Health Innovators
Health Innovators

Episode 75 · 11 months ago

Is building culture that important in the early days of a startup w/ Erik Osland

ABOUT THIS EPISODE

When it comes to building a startup, paying attention to the culture you build isn’t the first thing on your mind - but it should be.

There is a lot of work that goes into what entrepreneurs do - and a startup is only going to be as good - and healthy - as its employees. Build a positive culture and you’ll have positive outcomes.

Just ask Erik Osland of EvolveMd! He built a successful business using core values that include support, self-care, training, and creating a culture that benefits both customers and employees.

Come learn more about this win-win as Erik discusses this and much more in his recent episode on the Health Innovators Podcast.

Grab a friend (or a coworker) and hang out with us for a few minutes of healthy conversation.

Here are the show highlights:

  • How system disruptors can present entrepreneurs with opportunities for expansion or growth (6:16)
  • Focusing on quality employee relationships can boost positive patient outcomes (8:22)
  • Recognize the learning power of your mistakes (13:10)
  • You can create first, tweak later, and still come out on top (16:06)
  • Never say never - when a pivot opportunity presents itself, a learning opportunity is not far behind (20:40)
  • Self-care: Taking care of you will also benefit your company and those you serve (26:11)

Guest Bio

Erik Osland is the managing partner for EvolvedMD, a comprehensive behavioral health integration platform focused on program development, management, and implementation.

His education at the University of Arizona helped develop his background in leadership, management, and strategic planning.

Erik utilized that background to develop a process that delivers the best patient care and outcomes possible in behavioral health, while also minimizing barriers often found when trying to access those settings.

If you’d like to reach out to Erik, you can email him at erik@evolvedmd.com, find him on LinkedIn at Erik Osland, or reach out to him on his website at EvolvedMD.com.
 

You're listening to health innovators, apodcast and video show about the leaders, influencers and early adoptors who are shapingthe future of healthcare. I'm your host, Dr Roxy Movie. Welcome back healthinnovators. On today's episode we have Eric Ostlin with us, who isthe managing partner for evolved inmdi welcome to the show, Eric. Thanks forhaving us for excited to share a story. We're so excited to have you hereand kind of dig deeper into your commercialization story. So let's just getall of started by sharing with our listeners a little bit about your background andwhat you're innovating these days. Yeah, so, you know, our storyis unique in the sense that we're tackling a very complex issue that exists rightnow in the United States and in larger parts of the world around mental healthand access to care. You know, my journey into the space started abouttwenty years ago. I graduate from the University Berizon and down Tucson and,upon graduation, really entered the healthcare workforce, working predominantly on the device and manufacturingside and you know, over the following fifteen years elevated my position intokind of the national accounts Rolls, where I work promily with large health systemsto develop services and strategies for them to manage patient care, and did alot of contract acting and developed a lot of really great experience and, youknow, the time ultimately came where I felt that I was ready to takeon the entrepreneurial journey and left Corporate America about six years ago and and started. At the time it was a small family shop. We opened the pathologylaboratory where we processed tissue and specimen for different categories of healthcare. That businesswas ultimately divested in June of last year so that we could focus on theproject that we're talking about today, which is, you know, to me, the culmination of my entrepreneurship journey. It's a project that I'm passionate aboutbecause I have a personal experience in a personal story, and I'm also passionateabout it because I feel like this is an area that I can make itour team can make a substantial contribution to health and welfare of our community,that which involves our employees on the patients we serve. So tell us aboutthat personal story. Yeah, so I had an experience that is very commonwhen it comes to aging parents. I had a father who was chronically illand he was ill for a long, long time, about ten year periodof time. My mother was the primary caregiver and, you know, ourjourney really started about five years ago, four years ago, back in twothousand and fifteen. My Dad was chronically ill, had multiple disease sets,including onset dementia. He was on seventeen medications and he slept about eighteen hoursa day and as a family we were...

