0:10

we are

0:14

, talking hi everyone

0:18

Please welcome.

0:26

so, What

0:28

I to about today is the problem that obsessed

0:30

with which is bad customer service

0:33

and Healthcare. So I'd like to

0:35

start out by walking you through a

0:37

day at the office can look a little bit like

0:40

best.

0:42

You

0:42

can start out by making an appointment. So you call in

0:44

to talk to someone very unpleasant on

0:46

the phone , you on, you,

0:49

wait, or bad, hold music, you're waiting

0:51

and waiting. They come back. You

0:54

go back and forth a little bit on your calendars. You

0:56

got an appointment. It's in 21 days.

1:00

Now it's 21 days later, you

1:03

go to the doctors office. Someone very

1:05

unpleasant checks you in at the front desk. You sit

1:07

down. Super depressing, waiting room.

1:09

Bad wall art. Very

1:11

old is she was a parenting Magazine smells

1:15

of puerile in there? That's fine. This

1:17

is your hang out for a bit now and now it's

1:19

maybe Thirty or forty minutes

1:21

later. Someone calls you back. As

1:23

you may have, got there very unpleasant. They

1:26

take you back to the exam rooms,

1:28

very small black fluorescent lighting

1:30

everywhere. They take your vitals. They hand,

1:32

you essentially a sheet of printer paper. They tell

1:34

you change into this. Now, you're

1:36

in sort of a holding chamber,

1:39

it's Abyss time, you can hear

1:41

the doctor and the other room and they're saying,

1:43

hey, it's so great to see you and say, you know,

1:45

they're just getting started in there. Even

1:47

though your appointment was an hour ago at

1:50

this point. Pull up

1:52

your phone, you start to go through your little question list.

1:54

Got , the courage to ask everything.

