Entrepreneurs Rx_John Criswell: Audio automatically transcribed by Sonix

Entrepreneurs Rx_John Criswell: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt:
Hey everybody, and welcome back to Entrepreneur Rx. Today, I've got the real honor of showcasing someone I've known for a little bit now, his name is John Criswell. He is a multiple-time startup founder, CEO, he's a non-physician, and what I was excited about this is he's been so successful in this space that I really was excited to have him, John, welcome.

John Criswell:
Hey, thanks, John. Great to see you again.

John Shufeldt:
Thanks, good to see you, too. Hey, so give us a little bit. Give us, as I mentioned earlier, you know, we've had not all but mostly physicians on this one, and I want to start also highlighting people who've been really successful like you have, who didn't really come at this space, like, for example, I did through healthcare. They actually had some business knowledge instead of trying to figure it out in the way. So give us a little bit of your background.

John Criswell:
Sure, well, I guess, John, I'll start with I consider myself somewhat of a reluctant entrepreneur. I was working in a number of different industries from supply chain, which I consider healthcare, a complex supply chain problem, consumer products. And when I was leaving consumer products, I was enticed to get involved in healthcare. And the first thing I said to the CEO physician is, I don't know anything about healthcare. And he said, we'll teach you everything you need to know. And that really was the foundation of getting started in healthcare back in 2006.

John Shufeldt:
And what did you do before supply chain? Did you, I mean, you sound like you weren't an entrepreneur early on, would you? Did you have any inkling of that in your schooling?

John Criswell:
I did not, and when I speak with potential entrepreneurs, people considering entrepreneurs, students, one of the first questions I ask is, do you have any family members? Were your parents entrepreneurs? Have you done anything entrepreneur? In my background I did not. My grandfather and his brothers were plumbers and I think that was entrepreneurial, but I didn't really have access to that. He passed early in my life. So I was, again, really not surrounded by entrepreneurs, but always eager to do more, to do better, to solve problems. And that, in connection with some really fantastic entrepreneurs, learned a lot. With one of them, my formal kind of supply chain background, a family of entrepreneurs that I learned a great deal about, and then went into consumer products and learned a tremendous amount from the founder of Applegate Farms. It really helped build the foundation for what I've done since then.

John Shufeldt:
Very good. So what was the first healthcare startup you did?

John Criswell:
It was a turnaround. It was a five-unit urgent care in Maryland. And when I arrived, I thought, oh, my gosh, this is really an interesting problem, which allowed me to dip into this vast over a decade of supply chain experience that I had in consumer products. On the consumer product side, we had 21-day shelf life, right? Meat and cheeses and other types of products. And when I entered into the urgent care world, I was finding products that had spoiled a year, two years. I said, Wait a minute, we can do much better. And ultimately at that, at that time, taking that supply chain background, created very interesting models using data analytics. You might recall back in 2006 through '08, we had H1N1 swine flu. Some other interesting, very well, right? I felt like I was living what I perceived to be a clinical MASH unit without the artillery.

John Shufeldt:
It was the early, it was early COVID. I mean, it was the shot over the bow for COVID. At the time people were totally freaked out about H1N1, and when you look back at it, it was like, you know, that was nothing. But at the time it was, people were pretty freaked out about it.

John Criswell:
Well, as were we in practice, it's, the clinics we were running at the time were 5:00 to midnight and we were running almost till 3:00, 4:00, or 5:00 in the morning treating patients. At that same time, Google launched the flu trends, Google.org flu trend, since, removed it. And as a supply chain person, data is essential, and I found that data asset really critical to solving what patients were looking for online by typing things like flu-like symptoms, nausea, and others. And then we actually built a labor staffing model to support that so we could move patients more efficiently through the system.

John Shufeldt:
What was the name of the urgent care?

John Criswell:
At the time it was called Nighttime and we rebranded it to Righttime Urgent Care.

