Dr. Michael Varenbut On How You Can Survive, Pivot, And Change (#11)

Steve Wells: [00:00:00] This is Steve Wells. 

Jeffrey Feldberg: [00:00:01] And I'm Jeffrey Feldberg. Welcome to The Sell My Business Podcast. 

Steve Wells: [00:00:06] This podcast is brought to you by Deep Wealth. Are you a business owner who is wondering how to either grow your business, sell it, or both?

Or maybe in today's environment, you're wondering how to make your business pandemic proof. Visit deepwealth.com to find out how you can master the strategies to grow and extract the deep wealth from your business. Visit www.deepwealth.com.

Jeffrey Feldberg: [00:00:26] Welcome to episode 11 of The Sell My Business Podcast. We're delighted to have with us today, Dr. Michael Varenbut, who is a physician and an entrepreneur experienced in building world-class healthcare companies and organizations with a strong social purpose. Michael endeavors to combined his knowledge of healthcare with his business acumen to create healthcare companies that benefit all stakeholders.

It's a pleasure to have Michael with us today. And for those that don't know Michael, Steve, what do you think? I think the best way to describe Michael is he's a Renaissance man. If I can use that that term. He's a doctor. An author of a book, a successful businessman, and an investor.

Michael, welcome. 

Michael Varenbut: [00:01:13] Thank you. It's a pleasure being here and thank you for the invitation. 

Jeffrey Feldberg: [00:01:17] Michael, before we, we get going with some of your nuggets of wisdom and your insights, why don't you take a few moments and tell our listeners a bit about your background, who you are, what you're all about, and what you've been up to during this very interesting time that we find ourselves in right now with the coronavirus pandemic.

Michael Varenbut: [00:01:38] Sure. So, I always find this question a bit, unusual because I never know where to start, but I'll start from the point that I'm a husband. I'm a father of two, awesome, beautiful, young ladies. I'm a physician by first profession, but also an entrepreneur and a business person through, 25 plus almost 30 years of practice now. And, I've been involved in a variety of clinical and medical entities and businesses and practices from founding, a variety of, of clinics, business organizations, and multiple medical disciplines  For the last couple of years I find myself in  a bit of a vacuum in that I had, sold, one of our major assets, which was a clinic organization that we built up from scratch, up to 75 outpatient clinics, and that's from running at 150 miles an hour to full stop. And then having to reinvent and, rebrand myself. I've, been involved in a variety of entrepreneurial endeavors, investment vehicles, consulting work, board positions and so on. 

Steve Wells: [00:02:49] Michael, I'm really excited to hear what you have just because of your very diverse background. And so, there's a million questions I can start anywhere, but I guess one of the obvious ones, if we looked at it from a business point of view, with your experience in medicine and healthcare.

And your experience in business, what do you see right now as far as opportunities? And of course, we see a lot of threats. So, I was kind of interested in opportunities.  

Michael Varenbut: [00:03:15] So I think we're living in unprecedented times where everything that we know is as they're changed or is changing or going to change. Specifically, in healthcare were really switching from all in-person work where we touch and feel and examine patients in the room, to almost exclusively. virtually, treating patients now and in a vast, variety of specialties, where most physicians have never had to interact with the patients virtually by other phone or FaceTime or Skype or Zoom, to now almost exclusively having to interact with their patients because they can't be in the same room with them where you know, clinics have closed, outpatient surgical procedures have been canceled. Anything elective has been canceled. So, the medical profession as a whole has to reinvent itself really, but at the same time, still be able to provide and deliver a care that patients still need because cardiac disease, cancers, diabetes, don't go away just because we are sitting in isolation. So, physicians have had to become extremely creative, with such examples as you know, having to have peripheral devices at the patient's home to check blood sugar, blood pressure, heart rate monitors, and then be able to capture that information.

Analyze it from wherever the physician might be on an act on it. just to give a simple example. So, there's been a seismic shift really, and everything that physicians know and have been doing it for many, many years. So, the, the all processes, all procedures, workflow, anything that we know is, has had to change and we've had to really adapt.

So, there's been a tremendous amount of change. 

Steve Wells: [00:05:01] Do you see any examples around the world outside of North America that maybe they are, their practices are better than we have in North America to, to adapt to this kind of situation? 

