The Megafactory of Healthcare with Etan Walls, CEO at OnSite Medical Solutions: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody! Welcome back to the Outcomes Rocket, Saul Marquez here, and today I have the privilege of hosting the amazing Etan Walls. Now, you guys are probably like, wait a minute, I’ve heard of this guy before. Well, that’s because he’s been on here before. So he is a repeat guest here on the Outcomes Rocket, an amazing person. He served as Chief Operating Officer of one of New York’s largest medical partnerships. His vision is to redesign health care in a way that will not only protect patients but empower physicians and other healthcare workers. Etan is a dynamic and innovative executive equipped with a wealth of experience in achieving operational success. Possessing a progressive aptitude for business process mapping, organizational change management, strategic planning, and compliance, Etan volunteers on a regular basis and has sat on the board of three different health care startups. And that number of startups demanding his time is increasing. He has published multiple blogs on health care topics and is the author of a recent book, The Mega Factory of Health Care: Retooling the Machine to Create a Healthier World. He was recognized in Long Island business news as one of 40 under 40 to watch. And today I’m excited to have him on the podcast again. Etan, thanks for joining me.
Etan Walls:
Thanks for having me. That was a lot of stuff about me. I’m very embarrassed by that.
Saul Marquez:
Listen, you’ve been up to a lot. It’s been three years since we last connected on the podcast. Obviously, we’ve chatted and been together since then, but just incredible work. And I’m just honored to have you back on here to share with the listeners what you’ve been up to. So thanks for joining us.
Etan Walls:
Thanks for having me. I’m excited. It’s an exciting time in health care. We’re talking a lot about it. I’m excited to be at the forefront of some of the change that’s happening in healthcare.
Saul Marquez:
Yeah, well, your mindset has always been intriguing to me because you are always thinking about those angles that a lot of people aren’t. Why don’t we start off the discussion by really just touching on what inspires your work in healthcare? But I also want to know, what is it that inspired you to write this book? Tell us about the book as well.
Etan Walls:
So it’s actually one of the first things I talk about in the book is what inspired me to go and be in health care and it’s my mom who is a nurse and has been a nurse for a very long time. I won’t say how long he’ll have to book. I actually got a call from her about that complaining I was being too specific about certain things in the book. And I think that every person who is part of the continuum out there are saving people’s lives. And if you go in with that mindset, you’re excited about being able to save people’s lives. If you’re going and giving a COVID test or billing for a test, you’re part of that process a little bit part of that process. And so that’s why I got into health care. I wrote the book for a much different reason. I had the ability, as the pandemic was raging, to be reaching out to friends of mine and have really deep conversations because we had more time. And I was listening to them on chats on Zoom group calls talk about health care and really not understand certain things. Why is my be all messed up? What is that about? Why do I get charged this amount but my insurance pays this amount and then I have to pay more than the insurance pays? I don’t know how that works. And it was clear that over and over again I was having the same conversation bringing people up to speed about how health care worked, what were the economics about it, why we were where we were. And that became very important as we were in the midst of a presidential campaign and many people were talking about Medicare for all. So I really wanted to come in and kind of educate how we got here, where we are, and then some suggestions about the future. What are the things that we can do to really make changes? Wholesale change. Whenever the government gets involved in health care is scary because they kind of messed up every time they do it from meaningful use to some of the takedowns of different laws that have happened over the last five or six years. They’re there to be very tactical because that gets them re-elected. And that’s strategic, which is generational.
Saul Marquez:
Well said. Well said. Yeah. So Etan, there’s definitely the need for this context and I feel like in order to make an impact, you really have to understand where things started and also put that together with the vision with what could be. And I feel like you do a good job of both. So talk to us about really around what you believe this book could do to help the health care ecosystem.
