TCN Talks
Welcome to TCNtalks / Anatomy of Leadership.
TCN Talks
Quality Flows From Within
In this crossover episode TCNtalks and Anatomy Of Leadership, Andrew Reed, CEO and Chief Teaching Officer of Multiview Incorporated, shares his journey as a recording artist with Universal Virgin Music Groups and his experiences in the music industry.
He discusses with Chris Comeaux his unique podcast, "What Are You Willing to Throw Your Life Away On?", where he offers practical advice and philosophical insights. Andrew reflects on his bold life, marked by significant achievements and catastrophic losses, and how these experiences have shaped his music, public speaking, business ventures, and his consulting in the hospice field.
The conversation delves into the importance of quality, leadership, and the balance between art and science in both personal and professional realms especially in hospice and palliative care.
Guest:
Andrew Reed, CEO & Chief Teaching Officer Multi-View Incorporated & Recording Artist with Universal/Virgin Music Groups
Host:
Chris Comeaux, President / CEO of TELEIOS
Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast
But listen, someone has to challenge uh the status quo. You know, like us, we're we're gonna be talking about quality and stuff, but you know, we can't be mediocre, especially if we consider hospice profound work. Yeah, I'm not gonna live a trepidatious life. And and if we get hospice and we've been around it, why not fully extend our art? So yeah, I think I think all things good start with quality. And and and this idea that quality comes from within. So bad profits are slashing quality because uh, for example, Wall Street, they want more and more and more. There's a problem with more. You can ask for so much more that you literally squeeze all quality out of the fruit, leaving just an empty rind. Our goodness is not goodness without edge, as Emerson put it. That our words are hollow and meaningless unless we're willing to hold people accountable. That is, administer some pain if the standards are not being done. And I will not let anyone out alive. People, I've trained thousands of clinicians in the perfect visit. And I have no problem at this point in my career pressing people to their limits. I don't care if they cry, but they're gonna learn how to do a visit. And what happens when you press people like this? Oh, some people say this is cruel. Oh my god, Andrew. Yeah, it means something. That might be the first, last, the only visit that patient will ever get.
SPEAKER_02:Do you find, Andrew, that the visit is a little bit easier, although it feels like you're really kind of describing a journey that is the road less traveled?
SPEAKER_03:All I uh I guess want really is that uh people take out the mirror, and and myself included, and we take a look at and say, you know, I mean, what is real? You know, what is truth, and what is the best and highest purpose I can be doing with my life?
SPEAKER_01:Welcome to our crossover show with Anatomy of Leadership and TCN Talks. Now, here's our host, Chris Como.
SPEAKER_02:Hello and welcome today's podcast. I am super excited today. Our guest is Andrew Reed, the CEO and Chief Teaching Officer of Multiview Incorporated and recording artist with Universal Virgin Music Groups. From Andrew's bio, he's known for many things, but primarily for his music, expert organizational work, and especially in hospice. He's a critically acclaimed songwriter, studio guru, guitar whiz with Universal Virgin Music Group, under World Sound Artists International with numerous Billboard and other global charting successes with his own releases, and he's also been a producer of other artists. He's the founder and CEO of Multiview Incorporated, and Andrew also has a unique podcast, What Are You Willing to Throw Your Life Away On, where he liberally shares ultra practical advice and ideas as well as philosophical explorations on the topic of life itself. Andrew has absolutely lived a bold life, which has led to some staggering worldly achievements in the arts, as well as business. However, these attainments have been accompanied with some catastrophic losses, including two children, wives, health, breakdowns of injury, injury, properties and material possessions and natural disasters, and a few fortunes along the way in the process of epic comebacks. All of this experience comes out in the depth and profound nature of his music, his public speaking, his writings and companies that he creates and helps build. And on a personal note, I just got to tell Andrew thank you. Um, we're actually here in downtown Hendersonville, North Carolina. And many years ago, Andrew actually recruited me here.
SPEAKER_03:And so Yeah, no, I I actually I was chair of the board at four seasons, and I put my foot down. I said, here's three candidates, because you know, obviously we work with so many hospices, and here's two real seasons ones. Here's this young fella from uh Pensacola, he's the CFO, he's not he's not the CO. I'm putting all my chips on him, and I advise you to do the same thing. And that was it. But I I I twisted their arm, you know, because but they they did it, they had the sense. But because the point is you go with the energy. Well, and that we didn't need an old energy at that time. Not not to discredit the other.
SPEAKER_02:You took a chance on me. I was 30 years old. And you know, you said something to me. I was thinking about this last night, prepping for this podcast, and you said this community, this Hendersonville, North Carolina community, you said this is a place where you can put down your roots and raise a family. And you changed my life from that perspective. We've raised five kids here, and all of them are back in this, you know, mount now making careers and giving back to this community. So there's so many reasons why I'm thankful for you, but I just have to say that.
SPEAKER_03:Well, well, that's an impressive achievement. I think of all things in life. I think being a parent, uh something that again has not worked out well for me, uh, is probably one of the higher attainments, you know. And uh, you know, we I we don't know where our lives always go, but uh but that's a high compliment. Because I just think that being a parent's uh about as difficult of a job as there is.
SPEAKER_02:No, amen. I could we could do a whole podcast of all the screw-ups I did in that area. But I appreciate you saying that, Andrew. There it's interesting. One of them actually is in hospice. I don't know if you know that, which is kind of cool, seeing that next generation now of, and my son is one of many now that we're seeing, second generation or maybe third generation. Good point, yep.
