Health Innovators
Health Innovators

Episode · 3 years ago

Physician Co-Creation, Multi-Sided Markets & Planning Early for Commercialization w/Robbie Cape and Brad Younggren


Many innovators lead with their technology in their creation process, and in the process they leave behind the other important building blocks of a strong business. How do we avoid building a business with a singular muscle? How can we deal with the biggest barrier to successful commercialization? How can we get physicians involved in the ideation process, and what difference can that make? 

On this episode, we’re joined by the CEO and Chief Medical Officer of 98point6, Robbie Cape and Brad Younggren, who share their journey to commercialization and lessons learned.


3 Things We Learned 

The biggest mistake innovators make 

Many innovators lead with a technology and end up with that as the singular muscle behind the business. One of the things 98point6 got right is that they developed 4 core muscles in the business: the medical, technology, regulatory & compliance, and commercial muscle.  

How to build relationships with physicians 

When it comes to building strong relationships with physicians, we must look at doctors as a separate audience segment, understanding the problems they have and delivering a strong value prop to them as we would with any customer. 

How to get into healthcare and win the favor of stakeholders 

There’s a huge difference between coming into the healthcare industry as a competitor, and coming into the industry with the intention to find the right stakeholders and people and support their vision and goal. It’s more powerful to sit alongside the primary care community so that you’re not treated as a competitor. 

Innovators often focus mostly on raising money and building the technology. They think the vision, mission, values, culture and employee engagement are things that can be built-in down the road. The problem is, they miss the benefits of building these things into the system early on. In order to successfully commercialize, it helps to be deeply integrated with the people who will eventually become your customers and pay for your service. You do that by thinking beyond the technology and considering the greater ecosystem and stakeholders who are critical to your business. 