Etan Walls:
So first and foremost, it allows people who are engaging with health care to feel a little bit more comforted on why things are happening. Educating themselves on health care, how the doctor’s office is working, who’s providing our care, who is managing the people we’re providing our care, allows you to be an informed consumer. And I think that an informed consumer and the smarter consumer is much better than the alternative. That’s first and foremost. Secondarily, as we look at the things that are coming down the pipe around health care and understanding that the wholesale changes that we’re trying to make in the past be made in the past aren’t necessarily the ones that we want to have happened again. And we need to make some incremental changes to allow us to understand how things work for us to be able to understand which big changes we should be making. Should we have lobbying out of health care? Should we be more transparent in our pricing? Does Medicare for all work or will it ruin the rest of our economy? Coming out of the last downturn,ve know very clearly that they utilized health care as a driver for jobs, as a driver for building up the economy. I spoke about another place recently where if you look at what happens when GM builds a car, right. It’s not about just GM making the car. It’s about their suppliers and their supply chain. We saw that very clearly the last downturn that when they stopped making cars, other people hurt. And so the economy was downstream of that, a huge downstream effect. The people who were the suppliers, the people were making lunch for the people going to the suppliers and the people in the factory. The people cleaning the factory. If we start taking apart health care and say there’s only one player in this country, what’s going to be the downstream economic effect of that? And how will that lead to our own pocketbooks will, in fact, be more expensive for people? I don’t necessarily believe that government should get out of the business or get out of the way. I think that we need some baseline understanding of where we are in health care and how decisions that were made in previous administrations, whether it be meaningful use or others, has really affected us negatively over and over again.
Saul Marquez:
Yeah, Etan. Well said. And you know, the thing that I really want to hone in on here, just with all of your expertise, is around businesses today and maybe we could spend a second here understanding what you do with Onsite right. you’re working with a company today with a unique solution that I believe is very unique and an example of the types of unique perspectives that you actually can help operationalize out there.
Etan Walls:
So Onsite Medical Solutions, which was built out of COVID. We originally started as a concierge company and worked with whether it be construction or high-end commercial real estate or entertainment clients doing COVID testing. Before that, they were doing concierge medicine or doing vaccines. But really our pivot is moving into what we’re calling ultra communal care. And that goes along with a couple of things. The world has changed over the last 14, 15 months. Employers are looking at ways to reduce their costs in health care. They want to get their employees back in the office. They want to be able to provide a safe environment for them. And they want empathy to be a driver of their businesses. We’re seeing this over and over again. Employees want a reason to come back. They want to feel safe in the office. They want empathy if they get injured and have to file. It’s amazing when you’re empathetic to somebody who gets injured on a job site. Their chances of claiming for worker’s comp claims goes down because you’re treating them in a way where you feel good. They feel good that they’re being cared for. And when you care for people, again, shocking, they don’t want to sue you. And really, convenience is a huge driver. Compassionate care is a huge driver. So if we think about those drivers, what we’re doing with On-Site is taking the next step. The proliferation of telemedicine has been huge over the pandemic. And we’re using that as an enablement for us to put a whether it’s a paramedic or foreign, uncited businesses and buildings, commercial buildings and on work sites for construction enabled through telemedicine, utilizing emergency room physicians to do low acuity care. So about 60 to 70 percent of the things that you could do with monitoring care will be done closer to your office. It can reduce absenteeism. It can give you comfort that you do have a trusted medical profession there. And really our goal in every encounter is an empathetic, compassionate care at every turn. And we also have flat, transparent pricing to employers or building owners if they want to do it as an amendment that also gives a sense of security around where health care costs are going, which is a thing that I know many of our leaders are very concerned about as how their health care costs are going up and they don’t see an end to that. And so it’s pretty straightforward for them or transparent in our pricing. And it’s one of the. Failures I see in the world in general. So, again, technology-enabled frontline low acute care. I think it’s a game-changer for the way that we’re going to look at medicine going forward.
