Medicine Meets Business: Greg Sawchyn’s Unique Approach to Healthcare Innovation | Nursing Home Series | Senior Care

Anthony Codispoti: Welcome to another edition of the Inspired Stories podcast where leaders share their experiences so we can learn from their successes and be inspired by how they’ve overcome adversity. My name is Anthony Codispoti and today’s guest is Dr. Greg Sawchyn, Regional President at WellBe Senior Medical. Now, WellBe specializes in caring for older adults facing complex or chronic conditions. Their mission is to help patients lead healthier, more meaningful lives through compassionate personal care while promoting physical, social and emotional well-being. Greg joined WellBe in December 2022 and has a strong background in value-based care. He previously served as Vice President of Value-Based Care at Sound Physicians and Senior Director of Product Strategy and Innovations at Ohio Health. Greg is also a physician with an MBA in Corporate Finance from the Ohio State University, which gives him a unique perspective on both clinical and business strategy. Through his work, he has helped design programs that improve patient outcomes while reducing unnecessary costs. Today, we’ll learn how Greg’s leadership and medical expertise guide his team at WellBe to deliver top-notch care to seniors in Ohio. Now, before we get into all that good stuff, today’s episode is brought to you by my company, Add Back Benefits Agency, where we offer very specific and unique employee benefits that are both great for your team and fiscally optimized for your bottom line. One recent client was able to add over $900 per employee per year in extra cash flow by implementing one of our innovative programs. Results vary for each company, and some organizations may not be eligible.

To find out if your company qualifies, contact us today at addbackbenefitsagency.com. All right, back to our guest today, the regional market president of WellBe Senior Medical, Greg Sauchen. I appreciate you making the time to share your story today. Greg Sauchen Thanks, Anthony, for inviting me. Okay, so Greg, before you started your professional career, you obtained a lot of formal education. You have an undergrad degree, an MD, medical degree, and an MBA, all from the Ohio State University and all back to back to back. Sometimes people will get a degree, go work for a while, figure out that they need some additional schooling, but you got it done all in one fell swoop. Did you have a vision of where you wanted to go in your life right from the start?

Dr. Greg Sawchyn : Greg Sauchen Yeah, I think that from my history, I don’t necessarily recommend it for everybody. It’s one thing where things progressed and fell into place, and I just went with the momentum. To be honest with you, even throughout undergrad, and it doesn’t really show necessarily just by the end result, but I kind of went between science and business the entire time.

Actually, the stream said it would pause, but I guess not. So I actually switched my major like four or five times in undergraduate between science and business, and I still managed to get out in four years. So that was definitely an accomplishment. And then, you know, stayed at Ohio State at the time. He’s the current chief medical officer over at Ohio State. Dr. Thomas had started this like combined MBA and MBA program.

So you could actually go in and do a combined degree between getting a medical doctorate and an MBA and decided to join on with that and pursue it until the end. And there were a couple other folks in my class. I actually keep really good touch with all of them. And so it just ended up working out that I wanted to be in this space between the science, the medicine, and the business side throughout. And I kind of charted that path through my career in a kind of back and forth kind of way.

Anthony Codispoti: And so, yeah, you mentioned that in undergrad, you kind of went back and forth. So you had an interest in both areas from an early age. Where did that come from? Did you grow up in a household of doctors or business people?

Dr. Greg Sawchyn : No, I’m actually the first person in my immediate family to go to any college. You know, my mom is a registered nurse. I retired. But, you know, back then, you didn’t really have to go to college to be a nurse. You kind of went from like a high school to just go get an RN in nurses training. And my dad just really had a high school education. So I kind of grew up a little bit around nursing.

But, you know, really, it was kind of high school, right? I just really enjoyed science and learning more about it. And but at the same time, I enjoyed numbers and business and numbers seem to go together for me. And, you know, I’ve just kind of tried to push those two things together throughout my career.

Anthony Codispoti: So let’s maybe talk about some of the stops along the way. I’m looking at your LinkedIn page here. Right out of school, it looks like Lancaster Pollard. You were associate and then a VP there. What kind of what did you learn here?

Dr. Greg Sawchyn : Yeah. So Lancaster Pollard, middle market investment bank focused on hospitals and senior living. You know, I actually had the opportunity during my MBA to meet somebody who was already working there. And, you know, really, he told me about the firm.

So he was going to get his MBA plan to go back to the firm. And it just seemed like a good fit. Got to know them a little bit over the course of probably about a year. And then ultimately decided to join the firm right after I finished my MBA and MBA. Had the opportunity to really start learning about how the healthcare system works from the business side. So you go to med school, it’s all science, it’s all, you know, physiology and, you know, how to take care of patients, which is great.

I mean, that’s that’s what it should be. But your typical MD gets out and they really don’t know anything about the sort of business of medicine, maybe to the detriment. And I think that if you talk to most doctors, they would say that that they wish they had more of that training during their medical career.

And then similar with MBA, like it’s very sort of generalized business kind of education, not a lot about healthcare specifically, but just generalized business things. So by going to Lancaster Pollard, it really gave me the opportunity to kind of get some of the drivers of healthcare business. You know, what I really focused on there was critical access hospitals. So there’s a program that exists in the federal government where a hospital can get what’s called a critical access designation. So if you have 25 beds or less, you can be a critical access hospital.

And either some special reimbursement rules with Medicare, the way that works. This critical access hospital designation really came into the popularity kind of when I was kind of starting with that in the mid-2000s, where a lot of Hill Burton hospitals. So Hill Burton was an active Congress back in I think like 1950s that allowed a lot of these rural areas to build hospitals. But they’d always struggled to retain medical staff, to be profitable. And so a lot of these facilities were in somewhat disrepair. And then some more favorable reimbursement came online in mid-2000, and that gave them the opportunity to replace their facilities, renovate them, and things like that. And so we did a lot of business doing that. And I got to learn a lot about hospitals, especially in rural areas and the drivers. And it was a really great learning experience for me.

Anthony Codispoti: What is this critical access hospital designation allow? What’s the advantage of having this?

Dr. Greg Sawchyn : Yeah, so typically under Medicare, you get like a DRG reimbursement for an inpatient admission. So basically like Medicare will say, hey, this patient’s in your hospital for heart failure, and then we’re going to make some adjustments to it. But we’re going to give you $6,000 for that admission. It doesn’t really matter what your costs are, what the inputs are, or anything like that. It’s just sort of a flat payment. What critical access did was kind of take the reimbursement system back to the way it was before the DRG system came into place, where there was like a cost plus reimbursement. So basically they got 101% of their costs.

And there was very formulaic how you actually came up with cost. But that included interest and appreciation on a building, a hospital building. And so because of that, that allowed them to go out and actually issue bonds, and borrow money to replace or renovate their hospitals.

Interestingly, besides critical access, the other sort of DRG exemption that exists out there are like National Cancer Institute facilities. So it’s complete other end of the spectrum from like a 25 bed. And I even worked with hospitals that had like seven beds to like the James Cancer Institute, where they have an actual similar sort of reimbursement structure that allows them to build very large and nice buildings.

Anthony Codispoti: And how has this critical access hospital designation actually played out? Is it proved helpful? Is it helping these hospitals and sort of these smaller towns stay afloat?

Dr. Greg Sawchyn : Yeah, I mean, it’s tough right now for small hospitals in rural areas. So, and I think this has helped. It hasn’t solved all the problems. I mean, there’s a number of issues. One, in order to operate a hospital, you have to have a medical staff. You have to have physicians that are willing to be there. The reality is, is it’s harder to attract physicians to want to practice in rural areas.

