Robbie Allen - Chief Executive Officer

A Conversation with a Five Star Executive

Over the past several years, The Tolan Group (TTG) placed Robbie Allen at a PE backed porfolio company, where we built his leadership team and later at his current role at US Heart and Vascular, a rapidly growing cardiovascular platform. During that time, the organization has experienced significant expansion, navigating the complexities of scaling a physician-led business in an evolving healthcare landscape.

Recently, Tim Tolan, TTG’s Founder and Managing Partner, sat down with Robbie to discuss his journey from entrepreneur to healthcare executive, the lessons learned along the way, and his vision for the future of cardiovascular care. This interview has been condensed for clarity and space.

ABOUT ROBBIE

Robbie Allen is the Chief Executive Officer of US Heart and Vascular, a leading cardiovascular platform focused on building high-quality, physician-aligned specialty care.

A serial entrepreneur, Robbie began his career in healthcare technology, founding and scaling a company focused on early telemedicine solutions. What started as a technical challenge evolved into a global business, ultimately leading to a successful exit after more than a decade of growth.

He later transitioned into healthcare services, where he developed a strong track record of operational leadership and growth. Robbie led a multi-state orthopedic and spine organization through a successful turnaround before going on to serve as CEO of a private equity-backed gastroenterology platform. There, he helped scale the business significantly, expanding its footprint and building a high-performing leadership team.

Known for his strategic mindset and people-first leadership style, Robbie focuses on building organizations for long-term success. At US Heart and Vascular, he is leading efforts to expand access to care, strengthen physician alignment, and position the platform for continued growth in a rapidly evolving healthcare landscape.

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TOLAN: Robbie Allen. How are you, sir?

ALLEN: I'm good. How are you? I'm doing great and glad to be with you today, Tim.

TOLAN: Well, let's get rolling. I know your journey started as an entrepreneur. And I think it was on the healthcare tech side, correct? So maybe just to spend a few minutes and tell us about how you launched in and was there a WHY?

ALLEN: It was Health Tech. The WHY is probably embarrassing, Tim. I was challenged earlier in my career working for other people when I started my first company. I was young, reasonably smart, not as smart as I thought I was, and probably painfully difficult to work with. And so, I thought, hey, you know what? There's this really cool problem to solve, and it's centered around how to get telemedical information across the current modems of the day, which were, using dial-up 9600 baud modems.

And could we do that in healthcare? And so, the impetus was, gosh, nobody's figured this out. Everybody needs an answer. There are not enough people to do the work. So as an engineer, I'm an engineering student at the time, a couple of us got together and said, "Let’s go start a business." And we knew that we knew nothing about starting a business. We knew nothing about the technology problem we were trying to solve. We were not experts in the field of medicine, technology, or telephonics. So, I think we were blessed to grow up during a time when you could ask for forgiveness and figure things out as you went.

I mean, this was an era of healthcare when a rep might be scrubbed into a case, they were helping a doctor on. So, there was a little bit more gray area in terms of being able to play in the margins more meaningfully, and we took advantage of that. We were probably more lucky than good for a little while, but we parlayed that into, like all good stories. That's kind of how I got into it. And it grew from there, literally grew from, I can't find the job I want, so let’s start a company. I managed to borrow $40,000 from friends and family, and literally, that was the seed money that kind of launched that company.

So, the rest kind of played out over 15 years into a large company that we sold off. So, it was a wild ride. We had a great time. Along the way, I started graduate school, and we started a sourcing company for electrodes and materials out of China, and we began working in South America and Europe. There was no international set of rules, and people just kept saying yes, and we kept trying to figure out ways to make it work after we'd say yes.

And we began to inject professionalization along the way, brought in a board at some point, and some really smart and serious people that helped us understand what scale would look like. They helped keep ourselves out of trouble, particularly in South America, where some of the regulatory rules around working in Brazil, for example, and things like that were a little more complicated. So, I was fortunate to just run into some amazing board members, advisors, and executives along the way that, frankly, were way outside of my ability to out-kick my coverage by a long shot, so that was helpful.

TOLAN: Were you moving images over a 9600 baud modem? Tell me that's not what you were doing.

