Gary Cooper, Founder and Executive Chairman of Palmetto Infusion, joins us to discuss creating and maintaining a great company culture. With over 25 years of experience in the infusion industry, Gary has a wealth of insight into building and operating a successful infusion center. To learn more about Palmetto Infusion, visit www.palmettoinfusion.com.

WeInfuse podcast

Transcript: How to create a remarkable company culture with Gary Cooper

Dylan McCabe: WeInfuse podcast episode number 29. Welcome to the WeInfuse podcast. My name is Dylan McCabe. And in every episode, we give you a behind-the-scenes look at the infusion industry, as we interview owners and CEOs of infusion centers and industry experts, so that you can get tips, tools, and a roadmap to start, build or grow your own infusion centers successfully. And I’m really excited about this episode because we have Gary Cooper on the show. Gary is the executive chairman of Palmetto infusion services. He’s got over 25 years of experience in the industry. He helped found Palmetto infusion back in 1998. He exited in oh seven at a 10 x multiple after growing the business over 40 million in top-line revenue. He repurchased it in 2011 after it experienced some bumpy bumpiness. In the journey there, he turned the company around and grew it to over 225 million in revenue, and completed a funding round valuing the company at a 13 x multiple. Needless to say, there’s a ton of value. But what I love most that you get you’re going to get from this interview is Gary’s heart for the people that kind of culture they build. And he’s going to share some things about how they build that culture that are very unique. I think you’re going to get a ton out of this. Before we jump in If you have not taken the time to get a demo a free no-obligation demo of WeInfuse software. And if you haven’t been shown how it can save you money and make you money. If you are running an infusion center, you need to do yourself a favor, head over to weinfuse.com and schedule a free demo of the software you’re going to be blown away and how it streamlines the processes saves a ton of time, saves money, and enables you to scale and grow a successful infusion center, get everybody on the same page, especially as people are working remotely and dealing with a lot of hurdles in their processes in their infusion centers. You owe it to yourself to go to weinfuse.com and schedule that free demo today. Alright, guys, we’re going to jump into this interview with Gary Cooper. All right, as I stated, we have a special guest on the show, Gary Cooper. He’s the founder and chairman at Palmetto infusion. Gary, thank you for joining the show.

Gary Cooper: Thank you for having me, Dylan.

Dylan McCabe: Absolutely. Well, I’m excited because you guys have a unique story. You’ve got a seasoned journey in the world of infusion. And so just for those listening, just give our listeners a little bit of background on you and on Palmetto infusion.

Gary Cooper: Well, we started feminine fusion in South Carolina 20 years ago. I tell people we were country one country wasn’t cool. These drugs started 20 years ago and there we started pounding on infusion because there was nowhere else to get the drugs other than the physician’s office and hospitals. I wasn’t a home health care business at the time town. And hospitals truly did not want to do these drugs at the time. And as I was calling on them for home health care, they asked me Hey, could you get these Remicade patients out of the hospital. And literally, just overnight, we opened up a little ambulatory infusion center and it was truly started. We had no idea of the profitability, how we would do it. It really was started because patients needed it. And we were in the home infusion business and we just opened up a humble little office and started infusion patients.

Dylan McCabe: That’s great. And for people who may not know about Palmetto infusion and this is not a chance for us to beat on our chest or say Look how amazing we are or anything but it is definitely a success story. So kind of explains from your start 20 years ago to where you are now, how big are you guys? How many sites? What are we dealing with Palmetto?

Gary Cooper: Well, we’ve been very blessed. We are very fortunate. And we now have 22 locations in South Carolina, North Carolina, and Georgia. And we at one point in time, I still think I’m young, I’m not that young anymore, I’m 48 there was a point in time where I got lost in my ego, that I wanted to get bigger for the sake of getting bigger. And thank goodness, God has a funny way of waking us up. Now we want to go or patients need us. And so we grow where there’s a need for patience. And so we’re just growing inside out where we can really be good at what we do so we’re growing. We started in Columbia, South Carolina. We’re just growing inside out. So you’re not going to see us grow to the northeast to grow to the Midwest, you’re going to see our growth from the Carolinas throughout the southeast, slowly but surely a little bit like Chick-Fil-A did. Back in the day where they grew, where they can be responsible, and be very safe, we’re dealing with very difficult medicines. Very, very fragile patients. So we want to grow or we can be very responsible.

