Dr. Bruce Murphy 0:00
To do anything successfully in life, you can’t enter into it knowing that you’re going to be successful, you need to do it in stages. Okay, let’s test this hypothesis to see if this works. Then let’s test this hypothesis to see if this works. Now we’ll put them together. We’ll test this. This is the business way to do it.

Nate Disarro 0:19
Hey, it’s Nate Disarro, and welcome to Titans of Industry, the podcast where I talk to industry leaders and innovators who are at the top of their game and leading the pack in their fields, uncovering some of the best stories in today’s business landscape. In this episode, I speak with Dr. Bruce Murphy owner and CEO of Arkansas Heart Hospital and a pioneer of modern cardiology. At the time of its founding, Arkansas Heart Hospital was the nation’s second standalone cardiac hospital and there was no blueprint for success. Overcoming criticism from the medical community, Dr. Murphy went against the grain and ultimately bought the hospital with one major caveat. He had to forfeit his medical license in order to take ownership. This year, Arkansas Heart Hospital is celebrating its 25th anniversary and has expanded its presence to provide care in over 30 locations in multiple states. With a thirst for knowledge and an unstoppable drive for innovation. Dr. Murphy is truly a titan of healthcare leadership. Now let’s get to the episode. But before we do, let’s talk about content, strategy and Video for marketing your business. Our team at Content Titan is committed to great storytelling, no matter what industry you’re in, it’s crucial to engage, entertain, inform and captivate your audience. And video is the best way to do it. Having worked with people and organizations of all shapes and sizes, our team has the experience to deliver the right content at the right price. We are easy to do business with and we know how to get you results. Visit contenttitan.co to learn more. Now, here’s my episode with Dr. Bruce Murphy. Dr. Murphy, thank you so much for giving me the opportunity to have this conversation with you. And in telling your story on our podcast.

Dr. Bruce Murphy 2:13
Delighted. Thank you very much for inviting me.

Nate Disarro 2:16
So I kind of want to get to know you a little bit from from childhood. And personally, I grew up in Plano, Texas, which is often referred to as sort of the white picket fence of America, your middle class, everything’s great, no problems, you know, T ball fields look nicer than a lot of college facilities. But from my understanding your childhood might not have looked that way.

Dr. Bruce Murphy 2:38
Well, no, I was very fortunate in that I grew up in rural Americana in rural Arkansas, and I grew up in a you know, tiny town of 1500 people or so called Stephens, Arkansas. And I was I have all these advantages in life because I grew up in small town. And he said, Well, what what are your advantages? Well, they have to do with durable relationships, they have to do with respect, mutual respect, and they have to do with a lot of the, the, you know, the morality of Americana in a small town. And the fact that we lived in small towns to each other, and I knew every last person in town, every last person in town I knew. So I had this tremendous advantage. I didn’t realize at the time, I thought it was a disadvantage. But when I got off and went to meet people that had different viewpoints on the world, I realized that I had the advantage. So anyway, thanks.

Nate Disarro 3:39
Yeah, and you know, it’s interesting, you view it now as an advantage. Whereas from my childhood, I thought the world was great, and everything’s easy. And this is the way life is gonna be we’ll come to find out when everything’s sort of handed to you and you don’t have anything to work for. Life gets a little more difficult the older you get, and you have to figure out what hard work actually is and what not having things looks like did you experience?

Dr. Bruce Murphy 4:02
Yes, I did. Matter of fact, you know, I recall distinctly the seventh grade, I had two pair of pants and T shirts for the entire year. That was spring, summer, winter. Okay. And so you knew what I was gonna wear tomorrow. Because Mama was one of those one of those every night. And so I think because of that, when I became, you know, a businessman at at the age of 12 or 13 or so, and started running my own business in town. I probably over compensated for that. Alright, because it was a lot of peer of, you know, Bruce is back in that check shirt again tomorrow. And so, if anything, I turned into a clotheshorse because of because of my early childhood, but it was again I see that it is advantage, I just see it as advantage.

Nate Disarro 5:02
So as you grew up and determined you weren’t going to stay there your whole life, where did life take you? Where did you go to college? Right away? Yeah,

Dr. Bruce Murphy 5:09
I thought, first of all, I was the oldest of five children. And my father was a Baptist minister and a very small church there, probably less than 150 souls. And I, I decided a couple things. Number one, I loved jet airplanes. And I love the idea of me being a fighter pilot, I just thought that was great. And I thought about a few other things, too. It had been mentioned to me by one of my mentors at the time had I ever thought about being a doctor and, and I didn’t until later I mean, I was in my senior year in high school, and I actually thought about it, but by this time, I was committed to the Air Force Academy and, and went there with the idea that I was going to be a pilot and but in fact, fell in love with biology. And so, you know, within a short period of time I changed my mind to, from trying to be Superman to trying to be a doctor, a researcher, I wanted to be a medical researcher is what I changed my mind to. And so that that meant I applied to and went to graduate school here in Little Rock at UAMS. And the department of pharmacology, I became a biochemical pharmacologist, which means studying the science of drug action. And it has nothing to do with farming, it has nothing to do with pharmacy, all right. But it was more about cell biology. And in quickly after a couple of years in a graduate program, which I thought was really difficult, I think thought Military Academy was medium difficult. I thought graduate school was really difficult. That one of my major professor said, Well, you need to go to medical school, if you’re going to be a cell biologist, or whatever you decide to do. Because basically, practically speaking, if you’re a PhD, you’re gonna make half as much money as an MD doing the same job. And I said, Okay, well, that makes a lot of sense. Because medical school, I was able to accomplish both in five years. And, and actually, I thought medical school was easiest thing I ever did, compared to how hard you had to study to be a graduate student. But anyway, that’s kind of how I got into the doctrine business. I, I always had thought I might be a doctor after Mr. John Barbara Davis mentioned to me in a truck one day coming back from Magnolia right past McNeal. And on the way back to Stevens, and, and it happened, and it happened just like that.

