The Unexpected Lessons from a Pharmacy Tech Turned Healthcare CEO

[0:16]  Welcome back to another episode on the Hardhunter Podcast with Mr. Andrew. Andrew, where are we calling in from virtually in this world?

[0:25]  Yeah, I'm calling in from Columbia, Missouri. Thanks for having me.

[0:27]  Love it, man. And tell us what title you're holding, what organization you represent today.

[0:35]  Yeah, so I'm the CEO of Columbia Orthopedic Group. We're a private practice, musculoskeletal group, and kind of right in the heart of Missouri. And just excited for our discussion today and looking forward to all the stuff we're going to chat about.

[0:53]  love it man. And did you always know you want to get into this place? Like, did you just randomly get here? How did you land here Andrew?

[1:02]  Yeah, so, you know, it was kind of all by happenstance, if being honest. like, I wanted to be, uh, actually a pharmacist originally. Uh, and I just learned that, um, you know, counting to 10 all the time, wasn't going to be too thrilling for me. So I, um, kind of pivoted in college, uh, went more into the finance and administration world things and, uh, always been good at math and and luck led me down this path I'm on now and been with our organization eight years, four years in this role and just very fortunate to get the opportunities I've had along the way and serve and it's been great.

[1:50]  I love it man and you talked about how you wanted to be a pharmacist. you actually get a chance to experience that world?

[2:36]  Yes, I worked in the inpatient pharmacy for six years. Pharmacy tech and did a bunch of IV compounding and chemotherapy compounding and worked on installing this big automation robot. world and I've worked all sorts of shifts. O.R. Pharmacy, Night Shift Pharmacy, did a bunch of business stuff on the pharmacy side. I mean it's super exciting. Our group today owns a pharmacy so like I kind of get to you know still be a part of that world but it teaches you a lot in the pharmacy space but at the same point like from a job standpoint I don't know that I could see that as a long-term fulfillment for myself. You what they do is super stressful. I will say that because there's always doctors sending orders in and then the pharmacist is like, wait a second, man. Like, you want to order this or you want to order this? They're allergic to what you ordered. Can we sub that out and stuff like that? that's always pretty exciting, you know, to do that. But You know, I think that I kind of started from, I'd say, the bottom, you know, in the pharmacy tech world, just delivering medications to the floors and worked my way up slowly in that and just kept getting better opportunities in the hospital,

[3:22]  I love it man. So yeah, definitely got the experience into your feet, what I would say now sitting in a CEO seat. What do you think you've learned man? Just kind of being in that head of the table seat you say.

[3:34]  I will tell you the head of the table seat is, there's definitely not that feeling that I have. Some people just lead differently. I'm not somebody who has to be leading the parade. You know what I mean? Just as long as it happens and everyone is headed in the same direction. That's what I care about.

[3:46]  Mm-hmm.

[3:58]  You know, what were they talking about? Like, heavy is the crown or something like that? Like, it's definitely a job where, depending on the organization you're with, it's not for the faint of heart. You know, there's some stress that can come along with that, for sure. I think you just gotta take every day, every challenge with a lot of confidence in the fact that you're not gonna know.

[3:58]  Yeah.

[4:27]  everything and that's okay. You're gonna figure it out as you go. But if you're too egotistical to think that like you got all the answers and you don't need other people, you're gonna have some problems. And that's not my style. know, I think that I've seen a lot, been a lot of places, done a lot. I'm still learning stuff, which is great.

[4:52]  Absolutely. Yeah, man. I always hear you shouldn't be the smartest person in the room because then you're not really growing. So I tell my team that as well, like, listen, be creative. It is OK also to fail. It is OK to make mistakes so we can fix them, hopefully. But that's how we really truly learn, man, is making those mistakes. But I ask you because I think also that CEO head of the table becomes a little lonely, man. Like, who do you talk to? Who's kind of that mentor that is kind of also guiding you probably in the background that people don't even know?

[4:53]  Yeah.

[5:09]  is giving you that bug in the ear.

[5:26]  Yeah, I think that you, you've got to be humble enough to know that you got to reach out to somebody like that. Right. I had a couple of good bosses, before that I'll reach out to every once in a while, you know, and talk to them and be like, Hey man, am I, am I screwing this up? Like, what are you like? Here's what I got going on. What do you think about this? And they're like, Now you're headed down the right path. The thing is too, you need to find a mentor who's going to tell you you're wrong. Like if you're finding someone who's always going to tell you you're right, you don't have the right person. So, you know, I think finding somebody who's going to be honest with you enough to kind of crush you every once in a while is a good thing. I think like you said, like you're, you learn by failing, like fail fast, fail hard and get up and do it again. Like it's. It's not something where you're gonna just pick everything up and just head down the right path. I mean, I make plenty of mistakes, but.