John Shufeldt:
I remember that name. So why did they bring a non-healthcare guy with no urgent care experience in for the turnaround? How did you get involved with that?

John Criswell:
So it's actually a lifetime story. I knew the physician CEO and founder. He was my pediatrician when, I mean, from the time I was three years old bouncing me on my knee, and had stayed in touch with him over the years and just received a call from him and said, hey, we're really having some challenges here, and I think we need a business person to help solve this. And initially, I was reluctant because I, again, had no formal clinical training and ultimately, as I have shared, just realized that healthcare can be solved with just some really solid discipline supply chain practices. But it was really, it was, I got hooked immediately, like this is, we can solve this, we can make it better.

John Shufeldt:
Was it a, it was, it sounds like it was a pediatric urgent care.

John Criswell:
It started out as a pediatric urgent care, expanded to adults, and then we ultimately expanded to 9:00 am to midnight, seven days a week.

John Shufeldt:
Wow, very good. Okay, so how long did that last?

John Criswell:
I was there for about two years. So we took it from, geez, I would say 11 million in revenue to doubled it in that time and improved EBITDA significantly. So it was a great, really fantastic business and great experience for me.

John Shufeldt:
That's excellent. Okay, so you stay there two years, you do the business turnaround, now you're hooked. You get out of there and say, My turn.

John Criswell:
I actually, I went and worked for a data analytics company. I became intrigued by what Google was doing with their search engine and the data assets that they were producing and went to work for a data analytics company doing what was, or what is called risk adjustment and quality and using data to predict certain mortality, morbidity, and illness-wellness morbidity, became fascinated by that and doing in-home programs as well as encounter facilitation. So to encourage senior populations to connect with their primary care, to receive treatment for their chronic conditions.

John Shufeldt:
Interesting, and how long did you do that for? So that was, so now I get a sense of why you are where you are. How long did that one last?

John Criswell:
Yeah, so there for a little over a year. And I decided that I needed to start my own company, which actually became a personal mission. I had, my two grandmothers, both were suffering in different ways. One was healthy and unfortunately had a condition that led to her death, and then the other was in nursing facility because the family, we just couldn't care for her and she had dementia, Alzheimer's, multiple chronic conditions. And every visit I saw the deterioration, I saw the treatment, I saw the challenges. And I said, you know, this is there's an opportunity here to predict mortality, morbidity on these populations, to help people live longer and stay in their homes healthier. And I was also very aware that the, there was no quality measure. There's no way to rate these skilled nursing facilities, these special needs. There's no real mechanism. And so one was to get out in front to do predictions on data to eliminate fall risk. Fall risks have very specific categories, and we developed a model that we could do predictions to avoid fall risk, to educate patients on what to do, how to do it. And so from that launched Pulse8 as a bootstrap, which was a healthcare tech-enabled company with my primary cause. And back then, I think I launched in 2011, back then, data was not cool. People weren't playing with data. And, I absolutely believed through prediction, you could eliminate things in healthcare that were unnecessary and wasteful and drive the dollars to the individuals who actually need it, because we spend a lot of money, whether it's care management quality that's unnecessary. And I thought if we could do this better than those, those components could drive a better solution. Interesting, we filed for patents on that in 2016 and happy to report that in July of this year the patents were approved. And so I'm a patent inventor, which was just kind of neat, but yeah, we proved that out, but dude, that journey, it was really difficult because most in healthcare didn't believe that you could be precise, that you could predict, frankly, kind of like my urgent care. When I first said we've got this massive data around Google and I think it can predict which patients we're going to see and where and we can direct which units, I got laughed at and said, You can't do that. That's not possible, you don't know what's going to see, what's going to come through our front door. And I said, I think we absolutely can. And frankly, the Google data was far more predictive than CDC data, which is essentially a voluntary reporting mechanism by providers, which, again, it's delayed, it's lacking, it's not as, at that time it wasn't as effective as Google.

