Loading summary
Transcript122 lines
- [00:23]
Ben Walter
The emergency room is the last place any of us want to find ourselves. But the reality is you or your loved one may end up there at some point. And if you're dealing with an aging parent, things can get even more complicated.
- [00:36]
Kevin Bice
There are easily tens of thousands of older adults who are lining the hallways of the emergency department.
- [00:42]
Ben Walter
And they're not always taken there due to emergencies.
- [00:46]
Daniel Arteaga
The patients are neither straightforward nor clearly emergent. Their vital signs are okay. They don't look like they need an operation right away. They don't need to get whisked off somewhere.
- [00:57]
Ben Walter
So.
- [00:57]
Daniel Arteaga
So they wait.
- [00:59]
Ben Walter
They sit in crowded waiting rooms or on cots and hallways every single day. Doctors Kevin Bice and Daniel Arteaga are both physicians working in emergency medicine and specializing in geriatric patients. They've seen it time and time again.
- [01:15]
Daniel Arteaga
There was an older lady on a cot in the corner, and I don't think about it, except I come back 12 hours later, same corner, same cot, same lady. I got pissed.
- [01:25]
Kevin Bice
To us, that is a crisis. Medical humanitarian. It's a problem to be solved.
- [01:40]
Ben Walter
Welcome to the Unshakeables from Chase for Business and Ruby Studio from iHeartMedia. I'm Ben Walter, CEO of Chase for Business. On the Unshakeables, we're sharing the daring moments of small business owners facing their crisis points and telling the stories of how they got through it. And joining me today is Kathleen Griffith. Kathleen, let's dig in.
- [02:01]
Kathleen Griffith
I had a sneaking suspicion that you were gonna nerd out on this one. And you did.
- [02:05]
Ben Walter
Sorry, I can't help it.
- [02:07]
Kathleen Griffith
Yeah, I thought this one was great because this is a true startup. Ground 0, 0 to 1. We usually see businesses that are a bit further along. They're grappling with very early stage issues, but in a very complicated regulated industry that's got lots of headwinds.
- [02:25]
Ben Walter
That complicated regulated industry, unsurprisingly, is healthcare. Daniel and Kevin are combining excellent patient care with the latest in tech to change emergency departments across the country. On today's episode, Apogee Care from Chapel Hill, North Carolina. I was really excited to talk to them. I'm super interested in healthcare economics. More on that later. But I also love an unshakeable story. This one is different, though, because not only are Kevin and Daniel small business owners, they're doctors, practicing doctors. Both Kevin and Daniel specialize in the care of older or geriatric adults. Both came to care for this population in different ways. For Daniel, it started early.
- [03:13]
Kevin Bice
My first job in high school was actually serving tables at a retirement home that Group of people. That part of life started mattering to me more.
- [03:21]
Ben Walter
And Kevin ran head first into the issue. As a young physician, he was a third year resident. When he saw that older woman on.
- [03:28]
Daniel Arteaga
A cot, same corner, same cot, same lady, I got pissed. I think it's not hard to look around at the US healthcare system and say, this is not working for older adults.
- [03:42]
Ben Walter
And who exactly are those patients? Lets imagine Mrs. Smith, she's 82 years old, living in the memory care unit of an assisted living facility. One day, Mrs. Smith is taken to the ER.
- [03:55]
Daniel Arteaga
She goes to the ER because they found her sitting beside the bed and are afraid they might have hit her head.
- [04:00]
Ben Walter
She's confused, maybe a little disoriented, but it's not apparent that anything is wrong. When she gets to the ER, it's overwhelming.
- [04:08]
Daniel Arteaga
The ER's running around with the stroke and the heart attack and everything. They're not going to know why she's there. Ms. Smith has dementia. She's not going to tell them why she's there. They're gonna run some tests. If they find something that looks weird, they're gonna put her in the hospital and move on.
- [04:21]
Ben Walter
If you're a big fan of medical dramas, and Kevin loves some of them, by the way, you'll know exactly why the doctors have to move on quickly.