Nate Disarro 7:52
Now, we share that love of jet aircraft. But do you ever regret not going that direction?

Dr. Bruce Murphy 7:58
No, no, I don’t, you know, I wouldn’t be flying an airplane right now. And fortunately, I got over it.

Nate Disarro 8:07
So the the mentality of becoming a doctor was something that was cemented from somebody from from where you grew up. Somebody

Dr. Bruce Murphy 8:13
else mentioned it. Yeah, they did. And I, I, I hadn’t seriously looked

Nate Disarro 8:18
at it at the time. Was that somebody that that was sort of a mentor to you at the time? Yeah, I worked

Dr. Bruce Murphy 8:21
for him. He owned Stevens hardware. And I work in Stevens hardware for since I was in the eighth grade. And so that was this unbelievable advantage of working in this old old hardware store that was 125 years old at the time and, and to be able to understand how to connect a piece of PVC to something stainless steel, and how do you get that done? And what is a 20? penny nail what is an eight penny nail? I mean, all those advantages I got were I’ve used all my life.

Nate Disarro 8:52
I’ve never heard in my entire life, somebody say that medical school was easiest thing they’ve ever done. Granted, coming out of a graduate program that was very difficult, but looking at all the challenges, all the things that you had done to that point, did you feel like walking into becoming a physician would was something that you felt comfortable doing? Or did you see a lot of challenges ahead or,

Dr. Bruce Murphy 9:13
you know, I actually dreaded medical school because I had up till that point not had clinical interaction of any sort in medicine, okay, I’d really not seen a patient’s or worked in a doctor’s office or, you know, being a physician assistant or whatever, I had not done anything. And so I was kind of fearful of this. What will happen when you know, you’re actually supposed to interview patients and do a physical on patients, etc, etc. Because I knew that all my classmates and when I joined the class in medicine, they already had three years of that experience that I didn’t have. But now I said it’s easy. Yeah, it was easy because all of the subjects I had either taken are taught in graduate school I was I was teaching medical students at the time in pharmacology. So it’s not, it was that part of it, the academic part was really easy. The clinical part was, was worrisome to me. I mean, it worried me.

Nate Disarro 10:16
So at some point, you had to pick a specialty and become a cardiologist. Correct? Yeah. So what, what took you down that path?

Dr. Bruce Murphy 10:22
Okay, well, I thought I was going to be a pediatrician, I really did. I just love babies who doesn’t love babies. But you know, The Little Rascals when they get sick, they just scream bloody murder. And there is there is something in everybody’s DNA, especially females more that you know, wants to help the screaming, crying baby. And so that’s what I thought I was going to do. And even in my senior year, I did extra rotations in the in children’s hospital. But I decided I was going to go into internal medicine. And it was in internal medicine, that I had my first real encounter with cardiology. And in getting my first encounter, in cardiology, I was I was in the very early stage of what was the golden age of cardiology. And that’s when we developed abilities to actually measure the heart to image the heart, and then to actually stop things from happening through the right diagnosis and, and then later through the right procedure. So when I had all these great gadgets, I mean, the head the all of these great little things to use. And, and I was I was, I remember one important event that happened that I was when I was, I was still in medical school at the time, actually, in this, this cardiology fellow was going to do a right heart catheterization, which is a very simple, relatively low risk procedure on this patient over at the VA. And I was assigned to that patient, I was that patient’s Junior medical student. And so when we took him down there for his right heart, Cath, he said, you want to do it? And I said, Well, talk me through it. Sure. And he did, we were both gloved. But that I mean, I was addicted right there. I mean, when you got to do your first procedure on your patient, you see the you see the balloon goes through the right atrium, through the right ventricle out and the pulmonary artery out into the lungs. It’s like, okay, that was fun. That was fun. I’m helping this person by measuring these blood pressures in his lungs that really important for our right diagnosis. And so that got me.

Nate Disarro 12:43
And my understanding, you have a very successful practice, and ultimately, the opportunity came up to start a hospital. Well, this idea come up. So

