Health Innovators
Health Innovators

Episode 99 · 1 year ago

Your North Star: How to Pivot Without Getting Lost w/ Angela Fusaro


Being familiar with gaps in healthcare, especially around access to convenient and cost-effective care, can be motivating.

And it is precisely that familiarity with the lack of social equity in access to care that has motivated Dr. Angela Fusaro’s entry into the healthcare solution market.

It’s often difficult to see what’s right in front of you - but, sometimes, life hands you a pre-existing framework on which to build that’s so obvious, you have to act - and act fast.

Leveraging a career in emergency medicine and a passion for education, Dr. Fusaro identified a need and built an answer within the existing community pharmacy network.

From pivoting to iterating your sales strategy to seeking out a mentor who fits your current phase of commercialization, our viewers will find her insights both timely and actionable.

Come hear what Dr. Fusaro has to say about finding, and following, your North Star.

Here are the show highlights:

Virtual care and what’s happening in community pharmacies (1:44)

Iterating and adapting sales strategies (4:42)

Why it’s important to find - and follow - your North Star (10:04)

The importance of balancing passion for what you do with the flexibility (11:42)

Product roadmaps are important, even if they’re only inspirational (14:02)

There’s enormous value that can be found in customer feedback (19:33)

Guest Bio

Dr. Angela Fusaro is an emergency medicine physician and Co-Founder and CEO of Physician 360™, a company that is building a virtual urgent care system that helps decrease unnecessary in-person visits to the doctor.

A pioneer in healthcare innovation, Dr. Fusaro designed and implemented two entrepreneurship courses for medical students and led a national workshop that helped physicians develop insights necessary to improve the quality of patients' lives. 

Her extensive leadership experience in organized medicine helped drive business development for EMRA, the second-largest Emergency Medicine organization in the world. 

Dr. Fusaro received her Doctorate of Medicine from New York University, a BS in Neuroscience Behavioral Bio from Emory University, her MBA from Emory University’s Goizueta Business School and was a 2017 Poets & Quants recipient.

If you’d like to reach out to Dr. Fusaro, you can find her on LinkedIn at Angela Fusaro or reach out to her via the contact page on her website at

You're listening to health innovators, a podcast and video show about the leaders, influencers and early adoptors who are shaping the future of healthcare. I'm your host, Dr Roxy Movie. Welcome back health innovators. Today's episode I'm sitting down with Dr Angela Fusaro, who is the founder of physician three hundred and sixty. Welcome to the show, Angela. Thank you, REX's, for having me. It's good to have you here today. So I always like to start off the episode with having you tell a little bit about yourself and what you've been innovating these days, to give our audience a little bit of context for our conversation. Absolutely, I well, I'm an emergency medicine physician. That's probably a very relevant to how my journey and entrepreneurship started. You know, in that capacity as a frontline healthcare worker, you're really seeing the best and worst of humanity every day and you're you're very familiar with the gaps in healthcare, especially around access to care and care that's convenient and cost effective, and so it was really through that Lens that I was motivated distort physian three hundred and sixty. You know what we do at physician three sixty is essentially we partner with community pharmacies and empower them with tools like access to on demand tall medicine consoles and rapid test kids so that we can transform them into functional urgent cares, and in doing that we allow patients to have really increased access to care, and most of my innovation these days centers around that, at least professionally, and then in my personal life I do like to mcguiver gadgets for all kinds of different challenges, but that's probably not the the focus of today's conversation, though hopefully we'll have time to talk tree house at the end of this conversation. That'll be fun. So so you know why community pharmacies? What's happening there? You know there's so much happening in the market place with virtual care, with Talle health, and so why is why are you kind of linking arms with the communities pharmacies? What's happening? It's such a great prompt because, you know, our relationship with the community pharmacies is something that makes us decidedly different than other traditional telemedicing companies, and I think it probably is worth noting first that one of the most awesome thing about community pharmacies. Are many, many amazing things, but one of the most impactful parts of their structure is their footprint. So there is a community pharmacy within just a few miles of over ninety percent of Americans. So when you start to talk about how do we really need patients where they're at, you know in all these different types of settings, not just urban, you know set of cities, but also like really suburban or even rural America and tribal communities, there is a community pharmacy within a few miles of all of those different types of people and patients, and so that was a large motivation for us to say we've got the infrastructure, we've got this footprint. How do we empower them with these tools so that they can be not just a place where you fill your medications, but also a place where you can actually get care and comprehensive care, because pharmacists are seeing patients more often than just about any other stakeholder in the healthcare system. So when you talk about who's really going to be there to identify, you know, undiagnosed or subclinical symptoms, for many people it's their pharmacist yeah, I mean one of our earlier conversations you had mentioned that they're, you know, really under utilized in the healthcare continuum, and I couldn't agree more. There's there's definitely a lot of opportunity for the community pharmacies to kind of reinvent themselves on how they're going to serve those local communities. So it sounds like what you guys are doing is a good pathway ...

