Working in the health industry is not easy.
Most of us only know the perspective of a patient, so complaining about doctors who only talk to you for two minutes sending you back home is a low-hanging fruit.
But the truth is, it isn’t their fault. In fact, the insurance companies forces them to meet a daily quota of patients per day if they want to get by.
Fortunately, there are ways to ensure that doctors can take proper care of their patients.
In today’s episode, James Ogletree, Director at Health By Design, shares how agreeableness can kill a business, why doctors can’t take care of their patients, and how businesses can thrive with healthier employees.
Show highlights include:
- Why your likeability may hold you back from better results in your business ([5:47])
- Why small town people who choose big universities risk losing several years of their life (and what to do instead) ([7:14])
- How the health industry prevents doctors from taking care of their patients (and what you can do about it) ([10:40])
- How to prevent falling into a rut of regret as soon as you retire ([17:17])
Do you want a wealthy retirement without worrying about money? Welcome to “Retire in Texas”, where you will discover how to enjoy your faith, your family, and your freedom in the State of Texas—and, now, here’s your host, financial advisor, author, and all-around good Texan, Darryl Lyons.
Darryl: Hey, this is Darryl Lyons. You’re listening to Retire in Texas. Thanks for tuning in, I appreciate it. We do have legal disclosures, as always. This information is general in nature only. It’s not intended to provide specific tax or legal advice. Please visit PAXFinancialGroup.com for more information.
Also, I want to make sure that you know that if you need to meet with an advisor, text the word “TEXAS” to the number 74868. That’s “TEXAS” to 74868. Complimentary, won’t cost you anything, heart of a teacher. But if you just need some help, that’s a way we can connect with you. [01:00].6]
Okay, so I’ve got a longtime friend, Dr. O, here. Should I say Jim Ogletree?
Dr. Ogletree: That’s fine.
Darryl: Yeah, I could say James Ogletree.
Dr. Ogletree: Yeah, I’ve been Jim, James, and Jamie, so I still have an identity crisis at 68.
Darryl: All of us still call you Dr. O, like if we’re talking about you behind your back, it’s Dr. O, so to me, you’re Dr. O.
Dr. Ogletree: Funny story. I had a patient that kept calling me Dr. O before I met the patient, and, finally, she said, “I thought you were going to be Chinese because they kept calling you Dr. O.”
Darryl: That’s funny. That’s funny. I’m glad you’re here and got a lot to chat about. Actually, I know you, but I think I’m going to learn a few things about you today, so that’s why I’m looking forward to this. How long have you been retired?
Dr. Ogletree: I retired in June ’22.
Darryl: ’22, yeah.
Dr. Ogletree: So, coming up on a year.
Darryl: Yep, I was thinking about that. Okay, so we’re going to get into that a little bit, the transition of retirement and what that looks like, and I want you to share a little bit about what retirement feels like. We talked a little bit about this.
Dr. Ogletree: Yeah.
Darryl: But before I get into that, now, are you originally from Texas? [02:02].0]
Dr. Ogletree: Yes, I grew up out in West Texas and I’ve lived in Texas my entire life.
Darryl: Where at in West Texas?
Dr. Ogletree: Mostly Monahans, so from seventh grade on, I lived in Monahans, but I also lived in Kermit and Wink. Wink is a little town of 1.000 out in West Texas.
Darryl: Wink, Texas.
Dr. Ogletree: Wink, Texas, best known for a sinkhole.
Darryl: Oh, is that right? There’s a sinkhole out there? Did y’all mess around in that sinkhole?
Dr. Ogletree: No, it wasn’t there when I was there.
Darryl: Okay. Mom and Dad around?
Dr. Ogletree: Both my mom and dad had passed away.
Darryl: What about them? Were they around when you’re a kid?
Dr. Ogletree: Oh, yeah.
Darryl: What did they do?
Dr. Ogletree: Yeah, my dad owned gas stations. This was back during the full-service gas station days. And, of course, out in West Texas, we took care of a lot of oilfield trucks and cars, and I’ve washed many cars and many windshields and fixed truck flats. At one time, we also had the Greyhound Bus station in the same service station that we had, and so I could go fill up a car for five bucks and do the full-service thing, come back and make a ticket for a person to go to Indiana or somewhere like that on the bus. Hopefully, they got there. I have no idea. [03:08].0]
Darryl: Yeah, that’s cool, though.
