The Key to Growth in the HTM Industry: A Conversation with Jose Zambrano, CHTM
Sep 24, 2024
realize, jose, years, technician, htm, bachelor, kaiser, learn, leader, loved, today, insider, change, struggle, hospital, good, mentor, school, started, benefits
SPEAKERS
Jose Zambrano, Chyrill Sandrini
Chyrill Sandrini 00:14
Welcome back to HTM Insider, so excited to have you today. My name is Chyrill. I’m with MultiMedical Systems and the host of HTM Insider, for those that are tuning back in for maybe the 30th plus time, or if this is your first time to HTM Insider, let me remind you to listen through Tech Nation, because when you do listen through a Tech Nation, you get one CE credit. So today I have on my friend, my dear friend, Jose Zambrano. I think we go back maybe 12 years, and we could talk about our exact meeting here shortly. But if you’re on the West Coast or you go to any conferences, Jose is a bright light wherever he goes. Just so honored to have him on as a guest today. So with no further ado, I’d like to introduce you to my friend Jose. Jose, why don’t you tell everybody a little bit about yourself.
Jose Zambrano 01:09
Will do thank you. And first of all, let me say how honored I am to be here with you today. I know you’re no longer in California and spending some time in another state, but that’s wonderful as well. And yes, we go back quite a ways, and definitely within the HTM industry, right? I’ve been here at this organization at Kaiser Permanente in Southern California for about 12 years, going on almost 13 and then been in HTM for, oh my gosh, 28 years now, so on and off with different companies, and have worked my way through the ranks, per se. So happy to be here and share our stories.
Chyrill Sandrini 02:00
Oh, I’m so excited, because I think what we’re going to talk to talk about today is, if there’s any of you out there wondering if you should continue your education, should you go and get that degree, whether it be an AA, a BA, a Master’s or further, we’re going to kind of give you some guidelines and why you should do it first. I want to talk about when we first met. I was new in the industry. I think you were new to Kaiser. It was CMIA in San Diego, and you came by and you listened so intently on me describing the components of a rigid endoscope. I can remember the day right now like it was happening yesterday, and that just started this friendship, and we
followed each other and just stayed on top of what I’m doing what you’re doing, and it’s been great. So I do encourage you to make those relationships dips and stay in touch. In this industry, there’s so many bridges that you can go over that can help you succeed and further your career. So, Jose, I know you started with DaVita. Was it DaVita?
Jose Zambrano 03:07
Yep. And then, actually, first was Fresenius, okay, yeah.
Chyrill Sandrini 03:12
And then you became a part of Kaiser and as a biomed, and I think you were in Ontario? Was it Ontario? Yeah, my memory is doing well today. Now, as you got into Kaiser and you start learning the ropes of working inside a hospital, being part of it, you know, a hospital team, clinical engineering team, what was the first itch that you got, that maybe you thought maybe I should go back to school. Tell us where that happened in your life.