...for them to do that. Thank you. Yeah, I think, you know, in some ways it goes about saying that covid has really brought light to what you just highlighted, because up until the pandemic, I do think that we really I wouldn't say marginalize, that might be too strong, but we definitely underutilized on pharmacies and I think covid made us realize we have to leverage them in a more efficient and a more comprehensive way in order to get everyone access to care. And so, you know, using that initial use case which to some degree with out a necessity, but it forced us to see the true potential of community pharmacies and so hopefully we can get them to function in a much more robust way, which is, you know, similar to models that are occurring already in other parts of the world, like Europe and South America, where your pharmacist can truly function as like as a clinician. HMM, yeah, yeah, absolutely. So let's talk about covid and how that affected your business in your commercialization strategy. Sure, so, you know pre covid. So this you know, going back to the end of two thousand and nineteen, we were already we were already in the market. We were working in all fifty states with, you know, farm hundreds of pharmacies, with a real emphasis on other time sensitive conditions. So we were doing testing and treating for strap flu urinary track infection. So it made sense when the pandemic started that we would parlay that expertise and infrastructure into playing a meaningful role in the pandemic. You know, I will say that it just would like with anything, you know, there's there's some headwind and some Tailwin. That came to US specifically from covid. You know where? Yeah, yeah, I mean we had a significant amount of growth just because, again, tell a medicine and remote diagnostics got highlighted as like this is the foundation of how medicine will be practice going forward. But on the flip side, you know, part of the trade off there's that for an entire year, any customer that we interacted with, you know, saw us through that Lens also, right, so they saw us as, Oh, you're the the covid testing company, or you can bring this type of resource to me as a pharmacist. But it was all around Covid, and so there has definitely been for us, some heavy lifting now that has to go into being, like it worked for you, for Covid, understand the value and the other use cases where this is translatable. Yeah, so it sounds as though kind of revisiting your messaging strategy, brand strategy and maybe even, you know, a lot of your sales strategy has has to be iterated in order to adapt. Absolutely we you know, going back to Aprilish of two thousand and twenty, we ruled out one of the first, what one of the first testing programs in the country for Covid. Again, that was awesome in that we could become a thought leader in that space. But yes, we did have to completely revamp for the purposes of two thousand and twenty. A lot of our messaging and our in are, like you said, our brand strategy and then subsequently have to to do it again in two thousand and twenty one as covid starts to normalize and it becomes just another part of that suite of tools. And so there is definitely things that changed for us. Some were very granular, like pricing strategy and you know, how do you bundle certain products together, and then someone was more, much more global, just making sure people understood that what we had really built, the value of what we'd really built, was in this comprehensive platform. It wasn't just as a x, Y or Z company or this type of product company. Yeah, you know, and I think it's important to kind of dig deeper into this because I think a lot of our audience has faced that as well now that they become a different, completely different company, or maybe some of them have, you know, depending on whether it's a big pivot or a little pivot, but... know a lot of companies have. You know, we're offering the market place or offering a different customer segment, something prior to covid and then, with the changes in the market, having to adapt or wanting to adapt to be able to leverage new opportunities that were before them and then are still, kind of, like you said, at this point of trying to figure out do they go back to who they are? Are they what they were, just how they were defining themselves and presenting themselves in the market place during covid or they something all together different for twenty two and beyond? Yeah, and I think every company is going through that, even when there is no pandemic, right right, you're constantly presented with opportunities that you have to figure out a way to triage, because every opportunity has an opportunity cost also, and so I think this is a problem that companies, especially startups, face in general. I think the pandemic really accelerated that. It was this massive jolt. So you had to figure out, like you said, identity through every phase of it. You know, for us, I think it is important to have the at least the way I approach it, we had a core vision and that compass or that road map was really not going to change in this covid. Now, if it meant that that core vision, this wasn't the king, but let's say we our core vision was around a business that just couldn't survive. Covid then, I think coming out of it and being a decidedly different business. That's that's kind of a whole different ball right. But as far as like how do you how do you you know whether the storm of Covid, I think it's like you lay the foundation of this is the core business, this is the core vision and that compass isn't changing direction, and then you figure out what parts of that vision are translatable and covid. And so for some folks it's eat a little bit easier. I mean, I recognize that. We again, we're already doing telement us in and wrote Diagnostics. It made sense to translate it very directly to covid. But I think if you find yourself too off course from that core vision when you re emerge, it's you don't have the foundation, you don't have the right salid you don't have the right infrastructure to really then scale beyond the the Acutan issue. Yeah, and I think that that's a challenge that's worth US talking about. You know, I like to call it like Shiny Opportunity Syndrome, right where you know there's a very just what you're describing is that when you have a vision and a mission and your kind of Ank. If that's the anchor for your company, you can use that as a lens to determine those pivots and the direction that you're going to take the company. And it's not necessarily a bad thing if you decide that we are changing the mission and the vision and we are intentionally being something else versus if you're just kind of getting washed away with the waves of covid or the ways of those market trends or even changing customer demands, and that you don't really have that anchor to say this is who we are, so then we're kind of get really lost. I see this happen often, like now, all of a sudden, I don't even I'm having an identity crisis and I'm talking to different customer groups and I'm one thing with one customer, another thing with another one, because I'm just really not sure which one they're going to want to buy. So I'm throwing it all out there. So I think it's just I think it's good that you brought that up and it's good for us to talk about it, because I do think that is a challenge that a lot of people wrestle with. And again, I just I was. Want to acknowledge that. I'm not trying to be hypocritical. I think every company goes, needs to go through that to some degree. Rate it's that it's that constant iteration, the constant pivoting. But I think without that North Star, I think is, you know what what a lot of people call, without that North Star, it becomes, like you said, too easy to wake up one day completely off course, without the right tools to to scale. So yeah, I guess that I had on the show a while back was talking about that.

