Health Innovators
Health Innovators

Episode 99 · 2 months 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, adoctors who are shaping the future of health care on your host Doctor Roxeymovie welcome back health innovators. Today'sepisode, I'm sitting down with Dr Angela Fusaro, who is the founder of physician three and sixtywelcome to the show Angela, thank you recks for having me it's good to haveyou here today, so I always like to start off the episode with having youtell a little bit about yourself and what you've been innovating these daysto give our audience a little bit of context. For our conversation, absolutely I well I'm an emergency medicinephysician, that's probably very relevant to how my journey anentrepreneurship started. You know in that capacity as a frontline healthcare worker you're, really seeing the best and worst of humanity every dayand you're you're very familiar with the gaps in health care, especiallyaround access to care and care. That's convenient and cost effective, and soit was really through that Lens that I was motivated to start physician threeand sixty. You know what we do with physician through t is essentially wepartner with community pharmacies and empower them with tools like access,Dondametta, medicine consoles and rapid test kit, so that we can transform theminto functional urgent cares and in doing that, we allow patients to havereally increased access to care and most of my innovation, these days,centers around that at least perfessionally, and then in my personallife. I do like to macgyver gadgets for all kinds of different challenges, butthat's probably not the focus of today's cover. versation L, hopefullywe'll have time to talk tree house at the end of this conversation, that'll be fun. So so you know why community pharmacieswhat's happening there. You know there's so much happening in the market place withvirtual care with Talaheeti, and so why is? Why are you kind of linking armswith the community's pharmacies? What's happening? It's such a great prompt, because youknow our relationship with the community pharmacies is something thatmakes us decidedly different than other traditional telemedicine companies, andI think it probably is worth noting first that one of the most awesomething about community pharmacies or any many amazing things, but one of themost impactful parts of their structure istheir footprint. So there is a community pharmacy within just a fewmiles of over ninety percent of Americans. So when you start to talkabout how do we really need patients where they're at you know in all thesedifferent types of settings, not just urban, you know set it cities, but alsolike really suburban or even rural, America and tribal communities. Thereis a community pharmacy within a few miles of all of those different typesof people and patients, and so that was alarge motivation for us to say: We've got the infrastructure. We've got thisfootprint. How do we empower them with these tools at that? They can be notjust a place where you fill your medications, but also a place where youcan actually get care and comprehensive care, because pharmacists are seeingpatients more often than just about any other state holder in the health caresystem. So when you talk about who's really going to be there to identify,you know Nundinas or sub clinical symptoms for many people to theirpharmacist yeah in one of our earlierconversations you had mentioned that they're, you know really under utilizedin the health care, continue them and I couldn't agree more. There's there's. Definitely a lot ofopportunity for the community pharmacies to kind of reinventthemselves on how they're going to serve those local communities. So itsounds like what you guys are doing is...

...a good pathway for them to do that.Thank you, yeah. I think you know I in some ways it goes about saying thatCovin has really brought light to what you just highlighted, because up until the pandemic, I do think thatwe really, I wouldn't say marginalize that might be too strong. But wedefinitely underutilized pharmacies and I think Covin made us realize we haveto leverage them in a more efficient and in a more comprehensive way inorder to get everyone access to care. And so you know using that initial usecase which to some degree, was at a necessity, but it forced us to see thetrue potential of community pharmacies, and so hopefully we can get them tofunction in a much more robust way, which is you know, similar to modelsthat are occurring already in other parts of the world. Like you know,Europe and South America, where your pharmacist can truly function. Ize likeas a commission M Yeah Yeah. Absolutely so, let's talk about Ovid and how thataffected, O Your Business and your commercialization strategy. Sure so you know pre Covin. So becauseyou know going back to the end of two thousand and nineteen, we were alreadywe we were already in the market. We were working in all fifty states with you know, farm hundreds of pharmacieswith a real emphasis on other time, sensitive condition. So we were doingtesting and treating for strap flu urinary track infection, so it madesense when the pandemic started that we would partly that expertise in theinfrastructure into playing a meaningful role in pandemic. You know I will say that it just withlike with anything you know, there's there's some head win and some Talwinthat came to us specifically from Ovid, you know were yeah yeah, I mean we hada significant amount of growth. Just because again tell medicine and remotediagnostics got highlighted as like. This is the foundation of how medicinewill be practice going forward, but on the flip side you know part ofthe trade off there is that for an entire year, any customer that weinteracted with you know saw us through that Lens. Also right, so they saw saysoh you're, the the COVIN testing comather. You can bring this type ofresource to me as a pharmacist, but it was all around coved, and so there hasdefinitely been for us some heavy lifting now that has to go into beinglike it worked for you for Ovid, understand the value and the other usescases where this is translatable yeah. So it sounds as though kind ofrevisiting 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 gone back to a Breise of two thousand and twenty werolled out one of the first one of the first testing programs in the countryfor Ovid. Again that was awesome in that we could become a thought leaderin that space. But yes, we do have to completely revamp for the purposes oftwo thousand and twenty a lot of our messaging and R, and our, like you,said our brand strategy and then subsequently have to do it again in twothousand and twenty one as coid starts to normalize, and it becomes justanother part of that Swede of tools, and so there was definitely things thatchanged for us. Some were very granular like pricing strategy, and you know howdo you bundle certain products together and then someone's more much moreglobal, just making sure people understood that what we had reallybuilt the value of what we'd really built was in this comprehensiveplatform. It wasn't just as a x Y R S, Z, company or this type of productcompany yeah. You know- and I think it's important to kind of dig deeperinto this, because I think a lot of our audience has faced that as well note that they become a different,completely different company, or maybe some of them have. You know, dependingon whether it's a big pivot or a little...