SPEAKER_03:And because uh the Schumacher's and all, you know, the Deborah Dalys and all those Gretchen's that started, and then you know, as we're the young snot-nose guys behind that, and yeah. Yeah, that's pretty awesome. I consider both of us in the same class.
SPEAKER_02:I was wondering if, like, I've you know, I I remember I came from Business America, and I just felt like I always say I was like Dorothy and Oz when she woke up, and like these people are not talking about numbers, although I fell in love with a purpose and a passion. And I don't know if you remember where we met. It actually was it NHO.
SPEAKER_03:Yeah, no, no, I remember you, you, you know, you were there and I was stirring up the crowd as typical. But listen, someone has to challenge uh the status quo. You know, like as we're we're gonna be talking about quality and stuff, but you know, we can't be mediocre, especially if we consider Hasas profound work. And I'm just, you know, no, what is the highest ideals that we aspire to? And yeah, I remember you coming up and there's instant rapport, and I thought, ah, there it is. Wow, and and and and then as Providence, you know, has it, uh there's a need, and here's somebody that can feel that. I perceive them as having great leadership within them, and uh because that's what you hire for.
SPEAKER_02:Wow, well, thank you for saying that. Well, I always like to start our podcast, Andrew Asner, I guess. What's our superpower? And I was just I'm so interested to see what you're how you're gonna answer that.
SPEAKER_03:My superpower is probably my IQ of 40. Keeps me humble, but now I do keep 20 on each side of the brain just to keep it uh balanced and stuff. So uh that's probably it. That uh again from birth I was probably denied a few sop uh drops of sap, or maybe my oxygen too was constricted or whatever, but I think that's my superpower because I don't know enough not to go forward. That's awesome. You know, so therefore, um yeah, I'm not gonna live a trepidation life. And and if we get hospice and we've been around it, why not fully extend our art? So at least find out where our art ends. And that means a lot of defeats and failure, not being uh particularly uh devastated by failure.
SPEAKER_02:You know, it's interesting. If you have if you mirrored it back to me, I I kind of mirror back what you just said, but even just kind of knowing you and thinking of your life story, your passion and your your vision for more, and then your tenacity to stick to it. Does that does that resonate?
SPEAKER_03:Well no, no, okay. Yeah, you've hit on a couple of the tenacity, I think, is a characteristic. I in the podcast, I know I'm I'm working up like what is success, because uh people have very feeble and a lot of times relatively un unconsidered ideas about what success is. But uh again, I was a space cadet growing up and and why I would just get bored in school. I mean, I I you know IQ wise, I did very well on all this, but I was the class clown and I'd make uh Christmas trees on standardized testing forms and and and and all this. Uh and they they failed me and that devastated me. But the point is is I was focusing on something. And and so focus, as we know from all kinds of academic studies from Stanford to Duke to Western Kentucky, whatever. Again, the quality of the most successful people in this world is that of self-control, self-regulation or focus, which explains Steve Jobs and you know, taking a bankrupt Apple and in five years turning it into uh the most valuable company on the planet because of the vision of a leader. And having a clear vision of what quality looked like, you know, where the quality of the inside of the PC or the device was just as stunning as the external in a place where no one else looks.
SPEAKER_02:I think it was incredibly creative and and just uh and also a brilliant marketer. And I think about you, do do those you identify with those two comments? Uh well, yeah.
SPEAKER_03:Or just of all uh with stammering of the lips, I I go through most things in my most awkward way of presenting myself, but I think it's the passion or the mission, and I think uh any great teacher or really effective teacher has to be in love with her topic and willing to get lost in that. And though they stumble uh sometimes or maybe don't come off quite as polished as they would like, uh that passion for whatever uh hopefully that high ideal is really, I think, what carries the day. Wow.
SPEAKER_02:Well well, let's get into what you you gave me a good way to frame this. And so when I when I wrote my book, The Anatomy of Leadership, I literally had you in mind when I did the chapter.
SPEAKER_03:I would definitely be the feat.
SPEAKER_02:No, and I wrote the chapter. Because I'm on the ground a lot. Yeah.
SPEAKER_03:So you know, I'm familiar with that.
SPEAKER_02:But when I wrote the chapter on margin, just because I mean I I felt like you were the first person that now grew up in a in a world of accountants, KPMG, Pete More, like all these CPAs. I feel like you looked at numbers differently. And what I was trying to capture with that chapter was margin is not a mathematical equation. It really is an interesting barometer of all the interesting inputs, the leadership, the people inputs, how they utilize their time. And a margin is a barometer. And I literally was thinking about you. And you know, what we've done is kind of used this anatomy of leadership podcast, because this is kind of a table of contents of what is leadership, bringing great people. Well, you were the first guest I thought of, so it's kind of sad. It's taking me two years to reach out to you because when I thought, who do I want to talk to margin about? Yeah. When I asked you, you said, hey, we should frame the conversation about quality comes from within. And I had to stop for a second. I'm like, what? I want to talk about margin. Why did you want to frame it in that way? Because it almost feels like they're two different topics.
