Ask Me MD: Medical School for the real world

Ken Adams, MD - Non-Clinical Medicine

October 16, 2020 D.J. Verret, MD, FACS Season 1 Episode 16
Ask Me MD: Medical School for the real world
Ken Adams, MD - Non-Clinical Medicine
Show Notes Transcript

Dr. Ken Adams, Chief Medical Officer at United Healthcare- Texas, discusses his career path through non-clinical medicine. As a physical medicine and rehabilitation physician, Dr. Adams started in clinical medicine building a business and then transferring to non-clinical medicine, ultimately becoming a chief medical officer for United Healthcare.


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Announcer :

Ask Me MD, medical school for the real world with the MD Dr. D.J. Verret.

D.J. Verret, MD, FACS :

Thank you for joining me for Ask Me MD, medical school for the real world. I'm Dr. D.J. Verret. Today we have the pleasure of being joined by Dr. Ken Adams. Ken is a chief medical officer with United Healthcare, but has quite the story of a non clinical medical career. Stay tuned, we'll be right back with Ken after this.

Commercial :

Commercial runs here.

D.J. Verret, MD, FACS :

Welcome back to Ask Me MD, medical school for the real world. I'm Dr. D.J. Verret, and today I have the distinct pleasure of being joined by Dr. Ken Adams. Ken is currently one of the chief medical officers with United Healthcare, but has quite the story in non clinical medicine that we're going to be talking to him about today. Ken, thanks for joining us.

Kenneth Adams, MD :

Thanks for having me. Really excited to be here today.

D.J. Verret, MD, FACS :

So I know you and I have talked about your past but and like I said, when I when you first emailed me with kind of your background, I said, Wow, that is very interesting. So if you could kind of briefly fill our listeners in on your background, where you came from both educationally and then kind of through the non clinical pathway you decided to take?

Kenneth Adams, MD :

Sure. So I think like a lot of physicians here in Texas, I went to a Texas University, went to UT Austin, and finished up there in 93 and went to medical school at UT Southwestern. I had an Asian mom. So people ask, you know, when did you decide you wanted to be a doctor? And I don't have an answer for that, because I was just told I was going to be a doctor. And that was what I did. And so got out into the got out of residency in 2001. And back then I think there was still kind of a push to go out and do your own thing and maybe join a group but an independent group. And given the fact that I do physical medicine rehabilitation, there weren't a whole lot of large, you know, owned entities at the time. But I, I finished up and started my own practice, and within a short period of time, had accumulated a number of rehab contracts for facilities here in the North Texas area. And the organization that we contracted with rehab care group said, you know, you have, you know, built your business so quickly. And so many of our physicians around the United States who have been doing this for years are struggling, would you be willing to go around and do some consulting with these physicians, and help them grow their practice? And it seemed like an interesting opportunity. I still, you know, stayed on the call list and was doing direct patient care. And after a year or so of doing that my partner's back home said, you know, can it we kind of feel like you're not doing your fair share? You know, are you going to do clinical medicine? Are you going to be an administrator, and the organization at the time that I was working with rehab care group created a chief medical officer position for me. So overnight, I went from managing a small single specialty multi physician group with, I believe, at the time, we had eight providers, to 117 physicians across 48 states and Puerto Rico, with 150 acute inpatient rehabs, 120 acute inpatient rehabs, 50, eltechs, 1200, skilled nursing facility contracts, and a number of home health care and hospice organization. So it was pretty dramatic increase overnight. And that was that was a, a difficult leap. And I felt like I was drinking from the firehose on a daily basis for the first year or two there.