Welcome to Coiq and first of its kind video program about health innovators, earlier doctors and influencers and their stories about writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy, founder of Legacy DNA marketing group, and it's time to raise our COIQ. Welcome back coiq listeners. On today's show we have Robbie Cape with US and beat Bradyngren the too, two of the minds behind ninety eight point six, and I am really excited about this episode. They are doing some incredible things and I will let them tell you a little bit more about it, but welcome to the show. Thank you so much. It's so it's wonderful to be here with you. Thank you. I think that you guys are doing something really amazing because you have instead of leading with a technology, you are leading with a problem that you were solving that's just being enabled by technology, and I think that that's just brilliant and you're addressing a big challenge that we have in the market place of primary care access. So I can't wait to have this conversation with you today. So, just to get US started, just in case our listeners don't know who you are, Robbie, tell us a little bit about you and your background. So I'm originally Canadian. As it turns out. I grew up in a single pair system and I ended up going to school in the United States. I went to school in New Jersey. Right after graduation I came out here at Pacific northwest to work for Microsoft. I thought I'd work for Microsoft for three years and then start my own business, but my three year plan turned into twelve years at Microsoft and just amazing learning and a lot of fun. Finally, in two thousand and five I left Microsoft and found it a company called cozy that's in the business of helping families manage the day to day chaos at family life. Sold that to Time Warner in two thousand and fourteen and then in two thousand and fifteen got together with my cofounder here at ninety point six and began this new adventure, and the rest is the history of ninety point six, which I'm sure we'll get into. Yeah, absolutely great. And what about you, Brad? Tell us a little bit about your background as well. So I'm an emergency position by background. I went to the military medical school primarily interested in disaster and he manitran medicine, found myself deeply involved in evaluating how medical devices could scale on the battlefield. Became very interesting in the field of digital health care and how that could impact saving lives. After getting out of the army, after a number of involunteary vacation opportunities, sort of moved into the digital health care space and have been never really look back, but involved in a number of device companies as chief medical officer and most recently company called Q health down in La Joya. My first company was a one called mobisante, which was the first FDA approved medical device in the country. Was An older sound pro plugged into a windows phone and we built the CREDET systems for medical devices with smartphone technology. And so I've been with ninety point six since the beginning of January two thousand and seventeen, help build the clinic and get us ready to see our first patient and February of that same year, and have been ever since. I'm excited to be on the show. That's great. Thank you. So so let's just kind of level set here. Where are you in the commercialization process? Do you have paying customers now or are you still in the launch process. Well, we're very much in the commercialization, like deep, deep into the process. We launched commercially in January of two thousand and seventeen. Okay, you know, when we came into two thousand and seventeen we didn't have a single paying corporation on the platform. We now have over seventy paying corporations on the platform. As it turns out, close to twenty five percent of those very large companies are. These are companies with typically over twozo employees. Over twenty five percent of them are actually in the healthcare business, which is something we're super proud of. So it's been it's been wonderful to see healthcare companies be very, very early movers in offering ninety eight point six to bear employees. Hmmm, yeah, absolutely. So what was it like getting your first customers? You know, it's it's always hard to win your first customer when you're a startup. You know, we have this saying here which is that everyone wants to be first to be second, and it's just it is just a fact of... I don't think it only goes to you know, commercial endeavors. I think there's a lot of people out there in life in general, who like to be first to be second. It takes a certain amount of of sort of adventure seeking to want to be one of the first adopters of a new platform. As it turns out, our first customer, we are very fortunate, and this is typically what happens when you're when you're getting out the gate. Our first customer was actually one of our investors. It was an investor who had a company with a few hundred employees and he was kind enough and, you know, I think I'd even go so far as to say that, you know, he might not have been a customer of ours if not for the fact that he as an investor. But it gave us the ability to develop the experience a deployment, and you know, you need a first deployment because you need an opportunity to relentlessly improve and get the you know, get the experience right for both of them, both the employer and for the patients who are ultimately going to be taking advantage of the service. It was a great, great experience and, you know, just less than a year and a half later, you know, we've got over seventy of them. That's great. Yeah, that's that is such a huge hurtle just getting that first paying customer. A lot of the innovators that I talked to, you know, talk about it with chicken or the egg. Right now it's really hard to find the people that want to be the first, especially in healthcare and a very risk averse industry. Yeah, we we actually implemented a pretty cool concept. Verierl on so, a commercial leader, was one of our first employees on our seven full time employee was a commercial leader for the organization, and this is a good solid two and a half years before we were even ready to commercialize. So this is back in in two thousand and fifteen. You know, we brought this individual on board. His name was Stephen Hurwitz, and he put together this early development partner program where we had about fifteen employer in the Seattle area who all helped us build the product and gave us feedback very early on on the features that we were building and the types of deployments that we would do. Now, there was no commitment, they were just sitting around the table and giving us feedback and in fact, if you look at the first year of deployments, almost eighty percent of those early development partners ended up deciding to deploy the product to bear employees. So, you know, I'd say that that program was very effective in helping us getting many of those early deployments. So I just I think that that is just brilliant and it's so contradictory to what I hear in the market place. So I do a lot of educating around the fact that launching an innovation and commercializing and innovation is two very different processes and that launch is part of commercialization, but commercialization starts way earlier than launch and it continues way after launch, and not a lot of innovators get that. So what motivated you to invest in someone that was a commercial leader so early in the process? How did you identify that need? That's you know, that's a really good question. And it turns out that that there's a lot of things that we're doing here at any point six that are very unconventional and, you know, unusual. And I think that it's largely due to the fact, and you know Brad can can talk about this from his experience, that we've put together an executive team that is literally every simple one of the executives on this team is is covered with scar tissue. You know they've they you know, in the case of Brad, you know, Brad actually has some war wounds. For the rest of US literally sore, are a little bit more virtual. Yeah, you know, but it's incredible what twenty years of experience will bring to the methodologies that you employ to launch a business. You know, one of the very early things that we decided to do, and I'd say that this was a result of of my cofounder and I and the first few executiives who we hire, really having been through this experience of working at companies that had singular...