Where they came to and it wasn't covid related. This was prior to covid where, you know, they had been presented a number of different investors or board of Directors or, you know, customer segments that was luring them in a different direction. And you know, about a year and a half into that different direction, they just kind of like looked up and said, you know, that's really not the business I want to be in. It could be a viable business and a great business, but it's not really where my passion and my purpose lies and decided to completely go back to that original mission and vision and was kind of rebuilding and more anchored to who they were and who they how they wanted to impact the world. It's also, you know, it's I'm glad you brought up passion, because I, you know, I think as a founder, and I'm sure you know many entrepreneurs here this like you have to have passion to be successful, and I think that's absolutely true. If you don't have something that is purposeful enough for you, that you think is, you know, related to your many individual mission and purpose here on this earth, it's hard to get up every day and like struggling the grind. On the flip side, if you don't balance that out with another flexibility to listen to what the market is showing you and to see some of these required, you know, branch points and to make optimal decisions at each of the branch points, you're going to be stuck in a or to too inflexible, to a model that might not be able to grow at the market. And so it's, like with so many other things, the perfect balance of those two passion for the ultimate vision, but then flexibility and how it's executed is, you know, I see that in myself and my own challenges time and time again, and that's easy right, is super insci like every other part of this. Oh Man, I wrestle with that as well. It's that balance between this wild, you know, pioneering vision to change the world with this unique idea that you have, and how do you stay true to the crazy that's really going to, you know, change the world, versus listening to the customers and going, you know, what, they actually start them, you know, trump everything that. I think can believe in so many ways, because if I can be right but if no one's buying it, I'm not going to have a business. You know. To that point, and this is not something that I had done, I didn't have any insight about this until we were further down the road, but I think having a like specifically having a product roadmap, even if so much of it is completely aspirational from day one, I think helps to key focus on on that right and then having the discipline at you know, if you're if you're looking at your product Robapmen, you're supposed to be a point one, having the discipline at point one to not get overwhelmed to rush to point two and three. I think it would be enough be goat that. that. That is the the the trick is. Yeah, yeah, yeah, absolutely, get that. Get the first iterations of the product out into the market place and then build on it as you go and kind of get sales and revenue in the door right. Absolutely, and and and learn from that initial use case. I mean I it's something that, again, we struggled with to a and part because of covid. We were we were perfecting one thing and then this opportunity for covid kind of blow up at our you know in a good way, bloop at our face. Do we do? We fall the direction of this opportunity and I think the right thing to do, you know, which we did, was yes, but the tradeoff of that is, in the ideal world, I think you take one use case, you take one part of your product, you take something that you can really iterate to quasite, to perfection, before then you start building on top of it. And so, yeah, Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make just survive and thrive in the new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why...

