This week’s spotlight features Jim Aguilar, an entrepreneur who is founder and CEO of Periscope (formerly DME Consulting Group). I have worked with Jim and his team numerous times, helping them hire licensed therapists into consulting roles. I am so excited to share Jim’s story of going from treating physical therapist to where he is today!
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What is your full name and title at your current job?
Jim Aguilar, PT, MBA
Founder and CEO at Periscope (formerly known as DME-CG).
Where are you located?
Los Angeles, CA
Where did you go to PT school, and what year did you graduate?
SUNY Buffalo, 1992; Pepperdine Graziadio School of Business MBA 2007.
What did you do when you first finished school, and for how long?
Registry for 9 months (3 assignments). Acute rehab, pulmonary rehab, spinal cord injuries, and orthopedics.
What did you do after that, and for how long?
Director of Outpatient Orthopedics in North Bay Area California. The focus was on workers comp, sports injuries and post operative ortho, and neurorehabilitation.
With the Stark law, the opportunity presented itself to own the clinic, with a catch…the previous physician owners had signed a lease on another clinic, which had not opened.
To a more seasoned person, this was a conundrum. To me, I thought, if less is more, think how much more more will be! Ignorance truly is bliss!
This set my career on a completely different path. The shift from being paid to paying people, changes your thought architecture forever. In other words, you get paid LAST!
They say people only move under two circumstances, inspiration and desperation. I was initially inspired, but quickly became desperate to figure things out.
My business partner and I assumed the physicians might not continue to refer, which is what the Stark law was all about, usury.
Thankfully we planned accordingly. We developed relationship with all medical professionals and health plans to develop treatment algorithms. The goal was to get paid appropriately and reduce our back office costs. This worked incredibly well.
We expanded to 13 practices over the next 4 years and sold in late 2008.
What did you enjoy about your early roles? What didn’t you enjoy?
Liked: I was thrust into an unplanned immersion program for the entire health system. Working hand-in-hand with fellow practicing physicians, surgeons, psychiatry, psychology, anesthesiology, chiropractic, pain management specialists, and health plan leaders was exhilarating and exhausting. Our group was the only group in the country doing what we were doing as a private company. AMAZING!
Disliked: The reimbursement system. The system largely treats clinicians like criminals. “Give us more for less every year, year over year!” Also, the idea of a “customary and reasonable” fee schedule which they will pay you a percentage for your efforts, eventually, after you spend another 10% of that rebilling…Preposterous!
At what point did you realize you wanted to do something non-clinical?
About two years before we sold.
What are you doing these days?
There were two amazing opportunities after the sale:
First, we created a Healthcare Registry, “Registry 911” for Allied Healthcare Professionals.
This is a cautionary tale of too much success at the wrong time. The business took off, outpacing our available cash. This is normally a wonderful thing and banks usually will fund receivables. Unfortunately, this was right after the dot com crash. So we literally crushed under the weight of our success.
Secondly, a physician friend-turned Chief Medical Officer at a health plan asked if I could help him solve a challenge he had: “How do I make accurate decisions regarding requested medical equipment, when the people sending me the requests are the people who benefit from the provision of the equipment?”
It was all about his desire to be fair and objective. He felt the process at the time was the metaphorical wolf in charge of the hen house.
My take has always been and remains, people will always act in alignment with their incentives. Simple. So, he and I discussed the process and the issues and I developed a program for him.
Without my knowledge, he spread the news to other plan CMO’s who echoed the same problem. His message was, “We don’t have that issue anymore, we have “Jim.”
When I decided to earn my MBA, the project became my strategic entity, which morphed into DME Consulting Group (which has since been rebranded to Periscope).
During a stats and quant class, our professor—who is now our Chief Analytics Officer—made a comment to a class of people who didn’t want to be there that changed my life!
Here’s what. he said: “I know this may seem boring, but just remember, Without data, everyone is an expert!”
That hit me hard! I knew I was an expert, but had no data!
I stopped listening and went on a nearly 36-hour, Jerry Maguire moment, and I laid out our software platform (the needs, not the coding).
How has Periscope grown over the years?
We continued to grow in Northern California health plan by health plan.
- In 2008, we expanded into Southern California.
- By 2010 we expanded to 4 states.
- Now, we’ve just completed a brand and name change (from DME Consulting Group to Periscope)
We serve more than 100 plans nationally, covering more than 23 million lives—and we’re approaching 100k completed assessments in all 50 states.
The clinical team is composed of field consultants and senior reviewers. Right now we’ve surpassed 300 clinical consultants, an IT team of 7, and executive team, and more.