ALLEN: So, what we learned was how to transmit sort of the delta pixel, just the pixel changes on, like imagine an EKG is a line. And it doesn't change much, but we figured out how to change just the pixel, so it's kind of an early version of compression. So, we would send over data at 9600 baud speed initially. Pictures came a little bit later. We had to wait until we got to multiplexed 14.4 mode to do that. We were able to transmit basic what I would call telemetry data in a way that led us to jump into operating rooms and ICU rooms, and we could talk basically, and have a slight delay of 5-10 seconds.

TOLAN: And your economic buyer was the hospital?

ALLEN: Largely in the hospital space. There weren't enough people who knew how to do this. In other words, the kind of brain trust was very small, a couple hundred in the world. And they needed people in the room who knew how to kind of plug that in, so we developed a way to train those people, and then connected them to the brains on the other end, and we had to kind of syndicate this across this group.

TOLAN: That's an incredible story. And you did the exit, and then you stayed for a while, correct?

ALLEN: I did, and we were exposed to perfusion and OR second assist and PA services supply, kind of the back-end sterile supply side of things, as well as sort of endoscopy towers and stuff like that. So, all of those were core parts of the special care business that I ran in that book of business, for a few years, and they are literally across the street.

TOLAN: Wow. They are. Full circle! Well, then you did something really big that I would characterize as a big pivot. When we were recruiting you to become CEO of a gastro platform backed by a leading Private Equity firm. You went from technology leader into healthcare services. What kind of a pivot was that?

ALLEN: In some ways, I thought it was going to be an easy pivot along the way while we were running that first company. I finished my training as a neurophysiologist, so I thought like a clinician, not a very good one, I was always better at managing and kind of thinking about the problems than I was as a clinician. I thought it was simply going to be a large version of my experience as a clinician.

It is not. But at the same time, it was a kind of fortuitous problem. The first group that I joined, which was a large multi-state orthopedic and spine and physical therapy, was in trouble. And so, I think the helpful part of that, not that it was helpful ever to be in trouble, but they were losing money on a fairly large scale. But those types of problems are engineering problems. When it's a turnaround, it's simply about, "I've got to have enough of the resource”, in this case, capture patients and manage how I spend out until I can get things going on the output.

And I treated it like that, and we were able to turn that business around and inside of the year back to 20% margins, and along the way, it helped me understand where some of the key aspects of physician practice and large scale practices start to fall down, where the pinch points are, where the challenges are, and I became fascinated with that, so that when you guys called about the GI opportunity, it was less of a jarring transition and more of a, “all right, well, tell me a little bit more about what we're trying to do here with this.”

TOLAN: What's funny is that you never jumped across the primary care bridge. You’ve always kind of been on the specialty side, correct?

ALLEN: I have. I think primary care I would consider now, but about the time I entered the gastro platform,, all of primary care everywhere was migrating into this early version of what does risk look like across primary care, which had a very different paradigm. Not that I couldn't have learned it, but they were already five or six years into that by the time I took the GI CEO role, while the specialty care paradigm is not yet even today caught up to that. And in fact, one of the things we're trying to do now in a cardiac platform. And so, I think it would be interesting, and the eventual closing of this loop is to marry the two. Medicine is a team sport; all healthcare is a team. And the sooner we learn to play on the same team, instead of pitting against each other, I think the more effective healthcare will start to work.

TOLAN: Well, and then you go to the gastro platform, and I remember it vividly because when we first made the placement, I knew the size, the scope, I knew the metrics, and that organization just exploded both in terms of footprint, number of providers, numbers of employees. How did you pull that off?

ALLEN: A lot of that was when I joined. It was right in the middle of what was a land grab in GI. And so, I remember vividly, lots of board meetings where, as the board directors would say, "Robbie, this is a land grab”. It can't be, we need to pick our markets, and we shouldn't be losing too many of these on this land grab. We must go aggressively. We need to close these deals. And so, a lot of it was sales, honestly. Now you're trying to differentiate what makes your platform different than five or six others and at the end of the day, and you know this as well as I do. Ensuring the right people are in the right chairs with the right tools is what makes these things work or not work. And so, like pulling the right team members in, your firm was critical, on that in terms of basically helping place probably at least two thirds of my executive team but getting the right people in the right chairs is critical. And once you do, you step back and make sure they understand what you're trying to do, then things tend to run on a predictable autopilot basis.