- [04:28]
Daniel Arteaga
Cause like a stroke just came in and like, I have 20 minutes to take care of that stroke, so I know what to do there. I'm gonna go in that direction. You stubbed your toe or you twisted your ankle, or you broke your wrist playing pickleball. It's like, got it. Get an X ray, put a cast on you, out you go, we're cool. These patients that we're describing are neither straightforward nor clearly emergent. And it's going to take a long time to figure out what's going on. And you're still not exactly sure what to do.
- [04:55]
Ben Walter
And the more Mrs. Smith waits, the worse she gets.
- [04:59]
Daniel Arteaga
If you have dementia and you're waiting in an ER hallway for six hours, at the end of that six hours you have something called delirium, which is to say now you're completely agitated. They're not better. They're not at home and the hospital's more full than it was the day before, so they can't get the next person in who does need a surgery or whatever.
- [05:18]
Ben Walter
It's an enormous problem because Daniel and Kevin are asking how we change the care for millions of people across the country. But solving that problem is what Kevin and Daniel were obsessed with.
- [05:29]
Kevin Bice
Initially, it started as this idea of, let's help you take care of the older adults in your emergency room better.
- [05:35]
Ben Walter
So they tried what doctors are familiar with. New courses, new training, new protocols. They rolled out an accreditation program to 600 hospitals.
- [05:44]
Daniel Arteaga
Five of them took the next step and said, what if we got expert consultation for these patients when they're in the er? What if we got the right expertise on them? Could we get them home? Could we get them somewhere else? Could we get them out of the hallway?
- [05:58]
Ben Walter
But consultations take manpower. Someone has to triage the patients that need help. Someone then has to see them specifically, and then someone has to follow up to make sure they're doing well. A few weeks later, they turned to where so many of us do in a pickle. ChatGPT. Just kidding.
- [06:13]
Daniel Arteaga
But they did use AI, a service oriented company. But it's made possible by the technology that's now on the scene.
- [06:22]
Ben Walter
Daniel, when you first pitched this business, did you pitch it as healthcare? Did you pitch it as tech?
- [06:28]
Kevin Bice
Initially, we were pitching this as more of a technology solution. And then just as we learned more and we talked to more people, we started to understand better all the pain points that the different stakeholders experience, especially the patients and families. We realized exactly how much the human touch, the compassionate human touch, really, really mattered. That's what we bring to the table now. And it's up to us to leverage the technology to deliver it in a way that is efficient, that that is scalable, that improves the quality of care.
- [06:58]
Daniel Arteaga
We bring in the technology around the service model. We don't start with the technology and then figure out how the service fits into it. What service is required to get miss Smith home safely and in better shape than she would have been before saving the payer money and creating space in the hospital for the next patient. You define that service and then you bring the tech in to make that service more efficient, more expeditious, more scalable, and drive the workforce around it.
- [07:23]
Ben Walter
And that's how they arrived at what Apogee care is today. You see, their company's services can be contracted by hospitals, so the emergency departments can offer a consultation to patients who are a good fit for Apogee. An ideal patient for them is typically 65 years or older, not needing obvious emergency medical attention, and usually they have some sort of cognitive impairment. If it's a good fit, the patient gets a virtual consultation with a nurse or doctor who's an expert in geriatrics. And that leads to either a comprehensive care plan or a discharge plan, where the Patient will be monitored at home. Okay, you get all that? So now imagine trying to pitch that to investors. I've been told you pitched for the money, but you never actually asked for it.
- [08:07]
Daniel Arteaga
That's important. You probably know more about finances than I do, I'm guessing, based on our background. But everybody was like, that's so cool. That's awesome. And I was like, thanks for your support. And then the conversation would end. And so I went to one of my really good friends who fundraises for the university I work at. And I'm like, tim, what am I doing wrong, man? And he listens to the whole thing. He goes, well, do you ask him for money? And I'm like, oh, not really. He's like, you gotta ask him. You gotta, at the end of it, be like, if you believe in this, you wanna put in fifty thousand or a hundred thousand or whatever. Number.
- [08:37]
Ben Walter
Pick a number.
- [08:38]
Daniel Arteaga
And that same day, I got to the end of a conversation with a venture capital, an angel. He's like, I love this. And I got my courage together. I'm like, okay, then are you in for a hundred? And he's like, yes. And I'm like, oh, that works.
