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Leadership and Legacy in Healthcare Transformation · Taking The Supply Chain Pulse

• 0:10
  Speaker 1: Hello again everybody.
• 0:11
  Speaker 1: This is Fred Krams from St Onge with another episode of Taking the Supply Chain Pulse, and our guest is the esteemed Brent Johnson, the retired past president of the supply chain of Intermountain Healthcare.
• 0:24
  Speaker 1: Brent Johnson, the retired past president of supply chain of Intermountain Healthcare.
• 0:28
  Speaker 1: Just to read a little bit about Brent's background to let you know how fortunate we are to have someone of this caliber as a guest.
• 0:35
  Speaker 1: Brent Johnson has been one of the most successful and recognized supply chain leader in healthcare in the last 20 years.
• 0:40
  Speaker 1: He has over 30 years of experience developing supply chain strategies for major companies in three industries.
• 0:48
  Speaker 1: He was vice president of supply chain from 2005 to 2016 at Intermountain Healthcare, creating an industry top 25 Gartner supply chain organization number one in 2016 and 2015.
• 1:03
  Speaker 1: Before retiring, Brent served one year as president and CEO of Amerinet Intolere when Intermountain Healthcare completed the purchase of Amerinet.
• 1:13
  Speaker 1: Brent has too many awards to talk about, but, among others, he is a fellow Bellwether League inductee, having been inducted in 2014.
• 1:25
  Speaker 1: He has an MBA from the University of Utah.
• 1:27
  Speaker 1: He lives in Centerville, Utah, and has four children and 19 grandchildren.
• 1:33
  Speaker 1: I don't know, with 19 grandchildren, Brent, how you could have afforded to retire, because that's a lot of Christmas presents you've got to buy every year.
• 1:41
  Speaker 2: It is but it's a joy to do that.
• 1:46
  Speaker 1: Yep.
• 1:46
  Speaker 1: So, brent, welcome we are.
• 1:48
  Speaker 1: So you know you're the top of the top for us as far as the guest goes.
• 1:54
  Speaker 1: We're really honored to have you here, so tell us a little bit about yourself.
• 1:59
  Speaker 2: I fell into supply chain about 30 years ago.
• 2:02
  Speaker 2: I spent 21 years in the electric utility industry and while I was there I was administrative manager of a power plant.
• 2:12
  Speaker 2: And when they gave me my responsibilities they said, hey, your responsibility is also purchasing and warehousing, because I had kind of a business accounting background.
• 2:20
  Speaker 2: And so from that time on, because I had kind of a business accounting background and so from that time on over the next 10 years at this electric utility, I was given increased responsibilities in purchasing and materials management and supply chain at electric utility and I learned there the value of acting as a system, as a company, and the real benefits of supply chain.
• 2:45
  Speaker 2: Well, the company I was working for got bought out by Scottish Power and I elected to move on and work for a nationally known supply chain consulting firm called Denali Consulting.
• 3:01
  Speaker 2: And so for three years I worked for Denali Consulting and I thought I knew supply chain working at the power utility company.
• 3:09
  Speaker 2: But boy did I realize how much I need to learn from others.
• 3:12
  Speaker 2: They were sharp, really, really good supply chain folks.
• 3:19
  Speaker 2: So for three years I went in and out of companies and would do assessments.
• 3:24
  Speaker 2: After 90 days we could tell people how much money they could save if they followed our recommendations in the next few years.
• 3:32
  Speaker 2: And it was exhilarating, it was exciting.
• 3:35
  Speaker 2: I was able to know more than just electric utility.
• 3:39
  Speaker 2: After that, a neighbor of mine asked me to come and do consulting at ARUP Laboratories, connected to the University of Utah, and I said, okay, I'll go up and I did some consulting and I told him hey, if you do the following six things, you'll save $10 million after a year.
• 3:55
  Speaker 2: And they said no way, show us, prove it.
• 3:58
  Speaker 2: So I decided I didn't want to travel for the next 10 years.
• 4:02
  Speaker 2: I had 10 years of my life, working life and so I said okay.
• 4:05
  Speaker 2: So I went with ARUP Laboratories and we made the goals that we promised.
• 4:12
  Speaker 2: While I was there, intermountain Healthcare in the meantime was looking for a new supply chain leader and I looked at that.
• 4:20
  Speaker 2: I thought that's really unusual.
• 4:22
  Speaker 2: Why are they doing that?
• 4:22
  Speaker 2: As it turned out, they knew they needed help and their CFO, bert Zimmerle, had hired McKinsey Consulting to come in and do an assessment.
• 4:31
  Speaker 2: Mckinsey Consulting basically did an assessment and said hey, you spend a billion dollars on outside goods and services.
• 4:38
  Speaker 2: You give it very little attention.
• 4:39
  Speaker 2: You have a small central staff, negotiations are spread throughout the company and there's significant savings 10% to 15% savings if you manage supply chain right.
• 4:49
  Speaker 2: They recommended that they hire a supply chain leader from outside the industry and give that person a lot of support.
