“Listen to Your Heart Faster” - Dr. Luke Murray, Director of COVID Testing at Wild Health

SHIV GAGLANI: Hi, I'm Shiv Gaglani. Today on Raise the Line, I'm really happy to welcome Dr. Luke Murray, who's Director of COVID Testing at Wild Health, a personalized telehealth service based in Kentucky. When the pandemic started, Wild Health was just testing its own patients, but the demand for testing grew quickly, and the company managed to scale up to become a major testing resource for the entire state of Kentucky and beyond. Today, it can provide testing at more than 100 locations on the same day, and has more done than a million tests and 150,000 vaccinations. Luke is also a Family Medicine physician with a background in system design and tech entrepreneurship. He has shadowed, taught and/or practiced primary care and hospital medicine in 10 countries. I first met Luke about six years ago at the American Medical Student Association Conference in Washington, D.C. Luke, good to see you again thanks for taking the time to be with us.

DR. LUKE MURRAY: Glad to be here, Shiv. Glad to be here. 

GAGLANI: You have quite an eclectic background, and one thing we like to ask our guests for the audience, which is primarily current and future healthcare professionals is: what got you interested in medicine in the first place?

DR. MURRAY: I was in eighth grade and considering career options, and I made this checklist. I want to work with my hands. I want to use my brain. I want to make a difference. And for whatever reason, my 13-year-old brain decided that becoming a brain surgeon fit the bill, so to speak. It provided a north star, so to speak, when it came to, what classes do I take? Where do I head? By the time I finished my undergraduate degree, the Head of Neurosurgery at the University of Kentucky was my mentor. I created my own major called the Business Administration of Medicine, and he was my thesis advisor as well. When I finally graduated undergrad, I was able to spend a bunch of time actually with neurosurgeons doing neurosurgery. That's what kind of got me going in that direction. 

I realized I don't want to stand in an O.R. for the rest of my life. But I had quite a bit of momentum at that point. I think that kind of is how it started and how I ended up probably continuing down that path of medicine. 

GAGLANI: Yes. That's very relatable. I think when you're a bright person who's noticed by your teachers and your parents as being super bright, the two career options that immediately people tell you you should look at are president of the United States and neurosurgeon. The first doctor I shadowed was Dr. Thomas Paine. When I went to med school, my advisor at Osmosis was Dr. Daniele Rigamonti, another neurosurgeon. I actually didn't know about the neurosurgery connection. What got you to change into Family Medicine? You probably could have gotten into any specialty given what I know about you.

DR. MURRAY: Sure. I would like to talk a little bit about not being able to get into almost any specialty. I think that's something that I care a lot about—med students that are really, really bad med students—which I was definitely one of them. But yes, the reason I switched to Family Medicine. Obviously, I did neurosurgery. I was thinking neurosurgery at first, but by the time I was in med school, I knew I didn't want to do that. By the time I entered medical school, actually, I knew I wanted to be an entrepreneur. I knew that the products or services that I wanted to be a part of offering, and I didn't want to do that as either the chef making the cheeseburger or the doctor providing the medicine. I wanted to be the orchestra conductor, not the lead violinist, so to speak. I ended up switching to Family Medicine because I didn't like any of them. They were all very narrow, and my main reason for being in medical school was to, again, be an entrepreneur in the medical space. So whichever one would give me the most breadth, and honestly, the least depth, I was most interested in, because it would allow me to understand, connect with, and relate to the most number of potential products or services in the healthcare world. So I didn't fall in love with Family Medicine, it just frustrated me the least as an entrepreneur that happened to be trapped in medical school for six years. 

GAGLANI: Well, that's obviously very relatable. I left medical school to start Osmosis, and almost every week, I get contacted by someone who's a pre-med or a med student or resident, or a practicing physician who wants to get into business and medicine entrepreneurship. There's a lot of advice, there's a lot of similarities. Obviously, delaying gratification is the name of the game. If you're going down the path of medicine and also entrepreneurship, it takes a lot longer than you think. 

I'm curious to actually veer into the entrepreneurship stuff. I know you've also started a tech incubator in Kentucky called Awesome Inc. Can you talk to us a bit about that before we go back into COVID and global health?

