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Thanks for listening. Now here's the episode.
This is the Becker's Healthcare Podcast. I'm Molly Gamble,
vice President editorial, and today I'm spending time with Marty Bonk.
Marty is president and c e o of Ardent Health Services,
a hospital and healthcare network based in Nashville. Marty,
welcome to the podcast. Thank you so much for being my guest today. How are you?
And where do we find you?
Thanks, Molly. It's great to be here with you today, and I am in Nashville,
Tennessee, where our home office is located. Uh, great to be with you today.
Marty, before I continue, we talk some really important trends in the industry.
I have to ask, as a Nashville fan myself, your favorite barbecue restaurant. I,
I have my own favorite, but I'm always looking to expand the roster,
if you will.
Yeah, that's a great question. And, um, super competitive these days. Um,
I would say it, it's, it's a tossup for me between two, my namesake, um,
Martin's Barbecue is a, is a really good shop in town, um, but Ed Lee's, um,
is, is also really, really strong. So it's, uh, it's great to have choices, but,
uh, those are two are my favorites.
Martin's, uh, is one of my favorites. Ed Lee's, uh, is new to me,
so thanks for the, the recommendation. Marty. Um,
for listeners who may be less familiar with Ardent Health Services,
can we start off by learning from you a couple key facts or insights that would
help them better appreciate and understand your perspective?
Yeah, so, uh, historically, you know, you, you mentioned we are a,
a hospital health services company. Um, and,
and statistically we have 30 hospitals and 200 sites of care across eight
markets in six states. Um, we have about 23,000, uh,
team members in our company, including, uh, almost 7,000 nurses and, and 1400,
uh, uh,
providers that are aligned with us through employment or other contractual
arrangements. But, um, really the way I've been looking at our company is,
is much more than a hospital company or a healthcare system, but,
but really focusing on becoming a consumer-centric health services organization.
That that really is putting the person, that the patient, the consumer,
the center of everything we do, and realize that,
that we've got a number of facilities and services, whether those are physical,
uh,
bricks and mortar facilities or virtual services technology to interact and stay
connected with our patients. And so really in a transformation from, uh, uh,
a collection of hospitals and clinics to an ecosystem focused around the
consumer and, and all of their needs around healthcare services.
Mm-hmm. and Marty, it seems like, I mean,
I remember at Becker's even just a few years ago,
there were still articles in which people had conflicting viewpoints about
whether people who are the customers in healthcare should be referred to as
consumers or patients.
There were some strong opinions that consumers was not an appropriate term.
And as you just described,
you're looking to build a consumer-centric healthcare organization.
It seems like there is much broader acceptance of seeing patients as such.
Well, there, there is, and I, you know, I had the, the fortune or misfortune,
however you like to look at it, of, of becoming a patient after a,
a bike accident, uh, about a year and a half ago. And for the first time in my,
you know, adult life really became a, a patient. And, um, um, you know,
I'd say that we've got great caregivers, um, that are trying to do their best,
you know,
stuck with systems and processes that don't necessarily meet expectations beyond
the care, you know, and I'm talking about how do we interface with care from a,
um, insurance perspective or billing perspective, a scheduling perspective,
you know, all the things that we do in our day-to-day lives.
I can control my whole, uh, universe practically from my iPhone. Um,
but in healthcare, I mean, it's largely been a brick. I can call somebody,
navigate a phone tree, be put on hold, you know, get disconnected. You know,
it's, we,
we've been kind of our archaic historically in the way we've approached things,
and people want convenience in everything that they do.
Healthcare is no different. And, uh, to a certain extent,
I think we've got reluctant consumers. Nobody really wants to be a patient. Um,
you know, something happens and they, they become a patient.
But if you go back to a definition, a patient is somebody who is acted upon.
And I don't know about you, Molly, but you know, I think most people were,
you know, we don't wanna be acted upon.