1:56

You came in to ask. and

1:59

finally, they're not prepared

2:01

to be changing he can

2:02

then several small talk with you he goes

2:04

and sits down it's all the time houston

2:07

questions

2:08

maybe like eight minutes into the have given up the

2:10

site near like okay also off of questions

2:12

new collector little question less on your phone

2:15

and you got through may be like two or

2:17

three of these questions and then the

2:19

doctor starts to give you a look like let's wrap

2:21

this up and see wrap it

2:23

up yeah three questions you can't get

2:25

over to go outside you check

2:27

out if you're lucky they'll tell you how much how owe

2:29

if not you'll just find out later find

2:32

the mail so my guess

2:34

is that many many of you in the audience

2:37

have answers after that most

2:39

of us have an innovation and this experience

2:41

and same thing for a lot

2:43

of horrible things about a whole purpose of the the one

2:45

i want to complain about with for the grupo de la

2:48

, customer service at the point at which her after

2:50

consuming a house there is so

2:53

appallingly than and when i refer to customer

2:55

service that has anything that had insufficient

2:57

experience that your mind as and

2:59

the that yourself a long way time is as a

3:03

a service as that the

3:05

front that person there's

3:07

this i'm really grateful that

3:09

i love from bill girly prolific

3:12

investor and my relationship hall

3:14

pass sit

3:17

at know hes can be here

3:20

the you i hope your market his

3:22

least customer centric have any pets in

3:24

the service industry the oh so numb

3:26

to the pain and he rarely and just

3:28

a campaign for that's part of what i think the so

3:31

crazy about this is a we kind of just

3:33

to get on and so

3:36

but any three to four three patients i want

3:38

to go you do with you here today in

3:40

the wind blowing things up

3:42

how did he got me a number two

3:44

lot of the care that thing

3:45

so bad and number three what can we

3:48

do about it was a little something we can do to make it

3:50

better so upset with wire thing so

3:52

bad i'm a bit part of this

3:54

is our customer service problem

3:57

is really more of a consumer service

3:59

problem

4:00

and what i mean by that his patients are

4:02

consuming the whole kit admitted that he the

4:04

past summer and a traditional free market cancer

4:06

the term cigarette on the

4:08

us healthcare system as we know is an

4:10

employer sponsored model and

4:12

this was not very well thought out it's more of a world

4:15

war two relic that

4:16

came from a national mandated wage freeze

4:18

and nineteen forty two and we kind

4:20

of the had going with it and now today

4:22

the doctor not and

4:27

many of the major stakeholders in the industry

4:29

from hard include any signs

4:31

anthony third a pair of heard a real customers

4:34

in the soil

4:35

and doctors don't love this either by the way there's major

4:38

burn out in the medical community and but when

4:40

you play this all the way out in left with miss

4:42

a line incentive to seen physicians and

4:44

patients

4:46

the visions and the traditional fee for service model

4:48

which is our predominate model today where physicians

4:50

are paid per per patient encounter unfair

4:53

incentivized by volume and

4:55

not by quality and i can help our hands

4:58

so if know the tag purposes or need

5:00

to gain to cater to the patient and

5:02

winter becomes an early becomes a cancer every

5:05

doctor's office and get away with it and now you're left

5:07

with is to really bad stuff

5:10

wow

5:12

specifically the average mps

5:14

were provider

5:17

that are summer the

5:22

hope or a mob the service itself only

5:24

four percent or about the care delivered so

5:27

visions are really noticing how bad

5:29

the customer services and yet

5:32

the go back for earlier planes patients

5:34

have this sort of stockholm syndrome when it comes to

5:36

wanted a doctor specifically still like and

5:38

maintain can either because you don't think according

5:40

to drive all over the the very stating

5:43

that

5:46

even though we're not an easy to please generation

5:49

will become very submissive and it's the most

5:51

important service across any service industry

5:54

i'm so this is not a good thing lives is happening

5:56

and why should we care that we're having such

5:58

a bad time at the doctor's

6:01

bob roberts is bad for

6:04

our home

6:06

the partnership between a patient whose coming

6:08

in with real information on how they're feeling and

6:11

then a physician descending into the off the keys

6:13

to boon to that information and they were together

6:15

but if the patient is getting very anxious and exhausted

6:18

and the doctor is going very rushed and

6:20

dismissive

6:22

you're lucky moving a bunch and

6:24

really important information that you need to make new

6:26

one thousand ethic and treatment plan

6:28

the to give you an example stoppers are far

6:31

more likely to prescribe antibiotics in the afternoon

6:33

and they are in the morning for the same patient

6:36

with the same issues and because they're just running

6:38

way in a joint decision fatigue he

6:40

would anything from the pocket to be to make wanting

6:42

appointments and

6:45

then patients on the other hand know

6:47

all this and they felt this before and for what

6:49

many of them end up suing is referring treatment

6:51

altogether so patients get

6:54

this is also are not getting anything out of able

6:56

to set the muscle home health care has

6:58

a piece and fine problem

7:00

because they need

7:01

the period and going to the doctor's office

7:03

so bad and we only go and

7:05

we absolutely have to go and what did

7:07

we lose when we go with me only of will be

7:09

held today preventive care

7:12

preventive care is really the reason

7:14