...having the conversation around how do weprovide care for my father? Is Dad just really a sick guy, oris he a sick guy that it's been complicated by the fact that he's onall these medications? And then there were the financial considerations. I think myparents were spending about a thousand dollars a month on medications, even though theywere a medicare. And I was in a fortune position at the time.I had a pharmacist that worked for me on another project. He and Icame together and we ran what is known as a medication therapy management program ofmy father. We took some pretty progressive steps with my dad from a medicationfront, kind of with the notion of you know quality of life versus quantityand it was a great experience. I think it was the first time ina long time that anybody had really taken a hard look at my father's medicationsand looking at things like dosing optimization, polly, pharmacy compliance, those typesof things, and so we got really, really interested in the category. Wewent to the Arizona State Positions Association we said, Hey, there's thisclinical concept, we think it has a ton of utility. Give us ashot and find us a pilot. So they found us a pilot out inthe West Valley here in Phoenix. We launched that program back in two thousandand sixteen. We ran the pilot for about six months and managed for ourpatients and the experience is great. I actually did intake for the pharmacists.So, if you're familiar with that space, I did med reconciliation and patients wouldbring their back round bags of medication in and we'd recompcilid in the reportand then I would hang the patients off to the pharmacist would do a fullforty minute console. It was a great experience. We learned a lot oflessons. Number One, we learned that the business model we we would deployto plug other things into primary care. Would work to plug other things othersubspecialties. We learned that there was a ton of clinical utility as far asaligning pharmacists with primary care providers to manage complex patients. But we also learnedthe hard lesson that healthcare is complex and paying for these things can be achallenge, and so after running the pilot for six months, the practice askedus to continue. We didn't feel comfortable with the payment mechanisms that existed atthe time and so we made the hard decision to put that program on theshelf. But the takeaways were the business model would work and something from adata point came up that was really, really interesting, which was we decidedto screen all of these complex, chronically ill patients for the prepression. Thisis kind of before it was in vogue to do that, and what wefound was that forty percent of these patients with chronic illnesses screen positive for depressionand none of them is like a zero, had ever had a beabor health resource. And so we said, hey, there's a huge on met need.Let's take a look at different strategies to integrate services in primary care andlet's see if we can address this tissue. So we identified the model. Ibrought it a really strong partner,...

Steve Builgion, to help commercialize theprogram. We placed another pilot about six months later. We ran the pilotfor a year with a good deal success. And fast forward to today. Wenow have twenty one sites here spread across Arizona, with some pretty aggressiveexpansion goals here. In Two thousand and twenty one we're going to go fromtwenty one sites to somewhere in the neighbor of seventy eighty in the next twelveto eighteen months. So it's going to be a fun process. So it'ssuch an interesting journey and such an incredible need today. You know, obviouslythere was a need when you were able to discover that forty percent had had, you know, mental health challenges but hadn't been diagnosed or what weren't gettingany type of behavioral health treatment. But who would have ever predicted how wemight be accelerated and thrusted into the mental health concerns? You know that we'recurrently experiencing with the pandemic. So how has the pandemic impacted your your businessor your commercialization journey. Yeah, you know, change was coming from amental health and physical perspective, like we thought. Leaders, and I inacademia and throughout the country they understood, they've understood for a long time,that integrating these two services together would lead to better outcomes, but the changewas happening painfully slow and so yeah, I think if we look at covidand we try to pull something compositive out of it, I think that ithas driven the need to expedite the process of any rate in these two services, and so I'm really confident today to say then ten years you just won'tgo into a primary care practice and not have access to resources. We're headingthat direction and Covid as expedited that. Now, unfortunately, covids also takean assistant that was already stretched to capacity and added additional needs to it.Prevalence rates right now and the adult population the US for underlying health condition isroughly forty one percent. That's data from the CDC that was released and Ithink October, and also some really frightening metrics around suicide, all aviation.You know now eleven percent of the US adult population has actively consider suicide inthe last thirty days. And I think what's frightening within that data set isif you live at a younger people right the eighteen to forty four bracket,that numbers even higher. It's about one in five. So you know,it's really presented us took the situation where that we have to we can't ignoredit any longer. We have to get into address it. HMM. Yeah, for sure. So tell us a little bit about this commercialization journey.You know, you kind of told us a little bit about your background andhow you got started, but what do you think, you know, kindof as you reflect on that journey, what do you think are some ofthose key decisions that you made that have led you to the success that you'reexperiencing today? Yeah, you know, we were fortunate that a lot ofreally sure people did some very wonderful work...