Dr. Bruce Murphy 12:52
what happened in in the backdrop to all of this is that we, in a very short period of time, went from not being able to help a patient with a blocked artery, to being able to help a lot of patients with blocked arteries. And this happened just in a very short time twinkling of an eye between 1977 and 1985. We went from never having opened an artery in the human heart without surgery, to opening a much. And so I grew up in that era, which is called the golden age of interventional cardiology, where all of these gadgets were invented, that were so profound in the ability to change the course of an otherwise fatal problem. And so what happened was, is that because of that, so many patients now were candidates for an arteriogram of their heart. And the hospitals were not constructed for that. I mean, they only had, they only had, you know, two cath labs, one very primitive at Baptist and two cath labs at St. Vincent’s. And so they were basically overwhelmed. And so I distinctly remember one I got a referral of a patient with a heart attack in Malvern Arkansas. And there was no bed CC better or otherwise in Little Rock to send them to and I was on staff at Baptist St. Vincent’s and, and that patient had to stay down there with a big heart attack for five days with no treatment other than oxygen and morphine. And that didn’t that didn’t help a lot. And so by the time I got to that patient five days later and did the right test is way too late. Just way too late. The whole front wall, his heart was dead, he’s in heart failure. You couldn’t get him out of it. And it was only because we didn’t have the facilities. And I reach I’ll call also getting, you know, setting my alarm clock for 1am not being on call to get up at 1am Get dressed drive to the hospital for a plan to am I like the procedure, because it had been added on to the day. And so now, we were doing procedures at two o’clock at night in the morning on patients who had waited all day long with nothing to eat on families who were standing there waiting to know what is going on with the heart. And so you do the procedure go out and talk to the family, and come back if you didn’t go home and try to go back to sleep which impossible. But the point being is that suddenly we had a lack of major infrastructure and on a grand scale. And when we asked these hospitals to respond to us with more cath labs, more CCU beds, they had too many other departments to take care of, and 17 other departments. I mean, you we got to treat the neurology, the people in the neurosurgery people in the OB Jin people in the cardiology people with relatively equal apportionment of resources. And so infrastructure was a, it was just pitiful back then. And that that’s where this whole idea that, well, we need a cath lab. And then the question was, oh, Archie thinking too small, don’t you really need a hospital? And the answer was, I think he might be wrong.

Nate Disarro 16:09
Was a heart specific hospital a thing in America, I don’t know.

Dr. Bruce Murphy 16:14
And nobody had ever heard of it. There was one being constructed that had had didn’t even have the walls up no roof in McAllen, Texas by this group that I became affiliated with, or was introduced to. And so we met, you know, we got on a, we rented a plane and had somebody flies down there. And, and just to be sure, it was real, it was real, they were real. The idea was real. And within three weeks, we’d signed up to build a hospital in Little Rock. And you know, it, it began as a relatively small mall idea of a cath lab that went all the way to, you know, Cath Lab, oh, RS ICUs, to, to, you know, a, a program now that literally, our Kansans cannot live without, if we weren’t here, right now, there’s no place for them to otherwise go. And so we’re just an essential part of the fabric of healthcare delivery for Arkansas and, and in the course of that my job changed pretty radically,

Nate Disarro 17:27
I can imagine. So I want to shift gears a little bit and move into the business mindset for a second, because your whole practice at this point was, you know, on staff at hospitals, and really, you took care of patients, and that was your job, right. And now all of a sudden, this idea of a hospital comes up. And I think there were some other people involved, and you kind of have to shift your thinking a little bit and become a little bit more of a businessman as well.

Dr. Bruce Murphy 17:50
Well, I that it’s absolutely true. And I will tell you that I had once I had the idea planted in my head, and I did one week of due diligence and three weeks of negotiation, we signed up to do it. And, and I did that because I had really strong senior partners, but I was still the managing partner. Okay. And so if I hadn’t had them to help me with sharing the risk, and, and we started off with the idea that we were going to build something that was called patient focused care, in which we deliver all of the services directly to the bedside to the patient, and we focus on the patient, we don’t focus on the procedure, we focus on patient care. And that was what set us apart. I mean, that was the whole idea of what set us apart. But yes, we were sub specialty cardiology, cardiovascular surgery, etc. But it was the patient focused care that just had this astronomical thing ring. That patient satisfaction just became our marketing agent is people that came to us now they, they want more, they want more so

Nate Disarro 19:00
so to get a hospital like this off the ground, you can’t just sit in an office somewhere, think of it and go out start signing paperwork, and here it happens, right? Like, what’s the process look like to get because a lot of people go out and start businesses, they raise a little bit of money or go get a bank loan or whatever. This is a whole different beast.

Dr. Bruce Murphy 19:18
Yeah, it’s, it’s, if you knew how big it was, when you started you wouldn’t, you wouldn’t be as inclined to do it. The deal is once you do it, it becomes such a you know, a durable part of the fabric of helping people that you would you might rethink that and do it for that reason. But basically, you know, we we became friends with and partners with a a hospital management hospital building subspecialty building. entity that initially was private and then public then back private, then public but any event, they became our partners and the physicians raised. I think total, we raised $3 million at the time, which was a lot of money for all of us, because we had to borrow it. And most of most of it personally on a signature, and and then we borrowed the rest of the money for the whole hospital to be built. At that time, you could get 100% financing. All right, yeah, it was 100% financing. And it wasn’t bank loan, but it was, it was a REIT loan. And, and then it took, you know, it took 15 months to build the hospital, the first hospital 27 months a second hospital, but it, it and then to do anything successfully in life, you can’t enter into it knowing that you’re going to be successful, okay. So in order to test the hypothesis, you need to do it in stages. Okay, let’s test this hypothesis to see if this works, then let’s test this hypothesis to see if this works. Now we’ll put them together, we’ll test this, this is the business way to do it. Okay. So we started off with, you know, I think maybe 20 beds, 21 beds open, we’re in seven, we have a we have 112 beds at this one facility now. But we started with minimal number of beds open and, and then started just testing these various stages of now we’re going to do a balloon angioplasty on a patient. Now we’re gonna put a pacemaker into patient, now we’re going to put a defibrillator. But now we’re going to actually do heart surgery on the patient. So each one of these stages that we went through, and we were successful is like, Okay, this, we can put it all together now we can put it all together as a product. And, you know, if I were even starting a nursery business, I think I would start it in stages. I mean, I think I’d start off with hydrangeas, and then get into Japanese maples or whatever. Alright, but it would probably be done in stages. And I would, you know, I would strongly advise people in other businesses and in this business, to take the lowest risk, highest opportunity to help people approach. And you’ll probably be successful.