Dr. Ogletree: The training was not very formal.
Darryl: Yeah, you were able to kind of be efficient, like, I’m going to take care of the full-service thing and then I’m going to hustle over here to the bus stop.
Dr. Ogletree: Yeah.
Darryl: That’s cool. How old were you when you were doing that?
Dr. Ogletree: In the high school days.
Darryl: Yeah, okay, and I bet there weren’t that many people in your town.
Dr. Ogletree: No, it depended on what the oil field was doing, but somewhere 7,000 or 8,000 people.
Darryl: One time I was taking my family to– oh, we were going to New Mexico, that’s right, and we were going through West Texas, and I looked back at the windshield and I’m like, Man, there must be oil on this road because it’s spraying up on my back windshield. What happened was we got our oil changed and they didn’t put it on right, so we were leaking oil the whole way, so we get this.
Dr. Ogletree: I don’t think it’s that easy to get oil out there but.
Darryl: I know, right? Yeah, I was confused, like an idiot, like, What? So, we stopped there in this small town. We go somewhere like Wink and there’s no one there.
Dr. Ogletree: Right.
Darryl: And so we finally found somebody and I gave him 50 bucks to fix something really simple just because I was so happy. But, anyway, that sort of reminds me of it. So, you have brothers and sisters? [04:10].7]
Dr. Ogletree: Three sisters.
Dr. Ogletree: Yeah.
Darryl: What are you? Where are you in that?
Dr. Ogletree: I have one older sister who is a half-sister through my dad, and then I have an older sister that’s about four years older than me, and a younger sister. That’s about four years younger than me.
Darryl: Okay. Did your mom work?
Dr. Ogletree: Off and on in the station, and do some of the accounting and Greyhound Bus and all that, yeah.
Darryl: Yeah. If I think about it, you probably saw some interesting people along the way.
Dr. Ogletree: Oh, yeah.
Darryl: I bet, pass her by.
Dr. Ogletree: West Texas is a great place to grow up, great value, and hardworking people, and not that I would go back at this point, probably, but it was great. And there’s a lot of oil-field tax money and so the schools are very wealthy, and so you have great facilities, great well-paid teachers. I mean, our top 11 people I think in my class all had PhDs or MDs, or dental degrees or whatever. [05:02].8]
Darryl: Let me hear you correctly. The top five people and 10 people in your class?
Dr. Ogletree: About 11 Out of the 170.
Darryl: They ended up getting their PhDs.
Dr. Ogletree: Doctorates and PhDs, yeah.
Darryl: Are you serious?
Dr. Ogletree: Yeah, so it was very–
Darryl: That’s pretty cool, yeah, because I know a lot of small towns and they just go do agricultural work or . . . . I mean, nothing wrong with that, but you don’t hear that very often.
Dr. Ogletree: We had a great band program. I did athletics and band, so it was small enough to where you could do both. For instance, we had a marching band that marched 256 people and we only had 400 in the school, and we were the first halftime show at Texas Stadium.
Darryl: That’s cool.
Dr. Ogletree: That was great. And then when I played varsity football, I just didn’t march.
Darryl: Yeah, yeah.
Dr. Ogletree: But it was a great place to grow up.
Darryl: Yeah, it sounds like it. Did your parents ever teach you about money when you were younger, being at the gas station?
Dr. Ogletree: It probably taught me more about what I should not do.
Dr. Ogletree: Yeah, my mom and dad did not get along that well. They were both alcoholics. And my dad worked really hard. I mean, he worked seven days a week from about [5:00] in the morning to [8:00] at night. [06:08].5]
Darryl: Oh, wow.
Dr. Ogletree: Yeah, so I was pretty much on my own to raise myself through the school and coaches and band directors and teachers, and people like that I spent a lot more time with them than I did with my family.
