RX_Keith Matheny: Audio automatically transcribed by Sonix

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

John Shufeldt:
Hey everybody! Welcome back to Entrepreneur Rx. Thanks for hanging out with us today. I'm really excited to talk to Keith Matheny. Keith is an otolaryngologist, head and neck surgeon, and he's also a serial entrepreneur who was running, I think, Keith, four companies right now, plus practicing medicine, so you're putting me to shame, so I'm excited to talk to you.

Keith Matheny:
Not at all. Not at all. I think you're the sane one, you're the same one.

John Shufeldt:
Okay, so let's start with the basics. Go back to I want to be a doctor, Keith, and give us your progression of how you, how you went from that to, you know, kind of through residency, fellowship, and then we'll, then we'll get down to some nitty-gritty business stuff.

Keith Matheny:
Absolutely. Well, thank you for having me, John, I'm very excited to share this. So I love what I do, and that means I love practicing medicine, I love having the entrepreneurial things on the side, although they're taking front center as expected. So I love where my career has evolved and what being a physician has afforded me to do. So it all started in high school. I'm not a huge person physically, but I was determined to play football. And so every year I broke something. And so that got me very friendly with our team orthopedic surgeon, who was a magnificent surgeon and person who was involved in the leadership of the Texas Medical Association. And he, back in those days, you know, the hospitals were very loose and he would just drag me by the ear and take me in to watch all kinds of surgery and take me to the room next door to watch his friend doing some other type of surgery, and so that really ignited my passion in most specifically just his ability and the surgeon's ability to spend an hour or two of their time and completely change the trajectory of the patient's life and to heal them. And we all know, those of us that are physicians know that feeling that, for you, I would imagine, John, making that diagnosis in the emergency room, especially something urgent and saving someone's life, I mean, there's just there's not another job like it. And so, you know, being an athlete and playing baseball for a few years in college and I pictured myself doing orthopedic surgery. And when I got to medical school at the University of Texas down in Houston, the magnificent Texas Medical Center, I, our second block of material was the head-neck. And I fell in love with the intricacy of the anatomy of the head-neck. Now, this is going on 25 to 30 well, really closer to 30 years ago plus. And so ENT otolaryngology was a very different specialty back then, but that being said, a lot of the reasons I love ENT still ring true. The variety, it really is seven different specialties for one, you know, what I do is specifically rhinology, so sinus and skull-based surgery and then where the nose overlaps with sleep disorder breathing. So I do sinuses, but you can do ears, you can do facial plastics, you can do head and neck cancer, you can do pediatrics, you can do voice, and so I love the variety, I love the fact that we could care for preemies all the way to the elderly, males, females. The specialty was half clinic, half surgery, so there was quite a bit of variety. And even at my young age, I learned the value of quality of life and not being so tied to being on call in the emergency room and so, of the surgical subspecialties, I felt like that one offered me the best chance at having outside interests and really focusing on family. So I chose that and have been so grateful.

John Shufeldt:
Now, did you even know, though, back then when you chose it, that that there was an entrepreneurial path for you that was kind of looming? Because, I mean.

Keith Matheny:
Not at all, not at all. I'm glad you brought that up. You know, I'd envisioned my entire future just really focused on my practice, not that you and I aren't, but I never really imagined anything in parallel with it. And so I think probably in retrospect, the first time that I even uncovered that passion that I have for technology development in devices and pharma was during residency. So I was fortunate to go from Houston to Nashville and train at Vanderbilt. I did all, all five years of my training there, so including my surgery internship. And those were the beginnings of the times when the device companies and the pharma companies would give the residents, you know, back then we were making a dollar 50 an hour or something ridiculous, maybe less. If you really average it out is before the overhaul of residency work hours, right? And so any time you could get a free steak dinner, you were there. And so these companies would trot out their upstream products, new technology and get the 2 cents of the residents knowing that, I mean, we didn't know who we were, but they knew that we were soon to be their customers. And so I think that, that was when I first learned that I really enjoyed working with industry and helping develop new technologies and putting in my two cents and test pilot things.