TOLAN: But you still have the baton in your hand. You still must conduct the orchestra. And I think strategy is one of the things that I've always been impressed by in terms of one of the key attributes you bring into an organization. You're looking outward.  You're not trying to solve the problems of the minute - you're looking beyond that.

ALLEN: That's right. You can go where the puck is right now, but that's not going to work. You want to be open for where the puck needs to be. That, I think, helped us differentiate in the GI market, and I know it did. What got groups to say, “Hey, we like this group more than that group,” was that our focus was on building the GI group for the next 50 years, not on how we could flip this thing for maximum profit. And that can make some interesting board meetings and things like that as everybody's sort of talking about natural tensions, but at the end of the day, a physician practice is held together by largely shared belief.

Like, everybody in it has got to believe in what we're doing. At the end of the day, they don't. You know, it tends to get kind of messy. And that's communication. You've got to have this clarion repetitive, inexhaustible messaging on what we're doing, why we're doing it, how we're doing it. Just over and over, all the time.

TOLAN: Did you inherit a Strategic Plan, or did you create a plan?

ALLEN: There were one and a half groups in the building at the time. When I left, there were 18, or 17, something like that. So, the general strategy of, hey, let's put together some groups here, let's grow this with some geographic density, the thesis for this investment was done. How to do that was largely left to me and the team, as we thought through what makes sense, where do we spend our money, how do we pull in this capital, and what's the return?

But we got really creative in terms of having some natural JVs, some ASC management team providers in a real kind of thoughtful way that we use that equity to then go and continue to grow the platform. During the 2021-2022 shift, where capital went from very easy to get to where capital got hard to get. It was very cheap, as well. Super cheap! And then it went away... So, that was the strategy, and the future is going to be one of those interesting shifts that will be fascinating to watch and think through. What is this going to look like over the next 20 years?

TOLAN: Well, you also grew your leadership team, exponentially during that time frame. What were the characteristics that you looked for then? Has that really changed as you've evolved into your new CEO role?

ALLEN: That's such a good question, Tim. I think one of the things that I looked at, particularly in a turnaround or at a firefight, we're in a rapid growth scenario, different constraints, but the same type of thing. What you're really thinking through is, can this person be direct and candid? Can they have crucial conversations, can they own their own accountability frame or what they're doing? Are they afraid to make mistakes and are they mentally adaptable enough to kind of learn from a mistake? And so, that broadly describes what I would look for in anybody adding a function. If you couldn’t keep up with that, those were the changes we ended up having to make. Along the way, we’ve made one or two changes to the executive team at every company, where somebody is able to grow to a certain point and then kind of becomes a lid on growth beyond that. But that mental agility is kind of continuous learning and ability to have crucial conversations, regardless of the constituency here, and the ability to do it well is to sort of call people in on things and kind of move forward. It's not a terribly common thing right now, as you think about that subset, and it's not that we didn't want confidence in the individual specialty, but when you look at, for example, the CFO that you brought in and his ability to see complexity. It’s not so much his ability to manage the financials. I’m sure there are other people who can manage financials at the same level. The ability to quickly see complexity, sort it into something everybody can understand, and then keep learning is what makes a CFO a rock star.

As you know, our CIO that developed this place, has a very similar story. The ability to kind of take the thing that annoys people the most, IT. It's almost like the cable company. You can have that be the highest NPS-scoring function in the company because of the communication, the explanation, and that kind of relentless focus. That’s what I continue to look for today.

TOLAN: And do you just sort of set the goalposts for your leaders and get out of their way?

ALLEN: Absolutely - you're managing, but you're not hiring people to have to tell them what to do every day. I have a saying “the more that you need me, the less I need you at a certain point”. My goal is to get out of these people's way. Communicate where we're going, why we're doing it, how we're doing it, get out of the way, get them resources, move stuff out of their way, and lift them up and empower them so that they can go fast. Take bullets for them so they can. At the end of the day, I can't do any of their jobs. But I can run interference, I can get resources, I can kind of come in behind them and clean stuff up, so they can do the job.