Darryl: Yeah, it’s that era, and, also, entrepreneurs, they can get that way when they’re so wound up. Business owners can be so wound up that the only way they know how to unwind is the bottle.
Dr. Ogletree: Yeah, and my dad, he was very personable and he was friends with everybody, but he was a lousy manager of his businesses.
Dr. Ogletree: In that day in time, people would fill up with gas. These oil field guys would fill up with gas once a day because they were all over the place, and they would just leave their credit card with my dad up in the cash register, and so they would come fill it with gas. They didn’t even have to walk in. He would just run their–
Darryl: Oh, is that right?
Dr. Ogletree: Run their credit card, and then at the end of the month, they’d come in and even up.
Darryl: That makes it easy.
Dr. Ogletree: Yeah, a lot of trust in there. [07:04].6]
Darryl: After high school, so you played sports, which is cool, and coaches and teachers and other people kind of filled in some of that that your dad wasn’t providing. And then after that, what did you do after high school?
Dr. Ogletree: I went to the University of Texas in Austin. I was interested in pharmacy and got a little small scholarship from a local pharmacy there and in Monahans and went one year and in pharmacy, and then just kind of decided I didn’t want to do that. Got interested in chemical engineering and changed to that degree and went to work for Dow Chemical a couple of semesters in a co-op program, which is really important because it taught me I didn’t want to be a chemical engineer.
Darryl: Yeah, good.
Dr. Ogletree: And so I switched to premed at that point. I always kind of had that in the back of my mind, but . . .
Darryl: Yeah, you had to try those other things.
Dr. Ogletree: Yeah, I finally suddenly decided and went two more years, actually transferred to Texas Tech after my third year in college, so I went to Tech for two years. [08:01].2]
Darryl: What made you go to Tech?
Dr. Ogletree: Just similarity with West Texas and the people there.
Darryl: I guess, let me ask it differently. What made you leave UT?
Dr. Ogletree: I made the mistake of, my first year, I lived off campus.
Dr. Ogletree: And so I don’t meet people that easily, and so all I did was study and work and try just when they’re happy. And, plus, it was a campus of 50,000 people having come from a real conservative 7,000 people in the little towns.
Darryl: So, Tech felt a little bit more at home, yeah.
Dr. Ogletree: Yeah, more familiar to me. Yeah.
Darryl: And then after that, did you go to med school?
Dr. Ogletree: Yeah.
Darryl: And where was that?
Dr. Ogletree: In San Antonio.
Darryl: UT Health Science Center?
Dr. Ogletree: UT Health Science Center, yeah.
Darryl: Tell me about that experience, for those that don’t know how a medical school works.
Dr. Ogletree: It was very simple. You just show up and –
Darryl: That’s it.
Dr. Ogletree: – four years later, you’re done.
Darryl: Four years later, yeah.
Dr. Ogletree: Honestly, it’s really good.
Darryl: Yeah, exactly.
Dr. Ogletree: No, it was a great experience. This was a great place to be in terms of the program here.
Darryl: Yeah, it’s great and reputable.
Dr. Ogletree: I felt very comfortable here and my wife’s folks lived in San Antonio, so with me being out a lot, that was good for her. That’s the reason I picked San Antonio out of my choices. [09:04].8]
Darryl: That’s great.
Dr. Ogletree: It was good. It’s difficult. I mean, you work at it 10, 12 hours a day and then you get into the clinical rotations, and you’re up 36 hours and then off. Not off, but you’re just working the regular schedule for two days and then you’re on. You’re up 36 hours again, so I did a family-practice residency for three years.
Darryl: I was going to ask about that, yeah.
Dr. Ogletree: Yeah.
Darryl: Founding-practice residency.
Dr. Ogletree: Family practice.
Darryl: Family practice. I thought you said founding. I was kind of like, I’ve never heard that.
Dr. Ogletree: Yeah, family practice.
Darryl: Yeah, okay. And then, after that?
Dr. Ogletree: I went into practice on my own, had a friend–
Darryl: No fellowship?
Dr. Ogletree: No.
Darryl: No, okay.
