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Big Fish

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  • | 4:44 a.m. May 13, 2011
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You can tell a lot about a man by the way he fishes.

Consider John Langley, the president and CEO of Medscribe Information Systems.

His fishing buddy, Michael Morris, the president and CEO of Naples Capital Advisors, explains it this way: “He's looking for Moby Dick, like most of us. If it's not the biggest fish, it's the most fish.”

Langley is a patient fisherman, Morris says, but he expects results. Big results.

A similar story emerges when you speak with colleagues, customers and family. They say Langley brings the same quiet intensity to running the Naples-based medical transcription company he founded in 1992, the church-finance committee on which he serves, the Rotary meetings he attends and even the piano he practices.

An accountant by training, Langley, 51, has always been a detail person. But those who know him say he has the vision to look out years ahead for opportunities and challenges that may come his way.

“You'd never know he's a CPA if he didn't tell you,” says Jim Connell, a retired executive in Naples and fellow Rotarian. “An accountant can tell you what happened, but he can't tell you what's going to happen in the future.”

That uncanny ability to peer into the future is what makes him more of an entrepreneur than an accountant. “John doesn't mind taking risks, but he's got a good vision of where we're going to be,” says his brother Bill Langley, the company's vice president of operations.

That's important because the medical-transcription business will be buffeted by changes in technology and greater government involvement. Indeed, Langley's company currently transcribes 100 million lines of doctors' reports on their patients, a hugely valuable trove of data that has attracted plenty of interest from government and other insurers.

The government-mandated shift to electronic medical data is just the beginning of what could transform the industry. While the specifics of the government's medical-records plan remain unclear, like a good card player Langley leaves you with the distinct impression that he's already figured it out. Fellow Rotarian Connell agrees: “He's already making changes in his operation to meet the government standards. He might change the whole way his company functions.”

At this point, Medscribe is a relatively small player in this highly competitive business, currently providing transcription services to 74 hospitals, physician groups and specialty clinics in the U.S. But it is growing faster on an annual percentage basis than the two largest U.S.-based competitors in the business, publicly traded MedQuist and Trascend Services. Medscribe grew revenues to $9.5 million in 2010, up 48% compared with 2009. By 2015, Langley is forecasting $25 million in annual revenues.

Say no to Bangalore
Medscribe touts a singular advantage over its competition: It employs only U.S.-based transcribers while its biggest competitors offshore the work, mostly to India. It overcomes the labor-cost issue by letting employees work from home and connecting them using sophisticated technology.

Here's how Medscribe won over Laurens County Health Care System, a 90-bed hospital in Clinton, S.C., in 2009. “They allowed my employees to join their company,” says Gwen Tribble, the system's director of health information management.

The hospital had three transcribers who had been employed for more than 10 years each. But in 2009 the doctors there asked for round-the-clock transcriptions and Tribble couldn't afford to hire more people.

“We didn't want their jobs to be abolished,” Tribble says. Competitors wouldn't have hired the transcribers and instead would have staff in India or elsewhere to handle the work, a risk that Tribble didn't want to take.

Besides using domestic labor as a competitive advantage, Langley says the quality of the work in places such as India is so poor and he'd have to hire more editors to fix mistakes. “I don't trust them,” he says flatly.

While India pushed transcription prices down, Medscribe used technology to remain competitive. Langley sent most of his employees to work from home using their personal computers, saving office space and computer expenses and taking advantage of the rapidly falling costs of telecommunications and high-speed Internet.

One of Langley's biggest regrets is building an 8,000-square-foot facility to house a growing staff in Jacksonville before realizing it would be cheaper and more efficient to let them work from home. “It sucked the life out of us for four or five years,” Langley says, adding he sold the building in 2007 before the commercial real estate market worsened.

Technology's double edge
The technology brain behind Medscribe is John Langley's brother, Bill Langley. Before his brother recruited him, he was the lead mechanical engineer in support of the Navy F/A 18 and A-6E Aircraft Avionics Attack Systems group at the Naval Aviation Depot in Jacksonville.

Joining Medscribe wasn't a hard decision, Bill Langley says. His brother John was persuasive. “He laid out his vision, and it was very enticing,” he says.

John and Bill Langley always got along well. They both worked in their father's car dealership where they grew up in Jacksonville and understand each other's skills. Bill says his older brother used to drive him around when they were teenagers. “He doesn't micromanage,” Bill Langley says of his brother, who owns 100% of the company. “He comes up with the vision and we put in our experience.”