[6:24]  I was going to ask Andrew, what is that one failing moment that you just thought like, what the hell am I doing?

[7:12]  man. Man, I'd tell you, I probably got so many of them. My wife, you have her on next. She could tell you there's tons of them. So I think from a professional standpoint, thinking you know the solution to something and implementing that solution and then realizing you were completely wrong, I've done that before where I put something in place. like, man, I know how this works. I see this happening and I'm not the one doing it. What an idiot, right? But you know, I think that that gave me, would say, a little dose of reality on like, okay, you need to get the people involved that are doing the job. decision because you're gonna have a better product when that's all said and done like so, know, we've implemented stuff here before where it's not been what everyone's picked right, but it's been what's best for the organization and You know sometimes when you put that head down and you start running through walls And you're looking back going. I didn't have to do that if I would have done this instead. So I think that there's a lot of Humility you should learn along the way by failing and like you got to have an environment where that's possible, too You know not not every environments like that. Not everybody you work with is like that some people treat it as such a You know scarlet letter where they're like, my god, we screwed something up. Yeah, you screwed something up. We fixed it. We moved on so So I've done and I failed plenty of times and that that's okay

[8:00]  We're moving. For sure. I remember the, I wouldn't say that I failed, but at some time it feels like you're failing, but you're really learning. And I think that's really the difference is sometimes is to remember it's like, am I really failing or am I learning? Because when you start to think you're failing, that's when you start to beat yourself up. But when you realize like, wait a minute, there's actually a learning lesson here. You're just more thankful. And it's easier said than done because in the moment you don't see that, right? Like that's just us and how we believe, but I love it, man. I love that you're in this space. that was kind of almost unexpected but still kind of aligned in that passion and purpose that we talked about. And it looks like you guys, this is an organization that started in 1965, man. If you can talk about some of the things that you guys are doing over there at the Arthopedic Center.

[8:49]  Yeah. So we've been around a while, know, 60 years now, and it was founded by three docs a long time ago, three orthopedic surgeons who kind of had the same vision for taking care of patients and delivering really high value care.

[8:57]  Mm-hmm.

[9:06]  in a very patient centric way. So we haven't really, you know, I would say from a mission standpoint, we haven't changed a lot from the beginning. You know, it's always been patient first and like, what, what do we need to do to enhance the experience for patients? with that being said, like we made a lot of changes organizationally, you know, over the last 10 years, I'd say, you know, we, we are in a big building. in a hundred thousand square foot building, which is good size you know so we've got a surgery center we've got our clinic we've got our imaging center we got a retail pharmacy we got our durable medical equipment which is like the braces orthotics you know things like that you need for surgery non surgery you know recovery stuff we've got a telehealth company that we own and run we've got a lot of varying degrees of patient enhancers I would say along the way So it's truly a one-stop shop. So the last four to five years have been really hot and heavy with adding more value here. So we expanded our surgery center back in 2020. It's the perfect time to sink a ton of money. Nothing was going on then. So we just put a bunch of money out there and thought, hell, yeah, it's going to work. And then here comes COVID.

[9:10]  Perfect.

[10:30]  But it's been great. So we were able to transition a lot of cases from a traditional acute care hospital setting to an ambulatory setting. Saves the patients a bunch of money and time, saves payers money and time, just really improves things for everybody. Second to that, we expanded our clinic. We added a... of exam rooms, we brought in new services, so we have a really robust pain management program here, probably the most comprehensive pain management program in the mid-Missouri, maybe Missouri area. We just added a new pain center actually that just opened March of this year, so it's a fully integrated pain program that, you know, we don't offer like your... traditional opioid management type stuff because you know, there's a lot of evidence that points to patients doing better with more interventional type procedures as opposed to just medication, medication, medication. So we have three physicians in our practice who really specialize in that. It's been a huge success already. Like our patients are getting access to care way faster than they have ever been before. And they're getting, you know, experts that truly just only do that. We've added interventional and vascular radiology in the last couple of years. We brought on podiatry in 2024. We brought on anesthesia in 2024. We've got some pretty exciting stuff coming up, you know, in the next, you know, six months to 18 months, it's going to be really cool. Pretty cutting edge.

