An Entrepreneurial-Minded Approach to Medicine - Dr. Robert Lord, Partner at LionBird Ventures

Shiv Gaglani: Hi, I'm Shiv Gaglani and today I'm really happy to welcome a good friend of mine, Dr. Robert Lord, who recently completed his medical degree at Johns Hopkins capping an amazing decade of accomplishment as a venture capitalist and entrepreneur. He's currently a partner at LionBird Ventures where he supports digital health startups. Prior to that, he co-founded Protenus, which provides healthcare organizations with risk reduction solutions. Robert’s insights have been featured in Forbes, The Baltimore Sun, and at many national conferences, and he has briefed the U.S. Senate on cybersecurity threats to our nation's healthcare systems. So, Robert, it's good to see you all, and thanks for taking the time.

Dr. Robert Lord: Oh, thank you for having me. It's such an honor and a delight both to have a conversation with you, as well as to be a part of this program today.

Shiv Gaglani: Yes, we've been through a lot together.

Dr. Robert Lord: We sure have.  

Shiv Gaglani: Almost a decade ago, we met at the Johns Hopkins School of Medicine. I obviously know quite a bit about you and your background. Maybe you can, for our audience, give them a sense of what got you interested in a career in healthcare, because you had a very non-traditional background going into med school.

Dr. Robert Lord: I was not your typical pre-med. At Harvard, I studied basically political philosophy. We called it social studies. Then I went on to work at a hedge fund, Bridgewater Associates, for a few years, which was a terrific experience, but also, I think, gave me a lot of insight into how I wanted to spend the rest of my career. I think I really needed something with more mission, something that felt more tangibly hands-on in service. When I thought about the different options that were out there, medicine really came up as something that I thought would be quite interesting, but I had no experience in medicine. 

I took a bit of a leap of faith, I did a post-bacc program, which basically lets you take a whole bunch of pre-med classes in a highly condensed, extremely unpleasant year of science classes. I made great friends and colleagues from that time. Then I went to medical school at Hopkins. Once I really started working with patients, I think the remarkable thing for me, and that I feel very blessed about, is that this very intellectual decision - to say, medicine seems like this great service-oriented type of field and I wanted to take the quantitative background that I had from Bridgewater to apply it to what I thought would be very interesting problems in healthcare -  but that that kind of intellectual decision became one that just felt so joyous and viscerally fulfilling when you started working with patients. I mean, that was the magical thing for me. It was very gratifying to have that leap of faith be the reward. So that was kind of how I initially got into medicine. I'm happy to go into what happened. I didn't quite get to finish med school at that time. Life got in the way a little bit.

Shiv Gaglani: Yes, we're definitely going to get into that. Before we go into what you did once you started med school, Bridgewater is really well known around the world largely because their founder Ray Dalio has written a number of pretty great books, Principles, and most recently, Principles of a Changing World Order: Why Nations Fail. So you mentioned it gave you a really good quantitative background and really honed your quantitative skills, which obviously helped in your later career. Bridgewater is also well known for kind of how direct their approach is and how they've teamed up. I'm curious, what other things have you learned from that time at Bridgewater that maybe have helped you, or even hurt you in the healthcare system?

Dr. Robert Lord: It's too bad our podcast listeners can't see the grin on my face. But yes, exactly. Bridgewater is a really unique place, and I felt tremendously privileged to work there. While ultimately finance wasn't my personal mission -- that's just not where I wanted to spend the rest of my career -- the colleagues that I had there and the things that I learned there were tremendously valuable, as you alluded to. I use them every day. 

I think the big thing that I took away, and that I tremendously value from my time, I was fortunate to actually get to work with Ray pretty frequently. He was a great teacher in many ways, and just observing him is its own lesson in many ways, as well as that element of radical transparency that Bridgewater is so famous for. I would say that element of both really being honest with your colleagues in such a way that you're pushing them to constantly improve and also being really honest with yourself about your weaknesses and how you need to get better and also your strengths and how you can augment them. I mean, that core lesson, I think, built the foundation of so much of the rest of my career and my leadership philosophy, and how I like to both constantly interrogate myself and how I can do better, and how I can get more aligned to the missions that I have in my life and then what's important to me, and then also how I can help others achieve their goals and kind of coach them or assist them or mentor them or sometimes manage up and help them achieve something that's more true to who they want to be. So I think that that element of radical transparency is what was really fundamentally valuable for me.

