April 12 2021
This is the latest episode in our Women in Healthcare series for PointByPoint. Ashley Johnson is the Chief Development and Integration Officer of QualDerm, a physician practice management company specializing in the dermatology space.
Ashley has a decade of experience in healthcare revenue cycle and hospital and physician practice operations and most recently served as Chief Operating Officer of Saline Memorial Hospital in Benton, Arkansas. She led many business development initiatives as a hospital COO, and as a woman leading the way for a PE-backed healthcare services company.
Morgan Ribeiro: Ashley, welcome to the show.
Ashley Johnson: Thank you for having me, Morgan, I'm thrilled to be a part of the podcast series.
Morgan: Great. There's no shortage of topics for us to discuss today, given what is happening in your particular sector of the healthcare industry, as well as the focus on diversity, equity and inclusion that in recent times have begun to receive much deserved and overdue attention.
And that's really what we're covering in this podcast series and looking at it from all different angles, different perspectives, but those that are sitting in different seats across the healthcare industry. So let's jump in first to kick things off. I would love to hear more just about your current role and your organization.
Ashley Johnson: Absolutely. So currently I serve as the Chief Development and Integration Officer at QualDerm Partners. We're based in Brentwood, Tennessee, we're a dermatology practice management company that helps dermatologists and surgeons position their practices for sustainable growth.
We create market-leading practice partnerships through affiliations and de novo development and then we're here to provide the management support, capital and guidance for those practices to continue to grow. QualDerm has definitely earned a reputation for keeping quality as our core focus, and our physician partners maintain clinical autonomy so they can continue to provide the best patient care possible.
So we currently have 50 different practices across nine different states. And I would describe my role as a three-pronged role. We all wear lots of hats being a smallish company that's still on the growth trajectory. So the first piece of my role is the development piece and that involves sourcing and identifying potential new practice partnerships and also leading the entire process from initial introductions to a new practice joining the QualDerm team.
The second prong of my role is the integration piece, which is actually what I joined QualDerm initially to do. So that involves coordinating the various integration onboarding initiatives for adding new practices. It involves items such as IT, software integration, all the HR benefits, payroll transitions, physician recruiting, payer contracting, et cetera.
Lastly, to keep my foot in the operations realm - since I came from an operations background in the hospital world - I still do serve as the day-to-day operations leader for our Pennsylvania market. We've added eight different locations in that market over the past two and a half years since I've been here.
And I think that keeping that role has given me a good understanding and. allowed me to experience what the day is like for all of our new practices that are joining and I'm able to share with potential partner practices and physicians in my business development role how it's going to really be after they actually joined QualDerm.
Morgan: Wow. That does not sound like a boring role. It sounds like you keep yourself really busy wearing a bunch of different hats and really exposing yourself to all aspects of the business. And you made an interesting transition from working as a hospital operator to working in more of a development role for a PE-backed physician practice management company.
So fairly different sectors, as well as your role as being pretty different. And how did that come about? Can you talk about where are you started your career and how you've made that transition into a new sector and into a new role?
Ashley Johnson: Yes. So I have made quite the transition from consulting to operations, business development. Enjoyed the ride but definitely a lot of different learning experiences along the way. It has all been in healthcare so there is the healthcare theme that has run through - just different roles within the healthcare space. I definitely credit success to always being willing to dive into new challenges, opportunities and grow as a leader as I continue to strive to build a well-rounded healthcare perspective and hopes of someday being a healthcare CEO. Actually I'm one of the rare folks who actually did what they wanted to do when they were a kid growing up. I always wanted to be a hospital administrator. My mother worked for a large healthcare system in Chattanooga, Tennessee.
And my babysitter when I was a kid was usually anyone in the hospital who would let me hang out with them and shadow them for the day. I was initially interested in the clinical aspect. And then as I got closer to college, I learned that the bigger picture view and the development and growth aspects of being a hospital administrator was a little bit more interesting to me.
And so I began pursuing that path. I started after attending Vanderbilt for undergrad. I started in the healthcare revenue cycle world because the one thing I did not do in undergrad was anything finance-related. And I knew I needed to have a background in finance and accounting that I had not achieved in undergrad.
I began there to build that from financial understanding prior to going back to business school and was able to work on some exciting projects, building out billing offices for large healthcare systems across the country. Also spent time working in the insurance payer space on a project focused on the integration of two insurance companies and expanding their service line offerings to their members.