...pivot. But you know a lot of companies.Have you know were offering the marketplace or offering a differentcustomer segment something prior to Ovid and then with the changes in themarket having to adapt or wanting to adapt, to be able to leverage newopportunities that were before them and then are still kind of, like you saidat this point of trying to figure out, do they go back to who they were orthey what they were just how they were defining themselves and presentingthemselves in the market place during Ovid, or they something altogetherdifferent for twenty two and beyond yeah. I think every company is going throughthat, even when there is no pandemic right right, you're constantlypresented with opportunities that you have to figure out a way to triage,because every opportunity has an opportunity cost also- and so I thinkthis is a problem that companies especially start ups face ingeneral. I think the pandemic really accelerated that it was this massivejolt, so you had to figure out, like you said, identity through every phaseof it. You know for us. I think it is important to have the at least the way I approach it. Wehad a Corvis and that compass or that road map was really not going to changein this ovid. Now, if it meant that that core vision, this was the king. Well, let's say ourcore vision was around a business that just couldn't survive, Covin that Ithink coming out of it being a decidedly different business. That'sthat'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 Cogit, Ithink it's like you, lay the foundation of this- is the court business. This isthe core vision and that compass isn't changing direction, and then you figureout what parts of that vision are translatable in Covin and so for somefolks, it's a little bit easier. I mean I recognize that we again we're alreadydoing telemedicine road diagnostics. It makes sense to translate it very directly to Ovid, but I think, ifyou find yourself too, of course from that core vision, when you reemerge, isyou don't have the foundation? You don't have the right talent, you don'thave the right infrastructure to really ben scale beyond the the acute issueyeah, 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 youknow there's a bit just what you're describing is that when you have avision and a mission and you're kind of an, if that's the anchor for yourcompany, you can use that as a lens to determine those pivots and in thedirection that you're going to take the company and it's not necessarily a badthing. If you decide that we are changing the mission and the vision andwe are intentionally being something else versus if you're, just kind ofgetting washed away with the waves of Ovid or the ways of those market trendsor even changing customer demands, and that you don't really have that anchorto say this is who we are so then we're kind of get really lost. I see thishappen often like now. All of a sudden, I don't even I'm having an identitycrisis and I'm talking to different customer groups and I'm one thing withone customer another thing with another one, because I'm just really not surewhich one they're going to want to buy, so I'm throwing it all out there. So Ithink it's just. I think it's good that you, you brought that up and it's goodfor us to talk about it, because I do think that is a challenge that a lot ofpeople wrestle with and again I'm just. I was want to acknowledge, like I'm nottrying to be hypocritical, I think every company goes what needs to gothrough that to some degree right. It's that it's that constant iteration, theconstant of pivoting, but I think without that North Star, I think, is you know what alot of people call without that North Star it. It becomes, like you said too easy towake up one day, completely off course, without the right tools to scale soyeah. I guess that I had on the show a while back was talking about that wherethey came to and it wasn't provid...