John Shufeldt:
Yeah, it's funny, I thought I thought that Google, that flu tracker, was amazing because you're right, it's people in real time looking up flu and flu symptoms and where to go and what to do, and you get, you can absolutely see a trend. And I remember way back when you almost saw this wave going across different locations as the flu spread and people got sick from it. So I thought it was a great device. So that was.

John Criswell:
Pulse8, founded in 2011, my first healthcare startup. I've had others, but this was the first in healthcare, it was a bootstrap. We, once we were doing those predictions, when it was certain that the ACA or what is more commonly known as Obamacare, we moved quickly around predictions for one of the key tenets which was transfer payments, which was calculated based on the illness wellness burden rate. And from there the exchanges were delayed quite a bit. We had some contracts that we could not monetize because the exchanges weren't live. We were, I was bootstrapping funding the company personally, had everything for sale, my house everything, and raised a little bit of money from some friends, one venture firm, and we never looked back. And once the exchanges took off, we really accelerated, which was great, with primarily our data and analytics component.

John Shufeldt:
And who was buying that, who are you selling that information to?

John Criswell:
So there was primarily insurers. And at that time you had different what they call payviders. So health systems that offered insurance. So we had payviders in that mix and then expanded to value-based care. Anyone taking risk within a PCMH, MSSP, now ACO reach, those types of programs. Those were the primary customers.

John Shufeldt:
Interesting, and then, okay, so what was the outcome of that? What was the outcome of Pulse8?

John Criswell:
Well, I'll get to that. But I will tell you, when President Trump was elected in 2016, 95% of our business was on the ACA. And you might recall that the ACA was a target. And I got called the next day by a parent, a friend of my youngest. I think at the time he was probably five years old. He's like, Are you okay? I'm like, What do you mean, am I okay? He's like, Your son has come to school and told my son that you're out of business. My poor children are feeling the stress and pain of their father and what's going to happen. But we spent as a company about 60 days, I lost some people during that time. It was a real challenging period. And through that 60 days, I essentially arrived at a simple mission statement. We're not going to worry if the ACA is going to be here or not. So those that are arguing that it won't be here, let's agree, it won't be here. Those that are arguing it will be here, okay, let's agree that it will be here, but let's not worry about it. We'll create a separate financial document that will be our ACA. We know that's 95% of our business now, but we're going to launch all kinds of products and we're going to change our product mix. So it ended up being a rallying cry, and so we launched a Medicaid product, which I was very proud of, a Medicare Advantage product, and a risk and a quality program, so we became certified. Heat is reporting, engine stars quality reporting, and within 12 months completely diversified the business, and that 95% became 30% and then ultimately less. Medicare, Medicaid, and the quality products became a larger piece, which gave us, well, certainly grew, the business certainly grew the revenue, certainly grew the team, but gave us a much broader story to tell. In 2019, the business was acquired by a publicly traded company, and I left in 2020.

John Shufeldt:
So basically, Trump gets elected, you see, you see the possible writing on the wall and you proactively pivot, which is a huge lesson for, it would be a huge lesson for people, one that you did a prospectively. Before the elections, where you're thinking, okay, if it goes this way, I better have this construct, and if it goes this way, then I'm okay. And after, sounds like the election and I get into politics, but something like the election turned out to be a positive. You know, the result of election ... be positive for you because it expanded your footprint.

John Criswell:
It was, and it actually proved to me that you don't you shouldn't rely on an emergency, something critical to your business to make a change, and so that lesson will stick with me forever. But I'm embarrassed to say I was not prepared for a Trump victory with the business, and so it was a surprise. And from the time that he was elected, and I'm not making a political commentary, it was just a surprise to me. And, but from that, over that next 60 days and those next 12 months, what we did was unbelievable. And the team just got together, backs together, swords out, and we changed our product mix and we became way more valuable to our customers in what we were doing.

