The Healthcare CEO Podcast with Special Guest Dr. Bill Johnson

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Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate, leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives in the day in the life of a healthcare CEO.

*The following has been adapted from our interview with Dr. Johnson, which can be found here.

Meet Dr. Johnson

Dr. Bill Johnson is Board Certified in Internal Medicine and has been practicing his craft since 1984. He was born and raised in Dallas, Texas, graduating with honors from Texas Tech University as well as the Tech medical school. From 1983 until 2000, Dr. Johnson practiced at Lubbock Diagnostic Clinic. For the majority of those years, he served as president of the group. In 2002, he opened his own practice, incorporating cosmetic procedures. As a leading expert in the fields of cosmetic procedures as well as stem cell therapies, Dr. Johnson is a regular contributor to “Good Morning Texas”, the leading morning show in the Dallas/Ft. Worth area. He has also been  featured on ABC, FOX, NBC, CBS, and The Doctors.

Practicing Healthcare in the Lonestar State

Daniel Fernandez (DF): How did you get into healthcare? Tell us a little about your professional journey

Dr. Bill Johnson (BJ): When I started looking at what I wanted to do after the end of high school, I was thinking about going into the ministry, but a dear old friend of mine who was a judge felt that I needed to put my intellectual skills to greater use and suggested that I do that medically. So I pursued medical school and got in at a time when it was difficult to do so. During medical school, I got married and had two children, so we stayed put in Lubbock and practiced there for a while. Lubbock is a big medical town, so I was a big part of that medical community. Then when my kids went off to college in Dallas at the end of 2000, we decided to move there, too. My wife had just finished her MBA at that time, and there weren’t a lot of MBA-level jobs in Lubbock for her, so it was a good point to move. We had done the grow the practice, sell the practice, be an employee-doc in the mid-90s that a lot of practitioners were aware of — when the hospitals rushed to acquire physician practices. My group was a big part of that in the 90s, and so my contract was ending, and it was an opportune time for us to move, so we relocated to Dallas. I started practicing in Grapevine, and my wife started working at Merrill Lynch, initially as a broker.

Acquisitions, Telemedicine, and Technology: What’s Next for Healthcare?

DF: In the wake of Covid-19, we believe that a time of growth through acquisitions is coming, similar to what happened in the ‘90s. Do you foresee that happening?

BJ: I hope people have learned their lesson from the ‘90s because I don’t see a huge rush for physician practices, but I do think there’s going to be a real movement towards more and more telemedicine and a continuation of what’s been happening for many many years — a person had their doctor like they had their lawyer and their accountant. And when managed care came in pretty full force by 2000, people became less and less identified with their individual doctor. I think that with the continuation of the movement towards not being able to go into the office and not being able to physically be seen, it’s going to matter less and less who you’re seeing on a screen when it comes to your health care.

So I think there’s going to be more and more consolidation in that world, and then a readjustment of how that works — since there are certain things I can’t do for you when we’re on a video that I can do if you’re in person. And of course, now I do cosmetics and stem cell procedures, so everything we do, we do in person. Potentially I could do some of my return visits as video, but even then I can’t feel the temperature of your skin (which I do routinely) over a video.

DF: I know there are some devices that are hitting the market now with the ability to obtain vitals, for instance. What are your thoughts on this kind of technology?

BJ: Yeah you can take vitals remotely and even listen with a stethoscope remotely, but that’s not a tool someone can have at their house. They’re still having to go to a center somewhere where you have these specialized devices, and once I have you at a place with a nurse, they can get the vital signs.

We’re evolving. That tech is getting better, but I believe it’s a ways away from being able to do what we can do in person. I do think there’s going to be a big movement, and I think COVID is going to be a stimulus in that direction — as it has been already. I hope it’s not the death of doctors’ offices the way it’s the death of shopping malls.

Finding the Key to Patient Satisfaction

DF: You have so many happy patients and glowing reviews online. Are there any stories that really stand out to you over the years?

BJ: Well the stem cell patients are the most fun for me, but I also love doing the cosmetics. When I just started doing the cosmetics — and I was still really in internal medicine practice — I had a patient, and I was the sixth doctor she had seen for her blood pressure. Nobody could control her blood pressure, so over about a three-month period of time we got her blood pressure under control, and she felt good. But she would always pound me every time she saw me about making her medicines cost less. It got to the point where you’d almost dread seeing her because no matter how well you were doing on her blood pressure she was going to pound you over the cost of her medicines.

So one day she decided to do a cosmetic laser. We removed her age spots, and about six weeks after that I’m seeing her for blood pressure and she hugs and thanks me for removing the age spots. The same lady that was always telling me to lower the cost for meds was very happy to have paid me for removing her age spots. That’s when I said I’ve been doing the wrong thing. People are really appreciative, and that’s one of the joys in cosmetics.

When you’re a doctor and you’re making people pay on their co-pay or pay for their medicines or pay for their part of their procedure or even go through their procedure, you’re trying to do things they really don’t want to do, and you’re taking resources and funds that they prefer to spend elsewhere. When you’re doing cosmetics they’ve chosen to spend their money with you, and they’re much more appreciative, and they look forward to getting it done — it’s a lot of fun! Once I got into liposuction and fat transfer I realized I was good at it. I have a really good eye for how the shape needs to be, and people have told me I have quick hands, which helps a lot with doing lipo.