D.J. Verret, MD, FACS :

But Ken, let me actually, let me interrupt you right there because there are a couple of things I'd like to kind of expand upon. So first, you mentioned that you were kind of singled out because of what you had done to grow your practice. What do you think was the key that you identified and did in that practice to make it so successful Initially,

Kenneth Adams, MD :

I would say that I put together with the help of rehab care, a relatively decent kind of pamphlet of information of the services that we offered, and what what we were willing to take off the shoulders of the administration. So I think they they stressed a lot about having medical directors for their inpatient rehab facilities, they were really focused on at the time, it was called the 7525 rule. And, and, you know, kind of these administrative things that were requirements from CMS, that their medical director occasionally would fill them in on, and they just didn't feel like the, the information that was getting that they were getting was consistent. And they were worried from a compliance standpoint that they weren't in compliance. And so we just had a really convincing story that that was all stuff that we could manage, and that I personally would take responsibility for that and that we would hire medical directors who were competent, folks, but at the end of the day, they reported to me and I would report back to the, the CEOs of these hospitals, and it was a it was a good story. And the the CEOs, you know, generally didn't have any problem bringing us on board or having us replace the the medical director that was already there, or in some cases asking us to hire the medical director that was that was already there.

D.J. Verret, MD, FACS :

So when you look at that business model, it sounds like you went out, you found a pinch point for your target market, you found a way to fix it. And then you marketed that fix, is that accurate?

Kenneth Adams, MD :

That is that's very accurate. And I think maybe the the difference between what I did and the other medical directors, I really actually enjoyed talking to administration, I didn't have that kind of view that a lot of people do that, you know, administration's the enemy, and we can't collaborate with them, because they're always trying to screw us. And generally, you know, went out and had great conversations to be CEOs out to dinner and, and treated it like a sales position, essentially, which, which I think is a little bit different. I mean, I work with physicians even now today, and we were talking about it the other day, we were trying to get some of our CMOS across the country to essentially sell one of the services that we have to hospital CEOs, and almost uniformly across the board, the CEOs were like, I mean, the CMOS, were saying, We're not salespeople, we're clinicians, like, go get a salesperson to go do this. And I on the other hand, said, that's exactly what we're supposed to do, as CMOS is build those relationships with hospital systems and, and hospital CEOs. So I think it's just a different difference in perception as to, you know, what our roles and responsibilities are,

D.J. Verret, MD, FACS :

Well, it sounds like it's not not even so much sales, but maybe something taken from the sales environment of relationship building in a broader perspective.

Kenneth Adams, MD :

Absolutely. You're right. I mean, from the strictest sense, I'm not sales I'm, you know, relationship building so that someone else can get in there and get a contract signed.

D.J. Verret, MD, FACS :

So now, you you mentioned going from the small group to cmo at a large entity, and and drinking from the firehose, for physicians out there that may be looking to transition to more of a CMO role, what kind of advice would you give them for training or education? Or what should they do to kind of prepare for that transition you experience?

Kenneth Adams, MD :

So when I made that transition, that was kind of a unique period in time, MBAs were not that, you know that there were not that many physicians with MBAs. And if I was to do it all over again, now, if I was, you know, leaving the bedside and going into management, I would probably encourage someone to go get an MBA, because when I showed up as the CMO for rehab care group and got stuck in a boardroom with our quarterly board meetings with our board of directors, I was last I really was I was looking at, you know, balance sheets and profit and loss sheets. I didn't understand double entry accounting, and had no real clue about how the business actually ran. And the first meeting that I sat in, I was fortunate to be seated next to the CFO for the organization. And it was painfully obvious that I was clueless. And he pulled me aside afterwards and said, Hey, can you know what, Friday afternoons I have a little block time and every Friday for the next couple of months. Let's get together and I will bring you up to speed on what it's like to to run a business. And he did and it was awesome because I actually I had to fly to two St. Louis every week, I'd leave, generally Sunday night and come back Friday afternoon. And he would spend the last bit of Fridays with me, and basically kind of get me up to speed. So over six to maybe eight months or so I kind of have my little mini MBA on what it takes to run a billion dollar plus organization. What a unique opportunity. That's, that's not available everywhere. It's not and it was, it was really interesting. After I got through that there were there were multiple times in my career where I've had kind of blocks of time between jobs. And in each one of those kind of down moments, I thought, Oh, my gosh, should I go back and get an MBA? Should it you know, what should I do? And in talking with the counselors with the MBA programs, you know, generally the the, obviously, they're trying to sell you to come into their program. But consistently, they have said, I'm not sure what additional business education, we would provide you that you haven't already had hands on experience doing. And so 90% of the time, they've actually talked me out of going back and getting an MBA, though, I will say that I wish I had those three initials behind my name. As, as I've gotten older and had to go out, job hunting, I think sometimes my resume as passed over, just because I don't have those three initials, and they don't take the time to go into my resume, and actually find out what my work experience has been.

