you know, poor people who never got a chance to go to a specialist. So, we still are way behind on that referral queue. Why bother then? You know, when we try to facilitate that, we meet with all of our hospital partners. And our thing is we’re just trying to get the patients in there. We’re not really benefiting from that financially, but it’s kind of like a service we offer. And, that’s, when you say, well, what’s one of the challenges? I know that’s some kind of value, and it helps the hospital systems. I think we’ve been; it’s going to be a bold statement; I think we’ve been a big part of opening up the whole state to the subspecialist. So, a lot Jonesboro, Fayetteville, Springdale, Texarkana hot springs, I think we met big reasons for Bill and John over here. I mean, that’s what he does, he’s trying to say, hey, if you come into Our Care, we’re going to do everything we can to get you into a subspecialist. You got a little auditory neuroma, we’ll try to get you into a neurosurgeon, with really no questions asked, no questions asked, that’s what they all see you, because most of the hospitals are not for profit anyway, who have the auto specialist, and that’s a little service that we don’t really charge for. And it’s very valuable, I mean, I know if I had a brain tumor, I would want to know, who to go to, to get in that doctor store. And so, that’s part of my job as CEO, is I’ll call the CEOs of these hospitals and tell them hey, we have a patient, that I know, I just need to get them in your hospital, especially well, other not for profits. I guess that’s probably as radical as IKEA. I’m not like a radical either way and government, you know, Republican or Democrat, that was cool, people shouldn’t have health care. Well, I think they all should have health care, but when you get to the very top and you try to get them into a specialist and your care or they are not going to see them in the hospital, I feel like that’s part of my mission to break that barrier down to say, gosh, if you’re having a stroke, they’re going to sit around and argue about if you’re going to be able to come into that hospital. I like this part of it, is not for profit. And that’s usually it, and I can’t say 100% always get a man, but I know about it, I’ve had people call me from Chicago or New York say well, my brother’s here, in the emergency room or somewhere and he can’t see and they won’t get an ophthalmologist to say, this Friday afternoon at three o’clock. So, I call the administrator and just said, here’s the case, I know you’re not a doctor, but gosh, if it was my brother and he couldn’t see you next Friday at three, so, then he said, we’ll see you first thing on Monday morning. And, the lady was robbed, she just got off from Chicago or something. But I mean, you know, you would expect I could call the local hospitals and they give me, so that’s kind of weird, because we’re not hospital people. You know, but we know who the hospital people are.
Jordan: Yeah. And that’s awesome. And that’s crazy that there’s still that attention, you know, that you’re still the one picking up the phone. And I know that always goes back to what we’ve known about you guys for a little while from having the benefit of working with the offer the past four or five years, which is that patient first mentality. So, as you were looking at, like how to expand and which counties to go with into, what was–?
Was it always with that mindset? Was that kind of the mission statement, is let’s find out where we can do the most good, and let’s plant a clinic there. Or was it, you know, like RJ said, is it more of a real estate movement?
Dr. Collier: It’s all data.
Dr. Collier: So, it’s good data right now. You can pinpoint where people who need that service are. And usually we can talk, I have talks going on right now, that’s what I do, talks with hospital systems that are saying, hi, these are our patients. We’re just trying to get them taken care of.
Jordan: Very cool.
Dr. Collier: It’s not as much a government thing as you think it’s, you know, what’s this transition between the hospital and these outpatient services.
RJ: And a lot of it you’ve probably learned by just doing it in the past, right? You guys are where you are now because of those lessons that you learned, and through expansion. Step us back to when you guys had, you know, it was White River still. And there was a handful of clinics and you guys were kind of on the verge of, hey, do we, you know, kind of step me through kind of that middle ground where there was a handful and like what the struggles were with whenever you were thinking about expansion or, you know, how did you guys go from 30 employees to the first 100? Can you, kind of, can we go back to kind of that time period and–?