I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy and DNACOM. Backslash Kit. We've talked a little bit before about. You know, these differences in how maybe you position your your solution as well as your marketing strategy, that when you are marketing something where the problem is very the problem is very mature, that you market it very differently than if you are trying to market something to a target audience that doesn't even know that they have a problem yet and then having to educate that market. So just kind of talk about your experience a little bit with that. Maybe there are some pieces in your offer that you know we're problems that people were looking to solve for and maybe there's some pieces that, you know, you had to educate the market. Are are educating the market around? Yes, this is a problem and it is solvable? Yeah, we we completely went through that. So you know, again, precovid, the conversations that I were have, that I was having with cut pharmacy customers, with investors, with people in general. It was all around the value of telemedicine and remote diagnostics. To your point, we were educating at that time an entire market of people who would never even thought get care in this way right. They never saw their pharmacy as a place where they could pop in and get on their phone and use this test, and so we had the burden of educating about the model, about the value of the model, and I think at that time we talked about marketing strategy, the the real like one of the most salient things that we had to figure out was, because this wasn't, will say, yet a hair on fire problem for patients, like they didn't even realize what they're missing out on yet, because we were still in that education days. We had to figure out a way to get in front of the right subgroup of patients who was going to more immediately need our services, our products and services, so that we could increase the likelihood of the conversion. Right, because if unless you get anyone to the conversion point of like being like this is amazing, they're never going to then be able to see the value and they can't be advocates to their friends and families and there's no network effect right out early a doctor group. So I think initially our marketing strategy is really around how do we get in front of the right people bowl at the right time? And again, this was part of why pharmacies were such a great partner for us because as a consumer, as a patient, if you have a sore throat many times, where do you go to like get a throat spray or cough drop? You're going your pharmacy. So being able to get in front of that patient at the moment where they're going to need us most increase the likelihood of conversion. You know, the pharmacy is almost like them going on to Google and searching. Right, that's that the purchase intent. Intend to purchase rent right, that's exactly right. We had to figure out a way to find in a cost effective manner because we were startup. How do we find those with quasi immediate intent to purchase. That's yeah, and you know then, whatever you would change with covid. So we covid. Then was like, Duh, tell a medicine, Duh, use your pharmacy. So we didn't have to educate as much anymore. And now we had a much broader captive audience. That's like, yes, I'm looking for an opportunity like this. I want to get cared a more efficient, cost effective way. But then which shifted was there was all these new entrants into the market. So...