D.J. Verret, MD, FACS :

So now you're cmo and Rehab Care Group, kind of pick up the story there if you could for for your journey.

Unknown Speaker :

Sure. So I did a number of things when I was cmo for Rehab Care Group that were totally outside my comfort zone. During that period, this is like early 2000s. The RAC audit showed up in health care. For those of you who are unfamiliar with racks, if there's anyone out there unfamiliar with the racks, their recovery audit contractors, and they originally started, I think back in maybe the mid early 80s, with governmental contracts with the military. And they're the ones that discovered the $900 toilet seats and the $200 hammers, etc. And eventually they came to medicine. And so in this kind of rehab world post acute world, early 2000, the RAC audits were targeting, especially in California, there was a company out there PRG scholtz, it was iraq auditor, and they looked at all the post acute inpatient rehab facility claims and denied them at a 99.9% rate, which was devastating to the company that I worked for, we went from having a, you know, a black return on our investment out there, we were never in the red, to suddenly owing something like $90 million to the US government. Wow. And it was an it literally was almost overnight. And so it was all hands on deck with the senior management team. And I got put on the appeals and denials team to go and argue these cases. And at the time, we really felt like we needed to be in person, we need to have a physical presence in the administrative law judge courts to explain the services we were providing for our patients and the care that was actually being delivered, and have individual patient stories about our patients that we were improving their lives and how we were caring for those patients and really personalize it for the judges who are here to four had really not done a lot of this type of work. A lot of them were Social Security Administration judges, so they did have some health care background, but really not on the acute management of patients, especially, you know, immediately after a hospitalization or immediately after some kind of devastating traumatic brain injury or spinal cord injury or, you know, whatever total knee replacement. And so we really wanted to have somebody who could explain to a judge in terms that they could understand what was actually happening to our patients. And so I had the opportunity to defend three or 400 cases across four administrative law judge courts in the United States before, I believe 35 or 40 different judges and that was a really kind of eye opening. experience for me to really kind of see that, you know, sometimes you've had judges that were great and actually took the time to kind of learn about healthcare and learn about what was going on with these patients. And other times you had judges who kind of didn't give a shit. I mean, they just like, they'd show up, and they like, already had a preconceived notion that we were guilty of fraud before we even opened our mouths. So, you know, a lot, a lot of learning that went on during that three year period.

D.J. Verret, MD, FACS :

When we're coming out of that, I know, it's, that's a very unique perspective, and I've been subject to the RAC audits through Medicare in the past, what would you What is one thing that you've learned that you would give advice to physicians, when dealing with RAC audits, kind of, from your experience there?

Kenneth Adams, MD :

Oh, you know, it's, it's, that's a good one. Hopefully, you get a RAC audit, that if if, if you're unfortunate enough to get a rack audit, hopefully you get a rack audit, that's a reasonable audit, and they give you, you know, they're they're only asking for, say, five or 10 cases, and you're able to, you know, copy the charts and get them to them in a timely fashion. I know from having been on the other side on the on the rack audit side, that sometimes they inundate providers knowing that they actually can't keep up with the workload of getting those that information back. So they kind of stack the audit against the provider. But in instances where you're actually having to defend your cases, I would say, you know, you there are outsourced agencies that do do this work, and do it well. And because they do it every day, they kind of know what to say to the per to the administrative law judge. So if you've got a ton of cases, like, you know, 50 plus cases, or 100 plus cases, I'd probably encourage you to outsource the defense of those. But if you only have five or 10 cases, then it probably makes sense to do it internally and actually show up. And I think, first off, I think the best thing to do is to, you know, be respectful to the judge. Having been on the rack audit side, I've had a number of physicians who show up, who are incredibly condescending to the judges, and just so put out that they have to show up to this and that they're missing clinic, and, you know, just really berate the judge, that never goes over.

