Podcast appearances and mentions of sunshine act

What would make patients EXCITED to refer their friends and family to your practice?In this episode of the Ground Marketing Series, we unveil the secrets to crafting a high-performing patient referral program tailored for dental practices. Navigating the maze of compliance might seem daunting, but we're breaking down the barriers, offering you a roadmap to a program that is as effective as it is legal. We dive into a list of innovative strategies and enticing rewards designed to inspire your patients to become enthusiastic promoters of your practice. Learn how to play within the rules while making your referral program the talk of the town with ideas like luxury mini items, mystery gifts, and VIP dental perks.Beyond strategic insights, this episode provides a personal touch with practical examples, real-life scenarios, and ready-to-use scripts for engaging patient conversations. Discover how to transform your referral program from mundane to mesmerizing by tapping into psychological triggers such as urgency and surprise. By the end of this episode, you'll not only have a blueprint for invigorating your patient base to refer, but also learn how to stay within state regulations while doing so. Don't just aim for passive referrals—dare to craft an experience that keeps patients talking.What You'll Learn in This Episode:How to design a referral program aligned with legal and ethical standards.Impactful reward ideas that excite and engage your patients.The role of urgency and surprise in enhancing referral participation.Harnessing luxury mini items and local business perks for maximum appeal.Scripts and scenarios to easily implement these strategies in practice.The power of social proof to amplify your referral efforts.Let's learn how to create a captivating referral program—tune in now!‍‍Learn More About the Ground Marketing Course Here:Website: https://thedentalmarketer.lpages.co/the-ground-marketing-course-open-enrollment/‍Other Mentions and Links:‍TDM Articles: Legal and Ethical Patient Referral Strategies for Dental Practices‍Organizations/Laws:Anti-Kickback StatuteState Dental BoardsSunshine Act‍Businesses/BrandsChanelDiorYSLInvisalignKlatch Coffee‍If you want your questions answered on Monday Morning Episodes, ask me on these platforms:My Newsletter: https://thedentalmarketer.lpages.co/newsletter/The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041‍Episode Transcript (Auto-Generated - Please Excuse Errors) Michael: The ultimate compliant and irresistible patient referral program. We're gonna be diving into strategies and gifts that actually work. So this episode with ground marketing, we're gonna talk about creating a referral program that works. How to make patients want to refer while staying fully legal and ethical.Now, most referral programs fail. They don't excite patients enough, and let's be real. No one cares about appreciation clubs or educational seminars that much patients want something they actually desire. But we also need to ensure full compliance with the A KS, the anti-kickback statute, and the state Dental Board regulations.This episode's gonna break down highly enticing, fully compliant, and unique referral strategies that make patients want to refer without violating federal or state laws. Now, just a heads up, by the time this episode comes out there is going to be a article, out on the website titled Navigating Referral Marketing for Dentist.It's gonna say compliance and ethical strategies. And in there, I mean, you can kind of see the draft right here if you're watching on YouTube, but you can kind of see, I talk about understanding the Sunshine Act and the a KS for dentists. How can dentists reward referring offices without violating the law?Gives you exactly, Hey, gift cards, are they okay or not? What kind of gives thank you cards? What's legal and ethical? I break that down. How to stay compliant with referral marketing. So much more. And I'm gonna go deeper into the article as well. So that article is gonna be out.I'm gonna put a link to it in the show notes below by the time this episode goes live as well. But going back to this episode with ground marketing, we're gonna talk about right now, the secret to making a referral program work. Now, a successful referral program has three key components. One, the reward must be something they actually want.So if it's boring, they're not gonna refer right? Two, it must be compliant. So that means no cash, no high value gives, or direct financial incentives. And then three, it must feel like an effortless bonus. So effortless, the patient should feel like they're getting a pleasant surprise rather than being bribed.Okay, and I dive deeper into this in the ground marketing course. Now, the goal for this, instead of saying, refer a friend and get $50, we want to create an exciting, ethical, and legal reason for patients to spread the word. Okay? So now that we got that down, the three things that have to be in a referral program, has to be something they want.Nothing boring, must be compliant, and it must feel effortless, like an effortless bonus, right? So that moves on to number two. Now, here's where we can dive deep and let our imagination run a little bit more wild. But at the same time, remember the state that you're in, the law and everything like that.So I'm gonna give you some things that our members have used, I've witnessed, I've used, that is an incredible, fully compliant reward, right? It's highly enticing. So number one. Luxury experienced based gifts. Now, why this works? Patients love unique experiences. It makes them feel special. So instead of cash, offer low cost, but high perceived value gifts.Okay, A compliant experience-based reward. Here's some ideas. Luxury candle or skincare gift set. This can be under $15 coffee subscription, a one month trial, right under $15 as well. Designer Lip balm they have Chanel, Dior, YSL, et cetera. Those are under $15. Artisan Chocolate Box or Gourmet snack Pack, Those can be under $15. Then maybe like a cozy night in package, and that can involve face mask, herbal tea, mini candle, right under 15, $20. A lot of the times it's the way you're gonna word this and package it, I'll give you an example of the wording and how important it is. A lot of the times we may say, Hey, Free consultation on your Invisalign. And we see that everywhere all the time. Everybody's like, Hey, course it's free. Everybody else is offering it free. But if you say, Hey, your first session of Invisalign is free. Now, people who are ready to get it in their mindset. They're more ready than the free consultation person.They're thinking, holy snaps, I get the first session for free. They don't know. The first session is a consultation. They're just in their mind. The first session is free. Let's do this kind of a thing. Boom. So the wording has a lot to do with this. So you can, instead of just saying, Hey, face mask, herbal tea, and mini candle package, you know, you just say, Hey, a cozy night in package right?an example script for this could be, Hey, thank you for referring your friend. As a little appreciation gift. We have a luxury skincare set waiting for you at your next visit. I can guarantee this is gonna ensure. That they will show up for their next appointment. And it works because people associate luxury with high value, even if it's a small cost designer brand.Mini items feel premium, but they stay compliant. So that's number one, right? Luxury experience based gifts. Two monthly surprise gift box. Now, this adds like a fun mystery factor and why this works. Patients love the ex excitement of mystery gifts. The psychological trigger of surprise and delight makes them want to refer more and how this works.Each month have a small mystery referral gift box in your office. Patients who refer get to pick one at their next visit. It's a mystery box and the example items, they're all under $15. Okay. this is what you can have in these mystery boxes. Mini essential oil set. You can have a high end travel toothpaste kit, gourmet popcorn or snack packs, many hand poured soy candles.And now depending on the community you live in, you can purchase some of these things from small businesses in your community and have these in the mystery. Bags or gifts. And then not only are you partnering up with another business and creating rapport, and maybe y'all guys can do even more things together, but boom, this is your foot in the door in order to get into that small business and get the employees to come in.But at the same time, now you're having them participate in something. for example, the mini hand poured soy candle, right? There can be a candle shop somewhere. And then another one is premium hydrating lip balm, right? Like the ones we discussed before. So mini essential oil set, high end travel toothpaste kit, gourmet snack pack, popcorn, anything like that.Candles, mini hand or soy candles, and then premium hydrating lip balm. Anything in this referral gift box, can have that, right? An example script for patients is, Hey, you've earned a pick from our mystery referral box. So go ahead, pick which one will you choose, and you can even record this, put it on social media, make it a big deal.It's fantastic and it works because patients will refer multiple times to try different gifts. The mystery element adds extra appeal, so it's not just a one-time thing. They're gonna try to refer multiple times to get multiple things right. So that's number two. Monthly, surprise gift box. It adds a fun mystery factor.Now, three local business perks. Now this one's huge. This is one we always do all the time with a lot of our members in our offices. Now this works because instead of a cash or gift cards, you partner with local businesses to offer exclusive low cost perks that feel high value. Now, example of local business perks are VIP perk at a coffee shop.Hey, your next drink upgrade is on us, right? Two free ice cream scoop at a local spot. Hey, enjoy sweet treat on us. Three exclusive, $10 boutique store credit so you can get store credit, paid by your practice. You don't have to buy a whole thing. It can just be this is for store credit. Next 10 minute chair massage at a local spa.Same thing, right? Store credit. Another one mini flower bouquet from a local florist, that's it. I mean, Those are example local business perks. And the script you can say for that is, Hey, we partnered with The local business to treat you. Your referral earns you an exclusive free drink upgrade next time you visit.however you want to word that right? Your referral earns you an exclusive $10 boutique store credit at. And it works because patients get real perks at places they already visit. Making the reward way more exciting. So this involves you getting to know, obviously, your target audience, where you want more of your target audience to come from.But at the same time, if you do an EPA, which we talk about that in the course, an existing patient analysis where you sit down. And think, who are my favorite patients that I currently see right now, or that I want to see once my practice is open, write it all down and boom. You're like, okay, where do they go?Where do they shop? What kind of coffee do they like? Where do they work? Where do they live? All these things. Now you're able to tailor make your referral program to that. So let's just say they go to Clutch Coffee, right? And they love Clutch Coffee. They talk about all the time, I know that I've even seen them there.Blah, blah, blah. Boom. VIP perk at a coffee shop once their referral, right? So if they send a referral, be like, Hey, I got you a VIP perk at a coffee shop. Your next drink upgrade is on us. You ain't even gotta worry about it. they're gonna love it. They're gonna see, that's my favorite coffee shop. How'd you know I go there all the time?Oh, much, much bigger impact than, Hey, here's 50 bucks. Here's a reward, right? And then the ethics plays a role in that, and you're not gonna get as much. So trust me, that is huge. The more you pay attention to your patients and where they go and what they like to do and who they are, the easier it is to build a rewards referral program and it will skyrocket your practice.From that point on, you can do a number four, which is a VIP dental perk. So this is non-monetary, but highly valuable. So real quick, a recap. We discussed three things so far on building a Referral rewards program. So number one is luxury experience based gifts.Michael: Two is monthly surprise gift box, which I think is fantastic. Three is local business perks. Another one. Fantastic, right? All these are fantastic, but local business perks creates a community hype. The community gets more involved. You know what I mean? You'll get more referrals from other businesses like that and so forth.Now, number four is a VIP, dental perks non-monetary, but highly valuable. Now, this works because patients value, convenience, and special treatment more than discounts. compliant VIP dental perks idea would be first pick for preferred appointment slots. Priority scheduling for family members, complimentary comfort upgrade.So maybe aromatherapy, neck pillow, something right that you guys do. Massage chairs or a skip the line fast pass for check-in, right? That works once in a while, but you can do something like that, especially if you are a highly, highly busy office. So an example script for patients that you can say is as a thank you for referring a friend, you are now on our VIP priority list for scheduling.And you can mention things like that. And it works because it creates exclusive benefits without violating compliance laws. So those are the four things you can do now, how to make the referral program feel more enticing. This is huge right here because you've created it, you're excited about it. You wanna put it out there.But you want people to start referring and you want them to take advantage of this program that you've created. So if you're just offering it, Hey, we have a rewards program, that's not enough. You need to present it in a way that makes patients excited to participate. So there's a couple things we can do, but I'm gonna mention three.Number one, use fomo. Fear of missing out, how to apply that instead of, Hey, refer a friend and get a gift. Maybe you should use, Hey, there's only 20 mystery referral gifts available this month. Once they're gone, they're gone. And then you continue. This works because people don't wanna miss out.Limited quantities equals higher participation. Two, make it feel personal and unexpected. This is how you're gonna apply it. Instead of telling everyone ahead of time, surprise them after they refer with the small, unexpected reward. So an example script for patients.Would be, wow, you refer to friend. Thank you so much. That's amazing. We have a little something for you next time you visit, And then you have it. Or if you already have it right then and there, that's perfect. You can just give it to them. But it works because you surprise them. And surprise rewards feel more special than expected ones.Now, number three is use social proof, make people see others referring. So feature referral shout outs in your office or social media. An example is like, Hey, thank you so much for this patient's name for referring a friend. We love them. Enjoy your mystery referral gift, right? And then they get the mystery referral gifts.You can make it a whole thing. And this works because patients feel encouraged to participate when they see others doing it.Now, these referral rewards program have reciprocity. People refer when they feel they owe you something. So if someone receives value first, they feel an obligation to return the favor. This is the science of reciprocity, so how you can apply this before asking for a referral. Give patients something first.Offer a small, unexpected gift at the end of an appointment, Branded lip balm, specific gum, or a $5 coffee card. And when they say thank you, mention the referral program. Yeah, you know what we love surprising best patients with small gifts. Here's a little something to say. Thank you. Oh. And if you know anyone looking for a great dentist, we'd love to take care of them too.Do you know anyone? And then that's it. Ask the question. Hey, by any chance, do you know anyone? we'll give the time. Be in silence for as long as you need to be until they come up with a name. And then now it starts working. Now you can start asking for that referral. It works because patients now feel obligated to refer because you gave first.So train your team to mention the referral program every single visit. That's it. That's what's gonna do it all honestly, is the consistency of that. Your front desk and hygienist should mention it at checkout or any moment that they get and create a pre-written script for staff to use. Make it themselves, use their personality with it, but should be something short, sweet, and to the point.So how to create an unstoppable referral program. In summary, you want to offer high perceived value gifts, select luxury mini items, local perks, surprise gifts. Use VIP scheduling perks or priority treatment as incentives if you want. Leverage, mystery and exclusivity to create fomo. Partner with local businesses for exclusive referral only perks, and make patients feel personally appreciated instead of just earning a gift. What you don't want to do is offer cash, gift cards, or high value incentives, That's a violation of the a KS. You don't want to make it feel like a transaction instead of an appreciation, and you don't want to use complicated referral processes.Keep it effortless, even to the point where take out that card. Sometimes we see that, Hey, here's a card if you want. Just give it to someone then write your name on the back. And then when they come into the practice and then they give me that card, I'll see your name and I'll know that you're the one who referred.That's too much it should just be like, Hey, come to my dentist. And that's it. It shouldn't have to be that whole long process where you need to get all that stuff. So the final winning strategy, make the referral gift something patients genuinely want but wouldn't normally buy for themselves.Use this strategy and your referral program will be the most enticing and legally compliant patient growth machine ever. Okay, now let me give you some examples how this works. The situation a dentist struggles to get consistent referrals. So we're gonna call this person Dr. Samantha, the general dentist at a small but loyal patient base, yet very few people were referring friends or family, and she had tried offering $25 discounts and free whitening, but she realized that these incentives weren't compliant and didn't excite patients.The problem patients saw discounts as unexciting. Two, her referral program felt like a transaction, not a reward. And three, the discounts could violate anti-kickback laws. The solution she had to have high perceived value, low cost luxury gifts. So Dr. Samantha switched to a referral gift system based on small but desirable luxury items.So instead of discounts, she offered mini Dior. Chanel or YSL, lip balms, luxury scented candles, organic self-care kits all under $20. Now how it worked, A patient referred a friend and when the referred friend came in, the refer received a luxury mini gift at their next visit. So the friend came in and, yeah, I came in from this person.Okay, cool. Awesome, wonderful. And then they gave a gift. Then patients loved it because it felt premium and personal, not like a discount, and the script was, you deserve a little luxury. You know, When you refer a friend, we'll have an exclusive Dior lip bal, or spa candle or mystery gift waiting for you at your next visit.It's exciting. They come in the results. Are incredible. You'll triple referrals in a short amount of time. Patients actively were asking, do you still have those little gifts available? And it's completely compliant. There's no cash, no high value incentives, just low cost appreciation gifts. Always remember people love branded premium feeling gifts, even if they're small luxury beats discounts every single time.You can also do the mystery box, right? mystery box works well. Patient refers a friend when they came in for their next visit, they got pull a mystery gift from the box, and patients love the excitement of not knowing what they'd get. So when that happened, I mean, referrals skyrocket, right?Some patients referred multiple people just to get another mystery box, and it stayed compliant because the gifts were low cost, but fun and desirable. And remember, people love surprises and games turning referrals into a fun experience makes them want to refer again. if you do decide to do the mystery box, make sure you record it.Post it on social media, make it a whole thing that's exciting, that's fun. And also the local business local community referral rewards program. That too, record that, post that on social media. Make it a big, huge thing. Now, all these successful programs had many things in common.they offered something patients actually wanted, they avoided financial kickbacks and stayed compliant. They made referrals feel special, not transactional, and they created an experience. Patients wanted to repeat. Now, if you want more referrals, do that. Do exactly what you heard in this episode and this whole episode along with the scripts and everything you're watching and seeing along with more scripts will be in the ground marketing course.If you're not a part of the ground marketing course, make sure you go in the show notes below. And enroll. I love to see you in there. We're always growing at making more, in there as well. But at the same time, you'll see the scripts. You'll learn how to get into businesses. You'll learn how to get into corporations everywhere in your community and not just start tracking new patients obviously immediately, but at the same time, you'll start becoming the go-to practice in your community.go in the show notes below. Click on the first link in the show notes below. Check to see. All that's inside of the course. We continue to add to it, but at the same time, you can already see everything that's inside of the course and I'd love to see you in there. So in our next episode, we're gonna be talking about overcoming rejection in ground marketing.So thank you so much for tuning in, and I'll talk to you in the next episode.