SPEAKER_03:No, they're they're good. We have to separate good profits from bad profits or good margins from bad margins. And our phenomenal economics should be a natural byproduct of doing quality. So if we do quality, we're healthful, complete customer delight, satisfaction, and whatever we do, serving people well. Yes, and then we deserve margin. And obviously you get all the efficiencies, especially if we understand standardization. We understand Six Sigma concepts of how to institutionalize it within a uh an you know truly professional organization. Uh just how how to arrive at that. But yeah, the economics, of course, you know, I r you know, I refuse to work with anything that doesn't make money because that's not sustainable. Whether it's a f for-profit, not for profit. Obviously for-profit um really doesn't have any other option than to generate uh a profit, whereas a not-for-profit can be a little more sloppy. If you I I'm not not trying to be belittle that, but the point is when you have uh the community dollar, well, you know, when the more you have sometimes uh you can get a little bit lax. Whereas, you know, I want to have in both, regardless of for-profit, not for profit, is that people operate with integrity, that they manage the monies that we're getting from the taxpayers, from Medicare, Medicaid, all the forms. That we manage it well. You know, bottom line. So yeah, I think I think all things good start with quality. And and and this idea that quality comes from within. I uh after Helene and all the fires, we went through two natural disasters. You can listen to my podcast and learn all about burnt trees and things and bridges out and being cut off for six months and what have you. And uh we've got it back open and we've been doing these leadership, obviously gr Special Forces and Green Brave uh because we're doing work with them. Uh that we really met through uh Helene because they had never seen a civilian population quite organized um as effectively, and that apparently made some impression on them. So therefore you know, they've been sending their generals and colonels and stuff up for training. And uh 'cause they could use System Seven, of course, too. Uh but then uh we've been uh holding uh le you know, obviously CO retreats and and we've always again we've trained like 10,000 people in our leaders, CEOs and senior executives through our tough trainings and stuff. And uh the point I try to really get across to people is that our lives don't so much happen to us as they flow it flows out of us. So the quality that manifests in this w C1 world of tangible things that we can touch, reality starts from our hearts. And and it's getting a vision of what quality looks like, just like when we started Multiview, me and David looked at each other and said, you know, phones are very important. Let's have all phones uh uh be ring uh answered within three rings by a competently trained person and foster customer delight. And that whatever we say we have to be able to do because people want predictability and uh and having so these radical ideals of standard, i it came from from within. And just on that, you know, uh right now we're at three and a half years without a single phone call coming in. We get hundreds, obviously, because our clients are all across the country. Three and a half years without a single phone call not ringing more than three times. And of course and then follow through is virtually perfect. I mean, I think the last time uh even s uh there was any kind of screw up was maybe eight months ago. And this is yeah, that'd be thousands of interactions. And so the levels of quality that we aspire to is something else. I mean, now with that said, one one time we went like two months and the phone rang four times and it's like whatever. The longest we've ever went is uh in our th about thirty years of doing this is four and a half years.
SPEAKER_02:And you you alluded to you said something earlier, and so what what would bad profits be? Let me ask you two questions. What would bad profits be?
SPEAKER_03:Bad profits are not training your staff adequately, would be the first thing I would attack because all quality comes from the quality of our training system. And we're seeking more system solutions rather than people solutions. Too many organizations say if I just hire that great person, they're gonna make my world better, they're gonna be my savior. And that's silly thinking, unless you need a change agent. So bad profits are slashing quality because uh, for example, Wall Street, they want more and more and more. And there's a problem with more. You can ask for so much more that you literally squeeze all quality out of the fruit, leaving just an empty rind with no quality anymore. And whereas when we're talking about the model, you know, not just the financial part, which we're known for, is getting uh the the phenomenal economics, but but getting that quality up there. So with bad profits, uh all quality, of course, comes from the quality of our people system. Again, the system solution. And what I advise organizations to do is to make their standards, their quality standards, their financial standards that are sustainable rather than optimal. Why? Optimal breaks. When you're always pushing everything to the max, you break people, you you break systems, you do all kinds of things, always striving for more and more and more. That is a bad profit. Whereas if you can say, hey, I can give you a 21% return every single year, with very little deviation between that in good economic times and bad economic times, where it scales automatically, a system of really self-regulation. To me, that's a higher value situation than always going for record profits.
SPEAKER_02:That's a key point, Andrew. I was actually going to ask you. I was listening to a podcast, I think it was Jordan Peterson, and there was this Jewish scholar, and he just wrote this amazing book, and he was talking about basically seasons, and that he was kind of referring it back to businesses, but that you have harvest seasons, you have planting seasons. And and this is good because I'm asking questions of things I think people always want to ask you. Like is Andrew saying the numbers always should go up. And so now that I think about it, you don't revise the model margin every year.
SPEAKER_03:So that's a key. That's why it's always on based on a percentage basis. Everything is in proportion. And why we don't believe in budgets for the management of ongoing operations. I think that's just utter foolishness for a truly thinking person. For short-term building projects, yeah, a static budget works, but not for something where you have ever-changing revenues or sales or patient volume in the case of hospice. You want something that goes up and down, as well as a workforce that does the same thing.
SPEAKER_01:Thank you to our anatomy of leadership sponsor, Dragonfly Health. Dragonfly Health is also the title sponsor for leadership immersion courses. Dragonfly Health is a leading care-at-home data, technology, and service platform. With a 20-year history, Dragonfly Health uses advanced technology and robust analytics to manage durable medical equipment and pharmaceutical services as part of a single efficient solution for caregivers, patients, and their families. The company serves millions of patients annually across all 50. States. Thank you, Dragonfly Health, for all the great work that you do.
