Dr. Bob Murtaugh, the Chief Professional Relations Officer at Pathway Vet Alliance, states that communication is key when it comes to consolidation. Today’s episode is jam-packed with advice on how to make the consolidation process work for everyone involved.
Our conversation explores the types of skills and educational backgrounds which make good regional managers, and the functions which need to be cultivated at both local and global levels. During this episode, Bob shares how they go about the recruiting process at Pathway and the largely untapped avenue they are beginning to utilize.
Good morning and welcome to Consolidate That! We are very excited today to have a repeat guest, another – not a back-to-back but a hotly requested client, or guest, to come and join us today. Really excited to have Bob joining us again.
Great to be here, thanks Ryan.
Dr. Bob Murtaugh is the Chief Professional Relations Officer at Pathway Alliance. He is a double-boarded veterinarian and he’s joining us today to talk more about the operations and how they’re set-up in a scaled organization. Bob, thank you for joining us, thank you for finding the time.
Thanks Ivan, appreciate the opportunity.
I want to jump in and talk about this sort of dilemma that a lot of consolidators run into. When you start scaling and when your regional, sort of, coverage by one region is becoming large, how do you think about whether the people that are managing the region should be more of a business acumen or should they have more of a medical operations background? How do you guys deal with that at Pathway and what is the general thinking? Which one is best?
Yeah, that’s a really solid question and one that comes up frequently, Ivan. I think in an ideal world, you’d have a hybrid person that encompassed all of those skill sets and, you know, those are, not unicorns but those individuals are not common either. You know, I think there’s a lot on the business side but there’s also a lot on the medical or correlational side in veterinary hospitals and that then obviously pushes out the clients and pets and referring vets depending upon the type of practice.
I think, to my view and I think to most individuals view in the industry is that you need to have a balance of both of those aspects in the regional support team and I think ideally, you’d have somebody in the context of a regional medical director as well as a regional operations director and the two of those individuals would work in sync with the hospital leadership teams to make sure that the hospitals have the support that they needed depending upon the circumstance or the issue that might be at hand or the program plan that might need to be implemented. I think you need both.
It’s interesting because when I started digging into the entire organizational structure of the consolidation, if one were to build the large consolidation like you guys have, the regional manager is not something that you can go and take a course on, there’s no – you could be a practice manager, I think there is some sort of education you can take. You can take an education as a hospital manager, you could be a doctor if you’re familiar with the medical operations, you can have an MBA in the business background but the regional manager of multiple hospitals, that’s not something you can just go and become or get a license in.
What is sort of a background that you envision for these people? Is it business education or is it someone with a background from the veterinary hospital, who are the best candidates for those regional manager roles?
Yeah, you bring up a good point, I think, you know, it would make sense maybe for their – somebody to institute a program that would help to bring people along on that career track. That’s an interesting potential as an aside there. I think currently, what we look for is somebody that has experience in the profession, understands the profession and then has some business acumen or maybe has been in a managerial role to begin with prior to applying for the regional position, they may or may not have had multi-site experience but in my view, somebody that’s a CBPM and then follows that up with an MBA and then shows leadership acumen, those are the kind of people I think personally that would be and are good, not only as regional support people but then have the potential to grow into additional roles, vice-presidents of regions and so forth. From a business perspective, I think those are the kind of people that I would be looking for.
That makes sense. Maybe one more question then dipping into the level of the hospital. Because some functions that you design at the level of the organization, departmental functions let’s say like marketing. Not all the marketing is done centrally, even though that’s sort of what a lot of consolidators say, “We’re going to replace marketing,” but some marketing has to be done at the level of the hospitals.
Then, inventory management and certain processes that are then deployed from the organizational level to the hospital level, do you guys go and identify the functional leads or is there – do you kind of usually dip into the existing talent and train them in your processes or is that someone that you add to the new teams in terms of all these sort of smaller divisions of the functions in the hospital?