...muscles. You know, you know, you look at companies and typically, you know, a company will have a technology muscle and that will be very clear that that's their main muscle. Sometimes you'll meet companies, and I'm sure you know, Brad has seen companies that really had a really strong medical muscle and that was at therefore, you know, medical or research. But you know, this is very common to create businesses with singular muscles. You know, you want to be focused and you want to be strong and you want to be good, and we recognized in the business that we were entering that we were going to have to build a company that had, for muscles and then we were going to have to develop those muscles from the very, very beginning. One of the muscles is technology, it's true, but one of the muscles is also medical. You know, it's a major muscle for our company. One of the muscles that we developed very early on, like literally our fourth or fifth full time higher, was on the regulatory and compliance br we hired a full time attorney who had a specialty in healthcare related law to build our our regulatory and compliance muscle. And then, lastly, we made the decision that for us to build a successful, scalable business that we needed to have a commercial muscle. We need it to be deeply integrated with the people who would eventually be our customers, who would eventually be the people who would pay for the service, and that turned out to be self insured employers. And so our seventh full time higher was someone who would focus all of their time developing those relationship. Hmmm. So that is so true and it's so challenging. I just it's so challenging for health innovators because, as you know, in the beginning, resources are our slim and and so that is it's not expensive, I mean it's not cheap to hire for those for those muscles. Right, it costs some money. It's basically, you know, a big bet and a big investment that you're making into the future of the company. There's one of the layer to it which is probably worth highlighting is early on, when I started talking to Robbie about coming on a nine point six the chief medical officer, seeing the conversations around the development of the four muscles and, additionally, this notion that over half of the technologists in the company we're going to be focused on the physician facing side of the technology. That investment in the physician technology was something I not s team the market and really helpful in terms of hiring and building our physician medical culture. Having a deep interwoven relationship between the software engineers, product development team and the medical team has been incredibly valuable for us to scale as fast we've been able to. HMM, yeah, absolutely, it's so let's talk a little bit about that. We're kind of on the fringes about product co creation and it sounds like that's really fundamental to part of Your Business, and so let's just talk about, you know, that co creation process for you. How did you include them and who did you include? You want to talk about them? Sure, I can talk about the physician side, for sure. I think that what we're doing with our physician group that we call the core clinicians, is unique at the market and sort of answers at least part of your question perfectly. So our physicians to really deliver the high quality care that we wanted to at ninety point six across the country, across fifty one license boundaries, we decided that we were going to take a very different approach to delivering physician care on the platform. So, as opposed to most technology platforms that higher locom Tenems or part time physicians to operate on the platform almost independent of the rest of the organization, we took a completely different approach. We hired our clinicians full time at ninety eight point six so that they would be deeply invested in the corporate culture that we are building, with our core values and to make sure they're fundamentally aligned with us in our mission. And then, on top of that, all of our physicians have a percentage of time, about twenty percent, dedicated for nonclinical activities, so that freeze them up to impact on multiple dimensions across the entire company, which our position side is a big pleaser. They like to feel like they can be part of the product development, recruiting, UX research and design, really any domain you could think of within the context of the company, and that helps also the technologist get perspective, a physician perspective, very fast. When we have a question about what would physicians think about something, we ask our own internal physicians, which now is over north of twenty five in house physicians. You are full time that help us develop the product every day and and and that that same sort of integration.

That happens across all of the muscles. So whenever we're building a new capability in the product. I think our launch of pediatrics earlier this year is a great, great testimony to this sort of interweaving of the muscles across the company. We literally had to have every, you know, senior people from every single muscle in the room as we were defining our roll out of pediatrics. Like obviously there were deep, deep considerations on the medical front, but there were also incredibly complex issues to be grappled with on the regulatory and compliance front. The way you treat pediatrics and the way you flow information related to pediatric visits is different in every one of the fifty one jurisdictions that we're in and every fifty state and DC the rules are different, and so those considerations had to get woven in. There were different considerations for each of our commercial customers related to how they considered pediatrics as part of their membership and how they define those people. And obviously it was deep, deep consideration on the technology front around how we were going to build this motion and build out the capabilities that we're going to make the experience comfortable for, you know, a a two year old or a five year old or even a fifteen or sixteen year old, all of whom are our pediatric patients and yet clearly all of whom had very, very different capabilities when it comes to interacting with technology. Yeah, I remember when my three year old niece was showing me how to use the IPAD. They're pretty darn advanced, aren't they? So you know, how impactful would you say that getting physician input early in that ideation process? How do you think that that's been impactful or how do you think that shaped who ninety eight point six is today? I think it's poortant part of the core of what makes us different than anyone else you could find in the market. Just fundamentally it. It is really a created a culture where physicians are very excited to come work for us. We have a very large pipeline. Our fortunate and that in that regard, and so that's great to see where that the company is really on a mission to really deliver primary care to the no one has to make a financial trade off to get primary care. And I state actually globally. But there's also another mission which is sort of saving primary care. It's in a crisis. Yeah, position community is feeling as deeply and as physicians come across our company and discover the focus and intention we have around physician quality of life, physician culture. It just believes across the entire company. HMM, yeah, it mean it just it seems like that would trickle down to like employee satisfaction and customer satisfaction, you know, with the experience and employee satisfaction both with the culture and their ability to have impact as well as just their experience coming to work every day or stay in where they are at work today every day. It absolutely does. You know, we have a saying. Actually it was lent to us by one of our board members, which is that culture is not the most important thing, it's the only thing, and our mission that that Brad articulated is absolutely central to that culture that we've created. Were or a mission driven company like yes, we are, you know, building a profitable, commercially exciting corporation. Yes, that is important and we happen to also believe that, by virtue of the work that we're doing, we can make the world a better place and ensure that every human on this earth has access to high quality primary care without ever needing to make a financial trade off to get it. Yeah, yeah, absolutely, and I'm starting to so. There's a conversation that I have on a regular basis and it's this idea of why some innovations fail and why do some succeed. So, before I kind of go there, would what's your perspective on why some succeed in why some fail? You know it,...