• 4:57
  Speaker 2: So that's how I started with Intermountain Healthcare.
• 5:03
  Speaker 2: I was a little bit lucky but I didn't realize, even when I started with Intermountain Healthcare, the reputation it had.
• 5:08
  Speaker 2: I also did not know about healthcare.
• 5:10
  Speaker 2: No one told me about GPOs, no one told me about doctors, physicians, physician preference and all the hurdles that come in trying to implement supply chain best practices in healthcare.
• 5:23
  Speaker 2: So anyway, that's kind of how you know a lot of background in supply chain, a lot of passion in supply chain, and then along came the opportunity to work in healthcare with one of the best companies in the industry, intermountain Healthcare.
• 5:38
  Speaker 1: Well, you know you've got, you've answered about four of my questions here in that one answer, but let's go into them in a little more detail.
• 5:45
  Speaker 1: First off, you retired about six years ago, right?
• 5:49
  Speaker 1: Yes?
• 5:50
  Speaker 2: seven.
• 5:51
  Speaker 1: Ostensibly retired.
• 5:52
  Speaker 1: Yeah, yeah, how's that going for you?
• 5:55
  Speaker 1: Are you enjoying being retired?
• 5:57
  Speaker 2: Well, I retired because I always believed that once you had enough money to live, that you probably ought to spend your time doing other things serving people.
• 6:05
  Speaker 2: And that's what happened.
• 6:07
  Speaker 2: And so we retired and my wife and I moved to Oaxaca, mexico.
• 6:13
  Speaker 2: We spent a year and a half on a service mission helping people with our church, the Church of Jesus Christ, the Mormon Church.
• 6:19
  Speaker 2: When we came back from that I woke up I realized I had nothing to do.
• 6:24
  Speaker 2: And my wife says I thought this would happen, so I send out my availability to a few people and so I started doing a little bit of consulting, whether it's speaking, helping people develop strategies, whether it's supplier side or the IDN side.
• 6:39
  Speaker 2: So I'm still a little bit involved.
• 6:44
  Speaker 2: The only thing I do now, after seven years, is I help John Kelly with the IDN Summit.
• 6:49
  Speaker 2: I lead their executive forum every six months when they meet and I write a blog for them.
• 6:57
  Speaker 2: Mike Langlois and I have done that for the last seven years.
• 7:03
  Speaker 1: Right, I know that.
• 7:04
  Speaker 1: Lake Langlois and I have done that for the last seven years Right, I know that.
• 7:07
  Speaker 1: So when you sort of walked into health care, you've told me how you got into health care and how you went to Intermountain when you opened the doors and walked in with your experience outside of health care, what were your initial thoughts concerning the health care supply chain?
• 7:24
  Speaker 2: That's a good question.
• 7:25
  Speaker 2: When I asked you some basic questions, such as who's your largest suppliers, who manages them, what are the major commodities that you spend on and who manages them, they couldn't answer that they just process POs that come in from people, and it wasn't long before I realized that they really don't have a strategy and they're really huge and only have their arms around a little tiny piece of the non-labor spend.
• 7:52
  Speaker 2: But there's no question.
• 7:54
  Speaker 2: In spending just a little bit of time in healthcare, I realized that the supply chain in healthcare is very complex.
• 8:02
  Speaker 2: There's so many supply chains, so many touches.
• 8:04
  Speaker 2: It's very costly.
• 8:06
  Speaker 2: There's a low investment in supply chain compared to other industries.
• 8:11
  Speaker 2: The clinical emphasis in supply chain in healthcare is really interesting because you have to be very dependent upon clinical applications and the clinicians and where you can run things like a business, you should and they don't.
• 8:29
  Speaker 2: So I uh, I went to work and, but I started from the bottom.
• 8:33
  Speaker 2: Now, one of the good things of mckenzie is that they justified me hiring uh, to me, to the senior leadership, to hire a bunch of people, but I went.
• 8:43
  Speaker 2: I went to him and said, hey, I need degreed MBA, very talented people, and I want to pay them well.
• 8:50
  Speaker 2: So once I convinced them to do that, I hired 15 to 20 people.
• 8:54
  Speaker 2: When it turns out, over a three-year period, probably hired 25 to 30.
• 8:59
  Speaker 2: Every time they wanted to save money I said you, let me hire another person, I'll save you a million dollars a year off the bottom line.
• 9:05
  Speaker 2: And we prove it.
• 9:06
  Speaker 2: So it was really neat.
• 9:09
  Speaker 2: It was neat to be able to go into someplace that needed you and then to demonstrate your value to the company.
• 9:17
  Speaker 1: Yeah, that's an interesting thing.
• 9:18
  Speaker 1: I had heard you say years ago that you know you would hire somebody.
• 9:22
  Speaker 1: Years ago that you would hire somebody and at this time when $100,000 was a pretty good salary pay them $100,000 a year and guarantee your employer that you'd save them 10x.