- [08:52]
Ben Walter
It's funny how that works. All right, Kathleen, you're right. I was fascinated with this story, and it's for a couple of reasons. I was an economics major in college, and what always fascinates me about healthcare is that there's a fundamental piece of classic economics that breaks down, which is in regular economics, they teach you supply, demand, and the price goes up and demand goes down and vice versa, and the whole thing, except here, demand is completely inelastic, right? So when is the heart surgery too expensive? If the TV gets too expensive, you just say, you know what? I'm not going to buy the tv, right? But if you need the surgery, you need the surgery, or whatever the thing is, or the drug or the procedure or the whatever. We've tried to apply classic economics to a lot of these healthcare situations, but when what is classically called price inelasticity is infinite, that becomes really hard.
- [09:41]
Kathleen Griffith
That's so interesting. And you don't have the perception of choice either, as a patient. It's just you go as directed.
- [09:49]
Ben Walter
I liken it to when you go to the mechanic and he's like, you need a new gasket. What are you gonna be like, no, I think this gasket's good, right?
- [09:56]
Kathleen Griffith
Let me get into the fuselage.
- [09:57]
Ben Walter
Right, like what? And so when they say, like, you need a whatever other than a second opinion, and someone else who's an expert. There's complete information asymmetry.
- [10:04]
Kathleen Griffith
Yeah, it's so true.
- [10:05]
Ben Walter
I took away. Another lesson that I've learned from other entrepreneurs is you only get what you ask for, and that's when you're fundraising. That's when you're hiring people. That's when you are looking for advisors or connections or anything else. If you don't ask, you should not expect to receive. Yeah.
- [10:21]
Kathleen Griffith
Can we talk about pitching? Please, please? Okay. I eat, sleep, breathe pitches. I get pitched all the time. I feel like I'm constantly pitching for my life. So there's five steps. There's identifying the macro problem that you're solving for in the world. All good stories start from a broader place, and they do not start with you. So that's step one. Step two is key trends or stats that kind of substantiate that broader problem. Step three is you want to introduce the macro opportunity that is being solved for. And then step four is really where you're introducing your solution for the first time. So this is why you're unique or different. And then kind of wrapping with those proof points and dun, dun, dun the ask. Right. Like the actual investment. That was wild that they talked about not actually even making any ask at the end.
- [11:07]
Ben Walter
And how much do you think you have to get the balance between an emotional hook in your pitch versus cold, hard facts.
- [11:14]
Kathleen Griffith
I love this question. For me, you always need to start at, like, an emotional, evocative place, and then you want to land the plane with those facts and figures and the data points to substantiate the broader argument that you're making. I think what people really get wrong is they focus too much on the middle. It's like a very pragmatic, practical pitch that is neither here nor there. So I say go super high and super low.
- [11:39]
Ben Walter
Okay, so now you know how Kathleen approaches a pitch. And Kevin figured out that he needed to actually ask for money when he did so. But when fundraising, you also need to know how much money you actually need before you start. Kevin and Daniel were looking for a few million dollars. Small potatoes in the healthcare world.
- [11:56]
Daniel Arteaga
We raised our first million off of select angel investors.
- [12:00]
Kevin Bice
And that was like, keep the lights on. Explore the idea. Continue talking to stakeholders. Figure out what this is actually going to be. We were kind of floating the idea by different hospital leaders. Eventually, we started selling the idea to hospital leaders, which was a big jump for us.
- [12:17]
Ben Walter
And then when you didn't have anything.
- [12:19]
Kevin Bice
To sell, I assume more or less visions, dreams, aspirations. We were Very fortunate to find a hospital that saw the same thing we did and wanted to do it with us. And that's when the rubber hit the road.
- [12:31]
Daniel Arteaga
But the story is we had raised, like, half the money. And our first customer, we had signed them up and they're like, aren't you going to start? And we were like, oh, shit.
- [12:40]
Ben Walter
Because, like.
- [12:40]
Daniel Arteaga
Like, because we had to tell them we could.
- [12:42]
Ben Walter
No, it's a chicken and egg problem. Right? Like, we can't get the money unless we have customers. But when you get a customer, you need to already have the money so you can go build it.