it's so bad that we're not going to the doctor's office

7:16

me lose out on going when things

7:19

are early we lose out on all the upswing

7:21

lifesaving conflating benefit

7:24

of , so under hypnosis

7:26

off on not the first of

7:29

all about how all about top five causes

7:31

of death in the us open

7:36

the city paper whatever that so few avoidable

7:39

chronic disease account for

7:42

seventy five percent healthcare on on

7:44

finally on the other hand patients with

7:46

pd p primary care doctors spend thirty

7:48

three percent less on healthcare overall

7:51

because their front loading that spend toward

7:53

prevention wow that was a zipper

7:56

health what can we do about it and

7:58

the good news is this we

8:00

are heading to see more know purposes

8:02

shift towards models are incentivized physicians

8:04

to care about good customer service self

8:07

or two models we can use your to change the compensation

8:09

model to allow position to

8:11

have him face to think about on

8:13

the service so the first one is left

8:16

and simmer for that making the

8:18

patience to kiss him again in this scenario

8:21

the second one is leveraging value

8:23

based care models or the answers

8:26

the reimbursing face on

8:28

it on quality and set up the volume

8:30

and so in that case the answer so the personal

8:33

bank what what if an

8:35

intention

8:37

those are kind of the two options

8:39

that we can leverage fat as we can

8:41

see the have the tools that we

8:44

need

8:45

really now about shifting norms

8:47

and the healthcare industry and industry is very clunky

8:50

and it's the tp and

8:52

sort of crotchety at times and for the change

8:54

might feel a little bit slower than it does and

8:56

other industry is that we're starting to seem one more

8:58

common the has been

9:00

and as a pitch both patient expectations

9:02

change we start to expect more out of

9:05

our health care and now we're starting

9:07

to treat health care of the way we treat any other

9:09

certainly some interact with and we started to say goodbye

9:12

and i'm aaron you

9:14

would be model and changed incentives

9:16

for finishing this show me a free market think about

9:19

how do we get that the customer service how do we have

9:21

to get the patient by and get people

9:23

to launch go back to the doctor's office because

9:25

doctors and hospitals and of readers are not

9:28

is a thinking about this or not is treading on customer

9:30

service or bedside manner so

9:32

we need to have to another industry with as the

9:34

hospital the him how about

9:37

you on a sunny here today to tell you we need

9:39

to be feeling from hospitality industry

9:41

they have figure this out a already on

9:44

the know how to treat people like people they know

9:46

how about human to human services is ultimately

9:48

today what healthcare stop him

9:51

the so i really

9:54

think this definition of hospitality

9:56

from danny myers really great seemed

9:58

restaurant or my other the

10:00

papa

10:12

patients really miss when worthy

10:14

or at least very few of yelp review where these

10:16

health care and i want to share a few ideas

10:18

on how i think we can get there and

10:21

the cofounder of a primary care membership

10:23

service called the land be on

10:25

and we do what we call a helpful hospitality

10:27

training with all of our team members other

10:29

providers and i want to share a few central tenets

10:32

from naturally they

10:36

can be implemented at very low and

10:39

can really started to hip the norms

10:41

and ship the culture is what we need some

10:43

, these may seem obvious but

10:46

they're not and helpful so we got these

10:48

are my top five number one follow the

10:50

golden warm patients are interesting

10:52

us with our most precious resource which is

10:54

a whole

10:55

remember when you want to be treated in the doctor evil

10:58

the family cheated number

11:01

two separate occasions this is on

11:03

a subway trough know but eventually hold

11:05

information was one of the few minutes late for yourself

11:12

they're ask that question to get that

11:14

first treat every case like it's a medical investigation

11:17

if someone didn't think something was important they were brought

11:19

up with us danny

11:22

meyer lines the and agents not a gatekeeper

11:24

some agents less people and a gatekeeper

11:26

builds a barrier sixty people out we don't

11:28

want to be that kind of passes if a patient

11:31

has a good reason to the asking you to break

11:33

one of our rules and there's an easy way to

11:35

break that within the bounds of the law and just

11:37

take it i

11:40

need extra credit surprise and delight

11:43

how can we make less the best interaction

11:45

of a patient states even if they're going through something

11:47

really changing i think that's the fun puddle

11:50

of applying hospitality and how

11:52

can contact with standing right approach that

11:54

are popping remember something about someone and

11:56

make them feel scene and makes them feel like yes

11:59

i wanted the matter the doctor's office

12:02

right at

12:04

all possible punch ending hear some just gonna wrap

12:06

this up with healthcare

12:09

hospitality treat patients

12:11

the way they deserve to deserve to the operation

12:14

at some point and when that point palm the

12:16

sequel feel inherently hi

12:18

too high to get worse service then you what are your favorite

12:20

restaurant

12:28

i think the thing that struck me about

12:30

are dysfunctional system is the

12:33

, girly quote and then what you're doing there

12:35

is no customer hands

12:37

how does that change over time

12:39

in america and europe were you doing

12:42

with your company as part of this

12:44

so how do we say that

12:46

in americans perceptions americans got my knee done

12:49

and i didn't know how much your boss and then i found

12:51

out just cleaning out my meniscus a sixty