You actually, as a physician, can make a lot more money going in a rural area than you can, even in urban areas, somewhat sort of backwards of what you would expect. But, you know, that’s one aspect. And the second one is just by having a smaller facility, you still have to have resources and things like that.

So it is more expensive to operate. And so, you know, it has been very tough and continues to be so for rural hospitals. And then you see a couple of strategies. So, you know, one, they, you know, they’re trying to just hang on. You have seen a lot of facilities close, or they affiliate with a big health system, like in Ohio Health or Ascension or, you know, somebody like that, that can give them an umbrella to help allow them to continue to operate in a rural area. But it’s, I wouldn’t say that it’s been solved by any stretch of the imagination.

Anthony Codispoti: So in 2009, you moved on, you founded your own company. What was that?

Dr. Greg Sawchyn : Yeah. So, you know, in 2009, I ended up sort of breaking off from Lancaster Pollard and started my own financial advising company and started taking on sort of finance consulting sort of gigs as well as operational consulting gigs, really catalyzed by a necessary move in my personal life. So my wife’s also a physician and she got a fellowship, a very great fellowship in ophthalmology in Philadelphia. And so we ended up having to go out there, which, you know, kind of took me away from all these critical access hospitals at Michigan that I was working with. But, you know, it ended up being something that was a huge risk.

I mean, like, you know, I ended up, you know, walking away from a job, a study paycheck, and now you’re on your own where, you know, if you’re not bringing clients and things like that in the door, you just don’t get paid. Like, there’s no such thing as vacation time. There’s no such thing as sick time. There’s none of that. It’s just, you know, whatever you, in medicine terms, you use this term, you eat what you kill.

Anthony Codispoti: And when you’re talking, yeah, when you’re talking about bringing a hospital in, bringing them in for what purpose? The service of?

Dr. Greg Sawchyn : So to consult with them on similar sort of financing arrangements. So like, I would work with either hospitals on, you know, like a renovation or, you know, something like that they want to do for their facility, but actually ended up kind of migrating more towards working directly with physicians and physician groups on joint ventures with health systems and medical office buildings and things like that and end up being a really nice niche that with the MD and working with other physicians, you sort of like, you get what, get what makes them tick and, but you kind of bring this like, a little bit more business experience to them so that as they’re doing these negotiations with health systems and things like that, then, you know, they’ve got somebody in their corner who can really operate at the same level as the, you know, specialized people at the health system when they’re talking about joint ventures and things like that.

Anthony Codispoti: What do you think the future of these small rural hospitals is? My mother-in-law is affected by this up in northeast Ohio. They’ve had their hospital close and bankruptcy looming and acquired. Is it going to be acquired? Is it going to be shut down? And it seems like it’s kind of a common story right now.

Dr. Greg Sawchyn : It is. Unfortunately, that’s the case. I mean, I think when you look at the spectrum of healthcare, what used to exist in rural areas as well as urban areas is like you build a hospital and then that hospital provides all services to all people and, you know, that from, you know, OBGYN services to, you know, complex surgeries and things like that. The reality is that’s just not going to be practical. I mean, like, you know, a rural hospital with 25 beds isn’t going to be able to hire and retain a cardiovascular surgeon for just that facility. It’s just there aren’t enough cardiovascular surgeons around and they’re probably, honestly, it wouldn’t be enough volume at that hospital to really justify the expense. And so what I think you’re going to see over time, and I think you already are seeing quite a bit of it, is, you know, clearly you need hospitals, you need facilities in rural areas, or people can’t live there. I mean, you need healthcare. It’s not going to be all telemedicine.

You know, it’s just not practical. You know, you need to be able to lay hands on people to be able to take care of them, especially in an emergency. So I think what you’re going to see is, you know, these like emergency rooms with, you know, call them emergency room plus, where I can treat you in an emergency. I can do some observation. I can do some procedures.

I can stabilize you. But if you need something big, then I got to transfer you to a bigger facility. And similarly, like even in cities, like you have these sort of mid-tier hospitals with like 100, 150 beds, you can make a strong argument that like those facilities shouldn’t really exist either. Like if you really want to get efficient, there should be a couple very large facilities that have, you know, everything 24-7, you know, hundreds of ORs, you know, that kind of thing to really take care of complex conditions. Because it’s one of those things where, you know, there are economies to scale. And as you see in medicine, the technology, which is amazing, isn’t cheap. You know, I think that even in Columbus, Ohio here, that a bunch of the health systems kind of got together to buy one of these like protein beam therapy things for cancer.

Because they just realized it like, hey, we’re not all going to buy one of these on our own. So we just need really one for the city. And so that’s what they built.

Anthony Codispoti: So what is that protein beam therapy?

Dr. Greg Sawchyn : You’re getting out of my, you’re getting out of my area of expertise, but it’s a radiation sort of treatment modality that has like a very focused beam to go after like a tumor in cancer. So like normally like radiation, you radiate everything.

My understanding is like the protein beams more, functions more like a laser, where it’s like a very direct hit of a certain type of radiation to a tumor. But you need to, they’re very expensive. I want to say like they spent $50 million on this thing. And you know, somebody could probably correct me on that.

Anthony Codispoti: Like I’m, you know, are there specific types of cancer that can be used on?

Dr. Greg Sawchyn : Yeah, yeah, I mean, yeah, yeah, you really have to ask an oncologist for the details of that.

Anthony Codispoti: We’ve really gone outside your realm. Okay, let’s, let’s bring it back.

Dr. Greg Sawchyn : I think probably most solid tumors and you know, things like that, you would probably, you know, be this, but whether that or traditional radiation, you’d have to ask an oncologist for sure.

Anthony Codispoti: You don’t want my opinion. And this is something I appreciate you staying in your lane. Yeah, yeah, exactly. Like trust the experts. And I’m not an oncologist. All right, so let’s go back to the business that you started back in 2009. Looks like you ran through 2017. What was something you did there that you’re most proud of?

Dr. Greg Sawchyn : You know, there was a physician group that was in a joint venture with it already done this joint venture with a large health system. And that health system for its own sort of financial, you know, difficulties was really trying to strong arm them into, you know, selling this asset.

It was a medical office building to a REIT, a real estate investment trust. And this was like back in like 2009. And so it was, you know, the middle of the great financial crisis.

So, you know, everything was going for fire, fire sale prices. And this health system was just trying to unload this asset for its own cash reasons and everything else. And they were trying to bully this, this physician group and kind of going along with it. The physician group brought me in and said, hey, you know, I’m not sure this is a good deal that they’re trying to do.

And, you know, I kind of, you know, helped them and went through the financials and everything else. And it was not a good deal. It was a terrible deal. Basically, they’re going to be selling it for just a little bit more than the debt they owed on it. They would have walked away with their investments, but not much else.

And so we kind of put some strategies in place basically to assert their control over this joint venture and, you know, just kind of delay things. And sure enough, the market kind of settled itself out and things started coming back. And we actually did end up selling it.

I think it was two years later. And they all realized actually like a 10x return on their original investment. Because, you know, like that’s the way leverage works, right? So you have like a bunch of debt on something and then the equities based on sort of the gap to that debt. And so the asset itself was probably valued at, you know, call it 150% of what this health system was going to sell it for. But because of that, their equity went up something like 10x. That’s what they got to go home with. So, you know, I was just happy because I was proud of it because, you know, you have physicians that, again, they don’t get a lot of business training.

They don’t get a lot of that. And then, you know, somebody was really trying to take advantage of them financially. And, you know, it was kind of why I decided to do that during that part of my life was to kind of be in their corner and kind of give them an equal seat at the table of, you know, how they could really operate.

Anthony Codispoti: Oh, it had to feel very rewarding. So you had this company till 2017, about almost eight years. Then you decide to kind of wrap that up and move on. What was behind that decision?

