Nate Kaufman
This is Nate Kaufman with The Healthcare Bridge, a brutally honest and unscripted discussion with the leaders in healthcare around the country, and today I am excited because I have as a guest Dr. Imamu Tomlinson, aka Mu. Mu is the CEO of Vituity. He is a best-selling author and a podcaster. Welcome. Mu, why don’t you tell us your origin story? How’d you get here?
Imamu Tomlinson
Wow, well, how far do you want to go back?
Nate Kaufman
As far as you want.
Imamu Tomlinson
Thank you for having me, Nate. Amazing, always amazing to talk with you and really talk about healthcare, and talk about lots of things and disruption and everything. But my origin story is crazy. I was born in Toronto, so I’m Canadian, moved to New York when I was 18, thought I was going to be a rapper and a basketball player, but then decided on medicine—I always loved science. Went to residency and medical school in Cincinnati and Dayton, Ohio, and then was in California for 20 years, in central California, where I practiced in one of the poorest, actually, regions in the nation as an ER doc, mostly a nocturnist ER doc. I matriculated up in this amazing organization, Vituity, which is a multi-state, multi-specialty national partnership with no private equity, just a bunch of 6000 docs trying to make the world a better place. And then we moved our headquarters to Dallas, Texas, and I was flying into Dallas a whole lot so I live in Dallas now. I’ve lived here for about two years. I can tell you more, but I don’t want to let too much out.
Nate Kaufman
Well, you also wrote a book called Less than One Percent: How Disruptors Defy the Odds. Can you tell us a little bit about that?
Imamu Tomlinson
Thanks, Nate. I’m in that world like Malcolm Gladwell, where everything in the world is wrong, and here’s why. And in my leadership journey, what I realized is we really put people in boxes, we try to pick the winners and losers of the race before the race is even run; it’s not necessarily a book about my story. I do start with this unlikely CEO who was able to be in a position to really impact 14 million lives, but I talk about a lot of things. I talk about Steph Curry. I talk about Surya Bonaly, the skater that did the first back flip, I talk about Bob Marley. A lot of businesses where we try to put people in boxes, we try to really force people into an area, and I believe that we can disrupt that mindset through three things: disagreeableness, optimism, and relentlessness. How much more greatness would there be in the world if we did that? I’ll tell you the story a little later, if you want, Nate, but I hold grudges, and so Less Than One Percent really describes one of my biggest grudges in the world. [Laughter]
Nate Kaufman
I meet one of those—I’m disagreeable, so that works me, but what the heck. You have how many physicians in Vituity now?
Imamu Tomlinson
Right now I think we’re up to like somewhere between 6200-6300 and Nate, as you know, all of us are equal partners, so the doctor that just joined two years ago has the same ownership structure as I do. We all own equally, equitably, which is... I didn’t create it, but it’s fascinating to watch how that impacts the way you manage your business.
Nate Kaufman
I can remember meeting your predecessor many years ago, and I said to him, so what do you want to do? You want to go public? Do you want to do PE? Do you want to, what? And he said, “No, we just want to doctor.” Is that basically the philosophy?
Imamu Tomlinson
Yeah, my thinking, as we’ve talked over the years, my board holds me accountable to a lot of things, but the three major goals are, number one, improve lives. Every year I have to improve more lives than I did the year previous. If we don’t even have a top line revenue number—there’s none of that, it’s really just about how many more lives can we improve. The second is we call ourselves Vitans—a cool name—the second goal is to help Vitans do what they love. You and I both know how much more vested, productive, how much more caring physicians can be when they feel like they have a stake in the care that they’re delivering. Of course, the third goal is I’ve got to make sure the trains are on time. I can’t run the thing off the track. Those are the three goals. I don’t have top line revenue numbers, I don’t have any of that. And to your point about my predecessor, I really inherited the mindset of let’s help doctors deal with all this complexity in healthcare. But ultimately the increment of our business, Nate, is that space between the patient and their health, and that can’t be monetized, that can’t be digitized, that can’t be parsed out, because if you have a good relationship with a patient, you’re going to get good outcomes.