- [12:48]
Daniel Arteaga
Exactly. And so Daniel and I just looked at each other and said, we're telling them that we're going to start on this day. It's going to happen. It's just going to happen. We picked, like, the last week in March. It was, like, early February, and we are going to do it. And the next round of investors rewarded us by saying, now we see the conviction we're on too. Like, they needed to see us be like, yep, we're jumping in the pool and I imagine you're going to throw us a life raft.
- [13:09]
Kevin Bice
Our first hospital customer. Fantastic partner. Luminous Healthcare, Anne Arundel Medical Center. So it's the busiest hospital in the state of Maryland on a really busy day. They've got about 300 patients that go through that ER.
- [13:20]
Ben Walter
The hospital was thrilled to have extra help, but that also meant Kevin and Daniel were going in whether they were ready or not.
- [13:28]
Kevin Bice
The first patient that we saw was an older woman who came in with vague neurologic complaints. I remember being terrified that the technology wouldn't work, the sound wouldn't work, the video would be bad. A lot of those things did happen. And then I remember I took the call down the hall from the emergency room, so I'm actually on site. It'd probably be more efficient for me to just walk down the hallway and see the patient in person. But we're rehearsing.
- [13:50]
Ben Walter
You're trying to prove the system.
- [13:51]
Kevin Bice
Sure, Exactly. We're rehearsing a telemedicine model. And so I remember we completed the consult. I sent my findings, my recommendations to the ER document, and then I walked down the hall to go meet them, and I was like, hey, was that useful? They were like, I don't know who you are. It was a little bit jarring. It was a formative moment for us as a company. It was just like, oh, like, this is the relationship that we have to foster. Right. It's our team with these ER docs with These ER nurses. And it wasn't smooth right out of the gate. And it's really been based off the repetition, the weeks and months of getting to know each other.
- [14:23]
Ben Walter
And that allowed both hospital staff and patients to get to know what apogee was and the quality of the care they were able to provide.
- [14:31]
Kevin Bice
We're probably like four or five weeks in, still very, very new. I'm seeing a patient. It's a patient who's in a stretcher bed in the hallway. And the way that these interactions all start with the patient is we introduce ourselves and we say, hey, would you like this service? We'd like to help you out. The adult daughter says, thank you very much, but we don't need another cook in the kitchen. And an ER nurse who's overhearing this conversation, she steps in and she goes, I'm really sorry. I just have to say, I think that this team is really helpful. I think you should meet with them. And I was like, oh, my God, they like us. They think we're useful. And that patient and their family agreed to talk to us. We did a full consult. We helped sort out a discharge plan for them to get back to their assisted living. And that was the moment for me where it's just like, oh, my gosh, this is actually working. Now they're chasing our nurse down the hallway, asking her questions, asking her to see see patients.
- [15:22]
Daniel Arteaga
The other story that comes to mind that really illuminates this, the moment I realized what a difference we were making was Daniel was seeing a patient that had come into the hospital like, five times in the last year, had fallen two big falls, had been in the hospital for a week, had a hip replacement. And Daniel sees him for, like, 10 minutes and goes, my God, this is a variation of Parkinson's disease. But ER docs aren't great. Trained in Parkinson's, the orthopedic service that replaced the hip, they're not great trained in Parkinson's. So this patient had come in and out and in and out. I mean, we're talking several hundred thousand dollars, and more importantly, like, a year of misery. And not that we can just wave a wand and fix Parkinson's, but Daniel was like, stop. We gotta get this patient in the right direction. And I'm like, oh, that is what we are doing. We're getting the right eyes on these patients, and everyone wins. Like, the hospital wins, the insurance company wins, but most importantly, the patient and their family win because they're not being subjected to incredible misery without clear resolution.
- [16:17]
Ben Walter
Kevin and Daniel became doctors because they believed in helping others. But entrepreneurs need to have a slightly different goal. The product should help people, of course, but the business still needs to make economic sense for everyone involved. Luckily, they had thought that through.
- [16:31]
Kevin Bice
If we put a team in an emergency department and they're working 45, 50 hours a week seeing patients, they're saving an insurer something in the ballpark of $5 million a year.