• 9:38
  Speaker 1: And for many of us for most of us the most difficult part of managing the supply chain was getting the resources you needed to get the job done.
• 9:46
  Speaker 2: We weren't highly regarded, you know, but go back to that statement.
• 9:50
  Speaker 2: You know what's interesting.
• 9:51
  Speaker 2: So I said so I could save you a million dollars for every person you'd let me, and, and, and the clinicians, the management people that have risen up through.
• 10:00
  Speaker 2: But they say but Brent, you can't hire those type of people, they don't give care, they're not clinicians.
• 10:07
  Speaker 2: And I says are you listening to me?
• 10:09
  Speaker 2: Do you understand?
• 10:10
  Speaker 2: Do you have a business mind?
• 10:11
  Speaker 2: We'll save you 10X and you can use that money to buy more nurses, more technology, give better care.
• 10:18
  Speaker 2: And so it was kind of interesting how they don't necessarily have a business mind to help them understand, help them run things better.
• 10:27
  Speaker 2: But anyway, you're right.
• 10:29
  Speaker 1: Yeah, and back then I mean even then the systems, the IDNs were just starting to develop, and prior to the development of systems, there were 7,000 community hospitals around the country, and you name a town that had more than 50,000 people in it and there were two hospitals competing with each other, with the same doctors on both staffs leveraging the leadership to get what they wanted.
• 11:00
  Speaker 1: So, and they were able to do it.
• 11:03
  Speaker 1: All they had to do is threaten to take their business to the other other place and you, you had to.
• 11:07
  Speaker 1: You had to turn that around.
• 11:08
  Speaker 1: One thing you said a minute ago that we've talked about in previous discussions, I think.
• 11:15
  Speaker 1: I think Ed Hiscock mentioned it when we were talking.
• 11:19
  Speaker 1: You said there were so many supply chains in health care as opposed to a singular supply chain.
• 11:24
  Speaker 1: Could you elaborate on that Well?
• 11:27
  Speaker 2: if you look at all the products and services that are needed to support a hospital or a large clinic there's pharmacy, there's, you know, maintenance products, there's clinical products, there's anyway.
• 11:47
  Speaker 2: There's just so many products and they all come in on a different truck.
• 11:51
  Speaker 2: They all come in and are managed differently.
• 11:54
  Speaker 2: You know there's not a chance that Walmart would let six or seven different commodities all come in how they want.
• 12:01
  Speaker 2: They would be managed and brought in much more efficiently.
• 12:04
  Speaker 2: And then you go upstream how they're purchased, how they're managed, who they're bought from, how do you manage the suppliers?
• 12:11
  Speaker 2: How do you aggregate the best suppliers and grow them as extensions of your own business?
• 12:16
  Speaker 2: That's what's done in other industries.
• 12:19
  Speaker 2: I came from other industry but you know, what's really interesting is that I still don't know healthcare very well.
• 12:25
  Speaker 2: They hired me from outside healthcare, but what I did know was I knew supply chain management, strategies and best practices.
• 12:32
  Speaker 2: And I was successful in healthcare, because it doesn't matter what industry you're from, the best practices and the strategies are the same.
• 12:43
  Speaker 2: And so I didn't know healthcare, but I knew supply chain management and that's all that mattered.
• 12:50
  Speaker 2: Quite frankly.
• 12:52
  Speaker 1: Well, that's true, but I'll tell you from you know, just observing over the years, a lot of hot shots came into healthcare from outside of healthcare and failed.
• 13:02
  Speaker 1: They failed because they obviously couldn't adapt to the environment and they thought that healthcare was exactly the same as any other supply chain.
• 13:14
  Speaker 1: What did you see as similarities between healthcare and other supply chains, and what differences did you see?
• 13:21
  Speaker 2: Yeah, good question.
• 13:22
  Speaker 2: Let me just say the industry is a noble industry.
• 13:27
  Speaker 2: Good people, everyone's trying to do their best.
• 13:30
  Speaker 2: There's not a lot of similarities other than they buy things and pay for things, you know.
• 13:35
  Speaker 2: But who does the buying, buying and how is it paid for?
• 13:41
  Speaker 2: Um, I, I.
• 13:44
  Speaker 2: The one of the bigger things I realized is that people thought that, oh, we got our arms around all supply chain.
• 13:51
  Speaker 2: But you know, when I was a consultant, you would go into a company and you would say I want to see, I want to go to accounts pay to see, I want to go to accounts payable.
• 13:58
  Speaker 2: Why do you want to go to accounts payable?
• 13:59
  Speaker 2: Because I want a full list of everything bought in the company, everything non-labor bought in the company.
• 14:04
  Speaker 2: So then you get that and then you say, okay, now how many?
• 14:09
  Speaker 2: What's the volume of dollars that goes through your purchasing department, through POs?
• 14:14
  Speaker 2: And it's usually 20 or 30 percent.
• 14:16
  Speaker 2: Well, who buys the rest of the stuff?