Nate Disarro 22:18
You said something that’s very counterintuitive to most mindsets. And that is that in order to be successful, you have to go into something not knowing if it’s going to be a success. That’s correct. How many times have you had to implement that strategy? Oh,

Dr. Bruce Murphy 22:33
well, is that training for the business yet? You betcha. Absolutely. You betcha. Because you’re thinking on your feet. I mean, literally, your next move is either life or death, maybe you don’t know. And so this whole notion of dealing with something that’s broken that you fix, but you break it worse, and now you got to fix what you broke in and patch up what you. So it’s that part of it, gigantically prepared me for the ability to doesn’t realize you got to think on your feet. Now you got to problem solve this, you got to problem solve this in such a way that you got to go through the the list in your mind’s eye exactly what your options are, and choose the best one you think.

Nate Disarro 23:21
Now, the my understanding of the healthcare industry over the last several years is that it’s sort of gone in the opposite direction of the way that the Arkansas hospitals gone in that a lot of health care groups are now forming these huge conglomerates and have ownership of large corporations. Whereas at one point, you took full ownership over the hospital from a larger entity. That’s

Dr. Bruce Murphy 23:47
correct. I did not plan to retire from the practice of medicine until I was in my late 70s or mid 80s. So when people ask me, What are you going to do or when you’re gonna retire? It’s like, I hadn’t thought about it. I’m, you know, I’m 60, approaching 60 years old, and why would I be planning retirement? I feel fine. And I’m probably at the top of my game. And so when the resource became endangered, and I’m talking about the heart hospital became endangered. Health care is local. Now, it’s a locally administered a locally decided industry. And there are other industries that are all local to their depend on the local terrain, the local, or even the car industry, which maybe comes out of, you know, Nagoya, Japan or comes out of Germany or comes out of the Detroit. It’s still locally delivered locally. I mean, it’s all it’s a local thing. And so, the likelihood that if you’re that an out of state entity would have the same local interests that we wanted for our patients is a great fear for me, I thought we were in danger. When when when Metcalf the apparent Corporation said we’re selling all the hospitals, and then we’re liquidating all the assets to the shareholders. It was at that point that there was a series of visitors that they brought to town to try and sell the hospital to. And these were mostly growing medium sized or large corporations that really weren’t interested in the story. Okay, they were interested in the balance sheet. All right. And so is like, okay, you know, your questions are not, can I take care of this heart attack from Melbourne? Again, your questions are, can I hit an EBITDA number that suits you on an income statement. And so it became clear to me, after going through this maturation process of figuring out what these guys were really about, and they were nice, people don’t get me wrong, they just had a different business plan. That somebody local had to do it. And then I was obviously pointed out that I was probably the right person to do it locally. And at the time that I did, I didn’t realize completely that I was going to have to completely stop the practice of medicine order to do it. However, doing what I’m doing now is not much different than a teaching somebody and that, in that when I went to clinic, or I went to the heart cath lab, you know, I’m one on one with the patient, and you know, your one on one, you figure out their problems, you try and fix their problems if you can, or at least for me to them. But when you’re a healthcare professional or business owner, now I can simultaneously treat hundreds of patients in 30, clinics to hospitals all simultaneously. I’m not treating them directly, but I’m providing the basis for their providers to treat them directly. And so just like a teacher can teach one on one, or one on 30, or one on 500. It’s it’s a lot more economical to treat one on 30, or one on 500 than one on one.

Nate Disarro 27:23
So you mentioned having to relinquish your medical license in order to take ownership of the hospital. What’s the purpose behind that? Why? Why is that a

Dr. Bruce Murphy 27:32
great question, because most people don’t wouldn’t have any clue that there was a relationship between those two, what, but back in the 70s and 80s, a congressman named Stark from California passed, some had passed or sponsored and had passed in Congress, some anti referral legislation. All right, in that it was we normally think that every doctor is crooked, and every doctor is trying to self refer to himself so he can get compensation rather than patient care. That was the basis of the legislation which passed. All right. And so it was then part at the last minute of the Obama legislation, the Patient Care Act, that the Hospital Association came and asked to be inserted rules that said that doctors couldn’t own hospitals. And why would the hospital association go against doctors owning hospitals? Well, the reason was they they couldn’t compete with Doctor owned hospitals. Because the the patient satisfaction and the quality outcomes, were far in excess to a general acute hospital. It’s got, as I said, 17 different product lines. They’re trying to espouse and make business simultaneously. So because they couldn’t compete with a hospital based, a hospital directed physician on hospitals, they made it illegal for a doctor to own a hospital. And it’s the only profession. I mean, it’s like, you would never think that it’s illegal for a lawyer to own his law offices. Well, where’s the doctor gonna practice he has an office or a hospital, I mean, so they made it illegal for doctors to own even though doctors had been, you know, forming hospitals to put their patients in for hundreds and hundreds of years. But that was the presumption is that you can’t trust doctors. And so Obama actually didn’t want the legislation in there. But in order to compromise with all the other people he’s trying to compromise with at the time, he was inserted the moment he signed it, it became law all right, and not not at any point in the future at that instant. Well, the banks the consequences if you are considered a referral to that’s inappropriate referral to the hospital because you’re self serving. is basically the closing of the hospital. And so the banks, what didn’t want to sin, you know, they didn’t want to spend the money or invest the money with us in buying the hospital, unless it was absolutely no way that any action that Bruce Murphy took could be considered a physician action that is directing care in his direction. All right. So I resigned my medical license, I did not resign my MD or my PhD, those are still there. But the transition has been a wonderful transition for me.

