That Little Extra Is Everything (ft. Luis Garcia)

Everything that is worth in life is going to take that little extra. Every problem has a solution. Every person has a good side. Every issue has a commonality. The ability to identify what are my weaknesses, recognize that they are weaknesses, and work around them, to me, has given me more than understanding what my strengths are.

Welcome to Digital Voices, where healthcare and life science leaders explore the real Work Behind Transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marx.

Welcome to another edition of Digital Voices. Thanks for listening. I know you have a lot of choices, lots of great content out there, and you've chosen to spend time with us. And it's going to be amazing because I have Dr. Luis Garcia with us. Luis, welcome to Digital Voices.

Thank you for the invitation. And hi to everybody, everybody who's taking the time to listen to us. A great day here in Chicago. And Ed, let's go.

I love it. We met only recently. So, we were together and I was like, wow, this is a super interesting leader and physician. And I was like, you have to be on my Digital Voices program. And you were so gracious to accept my invitation. And so, as you said, here we are and here we go. So the most important question, Luis, that we ask all of our guests is what songs are on your playlist? What kind of music do you like to listen to?

Well, let me try to answer that question, uh, recognizing that I'm not necessarily a music man, but my playlist probably is a little bit boring to others. I have a combination of Spanish Music and, uh, and English music and mostly from the '80s. But if you allow me to share with you, I do have some favorite songs. And, um, and, uh, the reason why these 2 particular songs, for example, come to mind is because they, they meant something at a specific time in my life, you know? And, uh, the first song that is definitely in my playlist is called Home. And it's a song by Philip Phillips. That song is about finding comfort and belonging even when you are in unfamiliar territory. And it just so happened that, you know, I was in my late 40s, single, one of those personal gaps in your life that you're trying to find yourself and you feel stuck and you feel sad and you feel depressed. And God blessed me with putting my wife in my path. And that song reminds us about the strength of our unity because it so happened that she was also going through a very difficult time. And so that's our song. And then also as a result of having met such a great human being like my wife, which by the way, I'm a much better person of myself just because of her.

Nice.

And thankfully we've been able to raise 4 beautiful children. 3 of them are daughters. And that's where the second song comes about. And the song is called Girls, which is by Rachel Platten. And it's truly a love letter and prayer to her daughters. She dedicated this to her daughters and it's truly about resilience, self-worth, and strength. And how do you navigate a very difficult world? Not only as a female, but as a human being. And of course, when I'm raising 3 daughters, that song just really resonates with me.

Yeah, no, those are great examples because we, as our audience knows, we do have a Spotify playlist and we add from time to time all the recommendations that are made along the way. So we'll put that in the show notes just to remind people because yeah, there's great music and there's always a story behind the song. So thank you for sharing. What about life message and mantra? Are there words that sort of guide you, how you live, how you operate?

You know, I, I gotta start by saying that life has been so wonderful for me. And of course, uh, we get to be where we're at with combination of success and sacrifice and tenacity and resilience, and sometimes also a little bit of luck, right? Uh, but if you allow me to share, uh, a couple of mantras, From the professional standpoint, I always tell people that I mentor always to show up. Every day is an interview. And not only do you need to show every day, show up every day, but you need to show up on your A-game because you never know when the next opportunity would come. And oftentimes it's not about titles, it's not about a position, but it is about how have you performed throughout A period of time or through, or in a position or in a specific task that really makes you, makes you rise to the occasion. I'd like to share with you an analogy that very early in my career helped me. I dunno if you remember who Ian Thorpe is, uh, but Ian Thorpe, uh, was the Michael Phelps of the Australian team, right? And, uh, the 2000 Olympics in Australia are coming. And he was 17 years old, and he had the spotlight right on him because he had to deliver. And I remember watching an interview with him a few months before the Olympics, and the reporter asked him, why do you wake up at 3 o'clock in the morning to train? And he said, well, because I know that the Americans are waking up at 3 o'clock. 3:30. Everything that is worth in life is gonna take that little extra. And the difference between being ordinary and extraordinary is that extra. You as a human being always have a choice to leave a place better than how you found it. You know, I know no matter how difficult it is, no matter how complex the situation is, no matter how it looks, And sometimes it's just 0.1 mile in a run, or is one more lap in the pool, or is one more minute of training, or is one more minute of conversation with somebody that you're mentoring. It's just that little extra that if you, if that allows you to leave the world in a better place than how you found it, those little wins make a difference.