Nate Kaufman
Before I get into the your business units—because I’m very interested—one of the things that the Bain & Company did is an analysis of physician groups that were employed by hospitals and those that were employed by just fellow physicians like yours. What they found was that the satisfaction rate for physicians in physician-owned groups was 51%, I believe, which means 49% are going to be unhappy. That’s the bar you have to hit, at least, if you want to hit the national average. With health system employed physicians, only 19% of them were happy. What do you see as the difference? What’s your secret sauce with respect to how you can operate your physician group and keep the physicians engaged, and as you said, have the trains run on time?
Imamu Tomlinson
I think now I’m on a campaign, Nate, I’m on this campaign [laughter] to move away from—you’re laughing at me because you know how crazy I am. Listen, I don’t know if I believe in satisfaction or engagement. I know we use those as measures, and I think so do a lot of the big companies that manage this stuff, but I think in healthcare we have it wrong. You and I didn’t start this trek into healthcare based on something that we’d be satisfied at, we had a calling. I think to move away—to your point in a roundabout way, I’ll get to the answer—medicine is a calling, and so we have to remember that, especially when we deal with physicians. I believe in fulfillment, and I tell everybody—as a parent, man, I am not satisfied, but I’m always fulfilled. I think that’s what you’re keying into when physicians own the group, when physicians own the ability to... and when you empower them to care for people, they come at it with a different mindset that is more about fulfillment and less about just being satisfied. What we do, Nate, is we use the Medscape version of that tool that evaluates all physicians around the country. When we did, we found our—they call it burnout score, which I hate—our burnout score was like 50% lower than the rest of the country, and I think it’s because of that focus on just improving lives and fulfillment. And so, one hundred percent, everybody—you’ll see my LinkedIn posts—healthcare is broken, it’s all this, and it’s terrible and it may well be, but man, if you engage physicians—and patients, by the way—and you give them agency over their jobs, they’re going to do an amazing job, because they want to do well; they want to do well for the patients, for the community, for the health system. Sometimes we don’t empower them.
Nate Kaufman
In that book, Drive by Dan Pink, he talks about you have to give them the ability to master and you have to give them some autonomy, especially physicians. When they lose their autonomy and become RVU generators, what I found is that medicine is no longer a calling, it’s a job (Imamu Tomlinson: Absolutely) and that’s the difference. So, the group was originally called CEP, it was an emergency physician group, and that’s your backbone and I have some questions about emergency operations. Last time I checked, about 40% of the patients that come through the emergency department are Medicaid: they can’t find a doctor, they go to the emergency department. About ten percent are no pay, and then there’s some Medicare, and there’s commercial. Somebody, an emergency room doc, ran those numbers in 2020, and what he said was, if I just got Medicare and Medicaid, basically I would be underpaid by $100,000. How does Vituity deal with this issue if compensation for emergency physicians is not sufficient based on the work that they have to do and the reimbursement that they get?
Imamu Tomlinson
One hundred percent. If you look at it there are reasons for this, and you and I have talked about them over the years, and tele... there are other ways that I think emergency medicine is at the forefront of, I can’t decide who I see, and we actually love that. It’s beautiful, it’s the equitable thing. If you come to see me, Nate, or if someone from across the street comes to see me, I have to care for you and treat you in the same way. So, in that respect, I love it. The challenge with that, as you mentioned, is this disparate payer issue, and also the fact that we don’t have a rubric for every patient to decide whether the emergency department is actually the right place of care, so all of that history, that backstory in place. I think when you look at it, yes... we’re at Howard University, the payer mix around that community is challenged. We love being there, but we know that it’s a challenge to get enough money from the payers to be able to pay a reasonable doctor to do an amazing job. My answer to that really is diversity, Nate. I think that if you look at it, the reason we get around it in a way is because we have a diverse portfolio, we’re in communities where there are lots of commercial patients, and that’s okay, and we’re in communities where there are lots of Medicaid patients, and that’s okay, because we feel it’s our calling to treat everybody. The other thing we’ve done, Nate, you mentioned emergency medicine. We’ve diversified across the care continuum, so anesthesia, hospitals, medicine, psychiatric, psychiatry, neurology, and we’ve even ventured outside the hospital to take care of patients in new and innovative ways. I think that emergency medicine, just the way it is, might be at risk, but if we are able to diversify the portfolio and the work opportunities for ER doctors, that skill set can be applied in other venues.