Dylan McCabe: It’s such a great story. And you guys have grown and scaled in a successful way, what would you say has been the key to your growth. And we know we’re not just talking about revenue, we’re talking about as a culture, a company culture, organizationally you guys are in a healthy place, what would you say has been the biggest key to that?

Gary Cooper: The biggest key that really comes from my only job description. And that was to know from my father, it was to take care of your patients, take care of your staff, and they give business decisions. That sounds very, very simplistic. But at the core, that’s what we have to do. Now, it gets really complicated when you’re dealing with new drugs coming out every month, they own very complicated drugs. But what really, really changed us as that patient, taking care of the patient or taking care of the employee, sometimes you might have to put the employee first because they’re the ones doing the heavy lifting. And so we have a culture of what I didn’t know what servant leadership was, and had never heard of that term. But I told you a little bit earlier about sometimes my mind, mob desires might have come before others. And I corrected that about four years ago. And I caught it going from selfishness to selflessness. And we got intentional about putting others first. And then our desires, our own, even listening is a skill. So we started listening to our employees about what they needed and what they wanted. And that metamorphosis has changed us as a company. And that’s probably the biggest thing that changed us. And has caused us to grow the way we have because now it’s not a company that has grown around an individual and grown around people who actually touched the patients. And that’s because our nurses aren’t farm techs, delivery people.

Dylan McCabe: I love that because it’s like the concept John Maxwell talks about when he calls it the law of the lid, and that book, The 21 principles of leadership. And it’s at your organization that can ever exceed your own leadership, the limits of your own leadership and your own character vision skills, and relationships. And it’s so neat to talk about the kind of a shift that you made, and you guys made from the top down to say, hey, let’s really focus not that we haven’t been focused on our people. But let’s truly become people first and envision an action. And so what were some of the changes that you saw taking place when you guys started to implement that kind of strategy?

Gary Cooper: We saw ideas began to flourish from the bottom up. So we started pushing decisions from the top to the bottom. And in the beginning, I think people were a little reluctant to believe that we were telling the truth or not, whether they believe this or not. And it took a couple of difficult decisions. And once we made a couple of examples that they believe that’s all of the sudden, they believe that they were making a difference in the company and the true decisions that were running the company. So all of a sudden the idea started to flourish from the bottom Case in point during the Coronavirus, the best ideas and examples to help the company came from the people running the clinics. For example, we started free lunch Friday where we would buy lunches from local restaurants. So not only did that improve the morale of the local branches that also kept the local economies going in those branches. So that was a fantastic thing to do. They were the ones who came up with the idea to, to do all the safety precautions outside of the offices, before anybody in a corporate office or C suite thought of it, they continue to come up with ideas to keep patients safe. And to this day, we have not had a single person of 18,000 visits, where a patient has gotten sick or an employee’s gotten sick. We couldn’t have thought of those ideas in an ivory tower that have been organic coming from the people on the ground.

Dylan McCabe: That is so good, that is so good. Everybody has a lot to contribute. And you guys are actually putting that into place. I think the big dichotomy I see is guys who can say that kind of stuff. And then you got guys and gals who are leaving their companies that actually implement it, and you guys are implementing it.

Gary Cooper: And so well, I’m sorry to interrupt. I think the word we use a lot around our places is humility. And we define that as not thinking less of ourselves thinking of ourselves less often.

Dylan McCabe: So good. So we could talk about, we could talk about leadership principles for hours. So I won’t do that. But that is just great stuff. Well, let’s shift gears, you guys clearly have a story of success, you are building a great company culture where people’s lives are being changed. And I know we even talked offline about real life-changing stories that are taking place amongst the staff and the patients. Well, let’s talk about challenges for a minute because clearly when you guys started opening infusion centers, it’s not like, it’s not like the world rolled out a red carpet for you saying, Hey, here’s the door to success, just walk right through what some of the biggest challenges you guys have faced on your journey.

