One On One With Brevard Eye Center’s Gary Hardey
One of the most fruitful partnerships is between creative or scientific people and savvy, capable business managers. One has the vision for what they want to do; the other is able to handle the resources, in personnel, finances and facilities, to bring that about, thus freeing the former to concentrate on what they do best. The most famous is probably the relationship between Walt Disney and his very capable brother Roy or the Beatles and their manager Brian Epstein. At Brevard Eye Center (BEC), CEO Gary Hardey fulfills this role, facilitating the entrepreneurial and medical vision of its founder, Dr. Paul J. Befanis.
SCB: Often, where a person’s career begins and where he or she ends up, takes a whole different trajectory. Was that true of you?
GH: I never imagined I would be in health care management, actually I stumbled into it. After I got my undergraduate degree in sociology and psychology, I needed a job while I worked on my graduate degree. I had a wife and a young baby to support and found a job at a 40-bed psychiatric unit. I think I was hired as much for my size, in being able to handle the patients, as my degree and ability to work with people with disabilities. It was, with all due respect, right out of “One Flew Over the Cuckoo’s Nest,” where the doors are locked 24-7. I really began to wonder about my career choice. One day the Division VP walked in to do a tour of the facility on his normal checkup in rounds. I was in the hall when he came in; I greeted him and told him I would need to accompany him on the tour. A few minutes into our walk he looked at me and said, “Kid, you need to run this place. Go get your administrator’s license; I’ll pay for it and help you along.”
I got the professional license, took over this little psychiatric unit, and Dr. Wiederstein, the Division VP, served as a mentor to me. In fact, we both went through an MBA program at the same time, though he was in the Executive Program. After that I ran some of his larger facilities, before I moved to Denver to work for Mariner Health Care. Then a friend approached me about being a CFO in an ophthalmology group. After another professional move, my wife got the itch to move to a warmer climate; the choices were Texas, California or Florida. What sold me on Florida was the potential I saw with BEC and also the great quality of life here, where we could raise our family.
SCB: So what was it like when you came on?
GH: At that time I think BEC had five locations two of which were in Palm Bay (they now have 8 doctors, including 2 MD’s and 7 locations from Sebastian to Titusville, along with an ambulatory surgery center). I was really fortunate to meet Dr. Befanis at that time; they were looking to bring on some more docs, they wanted to consolidate in some areas, while expanding in others, essentially to move the practice to the next level. Through acquisitions, we were able to create some larger clinics and streamline a lot of the operations.
SCB: How many practices in the area do what you do?
GH: There are a couple of large practices like ours, along with a number of independent practitioners or specialists who work out of the local hospitals.
SCB: But you do virtually everything ‘in house,’ from glasses to surgery.
GH: Yes, 99 percent of the procedures we are able to do in one of our facilities; there are a few very specialized procedures that may require a hospital setting, many times due to the health condition of the particular patient. If a patient requires general anesthesia, we can do that, but we do not. In those cases we go to Holmes or Wuesthoff, both of which are great systems. That is another great plus about this area, there’s no reason to go elsewhere to get exceptional health care.
SCB: Since you came on, BEC has consolidated, expanded and has done some acquisitions. Could you walk us through the strategic and the tactical side of those decisions and their implementation?
GH: I keep maps of Brevard on my wall (pointing to them) and analyze what the population trends are, based on zip codes. We see where our current patient population is and where it is likely to be in the future. Also we ask, ‘Is there an opportunity to serve or is the area already saturated?’ We have six locations in Brevard and one in Indian River, which gives us multiple access points. Another question we ask, ‘Is it to our advantage to open a location or is someone selling a facility that is ideal for our purposes, enabling us to combine efficiencies?’ Or at times there is a medical provider who wants to join a larger group where he or she can concentrate on patient care and let someone else manage the business side of the operation.
SCB: Obviously you’re not only managing an existing staff, but you’re also marketing and strategizing for growth. Does this whole process fall under your umbrella?
GH: Yes, though it is a team effort. The times are a changing and by necessity you have to wear a number of hats. Beyond what you mentioned, we’re managing patient satisfaction and a host of policies and protocols that go into quality health care delivery. Therefore you have to harness the ability to work collaboratively with doctors, because the way things are going, you need that cooperative effort now more than ever.
For the most part this community is pretty progressive and is staying ahead of this evolutionary curve; many other communities are not so fortunate. There you find an adversarial attitude, an ‘us versus them’ relationship between managers and doctors. You have to have unity – both doctors and executives bring things to the table.
SCB: So when you make an acquisition you get more than the facility, you also get the patients that are a part of that practice.
GH: Potentially; in medicine you have to be very careful about patients’ records and confidentiality. We contact these patients, directly or through advertisements, offer them their patient records, explain our services and allow them to choose.
SCB: I would assume your training in psychology and sociology serves you well.
GH: This work is 90 percent relationships, which is dealing with people, ensuring the fit and the chemistry is there to make it work. Because we are so spread out over this rather long county, you have to have very competent people whom you trust to manage those facilities. I try and visit them weekly, but it is having the key personnel in place that brings success. Policies and procedures only take you so far.
SCB: Reading about BEC over the years, there seems to be a real entrepreneurial spirit in your practice. Does that come from Dr. Befanis?
GH: He has some great ideas and he has done some things over the last 25 plus years that have set him apart.
SCB: For instance?
GH: He is a Retina Trained Fellowship Surgeon – that is a very elite group. He is very meticulous and has to be, you are dealing with people’s sight; there is no margin for error. His mantra is, ‘If you stay focused on patient care and you stay centered on what is best for the patient, then everything else we do will encircle that core value.’ He wants things perfect; he wants every patient to leave here satisfied. He is very results-oriented in every area, as are all our doctors.
SCB: I would guess your industry is pretty much recession proof.
GH: You’re close; we’re not proof, maybe “resilient” is a better word. People have to have medical procedures done, but they may postpone those procedures longer than they normally would. Thus building bigger is sometimes better, it gives you stability and the ability to weather storms, but we have modest, attainable growth rates. We keep goals that are high and set to attain them.
I have a two-year goal board that summarizes my goals (pointing to a tempo board on the wall) so that every year, month, week and day I am asking myself, ‘How am I doing in terms of those goals? How will I increase my margins? What can I do to increase market share? What do I have to do differently? What do I have to do better?’ It keeps me focused.
SCB: What are the biggest changes in health care that you are aware of and that you are preparing for?
GH: The changes are very dependent on what the government is doing – the “what ifs” are limitless. If A happens, what are the B consequences – from health care legislation and payment to employee issues; labor and supply costs are skyrocketing.
SCB: This is a car being built, not in Detroit, but as it is driving down US1. What are you doing?
GH: First, asking, ‘What can we do better and what can we provide that we aren’t providing now?’ Internally, what can we improve in terms of customer service? We are already providing detailed reports to regulatory agencies, in many cases, before they ask, because we know eventually they will. Also we are looking at where the acquisition opportunities exist. Some practitioners are retiring and looking for acquisition partners. We can provide doctors with the ability to concentrate on patient care, while we concentrate on the management; it is simply providing economy of scale.
A respected author and speaker, Eric Wright is the assignment editor for SpaceCoast Business magazine.