- [16:41]
Daniel Arteaga
Essentially every time you do this type of consult, for every consult, whether they end up admitted or discharged, you save the payer around 3,000 dol. Our consults, they probably cost us like 4 to $500. So there's a 5 to 6 ROI just for every consult. You profoundly drive down the cost if you get patients the care they actually want in the setting they want it.
- [17:01]
Ben Walter
So talk to us a little bit about what both the sales cycle and the onboarding cycle look like. You're selling into and onboarding into an incredibly complex ecosystem. You've got. Hospitals are big, complicated places with lots of bureaucracy. Insurance companies are big, complicated places with lots of bureaucrac. How does that work?
- [17:21]
Daniel Arteaga
Slowly, but not super slowly. You're absolutely correct. And one of the advantages is it's not very capital heavy. I'm not asking to build a new hospital or buy a CAT scanner or whatever. I'm saying we're going to work in the ER that's already there, and we're going to deliver a different kind of care that's already there. You got to work from the top and the bottom two things have to happen. One, you've got to work your way to the decision makers. In a healthcare system and a healthcare system, everybody's empowered to say no, and few are empowered to say yes. So you got to get to the C suite. And they either say one of two things that is amazing, do not leave my room because we have a capacity crisis, or they say, that's really neat and cute, you should continue to talk to us, in which case we say thank you and go to the next hospital. Because hospitals are great followers, not great innovators. And so you want to catch the couple that there are, and then it'll spread like wildfire. And you've got to work really well in an integrated, supportive manner to all the stakeholders, the doctors, the nurses, the patients, the case managers. You got to make the CEO happy and you got to make the nurses happy. And if you do those two things, you'll work your way into the system.
- [18:26]
Kevin Bice
And that's exactly what keeps me up at night. Right. It's like how are we going to be the best possible teammates to our emergency room colleagues and customers? It's every little thing from who are we saying hello to? How are we communicating with the ER docs? What are we suggesting? What are we asking for? What are we advocating for for individual patients? These are all things that we are just laser focused on. We want to make sure that those ER docs find us helpful. They want more of our services because that gets us to the bedside of the patient. That allows us to have a larger clinical impact and at the end of the day allows apogee care just to make the biggest difference.
- [19:05]
Ben Walter
Wow. That's not a small undertaking. It is foreign.
- [19:16]
Chase for Business Announcer
When you run a business, it helps to have a full service banking solution that has products, tools and resources designed with your growth in mind. That's what you'll get when you switch to Chase for business as a new customer. You'll even get rewarded with a special bonus offer. Choose Chase and you'll receive the personal attention you deserve along with a large scale presence including more than 15,000 ATMs and 5,000 local branches. Plus you can enjoy innovations like the Chase mobile app which lets you do your banking on your phone. There are so many easy ways to get the guidance and tools to help you grow with Chase. You can meet with a banker in person, use the online support center or find helpful information in the resource center. And Chase Business. Complete banking offers built in card acceptance. A wide range of options for accepting payments and making deposits. So switch today@chase.com choosechase and get rewarded with a special bonus offer. This account has a monthly service fee that can be reduced from $15 to $0. Restrictions and eligibility criteria apply Deposit, credit card and lending products provided by JPMorgan Chase Bank NA Member FDIC Equal Opportunity.
- [20:15]
Ben Walter
Lender Kathleen I think one of the most interesting things about their setup and the challenges they have is that they're basically dealing with a multi tiered customer environment. You know, there's a lot of people who say, well I go to my clients and I sell or I don't sell. But here they have three layers of clients that they have to get on board. They have to get the hospital system, they have to get the insurance companies and they have to get the end patients to say yes. They sort of have three distinct but overlapping Venn diagram ish customer groups they have to cater to. That's not typical. Yeah.
- [20:47]
Kathleen Griffith
So what kind of biz is this? A B2B to B to B2C business.
- [20:51]
Ben Walter
It's sort of a B to many Bs to C business, I guess, B2Bs to C. Now, fortunately, they work in healthcare, so they understand a lot of it. But. And on top of all of that, it's highly regulated. Compared to selling software to corporate clients. That is a massive amount of sort of market complexity.
- [21:09]
Daniel Arteaga
Yeah.
