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PeopleFirst Leadership
In The Business of Helping People
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Joseph Giles knows healthcare. The former investment banker ran a billion dollar company before coming to Alpine. He most recently served as president and COO of Oak Brook, IL-based Athletico Physical Therapy, where he led 4,500 employees and grew the company from $35 to $100 million of EBITDA in just three years. The CEO and president of Midwest Vision Partners (MVP), native Midwesterner, husband, and father of two shares how his values—helping people, family, and community—shape the way he’s building MVP, the importance of investing in quality (people and companies), and how he’s energized by improving the ophthalmology experience for patients and doctors across the company.


Alpine is a middle market private equity firm focused on software and services businesses up to $500m of EV. We closed our seventh fund at $1 billion in November 2019. Our CEO-in-Residence (CIR) model allows proven operators to step into leadership roles within our portfolio while our CEO-in-Training (CIT) program has helped more than 20 newly graduated MBAs from the world's top business schools accelerate into the CEO chair. Alpine has deployed 35 CEOs in total since 2013.

Tell us about your first impressions of Alpine.

When I first met Alpine back in 2017, my first reaction was, "Who is Alpine?” As a former investment banker, I had worked on larger deals and they were a smaller fund at the time. I also wasn't as focused on tech and software as they were. As soon as I got to know them, I realized that Alpine was just different in how they talked about the importance of people in organizations. They believe there’s a different way to do things. You can do well by your employees and do well by your shareholders.


They called when I was still president of Athletico and I had no intention of moving or leaving. They explained that they had found me because I met several criteria on their executive scorecard, including a successful exit and running a big company. They were also interested in investing more in healthcare. [Alpine Partner] Matt Moore said, “We put a lot of thought and effort into the scorecard, and when we find people who meet our criteria, we put our time into them." It struck me as a very focused process.


When I flew out to meet the team in San Francisco I was even more impressed by their preparation for interviews. Generally speaking, people are pretty guarded when it comes to providing references. Matt went into his desk, handed me the entire list, and said, "Call any Alpine CEO you want." You don't find many firms that are willing to do that. 

You had a lot of options after leaving Athletico. What factors did you consider when choosing to join Alpine as a CEO-in-Residence?

I knew I wanted to be closer to home and Alpine understood that. My mom lives in Michigan and my kids were just starting new schools. Staying local was also important to my own personal management style. One of the things I enjoy most about running a business is connecting with people, and I could never see myself as a CEO that flies in on Monday, flies out on Friday. That schedule would make it hard for me to be present with my wife and kids.

Even with geography limitations, Alpine wanted to continue pressing forward. They believed in our partnership so I decided to believe in it as well. They were open-minded, they listened, and they were willing to adjust. When you choose a role like this, you're looking for a true partner. In partnership, both sides have to flex.

When you choose a role like this, you're looking for a true partner. In partnership, both sides have to flex.

Looking back, they have certainly flexed at different times during our working relationship, and I have, too. 

What concerns did you have about joining Alpine? And how did you resolve those critical questions and ultimately join?

Alpine had a smaller fund and less healthcare experience than other private equity firms that I had worked with in the past. But the more I heard about their focus on people first, the more I realized that they would be open to continually learning as they supported me and the many other CEOs running their portfolio companies. I appreciated that they weren’t set in their ways and they were willing to grow and evolve while building sustainable, highly successful businesses. They wanted to reach our return threshold, but they also wanted to be good stewards of human capital as it relates to our employees and patients. That really resonated with me. I felt like they were a partner who could grow with me.

I felt like they were a partner who could grow with me.

It was also important to me and to Alpine that we align on critical aspects of our investment thesis. For example, partnering with high quality physicians was very important to me. Alpine supported that priority because it would help us attract additional partnerships with other physician practices and it would help us recruit new physicians.

What resonated with you about the eye care industry?

In addition to my previous experience in physical therapy, I have served on boards in the dermatology and autism space. I have met with management teams and private equity groups invested in other physician practice management models. Eye care, especially ophthalmology and optometry, resonated with me for several reasons.