Shiv Gaglani: Totally. That sounds obviously very useful both as a clinician working in a team, leading a team, or just being part of a team, all the way to being a startup founder, which we'll get into now. So there was a pretty interesting time period at Hopkins med where for four years in a row two Hopkins med students took time off to start companies. We had Craig and David, who were two years above me, they took time off and did Blueprint Health in New York to start Simcat, and then both of them actually went back and finished residency and are still involved in digital health. The next year was Ralph and Mike, as well as Henry from my class, who took time off. They did Rock Health to start Reify Health, which has done tremendously well. Then there was me and Ryan, we took time off and did DreamIt Health in Philly to do Osmosis. 

Obviously, our audience is very familiar with Osmosis.

Then it was you and Nick, taking time off to do DreamIt Health Baltimore to start Protenus. I don't know what was in the water at Hopkins those days. We got to know each other pretty well. You've come a long way, and we've been very proud to see the progress you and Nick made with Protenus but for our audience that doesn't really know much about Protenus or cybersecurity in healthcare, can you tell us about the origin stories as well as kind of what the last decade or so has yielded for Protenus?

Dr. Robert Lord: Yeah, absolutely. Obviously, it’s a topic I enjoy talking about. So my good friend and co-founder Nick Culbertson and I were both in medical school in the same class, a year below you, I think, at the time.  We were doing this research project, essentially looking at electronic health records, and long story short, what we began to realize -- in what originally was more of an academic research project -- was that health systems had enormous, enormous risks from a legal, compliance and safety perspective across their very large system. There were so many things happening with electronic systems and physical systems. 

Some of the things that we tackle at Protenus are things like HIPAA violations. For example, people looking at records they shouldn't be looking at like celebrities, or coworkers, which, sadly, used to be very easy in the electronic health record and obviously, that's a terrible violation of patient privacy and dignity.  There were also challenges like drug diversion within hospitals. People were using the automated, almost vending machine-style units that we have for dispensing drugs, and they're often taking drugs that they shouldn't for either personal use or resale. So these are just two of the examples of the types of problems that Protenus tackles, but they're just many, many risks that exist. 

What we realized was that hospitals were so overburdened with trying to tackle these risks, they could really only address the tip of the iceberg. You know, they could maybe do some random audits, they could respond to complaints, but there were still tens of millions, hundreds of millions of activities that were occurring that they had no way to know if they were appropriate or inappropriate. Maybe they were fine, maybe they weren't. But there was no way to know because there was so much manual labor involved in these investigations. So, what we realized is, advances in artificial intelligence had enabled systems, obviously not in this space yet, but we thought was possible, to look at every single one of those individual transactions and say, is this appropriate or inappropriate in a clinical context and an administrative context? Does it make sense that this person is pulling these drugs out from this drug dispensing machine? Does it make sense that this person is looking at this record of someone who may or may not have the same last name or something complicated that might suggest this is their family member or it might just be a coincidence, it's very hard to tell. 

While people initially thought that it was kind of an impossible task, because of the complexity and scale, what we quickly found was in fact, we could build a new gold standard for what's now called healthcare compliance analytics. I'm proud to say that Protenus is the gold standard for healthcare compliance analytics in this country now. I'm not sure what I'm allowed to say on that at the moment, but it’s a very significant proportion of the United States health systems. We serve hundreds and I believe now in the four digits of hospitals across the country, so a very large number on that front. We're out there, I'm excited to say, really protecting patient dignity, protecting patients' safety, and importantly, helping hospitals systematically reduce their risks and ultimately, help translate that to improvements for patients, improvements for safety, and improvements to their bottom line as well. 

