Optimizing Your Primary Care Practice

Recommended Book:

Man’s Search for Meaning

Best Way to Contact Ron:

ron@beaconclinics.com

Company Website:

Beacon Clinics

Episode Sponsor:

Optimizing Your Primary Care Practice with Ron Barshop, CEO, Founder Beacon Clinics (transcribed by Sonix)

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes, and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.

Saul Marquez: And welcome back to the podcast. Really excited to have you tune in again. We’ve got some awesome stuff to chat with you about on the business side of healthcare. It’s a pleasure to host Ron Barshop. He’s the CEO and Founder of Beacon Clinics. Ron’s a seasoned business executive with the track record of company growth and business success. Beacon Clinics is a premiere provider of ancillary allergy immunotherapy services for primary care practices. They bring a complete and integrated solution for primary care physicians focused on allergy outcomes, patient volume, and patient safety protocols. Ron’s had a tremendous amount of success in healthcare business and also other businesses so it’s important that we tune into the business side of things to know how things are going because as we’ve discussed in the past it’s patients, it’s our people, but it’s also the business models because with no margin there is no mission. So it’s a pleasure to welcome Ron to the podcast. Welcome.

Ron Barshop: Thank you.

Saul Marquez: Ron, did I miss anything in your intro that you wanna fill in?

Ron Barshop: Well it’s hard to put in the intro that I was drawn to healthcare when I was 9 or 10 years old. I had a microscope, love my biology books that I got way ahead of high school. Dissected every frog within a mile of my house. Had a… just love for sure I was gonna be a surgeon when I grew up and then I attended a surgery at a young age where I smelt cauterized flesh I passed out for the first of three times the…

Saul Marquez: Wow.

Ron Barshop: Next while. So my surgical career was over before it ever got started but…

Saul Marquez: Oh man.

Ron Barshop: I have a couple of sons in healthcare and I’m now coming off the back towards the business world.

Saul Marquez: Love it man. I love it. Great story and it’s definitely an experience when you’re in surgery for the first time. It’s definitely not for all but you sounds like you really kind of have lived it through your sons now but now through the backdoor with your business experience are back in so. So glad you’re here. What is it that got you into the medical sector?

Ron Barshop: Well I started an angel network, we were the first. Texas Capital Network was the first angel network outside of Silicon Valley back in the day before the .com boom and we turned to basically a broken nonprofit into a highly successful in the whole world beat a path to our door to figure it out. And one of the guys I met in that was a life sciences guy who was a chiropractor. He was doing very well right about 10 times what the average makes in Texas. His doctor that hosted him was making about five times what a typical Internal Medicine doc makes. And that’s where I first got introduced to ancillary income services although we didn’t really have a name for it back I think because it was so new but he introduced me to a great business. I said Let’s scale this model I’ll teach you how to do that, run the bootcamp here. Doctor and he agreed and we built a very nice business. That’s my introduction about 10 years ago into healthcare ancillaries. The problem with that is the business model was relying on the kindness of strangers and like all human beings doctors can get greedy when their checks start averaging 10, 20, 60 thousand a month. And so they started challenging me with arbitration and I won them all but it’s just it’s not fun to be hanging out with lawyers in Texas or like crocodiles that can be shot on sight. Now without it there’s so many of them but they work these to be rare but the I just didn’t like hanging out with lawyers so I created a new. I went to a lawyer and done a new model that is currently the beacon model.

Saul Marquez: Well that’s really interesting and as much as people may not want to talk about this you know, there is a business side to healthcare and if we ignore it we are not going to be successful. And let’s face it you know some of the biggest challenges in healthcare are reimbursement and you know what is value based care. How are we going to do it. It’s a challenge. And so it’s great that you’re bringing these points up and I’m happy to talk about them and I’m glad you are too, Ron.