Dr. Collier: Yeah, and at that time period, it was more critical with the workforce. It was more critical that we monitor that and there are certain times during the year that we’ll have every position occupied. I mean, all the doctors and nurses, but then there’s a lot of up and down. And so, during that time, we were just desperate for doctors or providers. I mean, we’ve had, you know, got a lot of jokes you know, that a lot of times they don’t want to like Dr. Mountain, do not want to work in Lone Oak, because it’s just too far from the shopping center and we’re not, you know, gosh, so, we are like, we’ll come pick you up and while we are there, we can take you to a mechanic mall if that’s what you need, but in some of those recruiting wars, I can sympathize with the football coaches in the southeast conference. I’ll just say, whatever you want, we’ll give it to you. That’s how we are with doctors, trying to get them to cover frankly,
RJ: Yeah, sure.
Dr. Collier: You know, if you need us to take your wife over to shop, you know, we will but gosh, you just unlock it. You know, there’s no place in or out, there’s like, no place safe. That was at that time, I mean, it was just like, just promise them anything, to get them here. And, and we did that for a while, and then now I can tell with the new med schools, with the production of nurse practitioners, we’ve changed that just a little bit back to that app strength. We’re looking for the better experienced IPS and doctors too So, I haven’t even taught him the last two or three years that you need a quality doctor, and I can. And I’m not saying that we take some brand-new ones or new grads as what we call them. But it’s kind of takes them a while to get down around it, basically.
RJ: You’ve talked a little bit about real estate, you talked about how physician recruitment by itself is all ready, you talked about how even the referral process is difficult. In the beginning, I think you might have been really, busy but working with you guys I’ve seen, you’ve got a good leadership team. How important is a leadership team to you as being a CEO and being able to grow this way?
Dr. Collier: I’ll tell you what, our leadership team is phenomenal, you could do a book on each one of them. Same thing, we have an intricate system of splitting things up. But just to go over our what I call our regional directors, we have three or four here in Arkansas, or kind of have a half a one in Mississippi because we’re just getting started. And we have one in Kentucky, and ours is all about each one of them having an agenda. So, about every two to three weeks, they submit to me what their plan is, even if they’re having some kind of relationship problem with their doctor. If they have found a new clinic and we get that call from somebody out in the community, and we really push community involvement. We have one lady who is on the downtown rejuvenation thing that they got going on.
Dr. Collier: So, we’re working with the church, with the Methodist Church on that. And she serves up–
Jordan: I’m sorry to cut doc, but it’s so interesting you say that, because I think where I am in my organization is I still feel like, I’m going to give direction to the leadership team. And you’ve got the opposite where you’ve got your leadership team, kind of giving you agenda.
Dr. Collier: That’s right.
Jordan: Was there a flip? Did you make that happen? Is that the type of people you have but tell me about the difference between an organization your size, I think, you can’t point everybody in the right direction.
Dr. Collier: Right.
Jordan: Where I am now. I feel like I still have the ability to do that, but maybe that’s something that’s holding us up from growth.
Dr. Collier: Yeah. Well, we have a situation where I know that Boone Pickens does, he and some other companies, they look for their regional directors, that’s what we call them, that leadership thing become very involved in the community. And so, like this lady I was talking about, when we have one that serves down on the city council of Jonesboro, they very involved with the ISU Alumni Association. And then they will have one of, kind of like north central part of Arkansas. He just finished the leadership, the chamber leadership. And he’s just doing excellent up there, but sometimes he’s so far away up north, you know, we say up north is Mountain View or Mountain Home. He does things at Mountain Home; we have a clinic there. And then our regional director in Kentucky, he’s very involved in the community, it’s an event center like Robinson auditorium, he’s on their board of directors. So, he got to know a lot of people in Kentucky. And so, just because of his involvement in his community up there Paducah, he was nominated to be on the FDIC board, and the President Trump proved it or whatever. So, you know, because a lot of what we do, too, is evaluation of economic conditions. So, that’s why we are, where we are, it’s based on data, and also the economy. And then, so, we have a county judge up there who works with us in the pad. We have those same things in Arkansas, so we’re very attend to the economics, but like here in Long Walk, you all got so many people already working on the economy, so we have to have a town that’s kind of fits us, more of a smaller town. When, you know, we’re looking at 10,000 people, you know, that’s our perfect town, 10,000. person, and then those regional directors, they don’t miss a meeting and they go to those meetings, and they listen to all that community involvement. And almost always somebody else, I will wish your native clinic to center this to anchor it. But that’s how we know what communities walling.