John Shufeldt:
And you're in major undergrad?

Keith Matheny:
Not at all. I majored in biology, so the very common proved prescripted path. It's funny, my older daughter is a junior down at Baylor now where I went and go bears! We had an early exit from the tournament this year, unfortunately, but we're still basking in last year's success. So she's biology also, but her minor is fashion design. So she's obviously way smarter than her old man because she's already realized that there is life outside of medicine and there's so many things to pursue as an adjunct to what you're doing as a physician. But so I went to Vanderbilt and just loved my training there, very difficult, but wouldn't trade it for the world. Just amazing colleagues and attendings and experience as patients. And we had two babies there at Vanderbilt, so the decision to come back home, to be around the kid's grandparents, our parents, brought us pretty much back where I grew up here in North Dallas, and I joined two absolutely phenomenal physicians, one is still in practice with me, this would have been 18 or 19 years ago when I finished, the other one has since retired, but like most of us as physicians and many who are listening to this podcast, we go to school till we're 32, 33 years old and we never have three credit hours of business 101, and then all of a sudden we're unleashed on these multimillion-dollar businesses. So while I was interested in devices, John, I think what really ignited my entrepreneurial fire was the business aspects of practice. So describing those days, you know, I joined those guys and while I was very busy for my first clinic, I mean my first week of clinic, I had 50 new patients and I was already doing procedures. And I mean, during COVID, I would have killed for 50 new patients even that, right? And so obviously the business, the flow of patients was quite healthy. But in every other respect, there were, shall we say, major opportunities for improvement. We were at the time by a dying HCA hospital, it's since been revitalized and is thriving, the suburban hospital. The clinic itself was 30 years old, 20 years ago. And so I had 30 years of dust everywhere, old equipment. The staff was a mixture of three different practices that had merged. And so the three different groups of people didn't like each other and that showed in poor customer service. And it was only 20 years ago we had no website, we were using paper charts, rudimentary scheduling, scheduling software. Our ancillaries, ear, nose and throat is a specialty with a lot of ancillary revenue opportunities, like hearing aids and allergy shots and dealing with sleep, dealing with injectables, cosmetic injectables, and they either didn't have those lines of business or they were losing money. That takes a lot to lose money in hearing aid and stuff, but the practice was and so really anywhere we looked, we were busy in spite of the infrastructure. And so just because my colleagues didn't really have much interest in the business, obviously I took over business operations in long story short, within four or five years we had moved out of that initial office, away from that hospital and tapped into three different referral networks in the same ... area. But brand new offices, we're paperless, we had a robust online presence, again, this is 13 or 14 years ago, but whatever SEO meant back then, we had optimized. We had figured out how to utilize mid-level providers to truly elevate our patient care, but also as a revenue stream. Hearing aid and allergy and sleep and cosmetics were now profit centers for the practice. And so we were much busier because of our infrastructure. And so people took notice around Dallas-Fort Worth and, and started asking myself, my office manager, other, other team members, hey, can you guys help us bring on a PA? Can you help us fix our hearing aid department? Can you help us start allergy? Can you help us tighten up our revenue cycle? And so we did and we did just that and formed a consulting company, which is the underpinnings of a much bigger company today that I'm sure we'll talk about momentarily. But I found that I really, really loved helping my colleagues and helping our own practice run more efficient, absolutely love it, still love it to this day. So over the years, we've managed many, many different ENT practices, either in part or in total, some facial plastics practices, other things that are adjacencies to core ENT, and so I, that's still near and dear to my heart.

John Shufeldt:
So let's, let's talk about how, because I think what you're referring to is US ENT partners, how that started with, did it start off of your, you fix your own practice, you help other people fix their practices. And you realize well we're paying a lot, can we put together a GPO for that? Is that how that started?

