[00:00:02] Hey everybody, welcome back to the Outcomes Rocket, Saul Marquez here and welcome to another Founder Series interview. I'm so excited to have Rob Greer with us today. He is the founder and CEO of SovDoc. He's a seasoned healthcare executive with deep expertise in optimizing physician practices and guiding them through the complexities of the healthcare landscapes.

[00:00:27] He is really helping them take a look at what their practices are, how they're valued. As you all know, private equity is snapping up these practices and the best way to position yourself for success as a physician is to understand the models that they use to succeed. So with that, Rob, I want to welcome you to the podcast. Excited to have a conversation today.

[00:00:52] Yeah, thanks, Saul. It's a pleasure to be on and excited for the conversation.

[00:00:55] Likewise. So hey, look, before we dive into SovDoc, tell us a little bit about you. What is it that inspired your work in entrepreneurship and also healthcare?

[00:01:05] I've always desired to be an entrepreneur. I was always kind of a rebellious kid that resented authority. And so I always kind of knew I wanted to go down that path. But I took a little bit more of a patient approach. So I was born and raised in New Jersey. So kind of in the shadow of New York City, Bergen County specifically. After college, I worked in healthcare investment banking.

[00:01:24] So did the grind of 80, 90 hours a week in Manhattan. But it was one of those things too, where I spent two years working 80 hours a week, and it was comparable to almost four years of real experience.

[00:01:34] Yeah.

[00:01:34] I was in boardrooms with Fortune 500 CEOs and flying across the country doing IPO roadshows. So really a great kind of training ground and foundational business knowledge.

[00:01:44] I then took into healthcare private equity, which kind of will be more relevant to the conversation today. I was involved with the acquisition and growth of various kinds of healthcare companies across the space.

[00:01:54] We invested and touched everything pretty much outside of life sciences and biotech. We were in the largest capital and some large EHR providers. We invested in senior living facilities and medical office buildings to diagnostics and telehealth during COVID.

[00:02:09] And then we also played pretty significantly within the doctor practice PPM landscape. So DSOs to value-based primary care, aesthetics, and then multi-specialty ortho.

[00:02:18] And so developed a reasonably good appreciation for how to grow healthcare companies and specifically doctor practices.

[00:02:24] I obviously don't have an MD, but I think to some extent speak their language.

[00:02:28] Yeah.

[00:02:28] And I eventually became an entrepreneur. I was 27 about two years ago. I started with a health supplement company that I started with two doctors, and that's had some pretty nice success.

[00:02:38] And most recently, over the last few months, decided to start SovDoc. SovDoc is short for Sovereign Doctor.

[00:02:45] And Sovereign Doctor is essentially synonymous with physician entrepreneur, private practice entrepreneur, which, as you may know, is kind of an increasingly rare breed in today's healthcare ecosystem with hospital acquisitions and private equity acquisitions, which we could talk about.

[00:02:59] And SovDoc at its core is growth advisory. And what that means is essentially productizing the growth frameworks from private equity and applying them to private doctor practices.

[00:03:08] One more thought, and then I'll round it out, but we're geography agnostic and specialty agnostic, and everything we're doing is to increase EBITDA and profitability of the practice.

[00:03:17] And then, you know, secondarily, you know, having come from the healthcare private equity background, we're able to help illuminate that potential path for doctors, even if that's something that's in the medium and long term for them.

[00:03:27] Because our view is that if they're going to do some kind of a strategic transaction, instead of pulling the trigger on that prematurely, it's better to optimize the practice for that strategic outcome or that liquidity event, you know, far in advance, you know, months, ideally years in advance.

[00:03:42] So that's kind of where we sit within the ecosystem, but happy to kind of dive into any area that you think would be most impactful for your audience.

[00:03:48] Yeah, no, I love it, Rob. Thanks for the background there. It's an area of a lot of attention. The doctor practices and now for the last few years, ambulatory surgical centers, we're seeing a lot of involvement of PE, money, and frankly, like publicly traded companies really, you know, tripling down in the space.

[00:04:08] You know, talk to us about SovDoc. Like, let's unpack that. You know, what is it that you guys do to help a physician? How long does it take? What can they expect?

[00:04:16] So there's three main legs to the service line stool that fall underneath that broad category of growth advisory. And so really, the bread and butter of what we're doing is fractional CFO with a PE flavor to it is essentially what we call it. So most doctors, even large doctor practices with 10s of millions of revenue, frankly, oftentimes don't know what their EBITDA is. And EBITDA is essentially a proxy for profit. But it's also one of the two main components of the enterprise value of a practice. And so enterprise value is

[00:04:46] last 12 months of EBITDA times some kind of a multiple. And that is your enterprise value, you subtract debt from the enterprise value, that's equity value, then you know, the contribution of equity value and the distribution is what the doctors own. And so it's usually interesting for them to know what their practice is valued at. And that's core to what we're offering over the first three month period.