Shiv Gaglani: Yeah, it's incredible the scale that you guys have achieved in just a short amount of time. And I'm sure there are, of the hundreds or thousands of health systems you reach, that's millions or tens of millions of patient lives you've helped. So, at a certain point, you actually went back to medical school and finished and just graduated. Now you're an emergency medicine resident at Hopkins. Can you talk to us a bit about that decision process and how you decided to go back? Nick decided to stay on at Protenus, and then somewhere along the way, you picked up LionBird Ventures, so maybe talking about transitioning into how that came into play.

Dr. Robert Lord: Yeah. Ultimately, I was fortunate to have an experience that many founders dream of: you help build something that you don't need to be there every day for it still to be successful. You helped build this machine alongside our terrific team at Protenus that now operates with just a great team of leaders that Nick and I were really proud to have on board and train and work with and lead over the years. I'm also very lucky to have a co-founder, who was an able leader who, when I left, I knew I could trust the company in his hands, and I was very comfortable with that. Not every entrepreneur has this perfect confluence of events on that front, but those were sort of the facilitating mechanisms.

Those have to be true, because of course, as a founder, I have an obligation to make sure that I take care of my team, and I take care of our mission and customers. That's going to come first. But because those things were true, I also had this real passion to go back and pursue clinical medicine. I began to realize that while I of course love, Protenus -- I love the work, I love the mission, I love the customers that we serve -- I did still miss the laying on of hands that comes with medicine. There's something really unique to being one-on-one with the patient in one of their darkest hours, perhaps, and helping support them. 

I also felt that we're at this very interesting inflection point in healthcare right now, where the healthcare system is basically at its point of absolute break, I think, but simultaneously, we're seeing advances from a technological systems payments perspective, that I think have the potential to finally bend the curve of some of these problems. Now, I'm an eternal optimist. I have the cynicism of any entrepreneur who's sold to enterprise healthcare systems on how our incentives are rather badly mangled in our healthcare system. So I have no illusions about that. But I'm an optimist in that I do think that change is possible, and I think that change is going to come from people who both have the knowledge of how to build entities that scale in the private sector and in other contexts as well, and who also understand what it is to have responsibility for a patient's care for a patient's life, for that setting of really one-on-one interaction, that sometimes we don't understand on the pure business side. That's just the reality. As does the clinical side not necessarily understand some of the business reality. 

I knew I wanted to spend the rest of my career in healthcare, that's something that's very clear to me, and if I was going to continue to do that, I wanted to make sure that I both got back to the actual practice of clinical medicine and completed my training, as well as had the ability to maintain a longitudinal practice within healthcare. Because I think if you're not continuously maintaining that perspective, if you're not really -- we use this analogy in entrepreneurship frequently, it's obviously a little less applicable in healthcare -- but kind of ‘eating your own dog food’ with relation to the technologies that you're using every day with regard to medical records and analytic systems, devices, and all that, then I think it's hard to really fully be able to fix some of those problems. 

Now, obviously, there are a lot of great entrepreneurs who are fixing all sorts of different problems, and they've never spent a day in a hospital outside of their own personal medical needs. There are a lot of great clinicians who are doing systemic change with absolutely no entrepreneurial knowledge whatsoever. But for me, at least, I thought that this was a particularly perhaps useful intersection of my strengths and the things that I enjoyed, and that's how I wanted to spend the rest of my career.

Shiv Gaglani: That's really inspiring and pretty unique. Because again, you and I run in similar circles. We know a lot of people who, at various times, pursued clinical training and some of them dropped out, some have finished all their training and became physicians and then eventually became entrepreneurs after all of that. But it is rare, this is a much less common path. Partially because not all schools are as flexible as Hopkins has been for people like you and me, in terms of letting us defer to keep working on our companies, right?

Dr. Robert Lord: Absolutely. 

Shiv Gaglani: For instance, Harvard Med let one of our friends at Omada Health, Sean Duffy, only take one year off before they said ‘you either have to come back and finish or you have to drop out.’ Whereas Hopkins did not give us that kind of ultimatum.