So after consulting, I went back to business school was able to use that healthcare experience from consulting to move into the hospital administration side and started initially as an associate administrator in Sierra Vista, Arizona. I call this role the perfect example of saying "yes." I was actually about to move to a hospital in Alabama and got a call from the company I was about to work for who said "Actually, instead of signing that lease for the house you were about to move to in Florence, Alabama, could you go to Sierra Vista, Arizona where I think you'd have more opportunities to grow?" Because they were building a new hospital and had lots of initiatives going on that they knew I would be interested in doing.
So I knew nothing about Arizona, was just starting my hospital career, was provided an amazing opportunity to lead the hospital ancillary departments where I was also able to build a state-of-the-art 100-bed replacement hospital. This role then developed into the chief operating officer role after about a year or so that I was there and I was able to not only build and transition that new hospital to a new location, but also build out new service lines for the community.
And one that I was especially proud of was our new 19-bed behavioral health unit that we were able to build on the top floor of our hospital. I then had the opportunity with the same hospital system to move to a bit larger hospital in Benton, Arkansas, as the COO. And there, I was able to lead 11 different hospital departments and continue to work on hospital growth opportunities.
And then during this time, my family was looking to move closer to our parents for childcare assistance. And I learned of an opportunity at QualDerm from a former hospital colleague that was working at the time. Dermatology physician practice management was quite different than the hospital operations world.
I really felt like the culture alignment focused on physician partnerships really fit what I was looking for in my next role. And I joined initially as the vice-president of operations, where I was leading, as I mentioned before, our integration of new practices. And then over the last two-and-a-half years, this role expanded into leading operations in Pennsylvania as we enter that state and then moving into leading our development efforts that I do today as we continued to expand and grow, which transitioned me into my current role as the Chief Development and Integration Officer.
I'm fortunate. I feel like I've definitely been at the right place at the right time during our company's growth. And I've loved expanding into the different roles and the relationship aspect of the business development side of the house.
Morgan: So you mentioned this earlier but would love to have you elaborate on it. Why healthcare for you? You mentioned at one point in your life you thought maybe you would pursue more of the clinical side and then decided the sort of bigger picture aspects of being on the administrative side made more sense for you, but is there any more that you would add to that?
Ashley Johnson: Yes. I so growing up with a single mom role model, I was always interested in healthcare because that's what she did. And she was who I was with all the time. So I was always drawn to working in an industry that I would say has a higher purpose for a lot of the daily tasks and work that sometimes can't be fun.
I can always get myself back to knowing that I'm doing the right thing every day, because I am helping people, expanding opportunities, experiences for patients. Which I've been able to do in various ways throughout the different roles. I have really enjoyed the growth aspects of new service lines in hospitals or new partnerships that are allowing our physicians to have better lives and better work-life balance.
So all of those things have definitely been the driving factor to get me through the days where it's maybe not the most fun task, but it is serving a greater good and helping others out.
Morgan: Yeah. And it's so true. Healthcare is always evolving whether or not it's the regulations around it or reimbursements or sectors that are for consolidation, whatever sort of way you look at it - it's always changing.
And I think that makes it a really fun industry as well. And I think healthcare will always be around. And it's an industry that particularly in Nashville - where you're based - is going to be a hot one for a while. I completely agree with that.
Switching gears a little bit, just in terms of the emphasis for this particular podcast series, over the last several years we've seen increasing attention on the lack of women in leadership roles within healthcare organizations. And I think this is a really positive step, but we still have so much progress to make. Women make the majority of healthcare decisions for their families and the majority of the healthcare workforce is also women. And yet women still fill a small fraction of healthcare executive roles. I was recently reading a McKinsey study that stated that the proportion of women in the healthcare industry decreases as the responsibility level of the job rises. And the share of white women, in particular, in entry-level positions is 41% compared to 26% at the C-suite level.
And that this decline is particularly steep for white women at more senior levels due to the glass ceiling that seems to exist between senior manager and director and VP level. So those are some very specific statistics, but I think it's really telling of what we see and if you were to speak to say a young woman looking to pursue a career in healthcare administration and they see those numbers, that can be a little discouraging. What advice would you have for her and what can we do to improve these statistics?
Ashley Johnson: So I would say my advice would be to be flexible and seize opportunities when they arise. I think being women, we're a lot more likely to doubt our ability to hop into something that we're unfamiliar with and we tend to get scared of those and want to do the things that we are comfortable with or have done previously. But I think that all of us should be the ones to raise our hands when new opportunities arise within the organization and be that person that is constantly saying, "Yes, I'd like to try that or I'd like to figure out how to do that." It doesn't mean we have to know how to do it, but we can always work to figure out how to do it has been my approach along the way. And I think that's what's helped in advancing my career far beyond what I thought would have been possible at the age of 35 now.