Jose Zambrano 03:49
Well, first of all, I will tell you that my mom was so upset when I didn’t continue on after my certificate program, because I actually did finish the certificate program in electronics technology after high school, so in a community college in Northern California, and life happened. And, you know, I started having babies and got married, and before you know, the need for money was there and the need for benefits was there. So that’s what started the whole job hunt and career seeking. And although I will say that that foundation was wonderful, it sparked something in me, right? I, as a kid loved electronics, and particularly mobile, mobile audio, and so that was great. I equated everything I learned in the electronic school with a car stereo. And so it was wonderful. Loved it. I even started my own business doing car audio and security installs. Then I quickly realized that, you know. So the people just won’t pay for your labor. It’s it’s more about the resale. That’s where the where the money was at. So like I said, once the baby started coming, I realized I needed benefits and full coverage benefits for everybody. And so that’s when I landed at Fresenius. There was still a job back then. And then, as you know, the story of my grandmother becoming ill with end stage renal disease. That’s when it flipped on me. That’s when it became a career to really spark that light, that I realized that every piece of equipment that I was touching was for the benefit of another patient, somebody, somebody else’s loved one. It didn’t matter whether it was daughter, kid, parent, grandparent, etc. And so after a while, I realized that I had to move on and after field service, then I went on to the beat up, because I wanted to learn even more on the dialysis side from the provider side, and there I was actually given the opportunity to come back to California as a supervisor. Luckily, the certificate was still good enough. But then I tried a director’s spot, and I was denied because I did not have a bachelor’s. And so that was my first interaction where I felt like I knew that I had it in me to do it, but it was the first stop that came into that, into that playing field, that I realized I wasn’t going to be able to make it with just a certificate. So fast forward over to Kaiser, and same thing came in as a technician, and loved it. You know, the environments that we had within were wonderful. Came to a small crew where I was able to do anything, you know, just go from MLB Settings to all of the different departments within our hospital and surgical centers, etc. And then I realized that I wanted to make a difference, an even bigger difference. It was It wasn’t just good enough to just do the equipment work and do that well. I wanted to do more for our team, and I wanted to make a difference overall. And so once I was given the opportunity to become certified through them, by the way, you know, of course, I was a big one, so I went from technician to certified, and I was being mentored by my previous lead, Peter Ortega. And unfortunately, he passed, what a great guy, right? And oh my gosh, I still talk about him. I still talk about him as if he was coming back tomorrow. And let me tell you, with his encouragement, he was the one that told me, Jose, you need to get back to school. At some point you’re gonna need it. And didn’t think much of it. And once he passed, it became a reality, because then, as a lead, I realized, you know, he’s totally right. I need to look into this. And luckily, I had several options to choose from. And I started because I only had the certificate. I had to start from the bottom, go for my associates, then the bachelor’s. And during that time, I also applied for a couple of management spots. And every time I got close, but it just wasn’t quite there yet. And the last time I got beat out by another one, another cohort of mine now, who had an MBA and that now, all of a sudden I realized, Okay, well, the bachelor’s isn’t going to be enough. If I want to continue, I got to go even higher. Luckily, after I attained the bachelor’s, I had an opportunity to come to San Diego, and now I work within two hospitals and the 19, well, not 20 MLBs with two ASUs and oversee the two different teams. But again, you know, it’s just when you know, when you’re restless and you know you want more, and you know that you can do it? Yeah, you just have to figure it out. And that’s exactly what happened. I started seeing my mentors and people that I looked up to, and I started looking at their resumes or their LinkedIn profiles, and realized they’ve done all these different steps. And so when I look at a, even an executive director position within Kaiser. I take that job description and I make it a roadmap, and I have to start ticking those boxes off one by one.
Chyrill Sandrini 09:50
That’s a great idea!
Jose Zambrano 09:50
now, for some people, it might not work, right? Yeah, it’s, it’s, that’s exactly what you need to do. Look at the people that have come before you, that have helped you along. The way, see what they’ve done and figure out what works for you and what of the of what they have that you can be able to do. So,
Chyrill Sandrini 10:09
Find that mentor, exactly. I mean, had you not had, right, that someone who’s constantly pushing you along. You could do better, Jose, come on, Jose, right?
That’s right, that’s right. And you know, it was a reality. So I knew from early on in my teenage years that I love leading. You know, Spanish club president, band club president, you name it. I was always I loved being the organizer, right? I’d walk around with a clipboard. And so I started developing a lot of that as a young man, but now with schooling, it has really put everything
into a really nice package, because now I know that being a leader means that you have to learn all the leadership styles, because you cannot be just a transformational leader. You must be transactional, you must be transformational. You have to inspire others. And I didn’t know that at the beginning, when I was given my first opportunity as a supervisor, I was just, you know, trying to be a tech, a good tech, in front of everybody else, and teaching them how to be a good tech. But today, I realize that there’s more to it than just that. So it’s been a great opportunity, and now I continue on. I’m still not satisfied, but we’ll get into that in a little bit more.