Nate Disarro 30:38
So did you have to hang up the white coats forever? Do you date those hanging around?

Dr. Bruce Murphy 30:42
They’re in there in one of my old closets? They are. Matter of fact, my old nurse had Dr. mirboo, you need to put this on eBay. And I think no, Ronita I’m not going to put this on eBay.

Nate Disarro 30:54
So, you know, medical profession is probably the longest training period to become a professional, a practicing physician. So you spent your whole life you know, getting certified and then going out practicing. Now you got to hang that up, and you got to put on a CEO hat. What’s What’s that transition like? And was it drinking from a firehose? Yeah,

Dr. Bruce Murphy 31:16
it was I thought I had been running the hospital all along. I was wrong. I didn’t realize we had 46 departments. And I only knew about three or four of them. And so it was not like, I mean, it was there were many things that I have learned many things I have learned. And you know, not having the lingo. The the GAAP lingo, the all of God is the hardware store lingo. Okay, for business. I was not, I was not familiar with accrual based accounting. All right, I was not really, it had to be taught to me, all right. This is not checkbook accounting, this is accrual based accounting. And so it’s not a hard concept. I mean, when you’ve been a, you know, a practicing physician for a long time, but there is a huge list of things that you need to know it’s huge. And so I’m at the point of continuing to learn on a daily basis, every day, I’m continuing to learn about business. I continue to read about business, I am a addicted to training my own brain. And most of my hobbies have to do with things like that. And so it is no question that having it was going from the clinical side to the business side exclusively, was a big jump, big jump.

Nate Disarro 32:54
So through this process, obviously, you learn a lot, a lot of things that that you probably wish you knew a long time ago. So what what is what’s something that stands out as a monumental piece of information that’s really helped over the last 10 years, 15 years,

Dr. Bruce Murphy 33:09
let’s say over the last 10 days, all right. And it’s a real easy concept, and I’m going to explain to you but it’s so easy, that you’d say well, why didn’t somebody explain that to you? 10 years ago, and I actually came in contact with this particular concept about three months ago, but but and it’s, it’s so simple as third grade. Alright, so if you want to grow the income of business, and right now, all the hospitals in Arkansas are in trouble. All right, there’s 77 hospitals. 74 are losing money. All right. And it’s the consequences of Coronavirus, 19. It’s all those consequences. And but if you want to make income, if you add revenue, let’s say we got 10 more heart surgeries. Great. We add all of that revenue to income. No, no, no, no chemotherapy. You added. You added let’s say you get $30,000 for heart surgery, okay? Well, you only added the difference between your overhead and the top line. So, overheads, 85 to 90%, you added 10%. So you only got put, you only put $3,000 on potential bottom line money. However, if you cut something that’s unnecessary as an expense, no overhead subtraction, that is 100% goes to the bottom line. All right, so a bottom on me income. So if you cut $30,000 In expense, you just added $30,000 to your bottom line, not $3,000 to your bottom line. So third grade concept, all right, but no one ever taught it to me until recently and actually I picked up on it from an Have the conversation.

Nate Disarro 35:01
Yeah, it’s valuable. But But I think the important thing is what you talked about. And that’s to always keep training the mind always have

Dr. Bruce Murphy 35:07
to train the mind you have to.

Nate Disarro 35:10
So the medical industry, from from a consumer of the medical industry, you look at it and you say, Well, I want the tried and true method. I want what’s going to work? Because it’s worked for 10 years, 20 years, 30 years. But it’s also looking for disruptors, how are we doing things different? How are we advancing the practice of medicine and technology? Is there a fine line between those two? And do you see yourself and the organization as someone that’s more on the disruptor side are more, let’s do what we’ve always done so we can get consistent results.

Dr. Bruce Murphy 35:42
Our very existence is a disruption to medical care in Arkansas, because they all try to put us out of business. And that’s a whole different story. But But no, our very existence is a disruption. And we we think of ourselves as disruptors. Now, any that’s not always true. I mean, sometimes we’re thinking in too far a traditional way of of never saying the words, because we won’t say them out loud, of this is how we’ve always done it. But we have to be thinking in terms of disruption. Because this is not the situations that we’re in right now are not durable. And we have, we have this obligation to manage these healthcare assets. And it’s temporary, our obligation here is temporary. And our our quote, you know, being in charge of these assets is temporary. Because if 50 years from now are less, probably far less, somebody else is going to be managing these assets. And so we’ve been given and I see it, and I try and teach my staff is that we’ve been given temporary stewardship of these assets. And so our job is to pass them on better. But we have to disrupt in order to do it. Because we there’s no way we can live with the expense side, the way the expense side is going right now. And Shabbat.

