Episode Transcript
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Daniel Williams (00:02):
Well, hi,
everyone. I'm Daniel Williams,
senior editor at MGMA, host ofthe MGMA Podcast Network. Today,
we are spotlighting our mostprestigious MGMA award, and that
is our MGMA Lifetime AchievementAward. And it is such an honor
to share with you who ourLifetime Achievement Award
(00:25):
winner is. If you've been partof MGMA, you may have heard this
name before because our ourguest today and our Lifetime
Achievement Award winner is DaveGanz.
Now, Dave is a retired seniorfellow of industry affairs with
MGMA. He's also a member of theboard of directors for the
Accreditation Association forAmbulatory Health Care. And for
(00:49):
decades, Dave has been one ofthose most trusted voices in
medical practice management.We're going to get into that
story on Dave about hismentorship, his role at MGMA,
and all kinds of other things. Idon't wanna give it all away
right now.
Dave, welcome to the show.
David N. Gans (01:08):
Thank you so
much, Daniel.
You I'm just pleased and sohonored to be here.
Daniel Williams (01:13):
Well, it is an
honor for me to get to interview
you here. You have also been anMGMA podcast host over the
years. You focused onexecutives, And that is just one
inkling of things that you'vedone related to MGMA. So let's
talk first. We're going to coveras much ground as we can today.
(01:36):
As you and I were joking, weprobably could have done about
an eight hour podcast or apodcast series talking about
your history here. This is onlypart one. This is part one of
the series. So let's talk aboutthat achievement award first.
What have you been floating?
What has it been like since youlearned that you had been
(01:57):
honored with this?
David N. Gans (01:58):
I'm overwhelmed.
Yeah. Literally. I had a wake up
call a week ago Tuesday toinform me of the award. I was
unaware of anything prior.
I've admired healthcare leaderswho were the previous
recipients, and I never imaginedthat one day I would be among
them. And now I'll be includedin the company. It's humbling
(02:21):
and it's meaningful. Especiallyhonored to receive the award as
an MGMA staff member because Iknow their previous recipients,
and they were distinguishedpractice executives, healthcare
leaders, physicians, and I'mjust so pleased to be among
their company. I want to thankMGMA, its board of directors,
(02:44):
and the membership for therecognition.
I am, again, overwhelmed andjoyful that my contribution has
been recognized, and I want tocontinue to help the association
any way I can. Now, my onlysadness is that my wife, Joan,
excuse me. Yeah. It's not hereto share the moment. We were
(03:10):
married forty nine years whenshe passed away four years ago.
She was my greatest supporter.And I know she would have been
so proud to see if she may honormy contributions.
Daniel Williams (03:25):
Absolutely.
David N. Gans (03:25):
Yeah.
Daniel Williams (03:27):
Well, thank you
so much. I know you and I have
talked about your wife beforeand yeah. Anything, this is a
very human experience here to bepart of that. And so yeah.
David N. Gans (03:37):
Well, I'd be
Daniel Williams (03:39):
tearing up on
the stage. Exactly. Yep.
Exactly. Thank you so much foryour vulnerability and your
humanity here.
Thank you. Really appreciatethat. So, Dave, at MGMA, you are
considered an institution here.And on a personal note, I
interviewed with MGMA sevenyears ago. And when I was
(04:02):
preparing for my interview to behired at MGMA, I went out and
started doing research.
And one of the things that Ilanded on was in a podcast
interview you had done where youwere providing the history of
MGMA. You were going back, Ibelieve you can correct me on
(04:22):
this because you are the MGMAhistorian, I think all the way
back to 1926. Is that correct?That is correct. Tell us about
that.
How in the world did you becomesort of this MGMA historian?
Well, first you
David N. Gans (04:35):
know, well, I
gotta start. MGMA was founded in
1926.
Daniel Williams (04:39):
Okay.
David N. Gans (04:40):
22 managers got
together in Madison, Wisconsin,
and they had such an enjoyabletime. They learned a lot. They
met people who had likeexperiences. They decided they
needed to do the same thing nextyear, and they did. Yeah.