[12:05]  at any AI technology or anything like that?

[12:08]  So we've got AI embedded into some parts of our practice already. We're kind of dabbling in some other AI iterations now just to see what parts and pieces we can put in. The biggest place we use AI is really in the back end, the business side of the house, right? We're working on financial data and authorization stuff and things like that. I think AI is... really become like the most overused buzzword out there in the last couple of years. And what everyone thinks or says is AI is it might not be in any vendor in the healthcare space who's trying to sell you something. They're all saying they got AI, right? But then when you get under the hood, it's not really AI. It's just machine learning or a large language. some iteration that they've coined as AI or AI adjacent is what I'll call it. And I think the jury's out on some of the AI stuff that's out. There's some stuff that's really, really slick and works great. And it's very, very tactile at taking care of remedial tasks that are repetitive. It's not. in our space, it's not able to do high functioning stuff yet. You know, and that's where like, Elon and Bezos and all these ultra billionaires are talking about AI is going to replace doctors and it's going to do this and it's going to do that. It's never going to happen. It's literally never going to happen. and the reason for that is like twofold, right? the, the patient of today, they're not ready for that. My generation is not ready for that. and it can't diagnose empathetically with a patient like a doctor can. And second to that, it's not gonna accept the liability, right? So like some doctor, nurse practitioner, PA provider, whatever you wanna call them, that patients go see. The AI can't accept the malpractice liability related to providing care. like there's a whole element of this that no one's talking about or discussing that is kind of left out there in the ether where, you know, like I'm, I'm by natural. and stuff like that. I don't see how an AI is gonna replace a service-driven environment like what we're in 100%. It's just not gonna happen. I think it's gonna augment or be additive to what we do. I just don't see it completely eradicating medicine at the degree that some of these people think it will.

[14:59]  Yeah. I think it's in a space where it's going to allow us to do more of the things that we love. as you mentioned, automate and really kind of get rid of the things that admin work, right? The repetitive questions, the frequently asked questions, like those type of things. Communication, I think it's a really good space of where AI could really be helpful on how we communicate, for sure. But I actually ask you, man, because you mentioned your generation. And I'm looking at you. You seem very young. I love it too, because I feel like a lot of our new leaders are kind of in the game.

[20:47]  Yeah. Yeah.

[20:48]  30, 40 year old group? Are you in the 30 or 40s? Okay, okay, okay, cool, cool, 36. I just, I love it, man. There's not a lot of times that we get to really speak to another CEO across the table that isn't in that space or that age group. And I think about leaders like yourself, but even leaders like, have you seen the guy that has changed P.F. Chang's and then after P.H. Chang's now he's at Red Lobster as a CEO, the young guy. I think he's like 35 or something like that.

[20:49]  37.

[20:49]  You got to read up on him, man. He took P.F. Chang's during a pandemic and I think like got it to a billion dollars or something like that. So that's how he ended up at Red Lobster. And Red Lobster, obviously going through the that crisis of almost going bankrupt. I think within the first quarter alone, he's already up to 25 percent increase. And this is a guy that's 35 years old, Nigerian, came from a different country, but understood, you know, he had the American dream and he's doing it, you know. But it just goes to show that

[20:49]  Yeah.

[20:49]  People like in the 30s, we got it going on, man. Like seeing you right now CEO, that's huge, man. I love it.

[20:49]  I think there's like, you know, there's a, I don't know, you know, there's a, there's an element of like grit and tenacity that I think we had during the nineties of like, you know, we didn't have, I didn't have the internet, know, like smartphone, of that stuff. You know, like I look at my kids now and I'm like, man, y'all are doomed. Like, what are you gonna like? My kids are like, well, I'm bored. And I remember like,

[20:50]  you

[20:50]  You probably the same way like being a kid going on a road trip and you're like looking out the window and there's raindrops and you're those raindrops you're racing them. You know, you're like, my God, he's going to get him. He's going to win. Yeah, that was the entertainment. Now like my kids are like, where's my iPad? I'm like, no, no, no, you're going to you're going to play a game. Like let's do the license play a game or something. You know, like my kids like.

[20:50]  Yup. Yup. That is so funny. That is funny.