I say every single situation is is different. I think that likely most entrepreneurs feel, at least the stories that I hear as I talk to entrepreneurs in the market, is that is that most opportunities failed because they they don't end up with enough capital. HMM, you know, capital is this. For most CEOS, capital is the the the the resource that constrains them most dramatically and out ultimately the thing that they run out of. So I think that's most most clear, it's most salient, although I don't actually think that money is the issue. I think money ends up being a proxy for time. I think time is the scarceest resource that that startups have. I think it's not only the amount of time that it takes to build something and prove that it can be successful, but it's also the amount of time that you spend building something to prove it it can't be successful. You know, it shows out fast, right, that's exactly right. You know. You know they they don't teach you. If if there was, you know, start up entrepreneurs school, like if such a school existed, and it doesn't exist and there's no great signal book to you know that. On the topic, my bet is that there would be a bunch of talk about tenacity and continuing to push hard and push through object you know, objections, and keep trying and pivot and try again, and then pivot and try again, and and so there's a lot of talk about that, but it turns out that there's not nearly as much talk about how to fail right, and in fact, failing is way more important in some ways than succeeding. I mean, failing happens. You know, people say it's ninety nine percent. I think that that number is way, way too low. I think it's more like ninety nine point nine or ninety point nine nine percent of a time. You know, people fail, and yet there's no learning about how to fail. And I so, you know, I think one of the most important things that that entrepreneurs can do is even in those first six, twelve, eighteen, twenty four months, independent of whether or not they have access to a lot of money. Like, in some ways, access to a lot of money can be the worst thing that happened to them, because it enables them to take too much time right. Yeah, what really need to do is, and some investors are really good at putting these these milestones in place and if you don't meet that six month milestone and you don't meet or you don't meet the twelve month milestone, you know, know that it's done. Right now, the way you define those milestones is incredibly important, right that your milestone around consumer adoption and you're in a consumer space and you know that it takes a year or a year and a half to start getting consumer adoption. That's probably an unrealistic milestone to set. Sure, Yep, absolutely. So I think that that is just incredible wisdom for our audience to listen to, heed majority of our listeners or innovators that are in the trenches today and and there is a big fear of failure and right society does not embrace that enough, especially in the entrepreneur market, and I come across people that get access to millions of dollars and they pour it all into the product. They don't always do what you did, which they're not always including stakeholders in the product development, the CO creation process. And I've talked to someone not that long ago. They were three years in, like five million into the product, and they hadn't even gone to market yet. They were because it wasn't ready yet and it's so somebody needed to take that money from them away. Take that away a long time ago. Yeah, it's true. So there's there's another thing that really stands out to me that I think that you guys do extremely well and it's storytelling. So let's shift gears a little bit and talk about storytelling in how how do you feel, how do you think that storytelling fits into...