Dr. Robert Lord: Yeah, you know, as much as I love my alma mater from a college perspective, I have to say that I do think that a policy that penalizes individuals who want to go and take some time to do real systemic change in medicine through private sector endeavors or otherwise…I think that is somewhat short-sighted. I hope that institutions do have the foresight that I think Hopkins really does. I'm inspired by the leadership at the institution that was able to do this. I think those are the institutions that are going to be able to capture more of the future of healthcare. I have heard that I think there's a little bit more movement towards this. People are understanding the value of it. I mean, a decade ago, it was really, really weird, and only in the last few years have I seen more and more people do this, particularly on the East Coast. I think there is also some regional variation as well.

Shiv Gaglani: So not only did you go back and finish med school, but you were also a partner at a VC at the same time, LionBird. Can you talk to us a bit about that, and how you managed to be a VC while being a med student at the same time?

Dr. Robert Lord: Yes. So, for a little bit of background, LionBird is an early-stage digital health VC, focusing essentially on elements of healthcare that can range from the back office of compliance, billing, all those things, to front-end clinical devices that are ultimately connected to software on the other side. It really runs the gamut of everything I said, except, you know, surgical screws. We do a lot of really, I think, exciting stuff. 

I originally met the principles of LionBird because LionBird was an early investor in Protenus, so we had the opportunity to work together there. We've been on the board together, obviously. I am chair of the board and so I would work with Ed Michael, one of my fellow Partners all the time. One of the things that I really saw in LionBird was that they were always there for Protenus, good or bad. I just thought they were terrific advisors. I liked them as people. I was really honored when, you know, I said I was going to be headed back to medical school, that they very kindly said, “Hey, we don't know what your capacity is going to be like medical school, but we would love to bring you on as a Partner, if you were interested.” 

I was extremely flattered. It was a firm I admired a lot, and we made it work. Bottom line is yeah - you got to flex a little bit. Sometimes you're in the ICU for twenty-eight hours at a time, and you can't necessarily take as many pitch calls. But actually, it works out pretty well. You can kind of figure it out, if you're doing shifts and things like that. Obviously, I couldn't be 100% on that front. But I think we had quite a fruitful relationship and we continue to have fruitful relationships. I led a few investments on that front, I sit on a couple of boards on behalf of LionBird and we continue to invest out of our third fund, which has so far just been a really terrific experience.

Shiv Gaglani: That's fantastic, and do you mind talking to us a bit about some of the companies and problems you're most excited about solving? A lot has changed, obviously, the last two years, relative to when you and I were med students and first met a decade ago. The last few years have accelerated a lot of trends that we talked about way back then -- telehealth and remote monitoring. What gets you most excited about the next decade or so of health healthcare innovation?

Dr. Robert Lord: I can certainly speak to the "to come." Now, of course, I love all of LionBird's portfolio equally. We love all of our children. But there's two companies I sit on the board of that, obviously, I'm very excited about. One company, Phrase Health based out of Philadelphia, essentially helps solve the problem of what are the interventions that we place into the electronic health record that are valuable and improve patient outcomes. Anyone who's in healthcare knows that, if we're using EPIC, or Cerner or any other EHR, we're constantly getting these alerts that say, "make sure to start your sepsis timer," or "are you sure that these two medications don't have a bad interaction?" or, you know, "did you put on your pants this morning and are you gonna go walk out without them?" I say that because they range from extremely helpful and you're like, "Oh, I definitely need to start that antibiotic" to "Yes, computer I put my pants on this morning," right? 

What we need to do as a field is understand which of these alerts are valuable and downstream improve patient care, save costs, remove variation in healthcare, and which are just burdensome for the provider or potentially deleterious? Phrase Health has an extremely complex meta-analytic platform that nonetheless is extremely simple to use. Basically it allows teams to do their own quality improvement projects to understand how they're bending the curve within their own hospitals, and to understand how the alert-based interventions or reminders are ultimately creating value, and improving care for the health system, which is very exciting. 