[20:50]  so tech dependent and you know the crazy thing is like the schools embrace that too like my kids are doing like typing and computer and iPad stuff and like kindergarten and first grade and then like third and fourth grade they get into coding already and I'm like holy crap like this is

[20:50]  I'm scared actually, Andrew. I got a two and a five, so I'm not at those ages yet. But I hear friends that are trying to teach their kids math, but math is done a whole different way now. And I'm like, wait a minute, why are you teaching? That just seems complicated, like looking at some of these things. So yeah, I'm scared for myself as much as I'm scared for my kids, Andrew.

[20:50]  Yeah. I don't remember a comedian who does like the stand-up bit on like, you know, his kids failing math or something like that. And he's like, damn, we both failed math. He was helping him with his homework or whatever. I'm like, some of the stuff they learn, like even their spelling words in kindergarten, I'm like, man, that's pretty tough actually. That's a good one. You know, my kindergartner, she's like, how do you spell this dad? I'm like,

[20:50]  Hahaha

[20:50]  thank God. Okay, so they're doing like, my girls are doing like multiplication in first grade, you know, and I'm like, that's great. Like, it's awesome. So, but they are, you know, the question becomes with the generation, you know, next generation, whatever, right?

[20:50]  Yeah. Head to the curb.

[20:50]  generation says this about the following generation. You know they're like man I can't believe this is what it's gonna be like it's all worked out over time you know we've just never seen anything like this before with the technology the AI anything you know of this magnitude so it's it's a I don't know it's a every day is an exciting day to be alive right but like you gotta you gotta think like what's coming you know you know being

[20:50]  percent.

[23:06]  Like take half our life, right? Let's say we live to be twice this age. Holy crap. Like what's going to happen in the second part, you know, the second chapter is going to be even more insanity with technology and evolution and things like that. Yeah.

[25:22]  Yeah. We're still young, Andrew. We are still very young. And you are right. We've got to see. It's just always funny to even think about. mean, the computer. I was talking to some of my friend. I'm like, remember the AOL dial up when you had a CD? It was like a seven day free CD come to your house. Like you were so excited about that CD, right? We go into iPods, man, that only lasted but so long because then we got onto our phones like.

[27:39]  Yeah. Yeah. Yep.

[29:55]  Times have written computers, Facebook, the MySpace, as time has completely changed on how we even socialize, how we communicate.

[32:11]  My daughter was like, so how did you guys watch movies? Because I'm like, we had like a VHS. She's like, what is that? And we're at my grandparents' and my grandma's VHS's. And she's like, what does that do? And she like put it in the VHS player, which was built into the TV. And they're like, my gosh, look at that. It's going to eat that thing. And I'm like, that's movie. And they're like, no, it's not. Movies aren't that way. They're just on the TV. I'm like, not

[34:28]  That is... Yeah.

[36:23]  No, no, no, no. I remember when Redbox or whatever was out, and you go get a Redbox, or when Netflix first launched, it was all CDs to your DVDs, CDs to your house, and stuff. Blockbuster, my gosh. Look at it. Yeah. Yeah. It was cool. Yeah. yeah. Yeah. Yeah. So.

[36:26]  That was a good Friday night, man. Going to get Blockbuster. Nintendo 64 getting some games for the Nintendo 64. Andrew, was that you? Man, I really want to talk about some of the growth you mentioned. You talk about from that pandemic where it was a huge pivot. I can imagine there was a little stress there as well. I wouldn't be surprised if you grew some white hairs during that time. Were you CEO during that time? Oh, OK, good, good.

[36:30]  Uh, no, no, I was, uh, I was the administrator of our surgery center, which was, was probably equally or more impacted than the practice because you know, you're, you got somebody that you're putting them under anesthesia, right? So the airway is compromised. Everyone was wearing, you know, in 95 masks and everything, the health department and all these rules. Like there was a lot of, um, just varying degrees of uncertainty during that time and like every looking back on it knew exactly what to do. And like we all kind of did what we were recommended or at least, you know, uh, we were required to do too. And you know, surgery during that time was wild. Like you couldn't have like family in the waiting room that to be in the car and like, you know, induction timeouts were longer and like anesthesia was the only one in the room and stuff. Like there was just some very different things to the standard operating procedure that we had done and now do again. So it's, it's a very, it's, it's interesting to look back on that, right? Where you're like, my gosh, I remember all of those things that happened and we had to kind of overcome to continue to run our business. So it, it, yeah, I got some gray hair from that for sure.