Chyrill Sandrini 11:43
Well, I want to ask you that timeline so you have to start over right? And then now you have obtained your masters.
Jose Zambrano 11:54
I’m almost in December. How
Chyrill Sandrini 11:56
long has that taken? And how did you do it? Working full time with the family? How long? Oh, my God, I can’t imagine
it’s it’s definitely a commitment, right? And it’s one of those that, you know, it’s a marathon. You will hit roadblocks. There will be professors that you just do not click with the subject just does not spark your interest, and you will struggle and you have blockers, or sometimes you know a family member sick, and you have to tend to them, or you yourself get sick or get in the hospital, and you have to tend to your own needs. There will be a lot of that, and it’s, again, you have to realize that it’s a long marathon, so it’s not something that you’re going to gain right away.
Chyrill Sandrini 12:46
How many years are in your marathon so far?
Six years. And I did have to take a couple pauses, including when Peter passed. That was one that I, when that happened, I literally shut down. I had a real hard time with that. It was a very close death to me that was not within my immediate family, although he felt like family because we worked together. As you know, when you work with somebody every day, they’re part of you. They’re undeniably but yeah, six years, and we’re at the I can taste the end of it,
and I’ve had to make adjustments. So I changed schools for this master’s program. I’m in a much easier program where, instead of the shorter terms, they’re a little bit longer. So you have to realize, when you are experiencing problems, you have to figure out what it is that you need and be able to address it so that you can continue.
Chyrill Sandrini 13:47
Yeah, so you’re doing online courses, and do you recommend that to others? And how many classes do you take at a time to get where you’re at today? Because I can’t imagine the workload, and then getting home, and I’m sure your family still wants part of your time, and you better get the lawn mowed, or hire somebody to mow the lawn, or help with the dishes and the laundry, and you better go on vacation, because Mama’s not going to be happy. And you know those things, how many classes are you taking and are you doing it online? And how many hours a week are you putting into this program?
So this master’s program is definitely very time consuming. Typically, a day and a half over the weekend is literally all researching, reading, writing and whatever other assignments they have you doing. So it does take up a lot of your time. And then, of course, during the week, at least a couple nights a week, so you are you will lose some sleep. And my other mentor, Ray Delacruz,
you know, he was very forthcoming about it. He told me flat out, hey. So just let me know when you need to come in a little a little later, because I know you’re going to need it. And sure enough, it happened many different times, that balancing act is, is very real. The struggle is, is really real. And you have to say no at times, right? My son was here from Arizona this past weekend, and they came down to San Diego, and I literally had to say, I’m sorry. I really wish I want to be down there with you guys, but I have to sit and do my homework. So you have to be disciplined. So for me, the online schooling was it is ideal, because of the long days at work and the things that happen at work, you have to be able to reprioritize and make things move for your benefit. However, there’s a lot of other people that feel that the brick and mortar attending live works a lot better, and there’s nothing wrong with that. So if that’s how you learn. You learn by being with other people. Then do that, but realize that some classes will definitely be easier online. For me, it just really worked out to to to be able to be flexible with my schedule. I will say that being the online school made it so much easier these days, because you can do assignments literally on your phone, so if it’s just a discussion, you know, so much easier to read outside while you’re looking at at the birds and and your cat and dog that are playing outside. And you know, kind of have that feel that you’re still connected, but still doing your work, right? So it really, really made a difference for me.
Chyrill Sandrini 16:46
So I want to know people that might be on the fence considering going back to school or maybe just looking for the next step in their career, why is it a move they should make to go into leadership in HTM, from your opinion?