Show Notes and Transcript Welcome to Hearts of Oak, where today we're diving into the intricate world of government oversight with none other than Chris Farrell, the head of investigations at Judicial Watch. Join us as we explore Chris's remarkable 25-year journey at the helm of this influential watchdog organization, and his relentless pursuit of transparency and accountability. Chris Farrell isn't just a name; he's a force in the quest to keep government operations open and honest. With a background in military intelligence, his transition to Judicial Watch marked the beginning of an era where the Freedom of Information Act became a sword against corruption.  In this episode, Chris will unpack how Judicial Watch has evolved, facing both the consistencies and the ever-changing landscape of political oversight. We'll touch on the legal battles fought, the costs associated with seeking truth, and the organization's unwavering commitment to debunking misleading narratives. From election integrity to the media's portrayal of Judicial Watch's efforts, Chris will shed light on how these battles are fought on multiple fronts. We'll also delve into his view on the ideological divide concerning election accountability and why issues like economic stability and immigration are at the forefront of the upcoming election.  Judicial Watch is a conservative, non-partisan educational foundation, which promotes transparency, accountability and integrity in government, politics and the law. Through its educational endeavours, Judicial Watch advocates high standards of ethics and morality in our nation's public life and seeks to ensure that political and judicial officials do not abuse the powers entrusted to them by the American people. Judicial Watch fulfils its educational mission through litigation, investigations, and public outreach Connect with Judicial Watch... WEBSITE            judicialwatch.org

On this episode of Your City Defined, we look at a 1957 state law requiring elected bodies to hold all meetings in public. This is so we know what the government is doing. But...is it working?

One legal analyst has admitted that 814 Pred Hunters — a local child predator hunter group — does “good,” but has questionable legality. Penn State has been sued over accusations that it violated Pennsylvania's Sunshine Act. A number of you Met-Ed customers out there may lose power for a period of time tomorrow. Finally, an air show in Harrisburg will feature the Blue Angels.

Sara Schaefer discusses conflicts of interest and the Sunshine Act with attorneys John Hutchins, General Counsel of the American Academy of Neurology, and Mimi Riley, Professor of Law, Public Health Sciences, and Public Policy at the University of Virginia. Learn all about the levels of oversight, what kinds of things need to be disclosed, who discloses them and to whom, how they can impact your career, and where you might get tripped up. 

The Phillies face a game seven tonight against Arizona in the National League Championship Series. Governor Josh Shapiro's office will pay 295 thousand dollars to settle a sexual harassment claim against former legislative affairs secretary Mike Vereb. The election is two weeks away, which means candidate forums are happening across the Commonwealth. But some have stopped showing up. Are the Bradford County commissioners violating the Sunshine Act?Support WITF: https://www.witf.org/support/give-now/See omnystudio.com/listener for privacy information.

On today's episode of The Confluence: The Allegheny County Jail Oversight Board has been sued for allegedly violating the Sunshine Act by limiting the public's access to information about the jail, including deaths, overdoses, and facility conditions; a patient navigator with Planned Parenthood of Western Pennsylvania weighs in on the year that has passed since the U.S. Supreme Court ruled on Dobbs v. Jackson Women's Health Organization, overturning Roe v. Wade and leading some states to limit abortion access; and a conversation about the work by Johnstown resident Steve Ditko, who co-created Spider-Man.