And the year after that. Andthat eventually became the
(05:02):
Medical Group ManagementAssociation. So the twenty
twenty five LeadershipConference is the organization's
ninety ninth year. Well, I cameto MGMA in 1979 as a graduate
student intern. So I've been awitness to MGMA's history for
half of its history.
And I've had the opportunity topersonally know many of the
(05:26):
founding members and also, youknow, the leaders who made the
organization what it is today.So this was the opportunity, you
know, I've been part of itshistory. Yeah. And I, you know,
I like to say I know the highpoints and maybe some points
where we have had to struggleand we've overcome those
challenges. I also know wherethose few bones are buried.
(05:52):
The skeletons in the closet thatsays, okay, well, some things
are best forgotten.
Daniel Williams (05:58):
That's right.
David N. Gans (05:58):
All right, but we
need to celebrate what we do
have. Yeah. And we have a greathistory in the organization.
Daniel Williams (06:04):
Yeah. Well, I
don't think the history of MGMA
can be written without a coupleof chapters. Dave Ganza's name
owned those chapters. So let'stalk about that. When did you
first hear about MGMA?
You said you came in as astudent intern. What was that
introduction to MGMA?
David N. Gans (06:23):
Well, my
connection to MGMA came almost
by chance.
Daniel Williams (06:27):
Okay.
David N. Gans (06:28):
Alright? My first
career was I was in the United
States Army in the MedicalService Corps, and I had ten
years of active duty. And I wasat the time stationed at
Fitzsimmons Medical Center inAurora, Colorado. And I had
looked at my long term plans. Mywife and I talked about what we
wanted to be as as our for ourcareer and our family.
(06:51):
And we thought, well, you know,this was time for me to go back
to school. So I appliedUniversity of Colorado to the
graduate program in healthadministration, and I was
accepted. So I left active duty,remained in the army reserves.
So I had a parallel career forthirty one years in the
military, retiring in December2000 as a colonel in the Medical
(07:17):
Service Corps, Army Reserve, andhaving had just a parallel
career, but also one that gaveme great perspective into care
delivery and managing physiciansand clinicians and how they can
best deliver patient highquality patient care. Now but my
military experience said, youknow, I've really worked in a
(07:39):
group practice.
So I said, you know, I sharethis interest with the program
director because there's theprogram had a requirement. It
was a much more traditionalprogram than what you see in
today's education, you know,that where we did a three month
summer internship and two ninemonth, you know, half, you know,
(07:59):
years of class. Right. And butdoctor Lee Kaiser, the program
director, encouraged me tocontact MGMA. Says, you know,
there's a small organizationlocated on South Colorado
Boulevard that may be ofinterest.
Well, it was. I'll say. And I'mdeeply grateful to doctor Mary
(08:19):
Alice Krill, who is the directorof research at the time, and Al
Princke, is actually the personwho hired me. And I was an
intern in June 1979. Followingthat summer, I continued as a
full time student.
I worked part time at MGMA. Iattended my first MGMA Annual
(08:39):
Conference in 1979 in SanFrancisco at my expense. Wow. I
went to well, I ended up workingfor staff because I was on the
staff, but I was there to getthe experience as a student on
what is this organization andwhat is group practice. And that
convinced me on group practiceas a career choice.
(09:02):
March 1980, there was a jobopportunity in the MGMA Center
for Research to manage a grantfrom the W. K. Kellogg
Foundation that was to develop afinancial management handbook
for medical groups who are goingto be involved in capitation
(09:24):
contracts, because capitationand the whole concept of prepaid
care was new at the time andorganizations needed to
understand what did they need todo? How can they make this care
delivery model work for theirorganization and to be
successful? So I had thatopportunity and then continued
(09:47):
to have the added responsibilityof bringing the MGMA surveys in
house and taking fullresponsibility to conduct the
MGMA surveys and the dataproducts that it developed.
Daniel Williams (10:00):
Wow. No. I
didn't realize you started on
that data side so soon in thecareer.
David N. Gans (10:06):
Day one. I
actually on my internship, I did
a I earlier in the year, the theorganization had collected data
on academic practices Right. Butdidn't know what to do with it.