Keith Matheny:
Yeah, pretty much. I mean, that sums up about a decade, of course, as you and I were joking off, off recording, every overnight success really is 10 or 20 years of work, right? And so, but long story short, yes. So after three or four years of success in that consulting, the idea of having a larger footprint came about. How do we take this regionally and nationally? How can we help other people grow this business? And as is the theme in all of our lives, but certainly mine, I've just had so much serendipity and so much good fortune, so many people that have helped me along the way. I mean, just dozens and dozens, including my uncle. My uncle is an oncologist in Virginia Beach, Norfolk. He's retired now, but he is one of the founders of US Oncology, McKesson's prized possession, and he formed that in 1993 with the help of the esteemed private equity firm Wells, Carson, Anderson and Stowe in Manhattan, who I work with now, wonderful people. And when his practice Virginia Oncology Associates merged with Texas Oncology, which had already aggregated here and statewide and rocking out cancer centers throughout Denver and kind of the central corridor of Colorado, and they immediately, when they put that business together, they realized what they had. They realized the power of scale. And this was the early days of the Internet, and there was no such thing as online claims. But US oncology aggregated their claims data and went to famously Blue Cross Blue Shield of Missouri and took their data from Kansas City and started to use that to negotiate better contracts. They also procured amazing clinical trials where to for and this is when I was still in school at MD Anderson in Houston, you know, whereas before cancer treatment really came out of these highly esteemed cancer centers, US oncology now had thousands of oncologists and millions of patients to do trials. And so a lot of the ways that we treat cancer today came out of the US oncology, not the big academic centers, on and on and on. And obviously a big part of US oncology is a GPO. In fact, even today, that mature company that's almost 30 years old, I think the stats are that almost half of the oncologists primarily just take advantage of the GPO as opposed to all the other offerings that McKesson could bring. And so I happened to be on vacation with Michael in Jupiter, Florida, and this would have been about 2012. And I was talking about my consulting company, which then was called Solutions for Otolaryngology. He was talking about the US oncology acquisition by McKesson, which had just happened, $2.1 billion dollar deal ten years ago, and how much synergy there was with the power of McKesson and now the power of US Oncology. And he said, You know, they're so happy with this acquisition, the McKesson guys would love to replicate this in other specialties, you should talk to them. And so long story short, I spent a lot of time talking with leadership at McKesson, sold them on otolaryngology. The opportunities, the retail opportunities, the need and the transition of site of service, which we'll talk about in a second, what led to the device companies. And they said, absolutely, Keith, we love ENT, but we're McKesson, we're twice as big as JNJ. We have no idea how to do something early stage, but who does? The Wells Carson guys. And so they pointed me in that direction fortuitously. And so working with them for a few years, we tried to use the same playbook. By that time, as you well know, they had rolled up a company called M Care, competitor of one of your companies and many other medical specialties. And so but they did that by buying practices, lock, stock and barrel, because they really had a lot of hospital-based or institution-based specialties. No one had ever tried to wrangle those surgeons before, or at least successfully, people had tried, but no one had tried to wrangle surgeons before. And so we spent the better part of two years, even with a large sum of money earmarked for just buying 20 or 30% of these practices and working to create geographically 30%, 35% market share group, single tax ID groups, so that we could legally contract with insurance companies in those areas and also do a GPO and also do clinical trials and all the other stuff that the other companies would do. But the ENT space was not ready. There, finally now is some private equity momentum. I mean, literally, just post COVID. But ten years ago, ideologically, philosophically, my colleagues were just not ready for private equity ownership.

John Shufeldt:
And there's plenty, I tried to do that in urgent care in 2014 with urgent care, integrated networks.

Keith Matheny:
Same, yeah.

John Shufeldt:
Same playbook, 30 to 40% of a market, but LEGPO contract, collectively, they weren't ready. It was like, wait, you want me to partner with my competitor? I said, well, yeah, but they're not your competitor they're ten miles away, different catchment area, blah blah, literally, I might as well have been.

Keith Matheny:
Economies of scale ...

John Shufeldt:
... the ocean. Yeah. Okay, keep going. So it didn't work in the ENT.