Irfan Alam is the CEO of Frontrow Health, a startup with a mission to finally put Americans in the front row of their own healthcare. Will and Victoria talk to Irfan about his background in business strategy and development for healthcare companies, how he went about searching for and building the perfect team, and how he started the culture of Frontrow Health on a level where there is balance and people want to join because it has a good culture. Frontrow Health (https://thefrontrowhealth.com/) Follow Frontrow Health LinkedIn (https://www.linkedin.com/company/frontrowhealth/). Follow Irfan Alam on LinkedIn (https://www.linkedin.com/in/irfanalam12/). Follow thoughtbot on Twitter (https://twitter.com/thoughtbot) or LinkedIn (https://www.linkedin.com/company/150727/). Become a Sponsor (https://thoughtbot.com/sponsorship) of Giant Robots! Transcript: WILL: This is the Giant Robots Smashing Into Other Giant Robots Podcast, where we explore the design, development, and business of great products. I'm your host, Will Larry. VICTORIA: And I'm your other host, Victoria Guido. And with us today is Irfan Alam, Founder, and CEO at Frontrow Health, a startup with a mission to finally put Americans in the front row of their own healthcare. WILL: Hi, Irfan. Thank you for joining us. IRFAN: Thanks for having me; super excited to chat more about the whole process of building and launching Frontrow Health. VICTORIA: Yes, we're super excited. Of course, I know you as a client of thoughtbot, and I'm excited to hear your story. And you have this background in business strategy and development for healthcare companies. But what led you to decide to start your own platform? IRFAN: I think it was a combination of two things; one was a lived experience being inspired by the power of entrepreneurship with my family and then working at Everlywell. And then two, it was discovering and being reminded of a critical problem that I saw in the industry that I then became excited about solving. So growing up, I was raised by my two parents and my grandparents. My grandfather was an entrepreneur himself and also an immigrant and kind of brought our whole legacy of my family into the U.S. from Southeast Asia. He has always motivated me to take risks and to build something great for the world, and that's what he's always wanted for me. And so I joined Everlywell, a small digital health startup, back in 2019 because I was excited to get my feet wet in the world of startups. It was just within a number of months after that I had joined where COVID-19 hit, and Everlywell, a home lab testing company based out of Austin, got swept up into the storm of COVID and, in a lot of ways, threw ourselves into the center of the storm when we ended up launching the first home COVID-19 test. And it was that summer of 2020 when I probably had the most profound personal and professional growing experience of my life, just trying to handle this chaos and confusing world that we were all living in. But then also simultaneously watching how a small team could make an outsized impact in the world during a time of need. And that really led me to want to pursue my own startup ambitions. So I started thinking about business school. The founder and CEO, Julia Cheek, went to Harvard Business School in 2009 and publicly talks about it being sort of this magical moment in time where people were flooding in from the downturn economy, excited about solving new problems. And her class of graduates is sort of like a famous class of entrepreneurs. And so I brought it up with her, and she was super supportive. And I went through the process and got super lucky. And I decided to take the summer off in 2021 before coming to HBS and moving back to Boston. And it was during that summer where I started thinking about the problems that companies like Everlywell and direct-to-consumer health brands faced that I realized was not just at the fault of their own but because the industry didn't have the right digital tools necessary to succeed. That's sort of the origin of how Frontrow Health came to be. WILL: Sweet. So perfect segue; tell us more about the mission of Frontrow Health. IRFAN: We're on a mission to put people on the front row of their own healthcare. And we really just want to reimagine how people shop for their healthcare online. What I learned at Everlywell was that this boom of consumer health which means people who are taking charge of their own health and are able to do that directly through these digital health companies was a form of healthcare that could create a tremendous amount of value in people's lives. But that was only really accessible to a small niche audience. And it didn't feel like it was equitably accessible to the average American. And so some of those barriers that I realized as a part of my work at Everlywell for why the average American wasn't engaging with consumer health, this otherwise really powerful form of taking charge of your own health and wellness, was because of these three blockers that we're trying to address at Frontrow Health. The first being that people just don't know about what kinds of solutions are out there that can address their health issues beyond just taking a prescription medication given to them by the doctor that they visit in their office. The second is if they do know, they don't know what to trust. They don't know whether this spam of healthcare companies that they're getting advertisements on from Instagram are the right companies, whether these products are safe and effective for them uniquely because of their unique health issues their unique health history. And then finally, even if they are aware and they do trust the health product, at the end of the day, a lot of Americans just can't afford to spend money out of pocket to pay for these consumer health and wellness products like consumables, devices, virtual services, et cetera. And so Frontrow Health is all about trying to break down those barriers in order to unleash consumer health to the average American. VICTORIA: And were you always drawn to that healthcare industry from the beginning? IRFAN: Yeah. So I grew up very privileged with two parents who are physicians. My mom is a psychiatrist, which is quite rare for women of color, specifically of South Asian descent, to be a psychiatrist. And then my dad was a gastroenterologist. They were always the gut-brain connection between the two. And so, growing up, I somewhat classically assumed that I was going to be a doctor. Got to college, thought that that was going to be my path. I realized quickly that there is a whole world outside of being a physician yourself that I could still be a part of in healthcare without being a doctor. My parents actually, interestingly enough, began to encourage me to think beyond just being a doctor, with them both feeling like the amount of scale of impact that they could have would never be the same as someone who could do that through business or policy or these other facets that are important to healthcare. And so I got to undergrad, started studying policy economics. I started doing internships at different healthcare consulting firms. And I ended up first working at a life science business strategy consulting firm out of college. And it was great, but it ended up not being what I was most excited about because it was really focused on the biopharmaceutical and medical device industry. And what I realized when I got there was I just had this growing passion for digital health and technology, as I saw that it was kind of the future of how people were going to be able to take more preventative charge and improve their health over the long term. And so I was working on this digital health white paper with a partner at the consulting firm I was at, and I was doing research and stumbled upon Everlywell. And then, they had a job opening for this business strategy role. So that's why I ended up taking the leap into the startup world, into the digital health world, and just loved it and kept wanting to continue to grow my experience in that space. WILL: That's amazing. Your parents encouraged you to step outside of just the doctor-physician role and to think higher. So, as a founder, you know, it was amazing that your parents, as physicians, encouraged you to think higher and think into different roles. And as a founder, what were some of the decisions you had to make? What were some of the easier ones? What were some that were surprisingly difficult? IRFAN: I think the biggest misnomer of the founding experience is that founding a company is extremely linear. Sometimes you go one direction forward, and then you take a direction diagonally back, and then you go horizontally straight, and that was my story. When I do my pitch about Frontrow, I try to make it feel a little bit more linear, so it makes sense to people. But the truth is the quote, unquote, "hardest decisions" were about every time there was a direction changing point, and it required a decision about is this the right idea? Do I want to spend more time on another idea? Have I validated this enough? Should I validate it differently? Should I pursue this one further? What does that pursuit look like? Who should I pursue it with? Is it time to raise money? Do I drop out of school? Like, those direction-changing points that then create this much more complex map of the founder experience versus a linear line up into the right is, I think, the more challenging parts of being a founder. VICTORIA: That makes a lot of sense that you have to really go through this iterative process to figure out where are you spending your time, is it in the right place? A lot of hard decisions to make. And while you were founding Frontrow Health, you were also a part-time investor at Rock Health and reviewing other healthcare startup proposals. So did you see any trends or patterns that influenced how you progressed as a founder? IRFAN: Totally, yeah. That was actually instrumental to Frontrow Health. So the story is when I took the summer off before business school, I started thinking about different problems in the world, healthcare, and non-healthcare. Or actually, to be clear, I started thinking about lots of different solutions and ideas and then quickly began to realize that that was not the right approach to founding. I think the first step is to think about problems, problems you've seen, problems you've experienced, that you know others are experiencing, and then work to a solution from there by starting with what the user is experiencing. And so as I was going through that hacky journey over the summer, just randomly, a number of small healthcare companies started reaching out to me asking me for my opinion and advice about how or whether they should go direct-to-consumer, whether they should sell healthcare products direct to the consumer, which is what I did a lot of work on at Everlywell as one of the pioneering consumer health brands in the space. And I started to notice this trend of me telling these companies, "No, don't do it. It's really expensive. It's really ineffective and unprofitable to acquire customers through traditional paid media avenues like Instagram, TikTok, Snapchat, Facebook, et cetera." And, unsurprisingly, you could imagine Everlywell was trying to sell a home diabetes test for people who are type 2 diabetics but were only able to target people based on their interest in yoga and running, which is not really a substitute for a severe chronic condition. And as a result, thousands of people would see our ads every day that had no clinical relevance to our solution. And that was one of the deep problems of why consumer health companies weren't able to reach out to the audiences that actually really needed their solutions. And so when I got to Rock Health at the first semester in business school, doing this sort of part-time investor gig, on the first day, the partners basically told me, "Oh, we don't invest in consumer health." And I was like, "Oh, whoa, okay, that's my jam. That's a bummer. That's like [laughs] the only thing that I know about." And as I started to see the data and the pipeline of companies that were looking for investments and understanding what their unit economics looked like, what their go-to-market approaches looked like, that's when I started to put the dots together that this was not just an Everlywell problem; this was an industry problem. Mark Zuckerberg didn't build Facebook so that direct-to-consumer healthcare companies can cost-effectively target clinically relevant patients online. That just happens to be what it's being used for today. And so that's when I started to realize that there had to be a quote-unquote, "better way." WILL: You bring up social media at Frontrow Health. Have you had to combat the medical advice of social media? IRFAN: Yeah. You mean like this concept of quote, unquote, "Instagram medicine?" WILL: Yes. Yes. IRFAN: It's a great question. So as the story continues, I began to think about what is the right solution to this problem? And instead of Everlywell, I started thinking about the right solution to this problem. What I realized was instead of Everlywell wasting away millions of dollars to big tech companies that wasn't going to improving the health of anybody, what if we gave that money back to the consumer in reward for sharing their health information which would allow us to target them with the right clinically relevant products? That was the first version of Frontrow Health. I called it Health Mart back then. And so I basically started to get people to fill out a Google Form with their health data. And then I worked with my parents to send weekly product recommendations over email based on their unique health needs; you know, I want to sleep better; I'm a diabetic, whatever it is. And then, I wanted to see if I was just going to Venmo them cashback upon purchase if they were going to be any more likely to buy these products for these health brands. And at first, people were incrementally more likely to buy. It wasn't mind-blowing. And so, as I started to talk to the participants of the study, I started saying, "You know, you said that you have high cholesterol. These supplements have active ingredients that have been shown to reduce LDL levels. It's pretty cheap. I'm giving you 25-30% cashback. Why haven't you bought it?" And what they started saying was, "Well, I don't know what these active ingredients are. And before I put that in my body, I want to check with my doctor first." And so that was the final aha moment that led us to Frontrow Health, which is, what if we could bring the doctor into the fold? And instead of consumers just experiencing this Instagram medicine where they're just being blasted with Instagram ads every day about different health products, and they don't know what to trust, that second barrier that I talked about earlier, what if the doctor could instead of just being a guide for what prescription medications you should be taking could also be a guide on what health and wellness products you can be using? And so I added my dad to the email thread, and I said, "Okay, you can talk to an independent medical provider and ask them questions about the products that you're being recommended." And that's when people started buying because then they were able to find the trust in the products that were being curated based on their unique information. WILL: Wow, that's really neat. So to help the audience understand your iteration today, so the first iteration was just giving products and then Venmoing them back cashback. And then the second was bringing in a provider. So what does the product look like today? IRFAN: We went through, like you mentioned, a lot of different iterations of this. There were even prior iterations to this that are more representative of that founder map versus the linear line that you've sort of just heard now. But in terms of where the story went from there, I began to think about how to validate this idea further. I came into winter break; the pilot went well. People were buying a lot of products. And so, I decided to sunset my part-time investor gig at Rock Health and decided to reallocate all my time to working on Health Mart at the time. What I started to think about was, well, what if the doctor was able to earn compensation for writing private product reviews regardless of their opinions? So that was the next iteration was like, how do you incentivize a doctor to take time out of their day to do this new behavior that doesn't exist? Doctors are not writing personalized private product reviews for their patients on supplements, home medical devices, apps, et cetera. And how could we get them to? And so, I started thinking about what are the different motivations of providers? Their time is extremely valuable. How do you incentivize them correctly without incentivizing them to give good or bad feedback but just honest feedback? Then I started basically having my dad recommend Health Mart to his patients every day to see would patients sign up. Like, if doctors were intrinsically motivated to get their patients on the platform so that they can help them get away from Instagram medicine and at the same time earn compensation for themselves as an additional revenue stream, could independent medical providers see that as valuable and a good use of their time? And the first piece of that about whether patients would sign up worked unsurprisingly very well. If your doctor is telling you to sign up for something, or it's free to sign up, and you only pay when you want to buy a product, and they're going to, for the user, be able to ask for feedback from the provider, they were pretty excited. But then the question of would doctors sign up, I started...basically, I had my mom. The next iteration was I had my mom make a couple of posts in these doctor Facebook groups. I put together a little website, a very ugly version of what we have today for a provider marketing page. And I had my mom drop the link in a couple of different doctor Facebook groups. And we actually started getting signups from the doctors. And then, as we started talking to them, what we realized was two things; it was like a win-win. The doctor was happy because they were getting compensated, and they were happy because their patients' health was improving. So when Obama was in administration, he passed a really fundamentally important piece of legislation called The Sunshine Act. And that basically ended this quote, unquote, "golden era" of pharma companies giving kickbacks to doctors. WILL: Oh wow. IRFAN: And so since then, doctors have been very eager to find additional revenue streams that they can leverage their decades of medical expertise to earn. They got medical bills to pay off loans to pay off. They spent 20 years training for this job. And so they were excited about an additional revenue stream that leveraged their medical expertise and also helped their patient. Because they also started saying things like, "Well, my patients are always asking me like, 'What about these supplements I saw for these ads online?'" And the doctor says, "I don't know what these supplements are. WILL: [laughs] IRFAN: I don't have the data in front of me. I don't know what the ingredients are. I don't know whether to trust the company or not." And we are building a platform where it's all streamlined for the provider. The provider is able to review the clinical information. They're able to review their patient information. They're able to really quickly write reviews. We give them templates. We give them suggestions. They're able to reapply recent reviews. And so that was sort of the next iteration. And that's actually when thoughtbot came in and when I started thinking about raising a small round, getting a dev shop to help me build the MVP. And that's kind of how the semester ended up closing out. VICTORIA: I love that your mom and dad were so supportive, it sounds like, of you going full-time on this startup. Was that scary for them for you to do that? IRFAN: It's so funny, yeah. So what happened next was I decided I wanted to start raising a small round because I had the conviction that there was a problem to be solved for consumers, for doctors, and for health brands. And we could build this one unique multi-sided marketplace to solve them. I ended up going back to Austin for spring break partially to visit my family and partially because I wanted to pitch to Julia, the founder of Everlywell, who I thought of all people on planet Earth would understand what I'm trying to do. She would get it because I am building a SaaS solution for health brands like Everlywell and her consumers. And she got it. She was jazzed. And so, she decided to angel invest. And that basically spurred a ton of interest from venture capital firms. I wasn't originally thinking about raising an institutional round but was very lucky with the timing. Just before the market crashed, it was a very hot market. And so we ended up closing a real seed round with the question on hand about whether I should pursue this full-time because the capital that I raised necessitated building a real team. Or should I just take a smaller amount of money and go back to school? And it's unsurprisingly, every different person in my life had some opinion about this, from my wife to my investors, to my parents, to my friends. What I wanted was somewhere nestled in between all of those things. And when I caught my dad up on the phone a couple of weeks after spring break and told him of all the crazy stuff that had been happening...and it was just happening and unfolding so quickly. I was like, "Okay, dad. I'm laying out all my cards here. You have full liberty to be mad at me for wanting to drop out of Harvard." And his first reaction was, "Well, you know, I don't really see the downside. Like, you could either start a company that you're really passionate about and it could go well, or you could be the worst entrepreneur of all time and then just come back to school during this leave of absence," or deferral thing that I'm on right now. And that was the first time where I was like, "Oh, you know what? I think you're right." And the truth was I decided to just continue to let the summer go by to think about the decision a little bit more before I formally submitted my deferral to HBS. As the markets turned, we realized that we needed to hire internally to save on cash burn a little bit. And so once I had built this really awesome team that I'm so lucky to be surrounded by, that's when I was, you know, without a doubt in my mind, I was like, I got to keep pushing for this because now we have this awesome team that just wants to keep driving this mission forward. And we were getting traction. We were talking to hundreds of doctors over the summer. We were talking to health brands. And it really felt like we were onto something. MID-ROLL AD: thoughtbot is thrilled to announce our own incubator launching this year. If you are a non-technical founding team with a business idea that involves a web or mobile app, we encourage you to apply for our eight-week program. We'll help you move forward with confidence in your team, your product vision, and a roadmap for getting you there. Learn more and apply at tbot.io/incubator. That's T-B-O-T.I-OVICTORIA: I-N-C-U-B-A-T-O-R. WILL: I hear you have an amazing product team. How did you go about searching and building the right team? IRFAN: We got lucky in a second way because of timing, where the first time was I raised the capital when the market was really hot in April. And then, I started hiring when the market crashed. And, unfortunately, as you all know, lots of people have been getting laid off since the summer, particularly in the tech world: designers, engineers, marketers, et cetera. Now, all of a sudden, there was a flood of really great talent on the market. And that was also what spurred me to start thinking about hiring sooner than I was originally planning to. My forecast was to hire people end of this year, maybe in a month or so from now, to start that process. Versus, we ended up making our first full-time hire, I guess in July, maybe. And it was...the best way I can describe it is like dominoes falling where once you get the first one in, then it builds trust and credibility, and then the next one comes, and the next one. And so the first couple of folks were these two brilliant engineers who were close friends of my interim CTO and classmate, Amit, who was helping us build the foundation of the product this past summer. He did an amazing job of basically recruiting one engineer, Anand, our first engineer who started his career as a PM at Microsoft and then turned into a software engineer at a number of different startups and studied comp sci and electrical engineering at Berkeley with Amit, where they first met. And then the second engineer was Nupur, who was a colleague of Amit, a machine learning engineer at Google Brain and the moonshot X team at Alphabet. And they were both, I think, just kind of tired of big tech and were ready to bet on the upside and their career. And the timing was right based on where the market conditions were. And so they decided to take the leap of faith with me. And then after that, or around that time, kind of in the middle, we were able to bring on our head of design, Jakub, who is like a unicorn human with so much rich experience in the product world. So he was a computer animator and then studied visual arts, but then started his career very early in the coupon website space as a product designer actually. And then led product design as a founding designer at a number of different startups. And then, most recently, was a senior product designer at Roman, which is a really large digital health company similar to Everlywell. And Ro, Everlywell, Truepill, all these companies had mass layoffs in the middle of the summer. And so when Jakub took my call...He talks about a really funny story where he wasn't taking me seriously at all. Convincing these excellent, talented people to come join my dinky startup at the time was not easy. WILL: [laughs] IRFAN: And so he just kind of took it because there was a mutual connection. Or he just said, okay, I'll explore what's going on given how crazy the market is. But once he heard what we were building, he was immediately on board, actually, because Roman has also struggled with the same customer acquisition problems. And it's a huge reason why a lot of these digital health companies continue to remain unprofitable. And so he understood the problem deeper than I think anyone because of the experience he had in the same space that we were in. And he realized that there was an opportunity to build a solution to solve these problems. So that was the first core team. And then from there, it kind of just snowballed, you know, there was more and more interest from other folks to join. And we brought in a great junior product designer. We just hired our platform engineer. But that was the original core team from the summer who took the big leap of faith and joined because of the market conditions, the belief in the space. And we actually just met up in San Diego for the first time for a company retreat in person. And it was just fun meeting everyone in person for the first time because now I get to know them as real people and see all their personalities. And we're really psyched about coming to product launch pretty soon here. VICTORIA: That's wonderful and, you know, that compelling vision and having those first initial people join and brought in everyone else. You know, I think part of the reason people are hesitant to join startups is because there is that reputation for kind of unhealthy work-life balance. So you're a healthcare startup. So how do you start the culture of your company on a level where there is that balance and people want to join because it has a good culture? IRFAN: It's a super interesting question that we spent a lot of time actually talking about in San Diego as a team. And it was brought up because I have a somewhat unhealthy relationship with work. And I am constantly working. And this is the most important thing right now in our life. And so Nupur, one of our engineers, had a phenomenal analogy that I think is the right framework to think about this from a company culture perspective. Because I've always tried to share with a team, like, I don't expect them to work nearly as much as I do, and I don't want them to either. I think the analogy was such a fun, helpful way to think about why that was the case. And so she kind of said, "I'm like the aunt, and you're like the single father. And the aunt doesn't have to take care of the baby at nighttime and on the weekends, but the single father does. And it's not that the aunt doesn't care about the company, but there's some space and boundary in that relationship." And so that's actually our motto right now is like, yeah, we all care about this product and this company, quote, unquote, "baby," but there's always biologically intrinsically going to be a deeper relationship between me and this company, for good reason. And so that is going to require me to work harder and longer than anyone else, probably for a long, long time. And I had to be ready for that. My wife and I had to be ready for that. And so far, honestly, I've never been busier. But I've also never been...or, like, I've never had this ratio between busyness and stress where I'm really busy but not that stressed. And I think it's just because I love what I'm doing every day. I haven't ever found this happy balance where I actually just enjoy what I do. And I'm constantly excited about continuing to build the right product to help people. WILL: Wow. VICTORIA: I'm actually babysitting my niece and nephew this weekend. [laughter] My brother would say, "You need to be here on the weekends with them." IRFAN: Maybe not the perfect analogy. But-- VICTORIA: I like it, though. It makes sense. [laughs] WILL: There's a difference. [laughter] VICTORIA: Oh yeah. Will knows; he's a dad. WILL: Yeah. I know company values can be so...we have them. Do we follow them? Or sometimes they get put on the shelf. I was reading your company values, "People first, bias for curiosity, and dream big." For Frontrow Health, how does that play a role in the day-to-day? IRFAN: When Jakub, Nupur, and Anand had all joined like that first core team, we actually spent time writing all this out and creating a document that discussed what the company culture and values were. And we looked at different examples of other companies. Amazon famously has, I don't know, these 16 principles. And we kind of said, okay, we want to pick just a couple because you can't always focus on everything at the same time. And we need some sort of guiding North Star if you will. And so these were the three that we came up with, the ones that you mentioned. So we are people first; we have a bias for curiosity, and we want to dream big. So people first to us means that our mission like we talked about, we want to increase access to healthcare at home for the average American. And so every decision that we make at the company has to pass that litmus test first. Whatever feature we're building, whatever business model approach we're taking, whatever go–to–market approach that we're taking, is what we're doing going to increase access to healthcare at home for the average American? Yes? Then we continue onwards, and then we continue deliberating and deciding; if not, we pass. And so that is how we determine whether we can continue to be people first because that is our mission. And as we're going down that thread, we want to push ourselves to constantly be bettering and asking questions about how we can be better. That is the bias for curiosity. That was one of Everlywell's company values and was the one that I resonated with the most. I find tremendous value in asking questions. Nupur on our team, one of our engineers, is a great example of bias for curiosity. She's constantly challenging and asking the right questions. And that helps us be better at being people first and increasing access even more than we can because we're never settled with what exists today. And then dreaming big is about finding answers to those questions and not settling for the tried and true paths. Some of the greatest companies that have ever been created are the ones that invent new behaviors that have never existed before. So Airbnb, now all of a sudden, people are comfortable with strangers living in their homes. Uber, now all of a sudden, people are comfortable driving in a stranger's car. At Frontrow Health, we're dreaming big in a world where doctors are not currently engaging with their patients related to their home health and wellness journeys when they leave the four walls of their clinic. How can we change the behavior where doctors are more involved in that relationship in a way that doesn't exist today? And so that's a part of what we're trying to do, and dreaming big to go and increase access, like I said, is our ultimate North Star. WILL: Wow. You said something I think that was...it seemed very small, but I think it said a lot about you and your company. You said that you encourage your engineer to ask the hard questions. I think so many times, people hate the hard questions. They are fearful of that. But I think in your field, you have to be able to ask the hard questions. So that's amazing that you brought that up, and you're talking about that. IRFAN: Yeah. And it doesn't...it's not just me, for sure. I think my team is...and it's kind of you to point that out. But yeah, my team does such a great job of holding true to these values on their own and pushing me to remind myself of these values. Nupur actually is Slacking me right now about some thought that she had coming out of a meeting. WILL: [laughs] IRFAN: And two points about different alternative ways to think about things. And yeah, I want to keep encouraging them and our future employees to do that. Because you look at the worst examples in healthcare, in particular, tech as well, the worst examples of companies are the ones where the employees were not able to or encouraged to ask questions; that's when things go south. So Theranos is the simplest example of this where they were hiding everything from their employees, and people had questions constantly but never asked them. And that's when more and more bad decisions were made. So I don't want that to be the case for Frontrow. And so it has to start with, yeah, this bias for curiosity. VICTORIA: That makes sense. And I wonder if that's part of your success, being someone who doesn't have a background in engineering or programming specifically and enabling your technical team to build what they need to get done. IRFAN: Yeah. I can't honestly explain to you guys how much I've learned over the past six months from my product and dev team. And you're right that I think one could see my lack of programming as a weakness which, in a lot of ways, it is. But what has also manifested as a result of that is I have naturally had to lean more heavily on my dev team to be owners of decisions that affect our business and to challenge them to think about are we being people first if we build and design solutions in the way that you're describing? I don't know the right approach about how to build this, or on what tech stack, or in what capacity we have the ability to. You guys have to take ownership of thinking through those, solving those problems, and coming up with the right decision. And as a founder, that's scary to do. You're giving up control of the decisions to others. But at the same time, by giving them that autonomy and encouraging them to take ownership of it, they feel I think more and more invested in what we're building. And that hopefully builds the habit of what you guys were talking about around wanting to constantly seek better solutions, challenge because they know that they have a voice in how things turn out. VICTORIA: Right. Maybe you've discovered this naturally or through your education and background. But studies that are done around high-performing technology organizations find that no matter what processes or tools you have if you have that high-trust environment, you'll have better security, more software development throughput, all of those things. So I think you're doing it right by setting your values and creating that kind of high-trust environment. IRFAN: Super interesting. I didn't know that, actually, but it makes sense. [laughs] We've been seeing it. I actually want to give some credit to thoughtbot because thoughtbot helped us set a lot of this important engineering culture at the very beginning, where I had to rely on my thoughtbot engineers, folks like Jesse, Dave, and others, to help me make the best decision for my company. They taught me a lot of these things at the earliest stage back in May around, okay, like, you guys are a consulting firm at the end of the day, technically speaking. But they pushed me to think of it more as how do we co-make these decisions? Like, how do we leverage each other's strengths to make the right decisions? The thoughtbot design team and engineering team...one of our designers through thoughtbot, Steven, is so funny because...and I gave him this feedback, which is great feedback, which is like, he constantly asked questions. And if he hears this, he'll laugh because he's constantly pushing, like, "Why are we designing it this way? Why do you think it should be this way? Where is the evidence that the user wants it to be this way?" And it was a great setup for when our internal team came on because I just kept up that momentum. And then they just kind of took with it and ran. VICTORIA: How did you find us, or how did you find the right technical partners in the very beginning to help you build your vision? IRFAN: It was not an immediately simple process. But when I found thoughtbot, it kind of unraveled quite quickly in a good way. So I was working with Amit like I mentioned, who'll become our interim CTO, one of my classmates at HBS. And he helped me put together an RFP where we outlined all the different feature requirements, all the different intentions for our solution or timeline, our costs, et cetera. And I just did a lot of Google research about different dev shops, and I started talking to dev shops in lots of different locations, U.S.-based, European-based, Asian-based, Latin America-based, started comparing prices. We had questions where we wanted to see their creativity in developing solutions. We started accepting proposals, reviewing those proposals. I somehow stumbled upon thoughtbot's website during this process. And I noticed that Everlywell was one of thoughtbot's clients, Everlywell, the home lab testing company that I used to work at before business school. I was like, oh wow. I knew that our engineering team and our engineering leadership had a really high bar for when we worked with outsourced talent. And so I thought that that spoke volumes about choosing thoughtbot. And so then we actually ended up asking Everlywell CTO an unprompted question of like, "If you had to pick any dev house that you've known or have worked with, et cetera, that was supposed to build you custom software from scratch, who would you pick?" And he said, "thoughtbot." It wasn't even like a question of, what do you think of thoughtbot? Or, what was your experience? It was just like, imagine you had to pick, and, unprompted, he said thoughtbot. So that was actually what did it for me. And I kind of threw aside all the other logistical hoopla that we were going through and said, you know, I got to trust the people who I know and trust, and having verbal confirmation of that was huge. And then, of course, I enjoyed speaking with Dawn at thoughtbot, who was helping broker the whole discussion, and it felt easy. And their proposal was also quite strong. And then, as I dug deeper into thoughtbot, it became clear that no pun intended, you guys are kind of the thought leaders in a lot of ways. WILL: [laughs] IRFAN: It's funny, our head of design, Jakub, when I mentioned that he's a unicorn, it's because he also taught himself coding and programming. WILL: Wow. IRFAN: So he's like a pseudo designer and programmer. He can do a little bit of everything. And he actually...when I told him that we were working with thoughtbot, he was like, "Oh, I learned Ruby on Rails back in the day from thoughtbot with whatever content they had published back in time." And then, as I spoke to other dev shops about going with thoughtbot, they started saying things like, "Oh, thoughtbot, yeah, they're kind of the OGs of Rails and a lot of the core tech stack that's been around for a while." And so it was just continued validation of the right approach. And then, we started working with the team in May, right after my second semester of business school ended. And it's been an incredible process. We have never missed any deadlines, and we're actually two months ahead of schedule. And it's not just because they're good at what they do, but it's also because of the culture and the teaching me about the best way to run retros, and sprint planning, and things to think about in terms of trust in your engineer and building that trust, and all the soft, intangible things. It wasn't just like thoughtbot came in and built code. It was thoughtbot came in and helped establish the company in a lot of ways. VICTORIA: That's great to hear. Thank you for saying all those wonderful things. I'm sure me and Will agree 100%. [laughter] IRFAN: Yeah, it's been an awesome process. And yeah, we've even ended up basically bringing on as a full-time independent contractor someone who worked through thoughtbot because we love them so much. And they were just so excellent at what they did. And just, yeah, I think that probably speaks the most volumes about the kind of organization that you guys are running. WILL: I appreciate you saying that. That means a lot. It really does. I want to take a second to kind of circle back and kind of talk about how you find the providers because I think, for me, one of the most influential classes I had in college was my professor said, "Hey, meet me at the pharmacy." So we went to the pharmacy, and he started asking us questions. And he was like, "What medicine do you think would be the most impactful?" And we would try to pull it out. He taught us how to compare the active ingredients. IRFAN: Wow. WILL: Like how some stuff is just marketing, and it's not really helpful and things like that. But I also saw the side, you know, the amazing providers like your parents. You talking about your parents just reminded me of my parents and how supportive they are. So it's just amazing. You had your parents as providers. How did you find providers beyond that that you have to extend that trust to them? IRFAN: I guess two reactions. The first is how do we talk to doctors to get feedback on our solution as we're building it? And then how do we get doctors to sign up and use our solution with their patients? Those are the two chronological steps. So for the first one, we very liberally use a platform called usertesting.com, which we used at Everlywell, where I first got introduced to it. And it's amazing. We have the unlimited package, and we run tons of user tests a day. So, over the summer, we were literally having unmoderated tests from medical professionals, about ten healthcare professionals a day who were coming to our website, coming to our product, giving their feedback through these unmoderated tests. We were quantitatively assessing qualitatively assessing their responses to specific questions that we were asking them. Like, was it easy enough to write a review? What were you expecting to see? How did that compare to what you did see? Like, all the traditional kind of user research. They really helped us build the product, and then we were able to follow up with them, get on the phone with them, ask them more questions about their experience, about their current experience in their clinic, whether patients are asking them about these things, about their interest in certain supplements, et cetera. And then we actually had one medical provider, a family practice nurse practitioner from Vermont, who was so excited about what we were building. She was sending me all this other information and content about how to reach out to other doctors and stuff. And then, at the end of the summer, when we were just about ready to start getting our beta off the ground, we were going to choose one provider to work with who was going to recommend it to their patients, and they were going to slowly kind of monitor the experience. This nurse practitioner actually just happened to reach back out, and we happened to connect again. And she's like, "Okay, what are you guys up to? Are you guys done with your product? I really want to use it." And I was like, "Oh, wow. Well, it's great timing because we're looking for our first medical provider." WILL: [laughs] IRFAN: And so that's where we ended up launching beta with, which was awesome. And since then, I've been spending a lot of time thinking about the go-to-market approach beyond just one medical provider. How do we scale to thousands of medical providers? And luckily, selling to doctors is a solved problem, like; the biopharma and medical device industry has been doing this for decades. And so it was really just a part of me brushing up on a lot of the work that I was doing in life science consulting about helping Big Pharma and whatnot go to market and just stealing a lot of notes out of their playbook. So, for example, there are companies that allow you to run ads online that just target physicians. So instead of my dad seeing a Lululemon ad while he's reading The Wall Street Journal, he'll see an ad for Frontrow Health. And so we actually run marketing tests over the summer, towards the end of the summer, with a newer provider landing page that we had built to see what percent were going to click on the ads, what percent were going to come to the website and sign up, and then how much cost would that be per acquisition of a provider. And the results were actually much better than we thought. It was half as expensive as what we originally predicted, which is awesome. WILL: Wow. IRFAN: And that was before Jakub, our new head of design, had even touched the website. We're actually just revamping it right now because he's been going through and revamping other aspects of our product and marketing experience. And now we're at the provider part. So we're actually going to be just about a week or so away from launching the marketing tests and actually getting every day more providers on the platform. The product is now done, so they can start getting their patients on the platform. We just signed our first health brand. So now people are getting real product recommendations and getting ability to earn cashback. And we can be revenue generating, which is also super exciting that we're, like I said, a couple of months ahead of schedule, actually. VICTORIA: That's really exciting, and that certainly sounds like enough on your plate. But is there anything else on the horizon for Frontrow Health that you're excited about? IRFAN: Yes. We are super excited that we're just coming out of stealth mode and launching our full product experience for consumers, medical providers, and DTC health brands. Going forward into 2023, we're really looking to try to find this quote, unquote, "product market fit." Are doctors excited about signing up and getting their patients on the platform? Are those patients excited about the products that we're selling on our marketplace? And are we delivering new lifetime customers for these health brands at a more cost-effective rate than they've ever seen before? And solving that original problem that came to me while I was at Everlywell. And by doing all three of those things, hopefully, we'll begin to increase access to healthcare at home where people who are not suburban high-income folks who can afford to pay out of pocket for preventative healthcare; we can now make that more equitable by bringing down the cost through the cashback, by introducing the element of trust, by engaging with a medical provider, and by opening up people's eyes to thousands of different consumer health and wellness companies that now exist in the world that we want to be able to connect the right products to the right people with. VICTORIA: That's so exciting. I'm really glad we got a chance to talk to you today and hear more about your story. Is there anything else that you want to add before we wrap up? IRFAN: This has been super fun being able to even just reflect and think about our whole story. For anyone else listening who's interested or excited about entrepreneurship, there's a really good book that I read last summer as I started thinking about entrepreneurship for the first time called "The Hard Thing About Hard Things" written by Ben Horowitz, who co-founded the VC fund, Andreessen Horowitz. He was an entrepreneur himself. And it's one of my favorite books because, as the title [laughs] explains, it just talks about the difficulty of the experience and the journey that's still ahead of me. But I think the overall takeaway of the book and my experience over the past year is that it's just the single greatest learning experience of my life. And that's actually really all I'm trying to optimize for personally is I want to keep growing and learning, and learning about the space, learning about myself, learning about how to work on a team, how to lead a team, how to grow a team. And if you're at all interested in any of those things, keep trying to think about all the right problems that are being experienced in the world. And we still live in a world wrought with problems and don't have nearly enough founders trying to go and solve all of them. VICTORIA: That's a really great perspective, I think, to bring to it about your own personal growth. And that's what it's really all about. [laughs] And hopefully, we're able to solve some big challenging problems along the way. IRFAN: Hope so. WILL: You can subscribe to this show and find notes along with a complete transcript for this episode at giantrobots.fm. VICTORIA: If you have questions or comments, email us at hosts@giantrobots.fm. WILL: You can find me on Twitter @will23larry. VICTORIA: And you can find me on Twitter @victori_ousg. This podcast is brought to you by thoughtbot and produced and edited by Mandy Moore. WILL: Thanks for listening. See you next time. ANNOUNCER: This podcast is brought to you by thoughtbot, your expert strategy, design, development, and product management partner. We bring digital products from idea to success and teach you how because we care. Learn more at thoughtbot.com. Special Guest: Irfan Alam.