Dr. Ogletree: Went into practice on my own. A fellow by the name of Jim Martin, who’s a really well-known family physician here in town, was looking for somebody to share space with him and kind of share patients. He was full and needed somebody to take some of the patients, and so I was very lucky. He’s an extraordinary man and physician, and so I learned a ton just working with him. And I also didn’t have to pay for all the expenses. We were able to share everything, so that was good. [10:06].1]
Darryl: Especially having patients, it’s a business like everything else.
Dr. Ogletree: Sure.
Darryl: And sharing patients, that was very kind of him.
Dr. Ogletree: Yeah, because they want to have zero patients.
Darryl: And he didn’t ask for any compensation from those patients? He just let you have them?
Dr. Ogletree: Right, yeah. I’ll say his schedule was full and somebody got sick. Then they could come in the same day and see the PT.
Darryl: Yeah, that’s great. That’s a great thing.
Dr. Ogletree: Oh, it was great, yeah. It made it, back then, it was very– It’s even more difficult now to start a practice on your own, but I think I made $40,000 the first year. I mean, it wasn’t as lucrative as everybody thinks.
Darryl: Yeah, I know, and the family-practice primary-care physicians I want to get into a little bit about, because I think the story about how you ended your career is cool, or at least, the latter part of your business in practice. But a lot of people don’t recognize that primary care physicians and family practice, man, for the amount of liability and work for the reward, that ratio is off right now. [11:03].3]
Dr. Ogletree: Yeah.
Darryl: I mean, I compare that to maybe a nurse. When you look at the amount of work and the liability, in some cases, it can be better to be a nurse than it is to be a primary-care physician, and so it’s a tough gig. And we get frustrated, as consumers, with our primary-care physician because they don’t spend enough time with us, right?
Dr. Ogletree: Right.
Darryl: We’re always complaining about that and the primary-care physician is like, Man, I’m trying my best. I don’t like it either, but this is kind of the system.
Dr. Ogletree: Yeah, and that’s only gotten worse because of the . . .
Darryl: Oh my gosh.
Dr. Ogletree: Yeah, just to make ends meet, you need to see a good 30 people a day and it’s just tough to do that and do a good job.
Darryl: It is and so. Obviously, that system kind of got to you after a little while, so tell us a little bit more about the latter part of your career.
Dr. Ogletree: Yeah, I was in practice for about seven years and I was doing hospital and outpatient, taking care of my patients, getting up and going to the ER at 2 o’clock in the morning, if one of my patients got sick or whatever. But I could just tell, and that’s about when insurance started changing, and I could just tell that this life was going to kill me and I wanted to get to know my kids and that was super important to me. [12:07].4]
So, I started looking around to figure out other ways to work and came across David Player who was the founder of Health by Design, and I started doing executive exams a day or two a week just to augment my income. Eventually, I closed my practice down and went to Health by Design full time.
I also did some sports medicine. I became boarded in sports medicine and did a little bit more volunteer work and worked with some of the orthopedists and took care of some of the high schools and colleges in town.
Darryl: Yeah, that’s cool.
Dr. Ogletree: And I did that for several years.
Darryl: Dr. Player has a good reputation in the Greater San Antonio area, and Health by Design, I know the way it kind of grew. I don’t want to say the mission changed, but the service offerings changed over the years. It seemed like it really started to get an identity when it got a relationship with Valero. That seemed to put it on the map. But am I thinking of that wrong or was that . . .? [13:03].7]
Dr. Ogletree: No, it was at Diamond Shamrock at that point, and six months later, it was Valero. But when it was founded in the ’80s, it really was an executive exam center where an executive would come in and spend three or four hours and have a really comprehensive exam, and then a weight management section. It was completely outside of the insurance business, so we were doing that way before it was cool, and that’s what it was for many, many years.
Then, in about 2001, our frustration had always been we’d see these people in their exam and then they’d go back into the world, and primary care is so difficult that they’d come back and they’d still have the same problems because they hadn’t been able to work on it very well. So, we thought, What if we– We still did not want to be in insurance because that was what was dictating how you’d take care of people.