Nate Kaufman
You mentioned my wheelhouse, hospital-based physicians. I usually spend, well, I’d say about 80% of the time negotiating on behalf of a health system with hospital-based physicians, about 20% representing the docs, and it’s not uncommon for hospitals to provide stipends to subsidize the difference between what it costs to staff a unit and what you are receiving. Are you seeing that as a more common element in terms of your business?
Imamu Tomlinson
I would say what I am seeing is that in emergency medicine there’s no longer the interest or the ability for health systems to help with emergency medicine, which I think for rural communities and some of the poor communities, is challenging. It’s rare that a hospital will say, “Hey, I’ll support you in emergency medicine, because they see it as a per click model, where you can ramp up and ramp down as you need. I think the financial pressures, as you mentioned, on emergency medicine are much, much more severe than they were 10 or 15 years ago. Even five years ago, we know that hospitals, medicine, and anesthesia in some cases, are 50% or even more stipends. I think those stipends are being affected, but I think that hospitals can better tie supportive groups to their metrics when it comes to hospitals, medicine, and anesthesia and obviously, number of surgeries. Most hospitals generate revenue through their surgeries, and then, obviously, if you can decrease the length of stay in the hospital, you’re saving millions, and then you’re potentially affecting their profitability. So that’s my overall thing. I think stipends are harder to come by. Hospitals are being really prudent in where it’s needed, but I think in emergency medicine, it’s really rare. Last thing I ‘ll say, Nate—run on sentence here—I think that the fact that we’re transparent with health systems makes the conversations we have much different. They know how much we make, they know our overhead, they know how much we collect. We share that openly with them, and we also share it with our partners, so when there are times that we do need help, they’re fully confident that that money is going to the physicians who are doing the work.
Nate Kaufman
And not to a PE firm or somehow or other.
Imamu Tomlinson
Well, I tell everybody, my daughter goes to Boston College. She’s on a basketball scholarship. It’s not hospital systems that are funding my daughter going to Boston College.
Nate Kaufman
A recent New York Times article talked about the fact that 75% of all patients are admitted through the emergency department. I think it’s higher because you’ve got to take out obstetrics, that’s an elective thing, never happened. But anyhow, they come to the emergency department and we’re seeing longer and longer waits, we’re seeing more people off the Medicaid rolls as a result of that wonderful bill, we’re seeing people not signing up for the Affordable Care Act. What is your corporate or personal vision about the future with respect to the hospital’s front door?
Imamu Tomlinson
I think appropriately so, it is the hospital’s front door. I think people are desperately trying to figure out how to get the right care at the right place at the right time, and I think we’ve been involved in that conversation. We’re a little bit different, Nate. As you know, even though there are times where decreased volume can decrease the working capital that I have in emergency department, we try to do the right thing, and if it’s an opportunity... for example, you have a patient come in with congestive heart failure exacerbation, there’s the typical way I learned to take care of that—snap your fingers and get them to the floor, but diuresing a patient aggressively in the ER, making that ER stay a little longer, can decrease the length of stay on the back end—and get this—the whole system can work better in that regard. So I think that ER physicians, specifically to Vituity, but other people are trying to do this also, trying to create systems that get those patients to the right place of care, because we can’t just trust the system to do that for us. How can we create things like... we’ve talked about Rely, which is a company that we started that really works on care navigation, both on discharges from the ED and from the inpatient realm so you can navigate that patient and get them to the right care at the right time, so they don’t believe that anytime I need something I go through the ED. That said, to your point about the front door to the hospital, if you can make it as efficient as possible for patients to come in and get the appropriate care so they can get admitted and you speed up that process, you actually free up the emergency department. So, I would say more than just being inundated, which is, I think, where you’re going, it’s like, oh my gosh, are you going to be inundated? I think there are ways to get efficiencies and manage patients differently to disrupt the current paradigm, because in the current paradigm you’re just going to get a glut of patient flow, and it won’t be the best. But Nate, the whole thing I do is I love disruption.
Nate Kaufman
Well, I was going to ask you, so how are we disrupting the emergency department? I go to these hospitals and what I see is they hire the ED docs, there are people waiting, two percent leave without being seen, everybody gets a CT scan, how do you disrupt the ED?