So turning in the the wrench for a laptop is is a big transition. And let me tell you, these last in October will be full two years, and I’ve struggled with that a lot because you really want to get in there and put your hands in, but then you realize that it is not about you any longer. You are not it. You are responsible for others. So where before, you were responsible for your own toolbox and your own outcomes? Today now you’re responsible for a group, and so you’re literally in charge of making sure that they’re fine, that they need, that they receive all the different needs, whether they’re personal or work related. You are now the responsible party for it, and you have to answer for their actions. So it is definitely something that is a calling. You realize that a manager is not a leader and a leader is not a manager, but you have to know both. And when you realize that, you come to terms with the fact that as a leader, you have completely different duties. You have to back them up. You have to answer to their actions in front of a lot of other staff and management particularly, and then you have to learn to motivate people. And then that’s the easier one. Sometimes it’s easy, right? In HTM, food is a wonderful motivator, right? You get people out to eat together, camaraderie comes out. And yeah, it’s it’s big. And like you said, the conferences that we attend are a perfect example of that, where you actually get to see people. And it’s amazing. Over the years, all the relationships you build with other people from other health systems, your support systems. Because, as you know, I consider MMS and part of my support system, and you’ve played a huge role into that, because you guys have become solutionists for me, you know. So when I need something, you need to be able to reach out, and there are times where you don’t have the answer, so you need to have that base of people that you trust.
Chyrill Sandrini 19:22
Well, I agree. Do you feel like it’s changed now that you are considered a decision maker and that you can, you know, create that circle of trust? Has it changed for being a biomed and explain how that has affected you personally?
Well, it definitely, definitely has made a difference for me, right? The fact that you are, again, no longer touching the equipment. Now you’re having to guide other people with some of those decisions that have to be made. You are the expert, right? Because you have an opinion over Hey, this EKG machine has a much better cleaning surface than this one. Yes, I know you like this one because of xy factor, but you have to be able to articulate the reasons for for your decisions. And it’s really easy when you have that that big network, right? So building that network throughout HTM is is, I would say, critical for any leader, whether you’re talking Amy, the local state organizations and your local chapters staying involved, because guess what, if you’re struggling with it, so is somebody else. You are not alone, although it may feel like you’re by yourself, because this is your building, but the reality is, there’s other people struggling. So when I’ve gone to these larger conferences, and you hear Mayo talk about their challenges and staffing and what they’ve done, you realize, Aha, I can use that, and they’re willing to share, because we’re all going through the same struggles,
Chyrill Sandrini 21:11
And we’re all in it together. Right?
It’s definitely exactly and that’s what we do. We’re problem solvers. So you talk to somebody else and you tell them what your problem is. Guess what? In HDM, they’re going to give you a suggestion, you know. So it definitely has changed for me, because you definitely feel like you are now helping to steer the ship right. You’re no longer just doing the do. Now you’re actually part of the the setting of the goals, as well as achieving them together. So definitely a change,
Chyrill Sandrini 21:48
You know, I think in pictures. So I just see a bunch of people rowing a boat, and there’s one guy out front, the one no, this way. Turn left, row, row, you know, think that’s what it is as an HTM leader.
Yeah, and, and there are times where you’re going to have to, you know, go to the back and pick it up and help steer from the back. You sometimes, you know, being a leader is not necessarily always being in front. You got to get your team recognized. You got to help them to become into the forefront, because, again, they’re the ones that are there doing the regular work. You’re just there leading them. So it is important to realize all of that behind the leadership roles. It’s not for everybody, for sure, but when you come out of it, and for example, I have a few really close friends from my DaVita days, and they’re in other industries, one works for law enforcement, another one that works in banking, and we still stay together. We call each other, we message each other, because you build that bond and you realize that’s what leadership is about gaining that relationship that that lasts a lifetime.
Chyrill Sandrini 23:06
I want to ask you so when they’re trying to decide, okay, I’m going to go back to school, I’m going to finish my BA or get my BA, or I want to get my master’s, can you give us some advice on what type of degree we should get? Because there’s a lot of degree choices out there, and even the word clinical engineering gets very confused in higher education, so maybe give us some titles of some degrees that they should pursue or look at that would be helpful to them in their HTM career.