SPEAKER_02:So this key point that you just made, then optimal versus sustainable. Yeah. So how do you determine what's sustainable compared to the optimal? Well. Because that capitalist system, right, wants to push to, well, let's keep just keep running that thing hot and get that optimal for as long as we can. The numbers always have to go up.
SPEAKER_03:Little reptilian brain there. No, I sustainability and the one thing about when we set our economic standards, that is our model percentages of net patient revenue or net revenue, or earned revenue, you might say, is that they can be modified at any time. You know, with 15 minutes, you know, obviously you don't need a budget process. You don't have to send months and five minutes. You can set the new standard. Uh uh if there's an innovation or you're even an economy or uh payment method or whatever, that can be adapted to very quickly. But the I think the point is to have everything above, slightly above, maybe at the 60th percentile. So we're looking at this on a normally distributed bell curve with the median, uh, the mode, the 50th percentile, the place where all the measures of central tendency converge. We want to be better than that. We don't want to do average. And I usually find that when you go 60, 65% in on each of your amounts, the cumulative impact is astronomical. Usually three or four hundred percent greater than the median.
SPEAKER_02:This is gonna be a rabbit trail, but do you use this in your own investing strategy? Absolutely.
SPEAKER_03:No, no, I uh I I I live anything that we say in in the multiv world. I don't uh speak from an academic standpoint. I've hired three of those to run hospices, and they all failed because there's a big difference between, oh, this is how we manage the modern organizationist third wave management now and some information age, Andrew. You know, rather than spilling blood and saying, this division is gone. That nurse that's been with us for 26 years is not giving us much ROI, gone. And maybe that sounds cruel, but we live in a competitive world. And if we're going to be good stewards of things, everybody has to be doing their job. And we use the compensation system, of course, to force them out without any supervision. They just go on their own if they're not meeting their numbers because they feel some pain. On the other hand, they're richly rewarded, you know, better than any other payer if they're doing their job and getting their marks.
SPEAKER_02:You alluded earlier the system seven. And so I'm gonna actually let me kind of set the table on this one. So I know what system seven is. Some of the listeners may not do that.
SPEAKER_03:I I have a lot of acronyms. Andrew, you speak in different languages. Well, uh you haven't heard these Green Berets. I mean, these guys are language. I went up there to the Japanese house. That's the J house that we we that overlooks uh the church and some of the ponds that that we have. And they have all these acronyms, and I was looking at their boards and these these kernels and stuff and say, what the What did they talk about?
SPEAKER_02:Yeah. Oh, is that me? Well, I want to set the table because I want you to explain system seven, but I want to ask it in this way. Because the this is something that I've always wondered about you. And so you're an artist at heart.
SPEAKER_03:And so again, that I mean I I had the same uh Yeah, I sort of have pretty big league managers, managed uh you know, Don McLean, uh Janice and Bruce Springsteen, uh what have you. I was with the same outfit. Because I mean, we were good. Trevor Burrus, Jr.
SPEAKER_02:So how do I reconcile this creative person and this person like System 7, we train to the system.
SPEAKER_03:Oh oh the right left brain hemisphere thing? Oh, I think I start out pretty artsy-fartsy because probably early in my life, I think I was mainly right brain uh dominated. And I think that's really the thing that separates and causes some people to be more liberal or conservative. It's really it's almost biochemical because you can have a totally rational argument and nobody moves their positions.
SPEAKER_02:I always thought that. I've never heard someone actually say that.
SPEAKER_03:So I think it's that, but also you have to throw in environment and other things too. So that kind of makes the precise calculation a little clumsy. Uh but uh here's the thing is when I decided that the music business, uh, because I had a major label deal, six album deal, and then I went up to the top floor of the United Artist Building and and told them I quit. And I had just breached my contract because I didn't like the road, I didn't like all these fruitcakes and nuts in the music business, and I still uh have issues with that. But Alex here uh can testify that that you know we uh well again, I'm in that half a percent of all artists that are still with a major label, and you just cannot do everything you want to do. So so with that said, I say, the heck with this, no more fruitcake life and and strange people. Oh, I gotta make a living. So I thought taught myself how to program and C C and Basic, making compensation software uh and and and servicing, you know, that then became a system analyst, then backed in become a CPA and all that. Okay, so by cutting off some aspect of my life, I had to, I had to, or was forced to kind of recreate myself. And I discovered that I had a left brain too, which is the concrete, whereas the right hemisphere of the brain is spatial. And so I found I had abilities I would have never known except for the cutoff. And this is, I think, an aspect of the reconciliation of light and dark, good, bad, however you want to phrase it, but that both are needed in some way. And that negative forces us often to go in a direction that perhaps was not part of our grand design, but yet ends up causing an incredible benefit. You know, it's almost like nothing can be taken away from us where there's not an equivalent benefit that offsets it.
SPEAKER_02:That's an incredible point. So how did so do you take obviously talk talk about system seven for a second? And then I'd love to see how do you take this systems building systems approach, even into the artistry that you do now? Because they really do feel like this dichotomous world. And and because I think some of the pushback that people might get about like my first nurse mentor at Covenant Hospice and said, Chris, hospice is all art. I'm like, but I grew up in manufacturing, which was systems and processing. Yeah. And I bought what she said, but I also wanted to push back. And like there was you're correct in doing. And so, and it is a bit of both, isn't it? Yeah.