• 14:17
  Speaker 2: How is it decided upon?
• 14:20
  Speaker 2: Who pays for it?
• 14:20
  Speaker 2: So that's one of the things that I realized when I came in was that they only had their arms around some of the med-surg items and they didn't understand total non-labor spend, they didn't understand sourcing.
• 14:33
  Speaker 2: They didn't understand.
• 14:34
  Speaker 2: You know really best practices of supply chain management.
• 14:38
  Speaker 1: Well, that's for sure I can go.
• 14:40
  Speaker 1: I agree with you there.
• 14:42
  Speaker 1: So what tasks did you tackle first when you got?
• 14:46
  Speaker 2: there.
• 14:46
  Speaker 2: Good question, we were successful, though.
• 14:49
  Speaker 2: Let me tell you why we were successful.
• 14:50
  Speaker 2: Bert Zimmerle was the CFO, and it's not very often you find an aggressive finance guy, but Bert Zimmerle was as aggressive as I am had a hard time keeping up with that guy.
• 15:01
  Speaker 2: So I had senior level support.
• 15:03
  Speaker 2: So one I had senior level support.
• 15:06
  Speaker 2: The next thing we did was communicate.
• 15:07
  Speaker 2: We started to communicate with the clinicians.
• 15:09
  Speaker 2: We communicated with the management of all the hospitals and the company, and then we had to communicate to all the supply chain people, let them know what is happening.
• 15:18
  Speaker 2: If you're going to do change management which you have to do you have to get people involved that are going to be involved in the change management.
• 15:26
  Speaker 2: And then you have to measure yourself where you're at and where you're going to be later, and then demonstrate your change.
• 15:33
  Speaker 2: And then we had to hire talent that.
• 15:35
  Speaker 2: I've already talked about Strategies.
• 15:37
  Speaker 2: I knew strategies, but I had to adapt it for health care.
• 15:41
  Speaker 2: And then you needed data.
• 15:43
  Speaker 2: I needed data and systems to be able to know for sure how big a thing do we really have my arms around at Intermountain Health Care.
• 15:53
  Speaker 2: So the first thing we did was pick out a couple of big commodities and demonstrate that if you aggregate them and manage them from a company perspective and not let everyone decide what they want and then develop standards, how much can you save?
• 16:13
  Speaker 2: Then we demonstrated savings.
• 16:14
  Speaker 2: Then we picked off another commodity and another commodity.
• 16:17
  Speaker 2: By the time you got the eighth or ninth commodity, all of a sudden it says go ahead, do what you need to, but still every commodity you pick up, someone made the decision in the past, so you got to be an expert in change management and communication.
• 16:30
  Speaker 1: That's true, but you talked about commodities.
• 16:33
  Speaker 1: Commodities are one thing, but my next question is how did you build credibility with senior leadership and clinicians?
• 16:43
  Speaker 1: Because when you get to the clinicians, you're now talking about PPI physician preference items and they used to always get what they want, not necessarily what they need.
• 16:53
  Speaker 1: How did you go about moving that needle?
• 16:57
  Speaker 2: There's no question that was the biggest challenge that I had and what most people have.
• 17:03
  Speaker 2: Another big challenge is all the non-labor stuff that other people are buying.
• 17:10
  Speaker 2: You know all the services, all the support services, all the overhead of the company.
• 17:18
  Speaker 2: But back to the physicians.
• 17:22
  Speaker 2: We just started to communicate to them.
• 17:23
  Speaker 2: We got them involved.
• 17:24
  Speaker 2: The first was not going in to just come into just one knee supplier, but asked them if we could go from 13 down to you tell us how many, but let's do it together.
• 17:33
  Speaker 2: And so you get down to six or seven.
• 17:36
  Speaker 2: Then a year or two later you come back and get them down to two or three and you demonstrate the value.
• 17:41
  Speaker 2: And then we also developed savings and when we saved some we shared some of the money back to the physician offices, not to the physicians.
• 17:51
  Speaker 2: Couldn't pay them, but whatever they were needing in technology or expansion we would give them money from that would share them in some of the savings.
• 17:59
  Speaker 2: So that got them involved.
• 18:01
  Speaker 1: Well, that's pretty, you know.
• 18:02
  Speaker 1: And your other thing that you mentioned too was the, the remote purchasing people.
• 18:09
  Speaker 1: If you look at the laboratory, you look at pharmacy, you look at food service, you look at environmental service, you look at facilities, you look at IT, every one of those places would say in traditional settings, you look at facilities, you look at IT.
• 18:19
  Speaker 1: Every one of those places would say in traditional settings, you know, purchasing, which is what the place was called before it became materials management, before it became supply chain, it's not bright enough to buy this stuff, we have to buy our own.
• 18:33
  Speaker 2: So you would have five or ten standalone independent purchasing functions operating within any organization, which only made things worse, yeah all those commodity areas you just talked about were what I was trying to say a little bit ago when we talked about all the different supply chains.