Jordan: It’s being involved in the community and being a part of those discussions. So, that makes a lot of sense. Was that kind of, RJ always talks, whenever we have these about, well, what are silver bullets? What are things that we should look out for how, you know, how do we get to the point from a selfish standpoint, from you know, I promise standpoint of going from 15 people to 50 and all the other listeners out there that are wondering the same thing. I’ve got five employees, I’m keeping the lights on, I’ve got one office, are there some kind of milestones that you can share with our listeners that might help them get over that hump, whether it’s finding one solid leadership team person to help, you know, you share that vision and they pass that on. I don’t know, kind of share with us what you felt like milestones were with Our Care.
Dr. Collier: Yeah. Well, I would say when you said that, it reminded me of my past studies and how it took a course. I remember I was in Denver, and I hadn’t had a lot of business theory, but that’s in that quadrant of a cash cow. I don’t care what you’ve got to have a cash cow in order to expand from strength. And for us, our cash cow was primary care, and most of our areas we made sure were the only people there, only people providing that service that was able to give us a cash cow to look at something else, they also might be riskier. So, whatever that is, you’ve got to find that in our deal, it was the primary care and not being afraid of Medicaid patients. Because that’s kind of risky, but I guess now we have an economy of scale. But that’s risky because people can lose their Medicaid, just whoop, and it’s gone to the front page of the paper this morning. Now that they’re going to have a work requirement, then I guess the Medicaid advocacy organization is going to sue Arkansas and they did and Kentucky just happened to be the two states that worried and then they ruined it, and Arkansas overstepped his bounds. Now we don’t really, and the way we do that out of strength instead of weakness. We were prepared to go either way, and Kentucky. So, now we had to go both ways, because if you go with just what the governor says you would have gone down one way, but you’ve only done it for a month because they flipped the law back over to say that he overstepped his bounds. Now we’re getting ready to find out what that’s going to mean for arc itself. But the way we did in our minds, that’s another thing about strength that we go ahead and do proformas of sales, not like with optimum, all the stuff the government does. We are just going to say, well, what does all that mean for us? And then we go to work on those people to move them around to something else, we have a great insurance department. And so, we’re getting applied in both states with a lawsuit, but then we know that we’re not going under because of that law. And at first we’re thinking they’re all going to get locked out or they might even take Medicaid away, you know, but Medicaid, output, outflow was down. In other words, it didn’t cost us as much as we thought it would. So, we see a big tree on there and keep those expenses down. And I do some experiments at work.
Jordan: That’s interesting.
Dr. Collier: And then we’ll be okay.
Jordan: So, sticking with finding kind of a cash cow, and not necessarily a niche, but just something that you know, can help support these other departments, where you can kind of test some things out.
Dr. Collier: Yeah, and so, we had to go. So, we’re afraid of Medicaid because the instability of Medicaid, but that means that we need to try to pick up more of Medicare patients. And then, another year passes, you’ve been in business, before you know it’s 37 years.
Jordan: Cash. Yeah. You know, you’ve been CEO now for almost two decades. If you could go back to day one, whenever you started the, whenever you stepped into the role of CEO, what’s something you would tell your younger self?