Are you still treating patients, or are you solely non-clinical?
I’ve been solely non-clinical since 2017, but the reduction started in 2010.
How long have you run Periscope?
What types of products or services does Periscope offer?
At the highest level, we provide clients the information they need to make critical healthcare-related decisions for medically vulnerable individuals. But, like most things, the devil is in the details. The how, is the fun/hard/challenging part.
How have people reacted to you leaving patient care?
Unsurprised. While I loved treating patients, my desire to have a greater impact was something I discussed with colleagues regularly. Personally I thought seeing 10+ patients per day was great.
However, creating a company that augments the skill set/thought process of hundreds of therapists who see 10+ people per day…now that’s exciting!
What’s a typical day or week in the life like for you at Periscope?
For the most part, daily and weekly meetings with our executive leadership team to monitor overall business health, identify areas of opportunity, and develop strategies to take advantage of our strengths and market opportunities.
I have two primary passions:
- Developing/coaching people
- Meaningful tech creation. I love the idea of creating systems people feel like they “get to use” not “have to use”
Working closely with our IT specialists to develop a user interface and user experience that our staff and clients appreciate and are excited about excites me. Reduce the redundancies and nonsense so we can focus on being GREAT at what we do!
What are some of the challenges of your role? What are the rewards?
Letting go! It’s the entrepreneur’s dilemma. Can you let go of your baby? Thankfully, I learned this lesson in my earlier life.
The delusion that you need your thumb print on everything is a killer.
The key is simple, hire great people and work with them. Provide the resources financial and emotional resources and get to work. Create an environment where they feel valued, that their efforts make a difference, and they are part of a winning organization. It’s been amazing!
What type of person do you think would do well in entrepreneurship?
- Must be comfortable with risk
- Must prioritize getting it right over being right
- Must have a fail-fast rule: the quicker you acknowledge a mistake the quicker you get to solutions
- Must empower people
- Must enjoy intellectual challenge
- Must want to create opportunities for others to grow/develop/succeed
Do you work remotely or on-site?
The company has been remote and paperless since 1998.
Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?
Fact is, followers of The Non-Clinical PT have been an incredible resource, as they tend to “just get it.”
We’ve hired for consulting, part-time, and full-time roles in nearly all the allied health professions (PT/OT/SLP/ CPO/RN). These roles consist of:
- Field consultants: they go to individual residences to collect data and submit to our senior reviewers.
- Senior reviewers: once field consultants demonstrate a high level of competence and writing prowess, they are offered the ability to train to become senior reviewers. This inner sanctum works as a closely knit team to review and curate each and every assessment we perform, train our field consultants, and provide additional support to the clients.
- National, regional, and state roles: these are reserved for our very top reviewers. They focus on performance excellence for the entire clinical staff, state and federal regulations/changes, and training.
Hilary Gans is our Regional Clinical Director, and she’s an OT!
Did you read any books, take any courses, or do anything special overall to get you where you are today?
Clinical practice, taking risks, business ownership, and an MBA.
What is a typical career path for someone in your role?
The typical path is atypical.
What is next for you? What do you want to do with the business long term?
As it relates to this business, continue to develop solutions that matter to our clients, a company culture people are proud to be part of, and continue my hallucination: with a clear vision, an incredibly dynamic and focused team, and coordinated effort, we can make a dent in the healthcare space.
What would you recommend to someone who is considering going into a role like yours?
Take the time to understand how things work, find an area of need aligned with your passions, continue to learn, and go for it! When it doesn’t work the way you anticipated, pivot and keep going.
What would you like to change most in your profession, and why? How would you propose doing so?
This has been an incredible journey! I wouldn’t change a thing.
No, wait…the dot com bubble…I’d have changed that 😉
If you could give yourself one piece of career advice you wish you had during your PT program, what would it be?
Nothing. Had I been privy to more information than I had at the time, it would have altered my course. Maybe by pushing things prematurely or not pushing for certain changing or taking certain risks.
If you could teach anything to today’s graduate students in your profession, what would it be?
The standard career path is a product of aversion to risk. There is plenty of room for those looking for security and benefits.
There is also an untapped world of possibilities. If you ever feel like the profession is limited, just know that you’ve developed your own set of rules, consciously or otherwise, which is the real limiter.
Do you have any special advice for others who want to follow in your footsteps?
With healthcare business experience and an MBA, working on the business side of healthcare is a rich journey.
Curious how your own skills can translate into the non-clinical world? Feeling overwhelmed by all the options? Explore your options in an organized and strategic way with Non-Clinical 101: the comprehensive, fun, and inspiring course everyone is talking about!