We want to be involved in the care that we receive. Um, you know,
we wanna have our opinions be voiced in the, in the care that we received. And,
and historically, I think we have had this, we have built it,
and you must come to us mentality in healthcare. And, um,
the world is changing and,
and literally everything else that we consume as consumers. And,
and I don't think healthcare's really that different at the end of the day in
terms of what people expect. And the more that, um, people realize this,
the more, uh,
new entrants we see coming into the traditional healthcare space saying it could
be different. It should be different. And,
and they're trying to make it different. So it's,
it's really an imperative upon us to think about our patients as consumers and,
and not just as somebody that is sort of subjected to being acted upon by us.
Mm-hmm.
. Well, Marty, it sounds like from an unfortunate bike accident,
you know, you, that's valuable perspective gained,
especially for someone who sits in a position like you do.
But I think you're right. You know, I think the patient term,
meaning that you were acted upon is that cross purposes with the goal of people
being active participants in their own health and wellness. Um, let's,
let's talk about some of the headwinds you're looking at today.
You are c e o of one of the country's largest private health systems.
What do you see as the biggest headwinds in the near term and also long
term that are really commanding your attention?
Yeah, that's a great question, Molly. Um, you know, there,
there really is no short of challenges, I think, in, in healthcare today. Um,
but, but we're really tr choosing to look at them as, as opportunities. Um,
obviously we've got, you know, rising cost, um, you know,
and inflation that we're still, um, trying to get under control. Um, you know,
particularly in the workforce, uh, in, in labor. But,
but also the supply chain is still not, uh, back to where things used to be.
And, and, you know, we've taken that as a,
as an imperative to really work smarter and think differently about how we
approach the work that needs to be done. Um,
the workforce challenges I mentioned are, are getting better. Um, but,
but they're not back to, to pre pandemic levels. Um, and so, you know,
that's caused us to think about how can we use technology,
artificial intelligence, uh, machine learning, um, how do we,
how do we really embrace technology to get that to work for our caregivers
versus our caregivers having to work for the technology, which is,
I think of how things have been, um, up to this point.
And so we want to ease the, the workforce burdens that our, our people have.
If, if we've got a, a workforce shortage of, or talent shortage,
how can we make their jobs easier to provide better care, more efficient care,
more effective care? Um, so,
so that's a challenge that I know the industry's facing. Um,
as we talked a little bit about this, this changing consumer preferences, uh,
it is, is a headwind and we see disruptors, quote unquote,
come into the industry and they're trying to, to pick part pieces of,
of what we do as health systems. But, um, but,
but I think that's really a wake up call to our industry and a change that
really needs to happen. And, um,
as you said that the bike accident for me really was a,
a wake up call and a blessing in a sense that, uh, uh, one, I'm still here,
and two, I've got a, a platform now to do something with that experience and,
um,
really challenge our organization to change the way in which we interact with
our patients as consumers and, and really think from their perspective. Um, I,
I think from a payer perspective, we, we've got, uh, this, this gradual but,
but, but meaningful shift away from fee for service to value-based care. And,
and I think that's a way for us to, um,
care for our people across their health journeys and realize that we need to be
able to provide care on their terms where they want,
not where we want them to be necessarily. Um, but, but where they need to be,
uh, to get the right care at the right, uh, convenience, the right cost,
location, et cetera. And, um, you know, so that's, that's, uh,
certainly a challenge that we're navigating, uh, throughout all this, uh, the,
the headwinds that we have. And then, and again,
those disruptors that are trying to,
to carve out niche offerings or point solutions that we have provided. But,
but I think, again, it's,
it's a wake up call to us in terms of how we can think differently and,
and to ultimately disrupt ourselves, um,
versus just reacting to what's happening to us. So those are,
those are some of the, the big things that I think about that, uh, you know,
we're, we're dealing with across the industry and,
and how we're thinking about them at Ardent.
