Emergency Medicine Physicians drives a companywide vision for improved patient care

Dr. Dominic J. Bagnoli Jr., founder and CEO, Emergency Medicine Physicians Ltd.

Dr. Dominic Bagnoli Jr. has more customers in his waiting rooms than ever, and that’s the problem.

As health care costs rise and unemployment remains high, people nationwide are waiting longer to seek medical care when they think that they have a health issue. The result is that emergency departments staffed by companies like Emergency Medicine Physicians Ltd. are filled with patients.

“Not every patient needs to be in the emergency department,” says Bagnoli, the founder and CEO of the privately owned medicine group, which has hospital partners across the country. “So the question is, ‘How do we provide them a level of care where they get just as good of care but reduce the cost?’”

While there is no question that national spending on health care is not on a sustainable track, Bagnoli says that the healthcare industry has never been swift to embrace change.

“In medicine, we’re typically slow to change because we like to hide behind the art of medicine, hide behind this is the way that is has to be for patient care,” Bagnoli says. “But there are a lot of things that can change and a lot of things that need to change for the health care system to continue to evolve and improve.”

EMP has created a culture where employees and physicians don’t just buy into change, but are excited to lead the transformation. Here’s how Bagnoli inspires the company’s 1,200 employees to buy into EMP’s vision for more efficient health care.

Connect the dots

Bagnoli knows that having talented, passionate employees isn’t enough to drive change if they aren’t inspired by your company’s vision and mission. You need everyone in the organization working toward these common goals.

“It’s a team game,” Bagnoli says. “It’s like any successful team — if everyone is not on the same page, then you’re not going to win.”

That’s why he looks for ways to connect employees at all of levels of the organization to EMP’s vision for delivering patient care, not just the physicians who deal with patients every day.

“We’ve let everyone know that every person in our organization, from the person who answers the phones to the person that helps submit the bills to the person that answers the customer service calls, that what they do every day is not those little things,” Bagnoli says. “What they do is help physicians take care of patients.”

But how do you get someone in a corporate office to feel just as inspired as the person who helps care for a sick patient or helps solve a customer problem face-to-face? One way is to create a culture that feels small, even as you organization grows.

As one of the ten largest emergency medicine groups in the country, EMP has more than 1,200 employees and physician partners today, including 800 doctors and 400 non-physician associates. But Bagnoli says the company’s communication and employee education keeps everyone in the organization thinking about how they as individuals can impact the big-picture vision for improving patient care.

Dr. David Packo, president, Emergency Medicine Physicians Ltd.

President Dr. David Packo says that the company is known for its high quality, so it lets employees and doctors know whenever the organization is being recognized to keep motivation high. Its award-winning online portal for physicians also gives doctors access to everything from personal productivity statistics and patient satisfaction scores to expense accounts and educational materials for their practice.

“We create opportunities for them to see news reports and data reports from all over the country so that they can review those and start thinking about how they can improve things as well,” Bagnoli says.

Another piece is employee development. In July, Bagnoli says the company has plans to open a new educational center in Canton that will accommodate 250 people for physician training and company meetings. It will also be equipped with the latest technology for streaming and teleconferencing.

By investing in employee growth and development, you show people that they are a valuable part of the vision. When people feel connected that way, they’ll want to take on bigger responsibilities and roles in your organization.

“Our employees like being part of a company that’s growing and learning and teaching and helping people,” Bagnoli says.

“They like the fact that they know that we see almost three million patients a year and what they’re doing here in the company office in Canton is helping a physician in Hawaii or Connecticut take care of a patient, and maybe, save a person’s life. That builds a culture and is a reason why people enjoy working here.”

Give people ownership

Unlike many of its large competitors, which are public companies, EMP is privately held by its physicians and splits its profits with them every month.

Before implementing the profit-sharing program several years ago, the company found that more employees tended to push off work to others, creating silos rather than engagement in the overall success of the organization and its vision.

“What we used to have prior to the institution of the program is employees looking out for their own,” Packo says. “When we would add business, they would look for us to add new employees because they didn’t want the work.”

When people have a financial stake in the success of their organization, they are more engaged in innovation and support changes that can make the company efficient and contribute to its vision for growth.

An example is the growth of the company’s Physician First program, which makes a physician the first point of contact for patients who register at an emergency department. When EMP launched the program at its partnering hospital in Parma, it quickly made a huge difference in improving patient outcomes and wait times. Getting the buy-in from this first group was enough to convince other physician owners who saw the positive results to try it.

“By capturing the minds of a few people who are willing to be early adopters and try a process and then spreading that process through results and publicizing those results, you get people to buy in on a large scale,” Bagnoli says.