SPEAKER_03:So, no, that's the the balance, this the razor's edge in the middle, you know, the Zen man uh that can that can uh sit in the middle and say, Oh, this is an interesting interesting game here. Uh yes. Uh and I think that's uh the dichotomy in all of life, that it is art and it is science at the same time, just like leadership. You've uh alluded to that before, because you can do everything by the book. For example, the perfect visit. You could do a technically perfect visit and still have it be a failure. If the feel is not there. I'm so glad you said that. And and so you know, that brings us uh kind of kind of to uh you know the marriage, I think, of of both the the spatial aspect and the concrete practical. And they both have to exist in a healthy organism or you know, organization in this case. Uh but system seven and people development, obviously both you and I are CPAs, we've both been CFOs and and all of this. And so, yeah, we're absorbed with the numbers, we get pigeonholed into that. But when we really look at the financial statements, we realize that the true assets and liabilities of any organization are walking in the halls. They're not on the balance sheet. And so if we're going to make any real impact as far as best known practice, again, I don't like to say best practice because that's a bit arrogant. Nobody knows what the best practice is. Yeah, our team loves, we've adopted that. We love it's it's it's very liberating. To move the numbers, we've got to address the people issues. And and see, to me, the first question is how do we develop the most elite world-class workforce that we can? Ah, it comes to the training systems. Hmm. Where do we start? Well, let's start with modeling some of the best teachers that have ever walked on this earth. What practices, what methods do they use? Okay. What about the greatest organizations from the Romans to whatever, you know, it doesn't have to be modern people, it can be ancient times. And what have they done? And then have the humility to imitate and try to uh adapt those practices to our respective organizations. I I think that is the whole thing. And so developing people is at the heart. And this is when that that big Wall Street company paid me all this money years ago to develop this brand new hospice platform. They said, we Andrew, we want something very different, you know, and all this. And and uh the org charts, one of the places where I started, I said we're not gonna have this hierarchical pyramid, you know, the pyramid scheme thing, and we're not gonna like invert it and like the servant leadership thing. I think we can do better than that. And in the center of this, you know, at the at the top is patients and families. You could actually put God on top, since I mean I'd prefer to do that since I'm willing to you know avail myself to intelligence and energy beyond myself. But patients and families and community, because they will write every paycheck we will receive. So there's the real boss, then uh your clinicians. They have to be you know taken care of, then clinical leaders, and then we get down uh towards the center of the uh org chart, there's people development, the center of the universe. And that is where we want to have our most talented people and leaders in an organization because they will then help to reproduce quality of what they have become because quality's from within, or you know, it's within us, just like the kingdom of God, you might say. Okay, so we put our superstar people, leaders, trainers, because normally if someone's a good leader, they're usually a pretty good trainer as well, or or or teacher. But yet I can ask people in a typical uh people development or education area or even CEOs, uh, tell me the steps of standardization. Tell me the requirements for standardization, tell me how to uh design a position state of self-control. These are all things that we wire because you don't it's silly to hire supervisors to lower it over people to make sure they're doing their jobs. That that went out the MBI world. This is why we can flatten an organization like a pancake, even if if you have 20, 30 sites where you have your executives, and it's as flat as a pancake because you have no middle managers other than the immediate manager to misinterpret the directives. Trevor Burrus, Jr.
SPEAKER_02:Can you talk Andrew about some of the best people developers you've ever seen? Yeah. You kind of alluded to it, but say a little bit more about that.
SPEAKER_03:Yeah, I'll I'll even name uh Deborah May, uh Hospers. That's when I got my first real vision of what first-class educator would look like. And you know, she was, I think, ex-Air Force Deborah, if I get that wrong, you know, correct me, but you know, hands behind, uh, you know, she would walk in to uh a class, full dress, looking great, maybe in shoulder bag, rollerbag, whatever they're put down the barrier and say something to the effect of welcome to, you know, I'm gonna say sunny day hospice. Um it's so great to have you here because you have been selected in some way. And it's not easy to get a position here. So you're to be congratulated on that victory now. And a lot of you have been doing visits for a long time and think you know how to do a visit, and then you turn your back for a fact. But I'm gonna show you how to do a visit. And I love you all so much that none of you are gonna get out of here alive until you can do a perfect visit under stress conditions. Let's go. Because quality takes edge. Our goodness is not goodness without edge, as Emerson uh put it. That w our words are hollow and meaningless unless we're willing to hold people accountable. That is, administer some pain if the standards are not being done. And I will not let anyone out alive. People I've trained thousands of clinicians in the perfect visit at this point, as well as you know, Nancy, I mean the whole team that does the certification process. And by golly, not one of them is gonna get it. I'll fail the whole class if they can't do it to my standards. And I think that's kind of the attitude that you just have to own your students. And I have no problem at this point in my career pressing people to their limits. I don't care if they cry, but they're gonna learn how to do a visit. And what happens when you press people like this? Oh, some people are saying this is cruel. Oh my God, Andrew. Yeah, it it means something. That might be the first, last, the only visit that patient will ever get. And if you screw up the death scene, it's screwed because our return policy sucks. There are no redo's. We can't say, hey, hey, Joe, get back in the body, let's try that again. No, they're gone. And we've scarred that family. So screwing up is not an option in hospice.
SPEAKER_02:Aaron Powell How do you make latitude for them to bring their individuality into it? So that way they're still that heart and the purpose of the case.