Nate Disarro 37:14
door to balloon time, in one statistic I saw the national average is about 90 minutes. But I saw that Arkansas hospitals around 30 minutes. That’s a dramatic difference. How on earth can an organization be that much better than the national average?

Dr. Bruce Murphy 37:35
Ah, it’s commitment. It’s it’s the, the protocols, I mean, we we can’t have people that are on call to help us open up a blocked artery that live 30 minutes away. I mean, we can’t do it. I mean, you’ve got to be within a short period of time in a short period of time to get to get there. And then there’s a commitment by all of our doctors to when you get into this, we’ve got a heart attack in the IDI. Now everybody’s running, we’re absolutely running and is part I’ve witnessed and done myself pushing a heart attack down the hall on the gurney, and I’ve done it myself by myself, getting him out down to the cath lab. So it’s this, it’s this cultural need to save somebody’s life. And there’s not that many times you get put in the place where you can say, I saved his life. But that’s one of them. That’s one of them.

Nate Disarro 38:35
I mentioned we share a love of jets. I think you still do I don’t know. But you know, when you look at and I don’t know if you’ve seen the new Top Gun movie, but but there’s this this conflict between the future of pilots, right? Where it’s all becoming drones, pilots in the Air is just not a thing anymore. And we look at health care, you look at all the technology and the advances and you wonder, are doctors still going to be as important in the same roles that they happen? Where do you see the future going in cardiology and heart care

Dr. Bruce Murphy 39:06
robots? Absolutely. Robots. Now their, quote robots in medicine right now they’re not okay. The robots in quote in medicine right now actually emulate the human movement. All right, they don’t they don’t initiate the human movement or the robotic movement. They emulate it. And but I guarantee you that you’re gonna have a dog bite 20 years from now and the ad and you’d call an ambulance because you’re bleeding and you’re gonna tell them I only want to go to a hospital. It’s got robots, because you know the way they stitch it is gonna be perfectly straight and perfectly done well, so between artificial intelligence AI, and humanoid robots, that’s where we’re going. It couldn’t. It will be very fast. Once it happens. It’ll be like to change From a horse pulled on a buggy and a car, when Henry Ford did it from 1908 to 1913, it’s a dramatic change in Wall Street because they’re first of all full of horse drawn buggies. And now they’re full of cars. There are no horses at all. So I do think that there will be a role for the human touch. I think that a lot of doctoring and diagnostics will be done by robots, and also believe that the robot will have built into them all the facilities that the doctor doesn’t right now. Okay, so if I need an echo, oh, it’s just, it’s just right here, I just, I have the echo. All right, I need a chest X ray gene, I take a chest X ray, I need a CT scan. Okay, I can do the CT scan. So that’s where we’re going. That’s where we’re going. And, and, and, you know, it’s a little worrisome, frankly, because some of the super intellectuals of that are futurist. Worry about AI. And AI becoming dominant at the moment of the singularity. So at the moment of the singularity, when artificial intelligence is superior to all human collective intelligence at that moment, which is predicted to be in 2042, very soon, at that moment, AI will dominate the intellect of humans. And so it’s a matter of who’s in charge. Is it AI because we can self replicate? Now, we have all the things you’ve taught us how to do it. So it’s a scary time. I mean, there are a lot of really intellectual futurists that are very, very worried about AI. But I’m not worried in medicine, I think that that built in quality will be built into the robot, to you know, want to help people and help each other.

Nate Disarro 42:02
That’s a fascinating conversation, it could probably take up another hour, but we’ll move on from that. But But I think something that ties in really well to that is this idea of recruiting new talent, and bringing new people on staff who not only have the experience and mindset to do the job, but are thinking ahead far enough. So how do you approach recruiting and bringing in new people to the organization?

Dr. Bruce Murphy 42:28
Well, right now, you know, we need many, many nurses, we need many other providers, and a variety of of things, everything from support services, to biomed, to to culinary. But our method on doctors is real simple. We want new grads that have not had a chance to develop bad habits. We want to put them in our boot camp. We won’t stars now don’t get me wrong, we won’t stars and we don’t go through recruiting services to get them we get them through a different method, but it’s a it’s a tried and true method. And then we put them in our boot camp and our boot camp last four or five weeks, and they have absolutely no real clinical responsibilities during that period of time. But we’re role modeling them with good doctors that we know are good doctors that are good doctors teach them how to see patients in the clinic, teach them how to see patients in the cath lab teach them how to do casts differently than they were taught in academic medicine by academic cardiologists are surgeons. And then they get to have to get to know everybody in the whole organization virtually, and the geography and the marketing and all of this and then when we turn them loose, and once you turn somebody loose like that, that has had great role models, has a great talent, but also has great ambition. They’re just they soar like rockets. I mean, they just absolutely go straight up. And it’s so exciting every year in August or September, September. We get them in July, when they finish their their fellowship. And generally they’ll take a week or two or three off and then then we started the bootcamp in mid August and they get through it in mid September, then the next few months are just unbelievably all you do is walk around smile and when you see these guys, because they’re just killing it. I mean, they’re just seeing patient after patient after patient their want to become involved in the patient’s life. I mean, they’re, it’s amazing. It’s an amazing transition.