[36:33]  And we just start talking about growth there because really lot of things you were telling me from 2020 is growth, the expansion, the adding. How does that happen in a time where so many others in the healthcare industry are kind of nervous and scared?

[36:37]  Yeah. Yeah, think, you know, I think what's nice is our group, you know, the foundation of our group has always been physicians that are entrepreneurial who want to take a risk and want to be able to provide patients the care that they feel like patients deserve, right? So our physicians have always treated it as like, this is what I need or this is what we need to enhance the care we deliver to patients. So when everyone else was like tightening down, restricting, you know, not willing to spend money or laying people off or, know, just the varying things they did during COVID, like our group did the complete opposite. You know, we, created jobs during the pandemic. We opened more, you know, capability in our surgery center. Like we added more. volume during that time. Like our volume was actually up during COVID, not down. And then patients, you know, I think what, ultimately happened was there was a lot of care avoidance and care delays because patients were very scared and uncertain. And, know, I think you just gotta be during times of uncertainty, you gotta be very transparent and you gotta be very willing. just say, this is what we know, this is what we believe, this is what we think. If you wanna cancel your procedure, you wanna go forward, whatever you choose, right? Like let's put the ball back in your court. But our doctors were very on top of all of the regulations, all of the recommendations, everything. And like we had daily huddles from an administrative standpoint, talking about where we're at. know, gloves, masks, everything. What staff we need? What about this? What about that? You know, we've got to have temperature takers at the front door. Who's doing that tomorrow? What's the shift look like? All those things. Like there was a lot of, you know, just being a smaller private group, we were able to pivot quicker, you know, than... you know, the big behemoth, you know, hospital systems out there, right? Because the level of decision making was significantly, just easier to get through, you know, like, cause everyone's very aligned on what we're here for. it, it, took a lot of, I would say the bureaucratic frustration out of the health system side. Cause I worked on health system side for, you know, the first 11, 12 years of my career. And like it was,

[36:40]  Yeah. Yeah, it makes sense.

[36:44]  very very different compared And I think it's good when everybody here believes in the cause of what we're doing and we can all.

[36:48]  about that.

[37:02]  when you get to where you're so big that you don't know what the left and right hand are doing, you know, like there's a lot of disjointed practices that exist in the big environments like that, that I think made it even harder for them to navigate that time we were in during COVID. And then I don't know that... frankly, I don't know that they've fully recovered, if we're being honest. Every hospital around the country, think their volume is down post-COVID because everybody's realized they can move a lot of stuff. When I say stuff, mean procedures, injections, surgeries, whatever, to the ambulatory or outpatient world. So the volume of... I say kind of migration, it's just, it's going to keep getting more and more. It's going to keep going up. We saw the biggest shift, I'd say 2020, 2021 with total joints and some other stuff like that. And then they approved total shoulders later. And now they're trying, you know, the Trump administration is saying they're going to get rid of the inpatient only list altogether. So you're going to see more things leave the hospital setting to go to a lower acuity setting. for a couple of reasons. One is financially, economically, it has to happen. Hospitals are expensive. They're expensive for a reason because they have 24-7 coverage and things like that. Secondarily, think patients noticed that the... cost to themselves plus the outcome was lower from a cost standpoint and equal or better from an outcome standpoint. patients are now kind of saying, I don't want to go to the hospital. I want to do it here if I can, because I'm going to get home faster. I'm going to be in my own bed. I'm going to get it. there's a lot of benefits from a patient-facing standpoint for that. So there's kind of two levers that are being pulled to make that continuance of case migration happen. So.

[37:16]  And what are your goals now being in this seat for growth? mean, there's been a lot of growth. You have anything on the horizon that we can hold you accountable on?

[37:30]  Yeah. yeah. I mean, I think that we, as an organization, you know, we, we have continually been the group that I feel like has been out there kind of on the cutting edge of things. you know, right now our goal is really to not necessarily add more surgical, you know, volume or procedures to our practice. like not everyone needs surgery, right? Like you're not always going to be a patient who needs me to operate on your ACL or your spine or whatever. Right? So like our goal is really to develop in the region for sure, the most comprehensive musculoskeletal platform around. So we're going to be adding a lot of surgical stuff to, you know, the practice here. And that's going to look very different than what we've done over the years. So there's going to be a lot of, you know, emphasis on nutrition and health and, you know, peptides are something we can't ignore. Like they're, they're a growing, developing, you know, platform of treatment here in the U S like there's going to be more regulation that comes along with them for sure. and fitness are a big portion of what we do and we don't have you know a great mechanism here to make sure that you know if we see you as a patient do you follow through to some of the non you know surgical recommendations we give you so I think one of the biggest avenues we're gonna be building and partnering with other organizations on is developing a very large comprehensive MSK wellness center. So that's going to be a lot of different stuff, know, therapy, fitness training, one-on-one sports performance coaching, chiropractic care, massage, red light cryo, you name it, right? The body, our bodies are very powerful and like,

[37:45]  Wow. Yeah.