Dr. Ogletree: And so, we talked to HR people at Ultramar Diamond Shamrock into trying out this new concept of a company clinic, where we would come on site and provide care the company would know nothing about. No personal information would be passed to the company. [14:08].0]
But we didn’t have to bill insurance. We were paid by the month, and so it took away a lot of the bad incentives that medicine has and allowed you to spend, gosh, 15, 30, 45 minutes, 60 minutes, if you needed, with a patient, because you didn’t have to churn patients to make a living. That was our first clinic and, over the years, we ended up with 18 of those onsite.
Dr. Ogletree: Eighteen onsite clinics.
Darryl: I had no idea you had 18.
Dr. Ogletree: Yeah, most of them in Texas, a couple in New Orleans.
Dr. Ogletree: And one in Oklahoma.
Darryl: Yeah, so that’s kind of where I think when I think about you guys and how y’all became really successful was that relationship really got you guys on the map. And to think about it, it’s a little frustrating. I know you’re frustrated with the whole healthcare system, but you guys were able to create the type of healthcare experience that people deserve and need. Did I say deserve? That’s probably the wrong word, but need. But it’s not– the economics are challenging, so it’s really people who could afford it. [15:08].6]
Dr. Ogletree: Yeah, or the companies that could afford it for theirs so that the patients paid nothing, which was a great benefit for them to have comprehensive primary care by a board-certified family physician or internist, and same-day appointments, minimum 15-minute appointments, labs free, everything, yeah.
Darryl: How did you substantiate the cost?
Dr. Ogletree: Because of the improvement in health.
Darryl: And you were able to track that, monitor that?
Dr. Ogletree: Yeah, it’s difficult, to be honest. We didn’t really have the resources to do it statistically like it needs to be.
Darryl: Sure, I can imagine, yeah.
Dr. Ogletree: Most of the companies did it because they had a mindset of “We want to take care of our people. We want them to be healthy. We want them to be here for a long time.” If you had a company that they didn’t care if a person worked for them for a year or not, that’s not a good company for this. But they’re investing in their people.
Darryl: But they could anecdotally identify value enough that they continue the agreement, yeah. [16:03].5]
Dr. Ogletree: Sure, and it was a great recruiting and retention tool as well for them.
Darryl: Yeah. For some reason, in my mind, I thought it was just in executive, but y’all were doing it for the entire company.
Dr. Ogletree: Yeah.
Darryl: Yeah, okay. That’s really cool. Man, there’s just so much to talk about. Yeah, I think I kind of went down a rabbit hole here with the healthcare industry and your experience, but I hope the listeners appreciate and enjoy that, and I may have to have you back to discuss that more, but I do want to ask a couple more questions before we kind of lay in this helicopter.
What was the catalyst to say, “Okay, I’m finally ready to [retire]”? You’d been doing medicine for such a long time. What was the catalyst for you to retire, or pivot, I should say?
Dr. Ogletree: In 2001, we sold our practice. My two partners were in their 70s and I was in my 60s, and so we knew we needed to plan for the future, and so we started looking around and, eventually, were bought by a company out of Austin. I stayed on for another year. I was the chief medical officer, and so for continuity’s sake, I decided to stay another year, and so worked until June of last year. [17:00].3]
It was just time. I’ve been doing it for over 35 years, and, of course, at the end of Covid, which, for me, wasn’t too bad. I mostly loved it, I did from my home more management than anything else. I was tired and it was just time, being with a new company and all. It was just time to go.
Darryl: Now that you’ve been retired for six months, can you tell maybe what’s been good, what’s been bad? Just kind of an idea of what you can share with the listeners.
Dr. Ogletree: Yeah, actually, it’s been really nice. Number one, your schedule usually has one or two things on it, if that many, and so you get up when you want to. You can go exercise and spend as much time as you want. I’ve started listening to and reading tons of books. I’ve started walking four miles a day.
Darryl: Yeah, awesome. Yeah.
Dr. Ogletree: I’ll listen to a book while I’m doing that, so I’m going through books like crazy.
Darryl: I bet.
Dr. Ogletree: I’m still just very curious about lots of different subjects.