Nate Disarro 44:39
And I’ve heard you say something interesting with with your philosophy on teaching and that is that if you can teach something, it means you understand it. You have to So what where’s your role as a teacher these days versus sitting back and letting the machine run itself?

Dr. Bruce Murphy 44:57
I I started making power points for my executive management team, which has got about 1215 people on it who meet every Tuesday. And I started making PowerPoint presentations for them early in the time course of the pandemic, with an update of what’s happening here and there. And how do you understand what a vaccine? I mean, how does this work? What does it really? What does a CD 43 sale, what does a CDA sale I mean, all of these things, so I started with that, and I, I have changed course into things that interest me. All right, that I think that they were never taught, alright. And so I’ve put PowerPoints together for my staff, that are 1520 minute talks of trying to let them understand something that I just understood for the first time. And, and that can be very diverse. One of them is one of them had to do with the geography of the earth during the last six ice ages. And how that changed where were animals are all over the world. One of them had to do with how the geography of China has affected the fact that it’s only been attacked from the Mongolian plane. I’m about to give them one next Tuesday, on the atoms in your body are 4 billion years old, not the molecules, the atoms that make up the molecules that make up the proteins that make up the sailor. All of this is made from atoms that go back in time, 4 billion years. So there’s atoms in your body that were in dinosaurs, there’s atoms in your body that were in trees from 5 million years ago. And all of the water in your body has comes from some prehistoric ocean, our ice glacier, almost all of it. And so it’s now how does that affect the executive management team? So hard hospital? Science is not about remembering facts. Science is a method of thinking. And you want to teach them the method of thinking as scientist. And that’s my only purpose. Plus Andrews, me and I like talking about it.

Nate Disarro 47:21
Well, you’ve certainly given me a lot to think about now I am trying to think about which dinosaurs I might have been a part of. But that also is another conversation. You also referenced my favorite word earlier in the conversation and you use the word story. And you were talking specifically about the story of the Heart Hospital and the ownership group and where they may take it. And but but to me storytelling is is this idea of creating a human to human connection? Yep. And that connection creates emotions within us and those emotions result in actions. And so from your perspective, how important is storytelling in the role that you play? And the role the heart hospital plays in the community? That’s

Dr. Bruce Murphy 48:04
correct. It’s really that’s a really nice question I’ve never been asked. Storytelling is crucial for leadership development. All right, actually, standing up in front of a whole bunch of people that you don’t know very well, and are either peers are underlings and start talking. Intellectual teaching fashion, is a method of developing leadership inside your organization. It’s just one, but it uses the storytelling approach in order to do it. So leadership and storytelling is itself a hand in glove sort of relationship, you got to be able to relate what you’re thinking to somebody else in the form that they will remember it long term. And, you know, a lot of that is, you know, there’s very, very famous line about, it’s not what you said, but how you make them feel. But it’s crucial for leadership, absolutely crucial.

Nate Disarro 49:02
When it’s interesting that, you know, the first opportunity I think I had to interact with you was several years ago, we were telling the story of the transition in the culinary program at the hospital. And, you know, there was quite the dynamic that happened there. And what it ultimately is, is is using a story to help tell your patients we care about you beyond what we’re doing with your heart or the actual procedure. So are there any pivotal moments or stories within your time as the top leader of the organization that really stand out as pivotal moments in the history of the hospital?

Dr. Bruce Murphy 49:42
I think the story of our initial rejection by the healthcare community here, and now our embracement of it is a story that’s worth hearing by many people, historic historically for us to know What, what in what happened in, it was just a misunderstanding. All right, is just a misunderstanding and that, that one of the principles that we’ve never really talked about is that Arkansas has so many patients that have cardiovascular needs, that it There literally is enough business for everyone. There’s no reason for us to fight over this, because we can’t take care of it if we all got together and formed a pact to take care of it together. But I think they’re just a misunderstanding, when we showed up, that these you know, cowboys is what were recalled by other people, not in a pleasant way. But these cowboys that were going to be reckless with your dollar and reckless with your life. And story pick, just cherry pick the easy patients to take care of that story was promulgated by our colleagues. And that led to probably a lot of unnecessary meetings, some of them down at the county courthouse. And so, but that’s one very pivotal thing in the life of the hospital is that we were able to get past that we were able to get around it. And now we’re really good friends with all of our colleagues right now. And they have, I think, the same level of respect that I have for them for the enormous works that they do. That colleague hospitals are full of extremely smart people that are, are all intent on helping patients. And that’s all of our jobs.

Nate Disarro 51:46
I want to shift gears just a little bit talk a little about the personal side of Dr. Bruce Murphy. I understand. Well, first of all, for anybody that sees a video clip of this interview, we’re sitting in a Japanese garden is that what it’s a

Dr. Bruce Murphy 51:59
walled garden? It’s a walled shade garden that I created as somewhat of a reflection of some places I had been. Yes. And I

Nate Disarro 52:10
understand you’ve been to Japan a number of times or have a an interesting connection hundreds

Dr. Bruce Murphy 52:15
of times, hundreds of times and have businesses in Japan.