Yeah, I mean typically, for an acquisition company like Pathway Vet Alliance or others, those functions are existing and individuals are there doing those functions are in those hospitals when we partner with them and so, sometimes individuals are doing too many things and then we try to delegate and elevate others to fill some of those roles. Sometimes it’s not the right person in the right seat and they need to be trained if possible or replaced if needed and that’s a process.
I think you’re right that veterinary medicine is still a local business even if you’re on a platform like a Pathway and you need to have people on the ground that have the ability to do those functions and do those well and so, what we do at Pathway Vet Alliance is identify local leadership, have them create a leadership team that includes people doing those functions, have them meet on a regular basis. They become the – not only the implementers of things that might be coming from a central but also percolate up ideas that can be used across the region or across the platform.
We encourage that type of growth because from those people then come the new leaders to the future as well as we discussed, maybe the next regional operations manager might start out as an inventory manager in a larger hospital and grow from there. It’s important to cultivate and provide those functions on a local level. You mentioned marketing for example. If you’re a referral hospital, you still need to have somebody that’s a referral coordinator, somebody that’s out visiting the hospitals of the referring hospitals. If you’re a large general practice, you need somebody to manage the social media that’s local and so forth. You need that talent at the hospital level and you need to cultivate that for sure.
Bob, outside of a lot of the changes that come to the people in the people operations, how do you like to go about the change management strategies around whether it’s pricing or the inventory processes or those sorts of things at the clinic level?
Yeah, I think that’s a caveat to what we were just talking about on the last question. I think that it can’t be a top-down approach, especially with sensitive items like pricing because we’re a price sensitive industry and if there’s not a thoughtful, sort of, change management or input where it becomes their idea at the local level, they’re going to sabotage what it is you’re trying to do at a global level.
I think again, communication is king or queen and you need to have two-way communication around those things, you need to have a thoughtful timeline for implementation, you need to have input from the field on whatever the project or direction is you’re going, because if you don’t deal with the end user, you’re going to have problems, or incorporate the end user’s input and buy-in, you’re going to have problems.
Yeah, that’s exactly it. I know that we were working with someone here on the east coast and they decided to just go into PIMS and just change the prices, not telling the staff. They were fairly new and so they don’t understand that staff knows prices by heart and when they see something different, they probably will think it’s an error.
It was a large referral hospital and the entire staff walked out like that was the result. In the morning, they came in and then they said, “We’re not continuing to work today until this is returned and we’re communicated and everything is –.” I haven’t seen to that degree but this is what happens.
That forces you into change management.
That’s an extreme but you know, typically it’s more subversive than that, they’ll just change the prices back and you’ll not know it until you code check on it at some point but that’s pretty remarkable. But that shows the fact that you need to – whether it’s in veterinary medicine or any other profession you need to have the team on your side or you’re not going to be able to implement. And then everybody suffers, you know?
Should that be something – is that a conversation that you think the regional manager should be having with the former owner or the practice manager or are there a specific roles that you think align well to be able to have those types of conversations?
Yeah, I think it starts at that level. I mean, regional support and hospital leadership, making sure that that hospital leadership team which is generally trusted and respected by the rest of the team in the hospital is on the same page and aligned with whatever change management you’re attempting but then depending upon the extent of it, it may just be a staff meeting item and everybody buys in but you might have to have some additional conversations with select individuals in the hospital or maybe even a round table or a meeting where the regional support comes in and discusses it in a general staff meeting and it may take a couple of times to get people to buy into change and certainly, soliciting their inputs often makes the idea better, you know?
I think the sort of collaborative approach is an important aspect in veterinary medicine is that people want to be able to participate and they want to be heard and if you don’t give them those opportunities, you’re going to be in trouble.
Yeah, no, absolutely. Vets are for some reason, I don’t know which course they teach it in the vet school but somehow, we’re – probably the most discounting profession. For some reason, Ryan has to stop me all the time when we go on the client calls because I’m the first one – we just came out of one.