So one of my responsibilitieswas to take completed surveys
Okay. Questions in paper andanalyze them.
(10:30):
Well, I key entered the dataMhmm. Into key punch cards and
the tech the state of the arttechnology. Right. Analyzed the
information, wrote the report,and people thought, well, if he
could do that, he could do hecould do the other surveys.
Right.
And do them well. Well, that washow I started.
Daniel Williams (10:51):
That is
incredible. So in the military,
did you have a background in anykind of data analysis, or is it
just a happy convergence herethat got you there?
David N. Gans (11:01):
Well, actually, I
had a financial background.
Okay. I was I was trained as alogistics officer, but at one
time, my responsibility includedmanaging the military. The term
is called a stock fund, which atthe time was a 10,000,000 fund
Daniel Williams (11:19):
Okay.
David N. Gans (11:19):
To account for
the expenditures at the
Fitzsimons Medical Center andall the equipment and supplies
that were used. So I had a abackground that dealt with
finance and financing andmanaging fine and managing large
budgets, which contributed toyou know, of course, a lot of
(11:41):
the work most of that at thetime was done literally on a
Frieden calculator Mhmm.Mechanical because this predated
Daniel Williams (11:51):
Right.
David N. Gans (11:51):
You know,
computer systems that were used
other than in the mainframeenvironment. So this was this
was a different world at thetime. Wow.
Daniel Williams (12:01):
You have seen
so much change in technology in
healthcare over the course ofyour career, but I wanna go back
to that data analysis, thebenchmarking. When I started
back in 2018, so that just kindof dates it there, you are
already known as the go to guyin data analysis, benchmarking.
(12:22):
You'd already written a book onbenchmarking. Talk about that,
how you not only took it from,as you said, from day one, but
then continued to evolve MGMA'srole really in health care and
practice management as far asbeing a company that's known for
its data.
David N. Gans (12:41):
Right. Well, I
had the responsibility the first
few years literally by myself toWell, manage the it was a it was
a smaller environment. Okay. Andfewer and fewer data products at
the time. I had the opportunityto hire our first full time
employee, one, to deal withsurveys, and then we expanded
into a department.
(13:03):
And as my career evolved withMGMA, my jobs changed. I was the
first director for what we nowcall the Data Solutions Group.
And so I was responsible at thetime we'd created the first
compensation and productionsurvey for physicians. We, of
course, we took the managementsalary and compensation survey
(13:30):
to new levels and of courseevolved cost and revenue survey
and practices and developedsurveys for other groups as
well. We also created thelooking at how do some practices
perform better than others.
And we created a report thatlooked at the performance and
(13:52):
practices of successful groups.How do organizations gain their
success and what differentiatessome practices from others who
may be in the same environmentbut have different results? So
that was it was an evolutionover the years that that
changed. Also in a benchmarkingrole, I had the opportunity, as
(14:13):
you said, I edited I co authoreda book with Greg Feltenberger,
MGMA member.
Daniel Williams (14:18):
That's right.
David N. Gans (14:19):
And that we
looked at on benchmarking, and
the book focused onbenchmarking. Our theme that
throughout the book was gooddata yields good decisions.
Daniel Williams (14:29):
Mhmm.
David N. Gans (14:29):
You know? And
understanding how your practice
compares to its peers is thefirst step to understanding your
strengths and weaknesses. Thenyou can use under that
understanding to take your mostvaluable resource, which is your
time with the practiceadministrator's time and the
time of its physicians to getthe best results. So you can
(14:52):
most effectively improve theorganization knowing where you
stand compared to others andwhere your own organization is,
how it is changing over time,which is that whole concept of
benchmarking.
Daniel Williams (15:04):
Yeah. Share an
example then, if you practice
who is taking these benchmarkingtools and processes and seeing
success with it. I would love tohear one of these stories.
David N. Gans (15:17):
Well, we have
interviewed practices over the
years asking, what do you dodifferent? What did
Daniel Williams (15:23):
you do?