Ron Barshop: Yeah well there’s a few simple fixes in healthcare. Primary care is my focus and my priority because that’s where the greatest pain is. And it’s also where the greatest opportunity is because there’s more primary care providers than there are all the rest specialists combined. We have a huge number of people that are forced into corporate medicine, people that are forced into direct primary care although that’s a great model for the wealthy and affluent it doesn’t work for the other 95% of us they’re forced into quitting and we have a double the suicide rate of even the veterans in America for primary care physicians. We have over 55% of burned out it’s the top four out of six categories of professional burnout in America or primary care providers, nurse practitioners are right behind them. So there’s obviously some pain and I said to myself There’s gotta be a simpler solution than what the AMA and what the board groups are providing. They’re extremely complex and fighting city hall by trying to get higher reimbursements. And I luckily, and this was really kind of a aha moment in my life. I met a guy in the business world. You can kind of smell money when you walk into a physician’s practice. This one smells like Fort Knox and I hang out with the guy and his wife afterwards and I’ve been down there eight or nine times there’s not an airport in his town, he’s rural that he has take home pay of a million two and a bad year and two million in a good year. And he’s a family doctor and I said “What the heck do you do to get that? To achieve that? You’re essentially the George Washington of primary care you’ve invented a new model and you don’t even know what, do you?” and he goes “Well it’s just I started in business, went to medical school, approached medical school from a perspective of how do I have a good bottom line and do the very best care for patients?” And the more I got to know him the more I realized, money is not preempting great care. In his model was he had twelve ancillaries, get a sleep lab, he had a pulmonary function test, he had diabetes treatment, and obesity treatment, all reinsurance reimbursed. None of it was latisse or juvederm or eyelash extensions or all that garbage. That’s again for the rich. He was taking care of a rural population that and what he was doing was instead of sending him to a specialist for a workup, he created the talent, the training, and the focus to do it internally and I realized that’s the model of the future. That is really the answer to burnout. If you have take home a four six eight hundred million dollars as a family doctor internal medicine doctor pediatrician, you don’t have burnout, you won’t have suicide, you won’t have pressures of factory medicine and having to see a you know 25, 35, 40 patients in a day, you won’t have to work long hours. You can hire people to do that part of the job. So my mission in life is to scream from the rooftops about ancillaries and of course I’m in. So there’s a tiny bit of selfishness I guess. And I think we happen to have the lowest risk model and the highest out to model that I can find in the market. But you know without self promoting really the important thing is that primary care has a fix in it and it’s ancillary income solutions like mine and others. There’s many like me out there.

Saul Marquez: Well I think it’s a great message and there’s definitely a direct tie folks between burnout and the finances. You know the level of debt that physicians are coming out into the workforce with and and then the limited pay that they’re getting into as Ron’s calling corporate medicine is definitely a squeeze. And so I definitely think it’s a it’s a fascinating approach to take and it’s hard though Ron a lot. And today with all of these systems buying up practices and and really going on unchecked kind of monopolizing the care in areas, how do people do it? You know how do people stay independent? There’s a lot of people that are really just it’s a small percentage.

Ron Barshop: How do they do the ancillaries? Is that your question?

Saul Marquez: Yeah I… you know well really it’s you… who are we speaking to you know because the physicians that are primary care are still on their own is maybe smaller percentage I don’t know. I don’t know what the percentages but definitely small.

Ron Barshop: 38%. Yeah when I started in 2009, 68% were independent. Now it’s 38%. And that if you look at the rate of…

Saul Marquez: Bigger than I thought.

Ron Barshop: Yeah. It’s much greater acquisition rate than any time in world history in terms of acquiring practices and this could be larger groups or specialized groups or multi specialty groups but it’s mostly hospitals that are doing the purchasing and I don’t begrudge hospitals because they’re now starting to come to me and say they’ve got the same problem that it’s that independents have is that they need to create a better EBITDA because they’re that’s basically how they’re judged. Quarter to quarter. And so if I can help them generate a better EBITDA with zero brain damage without any risk to their practices or patients without a lot of legal standards that can tie them up what we call hair on the deal they’re happy to talk to me and so really for the first time in my career the corporations are starting to come to me and ask for help too and I’m getting tested I think we’ll expand out into pretty much all their clinics as they see how easy this is. But yes it’s the day of the Independent. It’s sadly going where the problem is that independents have not only less burnout and higher job satisfaction but they have a lot less medical errors. So once you get into this machine, this grind, you get exhausted, they kick the back of your chair and you had to see more patients you’ve got to get more value out of a firm more for sure internally. The cost of care goes up because the cost of the same procedure at a hospital versus the independent. So let me just say a hospital owned clinic versus an independent across the street is four times or two times, if it’s urgent care, which means that the place of service is becoming more and more important but it’s not transparent to the consumers that and transferring to the employer and the insurance company right now has not delineated the difference. They’re not trying to send people 10 dependents. So if you’re looking at just outcomes cost of care pretty much any angle you want to look at here an independent physician is almost always going to get a better product and I’m going to fend now 60% of people saying that but that’s just the national statistics. I’m not, just Ron Barshop’s opinion, that’s the data.

