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Jeremy Weisz 3:48

There’s a huge need for that. I mean, if you look at any medical practice, I mean, that’s what they want and need to do.

Peter Cunningham 3:57

Right. So, you know, we serve two distinct segments within healthcare where we do not work in pharma, or medical device, which a lot of people think of when I think of health care. We specifically work with typically larger physician practices and ancillary services, to help them get more patients better, faster, cheaper, and then are what we originally began with, which is business to business, helping service and technology providers sell into the provider community. And a big driver on all of this on both sides is the enormous amount of private equity investment that’s been happening in the industry for last 10 years. I think the latest stat I saw was that there’s about 1.3 trillion in private equity capital that is directed towards industry consolidation and, and that type of thing and so we’re right in the middle of it all.

Jeremy Weisz 4:55

Oh, there’s always something I feel like crazy going into Healthcare. Right. And I’d love for you to talk about the impact now and we could talk, you know, b2b or b2c sector, but some of the impact and maybe start with the b2c sector what’s happening now, with that?

Peter Cunningham 5:14

Sure. So obviously COVID impacted, you know, everybody individually, collectively, professionally, personally, so forth. Um, so a number of from our vantage point in healthcare, a number of things have occurred and are occurring. So during COVID, on the b2c front, so practices hospitals, so forth. elective surgeries were were paused. And that’s a big problem, particularly in hospitals, as the O R oftentimes represents about 90% of the profit for hospital. So that puts a lot of financial strain on the hospitals and health systems. And obviously, the the physician practices and so forth. So now fast forward through the various variants and things we have going on. You know, people are wanting their knee replacements. Now, doctors want to do those knee replacements, but the impact now is actually the, the shortage of labor. So I was talking to a friend the other day, who’s the CEO of a large gi practice in the Northeast, and he’s going nuts. He even said, he sent an email that was just a bit of a tirade when I asked him how things were going, because he can’t, you know, it’s not the doctors want to do the, you know, the patients want the service, the doctors want to do the service. But it’s the people behind the scenes that are answering the phones, cleaning the technicians, and so forth, that there’s a shortage of labor. And so they’re having a real challenge, recruiting and retaining those people. And so that’s a big issue there on the b2c side. And then on the b2b. What’s interesting about that is there’s a lot of conferences and trade shows, obviously, we’re shut down. Some of them are coming back, but they’re, you know, not what they were. And so that’s forcing a lot of b2b companies. And of course, in person meetings, you can’t, you know, just pop in, in a practice or hospital anymore. Those in person meetings have been shut down. So they need to start going digital. And in terms of being able to systematically engage decision makers to generate leads and support sales teams. And you’ve been doing

Jeremy Weisz 7:52

this digital thing for many years. So what are some of the What’s some of the advice, they’re probably turning to you for advice on some of this? Because this is new territory? What’s some of the advice you’ve had to give people as far as going digital the digital realm?

Peter Cunningham 8:07

So, yeah, good question. So on the b2b side traditionally, you know, healthcare, you know, we joke that healthcare is behind and best practices of many industries. And we joke that even on its best day, it’s about 20 years behind best practices. So if you think of like, technology companies, you know, they’re far more advanced, you know, in their demand generation lead generation, sales processes and everything. And then you have healthcare, you know, which is kind of way on the other side spectrum. So a lot of healthcare companies have not, you know, have not realized that the buyers journey changed long before COVID came that today, you know, it’s estimated that about 70% of the sales process is actually done online, before they even reach out to a salesperson, or agree to a meeting. And so COVID No, COVID The reality is the world’s changed. And unfortunately, a lot of b2b companies were still doing things the way that they were 15 years ago, and, and so COVID just cemented the shift that many of them have had to make. So what we’re doing is we’re working with a lot of these companies who are going digital for the first time. And they have a sales teams that are national, that can’t go there’s conferences and trade shows. If they do the decision makers aren’t there. They’re not allowed to just pop in First person meetings, but they need those leads to be able to hit the numbers. And then you throw in private equity. That’s investing money in these businesses, they have expectations for growth profitability. So that’s, that’s what’s been happening. So walk

Jeremy Weisz 10:18

me through, I think it’d be instructive for any company. Talk about the buyers journey. So, you know, the old school way, not the new school way. What when you’re on the phone with one of these, you know, facilities? What are you telling them as far as here’s what the customer journey actually looks like? And here’s some of the things you should be doing.