They're able to do some remarkable work, streamline in, package it and make it simple for hospitals to do this. This is particularly important now when we have challenges like the nursing shortage and rampant burnout among our clinicians, such that variations in care are increasing dramatically. Travel nurses are coming in, they might not know the protocols, very understandably. It's not the fault of nursing. But if you're moving to different hospitals all the time, how do you know which protocols to follow, which boxes to check and all that? Then just in general, we're strained beyond belief now in healthcare. Anyone who's on the wards knows what it's like now in health systems. And it's really, really, really tough. Phrase helps take some of that burden off and really improves patient outcomes. 

The other company that's just really terrific is a company called Phantom, which is completely different insofar as it actually provides what I like to think of as an API for the peripheral nervous system. It's a minimally invasive device that allows for connection to our peripheral nervous system and muscles, such that we can use extremely lifelike prosthetics -- instead of really burdensome kind of short-lived nerve base surgeries -- we can use them on a more ongoing basis with much less invasive surgeries. So, we can enable people to have full complex mechanical function of their limbs after amputation -- or perhaps muscle deactivation or a lot of other things -- and ultimately have that come in a relatively straightforward kind of outpatient deliverable way, instead of a highly complex neurosurgical or plastic surgery that needs to be done. So those are just two terrific companies, but also show you the breadth of what we invest in at LionBird. And I'm very excited about both of those.

Shiv Gaglani: That's fascinating, and it'll be cool to watch that space, and maybe eventually, we'll have them on the Rase the Line podcast.

Dr. Robert Lord: Their founders are just terrific. They're terrific.

Shiv Gaglani: Awesome. Well, it's so cool that you can wear so many different hats. You're an entrepreneur, yourself -- still involved in Protenus as a chairman -- so you get to see all these other companies share your lessons and not have to be the main operator across these different companies. So, turning back to the clinician side, we're recording this a month you’re your residency. You chose emergency medicine. How do you see this all playing out? Are you excited about practicing emergency medicine? How are you envisioning the future for yourself? 

Dr. Robert Lord: I was just so honored to be accepted to the Johns Hopkins Emergency Medicine Residency program. Obviously, they took a risk on a very odd-looking resume. I don't think there's too many candidates that pop out as this strange. I'm very thankful for Dr. Linda Regan and the rest of the leadership team -- like Gabe Kelen, our chair -- who were extremely supportive and continue to be extremely supportive. 

When I think about how I want to focus this time, obviously, you know, I'll continue my longitudinal engagement with the companies that I work with, I'll continue that investment. But of course, when you're treating patients, you got to keep your patient care first, as well. So, for the next four years, I'll be focusing a lot on becoming the best doctor that I can be, while of course maintaining my other responsibilities. But I'll say, I won't have too many hobbies, let's put it that way. Because between those two, yeah, that's a lot of work. 

I think in the long run, I'm trying to stay somewhat open as to the different ways that the problems can be solved. Obviously, investing with LionBird is something that I think is really important to me and continues to be important to me. I think that the firm has enormous potential to continue to transform healthcare in a really unique and special model and I love working with the team as well. And then I want to make sure that, as I mentioned earlier, I continue to intersperse that longitudinal clinical work as well. I think that emergency medicine is particularly excellent from the perspective of the fact that we do shift work in emergency medicine. When you're on, you’re on and when you're off, you're off, so you have a bit more of a predictable schedule. Of course, the cost of that is you might be working a bunch of overnights. You might not necessarily have the best hours in the world but that predictability is probably the reason why if you look at entrepreneurs, a lot of entrepreneurs and investors, who are physicians, there's an outsize proportion of Emergency Physicians because essentially, it's one of the only fields where you can really do that, I think effectively. 

But I think emergency medicine is also very exciting from the perspective of it is so much at the center of a lot of the core questions of what we're facing now with value-based care as well because essentially, all the flaws of the healthcare system become reflected in the emergency department, right? We've got bounced back patients because we're not longitudinally caring for our patients. We’ve got individuals who don't have primary care, so if they have an illness, they're coming to the emergency room where we have massive staffing issues across the hospital, and the whole hospital is backing up because we haven't yet figured out our operational workflows. Where's everyone going? In the emergency room? Right? And so you are right at the nexus of all these problems, but to me, the problems that our healthcare system faces are the fuel that shows me where the opportunities are, too. My passion is, how do we improve healthcare? How do we solve these big problems one problem at a time and tackle them? I don't think I want to be anywhere other than that. 