Nate Disarro 52:18
So how did that connection come about? And what what’s your interest with Japan,

Dr. Bruce Murphy 52:23
it came in, it came through, it came through a one of the pioneers in Japan, the father of interventional cardiology, for all Japanese was a friend of mine, and a good friend of mine. And so I visited his hospital, he visited my hospital, I visited his hospital, he wanted to hospital like mine, we tried to get him, any of it. That’s how it got started. And then it was very clear that there were certain areas in which the US protocols are far superior to the Japanese protocols. Not that they were not being run by very smart guys don’t believe me, but they just had a very traditional kind of old fashioned way of doing things. And so we got into the business of trying to help them and teach them and did and have. So that’s how I got into Japan.

Nate Disarro 53:17
So if I take a trip over there, what’s the one thing I have to make sure and accomplish while I’m there?

Dr. Bruce Murphy 53:23
Well, you have to go to the ancient capital of Japan, which is Kyoto, which has 1300 temples in it, I’ve been to maybe 70 or 80. But that Kyoto is essential for you to understand. And then modern Tokyo is also essential as well. For you to understand the vibrancy of this city. It’s just, it’s my favorite. I’ve been a lot of places. Tokyo is my favorite city.

Nate Disarro 53:54
That’s amazing. Okay, I like to ask just a few kind of quick hit. Chips. Get to the crux of it quickly. First of all, are you a Netflix guy or a news guy? Netflix. All right. What’s your favorite show recently?

Dr. Bruce Murphy 54:08
They’re mainly they’re mainly they’re mainly Japanese. There’s one called Midnight diner. And it’s a 30 minute that is centered around a diner that opens at midnight. Interesting. And guess what kind of people attracts weirdos, weirdos they can’t sleep or want to drink? Are they gonna get they’re hungry or whatever. But I enjoyed that I enjoyed midnight diner.

Nate Disarro 54:39
I’m gonna have to check that one out for sure. Best or latest book you’ve read. And beginning

Dr. Bruce Murphy 54:45
to read it was given given to me two days ago, the real Anthony Fauci.

Nate Disarro 54:52
That’ll be an interesting one.

Dr. Bruce Murphy 54:53
I think it will be interesting. I do.

Nate Disarro 54:56
What is something that’s a part of your daily routine that you cannot I go through a day without doing

Dr. Bruce Murphy 55:05
it’s weird. I shave twice a day. I shave twice in the morning. It’s kind of weird. And it’s a throw over from being in the military academy, alright? I can’t walk past an unmade bed is impossible. I’ll turn right in and start making the bed. Even if somebody else’s bed are in hotel room, got to know somebody’s gonna make it up. Those are some Essentrics

Nate Disarro 55:37
I like I like, best piece of advice you’ve either given or received.

Dr. Bruce Murphy 55:44
If your employees work like they own the company, they’ll be with the company for a long time.

Nate Disarro 55:50
I like it. What’s the best item you’ve bought in the last year under $100?

Dr. Bruce Murphy 55:56
A, a long spoon to put your shoes on with. So you never have to bend over. It’ll change your life.

Nate Disarro 56:09
I will look it up on Amazon right now. I think every passing year, I realized how much more those kinds of bending

Dr. Bruce Murphy 56:17
over and I mean, come on.

Nate Disarro 56:21
I think I know the answer to this but favorite destination you’ve ever been. Yeah,

Dr. Bruce Murphy 56:24
well, favorite destination is actually Antarctica. For which I’ve been twice, and I hope to go again and again. But it’s like time travel. It’s like going. It’s like It’s like going back 10,000 years to the Ice Age. It’s not about the penguins. It’s about the ice. That’s the reason to go to Antarctica. It’s amazing.

Nate Disarro 56:51
Interesting. I’ve not heard that question. But I am curious about is there anything there other than

Dr. Bruce Murphy 57:00
Oh, the sea is full. I mean, I’d see normally 300 or 400, humpbacks and maybe 200 killer whales. And of course, all the ice. The Pancake ice is full of all these bloody leopard seals and crab seals and I mean, it’s so it’s full alive. Mainly WaterLife there are no vascular plants in Antarctica. Okay, so they it gets water from a different by different mechanism.

Nate Disarro 57:33
That’s fascinating. Okay, favorite artist or musician?

Dr. Bruce Murphy 57:40
Van Gogh, Adele.

Nate Disarro 57:42
I like it. And favorite food drink or restaurant.

Dr. Bruce Murphy 57:47
I don’t drink them anymore. But Moscow meal is probably my very favorite alcoholic drink. A and they have too much sugar in it. So I can’t. I don’t want to. I don’t want to deal with that. It’s probably my favorite foods. Probably king crab.

Nate Disarro 58:06
Yeah. I love good king crab. Yeah. Okay. Dr. Murphy 25th anniversary of the Arkansas Heart Hospital. What’s What does that mean to you personally, having

Dr. Bruce Murphy 58:18
a complete surprise, stunned surprise. Who would ever have thought that? You know, I’d be sitting here 25 years after we started this as you know, just a ambitious cardiologist at the time. We wanted to take care of people one at a time, but the fact that it’s been durable, it’s expanded, it’s grown. You know, we’re gonna take, we’re gonna see 150,000 office visits this year. I mean, unbelievable. You know, we’re gonna do bypass surgery and close to 1000 people. And so, surprise, absolute surprise.

Nate Disarro 59:00
Well, I’ve absolutely loved this conversation. I really appreciate you taking the time to do this. And I My pleasure, best of luck with the next 25 years.

Dr. Bruce Murphy 59:07
Thank you very much.

Nate Disarro 59:10
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