Peter Cunningham 10:38

Sure. Do we want to start on b2c? Yes, which you say? Sure. Okay. So on the b2c side, and what I referred to on the 70% was on the b2b side, but on the b2c side, so folks that are looking for a physician practice or service. So traditionally, we break it down into source, evaluate and choose. So if someone if my primary care doctor diagnosis that I need a knee replacement, for example, or any other procedure, oftentimes they’re going to refer me to a specialist in their network, part of their health system, oftentimes, I’m or two independent practitioner would have whatever the case may be. And traditionally, folks who just go with whoever the doctor referred, or, you know, a family member said, Oh, doctor, so and so did a great job for me. So referrals, oftentimes was a majority of how patients flowed into a practice. That changed over the last 10 years where patient choice, the whole idea of consumerism of health care, has really risen. And with the advent of the internet, the latest stat, I think, is that one in 20, Google searches is healthcare related. Just to give you perspective, so today, and that idea of source, evaluating shoes, I’m going to share I’ll take that referral. But I’m going to be going online and checking out that that practice and that physician, I’m going to be looking at googling best knee surgeon near me, best knee surgeon, Chicago, whatever those services happen to be, I’m going to be looking at reviews. And so there’s source part of it is the practices need to pop up when they’re doing people are actively doing those researches. The second part is the Evaluate. Is does a website have content to support the decision decision making? Do they have reviews on Google vitals health grades? And are those reviews? Are they above four stars? Because if they’re not, that’s a real challenge. And do they have more than 30 reviews? Or is it nine reviews at 3.7%? You know, star rating? Well, I don’t know about you, but I don’t necessarily want to go to a doctor that has a 3.7 star rating. Right? So and then ultimately, source evaluate choose how easy is it to get in. So for years, Cancer Treatment Centers of America really ate the launch of a lot of health systems in oncology. And when you look at their billboards, oftentimes the call action is talk to a oncology specialist today, or within 24 hours, trying to get in with someone at typical health systems. It can take months to get it, which is the last thing you want to hear when you’ve been diagnosed with cancer. So those are the things that we’re assessing and helping to improve them, you know, throughout that journey for those practices, is that source, evaluate and choose you know, so that that those are the things that we’re working on with them.

Jeremy Weisz 14:26

Want to talk about that the easy to get in Part, Part of me thinks Yeah, I mean, as a patient, I want to call and get in. And part of you thinks well, is it social proof or like well, there’s a really long way because that means they’re really busy and they’re really good. So how do you and maybe that doesn’t matter I’m just curious your opinion on that same thing with a restaurant like I want to go to this restaurant looks good, but then you go in and it’s it’s, there’s a way there’s some kind of social proof there that it’s Great. So how do you balance? Or how do you think about balancing that? Yeah, get in today. And then the back of my mind, subconsciously or subconsciously, I’m thinking, maybe they’re not that good if I can get in the same day?

Peter Cunningham 15:14

Sure. So I think it’s a great, great question. So going back to that source, evaluate choose, right. So the source being findable, right, so the Evaluate, so building websites that have a lot of content. So for example, on oncology, if I have bile duct cancer, does the website have information about bile duct cancer? You know, that would make me want feel warm and comfy versus just a bullet point as something that they do? Or just general? Surely pre cancer? And then there’s, when they talk about the buyers journey, then it is it’s a process, but by the time they get to okay, do they take my insurance? And then can I get in? Because back to that dysfunction? Operational dysfunction that a lot of healthcare has. People get very frustrated because we live now live in a world where you have Instacart, right? I haven’t been to actually Costco and yours, I just order things on on Instacart and have it all delivered. Right? So we That’s the world we live in. And so how, why should it be different in terms of health care providers. So today, from a best practice standpoint, the providers that are really embracing patient engagement, you can schedule appointments with text message, you know, schedule everything right online, it’s no longer, okay, fill out a bunch of stuff online, and then you come, you go into the office, and they ask you to fill it out again, on paper, you know, and those types of that that friction that oftentimes people associate with medical practices, it’s hard, they make it hard to do business with them. In any cases. Yeah. And so but again, with the consumerism, of healthcare, they’ve got to make it easy. So like, there’s a company called One Medical that I believe Google’s an investor in, and they have offices here in Chicago and other markets around the country. And I’m a member. So you pay a membership fee, like $200 annually, and everything’s run through the app. So when I want to see the doctor, I can just hit it, and I can book an appointment in person, telemedicine, whatever, it happens to be super simple, super easy. I don’t have to sign anything when I get there. Um, and they’re a great example of someone that’s really embracing this trend.