[00:05:06] We're also working with their accounting firms and their bookkeepers to flow those existing financials through our private equity models. So basically representing a pretty meaningful upgrade to their financials, we'll give them kind of great visibility into the historical picture, where the practice is currently, but then the biggest thing and where the private equity playbook comes in is where does the practice going over the next three to five years, the doctors usually have a rough idea of like, hey, yeah, this is where we want to be in three years, we want to have x number of locations, we want to hire, you know, y number of

[00:05:36] new surgeons, we want to use surgeons. And you know, we want to ASC enable ourselves. But what we're doing is kind of converting that vision in their heads into Excel projections, helping them reverse engineer to the present moment, and then solving for that on a monthly basis. That's really, you know, what a private equity firm does. And so giving them that visibility and their treatment as if they were owned by a private equity firm without necessarily having to go down that route is really core to our offering. Secondarily, we can actually help move the needle on revenue. So specifically with some of our

[00:06:06] aesthetics clients, we're aesthetics clients. I'm here in Westwood. So you know, 10 minutes outside of Beverly Hills, we're working with a lot of aesthetic practices, and we could actually help plastic surgeons do more facelifts or more liposuction or dermatologists med spas via Instagram, Facebook ads, and things like SEO and Google ads, too. And then strategic advisory is the third leg. And that's really just all things like strategic initiatives that practice wants to undertake. And so that can be ASC enabling themselves doing a new practice in Calabasas or Miami or Manhattan,

[00:06:34] or it could be you know, a practice that is filled with more millennial doctors that are looking to sell 25% of that, taking that money on the balance sheet and using that to fund expansion. Or it could be the elderly 60s orthopedic surgeon that is looking for a path into retirement and looking to get liquidity for the practice that they've spent decades building. And now in that scenario, be, you know, substantially selling the entire practice and then phasing out over the course of three years.

[00:07:01] And so that is kind of like our specific service offering.

[00:07:05] Got it. Now, thanks for walking us through all the components from financial modeling, getting your practice ready to sell. But you know, the truth is, like, if you get it ready to sell, you might not want to sell it, you might optimize it to the point where you're like, man, I should keep this thing for a little bit longer. And actually, that's where you want to be. And then it sounds like as part of the financial modeling and optimization, you guys also help with

[00:07:31] you know, increasing sales through various different things and planning. What are you doing that other people aren't out there, right? Because there's other firms kind of working in this space trying to help physicians. What makes you guys different?

[00:07:43] Yeah, just commenting on the first comment you made, which was everything we're doing can help facilitate a private equity transaction. But regardless, if you want to stay in private practice, these are still best practices to employ that at the business in order to make it run more efficiently and to improve profitability. I think if you're taking a microscope to your expenses into your revenue trends, that is going to produce better profitability outcomes all else equal. And so the idea is like better financial visibility is going to lead to better financial outcomes. That's kind of core to what we're offering.

[00:08:12] In terms of differentiation, I would say to some extent, the digital procedure acquisition is commoditized. Although I do think we have pretty high quality ad creatives by leveraging AI for certain components of the video for some of the voiceovers. And our media buyers are quite talented. And we have really compelling case studies that we can bring to bear. But I think the idea that we're a growth advisory firm that is comprised of ex healthcare private equity and ex healthcare investment banking, individuals and professionals is a value proposition that I don't think any other growth

[00:08:42] advisory firm in the United States has specifically focus on doctor practices, I also think our fractional CFO work, I personally haven't found another company that's doing that specific service. And I think it's one that resonates with doctors, to put it transparently, you know, most doctors do not understand, or at least aren't fluent in the language of business and finance and by extension, private equity. So Sovdoc and me as a river guide, helping them understand that path, helping educate them on finance, I think is a pretty unique offer.

[00:09:12] And that's what they're offering versus what they're offering versus what other companies may offer in the space.

[00:09:15] Got it. I appreciate that. Appreciate you clarifying that. It's good to know. And so really, when you look at a lot of these physician offices, whether it's with Sovdoc or the previous work you've done, what do you find is one of the most low hanging fruit items that people should be thinking about and tackling?