Josiah Neeley, the Austin-based research fellow and Texas director with the libertarian-leaning R Street Institute, discusses a recent letter that the think tank and some 30 other interest groups sent to Energy Secretary Jennifer Granholm urging that DOE, when it is allocating funding under the Inflation Reduction Act and the infrastructure bill, to take into account areas of the country that have not yet adopted a regional transmission organization and organized competitive wholesale power market. He also discusses the debate in Texas about whether some kind of capacity construct should be adopted for ERCOT's energy-only power market. The PUC is expected to address the matter soon. State lawmakers' concerns about the regulatory commission potentially altering the energy-only market structure could become fraught as the biennial Legislature convenes soon. And on top of that, the PUC is up for Sunshine Act review under state law. "There's definitely going to be a lot of sparks flying related to that and I'm not enough of a prognosticator to tell you exactly what's going to happen. Will the energy-only market still exist at the end of that process? Will the market still exist? Who knows? But it's certainly something that there's been a lot of pressure, pro and con, of all these different options," Neeley said.Support the show

Being a specialist in the medical sales field is no small feat because you have to really hone in on the nuances of that particular niche. Imagine doing that for 28 years. That is what Shirley Taylor has done in the as a mammography sales specialist, focusing on breast imaging sales. In this two-part interview with Samuel Adenyika, Shirley shares everything there is to know about her particular field, from the Sunshine Act to Rodney King to George Floyd and everything in between. She also gives us some of the highlights of her long and illustrious career as a medical sales specialist. Tune in and learn what it takes to be one and thrive as one!