SPEAKER_03:Because only 30% of the perfect visit is prescriptive, that liberates the mind to be able to perceive the needs of really who they're serving, the the patient, of course, the caregivers as well. But by learning habits, because human behavior is based on these energy saving mechanisms, you train them under stress conditions, because that's how stress is what anchors habits, because our human brain is seeking the most efficient way to do things. Once the pattern has been learned, and we have IRMs, of course, image recall mechanisms, which basically are cues that prompt people in stress conditions to be able to remember things and how to do them in the right sequence. Uh at that point it frees the personality because nothing is missed. Nothing small, nothing large. Like our our record right now, because we again our measurements are so outrageous compared to like CAF. CAP is like and and and star ratings are just so low brow, because they consider like a 72 or 78, depending on whatever the question is, uh a good number, but that's technically average. It's not the 50th percentile. So it's a r a r a really low bar. Uh whereas we measure uh the number of visits or thousands of visits that they can go without a single complaint, service failure, or screw ups. And of course, if a complaint is not reported up, it's immediate termination. I terminated two nurses at one hospice. I had significant uh vestige in. And and uh because it's it's not tolerable. Any MBI person that doesn't uh report a screw up or a complaint from a client is going to be fired immediately. And you just have to have that to maintain that. But uh right now the the record is 5,553 visits, beating the former record of 4,222 visits without a single complaint. That's nobody running out of meds, nothing. And that's that's the power of a perfect visit. But the only known way to get those extended periods of time without screw-ups and complaints is to have a process of training people. Especially to me, phone interactions, perfect phone interactions, then uh perfect visits with perfect documentations. And that's the other thing. All these hospices that that we've trained over the years, we've only found one that we have went in, they're around 1,400 patients a day, pretty good sized outfit. And because we always say, okay, can you bring me a perfect chart for COPD? Oh no, we don't have one of those. Okay, how about a CHF? Oh, no, don't have one of those. Uh how about a dementia? No, no, no. How about any kind of cancer, generic? No, no. And I'm going, how in the heck do you expect your clinicians to be able to chart perfectly when you can't even give them an example? So let's start by putting together examples. And we do the same things with visits, because uh we're just taking advantage of really the way the mind works and we put images of what perfect looks like. Because otherwise people have very vague ideas. We can just say, do a perfect visit with 15 clinicians. And if you've not imprinted that image in their heads, you'll have 15 versions of it.
SPEAKER_02:Trevor Burrus, Jr.: Do you find, Andrew, that the visit is a little bit easier, although it feels like you're really kind of describing a journey that is the road less traveled. But the phone interactions, because especially as hospices try to diversify palliative care, home-based primary care, the number of pathways in that phone call become exponentially more complicated. Have you navigated that? Is it work to talk about that?
SPEAKER_03:Yeah, no, no. I mean, it can be done. Obviously, the more business exams we have, the our quality goes down because more dissipates quality. Again, take our Steve Job example where you got Sugarman, uh, ex-pep Pepsi CEO going in all these directions, and Jobs comes in and says, wait a minute, we're only going to focus on these three things. So a hospice, it might boil down to home care, impatient, palliative. Okay, let's just say that, okay. Whereas the hospital guy that says, Man, Andrew, we love this model. Our hospice and our home health are just killing it, and we want it all over the health system. And I always have to say, hey, hoss, let's back up. You're probably never going to be able to do it because you're trying to run 50 businesses. So by By calling back our offerings and simplification, because complicated breaks is a big key. So with this, it would have to be the sensitization. Because, first of all, you don't want automated systems if we're doing that. We're smoking dope. If we have untrained people that haven't had rigorous training in how to answer the phone, we're not getting in there. And most hospices are not very good. However, it's better than a lot of the large health systems we work with. I did a training for 21 large systems recently, you know, and they suck. If I can say that, hopefully you don't have to edit that out. But anyway, uh compared to hospices, and hospices are not very good either. So the thing is, I it comes back to quality. Quality comes within. We got to love our communities, our patience enough to put in the time to say this is how we answer it, that and we practice it where we get the mechanical feel out of it. You know, thank you for calling Sunday Hospice. This is Andrew. And then we go into the heavy listening, we write down so they never have to say their name again. We're listening for the emotionalized descriptor words, and on that. And then if we ever have to transfer them to another area, they don't have to say their name again. They don't have to retell their story, you know, and it's just seamless. And you win a referral source or you make a fan with a phone call. Because it's so horrendous. And and I think succeeding, I'm not going to say it's easy. It's a fairly simple thing, but it's easier than we think. I'm always just shocked at how much my life, how easy my life is relative, because I you know, if we're going eight, ten months without a single screw up, well, obviously I'm not doing damage control. Matt doesn't even mean David been talking about. I mean, we don't even think about damage control because there's no damage to clean up. There's no relationship to patch up. We can think about uh innovation or where we want to go or, you know, have a good life.
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SPEAKER_03:Phones, I will just say this, because the perfect visit gets a lot of airtime. Yeah. I mean, people are attracted, and and rightfully so. I mean, it it works. Uh folks gotta think about their phones more. And and uh we've got a great playbook, but it it comes down to s so few things. And we f have found that with two hours of intensive training, there can be about a 70 percent increase in the quality of the phone experience. And so that's a fairly minimal in investment. And we and and in our System 7 training, we actually move that relatively close right after people uh uh are initiated in the model concepts and all that, which everybody, CNAs, everyone learns economics. They learn really the whole thing that a CFO would learn. Because again, we don't underestimate the capabilities of anybody. We want to explore fully human potential. But we get into the phone quickly because it's something uh that can be done fairly uh in a few hours. And that sense of momentum, I've accomplished one thing, I have a pin and it says I certify, I'm certified in this. Uh but you know, but God help, I'll say uh the hospice that just lets somebody answer the phone, let alone or do a visit without them being properly trained. And a lot of the big corporate hospices right now, and I don't mean to to belittle some, but boy, they are just literally, hey, you want a job, here you go, here's your caseload. You got hospice experience? Great. And uh there they go. And of course there's gonna be screw-ups. This it's people are failed by their systems. Most people want to do a good job. I take a view that not people are lazy or whatever. I think want people want to do a great job. I think they're failed by their companies to provide uh their systems or uh the structures for success.