12:53

thousand dollars and that was like how much

12:56

sixty thousand dollars and years ago for

12:58

minister surgery new york and then some is a better

13:00

costs like ten thousand and there's so

13:02

many

13:05

when you go to the restaurant in italy like the when you go

13:07

to and there's no he ,

13:10

yes i love love

13:12

love i you , and you

13:15

have love make

13:18

is that some ,

13:22

to do americans

13:24

start changing how they perceive

13:26

this as

13:27

the parlor problem of it does definitely part

13:29

of the problem is that we all are tending to say okay

13:31

with it and assume that this is this industry well we're

13:33

not supposed to know the prices until afterwards no

13:35

other industry was dismayed to

13:38

that any well i'm anti

13:40

think fluoxetine supermodels pay huge role

13:42

in getting patients to think oh i can

13:44

treat this like other services it's not like we're not

13:46

annoying consumers and other ways we already are

13:48

and so we just need to apply that same annoying

13:51

attitude to healthcare and

13:53

then by leveraging direct to consumer models

13:56

part of this of this on higher deductible plan

13:58

so we started treat our dollars warwick mama what

14:01

normal dollars on putting money into a

14:03

to say that as i say the guess it's the sort of

14:05

thinking more like a traditional customer

14:07

and think about where we're spending on my end we

14:09

got a little bit with

14:11

a direct to consumer drug companies yep

14:13

i'm hymns hers get

14:15

roman all the stuff that freeburg uses

14:18

to get , for

14:20

battle david nice to me me yeah

14:26

prepare for war

14:28

,

14:29

those are a stars right people called things

14:31

from now on come on she i love yeah but

14:33

this is part of it that people are saying he

14:35

would have to oh dysfunctional to go to the doctorate so

14:38

dysfunctional deal my insurance company for

14:40

certain things yeah i'm just

14:42

going to go on a website in order

14:44

yep that is part of the frustration

14:47

right and

14:48

but given the a little taste the bed and then alternatively

14:50

if you don't want go to the doctor your go to urgent care which

14:52

has much more of an easy pricing menu in many

14:54

cases the you can look at so again we're starting

14:56

to get to see submit my thing patient expectations

14:59

would change and doctors will have to follow suit

15:02

we tend to index the quality

15:04

of american health care when you look at the average

15:06

life expectancy

15:09

first you do men women and then you you know you look

15:11

at white men versus black men versus brown

15:13

men you know white women vs black women

15:15

etc and white men have always sort of been

15:17

the standard bearer then it

15:20

all thing has happened over the last three or four years

15:22

where the life expectancy started to get worse and worse

15:24

as our percentage share of health care

15:26

expenses as a percentage of gdp have gone up

15:29

seasons and everybody gets up in arms

15:31

because you're like well within a week has something

15:33

is clearly so structurally broken that

15:36

we're spending fifteen twenty thirty

15:38

percent a year increasing every year

15:41

and we're dying now under the age of eighteen where

15:44

this thing should be a thing where we're living

15:46

two hundred why

15:48

exactly is that thing happening i

15:51

i could understand like where you could say maybe

15:53

it's segregated to you know

15:56

minority men or women or something but it is

15:58

offices everybody the why

16:00

are we die

16:03

sooner as we spend more yeah but

16:05

are also increasingly spending increasingly lot of thing

16:08

how am i am and we're not worse

16:10

over spending on health care because we're spending on things

16:12

that kill us and that are healthier gets very expensive

16:15

because the a terrible terrible lifestyles

16:17

and everyone is shrinking way too much because

16:21

all communities everybody is eating totally

16:23

processed foods these are becoming more and

16:25

more readily available increasingly so every

16:27

year and so yes in the very

16:29

upper echelons they're sort of a movement towards

16:31

vileness a more holistic lifestyle that other

16:33

half was swept the nation yet and so we're all

16:36

living really really unhealthy live not

16:38

caring about our preventive health and i'm spending a lot

16:41

on health

16:41

the down the line so you're saying it's really not

16:43

we just can't outrun our lifestyle

16:45

exactly exactly which is not our fault

16:47

and mean corporations make it very very difficult

16:50

to live a healthy lifestyle i'm in the us

16:52

do you find examples of countries

16:54

that have gotten population level health issues

16:57

right whether it's with it's with to costs

16:59

are outcomes were you say status direction

17:01

only something that we can learn

17:04

now i have no good answer to that question because

17:06

every company besides the u s think that has

17:08

like the best healthcare system for that any time

17:10

i talk to anybody in one of those countries like i was

17:12

speaking to the one canada the other week

17:15

and base hits are healthier and second floor thing

17:17

ever and me like point eight weeks to get

17:19

you to i medication and self a

17:21

i just think it's too hard to compare our unwieldy

17:23

country to other systems and be i

17:25

don't even know people who are that happy with other system

17:27

so i don't remember

17:30

how much of a role you think medicare

17:34

medicaid cms can do

17:36

the break the logjam vs waiting

17:38

for politicians to pass legislation

17:41

like obama care to clarify to reorient

17:43

what's wrong i think it's i think

17:45

really in both i think size is

17:47

as eight eight as an earthling a huge role

17:49

in trying to get more no value based care models