Gino Barbaro is an investor, business owner, author, and entrepreneur. As a real estate entrepreneur, he has grown his portfolio to over $100,000,000 in assets under management and is teaching others how to do the same. Gino Barbaro is the co-founder of Jake & Gino, a multifamily real estate education company that offers coaching and training in real estate founded upon their proprietary framework of Buy Right, Manage Right & Finance Right ™. When starting their real estate investing career, most investors initially think about buying a single-family property (whether that's one home or a condo) and renting it out. Multifamily, though, is an entirely different story. Few people have experience buying an apartment building, let alone being in charge of running one. How does multifamily compare to single-family investing? In today's episode Gino shares insights on being a multifamily entrepreneur and syndicator.   Episode Link: https://jakeandgino.com/ --- Transcript   Before we jump into the episode, here's a quick disclaimer about our content. The Remote Real Estate Investor podcast is for informational purposes only, and is not intended as investment advice. The views, opinions and strategies of both the hosts and the guests are their own and should not be considered as guidance from Roofstock. Make sure to always run your own numbers, make your own independent decisions and seek investment advice from licensed professionals.   Michael: Hey, everyone, what is going on? Welcome to another episode of the Remote Real Estate Investor. I'm Michael Albaum and today I'm joined by Gino Barbaro, and he's going to be talking to us about being a multifamily entrepreneur and syndicator who used to be a restaurant owner. So let's get right into it.   Gino what's going on, man, thanks so much for taking the time to hang out with me today. I appreciate you coming on.   Gino: Michael, thanks for having me on. It's gonna be a lot of fun. We're going to talk a remote investing seems like an all you single family, people out there. Come over to the dark side. The dark side is multifamily. I know it's the pie in the sky out there but trust me if the pizza guy and the drug rep can do it. Anybody can do it, Mike.   Michael: I love it, I love it. You know, so I know a little bit about your background. Give all of our listeners who might not be familiar with who you are, where you're coming from, and what is it you're doing in real estate today.   Gino: When people ask me that my wife always says Gino, you need to expand upon your background and I'm like, I hate talking about myself and I could spend the next 30 minutes talking about myself because I'm not a young dude anymore but real quick. I'm gonna give me the 32nd overview. I got into real estate, probably out of college family. I went into the restaurant business and it was awesome. The first 10 years the restaurant business back in the early 2000s. Late 90s was phenomenal every business was great back then you could actually have an you know, a middle class lifestyle that way we were having a small business 2007 hits my father passes away and I went to work with my dad since I was eight years old. So I was in the business with him. I saw him every day and at that point, I start saying to myself, and I've shared this story a couple times in my living his dream or is it really my dream coincided with the Great Recession of 2008 all of a sudden, I'm working harder.   I've got freaking GrubHub I've got Uber I got all these things delivering you can buy Taco Bell for three bucks was gonna come on by Geno's pizza. You know, I mean, the competition was fierce. I was losing the appetite for business because I didn't have a business. I basically had a job. How many of you out there feel like that have a small business and I didn't understand core values. I didn't understand how to scale a business. I had one restaurant, and I met Jake. Fortunately, in 2009, he was a pharmaceutical rep getting food out of my restaurant and delivering it to doctors' offices but that was starting to end because of Obama's Sunshine Act. So that started waning and Jake says to himself, I'm leaving New York, I'm going to Knoxville Tennessee, and me is the proud New Yorker says where's Knoxville didn't know where it was back in 2009. I didn't and he goes down there. I would open a laptop. I'm like, dude, you got some deals down here. Let's start looking at deals and at that time, I was fortunate because I just started my mentorship program. I started investing in education. I knew the business aspect of it. I had done a few deals prior that were terrible. They weren't real, they weren't multifamily. There were other real estate deals and that's why I decided to really get focused on the education aspect of it. In 2011, we get together and partner up, it takes us 18 months to find that first deal. We closed our first deal in 2013. The rest is history in like five years, we were able to close 1500 units and we're sitting at around 1600 units right now with you know, one syndication and the vast majority of our portfolio is owned by just me, Jake, and my partner, Mike and some of our, you know, employees are investing in our deals but you know, I guess probably the most important thing I left out as I've you know, husband, wife, a six, my wife, we have six kids, homeschool of six kids, I've got a 23 year old down to a seven year old and you know, everyone always asks, what's the why do you do what you do?   You know, always said that's the big question, Simon Sinek and for me, it's not really anybody can say family and it's really important, obviously, the family. But for me, I wanted my kids to have a really healthy understanding and a healthy relationship with money. I wanted to be their role model, I wanted my kids to see me that I love my job and I want to sit here in the studio, love what I'm doing. I also want my kids to see that we can create impact in our lives and really work towards our sole purpose and I saw that as multifamily as being that that vehicle. Now if I was educated enough where I was more intelligent enough younger, I could have done that with the restaurant. I just didn't know how to set up the business and with the restaurant, I still would have had to work on the weekends, I still would have worked the holidays. It was a different lifestyle. So I think multifamily is just gives you that amazing lifestyle. It gives you the generational wealth and it's also given me the ability to create legacy skills for my kids. I'm not going to give my kids a pile of money. I want my kids to work and to learn those skills and to be able to say hey, dad, you know what real estate really is a business so you can become an entrepreneur doing this and here's what you need to do and I want to translate those skills into my children and as well as the Jake and Gino community. That wasn't 30 seconds Mike I'm lying. It was probably about six minutes but I try I'd my best bro.   Michael: You're pretty close. So, you know, rewinding the clock a little bit, you said you did a couple of deals that didn't go so well, and then you kind of ended up in multifamily. So talk to us a little bit about what those deals were and then how did you end up with multifamily, like, how did you come to that conclusion?   Gino: A person with money meets a person with experience, the person with the experience gets the money and the person with the money gets the experience that was made in the first two deals and, you know, it's one of those things where one of our coaches says you either pay for your education in the classroom, or on the streets and unfortunately, I paid on the streets and looking back at it, it was, it wasn't my fault. The first deal, my partner was terrible. He was probably bordering on criminal, we had a syndication going on, but it wasn't a syndication but at the end of the day, I am 100% responsibility junkie. So it was on me not to do due diligence, it was on me not to flower to the property, it was on me to invest in a deal. So even though it was his mistake, ultimately, I had to take responsibility and that was a shift back in 2008. When I read the book by T Harv, Secrets of the Millionaire Mind, I understood that your fruits are in your roots and if you don't take responsibility for your actions, I mean, shame on you. I mean, I made a big mistake, I should have never invested in that first deal. That didn't stop me again. It's my second deal in 2000, late 2006 had extra money lying around, we bought a building up in New York, what are the wrong part of the cycle, wrong market, blah, blah, the list goes on and on made a huge mistake on that and then I ultimately said, Listen, I've got a four Plex that I invested in years ago. I liked the small multifamily. I can do it part time while I'm working the restaurant and I like dealing with residents and it's an asset class that I understand renting out. I don't know anything about commercial leases. I don't know anything about mobile home parks. I like the basic human need, its food, clothing and apartments. I like that my brain can understand that and that's a pivoted me over multifamily and didn't know anything about syndication.   They just knew that if I keep buy a couple of these a year, refinance my money out and continue to, you know, build a portfolio, there was no burr that you know, 10 years ago, 50 years ago, there was just a refi and roll. That's what we call it and that's why I got into it and I love the model. I love the simplicity, I could do it part time. I didn't want to get into single family homes, because I didn't want to fix and flip I had the job already. I'm like, how can I pay for my kids college and how can I pay for my retirement and how can I pay for their weddings and I'm like, well, I know what wealthy people do. They don't save for the event they save to buy an asset and that's why that's what ultimately shifted my mind and are they I'm gonna buy these assets. I'm going to start building wealth and I'm gonna let these assets pay for these events and that's why to me multifamily was a natural fit because I did not want that nine to five fix and flip mentality, work all that I'm already making transactional money, how do I get that equity and how do I build my wealth at the same time and I thought multifamily was a fantastic vehicle.   Michael: I love it and just for our listeners, let's clarify something when you say multifamily. What is it that you mean because there's obviously the small multifamily and then commercial multifamily. So it's clarify for us, what do you mean?   Gino: For multifamily to me, it can be duplex, you can go out there and buy duplex that's a multifamily to me maybe if it's for commercial purposes, five units and more is commercial. But crap. I mean, I bought a four Plex back in 2002. I sold it in 2019. That little bad boy cash load for me every month, I use it as part of my business one of the garages, I was paying myself 1500 bucks a month for to rent it because it was a it was a storage unit there as well. I would store the stuff in the restaurant there, I had rentals coming in, I was able to leverage it where hey, you have to plow that driveway, you plow my driveway, give me a break. So that four unit paid me really well over the years I use that as far as cost segregation went. So you stack a few of those little multi families and the sky's the limit and I want everyone to really think about this process that we were talking about. I'm talking about the conveyor belts, we were coming out with this trademark. It's called conveyor belt of real estate and what it is it's an imaginary conveyor belts in front of you picture in your mind, you're starting to buy assets, or you're starting to stack these assets on this imaginary belt, and it can be a two unit. Then next year, you buy a six unit, then it's a 12 unit and as these assets start to matriculate, and you start to get equity out of them. What do you do with them, you either refinance them out, pull the pull the equity out, and put it into the next deal, or you sell it, or you continue to hold it but you want to start putting assets in that conveyor belt. It doesn't matter how big they are, it matters how well they're going to do for you and just starting, if you're waiting to buy assets, you're waiting for the next correction, it's never going to come you have to be ready when you're ready. I was ready in 2011 with Jake, I said I'm done. I need to start and in 2013 everyone's like oh the deals are great back then GDP suck. It was a 1% rents back then for a one bedroom worth 350 bucks. Now rents that same apartment complex for 995 plus rubs because we still own it. So evaluations have exploded. There was no syndication back then. You couldn't you couldn't read was money back then who nobody was giving you money to buy multifamily cap rates were high, because there was a lot of risk in the market because the economy was terrible. So don't blame circumstances or where you are in the part of the cycle. Great Investors, whether you're in the stock market, real estate, self-storage, you're making money on them when the market goes up and when the market goes down.   Michael: Yeah, no, I love that and you know, you said something that I want to come back to because I love the strategy. But you said rubs rent plus, rather in Santa Ana five plus reps, what is rubs for all of our listeners,   Gino: Sorry about that. So rubs his ratio utility billing system and what happens is a lot of these Mom and Pop owners when they have a property, and it's all bills paid, so let's say a little 10 unit apartment complex, and there's one water meter, well, the owner traditionally pays for all of the water on the on the property, because there's no separately meter. So instead of separately metering it, what you would do is you'd buy the property, and then you say to yourself, okay, the water bill is $1,000, there's 10 units, I'm going to split up and pro rata share each one of those and let the residents pay for that and it doesn't seem like a lot of money. But if there's 10 units, and let's say the water bill is 50 bucks per unit, 50 bucks times 10 unit is $5,000 a month of 50 bucks times 10 is $500 per month, and then times 12 is $6,000 a year. Now, $6,000 a year at a 10 cap is $60,000 in value at a five cap, it's $120,000 that you've just created in value on a little 10 unit apartment complex.   Do you think you can get rich doing that once every couple of years? How many pizzas do you need to make to make 120 grand? You don't know, I know there's a lot of flour and a lot of sweat doing that. So there's so many ways to make money in multifamily and that's just a little 10 unit apartment complex. We've done that with 300 unit apartment complexes where all of a sudden, you're billing back. That's your billing, you can't build back more than what you're collecting. But you can build back for water sewer garbage trash, so you can collect it all back and obviously if the market allows it in Knoxville, Tennessee, where we are, it's traditional up in New York, we can't do that I had an oil tank for a four unit complex and my four units. That was just one heating bill. So what I did it I raised I raised the rents on average about what it was costing me to do that. So either way, you need to get it back to the residents, because they're the ones who are utilizing it and obviously, the most amazing thing happens socialism doesn't work. All of a sudden, they're seeing that they get no water bill, guess what? Water consumption goes down. So not only is it good for you, it's good for the environment, people.   Michael: Yep, no, I love it. I love it and people always make the joke, you know, the owner is paying for the heating in the wintertime, windows open heats on 80 degrees in the house and it's like come on.   Gino: And that's it's real, Michael that that I mean, I drove by that place on or when I had it back in 2015. I drove by one day putting stuff in, it was 22 degrees out in New York and I see the window up and I go up says I go Bros and they're like, Hey, there, it was 84 degrees that throws in Jamaica or something. I'm like guys, really, and they're not paying for the heat, because just kicking along. So for those of you out there, what I ended up actually doing was I ended up bringing the thermostat to the basement and putting the thermostat in the bait leaving the thermostats upstairs, but putting the control downstairs in the basement. So I had the control set. So then they couldn't touch with the controls and I was I was able to control all of those three apartments from that thermostat that was located in the base because after a while, it's like you get fed up with it and that same apartment complex I had all of the electric on one electric meter for the three units and I would always drive into that place my father would always tell me show you that the lights on the old Italian guy, the lights on the Dekoven are what are you gonna do? I'm like, Dad, I paid I paid the electrician six grand they get it a whole new panel and everything and that was the best six grand respects I shut my dad off.   Actually got I actually got electric consumption down. I pushed the electric onto them. So there's a ways that you can you can you can, you know, save the multifamily and you talk about a single family home, you can do that with one unit. But can you imagine if you have a 50 unit complex, are 100 unit complex. I think with entrepreneurs, the more problems you solve, the more money you're going to make. So the more residents you serve, the more units you have, the more money you're going to make and that's the dawned on me when we thought when we bought our first 25 unit property it was like wow, I 25 units in one location Jake is doing his pharmaceutical thing I'm doing my pizza thing. We can manage all 25 of those units, you go to the complex once and collect rents there you're showing units there. Every unit is very similar. So it's very easy to scale that you know where the hot water heaters are, you know, where the you know, one or two roofs on the property one or two landscapes grasses to cut hot water heaters. It's all very similar. You're buying basic boxes, and it's so easy to manage and it's so easy to scale that model as opposed to single family homes. Now if you're doing single family homes, congratulations because we've got a bunch of students in our community. I mean, there's one guy Andy and Scott, and they're both from Scotland. These guys amazing. They bought 100 they're up to 100 single family homes and it dawned on them maybe I could be doing something different.   Amazing, they're managing themselves and they still got a W two job one of them, kust the I don't even know how exactly, it's amazing. But to do all of that, you could have bought 100 unit complex and had the same scalability and had the same results. But you don't know what you don't know and that's what happened, me and Jake, we thought, hey, four units, let's do that we're great. 25 units, great. But once you start buying these assets, you start seeing, and I'm sure a lot of your guests have said, this is just numbers on a paper, right? That's really what it is, your behaviors are belief driven. If you think you can buy a 20 unit, you can, if you think once you've done that, you're like, oh, I've done that. Let me push the envelope and go to a 40 unit, then you can believe you can do it, then you'll end up achieving that it really does limit us sometimes when you think you can't do something is everyone's always saying to me, well, what's one of your regrets. One of the regrets was I should have probably started buying 100 units early on, but I didn't have the skill set, I didn't have the mindset to do it. So wishing I would done something and actually doing it are two completely different things.   Michael: Yeah and I think that makes a ton of sense and I'm a big believer in that too. But do you know, let's touch on like the mindset, because so many folks in our community, both on the rootstock side in the Roofstock Academy side, are very comfortable with single family because they understand it, they lived in one or they've owned it as their primary, they maybe never owned an apartment building or maybe I've never lived in an important thing. So if for whatever reason, there's this mental hurdle that needs to get overcome to make that leap. What does that look like and what have you seen work for people in describing and kind of coaching people through how to make the leap from single family to multi?   Gino: Michael, that's a great question. If I had to stop and think for a second, I think multifamily tends to be more of a team sport, or a single family, people are more comfortable owning three, or four, or five or six, and they're doing everything themselves and unfortunately, there's a book called Built to Sell when you're buying single family homes scattered about you don't have anything really that's I'm not saying that that's sellable, you can still package it. But there's not an intrinsic value. As far as if you're having these apartment complexes, where you're looking long term and saying, hey, I have this 40 unit here, this add to here, much easier to sell, they're more of a business and it's the much higher multiple. When you're looking at it, I would say if you're really afraid of getting into the multifamily space, first thing I would always recommend everybody to do is what I did, I just go out there and pay for your education. I say invest in education, but find a mentor, find a group, find somebody who's doing it at a high level that you really respect that you really admire and the accountability piece that comes with it. Once you spend money on that you're going to show up for those calls, you're going to come to these events, you're going to do the work you got you're going to follow through with what the coach tells you to do, because you've invested in it.   I think the other thing is start small, I would say think big think as big as possible. But start with a two unit or a four unit. It doesn't matter how big it is. It just matters that you buy something and my other thing is I will probably would not be here if it wasn't for my partner, Jake, I had an amazing partnership and for us, we only needed just me and him. It wasn't anybody else. It was just the two of us. There's groups in our community that have three, four or five people on because one's a capital raiser one's boots on the ground, one's an underwriter, one loves to talk to investors, just start out small and start out if you can't do it yourself, find somebody who's going to hold you accountable. Find someone who has, you know, their, your values aligned with each other, find someone who's going to want to be into multifamily for the long term, instead of someone who's jumping around in crypto and next week is self-storage and the week after his mobile home parks really playing your flag and multifamily, give yourself a couple of months to do the homework and then go out there and start networking and selecting that market is very, very important and once you select the market, start networking with brokers, and you know if you're in a community with other community members who are investing in that market, and like I said, it's important once again, start small, you don't have to start with an eight unit complex. Start with a duplex a quad and what I've seen from students and myself and Jake, you know, very similar, you'll start with a two, then go to a six, then go to a 20 unit, then when you're 20 units, you're like I don't have any more money, well, maybe you'll refi a deal out or you'll start syndicating and raising capital for a larger deal. I think the quote from Mark Twain I always I always mentioned it's not what you don't know that what hurts you. It's what you know, for sure. That just ain't so and what I really mean by that quote is that people like well, you need money, and I don't have any money, or I don't have a balance sheet to get into multifamily and I mean, did Mark Zuckerberg stop from creating Facebook because he didn't have money. He had an idea. He had no money. Michael Dell, Bill Gates, a lot of these entrepreneurs didn't have the money, but they had the idea and they have the experience and they had the systems and they had the knowledge. If you're gonna get into multifamily learn the business itself and if you can understand how to create value in that space, you'll learn how to raise capital for these deals, and you will begin to bigger deals.   Michael: I love it, I love it. Do you know let's talk to that was it Andy and Scott, who are two of your students that have the 100 single families? Yes, talk to the Andes and Scouts of the world for just a minute and they understand clearly the single family mechanics how to buy single family homes. So what we love on the show is really actionable steps and takeaways things that people can go really chew on. So what are the physical mechanics that are different rent for somebody if they want to go buy that quad. It's like I understand single family, what do I have to do differently to go and get into a quad?   Gino: Andy and Scott did something that I don't think a lot of people in the single family space and very few people in the multifamily space do. They have a certain buyer criteria that I don't even think they understood themselves, they were buying a specific house in Section eight with a specific tenant and a specific area with a specific unit mix and I looked at your portfolio and like wow, you guys own very similar with using creative financing. I mean, it's amazing how dialed in they were for us when students start learning the process and this should be for your single family home investors as well or any market real estate market niche understand where you are in the market cycle, we call it the three pillars of real estate because this is really important and no take notes on this because this translates I think throughout all niches real estate, the three pillars are market cycle, their debt, and their exit strategy and you have to understand where you are in the market cycle of your specific market. Because back in 2013, that was a buyers' market cycle, back then you're buying anything you can you're buying old assets, new assets, old assets, because they're cheap, and there's a runway for you to make money on them. So you can fix them up, buy them cheap, fix them up, and then sell them.   It's very similar to the single family space, as the market cycle gets longer, and there's more risk and these assets are getting older, the older assets, those older houses are probably just as much as expensive as the newer houses. So why buy the older houses with all that capex and all that work, where you could buy something a little bit newer, and you're going to hold it for a longer part of the market cycle. So understanding where you are in the market cycle will help you formulate what you're buying. Right now we're buying assets that are newer, we're buying assets that are in really good parts of the market, because the market cycle right now, if there's a downturn, guess what you're gonna have to hold on to this deal a little bit longer than what you thought I'd rather buy an asset that's a little bit newer and that's in a better market part of the market cycle and a better part of the market than something that's older. So we've transitioned into that. I would also say that exit strategy, understanding what you're going to do with this, you know, a lot of people buying these homes, what are we doing? Are we going to keep them for the next two years? Are we gonna flip out, people just buy a deal because they think it's a great deal? Well, every deal, as our coach Bill Hamm says, you know, wheels up, you're on the air, he's a pilot, you're flying that plane, you don't have to take off, you'd have to buy the deal. But once you buy the deal, that deal is gonna land sooner or later, you're you know, it's either crashing down crashing, you're gonna get foreclosed on, you're going to sell it, you're going to refi it, whatever that looks like. So understand what your exit strategy is and then let's talk about what the debt component is because once you know what the exit strategy is, are you getting bridge debt? Are you getting community debt? Are you getting agency what we talked about Fannie and Freddie and these bigger multifamily deals? Is it going to be shorter term debt, long term debt, we're even using credit unions. Credit unions are really big in this space and multifamily is all of a sudden they've seen they're not banks, they're nonprofit. I don't know how they make their money, but they're getting their way into it and it's really a big viable option.   But once you've taken all that into consideration, you're looking at the three pillars of real estate, you're looking at market cycle, debt and exit strategy. Now let's chunk down what kind of assets you're buying in multifamily, specifically and even single family, what kind of homes where are these homes located and for us, we like to look at median income, because we're looking at median income, we can figure out what kind of renters there are, when we've made mistakes on deals, it's when the median income is lower, it's mid 30s 35, 40. That's when we have problems when we're buying in those areas that are marginal, because unless you know the path of progress is going there, meaning incomes gonna rise. That lower median income means you can't raise rents as much it means the quality of the resident is harder, there's more return on effort. There's so much effort involved in that asset. So be wary of that. So we're looking for specific median income, at least 50 grand we're looking for our for our specific, you know, niche. We love two bedroom townhomes. So if you're if you're a single family home investor, okay, I want to look for three bedrooms, two baths $50,000, median income, this part of the city I like garages, whatever that looks like. So figure out what for your criteria is because when you're looking at a deal, you can just check it off and say that doesn't fit my criteria or hey, I liked this deal. Even more importantly, when you're talking to brokers, you can push it out to all your broker friends and say when this kind of deal comes across your table, call me up and getting crystal clear on more, I guess buyer criteria. We love assets that have amenities in the multifamily space washer dryer hookups, for some reason are really huge.   So maybe in the single family space, hey, you want to have a place with a pool, maybe a little patio, Little Dog, a little enclosure place for the tenants, or maybe having washer dryer hookups in the single family home and offering that amenity as well. So figure out what the criteria is what kind of asset you want to buy. I think that'd be really helpful for anybody, whether they're buying single family homes, whether investing in self-storage, or multifamily and this criteria is going to change. That's why you really need to stay educated because market cycles change. As the market cycle changes. You're going to you're going to be buying assets that are different because as the as goes from a seller's market back to a buyers' market prices are going to drop, you're gonna see those see assets come down in price, maybe. So looking at those assets more you can pay it's a function of price. If you can pay less for an asset in those buyers markets, you're more willing to buy an older asset because your capital requirements are still there. But you're still able to make money because there's a bigger, bigger, bigger price range where you can go up holding these assets for a little while and refine them is really important in our strategy as well, I did it.   Michael: Gino, you said something that I want to circle back to you were talking about the exit strategy and I love the pilot analogy that you shared a question for you if someone is listening to this, and they're just getting started and they understand that real estate investing is great. It can be powerful to understand the fundamentals. But maybe they're not sure what their exit strategy looks like. They can't think that far ahead. Should that person wait? Is that person not educated enough in your opinion or should they? Are they okay to figure it out on the fly?   Gino: That's a that is a good question. I started not understanding it myself. So don't let that hold you back. I you know, the thing is we it's so hard to be an entrepreneur and to be an investor and to how we will we call the long term mindset, we created a brand called the 100 year real estate investor because what me and you're doing right now, our actions are affecting our kids and our grandkids. That's the reality. So if you're waiting to buy multifamily, you wait five years, well, that's five years that you could have owned something and waiting and waiting and waiting for me. When you buy an asset, it depends on the size of the asset. If you buy a $50,000 home, there's less risk in that than investing in a $70 million multifamily. So it depends what you're starting on as well. Also, that's the that's the important thing. But getting clear on why you're choosing real estate. I mean, why real estate? There's so many vehicles out there. There's so much out there. Real estate is a business and I think people don't understand that I didn't for a long time i Our slogan Jake and Gino as we create multifamily entrepreneurs, that that's the reality when you buying real estate, you're buying an asset, but you're also buying a business. How many investments can you do that with if you can think about it, you're buying a stock, you're just doing an investment as a stock.   But with real estate, you can become a real estate professional, it can really help you immensely on your taxes, you're actually buying assets that you start asset, managing it and looking at it from the from the investors perspective, and you're able to scale up and start hiring people. So you're building the business and then from that, you're able to create multiple streams of revenue from that one asset. So if you have 30, single family homes, you're out there, you're like, wow, okay, I've got 30 singles, I can start an education platform. I can start writing books, I can start doing YouTube videos, I can partner up and I can start lending private money, I can start doing hard money. I can have a little fix and flip business going on. I can get my broker's license, Title Company, why don't I partner up with Sony's as a title company all these different streams of revenue coming from that single family home portfolio. We did the same thing with our mobile with our multifamily portfolio, we started the education company, we started a syndication company raising capital, we have a development company now that will start building multifamily assets. We have 100 year company that we're selling whole life insurance to our you know, students as well to be able to invest in multifamily. So I think when you're looking at real estate, and you haven't started yet, it's an amazing business, learn the whole entire business and the and the opportunities that it gives you because that's why I want people to stop investing in single family and get into multifamily, because you can start hiring out a property manager, you can start hiring out maintenance techs to help you with that part of the business. That's very important but I mean, should you be changing toilets. I mean, when you first started, obviously, when you have six to seven units, you should be really going out there paying somebody to do that and your value is an underwriting deals, your values and talking to investors to invest in your next deal your values and creating another business that aligns with multifamily not doing those tasks that really pay 30 or 40-30 to $40 an hour, which is probably a lot in a lot of markets. But still, that's not what you should be doing. You should be focusing on those bigger tasks.   Michael: I dig it, I dig it. Gino, one more question. Before I let you out of here. You talked about being familiar and aware of where we are in the market cycle or where you are as an individual as an investor in the market cycle. Where are we right now?   Gino: Michael, this is one of the weirdest economies that I've been ever involved in and I'm a lot older than you I just don't when a recession. Can we define what a recession is if you're a Democrat, right? The definition if you're a Republican, you're screaming bloody murder. I'm an entrepreneur. I'm trying to figure out where we are. We've added so many jobs but yet companies are talking about laying jobs off. I just don't get a it's a such a dislocation, the supply chain. I try to buy a car a year out from buying a car, airplane tickets or double hotels or not avail I just I can't figure it out. But I think long term. I'm always bullish on the economy. I'm always I know there's there will be a way for to figure it out. Because if the person is not doing the job in office, that's why we have elections every two years. They're going to vote them out. Someone else is going to come in and things are going to change. I think long term real estate is will always be the place to be because it's an inflation hedge my rents are going up the same amount as inflation is going up or rents have been going up the unfortunate thing you've seen what's happened with the middle class, the middle classes get a paycheck. They've got you know, raises of seven, eight 10%.   A person who owns $50 million in real estate, their portfolio has gone up 10% In the last five years or whatever, they're up 5 million bucks. So it's you know, you have hard assets when all this money has been given to banks, what do banks do with this money, they lend it to people who buy assets, so assets have just gotten this natural swell. So if you're looking at it from the equity perspective, it's amazing and like I said, it is a basic human need demographics are such that the build to rent space has gotten huge because people don't want to buy homes, they want to be able to be you know, wanna be able to move wherever they want to their job trips over, they don't want to fix screen doors, they'd rather rent and that's really bodes well for multifamily and further for the rental space going forward and there's not enough there definitely is not enough of a supply of rentals out there and you saw what happened with rents in the last two years are up. You know, Knoxville alone was up 20% last year, year over year in one year because there's just not enough just be aware of where you're investing. I mean, I think areas that have job growth and population growth are always going to stand out. We love the Southeast Conference. You know, Tennessee, Florida, Carolinas Georgia, great part Texas. You know, everyone says Texas is booming as well. parts of Arizona are doing really well wherever you see migration wherever you see people moving to I would say you know bide here and Michael if you ever speak in the next five years anyone listening to this I'm sure even if they paid a little bit too much for the real estate today. They'll be happy five years from now that they invested in the deal today.   Michael: Love it Gino as we get you out of here if people want to learn more about you continue the conversation learn more about multifamily where's the best place for them to get a hold of you and do that?   Gino: Just go to https://jakeandgino.com/ , we've got an event coming out November 5 and sixth it's in it's in Orlando. It's our fifth conference multifamily mastery five we had 900 attendees there last year. I think this year we're going to top 1000 and it's just an awesome place to get with people who are doing deals who are raising money who are networking you're gonna find your next partner there we've got amazing speakers as well so just go on the Jake and Gino website figure out if you've got the ability we call on it. We always call it the financial vacation for smart people because you're gonna be down at Disney you gonna be hanging out with people and it's great. You bring the kids nine to five you know during the event afterwards you're at the resort you go to Disney so that's our flagship event for the search go to https://jakeandgino.com/   Michael: Awesome. Well, Gino you know, hey, thanks again, man for taking the time. This was super fun, really insightful. Definitely look forward to continuing conversation.   Gino: Thanks, Michael. Appreciate it.   Michael: Hey, you got it, take care.   Alright, everyone. That was our episode a big thank you to Gino for coming on and sharing some really great wisdom with everyone. For anyone who is interested in the space. Definitely go check out Gino and Jake's websites and as always, we look forward to seeing on the next one. Happy investing…