Jeremy Weisz 17:57

Yeah. Yeah, thanks for going into that. So it seems like people do a good job on the front, if they’re doing a job on the front end with the kind of the evaluation part and they have all the content by the time if that you can get in same day, those the credibility in everything’s already been built at that point. They don’t really care as much as is, is that?

Peter Cunningham 18:18

Yeah, and if they, if they are really good specialists, they may not get in the first day, that same day, but they will have had communication with someone quickly and easily and have things booked. And, and done. So in a way that is easy.

Jeremy Weisz 18:37

Yeah. I want to get a little bit into the nitty gritty for a second, Pete and talk about maybe on the b2c side, some of the things you actually do, and there was one with the ABA, I’d love for you to talk about that.

Peter Cunningham 18:56

Sure, so because of a lot of the private equity, that money that’s sloshing around in healthcare, I’m about 40% of our clients are private equity backed. So in private equity backed practices, that they have to grow organically, you know, same store sales, if you will. And then they’ll grow through acquisition as well. And so we operate on the organic side of things is help them get more patients, you know, and or when they’re opening up new locations, help them fill the providers dance cards as quickly as possible. So a good example of that would be a ABA provider. So ABA is essentially autism therapy for kids and adults with autism. Very much a cottage industry. I have a son who’s autistic. So we’ve been a consumers of ABA therapy for a number of years. And so that over the last two years has been an area we’ve, I think we’ve worked with five different ABA companies around the contrary, but there’s

Jeremy Weisz 20:20

a closing personal to your heart. Oh,

Peter Cunningham 20:22

yes, yes, they do great work. Um, so one organization in particular, that is private equity backed, I believe they had, they had nine locations, when we started with them. They really weren’t doing anything digital. And what they were doing was not very good. And so we help lay out a strategy where we can help them figure out before they even open a location to determine the demand in that geography, and determine and develop performance for them to say, Hey, if you do move, you know, sign a lease and open up in this location. You know, here’s a budget of if you invest X, you should expect y in terms of number of inquiries, and, and then based on their historical data, figure out how many of those inquiries convert to actual patients, and then you multiply that by revenue and, and essentially can perform everything out. So by doing that, we’re able to help them grow from nine locations to over 60 locations in about two years. And today, about 75% of their patients all come in, through our digital programs, which reinforces the whole idea that referral is always going to be a strong component of how patients come in, you know, some practices more than others. But the fact that 75% of their patients are coming in through digital programs illustrates the the importance of patient choice. You know, today?

Jeremy Weisz 22:15

That’s pretty amazing.

Peter Cunningham 22:17


Jeremy Weisz 22:18

I mean, anyone would like to see a crystal ball into, hey, if we were to open this location, how successful is it going to be and and then have the means to actually execute on it?

Peter Cunningham 22:32

Yeah, it’s well, and there’s a saying that medicine is local. So every, every market is different, you know, the competitive the competition, the number of competitors, the types of competitors, to the pair environment, to the demographics, and so on, so forth. So it’s not an exact science. But the good news is, if you’re collecting the right information, historical information on how things are operating with other locations, you can model things out with some accuracy. And, and I, and, you know, it’s funny, when, when you’re working with someone who moves from nine to 60 locations, and they’re all different parts of the country. Um, you know, I would say that we are on target probably 90% of the time, you know, where we predicted outcomes in terms of okay, you should expect a certain number of inquiries, you know, in certain amount of time. And then there are markets, there were a couple markets, maybe 10% of markets where it’s a bit of a grind, because the competitive landscape or some other variables are making a challenging, and then that’s, you know, that’s where we have to really put our work in.

Jeremy Weisz 24:00

What tends them when you look at that what is on the challenge side, so I could see, there’s competitors, what else do you look at as is that would make it challenging open up a location somewhere?

Peter Cunningham 24:14

Yeah, so um, so competition, there’s a lot of levels of that, you know, is the competition. A dominant health system? Is there is there traditional you know, there’s like, Indianapolis, for example. Another issue is primary care doctors, which are oftentimes chief refers to specialists. In Indianapolis, they’re very few independents left, almost everyone is employed by one of four health systems. So that creates a challenge

Jeremy Weisz 24:58

they’re gonna refer within their health system.