Mm-hmm. and Marty, I appreciate how you put,
I think on your first mention you put disruptors within quotes,
and I think that's,
that says something to me because we've been talking about different forces in
business, whether it be several years ago, Airbnb, Netflix,
how Netflix disrupted Blockbuster. I mean,
now that's a really archaic and old example.
And now Netflix is having its own challenges, of course,
but these disruptors have changed. You've seen some move in, some move out,
some that perhaps pose some risk, at least in theory initially,
and then that never really played out. So I think it,
it's a fit to put that in quotes.
'cause there's been a lot of churn to what and who is a disruptor to health
systems traditionally. How are you thinking about this? I mean, this is a,
a category of of business strategy and awareness that can,
you need to be flexible, nimble, but you also need to be really aware.
Can you talk about how you balance the days issues at hand
and then also kind of this big category of disruptors or disruption
that could someday really come to affect ardent health?
Yeah, let, let me start with the disruptor part. Well,
it's what's fresh in my mind. Uh, I was listening to another podcast, uh,
n y u professor, uh, Scott Galloway. He's got a podcast, the Prop G podcast.
And, uh, he was just talking about this in the episode I was listening to and,
and, and the paraphrasing what he said, but he says, you know,
all the attention goes on these disruptors,
but it's really much more of a statement about the disrupted and, you know,
a reflection on an incumbent in not meeting their customer's needs or wants, uh,
you know, in a relevant way today. And, and he, he mentioned also Netflix,
not in the blockbuster day, but uh,
you know how it kind of disrupted cable tv and you see all these people cutting
the cord right now. You know what,
we don't want to pay $150 a month for a bunch of channels that we don't really
want and be subjected to watching commercial advertising for products we don't
want. We just wanna watch the content we want when we wanna watch it. And so,
so, you know, Netflix delivered a different, uh,
value proposition at a much cheaper cost point, you know,
and so you can see how they gain popularity,
and now there's much more competition for Netflix than there used to be,
which is different challenge. But, you know, for,
for us in the healthcare space, it's the same way. You know, we,
we have expected people to take time out of their day or out of their workplace
to come and sit in a waiting room.
And even though we give you a 10 o'clock appointment,
we don't call you back until 10 40.
We make you fill out all these paper forms and, you know, we're disjointed and,
you know, repetitive in what we do. And, um, you know,
the world has worked differently. So it,
it's no surprise that an Amazon who's obsessed with customer
satisfaction sees healthcare as an opportunity, you know, to be disrupted. Um,
but, but I look at Amazon and go, okay, you're, you've bought a company, uh,
you know, you can't possibly, you know, have the geographic coverage in a,
in a short timeframe at least to provide physical interaction with every patient
across America. So you have a telehealth offering, which is great, and,
and I think telehealth is, um, here to stay for our industry,
something we need to embrace. But,
but what happens when you need something beyond that telehealth,
when you need the x-ray, you need the lab test, you need, uh,
something beyond what can be done virtually. Um, Amazon's, and again,
struggle with that is my prediction. And, um, you know, they, they, they're,
they're a force to be reckoned with for sure. But,
but I really look at this as ours to lose, we provide, you know, primary care,
same day, walk-in appointments, virtual care for all of our patients. Um, but,
but do we think about it in a way in which, um, you know, it running,
this is a, a separate business unit, a company just like Amazon.
So a little example, my wife got a, an email from Amazon, uh,
saying, as a loyal Prime member,
we'd like to introduce you to one medical group and come and get, uh, you know,
your, your on demand 24 7 virtual care option for
$169 a year, or whatever the, the number was. And, uh, you know,
I look at our community and we've got several big name organizations in,
in Nashville, uh, reputable health systems,
and I'm pretty sure they all do the same. Um,
but I haven't gotten an email or she hasn't gotten an email from them offering
the same value proposition, you know, and that's an opportunity. So as,
as we think about it, as ardent, you know,
we know what the disruptors are trying to do,
and they can really only operate in a narrow sliver.