Saul Marquez: Yeah. And by the way you know we’re having an objective conversation here, you know we’re not throwing anybody under the bus, we’re just talking numbers and so let’s dive into this a little bit deeper Ron. How have you and Beacon Clinics and maybe share a story here created some some success by doing things differently?

Ron Barshop: Well the funny thing is I didn’t think I was doing anything differently. I started measuring our outcomes day one so by the time a patient got to their ninth month of treatment which is about 9 nine 12th of the way in their two year treatment. I asked how they’re feeling and we have a twelve step questionnaire. So eight particular medical outcomes and four quality of life outcomes. And I started learning that we have a secret sauce that only 10% of us have and I didn’t realize that then either when you started this but our secret sauce is that we get basically 100% of our patients heal from allergy versus an 85 percent number that you see a national national statistics. Hundred percent of our patients start healing from allergy and get completely free of allergy and heart. And our secret sauce is and so secret 10% of all are allergists, use compounded medications in iso five clean rooms. So they go to basically there’s only two providers that do that today each pharmacy. Greer labs and pretty much every allergist will be using them because it’s so expensive to try to do this in your allergy clinic that’s essentially unaffordable. And the regulation is attainable so we use these providers, they make the medications for us and then we get a higher quality pure bed I believe. I can’t prove that to my investors months when hundreds in my opinion but why I’m 100% of my patients getting better and 85% of the national statistics I don’t understand why there should be a difference. And so the bottom line is what we do that makes us unique is we 100% guarantee our primary care physicians, their patients are going to get fully satisfactory outcomes. And you can’t really do that in medicine too often today right. I mean you can’t. The drug compliance right now does you know that six to 16% of people follow the drug compliance protocols that their doctors. So you can’t even say drugs are successful. Are our numbers are double that. I wish more than 30% went and finish their shot protocols with the allergy immunotherapy but we’re double that. When I go to my patients and ask “why do you keep coming back for these shots you get to do 30 of these” they say “I have hope for the first time. I’m sick of the antihistamines, decongestants, steroid all, merry go round and you guys give me hope and I’m actually feeling substantially better, I’m sleeping better, I’m playing better, I’m working better, all my symptoms are disappearing” so I’m in the hope business.

Saul Marquez: Well I think it’s neat that you’re doing this and and you know fascinating approach. We always have to be open to ideas and maybe this approach may be something you consider for your practice your wife your solo practitioner or if you’re an exact cat at the end enterprise you know at a hospital and you run a primary care division of NIHN and maybe something for you to think about. So give us an example of when you failed, Ron. Give me an example of a setback. Share a story. What happened? what did you learn?

Ron Barshop: I’ve got too many too. And you only have twenty five minutes but you know that I mean that’s really kind of what gets us where we are today as failures does makes the success sweeter. But I… every partnership I’ve ever had, they disappointed me I mean I don’t think I disappoint them but I know that’s my ego talking. But I had, my partnerships don’t work and I’ve hired the best of the best the smartest of the smart but they disappoint in some way one way or another. So my darkest periods have always been right after the partnerships break up and I… my best friends and the other fellow CEO’s have asked me to change my name middle name legally to no mo which means no mo partners.

Saul Marquez: No mo.

Ron Barshop: Now my plan is I just hire that expertise that I thought I needed as a partner and I try to be the dumbest guy in the room. So my role is to surround myself by people a lot smarter than me but just ask the right questions so we get to the conclusion that we need to.

Saul Marquez: I think that’s a great nugget of wisdom. You don’t necessarily have to partner consider hiring the expertise. I think it’s really really wise. So Ron, give us a time or maybe one of the things that you’re most proud of in your healthcare career.