D.J. Verret, MD, FACS :

That's not a good idea. It just doesn't sound good.

Kenneth Adams, MD :

It doesn't and I I just don't understand why physicians do that to themselves. But they do and the judge instantly picks up on those, you know, types of physicians and they're not kind in return, I mean, they're you just essentially blew your chance of winning that case out the door. So you know that that first off, that's the easiest thing you can do is just be respectful to the judge, even if they're stupid, and they're plenty of them out there. Don't get me wrong, that haven't done their homework. And you really do have to sit down and explain the case to them. And walk them through why from a clinical standpoint, you provided the services that you provided. And then I think that the most important thing after being respectful is just constantly focusing on medical necessity. Why is it that what you did for the patient, only you as a physician could do that the decision making around this particular medication combined with this particular surgery or service, that particular decision could only have been made by a physician, a nurse couldn't have done it a PA couldn't have done it, you know, an NP couldn't have done it, you're the one that made that decision. And that's why your services were necessary. That's, that's really important. And to to speak to the other clinicians in the workforce and why they couldn't, they didn't have the knowledge to make that decision, or they didn't have the regulatory capacity to you know, write a prescription, or make that medical decision. That's that's what you have to convey to the judge.

D.J. Verret, MD, FACS :

And you mentioned during that, that you have some experience on the other side of the coin. So So take us forward. You're at Rehab Care Group defending the RAC audits, but then something happened and now you're on the other side.

Unknown Speaker :

Yeah, this is where I get all your listeners to hate me suddenly. If any of them liked me, now, for a brief moment, you're gonna hate me.

D.J. Verret, MD, FACS :

They'll come back around. We'll bring it back around. It's okay.

Kenneth Adams, MD :

I hope so. During those Three years when I was actually defending cases for the provider, I spent a lot of time going around the country providing education, through different organizations trying to get providers to say, or to show them, what they were doing was was not in their best interest in regards to being audited. And some of those things were around physician documentation. I think one of the most consistent thing I saw among key m&r doctors, were these four line notes, that would basically it had the date. And then it would have you know, PNR progress note, and then it would say patient seen and evaluated doing well, physical exam done, continue current care and rehab, and then they sign their name. And then they build a level to note. And I was like, there was no medical decision making in there that you distinguished what you actually did on that particular day, as opposed to the day previous. And there's no indication that you actually spent the appropriate amount of time with the patient. And they would have a page of those like, I mean, it was really, it looked like they had a stamp, and they just change the date. And you know, just went down the page and then made five stamps of a week's worth of service. And as I went around the country, trying to educate providers on what they could be saying that would indicate what kind of medical decisions were being made and why the services of a PMR physician were needed. In those instances, it was frustrating, because I didn't see any change. You know, over the years of doing this, and there were even large national providers out there, who knew that they were going to be audited, and actually would keep 10% of their revenue in a bank, essentially. And when they got audited, and they got denied, they just paid the money back to the government. And in those situations, it was a slap on the wrist, because they basically got to hold that cash for 18 months or two years interest free, do what they needed to do with it from a capital perspective, if they were, you know, building new facilities or wanted money on their books for their investors, to demonstrate that they were making money, and there's really no penalty for it. And that that got frustrating to see. And so a RAC auditor approached me a couple years later, and had had the opportunity to go in and do RAC audits on the government side. And there is a lot of abuse out there that does occur, I would like to say that I was reasonable, and that we really tried to only focus on the abuse that was occurring out there. But I know that there are providers out there that that don't like me, because I think I was picking on them.

D.J. Verret, MD, FACS :

What sounds like some of those providers, though, just saw the RAC audits in the lack of documentation as a cost of doing business and operated without real concern in that realm.

Unknown Speaker :

They did. And, you know, especially with Medicare, it's so unfortunate how Medicare runs its business, that they don't have, you know, pre authorization, pre approval for procedures and for services that are rendered. And that's how they kind of you know, are able to process payments to physicians within two weeks. That doesn't happen in the rest of the healthcare industry. And also why I think the for profit world does a better job of controlling fraud than Medicare does. There's still a ton of Medicare fraud with, you know, dead patients getting wheelchairs, and, you know, any, you know, home health care services, because there's there's not that pre approval process.