17:53

through medicare and they're making they're making push to

17:55

do that and so it's slow and clunky but

17:57

i think they have the right idea they wanted to

17:59

move toward they care model

18:02

the thing a lot about mental health recently

18:04

seen what we've seen during the pandemic a lot

18:06

of young people are kids having these two

18:08

years alone and what the

18:10

second or third order effects about and

18:14

just trying to get consensus in america around

18:16

healthcare is very hard but i think since

18:18

we've all suffered some degree of

18:21

mental health hovers coven break

18:24

with setting for of a lot of people crazy and cradle

18:26

of anxiety

18:29

it is there any way for us to think about

18:31

universal healthcare but not have

18:33

to have this nationwide discussion of all

18:35

or nothing and i was just thinking mental health

18:38

is something that everybody can appreciate it's not

18:40

that expensive to deal with as much surgeries

18:43

my can't we just agree as a country that

18:45

anybody who wants to talk to a therapist

18:47

or pounds were will , able to do

18:49

it for a sliding scale were very

18:51

small amount of money and

18:53

maybe be able to just zip off one

18:56

piece of the puzzle and say you know it's

18:58

therapy will be fifty bucks swat raids

19:00

the country will pick up the other fifty or one hundred fifty

19:02

whatever it is to to get this done

19:05

and maybe you'd speak about mental health

19:08

you know as you know are larger issue because

19:10

it it does seem to have so many

19:12

downstream effects in terms of or

19:14

or physical health the thought

19:16

of about this a lot of the

19:18

he tried to figure out a way to intubate

19:20

mental health and a way for we would be able to

19:23

make money and

19:23

can i am just yeah so

19:26

so yeah there have been a lot of models that came out during kobe

19:28

that allows the the sex with somebody and do

19:30

like virtual therapy and there are a lot

19:33

of the and therapists who offers sliding

19:35

scale bites part of the reason it's it's a little

19:37

bit more difficult as as the peace and panel size

19:39

number of people they can take on a so much lower

19:41

because it's such a higher touch experience

19:43

and so it's hard to integrate it into that traditional

19:45

primary care model where

19:48

in in the across the us

19:50

one physician has a panel the three hundred percent

19:52

on average and see just can't do something like that from idaho

19:55

there are large population

19:57

health issues that the

19:59

lot the just get on the radar folks in this

20:01

room that are

20:03

poorly understood i'll give you an example like

20:06

there is somebody or follow she's a writer i think for the

20:09

remember when your ten something and she said

20:11

her best friend died of a heart attack in her

20:13

forties been and shed some sad about

20:16

the incidence of heart disease amongst women versus months

20:19

and i had always assumed that it was largely

20:21

a male predominant issue until i saw those thoughts

20:23

and i realized my god like this is a broadly

20:25

pervasive issue maybe it's because of lifestyle etcetera

20:27

so i learned something in that moment i didn't know before

20:30

but any broad population level issues

20:32

are you think a really important for folks here know

20:35

yeah i mean sort of related to that i would say

20:37

nutrition label literacy is so simply

20:39

important there are so much scary marketing

20:42

that people have to educate themselves on and

20:44

it's such a part time job to have to learn

20:46

about why this product that looks

20:48

extremely healthy as like using the new brand

20:50

followers that are not dario he still looks

20:52

like it should be being an organic is actually really bad

20:55

for yourself having more education on

20:57

what makes for good food i think would cut out a

20:59

huge huge portion of our friends of like of

21:01

have

21:01

people find out more about the it's

21:03

landry away and d r

21:06

if as the nightmare of my life it's the

21:08

land be l a and b y

21:10

i'm a big friends are such as right says

21:13

brian how can i find out

21:15

more about it if they wanted to become wanted member

21:17

how do they become a member of their members as it over there

21:19

without l a and they're loyal to they're

21:21

start of your website i'm assuming are you have an email

21:23

or something and then yeah harry harry potter well aren't

21:25

as i only and be why i like landry

21:28

lovely people call it the land be like a lamb

21:30

saw the land was a two parent of a mispronounce

21:33

it's the is it as i've already lived a life once

21:35

long can this life and now i have

21:37

like a month myth pronunciations went beyond the time

21:41

changing just go lambie dot com you can apply for membership

21:43

at the top of website its new

21:46

kenneth scale and and and are you

21:48

going to raise money for this is it going to be a venture

21:50

based investment because it sounds fascinating

21:52

to me as a as a business model

21:54

yeah so receive raising our seed right now

21:56

we've we predominantly raise money

21:58

through our members so far with them really

22:00

nice having our consumers as editors

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ah by yeah it's me

22:04

to mentor sell because they were doing it's not

22:06

a that's when the resist arrest three person charity

22:09

model so we're able to take on more patients

22:11

per panel because your thigh not just a doctor

22:13

but also nutritionist and also concierge manager

22:16

who does nomination whom are free of raising

22:18

a seed and let , know what is

22:20

the lieutenant stress

22:23

left a tennis with a gimmick now

22:37

we'll have a source

22:57

about

23:01

one of the

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second and