Starting at the beginning, Ryan was born in Columbia, Missouri, but grew up in Houston.Ryan began studying improv in 2005 with Houston's Massive Creativity, led by MacArthur Antigua of Improv Olympic (IO) Chicago, performing at Avant Garden. In 2006, Ryan moved to Los Angeles where he completed IO West's Training Program, and performed with “Kick Drum Decade”, a main stage Harold team, 19-time Cagematch Champion, and 2- time winner of the 2008 and 2009 Los Angeles Improv Festival Cagematch Tournament. While in L.A., Ryan was cast in several commercials and web ads including for Cabela's, Honda, Top Flite (with Kenny Mayne), and Baby Ruth. Notably he performed several voice overs in the animated short, “Meltdown” (with David Cross). From 2009-2011, Ryan co-directed, taught, and performed with Houston's Rogue Improv (formerly Massive). In recent years, Ryan has coached and performed improv most notably with Baby Knuckle, Corner Office and Damaged Goods at Station Theater and other Houston venues. Additional improv festival performance credits include the Trill Festival (Houston), Out of Bounds Comedy Festival (Austin) and the @Del Close Improv Marathon (NYC).Separate from improv, Ryan has had a unique and evolving career path. He is a former practicing attorney and is now a sales specialist in pharmaceuticals. He loves dogs, cooking, sports and a lotta other stuff.Topics:- The Houston Housing Market- Ryan's Improv Journey- Work Job Lunches- Selling What You Don't BelieveScenes:- The Uncertified Lawn Man- The Sunshine Act- The Date Night Presentation- Drug Rep NotesWe have opinions and you're gonna hear them! Follow our characters down rabbit holes in our fast-paced improv shows.Hosted by Amechi Ngwe, Antoine W.B, Jon Myles, and Tandiwe Kone.Edited by Antoine W.BHosted on Mocking Bird Network

In this episode of Causes or Cures, Dr. Eeks chats with Dr. Joel Lexchin about his recent research published in the Journal of General Internal Medicine titled: A Ray of Sunshine: Transparency in Physician-Industry Relationships Is Not Enough. He will discuss what the Sunshine Act was designed to accomplish in terms of being transparent about physician-industry relationships, what it actually did, and how it did or did not change physician behavior, industry behavior and consumer behavior. Dr. Lexchin is a professor at the York University Faculty of Health where he taught pharmaceutical policy, an emergency medicine physician, and an Associate Professor in the Department of Family and Community Medicine at the University of Toronto. He is a Fellow in the Canadian Academy of Health Sciences and the author of over 160 peer-reviewed publications. He was a member of the Ontario Drug Quality and Therapeutics Committee and chair of the Drugs and Pharmacotherapy Committee of the Ontario Medical Association for 2 years.To contact Dr. Eeks, do so through bloomingwellness.comOr follow her on Instagram here.Twitter here.Or Facebook here.Subscribe to her newsletter here!