D.J. Verret, MD, FACS :

So you were also telling me though, you went through this, the we'll call it the RAC phase of your professional career, and then an opportunity came to you kind of sounds like kind of out of the blue, that it was too good to pass up and you decided to start another company.

Unknown Speaker :

So yeah, the RAC audit position occurred at the same time that this was going on. So I worked for it. This was back when I worked with rehab care group, we were looking as an organization to invest and purchase a long term acute care chain. We had to partner with a private equity firm in order to get the capital to do that. And the private equity firm when they came in and looked at the books for rehab care group. I was a huge line item on sgma. And, unfortunately, I had never had this perception and I kind of wish the CFO that had been providing me all this Training had had made me think about this. But I had never documented what my return on investment was for providing the chief medical officer services that I did. And so it was it was hard when the private equity firm came in and said, Hey, you know, Kansas, huge line item on your, on your SGA. And I, it doesn't look like there's, there's a reason for him to be here other than kind of being like a figurehead cmo. And so we think that he's one of the people that you should let go. So I, you know, I talked to the CEO of the company, and the CEO was very apologetic that he was going to have to let me go. But internally, we'd been working on a business proposal for a couple of years on employing physicians to work out in the post acute world outside of inpatient rehab, so skilled nursing facilities, assisted living, independent, living, etc. Because we were having such a problem with RAC audits, and they had expanded to the skilled nursing facility world, and we had no control over the physicians there on their documentation, because they were usually independent practitioners, contracting with the skilled nursing facility. So the plan was to employ physicians to round in post acute, and, you know, provide them with education, provide them the templates, provide them with billing and collections and do a better job of documenting the services that were being provided from a therapy standpoint, rehab care, as an organization, their legal weighed in on our business proposal and said, We don't want to own any more physicians, we feel like the liability for physicians rounding out in the skilled nursing facility is too big. So they put a squash on that. But the CEO still felt like it was a viable business that he wanted to see created. So he ended up saying, Hey, can you know, apologize, I'm gonna have to let you go. But I'm going to give you a severance. And I'm actually going to give you a really generous severance plan. And I expect you to use that additional money to go out and start this company that we've been talking about internally, and all contract with you exclusively for the next two years, to give you business, and then you'll be on your own. I'm not asking for any equity. I just want you to go create this business. So I mean, where Where else? And when else are you going to have the opportunity, and someone provides you with a startup capital and a contract to go start your own business that you own 100% of?

D.J. Verret, MD, FACS :

I've never heard that story before. So when you ask that question, I know I've never seen that. It but it sounds like it's another common theme. You You had a pinch point that needed to be addressed you and so you developed a business that addressed it. And, you know, take us through that process.

Kenneth Adams, MD :

Yeah, so that was that was a difficult process. But one that we scaled up and we you know, they did provide contracts to us. I had to go find a partner who was going to recruit physicians for me. So we found a company that exclusively worked in the post acute world recruiting physicians. And I had a relationship with him, I gave him the company that he ran, we gave them some equity that had, you know, periodic earnout points to get more equity in the company. I went out and found a technology company that was going to build us some software for documentation back then. This is, you know, 2008, I believe it was and there wasn't really a good physician documentation system that could be used in the post acute world. I gave that company, some equity to help me develop that product. It also helped with billing and collections. And then I contracted with a billing and collections company, and then we went out and started hiring physicians. You know, it was a typical startup I while I said I was the CEO, when we first started out, I was the CEO of me. We had no employees, we had a lot of, you know, contracted entities that we were working with a lot of partners, but really no employees. And the first contract that rehab care gave me I provided the services in that situation until I could hire somebody. And that was our model. As we grew, I would find a contract work in that position for a month or two until I could land a position to work in that. And then I'd go on to the next next contract. So it did limit a little bit how fast we could grow. But at the same time, it gave us a consistent opportunity to grow because when you're building this kind of business, you're essentially trying to recreate a perfect storm every time Having a contract and a facility of having a physician who wants to work in that facility, and making that all happen at the same time. And that's hard. So that the the way I was able to accomplish that, over multiple times was to have me be willing to go in there and do the work. So, you know, like most startups, I'm the CEO, and I'm taking trash out at night, and just fill in every single role

D.J. Verret, MD, FACS :

As CEO and the janitor.