We can provide the full continuum of whatever we need.
We just have to think about it differently.
And so this can't be something we do off the side of our desks. Um,
this can't be something that we're, we're thinking about part-time.
We've really gotta think about, you know, what do our consumers want?
How do we deliver to that them to that,
and give them what they want on their terms. And so to your,
to the second part of your question about prioritization, you know,
how do we distinguish what's, what's there, what's noise? Um, you know,
we always start with the question, you know, how does this support our purpose?
And our purpose is, is caring for others, and it's our, it's our patients,
it's their loved ones, it's, uh, our communities and it's, it's each other and,
you know, what do we need to do?
And so that helps us to put a lens on what we're trying to do.
Is this gonna help us deliver better care, achieve safer outcomes? Um,
is this gonna relieve burdens to our caregivers? Um, and the,
the daily challenges that they face, um,
is it gonna help us better deliver care outside the four walls of our hospitals
and clinics to, to, to develop a, you know, better,
more consumer friendly experience?
And so those are some of the true Norths that we look at when we're making
decisions and, and how we're thinking about things. And, um, you know,
we've really got a, a plan that we're calling essentially Den 360,
that that puts the, the person, the patient, the, the consumer at the center,
and realize that our, our facilities, our assets,
our technology are all there to support that consumer's interaction and,
and their healthcare, personal healthcare need versus, uh, you know,
just statistics of, of patients and heads and beds or clinic visits or,
you know, throughput metrics or what have you. So that's,
that's how we're thinking about thinking like a disruptor against ourselves and,
and, uh,
keeping our true north of our purpose at the center of everything that we're
doing. Mm-hmm.
, a couple reactions there, Marty. I, I love Scott Galloway.
I'm so excited to hear someone else mention him. Prof g um,
if listeners are familiar, a a brilliant business mind, um,
for things across numerous industries. So it's,
it's great to hear a plug for him,
but also to your example about your wife getting that email from Amazon about
one medical, you know, this was the first year Amazon, I mean,
with the one medical acquisition now complete, um,
was able to plug healthcare services through one medical on its prime day,
which is just interesting to think about healthcare being included in something,
um, that, that consumer friendly, that targeted, uh, like you said,
not typically communicated as such from the traditional brick and mortar health
systems.
Yeah, yeah. And I, I, again, I I think that's exactly right. And it's,
it healthcare's mainstream. You look at politics, I mean,
this is gonna be another central point in the next presidential election as it
has been. Um, you know,
healthcare is not seen as affordable or accessible as it needs to be. And,
you know, that's, that's, uh, an indictment on us. You know, I mean, there's,
there's lots of moving parts there. Um, you know, the insurance system is,
you know,
challenge that we have and the entitlement mentality and all these things. But,
but it's, it's really an opportunity for us to step up. And as I say, it's,
it's ours to lose. We, we've had the patient relationships,
and I believe as a health system, we should be the trust broker. Um, I,
you know, as, as I think about my personal healthcare journey,
I don't think about, uh, my insurance telling me where I,
I should receive care or an Amazon or a technology company.
I trust my physician, but,
but if we don't give them the tools and the technology and the resources to
provide an Amazon-like experience,
it's not gonna be a surprise if people go and, and,
and shop and test the waters and see what else is available.
So I agree with you completely. Mm-hmm.
You had mentioned in your introductory remarks that ar I is aligned with 1400
providers, whether that's through affiliation, employment,
I wanted to carve out a moment with you to talk about physicians. Right Now. I,
I, in talking with other health systems CEOs,
I really appreciate the thought they raised to me, which is that, you know, yes,
let's talk about shortages, let's talk about deficits, but at the same time,
let's make sure we are really appreciating the physicians who are with us and
making sure that we are doing things and accommodating them in a way that
empowers them. So I'm curious what that looks like at Ardent. You know,
you mentioned you trust your physician.