...in front of us to develop modelwe use today, which is called psychiatric claric care, and so we knewthis model was a good platform to start with. I think we're we garnsome initial successes. We we didn't initially look at it from a called atherapeutic perspective. We looked at it from an operational perspective to kind of figureout, you know, what are the challenges we're going to face with scalingthis model. And specifically, we looked at the provider base and very quicklywe identify that there was a systematic issue when it came to call a therapistor social workers, which is you know, if you look at that subclass ofemployees, these folks are typically the most Compassionate folks you will ever meet. It made sacrifices economically to take on the positions that they take on becausethey genuinely care about people. And then we as a system, what dowe do with these folks? We give them complex patient case loads, weoverwhelm them and we burn them out. And so turnover in these two subsetsis very, very high, and so we very quickly identify the need tolook at how we would pursue employees or future employees and then ultimately support themthroughout the employee life cycle. And so, you know, we tell a lotof people that we are an organization as provider focused, which it's alittle bit different than what you hear in the health care you hear a lotof like we are a patient facious focus organization. Now we care dearly aboutthe patients we serve, but we just feel like if we attack it froma different angle, which is let's bring, let's identify a great people bringing theorganization and then let's support them both personally and professionally. And if wedevelop these folks along the way and they're healthy and they're happy, guess what, the product and the therapy that canterventions they put out in the high leveland we're going to deliver good patient care as results. So we just alwaysknew that that was going to be a core focus and we built that intoour culture, and so that's put us in a position today where it's avery competitive landscape to hire entertain social workers and counselors and you know, we'reviewed as a good place to work, which is nice. And so Ithink that is one of the most important aspects of our journey, is that, you know, we can do all of these things. Will workflow andan efficiency perspective and from a financial modeling perspective, but if you can't goout and hire good people and then keep them, you're in a bad spot. Yeah, and still really did. least it's a key part of ourgrowth, our growth story so what about the the providers themselves, your customers? How did you persuade them to adopt your solution? Because you know practicescan be, you know, kind of stuck in their old way of doingthings and you know you're kind of putting the other other team members that aren'tpart of their you know, direct staff into those practices. So tell usa little bit about how did you persuade...

...them to say yes and come onin? It wasn't easy at the start. It's getting easier because the markets changingand people are more open to the dialog, but man, it wasa tough slog and fortunately our backgrounds, we have some traditional sales experience andwe just knew how to kind of slog it out in the trenches. Yeah, but you know, I think fast forwards today and how do we garneradoption? It's that, you know, integration can be difficult, especially whenyou think about physical and behavior, because they've been so separate and they're almostlike two different languages. And so our value props practices is look, itcan be difficult, but that's what we're being hired to do, right,is to do the heavy lifting and work with you to set protocol and understandhow you want to manage your patients, both from physical and behavioral health perspective. But once we understand how you want to measure your patient population, thenit's our job to go and and do the heavy left, to design theworkflows, train the staff, higher the staff, place them, manage themand make sure the program is not only successful from an economic perspective, butthat it's sex successful ongoing from a clinical perspective. So you know, ourvalue prop is, you know, we're going to come and do the heavylifting on what is a very difficult process of the integrating to Gabor all services. Yeah, yeah, that makes sense. So one of the things that Ialso here pretty often is, you know, you might get, youknow, some of these companies, health systems or practices to say yes towhatever innovation, whether it's a product of service, whatever that looks like.Say Yes, but you know, like anything, you've got a mixed bagwhen it comes to the actual implementation on opera opportization of that. So youknow you have blockers, you have naysayers, and so tell us a little bitabout how you what you encountered and maybe how you overcame that. Yeah, so, you know, we've been fortunate to make some mistakes when itcomes to garnering support across the entire stakeholder environment and and through those mistakes we'velearned really good lessons that will lead the way. But yeah, but,yeah, I think it's going into an organization that's external, identifying who thekey stakeholders are in the decision makers are really top to bottom, and andthen, you know, having a collaborative conversation and building consensus, because themistakes that we've made is it. We've been a situations where we have toplevel executive support but we didn't get all the way across the spectrum and weultimately ran into challenges that we had to go back and course correct on.And so, you know, really identifying who all the stakeholders are in theprocess, you know, helping them understand the process, the model, howwe cooperate. We are not consultants, we are true clinical operators. Sowe place people in these clinics and then we continue support them. So thisis really a very high level of alignment...