DR. MURRAY: It's funny you bring that up; I'm sitting in that incubator right now as I talk to you. Before I went to medical school I sold books door to door for a company called Southwestern. They're based in Nashville, Tennessee, and they are so old, that the reason their name is Southwestern, is because they were in the southwestern United States when they were founded. Nashville, Tennessee was southwest as the crow flew in the years it was founded. So when I did that, they do a lot of brainwashing to get you excited about working 80 hours a week knocking on doors, selling encyclopedias, so to speak. 

I had also, in undergrad and in high school started businesses. I thought, “Man it would be great if you could create an intense environment that encourages folks to start companies instead of sell books.” This was in 2000, and I started med school in 2009. In 2005, I believe, was the first Y Combinator class, a very famous tech incubator that pioneered a new way of helping people start companies. In 2007 or 2008, TechStars Boulder started, which is the second version of this. 

I heard about this from a friend—basically, the other guy that was in medical school to become a businessman and entrepreneur. We ended up becoming best friends, and he said, "Hey, you like mentorship? You like startups? Maybe you should start a tech incubator." So we tried to be the third—one in Silicon Valley, one in Boulder, Colorado, and then Lexington, Kentucky. We tried to launch and to raise a quarter-million dollars. We tried to copy them, and we failed miserably. But we did succeed. This is back before co-working was very popular, but someone told us about the concept of a co-working space. It is now a co-working space, and we do have an accelerator, and we do have an investment fund. We do have a coding school and a software company. But yes, 12 years ago, the whole vision was, we just want to become the third Y combinator out there, so to speak. 

I went to med school for two years and I took a year off and slept in the garage on the other side of that wall over there, and showered at the YMCA, and really, really loved getting this place off the ground. Then I went back to medical school and finished up. So yes, that was the impetus for it, and that's what it's become since.

GAGLANI: That's really cool, and very close to our heart. When we left med school we did a health tech incubator in Philadelphia called Dreamit Health, run by another physician, Dr. Elliot Menschik, and we owe a lot to that experience, so obviously, the companies that have gone through Awesome Inc. probably feel the same way. 

Switching gears, let's actually do a quick foray into global health, because that's been a passion of yours for a while, and global medical education, before we go on to Wild Health and COVID. How have you managed to practice in so many countries?

DR. MURRAY: Yes. That was what I wanted to do for a long time. I wanted to learn languages. I wanted to understand cultures. As early as undergrad, I looked for opportunities to go shadow folks, and obtained more and more responsibility as I went to medical school and then residency, and just made it a priority over a lot of years. It was really fun to see when I was for example, 19 years old and looking at Doctors Without Borders and seeing how you need all this experience, then, in my early 30s realizing that I'm a board certified, Family Medicine physician that can speak enough of Spanish or whatever the rule is, and being like, “Man, these are credentials that I dreamed of having for a very long time. I can actually go to do this now.” So yes, I just had an interest for a very, very long time.

I think something that is important to share with your listeners, at least the ones that are still figuring their lives out professionally, is that I set the goal of saying, "Hey, I want to serve the world. I want to, work and help in other countries," and it was in January of 2020 that I was laying in a hotel room in Ethiopia; it was my second time there and I was with a group of folks that were trying to start a medical school. So very much, at least on paper, in line with what I thought I wanted to do in life. I went to med school and as an entrepreneur, I thought, “Hey, I think I can do this better,” and I was interested in third world countries. So I thought, “Well, I'll start medical schools in other countries.” I was laying in this Ethiopian hotel room thinking, “I'm not having fun. I don't like this.” I was like, "Well, then why am I doing this?" "Well, because I said I would do this." “Why did I say I would do this?” "Well, because I thought I was supposed to." “Why did I think I was supposed to?” "Well, it was just a goal that I set.” 

I realized, man, I can change my mind. Just because I've done this for years—I mean, I applied to Doctors Without Borders, actually, reached out to them halfway through residency. I spent two years following up regularly with them to say I wanted to work with them and then I didn't get in. I made it to all the different rounds, all the way to the orientation, actually. They were like, "Yeah, we don't want you." I kept trying to go abroad. I went abroad several times, and I eventually just admitted, “I don't have to do this if I don't want to, and it's not wrong that I don't want to be an international do-gooder.” Which again, I had felt was the right way to live my life. 