How are you really putting physicians in place to be
partners and the primary point of contact for consumers?
Yeah, so, so let's start with the statistics, uh, for a second. We, we,
our physicians, uh, and, and, uh,
allied providers see about 3 million patient visits a year, uh,
which is probably more than 20 x. The number of inpatient admissions we have,
we have as a, as a comparator. So, so we've got a lot of touch points with our,
uh, with our communities, with the people that lives in our communities,
many of which don't ever need to step in inside the,
the four walls of a hospital in a, in a given year. Um, but, but, um,
but have a lot of healthcare needs nonetheless. And so, so historically,
I think where health systems have, have, have maybe lost, uh,
lost their focus is we've,
we've thought of physicians as a mean to putting people in bed to, to,
to putting people in the OR and, and, uh, you know, creating these, uh,
opportunities for facility-based, uh, statistics. But, but really, uh,
it's that patient relationship that's so important. And, you know,
do we have the ecosystem to provide the health services that patients need in
their everyday lives beyond the four walls of the hospital? So for us, you know,
we really see the physicians as the is is the front door to our community, um,
to create those trusted relationships. And, um, you know,
some of those patients will,
will end up in the hospital and need those services, but, but many will not.
And so, um, we're, we're thinking about, um, you know,
our physician platform as the, is the catalyst for our value-based care, um,
for providing the right level of services in the right place and the right
location and the right fee structure. Um, and, and really, you know,
that being the, the driver for our, our company going forward. And if you,
if you go back to the disruptor comment, um, what, what does c v s,
Walgreens, Optum, uh, Amazon all have in common recently? You know,
they've, they've purchased large platform position groups or are expanding their
physician private presence. Why, to get closer to that, that personal patient,
you know, consumer relationship, uh, where,
where I think we have the opportunity as health systems is to embrace that same
mentality and, and physicians aren't there just to put people in the hospital,
they're there to lead the relationship. And if we do that, we have that,
that ecosystem around to provide care when they need more than what can happen
in that office. And,
and where I think ultimately we have the upside still on an Amazon or, uh,
an Optum or c v s, et cetera. So,
so that's how we're thinking about the physicians and how we,
how we work with them.
And so how do we give them the tools that they need to be successful? Um,
how do we help grow that pipeline that you alluded to? Um, you know, we,
we've invested even in technology,
we've got a company called Winnow that we created to help us to recruit
physicians into our network. And, uh, the way I look at winnow is it's, uh, we,
we kind of created the LinkedIn for physicians without them knowing they joined,
you know, so we know every physician across the country where they trained, uh,
where they live, where their spouses, uh, or partners, uh, um,
reside where their families grew up.
And so we can try to triangulate and find warm candidates that would be, um,
you know, good candidates to, to go and try to recruit, um,
bring people into our markets that we, we operate. And so, you know, we're,
we're just trying to think about, you know, again,
how do we put the physicians and,
and our patients as consumers at the center of what we're doing to be able to,
to drive that, those interactions and trust, trust relationships. Mm-hmm.
.
And, and just to kind of loop back on the disruption piece, you know,
when you talk about C V S Health, Amazon,
these big companies buying these phys physician groups and platforms,
you know, do you see any, I I guess my question is this,
it's that like primary care physicians especially are in such a powerful,
they hold such a powerful seat, but they typically,
it's not a lucrative specialty compared to some others.
There was just an article in Harvard Business Review,
I believe a couple weeks ago about how PCPs more than some other specialties,
need a lot of encouragement to take on leadership roles.
They're often reluctant to do so,
but when you see these big companies looking to add more physicians to their
ranks, Marty, do you think that kind of
renews the importance or power that these healthcare players
hold, um,
and what can often seem like a very system to system landscape
of healthcare?
Do you think it renews any empowerment or interest in the individual physician
and the influence they can yield and kind of, and where patients are going,
how care is delivered?