Dr. Greg Sawchyn : Yeah, so it’s interesting. So I, you know, I started at Ohio Health. And Ohio Health was effectively like a client of mine. You know, they were kind of getting into value based care, got to know Dr. Bruce Van Der Hoff, the chief medical officer there at the time.

He’s over at the Ohio Department of Health now. And just, you know, really had a good relationship with him. And he kind of told me about kind of what they were looking to do and whether I could be helpful with that. And so I said, yeah, like, let’s, let’s do this. And then actually took them on and they were, you know, a large client, I was spending half my time there. And eventually, they said, Hey, you know, we want to, we want to do more of this. Do you want to come on full time?

And I said, Yeah, I think so. I’m at a time in my life where that makes a lot of sense for me to do. And I love the work that I was doing in this value based care space. So made that move and decided to kind of let the other sort of consulting stuff run off and join Ohio Health full time at that point.

Anthony Codispoti: Yeah, there’s definitely there’s security, especially as you’re starting a young family, there’s security and, you know, kind of having a regular stable paycheck from, you know, a well established employer like that. And so you started out and director clinical guidance councils, you moved up supply chain medical director, senior director, product strategy and innovation kind of tell me about this ascension.

Dr. Greg Sawchyn : Yeah, so it really paralleled what Ohio Health was doing in the space at the time was, I’d say when I started there, they’re very early in sort of this value based care journey. And really is a hospital system, they’re going through a lot with a lot of health systems were going through at the time is that, you know, you essentially had this, call it confederation of hospitals, you had a bunch of hospitals that it always just kind of operated independently, but were part of a system because there’s some leverage there and reasons do that.

And under the leadership at the time, they said, Hey, we really want to become a system, like we want every all the pieces to actually work together. We want the system to be before the sort of confederacy of hospitals from a confederacy to a federal system in more ways than one. And so, you know, as they did that, they started these things called clinical guidance councils to bring in the specialty areas from the different hospitals and kind of agree on standards of care and practice and best practices amongst all the hospitals so that where you would go is at the end of the day, if I went to one hospital or another hospital or another hospital, and you had the same condition, you’d be treated in the same way that wasn’t necessarily true prior to that work.

Anthony Codispoti: And then as you know, this is really about standardizing the care across all the different locations.

Dr. Greg Sawchyn : Yeah, yeah, in an evidence based way. So like, you know, you kind of looking at what’s the literature say that we should be doing and looking at sort of the best practices from a lot of like really smart experts in the room and whatever the specialty was. Again, it was one of those learning experiences where you know, you definitely trust the experts in the room, like when you get a bunch of really smart, like critical care doctors around a table, you know, you’re going to get a good result at the end if you just listen to them. And that was sort of our approach there to look at the different specialties of medicine and really come up with those best practices.

Anthony Codispoti: You’ve used the term value based care a couple of times, I can kind of infer what it means by you know, the words in the phrase, but the fact that you keep packaging them together, I have a feeling it kind of has a bigger meaning here.

Dr. Greg Sawchyn : Yeah, I mean, you know, like there’s a lot of definitions out there and people will say value based care is this or that at the end of the day, it’s doing what’s most efficient to get you the best result, which you know, for any business or practice or specialty or trade, I mean, that’s ultimately what you’re trying to do.

How do I employ resources in an efficient way to get the best result at the end? And you know, it’s taken different flavors throughout that, but it’s really a shift in thinking from the way medicine has traditionally operated like traditionally, it’s like you show up in the ED and it doesn’t matter what’s wrong with you, I’m going to pay you the same amount and you’re going to get the same sort of thing. Value based care says, okay, well, let’s look at do you have something that’s serious, do you have something that’s not serious, and we’re going to treat those and pay for those and, you know, apply resources to those in different ways, depending on, you know, what we expect the ultimate outcome to be.

Anthony Codispoti: So your time there at Ohio Health, what was the thing that you’re most proud of?

Dr. Greg Sawchyn : You know, we came up with a way to be innovative and the, you know, giant, you know, 30,000 employee organization always has, you know, some difficulties with innovation, I mean, but it operates as a bureaucracy almost by necessity.

And, you know, the momentum and the flywheel kind of do their thing, and kind of changing that is very, very difficult. One of the things we actually did was come up with a fund to effectively internally seed, like in like a venture capital kind of model, innovative things coming from clinicians that were evidence based, that might have a major impact on, you know, efficiency or better care and things like that that just didn’t make sense necessarily in sort of this fee for service world. So I want something that’s, you know, FDA approved and, you know, evidence based and everything else, but the insurance companies don’t pay enough for it to cover the cost of the intervention. But it’s still the right thing to do for patients.

Anthony Codispoti: We’re talking about like, I don’t know, different pieces of hardware or different medications

Dr. Greg Sawchyn : or There were some of that hardware medications. We actually, one of the things was like an analytical tool that we could build into the EMR to like kind of push out evidence based medicine of, you know, what’s appropriate to order an MRI on and what’s not and, you know, that kind of thing. And but yeah, exactly that of kind of looking at some of these things that, you know, don’t necessarily get drastically reimbursed cost more than what we’re currently doing, but might result in a better outcome at the end.

And then we, we measured all that as we did these sort of fundings or and, you know, looked at the end and said like, Hey, this work, this didn’t work. You know, this is one of the things that made a lot of sense, you know, one of the to give you an example, one of the things that, you know, we did that I really enjoyed doing it was because it was novel. And it was one of those things that like this, this makes a lot of sense was like a special nutritional shake for people going into complex oncology surgeries. All right, so like I’m going to give you a bunch of these like milkshakes, there was no dairy, you know, but I’m going to call milkshakes anyways. I’m going to give you a bunch of these milkshakes and I want you to take like, I remember it’s like two a day for a week before your surgery, because there were some evidence out there that these things made a difference in post surgical complications, faster recovery, you know, things like that. And so these shakes, just vitamins or yeah, it was, you know, they’re kind of like an insure shake, but they had some extra stuff in them.

There’s called like immunonutrition. Pixie dust. Yeah, exactly. I think I mean, they were like made by Nestle and you know, it was a, it wasn’t much of chocolate or you know, it wasn’t like Nesquik or anything, but

Anthony Codispoti: so it wasn’t a product that you guys developed, but you wanted to include this in the course of

Dr. Greg Sawchyn : the yeah, we did not develop it. But it was something that was on the market, but not very widely used, partly because like there was no reimbursement for it. So you like, you’re a hospital system, and I’m going to go do a surgery and my surgery costs this amount. And I can do that surgery and get my reimbursement by just doing these things. Why would I go out there and spend an extra $100 for a bunch of milkshakes for the week before surgery?

If I’m going to get paid exactly the same amount, whether I give you the milkshakes or not. And so, you know, this was one of those things that like there’s no way they had no reason to approve that in sort of like this fee for service, like maximize profit kind of environment. And so we used it like I said, they didn’t cost much. I mean, it was like $100 for a course and these people are going in for $10, $20,000 surgeries. It wasn’t an overwhelming amount.

But the thought is, is that you have faster recovery, less complications. And you know, it was a small sample size. I don’t remember David Arisi, Dr. David Arisi is the one who kind of pushed this along.

I don’t remember if you published anything on it or not. But anecdotally, and you know, in the data that we saw, the complication rate for the patients that had the milkshakes was actually a little bit lower than the folks that didn’t have the milkshakes. Now, there could be lots of confounders and things like that in there. But it was something that was like, huh, like there’s something here. It was just really interesting to kind of look at the scenario and see how it played out for that program to get continued. We continued for a little while. I actually have no idea if they’re still doing them or not.