I love it. We could stop the podcast now because I think, uh, We've given our audience a lot to think about already between music and mantra and life. But Luis, tell us about your background. That's something else unique about you. Obviously, you have an accent.

Tell us a little bit about yourself.

Like, where did you grow up?

What's your story? Yeah, thanks for that, Ed. And I do have an accent. My wife tells me that she likes it. I don't like it, to be honest. And, but I was born and raised in Mexico City. And, you know, I was born in an environment where my mom and dad were excellent role models. They were very strict and they always made it clear that the path to success was hardworking and education. So we didn't have a choice. I was one of 4. I have a brother and 2 sisters. We grew up in a very poor neighborhood in Mexico City. My dad was the physician In town. And, uh, he started with a small clinic in my grandmother's kitchen. Hmm. Wow. That eventually became another room, another room, and now it's a hospital. And then, and then my mom brought the business background to, to that relationship. And between both of them, a lot of sleepless nights, nights, a lot of sacrifice. They were really able to give us a life that, that was better than That we would have ever imagined. Once again, strong on education. For us, failure was not an option. And we had 2 great role models. And not only did we have great role models, but we had a platform where we could really identify what truly matters in life. Of course, because of my mom and dad's sacrifices, we had everything. We had every toy. We had good clothes. We were going to a private school, but yet our neighborhood was a neighborhood of really poor people. And just being raised, watching those contrasts where if I went to school, I was friends with very affluent people, came back home and I was friends with my neighborhood friend, and we were playing on dirt streets after the rain, getting muddy and And those contrasts really allowed us to find meaning in life, no matter what the circumstances are. And it also gives us the sense that we had a duty in life to become better so we could help others become better as well.

Yeah, no, I love that. It's so interesting, so powerful. Was there a pivotal moment in life that fundamentally changed your trajectory? And maybe that was part of it, just how you grew up, but was there something else that happened along the way that sort of like took a big shift in your life?

Yeah, that definitely. And, and, you know, interestingly, every, every successful person that I have had the chance to, to, uh, speak with, I'm always intrigued about what was the fork on the road, right? Where they needed to choose either left or right.

Yes.

And what made 'em choose one or the other and what was the impact of that? I have had 3 or 4 forks in the road in my life, but perhaps the one that definitely created a difference was the decision to leave home, to leave Mexico and come to the United States. If you think about it, my dad, once again, his own hospital, very successful surgeon, super known in the community. I had everything set to be successful by my dad's side, but at the same time, I discovered that if I stayed, I was always going to be my dad's son. So it was that angst to create my own identity, and if I was going to come back, I needed to bring something better to what my dad was offering. So that really allowed me to start exploring what were the opportunities Outside of the environment that I grew up and maybe outside in another country. Uh, so I decided to go for the most difficult piece, which was training in the United States in surgery. And as you know, as a foreign medical graduate, that's not easy. Uh, so it meant leaving the comfort zone for me, but it also meant being exposed to challenges and sacrifices that I never thought I was going to face. And those sacrifices and challenges really allowed me to be a lot of who I am. For example, at that point, this is before email and before internet where you needed to send your application set with a stamp and send it via regular mail. So guess what? There were 220 programs in the United States. I applied to all of them. And I got 2 interviews. Uh, one of the interviews was at the University of North Dakota. And, uh, I get the letter back in the mail mid-December. And of course I'm all excited because I'm getting an interview and I open it and it's dated like 2 months before I got it. So of course I called the University of North Dakota and they tell me, well, Dr. Garcia, I'm sorry, but we already finished our interview process. So I just went like, you know, I just got the letter. I'm excited, this and that. And they tell me, okay, this is Friday. And they tell me, okay, Dr. Becker, the program director at the time, is going to interview you on Monday over the phone. And I'm, I'm thinking, that's not gonna happen. I said, I am going to go to North Dakota. I'll see you Monday wherever you tell me. And I didn't know where North Dakota was. I didn't know what it meant to travel from Mexico City to Fargo, North Dakota. But guess what? I showed up Monday morning in the middle of a blizzard. The disposition to take that step forward, the fact that they were able to see me in person, the fact that they got to know me in a more broader way than a phone interview. made them change their mind about ranking, you know? And, uh, and, and like that, you know, there was another instance, uh, for example, where, and by the way, they gave me 1 year of preliminary. So I finished a year and the program director calls me. He's like, well, Luis, I have good news for you and bad news. I said, yeah. He says, well, the good news is that everybody wants you to stay for the categorical. The bad news is that the ECFMG, the Educational Commission for Foreign Medical Graduates, they do not want to sponsor your visa because you need to start again and they feel that you're retroceding in your training.