• 18:50
  Speaker 2: One of the things, one of the first things I did in the first year was we consolidated, centralized into our corporate office all the buyers, including IT, and it took us a little while to get pharmacy, but everything else came in.
• 19:05
  Speaker 2: And then we had the warehouses report to us but also report to the plants not the plants but to the regions.
• 19:16
  Speaker 2: And then over time we realized that we wanted to build a central warehouse and that took a couple of years to do.
• 19:25
  Speaker 2: We had to stop because we realized we couldn't build a big enough warehouse for all the commodities that everyone had because there was lack of standardization and med surge.
• 19:32
  Speaker 2: Then we had to stop because we were buying from so many suppliers.
• 19:36
  Speaker 2: We had to reduce the amount of suppliers that we bought If you want to get down to 5,000 to 7,000 items in our warehouse.
• 19:45
  Speaker 2: And then someone stopped and said why are we doing this anyway?
• 19:46
  Speaker 2: We don't know how to manage.
• 19:47
  Speaker 2: We're not distributors.
• 19:47
  Speaker 2: Distributors really know how, but when we realized that if we had the right geographic density and the right volume, that we could do it ourselves if we did it right.
• 19:57
  Speaker 2: So in 2012, we opened up probably the best distribution center in the country at the time.
• 20:05
  Speaker 2: I know there's more now, but when you actually pay for every touch and every part, all of a sudden you care about that and there's so many hidden touches.
• 20:16
  Speaker 2: We changed how we did a lot of things because we had to pay for them and it was more visible to us.
• 20:23
  Speaker 2: It wasn't hidden behind, you know, a distributor or a gpo or a supplier.
• 20:28
  Speaker 2: So you know we centralized purchasing, we centralized distribution, we build this, we build a supply chain center and we put everybody in one building and that all of a sudden caused synergistic communications and strategy development.
• 20:45
  Speaker 1: Yeah, what's interesting about that too is that every place or every commodity had a different pricing structure.
• 20:53
  Speaker 1: If you're in a GPO or you're buying from a distributor, it was a cost plus situation, and I never could figure out in pharmacy how it was a cost minus situation, because that's just by stating the term sounds stupid, and fact of the matter is that nobody knew what any of that meant.
• 21:15
  Speaker 1: So at least you got your hands around, knowing what the true costs were.
• 21:20
  Speaker 1: Correct, yeah, we did.
• 21:23
  Speaker 1: So what do you think of the current state of healthcare supply chain leadership?
• 21:29
  Speaker 1: You go to the meetings, you see folks.
• 21:31
  Speaker 1: What do you think?
• 21:32
  Speaker 2: Yeah, well, you know, I stepped away for a year and a half when we were retired and when I came back.
• 21:37
  Speaker 2: But when I stepped away, let me stop.
• 21:38
  Speaker 2: The last year before I retired I convinced Intermountain to buy the other half of a Marinette that we didn't own, because I wanted to turn a Marinette into a supply chain organization, not a GPO, provide the same services and let people pay for them as a fee, but not as an admin fee, which is really a perverse incentive.
• 22:02
  Speaker 2: I wanted to get rid of admin fees.
• 22:05
  Speaker 2: It didn't make sense.
• 22:07
  Speaker 2: I didn't stay long enough to really make that change, but we were going to try.
• 22:11
  Speaker 2: And yet they knew I was only going to stay one year.
• 22:14
  Speaker 2: I told them I'm only going to work for one more year.
• 22:16
  Speaker 2: So the Intermountain buying of Amerinet changed the name to Inteler, didn't work out and I feel bad about that.
• 22:24
  Speaker 2: But the fact of the matter is, I thought it was only a matter of time before GPOs and the value of them would go down.
• 22:29
  Speaker 2: I thought there'd be consolidation in the industry and people get smarter and do more self-contracting.
• 22:34
  Speaker 2: Well, I came back after two years and three years and I looked around and GPOs were as strong as ever, distributors were as strong as ever, and I realized that there's very little change.
• 22:45
  Speaker 2: And so then I sent an email out to 120 people saying what has changed in the last five years, and they couldn't identify major changes.
• 22:56
  Speaker 2: They're little, tiny mini steps.
• 22:57
  Speaker 2: And so I realized that health care just does not change very fast and some of the things that I was struggling with 10 years ago still exist today, and there's still a need to develop and to invest more into supply chain, have more talent, have it recognized by senior leadership as truly a C-suite position, and manage suppliers better, manage total costs, manage more than MedSurg, manage all the services.
• 23:25
  Speaker 2: There's so much to do and we just don't.
• 23:28
  Speaker 2: Let me tell you one thing that was on my mind, I was going to tell you a while ago, when we had the tough year financially 2008, 2009,.
• 23:35
  Speaker 2: My boss the boss that hired me came in and said Brent, we're in trouble financially as a company.
• 23:42
  Speaker 2: Can you think of anything?
• 23:44
  Speaker 2: And I said why don't we send a letter under your hand to all the bankers, all the financial insurance, all the partners we have that are administrative, that you and all your people manage?