Jose Zambrano 23:40
Exactly the first thing that would say is realize that your goals will change. Right? What you think is what you want today will not be what you are aspiring in five or even 10 years later. So if you’re an aspiring technician that wants to come in. Of course, you’re looking at the different programs that give you your certificate to get in, and then you quickly realize that I don’t want to be just a technician. I want to be a lead, or I want to learn to program the network or write code within cybersecurity to help protect these devices, and therefore that clinical engineering,
or biomedical engineering program will suit you perfect. So all of a sudden you start looking into that as a bachelor’s program, to get into that realm as a clinical engineer, and yes, you’re setting up the whole patient monitoring system. You’re helping build cybersecurity, and you are responsible for getting those things to come into our environment, and then the technicians take over as the systems are being actually deployed. So you realize, hey, that might be a really good field, and I want to do that. However, again, for the ones that want to become leaders, you start realizing that what is a PNL statement and why is it in brackets? I thought that was a good thing. No, you know it’s not. And until you take a course that teaches you what the variances are and you start realizing that your actions of ordering all those extra bonus parts that you stock in your drawer to make that quick turnaround are actually hurting you, because now you’re looking like you’re spending too much, or you order all your PM kits in one month for the rest of the year, and you got this huge spike that now your manager has to account for. You start realizing that you need some business sense and you need some basic accounting to understand the rest of it, because you can go into meetings where they hold you accountable for your budget, but you don’t know what these are. You don’t know what these reports that are being shown to you, and you have no clue. So how are you supposed to address that if you don’t know it? So for me, it was a realization that business was it if I wanted to really make a difference at the larger realm, for the groups, I was going to want to continue on with a business degree, it became fairly clear within the last five years that that was what I needed to do in order to reach the larger goals.
Chyrill Sandrini 26:26
Yeah, because I don’t think that people do realize, you know how expensive it is to run a hospital or be into healthcare with parts, and then you know when you add labor and you know benefits into it, how expensive it is just to have personnel. And in a hospital, there’s many parts of a hospital, it’s there’s food, there’s, you know, EVS, there’s so many different divisions, and everybody needs a piece of that pie. And you need to come down to those little numbers at the bottom of the page, right? The little numbers to make sure that you’re, you’re you’re in the positive, you’re not in the negative, right?
Jose Zambrano 27:05
That’s right, that’s right. And I think that’s where learning and taking all those different classes that teach you HR management, let me tell you, that was huge for me. I just finished my bachelor’s degree, and I decided to take the CHTM exam. And I take it was a perfect timing, because I had just completed a bunch of HR courses, and there was so much of that within that exam. Of course, the CBET, you know, is completely technical, and you want to be, you know, up to date with all the physiological and realize that there’s a lot of technical questions in there, but as the CHTM exam was a completely different level. It wasn’t about the technical questions. It was about, hey, we’re putting, you know, an MRI here, and we’re looking at these cost of service ratios. What do you recommend? You’re like, whoa, wait a minute. Okay, so what was cost of service ratio? How did I figure that out? And how do I compare the two between one and the other? It really does change. So when you realize that you want to get into leadership, you really change that perspective. Because, again, you’re not worried about the one single cost. Now you’re talking, hey, let me take a look at that contract cost, because I might, I might benefit from, you know, that that need that I have within my technical group, and take
advantage of that cost savings. Or it might even be that you might need to bring it in house, you know, whatever the the case may be, but there’s a lot that you as a technician, you just simply don’t practice or don’t know, right?
Chyrill Sandrini 28:49
So, you know, I find we often, as managers, propose ideas and solutions, and we’re cheerleaders, but the person that you’re talking to is always what’s in it for me, what’s in it for me?
Jose Zambrano 29:07
That’s right.
Chyrill Sandrini 29:08
getting your education, I want to ask you, what’s been in it for you? Was there money as a motivator? Is there a way to climb the ladder and also earn more financial success in your career? Continuing your education, if you could equate that for the listeners to tell them why, that might be a bonus as well?