Gary Cooper: Oh my gosh, reimbursement was a giant one. That was probably one of the bigger ones; purchasing wasn’t another big one. Logistics was a huge one having multiple sites and having to arrange multiple sites and then having all that arrange. The reimbursement is a huge one having new drugs come on. And having generic j codes mean there’s so many I can keep going on having facilities by him a villain. You can keep going on and on in this industry; one of the fun things is the challenges. What to get to the level we got to go into your line of credit was gigantic. We were always going through our line of credit. And I think anybody starting new will experience having to always contend with shipping drugs versus dealing with the PBMS and all of that, which I think will continue. There’s a lot of scary stuff on the forefront, in my opinion, coming at this industry in this face, which is extremely surprising to me when we are the safest. And that’s been proven now by an epidemic, that this is the safest place for people to receive these drugs. So it’s, it’s, it’s like the tale of two cities. It’s the safest place to get drugs, the cheapest place to get the drugs compared to hospitals. Yeah, there’s all these barriers to do this kind of healthcare, because we’re still considered like a physician practice or physicians, we believe a physician practice. So you’re out there and there’s no man’s land and the reimbursement world. So there’s no one out there to defend you until Nike comes along. And so you’re starting, you’re starting your own trade association. So really you’re in kind of like the Wild West, which for an entrepreneur like me is a lot of fun. For somebody who’s not used to that is not alone. But we are getting some cohesiveness now. We are getting some traction. There are a lot of new players coming in the game, explaining some of its own barriers, some of its own hurdles to get over. With that brings some healthy things to bring some consistency and competition always makes people rise to the occasion. I’m a little concerned about the future, what would that hold? But I’m a firm believer chaos comes opportunity. I think there’s going to be some chaos; I really do think there’s going to be some gaps. So you’re kind of like hold on hold on, and we’ll see what’s going to happen in the next couple years. I think the election is going to be a common, kind of a big sign on which way we’re going to go, kind of holding my breath to see what happens with that.

Dylan McCabe: Right? I think a lot of people are. Well, that’s the first thing that came out of your mouth. When I asked you the question about challenges was reimbursement. So share one of the biggest challenges with reimbursement that you guys faced over the years and how you dealt with that challenge and developed a method or a process or a strategy in place to where it wasn’t so daunting.

Gary Cooper: Gosh, I’m not the best person to answer that question. We have a person named Connie Hart, who’s been doing this billing for 30 plus years. But getting them because we’re a freestanding clinic, we are a little unique. I really don’t know the perfect answer to that. I will say that having a generic Jayco. And being a free-standing clinic puts a little risk on us when physicians don’t want to do so many infusions. The biggest part of reimbursement for me, I really don’t have the best answer for you on that deal.

Dylan McCabe: So it sounds like he’s hired. So you’ve hired a rock star biller, though that’s got it handled.

Gary Cooper: I surround myself with really smart people. The opportunity than we’ve ever come up with is I was told when I was a young man, from my only boss is to find a niche in a business where you can provide health care and a safer place or a safe in a place where that is cheaper than hospitals. Now then home health care, hospice, home medical equipment, and home infusion and ambulatory infusion centers have been the perfect place for me. It is safer, more convenient, and cheaper than hospitals not taking anything away from hospitals there. They are wonderful at what they do. But Connie has figured out the reimbursement side of that for us and has figured out how to run.

Dylan McCabe: That’s great and so going on from there, your startup, your journey to scale and growth and multiple locations. I know it’s big on your heart to have a great company culture. With servant leadership, what’s one of the biggest light bulb moments that you’ve had over the last couple of decades in this space?

Gary Cooper: The biggest light bulb moment I was sharing with you earlier is the amount of depression and the sense of loss that our patients have experienced as a result of having these diseases. An ms patient or Crohn’s or colitis patient or some of these really debilitating neurological diseases, they experience such traumatic loss, some of them early-onset, some of them immediately some of them over a long period of time. And at a normal pharmacy like for me if I go to Walgreens not picking the owner certain company, if I go to our retail drugstore there. I don’t think there’s any kind of emotional support for that. But being in a setting like we have or any of our fellow companies or physician’s offices have, we see that patient over and over again, and it’s really sad. And so, a lot of us, not just us, citizen a plug for our particular company. But a lot of us have recognized that and we’re going to address it. Whether that’s hiring a social worker, whether that’s helping them form their own support groups and our buildings when they’re not occupied working with the existing organizations that support their disease tape, there’s just a tremendous amount of depression. And other things like their diet. There’s other things like loss of income. And so we support it, we and other people have figured out how to get them in touch with other outside help, like natural assistance, help, or light bills, rental assistance. A lot all of a sudden figured out how to get them rides, free rides, whether that’s through Uber or the other Lyft. We work with a lot of outside help to get a patient’s assistance. When depression or loss of income I can