David N. Gans (15:24):
And one of my
best examples I can give, there
was an organization, it happenedto be in Salt Lake City, Utah,
that had had some crises. And sothey the other practice
administrator and had talkedwith his physicians and says, we
need we we need to look whatwhere we are and what we're
(15:47):
doing. And came to the MGMAdata, did a an a internal
assessment comparing theinformation, realized where they
had problems Mhmm. And thenutilized some of the reports
we'd created, the successstories, which we still do.
Daniel Williams (16:02):
That's
David N. Gans (16:03):
right. You know,
saying, you know, what what
contributes to success? So theywent they read the success
stories. They did it as a group,you know, with the the
administrator and had a team ofsome of his staff, but also some
of the nursing clinicians andcouple of the providers to say,
what how can what can we learnfrom this? Yeah.
And they modeled changes intheir organization. And they
(16:27):
said, in a year's time, we madeprogress. In two years' time, we
were among the best. So it was agreat example of using
information from otherorganizations and taking that
information, applying it intheir practice, and getting the
results that they had hoped.Wow.
Daniel Williams (16:45):
All right.
We've talked a lot about the
data side, the benchmarkingside, but one of the things that
strikes me about you and fromthe very first time I ever met
you is how compassionate you arefor other people, how giving of
your time. So when I started, Ikeep using me as a reference
because I wanna make thispersonal as well of what kind of
(17:08):
person you are. I started in May2018, and I asked my boss, Andy
Swanson, at the time. I said,what should I do?
And he said, go shadow somepeople at MGMA. Go downstairs
and shadow Dave Ganz for alittle while. We had set up an
appointment, went down to yourworkspace down there on the
(17:31):
First Floor, and you were, youmay or may not remember this,
but you were preparing for apresentation. You were a co
presenter, and you were walkingthe person step by step very
patiently. You were fieldingquestions from them.
I don't know who you presentedwith in 2018. But There were
(17:52):
many. There were many. So inthis particular case, y'all were
going through a slideshow, aPowerPoint. Yep.
And you were just so patientwith your time, and you were the
same way with me. I had athousand questions, for you, and
you were ready to answer athousand and one. What is it
about you that has thatmentoring capacity where you
(18:12):
really do like to be with peopleand mentor them?
David N. Gans (18:15):
Well, thank you.
Well, being honest, helping
others and witnessing theirsuccess has been one of the most
rewarding aspects of the career.You know, knowing that that I've
been able to influence and helppeople solve their issues and
solve their problems and makebetter decisions is a tremendous
(18:37):
reward. I've never consideredmyself too busy to help someone
even though it meant extendingmy workday.
Daniel Williams (18:45):
Yeah. Yeah.
David N. Gans (18:45):
I remember
conversations with our HR vice
president about the workday atthe association. I said, well, I
could probably cut back to fortyfive to fifty hours. You know?
Yeah. He says, well, you know,sometimes you you you do what
you what what needs to be donefor the organization.
(19:06):
Over the years, many of thepeople I've supported have re
have returned the favor. Theyreinforced to me that how MGMA
is a collaborative andreciprocal organization. You
know, what what you give comesback to you. And I've always
felt the time and energy Iinvested helping others brought
(19:30):
far better far greater rewardsto me than I could have achieved
otherwise.
Daniel Williams (19:34):
Yeah. You and I
drove over here together to the
studio here at Brand Viva. Wewere over at MGMA and we were
chatting because we had bothbeen on the road a little bit.
You were in Chicago. I was inDallas.
We were just crisscrossing atother organizations where we
were speaking and interactingwith people. What has that role
(19:57):
been like to be on boards, to bea public speaker, to hear the
voices of other people? Talkabout what that's been like for
you in your career and to beable to learn from others and to
help others.
David N. Gans (20:09):
That external
perspective is critical, you
know, because we don't work inisolation, you know, that we
don't live in isolation. We livein this broader environment, and
you need to get exposure to whatother peep others are doing.
Also, you need to understand theissues that they may have.
(20:30):
Travel does that. And theopportunity to be at meetings
with other people to share theirinterpretation of what the
speakers may be saying is animportant element of learning as
well because you gain from theirperspective.