Ron Barshop: So look you know when Moses came across the burning bush the rabbis tell us that thousands of people pass a burning bush but he had a special set of eyes to see it. Somehow I have special set of eyes to see Dr. amazing. This genius because he got called on by pretty much every farmer read by hundreds of people that passed about minimum sat down and realized he was the George Washington of fixing primary care. He had the answer and I remember I was riding in a train right after I met this guy, met a cardiologist who was an Upper East Side Manhattan and he was making I said “What do you make a year? We’ve been hanging out for eight or ten days, what do you make a year?” and he said a buck two which is a million two and a cardiology talk I guess. And I said I know a primary care physician who makes two bucks. And he said well that’s impossible and I explained to him about the ancillary practice and how serious he was about taking the business of medicine as seriously as the outcomes and the guys like vein in his head started vibrating. It was like he was so mad, he was so red, he was so enraged that a primary care doctor had sort of cracked the code. So my proudest moment, Saul was really just discovering this guy that everybody else passed up. I’m certainly no Moses but I did have a different set of eyes to recognize him.

Saul Marquez: I love that. Yeah I definitely appreciate that. You know I used the analogy, the same kind of having the set of eyes to see, my wife and I went to Hawaii Ron and we were wanting to see whales and we just couldn’t see them it was whale season we got onto this whale tour, the whale guide tells us what to look for. And I kid you not it was like an hour and a half, we get off and literally we’re driving back up on the mountain and we see whales everywhere.

Ron Barshop: That looks funny.

Saul Marquez: And I’m like “oh my gosh there’s the water coming out of the spout, there’s the splash of the fan or the tail or the surface and nerve just like the stuff that we didn’t even know to look for we knew to look for.”

Ron Barshop: That’s awesome.

Saul Marquez: Yeah. So hey folks you know and this is why we do this. I mean this is why we have this podcast, we have guys like Ron and both men and women doing great things in healthcare is that you don’t know what you don’t know and maybe one of these episodes maybe it’s this episode is going to be that first domino to a domino effect of of excellence in outcomes excellence in business success because both of them are important. So I really really love that story. Tell us about an exciting project that you’re focused on Ron.

Ron Barshop: Well really I believe that the ABC’s of medicine or overcomplicated. I do a lot of reading on solutions to the problems out there and the project that I’m most interested in is to get the word out that we should be celebrating the fixes that are already in our system. We don’t have a broken system. We have a fixed system but it’s on such a minuscule scale. It’s like looking under a microscope and I’m 9 years old and a piece of tissue is just so the world doesn’t know it exists. It’s just too small. So I believe my mission on Earth but besides having three beautiful boys, besides creating a nice company that employs a lot of fine people, is to tell to teach the world in some form or fashion how to become a genius like this guy. There’s no shortcut but there’s certainly no reason he’s not and he’s not that much of a genius he’s just a guy that thought differently. He too had a different set of eyes. So the project I’m working on is to figure out exactly how to put a group of primary care physicians together that are all using best practice to get to a sharing and caring genius network of mindshare group. And let us all attack this problem as a group with collective thinking instead of from just the perspective of everybody trying to do this by themselves.

Saul Marquez: Well it is an honorable project then definitely one that I think is worthwhile of a life mission. And listeners definitely the beauty of podcasting is you could rewind and listen to some of the things that maybe you want to relisten to, or take a note of what you listen to and come back next month if you want to. The content always lives on the site, lives on Apple podcasts or Google so always come back because there’s definitely some good stuff here being shared by Ron. Ron, it’s getting close to the end of the podcast here. Let’s pretend you and I are building a leadership course on healthcare, the one to one of Ron Barshop. And so I’ve got five questions. Lightning round style for you followed by a look that you’d recommend to the listeners. Ready? All right. What’s the best way to improve healthcare business outcomes?

Ron Barshop: To learn the ABC is a risk. There is a you can literally quantify risk of adding an ancillary in my case so you can compare ancillaries and see where the pain points could be or where the damage could be or where the downside could be for your practice. So it would be that would be it would be the ABC as of analyzing risk.

Saul Marquez: What’s the biggest mistake or pitfall to avoid?