Sleep experts partially agree with the U.S. Senate on moving away from the seasonal clock changes. Reset talks through how that bill could affect your sleep if it were to become law.

At the February 16, 2022, “Basics of the Sunshine Act” webinar, George Spiess, Chief of Outreach and Training, PA Office of Open Records, reviewed what constituted a meeting covered by the Pennsylvania Sunshine Act. In this audio segment from the presentation, Mr. Spiess answers my question about establishing a quorum. In particular, can members of a committee participate remotely – via speaker phone or Zoom – AND be counted as part of the quorum to thereby make it an official meeting? The answer to that question depends upon whether we are talking about committees of a first-class township, second-class township, or borough.

Welcome to Episode 3 of Reddit and Wiki! We are back this week with John as your host as he talks to you about Florida Man. You've heard the Florida Man memes and Florida Man headlines right? Listen to his futile attempt of reviving his old gig as a pun master and how both his co-hosts sucks as hype men. Josh brings a couple of not so feel good stories, while Sean retells the story of the creepy Miami Zombie. All that plus many more, so make sure to tune in. According to Wikipedia: "Florida Man is an Internet meme, popularized in 2013, in which the phrase "Florida Man" is taken from various unrelated news articles concerning people who hail from or live in Florida. Internet users typically submit links to news stories and articles about unusual or strange crimes or events occurring in Florida, particularly those where "Florida Man" is mentioned in a headline. The stories call attention to Florida's supposed notoriety for strange and unusual events. The Miami New Times claimed that freedom of information laws in Florida make it easier for journalists to obtain information about arrests from the police than in other states and that this is responsible for the large number of news articles. A CNN article on the meme also suggested that the breadth of reports of bizarre activities is due to a confluence of factors, including public records laws giving journalists fast and easy access to police reports, the relatively high and diverse population of the state, its highly variable weather, and a lack of mental health funding." Follow us on social media on Instagram and Twitter @redditonwiki. Follow us as well on major podcast platforms such as Apple, Spotify, Goodpods and Podchaser. Don't forget to leave a 5 star review if you enjoy what you hear. All links here! https://linktr.ee/redditonwiki (https://linktr.ee/redditonwiki) Today's podcast promo is from our friends at Have You Seen It? All their information can be found at https://linktr.ee/officialHYSI. Consider being a Patron! The biggest benefit to you Wikimaniacs is that we have a combined https://www.patreon.com/cultiv8podcastnetwork (Patreon)! Signing up for only $5 will not only get you access to this show a week early and ad-free, but it will also get you a week early and ad-free episodes of Let's Start A Cult and The Dumb, Found Dead! A god damn it that's not all because you will also get access to John's new series Kaba, where he dives into cryptids, spooky stories, and creep folklore. So sign up today and help support yuh bois in starting something fun and exciting! RESOURCES Florida Man. (n.d.). Wikipedia. https://en.wikipedia.org/wiki/Florida_Man (https://en.wikipedia.org/wiki/Florida_Man) Miami Zombie. (n.d.). Wikipedia. https://en.wikipedia.org/wiki/Miami_cannibal_attack (https://en.wikipedia.org/wiki/Miami_cannibal_attack) Florida Man. (n.d.-b). Florida Man. https://floridaman.com/ (https://floridaman.com/) Barach, P. (2018, April 12). The Origin of Florida Man: The World's Worst Superhero. Medium. https://medium.com/ (https://medium.com/)@PaulBarach/the-origin-of-florida-man-the-worlds-worst-superhero-34df69c806c3 Smart, G. T. C. (2019, March 25). Why is ‘Florida Man' a thing, when ‘Pennsylvania Man' (or Iowa Man or Ohio Man) isn't? Treasure Coast Newspapers. https://eu.tcpalm.com/story/opinion/editorials/2019/03/25/heres-why-florida-man-thing/3266020002/ (https://eu.tcpalm.com/story/opinion/editorials/2019/03/25/heres-why-florida-man-thing/3266020002/) Government in the Sunshine Act. (n.d.). The First Amendment Encyclopedia. Retrieved 27 July 2021, from https://www.mtsu.edu/first-amendment/article/1244/sunshine-acts-federal-and-state (https://www.mtsu.edu/first-amendment/article/1244/sunshine-acts-federal-and-state) Luscombe, R. (2019, May 21). Florida Man: what lies behind the Sunshine State's crazy stereotype? The Guardian. https://www.theguardian.com/us-news/2019/may/21/florida-man-what-lies-behind-the-sunshine-states-crazy-stereotype...

Is your loved one missing?   Turn to Missouri Missing to help you navigate this path.  Each path is different in the unknown but they have walked in your shoes.  They can help you navigate the system.  They can create a flyer for you and reach out to the media to bring awareness to your case.  They are here to answer your questions. Theyare here to walk beside you from the missing phase until your answer comes in and beyond.   From those that know.   - National Missing and Unidentified Persons System (NamUs) - National Center for Missing and Exploited Children (NCMEC)  ​ ​- Missouri State Highway Patrol Missing Persons Clearinghouse  - Kansas Bureau of Investigation Missing Persons Clearinghouse   Missouri Missing approved resources.   Missouri Missing is highly trained and experienced in the world of the missing. Most of our board members have or have had a loved one missing. Please contact us at info@missourimissing.org or (573) 619-8100.   They have developed a list of suggestions that you may want to read: Missouri_Missing_Suggestions_for_when_a_loved_one_goes_missing.pdf

In this episode, the guys chat about the way a big organization can do terrible things in plain sight. Chad and Nico recall how a pharmaceutical company transformed itself into a neighborhood drug dealer.  The guys start the show talking about the background of Purdue Pharma. Purdue decided to create a new market entirely by aggressively working to normalize the use of opioids for the management of chronic pain. Purdue created a campaign claiming the idea that there was a national epidemic of untreated pain in America. They wanted the medical industry to do a better job of prescribing opioids.  Purdue utilized an AstroTurf campaign by creating unbranded websites that were supposedly independent information from independent groups. However, the contributors were fake, and the information was completely misleading and false. Purdue even created sales ads that purposely underemphasized the addiction element of opioids. The addiction rate was at least ten times what they were claiming.  When marketing the opioids, Purdue made a point to say that the people who got addicted were of bad character. Plus, they claimed those people were intentionally trying to abuse the medication and that it wouldn't happen to a responsible person. Typically, in an ad, you have to balance fair and balanced information. However, Purdue completely minimized the risks of opioids. In 2001 alone, the company spent 200,000 million dollars promoting Oxycontin. In 2004, it became the leading drug of abuse in the United States. However, sales representatives were making six-figure bonuses and loving it. Purdue recruited and trained doctors, nurses, and pharmacists to be their spokespeople.  Purdue kept a database of doctors in order to influence them to prescribe their products. The company would identify physicians with high numbers of chronic pain patients and determine which doctors would prescribe more willingly. Purdue gave away their products for free, knowing those patients would want more.  The guys describe how Purdue manipulated the system and created drug addicts. Plus, they reveal Purdue's secret plan to profit off of opioid addiction caused by their drugs and explain Purdue's eventual demise.   Enjoy the show! We speak about: [05:00] About Purdue Pharma [11:30] About creating an AstroTurf campaign [17:30] How Purdue marketed their opioids [24:15] About the Sunshine Act [26:30] How Purdue influenced doctors to prescribe their products [32:10] The ways Purdue manipulated the system and created drug addicts [36:00] Why Purdue never received warning letters [40:20] About Project Tango [42:20] The demise of Purdue [55:10] Podcast reviews Resources: Website: https://www.marketingrescuepodcast.com/

Today's episode checks back in with the status of the consolidated cases pending before the Supreme Court regarding Trump's tax returns. As it turns out, this overlaps pretty strongly with the show's "B" segment about the potential for abuse in the CARES Act. We begin with a colossal "Andrew Was Wrong" -- in which Andrew optimistically predicted we'd see Trump's tax returns in 2019. That... turned out not to be the case. So what are the odds that we'll see Trump's taxes before the November elections? Listen and find out! After that, it's time for another semi-deep-dive, and this time we're checking back in with the just-passed CARES Act as Andrew talks about a provision we missed the first time around that has the potential to... well, you'll just have to listen and find out! Then, it's time for the answer to #T3BE 176 involving burning a copy of the IRS Code. Is it illegal? If so, why? Patreon Bonuses If you missed our live Q&A, you can check out the audio here! Appearances Andrew was just a guest on Episode 121 of the Skepticrat, talking about the abuse of the Paycheck Protection Program and other crazy legal stories in the news. And if you’d like to have either of us as a guest on your show, event, or in front of your group, please drop us an email at openarguments@gmail.com. Show Notes & Links Click here to read the letter sent by Liz Warren & other Democratic Senators to Deutsche Bank. Our comprehensive overview of the CARES Act was in Episode 372, and you can read the final CARES Act here. The Sunshine Act is 5 U.S.C. § 552b. -Support us on Patreon at: patreon.com/law -Follow us on Twitter:  @Openargs -Facebook:  https://www.facebook.com/openargs/, and don’t forget the OA Facebook Community! -For show-related questions, check out the Opening Arguments Wiki, which now has its own Twitter feed!  @oawiki -Remember to check out our YouTube Channel  for Opening Arguments: The Briefs and other specials! -And finally, remember that you can email us at openarguments@gmail.com!

In this continuation of a special series on data quality, you’ll hear different perspectives from other industries regarding market research and the analytics industry. This episode, Sima chats with Charlie Allieri, CEO of Imperium, and the sponsor of this series on data quality, and Bill Reinstein, who is CEO and CTO of MedData Group. Bill is a seasoned entrepreneur with over 20 years of expertise building interactive media and technology-enabled service organizations. Bill has built MedData Group into the leading provider of healthcare professional data for digital marketing From Direct Email Marketer to Aggregator of HCP Data MedData Group offers extensive demographics, firmographics, clinical behavior, and full contact data including email and digital IDs to support multi-channel marketing outreach. It also creates custom programs for vendors seeking program registrations, leads and/or web site traffic from its databases of over 4.2 million healthcare professionals. Originally Bill’s company had a product that was focused on email direct marketing for the healthcare segment, specifically targeting healthcare professionals. As noted by Bill, HCP’s include physicians, nurse practitioners, physician assistants, and a wide range of allied health professionals, such as psychologists and chiropractors. His company evolved into a data-licenser and data provider extending beyond the performance-based marketing business.  A few years ago, MedData Group became one of the largest aggregators of healthcare professional data and they realized they had an opportunity in the digital marketing (also known as “omnichannel”) space, leveraging that very large scale of offline data. Through some of their proprietary processes, they were able to link that data to what are called online identities, in a privacy-safe way. MedData Group’s customers are primarily pharmaceutical brands and their associated advertising agencies, and they are able to target digital advertising through different channels. Public Domain Data The large volume of MedData Group’s data is in the public domain, or what is better known as the “quasi-public domain”. Healthcare differs from other professional segments because of the nature of the services that they provide. Every healthcare professional has to be licensed at both the state level and at the federal level, and they all have a common identifier (also known as a “key”), and that’s the National Provider Identifier or NPI. This identifier remains with them through the bulk of their career.  Due to certain types of federal legislation such as the Sunshine Act, and in terms of transparency of what drugs the HCP’s provide and what diagnoses they’ve made when it’s related to federal reimbursement programs, for example, this information is out there. It’s not necessarily easy to find nor is it easy to aggregate, but that’s not what makes this data valuable. Rather, it’s the value-add that the company provides that makes the aggregation of structure and normalization valuable. Measuring Data Quality It’s necessary to bifurcate and look at the data in different buckets, Bill explains. At the top level, the dividing line is whether it’s offline data or online data.  Starting in the offline space, there are around 100 input sources of data from every state-licensed database and multiple federal-level databases of information, as well as commercial data that MedData Group licenses that come from medical claims data. This medical claims data is at the patient level but is HIPAA protected in a non-identifying kind of way.  On the front end, it starts with the various ETL (extract, transform, and load) processes that the data management team examines by automated scripting in the platforms that they use. The scripting looks for anomalies and then moves to more demographic data. In addition to automated review, there is a team of researchers that are responsible for qua...

Attorney Peter Ruth speak about the Sunshine Act and how it relates to Public Officials.

Should doctors with commercial interests lead research on their products? Should we forget ‘conflicts' and discuss ‘declarations of interest' instead? Who should hold and maintain conflicts of interest registers for doctors? Should practicing doctors work with the pharma industry as well as serve on guideline committees? Should researchers with extensive financial interests be disqualified from studies of their own products? The Physician Payments Sunshine Act requires US manufacturers to collect, track and report all financial relationships with clinicians and teaching hospitals. Professor Heneghan will discuss the failings with the current system of reporting of conflicts in medicine, what's been tried so far, and why it is time for a UK Sunshine Act. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was held as part of the Practice of Evidence-Based Health Care module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Systematic Reviews. Members of the public are welcome to attend.

Should doctors with commercial interests lead research on their products? Should we forget ‘conflicts’ and discuss ‘declarations of interest’ instead? Who should hold and maintain conflicts of interest registers for doctors? Should practicing doctors work with the pharma industry as well as serve on guideline committees? Should researchers with extensive financial interests be disqualified from studies of their own products? The Physician Payments Sunshine Act requires US manufacturers to collect, track and report all financial relationships with clinicians and teaching hospitals. Professor Heneghan will discuss the failings with the current system of reporting of conflicts in medicine, what’s been tried so far, and why it is time for a UK Sunshine Act. Carl Heneghan, Professor of Evidence-Based Medicine, employs evidence-based methods to research diagnostic reasoning, test accuracy and communicating diagnostic results to a wider audience. This talk was held as part of the Practice of Evidence-Based Health Care module which is part of the MSc in Evidence-Based Health Care and the MSc in EBHC Systematic Reviews. Members of the public are welcome to attend.

The Vexatious Requester of Gregg TownshipKen's guest is Michelle Grove, a local political activist from Gregg Township near State College.  Imagine a local government out of control.  Imagine the sparks when it meets a regular citizen, affectionately known colloquially as “the vexatious Right-to-Know requester of Gregg Township”.  Then there are the listener-submitted questions regarding forced vaccinations, zoning, and pollution, plus a vignette about one ranger's reaction to hunting endangered species.  What “sticks in Ken's craw” this week?  Audiences Guest Toastmaster Narrator: Karen Flam, of the Positively Charged Toastmasters club, Found in this episode:What's in the Mail Bag? xx:xx:xx-xx:xx:xxDon't force vaccinations on his kid!  But force them on his kid's classmates?Zoning and compost heapsDealing with pollution as a trespass What happens when you shoot a protected species, and the ranger is standing right there? A Conversation with Michelle Grove    xx:xxWhaddaya mean, the township destroys records?Whaddaya mean they violate the Sunshine Act?Surely they didn't mean to slander an inquisitive citizenVictory in court!! What Sticks in Ken's Craw?  Audiences!They stroll in late, walk out early, fall asleep if I'm lucky, and snore if I'm notYou know at some point someone's cell phone's gonna ring....All about Ken, Monica Lewinsky, and uppity, arrogant political audiencesPresenting to an audience of police at a DUI checkpoint!More Information:Guest:Michelle Grove: https://greggtownshipunofficial.org/Pennsylvania Constitution: https://www.paconstitution.org/ Commercials:Amendment 16: http://AmendmentSixteen.comFreedom Financial Tax: 866-401-1090Libertarian Party of Pennsylvania: http://LpPa.orgIron Will Tattoo Club: https://ironwilltattoo.clubSteven Werley Digital Marketing: https://www.stevenwerley.comToastmasters International: http://toastmasters.org

Starting in 2010, CMS “Let The Sunshine In” and now reports data about financial relationships between physicians and pharmaceutical companies (and others). In the episode, we explore the policy behind this change, advise you how to find what is reported about your practice, and discuss the impact of these rules.