• 24:00
  Speaker 2: Let's send them all a letter saying we appreciate what you've done for us.
• 24:04
  Speaker 2: But we're having tough times, as you are, but we would like a 15 to 20% reduction in the fees that we pay you for your services.
• 24:12
  Speaker 2: We send it out to 47 firms, not said no, they all reduced their fees.
• 24:21
  Speaker 2: And my boss my boss says holy toledo, that tells us that we're not doing anything, we're not doing everything that we said.
• 24:29
  Speaker 2: So, starting at that time, he says okay, everybody, nobody buys anything in the company without going through supply chain and Brent's folks not that we're going to make the decisions for him, we just want to be side by side with them.
• 24:40
  Speaker 2: You know they're still going to be the technical, you know the primary experts and the content experts, but we want to make sure that they're looking after the company, looking for the long-term, understand, total cost, and so, anyway, that was a real mover for us when that happened.
• 24:59
  Speaker 1: Yeah, and that's it, you know.
• 25:00
  Speaker 1: Getting back to your Intel Air experience, I've always thought that the real value of what we call GPOs but really should be a service organizations that can provide resources as part of their offerings that smaller IDNs can't afford to hire for you know, yeah, smaller IDNs can't afford to hire, for, you know, yeah, and I think that was, you know, a noble move forward.
• 25:31
  Speaker 1: And the other thing is, you know, looking at things differently, your letter to the banks and all those folks was completely out of left field compared to the traditional way of doing things and it had a favorable impact on stuff.
• 25:44
  Speaker 1: So that was interesting.
• 25:46
  Speaker 1: So what challenge do you think that today's leaders are going to be facing and what do they have to do to meet those challenges?
• 25:54
  Speaker 2: Well, I think they still need to accept that we need GPOs and distributors, but manage them as if they're extensions of their own companies.
• 26:04
  Speaker 2: Don't just do what they say.
• 26:05
  Speaker 2: You're still in control of what you buy and you're still in control of how things get into your, your company.
• 26:11
  Speaker 2: No question, do that and a whole bunch of other things.
• 26:15
  Speaker 2: You need more talent, and it's hard to justify more talent when the profit margins are so light on on on healthcare companies yeah, it is.
• 26:25
  Speaker 1: Look what, look what you've shown there, though that's right that's.
• 26:27
  Speaker 2: And the profit margins are so light on health care companies.
• 26:29
  Speaker 2: Yeah, it is.
• 26:29
  Speaker 2: Look what you've shown there, though, that's right, that's right.
• 26:31
  Speaker 2: And then you know the pandemic was really interesting.
• 26:33
  Speaker 2: You know, I used to tell I have a car.
• 26:37
  Speaker 2: I have a car that I've had for eight years and it's an old Mercedes, and on the license plate on it is seo, supply chain organization.
• 26:48
  Speaker 2: Because I always I bought it for my retirement because, although I had it before I retired, because I wanted to always remember the supply chain organization.
• 26:54
  Speaker 2: You know, it's a passion I had.
• 26:56
  Speaker 2: But what's interesting is most people, neighbors and families and grandchildren say what's seo?
• 27:01
  Speaker 2: Stand for it.
• 27:02
  Speaker 2: It's Supply Chain Organization.
• 27:04
  Speaker 2: What is supply chain?
• 27:06
  Speaker 2: After the pandemic COVID, everyone knew what supply chain was, because the media outlined how supply chain messed up things on everything from toilet paper to medical products, and so the one thing that the pandemic did was highlight the need for good supply chain strategies.
• 27:26
  Speaker 2: But it also highlighted that we've got to prepare ourselves.
• 27:28
  Speaker 2: What's the next big thing coming around the corner, if it's not another pandemic?
• 27:32
  Speaker 2: Is it something economic?
• 27:34
  Speaker 2: Is it a world war?
• 27:35
  Speaker 2: Is it?
• 27:36
  Speaker 2: Whatever it is, you've got to prepare.
• 27:37
  Speaker 2: You've got to prepare the products you have, you've got to prepare for the suppliers you have and where they're at, and you need a risk management strategy.
• 27:47
  Speaker 1: Well, I agree with that.
• 27:48
  Speaker 1: We were talking about that the other day, and do you think we're?
• 27:52
  Speaker 1: I have seen the new folks that are coming out and I mean you've got a few of them.
• 27:57
  Speaker 1: You've got Joe Walsh and you've got Richard Bagley and you've developed a pretty good group of folks that have come out of the Brent Johnson School of Supply Chain.
• 28:07
  Speaker 1: I think the emerging leaders are better educated at the same stage in their careers by far better educated about supply chain than I was.
• 28:19
  Speaker 1: So I'm at least a little bit hopeful that we're putting out some quality leaders.
• 28:26
  Speaker 1: Would you share that?
• 28:27
  Speaker 1: Do you agree with that or not?
• 28:29
  Speaker 2: Yeah, I agree that totally.