Anthony Codispoti: But yeah. So I mean, that’s a fascinating idea. And I love it. Like I love innovation. And I love that it’s sort of like, hey, you know, this, this isn’t something that we’re going to get reimbursed for. But this could produce a better outcome for the patient, which in the end is better for everybody, right? They don’t have to come back. You know, that saves money.

You know, it’s less money out of everybody’s pocket, it’s less time, it’s better health result for the consumer. Before we move on and talk about kind of your next couple of stops, is there one more of these innovation products that might be projects that might be interesting to hear about?

Dr. Greg Sawchyn : So let me tell you about one that actually like did not give us the result that we wanted. Because you know, like that, that one I thought we learned from those things too.

Yeah. So so one of the things that we did, there was a software suite that we could alluded to it earlier, embed in the electronic medical record, the system epic system that would, you know, it was one of those things where there was an analytic on the back end. So we kind of knew things that were evidence based, things that were not evidence based and, and kind of how that worked and who was doing certain things. And, you know, ultimately, you know, it ended up not working out. We ended up not actually turning on the alerts. There was a lot of concern, both amongst the physician and the administration, that it wasn’t, it wasn’t firing. You know, it might lead people astray. Now at the end of the day, the physician could say like, okay, well, thanks for the reminder, or I’m just going to do whatever I want. But ultimately, we ended up not turning on those alerts for, for a variety of reasons. You know, like one example of one of those alerts, you know, like vitamin D testing, people do this all the time today.

And it’s, you know, it’s sort of the bane of my existence. You know, I live in Columbus, Ohio, you know, Columbus, Ohio in February is very cloudy. You can make a bet that virtually everybody in Columbus, Ohio in February is vitamin D deficient, if you were to do a test on them, unless they just had a trip to Florida or something. So, you know, I can do one of two things. I can say, hey, take a vitamin D supplement or take a multivitamin or, you know, something like that.

You know, a couple times a week and that’ll make sure your vitamin D is where you need it to be. Or I can go get a, you know, 50 to $100 test that tells me what I already know. And then my treatment is going to be the same anyways. I’m going to tell you to take a vitamin D supplement. Maybe I’ll give you a shot of vitamin D, which, you know, doesn’t, it might raise it a little bit faster, but doesn’t really have a huge other effect. And, you know, there are conditions where you do want to do vitamin D testing. But like for the average person going into a primary care office, there’s no evidence basis that, you know, everybody comes in should get a vitamin D test. And there’s plenty of primary care docs out there that are doing vitamin D testing on all their patients, even though you already know the result. I’m in Columbus, Ohio, like in February, your March, your vitamin D deficient, just take a supplement because, you know,

Anthony Codispoti: avoid the cost of the test and you just take the supplement, which is relatively inexpensive and unlikely to cause you any harm if you didn’t actually need it in the first place. Am I right?

Dr. Greg Sawchyn : Yeah. Yeah. So, you know, ultimately, again, you know, you don’t win them all. And that continues to be a, anytime I hear vitamin D testing, I’m just like, what are you doing? What’s the indication? Why are you doing it? Because, you know, in 95% of cases, the vitamin D testing that’s being done in this country is completely unnecessary.

Anthony Codispoti: Unnecessary. Unnecessary expense. Okay. I really want to get to Welby, but you had one more stop before that. Tell us about that. Yeah.

Dr. Greg Sawchyn : So, after Ohio Health, I went to sound physicians, sound physicians, national hospital medicine, mostly organization, but also emergency medicine, critical care, anesthesia. At the time, biggest participant in the Medicare BPCIA program, the Medicare bundle payment for care improvement, advanced, I think, for the acronym for that. So, basically, taking what I alluded to earlier, hospitals are reimbursed on a DRG basis for a hospital admission. Well, now I’m going to give you essentially a payment for not only the hospital admission, but for the 90 days thereafter. And so, if you have a complication, if you have a readmission, if you go to a skilled nursing facility or an inpatient rehab, you know, that’s all sort of coming out of it. And so, the ideal scenario is you’re going to the hospital, we’re going to fix you up, and then you’re going to go home and you’re going to get better and you don’t come back to the hospital. You should be rewarded more than somebody who goes to the hospital, then goes to a skilled nursing facility, then goes home for a week, and then, you know, decompensates, gets readmitted to the hospital, goes back to a skilled nursing facility, gets readmitted.

You know, you can do this several times over 90 days, and many patients do, but the hospital system’s never really had any incentive to change that because they got paid every time that patient comes back to the hospital, skilled nursing facility gets paid for every day that patient’s in the skilled nursing facility. And so, everybody’s just sitting there like, hey, well, I don’t really care that much about the complications because I get paid every time something bad happens. Well, under this program, you kind of got paid more for having a good outcome, which, you know, aligns with really the way things should work.

You know, you, I guess you could call it kind of like a warranty. And, you know, because of that, we did this hundreds of hospitals across the country, and, you know, really had the opportunity to learn a lot about the way different health systems work. So, you know, before I went very deep into a place like Ohio Health, and now I’m working more superficially probably with virtually every, like, big name hospital system in the country in some way, shape, or form because of sounds overall reach. I think at the time we were in 400 or plus hospitals across the country. And so really learned a lot about, you know, people will say health, like when you see one health system, you’ve seen one health system.

I completely disagree with that notion. The health systems that exist in this country all operate on it almost exactly the same way. They all have the same motivations. They all have the same goals. Many of them have sort of developed in exactly the same way. They’ve taken a strong hospital, or maybe two hospitals they had in the city, and then they start adding hospitals and they grow, grow, grow. And, you know, they’re all essentially doing the same things, maybe at different paces, and maybe the political power within that system is a little bit different. Maybe the financial health is a little bit different just based on where they’re operating. But, you know, all the big health systems in this country actually all operate almost identically, no matter what sort of the headlines tell you about that not being the case.

Anthony Codispoti: So Greg, this is a fascinating model that you’re describing here, and it makes a ton of sense, right? It aligns everybody’s goals. I’m curious, how did the data actually play out?

Dr. Greg Sawchyn : So it really depends. And, you know, effectively the federal government, it might still be going, but they sort of, they rug pulled it for lack of a better way of putting it. Because, you know, there were, there were certain aspects of it that didn’t necessarily align with the way that they intended to. So like in, in certain scenarios, like if I’m going in for a, if I’m a relatively healthy person, I go in for a total joint replacement.

It’s a great program, right? So I go in for a total joint replacement. I’m in the hospital for a day.

Actually, most total joint replacements are being done outpatient now. But let’s say, you know, I have to be in the hospital for a couple of days. And then I’m going to go home. And then, like, you know, I just had my total joint because I had arthritis or something like that. The idea is I’m going to get better. You shouldn’t have done the total joint if the person’s not going to get better. But then if you have complications, if you have to do all that, then you end up, you know, not doing as well as if you do a total joint and the patient goes home. You know, for us, Medicare actually changed some of the rules where, because we were a hospital medicine group, we were disadvantaged in that kind of scenario. So, like, if you think about the way a hospital works, if I’m an orthopedic surgeon, I’m going to have somebody who comes into the hospital for a day or two days to have a total joint, no complications. I’m going to keep them on an orthopedic surgeon service, the service in the hospital, they’ll probably never be seen by a hospital medicine physician, because the orthopedic surgeons is going to come in around and say like, Hey, when looks good, how you doing?