TOLAN: The other challenge, I would think for a lot of people is growing and scaling a provider platform. It's not easy, and we both know that. What is the secret sauce that allows you to sell the future vision of where you want to take these companies and the companies you’ve led? Because it’s a different game, and they’re all getting their doorbells rung by private equity firms left and right.

ALLEN: I think they have to believe in what they're doing. And I tell this to the team all the time. If you think what we're doing is a load of garbage, we're going to need to talk about that because if we don't believe it, nobody else will. Number one. Number two, the challenging part of leading a provider business is representative governance.

Once you get north of about 100 really smart individual contributor type people in the same group? They're used to a vote on everything, and you have to move to a voice, not a vote. And that's where the training wheels come off. Just setting the governance properly. Just getting that governance and that feedback up and down. That has to be done correctly, and everybody feels like their voice matters. Doesn't mean it always goes their way, but their voice matters and there's up-and-down feedback, and it's exhausting. When setting those things up, you must be in front of people 70-80% of the time. You have to over-communicate everything; you have to begin to show results. That’s really where most of these things kind of come off, where they don’t continue to evolve. You've got to be aligned with what we're doing, why we're doing it and how we're doing it. Everybody must believe in that story. And then you've got to integrate everything. Everything that you can integrate in the business has to be as integrated as soon as possible.

We use an NFL model. Every company operates a little bit like this. The league sets the rules by which everybody plays. You wear a patch on the sleeve, but the name on the front is your local brand, and the name on the back is Dr. Smith. That matters. But the value comes from being part of the league. That’s kind of the way I think about it.

TOLAN: I would think also having a solid board chair is probably helpful.

ALLEN: Absolutely. I believe in the power of a good board and in the opposite of that. You know a disengaged board can be almost as negatively impactful as a really positively engaged board. It depends on how they're leaning in.

TOLAN: Well, you’re in a very unique specialty within the cardiology market that is obviously becoming more challenging due to a growing number of issues. Number one, shortage of providers, I mean, you know that, because you deal with it every day. Increasing demand for specialized care, rising health care costs. And those challenges are really impacting patient access, reimbursement, and kind of the overall financial strain on providers. How do you navigate those challenges while maintaining your growth trajectory? Because they don't always work hand in hand?

ALLEN: I mean at the end of the day Tim, you have to make having the platform that you're in, be the place people want to work, one of your top two priorities, your patients have to be one of those top two priorities as well, and we take a tendency to lean towards our staff. We want happy staff; we want this to be the place they want to work, which then in turn makes it the place people want to come. And those two things together, coupled with the culture amongst the physicians, make it a place that they want to come. If you don't get that part figured out, none of the rest really matters, it can be about pay, but it's also about everybody kind of falling in line with what we're doing, why we're doing it and how we're doing it and communicating with it, you do have to pay people the right way.

You have to have the incentives lined up. And here's probably the most important part nobody really likes to think about. Some of the most productive, particularly the physician side, are positions that I've met, don't do well in large frameworks. And, you know you get excited about their numbers, but they are not meant to work well in getting along with others in a large group. They're not going to play in a sandbox.

We spend a lot of time together and we'd like to enjoy it. And if somebody can't embrace that, they're probably not a good fit here.

TOLAN: What about the physician shortage aspect of it? How do you deal with that?

ALLEN: So, we have the market where we can manage through that. Predominantly, what we expect to see over the next 10 years is a bit of a cliff as older physicians begin to retire in larger numbers. There are definitely headwinds. First, we’re not training physicians fast enough to keep pace with projected retirements. Second, I don’t think we talk enough about AI and the capabilities that are coming alongside it. Coupled with better training, our mid-level providers and nurses are going to help absorb some of that pressure.

You could make a strong argument that feels like pathology and radiology are going to change dramatically. You’re probably not going to want a person simply reading a radiology film. You’ll want AI and the radiologist helping determine what to do with the diagnosis, but not necessarily doing the initial read itself. Those same changes are coming to cardiology, too. Eventually, most diagnostic procedures evolve, and we’re already watching that happen very quickly in cardiology. That should help alleviate some of the physician shortage pressure, along with getting cardiology better at utilizing providers at the top of their license.