I'm just curious at a high level what your thoughts are on that. Yeah.
I, I completely agree and I, uh, I missed that particular, uh, H B R article,
but, um, but it, but it makes complete sense. And, you know, if you step back,
I think you,
you can understand maybe how the primary care role got diminished, um,
in a sense when you, when you put that hospital lens on top of it, you know,
primary care, um, largely exists outside the four walls of the hospital.
And as, as the rise of hospitalists came about, you saw, you know,
a lot of primary care physicians even giving up some of their hospital
privileges because they weren't following and rounding on their own patients
anymore. You know?
And so there's been an evolution over the last couple decades, um,
that has taken primary care further and further away from the hospital, which,
you know, if you're a hospital, if you're, if you're a hospital c e o,
and just looking at that lens, you're,
you're completely dependent upon that referral strain,
but yet they don't practice in your hospital,
and you don't see them every day in the doctor's lounge or cafeteria. And,
and so it, it's easy to see perhaps how, how things have evolved.
But I think it's also indicative if as you look at an Optum or you look at a,
you know, an Oak Street or one medical group,
how the rise of primary care has come back and, you know,
I think primary care is central to a successful value-based population health
strategy, and they're going to be the,
the quarterbacks and at the center of that, and the rest of us are,
are going to be, um, um, living off of, of that. So, um, I,
I completely agree that there's an opportunity here that,
that needs to be taken advantage of. And, um, you know,
and we need primary care to reengage in this holist holistic healthcare,
uh, mindset about how do we care for a community, a population, and, um, they,
they have to be tip of the spear because they're the ones having those
conversations and making the decisions of where patients are ultimately,
ultimately gonna be. Mm-hmm.
, as we down wind down here this year,
RNA introduced the role of C M I O to its executive ranks.
Can you tell us more about that, Marty,
and what the impetus was for that addition?
Yeah. So, uh, Dr. Brad Hoyt, uh,
stepped into our chief medical Information Officer role and, uh,
great addition to the team. He,
he's been a practicing physician with us in our Tulsa market, um, for,
for a number of years, but, uh,
has always had a bend for technology and, and what do the physicians need?
And so this was a role that we brought on, uh,
as part of our growing focus around, uh, again,
embracing technology to improve what we do,
how we do it to make our hospitals smarter, to interface with our patients, uh,
more effectively. Uh, you know,
everything that we do has a technology component. And so, so Brad's role is,
is central to understanding what do our providers need to be successful, um,
and,
and embrace everything we've been talking about from being the trust broker with
our patients to managing their, their care, um, as a population, uh,
working with our payers. Uh, so it's, it's really central to that. But,
but Brett also plays a role in, um,
our innovation and transformation committee that is focusing on, you know,
what other technologies do we need to bring into our organization and do we
build those? Uh, we, we recently announced, uh,
a launch of a venture studio with a company called Switch Point, uh,
here in Nashville. And, uh, you know,
there's gonna be solutions that we need that don't really exist out in the
market. We're gonna go build our own. And kind of like winow, uh,
or Polaris is another example, uh, around, uh,
demand prediction and staffing and scheduling, uh, that we created. And, uh,
what are the things that we need to go buy or partner with other, uh,
organizations. And so we need to have that, um,
that physician clinician mindset, uh, as a part of,
of making sure we're making good investments in technology that really are gonna
solve our problems and advance our organization. Mm-hmm.
, I wanna wish Brad continued luck and success in his new role.
And Marty, I wanna thank you for being my guest for this dynamic conversation.
You touched on a number of really important issues right now and interesting
issues, uh,
that are in play right now for big health systems and smaller organizations too.
So, wanna thank you for being my guest, Marty Bick,
president and c e o of Ardent Health Services. Wish you a great and,
and continued success in the year ahead. Marty, thanks for joining us.
Thank you so much, Molly. It was great to be with you today.
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