Discounting 101, it’s a semester long course, I think.
Right, yeah that’s five credit.
There is a section on the boards for, “What does the corporate group think you should charge and then what should you actually charge?” It’s a tough one to pass.
They’ll be getting it.
It’s the reason why I am not allowed to sign anything officially at Pathway.
There you go. Because you get the relationship done but then it all comes with a price, right?
Right. We want to make sure we make some money and not just give away the farm, yeah for sure.
Yep, no for sure. About you’re a chief professional relations officer and we talked about what that means and this probably relates to quite a few questions on the recruiting because as we know there’s too many pets and there is not enough vets at the moment and recruiting is becoming increasingly a harder thing to execute on.
Aside from incentives, maybe first question is what is harder, hire vets or the staff in the past year and given the COVID and all of the circumstances, is it the vet shortage or we’re short of techs, vets and everybody else? And then what are those tools to do at scale when you’re growing to that significant number of hospitals like you guys are, what are the tools that someone should look into to start scaling that process?
Yeah, I think to answer the first part of the question, in my experience and I think the experience of Pathway, is that it’s harder to find vets than it is to find staff. I mean I think both are full-time jobs, so hiring whether it’s an individual hospital level or a platform level but definitely and maybe because of COVID and people not being willing to kind of move around or relocate or have in-person visits that the ability to feel vet positions has been more troubling or problematic I believe.
From a standpoint of scalability, you know you need to, again, start with finding somebody that’s familiar with the maybe healthcare recruiting or multi-site recruiting and you need to have the right leadership and the right framework of people to pursue, whether it’s on the staff side or veterinary side and, you know, at Pathway, we have talent relations partners that are involved just strictly with regional staff hiring and we have people that are involved with general practice hiring and we have people that are involved with specialty and ER hiring.
I think as you grow and build your business, you should think in terms of having people that have that sort of expertise or a niche approach that then they can focus on one piece of the staff pie instead of having to try to cover all of it. Then you need some sort of platform to onboard and work with candidates and we use one called Jobvite. There are a few other ones out there but you need a platform in which to put out, disperse ads I guess, to Indeed and other locations but also have a common platform for candidates to come in through and a process that works uniformly in that regard.
I think if it’s active, you need to – you can’t just put out an ad and be passive and wait for people to come. It’s not like a field of dreams anymore. You need to actually maybe solicit candidates directly through LinkedIn or some other social media platform. You need to be in contact, use all of the means that you have both internally and externally to attract candidates or at least touch candidates and figure that it is going to have to be a repetitive process.
Makes sense. And then, so the other way to relieve sort of the load on the veterinarians as well as to, while you’re looking for the full-time veterinarians, locums or relief work sometimes is a great resource and that’s what I’ve been doing throughout my career. I was always an ER vet and then I was doing a lot of relief work. There are a couple of platforms that are doing that right now trying to source those.
Are you finding like Roo Vet, I don’t know if you are familiar with them, are you finding that those are helpful and in general, is the locum strategy, relief strategy something that you think of when you are thinking about hiring people and kind of managing their workload?
Yeah, we definitely take advantage of those platforms and also individual independent relief for contract veterinarians and staff to fill holes. One of the sort of innovative approaches we’re taking at Pathway and you guys are maybe familiar with those but there are some, I don’t really know the word for what sort of platforms they are, but you can put out information within your own ecosystem, the area where you may have a cluster at the hospitals and look for people internally to fill the positions, you know, if they have availability and inclinations. So then you actually kind of create your own internal relief network if you will or – so that sort of an idea that we’re pursuing with some aggression because I think it should be the first tier for how you fill those positions as opposed to going outside the organization.
Yep, that would definitely be nice.
Yeah. It’s an untapped aspect. It’s not something that’s been really looked at until recently and now I think organizations like ours and others that have scale in certain areas, why not use a tool that allows you to fill from within? So that’s kind of exciting. We’ll have to see how that works to help us out.