As the company implements new programs or operational changes, connecting people to each other in ownership is also beneficial because it helps eliminate silos in operations. That’s because employees and doctors benefit from helping colleagues succeed and getting more involved.

“We ask them to do their jobs to the best of their ability, and when they do, they get rewarded for it,” Packo says.

“Now they want to take care of things themselves and do more so they can win more. So that was a huge piece of being able to grow and keeping expenses down yet growth up.”

As the company grows in size, Bagnoli says the profit sharing is even more important in motivating physicians to be leaders in the organization as the industry continues to evolve.

“We’ll be more successful than everybody else because our physicians will directly benefit from that change,” Bagnoli says.

“Passion can carry you when you’re a small organization. If you believe in what you’re doing and you can inspire other people to follow you, you can lead a small organization fairly easily. But you get to a point once you get to a certain size that if you don’t have good people around you that you trust that you allow to lead, you’re not going to make it.”

Make life easier

Bagnoli says that he’s always looking for opportunities for EMP to partner with health systems, technology companies and service companies in order to develop solutions that make providing quality patient care more efficient.

“We typically look to see if they can provide a better process for us or a better service for our patients,” Bagnoli says.

The company has been involved in two of these significant technology projects in the last three years. In both of these cases, Bagnoli says the company thought long and hard about the value for its employees and physicians who would be learning and using them.

“In general, if you give someone a piece of technology that doesn’t make their lives easier, it’s never going to get used,” Bagnoli says.

“Technology for technology’s sake isn’t always the answer. But we’ve been very careful to develop products that help people do their jobs.”

Often, employees will be worried that new technology or new processes will make their jobs more difficult with extra steps, operational disruptions or functionality issues. So if it will make their jobs easier, they’ll probably be happy to make the change if you show them why and how it will help.

“It’s people,” Packo says. “You realize a lot of companies and the ones that are successful are the ones that grow their people along and empower their people to do what they need to do. That’s been a big piece of what we do.”

Through its partnership with Stat Health Services Inc., the company recently took a huge step by developing a telemedicine program. The technology gives qualifying patients 24-7 access to certified physicians, so they can receive treatment for minor complaints and illnesses through the Internet. As an early investor in the iTriage, it’s also now incorporating technology that allows patients to use their smartphones to identify illnesses and get care information through mobile channels.

“Any way to deliver health care in a less expensive manner, but keeping the quality there is going to be a big win, whether it is by telemedicine or other venues,” Packo says.

The same goes for the new protocols such as Physician First.

“So we’ve created a new process that’s been successful and we’ve implemented it at over half of our hospitals across the country,” Bagnoli says. “It makes a huge difference in the patient experience, improves the quality of care and lowers the risk.”

Improving care delivery and the way that people interface with the health care system empowers the company’s employees and physician-owners to do their jobs better, so patients profit and the company profits. As a result, it remains one of the consistently growing companies in Northeast Ohio.

“We’ve improved the patient experience, we’ve lowered the cost of care, and we think that we’ve improved the outcomes as well,” Bagnoli says.

How to reach: Emergency Medicine Physicians Ltd., www.emp.com


1. Help people see their role in the vision.

2. Give employees a stake in growth.

3. Empower your team with new technologies.

The Bagnoli/Packo File

Dr. Dominic J. Bagnoli Jr., founder and COO
Dr. David Packo, president
Emergency Medicine Physicians Ltd.

Bagnoli  – Canton, Ohio

Packo Toledo, Ohio

Bagnoli – The Ohio State University and Wright State University Boonshoft School of Medicine

Packo University of Notre Dame undergraduate, The Ohio State University College of Medicine medical school
If you could have dinner with one person you’ve never met, who would it be and why?

Bagnoli Unfortunately, Steve Jobs has passed, so my second choice would be Bruce Springsteen because he’s the Boss.

What is your favorite part of your job?
Bagnoli – Leading a growing, dynamic business that helps people. Now as CEO, I come in and I don’t exactly know what I’m going to do each day, but I know that there is going to be 50 or 60 problems that I get involved in or projects, and at the end of the day I feel like I’ve contributed and helped the organization grow. Also it goes back to helping the physicians that are out there taking care of patients and making it easier for them to do so.”

Packo – Helping partners to better work life.

What would your friends be surprised to find out about you?

Packo – I boxed in college with some tae kwon do and wanted to cage fight but never did. I still would be interested in MMA (mixed martial arts) if I were younger or if it was around when I was younger.

What would you being doing if you weren’t in health care?

Bagnoli – I’m a college football freak. So if I could do any job I would love to be on college game day televising games on Saturdays and going to the best college football games in the country every weekend. If (ESPN analyst) Kirk Herbstreit ever retires, I want the job.