...your commercialization process, and what was your purpose and intention behind building out such an incredible story? I think our storytelling is likely more related to the brand and the trust and our position in the market then. I mean, obviously all of that is incredible is directly related and feeds into commercialization, but it really started with the the need to make decisions around what we were going to stand for as a product. Like, like, yeah, it's true, we're delivering primary care and people get sick and they come to us and we dignose and treat them, and yes, we can look at it at that level. But what we wanted to do is really stand back and and think about our role in this incredibly interesting, this complicated and and sort of rich with history ecosystem. You know, it's easy to stand and throw darts the you know, at the healthcare ecosystem in the United States, and I know there's a lot of people who like to spend most of their past time throwing those darts. But we wanted to take a position in that ecosystem, which meant that we were going to become part of that problem, you could say, and we wanted to define what our role would be within that ecosystem, an ecosystem that I happen to believe is actually pretty incredible. I mean, you look at the work that Brad has done, you know, in his time before he came to nineteen point six. You know, you look at the innovation, whether it's innovation that happened on the battlefield or the innovation that that he was a part of around micro fluidics or any of the other amazing innovations that are happening. Some of them are happening at health systems and it you know, in in laboratories. I mean it's an amazing ecosystem. Yes, there are problems, but our narrative, our story, was about beginning to lay out how we wanted to take some degree of responsibility in this incredible ecosystem and the impact that we wanted to have. That's that. That was really the purpose for the storytelling. Yeah, yeah, well, I think sometimes health innovators really with struggle with trying to figure out what's their clear and distinct value proposition. Right. I hear from investors quite often of them being pitched by innovators to raise that capital that you were talking about. And in and I set them, set with these folks for forty five minutes or an hour and I still don't really know what they do. And and and and I think it's even more complicated when you're talking about a breakthrough innovation because it's radically different. No one's really set the ground work right. So what does on demand primary care mean? You know, and you've got to kind of create a story to communicate that and what it means. And so I think that you guys have done a really good job and in a real good example for our listeners to kind of heed some of that storytelling that you've done. It takes a lot of work, you know. When you see that single value proposition, you think that it's Oh, it's just one sentence. You just, you know, take a few minutes, twenty minutes and just knock that out and it's it's not right, right, right, it's so you know, when it came to the messaging, you know tied to the storytelling, you know what was some of the things that you struggled with because, again, our audience is is kind of doing this right now, trying to figure out what their value proposition. So how did you go through that process to in where you are today? Good, thanks. Yes, just the on the physician side. I think we've done a lot of work around understanding how to exist within the ecosystem and there's tons of very passionate people in healthcare who are trying to do the right thing. Some of the infrastructures and place for them to make the impact they would like. Our approach is to come into that space and find those advocates, find how it can align and support their visions, look at as partners and solving problems, not necessarily even as disruptors to the existing ecosystem. That allows us to sit alongside the existing primary... community instead of looking as like a threat to the primary care community. And and Brad is raising the the element that was by far and away the most complicated part of building our narrative. It was thinking about all of our constituents. It turns out we have a lot of constituents. We have some of these constituents, well, actually all of them are people who we want to ultimately serve. You know, in fact, here at ninety point six we we try to avoid using the word customer because I never want us to be sitting around the table and debating about who our customer is. It turns out they're all our customers, right. The patients are our customers, the self insured employers are our customers, the health plans are absolutely our customers. We are hopeful that the health systems, with the physicians who ultimately carry those health systems day in and day out, are our customers. You know, we're learning that there are other elements of the ecosystem the people often don't even talk about, you know, like the pharmacy, you know, like all of these people are our our constituents, who we believe that we can serve. You know, we didn't think about the physicians who we were hiring as people who we serve, but that that was actually that was a mistake we should have now it turns out our narrative work really well in that context. But the truth of the matter is our constituents include every single person who we hire. It includes every physician who were trying to recruit. So the hardest thing for us was building a narrative that would be compelling to every single one of these constituents. That's really, really hard in this industry, you know, and unfortunately, if you're if you're building a narrative that is compelling, the chances are that it's going to upset someone right, that someone is going to be turned off by that narrative or think that you have Hubris, you know, representing the narrative in that voice. And so we were really careful and ultimately had to come come through with something that we not only believed in deeply, you know, in our soul, but also was a narrative that we felt would be embracing of all of these different constituents. HMM. Well, I think that's so right, because a lot of people ask me, you know, why is it so complex? Why is it so difficult to commercialize and innovation and healthcare compared to other industries, and being a multisided market that you just described absolutely aids in that complexity and that difficulty because, like you just described, the the the user, is not necessarily the by are right, it's not necessarily the prescriber. I mean it's just it's health care is just such a complicated ecosystem in buying process in and I find that sometimes stayholder groups or constituents can be eliminate, it forgotten when we're going that messaging process, or they can be just muddled and tangled and in we or we're just we're always like we're really excited about the patients and how we're going to change their lives and make their make this world a better place. That we forget, you know, a lot of the value proposition to the V to be stakeholder. So that's just so, so true. So you kind of touched on this a little bit. So want to talk now about like what are some of the things, the decisions, and we touched on it, but what are some of the decisions that you think that the I didn't know it then, but when I made this decision it was really, really influential and the success that we're experiencing today. So I'm going to sort of set brad up here a little bit because I'd like him to answer this question with a little bit of back drop. Yep, when when we hired Brad, it's fair to say that, well, I certainly had no I had no more than a year of experience with healthcare and I certainly personally, you know,...