[37:45]  There's a lot of things out there that aren't in traditional orthopedic care that happen, but they're not all done comprehensively. So, you know, there's groups who do this and there's groups who do that and it's kind of peppered all over the place. You know, we're trying to pull all that together to say, why don't we have all

[37:46]  Yeah.

[37:46]  in a care continuum to where we can treat you from A to Z, you know, and we don't need to jump to surgery, right? There's no reason for that. Surgery is really kind of honestly your last resort. Like, okay, you broke your leg. We need to fix it. You know, you have osteoporosis or you have osteoarthritis or whatever. We need to fix that. So there's, there's avenues there. Like our practice today, I'll an example. Our practice today, we see about 130,000 patients a year, patient encounters.

[37:46]  Yeah.

[37:46]  Okay. That's a big number. The volume of people we operate on is about 13,000. So 90 % dang near of the encounters we see, we don't operate on, like we don't need to operate on. They may transition to an operative patient six months, a year, two years, five, who knows? Right. But

[37:46]  lot.

[37:46]  We don't go straight to cutting. That's not the goal here. The goal is to get the body back and get people back to living what their why is, right?

[37:46]  Mm-hmm.

[37:46]  taking care of their grandkids or being able to play pickleball or whatever it is, right? Like let's just align on what the patient wants and get them back to that. So we don't have that flywheel as part of our practice that has this non-operative care continuum. And like, that's what you're going to see us develop in the next six months to a year.

[37:46]  That's good. That's good. Actually, it goes back to like falling in line of passion and purpose and not paychecks because easily cut somebody open. You're talking about paychecks, right? But it is about the passion and purpose. It is about humanity. It's about people and, you know, as you said, getting them back to their day to day. So I like that you say that actually my wife is going through gallbladder. She had her appendix removed. They told her maybe her gallbladder may have to then she's been kind of dealing with some issues because of the stones. But the doctor is like, listen, you're too young to just have surgery. Like you have to start to work on it. You know, if it's the thing that you're eating, if it's the working out. And I love that, you know, and I have to tell my wife, because obviously people say, just get it out. But it's like, just put in the work as well. You know what mean? Like, and for someone to be able to say they have that option and then you guys are going to guide them on what that actually looks like. And you talked about, you know, the expansions. That's actually a really good just make people feel more that you care. And it shows that you guys do care. Andrew, Andrew, what? Andrew. I don't know why I called you Andrew here. But Andrew, man, we're about to start wrapping up. What can people, where can people find more information just on the organization? But also they wanted to tap in with you. Are you on LinkedIn? Someone can reach out.

[37:46]  Yeah, so I'm on LinkedIn. You know, just hit me up there. And then as far as organization goes, it's, it's just Columbia ortho group.com. we've got blogs, we've got a YouTube channel, we've got podcasts, we've got all sorts of stuff out there. We produce a lot of content. you know, just educational information directly from the physicians, know, where they're providing, their expertise and energy, pretty continuously. And then we usually do one or two free seminars every month where the docs are kind of picking a topic. And this is what we're talking about.

[37:46]  I it.

[37:46]  out and we got one. hand and hand surgery and pain and stuff like that. We just did one on your foot, which, know, getting back on your feet is a big deal to some people. We did one on vein disease. there's a, we do these pretty regularly because, know, I think in today's world of AI, right? Like there's a lot of people used to say Google that, right? But now people use AI as a search engine dang near. But the AI, problem is there's a lot of hallucination that can happen with AI where it finds a bad source or a fake source or it makes its own sources up. We've actually seen it do that. so like we're trying to produce reputable physician content that's at a high level, but easy to follow to where it's practical advice for people to use. Like that's, that's the goal, right?

[37:46]  Whose idea was that? Was that something you implemented or was that already in place?