Keith Matheny:
Didn't work. So we went back to the drawing boards and what was happening in the space was this magnificent transition of site of care. So the adjacent to Developing US ENT, what was happening, starting with the advent of balloon sinuplasty around 2006, 2007, namely the transition of angioplasty catheters out of the cath lab into the nose, and that in and of itself is a long story. But sinus surgery, in particular, became very minimally invasive, to the point that by 2012 we were able to do it in the office and there actually was differential CPT coding and reimbursement for site of service, which is still unique even today unfortunately, but certainly was revolutionary back then. The unintended consequence of that, that while that was better for the patient, better for the physician from a reimbursement standpoint, by far it totally changed the economics of practicing ENT to the tune of, now, even today, the average ENT physician spends about 400,000 dollars a year just on supplies. That's not payroll. That's not the electric bill, that's not rent, that's just on sinus balloons, hearing aids, allergy supplies, sleeps, diagnostics, capital. And so, as you well know, the economics started to not work out. Yeah, it was great to do a balloon sinuplasty, you may get a pretty high reimbursement compared to what you got in the OR, but you got the bill from Johnson & Johnson, you had the bill for this and that, and so it really became tough. And so knowing that that was going on in the marketplace, we said, all right, well, what the ENT space needs is cohesive purchasing, logical contracting, price discounts, intelligent inventory, those types of things. Because again, going back to my first comment, as a rule, physicians are brilliant people that don't run brilliant businesses. And so we did just that and we negotiated what are now about 35 direct supplier contracts with those suppliers, bringing an average of about 20% discounts on the stuff that we need to practice our craft without having the physicians having to switch their favorite suppliers. I love that, I love how that business is unfolded, I'm so glad it unfolded this way, John, because as my team now, I have a wonderful large team that works with me and we have hundreds and hundreds of physicians that are members of US ENT and purchasing millions of dollars of equipment through us. We never have bad news. Every time that we interface with a new practice, large or small, our larger practices of 60-70 physicians, we have many that are solo practitioners. Every single time that we look at their spending, their historical spending, their contracted rates, we can provide meaningful value, so gratifying. But that's all we do on day one, cost savings, day two, day three, my team is working on what new revenue streams and new opportunities that practice has. So it's really the same thing I was doing with the little tiny consulting company 15 years ago, but on a much grander scale.

John Shufeldt:
That's actually.

Keith Matheny:
I love it, I absolutely love it.

John Shufeldt:
So how did you flip? Now, you were in a service business and then you went into devices and now that's something I had my toe in the water but never really did in medical devices, for all the reasons why, I'm sure you're going to tell us why they're so difficult to get into.