...with our with our customers. Sure, yeah, absolutely. So it sounds like it sounds like you know,like many innovators, you've run into some obstacles in some roadblocks along the way, but you've made sure that you were, you know, paying attention to thatand learning and then being able to adapt, which is really what we'reall experiencing in this journey. Yeah, I mean, the stakes are partof the process, right and right. As long as I was learning fromthose states we make and as long as we have good intentions, then,you know, we should be able to move forward, and I think that'sa message that we give to all of our employees as well. Right,you know, we want to equip our folks with the ability to make decisionsfor their sites, for the organization, and typically what will tell folks is, look, if you're thoughtful about the problem and you come up with asolution and and we make a mistake, that's fine, as long as youwere thoughtful. When you work for the process, mistakes are fine as longas we have the ability to address them and then learn from them and tomove forward. And obviously that's a big part of the culture. You know, when your leadership being able to create that culture to become a learning organization, that's embracing that. Yeah, yeah, and then being a learning urizations.That's one of our quartets. So, yes, yea, so I didn'tknow that, but I get already sense it. Oh yeah, sogetting the first pilot, turning that into a pain. Customer, you know, tell us that story. You know, it's funny. We used to saythe joke where when we first started we didn't have all the answers andit was sometimes taking these folks, I believed in our journey and believed inus and just kind up grabbing by the shoulders and just say trust us.And it wasn't quite that simple, but in a lot of ways our firstfew customers really they just bought into who we were and when we were tryingto achieve and you know, they knew this wasn't just a slam try tomake some money and get out. It was really trying to hear. I'mso. So it took a lot of trust from our core subset of customersand I think we're very appreciative of that and I think, you know,we worked hard of the last few years to prove ourselves there. And so, you know, initially, you know, at anytime you're driving changing in somethingdifferent. You just you need to help your customers understand the journey oron and they need to trust you and understand that you have good intentions andif you do those things, they're going to give you a little bad withand and we are fortunate, you know, we got in, we executed,we created a statable program maybe not a really efficient organization, but wecreated one that was sustainable and then we built off of it and we spendthe last four years trying to figure how to make this more efficient, howto make the clinical output more positive, how to add additional, you know, modules, whether it's diabetes or pain management, to it. So reallyjust continue to enhance upon it, because our our journey were nowhere tire nearthe end. You know, we kind of look at this as a versioningfield where certainly one of the first players...

...and our goal is to advance ourmodule to the point whereas new players out of the market, it's going tobe very difficult for them to compete because we are constantly reinvesting in the organization, the people that that support it. Yeah, Yep, always one ortwo steps behind you, right, and and not having all those learnings toalong to leverage along the way. Yeah. So, as we kind of thinkabout, like, you know, the future, what's next for youin two thousand and twenty one and beyond. You know where to use kind ofsee the growth and how that's affecting your commercialization. Yeah, so youknow, growth is exciting, it can also be painful if it's not donethoughtfully. And so you know, for us, I think at the coreof what's going to happen for us in the next year we are going togrow and we'll grow substantially. You know, we're we will most likely our FDAFT account will triple this calendar year. And so with that the core objectiveis is can we grow and retain our culture, and so we've madesome significant investments in our internal infrastructure to prepare for that growth. But youknow, growth is coming both inside the state of Arizona and outside. Youknow, we we do have an aspiration to be a national provider and thatthat will become a reality this year, and so there's new markets that willbe launching and announcing here in the very near future. But you know,beyond that, I think you know one common theme for entrepreneurs is, especiallywith a start up, and I guess we are startup, is how doyou fund these activities? And you know, the typical journey. There's a lotof different ways to get the game. A lot of folks will see externalinvestors and give up equity. You know, our perspective is we wantto bootstrap this as long as we can and we've been able to do thatup into this point and we will continue down that path in two thousand andtwenty one. And so we really love a strong relationships and these stitutional lendingspace. You know, we've learned lessons about the importance of evolving relationships witha band and can specifically a local bank that can actually be invested in yourbusiness. HMM. And you know, I think we've probably experienced the frustrationsthat other other small business has around SBA lending and access to capital. It'sjust not not necessarily easy, as easy or as smooth as sometimes you likeit. But you fight those battles with doubt and you know, we've justreally focused on that as a as kind of our engine for growth on acapitalization side. Yeah, that's good. You know, everybody takes a differentpath and it sounds like that's working for you. Yeah, you know,so far, I think giving up part of your company now, now thatwe're going to hold on to it as long as we can because we thinkthat's part of the special sauce as well. Sure, Yep. So let's kindof just go back to the covid rights, the covid impact that it'shad on small businesses and growing businesses,...