- [21:10]
Ben Walter
For me and for our listeners who own their own businesses in particular, I think this idea of deciding who your customer is is not a small decision. And when you have multiple, how do you think about rank ordering them? Or if you can't rank order them, how do you think about how you divide your time, attention, focus to those different ones? And it might be different at different times, it might be different for different activities, but having a map that lays that out, I think is quite important.
- [21:37]
Kathleen Griffith
And I always suggest that they have separate work streams for customer bases. So you should have a key stakeholder within the company that is wholly responsible, for example, for the hospital experience or the insurer experience or the patient experience, as well as the customer feedback that's coming in from each of those different cohorts. And then you try to find common ground. So I think for anyone who's running a more complicated business, like we're talking about, it's important to be serving all of your quote unquote, customer bases uniquely. And then you've got to duke it out.
- [22:11]
Ben Walter
They are really clear on the two things that matter, which is what is the problem they're trying to solve and how much passion do they have for solving that problem. And that sort of clarifies everything else around it. So, yeah, it might be complicated that you have to deal with a nurse and a doctor and an insurance company and a patient and, you know, probably an orderly and everything else in between. But they know the problem they're trying to solve, and they're enormously passionate about solving it. And that clarity is probably pretty helpful. One thing we talk about for business owners is scale. But scaling here means something totally different than what we see for other B2C or B2B companies. For Kevin and Daniel, it's not about having apogee in every single hospital in.
- [22:50]
Daniel Arteaga
The US we do best in certain markets. We're not best in 30 hospitals in 30 states. We're best in, you know, 10 hospitals in a geographic region, because then we know Alzheimer's Association, Meals on Wheels, what are the best clinics? Because these patients still need help after they leave the hospital. So scale for us is going deep in markets, not just across every hospital that there can possibly be. The other thing that's really important is we need technology. So we started talking to technology firms and I had no idea what they were talking about, because part of the answer to your question is you have to leverage AI to help us work differently. Most of the information we need is somewhere in these people's medical records. The computer can pull that out for us, organize it in a new way, tell our work stream. Because we can't afford to have Daniel seeing every one of these patients. There are not enough Daniels in the world, but we can get great providers and then use the computer to help tell them which patients to see. And then use the computer to help figure out what are the right care pathways that are most efficacious for those patients.
- [23:45]
Ben Walter
Yeah, this is the same place in financial services where we see the biggest leverage for AI. It's not that AI is going to do everything for us, but the efficiency and the productivity that it can add to the existing workforce. Tremendous.
- [23:55]
Daniel Arteaga
And that goes back to this. What is a service? Tech enabled service? Service enabled tech.
- [23:59]
Ben Walter
That's really interesting. And just out of curiosity, how many patients a year do you think you're seeing now?
- [24:04]
Kevin Bice
It's in the ballpark of 120 patients a month, 1,440 patients a year.
- [24:09]
Daniel Arteaga
And we have a bunch of healthcare systems circling right now. I mean, like, getting a contract, as per our prior conversation with the healthcare system isn't a super quick process. And so we have several in four different markets. We really can't go to more than three markets in 18 months, but we have several in four different markets that I think will start to engage with us very soon. And so that number will go up relatively quickly.
- [24:30]
Ben Walter
Okay.
- [24:31]
Daniel Arteaga
And one health insurance plan, there's one large health insurance plan that we're also talking with about how would you do this across their population, not just in one hospital, but like all the places their members go.
- [24:41]
Ben Walter
Interesting. So I want to talk a little bit about both of you as individuals. So first of all, you've both said, Kevin's the forest and Daniel's the trees. Say more.
- [24:52]
Daniel Arteaga
You need both.
- [24:53]
Kevin Bice
Kevin is the ER doc, so he's down in the trenches, so to speak, with the constant stream of patients. Right. It's a non stop flow. I came from the background of being a geriatrician who was working in the hospital and feeling frustrated because I was seeing a lot of patients who came in through the ed, but I was seeing them on day five, day six, day seven of hospitalization. The way we operate is incredibly different in ways that are complementary. And I think it makes both of us better. I really enjoy digging into complex processes. I've got all of my flowcharts, my decision matrices, figuring out how do we put all these pieces together? Where are all the different stakeholders interacting, and where do we see potential frictions happening, and how do we solve for that? That's what I enjoy doing. It's my happy place, so to speak. I think that would be torture for Kevin.