Kenneth Adams, MD :

Yep,

D.J. Verret, MD, FACS :

it sounds like this, this to relied on relationship building now, right?

Kenneth Adams, MD :

It did, it did. And it really it relied on having a business plan that you can present to a skilled nursing facility that made them recognize the benefit of having you on board. And that was, that was kind of a hard sell. But, you know, we had contracts in Florida, Missouri, Nevada, and Texas. And you built that company up over the course of six years. And ended up finally contracting back to Texas, that was interesting. You know, we had two providers, three providers in Florida, we had four or five providers in Missouri and a couple up in Nevada, and ended up letting all those go, but adding many more physicians in Texas, because we as we looked at the the financial considerations for managing people out of state and the amount of travel that was required for business development, it became obvious that it made more sense to have a very concentrated group of activity. So that the the business development person could drive where they needed to, rather than having to fly between locations, and having hospital systems that you contracted with, rather than just individual hospitals. So by the time we exited in 2014, we have 30 providers in the North Texas area. And I sold the company to a regional healthcare system here in Texas.

D.J. Verret, MD, FACS :

So it sounds like you know, it's interesting, as I'm interviewing entrepreneurs on their startup businesses, there's some common themes that that roll through, regardless of the industry or the specific startup. It sounds like one of the common themes that I'm hearing, in the end of your story there is the ability to pivot and refocus the company based on the market conditions.

Kenneth Adams, MD :

Absolutely. That's, that is probably been the most significant. You know, takeaway, I guess from my entire career, is I am often put in situations where what I thought was going to be the business plan to take us to an exit has to pivot midstream. I mean COVID is a perfect example of of needing to pivot for so many providers as they move from in person visits to telemedicine, and for other companies to figure out how to move their business to different different model.

D.J. Verret, MD, FACS :

And if you could take us now to kind of today, we were just a little bit over the 30 minutes, but I think it's fascinating. So let's keep going. But so you you have an exit of your staffing company there, next step for you?

Unknown Speaker :

The next step was to travel the world. My daughter started a nonprofit when they were five and eight. And they had been building water well water projects around the world. And so we spent eight months traveling around the world. Before we left, I had started a another startup that I tried to percolate while I was gone. And so when we came back and Dove back into that startup, which was a data analytics company, with my work with the regional health care system, as their system Vice President for post acute services, I began to have access to just reams and reams, terabytes of data on patient care. And recognizing that we don't take advantage of it in the way that we could and wanted to explore that further. And that's what I came back to in 2017. I had some outside funding to start this organization and unfortunately that that funding dried up and in 19 and I had to figure out whether I wanted to continue to self fund it and I have continued to self fund it. It's been a little bit painful but At the same time got a paying job which is good and went to work for United Healthcare in December really kind of leveraging my entire experience and career to to work for United because I think United at the at least at the chief medical officer level looks for people that have had a lot of experience in the insurance on the payer side. And I didn't have a whole lot of experience on the payer side. But um, when I was interviewing with the the plan CEO, he was actually really looking for a salesperson, from a physician, someone to go out and build relationships a relationship donor, I should maybe I shouldn't say salesperson has such a negative connotation, I think of it positively. But you know it, he was looking for a relationship builder. And so out of a relatively large pool of candidates I got picked, I was the only one that didn't have significant insurance experience. Because he wanted someone that was going to go out and press the flesh and talk to hospital CEOs and large IPAs and a CEOs and just meet with, meet with people and build the the UFC brand, and the UFC relationships with providers.

D.J. Verret, MD, FACS :

We're talking to Ken Adams, you're listening to Ask Me MD medical school for the real world. We're gonna take a quick break. And after the break, we're going to ask Ken what his top three tips for physicians looking for a non clinical career are? Stay tuned.