Keith Matheny:
Yeah, it's, it's very doable. You just got to be careful, right? But I encourage you to and happy to because so many people helped me. So being someone that was interested in product development, testing new products, even as a resident, being someone that was very interested in the business side of things, being someone that was interested in industry, I was fortunate, really fortunate. And I tell these folks, I told the, the founder, the inventor of balloon sinuplasty yesterday, his name is Josh Makower, he runs the Stanford School of Biodesign. He graciously commented on one of my LinkedIn posts yesterday, in fact, but because he and Bill Fecteau and Greg Garfield and the People at Clearance, the Johnson and Johnson Company, when they launched balloon sinuplasty, they came to guys like me. So community physicians, as is commonly the case technologies are launched through academia, there's nothing wrong with that. These are brilliant professors and prolific speakers and teachers, but this company chose to do it differently and come out to the community. They gave someone like me a voice and that was just four or five years out of my residency. So, and by voice I don't mean just being able to test a balloon and give my two cents, I mean sitting on podiums at national meetings, broadcasting cases during those meetings, participating in clinical trials of learning how to do scientific analysis of technology and procedures. Speaking events, you and I talk now so often, but back then that was new and it was something that they gave me a chance to do. And so by about the time that my uncle and I were talking to McKesson about US ENT, simultaneously with that Intersect ENT, which just recently has become a Medtronic ENT company, amazing consolidation in the ENT space, but Intersect ENT had just obtained their FDA approval for their revolutionary propel stent. Lisa Earnhardt, who's now back at Abbott, she was CEO at the time, Rich Kauffman is an absolute genius and polymer chemist who's won multiple Edison Awards for his work in the cardiology space, and then now in the ENT space, they had just obtained approval for their bioabsorbable local drug delivery stent after sinus surgery called the Propel. And so I was fortunate again just because I had developed some sort of reputation as someone that was an early adopter of technology that I would give good feedback. And what I always joke about is I would tell them if their baby was ugly, but then I would make some suggestions on how to make it cute. And I think they liked that honesty. They liked if something was difficult for me in my hands, you know, I didn't get angry about it or get embarrassed or think, oh my gosh, I must be a terrible person. I said, no, we have some work to do here before my colleagues and I really can use this on a wide, wide basis. And so Lisa and her team came to me to do the first couple of commercial propel cases, and immediately when I held that stent in my hand before I placed it in that patient's adenoid cavity, I thought, wow, there's a million other things that we could use for in ENT, and really the rest of the body, namely something bioabsorbable that's mechanically active, that has some sort of local drug delivery capability. And as has mostly been the case in my odyssey, Lisa was, Lisa ... was extremely aboveboard, ethical, honest, and said, Keith, shut up, you don't need to be spouting these things off. Which you need to be doing is filing patents and protecting this. And then once you have protected yourself, I'd love to talk about these things. And at the time, it's hard to believe, as I'm fortunate now, to have dozens and dozens of patents. But just ten years ago I had no idea what to do to file one. But I pushed through and filed an initial application that we continue to carve up and get new claims and form new companies out of on just that, bioabsorbable mechanically active local drug delivery devices.

John Shufeldt:
Wow!