This is the value ofcollaboration and the value of
(20:53):
getting other others insightsinto what they see and how they
how they planned to respond inthe future. So I gained from
that.
Daniel Williams (21:02):
Yeah.
David N. Gans (21:03):
And you do that
by being outside of your normal
comfort zone.
Daniel Williams (21:09):
Let's see.
We've got time for a couple more
questions. And as you and I werejoking again, that we could
spend about eight hours justdoing part one. So I'm gonna be
very choosy with what I ask youabout. So let's think about
those practice administratorswho are listening now.
(21:29):
And I want you to just thinkback and think about what advice
you would give them, becausethere's so many decisions to
make. And even though technologymakes things easier, it also
kind of speeds things up and canmake them more complex as well.
So what is some advice you woulddispense to those practice
leaders and things you wouldwanna share with them?
David N. Gans (21:52):
Number one,
healthcare is changing. That is
not a surprise. No. And it'schanging faster than ever.
Daniel Williams (22:00):
Right.
David N. Gans (22:01):
Okay. New
technologies, innovative
applications are solving oldproblems. Oh, and they're
creating new ones too. That'strue. You know, practice
leaders, they need to be awareof what is happening in our
industry, how outsideorganizations are responding to
current issues.
Now, one of the key elements ofbenchmarking is learning from
(22:25):
out of industry organizations.In other words, how do they
solve problems? And then you canapply their solutions to our
environment in healthcare andpractice management. Health
health care in general and grouppractice specifically is in a
(22:45):
critical time. Increased costs.
We know we know that. We havestaff shortages. Okay. We have
lower payments. This is acrisis. We cannot solve
tomorrow's problems with today'sresponse or yesterday's response
especially. So we have to lookwhat how do we innovate? Okay.
(23:08):
Technologies like AI have thepotential to reduce costs,
improve patient service, andenhance outcomes only if we
apply them in the appropriateway.
How do we do that? We don't havean easy answer, but this is this
is what we have to think about.How do we apply new
(23:29):
technologies, new concepts tosolve our current issues, and
we'll get new ones, which keepsour business, you know, you
know, you know, keeps keeps usvery active and say Right. What
are we gonna do? We you know, wehave to solve new problems.
Amid the changes, we don't wantto lose sight of the core
(23:50):
purpose. Why are we here? Why dogroup practices come to work?
Why do our physicians and ourclinicians, why are they in the
office? They're to provide highquality care and focus on the
needs of the patient.
So you cannot get lost for theso called losing the sight of
(24:16):
the forest because we're in themidst of the trees and in the
underbrush. Yeah. Practiceadministrators had the critical
role of managing systems in theorganization. Okay. They need to
manage the systems to optimizepatient care.
Okay? Allow the practiceproviders to focus their
attention on the patient. Thatis something we don't want to
(24:36):
forget. We want to focus on howcan we provide the best quality
of care to our patients? How canwe provide a safe working
environment for our staff?
And how to reward our providersfor the work that they're doing.
It's not an easy task, butthat's our role.
Daniel Williams (24:57):
Love that. I
love that. Alright. The last
question, and this is a fun one.One of the interesting things
about you, we were talking aboutthis on our ride over, is that
you stay mentally active.
You were in a board meeting inChicago just a couple of days
ago, but you also loveadventures. And every time I
bump into you, you're aboutyou're either planning, another
(25:21):
adventure or you're just backfrom another adventure. So you
have something coming up. That'swhy we moved up this interview.
What's going on?
David N. Gans (25:29):
Well well, today
is Tuesday.
Daniel Williams (25:31):
That's right.
David N. Gans (25:31):
Alright. In two
days, I am on a flight to
Copenhagen. Right. And I amabout ready to leave with
friends and on a fourteen daybike ride. Wow.
We're gonna we're gonna ridefrom Copenhagen to Oslo, Norway.
Daniel Williams (25:48):
Right.
David N. Gans (25:48):
And I've always
felt that the best way to
experience a country is from theperspective of a bicycle seat.
The pace is appropriate. Mhmm.You know, your eye when you're
traveling in car at 70 miles anhour, you don't, you don't, you
see the white, you see theasphalt ahead of you. Yeah.