All right, time to go home. However, if you have complications, if there was some sort of trauma or something like that that was involved, and that’s why you had to have the total joint, basically you’re a more complicated patient, you might be there for a longer time, but you’re also going to see a hospital medicine physician. Inherently, the risk of that patient is higher. And because of where sound was positioned in this, you know, it made it very difficult because like for the instance of a total joint, Medicare sort of changed the rules and said, hey, it doesn’t matter what kind of physician you are, you’re going to get paid the same amount, your target price for this episode, this 90 day episode is going to be the same.

And so we essentially had to figure out how to take very complicated patients that will naturally have a more complicated course, higher likelihood of readmission, higher likelihood of going to skilled nursing facility, not because of anything we’re doing, but because of the risk associated with that patient, evidenced by the fact that they were even seeing a hospital medicine physician in the hospital. It just made it impossible for us to do well. And so we ended up kind of pulling out of the program, basically completely, because of that. And the government shut it down.

Yeah, so I think it might even still be out there in some form, but basically all the big participants that were doing it, the amount of participants decreased like 90%. Okay.

Anthony Codispoti: And so, yeah, I guess on the surface, it sounded like, why haven’t we been doing this all along, right? Everybody’s goals are aligned. Let’s keep, you know, to do our best job to keep, you know, folks from those complications and from the readmissions. But right, there’s the wrinkle that you just threw in there. It’s like, you’ve got some patients that are just naturally more complicated. They’ve got more, you know, comorbidity factors that are at play here. And so how do you factor that all into the calculation? Yeah.

Dr. Greg Sawchyn : And so this is, you know, like that, that’s sort of the clinical aspect of it. There’s certainly a financial aspect. So let me put it on my business hat for a second. There was definitely an arbitrage opportunity that existed in target prices because of the, it was a very complicated methodology that CMS put in place. You could make an argument way too complicated. And, you know, one of the things I’ve observed about healthcare, the more complicated a system is, the more easy it is to game.

And, you know, you could shift things around and you could increase your target price, deliver exactly the same amount of care, but do really well. And so, you know, there was, there was a lot of that going on as well. So that’s essentially, you know, the federal government will say that’s why they rug pulled it.

I don’t think they’d use that term. But, you know, I, I see why they did it. But at the same time, there was a lot of good stuff going on too.

But like most things, you know, it’s, you know, I think it probably could have been tweaked more versus just saying like, Hey, we’re just gonna, we’re gonna shut this off all together because, because some players in the space were definitely gaming it. Yeah.

Anthony Codispoti: Okay, so December 2022, you joined WellBe. This is what I really want to talk about what you’re doing now. What drew you to WellBe? What did they, what did they got going on that was so exciting for you?

Dr. Greg Sawchyn : Yeah, it was interesting. So as I mentioned, like, you know, Sound was exiting this BP CIA program. So, you know, kind of see the writing on the wall, right? I’m brought in to kind of help manage this, this giant program across the country. And like, we’re, we’re going to decrease our participation by 90%. It’s like, Oh, you know, you know, got to find like, my days here are probably numbered.

So, you know, and so I sort of kind of put in feelers out there and that kind of thing. And one of the folks that reached out to me was a recruiter named independent recruiter named Steve Kloppfer. And he’s like, Hey, let me tell you about this, this company called WellBe Senior Medical. Honestly, I’d never heard of them. They were operating in Ohio at the time, I’d never heard of them. And, you know, he tells me about this company.

And I’m just like, you guys, like, I really like this, where you are with this. So WellBe overall, we’re taking care of like the highest risk seniors in their homes. And so as I mentioned, like, you know, value based care, applying resources to the people who need it the most and not necessarily applying resources to people that don’t need it. The way that WellBe works is that we’ll take sort of a patient population.

And it’s all under Medicare advantage for a variety of reasons. But basically, like, we’ll go to like an ad now and say like, Hey, give us your top 20% of sick patients. And we’ll take care of them, we’ll take full risk on them. And we’re going to send somebody out to their home to take care of them. And so by targeting this like top 20% of patients, in what is admittedly an expensive care model, I mean, it’s not cheap to put a physician or a nurse practitioner into somebody’s house to take care of them. Because, you know, like, you go into a primary care office, and they’re seeing 30 plus patients a day. And they’re just, you know, I have got 10 minutes.

Anthony Codispoti: So how does this meet the definition of value based care?

Dr. Greg Sawchyn : For WellBe? Yeah. Yeah. So, you know, primary care, 30 patients a day, I’ve got five, 10 minutes to spend with you. There’s a subset of those patients called the top 20% of sick people that need a lot more than 10 minutes at a time with their primary care physician. I mean, these are folks that one have a lot of different medical conditions. So they’ve got the heart failure on top of the COPD on top of this, on top of that. They also have potentially like a lot of sort of like social issues, like social determinants of health issues, food insecurity, housing insecurity, families that may or may not be supportive. And, you know, a lot of kind of complications there, potentially you have low health literacy, the patient and their family don’t really understand what’s going on with them. You know, because they get it 10 minutes at a time in a primary care office where the person’s, you know, typing on the EMR half the time.

Anthony Codispoti: So it’s not necessarily less expensive. It’s just more appropriate level of care. Yeah, that’s a setting that’s more comfortable for the patient. Yeah.

Dr. Greg Sawchyn : But ultimately, it ends up being less expensive. So while our physician services and our nurse practitioners, they cost money and everything else, it pales in comparison to the cost of an ED visit or a hospital admission or unnecessary care that that patient’s going to get.

And so even though our sort of physician services cost more and they don’t cost anything, the patients don’t pay anything for it. It’s all sort of covered. We’re at full risk. So we’re actually, we sort of eat our own costs as part of the part of the model. You eat your own costs. So being reimbursed by Medicare? No, we don’t.

Well, because of the billing rules, like we get a fee for service reimbursement for doing essentially like a primary care visit when we go into the home. But that’s not how like we would be underwater. We would never make money if we did that. Effectively, what we’re doing is we’re taking full risk on these patients. So what that means is that like an etna etna gets $20,000 from Medicare to take care of a patient. Today before Welby gets involved, let’s say that patient costs $25,000 a year. So etna is underwater $5,000 on these patients.

And again, these are just all relative terms. And they’re losing money on these patients. Now, it makes a lot of money on the healthier people. But you know, for these patients, they’re losing money because they’re not being well managed because they’re trying to be taking care of by 10 different specialists, each seeing this patient for five or 10 minutes at a time, getting different stories.

And you know, it’s kind of all over the place. And so the patient’s not getting any better. They’re back in and out of the hospital. We’ll come in and we’ll say, okay, we will take risk on that patient. So all right, etna, you give us the $20,000 that Medicare is giving you. And if the patient costs $25,000, and that’s on us, we’ll make up that different. But if we can get it done for $18,000, then you know, Welby makes some money. Now our model, you know, might cost, and again, I’m giving you just relatively $1,000 to take care of that patient. So we’ve gone from, you know, we’re getting $20,000 from CMS, $18,000 in care costs, our costs are internally our internal costs like $1,000. So now we’re at $19,000. Medicare gives us 20. There’s like a $1,000 profit there versus where etna was before, where they’re like getting the same $20,000 from CMS, uncoordinated care, more hospital admissions, more ED visits, and they’re coming out $25,000. So they’re losing $5,000. So it’s like a win-win. Patients in the hospital less, patient ideally is getting better. The insurance company isn’t losing money. It’s just more efficient, kind of better care.

Anthony Codispoti: What’s the single biggest factor in this being better care? Is it the fact that you’ve got one physician who is spending more time and being the quarterback?

Dr. Greg Sawchyn : So the way that we operate, it’s a concept we call a community. So we’ll have a physician and like nurse practitioners or physician’s assistants and you know some of this varies by state depending on what the laws and regs are. A community will take care of, call it 2,000 patients. And that, those 2,000 patients belong to this community and that’s a physician, a bunch of nurse practitioners, pharmacy, social work, behavioral health, you know, it’s a care team. An individual and nurse practitioner will only take care of, call it 200 patients at a time on their panel.