...but also particularly businesses like yours,where you're literally placing people into a medical practice. So, you know,I talked to clients all the time and you know there's a bit of apanic of like, oh my gosh, doors are shut, conferences aren't happening, practices aren't letting people in, and so how are we navigating that?You know, and it's really forced us to really think about connecting with peoplein a more digital and virtual environment than ever before. So, you know, has your model changed where you were were tapping into some of the telehealthmodality to be able to augment what you might have been doing in the practice? Yeah, absolutely. I think like everybody, we had to pivot veryquickly in two thousand and twenty and you know, it was a tough yearin a lot of different ways, maybe more emotionally than anything, but butit but it would. There was also some great lessons to be learned andI think the virtual platform. You know, everybody healthcare learned about the value andthe efcacy of this. You know, we as an organization feel very stronglyabout personal connection with patients and we feel very strongly about the notion thatwe can most effectively deliver care in an environment where we can sit in frontof a patient and when that patient is to strawte or upset, we canembrace that patient. But COVID has taught us that we have to have alternativestreams to communicate with patients because maybe that is a better avenue for the patientsaccess care and in the accurrent environment. We have to and so we didnot embrace virtual care at all leading up to covid and we were forced topivot very, very quickly, and I want to say within two weeks ofkind of the onset and a shutdown, we had pivoted over, we hadour folks up and running on a system and and we effectively converted and thenet impact of that conversion was, number one, we could service the existingpatient, a face which we saw grow by about twenty percent, kind ofin our existing Clinex just based on what's happening in the world. And sowe could embrace. We could see more patients are no show ray drop fromabout forty percent down to twenty five. So that was a positive and nowthat's huge. And you know, I think Clily, I think we learnedthat, like, this is a Plat this is a platform that you candeliver behavior hall through. Maybe not, maybe not as efficacious as the faceto face, which will always be our core business, but this is agood platform for certain people in certain markets. So yeah, yeah, I meanthat, you know, a hybrid model, you know, thinking aboutjust as individuals, as people, where we all have different preferences and inbeing able to accommodate that. So, even past the pandemic, those thatstill want to connect digitally and those that still want a human hug. Yeah, I mean I want to say the...