Imamu Tomlinson
We’ve iterated on disruption through our 50 years of being existence. We started RME, which is Rapid Medical Evaluation, that a lot of people are doing now, where you push the provider up to the front and that stops the clock. But it’s only partially what you really need, you really need to create flows throughout the entire course of the patient’s stay, and then you need to stagger it based on acuity. Obviously, you want to see the heart attack really, really, really fast, and you want to get them to the cath lab. So we have a couple of different things that we’re doing, Nate. We have something called the Waterfall, which is a rendition of RME, where we actually take physicians and advanced providers and start their shift in the front. We start them in the front, they stop that clock, the clock of the patients waiting, but then they manage them through the process. You think about going to an ER and going through shift change where you have a different doctor, a different nurse, you’ve got all these different things going on, but if you can create that continuity, we find that when providers have continuity in that ER stay, the patients are admitted quicker, the patients are happier because they’ve only seen one provider. That’s the disruption we’re doing, can we flip the whole staffing model and care model on its head and not just do the old triage? Think about it, Nate—I write about this in the book—triage was started in a war zone, tagging people and saying, “You’ll live, you’ll die, you might be saved.” We still have that model today. The idea is to upend that and really treat all patients as efficiently as we can, but then don’t just let them get stuck in the quagmire of waiting for tests.
Nate Kaufman
You mentioned earlier that you express a lot of dissatisfaction with the current non-system that we have in LinkedIn. I think I beat you by the way, in terms of the intensity of dissatisfaction, and one of my big dissatisfactions is what I call verticals. You go into a health... First of all, on a big scale, we’ve got pharmacy, all they care about is pharmacy. You have health plans, all they care about is health plans, and so on. The whole system doesn’t worry about the patient like you talked about, but within health systems where you work, you’ve got HR, and you’ve got supply chain, and you’ve got this institute model, and you’ve got all these different components. They’re all worried about their own vertical performance, not worrying about how well the health system is operating. One example, which you may be somewhat familiar with, is this one hospital which said, okay, supply chain, reduce the cost of implants, and they did. And as a result, a thousand surgeries walked out because they limited the implant selection and the doctors didn’t want those implants so they left. How do you work with health systems and deal with the inherent vertical organizational matrix structure that doesn’t seem to be able to get a lot of things done quickly?
Imamu Tomlinson
You mentioned matrix. In our organization I still get a lot of flack for it from my team. We’re still figuring out pieces of it, but I don’t like heads—heads of anything. And so if you look at it, we split the country up into divisions, and our divisions are led by a team, and those team members, there’s no hierarchy between them—they actually report up through function. I think that’s a model in healthcare that, to your point, we can move to if you didn’t have these department head or in some ways they were accountable to each other. For example, if you made the lab person accountable to the time to provider, or you made the physician accountable for CT throughput time, you would see very, very different outcomes. And we do some of that, Nate, with integration on hospital medicine and the emergency department. We have shared incentives and shared metrics when we have the ED and HM, so one plus one equals three, that way I’m incentivized by length of stay in the hospital. And I can say, well, Nate, that has nothing to do with me, I just make the decisions on whether they need to be admitted or not. That’s one mindset. Or you could say, hmm, what can I do so that my partner—when he or she is in the hospital—has a better throughput of that patient. So I think shared incentives in those verticals, that’s where you could start, but ultimately, if you could create some matrix reporting I think that’s where you go. It’s complicated. Don’t get me wrong, it’s hard to manage, but I think that’s the answer.
Nate Kaufman
Well, you mentioned the answer earlier, which I believe in, which is, why don’t you talk to the doctors and nurses? Design a system that’s going to work; talk to the doctors and nurses, as opposed to meeting with each other day in and day out. I guess that’s an area of frustration. The biggest issue now is board. It’s considered a national crisis, and one of the reasons it’s a crisis is there’s not a forcing function that says this patient at 7am is ready to be discharged, discharge them and get that bed ready. Are you guys dealing with that since you’re in the hospital medicine side of this?
Imamu Tomlinson
Yeah, absolutely. The traditional model, we’ve been able to flip it on its head. But the traditional model, what do you do? You start rounds at seven in the morning, you see the sickest patients first, and somewhere around 5pm is when you end up seeing the patients that need to go home, then you find out they can’t get a ride till the next morning, all those things. We reverse round—we know the sick patients are going to be there, of course we tidy them up, make sure there’s nothing acutely going on—we quickly go to the patients that could go home today. They want to leave, they’re ready, and you round on those patients first. The other thing too, I think Nate, we try to do is—and we’ve learned this over time and mistakes and iterations—you probably need to round with the whole team. That’s where you write the discharge home, oh, they need a new wheelchair, oh, this, all these things. So rounding together and flipping the the way you round.