John Shufeldt:
I like that analogy backs together, swords out. I don't think I've heard that one before, so I'm going to have to steal it from you. I was just going to, I'll plagiarize and give you credit for it. Looking back at it, can you say that, like, how did I not see this opportunity? Why did it take an election result to open my eyes to this? I mean, did you ever look back? Not that you should, but you ever look back and say, okay, what can I do in the future to prevent this from happening again?

John Criswell:
Well, I think one of the key things as a leader within any organization at any size, having self-reflection and self-awareness is important. Frankly, I was happy with where we were. I was delighted. We took this small little idea that we would talk to customers, we would go to presentations and people would laugh at us and tell us what we were talking about is not possible and not what the industry was doing. So I felt, I don't want to say complacent, that's probably not the right word, but I was like, We are going to continue to grow. We were dominating the ACA space and this is what we were going to do, and when we're ready, we'll launch new products. That was wrong. I was, that was not the right approach. And so now I try and operate with a sense of urgency around everything, not in a destabilizing way, but in a way that anything can happen at any time.

John Shufeldt:
Right, and that's the great learning from all this is to keep your foot on the gas even when you don't need to be.

John Criswell:
That's right.

John Shufeldt:
Yeah, complacency is always potentially fatal. Okay, so your last of the estate of the publicly traded company for a year, was that your workout clause?

John Criswell:
No, I could have stayed longer. The organization ran into a number of challenges pre-COVID that ran into COVID. They had a large debt load and we're really trying to figure out what they needed to do and how they needed to do it, and they asked me to leave. And so I, asked is probably they let me go, and that was it, so onward and upward.

John Shufeldt:
And that turned out to be a blessing as well. So talk about what you're doing now.

John Criswell:
Yes, so started a company called Porter. Like my previous company, in terms of cause motivation, we want to make healthcare simpler and easier for every American. And I got to this place, I was riding my bike and had a fall, fractured my pelvis in two places, and I had to navigate it myself. And I said, Oh my gosh. Like, why is this so hard? I think this can be easier. Shortly thereafter, my father had a heart attack, was being discharged from the hospital on a Saturday right in the middle of COVID. And it was really difficult to figure out all the things that he needed on a Saturday. I then went and met with one of my good friends who is a two-time cancer survivor. I explain these two stories. He laughs at me and says, You think you have it hard? He shows up at my house a few days later with five three-ring, three-inch thick binders of his journey from medications, discharge instructions, home care, and through a very emotional three-hour meeting, tells me how difficult, not only that it was for him, but for his wife as a caregiver and how they would just cry together, trying to solve for things that should and can be made easier. And so at Porter, that's what we have endeavored to do, is make healthcare easier for every American. And there is a difference between healthcare, as you know, John, and health insurance, and bringing those two together, whether it's acute or chronic, is essential to making it easier, both the physical, emotional, and financial toll that this has on so many Americans.

John Shufeldt:
Yeah, it's amazing. So give me some perspective on what does Porter do? What's the elevator pitch for Porter? I know it makes healthcare easier, but specifically, how does it do it?

John Criswell:
Yeah, so we are helping connect people with the resources, the products, and the services that they need. So in a condition-centric way, we build kits and recommendations using data and analytics to create a bundle of those items, resources, service, and products that will help your speed to recovery. And so we believe, like supply chain, speed, cost, quality, pick two and we will serve those up for you. We will let you know what items are covered by your insurance and in your benefits and what items are out of pocket. And that's essential, and frankly, as a physician, I know you'll understand this, you can't possibly understand all of the benefit, all of the network, all of the components that exist. And in the case of my good friend, the two-time cancer survivor, for illustration purposes, he was prescribed a genetic testing and his physician didn't know, and he didn't know, and he went and had the testing done and it was $2,500.

John Shufeldt:
Yeah, I was going to say.