Right.

So I go with the program administrator. They tell me that the answer is no. I ask to talk to the ECFMG. She tells me, no, we're not calling. So once again, I'm like, Michelle, Please let me talk to them. Let me just make the case.

Yeah.

So reluctantly she calls the ACFMG, and now I remember her name was Laura Coe. Never met her, but I got on the phone with Laura Coe. I said, Laura, listen me out. I said, I, this could have been the best day in my life. It is not. What can we do? And I just started, you know, selling myself and this is what I want. This is. And thankfully, we found an opportunity for them to make an exception and to give me the whole category kind of training. But it's just those things that unless you get yourself out of your comfort zone, you never get to experience.

Yeah, no, that's so cool. Yeah, you're just full of great stories of perseverance and dedication. This is a lot of fun. So yeah, so you're in the Dakotas now. You graduate, you stay, right? You stay in, uh, is it South Dakota where you spent the bulk of your, you know, mid-career?

Yeah, Ed. So, uh, I finished general surgery at the University of North Dakota. Uh, then I went to do a mini fellowship in bariatric and advanced laparoscopic surgery at the University of Pittsburgh. And I came back and the reason why I came back is because at the time, I trained under a J-1 visa, which is a student visa. So in order to transition to a working visa, you needed to be in an underserved area for 3 years. And it just so happened that Sanford Health at the time sponsored my visa to be in an underserved area. So my very first position as a surgeon was in Valley City, North Dakota, 7,000 people. As a solo surgeon, I, I was it. So just imagine finishing training thinking like, I'm going to really dominate the world, but at the same time recognizing your limitations and trying to be fair and honest to your patients. So what can you do? What can you not do? What can you do in a setting of 7,000 people, small hospital, rather than a big academic setting? So that created right away a lot of maturity for And make a long story short, in my learning process, I also identified that as physicians, we're very poorly educated on the business of medicine. So I did an MBA as I was doing that. And the combination of the MBA, the solo practice, and transitioning then into a group practice in Fargo, North Dakota allowed me to evolve professionally as a leader, as a clinician. And I stayed with Sam for nearly 30 years.

Yeah.

And, uh, and I eventually grew, became the chair of the department, subsequently the president of the medical group for Samford Health, large integrated healthcare system, about 3,000 physicians and APPs in 5 states. And, uh, I was in my 5th year as the president of the medical group When a new opportunity came about, which is the one that I hold now. And, uh, that's the story, you know? So it worked truly about, you know, being thankful, loyal to the system that gave me opportunities. And, and, uh, and going back to my mantra of always leaving a place better than how you found it. I, when I finished my tenure in Sanford, it, I, I love Sanford. It's a phenomenal organization. And what made me proud was that I was part of a great thing going, and I left a legacy that allowed me to move on with no regrets. Oh, that, that's a fabulous story.

And, and, uh, it was, it in the Dakotas then that you met your wife as well?