Nate Kaufman
If you have any advice for health systems, because you work in how many hundreds? [Chuckle]
Imamu Tomlinson
We have 900 practices in, I’d say, 60 health systems.
Nate Kaufman
If you do have any advice for health systems about, okay, we’re in the gutter doing the hard work, taking care of patients, is there any advice you would give them so that they could operate a better, more patient-oriented institution?
Imamu Tomlinson
The first thing I tell them is, call Nate. [Laughter] You want to know what to do, call Nate Kaufman, because he’ll tell you what to do and it’ll be... and you may not be—listen, you’re my friend—it’s not going to be fluff at all, it’s going to be very straight and to the point, and that’s why we love you, Nate Kaufman. I think the other thing that they should do is—and I know that they’re busy and I know they’re worried—you have to really focus on the patient processes, the patient flow. I know the CFO is staring down their necks. You’ve got to put the CFO on hold for a minute, find out what is best for patients. I guarantee you, if you figure out satisfaction, flow, and doing quality care, the finances will work itself out. The second thing I would say—and you mentioned that earlier—is you’ve got to get doctors on board. Number one, you have to hear them out, which can be difficult because they’re very opinionated. But you’ve just got to sit back and listen, because even when they’re just complaining, there’s one nugget that you can find that’s going to make the care better. And then after you listen, you can’t just go back to the Lean Six Sigma people and figure it all out. You’ve got to get them in the process and make sure that they are the ones, because they’ll tell you—if they’re walking down the halls, talking to nurses, talking to department heads, talking to the head of radiology, and they’re excited about your process, I guarantee it’ll be successful.
Nate Kaufman
I can’t disagree with that. It’s amazing how many organizations have forgotten about the physicians and the nurses, in particular, as the people that know what’s going on.
Imamu Tomlinson
Nate, it’s historic. I think physicians, myself included, have learned. Fortunately, Vituity is a great leadership development program, so I’m much more refined than when I started, and I think physicians can do it better. We are doing it better, but we still can get better about how to communicate in a way that advances the ball instead of sometimes not having all those leadership qualities. So I think that’s something that I’ve seen more of. I’ve seen many, many more CEOs who are physicians, I’ve seen many, many more physician leaders, and I think that’s a good sign for a future where the care is better.
Nate Kaufman
I remember many years ago, I think I spoke at a Vituity conference and I was impressed with how many leadership meetings you had going on, training people on how to be better leaders and do the right thing and those kinds of things. Where I see that differently is hospitals have general overall leadership stuff, but yours can be targeted to the specific specialty, and there are a lot of issues that need to be resolved in those individual specialties. Just a couple more questions. One of the things I’m curious about because you expressed dissatisfaction with the system, and you’re a big thinker and you’ve been on podiums with Scotty Becker and all these other folks, you talk about disrupting to defy the odds. What’s your solution for our nation’s healthcare system? Or what incremental things do you think need to change sooner rather than later?
Imamu Tomlinson
The first two words that came to my mind were reflecting pool, but that’s.. [Laughter] I think there’s a couple things, to be honest, and this is a Canadian response, so I apologize. I think that healthcare is not political. And I think that the solution for healthcare is people who want to solve problems in healthcare, want to do amazing things, and are able to speak to anybody about it, no matter what team anybody’s on. I think there are solutions out there in the middle that can bring people together, but I don’t think people are schooled in that way of thinking. I think the second thing, how do we solve healthcare—and you and I have talked about this and I think you talked about this with Mark Cuban—how do you create a financial model that is everything else, especially in America, is structured in such a way that I will pay for better, I will pay for faster, I will pay for whatever. Healthcare is this model where I serve you dinner and you think it’s great so you give somebody else the money, and somewhere down the line I get paid a percentage of that. That model just... people talk about single payer and all these different things; I grew up in single payer, I know the pros and cons of that. But there is a modeling here around compensation that can still allow you to grow and retain and recruit amazing physicians, not be onerous to the patient, but also be more consistent with the care you received, and not just necessarily what zip code you’re in, or what you do for work.