John Criswell:
It was a covered benefit. If he went in-network and would have cost him zero. And that plays itself out time and time again. We have a member on our platform that was, that lives in Salt Lake City, was receiving his cancer treatment at Johns Hopkins in Baltimore. And we were caring, and supporting him in Baltimore. When he went home, we helped him with all the things that he needed. And we said, when you go to your physician in Salt Lake, your oncologist, make sure you get a prescription for your $500 defined benefit for dietary supplements. He had had no idea to do that, and his physician would have had no idea. And the insurer, the payer, absolutely wants that benefit because this is going to help reduce costs and reduce outcomes, which everybody wins in that case.

John Shufeldt:
Yeah, but nobody has an idea to get it. You know, it's funny, I remark on this literally all the time. I mean, I'm in the healthcare space and I've had a couple of healthcare issues in the last couple of years. And fortunately, I can pick up the phone and call people who I knew and who really helped me. Man, if you're not in that, I mean, I call, I just literally, as you saw right before the podcast, got a call from somebody who was struggling to navigate this healthcare issue and felt like they were getting the runaround, and frankly, they kind of were. And I don't blame the physicians, they were just saying, okay, well, here's what I do in this case. But there was no connectivity between the different modalities they were trying to navigate through, and it is, it's got to be incredibly frustrating. It is incredibly frustrating.

John Criswell:
It is, incredibly, and no matter how insignificant or significant of an issue, technology can enable a lot. And under the Trump administration and now the Biden administration, under the No Surprises Act and the Transparency in Coverage, Insights, and Interoperability Rules, the government has taken an active role to drive more transparency, more visibility, more capability so companies like Porter can utilize those tools to make it easier for the member, make it easier for the patient.

John Shufeldt:
So what's your revenue model?

John Criswell:
So PMPM, we also take risk, and for those of your audience, per member per month, or per member per year. We have a risk model. We will take risk on certain cohorts of populations. We're very versed in reducing remits to the appropriate site of care, education. So those are all areas that we believe, strongly, in what we do, and so we're happy to take risks on managing certain cohorts of populations while improving quality and improving the illness burden rate for whether it's Medicaid, commercial, or Medicare Advantage.

John Shufeldt:
And then how do patients find you? Do their health plans direct and the health plans pay you and say, Look, We know you're going to reduce costs, so we're going to pay you a pmpm for their entire population of patients, I suspect.

John Criswell:
That's right. It can be done either the entire population or a cohort of a population by chronic conditions.

John Shufeldt:
Interesting, and what's your data showing to how much have you been able to reduce costs? Because it seems like even a little will go a long way. I mean, one unnecessary MRI, one unnecessary ED visit, and everything transpires from it, I mean, is thousands of dollars.

John Criswell:
It's, we're on readmissions somewhere around 43%. It's astounding, it's astonishing, really. Once we engage that patient, we connect them with their, either their primary care or their specialists. We begin the education, that concierge care guide. Once they get into that, no one wants to end up in the emergency department. But I'm most proud of our Net promoter score, which is 90%, and our engagement rates are about 77%, which is phenomenal. We're capturing at the episode. So if you're in the hospital, you're soon to be discharged or during an event, we're capturing that member at their most critical time when they need it and where their caregiver needs their support.

John Shufeldt:
Interesting, you know, just example you had about the dietary supplements for cancer patients. I mean, you know, one of the big risks of cancer is people become emaciated because they can not get enough caloric intake. But you're right, I would not as a physician would not have thought, oh, my gosh, let's give us a prescription for dietary supplementation. And the physician, the patients wouldn't know to ask until you tell them. And then, then I'm like, of course, that makes total sense, but I don't know if I would have thought of that prospectively.

John Criswell:
Well, and then you add to that, then find the vendors that are curated that you would want to purchase those products. This isn't like going to an Amazon. You have cancer. You want to trust that you're getting the right dietary supplements by an approved, curated partner that is trusted like Porter. And then you expand to that to, beyond the dietary, the right nutritional products that help support your journey as well. Meal replacement, meal preparation, all of the things that most of us don't think about in healthcare or health insurance that health insurance provides today. Many, many provide today.