...whereas we had been thought leaders pre COVID, now every until a medicine. It's so then the marketing really changed around. Well, how are we different and better? What exactly are we doing? It's not we don't need to educate you anymore on the value of this entire sector, but how can we educate you on how we are uniquely different than the other options you have now? It's to be able to since that change in the market it and then be able to be agile and Nimble enough to be able to adapt your marketing strategy and message. I think is really critical being able to stay close to the customers and hear what they're saying so. That way you can, you know, even make those little pivots within your marketing strategy. One of the things that we did around that, specifically, we created at the beginning of this year, was a pharmacy advisory board. So, you know, we're a BE TO BE TOOC model. We sell our products and services primarily to pharmacies. They resell them to patients. So we got a, you know, a dozen or so pharmacists together who represented different, again, parts of our reality, some that were overperforming, some that were underperforming, some that weren't even customers yet, but they represented certain types of communities where we wanted to be successful, and we can be in them once a month to essentially ask them about things like this. You know, what are you seeing that we're not? This is what we're thinking. What are your what's your feedback? You know, so some sense of of evaluation from a from someone who's going to be the end user, or at least the intermediary user in the process. And was that valuable? was that something that you were able to glean some insights from? Yeah, I mean it took a little bit of wrangling to get things up and running, but once we did, with with consistency. Every one of those conversations. You know, some real a pearl of wisdom comes out of it. So yes, I would say it's really been not not only immensely helpful but way more efficient. You know, we were making cut we always make customer calls, like to our pharmacies and stuff, but it's a lot harder when it's kind of Piecemeil like that. This was like a very organized way to rapidly assess that the iterations that we were making sure. So what are some of the other lessons that you've learned along the way in this journey? Whether it's been some of the entrepreneur or entrepreneurship courses that you've taught or whether it's been that real world expense experience of being in the trenches are as we kind of start to wrap up here. Are there any other lessons that you've learned along the way that you would want to share with our audience? Let's see, I will make, I guess, two comments. One is one is around mentorship. So I think every phase of your company's development will require and demand different types of mentorship. So understanding exactly, in a very, very like tactical way, what is it that your company needs to move from point a to point B, helps you identify who the actual experts are in doing that and and those are the best targets for mentorship. You know, I think a lot of times, especially in the early stages, mentorship is more of a it's a relationship, it's a it's a motivational relationship and and it's more, if it's a little bit more, cheerleading. As things go on, I think most of us need maybe a little less cheerleading but a lot of tactical guidance that can shorten the learning curve, because that's part of the game is how do I how do I learn how to do this from pointing to point B as quickly as possible, and I think one of the best ways to do that is with the right types of mentors. And then the other thing that I've learned that I try to say as often as possible to be motivating, is people often ask me about like what the formula is for like for success in this world, and I'm like still trying to figure it out myself, but I do feel fairly confident that there's no there's no secret sauce, there's no there a lot of... is just believing that you have the ability to figure it out, if you have surrounded yourself with the right team, that collectively you can figure it out. To me, that is, you know, the majority of the battle. Yeah, I think you bring up a really good point of the experts or the mentors that you surround yourself with, you know. So your advisors will change right as they come, like what you're saying, evolved as the company grows into different stages as well as those, and it maybe even investors, you know, the folks that you actually hire within the company. A lot of that will change because the skill set and the the pace, the knowledge that's required in the beginning changes over time. And sometimes those people are, you know, tried and true and they've kind of built businesses, you know, through all of the entire steps of inception to, you know, this repeatable revenue model and high scalable growth, and sometimes they haven't. And so being able to sense that in being able to say it's been a great ride with you this last six months or this last year, but we need something new, we need something different to take us like at this new destination, this new point or step that we're going to. I think that's really great wisdom to share with everyone. And I read this Article One I think it was, I don't know what Harvard buses here. You is about Netflix and their approach to performance improvement and just ten yeared a company and it really changed the way I saw this concept. And it's exactly what you just said. As a everyone should look at themselves and then and their team, and you're being brought here for a reason and I want you to crush it at that reason. But once you do, if that reason is no longer irrelevant, it's everyone should feel like the goal was accomplished and then it should need this compassionate moving on. Not so much that anyone's being phased out or appreciate it anymore, but it's more about, like you said, every phase of the company's growth will have a different need and you have to be true to that need and true to the people who could address that need. You know, and it's interesting, I think that even goes for ourselves, right as the founders. Co founders are CEOS of the company that you know, this kind of like scrappy Hustler, comeback artist kind of attitude and ability that is so invaluable in the early stages of a company might not necessarily be what the company needs from their CEO when they're fifteen, twenty years in and they're looking at that you know, exponential growth or scalable growth later on. I just have someone I was talking to and, you know, they founded a company, they built it the very proud and a lot of success and they've been, you know, leading the company for seventeen years and just recently decided to you know, become part of the board, still so still incredibly involved, but recognize that they're no longer the best person to be the CEO to take the company to the next level, and that is got to be very, very difficult and very humbling, but also something to really admire when someone can come to that point. And I think it goes back to, you know, believing that the team, that the team, and the team includes you. Right, you're always doing the best that you can, but you want to grow in that role to the point where you've sort of made yourself you know, you've outgrown your own skill set, and you're right there. There is a lot of humility that has to go into that, but I mean the statistics show I think it's less than five percent of founders who go from, you know, day one to IPO. And so if I think we can leas just use that and say what's said, I'm I'll be thrilled of all my statistical outlawer. But if I'm not, that doesn't mean I haven't done my job as a founder at an early stage CEO to the best of my ability and I haven't done a successful job. It just means that that's where I shine, this is where the team shines, this is where...