- [25:42]
Daniel Arteaga
I would be awful at it. I'm definitely the big picture person of, like, wait, where do we need to go? What's the simplest thing? How do we communicate this? I think the important point for me, from a leadership standpoint in that, is that you better surround yourself with people that make you a little bit uncomfortable. Like, Daniel and I are good friends, but he's gonna say things that I'm like. I don't like that because it's not what I would say, and I'm sure it's reciprocated. But if I like what everybody around me is saying, I'm not doing a very good job leading anything because I'm just getting an echo chamber. And you've gotta bring in people that see things differently and bring in different skill sets and even challenge each other. Otherwise, I think we will just collectively, you know, blissfully fail. Like, if we don't challenge each other.
- [26:24]
Ben Walter
Well, it's a very adult way to think about it. One of my favorite phrases is, I'm not crazy. I'm just not you.
- [26:31]
Daniel Arteaga
I love it.
- [26:31]
Ben Walter
That's always stuck with me, is two people can approach a problem completely differently, come to completely different conclusions, and it doesn't make either of them insane. What's next for Apogee? I guess I should look at the big picture, guy.
- [26:42]
Daniel Arteaga
I think that big picture, we are going to sign up a handful more hospitals. We're going to be in three markets in 18 months, and we're gonna go deep. We'll be in 10 to 20 hospitals in those three markets, and we'll start to get a lot of attention. And when we do that, we will be set up with AI, the scalable workforce, the care pathways and models that allow us to deploy this even without us directly caring for the patients in other hospitals. So what's next for Apogee? It's picking those three markets, making sure that all the right components are lined up in those three markets, going deep into those spaces and nailing down our workflows, and making sure we're optimizing the integration of technology so that when those three markets get attention and they want us in 20 markets. We can deliver on that scale.
- [27:26]
Kevin Bice
Beautifully said. No notes.
- [27:30]
Ben Walter
My last question is something we ask every guest we have on the show. So I'd like an answer from each of you. You've both been through the joy and pain of starting a business and running a business. So what is the one piece of advice you have for aspiring or current small business owners?
- [27:45]
Daniel Arteaga
Daniel usually likes him when I go first because it gives him a second to get his thoughts in order. Having my thoughts in order has never been an impediment to me speaking. So my advice would be make sure that what you're creating is addressing an oh, shit moment for stakeholders, for the public. Like, at the end of the day, what we are about is that moment when you realize you've got to go back to the er, either for yourself or for a loved one, and you're not sure. Sure that you're really going to get the care you need. You got to be solving something real. And so if you're going to create a small business, at least in healthcare, it better be engineered towards real pain points that your customers are already experiencing and that you can meaningfully address, not what you think they should be doing, because there's a cooler way to do it. And I think a lot of where we're missing the mark in integration of technology and healthcare right now, there's a lot of really smart people creating a lot of really cool things that aren't addressing the actual pain points that are being experienced by the care delivery system right now. So start by listening. Start by understanding where you provide value, and then infuse the technology and the workflows that allow you to address that.
- [28:49]
Ben Walter
Okay, top that.
- [28:50]
Kevin Bice
Daniel, my answer, I think is going to be very complimentary, which is I think that if you're going to take a leap like this, you have to be obsessed with the problem you're trying to solve. As physicians, we love solving problems. Whether it's solving the problem of an individual patient in front of you or trying to solve problems for a broader health system that's struggling with their inpatient capacity. If you are obsessed with the problem that you are trying to solve and you are understanding that problem in 13 different dimensions and catering to that problem in everything that you do every day, then you're going to build something that has value.
- [29:30]
Ben Walter
Kevin and Daniel, thank you very much.
- [29:32]
Kevin Bice
Thank you.
- [29:33]
Daniel Arteaga
Thank you.
- [29:39]
Ben Walter
All right, Kathleen, we're sort of at the end here, and I hear all this about going deep versus wide, but I think these guys probably convinced a lot of People to bet on them.