• 28:30
  Speaker 2: You mentioned a couple of my people.
• 28:32
  Speaker 2: The only other people that I'd like to highlight is Jeremy Atkinson's the number two guy underneath Tom Levotsky at Alina, craig Colford is head of supply chain, and a whole lot more back at Memorial Sloan Kettering, and so those are good people.
• 28:46
  Speaker 2: Now, I used to do what I was doing consulting.
• 28:50
  Speaker 2: I would help people recruit, and in those days we're talking back 20 years, 25 years there was only two supply chain schools in the country Michigan State University and Arizona State University had MBA supply chain programs.
• 29:05
  Speaker 2: What's interesting, today, every major university in the country now has a supply chain program, either undergraduate or an MBA, with a supply chain emphasis.
• 29:17
  Speaker 2: So that tells you that we're putting out smarter people.
• 29:20
  Speaker 2: We have access to more strategic thinking, talented people.
• 29:28
  Speaker 1: So then it gets down to two challenges.
• 29:30
  Speaker 1: Number one the people that we're putting out have to be able to sell their message to the C-suite so that they can be accepted as C-suite level people, and the people in the C-suite have to be smart enough to realize that they need to include the supply chain leaders as C-suite level people, and the people in the C-suite have to be smart enough to realize that they need to include the supply chain leaders as C-suite level people.
• 29:48
  Speaker 1: Would you agree with that?
• 29:50
  Speaker 2: Exactly right.
• 29:51
  Speaker 2: Exactly right.
• 29:52
  Speaker 2: You know.
• 29:53
  Speaker 2: We hired people because if they're going to be in front of C-suite, other C-suite people are in front of doctors or in front of managers.
• 30:00
  Speaker 2: They got to be able to.
• 30:01
  Speaker 2: People got to look at them and say I am impressed with you.
• 30:05
  Speaker 2: You are sharp, so that's real important.
• 30:09
  Speaker 1: So what do you think your legacy is going to be, Brent?
• 30:12
  Speaker 1: I?
• 30:14
  Speaker 2: don't know.
• 30:14
  Speaker 2: I mean, that's kind of a very prideful statement, that's okay.
• 30:18
  Speaker 1: You've got, you've earned it.
• 30:19
  Speaker 1: What do you think you know?
• 30:20
  Speaker 1: Tell me.
• 30:21
  Speaker 2: Well, we, there's no question.
• 30:24
  Speaker 2: I love the opportunity of having support from senior leadership to develop best practices of supply chain at Intermountain Healthcare, which is considered one of the top healthcare organizations by outcomes and by all the best practices they do on the clinician side.
• 30:43
  Speaker 2: Outcomes and by all the best practices they do on the clinician side.
• 30:46
  Speaker 2: When I went to even though I grew up in Utah and I knew Intermountain Healthcare is the largest company in the state of Utah, 47,000 employees I didn't realize how well it was known throughout the country and throughout the world on its high quality, low cost outcomes and that's a whole other story.
• 31:00
  Speaker 2: But it was real an honor for me to develop true supply chain best practices in such a good company and then to hire people and develop them.
• 31:11
  Speaker 2: All these people.
• 31:13
  Speaker 2: I didn't teach them everything, but I had a passion for the direction that we wanted to go.
• 31:17
  Speaker 2: But they learned, along with me, supply chain applications in healthcare.
• 31:23
  Speaker 2: I would go to Jim Francis.
• 31:27
  Speaker 2: I would go to people all over the country hey, I don't know how to do this in healthcare.
• 31:30
  Speaker 2: Could you help me?
• 31:31
  Speaker 2: And they'd help me.
• 31:32
  Speaker 2: I knew what we ought to do, but I didn't know how to do it in healthcare.
• 31:35
  Speaker 2: So I always found the best practices of other people and came back, stole them and came back and applied what made sense to Intermountain health care and all of us learned that and did that.
• 31:45
  Speaker 2: So I think my legacy is what we did at intermountain health care.
• 31:49
  Speaker 2: You know it's number one rated in in gartner has been for about the last since I left, and then the people that we hired and we developed and now they're off doing the same thing throughout the country.
• 32:00
  Speaker 2: I'm proud of all of them and I'm not any better than them.
• 32:04
  Speaker 2: We all learned this together.
• 32:05
  Speaker 2: I was not the smartest person like you, joe Walsh.
• 32:09
  Speaker 2: Joe Walsh is probably a genius.
• 32:13
  Speaker 2: Took me a while to figure out, joe.
• 32:15
  Speaker 2: How do you always know the right answer?
• 32:16
  Speaker 2: And you know he says he has a gift.
• 32:18
  Speaker 2: But I don't need but once people.
• 32:21
  Speaker 2: I had smart people around me and once they convinced me what needed to be done, I could sell it.
• 32:26
  Speaker 2: I could sell it in the organization and I could sell it up the C-suite.