Nate Kaufman
My pet peeve right now is this whole price cap thing. That first of all, some hospitals deserve it. There’s no question, some hospitals are mismanaged and need better management and are inefficient. Some hospitals are promoting sports teams when maybe they should have invested in other things besides that. The issue that I have is you can’t talk about reforming healthcare and just look at one vertical. You can’t say, well, the way we reform healthcare is we’re going to cap commercial rates, but then ignoring the unethical behaviors of the insurance companies denying care and disrupting care and keeping people in pain. How can you talk about healthcare reform and not have both of those things in the same sentence? The only way I can think of that is you’re hired by a lobbyist who wants to puke on hospitals.
Imamu Tomlinson
We don’t have a lobby, we don’t have an advocacy wing of our partnership, so to speak. We do like to be involved in communities and make sure we communicate with our leaders, politicians, what’s going on. But I decided, Nate, that I’m going to go to Washington, so I went and I didn’t go with a team, I went just by myself. I was able to have some friends who got some meetings with people, and everybody I talked to on both sides of the aisle, they were like, “Oh my gosh, like you’re dealing with a lot of stuff.” And so, to your point, they were talking to a night shift ER doc, who happened to be the leader of a 6500 physician partnership, and they were intrigued by the conversation. The reason I got to this story is because one of the politicians said to me, how much profit do you make when you see a Medicare patient in the ED? Their mindset to really understand the breadth of the fact that, hey, I have all this uncompensated care, I have all this low paying care, and then I have people who will give me more than I deserve to offset that. It’s hard for them to really see that, and then they also think, well, Mu, why do you need more money? Or people on your podcast say, Mu, why do you need more money? The only reason we need money is to make sure we can get an amazing doctor there, we don’t have anybody else, any other mouth to feed. That concept to them, you would think that they would know, but they still are struggling through—especially in emergency medicine, but also in any of the hospital medicines. The fact that it’s more than just one for one, where I think, obviously, in the outpatient realm it’s a little bit different because you can choose the provider you see, you can choose when you have that mole removed, and things like that.
Nate Kaufman
You mentioned the reflecting pond; at the end of the day, when you think about it, most of the policies that we live under—those of us, you especially, that deliver healthcare—are policies made by people that are picked based on a popularity contest that has nothing to do with their competency and understanding of healthcare. And the nuances of healthcare are so complicated that if you create a policy and you don’t understand the nuances, you’re probably going to make things worse. And that’s what we’re seeing with rural hospitals, as an example. The policy is just leave them alone, throw them a few bucks. But the problem actually in rural hospitals is, in order to for them to survive, they have to have enough revenue, and that revenue has got to come from the private payer, because they don’t have the volume. And who gets paid the least for emergency services and other services—it’s the rural hospital so of course, they’re going to go out of business. But if you don’t understand those nuances, you’re probably going to get influenced by somebody who has some knucklehead idea and things are actually going to get worse for patients.
Imamu Tomlinson
I one hundred percent agree with you. What I try to do with these things is blame myself. I blame myself and that’s why I took it upon myself and others in the partnership to say, let’s educate, let’s teach, let’s communicate in a way that is... growing up in Canada, I learned how to say things that were terrible, that made everybody feel like they were amazing. So how do you communicate with people in a way that lets them know how much you care for the community, how much you care for America, and how much you care for providing the best healthcare. I think we’ll always have the politic stuff, but I do think— and maybe I’m naive to say—that somebody like Mark or me or a combination of different people, are going to figure out a way to disrupt it. Hopefully they talk to physicians, but I think they’re going to figure it out.
Nate Kaufman
As a patient... maybe because I’m in the secret society, I can tell when there’s a good doctor, you can tell when somebody is a good doctor. They know how to communicate with you, they’re not just interested in the visit. It’s a huge difference, and my feeling is whoever has the best doctors wins in the long run. You, Vituity, definitely have a lot of the best doctors, for sure. Two last questions... no, one: any advice for patients?
Imamu Tomlinson
The advice for patients is almost the same as the advice for physicians. Agency—it’s one word, agency. We’re in the biggest... one of the biggest disruptions to healthcare today is the fact that patients can take control of their care. We’re seeing this in the longevity space. We’re seeing people that are trying to figure out exactly what’s going on with their body in these tests that may be different, and they’re doing treatments that aren’t approved, but they want agency, they want control. So, the recommendation I have—especially with AI and a lot of other knowledge-based support—is take agency, ask questions, talk to people, talk to your physician about the choices you’re making, because at the end of the day, it’s your care.