- [29:47]
Kathleen Griffith
Yeah, it seems like it. Also, you've got this co founder element, which is really nice. And the lion's share of businesses that are backed at a venture level or co founders. So that was great to see their dynamic. Between the two of them.
- [30:01]
Ben Walter
I can't tell you how many, either clients or prospective clients, meaning people I talk to who ask my advice for starting a business. My number one piece of advice for many of them is find a co founder. I think it is too hard, too consuming, too diverse, too everything to do by yourself in most of these cases. I think having a co founder is critical. I don't care if you're venture backed or not. Not. And it's a few things and these guys really embody them. I think it's one having someone to share the load, both cognitively and physically. I think it's having someone to challenge you. And I'm super impressed with how they manage that dynamic. And they clearly come at problems differently and they're open to each other's viewpoints and they respect that challenge and internalize it and think it through and pay it the time it deserves. I think that's really important. And then I think specialization quickly becomes important because you have to start to go deep on things and you just run out of capacity. So I'm a huge fan of the co founder model. It takes a ton of work upfront to find the right one. But on a personal level, I would often bet on the right two co founders with a good idea versus one co founder with a great idea.
- [31:09]
Kathleen Griffith
And one of the main questions is like, well, how do I find my co founder? You know, it's like you gotta go on a bunch of dates.
- [31:14]
Ben Walter
Yeah. The same way you find a spouse or a boyfriend or a girlfriend or whatever you have.
- [31:17]
Kathleen Griffith
We need an app for that.
- [31:19]
Ben Walter
Well, there are. Are there? I think there are, yes. But I would say for people who are looking for a co founder, the most important thing is to make a list of what you want and don't want in a co founder and be absolutely strict about it. Be honest about if it's truly things you have to have or can't live with and then don't compromise on it because you know the things that drive you crazy and those aren't your fault. They're just who you are. We all have them. So don't partner with someone who has the trait that drives you crazy all the time.
- [31:48]
Kathleen Griffith
Yeah, that's good advice. And I think also making sure you're not just getting your doppelganger. Because you're just, you're drawn to people who are like you. Right. But today we saw just a great example of someone who's a total yin to his yang. You know, they're counterpoints to each other. They have really complimentary skill sets. You made me chuckle as you were talking about that. Because I've heard recently that there are therapists and coaches now who specifically helps co founders deal with communication issues and breakdowns in the business. And it's a growing business for good reason.
- [32:21]
Ben Walter
I also know some people now who sign prenups. So what happens if one of us decides we want to leave?
- [32:26]
Kathleen Griffith
The business walks out the door.
- [32:27]
Ben Walter
It's better to agree that up front.
- [32:29]
Kathleen Griffith
Yeah.
- [32:29]
Ben Walter
Especially because sometimes the amount of money put in isn't equal. Or maybe it is, or the time hasn't been. It's better to agree up front. If one of us goes, here's how, we'll deal with it.
- [32:38]
Kathleen Griffith
Yeah, it's interesting. I was just talking to a small business. Three co founders. One decided to leave for a full time job because they were having a bit of a lull in the business. Now they're trying to ferret out what happened. So there's debt in the business, but there are also assets. Right. And so it's so much better to do it up front to have those tough conversations.
- [32:58]
Ben Walter
Kathleen, this is a really interesting one. Thank you for joining. Thank you for coming in and thank you as always for your insight. It's always fascinating.
- [33:03]
Kathleen Griffith
Yeah, I enjoyed the conversation and it's fun to be together in person too.
- [33:07]
Ben Walter
Yes, it's always better. If you're like me and are in interested interested in how technology is transforming healthcare, check out the newest episode of JP Morgan's Making Sense. Their latest episode explores how artificial intelligence is revolutionizing clinical workflows, improving patient care and reshaping the business of healthcare. Give it a listen in the show's feed or visit the link in this episode's description. Thanks so much for listening to this episode of the Unshakeables. If you liked this episode, please rate and review it on our next episode. We'll have two guests for you. One is from Fernandina Beach, Florida and the other is from Charlotte, North Carolina. And it'll be great because they'll be live on stage with me for a special episode. I'm Ben Walter and this is the Unshakeables from Chase for Business and Ruby Studio from iHeartMedia. We'll see you back here soon.