Fact is, most of the company's 220 employees are scattered around the country in 36 states, all linked into the same computer system that tracks their every keystroke. “The way the technology is, there's nothing I can do in an office that I can't do from home,” says Gary Jurenovich, the company's director of recruitment who works from his home in Ponte Vedra Beach and has been with Medscribe for more than a decade.

In 30 minutes, Jurenovich can review an applicant's questionnaire and test his or her computer remotely. “You can be hired in an hour,” Jurenovich says. “We can do that because we're not a big company.”

But Langley says he also watches technology with a wary eye. That's especially the case because of the government's mandate for electronic health records. “Most people are buying vaporware,” Langley says. “Everyone is still trying to figure out this electronic health record.”

And then there's voice-recognition software, which Medscribe uses now but is only reliable 25% of the time. Still, some health care companies are opting for less-expensive speech-recognition software that lets doctors fill in forms instead of dictating their notes. Medscribe offers that option to its customers, but at one-third the cost of its transcription service. “It's either that or lose the business,” John Langley says.

Still, he says the core transcription business remains sound because of its principal purpose is to save doctors time. “Go ask a doctor if he's going to spend 10 minutes on a chart when he's seeing 40 patients a day in the ER,” Langley says.

Hands off good people
Jurenovich says John Langley pays his employees better than the competition. Depending on how productive they are, transcribers can earn as much as $70,000 a year. “We have trainers who have been around since we opened in 1992,” Jurenovich says. “John rewards his people well, but we're a lean, mean machine. There's not a lot of fat in this company.”

Langley's special skill is hiring good people and letting them do their work. “I know exactly what is expected of me, yet I don't have to call him and ask him when I'm doing something new or different,” Jurenovich says.

Hiring good people and letting them do their job flows down through the organization. “I will never hire somebody for their first at-home job,” says Jurenovich. “You have to hire the right person.” A questionnaire that only 10% of applicants pass and a personal phone call by Jurenovich winnows the hundreds of applicants.

Because employees work from home all over the country, Langley has never personally met many of his employees. He hasn't held an office Christmas party since 1999, when some employees asked him if they'd be paid for showing up.

“He's definitely not a micro manager,” says John Langley's wife, Lori Langley. She's a vice president with the company and a former hospital medical-records specialist.

But while the Langleys like to take time off to ski in Montana and go running together (they have identical Garmin 410 GPS watches to keep track of their pace and distance), Lori Langley says Medscribe is always present in their lives. “Sometimes I have to remind him that it's my time, not Medscribe's time,” she laughs. “I remind him that it's a partnership. I work with him, I don't work for him.”

Every year, Langley and top managers hold a retreat at which time the CEO shares Medscribe's vision for the next one, three and five years. Then, Langley lets Medscribe executives make day-to-day operating decisions. “The thing I like most about John is that he's the kind of boss you can take a problem to, but he tells us all: You better bring me an answer,” says Jurenovich.

Langley says it hasn't been hard to delegate and wonders why he hadn't done that sooner in his company's earlier years. For example, Langley doesn't delve into hiring decisions or employee matters. “I have an HR person,” he says.

Still, Langley is not so hands-off that he doesn't monitor the business carefully. He says he gets about 350 work-related emails a day, he receives weekly reports from his managers and he can log onto his computer in the evenings to check on any aspect of the company's operation. “If we made a bad decision, he'll bring it to the table,” Lori Langley says.

Thoughtful leader
Whether it's fishing or working, no one has seen Langley lose his temper. His fishing partner, Morris, says Langley's people skills were particularly apparent when he became chairman of the finance and endowment committees of the First United Methodist Church of Naples.

As anyone who has served on a church or other volunteer committee knows, the job requires patience and consensus. That was especially so a few years ago because of poor recordkeeping and ineffective use of capital. “These are business decisions you have to make in a church environment without hurting anyone's feelings,” Morris says. “He quickly gained the faith and trust of other committee members. He's very thoughtful and not reckless.”

At the Naples Rotary club, whose membership consists of Type-A entrepreneurs and retired executives, Connell says Langley is a “leader, not a pusher.” This consensus-building style is persuasive without offending anyone. “He's very soft-spoken. He speaks with great thought and completion,” Connell says. “He doesn't give you the impression that he short-changes you in any way.”

But behind that soft-spoken appearance is a quest for perfection that is palpable. The first piece of furniture Langley bought for his new house in Naples was a Yamaha baby grand piano with an electronic recorder with a playback function. “I want to get it perfect,” he says.


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