[00:09:34] Yeah, I mean, I think like table stakes in terms of like, generating digital patient acquisition and procedure acquisition online, a lot of practices aren't even doing Google or Google or ads or SEO. So like, that's a really easy one to institute, you know, SEO, just creating content and becoming thought leaders on certain keyword phrases that are relevant for your practice. And then complementing that with Google ads as well, since SEO is more of a long term game. That's a pretty easy one. I think Instagram and Facebook is certainly a next another layer of complexity, because you have to create a lot of things that are relevant.

[00:10:04] You have to create pretty sophisticated creatives, you have to do pretty relentless A-B testing. And the optimization of results takes a significant period of time. And so I would say that's other low hanging fruit if they're not already doing that. From the expense side, one, you know, just building those models. Oftentimes, you know, these doctor practices can be five to 10 million of revenue, and they have, you know, a single bookkeeper in the mix. And so they really, you know, I talked to a doctor yesterday that says, I haven't looked at my books in 24 months.

[00:10:30] And so helping them improve that financial visibility and upgrading the financial infrastructure is in itself low hanging fruit, but where we'll come in and say, hey, like this operating expense category for your orthopedic practice is far more bloated than some of the other practices we're working with, or some of the other ones that we're aware of in the market.

[00:10:46] And so we could actually draw their attention to where there's undue fat, expense fat within the organization.

[00:10:52] I also think like, although we're early in the world of healthcare AI, this is going to play an increasingly prominent role in the healthcare ecosystem.

[00:11:00] My view is AI is not going to spend doctors anytime soon, but maybe that same physician is able to see three times as many patients or five times as many patients in 2030 as they can today with the same amount of time.

[00:11:11] It's going to fundamentally remove or reduce the administrative burden that's taking the doctors away from their patient care and also contributing to burnout.

[00:11:20] And I think also it's going to take a step towards alleviating the physician shortage in the United States, which is very pressing for us, certainly in rural areas.

[00:11:27] So things like AI receptionist for patient scheduling, AI interfacing with payers for reimbursement, surgical scheduling, or having an AI listening in during the patient encounters in real time updating the EHR, or maybe the doctors in a meeting and there's some unique condition or side effect that the patient is dealing with and they need to refresh their memory.

[00:11:47] And the AI could actually go through PubMed and reeducate themselves on some topic that they probably haven't addressed since medical school.

[00:11:54] And then eventually, you know, I think AI will, our view is that AI-enabled doctor practices are going to succeed in the healthcare ecosystem of tomorrow.

[00:12:01] And so even if it's just doing things to unlock $50,000 or $100,000 of profitability, I think embracing it early is going to be a good and prudent place to be for a lot of these practices.

[00:12:11] Yeah, no, I love that. And all of these examples that you shared are great applications of AI in a healthcare practice, you know, really thinking through biggest obstacles to creating the business.

[00:12:25] Obviously, we're here founder stories. Talk to us about that. I know you're earlier on this venture. So talk to us, you know, early on any obstacles to getting it started?

[00:12:36] Yeah, I mean, entrepreneurship is not for those with a sensitive stomach. And it very much resembles a roller coaster. However cliche it is, it's how it goes. It's not just like, wow, this is a really crappy month. It's like, half this day was terrible and half the day was fantastic.

[00:12:50] And it just navigating the peaks and troughs just emotionally, right? I think like so much of entrepreneurs about pain tolerance, and just, you know, stoicism, if things are outside of your control, you just need to accept that.

[00:13:01] And you need to focus on the daily inputs and just showing up every single day instead of some arbitrary net worth goal that you have by a certain age.

[00:13:08] And like, so much of my first leg of the journey was like, hey, I want to be worth x at y age. And now it's just like, I'm going to show up every day and do my best and things will solve themselves.

[00:13:18] So that's kind of this like the high level entrepreneurial philosophy that I kind of live by. But in terms of obstacles, I mean, this business is in September is going to be fourth month revenue. So it's still nascent, it's still fluid.

[00:13:29] I think part of it's just like, you know, I have this high level skeleton of the business, but like, I'm letting it flow in the directions that have the most product market sit and where we can frankly add the most value because as an entrepreneur, your compensation financially is a fractional piece of the value creating for your clients.

[00:13:46] And so as long as we're preserving the ROI, even if we're doing it across five clients now, but 100 in a year, I think like if we take a piece that ROI, you know, it's going to be really successful outcome for us and really successful outcome for them.

[00:13:59] I would say, because of the fact that doctors don't oftentimes understand the power of financial visibility and finance and business, it takes a little while to educate them.

[00:14:09] And so like the sales cycle is a little bit longer than I anticipated. Maybe it takes three or four calls, whereas I thought it might have taken one or two.