Shiv Gaglani: That's awesome. That's really exciting. We have a lot of friends who've gone into emergency medicine. We've had a lot of them on the podcast, because as you said, it's a field that's well suited to wearing other hats. 

Dr. Robert Lord: Plus, it's just super cool. I mean, emergency medicine!

Shiv Gaglani: Yeah, it's the best, for people who like risk and adrenaline. It's great, right?

Dr. Robert Lord: The entrepreneurial personality, I think, is inevitably attracted to the emergency medicine side. But also it's just a privilege to care for such a diverse patient population. People are coming from all walks of life, all sorts of situations, and to be there to support them in their hour of need is a really unique and special honor and privilege too. I'd be remiss if I didn't note that as well.

Shiv Gaglani: I know we're coming up on time, so I had two other questions for you. The first is, as you know, Osmosis is a teaching company...

Dr. Robert Lord: I remember using it as a med student. 

Shiv Gaglani: That's awesome. Yeah, exactly. We want to fill in knowledge gaps, and I'm curious, given all the things you've learned along the way -- and the fact that you're now back into practice -- if you could snap your fingers and teach the next generation of physicians, nurses, etc. something about healthcare, what would it be and why?

Dr. Robert Lord: You know, I was thinking about this the other day in a different context. I think the thing that I find interesting is, so much of healthcare actually does have parallels to the business world, insofar as much of our job is to help align people to the course of treatment, or the next steps that are in their best interest. But they might not, for a variety of different reasons, understand or accept, or want to be a part of that. And some of the reasons are completely legitimate, obviously, we respect patient autonomy. But sometimes it's just a matter of saying, "hey, you know, you may think that you want this or you don't want this intervention, but let me explain how this is going to affect your life. You may not want to take this medication every day, or pay for this or deal with this hassle but think about what's going to happen ten years from now, if you don't. This surgery, I know sounds scary. But if your goal is to be able to hold your grandchildren in six months and help take care of them with your family, that's how you're gonna get there.”

Sometimes the answer is they're 100% right. We explored all the options, and they should be doing exactly what they thought from day one. That's fine. We're not there to impose our will on patients. But so much of this is extremely analogous to the complex sales process as well. How do you understand what people really need? What drives them? What are their goals? How do you understand the problems that they face in their day to day?  I think that a video on how do we elicit the truth of someone's motivations and how do we connect that back to their care even in this really bite-sized way that I think draws on some sales principles, connects them to the realities of medicine, which are different, of course than sales. That might be a fun, educational video and I think it'd be a very high-yield five minutes as medical students and residents go on the wards and really have the job sometimes being salesman of people's good health.

Shiv Gaglani: That's a really good point. I agree, there's a lot of parallels between just seeing everyone as a person and everyone has motivations, and the better you can understand and empathize with those motivations -- whether it's hiring a VP of sales or selling a health system, or trying to convince a patient to do or not do a certain course of action -- that makes sense. It's persuasion and behavior change. So yeah, I'll take that back to the Osmosis curriculum, to see what we can do. My last question is what advice would you give to this next generation of healthcare professionals about meeting the challenges of the hopefully post pandemic world, and then finally, is there anything else that we haven't talked about that you wanted to bring up in this conversation?

Dr. Robert Lord: I guess to your first question, there’s no sugarcoating how terrible the last few years have been in so many ways. I wouldn’t want to say anything other than that, at some level, and it would be unfair to all my colleagues and mentors and friends who have gone through what was really hellish and horrible. There’s not a lot of words that can quite articulate the despair and burnout that was created by the very complex medical, social, political, legal issues that we saw. But, ever the optimist, I do like to think that in tragedy sometimes comes opportunity. 

