← Becker’s Healthcare Podcast
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- [00:00]
A
This is Scott Becker with the Becker Healthcare podcast. We're thrilled today to visit with what I want to say is the best kept secret in health care. An incredible physician driven clinic that has grown to be immense and a huge part of the landscape in Illinois and the greater Chicago area. It's led by a remarkable CEO, Dan Greenleaf who said just tremendous experience in leadership. We're talking today about Duly Health. Dan, can you take a moment and introduce yourself and tell us a little bit about duly Health and sort of the size and scope of it? Because I don't think everybody even in the Chicago area understands the magnitude of what's been built. Take us through it if you don't mind.
- [00:46]
B
Well, first of all Scott, thank you for having me on. It's a real pleasure and a real honor. Haley, also thank you for helping coordinate this call. So I'm, I'm a six time CEO, been involved in the sale of four companies to date. I have. My career has been split between 15 years in pharma and 15 years in healthcare services and also has been split in time running public companies, in time running private equity backed companies. I grew up in the D.C. area. I was fifth of five. My father was a military officer, my mother was a special needs teacher. The reason I bring that up is they instilled service by example. And I really believe that, you know, their example is the reason I went into healthcare. And a little about Dooley. We are the largest independent medical group in the country. We have 1600 clinicians in 190 locations. We have 1.5 million patients that we serve in greater Chicagoland and we do about 35,000 visits per day. We have a scaled fee for service business, we have a scaled value based care business. We have a scaled ancillary business. So think on the ancillary side. 6ambulatory surgery centers, 30 lab sites, 15 imaging centers, 10 immediate care centers, 100 infusion chairs, 50 physical therapy locations the company generates. I mean I think you've seen it grain somewhere in the neighborhood of of $3 billion in revenue. It's been around approximately 25 years. I tell people this is a national treasure that happens to be in Chicagoland because there isn't really a model like ours and we're a hospital without walls. But the real difference is what I describe as the dually difference. And what's different about us than other people that provide care, for example in greater Chicagoland is number one is affordability whereas one ninth the cost in many instances of similar care that would be received In a hospital system in Chicagoland, we save what I estimate, the employers, the unions, in the taxpayers, who are really the only payers in. In the marketplace, over $2 billion a year. Because we're here, a family of four. If we serve them, we can save them somewhere between seven and $14,000 a year. So affordability is we're best in class access. We're average two days, which is on average 20 days better than health systems in Chicagoland, which range from anywhere to eight to 60 days, depending on the type of carrier you're receiving. Our consumer experience, our net promoter scores are in the 70s or as high as 74 right now. So if you think about the global brands that people have such great affection toward, whether that be Amazon or Starbucks or. Or Netflix, those are the people we compete against when it comes to our net promoter scores. The hospital systems, again, from a net promoter score standpoint, are in the 30 to 50 range. And then finally, quality, our quality is just extraordinary. And sometimes it's not well understood. I'll use a couple of examples. When we do biopsies for potential cancer, we're correct on those biopsies about 77% of the time. The national average is 25%. So you think about the waste and inconvenience that means to the patient. And then the other one is just what we do with lung screening. And 77% of the time, we detect lung screening. In stage one and two, the national average is 25%. And most detection occurs in stage three or four. And oftentimes that's well beyond being able to change course on the conditions. So, Scott, that's an overview with the company and a little overview of me. And I'll stop there.
- [05:52]
A
Dan, it's really remarkable what you've accomplished. I knew the predecessors to Dooley. Back in the day, it was DuPage Medical Group. When I had a chance to revisit with you and talk to you, I remember the original formation of the group. I was blown away that it's grown that big. I know. I hear about the presence that he has a lot. But so many things seem to be going right. At a time when healthcare seems so challenging for so many health systems and so many clinics, what advice would you give to other leaders? I mean, at a time where it's very hard to find doctors or it's very hard to find staff, where reimbursement is challenging, you just have a lot of things going right there. And I know that from a lot of sources, quite frankly, that it's going well. What advice would you have for others in terms of today's healthcare landscape and how do you make things work when somebody are struggling?
- [06:46]
B
Yeah, I think that's a really good question. So, first of all, we're really clear on our priorities, Scott. We have five priorities. They are making sure we put the right people in the right seats. Voice of the customer is number two, which is how are we reducing friction for the patient? How are we reducing friction for our clinical teams? Best practice development. So what are we doing there? And how do we reduce variation? How do we adopt best practices? How do we drive out waste? So that's number three. Four is profitable growth. I mean, we have to have margin, Scott. There's just no way around it. And then innovation and automation. I am really excited about what's happening with AI. I think it's going to transform and we're seeing it transform the, the clinical experience for our doctors and our patients. So those are the kinds of things that we're just very committed to, Scott. And the other things I would share is never forget who you serve. We never forget that, Scott. It could be our best friend, it could be our parents, it could be our children, it could be our significant other, could be our grandparents. And, you know, we just, every day we think about, like, how do we serve people in the way that if those people were, you know, associated with us, what, what would we do? I'd also say we're being bold too, Scott. I mean, you know, we're, we, we're going to net out 150 clinicians this year. We're growing and, you know, we've made a big investment in Schaumburg, which was, for all intents and purposes, a healthcare desert. And we, it's incredible the results we're seeing in Schaumburg. I mean, we had a forecast to get to 15,000 encounters per month by December. We're going to get there by October. And so we, you know, I think that's part of it is we're, you know, we see lots of opportunities where, you know, a group like ourselves can continue to grow and expand and drive more affordability and drive greater access and drive greater consumer experiences and quality and then just ancillary expansion. Scott. I mean, you, you know, an MRI at our facility is $500. At one of the hospital systems, it's $4,500. I had a friend that you got two knee replacements. One was done in an ASC and the other was done in, in a, in a hospital system. And, you know, the hospital system was $65,000. ASC was so $8,500. So I think part of this is, you know, we feel like we're doing something that's, you know, really good for our community. And you know, I've got a whole bunch of other things I, I could talk to, but just in the interest of just, you know, keeping things on track here, I'll, I'll stop there.