And then also as a woman, I think one thing that I have done that maybe isn't the most popular thing in the world, but to be careful to ensure that all of our at-home duties don't interfere with our work, I've seen that as something that is a good way to get passed over for the next opportunity.
So I've been very careful in keeping my home life separate from my work life. Probably more so than any of the males that I work with just because I'm very conscientious about it. Been very fortunate to have a husband that has supported my growing responsibilities over the past 10 years.
And it's certainly been a teamwork effort with both of us traveling- a five-year-old and a two-year-old - and very busy hectic jobs. But that teamwork aspect at home has allowed us to both expand our careers, as well sharing all the fun household duties.
Morgan: So those are both really excellent points. Do you have any mentors or have you had any mentors along the way who have helped guide you early in your career or even have a mentor today that continues to encourage you? And sometimes those can be very formal mentors that you're regularly meeting with and sometimes they're more informal with just people that you pass along the course of your career who have encouraged you to take those extra steps. Any particular points on that?
Ashley Johnson: Yeah, I think it's very important to have other women leaders that we can rely on and advise us along the way.
I think some of the conversations I've had with some of the women mentors that I was very fortunate to work with in my consulting roles have been around once I did have small children and was trying to work a big job and bouncing ideas off them of how in the world did you have any work-life balance and how were you managing your career and your home life and all the other things that come along with being a mom.
So I think they have been very helpful along the way and have encouraged me and advised me at any tough points or tough spots. And also in thinking about current work roles and what I want to do with my career. They've all been very helpful in getting me to the next level and also not just from the professional side, but I was just in a meeting two weeks ago with one of my female mentors that led the consulting group I worked in that was plugging me into some interesting charitable organizations where I can give back. And it's always helpful to have those non-biased sounding board folks to connect you with the right place.
It doesn't have to be your direct boss. But one of the quotes that I will never forget was from the CEO of the first hospital system that I worked for, I met him for the first time and was interviewing for my first hospital administration job. He knew nothing about me, I knew nothing about him and I was definitely terrified to move to Arizona, build a hospital when I'd probably never picked up a hammer in my life and his quote to me was " You're going to be fine. Go make a ton of mistakes and just make sure that you learn from them every time you make a mistake." So that quote from him has definitely stuck with me along the way, because we're all gonna make mistakes, but it's okay.
And I love working in organizations where everybody understands that and we just pick up, move on, learn from it and go onto the next item.
Morgan: That's so true. You had mentioned to me that you were expecting your second child when you were hired to join and that obviously says a lot about the experience and skillsets that you bring to the table, but it also says a lot about the organization investing in a woman's career as she is about to take several months of leave and be with her family. Can you speak more to that particular experience?
Ashley Johnson: Yes, certainly. So my current CEO had never worked with me before. I did have some mutual connections when I joined, but I came to interview for the first time as we were looking to relocate back to the Nashville area.
And I can definitely say I was scared to interview. I had never been into a big interview, six months pregnant, and I'd already tried my best to convince my husband that there was no way anybody would hire me until after the baby was born because that was just weird. Meanwhile, they were so inviting and so excited.
There were definitely plenty of questions about my long-term work goals. And I was actually talking to my CEO yesterday about it and telling him I was going to give him a shoutout on here for giving me a chance. And he mentioned that even though it was an all-male leadership team at that point, he was very much focused on what people can contribute for the entire future of the company. And if I could only come to work for a few months and had to take a couple months off, then that was just a short period of time. And the overall long period of time that I hopefully will be working at QualDerm. But I definitely think it solidified my alignment with the team, the values of the company and the leadership definitely encouraged me along the way to make sure I'm doing my best to achieve the company's goals because that was very kind of them to take a chance on the 6-month pregnant girl.
Morgan: Switching gears a bit, I do want to focus more on QualDerm, and just would love to learn more about the company and how you and your particular role have responded to the pandemic. Obviously for healthcare, COVID has certainly impacted the industry more than a lot of other industries, but how has COVID and the remote working environment changed the way that you get deals done.
Ashley Johnson: The pandemic was definitely a learning experience that we hope we never have to revisit again. From a deal perspective, all was on hold for about a three- or four-month period while we were really focused on our core businesses and putting those back together for long-term success and our future partners, we're also doing the same.
