HJAR May/Jun 2024

DIALOGUE 10 MAY / JUN 2024 I  HEALTHCARE JOURNAL OF ARKANSAS Editor A lot of egos involved. Collier Yes, and that's my claim to fame. I think we have 1500 people, and it's really a challenge to keep all those people happy. We really take that seriously — keeping our employees satisfied. I know the leadership is here because I selected them to be here. Editor Reflecting on your journey as a physician and founder of ARcare, what were some of the key challenges you faced in establishing a community health center in Arkansas during the ‘80s, and how did you overcome those? Have some decades been harder than others? Collier Well, I would say the challenge is it was really difficult work. It was some all- night encounters, it was tragedies —medical tragedies. It was going back out on Sunday nights at 10:00 or 11:00. It was having a tornado rip through the community and actually kill people on Christmas Eve, being stuck in the hospital with just a state trooper in the middle of a tornado. Definitely, the ‘80s was the physical challenges and barriers. I'm not going to say, “I don't know if I could do it again,” but I'll tell you what — it was the real thing. It would have been a great movie. In the beginning, the second Editor You say it softened your touch. What do you mean by that? Collier Well, it's not just about the number of patients you see, it's not just about if you can turn them around and get them out of the office; it's that you follow that patient, they become loyal, and you care about doing that. I still see patients; some of those patients are from 43 years ago. I've got a roster of patients tomorrow. I think that the reason that they still see me is not because I'm a great doctor, it's because there's a softer touch that I have with patients. In hospitals and in clinic systems, some- times there's some friction between the administrative wing and the clinical wing. I felt that in the beginning, but over time I learned to soften that, to try to work with the administration. In 2000, I served as chief of staff at White County Hospital in Searcy, Arkansas. They sent me to a lot of training on how to run a hospital staff, and that would've been great, but I knew I was not going to stay in a hos- pital. That's not my deal. I'm an outpatient person. I felt comfortable managing doctors and mid-levels and privileging, and we had some great cases back then. We still do, but you really have to have a soft and profes- sional touch to help your doctors. in family practice clinics. I didn't know how that would go over, but it's gone over great. In the doctor world, you would see a chil- dren's clinic and then you would have your adult medicine. Well, in some of our ARcare clinics, we have pediatricians working alongside family practice. Now, they have different parts of their clinic, and that model has been excellent. That's what I mean about integration — we sure didn't start with pedia- tricians in the original clinics. Editor What inspired you to start ARcare? Collier It was a realization of the potential of creating a system that could be exponential in growth, and I had a mechanism to do that. From '81 when I started coming back from Pine Bluff, I never took a break for seven years — worked all the time, was a doctor, delivered babies, assisted in surgery, saw patients in the hospital, ran a busy clinic, and was on call all the time — 24/7, Christmas, whenever. I did that for seven years, which was an awakening to my brain — not that I needed to get out of it, but I needed to improve on it. But I knew I was limited with just one doctor. In '88 to ’89, I started recruiting other doctors at mid-level to come back with me and practice. In the beginning, I was running three or four clinics and that's what devel- oped the network. Then somehow around 2000, I got onto the American Academy of Physician Leaders (AAPL) and took their course of study out of Southern Califor- nia. It was really good because it was pro- moting physician leaders. I learned a lot. In 2006 or so, I sat for the ACHE, which is the credentialing that hospital administrators have. I enjoyed that study. And then, through reading and through those courses, I saw another side of medicine that you don't learn in medical school and you don't learn practicing medicine the first 7-10 years, which was all about seeing patients and always being there. I gradually softened in my touch from those first years, which I think changed me; it changed the way I think about medicine.