Keith Matheny:
And so when, when I was ready to go back to her and other companies, that was really when the education start on how the device world works. So I think as physicians, John, we think that someone has a brilliant idea, you tell your device rep, they run it up the flagpole and three months later they're doing a clinical trial and a year later it's on the market and you have all these royalties, oh my goodness, no, that's not remotely how it works. So these companies, what I learned and it took me four years, a very thick skull, I guess, to learn that the big companies have no capacity for early-stage ideas, that's not what they do. What they do is widely distribute proven technologies and grow market and transform a medical specialty, that's not the place that you take new ideas. And you also realize, and I don't mean this in a critical way, but by that point, I was a fairly important customer. I mean, meaning not an important, I mean, that I was a high-volume customer, I was, I represented a lot of revenue for some of these companies. And so they were very polite, they listened to me, they offer good advice. But in retrospect, I wish they had kind of told me a couple of years earlier that we have no capacity to develop these ideas, so I think they're solid ideas, but here's where you need to go. You need to go over here, you move down the street in Silicon Valley or wherever. But I finally learned that, again around the time that we were forming the EGPO over at US ENT, and I was fortunate to come in contact with a crack team that is very good at early stage, and most of their experience had been in the pharma space, but a lot of the principles are the same. And so what we did, and it's probably worth us talking about from a physician standpoint, how much do you dilute yourself? But I chose to give three or four colleagues of mine meaningful equity in the company. We formed around this first set of claims out of my initial IP because I could own 100% of as I joked, I had this little zipper pad folio thing, it was like a little briefcase which had a whole bunch of notes and I had a whole bunch of emails so I could own 100% of that, or I could own a substantial portion of a real company that was actually delivering technology to patients. And so I'm glad I chose to do that, the latter. And so even then, what I set out to do was to develop a bioabsorbable post .... So when we do sinus surgery and nasal surgery, the balloon revolutionized how we open up sinuses, prior to that, in some cases, even still today, it's the right thing to remove tissue and create large windows, especially in patients that need long term topical drug delivery. But not everybody needs that aggressive sinus surgery, in my opinion, and in many of my colleagues' opinions. And so the balloon, being a minimally invasive option, was perfect for that. Well, extrapolate those concepts to set the plastic in rhinoplasty. So those traditionally had been really barbaric procedures, very painful to recover from, required a lot of nasal packing, that was painful in and of itself for everybody involved, the patient mostly, but everybody or some very rough, rigid splints that had been commercialized in 1974. But the splints that I used in surgery yesterday morning, because mine haven't lost a couple more weeks, 1974, we sit here in 2022. And so there are nighties for infection, they're obviously very uncomfortable, they require removal after surgery. And so that was my first idea is to make a dissolvable form of that. And over the years, again, thanks to many other colleagues, I had been exposed to a material called Chitosan, something that many of us in the medical field use for hemostasis, our soldiers use it for battlefield dressings, for burns and wounds. But it's, it's a ubiquitous material, it's very inexpensive and very conveniently, it's not considered a pharmaceutical by our Food and Drug Administration. And so I became enamored with the idea of not only do I want to dissolvable post ... stent, but I want it to be made of Chitosan. And little did I know what I was asking, my, my team of developmental science, my polym chemists and etc. just for shake their head, typical surgeons who wants the impossible. You want something that's very strong for 1 to 2 weeks and you want it to go away in a puff of smoke. And oh, by the way, let's also make it hemostatic and antimicrobial at the same time. And I said yes. And I've said yes for five years now, and damn it, we did. And so very, very pleased that we have exactly that, that we have a well-performing Chitosan-based splint that we'll be launching at our upcoming meeting here in Dallas in April. And it performs beautifully and even more so, the icing on the cake is we figured out how to 3D print it. So that has made manufacturing very swift, dramatically reduced our costs. And fortunately, we're the only company that knows how to 3D print Chitosan, so that knowledge is valuable as the device is market opportunity, probably that know-how, that secret sauce is the most important of all. So all this is going on concurrent, as you can imagine it's, it's a busy life like yours, but man, do I love it. And I've found a way pretty much. And you have to ask my wife and family and friends, but I feel like I found a way to overlay things where I'm effective, I could not do this without amazing teams and all these different companies. And it's what I plan to do when I grow up is to continue to develop technology and products. Very excited about my newest company, Sleep Vigil.

John Shufeldt:
Well, if you had a little time left and I have a, I have a definite interest in any sleep technology. So give us, give us the elevator pitch on that one because I want to learn about it.