Ron Barshop: Not looking at the ancillaries. This… it’s the answer. It is such an it’s like staring us in the face. It’s the answer to pretty much if you had to change the matriculation rate… my grandfather 70% of people chose primary care my grandfather’s day. In my father’s day, went to half that about 32%. Today it’s 16%. Well how do we turn that around so that we don’t have a giant shortage. What is the primary care pay point four hundred thousand, five hundred thousand like cardiologists like a plastic surgeon, like a dermatologist. We wouldn’t have any shortages. Long answer to your short question, ancillaries.

Saul Marquez: How do you stay relevant despite constant change?

Ron Barshop: I try to avoid reading idiots or recognizing them. There’s a lot of there’s a lot of people out there that are spouting complicated solutions to simple problems and I tried to take their articles and show the world that there is really a simpler answer than this complicated blueprint for change.

Saul Marquez: What’s one area of focus that drives everything in your organization?

Ron Barshop: Well for me it’s storytelling. It’s important that I keep my culture, my clients, my patients, my employees keep them. That all happens through storytelling. So for me it’s boiling down complex into simple and telling it is a story that’s really the focus for me in my practice I want the best thing for you to get out of the way of all these talented people I’ve hired and just storytell.

Saul Marquez: Love it. What’s your number one success habit?

Ron Barshop: I probably read two to three hours a day and I’d probably write two or three hours a day.

Saul Marquez: Nice.

Ron Barshop: So unlike most CEO’s I’m not having meetings. I don’t have an office, I don’t have a desk, my phone is my office. I don’t have a complex burdens of managing because my good people are managing and operating the company but what I do is I’m constantly reading and constantly writing and constantly to storytelling. That’s really my job as a CEO is I can lead by knowing what’s going on from on high. And then by asking the right questions I can get. That’s where we need.

Saul Marquez: What book would you recommend Ron?

Ron Barshop: Well it’s not a healthcare book but it’s there’s five of the things I like but this one has meaning called The Meaning of Life and it’s been around for 40 years and it basically teaches you that life is whatever you make it. It’s not…

Saul Marquez: Who is the author?

Ron Barshop: Victor Frankl.

Saul Marquez: Oh wow.

Ron Barshop: Victor Frankl changed psychology forever. He was a Holocaust survivor and he wrote it literally during his internment. He had scraps of paper and he had, he learned memory tricks and he memorized that chapter one and chapter two and he would go back and practice chapter one again. But the book was written painstakingly over eight years but then it was finally written when he had a typewriter and time and he wasn’t starving, so amazing book.

Saul Marquez: So I’ve not read that one but I’ve had a chance to read Man’s Search for Meaning.

Ron Barshop: Yes.

Saul Marquez: Wonderful book. I just I mean floored by by this man’s experience and his survival skill, his spirit right the strength of spirit. Folks take this recommendation. The Meaning of Life, Victor Frankl. I think it’s anything written by that man is something that is worth spending your time, investing your time to read so appreciate that recommendation. Listeners you could get all of these resources, links to Ron’s company, all the things that we talked about on outcomesrocket.health and then in the search bar, just type in beacon clinics, you’ll find the show notes, the transcript, everything that we’re discussing here today with Ron, it’s all there. So Ron, this has been fun. I’d love if you could just share a closing thought with the listeners and the best way that we could get in touch with or follow your work.

Ron Barshop: Well anybody can e-mail me at ron@beaconclinics.com just like it sounds but really there is a lot of misinformation out there and it’s not, it’s sincere it’s coming from a good place. There are people that are struggling so hard and they’re swimming upstream. They’re swimming you know without a paddle without a boat. There’s a motorboat that takes you downstream and it’s a simple solution to solve not only primary care but pretty much all the ails anything and any aspect of medicine because you can start a clinical research organization site and you can have an ancillary income. Some people do side hustles and they do speaking engagements or consulting. Does take time, ancillaries don’t take any time. They are recurring revenue and they run themselves essentially as you because you get them off the ground. So yeah it’s I hate to keep beating that drum but ancillary income solutions are a solution for all of healthcare.

Saul Marquez: Beat the drum Ron and that’s why we’re here for so folks. Anything that resonated with you from this podcast hit rewind, relisten. Reach out to Ron ultimately take action because that’s what’s going to help you improve outcomes. So Ron, just want to say thanks again for spending time with us.

Ron Barshop: Yes I enjoyed it Saul. Thank you for your service again.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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