Jose Zambrano 29:26
Most definitely the of course, we all work for a living, right one way or another, and I tell my team that all the time my job is I’m still here for paycheck, just like you, just our definitions of what we do is different. That’s all. I still, you know, I don’t necessarily punch a clock anymore, but I still have to deliver and give these outcomes at the right times. If I don’t, that’s when you know, of course, you could be looking at some discipline on yourself as well, because you’re not taking care of business. When, when you are looking at the roles, that’s when that network comes in. Because you can ask, Hey, is 10,000 20,000 more over what I’m making? Good enough, you know? Because you really don’t know. You have no idea. And only people that trust you, and you trust them, will tell you, because they’re not. They’re not afraid to talk about it. They’re open about it. Hey, make sure you negotiate this. Make sure you negotiate that you know. Make sure that that comes with it, whether it’s a moving bonus or a relocation bonus, as they like to call it, right? Of course, your your bonus structure is different, right? So you have to be in it and understand that, because you don’t as a technician, you know, you’re like, What? What are you talking about? A bonus, right? As long as my hourly is good, I’m okay, but it becomes different to realize that there’s a lot of other layers that you just are simply not privy to, but again, that large network of people will help you and understand that when you apply for these roles as a leader, guess what? They want outcomes just like a technician. So you have to come in with a, what they call a business plan, right? And you have to find out what their business is and what they expect from their manager, so that you can give them an idea of what you want to do for yourself, right? Whether it’s if you’re over a large territory, hey, I’m going to plan on visiting the West Coast for these many months, and then I’m going to move over here, and you have to give them that business plan of how you’re going to achieve the results by being out there, by being involved with the teams, your one on ones, your team
meetings. Those are important because they want to know that you’re involved with them as well. I’ll tell you the biggest thing that I learned many years ago, and I’ve said this in several interviews, even in the management… People will do what you inspect, not what you expect. So if you inspect what you’re expecting, people will work to that. But again, right? It’s, it’s important, and it’s something that I always have to keep that, because sometimes I realize I give that goal, but I didn’t give enough direction, oops. You know, I need to go, come back and revisit that and go back to square one. But, right? Yeah, definitely. Get that relationship with other leaders that are already there or have been there, because, as you know, we have a lot of people who have retired and go on to do entrepreneurship on their own, and some of them have been entrepreneurs for many years. We have many of those as well, so being able to talk to them and finding out what they did, how they did it, is also crucial.
Chyrill Sandrini 33:09
Well, Jose, it’s been a joy to have you on today. It’s always great to sit down with you in person or even on this podcast, we always close HTM Insider with a wow word or words of wisdom you just gave us, like that one right there. I’m going to write that down and save it. Is there anything else you’d like to add today that maybe you can that
Jose Zambrano 33:33
I’ve used in the past? And people always ask me, Jose, Why do you smile so much? Why? And I feel blessed, right? But know that positivity is definitely a lifestyle. It’s definitely something within you. It’s a life force. You must culture it and nurture it. But in order to be a good leader, you must lead with your heart. You must smile from your soul, always be the best you, and always try to be better than yesterday.
Chyrill Sandrini 34:07
Oh, I love that, Jose. Oh, it got me goosebumps all over. If you haven’t met Jose, he is on LinkedIn, he’s on social media, he’s at all the events. And I know he’s got a full docket, but I know that he’s well connected in the industry. So if you’re someone looking for a mentor, you can message myself or Jose, and we’ll even connect you with AAMI, who has a great mentorship program to connect those that are looking and seeking some advice, maybe some leadership, maybe some direction, whether it’s going back to school or just seeking out your CBET. So if you want more information on that, like I said, you can message Jose or myself. We’ll make sure that you have all this information to reach out to him. And we’d like to thank you again for tuning in to HTM Insider, follow us wherever you listen to your. Podcast, whether it be Spotify Apple Music or even on YouTube on HTM Insider TV, please connect with both of us on social media, and we look forward to seeing you next time on HTM Insider.