Keith Matheny:
Yeah, here's the elevator pitch. We do a terrible job caring for a very severe disease, obstructive sleep apnea. 40 million adults have diagnosable sleep apnea. We've diagnosed 10% of those we're treating on a regular long term basis, 10% of that 10%. These are people that are out there having heart attacks and strokes while they're sleeping. You've seen them in the ER a million times, John. These are people that are out there having car wrecks because they're falling asleep, crashing airplanes. You've seen them in the ER. And so we've got to do better, and that's why, even though I like picking boogers and being sinus surgeon and skull based, I really am passionate about sleep because we've got to do better. So if you ask me, five years ago, six years ago, Keith, is sleep a part of your practice? Absolutely. And what I meant by that was I saw snoring patients. Usually the bed partner would drag them in by their ear and demand that I fix the snoring. But what was going on was much more sinister, the actual collapse of the throat and the low oxygen throughout much of the night. But what I would do is send them elsewhere for a sleep test, and then that sleep physician will usually prescribe CPAP, which many, many patients are not compliant with on a long term, and that patient would be lost until they finally came back in demanding some sort of surgery, which is back then, at least before we had technologies like Inspire was also not very effective on a long term basis, or they would get shunted off to the dentist to have a dental appliance. And just the way our health care system is so fragmented, many of the dentists, most are out of network, unable to provide dental sleep appliances through health insurance plans. So they're very expensive to the patients, which was a huge deterrent. So the bottom line is 10% of 10% are getting treated long term, that's not okay. So I brought through US ENT, the Sleep Diagnostics into my clinic first with home sleep studies. Then subsequent to that, we brought the dental appliance fitting into my office by contracting with a sleep dentist. But what that allowed to happen is that the patient can run that appliance through their health insurance. Me, my NPI number and the dentist just receives a flat fee, so we're very compliant from a kickback standpoint. They get paid the same whether they fit zero appliances or 30 appliances. And so this is passed muster in many US ENT practices around the country and it's a win-win-win. We're treating more patients with dental appliances that are candidates, the patients are paying less for it, the physicians are generating revenue within their clients. But the company that is next is, that's all great, but the follow up after CPAP, dental appliances, Mr. Jones coming into my office once a year and me talking about golf or Arizona or whatever and then saying, how are you sleeping? Well, the boss says, I'm snoring less than last year, doc, so I think I'm good, I feel pretty good. Okay, well, we'll see you next year. Well, that may be true or maybe not true. And even the data that comes electronically from CPAP machines is derived data in my opinion, it's not true physiologic objective data. So during COVID, obviously, and you've been very involved in the telemedicine movement, as many of us have been, some codes came to light that had just been approved right before code for RPM, remote patient monitoring. And there are many, many companies in this space, in fact, it's a, it's a very fertile ground for acquisitions from an investor standpoint. But most of those RPM companies, to my knowledge, are in the cardiology space and monitoring blood pressure. But the key tenants are, for RPM are, the patient has to be uploading data automatically from some sort of electronic device that they can't manipulate. In other words, you can't write your blood pressure on a sticky note, drop it off in the nurses window, it has to come unadulterated from the patient to the clinician's chart. And then if that clinician reviews, it interacts meaningfully with the patient for a few minutes a month, you can build certain CPT codes. And so there's, there's a nice new revenue stream for the physician, but that's beside the point. Now, we have a way or cardiologist has a way to look at the blood pressure every day, it's like having a clinic appointment every day. Well, once I learned of this, again, serendipity, thought that's what I need to do in my sleep patients because I don't know after we intervene how they're really doing, certainly not night by night. And so what that company we built is called Sleep Vigil. We take data from consumer wearables like my Apple Watch that I'm wearing right now and look at various vitals, obviously spo2, etc., on a daily basis. And so, again, congruent with US ENT and congruent with everything, we're providing a new revenue opportunity for practices, but most importantly, we're dramatically improving how we care for these patients. It's shocking to me how much hypoxia there are, no matter what treatment modality there is when we think that, and patients think that they're being treated well. And so it's afforded me opportunities to make interventions and pivots throughout that year and do a much better job, like I said, caring for a very serious disease state. So very excited about that, that one's pretty new. We have several practices around the country that are just figuring it out, but we think RPM is here to stay because that's the way that the physicians can partner with the payers, right? We're helping them have healthier patients. So that's good for their business model, it's good for our business model, but it's good for the patient, the most important thing.

John Shufeldt:
Yeah, it's the triple aim. So Keith, work at this has been, this has been good because you've touched on all sorts of entrepreneurial efforts that I think are going to spark people's interest and hopefully get them to be more creative on the device side, on the service side, on looking at CPT codes and seeing how they can change your practice and help patients. Where can people learn more about you?

Keith Matheny:
Well, I am very active on LinkedIn, so people feel free to connect and reach out, messaging there, you'll see it's just under Keith Matheny. In my practices here in North Dallas, so feel free to reach out through our website, so many people have helped me and given me guidance, I thoroughly enjoy doing the same.

John Shufeldt:
That's awesome. Well, thank you very much. Folks, we'll have all of Keith's contact information in the show notes on our website. Keith, that has been a pleasure. I've learned a ton. And when you're out in Arizona, we are hanging out.

Keith Matheny:
Absolutely, John. I look forward to it. Thank you so much.

John Shufeldt:
I appreciate it. Thanks, everybody. See you next episode.

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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Sonix has many features that you'd love including collaboration tools, advanced search, transcribe multiple languages, automated transcription, and easily transcribe your Zoom meetings. Try Sonix for free today.