...related. This was prior to Ovid, whereyou know they had been presented, a number of different investors or boardof directors, or you know, customer segments that was luring them in adifferent direction, and you know about a year and a half into that differentdirection. They just kind of like looked up and said you know, that'sreally not the business I want to be in. It could be a viable business and agreat business, but it's not really where my passion and my purpose liesand decided to completely go back to that original mission and vision andwas kind of rebuilding and more anchored to who they were and who theyhow they wanted to impact the world. And it's also, you know it's I'm glad.You brought up passion because I yeah you know I think, as a founder and I'msure you know many entrepreneurs hear this like. Youhave to have passion to be successful, and I think that's absolutely true. Ifyou don't have something that is purposeful enough for you, that youthink is, you know related to Euromin individual mission and purpose here onthis earth, it's hard to get up every day and like struggle in the grind onthe flip side, if you don't balance that out with enough flexibility tolisten 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 branchpoints you're going to be stuck in a R T too inflexible to a model that mightnot 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, butthen flexibility and how it's executed is you know I see that in myself and myown challenge is time and time again and it's easy right. You just out superare of this. Oh Man, I wrestle with that as well.It's that balance between this wild. You know pioneering vision to changethe world with this unique idea that you have,and- 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 whatthey actually circum. You know trump everything that I think and believe inso many ways, because if I can be right, but if no one's buying it I'm not goingto have a business, you know it's that point, and this isnot something that I had done. I didn't have the insight about this until wewere further down the road, but I think having a like specifically having aproduct road map, even if I was so much of it, is completely aspirational fromdoing on. I think it helps to keep a focus on on that right and then having thediscipline. You know if you're, if you're looking at your product robotbut you're supposed to be a point one having the discipline at point one tonot get overwhelmed to rush to point two and three. I think it would be a because that athat is the trick. Is Yeah Yeah yeah absolutely get that get the firstiterations of the product out into the market place and then build on it asyou go and kind of get sales and revenue in the door right absolutely and learn from that initialuse case I mean it's something that again we struggled with to and partbecause of Ovid we were. We were perfecting one thing and then thisopportunity for Ovid kind of blew up in our you know in a good way, blue in ourface. Do we do we follow the deck of this opportunity and I think the rightthing to do. You know which we did was yes, but the trade off of that is inthe ideal world. I think you take one use case. You take one part of yourproduct and take something that you can really iterate to quasi to perfectionbefore then you start building on top of it and so yeah hey it's Dr Roxy. Here with a quickbreak from the conversation. Are you trying to figure out what moves youneed to make to survive and thrive in the new Co vid economy? I want everyhealth innovator to find their most...

...viable and profitable pivot strategy,which is why I created the Co. Vid proof, your business pivot, Kit, thepivot kit is a step by step framework that helps you find your best pivotstrategies. It walks you through six categories. You need to examine for athree hundred and sixty degree view of your business. I call them the sixcritical pivot lenses, as you make your way through this comprehensive kit,you'll be armed with the tools, chips and strategies you need to make sureyou can pivot with speed without missing out on critical details andopportunities, learn more at legacy. Hyphen DACO BACKLASH KIT: We've talked a little bit before aboutyou, know these differences and how maybe you position your solution aswell as your marketing strategy that when you are marketing, something wherethe problem is very the problem is very mature thatyou market it very differently. Then, if you are trying to market somethingto a target audience that doesn't even know that they have a problem yet andthen having to educate that market. So just kind of talk about your experiencea little bit with that. Maybe there are some pieces in your offer that you knowwere problems that people were looking to solve for and maybe there's somepieces that you know you had to educate the marketor are educating the market around. Yes, this is a problem and it is solvable yeah. We completely went through that,so you know again pre coved. The conversations that I were have that Iwas having with pharmacy customers with investors with people in general. Itwas all around the value of Tele, medicine and remote diagnostics. Yourpoint we were educating at that time, an entire market of people who hadnever even thought get care in this way right. They neversaw their pharmacy as a place where they could pop in and get on theirphone and use this test, and so we had the burden of educating about the modelabout the value of the model, and I think at that time we talk aboutmarketing strategy. The Real, like one of the most salient thingsthat we had to figure out was because this wasn't will say yet a heron fireproblem for patients like they didn't even realize what they were missing outon yet because we were still in that arcades that we had to figure out a wayto get in front of the right sum group of patients who was going to moreimmediately need our services, our products and services, so that we couldincrease the likelihood of the conversion right because I, unless youget 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 beadvocates to their friends and families and there's no network effect right outearly adopter group. So I think initially our marketing strategy wasreally around. How do we get in front of the right people at the right time?And again? This was part of why pharmacies were such a great part ofher for us because as a consumer as a patient, if you have a sore throat manytimes where you go to like get a throat spray or cough drop you're going yourpharmacy so being able to get in front of that patient at the moment, wherethey're going to need us most increase the life rolighed of conversion, you know not like the pharmacy isalmost like them going on to Google and searching right. That's that purchaseintent, intend to purchase rendait, that's exactly right. We had to figureout a way to find in a cost effective manner, because we were we start up.How do we find those with quasi immediate and tent to purchase? That'syeah, and you know, then whatever would change with Covin, so we Covin, then,was like do tell e medicine use your pharmacy, so we didn't have to educateas much anymore. Now we had a much broader captive audience. It's like!Yes, I'm looking for an opportunity like this. I want to get care and amore efficient cost effective way, but then w t what shifted was there wasall these new entrance into the market.