...the company's going and I want to bring the right team into shine at this next phase. So I absolutely agree with you. And it's so much easier to have that conversation with someone else that's on the teams and the look in the mirror and have that conversation ourselves. Right. Will say sometimes when I'm trying to like talk through this with my own team, using myself as an example, I think it at least shows them like how this is kind of a universal truth, right. I'm not I'm not telling this to you, I'm not like dictating it at you so that you like, this is something that might happen to you. It's like, Hey, no, this is what we should all be aspiring to there, because that we crush it so much at this phase that the next phase where we're passing the baton. So what is a head for physician? Three hundred and sixty and two thousand and twenty two. So we will continue to March at our vision, which is that we're creating, you know, the largest network of affordable care clinics in the country by transforming these pharmacies. So you will continue to see us in more and more communities, you know, as we as we continue to grow our footprint overlaid in their foot print. There's a few other, you know, conditions that we will probably start to pay more attention to once covid normalizes a little bit. But ultimately, you know, we will be able to service just about any urgent care condition that you would otherwise have gone to an urgent care for. So I think be on the lookout for some fairly creative ways of doing things, as far as you know, getting imaging studies done or things of that nature. That that's really where we're aheaded. Awesome. So how can folks get Ahold of you? If anybody wants to follow up with you after the show, the best way is probably through linkedin. I'm I'm on Linkedin. You can also go to our physician three hundred and sixty dot CEO website and you can find contact information for me or anybody else on the team. They're awesome. Thank you so much for joining me today. It's been great. Thanks Roxy Appreciative. Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who shared the show with friends and colleagues. See You on the next episode of Health Innovators.

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