Peter Cunningham 25:00

They’re gonna refer within their health system. And so that could be a totally different challenge. And so there are data products out there, but definitive health care and some others where you can assess markets before you go in and know like, how many primary care doctors are there are practices? And are they independent? Or are they owned? And then who are they referring to? And for what and what value them. So being able to do assessments like that, in markets, is really helpful. And that’s kind of where it begins, and then we start drilling into okay. For example, on Google, you can you can determine, it’ll tell you how many people are doing searches for ABA therapy, or ABA therapy companies in a 10 mile radius of a specific location. And what’s that cost per click, and so on, so forth. So there’s different levels of information that we’d be looking at. To help determine a is it a location that you want to move into? And be? What’s it gonna take to be filled dance cards once you’re there?

Jeremy Weisz 26:17

I want to switch gears for a second in in talk about the business itself, and what’s been helpful to grow the business. And I don’t know, you know, before we hit record, I don’t know if you said this in jest, but starting the business at a kitchen table, and then growing from there, what’s been successful and growing. And one of the things you said was about getting out of the way, so I wanted, you just go into what that means.

Peter Cunningham 26:46

Yeah, I call it the, the entrepreneurial dilemma. There’s lots of business books that talk about, you know, hiring the right people, you know, fill in the right seats on the bus, you know, type of analogy. What they don’t talk about a lot is getting out of the way that the entrepreneur know how to and when to get, you know, it’s not just hiring the right people, it’s then also getting out of their way to let them do their jobs. And, and theirs for and in talking with other entrepreneurs who’ve been through this. There’s, it’s emotional, you’re used to being in there and diving in there, you know, rolling up the sleeves, getting dirty, fixing things. But as you grow, and you expand the team, and you’re hiring professionals, that’s what they’re there for. And the reality is, they can, I will say this for myself, the people that I’ve hired, do their jobs better than I could by design, but it is hard to just get out of the way and let them do their thing. And since I’ve done that, this year was mid year that I my COO, and I had the big talk and, and I stepped away went on vacation. It was wonderful. I was able for the first time to go on vacation and not be working for hours every morning. So it’s been a it’s been a game changer. But I still screw up sometimes it gets people’s way. But but it’s it’s definitely, definitely a challenge for entrepreneurs.

Jeremy Weisz 28:37

So how can someone if they’re listening step into that, if they’ve you know, it’s something they’re struggling with or something they’ve thought about stepping into what what’s the first step you recommend?

Peter Cunningham 28:47

Well, I think the first step is obviously, you know, yes, hiring the right people, the right seats to the bus, hiring real pros who really know what they’re doing. And then a be have ongoing communication with them about where the boundaries are. And just in my case, I’ll speak to my case. I just admit to them, Look, I’m used to doing a lot of different jobs. I’m used to doing your job. Tell me if I’m interfering. Yeah, tell me, you know,

Jeremy Weisz 29:26

so basically give them authority to say back off. That’s exactly because if you don’t give them the authority, they’ll just be like, Ah, I guess maybe they’ll just roll with it.

Peter Cunningham 29:37

Exactly. And and, you know, as things kind of grow, and then people are under them and so forth. You know, I’ve learned that by not backing off, not letting them do their jobs that actually it circumvents their authority to do their job and also support their people.

Jeremy Weisz 30:00

Yeah, I love that. Yeah. So give them authority to say back off. Let me do my thing. Okay, cool. Um, when I think about what you do, I’m sure you have a lot of complementary partners. Because you do certain things, your partners do certain things. And, again, you mentioned, like a neurosurgeon, I want you to talk a little bit about the ecosystem. A little bit.