So, whereas we had been thought leaders,pre, Ovid, now ever o tell medicine it. So then the marketing really changedaround well. How are we different and better? What exactly are we doing? Isit not? We don't need to educate you anymore in the value of this entiresector, but how can we educate you on how we are uniquely different than theother opportunties you have now and to be able to sense that change in themarket and then your able to be agile and Nimble enough to be able to adaptyour marketing strategy and message, I think, is really critical, being able to stay close to thecustomers and hear what they're saying so that way, you can, you know, evenmake those little pivots within your marketing strategy. One of the things that we did aroundthat at specifically we created at the beginning of this year, was a pharmacyadvisory board. So you know we're a be to be to see model. We sell ourproducts and services primarily to pharmacies, they resell them topatients. So we got a a you know, a dozen or so pharmacists together whorepresented different again parts of our reality, some that were overperforming some that were under performing some that weren't evencustomers yet, but they represented certain types ofcommunities where we wanted to be successful and we convene them once amonth to essentially ask them about things like this. You know what are youyou're seeing that we're? Not This is what we're thinking. What are you?What's your feedback? You know so some sense of of evaluation from from someone who'sgoing to be the end user or release the intermediary user in the process, andwas that valuable? was that something that you were able to believe someinsights from yeah? I mean it took a little bit of ofwrangling to get things up and running, but once we did with with consistencyevery one of those conversations you know some real pearl of wisdom comesout of it. So, yes, I would say it's really beennot not only immensely helpful but way more efficient. You know wewere making cut, we always make customer calls like to our pharmaciesand stuff, but it's a lot harder when it's kind of peace mill like that. Thiswas like a very organized way to rapidly assess the iterations that wewere making sure. So what are some of the other lessons that you've learnedalong the way in this journey, whether it's been some of the Entrepreneur,entrepreneurship courses that you've taught or whether it's been that realworld expense experience of being in the trenches are, as we kind of start,to wrap up here there any other lessons that you've learned along the way thatyou would want to share with our audience. Let's see I will make. I guess twocomments. One is one is around mentorship, so I think every phase ofyour company's development will require and demand different types ofmentorship, so understanding exactly in a very, very like tactical way. What isit that your company needs to move from point at to point b? Helps you identifywho the actual experts are in doing that and and those are the best targetsfor mentorship. You know, I think a lot of times, especially in the earlystages. Mentorship is more of a it's a relationship, it's amotivational relationship and then it's more it's a little bit more chelating,as things go on, I think most of us need may be a little less Tuladi, but alot of tactical guidance that can shorten the lorning curve, becausethat's part of the game is how do I? How do I learn how to do this frompointing to point B as quickly as possible, and I think one of the bestways to do guys with the right types of mentors and then the other thing that I'velearned that I try to say as often as possible to be motivating. Is Peopleoften ask me about like what the formula is for like for success in thisworld and I'm like still trying to figure it out myself, but I do feelfairly confident that there is no there's no secret sauce, there's notthere. A lot of it is just believing...