John Shufeldt:
Yeah, and I would have had zero idea because as you said, no one calls you up and tells you don't forget to do this. What was the biggest takeaway as you've learned from your entrepreneurial journey thus far, and what were the biggest surprises?

John Criswell:
So biggest takeaway is, never give up. You did a post recently on It Takes Hard Work, and I've read enough books around the eight-hour work week and I'm like, that must really be good. I want to do, I would like an eight-hour work week. The truth is.

John Shufeldt:
... the four-hour workweek.

John Criswell:
Or the four hour, it's.

John Shufeldt:
Embarrassing, I remember my son read that. I'm like, yeah, that'll never work.

John Criswell:
You got to the answer faster than I did. John, I, it takes hard work. It takes grit, it takes stubborn persistence. So I think that's, what's the definition of an entrepreneur, the number one trade. I think it's grit, stubborn, persistence, never giving up, but being self-aware and self-reflective enough to know when something's not working. If you haven't figured out the marketplace, the market, the product fit, they need to change. Oftentimes change is iterative, and especially in healthcare, healthcare is typically risk averse. And so startups struggle with these great ideas. We're seeing it now play out in the marketplace. A lot of these companies do not have market fit, product fit, whether it's on the health system side or on the payer side. So I think stubborn persistence with an open mind to not falling in love with your own idea to change and to figuring out what the market needs, and then building to your ultimate goal, whatever that purpose is. And I think that's kind of number two, purpose. My last company and this company has been about trying to change an industry. And it was terrifying in those early days going to speak in front of 100, 200 people about doing things different, and the criticism, or if you were in a meeting with a large insurer and there's eight people sitting around the room and you're reading the tea leaves and you've upset half the room by what you're saying, you're walking out. They're like, I'm not sure this is the right approach, but ultimately you get those first customers that validate you, and then it begins to expand. I guess those are kind of the key parts up front. But there's a second part to your question, John, that I didn't address.

John Shufeldt:
Yeah, the biggest surprise, like what's you know, there's, frequently I say, like Mike, you know, I didn't see that one coming that was out of left field.

John Criswell:
Well, we talked a little bit about the Trump presidency, but on the, I guess when we did sell the business, I was heads down. I wasn't really paying attention to how it would feel to the team. And I'll never forget we had a, just a fantastic developer who was with us since the beginning, and he had a son who had disabilities and he called me up in tears. I was in tears. I still get choked up. And he's like, you know, this is, you have changed my life. I now have, my house is paid off. I have, I can see the future for my son. He has, we have money to care for him after I'm gone. And I just, it gives me chills every time.

John Shufeldt:
You just gave me chills. I love that feeling.

John Criswell:
That story just, you know, played itself over so many different times. And I was at war as an entrepreneur that was doing something different. And so kind of like, well, I'll just, we'll have fun later. So, and we had a good time, don't get me wrong. We had a good time, but we had the gas in a pretty, pressed pretty hard, and just the reaction from the people who didn't necessarily expect it. I spent a lot of time as a number two in different industries, and I always had the promise of equity and that never materialized and that has stuck with me. And so I have, I consider myself somewhat generous to the team. I like to be generous. I want people to have ownership and feel equity as much as it matters, and that's important because I never had that for myself. And I want my team members to know that we're in this together and we all win together. And a lot of people create separate deals for themselves, that's not who I am. I'm a member of the team. We're at the same level. Let's do this, backs together, swords out.

John Shufeldt:
Did you have trouble transitioning? From, because as I know, you know, I mean, once you're the owner, the buck stops with you, good, bad, and different. Then I always tell people, you know, I accept all the blame and give all the credit. I mean, that's how I try to lead. Was that a difficult transition for you where no matter what happens, it's ultimately your fault?