Cardiology lags behind the rest of medicine by probably 20 to 25 years in terms of how effectively it uses PAs and LPNs. There’s still a mindset of, “You’re coming to see Dr. Allen and nobody else.” But when we talk to patients, most just want reassurance and timely care. They’ll say, “My doctor told me I have X, and I need to see somebody.” When we ask who they want to see, most respond with, “I don’t really care who I see. I just want to know I’m not going to drop dead tomorrow.”

At the same time, a lot of older physicians are understandably cautious about AI. The pace of technological change right now is incredibly fast, and even younger generations are struggling to keep up with how quickly things are evolving. One thing we focus on is helping people understand how they’re actually going to use these tools. We use a lot of ambient listening technology, and even our older physicians tend to love it because it’s frighteningly good. They come out saying, “Wow, I didn’t have to type my notes.” And we tell them, “Exactly. We’ll help manage the backend workflows.” The cleanup is minimal because the system automatically flags repetitive or unclear documentation. It’s impressive.

TOLAN: Sticking with the same theme for just a second on human capital, like a lot of other specialty organizations, the cardiology workforce is aging. We see it across all the specialties and obviously create significant challenges in meeting the growing need for care, particularly when you're scaling a platform as you are. So how do you deal with that whole multi-generational challenge of hiring great people to evolve different ages and subsets?

ALLEN: We spend a lot of time talking about this on the side of security, so that gives you some sense of the level we put this on. What we've come to believe is we need to address people where they are, and we need to stop trying to make that an aspect of this uniform. In other words, we need to create a place where people can be partners and go blast it out and try to collect every dollar they can. But then we need a pathway for somebody who says, “I just want W-2 employment, and I want to make sure I have the right kinds of benefits and leave. I want to teach here, learn from each other here, and take my trip to the Himalayas every year for my mental health. Great, here’s what that looks like.

How do we incorporate both approaches here, and how do we balance the economics of that, so people own their own agency and understand what the outcome is? Why does one person make more while another makes less? It comes down to the benefits you’ve chosen.

So, in fact, the cafeteria style compensation plan, where you can say work life balance is a nine for me, and cash is six. I'd like to do it that way. This is how we're beginning to address that, because across the generational providers, it's a big deal. The 30-year-old doctors want to have the notion of having to hack a trail with the machete to build their own practice and compete against their own partners with patients? They won't do it. And, by the way down, I think every generation, at this point, I'm probably in that generation, every older generation has looked upon the young one, and amongst complaining about their music and taste in haircuts and clothes, has fussed about their lack of work ethic. So, this is nothing new. We're just having to solve it kind of in real time at a big scale. It's a challenge for all industries. It's not unique, certainly not. You need to take healthcare.

TOLAN: As both of a serial entrepreneur and obviously a successful CEO of several healthcare companies, one of the three or four pieces of advice that you might share with up-and-coming CEOs who aspire to do some of the things that you've done, Robbie, because obviously you set up a pretty high mark. What are some of the pieces of advice you would offer?

ALLEN: No, goodness, will try to avoid the advice-giving business, but I think a couple of things come to mind. I get asked this question all the time, Tim, “what's the best leadership book if you’ve ever read?” And the response I have to that is, all of them, almost every leadership book I've ever read, and I've read damn near all of them, have great things in them. The problem is, if you're a ruthless go getter or ADHD from hell, Brené Brown's probably not your style of leadership. So, if it doesn't, it can't be incorporated into who you are, but it's a really bad idea. It's kind of like a diet, which one works best, the one you can follow. And I think that figuring out who you are and how to incorporate that advice, the back half of that, the second part of that is, figure out who your little mini board advisors are in your life. That isn't part of your company. The people that you, the two or three or four, probably not a lot more than that, that you can give them the straight scoop regardless, and you're going to get straight and honest feedback about what you're doing. That's invaluable to keep you sane. CEO jobs are kind of a little isolated, and I think it can be, people say they feel lonely. In a way, it's the worst kind of loneliness. It's a bunch of stuff going on, and you're surrounded by people that you interact with on those problems. And so, it's kind of what the marriage therapists described as loneliness, and marriage is the worst kind of loneliness. Then the last piece is really. I think you should never do your job, afraid to lose your job or put differently doing it to try to keep it is a fast way to lose it. Yeah, it's the best job. Do the job, you know how to do.