Saul Marquez:
Yeah, it definitely is. When I learned about the model, I just thought to myself, man, this is a fresh approach that our health system needs. This is the fresh approach that your thought leadership offers to companies trying to get an edge because the models of yesterday are not going to work today. And so we have to be thinking outside of the box. The front door to health care has changed and it will continue to change. And the ideas that you have kind of implemented there, along with the team and On-Site Etan, are going to make a big difference. We’re paying so much money for health care, we have the time. Don’t know what it’s for or even how much it costs. So, yeah, I think you’re spot on with what you’re doing there in your vision. What could businesses be doing to improve outcomes or make business better in health care? What could they be doing?
Etan Walls:
So I talk about this in the book a bit, not in the vein of employers, but in general where we’re going. We are starting to build a health care model around quality, quote-unquote, quality care. And I think that we’re thinking about this in the wrong way. And employers are right at the front of this because they make decisions if they want to be in those quality programs as they’re being sold by commercial payers, right. The health care Aetna comes to them to sell them a product or broker with those companies, come to sell them a product to be able to ensure their employees. And a quality program could be attached to it. But they’re making the decision they want to be a part of it or not. I think that right now those quality programs are two legs of a three-legged stool. And let me explain. One is the physicians who are being incentivized and penalized if they’re doing well with their quality programs, the second leg being the insurance companies and de facto the employers who are paying the insurance companies to incentivize or penalize those employers or insurance companies to do well on these quality programs. But we’ve left out the third leg, which is the patient. Employers are in a really good position to be able to include the patient in their care.
Etan Walls:
Quality programs will only work if somebody cares about their health. They don’t care about their health, then it can’t work because you need people engaged in their health to be better. And so employers offering mental health via telemedicine to make it easy for people to go seek out care and preventive screenings like a prostate test or PSA Test, to go get a blood test, not a big deal, but if it’s in your office, it’s really not a big deal to check your blood sugar or blood pressure right. if it’s there and it’s a preventative screening, why not have it at your office rather than having to do it on your own where you don’t know how to navigate care?
Saul Marquez:
Yeah, you know, that third leg and like for the longest time, like, we just have neglected the patient because in health care and if you take a look at Etan’s book, you’ll learn that if you don’t know already that typically the patient has not paid. You know, it’s been between the payer and the employer and the health care provider. Today with increased deductibles and just so many other things, the voice of the consumer has become that much more important. We are starting to care more because the dollars are coming out of our own pockets. So this program that Etan is talking about enables us to take that interest that has so long been ignored of the patient of us and actually meld it to make the entire program work. I think it’s a great way to approach it. And so as you view the changing, everchanging health care landscape, what would you say is maybe one of the biggest setbacks you’ve experienced or you’ve seen one of your client’s experience and a key learning that came out of it?
Etan Walls:
Oh, this is this was the worst question the last time I was here. And I think I gave you the answer that I usually give, but I’m going to give you a new answer. The usual answer has been to this point, is the person that gets the way that gets you there isn’t necessarily the things that will keep you there. And so looking at getting help in terms of being a leader was really important to get me to a certain point. I think that the biggest setback I’ve had over the last year was leaving Allied and leaving that organization in July and doing something new. Walking away or separating from a company is a hard thing to do. It was the right thing to do, but that was a big setback for me and it took me some time to get out of it. But I think I’m in a much better place now.
Saul Marquez:
Yeah, now for sure. And it’s one of those decisions that is tough, right? Because you were you’re doing great things and you just have this calling to do something different and something else. And now here you are. You’ve written this. Look, you’re helping companies with their business models and you feel like it’s been a change worthwhile.
Etan Walls:
Yeah, look, Alled has some of the best doctors in the world. I truly believe that. Some of the best people too. But having some distance has allowed me to really figure out how I can be much more impactful on the larger world outside of where I was. And so that’s been a great opportunity for me. And I’m excited about the book. I’m excited about On-Site and I’m excited about the things that we can do.