John Criswell:
I think, I appreciate, I respect, I honor kind of the buck stops here and the I believe in collective intelligence. I want everyone to be able to provide their thoughts and opinions. At some point, somebody's got to make a decision. And so if there's a tiebreaker, we can make that call. If you're reflecting in terms of from the acquisition forward, in terms of how that changed, or just more in general.

John Shufeldt:
More in general, my next question is on the acquisition.

John Criswell:
Yeah, so for six years, most of the team, we worked seven days a week, and I don't mean the figurative seven days a week, I mean I was in the office seven days a week, 6, 7 a.m. till I'd go home, 6:00 for dinner, I'd go back to the office at 7:38, worked as long as I could. If I was traveling, I'd constantly fall asleep with my laptop on my lap in the hotel. Wake up at 3:00, 4:00 in the morning, go back at it. Saturdays, outside of activities with the kids, I'd be in the office pretty much till 3:00 or 4:00, and then Sundays till noon. So we were heads down, we just kept grinding it out to prove what we were doing. Making the decision that was just, you have to make decisions right or wrong. And we had to, we had a philosophy. I have a philosophy in life. You go to a restaurant, you have a bad meal. It's like, glad we tried it, let's move on. We have choices, free choice, free will. So in business, let's, we're going to break things, things are going to happen. That's okay, glad we tried it, let's move on. So if I or somebody else made a bad choice, you know, it's important to keep yourself out of the ditch, right? But staying a course in making a bad choice or bad decisions, like let's not lament, let's learn from it, but let's move forward. There's, no nobody wins in blame game. Let's move forward and be positive, and we can learn and grow.

John Shufeldt:
No, totally. And I know you know to some respect, but I also have, I think I have a good sense from you. I suspected that you had a very strong culture in Pulse8, in Porter. Did your team have difficulty going from the Pulse8 culture to this large publicly traded company culture?

John Criswell:
Yeah, it was difficult, I think. We were probably somewhere 200 members on the team during acquisition and there was a lot of things that I think people accepted and there were some things that were difficult. We had a, not one inch, and frankly, the acquirer wanted us to maintain our culture because our growth rates were strong and they continued to accelerate even as our revenue increased. But after I left, I think they lost about 50% of the staff. Some of that was just the public challenges they had around COVID that required them to do certain things, but I think it was a challenge for a lot of people to kind of shift, and those that are still there, I think they embrace on the open culture that we had before that might be different now.

John Shufeldt:
Right, yeah, very good points. Well, any closing thoughts for all the entrepreneurs and budding entrepreneurs that are listening?

John Criswell:
I start with, what's your cause? What's your motivation? What's your purpose? I am asked often by investors and venture firms, What's the exit strategy? I think that's a silly question to ask. I think you don't worry about the money, you figure out what the market fit is, and know what's going to be the hardest thing that you ever do because it typically is.

John Shufeldt:
Yeah, that's very true. It's actually, I'm going to steal that one from you, too. It actually, it is. It's probably the hardest things I've done are staying present on the journey, even when everybody's telling you you're an idiot, and you're going down the wrong path.

John Criswell:
And that happens.

John Shufeldt:
Happens every day, just for other reasons. Well, John, this has been great. Thanks, I really appreciate it. I'm looking forward to supporting you and Porter and seeing how this all flushes out.

John Criswell:
Thanks, John. It's been great. I love what you're doing. The podcasts are fantastic. Your posts are fantastic.

John Shufeldt:
Thank you.

John Criswell:
I wish I was a prolific writer as you are, and how you articulate things, I think it's helpful for all the entrepreneurs that are out there listening to you.

John Shufeldt:
Thank you, John, pleasure. Well, folks, it's another really interesting episode of Entrepreneur Rx. We'll have everything in the show notes, including the transcript of this, and we'll be back to you soon. Thank you all.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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