[00:14:17] Also, like just the dynamic of these doctor practices where you have 10 orthopedic surgeons, five of them in their 50s and 60s, and they're looking to kind of sell the practice.

[00:14:27] Five of them are in their early 40s, and they don't want to be employed by a private equity firm.

[00:14:30] It's like reconciling all those different priorities and preferences.

[00:14:34] And I mean, they usually have to operate with unanimity before hiring us.

[00:14:38] So like it takes a little bit of massaging and a little, you know, several calls.

[00:14:42] But I'd say those are probably the biggest obstacles, but there's also just this glaring opportunity in the market.

[00:14:47] And I think, you know, we're going to be well positioned to take a lot of that market share.

[00:14:51] And so I'm really excited by the opportunity, but not going in blind that it's going to be an easy road.

[00:14:55] Love it, man.

[00:14:56] Now, I appreciate you highlighting that while at the beginning of the road, certainly some great insights there from Rob.

[00:15:02] Hey, Rob, you know, if you wanted to leave our listeners with a takeaway, what would you leave them with?

[00:15:08] And if they want to learn more about you, where can they find you?

[00:15:11] Yeah.

[00:15:12] Takeaway.

[00:15:12] Is this from like an entrepreneurial perspective or from the perspective of doctors or anything like that?

[00:15:17] You know what?

[00:15:17] Let's make it from the perspective of SovDoc.

[00:15:20] So I guess as an entrepreneur, I think it's clinging to the idea that everything is going to work out in the long run.

[00:15:25] And just having that confidence is really kind of a stress reliever for me.

[00:15:28] I think when I encounter micro adversities on a day-to-day basis, I try to remind myself, is this going to matter in a month?

[00:15:34] Is this going to matter in a year?

[00:15:35] And that kind of helps me push through some of the obstacles on a day-to-day basis.

[00:15:39] But as it pertains to SovDoc, I think doctors should empower themselves to understand business and finance more.

[00:15:46] And our view is that they should be teaching that in medical school.

[00:15:49] And because they're not, that's where we're going to kind of come in and solve that gap in the market.

[00:15:53] So much about so much of sovereign entrepreneur, the philosophy is empowering doctors to stay in private practice if they want to.

[00:15:59] And empower doctors in the healthcare ecosystem of tomorrow.

[00:16:02] One where private equity and AI are going to play an increasingly prominent role.

[00:16:06] You know, the next four to five years, we're at the being of a new industrial revolution.

[00:16:10] And I think doctors upskilling themselves on AI is going to be very lucrative for them.

[00:16:14] Especially if they're millennial doctors that have another 10 to 20 years left in the tank.

[00:16:18] And as it pertains to private equity, the percentage of doctors that are going to be employed by PE firms is going to go up no matter what.

[00:16:25] But certainly is going to be the case if there's a change of administration in November.

[00:16:29] And so I think just preparing for the healthcare ecosystem of tomorrow, it's going to be a prudent move for doctors.

[00:16:34] And we hope to be able to do that.

[00:16:36] And help them do that.

[00:16:37] Love it, man.

[00:16:38] Well, hey, you guys are providing a great service for physicians out there looking to take their practice to the next level.

[00:16:45] Get ready for acquisition or just have something really strong that generates cash flow for you, even if you decide to move on.

[00:16:53] Important things to consider, folks.

[00:16:54] So if you're in the place where you might need some help from Rob and his team, reach out.

[00:17:00] You could find his information, best ways to connect in the show notes.

[00:17:04] And by the way, Rob, what is the best way to get into it?

[00:17:06] I didn't call that out.

[00:17:07] Yeah, I was just...

[00:17:07] No, you're good.

[00:17:08] You're good.

[00:17:08] I noticed that.

[00:17:09] So my email is rob at sobdoc.com, S-O-V-D-O-C.

[00:17:13] I think that's the best route.

[00:17:14] And then you could also go to our website and book a call directly with us.

[00:17:17] It'll go directly to me as well at sobdoc.com.

[00:17:21] And so to the extent anyone is interested in receiving kind of a bespoke plan, analysis of their practice, and even a free practice valuation, please feel free to give me a call.

[00:17:30] Even if you're not a great client sit right now, maybe you will be at three years.

[00:17:33] And it's always great to make a connection.

[00:17:35] Love it.

[00:17:36] Rob, thanks for that.

[00:17:37] And folks, thanks for joining us.

[00:17:39] We've got Rob Greer here, founder and CEO of SovDoc with us.

[00:17:44] Rob, thanks for joining.

[00:17:45] It's always a pleasure.

[00:17:46] Appreciate it, man.