I watch a lot of new CEOs so desperate to get in the chair that they forget the things that gave them the shot, which is rarely being a suck up. So... and they self-sabotage, in most cases. They always do. Have a good CEO to be mentored by, too. I think certainly I have, particularly as I've grown and scaled there, I have a group of four or five now public company CEOs once a month, I sit down and talk to and buy lunch, and we have a drink and I kind of share a problem listening to their stories. And hear how they solve things. Which are the same problems. Sometimes there's another zero or a comma, but it's all the same stuff. At the end of every problem, is a group of people.

TOLAN: Well, obviously, I know you and know your background, know your family story, which is a phenomenal story. So, nine children, you're all over the map in terms of what you do, you're a scuba diver, you do all kinds of cool things. But when you're not doing all of that, are there particular things that you are reading or podcasts that you listen to that you find interesting?

ALLEN: Right now, about once a year I read crucial conversations, which I think is just a great book. A good book to the crux of most problems. The one I just reread is Think Again. Adam Grant’s books tend to have a consistent style and set of ideas in his later work, and from a podcast standpoint, I'm a pretty big fan. I know that the podcast is on the New York Times series, which I think turns off, at this point, half the country. But Ezra Klein does a good job, even fully understands his biases. But he brings in every point on the spectrum and his interviews on this podcast are about trying to understand, not about trying to make a point, which is a lost art. I’ve been focused on all aspects of bringing in somebody who doesn’t think the way I do. Instead of trying to challenge them, the interview is about understanding. Walk me through how you think about that. What's the counterfactual? It's kind of brain food, it's helped me see, particularly over these last five years. His show has been instrumental in understanding points of the spectrum around both politics, religion, government, things like that. I think, probably five years ago would have just made me crazy and angry. Now, thanks to his show, I kind of think it through, and I'm like, all right, let's figure out ways to kind of think about this differently and think how do I go talk to these people? Which says family's been kind of ripped apart by the politics of the last six years. So, it's great. And so that's why I like this show. He's pretty phenomenal.

TOLAN: That's good advice. Well, you’ve been a great friend of our firm. We obviously have a lot of good things to say about you. We think a lot of you and your team, and you all have obviously been there for us, and I wanted to express our sincere gratitude to you for that and for your time today. This was very helpful for me.

ALLEN: So that goes both ways, Tim. We were all fans of The Tolan Group. Truly, you are all phenomenal. You've been kind of one of the key elements of me getting where I am, so I was on a panel, not too long ago, that I don't remember where I've done a lot of panels over the last six months. But somebody was asking, well, what are the things nobody would know and the keys to your success? One is an executive leadership coach that we have used for the whole team, and the other one is you guys. So, yeah, you guys have been phenomenal, so it's been great. It's been great, Tim.

TOLAN: Well, thanks for your time, Robbie. I really appreciate it.

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About US Heart and Vascular:

US Heart and Vascular is a physician-led cardiovascular platform dedicated to delivering high-quality, patient-centered care across the United States. The organization partners with cardiologists and vascular specialists to support the growth of independent practices through operational, strategic, and administrative resources.

Focused on clinical excellence and long-term alignment, US Heart and Vascular enables physicians to maintain their local identity while benefiting from the scale, infrastructure, and innovation of a larger platform.

About The Tolan Group:

The Tolan Group is a full-service human capital solutions firm recognized for their performance-driven placement services. Our talented recruiting team makes placements for executive leadership and middle management roles in healthcare services, behavioral health, and healthcare tech. We find and place the ideal candidate for our clients in the shortest amount of time possible. 80% of TTG's clients use them time and time again as talent needs arise. We have a 98% completion rate and most of our assignments are completed in 10-12 weeks. We take the time to understand each client’s goals and thanks to our deep industry experience, we know where to find the best candidates to meet and exceed our clients' expectations.