...two thousand and twenty one is goingto be here. The hugs again, we're going to get, yeah,acrid yet. Wait. Yeah, I also yeah. So you know,as you kind of think back on your journey, who has been instrumental inthis? You know, whether it's been like your rock and your shoulder tocry on, or it's been, you know, somebody who's been mentoring andadvising you. You know, having those types of people and network is socritically important. I feel so strongly that everyone needs a thinking partner that's externalto the organization to really be able to help us see things maybe that wecan't see internally. So who is that been for you and and how that'stell us those stories? Yeah, so I totally agree. I think itas an organization with a learning culture. You know, we have to bewilling to listen to other voices both inside and outside of organization. But youknow, I've been really fortunate. I think it starts with my business partner, Steve Builgion. I've known Steve for a long time, one of themost thoughtful individuals that you ever have and I think you know what's been greatfor us as we both have very unique skill sets and and they compliment oneanother. And so, you know, Steve Really has been, you know, the popul voice in my head for the last couple of years and webuild us. We've been going through this process together, and so it startsto Steve. You know, certainly my wife. It's tough. I youknow, we try to have a live a balance that I don't talk aboutwork a whole lot. If I if I can and all, I don'tbring a computer home at all. That's just kind of rule of mine.So I try to separate it. But you know, beyond that, I'vebeen fortunate seas unfortunates, really getting good mentors in the marketplace, folks havegone through this journey, maybe not not a favoral health, but in abusiness perspective or entrepreneur perspective. So you know, there's a there's five orsix people that I won't call well, but there's these are folks when Irun up against a complex situation that I maybe don't have the confidence with,the experience with, I reach out to them. I asked them their opinionand and I listen. And, you know, beyond that, to wewe also understand that we have some weaknesses that we can fill with really talentfolks that we've been recruiting and bringing really sharp people into the organization. Thatreally enhanced what we're able to do and how we can operate. You know, you touched on something that I'm starting to see this pattern as I,you know, talking to different innovators at different company sizes and stages, andit seems as though, which is not really surprisingly, surprising, but Ijust didn't put it together. Is that it for the innovators that are leadinga mental or Behavioral Health Company, you all have a tendency to have justsome different habits around technology, around rest, around boundaries between work and personal.I was spot speaking to someone the...

...other day and hers was a MentalHealth Company and she literally talked about turning her phone off on Friday and notturning it back on until Monday morning as an as a startup entrepreneur, andyou just said that you don't take your computer home your you guys are blowingmy mind right now. I mean especially for you know, start up entrepreneurs. I mean that's just it's a rare thing and I can only imagine howthat's really helped you well, create more balance between your personal life and yourprofessional life, which makes it all around better. And then just also rechargingand refreshing, and I don't think that's something we really talk about enough inthis entrepreneurial or commercialization journey, the importance of making sure that you, asthe managing partner, don't burn out. Yeah, I mean I wish Icould stay that. I'm perfect when it comes to habits around self care,but you know, it's an important aspect. I think, you know, moreand more people are learning about the fact that, you know, look, I my run, this is a marathon. That's a cheesy analogy,but yeah, it's finally important. You know, I am also probably abeliever that, you know, part of what we're seeing from a mental healthperspective the US might be might be related to this thing. That's my anwe're too connected and it's too program to get certain responses from us. So, you know, I do mitigate it. We certainly have the same approach withour kids and how they look at technology. Yeah, but you know, at the core of it how we look at technology and working from home. There has to be balanced. Yeah, and you have to commit every dayto doing something for yourself, and that could be meditation, that couldbe extra size, that could be whatever is that's important to you, butit's really it is key to keeping you healthy and happy. And you know, for us as entrepreneurs it it's hard. I mean everybody does. It's jury. It's hard and if you don't take some time to reset, thenyou're going to be a bad spot down the line. So it's important.So do you think that you're just more tuned into that. Again, I'mnot claiming that you're perfect about it, you know, and then trying toset you up on some false expectations here. But you know, do you thinkthat, because of the business that you're in, that you're, youknow, creating that for yourself and for the culture of your organization just becauseyou're seeing the impact of not doing some of that? Yeah, I meanI think, you know, based on the industry we're in, we understandhow important is. But but I also see it. I know how Ifeel when I reset or if I exercise, if I go for a walk,so I can also feel it. But you know, we're all soaccountable for it. I mean we have a leadership bonus and one of thecomponents to qualify for your bonus is daily Selfcare. We track it on ahabit tracker to keep people accountable and you...