Darryl: Faith, too, right? Your faith is still strong as ever, and so I’m sure that’s part of your–
Dr. Ogletree: Yeah, I’ve started doing a little mentoring with a middle school kid. And we’ve traveled quite a bit this year as well, which we hadn’t really done that much for years. [18:02].6]
Darryl: For years. What would you say, man? Okay, the six months, I didn’t anticipate this. This kind of was a surprise. Was there anything in particular?
Dr. Ogletree: I’m a little surprised that I don’t miss it more than I do.
Darryl: Oh, okay. Yeah.
Dr. Ogletree: I miss the people, but I don’t miss the work.
Darryl: What I would say about it, knowing you, is your identity truly wasn’t in the work.
Dr. Ogletree: That’s right.
Darryl: Yeah, and I think that’s the difference, and people kind of discount that because it sounds Pollyannaish or kind of a nebulous thought process. But, for you, I can sincerely say your identity was in the faith of your relationship with your Creator, not in your work, and so I think that makes that easier. We talked before the show about how heart attacks go up by 40 percent—I have this statistic somewhere—the first year after you retire, and many times it’s because people’s identity is in their work.
Dr. Ogletree: Yeah, and sometimes, I mean, you have to decide what you’re going to do with your life habits. Are you going to eat better? Are you going to exercise? Are you going to work on your weight? If you don’t do those things, your risk goes up a lot. [19:00].8]
Darryl: You’ve been eating okay?
Dr. Ogletree: I mean, I could be better.
Darryl: That’s okay.
Dr. Ogletree: I’m working at it.
Darryl: Oh, man.
Dr. Ogletree: But I would not be a poster child for that.
Darryl: Yeah, that’s okay.
Dr. Ogletree: Yeah, and I’ll start doing some real estate investments.
Darryl: Yeah, nice.
Dr. Ogletree: And kind of learning about that.
Darryl: Yeah, cool.
Dr. Ogletree: I have ever done that before, and so that was kind of fun. A couple of my friends have been doing that for a few years.
Darryl: Yeah, yeah.
Dr. Ogletree: So, I’ve been studying, studying on that, learning about taxes and all sorts of fun–
Darryl: Oh, yeah, lots of fun stuff. Oh, man, yeah. It’s going to be hard for me to ever retire because I’m just not going to want to do any of that anymore. No, I appreciate you coming on the show. One last question, probably the most important question. What’s your favorite salsa?
Dr. Ogletree: I like that, is there a mango salsa?
Darryl: Oh, yeah.
Dr. Ogletree: Oh, yeah? I like that.
Darryl: I do it different, but mango habanero is one of them, but, yeah.
Dr. Ogletree: Yeah.
Darryl: You like the mango in it? Sweet? You like it sweet?
Dr. Ogletree: I like regular old salsa as well.
Darryl: Yeah, good, good.
Dr. Ogletree: I’m not an aficionado of any sort.
Darryl: Mango is good for me, man. I love it. Look, thanks for being on here. Thanks for sharing the story. Didn’t know that about you. It was pretty cool.
Dr. Ogletree: What, the mango or the . . .? [20:01].1]
Darryl: Yeah, I didn’t know about the mango. You might have told me this, but I did not know that your parents ran those gas stations.
Dr. Ogletree: Yeah.
Darryl: It’s pretty cool. I can picture it.
Dr. Ogletree: Yeah.
Darryl: So, I bet that if you reflected back, you’d learned a lot about business and money just either directly or indirectly from that.
Dr. Ogletree: Yeah, particularly, taking care of your clients or your customers. My dad called it Smiddy Super Service.
Darryl: Oh, okay.
Dr. Ogletree: That’s what you had to do to make a living. It’s to take care of every customer that came in.
Darryl: That’s great. Yeah.
Dr. Ogletree: So, I kind of did the same thing in medicine I think.
Darryl: Very cool, yeah, okay. Thanks, for everyone that stayed with us to the end. Thanks, Dr. O, for hanging out.
Dr. Ogletree: You’re welcome.
Darryl: And you’ve listened to Retire in Texas. I want to remind you, if you need to speak to an advisor, text the word “TEXAS” to the number 74868. As always, remember you think different when you think long term. Have a great day. [20:51].5]
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