So they’re responsible for the care of 200 people versus, you know, 10 times that if you’re a primary care physician. Is that right? Wow. So imagine it, like you’re only responsible for 200 people. I mean, you probably know 200 people, you know a lot about them.

Like, and so like your job is just to like know these 200 people, know their families, know what their their conditions are. That patient has the well-be phone number that they can get a hold of a provider 24-7. Not necessarily their provider because we don’t make our people like be on call 24-7, 365. But you know, when you call in during business hours, you’re going to get your own nurse practitioner on the phone like, hey, John, how you doing? You know, I know you were in the hospital last week, everything okay?

You need me to come see you today. Because you know, we don’t stack our nurse practitioners with 30 patients a day with no time slots, no time to spend with people. And so if, you know, patient John needs somebody to come out just to hang out for an hour and kind of get their meds right from the hospital stay they just came home from, we can go and spend that time with them. And by getting their meds right and them not doubling up on meds and things like that, which happens very frequently, patients get discharged from the hospital. It prevents another ED visit. It prevents a readmission. It prevents John from, you know, taking too many medications and getting dizzy and falling down and needing a surgery and things like that.

Anthony Codispoti: So you may have just answered my follow up question, which is could this same model of having a community of medical professionals caring for a smaller collection of people work where you’re not going into the homes, where they’re still coming to visit you physically in a doctor’s office?

Dr. Greg Sawchyn : Yeah, I mean, that’s essentially the, and there’s other entities out there doing that, like Chen Med, all clinic based, very similar model where you have small panels, people coming into the office, Oak Street Health, same model, clinic based, complicated patients come into the, come into the office. Our difference from them is that we’re actually kind of targeting the same patients, but we’re all home based. So we’ll come out to the home versus having the patients come into an office.

Anthony Codispoti: Which is one of those models, do you think is more financially efficient?

Dr. Greg Sawchyn : Our model for sure. So, you know, you talk to the Chen Med or Oak Street, I mean, those clinics that they build are not cheap. And they’re building a clinic. It’s just a normal clinic.

Anthony Codispoti: So even though your medical professionals have got all this travel time, you know, going to see folks that the fact that you don’t have this expensive medical facility wipes out the difference of those inefficiencies.

Dr. Greg Sawchyn : Yeah, yeah, it really does. And so because of that, you know, I think that we are more efficient than those other entities. And, you know, there’s also a complicating factor here. So in order for patients to go to a clinic based thing, remember, we’re talking about the sickest patients, lots of social issues, potentially lots of, you know, comorbid conditions. They can’t always get to a clinic.

You know, you’re talking about folks that maybe they drive, maybe they don’t, maybe they have a family that can drive them, maybe not. We deal with a lot of homebound patients. You know, there’s, we have a great success story of a patient down in the Cincinnati area that hadn’t been out of her house for a significant amount of time.

They might have been measured in years, except, you know, they would have a child that would take them to some of their doctor’s appointments every once in a while. Until we got in the home, like we didn’t know, nobody knew that this patient couldn’t get out of the house otherwise, because they were wheelchair bound and they didn’t have a ramp. And so one of our social workers called up an organization down in Cincinnati and that happens to build people ramps.

And so they literally went in a weekend, you know, took them, you know, half a day, they built this ramp and the patient was able to get out of her house for the first time without assistance in years. And it’s just one of those things, one, from like being able to go and kind of recognize that situation and do something about it, that patient’s life was materially improved by that taking place. And nobody that patient was seeing in a clinic had any clue that that was, was the situation. And so you have these patients not only in that situation, but also they just can’t get out at all. Like, you can’t get a ride from your daughter to your doctor’s appointment, you’re going to miss the appointment, you’re gonna have to reschedule it. Well, that might have been an important appointment and now you’re in the ED two days later because you, you miss an infusion, you miss some medications.

By us going into the home, you have the ability to take that complicating factor of getting the patient from home to the clinic out of the equation. And I think that is something that is sort of underappreciated as a huge risk factor of patients not showing up. You talk to any physician in the country and ask them, you know, how often do all your patients actually show up for their visits? And, you know, there’s the reason why a lot of physicians get overloaded is because all the patients actually show up is actually a kind of operates like an airplane model, where they’ll sell more tickets than they actually have seats because they know some people just aren’t going to show up. But if everybody shows up, then they got to figure something out and just work extra.

Anthony Codispoti: What’s the data show, Greg? In terms of improved efficiencies, better patient outcomes with your model versus the traditional.

Dr. Greg Sawchyn : Yeah. So, you know, our model, we do have a demonstratable month over month over month decrease in overall patient costs. Now, you can make an argument like, hey, you know, everybody’s cost going to decrease because you’re taking the most expensive people. You know, when we have a population, we call them like engaged and unengaged people. So, not everybody agrees to our services right away.

Like, you know, we’ll call them up and they’ll say, hey, we’re from Wellbee, we work with your insurance and, you know, we’d love to come and see you. I got who are you guys? Like, I don’t know who you are. Like, I know you can’t come and see me. You know, like anybody, somebody calls you up and asks you something. If you get them to pick up the phone, which, you know, I never pick up the phone.

If I don’t recognize the number, you probably don’t either. And our patients are the same way. You don’t get seen. But we do have a lot of data on them because we’re already at risk for them. So, we’ll actually look at people that never see us and we’ll look at people that see us. And we consistently see the cost going down to the patients that see us, whereas the patients that don’t see us see their like level or they’re kind of moving up a little bit. So, we have very good data that shows our model works. We also have other objective data on quality. So, like HEDIS, which is a Medicare Advantage stars rating. So, like there’s different rules in Medicare Advantage that there’s certain advantages if you deliver high quality care and quality, they have like 20 something measures from like, you know, breast cancer, colon cancer screening to if somebody prescribes you a stat and are you actually taking they measure all this stuff objectively. The number of stars ratings that our patients have are generally, you know, four and a half fish stars out of five. And our patients typically come in because these are again very complicated patients like two, two and a half stars for that population. And so, we’re materially like even the way CMS measures it, increasing the quality of care that’s delivered to these folks.

Anthony Codispoti: Is the data that we’re sort of talking about in the general sense, is it considered proprietary private information or like would you be able to send us links to somewhere on your website that we could put in the show notes that, you know, people could kind of look at this?

Dr. Greg Sawchyn : I’m sure some of it’s proprietary, some of it’s out there. Like I know that on LinkedIn, you know, we’ve all been kind of posting this thing about our stars rating because we’re very proud of that. You know, like we’re, you know, it’s a challenge for all Medicare Advantage plans to deliver sort of high quality and, you know, get to five stars. And the patients that we take care of, like I said, they come in two, two and a half stars are really the patients dragging down an entire Medicare Advantage population for a payer.

And then by us taking some of the toughest patients and getting them to that, you know, kind of highest echelon, it really bumps up the entire plan. So, we’ve kind of put a lot of that data out there. And I’ll try to find you a link and send it to you.

Anthony Codispoti: Yeah, if you can, I think that would be neat for everybody to check out. I certainly know that I’d love to see it. So, what is your role then, Greg, as the regional president?

Dr. Greg Sawchyn : Yeah, my role is to kind of coordinate all the resources in a market, as well as, you know, coordinate things with health plans and, you know, do a lot to just make sure the market is running well and making sure that we’re meeting our metrics and that we’re not spending too much money and, you know, that kind of thing. So, you know, I kind of take care of our Ohio market, which is our biggest market.