I think that what we saw in the last couple of years is that people did start to realize that there are things that are unsustainable, and that there are a lot of things that can transform the future of medicine.  People actually started to realize “oh telehealth can make a big difference,” right? That’s the classic example. Now we’re retrenching a little bit, but I think we did see a lot of that.  We’re starting to understand that healthcare workforces are just not going to put up with some of the behavior they’ve been forced to put up with because that’s the way we've always done it. I think systematically we are overtaxing and overstressing our healthcare workforce. We’re putting them in ethically challenging positions where they’re just part of this grinding misaligned set of healthcare incentives and they have to find the best possible outcome of a bunch of bad outcomes. Any clinician who’s listening knows the types of things that I’m talking about, and I won’t go into too many examples, but fundamentally, sometimes it can feel like you’re a cog in a heartless machine that nonetheless is supposed to be delivering patient care to people. And that’s a terrible paradox to feel, I think, as a clinician. 

So what we're seeing are technologies that actually could finally start to say, “we're going to take all this busy work off your plate.” Why are you doing all this extra documentation and clicking all these boxes, going through paper, sending a fax -- which we still do all the time, right? Or how are we taking innovations that we have built -- like ever expanding EHRs -- and finally leveraging the data in that to build more advanced diagnostic systems instead of just constant billing entry systems. How do we take all this data and turn it into actionable insight and then ultimately, true transformation of these systems? 

So what I would tell people is, yes, it feels bad. There's a lot of bad right now. But I think we are at a transformative point in healthcare where those who want to take up the mission and run with the baton can make a real difference. The inflection point is there, and I am absolutely confident that the next couple of decades are going to bring exciting transformations in healthcare. Some are gonna say "Robert is very naïve. Nothing's ever going to change." But we are in the business, you and I Shiv, of telling people who tell us stuff is impossible to you know, "go shove it" and then show them what we can do. I hope more people -- whether you come from the clinical side or the entrepreneurial side, or you're thinking about one of these hybrid careers, which I of course, recommend, that voids out a lot of school and effort -- if that's something you're interested in, go for it. Don't let some of the despair that very logically trickles in stop you from being a part of bending the curve, and perhaps for this podcast today, “Raising the Line.” 

Shiv Gaglani: That's incredibly motivating, and well said, I agree. I'm trying to find more sources of optimism, and I think one of the key pieces of advice I would give people is surround yourself with people who are optimistic, who lean towards optimism. Not irrationally optimistic, but passionately optimistic. If anyone's feeling despair because of healthcare, climate change, pandemics, political divisiveness, then reading people like Steven Pinker, Naval Ravikant, and even Elon Musk is pretty optimistic about the future in ways that most people are not. I think it is a really helpful thing to do. Anything else Robert, before we let you go?

Dr. Robert Lord: It's always such a delight to catch up with you Shiv, and congratulations on all your success and the wonderful success of Osmosis. I remember when it was an app on my phone and we were sending you bug reports directly. Now it's just this wonderful transformative tool for the medical education system. So gosh, I applaud you and your team for that.

I just have thanks and I have thanks to everyone who listens to this, and I hope there's a little piece of this that might have resonated with someone. If you're listening to this, also feel free to reach out if you've got great company ideas, if you know of people who are interested in investing, or if you're someone who's thinking about combining these two careers. It's kind of a small world, and we all try to help each other and lift each other up. We have each other's back. So you can reach out to me. I'm at [email protected] I'll give you my direct email address. How about that? 

Shiv Gaglani: And I'll give everyone Robert's cell phone number in case they want to reach him too. (laughs)

Dr. Robert Lord: Yeah, maybe not that one. Even now as a resident I still get sales calls for Protenus.

Shiv Gaglani: Well, Robert, thanks so much, again. I’m really proud of what you've achieved. I’ll vouch, for anyone who wants to reach out to Robert via his email address -- not cell phone number -- that he's been extremely helpful to me. I’m sure I've sent a couple of people who are interested in doing similar things his way as well. So definitely, take advantage of that knowing that he is a resident, so be judicious about that outreach. But, again, Robert, thanks for everything you've done. Thanks for Raising the Line. And with that, I'm Shiv Gaglani. Thank you to our audience for checking out today's show, and remember to do your part to flatten the curve and Raise the Line. We're all in this together. Take care.