Yes. And, you know, she was a, she was a nurse and, uh, I was doing endoscopy. And she was giving sedation to the patients. I kid with her that she gave me sedation that day and I ended up asking her out. But, uh, you know, no, in, in, uh, uh, in all being serious about this, I mean, she, the first thing that I recognized is that she was a phenomenal nurse. And, uh, and I never thought that she would pay attention to me yet because she was so out of my league. Uh, but you know, we developed a good working relationship and we got to understand each other at different levels, have great conversations, and we both recognized that we, what we appreciated of each other was the content of the relationship. It was, of course we liked each other physically, but that was never what led. It was always about perspective of life, about content, about conversation, about being best friends, you know? Yeah.

Uh, she sounds amazing. I'd love to meet her. Maybe next time I'm out in Chicago, we'll get together. Um, so the other thing that you have been doing for some time is the International Esperanza Project, or IEP. And that was intriguing as well. Tell us a little bit about IEP. Yeah.

So IEP, the International Esperanza Project, It's a non-for-profit that a couple of friends and I founded, and it was based on providing humanitarian and medical help to poor countries, particularly in Central America and particularly Guatemala. And, you know, I've always had that in my blood because with my father, my mom and dad are Rotarians. And through Rotary International, I was always exposed to helping people and finding ways to raise funds and, and, and help people. Then a college friend of mine one time called me. It's like, hey, Luis, I'm putting together a mission team to go to Guatemala City and I need a surgeon. So I need you. And his name is Jorge Corona. He's an oculoplastic surgeon in Dallas. I was like, oh, Jorge. You know, I'm super busy. I'm, I, I don't have time. And to be honest, I did it just because he's a great friend.

Yeah.

And I'm like, okay, I'm gonna go. And, but then I tell you, after watching the, the level of mission, the level of impact, and, uh, and when you have, think about this, when you have a group of 120 people get together at the Dallas airport on a Saturday, Fly to Guatemala City Sunday, we start to work together as a team, people that you've never met.

Right.

And then you work throughout the week. It's just amazing how in, in a span of 5 days you create so many great bonds, friendships.

Yeah.

And it just reminds you that when you have a common mission and a positive purpose, You can almost overcome every single barrier that you have. And that, that was like an addiction. It was like, now we need to do it again and again and again. We started this 12 years ago, and now we have 7 teams that go every year. We expanded not only from surgical and medical missions, but we have now a school, we have a water filter program, we have a stove program. So we created programs that bring sustainability to the local population. So it's not just sporadic care, it's truly creating platforms where in which they can be successful and support and grow themselves. And that project now is, is a very important project that has a tremendous impact in Guatemala. And, uh, you know, I'm part of the board and it's something that makes us super proud. And the most important piece that you think when you get in mission trip that you're helping people, it's just amazing. You go there and the way you are changed is just something that, that I cannot explain. It's until you live it when you realize that people that have nothing are happy.

Yeah.

People that have nothing have a lot more to offer that sometimes we We offer. And it truly, the way it changes you to help others is something that is very difficult to explain.

That's a profound point. Uh, counterintuitive, but, uh, I learned that I've learned the same thing. I wanted to switch and talk a little bit about leadership, but before we get there, I don't want to ignore the fact that you're the, uh, CEO or president, a president of Rush Medical Group. Um, tell us a little bit, whatever you want to tell us about Roche and what's it like on a daily basis to be in that type of a role?

Yeah, Roche, well, what it's like, uh, Ed, is that Roche is a tremendous organization that I'm lucky to belong to. Uh, you know, I think Roche is very well known in the industry for a system that is very high in quality and very high in community engagement. You know, we take care of the most the people in most need in the Chicagoland area. And we do it with tremendous amount of pride and a tremendous amount of effectiveness. So when the opportunity came to become part of that mission, it was a no-brainer. You know, I spoke about how proud I was to be part of Sanford, but this represented another opportunity to be part of something big, something impactful in a very different setting that I had experienced before. So now I have the privilege to lead the Roche Medica Group. We have about 1,000 employed physicians, both in the academic and community setting, and about 500 APPs all across the footprint of Roche in the Chicagoland area. And my job is to create the integration and create the platforms that would allow to find the operational efficiencies to be sustainable and grow and continue to have that impact into our community. So that's my job and passionate about it, love it. And I'm super lucky that I get to have these opportunities every day.