That was, if you caught that date, January of 2020. I went back to the United States. I moved in across the street from an incubator, which is the place in the world that makes me the happiest. I called a buddy of mine that was one of the most successful entrepreneurs and physicians that I knew, and said, "Hey, will you be my mentor? Will you coach me?" And he said, "No, but you can be my employee. Want to help with this COVID thing?" The rest is history. 

GAGLANI: Well, first of all, I really appreciate that, your talking about all the zigzags in your career, neurosurgeon from 13 as the goal and global health, global medical education. I think that's a really important take-home point for any of the listeners who, many of them subscribe to things like “I thought I wanted to do this from age 12.” It's in their personal statement. They've literally told all these people at all these different schools to even get into medical, nursing, PA, and other schools, this is what they're going to do. Then to change their identity or what they want, it's a skill. It's really important to be able to honestly assess where you are in your life, and what makes sense. Because things change. Your interests change, you mature, but also the environment changes. 

So going into COVID. Let's go into Wild Health. Can you tell us a bit more about Wild Health, what it was doing, and then specifically about being director of COVID testing? I've seen interviews you've done for Kentucky news about going to rural Kentucky and trying to convince people who don't want to get vaccinated to get vaccinated. Give our audience a bit of background on Wild and your role there. 

DR. MURRAY: Sure. I'm happy to. I would like to put an exclamation point on the point you just made, though, about folks saying, "Hey, I'm going to do this," and then they don't do it. From 13 to 23, that was my answer to the question, “What do you do when you grow up?” “Brain surgeon.” And everybody's like, “Oh, my—!” You couldn't be patted on the back harder than brain surgeon. I'm not even trying to mess with these lowly doctors. I'm trying to be a brain surgeon now. I call that phrase or that concept you just described “listening to your heart faster.” Recognizing, "Hey, this is the direction my heart is pointing." How long is it going to take me to recognize it and align it to where I'm headed? 

I use a couple of examples. I wanted to travel before I went to medical school and I deferred medical school so I could travel, and my parents were like, "Hey, you should get a job." Essentially, I went down and I got a job, and it was the worst year ever, working in corporate America. It is one of the things that drove me to be convinced that I want to be an entrepreneur. Then when I was in medical school, I thought, man, I should start this incubator. Over the course of months, I made that decision. Then when I was in residency, I eventually did listen to my heart instead of ignoring it. My cousin sent me a Facebook post about a ski resort that was for sale, and I'd always said, "If I had a trillion dollars, I'd want to buy a mountain." This one was only 150 grand. Within 48 hours, I was in the lobby of that ski resort, saying, “Hey, I'd like to buy your mountain.” I didn't end up buying it; didn't end up succeeding, but just examples of how I was able to recognize what my heart was telling me and listen to it, quicker and quicker each time. It took me a second with the whole global health thing. But yes, I think you should listen to your heart as quickly as possible. That is a skill. 

GAGLANI: Totally.

DR. MURRAY: Yes. To your question about what the heck happened with Wild Health, we are a genomics-based, precision medicine company. Genomics-based means we use 23andMe, or any other number of services, to get your genome, and to look at your epigenetics as well. Then we use that information to make recommendations that are specific to you. Genomics-based, or precision or personalized medicine, is, as the name implies, precisely personalized to you. An example of that, that's the easiest to describe, would be pharmacogenomics, which is a fancy way of saying, "Hey, which drugs are going to work on me specifically?" You, Shiv, may have something in your genome that tells us that Hydrochlorothiazide is the most common first-line blood pressure pill, but you, personally, should start with a beta blocker, for example. That is what genomics-based precision medicine is. Of course we offer it via telemedicine so that we can we can have patients around the world, which I think we do. However, I don't have much to do with that, so I won't speak much more about it. 

As I mentioned in my story, I flew back from Ethiopia. I moved in across the street from my incubator and I just started reaching out to people that I looked up to, saying, "Hey, can I help out?” I think I told you, I would have called you next if I hadn't gotten a job doing what I'm doing, because I think Osmosis, and what you guys are doing, is so fantastic.