Peter Cunningham 30:23

Yeah, I would say, you know, just definitely an ecosystem and healthcare. You know, it starts with, actually, there’s a fella named Scott Becker, who’s lives near me, here in Chicago, he had started a couple, he’s actually an attorney was, I believe the head of the healthcare practice McGuireWoods, you know, for years and still with them. And he had started a newsletter for owners and operators of surgery centers 20 years ago, that just grew. And then it became, they started doing conferences and trade shows. And now they you know, that Becker’s healthcare review, for example, overtook modern health care, as the leading business magazine years ago. And he has grown, I mean, it truly is an ecosystem. And so particularly in the b2b side, their conferences really are the leaders and great people. They’re all here in Chicago, which I think is really helped Chicago. And Nashville is obviously another major hub for health, the business of health care. But Chicago really is a is a big major hub here, not just because of backers, but but also because a lot of the trade associations like the AMA, and folks like that are all based here as well. And a lot of conferences are here. So that’s like macro. And then micro would be companies that are complementary, but we do so for example, Raider eight is a company that will refer in to manage online reputation management. So there’s Google reviews, and vitals and Healthgrades, and so forth. And yes, so there’s another person company called Callidus health that’s out of Madison that founded by a ganache, who’s a new trained neurosurgeon, who then broke his parent’s heart by not practicing medicine, and going into technology. And so we bring them in when, for example, we’re doing our programs and we see that you know, 30% of the phone calls were being answered by the staff, here’s a missed opportunity. And so he’ll come in and provide after hours call, you know, overflow calling workflow automation, you know, it gets into that patient engagement, making it easy for people to do business with these practices. So a wide variety of folks that we work with, but yeah, those would be some of

Jeremy Weisz 33:02

you love it. Thanks for sharing that. Um, I’ve one last question Pete and I just before I ask it, I want to point people to learn more check out more and people can go to Are there any other places online? We should point people towards?

Peter Cunningham 33:20

Well, eh, eh, eh, yeah, is Evolve Healthcare Marketing. And then we also have something called the American Healthcare Journal. That is a leading source of Business and Public Policy, news information for the healthcare industry. So we have members of Congress, Senate disease, CEOs of disease societies, all right, writing op eds, and various things on a regular basis with the publication.

Jeremy Weisz 33:55

Where can people learn more about that? Is there a certain website or place on

Peter Cunningham 34:02

Jeremy Weisz 34:03

Got it? Perfect. So last question. So yeah, check out check out To learn more, you know, a lot of these these things these companies in health care plays you work with are near and dear to your heart. We mentioned earlier. I like to talk a little about you started a charity why you started the charity and in a little bit about that on the personal side.

Peter Cunningham 34:32

Sure. So you know, one of my reasons for having strong interest in working with within healthcare, and then in particular, with health care for good health care providers, is you know, I have three children and two of which have had special needs. And so one daughter had acquired On a form of epilepsy, and, you know, she passed away at the age of three. And that they came and, you know, from there we we, my wife, and I, sorry, my dog is barking here. My wife and I had started a foundation a number of years ago, but tried pediatric epilepsy foundation, you know, to help give money to organizations that were supporting families with chronic children with chronic forms of epilepsy. And, but from on the professional side, that is, you know, what helped drive my interest in working with really good health care providers, the idea being that these providers, you know, if we can help them grow their practices, increase the number of patients grow their practices, that enables them to hire up additional great providers and expand our capacity to serve. As a,

Jeremy Weisz 36:13

you know, your son being autistic? Have you seen the changes in in care over the years?

Peter Cunningham 36:24

Specific to autism?

Jeremy Weisz 36:25


Peter Cunningham 36:27

Yes. So I would say, you know, ABA therapy, in particular, a lot of changes used to be that ABA was a carve out in many cases with self insured, companies, plans, deemed experimental. So they wouldn’t pay for ABA therapy and some related therapies. That sense has changed. And so that’s in a big way has driven much of the growth of that industry, and also a lot of the private equity investment that’s been happening the last couple of years,

Jeremy Weisz 37:05

I feel like the diagnosis in general has changed as well. And I don’t know if that’s because of the different therapies that have come out or different treatments, but I feel like that has changed a lot. And the awareness, I don’t know, maybe it’s just me paying attention to it, but I feel like I’ve been more aware of it in general,

Peter Cunningham 37:23

there is definitely more awareness. And I would say that also and I’m not not an ABA spread expert, per se. But they’ve also changed the diagnosis a bit. So they just call it being on the spectrum. Because people would talk about autism versus Asperger’s versus this versus that. Now, they just call it being on the spectrum. And, and it encompasses a lot of different things. You know, I’m

Jeremy Weisz 37:54

Pete, first of all, I just want to thank you, thanks for sharing your journey, your story, your knowledge, I want to point people towards your websites, you know, and To learn more, check out more episodes of And just I want to be the first one to thank you.

Peter Cunningham 38:14

And thank you really appreciate it.