Starting in a new industry can be overwhelming.  Whether you are new to healthcare or a veteran you will relate to Janet Aguhob, Senior Convention Planner at Allergan and her story about what she wished she knew when she started in healthcare.  Janet shares how she transitioned from non-profit to a highly regulated industry and what every healthcare marketer needs to know. Get this insider’s perspective of leading a large healthcare exhibit program and how you can apply her proven strategies to your marketing program. Healthcare Exhibitors All Need To Know “The Big 3” The Office of Prescription Drug Promotion OPDP: The mission statement for this office includes: “traveling to major medical meetings and pharmaceutical conventions to monitor promotional exhibits and activities” Pharmaceutical Research and Manufacturers of America’s (PhRMA) Code “The PhRMA Code reaffirms that interactions between biopharmaceutical research companies and healthcare professionals should be focused on informing the healthcare professionals about products, providing scientific and educational information, and supporting medical research and education.” The Physician Payments Sunshine Act (PPSA)--also known as section 6002 of the Affordable Care Act(ACA) of 2010 “requires medical product manufacturers to disclose to the Centers for Medicare and Medicaid Services (CMS) any payments or other transfers of value made to physicians or teaching hospitals.” The Sunshine Act dramatically impacted exhibiting in healthcare. What Happened Post Sunshine Act In Trade Shows? Prior to 2010: PhRMA marketers were allowed to provide giveaway reminder items including pens, tote bags, wireless mice etc. The trade show floor was a popular spot.  Post 2010: Initially there was a dramatic drop in overall spend across many areas. Vendors and Medical associations lost business. Exhibitors reduced booth size and trade show floor plans were reduced. Exhibit partners saw lower revenues, general contractors saw reduced revenues. Few Sales Reps were needed and hotels lost room block space, and host cities lost revenues from conventions. Positive Results of the Sunshine Act Attendees who come now are motivated to learn about the products. There are more qualified leads. Healthcare Practitioner (HCP’s) are motivated to learn. Improved interactions with attendees who value information over giveaways. Educational items are the focus of giveaways.  Sales Reps are able to follow up with busy physicians at their office with a disease-state product that will help them in their practice. Increase in CSR (Corporate Social Responsibility) giving on showsite. Allergan did a CSR project with a signature wall-the more signatures collected $10 was donated for every signature to the non-profit wing of the association. Sales Reps found it provided a different way to approach the HCP People feel good and conversation is more at ease when there is a CSR component Janet manages 62 shows of various sizes, sponsorships, product theaters, room blocks, pre-con meetings.  In addition, she helps coordinate KOL (Key Opinion Leader) meetings.  Her marketing role includes collaborating with brand teams and in-house graphics for art production and approval. Her expansive role includes managing product theaters where she acts as the coordinate and helps speakers with transit, badges and lead scanning. How does Janet Relax on the Road?  She makes a point to visit the host city of the conference. You can find Janet on LinkedIn or email her at Janet.aguhob@allergan.com Interested in finding out more about how to exhibit in healthcare, read the full article with tips on how to plan a trade show project, FDA at trade shows what to say to International exhibitors and more! www.rockyourtradeshow.com/hcea. Credits: A big thanks to Christy Haussler at Team Podcast for editing this episode.

Does the Sunshine Act Apply to You? James A. Dwyer and Dan Gilman of RxVantage with First Healthcare Compliance. The post Sunshine Act Webinar appeared first on First Healthcare Compliance.

Does the Sunshine Act Apply to You? James A. Dwyer and Dan Gilman of RxVantage with First Healthcare Compliance. The post Sunshine Act Webinar appeared first on First Healthcare Compliance.

Welcome to TheBurg Podcast, a weekly roundup of news in and around Harrisburg. March 4, 2016: Let the sun shine... This week, Larry and Paul discuss a City Council workshop on the recovery plan, the Sunshine Act and a government-related nonprofit's closed-door meetings, and a U.S. News & World Report survey that gave high marks to the Harrisburg metro area as a place to live. TheBurg Podcast is proudly sponsored by Ad Lib Craft Kitchen & Bar at the Hilton Harrisburg. Special thanks to Paul Cooley, who wrote our theme music. Check out his podcast, the PRC Show, on SoundCloud or in the iTunes store. You can also subscribe to TheBurg podcast in iTunes.

On this first episode of the Open Records in Pennsylvania Podcast, Erik Arneson, the Executive Director of the Office of Open Records, interviews George Spiess, who has conducted training sessions across the state on the Right-to-Know Law and the Sunshine Act. The Office of Open Records can be found at http://openrecords.pa.gov

Reading by Eli Adashi, MD, MS, author of The Physician Payment Sunshine Act: Testing the Value of Transparency

Your next contact lens patients asks you, "So doctor, I saw on a website that the same company who makes my contact lenses paid you $1,417.29 for "Travel Expenses."  Are you fitting me with these contact lenses because they paid for your vacation? Sound impossible?  The Sunshine Act is in full effect and scenarios like the one above are bound to happen in your practice. Listen to experts from the Contact Lens Institute, Alcon and Vistakon share their wisdom about how the "Open Payments" program works, where you can see it online and everything else you need to know about it.

1:00 - The trajectory of Leo's career. Biology, Pharmacology and English Literature. First job was working at a CRO and commercial incubator doing Phase I studies. 4:00 The power of language. The way we articulate can mean what we intend to communicate doesn't match what the listener hears. Leo “places science in context” to derive meaning and relevance, and from this, you derive value. If not relevant, you merely convey information. There's no value to the listener. 5:25 Next career step was working in the clinical research department of a biotech company, writing protocols and performing clinical investigations. Thereafter, having submitted the NDA, started to get involved in product support— help sales reps and product managers because of a deep understanding of the data. Found the commercial side incredibly interesting and from there was head-hunted into medical communications agency. 8:00 The value of both understanding the clinical, commercial aspects and also having the talent to “tell the value story.” 9:00 Going from business development in strategic publication planning to the President of the Med Ed division of Publicis Healthcare. Steps along the way included working with pharma manufacturers at a global level, and then supporting local markets in commercial development. “The nexus of science and commerce.” 11:25 Leo's current consulting engagements. Creating solutions to communicate and deliver value. Some of it is about expertise that Leo brings, or ways that he can aggregate expertise to solve a problem. More about solving problems and less about the discipline of a certain channel. 13:00 How has Leo's task altered given the changes in the US healthcare landscape? Consolidation in the marketplace means that the nature of the customers and the stakeholders that pharma needs to work with are changing. There has always been a myopic focus on the prescriber, but now it's about who are the aggregate group of stakeholders that we need to build relationships with and help deliver the best healthcare outcomes at the best price. 15:00 Collaboration is a tough thing to do even if though there's a common view, about the patient at the core. “We're here to serve the patient.” But all stakeholders come at this from a different direction and these different approaches can lead to challenges. Need to be authentic and share values and be able to clearly identify these commonalities. 16:35 Don't forget shareholders are patients. Pharma is also in the service business. The question to ask is “who do you serve” and if, for example, you think of the pharma brand as the centerpiece of a solution to deliver better patient health, this creates a commonality which stakeholders can align around. 18:00 The changing role of the pharma sales representatives. Some companies are further ahead of others. It is a dangerous place to go if regulation forces greater separation of pharma and prescribers. It's not constructive to disentangle stakeholders who have an important relationship. We need to be transparent about the nature of the relationship, but having a relationship is fundamental to getting the best results. 19:40 Examples of when barriers to collaboration— regulation, limited authenticity— have limited collaboration. This can happen on the clinical development side or on the communication side. Institutions preclude their members from working with pharma— ultimately this will have a negative impact on the ultimate quality of health that can be delivered. We all need to challenge ourselves to figure out to make these relationships the best they can be. And transparency will be a big part of this. 22:00 Compromise could be construed as each party as giving something up to get to a better outcomes. Clearly defining what those objectives are, and being committed to those objectives means that you will freely do what it takes to get there. Also need to look at interactions longitudinally … if look at interactions as one & done, then there will be less understanding of the potential for the relationship and therefore less willingness to compromise in the short term for long term gains. 24:00 Ian Altman and Gary Vaynerchuk both have said in many different ways, “You have to give to get.” You have to stay true to your objective. This then defines decisions you're going to make. You don't then look at this as compromise because you're committed to the objective. And if questions continue to arise, then we need to ask ourselves if we're really committed to that objective. Are you authentic… are you talking about this commitment, or are you really committed? 25:00 Big network agencies these days are divided into smaller business units who are incentivized on their individual performance.  Why don't these individual units work together to best serve the customers? But it would take courageous leadership to make these changes. “Staying the course is a continuous, every day, consideration.” 28:00 The segmentation between disciplines … advertising and med ed. More now than ever, these lines are becoming ambiguous. So need to be focused on solutions as opposed to selling the client a new initiative. But thinking at its core about what problem our clients have and trying to solve them. This means organizational and asset agility. It means being able to pull our resources together in order to quickly solve a problem for a client. So instead of having 10 people working on a piece of business for the next year and more about what disciplines are needed and organize them. Clients are willing to pay for solutions. Solutions have value. 30:50 The burning challenges, on commercial side of smaller pharma trying to have deeper interactions with healthcare providers and thought leaders. This is hard because of regulations, not just the Sunshine Act. But the very people that they need to help them, they can't reach. It's almost a false separation, because if thinking about a product, still trying to access the information whether through commercial lens or medical lens. But seems like over administration for what should be a pretty simple interaction. 32:00 Talking about GSK not paying physicians any longer. We need to find the way, even within this regulated environment, to enable legitimate, meaningful, appropriate interaction. Because of a few unfortunate incidents that were inappropriate, the regulation has probably gone a step too far. The normal pendulum will likely bring the regulation back to an appropriate place. But key question: should healthcare professionals be paid for their interactions with pharma? Perhaps that is not the right question. The right question might be, “what is the cost of not having physicians involved in these interactions?”  The price is far greater in terms of how you ultimately help the patient. 34:00 Leo stays on top of industry trends by being invited to participate in thought leadership forums and also having a close proximity with clients and healthcare professionals in order to understand their emerging challenges and needs. Ultimately, our jobs, when people talk about behavior change, is creating the competence and confidence in the audiences we engage with in order to create action. 37:00 As market continues to evolve, as regulations change, as dynamics internally and externally change … as agencies our focus needs to be about creating value. Not adding value. Creating it. “The competitive advantage for an agency will reside in it's ability to create clinical value.” How you unlock the power of evidence to create and deliver value for both patients and for our clients. 38:00 Insights are needed to understand what is of value. 40:00 Leo talks about the future, creating value and orchestrating skill-sets and assets.   LEO P FRANCIS, PHD – President, LPF Solutions Leo Francis is an award-winning communications professional with a unique mix of commercial and scientific expertise and a proven record of success.  He is a skilled communicator and visionary who is also operationally robust in translating scientific ideas into organizational value. He began his healthcare career in international clinical development at Gensia Europe Limited with a focus on the development of novel cardiovascular agents in surgery and arrhythmia diagnosis. Leo was instrumental in the preparation of the NDA for this unique device-drug combination Over the next several years, Leo moved into medical communications leadership positions at Adelphi Group (US), OCC Europe, Ltd (UK) and Gardiner-Caldwell Communications (UK) deploying his expertise with most major pharmaceutical manufacturers on all aspects of the prelaunch/launch commercialization process from clinical study design, market shaping and preparation, positioning, thought-leader development engagement, healthcare organizational alliances, value proposition development and tactical deployment of medical communication strategies at both the domestic and global level. Since being US-based, Leo's recent roles were within Publicis Healthcare Communications Group (PHCG) as President, Publicis Medical Education Group (PMEG), leading an eclectic group of six medical education agencies, following which he progressed to the role of Global Group President responsible for a portfolio of Global Advertising and Medical agencies (market research, market access, healthcare consulting & managed markets) and cross discipline skill centers (strategic planning, patient & consumer insights, data analytics & strategic services, medical insights/analysis). In 2010 and 2012, Leo was honored in PharmaVoice 100 as one of the 100 most inspiring leaders in the life-sciences industry. Thereafter, Leo has been developing his Healthcare Consulting business, LPF Solutions LLC  (www.lpfsolutionsllc.com; Twitter: #lpfsolutions) and has Pharmaceutical company and Healthcare agency clients across several business areas and therapeutic categories.   Leo's holds a Ph.D. in Physiology and Pharmacology from the University of Central Lancashire, UK

Faculty: Camille Bonta, NASPGHAN policy consultant

Faculty: Camille Bonta, NASPGHAN policy consultant

Faculty: Camille Bonta, NASPGHAN policy consultant

Richard S. Saver, JD, is interviewed by CHEST Podcast Editor, D. Kyle Hogarth to answer questions that physicians in research medicine will have about the new Physician Payments Sunshine Act; the new regulations mandate the a Centers for Medicare and Medicaid Services website begin publishing data provided by manufacturers on payments to physicians. Topics they cover include how patients might use the website, how physicians might monitor what is reported, and which entities are required to report.

If a sales rep leaves behind a pen or post-it notes on Monday, and for whatever reason you start prescribing more of their drug on Tuesday, are you in violation of this new regulation? Are you required to keep track of how much the lunch with your contact lens rep costs and if you don't, is there a penalty?  What if the lunch was $9 vs. $20?  What if that lunch is a buffet at your state meeting  and during that meeting, you walk through an exhibit hall and pick up a pen.  Is that a problem? The Sunshine Act is addressed by two industry veterans from Alcon and Vistakon.  Even if you do something as seemingly benign as attend an industry sponsored CE event, you should listen to this show to learn about this important new law.

A series of independent, unsupported programs developed by theheart.org featuring discussions with world renowned cardiologists on the importance of the latest clinical trial findings and cardiology news.

Date Posted: 02/22/2010 Size: 5.62MB Length: 00:12:17 Thought Leader: Daniel Garen, Chief Compliance Officer and Senior Counsel, Siemens Healthcare Sector, USAIn an exclusive interview with PharmaVOICE, Mr. Garen shares his expertise and insights on a variety of commercial compliance issues, including The Sunshine Act, Healthcare Reform, the Foreign Corrupt Practices Act (FCPA), and how companies can create a culture of compliance through proactivity. Mr. Garen is also the keynote speaker at the upcoming Marcus Evans' Commercial Compliance for Pharmaceutical and Medical Device Companies Conference, April 12-13, Washington, D.C. For more information about the conference, please go to: http://www.marcusevansch.com/commericalcompliance.Play PodcastFor more information on how you can be featured in a podcast, contact Dan Limbach at dlimbach@pharmavoice.com or call him at (847) 594-0157.