So while we were on a pause, they were also going through the pandemic in their individual practices. So they were trying to figure it out along the way as well. And then towards the end of the summer of last year, we, once we were able to pull ourselves together and started coming out of the COVID downturn, we were able to move on deals that we had in the pipeline that were pre-COVID.
And we had a few new ones that had joined along the way of COVID that we'd been reaching out to and we're actually able to close 10 deals. Ten total deals in 2020, which was the most of any other dermatology company in the industry, which we were very excited about. And then during COVID to stay in touch while we were all on a pause, we really shifted our gears.
How do we help our potential partners and how do we be helpful to them? As a practice management company, we are doing all of those things for our practices, whether it involved COVID recommendations, signage, examples for offices that we were using, templates, reviewing unemployment planning for staff that was going to need to be furloughed or terminated or whatever needed to happen from a staffing and expense perspective. We were sharing that with all of our target practices and target physicians. And that has certainly served us well, post- COVID as far as staying in touch and they could see the helpful and useful attitude that we have as a management team.
And then starting in August of last year, we really began traveling and meeting with prospective partners as soon as everyone was comfortable. I definitely feel like the process of selling your practice partnering with QualDerm is a very personal matter, and it deserves an onsite presence where you can actually build a relationship better than a Zoom phone call.
We did delay some of our integration aspects that are related to it, where we've got to have a lot of different folks from our team on-site. But we moved forward with deals while minimizing travel and exposure for our teams. But for the most part, I'd say from the business development side, we were back to normal starting about August of last year.
The one thing that we did learn from the Zoom world. We have had a lot of success with connecting our physician partners to new potential partners via Zoom. It's hard to get them in touch in the first place, but I do think the Zoom connection between them able to meet each other and learn more about QualDerm from other peers has been something that will stick with us.
And it's been more convenient and also more personable for them to begin building relationships.
Morgan: Yeah. I think the face-to-face interaction and the relationships are so important for both parties, right? As, as QualDerm you're looking at potentially partnering with a practice and vice versa, right? If I'm in a position and I'm looking to potentially sell my practice or partner with you, the way that you work together is so important and there's that doesn't come across, I feel like in a Zoom. You go to dinner with someone and you visit with someone over the course of a couple of days, you're going to get that feeling more than you could over Zoom. And so I'm just curious if you think that some of the things that happened over the course of the last year if those will impact the way that the deals get done moving forward.
Ashley Johnson: Yeah. I would say from a deal process, I really don't anticipate many changes. I do think the partnership process is a very personal experience.
These are physicians that have managed their own practice sometimes with spouses and family members alongside them for 30-plus years. It's a big decision for them. And I do think that we will be back to our pre-COVID normal of having lots more in-person connections ensuring smooth transitions both for the physicians and for the staff.
Even all the way down to benefits presentations that used to be in person and have switched to Zoom. We've had lots more issues with benefits transition because people just aren't listening on the Zoom calls and when you're in person and taking notes and have live people in front of you, you tend to pay more attention and get the answers that you need to make any transition a little bit smoother.
Morgan: What are the next 18 to 24 months look like for QualDerm? And you mentioned you all closed more deals last year then than anyone else in the dermatology space. And what do you find that's really driving that deal activity over the next few months.
Ashley Johnson: So we're certainly on the growth track of adding new practices, both within existing states that we're in and we're looking in potential new states that we would be interested in having a presence in as well.
There's definitely a lot of physician leaders that have learned going through COVID that it would be much easier if you had a large group practice and the management expertise to guide you along the way. So that has been very useful to us at the beginning of this year in helping us generate new discussions.
There are a few out there that are still trying to get back together. No dermatology practices back to totally normal yet. So there are those that are still working on themselves before they start moving forward with a company like ours. But I think COVID has certainly given us some power behind the need to be together and get through any situations that come up.
Hopefully not like COVID again.
Morgan: I think after that we can all handle most curveballs coming our way, but anything else that you would want to add for our audience?
Ashley Johnson: I just wanted to thank you, Morgan, for inviting me to participate. And definitely happy to share my contact information with any other women in business, women in healthcare.
Anyone that is interested in connecting more than happy to do that. I'd love to carry it forward. I've had so many people help me along the way to get where I want to be. And appreciate anybody's interest and happy to help anybody else in that way.
Morgan: Appreciate your willingness to do that and to join me in today's conversation and look forward to future Women in Healthcare podcast conversations. Sounds great. Thanks, Morgan.