Dr. Collier: Well, number one was to get to paediatrics quicker. We’ll just let the kids fend for themselves, I would say that would’ve been more inclusive with children. And, you know, some of our education facilities, we should have done that sooner as a society, and I just kind of stumbled onto it. Now, there needs to be more preventative medicine. I used to be, you know, I used to be, “Well, yeah, we can do this, or we cannot.”. But we could have made that screening for HIV, screening for Hep C, and the screening that you can do. And also, there’s something I knew was there, but we could never get it to work, was actually having anything that an RN could bill for, but those annual wellness visits for older people. We talked about it, but we never did it, until just recently. Because you know, you do have tremendous talent and brain power in your Aryans. But that was really under-utilized. And so, we created a new programming, and it’s actually working. And I would say actually just for the last year and a half, that we’re able to really put our Aryans something that we’re doing, we have a grant or had a grant for colon cancer, we’re looking strong and prostate cancer. And we’re working with the Arkansas prostate cancer Association. And so, some of those things we probably should have been doing. And we would just, you know, there were some doc in the box, you know, and right now, we’re trying to have two sides of our practice. Still pretty medical, have one side that’s chronic disease, or diabetes, HIV, hep C’s, and also have your children and they will have your episodic. I had a migraine the other day. I should, you know. What’s the acute care? You get a pharyngitis. Well, that’s acute care, of flu or flu vaccine that, you know. So, we’re having to look at our practice a little different.
RJ: It’s interesting, because, you know, you said you find your thing that is your cash cow, and that might be your primary care business. But it seems like you guys are always doing what seems like new little start-up ventures that always feed into this. I think one of the things is you’re graduating your education program. Are those just like ideas that pop up? Do they feed into a bigger vision for you? How do those things happen? Because, you know, that’s just one example. But even the paediatric side is almost a new start-up world, is it innovate or die?
Jordan: And I’ve got a second part to that too, which is, did most of those come from the bottom up or the top down? You know what I mean? Do a lot of those come from you sharing your vision and somebody coming in and implementing that vision in a way that, in, like a tactical way that you didn’t think about, or vice versa? That’s a big question, I know.
Dr: Collier: Yeah. And it goes both ways. If I can take– if I can think of a specific program, I started like that, you know, I can give that history like substance abuse. That’s the one that’s hot off the press. Because I like to mix the politics with it. But I like to think that substance abuse and behavioural health are sorely needed. And I think it’s bipartisan because President Trump during the campaign, he talked about that too, which that was in our wheelhouse. Now, we don’t want to have whoever’s not in our niche to run a psychiatric hospital, we got to deal with people out in their community. And so, we got a grant. And, gosh, I guess I went to Seattle for that, and listened to substance abuse talk for three days, and what came out of that was we ended up getting a grant to institute and start that business. And then we got a consultant in Betty Ford Centre up in Michigan, and so they trained us for six months. And so, we’re thinking that we’re going to get another grant. And you know, there’s been a lot of instability in Arkansas, in the behavioural health, substance abuse. Doctors, a little bit, were afraid and then as you see, there’s a trend that’s medical, you got HIV, you got Hep C, those would be the same guys or girls that are abusing those drugs. Plus, I just as a doctor, know how many people that we’re losing, and that are overdosing and so, there was a time and in timeline, where we honestly didn’t know if we were going to do that. We didn’t, you know, a finance officer was talking to our operating officer, and we really didn’t know, we’re still not making any money. You know, I mean, you’re going to look at somebody that’s lost his family or her family and has no job, and the least of their problem is insurance because insurance companies are really afraid of mental health issues and substance abuse, and that’s just really starting to kill our next generation, plus the abuse part. So, we just, I guess, we finally made the decision to do that, is to say, “Okay, we’re going to do the best we can.”.
And so, I was there yesterday in the clinic, I’m still in and out the clinics and we had more inductions is what you call it, when you induce somebody with the Suboxone, or you start their therapy, and there was a guy there, 35 years old, and he had two little boys there with him, I think three years old, one was four. But that was it. And so, I was just so proud that we could offer them that service. Well, you know, you got the other statistics, probably 60-70% of those are going to backslide or recidivism is high, but he’s trying. So, and then I said, “Well, I guess we made the right decision”, because we’re really saving people’s lives. But that’s a tough business, we never started off to be you know, we didn’t start out like that. I think the reason they’re giving grants; we didn’t start out to get in that business, but the reason that they’re giving out grants is nobody’s really saying, “We’re going to do this and block”, and we’re going to just do it. It’s not– and there’s not a lot of psychiatrists. So, we’re looking at some other models, like a nurse practitioner model, but I’ve got to get an X number and it’s complicated, but we’re willing to take that on. Now, that came from our staff, from, you know, they do it like a study. You know, you get the grant money, you’ll turn in all of those patients, how many of them dropped out and– So, but I think that’s a good example. We just knew that we had a lot of patients overdosing and so. And so, we thought, “Well, we’ll try to do something about it.”.