...and and a bunch of people who I had, you know, on the executive team, even at that point had no experience actually building a clinic. And you know when, when, when Brad came on board and we were just incredibly fortunate to be introduced to him and you know, our conversations spend several months, you know, before Brad was ready to to join us. You know, I gave Brad and his peers all gave Brad an enormous amount of room to to build the clinic of the future, you know, to build a clinical operation that likely physicians only dream about and and but unfortunately, you know, never really have a chance to dream about. And there were a lot of decisions. I let and Brad will talk to you about a couple of them that Brad made early on that weren't they weren't part of they couldn't have been part of our plan at the beginning because we had no business making a plan around those issues because we not had no history. Yeah, but but what we knew was that we had to have incredible talent at the table to help us make some decisions. So, Brad, maybe you can talk about some of those critical first decisions you made around building the clinic that have ended up just being pore to to how we operate s thanks for having I think, to Robbie's credit, you gave me a lot of space the first few months to really dive into one of our core values of critical and informed thinking and on constrained thinking around what could we do to really build this clinic of our dreams that he asked asked us to build. And there are a couple dimensions to that which were even new for me. I'd built clinics in the past, but obviously nothing on this scale, nothing that demanded this sort of to build it on demand primary care service that crossed the boundaries ultimately provided seven care to adults end kids, was a fairly heavy lift. When I looked at the market, I just felt with the most important thing to fall back on was quality, that if we could build a quality physician service, a medical service that was consistent with the brand, but that ultimately that that over time, would really allow us to come to the market and have hell systems and employers as well really appreciate the work we're doing, and so that we had to start from the beginning with that fundamental approach. So I went to Robbie and I said, after a few months of molling is over and saying, you know, I think we need to license our physicians across the country. I haven't seen any company that's done that yet. So, but we're gonna have to be the first. It's going to cost a fair amount of money. Doctor. Yeah, you know, I know, I just get a couple months ago, but I need a lot of money to do this. And and, but I think it ultimate give us way you want, which is instead of being a company that it's out the market, saying we have five, three, four and four thousand doctors in the market that service our clients, that we have a smaller number of core clinicians who deliver the care every day. When you when you come in a ninety point six, you know exactly the kind of care getting because you can look on our website and see exactly who our physicians are their work for ninety eight point six. So we started that process and I had never worked in the company that had a core value set that was so lived, believed and discussed on a daily basis. I'd never experienced that personally, and I think a lot of physicians health care. I've never seen that. So to impart that kind of culture on to dephysician through are coming on was incredibly exciting. Everyone was really on board of that and we started licensing those clinicians across the country and we've continued with that strategy since the beginning to this day, and that's still how we're approaching our physician hiring. That, you know, as long as we continue to hire our physicians as full time and so put them to the same rigorous tests that the other members of the company have. So one of the things that's probably worth highlighting is I didn't want the physicians to be looked at any differently here for the the easy and for the heart. So they go to the same interview process. The soptware engineer goes through the same interview loop. They don't and there's no shortcuts. And I think you know we only hire one out of every maybe twenty applicants, but the ones we hire are of the quality that can really represent the brand. Seven three hundred and sixty five. Are you guys very intentional about the the training and development...