I've heard, know a lot about it, heard a lot about it. I've known people who serve there and yeah, it's a fantastic organization and people in Chicagoland and beyond are lucky and blessed. Yeah. So on leadership, you obviously have this storied career, which continues, What, what would you say if you had to look back, or, or one or two key skills that sort of have enabled your success?

I think that the general teaching around leadership by default allows you to concentrate on your strengths and exponentially continue to support those strengths in your development. And what I found For me, it's been a lot more helpful to identify in any given setting, any given problem, any given environment, what are my weaknesses? What are the things that I don't bring to the table on any conversation, on any table, on any institution? What are those things that I don't have? And then find the right people to complement my strengths. So the ability to identify what are my weaknesses, recognize that they are weaknesses, and work around them, to me, has given me more than understanding what my strengths are.

Yeah.

Yeah, I get it. So that's one thing. The other thing, Ed, is that I think as a leader, And as a surgeon, think about it, as a surgeon, you always call the shots, right? You're in the operating room. You say who moves to the left, to the right. We're gonna do this, we're gonna do that. And, and, and everybody tends to listen, right? So you get used to that. But the reality is that as, as I grew as a leader, whether it was in the clinical setting or the administrative setting, the, the greatest successes that I found in my career is not because of me, but is because of the teams that I put together. The greatest successes is when I found talent, I put groups of talented people together, I declared a vision, and I let them take over. And I can tell you, I'm not a micromanager, and I always tell my teams, Don't be afraid to take risks. Don't be afraid to fail. Now, if you fail, you need to fix it, but, you know, go with it, go with the vision, get to the finish line. And when you put the right people at the right time together, it's just amazing what you can do. And I love when I'm not the smartest person in the room. I love it. I love to surround myself with really, really smart people.

Luis, this has been an amazing experience. I knew it would be, and I was so excited when we were together in Chicago, and I knew I was sitting next to someone pretty extraordinary. We talked a lot about a lot of things, including some unique music that we're going to add to our playlist. A lot of your mantras, leave everything better than when you got there, always show up. The difference between ordinary and extraordinary is actually the extra. We talked about your growing up in Mexico City and the dichotomy of both being in the affluent side as well as living day to day in, uh, in, in more of a reality. And then how you got to the United States and, and just this, your stories are just full of great principles and great actions that people should embrace. Talked about being missional and how important that was and how you said mission and purpose can overcome any barriers and obstacles. Um, we talk a little bit about Rush and we talk a lot about, uh, leadership. Is there anything we missed or is there anything you want to double down on? I'll give you the last word.

And I appreciate this opportunity to give the last word. And I want to just highlight that whether you are a leader in life, in medicine, in the clinical setting or administrative setting, these are not easy times to be a leader. Whether it is because of a political preference or because of social media or because of antagonism within the workforce, It is very easy to concentrate on the negative. It's very easy to deviate yourself from that mission purpose. And what I would just like to double down is that for every piece of negative that life has, there's 100 pieces of positive.

Yeah.

But sometimes takes a little bit more effort. It takes a little bit more of proactivity. It takes a little bit more to identify where the positive is. In my opinion, every problem has a solution. Every person has a good side. Every issue has a commonality. And with how difficult life is today, I would like to double down on that positive aspect because we need it. We need it every day. We're constantly bombarded with negative stuff, and it is on us to create a positive environment. When the tendency is to be negative. So Ed, just like your respect for me, the respect is mutual. The admiration is mutual. I thank God for the opportunity to meet you. I thank God for the opportunity of that first interaction that we had that led to this podcast. And it is with the same level of admiration and respect, Ed, that I also like to highlight your Tremendous success, and thank you for the opportunity to be here today. And to your listeners, thank you for taking the time.

Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection, and connection. Subscribe on YouTube, Apple, and Spotify Podcasts so you don't miss an episode.