When I called him, I said, "Hey, can I be helpful? Can we hang out?" He said, "Hey, I've got this practice, and people are asking us for these tests and we have access to scientists and lab equipment." I just asked him, "Can we do a PCR COVID test?” and the scientist that we had worked for said, "Yes, we could totally do that for you." We just started offering the tests to our patients, because nobody else could get them. Then, those patients had like horse farms, because we are in Kentucky. So we would go out to a horse farm and test 30 people. Then those horse farms referred us to the Kentucky Derby, which we tested in 2020. 

Then the University of Kentucky called us, which is here in Lexington, and said, "Hey, can you test all of our students before they go back to school or before they start school?" Then the state of Kentucky said, "Hey, will you help set up these testing facilities all over the state?" Then in March of 2021, they said, "Hey, all that stuff you've been doing with testing, can you do the same thing with vaccinations, please?" That got us to where we are.

GAGLANI: That's amazing. I think one of my favorite quotes is Louis Pasture, "Chance favors the prepared mind." All these things kind of led to you being in a good place and then being able to scale it up. What are some of the lessons you've learned trying to scale up, both testing as well as vaccinations, both in terms of setting up these sites, but also convincing people? I mean, I don't know what the vaccination rate is right now in Kentucky, but I assume it's not the same as in California or Boston. What are some things you've learned, and maybe if there's any advice you can give our audience about how do you get people interested in getting vaccinated? Because I know you've had those direct conversations with people who are pretty vaccine-hesitant.

DR. MURRAY: I don't think I'm going to be able to say something very profound about that. Much of my time was spent sprinting all over the state, setting up sites and just meeting the demand that existed. We had some marketing campaigns, of course, to try to get people to come. But we had a very rare problem in our business. Most of the time you spend finding product market fit, which is something I'm sure you've talked about on this podcast and learned about yourself. What is the specific product or service that our customers want? How exactly do they want to receive that product or service? In our case, they just told us. They said, "Come here. Test on my employees. Give me a spreadsheet that has the positives, and do it as fast as possible." We just had so many of those coming our way, that our biggest challenge was not trying to get folks to sign up; it was just meeting the demand of the avalanche of need in our state. So can't really speak to how you talk somebody into it. I can speak a lot to what it's like to drown in opportunity.

GAGLANI: Where are things right now with Wild Health and COVID testing? Obviously, right now, the headlines dominating as we're recording this podcast are Ukraine and Russia, but just a month ago, Omicron was everywhere, and the hospitalizations were up. It almost feels like people have forgotten about COVID in the last week or two, for good reason. So what's the current situation at Wild Health in terms of testing, and are there new variants? What is your take on what the next few months are going to look like?

DR. MURRAY: A couple of things. Last month was the largest month we've had in the history of our company. This month is the smallest month we've had in almost six months, and it is hands down the largest single month-to-month falloff in terms of percentage and absolute volume that we've ever experienced. So I'll speak to what we're going through now, which I think is relevant to folks on a personal level, and that is, we're having to let most everyone go on our entire team. That's really, really difficult, because I care about them a lot and they care about me a lot, and we all believe in the cause that we are fighting for. 

It's strange. We're talking about right now, Ukraine is in the headlines. I've read a book by Sebastian Junger called Tribe, and he speaks about how people become sad when a war is over, which you'd think that we'd all be glad that we're going out and getting different jobs because people aren't dying anymore. Speaking of wars, COVID has taken more lives than the First World War, the Second World War, and Vietnam combined, and it's over. It looks like we've won, or come closer to winning than we ever have. So we should be glad, and we are on some levels, but being in the trenches with some incredible people has formed significant bonds that I'm sad are over, even though it means that we're going to stop losing so many lives. 

The analogy also that I would say is going to play out in the lives of the folks that are going through nursing school and medical school and PA school, is that the folks that you're going through difficult times with right now—I mean, med school was some of the hardest years of my life; I formed some really close bonds with those folks, and I haven't seen them since. So while I wished medical school was over, while I was in it, when I finally succeeded, I was like, "Man, I miss being in such a difficult experience with such incredible people."