...that goes along with them to be able to live out those values, you know, without being under your roof? Yeah, I mean the we're we the clinicians have their own private communication channels to discuss the core values and how how those are impacting the work they're doing. They're discussed by everyone in the company on a day day basis or called out in meetings, in group meetings and one on ones on a day to day basis, which it's really excited unique at. The physicians are engaged in that same type of behavior. So they're we have really spent a lot of time, as we fired some clinicians who are not in Seatt all for variety of reasons, that they really have to be as deeply engaged in the company as everyone else. So they're in the office a lot because we want them interwoven the same way and sort of ultimate charge to the team was that I want the clinician in Florida to feel as deeply connected to Robby Cape as the physician who lives in Seattle, and I think we've accomplished that. Yes, it's great and I you know it is. It is so deeply impactful we are and it's one of the reasons why we've been so successful at recruiting some of the best primary care physicians in the nation. To nineteen point six, you know this, this point that that Brad made around every one of our employees being one of our physicians being one hundred percent dedicated to ninety point six and being being being a permanent employ the company. That is part of it. The other part of it is everything he talked about around the way that we treat them at the company. You know, a lot of a lot of physicians. I hear this. I've I am not a physician, I've never been a physician, but I hear from physicians we hire that they're they're used to working in this environment where they're they're almost lone wolf's, even if they're part of a huge system, still like they're alone in the room. Yes, they have a patient there, but the patient is the person they're serving. They they operate very alone the vast majority of the time, whereas here, even when a patient is in that that chat with a single position, that physician feels like they are part of a very large team. I'm and it's not just because of the software that they're using. It's because, you know, when when they get off that shift, they're probably going to be jumping into meetings with, you know, five or six or seven people across the company talking about some future innovation that we're going to build into the product that's going to make a difference for our patients or for them in their physician experience. And that team dynamic is incredibly powerful and it ends up recruting all these other values, you know, just just as a matter of nature. It's really just it's really magic. HMM, it sounds like it and you know it. To me, it kind of goes back to looking at the physicians as a separate audience segment, understanding the problems and needs that they have and then being able to deliver a strong value proposition to them, just like you would paying customers. That's right. Yeah, that's about it, just just like we do for the software engineers who you know, who we're out there trying to recruit, and just like we do for the marketers or the communications people. I mean, you know we we have to builds up as a company, as a growing company that's out there competing for talent in an aggressive market place. We we think very carefully about the value that we're delivering every single person who has a role to play on this team, and the physicians are no different. And it sounds like you had that mindset early on, which you know in the conversations that I have with a lot of health innovators, they think about vision, mission, values, culture, you know, employee engagement down the road. Right now it's about raising money and building the technology and I think that some of the some of them kind of miss out on the benefits of putting all of those other things in place earlier on in that process. Yeah, that's that's really true. I I happen. You know, personally, I'm incredibly fortunate in that, you know, we have I have a CO founder...