Jordan: So, that’s one of the things that came from kind of the bottom up to leadership. And then yeah, okay. Very cool. So, tell us what the future looks like for ARcare. How are you going to continue this growth? Or do you need– is growth not really part of it?
Dr. Collier: Well, you know, I think a lot of people think that we want to get bigger and bigger and bigger, but we want to do a better job, and really, with just what we have, it’ll keep me busy too, for seven years if we never, I mean, all the counties that we’ve got, it’s all we can do to do a good job. And it has to be somebody else, you know, wanting us to come in? Because sometimes when somebody builds a new hospital or new clinic it’s like, “Good, at least we don’t have to go there.”.
Jordan: Yeah. Well, if there is another administrator or another CEO that’s in a different state or in a different area that’s listening to this thinking, “Well, how can we do the same type of stuff that that ARcare’s doing, that Dr. Collier’s doing?”. What? Are there any tips? Or is there kind of Is there a roadmap where you can say, “Hey, if you follow these three or four things, you know, you’re at least going to head in the right direction?”.
Dr. Collier: Yeah, that’s a great question too. I’ll just tell you the ways that we do it, that works like a charm. We found those other institutions or centres or clinics, but we– and we call them our sisters, Houston, Texas, his legacy, they’re just like us except bigger and they’re riding downtown Houston. And so, we go down there and visit with their leadership team. And they do an excellent job and a lot of these things like what about HIV? Well, they have, you know, a lot bigger program there. And they have a GMA and they have a lot of sub specialists, like they went all in with the psychiatric offering and then have family practice you know. But you know, it’s a different city, it’s easier to get to those sub specialists. And then we have another one that’s a sister, is similar organization out in Tucson, Arizona. And so, we go in from time to time, I’m going to need to be stimulated and go out there and visit with them. Now, some of their relationships with their faculty, you know, the GMA, it’s more solid than what ours is. So, in Arizona, they have a, like a medical school that would be like under our umbrella. And so, there is a lot of room for improvement if we just did a good job, you know, here in Arkansas.
Jordan: Okay, well, for any listener that’s listening and wants to reach out or help you in any way, what can we as an audience do to help you and your organization?
Dr. Collier: Well, you know, for us, there’s a lot of ways to, you know, to serve in these programs, are open to anybody. So, I’d say you know, the volunteer part and be aware of what’s going on in your community. Now, and by that, I mean, if you’re just there and just aware of what’s going on, you’ll get some really good ideas. I’ve been into, you know, meetings here, you know, some of the clinics that, is that we have here, we get some good ideas just from the people working there.
RJ: Dr. Collier, I can’t say how much I appreciate your time and spending it with us and giving back even to us and our organization and our listeners’ organizations on ways that they can kind of grow their business. Always, we’d love to have you back on, love to talk to you some more, but just really appreciate your time and effort today.
Jordan: Yeah, it’s been great. Thanks, Doc. All right, everybody. Dr. Collier, RJ, any closing thoughts?
RJ: Now, you know, if I could, every one of our podcasts would be just like this, getting actual people to tell their whole story. It’s just there’s so many lessons in everything he said, that it is more powerful than just trying to read it like it’s a poster on the wall. Just hearing the story first-hand is amazing. Unfortunately, unless you the audience helps us, we can’t hear more stories like this. In fact, if you think there are some people whose story you’ve heard that needs to be told to the audience, please shoot us an email, give us some recommendations on people to talk to because I would love to do more of these.
Jordan: I would too, and if you guys prefer this type of format, let us know too. Again, we’re doing this for you guys. So, like, subscribe, email, reach out to us personally. Again, if you know anybody that has a story that’s interesting and that other people will get value from or even if you want more or less content like this, please feel free to let us know. Until next time. Thank you, guys.