SPEAKER_02:I don't know if I've ever asked you this before, but are you a huge fan of dimming? Yeah, uh you'd appreciate this. We did a uh a skit at one of our leadership development institutes many years ago. Uh Dave Cook, who's now the CEO of uh of Hospora soon Everett, he played um Demming and I played Drucker, and we both dressed for the part. And the the skit was this Demming was all about systems and processes, Drucker was about mission, vision, and values. That's an oversimplification, but it's a pretty good one. And we did this wonderful kind of back and forth, and no, no, it's about, but you know the point. Yeah, it's actually, at least I believe it's both. It's both.
SPEAKER_03:Well, yeah, well, and that's the thing about life. Uh, if I've had to reconcile all these catastrophic losses in my life, but yet, I mean, two kids dead from accidents, uh I've lost, you know, use of both my arms. I mean, just you know, one thing right after another, natural disasters add to the list. Um and there has to be at some point some integration or reconciliation process that there's either a bothness mindset or a multi-mindset that has to come in because singular explanations for anything are insufficient. Why? It's because every topic is infinite. So therefore, yeah, duh. Uh whatever explanation we have for a question, there is more to it. It's just like like like hospice, you know, like you know, what is it? I think I've been working in it uh way too long. I mean I when I count it up, it's like 35 years. I was gonna say you're 35 or 38 years old.
SPEAKER_02:Aaron Powell That's a very daunting comment. Let me ask you one final and then I'll give you final thoughts. I because this is something I think you get painted, and I'm not sure it's a fair comment. Well, Andrew just believes that the guy who makes the biggest margin is obviously doing the best job.
SPEAKER_03:Aaron Powell No. No, no. Explain. No, it's just it's so it's about the sustainability. The fact that we do tend to produce these phenomenal economics, or like we're s we can go in, someone's losing 10 percent, well, I'm up to 20. Okay, that's a 30 percent turn. Uh but uh but that that that's just it. You know, I just know that you can't grind and ask people to do more and more. You want that stable business. And uh No, and I'll just say no by a huge quantum. That quality is it. The spirit of helpfulness, customer delight, serving people, honoring our promises and vows. That's what it's about. And uh if anybody really looks at our stuff, even okay, we have 20 manuals on almost every aspect of hospice, from volunteerism to board of directors to uh uh just this almost name it. There's not that much about finance. Almost all of it is about people development. And and how do you, you know, inspire that workforce. I don't even like to talk about leadership. I mean, I've I I do the seldom spoken aspects of leadership, but it's something I I I I I that's kind of everything. Uh it's it's involved. I I should say let me just say it like this. Leadership is around everything, you know, right? And uh so there's there's a lot of that. I'll say even in an indirect way, but that we have to inspire the workforce, we have to motivate, because that's really what the job of the leader is to get people going in a common direction, common goal, mission, inspiring them, getting uh our ideas, this intangible force out of our head, into the heads of others, and winning. Because really the job of a leader is success. What final thoughts, Andrew, you have? Oh all I uh I guess w uh uh want really is that uh people take out the mirror and and myself included, and and we take a look at it and say, you know, I mean, what is real? What is truth? And what is the best and highest purpose I can be doing with my life? That's I guess I I go back to those things all the time. I'm always I'm seeking reality, I'm seeking truth, what is because if it's not based on reality and truth, and this is where the numbers help us up, help us out, they don't explain everything because frankly, the most important things in this world cannot be measured. To me, numbers peter out at a certain point because try to measure love. Try to measure compassion. Well, I don't have a thermometer that I can just poke and say that this guy's got more compassion, whatever. I can't even do that with a hiss song. When when we had like a few of the billboards, like we produced that top five billboard album, I didn't know that was gonna be I was gonna get a call from Billboard, say, hey, you got a top top five record in in in this USA. And and uh I I didn't have a thermometer to say that was gonna happen. It it it just happened. But I think dedicating ourselves to the truth, that's what I th I think is is the highest we can do. And and it it starts with the question, because again, most answers are dead ends. Whereas questions imply a quest and that's movement, which that aligns with the nature of of life. It is movement and uh change. And our hospice world um makes that very self-evident.
SPEAKER_02:That's incredible, Andrew. And to think we started this talking about margin, but I I I think that's very profound because I do think that you push back if you disagree that the margin is a barometer. It's like a CAT scan on the organization, but that's just like saying, Well, I just took a CAT scan of you and I now understand you as a human being. No, it's just a tool to help that the physical body, but the human being is much broader than that, the margin is very similar.