...who is able to spend the majority of his time focused on fundraising, which has allowed me, you know, in my position as the CEO, with the executives on the team, to focus almost all of our time on building the company. Now the the other thing that was important to us from the very early days, and again I'd say that this was related to advice that we got, odd not only from my cofounder, but also from the other people who we were seeking advice from, who are some of the most phenomenal business leaders in the world. We we decided early on that we had to build the company for scale. From Day One, we knew, or actually we couldn't have known. We imagine that the value proposition that we were creating was going to be incredibly compelling and the people were going to want to adopt it quickly. And then we wanted to be in a position to deliver. So we were going to have to grow the company quickly. In order to do so, we we needed to build a very solid foundation. You know, it's like you know you're building a skyscraper and you want to be digging, you know, your foundation deep, deep in the ground because it's got to carry this incredible building that you're going to build up on top of it. And so we literally thought from day one about building the infrastructure that would support a business that we imagined could be incredibly impactful in the industry. So things like the core values that we set, we set those very very early. The muscles that we set, we set them very very early. The executives who we hired, you know, we brought those people on very, very early, all to support the growth that we were hoping would happen. We couldn't know, but we knew that if we executed, it would happen. Yeah. So so I think that you've, you know, as as we've had this conversation today, you've shared a lot of your personal experience and that that's been really invaluable for the listeners. The last question I have for you is there anything else, any other advice that you would want to give to those other health innovators that are out there in the trenches right now? It's from my perspective I would just keep keep motivated in on the task that you believe can actually change healthcare and keep driving forward to that and don't be lulled by the traditional sale cycles that hospitals may have, because there's other many of the opportunities to drive your idea, Your Business, your company forward more than an annual sale cycle. Will have to have a whole another episode to talk about that. Yes, sorry, what do you have to say? You know, it's it's almost it's almost the same point the brad made and maybe just said slightly differently. Sure it's it's about fail fast, but even at the micro level, which means you need to take what you're building or what you're thinking you want to build out there as quickly as possible. Certainly it shouldn't take you more than a month or two months to go out there and begin gathering feedback from the market that you're ultimately going to want to sell to on whatever it is that you're planning on building. You know, if it's consumer business, you should be able to stand it up in a month or a month and a half. Absolutely you should. It might not be everything that you wanted to be, but you need to start that cycle of failing and relentless improvement and failing and relentless improvement. I mean that is you know, it's all about failure. You know, you said no one wants to fail. If you don't want to fail, you shouldn't start a company. It's all right, okay, where's the wildom? You've heard it right here. Okay, if you got to fail, you got to learn, you got to change, you got to grow, and the sooner you can get that cycle going to better. If, if it is a a an enterprise sale that you need to do and you're thinking, oh my God, it's going to take me a year and a half or two years to build out a product that I can actually sell to the enterprise, I don't agree. Build a prototype, even if it's even I if you build it with a sharpie and a piece of copy paper, Yep, build a prototype and...

...then go sit down in front of the people who you'll ultimately sell that product to and get their feedback. Let them tell you that your baby is ugly and actually want to hear it, because that's what's going to get you to go back and relentlessly improve. That's what it's all about. Yeah, sometimes I think that innovators, they are afraid to ask those constituents what they think because they might not think like they think and they really want to build what they want to build and they almost don't care what the audience wants. I know what you need, let me give it to you. Well, we we, we all know how that story is, right, right, right. Yeah, those are the ones, just maybe that aren't failing fast. They're taking a whole lot of time and people and money down with them in that failing process. That's right. But I mean I'll ultimately ultimately those people like yes, there might be a one in a million of them, and everyone likes to focus on the one in a million that ended up just building what they wanted and didn't ask anyone and they ended up succeeding. It's very easy to focus on that one in a million. Yeah, yeah, what one in a million doesn't happen right? That's not how the vast majority of successes occur. Sure you know success is happening. Happen by building what the customer wants, and the only way you know what the customer wants is by sitting in front of them and asking. Now. Absolutely well, I think that that was a great way to in this episode. I have thoroughly enjoyed this conversation. I hope everybody that's listening is taking notes, because there's just a wealth of wisdom that's peppered in throughout this series, and so I'm just going to ask you as our closing question, how can people get Ahold of you if they want to find out more about ninety eight point six and what you're doing? What's the best way for people to reach you? So there's there's two things that I'd love for for every listener to do. First of all, go to the APP store and download ninety point six and try the product and send US feedback. I mean it's twenty dollars for the first year for unlimited access to primary care. So even on your first visit the the APP will have paid for itself and you can use it another ten times, you know, for the reminder of the ear, and it's not going to cost you a single penny. The most of all, send US feedback. So that's the first thing that we'd love for you to do. And the second thing you know, if you you know, if you directly or indirectly know of people who lead benefits or going zations and who are delivering benefits to their employees, please have them go to ninety point sixcom and learn about our offering for employers, learn about our offering for health plans and then send us a contact us note, because we'd love to talk to you about how we can bring the value of ninety point six to those people who depend on you. Well, that's awesome. I'm a raving fan and I will help you promote this company as best as I possibly can. Okay, okay, what's the difference between launching and commercializing a healthcare in avation? Many people will launch a new product, few will commercialize it. To learn the difference between latch and commercialization and to watch past episodes of the show, head to our video show page at Dr Roxycom. Thanks so much for watching and listening to the show. You can subscribe to the latest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes on our youtube channel. No matter the platform, just search coiq with Dr Roxy. Until next time, LET'S RAISE OUR COIQ.

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