Commercial :

Commercial inserted here.

D.J. Verret, MD, FACS :

We're back with Ken Adams on Ask Me MD. So we've been talking to Ken today about his experience in non clinical medicine, your as we do with most of our shows, we're going to end it asking Ken for his top three tips for physicians who may be looking for a non clinical career can take it away.

Unknown Speaker :

Yeah, thanks. Thanks for pitching that question. I think that, you know, the The first tip I would say is that in the current environment, if you want to stand out with your resume, getting an MBA is helpful. Absolutely. I think that it moves you to a different stack. Although that stack is beginning to become in undifferentiated, I don't know if that's a word or not.

D.J. Verret, MD, FACS :

We'll take it, it's fine. Yeah,

Kenneth Adams, MD :

But there are a lot of CMO's out there. I'm sorry, a lot of MD's out there that are going out and getting MBAs and there's, there's a surprisingly larger number of pool of those types of physicians. So, you know, to differentiate yourself even further, having, you know, some type of business experience that you can point to, that gives you that ability to differentiate yourself, you know, being able to say, Hey, I ran this organization and had a p&l and had this many direct reports, that's really significant. Because that that doesn't, you know, when you're interviewing someone, most physicians don't speak that way. And you can, I guess, we can even talk about your own business and in in that perspective, because I think most of us talk about our businesses, as how many patients we cared for, etc. And I think the third thing would be finding a mentor out there in the physician kind of non clinical role to guide you through things. And, you know, I would try to find someone that that had some good business acumen, and has has done it before. And have them kind of guide you through it. So those would be my my three tips, MBA, get get some relevant business experience and find yourself a good mentor.

D.J. Verret, MD, FACS :

It's interesting, you bring up those three, I think they're great points. The third one finding a mentor is is something we've actually heard from other entrepreneurs as well. So it's, it's interesting to hear you mentioned that,

Kenneth Adams, MD :

You know, I think that the mentor is really key because I we didn't, we talked about all my successes. And we could have spent probably two hours talking about all my failures.

D.J. Verret, MD, FACS :

Also very important, though, is the failures and what you take away from them, though,

Kenneth Adams, MD :

Exactly. And that that's where a mentor can hopefully you know, reduce the number of failures. You have by half maybe making a mistake getting back on the horse is incredibly valuable actually, when I hire people now I talk to them and I ask them about their failures. Because to me, that is the big differentiator, someone who's been had had repeated success after success might not actually know what makes them successful, it may just be luck. But the person who has several failures and gets back on and then is successful, they've I think they figured it out, they've have been able to hone their experiences to figure out what their success keys are.

D.J. Verret, MD, FACS :

Well, one of one of the other folks we then I interviewed, a friend of mine, Erik Kulstad, Erik developed a medical device. He's an emergency room physician, we talked about developing medical devices. And he brought up the exact same thing and made the point that physicians generally are very successful people they've scored well, in school, they've they've, you know, gotten into medical school, gotten their college degrees, find a lucrative job for the most part. And so it's difficult for physicians, when they're rejected, to actually take the rejection, learn from it and move on. And he used it in his example, because I think he he had over 700 presentations for funding he had to put together before he actually found funding for his ideas. So he took a lot of rejection before it actually worked out.

Kenneth Adams, MD :

I think that's a really good point, because we are kind of in our own echo chamber. And once we get out into the real world, we don't get a whole lot of feedback, that that's meaningful. And that's, you know, as you get a mentor, hopefully, it's a mentor that's willing to give you some some potentially hard to hear feedback about how you present and how you show up in the world, because that's really going to be key.

D.J. Verret, MD, FACS :

We've been talking with Ken Adams, currently Chief Medical Officer of United Healthcare, but with quite the story of non clinical career. I'm Dr. DJ Verret, you've been listening to Ask Me MD, medical school for the real world. Thanks for listening. Make it an awesome week.

Announcer :

Thank you for joining us for another episode of Ask me MD medical school for the real world with Dr. D.J. Verret. If you have a question or an idea for a show, send us an email at questions at ask me Md podcast.com.