Dylan McCabe: See that’s huge because that goes back to the people’s first perspective that you talked about earlier, not just with your staff, but with all the patients as well. And I think it’s huge for two reasons. One is I know it’s a massive problem. Statistics showing that especially in a Mr. COVID-19, with the unemployment rate that drug abuse is skyrocketing, alcohol abuse is skyrocketing. Child abuse is on an intense curve up, it’s just terrible. People are stressed out to their Max and it shows. And so you guys have come in and you’ve addressed something, that’s the biggest reason I think it’s amazing. The number two reason I think it’s amazing is because people are not prone to share. I’m really struggling, I’m really depressed, or I’m really whatever. People just aren’t prone to share that kind of stuff, unless it’s with a close friend or family member. And I think it’s really interesting that you guys, as a company, have figured out a way to not only expose the need but answer it in a company. And you’re and you guys are not a church. You guys are not, you’re not a nonprofit that’s out there to just give stuff to people, you guys are actually doing this as a company and I, I’ve talked to a lot of owners of infusion centers over the last few years. And I don’t think I’ve ever heard anybody talk about this, what you guys are doing.

Gary Cooper: Well, we have one lady in our Columbia office. And she started a group called the 22:38 group. And we heard about it. And she’s an MS patient. I can’t remember what all her friends had, but it’s a lot. And then this guy’s had like 27 surgeries. It’s unbelievable. And they started to 22:54 group. And they call it that because they said they weren’t going to get around together and bitch and moan. That’s their words, not mine. And we heard about it and we said look what would it take for you to become a 501C3. They’re like x, y, and z. So we gave them the money. And they started their own 501 c three. And we said look, we have 22 buildings, we would like you to figure out if you have the time and energy, we would like you to figure out how to have about 30 people that meet that have an autoimmune disease or the life. And it’s like that for people with autoimmune diseases. It’s like a 12 step program, if you will, for people with autoimmune disease. And they get together and they trade numbers. And when one of them was down or can’t come to the meeting or their own walked in, people go to them. And like you’re saying If I tell you about an autoimmune disease, how bad my day is, you don’t get it. Because you don’t have an autoimmune disease. They can tell each other what’s going on. And they give her story is about the day the shoe drop. Her story is about when she couldn’t wear stiletto heels anymore. And that’s the day that really took her identity away. And she talks about that story. But then she says that that’s also the day that she became who she really is today. And she uses that story to say MS doesn’t define me anymore. And it’s uplifting because she says now I’m a better person than I was ever before at MS and her story is powerful. And she uses that story to go tell other people that your disease doesn’t define you. And she’s building this group of people. We just loaned our buildings to share that powerful story to other people with those, those diseases. So we were not doing anything, there are buildings sitting there idle. But we didn’t hear the message. And we’re like, more people need to hear, please clean their messenger that might be more valuable than the medicine that they’re getting.

Dylan McCabe: Yeah, that’s huge. That’s huge. The power of encouragement and giving somebody the gift of hope. And that it’s so much more powerful like you said when it comes to somebody else that’s on a similar journey that you are. And they can say, here’s how I’ve overcome, you can’t do that. It’s just priceless, like you said, so I think it would be amazing if a lot of our listeners that are owners, and CEOs of infusion centers would take a page out of your playbook. And I’m sure many of them are in some ways. But you guys figured out how to make a kind of a strategic alliance with a group of people who are doing this because you don’t need you guys are busy running your lane doing what you do best. But you’ve made a strategic alliance with somebody who’s doing this and doing it well. And you’re helping them take flight in that vision, and it’s just great.

Gary Cooper: Well, we all work together, all the infusion providers are a close-knit group, and we all like each other. And it would be fun to see her group become contagious across the centers and crave uplift and all these other people’s lives that it’s free. I suggest that you charge people $1 a day like some of these 12 step programs, where there are eatings anonymous here, anonymous herb a year in a year, whatever. Because man $1 a day to get some hope in your life. That’s not a whole lot of money for a cup of coffee and some hope.

Dylan McCabe: No, it’s not. That’s great. Well, since you had that light bulb moment, and you guys kind of figured out a way to address a need that was huge amongst your patients. What’s the biggest lesson that you would want our listeners to take away from that? Because we’ve got a lot of listeners that own infusion centers or managing fusion centers. We have a lot of entrepreneurs that listen, what’s the biggest key take away from that as a lot of a lot, everybody has to focus on the numbers. Everybody has focused on a successful business model. What’s the key insight you’d like to share from all that?

