Revolutionizing Women's Healthcare: The Her MD Story

<p>hello everyone this is Cole from the American Journal of healthc care strategy joined by a very special guest today Dr somi please introduce yourself hi I'm Dr somi javade I'm a board certified OBGYN I've been practicing about 20 years and I am the founder of a company called her MD [Music] I love The Branding so much you know your LinkedIn page is excellent I think you've done very well on the marketing end of things and that's one of the reasons why I wanted to bring you on is because we want people from medical backgrounds to get comfortable with founding organizations that can make a big impact in their Community I wanted to ask way back at the beginning of your career how did you get interested in medicine and then how did you and why did you choose to be an OBGYN well I was always good at science and math as a child went into pred because of that but went into women's health care because I nearly lost my mother when she was only 45 years old so I was Premed at Northwestern at the time and got a phone call from my father saying somie you need to come home my 45-year-old young non-smoking thin mother had left arm pain shortness of breath and chest pain you Google that now now and you're like it's heart disease right but her doctors kept telling her it's too much caffeine it's your kids and they kept blowing her off she ended up getting rushed into emergent quadruple bypass surgery and nearly lost her life and it was at that moment that I decided to go into Women's Healthcare well Flash Forward get through medical school and residency get my first job I'm seeing 50 patients a day I don't have time to eat let alone go to the bathroom or to be an advocate to make change and so after listening to women for nearly a decade I was like I'm G to open a center where women are Partners in their care I wrote down three words on a piece of paper Empower educate Advocate I was going to give them longer appointment times it was going to be insurance-based and we were going to specialize in Gynecology menopause and sexual healthare so I opened my first center in Cincinnati Ohio and a few years later witnessed women coming from 35 States and three countries wow so I knew I was on to something I have a question about that the longer appointment times so I I'm sure you've probably dealt with the coding and how a lot of these insurance companies they don't like that we've done something similar with a Delaware Valley ACO right where we had these great customized appointment times and then they said we're not not going to really deal with any of this so not the Dela ACO but the insurance company said we're not going to deal with any of this how have you gotten the insurance companies to cooperate with these appointment times I never said I got them to cooperate with me it's still one of our biggest barriers to growth are getting rates that we deserve uh particularly given our outcomes we do research and have outstanding outcomes we sometimes have a hard time getting on plans going into new States they're saying we have enough gynecologists I'm like well less than 20% are trained in menopause sexual healthare so a lot of companies have gotten around the financial piece by either going membership or concierge that was the antithesis of the mission of the company right we wanted to be inclusive we wanted to be approachable we wanted to be accessible so I opened a full-blown Medical Spa in each of our locations which allowed enough cash to come in Surgical Center Imaging so multiple revenue streams that really supported the 40 to 60 Minute appointments and allowed for Superior outcomes and very few women had to cross over to the spa and by the spa I don't mean we weren't doing massages or IV hydration I mean laser hair removal for women who have hormonal imbalances body shaping Botox lasers I mean very mainstream evidence-based FDA cleared treatment optional and I ALS also made sure that the medical providers were different than the aesthetic providers so your gynecologist wasn't going to do your paps mirror then walk you across the room and inject your face I just didn't like that feeling and so the model has worked inherently well women want to look and feel better and they love the convenience of having all these Services Under One Roof and it helped me not go concierge cash based or have to pay a membership for our patient yeah why are women traveling from different states to use your services that's one of the questions that I have well I think up now we're seeing more and more companies popping up right menopause everyone's talking about it but back when we started in 2015 if you think about it we were actually called the Blue Ocean opportunity when we when we went to fundraise because no one was offering true menopause and Sexual Health Care in an insurance-based system and so it was almost unheard of and so that's why they were traveling to us because they were desperate for care and so I one of the things I wonder though is that why why did you want to Target this group of people and go the insurance-based Dr I mean I know you wanted to be an advocate but a lot of doctors do choose to to do that concierge route so why not offer services at a premium or at a subscription base what was it in your life that you experienced that made you want to serve this population I love to teach I teach providers I'm on stages all the time I I love to teach patients and the general population but I learn every single day and sitting in those rooms day after day listening to patients experiencing their stories wiping their tears holding their hands I'm a Problem Solver like that was the thing I wanted to help and to say that I'll go concierge oh my God it would have been so much easier but a concierge physician on average can have a panel of patients about 150 okay her MD locations can handle about 10,000 and so if you are truly trying to change health care beyond the room that you're in you have to make it accessible and so I have lots of colleagues and friends that have gone concierge because insurance companies do not pay enough to cover the cost of health care for the provider or the patient but it just wasn't for me because after listening to a decade of stories and then going through my you know my own personal Journey with my mother I was not going to be yet another barrier to Health Care by putting up a fiscal or a financial barrier okay that makes a lot of sense I have a couple questions as well on on this note one of the questions a lot of our colleagues in the health systems have is how are you handling Specialty Care in a way that has good continuity we kind of worry about these you know CVS City Block Oak Street and then you know of course her MD some of these patients probably do have some serious health concerns what are you guys doing to facilitate that specialty kind of link so when you talk about menopause and sexual health care and advanced gynecology which oftentimes requires surgery or biopsy or Imaging you have to make sure that not only patients are educated and know their options but you have to train providers because less than 20% I think I saw a statistic