Michael Varenbut: [00:05:13] Hard to know because there's a lot of misinformation.

There's lots of bits of info that you don't really, you can't really vet to get a sense of its validity, but some jurisdictions are approaching the covert pandemic by simply saying, let's just expose everybody and let's get as many people exposed as possible. Those that are weak and elderly and frail will die, and they're giving it a bit of a survival of the fittest, kind of an approach, hoping that there'll be enough of us surviving and standing at the end of this, whereas other jurisdictions are completely the opposite and isolating everybody, putting everybody in a bubble. And it's really difficult to know where things will shake out because we don't know that if we are in complete isolation if that will be better long-term for this pandemic and other pandemics, or if it's better for us to be exposed, heal, develop antibodies, develop some form of immunity, and then move on and be able to fight off a future pandemics. It's a bit like, you know, as a parent trying to keep your children from eating anything on the ground.

You know, if they dropped a bit of food on the ground, some parents will stop them and wash it and make sure that there's nothing dirty going in. Other will say, no, no problem. That's great. Let's expose them to as much dirt and bacteria as possible because once they ingest it, they'll develop immunity.

So, it's really difficult to know. And you're seeing countries. And even jurisdictions within the same country, different States dealing with it differently. So, I think the jury is still out and will probably only be able to tell in retrospect, unfortunately with respect to which approach was better, 

Jeffrey Feldberg: [00:06:50] Michael, since you have the unique perspective of being a doctor and you have the medical perspective and running your own clinics, and you're a businessman and have a business perspective.

There's some business people that I've spoken to who said, you know what, Jeffrey, I'll put my business on hold because three months from now, six months from now, a vaccine is going to come out and then life is going to be good and his business back to normal. When you combine all of your background and your disciplines together, what would you say to people who are saying, well, you know, three or six months from now and depending on when you're listening to this episode where we're just still fresh coming out of, the whole awareness of the coronavirus lock down in an isolation mode.

But it is that fiction. And what advice would you be giving to business owners to start doing now today so they cannot just survive, but to thrive? Where would you be on both those topics? 

Michael Varenbut: [00:07:44] So lots of, confounding variables there as far as vaccine from anything I've seen and read we're months and months away. I don't see it as being three to six months, but more probably 6 to 12 to 18 months for a vaccine. there may be some clinical trials that are going to be, undertaken and various restrictions with smaller groups that are going to need going to need to be vetted out. But a widespread, nationwide or global vaccination programs, they take years to develop.

And even if we just use the influenza vaccine as an example, we have, we have an annual vaccination for the flu vaccine, and it typically takes a year to develop every new annual vaccine. So as soon as the vaccine is out, the scientists and researchers are already working to modify next year's vaccine because we're only as good as the previous year's infection.

And that's how the pharmaceutical companies come up with, with vaccinations for the flu vaccine is looking at the most common pathogens that infected last year, they modify the vaccine, tweak it, and hopefully come up with a vaccine that's going to be effective to prevent the infection itself. We're not anywhere close to a hundred percent effective.

We're very good. But even looking at things like the influenza vaccine, even all those patients that are seen that they should be. Eligible or should get the vaccine. We're only at about 50% in developing in developed countries. 

So going forward with COVID-19, the media is out, everybody is more vigilant. So as soon as the vaccine is available, we have lots of issues as far as procedures and processes.  Will we have a vaccine that's going to be suitable for all ages?

You know, different vaccines for kids, adults. There's lots of patients who can take vaccines. Is it going to be a live, vaccine or is it going to be a different form of vaccine that's a killed vaccine? All that still out. So, I wouldn't, I wouldn't be basing business decisions personally on the expectations that we're going to have a vaccine in the next three to six months and therefore I'm going to act accordingly.

I would look at a much longer window of 6 to 12 to 18 months and modify my business strategy according to that plan. 

Steve Wells: [00:09:58] I may be asking a question outside of your expertise, but even if you are immune now, there's a limit on how long you, you have built up immunity. And that's probably not even necessarily known, with WHAT Corona is, and so what does that mean?

is going to be around for a while, is this going to be something we're going to deal with forever? 

Michael Varenbut: [00:10:18] Great questions. You know, the best answer is that there's a lot of unknown to everything that you've asked. we can only use past experiences.