SPEAKER_03:Yeah, the margin and really all the numbers. Like here we measure these 989 data elements with these 922 cross calculations from approximately a thousand hospices. It's it always shows lesser number because there's some in there that have like 50, 40 sites, and then I I'm always uh gasp at that. But anyway, uh the importance of the numbers is just less you said, they're tools. And to me, the numbers give us a roadmap that we can take a look at these 900 points or whatever, and we can work with intelligence. We know where to precisely direct our energy, our resources for the benefit of the organization. And and that is one of the main things in the um MBI world. We use the red circle method, we just run out the benchmarking reports because you have to have that perspective of comparing yourself with other organizations, elite organizations, not just not-for-profits, not just a certain little peer group or anything like that. The whole world, because you want hot dogs, you want large, you want small. And so we have that professional perspective between those and say, ah, we're not so good in this. And thus we take our red pen or marker, or as I is uh becoming a CPA, a red pencil, and we circle those areas. And then it comes down to the question: what is the best known specific practice we could implement? And that's how we move the numbers from a minus 10 to a 20 in about nine months. And I'm not saying everyone has to has to go to that 20 number, but you s we certainly should be two or three hundred percent better than the 50th percentile or the median. Uh because if if you're just running with like a 5% margin, you don't have a lot of screw-up factor, especially if you haven't built up a lot of reserves. And and of course, we we advise most organizations to have six to nine months of cash reserves. That way uh you can retool if somebody outmodels you have a uh some hot dog multiview or teleos uh hospice come in and just decimate your census. Well, if you got money at the bank, that buys you time to get your quality.
SPEAKER_02:I've always always wanted to ask are you taking these principles into your music business as well, out of curiosity?
SPEAKER_03:Uh yeah, to some, but I find I find it a little more difficult. Again, I'm under Richard Branson's uh outfit. So you know, a lot of my stuff's coming out of uh, you know, London and and and what have you. And uh uh we do not have the same sway there. We're look they look at me like I'm just this artist guy.
SPEAKER_02:You had other businesses come to you like try to apply it to other people.
SPEAKER_03:Oh yeah, oh yeah. No, I there's been ton agriculture, retail, manufacturing. I did 38. Yeah, yeah. Uh for example, one of the major uh uh brokerage firms I won't mention, but they fly their corporate jet uh down and pick me up like every month. And I go and I teach them about customer delight and service and even standardization. And and here's the crazy thing is uh whenever I go into something that's not a hospice at this point, I always say, well, what are your measurements and all this? Because I don't pretend to be an authority on all things. Nobody can can do that. And so there I say, well, you know, what's your uh average return for your average investor? You know, these are you know bil you know hundreds of billions of dollars, you know, uh going, oh well, it we really don't know what it is nationally here. Oh, well, what what about the fees? What's the average fees? And it's just like wow. That's what the benchmarking is like in most industries. And that's one thing when I look at the the multiview thing, and I'm not trying to toot our own home, but and these hospital guys, okay, I just did the these 21 uh the CFOs and and all their stuff, and they don't have anything near the benchmarking we have in hospice. I mean when we go, yeah, we got nine uh uh nine hundred and eighty-nine and then it's instantaneous almost, well twenty-second delay uh when your results come back and you get a a full data set. They don't have anything like that. And and so I haven't found it in the brokerage world of the mirror lynches and the beards and and Goldman Sachs and all that. Uh and and as well as other places, you know, they're they'll know some, but uh people are pretty covetous, I think, of their data, and that's part probably part of the pr the problem. I'm not even saying it's a problem. Well, yeah, it is. It it'd be nice to to measure, but it's it's more scant. They use a much more broad brush.
SPEAKER_02:Well well Andrew, let me just end with just thanking you. I mean, you've impacted so many of us throughout this. I I I hate calling hospice an industry because it's a injustice. It's a field, it's an incredible movement. And a movement. It's a beautiful thing.
SPEAKER_03:We're still a movement.
SPEAKER_02:Like you know, we're still innovating. And just for you to say that, you know, with your experience and say the comment of, you know, I still only understand that much, that that just hits me as a very profound comment. So thank you. You've impacted my life, you've impacted my family's life. Um I'm in and and ever in your debt for that. And then so you told me, Oh, it'll change your life, and you were 100% right.
SPEAKER_03:No, and Chris, the point is, and and you're doing great things. And uh listen, you took this hospice from I think we had census of 20 something, like 29 or whatever, and built it up into this great thing, which that that was the potential. And of course, you outgrow the box on on some level. You gotta go to the next place. And that's just the natural evolution of of really the explanation, uh, exploration of our potentials and stuff. And I just you're doing great things, these settings, these surroundings, uh great uh digs. And uh I just thank you for uh you know inviting me and and letting me uh speak some of my nonsense.
SPEAKER_02:No, you it was great wisdom. Thank you for taking the time. And this is only our second podcast we've actually done in studio. Most of the time our guests are elsewhere. So you're you're extra special because you're the only second time we brought someone in studio. Oh boy. And so thank you for doing that. Thank you so much. Well, to our listeners, we want to thank you. And of each episode, we always leave you with a quote, a visual. This one's gonna be really fun. We call it a brain bookmark. It's a thought prodder about our podcast subject to further your learning and growth and thereby your leadership. What we're going for is like a brain tattoo. We want it to stick. Be sure to subscribe. Don't want you to miss an episode. We're gonna give a link to Andrew's multiview, to his podcast, uh, maybe even some of his records as well. And so thanks for listening to the Anatomy of Leadership. And here's our brain bookmark to close today's show.
SPEAKER_01:Our lives don't simply happen. Quality flows from within. By Andrew Reed.