...know, it's just a core partof who we are and we want to encourage it for everybody an organization.I love it. Everybody that's listening. I hope you were hit. rewindand take notes and adapt that for your own organizations. You will thank yourselffor it, as well as your employees all of your everyone on your teamwill thank you for that, and I mean, you know, we probablydon't have any, you know, in specific scenarios about this on the impactto your bottom line, but it's there and you will be able to readthe benefits of that one day in the near future, if you're not alreadybenefiting from it. I totally agreet really agree. So, as we're startingto wrap up here, what are some lessons learned along the way, somegolden nuggets that you would want to share with our viewers and our listeners whoare, you know, at different stages of the innovation process, maybe largeorganizations that are in innovating internally and maybe a separate business unit or some otherstartup entrepreneurs that are kind of hand in hand in the trenches with you.Yeah, I mean there's some lessons that I've learned from other entrepreneurs and,like you know, I really like Sara, Sarah Blakeley's story. If you've everheard of on spanks. I don't are any spanks, but I stilllike her story. And, Oh, come on, yes, a playerattention and the fact that, you know, as you build an organization, earlyon she took a very personally when people would leave you organization. Andhowever, time she's learned that different people have different journeys and he shouldn't takeit personally. And that's certainly something that I were by myself as we bringpeople on and people. Yeah, but you know, beyond that, likeI would say, for me, you know, perspective of Wise, whathas changed over the last ten years is how I look at the role thatemploys play an organization in our success. And you know, so many timesyou can just look at them as as cogs in the wheel and replaceable andyou know that might help the bottom line or that might, you know,help your shareholders, but at in a very short period of short period oftime, but in along run that that doesn't help the organization. It certainlydoesn't help your employees. And so you know, we really tried culturally tobring in good people that are aligned philosophically and we care about them, andthat's to me, that's the thing that as we grow it's going to getmore difficult because where a large organization and it's hard to know everybody a personallevel. But we really do generally care about people and it's a priority forus and we think that that's going to lead to the law firm success ofthe organization, and success means a lot of things. It means that wehelp more people, it means that the organization prospers and from a financial perspective, it means that we generate positive revenistry and that's marginally aligned with our expectations. And those things don't have to be separate. You can treat you generategood margin. So you know that. That's my big takeaway. But beyondthat, you know, being entrepurse huff...

...and I think the biggest reason it'stough is that it's mentally taxing. You live and breathe, and you know, as you're becoming an entrepreneur, you know they're they're as a certain thingthat most of us fell which is like this dread. It's dread, it'sthe sphere of things that could happen and it's natural. And I think thisis another reason why s daily Selfcare is still important. It is because itas you to address those feelings and come out the other side with more productiveapproach. Well, I think that says a lot about you and about yourleadership. You know, you're talking about employees and viewing them and treating themlike human beings, you know, like how you would want to be treated, and then being very intentional about the culture that you're creating. And thoseare two things that I hear leaders talk about, obviously, but it's notsomething that I hear a lot of startup entrepreneurs talk about. Like those arethings that people think are important, but it's like phase two or three ofthe business when we are not having to, you know, just roll up oursleeves and get stuff done and like grind, grind, grind, andso that, I think, that's what I'm, you know, really hearing. That's a start contrast from the stories I hear from a lot of otherinnovators and I would encourage everyone to think about culture that fits into the employeedynamic much earlier than we have traditionally as entrepreneurs. Yeah, it's way easierto instill culture when you've got a ten employees verst a thousand, right,so start early and and and make it a very deliberate act as as yougrow. It's just a very important central focus for the over the vision.Yeah, well, thanks so much for sharing your time with us and yourexperience and stories. I know that our listeners and viewers have gotten some valuableinsights from you. How can folks get a hold of you if they wantto follow up with you after the show? Yeah, first and foremost, thanksfor having us on. Really enjoyed the conversation. Thank you for lettingto share a kind of our story. Folks want to to get in contactwith us, you can reach me at Eric here Ik at evolved M d. that's evolveed mdcom. We have a website at the same address. Headsup to everybody listening, we've got a major rebranding initiative underway right now.So in the next six to eight weeks you'll see a new website for USlaunch with some more information. But yeah, happy to chat with folks that areinteresting what we're doing and and thank you again for Hav us on.DCOR Rossi, awesome. Thank you so much for being here. All right, have a wonderful day. Thank you so much for listening. I knowyou're busy working to bring your life changing innovation to market and I value yourtime and attention. To get the latest episodes on your mobile device, automaticallysubscribe 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 showwith friends and colleagues. See You on the next episode of Health Innovators.

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