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: Episode 29 – How to Create a Remarkable Company Culture with Gary Cooper

Dylan: 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: Thank you for having me, Dylan.

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

handled

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

Dylan: 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).