Gary Cooper: Yeah, I think the biggest thing that we learned recently is it’s easy to get lost in what we do every day. It’s easy to get lost and buying and building and shoveling paperwork and shoveling all that stuff and dealing with the corona virus and dealing with all the racial tensions that we have. Today, it’s easy to get lost. And we’ve been intentional about we’re not in control of anything. What we are in control of is how we respond to things and taking time to spend time and be kind to one another. And I know that sounds a little cliché, maybe. But we really, really taken time to do that. One example was we’ve been doing freelance Fridays since Corona virus started. And we asked people to do that on with local restaurants to continue the economy and local restaurants. That’s a little bit of putting our money where our mouth is it’s easy to say be kind to one another. But we said we spent a little bit of money, saving the car, and then that’s putting a little bit of our money where our mouth is. And so smiles are free. We can’t see him when I’m asked home. But we all have to do our work but we can do with a positive attitude. And it’s amazing how when we do that, actually our profits increase. Outcomes increase our satisfaction surveys increase. And it really is amazing how those parallels work. You tend to attract the people that you want and repel the people that you don’t want and employees and patients. And it’s funny how a positive attitude really does change the culture of the company and ultimately changes the success of your company. It is proven in companies like Chick-Fil-A is proven and companies like Zappos. And we’ve been fortunate enough for this period of time that is working for us.

Dylan McCabe: So good. Well, I hope your phone doesn’t blow up after this, because we got a lot of people that listen to this that want to get into this space. And you guys have such a great story. And you clearly care a lot about people and good leadership and stuff like that. But this has been really neat. I think there are some key insights here, what what’s one parting piece of advice you would have for our listeners before we end this interview?

Gary Cooper: Gosh, that’s a tough question man is open. And the questions always kill me. I wish I could come up with a really wise answer. But just because I know people, that’s really, really the wisest thing I can say, in terms of that, in terms of the fusion space, it is not a get rich, quick scheme. There are a lot of people jumping in this space. And if you think it’s a get rich quick scheme, don’t do it if you’re in it for the right reasons, it’s a great business to be in. It’s, it’s a tricky business. But I can tell you that there, there are tourists and there are tourists and the business will be will have a rough road. And people in the business that are in and mean well will probably not last. And people that that are in it are going to have ups and downs and ups and downs and ups and downs. But as they are in it for the right reasons, they’re going to stay in it regardless. Because they’re no different than people and other industries. If you’re going to last, you’re going to stay in it, you’re in it for a quick turn, it’s going to be a rough turn.

Dylan McCabe: So that’s a good parting word. And I love the part about time is too because you hear the phrase that people don’t leave companies, they leave bosses. And it’s such a key that you enjoy who you’re working with. And the impact that your boss can have on you as an employee when they communicate to you kind of like the zig Ziglar principle, that if you help people get whatever they want, they’ll help you get what you want. And when that’s truly embodied, it’s very powerful. So appreciate that. Well, Gary, we could go on and on. But we really appreciate having you on the show. So thank you for joining us.

Gary Cooper: All right, man, I appreciate it as well take care.

Dylan McCabe: Wow, great interview with Gary Cooper. I love what he says about kindness. It just really comes down to caring about and loving people. Well, that’s truly the key ingredient to running a successful business right, whether it’s in an infusion center or any other but the great thing about that is he also has an incredible track record of scaling a business successfully and he’s got a master’s degree in healthcare administration. He’s got success on the side of being a founder of Palmetto infusion, but it’s so clear that his focus is on building a great company culture. So just a great challenge to all of us to make sure that we let people well and make the main thing the main thing which is relationships, it all comes back to that as we try to grow successful businesses. If this has been helpful to you please take a minute to rate and review on iTunes and definitely head over to weinfuse.com you can schedule a free demo of the software today if you have not done so already. You will be so grateful that you did we know your workflow. We’ve been in your workflow as infusion center operators and owners and we think we can do it better than anybody else and we want to show you why infusion can save you time and money. Just head over to weinfuse.com. This is Dylan McCabe with the WeInfuse podcast very excited to be on this journey with you and we will catch you in the next episode.

Guest Speaker: Gary Cooper, Co-Founder & Executive Chairman at Palmetto Infusion Services, is also the President & CEO of The Carolus Company, a healthcare firm. Gary has over 25 years of healthcare experience and is part of multiple health foundations, including the Medical University of South Carolina (MUSC) Foundation and the National Infusion Center Association (NICA).