- [10:17]
A
Thank you. And Dan, talk about we're getting to the end of 2025, which is just incredible. I'm a Chicago Bears fans, they're still awful, so we won't talk about that. But, but, and after such high expectations going into the year, it is what it is. But, but tell us what you' on and excited about as we get into the end of 2025, into 2026. Where are you most focused?
- [10:41]
B
Yeah, it's part of it is, you know, just really focused on building a great team, building a world class team, you know, making this the best place for a clinician to work, making this the best place for a patient to be cared for and doing everything. I wake up every morning and ask myself, how am I reducing friction for the patient? How am I reducing friction for our clinicians? How can I make this a better experience? How can I put a better team in the field? I've replaced 23 of the top 25 people at this company and I'll be relentless about that. Scott, I have a responsibility. Most important responsibility is, is the team I put on the field. And just like the Chicago Bears. And you know, if you don't do that well, you get, you know, you tend to get similar results, which I, I think you've seen probably since 1986 when the last great Bears team rolled through. And so that's, that's, I mentioned the growth and expansion, you know, onboarding physicians, ramping physicians, you know, engagement with our current clinicians, you know, driving, you know, making sure we're, we're putting people in our ASCs, making sure that we're putting people in our imaging centers that, you know, we're managing that referral, that referral experience exceptionally well for our patients. I mentioned Schomburg already and how do we grow that, but also, you know, how do we grow our other chem mobs? And again, I've mentioned patient experience, clinical experience. I'm really excited about AI. I mentioned that already, Scott, because, you know, again, I think it's transformational for the patient where. And clinicians, you know, we've put it in place. We expect to have, you know, 60% of our, our physicians on it in the next month. And you know, we're seeing five hours less of, of pajama time every week. You know, we've seen 5 percentage points increases in patient experience and just clinical documentation is invariably going to get better. But think about that. When you think about what drives physician dissatisfaction, one of the biggest issues has been the amount of time they're spending entering notes. That's exciting. I think there's AI for scheduling. We're doing a bunch of work on that. I don't know if you know, Scott, about a third of our patients cancel their appointments. Only 2/3 reschedule. That's pretty standard. You know, we're, we're looking at those patients who are most likely to cancel and we're double booking in those areas, for example. We're also using it to streamline inbox management because a lot of the notes that physicians get from patients are things that are very routine and they don't necessarily have to answer themselves. They have to certainly check the message that goes out. But again, these are just things that are, we're trying to do everything we can to just really allow our clinicians and our patients to keep that relationship as sacred as possible and mitigate those distractions. We're fighting hard to get candidly appropriate rates. Scott, the physician groups have really not, I look at what the payers have done in Chicagoland and they've given increases to the hospital systems that tune a 3 to 6% every year. Again, most costly place you can get care delivered. And the physician groups have been less than 1%. And we have to fight very hard to make sure that the group that's providing the most affordability, the best access, the best consumer experience and the best quality is getting reimbursed appropriately. And then other things are just, you know, what we're doing in MA and ACO reach with, you know, our full risk business. We, we think that's a really incredible opportunity and we're doing a great job of, you know, making sure we understand where fee for service begins and ends and where value based care begins and ends. I think as an employer, you know, we, we spend $100 million on our healthcare services and, you know, we just don't think that's sustainable. And we think that, you know, the TPAs in the marketplace have not done a good job of, of helping us manage that. And, you know, I'm, we're looking at ways that, you know, we can lower those costs for our, our team members so that we can put money back into our team members pocket. Scott, if I look at, you know, what's happened over the last 20 years, and I think I shared these numbers with you, inflation's up 61%, wages are up 111%, premiums are up 314% in and family responsibility is up 326%. When it comes to health care, the average American makes $74,000 a year. Health care has gone that 20 years as, as a portion of family responsibility is somewhere between 6 to $24,000. And you know, Duly feels like it has a moral responsibility to bend that curve. We owe it to our, the middle class. And you know, I was in a group of CEOs a couple of weeks ago and I asked them, like, how many of you came from a middle class background? And the answer was 100%. And like, so what are we doing here? You know, why are we letting this continue to happen and see this level of financial discrimination that continues to occur in the marketplace? And again, I think Duly can play an incredible role of changing that narrative. So that's something I'm really excited about too. Scott.
- [17:25]
A
Dan, we absolutely love what you're doing at Dula. We have followed it for literally 20, 30 years, since the inception, since the, the, the Dr. Merrick and Darrell Stremler and some others who found and founding it a long time ago. It's amazing the transformation that has continued to occur in the growth under your leadership. It's really remarkable to watch. Dan, I am so thankful to have you on today and speak with you about what you're doing at Duly Health. Congratulations and thank you so much for joining us on the Becker's Healthcare podcast today.
- [17:57]
B
Yeah, thank you, Scott. It's always a pleasure to talk with you.