that it went from now 20% to 31% of providers are trained in in menopause and sexual Healthcare I developed something called herd University which is all evidence-based referenced doubly peer reviewed and published for her MD providers it's an our internal training program but what we've done with that so not only has that taught a standard of care and given care algorithms to our providers but then we've been pulling data on our outcomes to see hey is our way truly better you know seeing the patients at this Cadence using these medications starting this way doing these procedures and we have been pulling data across multiple Chief complaints vasom motor symptoms are hot flashes vaginismus incontinence genital urinary syndrome of menopause and we are finding we are smashing the status quo and so how have we proven this we have operationalized ized the education and the treatment um algorithms of care and so we're training not only the patients but also the providers what does that patient training look like and the reason I asked this I was at a conference about a year and a half ago and I was working on getting our patients at the time at my job getting our patients to their OBGYN appointments really wanted to get them just to get their paps mirors that's all that we were really trying to do and at the conference we had a students panel and they talked about how in sex class they don't talk about women's health at all so these women come out of school at 18 19 they hit 21 and they have to get this past me and they have no idea what it is and I talked to my wife about this as well and it's terrifying right and once we implemented those Educational Tools at at Jefferson we saw a big increase in patients that were able to get this because they knew what it was how are you educating the community what are the techniques that you're using to get those patients to come to your clinic and feel safe so I'll tell you it's multimodal approach I take a lot of stages speak at a lot of events we hold a lot of herd events ourselves because education is one of the core pillars education advocacy and empowerment and I don't believe that women can make true choices or be partners in their care without that education that's been so lacking social media you will always find us on Instagram or Facebook either teaching live streaming events community events uh we send out a new newsletter which is very educational and has a high click-through rate and then if you look at our website uh it's been done very well this year um the final part of the herd initiative is to take those provider facing algorithms that are really written with a medical vocabulary in mind and break those down into patient educational handouts whether it's you know it it's going to be digitized but also in the offices and so it's really a multimodal approach but if you think about it adult Learners we have to see things multiple times especially hav't seen it before and we all learn differently and then we do have a podcast that I think we'll be relaunching we've kind of been as we're building out clinets and expanding that's gone by the wayside and people are like Dr Dade you need to get back on the podcast so multiple ways that we are educating our patients and the general public like whoever wants to tune in to us of course that's how I discovered you know you guys I'm in the space a looking for different organizations but the marketing was really well done and it really does give off a kind of a premium almost like what a conier service does offer for marketing but much more accessible and I really enjoyed that you mentioned a few times that you're building out these clinics and one thing that's really interesting is each Clinic you're saying can have 10,000 patients but with those 45 to an hour long appointment times that's triple to quadruple what most practices offer how have you been able to manage the staff to get those appointment times up so most of our clinics have one to two Physicians and then three either nurse practitioners or midwives or PAs that are prolific at menopause Gynecology and sexual Healthcare they just can't do the surgical piece and so that's the way we've staffed our clinics to maximize the number of patients we can see and then you have to remember something we don't have OB patients we do Gynecology OB patients are the ones that have to be seen weekly and that's why Hospital systems are wanting to partner with us because all of their providers their schedules are full of OB appointments that the last trimester women have to be seen almost weekly or every other week we don't have that Cadence of followup so it doesn't fill our books like a traditional OBGYN who's still trying to do Obstetrics and Gynecology right and obstetrics of course you're going to have probably more urgent situations as well that affect that scheduling and make who you have to have on staff a bit more complex how is your satisfaction though of your staff we know it's a big problem in Health Systems right now low satisfaction among physicians High attrition rate what does yours look like our patient reviews are 4.9 aggregate across the board culture is very important to us and a huge Focus the nice thing about our company is that it doesn't matter where the feedback comes from there are growing pains for sure as you take one location to two to three to four and then you're dealing with multiple states have we had turnover yes the sad fact is by 2025 47% of the workforce that was there before covid is not going to be there anymore because they don't have jobs that give them Mission uh driven work which we provide work life balance which we provide and the ability to grow at a hospital system they might say you have to have this many um years or this specific title but if we have somebody I mean obviously within scope of practice okay no one's doing what they they should be doing you have immense growth opportunities we may have someone who starts at front desk and becomes a national trainer and so we tend to attract the best of the best and we tend to retain them but if any Healthcare startup says that they don't have any turnover they would not be being honest with you of course there's always going to be some of that turnover how does that work life balance look like what is that are you guys leading the industry in that area uh I think the things that we have done some very unique things so number one just inherently with longer appointment times you're not going to be seeing 30 40 50 patients day number one number two we have hired a third party to take call for our providers so our providers take I'm not not going to say zero call because they do handle the surgical calls that come in but nearly zero call so can you imagine going from 50 patients a day to being on call every third or fourth night to having a job where you see 15 to 17 patients a day with zero call you know they don't work weekends and you can't say that at a hospital- based job I know I've done them and we rotate their evenings so yes we have to have evening hours because we have patients that work and they can't take time off or they have child care issues and so we are there for the patient