GAGLANI: That's a really interesting point. First of all, I'm sorry to hear about that. As far as the company goes, I know to scale up to 150,000 vaccinations, and then eventually the vaccinations—if we're doing a good job, which you guys did, will do the job. Maybe there's a pivot to other types of healthcare testing and delivery that needs to happen, which we can get into. But I couldn't agree more that some of the happiest years at Osmosis were some of the most challenging, where it was fewer of us, and very much a tribe. Now it's much bigger, obviously, and doesn't feel as tribe-like, because there are layers of management and it's not a fight to survive as much as it is a fight to grow incrementally. 

What do you think is next for Wild Health, given that COVID is going down? Obviously, you didn't start with COVID in mind; it was personalized genomics. Are you turning a lot of your attention back to that, or not only what's next for a Wild Health, but what's next for Luke?

DR. MURRAY: Yes, I've been joking all along that I can't wait to be done or not need my job. But Wild Health, the genomics-based precision medicine side, has split with the COVID side. So we are two separate companies, just to kind of have a more appropriate separation of church and state. What is Wild Labs going to be doing? We actually—this is good entrepreneurial advice. Instead of us just thinking, "Hey guys, it'd be cool if we did this. I bet people will love it. Let's go ahead and spend the next six months building this product and then launch,” I had our customer service team reach out to our half million people that have gotten tested with us and said, "Hey, what do you wish we would offer you guys? You've seen what we can do across the state. What do you wish we would do?" We reached out to our corporate clients, Toyota and Nestle, and said, "Hey, what do you see us being uniquely capable of providing for you?" I reached out to the Director of Public Health for the state, Dr. Steve Stack, just a couple days ago and said, "Hey, how can we serve the government?” because they've been a client and then also we as a group spoke. We'll talk on Friday about this list of ideas, and we will then form some ideas for ways to test them, you know, firing bullets, first, and then cannonballs, from Jim Collins' book, Great by Choice.

So yes. I think that it has to do with us being very very mobile. I think it probably has to do with us providing very simple testing or vaccination services like flu shots or basic blood draws or drug screens, but we're trying not to decide ahead of time. We're trying to listen to our customers first and then come up with ways to test what we think are good hypotheses. 

GAGLANI: That again is really great advice. It's really important to be adaptable—to your own career, as you said, follow your heart faster, but also to tweak product market fit or tweak the products. There's so many different examples of companies that started with one hypothesis and moved into another one. 

I know we're coming up on time and want respectful of yours. You've already given our listeners a lot of good advice, given your own personal journey. Is any other advice you'd like to leave them with before we end?

DR. MURRAY: Yes, I'd like to leave them with this one thing, and I think it's fitting because it's the only reason that you and I know each other personally. I knew that I was interested in entrepreneurship. I knew I cared about healthcare, and I knew that the education system I was in was really frustrating, because it didn't feel like, if Google was going to start a med school, it wouldn't look like the med school that I went to. 

The only reason that I'm friends with you, Shiv, is because I went to the American Medical Student Association to walk around and meet other startups that were in the medical education space, and some of those folks have become my friends. Again, if I'm looking for a job in six months, which may well be the case, you'll be seeing my resume. So, I would just say, pay attention to where you're headed, and then go where those people are, and you'll form some pretty important friendships and some pretty exciting career opportunities. 

GAGLANI: That's awesome advice, and very much in line with the kind of serendipity of who you meet, whether it's an advisor or it's just a friend who then eventually becomes a colleague or in some other role. Anything else you'd like to share with our audience that we didn't cover today about you, about Wild, about COVID? Anything else you want to share?

DR. MURRAY: No, I would just repeat myself about how I met you. I didn't do it to build my resume, or to look good. I did that through much of my undergrad. I was just at AMSA because I cared about medical education entrepreneurship. You know when you're doing it because you care, and you know when you're doing it to look good. I just hope you have the courage to do it because you care, because you wind up a lot happier when you're following your heart in that direction.

GAGLANI: I love that. Well, Luke, the feeling's mutual. I'm very impressed with everything you've done, and deeply appreciative of the friendship we've built over the years. I look forward to seeing what happens in the next few months. Thanks for taking the time to be with us on Raise the Line.

DR. MURRAY: Sounds good. Thank you, Shiv, it's been a pleasure. 

GAGLANI: With that, I'm Shiv Gaglani. Thanks 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.