• 32:31
  Speaker 2: And that's how our success was Probably me, a good leader, good listener, smart people around and then we together not me, but together we all developed best practices and that's the legacy that we all created at Intermountain Healthcare.
• 32:45
  Speaker 2: I'm very proud of it.
• 32:46
  Speaker 2: That's great.
• 32:46
  Speaker 1: You know you talked about stealing from others.
• 32:50
  Speaker 1: Willie Nelson once said that amateurs copy, professionals steal.
• 32:55
  Speaker 1: So that's the way to go about it.
• 32:58
  Speaker 1: And I have one final surprise question.
• 33:01
  Speaker 1: When I was getting ready to do this, I saw that you and your wife spent a year and a half in Oaxaca, mexico, as missionaries, and I know that I just like to.
• 33:13
  Speaker 1: I can only imagine that.
• 33:15
  Speaker 1: You learned a different culture.
• 33:17
  Speaker 1: You learn, you learn so much there.
• 33:19
  Speaker 1: What was that experience like for you?
• 33:21
  Speaker 1: What did it do for your life?
• 33:23
  Speaker 2: Thank you, obviously, and it wasn't about religion although we were part of a church it was about helping people.
• 33:30
  Speaker 2: You know, we would go in and just help people in leadership or help them be self-reliant or help teach them principles that they could be successful in their life.
• 33:41
  Speaker 2: But living there for a year and a half, and you look at the people not all the people, but a third of the people, maybe the half of the people just needed to make enough money today to live off tomorrow.
• 33:51
  Speaker 2: So they sell tortillas on the street or they sell tamales out of their window of their house, but all they got to do is just make enough money to feed their family tomorrow.
• 34:02
  Speaker 2: And they were happy.
• 34:04
  Speaker 2: And you look around and say these people are happier than my neighbors in the United States.
• 34:08
  Speaker 2: How come?
• 34:09
  Speaker 2: And it's because they're not driven by pride, they're not driven by worldly possessions, they're very family oriented.
• 34:16
  Speaker 2: But we learned a lot that happiness does not come from worldly possessions or money.
• 34:21
  Speaker 2: Happiness comes from just enjoying life.
• 34:25
  Speaker 2: Recognizing God in your life and recognizing your family is real important.
• 34:31
  Speaker 2: You know, in Mexico we couldn't ever find an assisted living center.
• 34:36
  Speaker 2: When an old person got old, they stay with their family.
• 34:40
  Speaker 2: Well, if no one's home.
• 34:42
  Speaker 2: Someone quits their job to take care of grandpa.
• 34:45
  Speaker 2: They all live together and they all take care of each other together.
• 34:48
  Speaker 2: It's really interesting.
• 34:50
  Speaker 2: There's a lot to learn.
• 34:51
  Speaker 2: Yeah, there's some bad people in Mexico, but it's really a small percent.
• 34:55
  Speaker 2: Everybody else generally.
• 34:57
  Speaker 2: If I go to an average home here in the United States, knock on the door and say I want to come in and talk to you, only about 10% will let you in.
• 35:06
  Speaker 2: If I go to a Latino family, a Hispanic, mexican family, knock on the door and say I got a message, I'd like to just talk to you about life and stuff, 80% of them will let you in and want to feed you.
• 35:16
  Speaker 2: My wife had to learn not to say oh, I love that picture on the wall, cause it's take it down, it's yours, you know, and yell at her.
• 35:22
  Speaker 2: Yell at her husband saying, hey, wrap this up and wanda johnson's taking this home.
• 35:27
  Speaker 2: So we had to stop.
• 35:28
  Speaker 2: I mean, that's how good of people they are.
• 35:30
  Speaker 2: So, yeah, we learned a lot of things.
• 35:32
  Speaker 2: That it's not about possessions, we're not necessarily the best people by happiness in the world, but we had a lot to teach them and they had a lot to teach us.
• 35:40
  Speaker 2: Does that help?
• 35:42
  Speaker 1: yeah, brent, thanks.
• 35:43
  Speaker 1: Thanks so much for sharing with us, brother, it's been a real honor to have you as a guest.
• 35:48
  Speaker 1: Uh, I knew you, I knew it would be great to be talking to you and uh, I'm.
• 35:53
  Speaker 1: I thank you again for accepting our invitation to be on the podcast thank you.
• 35:59
  Speaker 2: It's an honor because I know your podcast well.
• 36:01
  Speaker 2: You've got a lot of good people on it and and I know you for many years not well, but I knew who you were because of how you dressed at all the the conventions.
• 36:10
  Speaker 2: So you're, you're a great guy and I think you know how to sell yourself, which is good.
• 36:15
  Speaker 2: That's all I got, brother.
• 36:17
  Speaker 2: Yeah, it's all all of us got, even though sometimes we think we got more, we don't't.
• 36:23
  Speaker 1: That's right, brent.
• 36:24
  Speaker 1: Thanks so much and thanks for joining us and have a great day.
• 36:28
  Speaker 2: Bye-bye Thanks.
• 36:29
  Speaker 1: Bye.