First, unlike in physical therapy, technology plays a major role in the actual treatment options available for patients. From recent advancements in drugs that treat retinal diseases to improved premium lenses used in cataract surgeries that free patients from glasses, it’s refreshing to see how advancements in technology have improved patients’ treatment options and overall sight. Second, many of our patients are 65 and older. Now that I’m in my late 40s, I’ve gained an appreciation for taking care of my mom and the next generation. In my hometown of Flint, Michigan, we partnered with the leading ophthalmology practice, Michigan Eye Institute where many of my older family members have been patients for decades. It has been personally gratifying for me to support our practice there while providing great care for many of the residents in my hometown and surrounding communities.

How did you build trust among physicians? 

I wanted to learn the business quickly and to establish close relationships with the physicians. So I spent four weeks in Ohio working with our partners in that market. The doctors really appreciated my hands-on approach. I spent a lot of time meeting all of our staff, shadowing our physicians, and spending time with patients to see what our physicians go through and to better understand our patient journeys.


Our initial partnership with Dr. Lawrence Lohman of Northeast Ohio Eye Surgeons helped us attract other top physicians. Dr. Lohman is well-known and has a great reputation. In our early conversations with other doctors, they respected Dr. Lohman and the thoughtful way in which he evaluated a partnership with Midwest Vision Partners and Alpine Investors. That credibility led to our next partnership with Cleveland Eye Clinic. 

How did you convince a strong leadership team to join you in such an entrepreneurial pursuit?

After spending time with our first practice, I turned my attention to building my executive team. I hired Jonathan Jean-Pierre, a CIT with Alpine. A former colleague, Jorge Lopez, joined as my COO, and with Alpine’s help, I hired Sean McMillen as our CFO. Sean had previous experience working in a large, PE-backed healthcare business.


This was my first time building an entire leadership team from scratch, and we all viewed it as an entrepreneurial opportunity, especially as we built our organizational structure. But unlike most startups that are high risk with unproven business models, we had the benefit of partnering with established physician practices. We had the flexibility to build a team and corporate infrastructure from the ground up, but without the business model risk associated with a pure startup. I believe my prior success with Athletico and clear vision for Midwest Vision Partners also helped to recruit my executive team and other talented individuals.

You’ve now hired a couple of CITs. How do you approach leadership and mentorship?

Mentorship means a lot to me and it’s something I enjoy. When I sit in front of someone like Jonathan Jean-Pierre or the other CITs we've hired, I understand their perspective personally. I've been there. At Vista Equity Partners when I was transitioning my career from investment banking to operations, I remember wondering: where am I going to live? I've got to move my family. Where will this lead and how will this experience shape my career? All of those questions are similar to the questions CITs are thinking through. I tell my team, “I can't promise it's going to be a great investment, but I strongly believe it will be. I can promise that I will mentor you and develop you and that I understand exactly what you're going through.” 

What’s next?

The initial stage of MVP was to partner with well-established ophthalmology practices, now we’re focused on integration. We kicked that off this year. We're integrating the business, including some back-office things like payroll, finance, and accounting. And we're starting to embark on some really meaningful integration with the systems that the physicians use, including practice management systems and electronic health records. That's going to be a significant change for the physicians, hopefully in a positive way. But we all know no matter the change, change is still difficult. So we're preparing for that right now.

What are you most proud of over the past year and a half?

I am proud of the quality of the physicians that we have partnered with as well as how quickly we have become the second-largest ophthalmology-focused player in the Midwest in our first year of operation.

I am proud of the quality of the physicians that we have partnered with as well as how quickly we have become the second-largest ophthalmology-focused player in the Midwest in our first year of operation.

Also, I believe we have built a unique leadership and ownership model. Four of the physicians serve on our board of directors. They genuinely appreciate learning how to scale a larger healthcare organization and I genuinely appreciate their energy and mentorship. Many of our physicians are invested in MVP, which furthers their ability to continue creating wealth while doing what they love to do—helping their patients.