that is why everyone shows up but we are able to rotate that evening schedule so that it's very fair and people can go to their children's games or go out to dinner or go play Pickleball whatever they want to do in the evenings they have that ability so I would say I don't know if we're leading the industry but we are definitely innovating it for sure absolutely it seems like uh Pro probably leading the industry compared to health health systems I know Health Systems have some pretty big trouble in that area so it sounds impressive I I think one of the other questions too that's really important is you mentioned you know that blue ocean kind of situation that was going on when you first started the organization this is a kind of a challenging question but what would you have done if the industry was already saturated would you have still plowed forward or would you have done something else and I'm asking this because of the Physicians who are here now or other people who may want to start an organization in in a saturated market so I bootstrapped the industry or I bootstrapped my own locations for nearly seven years and I started expanding on my own so I opened my second location and broke even in six months so I would have just kept expanding with the profits from the first location built the second but it would have been a very much slower paced uh growth obviously because I don't have the capital a physician right I graduated with med school debt put myself through med school I would have continued to do it just at a much slower pace and regionally maybe not gone as far because the further and further you go the harder and harder it is to quality control and to visit those locations and travel right and to make sure they feel good about the brand and they've been adequately trained I think it would have been geographically a lot more constrained had I just continued to bootstrap my own company very good answer there and so do you recommend this path to other Physicians the path of founding an organization of becoming kind of a people leader and a population leader would you do this over if you could do it again um wow those are some pretty heavy questions I love what I do because of the differences that we make I am a very driven person hard work has never scared me I mean as an OBG was working a 100 hours a week I have three kids I'm married to a oncologist but when you do start a company you do give a part of yourself away it's like giving birth yet to another um individual and so it's it's very emotional and being an entrepreneur is the highest of highs and lowest of lows would I tell people to do it absolutely because one of the number one things that's missing in um Healthcare is physician leadership and no one understands the provider patient Dynamic like we do because like I said we are in those rooms we are the ones making those decisions um for the patient and most of us are out there to help the patient and for provider outcomes and so to have the voice of the patient and the data and the science and the provider represented we need patient or provider leadership and so whether it's starting your own company whether it is joining the SE site of a healthcare organization that doesn't have uh Healthcare representation meaning a provider definitely need to start your own practice I had done Private Practice I had been an academic I had done part-time in a boutique like practice for me being my own boss was the best thing that I ever did I have an entrepreneurial spirit that had kind of in medicine they just want you to follow the leader and I was always the square peg in the round hole and always the one saying I have an idea and this can be done better I got my best ideas when I found that the problems or I've experienced them myself and I'm like this could be better for the patient this could be better for the provider so when I designed her MD that's what I talk about everyone who's looking at healthc care who's not a provider is you looking at it with a unilateral Focus they are focused on patient Centric Solutions which is great because Healthcare is really messed up right now but they forget about the provider and without providers we can't provide health care and I think that I would encourage people to take the leap it's a scary one would I do it all over again yes I love what I've done when I get women in multiple States telling me we've like literally changed their lives or the other day I had a patient come up to me and she's like my daughter is going to medical school and she literally said to me I want to be so when I grow up I want to cry but I don't want to minimize the sacrifices that it takes I feel like I'm working just as hard as when I was delivering babies it's a big undertaking really appreciate the honesty there I know I I've thrown you some tough questions but I really do appreciate it I hope that it you know it inspires me hearing it I hope it inspires others I'll leave you with kind of a maybe an easier question just to to leave off on where is her MD going from here what is does the future look like yeah so the future looks like opening more locations for accessibility and I think putting more locations in the states will already in actually will maximize our impact for now round of capital infusion next year is the goal and then to pick uh states where we can put down three or four locations and that's better for marketing it's better for Branding and brand recognition I mean you commented on that and it's also better for um insurance rates easier to negotiate when you have three or four locations opening up and frankly it's easier for hiring and moving staff around from location to location if someone calls in sick or has a baby and needs time off then you can move people around and so that's the lesson I learned the dreamer and me I wanted to expand as to as many states as possible and that's what we did but now from the learnings it's like okay we're in four different states let's just go deeper into the markets we're in and then pick up tella Health around all of those locations because we find that women are still traveling from multiple states to the locations we have any uh time that we might be coming to Philadelphia is that something that's uh in the future possibly it's on the road map I don't know what year it just depends on what happens with these Capital markets and honestly you know fem tech companies I think the years I've raised have raised less than 2% of of all the capital out there and we were over subscribed both of our rounds and so I think that really speaks volumes to what we're doing at her MD well I do hope you come to the area because we desperately need help here with our uh GYN Services it is uh terrible right now like three or four months waiting for just a simple 15minute appointment so it's a very challenging situation right now and your company I think is absolutely incredible Dr somy I couldn't be more thankful for you coming on and talking with Mar audience and sharing your kind of story with us hopefully we can have you on again and maybe in person when you open up the clinic in Philadelphia I would love that thank you for having me</p>