[37:46]  Man, we got a marketing guy who's fantastic. He's like, you know the biggest thing, because he's a consumer, right? Just like you guys, right? He's like, know the biggest frustration for me as a consumer is like, the information is just, one, it's too medical or hard to follow. Two, if I Google something, the varying degree of references and sources out there, who knows what's right? And then three, patients have no idea what to trust. you know, my grandparents, my God, my grandma believes everything she reads on the internet. You know, you gotta make sure that like, it's a reputable, honest source that is reproducible. like, so we're producing content that we feel like is easy to follow, that people can jump into and out of when they want, right? And they're

[37:46]  You

[37:46]  here's how I prevent a gardening injury. We just did a YouTube video and a Facebook post on that, one of our pain docs where he just, a simple hip hinge, instead of bending and using your back to pick up gardening tools. And there were tons of people who shared that. They're like, my God, what great information. And it was a minute and a half video. there's just a plethora of things out there that we feel like can be done in a know, patient centric way to just give good, honest advice.

[37:46]  tell you what man before we start wrapping up. I love it. I love that you guys in the education space and even TikTok. I'm a big TikTok and we'll talk about what I do on TikTok out of this because it's more in the wrestling space. But one of the top four search is education around something. So it's like people are always especially like between YouTube, the huge search engine, but also TikTok being that search engine where people are talking about that minute and 30 seconds. I just think it's my wife is that person that if something is happening the other day, she it was something that she looked at me. She said, I'm going to look it up. And she starts looking it up and going, you know, I'm like, and it just drives me nuts to be quite frank. And I would always ask her, like, she says, yeah, they said I'm like, who the hell is day? Like, she says, the mom community. Well, whether the mom community get those answers from right, because I can't just go based off what you read. Like, but to go and I'm looking or whether it's AI or Google and I see that the resources actually came from a hospital or from somewhere that people actually know. Yeah, I can actually take those answers, right? Yeah, that's really good that you guys doing that.

[37:46]  Yeah, my wife does the same thing with TikTok. She's like, well, the car mob group. I'm like, OK, listen, I don't care what the car mob group said. We don't need a new car. It doesn't matter. She's like, well, they got a built-in vacuum. No, no, no, no, no. We don't need a built-in vacuum. We got this thing called a portable vacuum. So yeah, that's true. I don't even use TikTok. And my daughters, they do competitive dance. And they're like, we made a new TikTok. I'm like, first of all.

[37:47]  Ha ha ha That's funny.

[37:47]  How do you know what TikTok is? Second of all, what is the TikTok? And you know, made some little dance video to one of the fad dances that were out there. And I'm like, all right, that's pretty cool. But I'm like, how did you get that posted on TikTok? And they're like, one of our friends at dance has a TikTok and we posted it on the dance TikTok page. And I'm like.

[37:47]  That is funny. You got to my brother. started three, two and three years ago and I'm at 80,000 followers on wrestling. So, and then when I think about just, I just had a friend now and he's going to be more in the education of people, helping people like stream and doing all these different things. People just want to learn, man. And if you can sit here and give them that in a bite size, like it is, it's very valuable. But in what you guys are talking about of someone's health and how to take care of something, there's so much value in that because people are looking for it. And as you mentioned, someone's, I see so many videos on

[37:48]  Dang, that's awesome. Yeah.

[37:48]  like fruits and vegetables that are good for the body and like AR cartoons, right? And there's like a voiceover on that. But it could be in a sense that you guys are at, you know, the orthopedic center and have the visual that is not AI, that it's actually live. Like there's so many cool things, man. So shout out to your marketing director. What's his name? So we can give him some kudos. Josh, kudos to Josh. He's on it,

[37:48]  his name's Josh.

[37:49]  Well, Andrew, I definitely thank you for your time here this morning, being able to have these conversations. And I know that I'm just so happy to know that you're in your 30s and you're running this huge organization. And this is just the beginning for you, I would say, man. You're still so young. You still look great, man. I've pretty much... Your kids are giving you all the energy you need, I can imagine, but keeping you busy as well. So... Yup, yup, yup. Well, listen, guys, if you guys haven't already, make sure you guys do like, subscribe and comment.

[38:03]  They suck it out of you too. You know that.

[38:17]  This is a great conversation that we continue to have leaders with leaders in the higher ed or the healthcare or those that are in the nonprofit space. Why? Because this is where a lot of the passion and purpose is happening. It's not about paychecks. It's leaders that really truly care. It is the next generation showing up. So thank you, Andrew, for that. I'm Efrain. We'll catch you on the next one.