We’ve got like 40,000 attributed patients here, but I’m also covering New York, Oregon and Utah as well. So, it’s a little bit of travel. It is. Yeah, it is. But it’s very, it’s very doable. I’m kind of used to it at this point.

As I mentioned, you know, from previous consulting to Ohio Health, one of the things that I did there was, you know, there was a lot less travel involved by going to Ohio Health. Not my kids are old enough. I know we were talking, you know, just a little bit ago, I got a 14-year-old, 11-year-old and almost 9-year-old, and they’re old enough now that, you know, I can do a little bit more travel. And, you know, honestly, I don’t mind going to Park City, Utah at all.

Anthony Codispoti: That’s not too rough. Yeah.

Dr. Greg Sawchyn : Our office is in Salt Lake, but we’ll, you’ll divert while you’re out there.

Anthony Codispoti: Yeah. Got to put in a little R &R time too. Yeah. So, is there a big focus on growth at the moment? Yeah.

Dr. Greg Sawchyn : So, we’ve been growing kind of like crazy. I mean, it’s been a wild ride. I mean, so I’ve been here a little, going on two and a half years now. When I joined, there were less than 200 employees at Welby. We’re currently at right around 1,000 employees. So, you’ve grown 5X in just from number of employees in two years. And I think our overall attributed population of patients has grown maybe even a little bit faster than that. And so, yeah, it’s been, it’s been a wild growth ride for sure at Welby.

What do you attribute that growth to? I think we’re in the right place at the right time. I mean, I think, you know, this home-based care is something that I think people are starting to recognize for the same reason that I just described with, you know, some of the deficiencies of a clinic-based model for this patient population is one thing. Two Medicare Advantage plans are very focused on their STARS ratings. And as that data kind of gets out, we’re getting a lot of phone calls of Medicare Advantage plans that are looking for that help. And so, you know, I think generally you have a space right now where everybody is trying to figure out what’s the best way to take care of these like really sick people, these top 20% of a patient population. And I think there’s just universal recognition in the medical community that you can’t just force these people into a, you know, 30 patient a day primary care model and expect to get a good result at the end.

You need to be able to spend more time with these people, ideally in their own setting like home, and, you know, hold their hand. I mean, like, you know, some of what we do is, you know, we provide medical care. I mean, we’ve got physicians and nurse practitioners, but I’ll tell you, like the secret sauce is really listening and giving the patient and their family the time to ask questions, to understand what’s going on, to be able to work with them, to hold their hand. I mean, like that more than the medical care we provide, which, you know, all these patients have 10 specialists that are providing great care. But like, nobody’s ever tied it all together.

Nobody’s ever asked a patient like, Hey, what, how do you want this to go? You know, like, what, what is your interest? You know, do you understand what’s going on with you? Do you understand where this goes?

And what do we want this to look like? And just, you know, being able to spend an hour or two hours with the patient and their families, which in many cases, nobody’s ever done, despite all these complications, that that’s really what makes the big difference in the care that we’re providing. I think people are recognizing that.

Anthony Codispoti: You guys are looking at the physical, the social and the emotional well-being.

Dr. Greg Sawchyn : Yeah. Yeah. And honestly, I think like the emotional part, you know, like you, you have objective data and everybody likes numbers. But, you know, when you go on one of these visits with one of our nurse practitioners, it’s, it’s just being there for the patient, listening to them, you know, listening to their family and, you know, helping them out where, where they need help. And, you know, that’s something that is, is not really capable of being done when you’re seeing 30 patients a day.

Anthony Codispoti: Greg, do you think that this model could work for patients that are outside of the sort of 20% most ill? Or do you think it specifically works just for that population because of all the things we’ve talked about?

Dr. Greg Sawchyn : It would have to be different. So, you know, our goal is to make in-home care accessible to everybody in America. So the model that we’re delivering to this top 20% of patients, like, it would not make sense for a provider organization to deliver me that level of care. Like, honestly, like, I’m, fortunately, I’m in pretty good health. I go to my primary care doc once a year.

They do a little blood work that may or may not be evidence-based, but I have to do it because of health insurance and biometric screening and the whole deal. But, you know, and that’s all I really want. Like, honestly, I don’t, I don’t want somebody in my house once every couple months, you know, for an hour talking to me about my health.

I’m like, I’m fine. I’d like, how about we skip the visit? I’m just going to go for a run.

We’ll just call it a day. So, yeah, like the exact model that we’re delivering would not work for everybody. There’s a flavor of it that would. I mean, like, you know, like, honestly, my experience could be improved potentially by going all telemedicine with, you know, delivery of services to me. Like, you know, if you need blood work, it’d be really convenient if somebody just came to my house to take my blood. Now, whether you can make that work from a business sense or whatnot, you know, I don’t know, but we’ve got plenty of growth ahead of us with this top 20% population. And honestly, those people need it more than me. So, you know, I think that’s going to be our runway for the foreseeable future. But ultimately, our goal is to be able to provide in-home care for everybody in America.

Anthony Codispoti: Greg, let’s shift gears. I’d be curious to hear about a serious challenge that you’ve worked through in your life. What was it? How’d you get through it? What did you learn?

Dr. Greg Sawchyn : Yeah, I mean, you know, I think like even going back to my consulting days is a good example. You know, I, during that period, took on another big client that was taking up, you know, half my time. Venture-backed, working with Israeli medical device companies.

And it was a really novel approach to how to bring, you know, sort of single device kind of companies with, you know, really novel things to the United States. And ultimately, you know, it didn’t work out. The company ran out of money. And so, you know, from that point, you know, having to go through as, you know, an executive on this team to not only telling everybody working there that, hey, like, we’re closing up shop, but then also like effectively firing yourself. You know, that was tough. I mean, like, you know, like I said, I was spending half my time with that company at the time. It was just a good chunk of change that I’m like, yeah, Greg, you know, you look in the mirror and it’s like, you’re fired too. And there’s nothing you can do about it.

You know, the situation it was. But, you know, I think what I really learned was that, you know, nothing in the professional world is really, it’s not existential. You know, it’s not like somebody just gave me a terrible diagnosis that’s going to alter the rest of my life. You know, it’s something where like, you know, you learn to appreciate like what’s really important and what’s not. And, you know, you sort of in the moment, it’s tough. I mean, like, you’re like, what am I going to do?

And, you know, it seems like really bad. I got bills to pay. Yeah, take care of.

Exactly. So, but at the end of the day, it’s like, you work it out and you’re fine. And sort of I think that that experience has guided me quite a bit in other things. It’s like, you know, like I gave you the example of the sound position, you know, if I’d changed the rules, I kind of see the writing on the wall, I’m like, well, you know, you kind of you almost approach it with a, you know, a seriousness, but you kind of have a little bit of a sense of humor about it. Like, yeah, seen this story before, let’s see where this goes. And, you know, I think that it’s one, maybe more optimistic in a professional sense that, yeah, things, things will land.

I don’t know exactly where the land, I don’t know when they exactly they’ll land, but they’ll land. But I think it’s also maybe just appreciate more in my personal life, the sort of the blessings that you have. I mean, like the, you know, I’ve been fortunate that, you know, nobody has given me a terrible diagnosis, you know, not kind of with that’s not going to happen anytime soon. But, you know, it’s one of those things like, like I, you appreciate, you appreciate every day more, I think. And you really try to focus on what’s truly important and what, what can, what can be changed, what can be mitigated, what, you know, what, what can be figured out versus what can’t be figured out.

Anthony Codispoti: It almost sounds like your experience as a physician has kind of helped to inform this perspective. You know, because you said, I mean, losing a job, I mean, that’s, that’s a huge stress.