Nate Kaufman
Yep, absolutely. Anything we missed, did we cover everything pretty well?
Imamu Tomlinson
We didn’t cover... did you want the Less Than One Percent story or not?
Nate Kaufman
Yes, yes, absolutely, you boggarted me on that, [laughter] so I didn’t know what the heck you would...
Imamu Tomlinson
Well, I was trying to stay healthcare focused, Nate. Part of my whole mindset now is that, again, my predecessor... I was in no way interested in being the CEO of Vituity—I am what you call a reluctant leader. I had a coach that pushed me to decide, hey, you’ve got to think of something more here, you can’t just keep working night shifts and just coaching your kids in basketball. So he challenged me, and I said, well, I like that CEO thing, that’s cool, it’s like being a point guard—I was a point guard in college. And he said, there’s no chance. I said, well, you’ve got to give me a percentage, give me some odds. He said less than one percent. So, I hold grudges, and I built a whole brand around the idea that we should never pick winners and losers before the race is even run.
Nate Kaufman
So that’s it, huh? You’re one of the less than one percent.
Imamu Tomlinson
No, I would say it’s... I don’t know if I am. I just know that there are so many people out there that are underrated and that feel like they could have a greater impact than they are having. And I want to be an advocate for those people who feel like that.
Nate Kaufman
Yeah, I think that’s great, especially doctors, again, down in the trenches. If we can be an advocate, advocate for them, we’re advocating for patients, and we’re advocating for better care. Absolutely, agree. And it is an Amazon bestseller, if I’m not mistaken.
Imamu Tomlinson
Yes, sir. Yes, sir. It’s done well. [Laughter]
Nate Kaufman
Congratulations.
Imamu Tomlinson
I appreciate it. I appreciate it. Of course, I’m not where I want to be, so I’m writing a second book, so... [laughter]
Nate Kaufman
What is this one about? Or can you say?
Imamu Tomlinson
My next book is called Almost: The Other Side of Winning. It’s really talking about the idea that we believe greatness happens when people win, or when businesses win, but there’s a lot of greatness in people who come second and third, and there’s a lot of greatness in people who just don’t ever happen to get on the podium. And so, how can we look at more of those individuals and really find greatness in them? Again, same theme, trying to find untapped greatness, untapped success.
Nate Kaufman
Well, you’ve done a great job, for sure. Vituity has grown under your leadership, and it has to be the largest independent physician group in the country, at this point, that’s not backed by any financial PE firm or whatever. Is that probably true?
Imamu Tomlinson
Yeah, I think that’s definitely true. With the number of physicians, our revenue is close to 3 billion a year. So, yeah, I think we’re definitely the biggest, but I don’t think we decided that. I don’t think we tried to be. You talked about the growth, Nate, I appreciate it, but I didn’t try to grow that rapidly or that fast. It’s just that the model resonates: resonates with health systems and resonates with doctors and ultimately resonates with patients. So as long as it resonates, I feel like we’ll continue to grow.
Nate Kaufman
That’s great. If they want to get in touch with Vituity, I’m sure they can go to your website.
Imamu Tomlinson
Yeah, vituity.com. You can also check out our not-for-profit Vituity Cares, where we provide care for people in 60 clinics around the country. If you want to volunteer for your clinician or non-clinician, go out there, we just take care of people for free, mostly unhoused communities, so that’s something that’s real passionate to me also. And you can find me at my name: it is ImamuTomlinson.com. You can email me, text me, LinkedIn, Instagram, everywhere, if you just want to talk, or want to talk about healthcare, or if you want to hear crazy stories about growing up as a rapper and a DJ and a basketball player.
Nate Kaufman
That’s great. Good luck to your daughter at BU.
Imamu Tomlinson
BC, Boston College, yes, she’s in her junior season, and hopefully we got a new coach. I just want her to have fun and excel, it’s amazing.
Nate Kaufman
Great. Well, this is Nate Kaufman thanking Imamu Tomlinson for taking time out of his extremely busy day to have a unscripted, brutally honest chat about healthcare. Mu, thank you so much, and hope we can connect at sometime in the future.
Imamu Tomlinson
Definitely, I appreciate you, Nate. Thank you so much.
Nate Kaufman
All right, Mu. Thanks.
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