Yeah, one resource that I wanted to make sure that we hit on was – and I am not sure if you’ve come across this yet, the AVMA just released their new grad study, which, usually when I see a new research paper, it takes me a while to get through it but I’ve read through this one real quickly. They did a new study on all of the grads from vet schools this year. It had a really great responded rate, over 80% respondents and it’s really interesting to see where the grads were going, sort of the change in COVID on their comfort level of practicing medicine and all of that.
I thought that was something that I’ll make sure that we link in the show notes as well and I’ll send over to you as well if you have a chance to read it. It was really, really interesting just to see where people are working, what their pay was going to be at, the changes of demographics and the overall groups of people, so really interesting. A really interesting research study.
Yeah, I agree. I did see that, I didn’t read it as thoroughly as it sounds like you did Ryan. My usual ADD won’t allow me to do that in my stage of life any longer but
How do you get double boarded? I don’t believe in that ADD.
Well, I have a sister-in-law who is one of those new graduates graduating from Auburn, so I was interested to see where she fell in that category. It was fun to watch the results and know, “Oh I know one of these 2,300 people that was graduating from vet school this year,” so that was really neat to see and cool stuff to learn about the practices.
Good for her, congratulations.
Yeah, thank you.
It’s interesting that with that, you know, I think that it does look like we’re trying to throw more money at the veterinarians and to motivate them to work for us. I think that I’m still a big believer that building great organizations like, you’re a part of one of them, that should attract people more. Not just the money because money is only one aspect and according to one study that I read is, you know, anything over 75 grand in North America is really sort of a level of comfort and everything else is just, you’re upping your level of course but to sort of have the basic needs covered and where the money is not as motivating is anything under 75K and that’s definitely beyond that for the past decade I would say.
Bob, again we’ve run out of time. We do promise our listeners to sort of cap it at 20 minutes. I know that we can talk with you for very long but I really appreciate you joining us again. It was very insightful. We want to ask you two questions we usually ask at the end and one is, is there any book that you could recommend to our listeners to get familiar with or something that would inspire them to sort of become as wise as you are in the consolidation business?
I don’t have a book that I could point to, I think I remember reading some books right now on servant leadership, which is helping me to sort of retool a little bit. John Maxwell is an author that I like to follow. From a standpoint of Pathway specific, we recommend a book to our hospital leadership teams called Traction by a guy named Gino Wickman and that’s a book that we use to create, sort of, what we call Pathway Planning. This is where our hospitals develop their own business plan if you will, and implement it, and that can be scaled up to an enterprise level.
We have a Pathway Plan in the executive team at Pathway and on the ops side and all the way down to individual hospital ones. We use that as a way of keeping ourselves on track and accountable to our plans and our vision. I think something like that may be useful to individual hospital owners or to other consolidators that might want to try to get traction if you will.
That’s their motive, very familiar with that book. In the last two, three companies that I’ve built, we implemented traction from day one. Smart Flow had traction incorporated. I got it from – who recommended to me? Guys from, what’s the online pharmacy, not the Vets First Choice, the other one, the Vetsource. Vet Source guys, they recommended it to me, we implemented smart flow then IDEXX and now with VIS, we’re also running everything based on traction, that sort of a core – I really like that book so thank you.
Then the second question we usually ask, is there someone that you would recommend we invite to this podcast that might interest the listeners as well?
I think you guys know Mark Cushing.
He is an attorney that runs Animal Policy Group, he likes to talk and he also has insightful things to say so it’s a good combination.
That’s a good combination, that’s a great combination.
I think people would say the first part about me but I’m not sure about the second part.
You want to give yourself an upgrade Ryan. Bob, thank you so much, thank you for spending the time. I know you’re a busy guy and I’m sure that this episode will be as popular as the other ones so thank you for joining us again.
Yeah, you’re welcome, thanks guys, have a great day, take care.