Saul Marquez:
Yeah, that’s fantastic. Well, congratulations, Etan. I know that Allied benefited from having your brain in that organization at work for a long time and now there’s an opportunity for others to benefit from what you can offer. And so as we share this message to everybody listening, there’s an opportunity here for you to really team up with an advisor that could probably help you see things that maybe you haven’t before and help you tackle your business in the new angle that maybe you haven’t thought about in the past. This show is all about taking action, about the things that can improve outcomes and business success. And I would tell you that knowing Etan, tapping him for the direction of where you’re going, if you’re not sure, it’s probably one of the best decisions you can make today. I’ll say that lightly. So really thinking about the future, what are you most excited about today, Etan?
Etan Walls:
I’m most excited by the rapid change that’s happening in health care right now. We’ve jumped so far ahead in some of the things that many people in the industry have been pushing for so many years telehealth, patient engagement, empathy towards patients, customer service as a guiding North Star in terms of what we’re trying to do in health care and the rapid growth of health care I.T. is the tools that we’re utilizing to engage with patients and engage in the world. I’m no expert in social determinants of health. I don’t purport to be, but understanding that that is part of the process is really exciting to me. I’m really excited to see what the next year it’s going to take. I’ve gone from trying to make long-term plans, just making plans next week because things change so rapidly these days and we don’t know anything. Like if people have asked me 15 months ago what I’d be doing now and I could have given you a really clear answer on that these days, I really don’t I don’t know what’s going to happen next. I’m hopeful for what’s going to happen next. And I have a positive attitude that’s going to happen. I love that.
Saul Marquez:
Yeah. And the opportunity to create great things starts with that faith backed up by purpose and a clear understanding of the industry you’re working in and you have all those items. So I am certain that there are great things ahead here. Always fun to connect with you. And by the way, you mentioned at the beginning of the podcast that your mom is a nurse. And I have to tell you, man, we just did a series on nurses. It’s happening right now and it’s about the power of nurses and innovation and business leadership. Oh, my gosh. And when you said your mom inspired you and she was a nurse, I just wanted to say, man, that’s so cool. And thank you to your mom, for all that she’s done. And she’s still a nurse, right?
Etan Walls:
Yeah, she’s still a nurse. She tried to retire three years ago and it didn’t take off. She said to me on Mother’s Day that she going to try to retire again. And I’ll say we’ll see if it takes this time.
Saul Marquez:
That is too funny. Well, God bless her and the work that she and all nurses do and in our world, because I never realized how broad and deep nurses touch our country and the globe. And so kudos to all the nurses out there. A reminder that we appreciate and love all the work that you do love nurses.,
Etan Walls:
Love the nurses!
Saul Marquez:
Love the nurses. Ayten, thank you. Just an incredible time. Why don’t you leave us with a closing thought? What should we be thinking about? And then what’s the best place where the listeners can reach out to you and connect.
Etan Walls:
You know, look, my closing thoughts really simple. Engage in your own health care. Take control of your data, control of your of what you’re doing with your health care. Understand the things that are in front of you and being sent to you. Understand who’s seeing you. Is it the doctor that’s owned by a hospital, by an insurance company or they owned by private equity? Where am I getting my care from? Is the quality of care what I want it to be? Am I comfortable going to somebody else? We look at social media, we look at reviews to find our doctors these days, talk to people, and many people are still getting word of mouth. It’s OK to switch doctors if you’re not getting the service if they don’t have the technology if they have a clipboard and doing a bunch of paper, is that what you want for where your data is going in, for what you’re doing? And is that part of your value system? Right. That’s the question I asked here to go take a look at. You can find my book on Amazon. It’s The Mega Factory of Healthcare: Retooling The Machine To Create A Healthier World. And I can be found at strongwallsconsulting. or onsite.com. And reach out. etanwalls@gmail.com.
Saul Marquez:
I love it, by the way, folks, Etan is E T A N W A L L S. We’ll put it in the show notes too. So if you want to get in touch with Etan, very easy to do it through the show notes and also up through the various aspects of businesses that he’s involved in. Of course, last but not least, make sure you get his book. Well, Etan just incredible. Appreciate it. I definitely will be picking up a copy of your book. I look forward to reading it and also I encourage everybody listening to pick it up as well. Etan. Thanks for joining us.
Etan Walls:
Thank you. Saul.
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