(26:10):
Right. And the cars around you.
Daniel Williams (26:11):
Yeah.
David N. Gans (26:12):
But you're not
looking at anything else. Mhmm.
Because you have to be safe.Yeah. On a bicycle, it's a
slower pace.
Right. And if you wanna stop andsmell the roses, the roses are
right there. Yeah. It's an easystop. So this will be my twenty
seventh bike trip in Europe.
(26:34):
I've cycled throughout Italy andSpain and Portugal, Greece and
France. Mhmm. And this will bemy first time in Scandinavia.
Daniel Williams (26:45):
Okay.
David N. Gans (26:45):
So I'm looking
forward to the trip. My most
recent trip was in June. I had awonderful vacation in Champagne
and Burgundy provinces ofFrance. It was wonderful
cycling. We had good weather.
Know, cycling through ruralroads and vineyards cannot be
(27:06):
beat.
Daniel Williams (27:06):
Yeah.
David N. Gans (27:07):
Great scenery,
good food, fine wine. It was a
wonderful vacation. I'm lookingforward to doing it again.
Daniel Williams (27:13):
I have to
follow-up. On a fourteen day
bike ride, do you pedal up to ahotel or an Airbnb, or do you
sleep under the stars? Whatdo you do?
David N. Gans (27:23):
This is
civilized. That this is with a
bike tour group called the nameof the group is called
Experience Plus. They've been inthe business for fifty years.
Daniel Williams (27:33):
Okay.
David N. Gans (27:34):
And they are well
familiar with with what the
American tourists wants. So westay in good hotels. Nice. We
have fine meals. K?
We have full support of of ofour guides and a van and a van
to help with your luggage. Sure.And should you find that last
hill too much or if it's rainingtoo hard, you can always get in
(27:57):
the van and go to the nextplace.
Daniel Williams (27:59):
Oh, that's
wonderful.
David N. Gans (28:00):
And each night,
you know, you're gonna have
people take help take care ofyou.
Daniel Williams (28:04):
Yeah. That is
wonderful. Well, you've been
taking care of us and the MGMAfamily for forty three years.
Where are we in the Well, years
David N. Gans (28:14):
I actually had,
well, I retired from MGMA in
2022. Okay. Alright? So I havebasically forty two years of
employment, one year of being anintern. Right.
And I've now been retired forfour years.
Daniel Williams (28:36):
Okay.
David N. Gans (28:36):
Well, I still
continue to work for MGMA in the
context. I still provide mycolumn that I do the data mine
to the MGMA connection. I'vebeen able to serve in other ways
for the association. So I lookat, know, I no longer work cause
I'm not getting paid. Thatdoesn't mean I'm still not
(28:58):
assisting the organizationfulfill its goals.
Yeah. And I look forward tocontinuing to do so.
Daniel Williams (29:06):
Yeah. Well,
Dave, we are grateful for you
and grateful for all the workand just the joy you've brought
to MGMA and its members. Sothank you so much.
David N. Gans (29:15):
Thank you. This
Dan, this has been a a most
enjoyable experience Yeah. And agood interview. And I wanna
thank MGMA, its its board ofdirectors, and the membership
for the recognition. I am,again, overwhelmed and joyful to
be that my contribution has beenrecognized, and I want to
(29:39):
continue to help the associationany way I can.
Daniel Williams (29:42):
Well, thank you
for that. So everyone, Dave Ganz
is our 2025 Lifetime AchievementAward winner. He will be
recognized during the generalsession at the twenty twenty
five MGMA Leaders Conference inOrlando. That is going to be
Monday, September 29 from 09:30to 11AM. That's eastern time.
(30:06):
That's where Orlando is in thateastern time zone. So we look
forward to celebrating hisremarkable contributions to the
field of medical practicemanagement there. So if you want
to learn more, if you want toattend, go to mgma.com/leaders
where you can learn more, whereyou can register. And Dave and I
(30:28):
look forward to seeing you therein Orlando. So until then, thank
you so much for being MGMApodcast listeners.