In your case, losing a client, you know, that was a huge part of your income stream. That’s a huge stress. But the fact that, you know, you, you could sit there and say, at least I’m healthy, I don’t have a bad diagnosis. And as a physician, you know, somebody who’s worked in the medical field, I have seen that story over and over again, something that would be well out of my control, something is to use your word existential. And so, yeah, I kind of get that sense that your, your experience as a physician, you know, is kind of set you up to have that, I think, I think very healthy perspective on, on big life events like that.

Dr. Greg Sawchyn : Yeah, I think so. Now, don’t get me wrong, like the first time it happened, it feels existential. You know, like, I can’t imagine anybody who loses a job, loses a big client, has some sort of major sort of professional setback, doesn’t in the moment, especially the first time it happens, feel that it’s existential. And I guess the sort of advice that I would give them is like, there is another side, like you, you, as long as you, as long as you allow yourself to get through it, you will get through it. And you know, I see people that similarly, potentially have that, and, you know, really struggle to recover from it, not just from like, hey, I need to find another job or things like that, but that it like, it permanently scars them, and probably holds them back even further in the future. And I guess sort of like my advice is like, just lean into it, I mean, like you, you survived it, if it happens again and again and again, like it’ll, you’ll be okay. And actually, the more repetition you have, the more likely it is that you’ll even end up with like an even better result.

Anthony Codispoti: It’s interesting what you said, lean into it, almost like the, like sort of being afraid of the fear itself is, is causing it to be worse and to stick around longer.

Dr. Greg Sawchyn : Yeah, I think that’s, that’s accurate. And you know, like, I, you know, I go on LinkedIn and things like that. And you see folks that are, and I certainly, I generally, I feel empathy for them, you know, saying like, Hey, I’ve had been out of work, I’ve got, you know, 800 applications out, and, you know, two people who interviews. And it’s like, you know, I wonder how much those folks potentially are holding themselves back, because they’re almost sort of either projecting that fear, or projecting sort of a sense of doom or something as they’re kind of going through this, it’s like, you have to, you have to elevate yourself above the situation and like really focus on yourself and like what, you know, personal blessings and what personal is, is really going well and put things in perspective that like, you know, if you’re, if you’re well enough to be posting on LinkedIn, like you’re, you’re probably in pretty good health, like enjoy it, like, you know, like get out, get outside, go for a run, you know, so it’s kind of my, my sort of attitude about it.

Anthony Codispoti: Greg, I’ve just got one more question for you. But before I ask it, I want to do two things. First of all, for everyone listening today, this has been a fantastic episode. Dr. Greg shared a lot of interesting insights into the industry with us. Who do you know that might be interested in listening to this as well? Go ahead and take a moment and hit that share button, send it along to them. Dr. Greg, I also want to let people know the best way to connect with you. What would that be?

Dr. Greg Sawchyn : Honestly, it’s probably something like LinkedIn. Fortunately, I have a very unique last name. You’re not going to find another Greg Sochen. There is one more Greg Sochen. He lives in Canada, and I once met his boss on a beach in, I think it was the Bahamas. How random? Completely random. Yeah. But anyway, he does it completely different fields. So if you, but yeah, so you search Greg Sochen on LinkedIn and you look for healthcare, you’re going to find me. Honestly, like I don’t do a lot of other social, like I just, I don’t, I, I like to, as my, my kids say, I like to touch grass.

Anthony Codispoti: And Sochen for folks listening and not watching SAW, C-H-Y-N. And we’ll, we’ll have the, the link to his LinkedIn profile in the show notes. But last question for you, Greg, as you look to the future of the industry, what are some of the changes that you’re most excited about? Yeah.

Dr. Greg Sawchyn : I mean, you know, healthcare is interesting. I mean, first of all, you have technology. I mean, I think we’re really on the cusp with the combination of genetic knowledge as well as just advancements in our understanding. And, and, you know, I hate to be sort of just like living the moment, but genuinely AI, to really understand things that we don’t understand today. Like I really feel like sort of human health will be figured out probably in the next 10 years. What do you mean, human health will be figured out?

Anthony Codispoti: So I mean, statement. Yeah. So I mean, the drivers of health, which doesn’t necessarily lead to a therapeutic or treatment or, you know, I think, but, but, but just the drivers like cancer is a great example where, you know, we sort of bucket cancers into different categories based on where it starts and things like that. But, you know, part of the challenge with cancer is that it’s sort of like cell division gone haywire.

There’s different genetic mutations and things like that. It’s really hard to get your head wrapped around. In fact, I don’t think any human really can from a sort of personal standpoint of knowing everything. But like you combine like genetic sequencing, you combine that with potentially AI.

And like you’re going to have, you’re going to know exactly what’s going on with that person and hopefully how to treat them in a way that’s just not possible today. You know, I’ve, I’ve, I’ve been in sort of like the analytic space and we’ve never talked about that, but like that. It’s always been an interest of mine. One of my major switches was computer information systems back in the day.

I’m actually only a couple of classes away from a degree in that. But I’ve seen just even from like when, you know, the hype first started a couple of years ago with chat GPT, just the advancement in two years has been unbelievable to the extent where, you know, AI is effectively replaced Google for me at this point. It knows a lot. Like in, you know, things that you can ask it and it will give you accurate answers on very complex topics. I think that combined with just knowledge and especially for complex patients, I think we’re, we’re on the cusp of being able to put a 400 page, you know, medical record into an AI and it’s saying, you know, Hey, this is what this medication is the patient should be on. This is what’s going to happen next. This is, you know, and it’s all probabilistic, you know, it’s nothing’s ever for sure, but anything a physician does is going to be probabilistic as well. I think we’re really on a cusp of that happening in the next, you know, call it 10 years. I’ve really been able to figure that out.

Anthony Codispoti: Is there something that this combination of AI, analytics, genomic sequencing can already do for us that might surprise a lot of listeners? Yeah.

Dr. Greg Sawchyn : I mean, I think that a lot of it’s being used right now in pharmaceutical development. I think that’s probably a space where it’s furthest along. Some of it’s being used in cancer diagnostics, you know, like a lot of times if you, if you’re diagnosed with a new cancer, they’ll, they’ll send a blood sample or a tumor sample off to have a genetic sequencing. Even cancer targeted therapies are all, you know, some of them are very much based on mutations that you’ve had within your, your particular cancer.

And it’s very targeted in that way. So I think we’re already doing some of it, but it’s, it’s still being driven by call it the, the limitations of a single brain. And so we’re on the cusp of not being limited to a single brain or a single oncologist making decision of being able, having a brain that is legitimately capable of taking in all medical knowledge known, putting pieces together that, you know, just because a human brain can not take in all the medical knowledge ever known and synthesizing very quickly, you know, what a logical next step might be. And then, and then honestly, that’s something I’m very excited about. From, from that standpoint in, in healthcare, like I think it in many industries, you know, honestly, it’s going to be tougher in healthcare than some of the things like, you know, next year, I bet 10 to 20% of Americans are doing their taxes completely with it by taking a picture and AI just fills it out. The fact that we’re not doing it this year, like, I think turbo tax missed the ball, but maybe they’ll get it together for next year. But we’ll see.

Anthony Codispoti: All right. Well, for me anyways, you hear to hear, you heard it here first folks, doing their taxes with photographs and AI next year. It’s going to be very exciting to follow the future of AI and healthcare space. Maybe we’ll have you back to talk about it at some point. But for now, Dr. Greg Sachin, I want to thank you for sharing both your time and your story with us today. I really appreciate it. Yeah, thanks, Anthony. Thanks for having me. Folks, that’s a wrap on another episode of the inspired stories podcast. Thanks for learning with us today.