...that you have the ability to figure itout. If you have surrounded yourself at the right team that collectively youcan figure it out to me that is, you know the majority ofthe battle yeah. I think you bring up a really good point of the experts or thementors that you surround yourself with you know, so your advisors will changeright as they can like what you're saying evolved as the company growsinto different stages, as well as those maybe even investors. You know the folks that you actually hire withinthe company. A lot of that will change, because the skill set and the the pace, the knowledge that's requiredin the beginning, changes over time, and sometimes those people are, youknow, tried and true and they've kind of built businesses. You know throughall of the entire steps of inception to you, know this repeatable revenue modelin high scalable growth, and sometimes they haven't and so being able to sensethat in being able to say it's been a great ride with you this last sixmonths or this last year, but we need something new. We need somethingdifferent to take us like at this new destination. This new point for stepthat we're going to, I think, that's really great wisdom to share witheveryone, and I read this article ones. I thinkit was. I don't know what harver bites his here, you as about Netflix andtheir approach to performance, improvement and just ten Yur a company, and it reallychanged the way. I saw this concept and it's exactly what you just said is thateveryone should look at themselves and he and their team and you're beingbrought here for a reason, and I want you to crush it at that reason, but atonce you do if that reason is no longer relevant, it's everyone should feellike the goal was accomplished and then it should be. This compassionate movingon not so much that anyone's being faced out or unappreciated anymore. Butit's more about, like you said, every phase of the company's growth will havea different need, and you have to be true to that, need and true to thepeople who can address that need. You know, and it's interesting. I thinkthat even goes for ourselves right as the founders, co, founders or CEOS ofthe company, that you know this kind of like scrappyhustler come back artist, kind of attitude, an ability that is soinvaluable in the early stages of a company might not necessarily be whatthe company needs from their CEO in they're fifteen twenty years in andthey're. Looking at that, you know exponential growth or scalable growthlater on. I just have someone I was talking to you and you know they foundit a company. They built it very proud and a lot of success and they've beenyou know, leading the company for seventeen years and just recentlydecided to you know, become part of the board, still so still incrediblyinvolved, but recognize that they're no longer the best person to be the CEO totake the company to the next level, and that is got to be very, very difficultand very humbling, but also something to really admire. Whensomeone can come to that point- and I think it goes back to you knowbelieving that the team that the team, the team includes you right- you're-always doing the best that you can, but you want to grow in that role to thepoint where you sort of made yourself. You know you he's hot grown, your ownskill set and you're right there. There is a lot of humility that has to gointo that, but I mean the statistics show. I think it's less than fivepercent of founders who go from you know day one to IPO, and so I think wecan at least just use that and say listen I'll, be thrilled of almoststatistical outlier. But if I'm not that doesn't mean, I haven't done myjob as a founder in an early stage to you to the best of my ability- and Ihaven't done a successful job. It just means that that is where I shine. Thisis where the team shines. This is where...

...the company is going, and I want tobring the right team and to shine at this next phase. So I absolutely agreewith you and it's so much easier to have that conversation with someoneelse. That's on the teams and the look in the mirror and have thatconversation ourself right, I say sometimes when I'm trying to liketalk through this with my own team, using myself as an example, I think itat least shows them like how this is kind of a universal truth right, I'mnot I'm not telling this to you not like dictating it at you, so that youlike. This is something that might happen to you. It's like hey! No, thisis what we should all be aspired to, then, because that we crush it so muchat this phase that the next VAT is we were passing the baton. So what is a head for physician, threeD, Sixty and two thousand and twenty two? So we will continue to March at ourvision, which is that we're creating you know the largest network ofaffordable care clinics in the country by transforming these pharmacies, soyou will continue to see us in more and more communities. You know as we as wecontinue to grow. Our footprint a overlaid in their footprint there's afew other. You know conditions that we will probably startto pay more attention to once covin normalizes a little bit, but ultimatelyyou know we will be able to service just about any urging care conditionthat you would otherwise have gone to a Merton here, for so, I think, be on the lookout out for somefairly creative ways of doing things. As far as youknow, getting imaging studies done or things of that nature that that'sreally where were rated awesome. So how can folks get a hold of you if anybodywants to follow up with you after the show? The best way is probably through Linkin,I'm I'm on Linkedin. You can also go to our physician three D, sixty dot cowebsite and you can find contact information for me or anybody else onthe team there awesome. Thank you so much for joining me today. It's beengreat thanks for oxpect Ive. Thank you so much for listening. I knowyou're busy working to bring your life changing innovation to market, and Ivalue your time and attention to get the latest episodes on your mobiledevice automatically subscribe to the show on your favorite podcast at likeapple podcast, spotify and stitcher. Thank you for listening, and Iappreciate everyone who share the show with friends and colleagues, see you onthe next episode of Health Innovator, a.

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