When it comes to stem cells and getting good reviews, we’ve had several people come in with things like Lyme disease, for example, who have been to multiple doctors, have been on treatment for years — we do the stem cells and now their joint pain is gone, their mental cloud is gone, and they’re feeling better and better all the time. For them, five stars is not enough for what you’ve given them back. We’ve got similar stories with a  number of disorders. We get a number of patients with osteoarthritis who can now go back to doing their regular activities. We even had a gentleman a few years ago who was in a car wreck and had an injury to his nerves and shoulders, and he was in so much pain and discomfort the first time we saw him, it hurt just to watch him. Now he’s pain-free. And so that’s really rewarding, and it’s a lot of the reasons you went into medicine in the first place. You’re improving people’s quality of life, and that’s very, very important and makes a real difference.

Internal medicine is all about management — you manage people’s health, that’s really what you do. But with stem cells, we really are fixing things. I stop short of saying the word cure because, with conditions like osteoporosis, the joints wear out again eventually, of course. But we’re giving long-term treatment to folks on a regular basis that is enduring and does make a big difference in their lives.

Innovations in Cosmetic Medicine

DF: The name of your practice is Innovations Medical, and obviously you’re doing a lot of innovative things. You talked a little bit about stem cells, but you also mentioned fat transfer. Can you talk more about that aspect of your practice?

BJ: Fat transfer is probably the largest growing area of cosmetic medicine. It’s when we liposuction the fat from one area — say, your stomach area — and then we move it to an area where you’d like it. For women, that’s predominantly the buttocks. But we also can do what we call a natural breast augmentation, which is an augmentation without implants. This is growing regularly and has already become a major part of reconstructive breast surgery because it gives them a better texture and feel than a traditional implant. But it’s also becoming more and more popular as people are becoming more aware that there can be some long-standing medical problems from implants, and so fat transfer avoids all that. We just don’t have those problems with it.

And then there’s also facial fat transfer. I think this is one of the most fun procedures because you can really take years off a person’s face, and then it doesn’t give them a drawn or “cat-like” look like you see sometimes when you do a traditional facelift. So yeah it’s all very exciting technology. It’s also appealing that you’re simply transferring something from one portion of your body to another, as opposed to introducing something foreign to it. It endures well, and there’s no chance of rejection since it’s your own tissue.

Facing the Challenges Ahead

DF: In light of what’s happening in the world today, obviously a lot has changed, and there’s a lot of talk about a new normal. What are some of the challenges you’re seeing because of what’s happening?

BJ: Well unfortunately for us, we had just expanded in order to provide facilities for other doctors so that they could refer stem cell patients to us or perform the procedure themselves inside our facilities. This allows them to get some revenue from the procedure as well as allows us to harvest and process the stem cells. These facilities are very expensive, so by allowing them to train and use our facilities and staff to do liposuction, fat transfer, etc., they are able to perform these procedures and send their patients here without being out of the capital costs of equipping the OR and maintaining it. So we had just finished that expansion and moved in when Covid hit, so now not only am I unable to go out and visit docs, I’ve got the extra rent, extra expenses, and extra equipment. We were shut down a month in the heart of our season. From March through June we make about half of our revenue, and we were closed for about a month of that. And we’re still nowhere near full capacity, so it’s been a real challenge, and we’re really trying to work to turn Fall — which is typically our slow season — into a busy season.

DF: Thanks for sharing that. I talk to a lot of CEOs and so many of them feel like they are in the boat alone, but they’re really not. Everyone is struggling with their own challenges. Is there any advice you would give other CEOs or healthcare leaders right now?

BJ: I think as a leader you’re really at a decision point right now: do I expand? Do I try and take advantage of this low and do acquisitions? Or, do we want to center our capital and see what’s coming back? So I think that there’s going to be some real opportunities, but I think the challenge is being judicious with your capital and where you’re going to put it. What or where are the opportunities that make sense?

What we’re trying to do right now is to reach out to other doctors to see what the interest is in utilizing some of our facilities that we’ve built for that purpose, and we’ve started doing some low-dollar advertising on cable TV where we can afford to have some significant presence without breaking the bank. So if you’re trying to broadcast channels in a market like Dallas, which is the fifth-largest media market in the country, regular broadcast is very expensive — several thousand dollars per 30-second spot — so I’m purchasing spots for as low as two dollars, which allows us to do a lot more spots and get a lot more coverage. You don’t have as many viewers but if you’re on 30 times in a day, it gives you a better chance of someone seeing your spot than if you’re on just once.

With regular doctors and physician groups, if I were looking at them I’d be looking at what their plans are. Are they going to look for new sources of revenue and new ways to make money or are they going to try and move more towards video? And does that mean more physician expanders? What does that structure look like? And then you have to consider insurance, which is a moving target. They like being a moving target, so how do you stay in the crosshairs and make sure you’re getting reimbursed on your best basis as you change how you see patients? I think it would be interesting to hear from some of the folks who are doing regular medical visits and how they’re planning on adjusting to some of these new challenges.

Connect with Dr. Johnson online at Innovationsmedical.com. If you’re a physician who is interested in their products or services, visit Innovationsphysicianservices.com.

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