So, if you look at pandemics and, and, infections that we've been able to eradicate and how long it took. So, smallpox, there are lots and lots of viruses that we fight and, and get exposed to on an annual basis. And even if you look at the influenza as an example, it's simply not possible to eradicate influenza because as soon as the virus is out there, it's constantly changing and mutating, and the virus itself is a war to protect itself and make sure that its genetic material survives to the next generation. So, we're always a step behind. So. It's not going to be possible to eradicate the COVID-19 virus to coronavirus because it's likely not. One virus is like, like the thousands or more different subtypes and species.

And as soon as we research one, it's already modified and mutated. The best that we can do is we can try to isolate the proteins that are currently infecting humans, try to find some way of vaccinating. individuals so that they develop their own antibodies, their own IgM or IgG antibodies that are specific to that current infection.

But we don't know how long the immunity will last. We don't know what percentage of individuals will actually respond to the vaccine and at what levels. And will they be therapeutic levels to prevent subsequent infections. And from what I've seen and read is it's likely going to be an annual vaccination, a program that's going to need to be undertaken globally.

Depending on how the pandemic rolls out. But it will be like the akin to somebody like the influenza or the flu vaccine, where every year we'll have a menu or a smorgasbord of, of vaccines that we can take, depending on your, underlying health status, your preexisting medical condition.

And your risk factors, you're going to be advised to take, any combination of vaccinations, which is what we're doing now. And then it'll be up to the individual patient to weigh the risks and benefits of taking any given vaccine or any combination of vaccines and the good thing is that, you know, the vast majority of patients who have been infected do very well. it's those that have been ill and elderly and debilitated, that are at a much higher risk. These are the types of individuals that need to be vaccinated. but the problem with the infection right now, as well as that there are millions and millions of people that are completely asymptomatic.

They either have no symptoms or they have symptoms that mimic. your simple cold. There's no way of telling if somebody has a runny nose or a sore throat or a cough if it's caused by virus A, B, or C, unless we do some form of testing, which makes it very difficult to fight. So those are all extreme challenges that, you know, we're facing. 

Jeffrey Feldberg: [00:13:07] Michael, you've shared a few important takeaways. So business owners that are listening, I think it's important that you hear that even if a vaccine magically came out today, it's not going to be the cure all and the end all, because it doesn't necessarily address what's going to be happening tomorrow.

So, Michael, now let's, let's put your hat on as a business owner and also an investor. Let's call for what it is that, the coronavirus COVID-19 is going to, it's here now and it's going to be here for a while. What kind of strategies, what kind of advice and insights would you be giving to business owners of how do they not just survive in this new era, in this new way of doing business, but how do you thrive?

Michael Varenbut: [00:13:58] That is a great question. Again, I think we're really delving in, you know, my opinion is that we're delving into human behavior and social psychology, and just behavior patterns in general. But as a business owner. I think we need to recognize that everything has changed. And even if we have a vaccine or a treatment and something changes in the next couple of weeks, I think human behavior is going to be modified. So, it's not reasonable to expect that everybody who has been in social isolation, all of a sudden is going to go out there and want to congregate and want to be in groups of large individuals. A, it's going to take time. B, there's going to be a lot of distrust and fear amongst consumers with respect to what they can and cannot do.

So, I would be thinking, depending on my, exactly, you know, on the specific nature of my business, I would be thinking. Along the lines of how do I need to modify my business, my practice, my processes that will cater to the change in social norms that people are not going to be congregating. They'll be sitting at home.

So, if I'm a restaurant owner, I don't think I can expect that in three months I'm going to be sitting there with a restaurant full of customers sitting a foot away from each other. I'm going to need to modify my physical layout potentially. And we've seen people doing that. We've seen business owners doing that already.

Relying more on takeout, on delivery services, on people sitting at home more or staying closer to their own homes rather than going outside and congregating. Thinking broadly along the lines of we need to do things more virtually. We have to be able to do everything we used to do in person virtually, you know, be it going to a grocery store or a supermarket or buying whatever we need to buy.

And we've seen the, the unbelievable, increase in business for companies like Amazon, which is expected. So, I would be thinking along those same lines, what is it that I can do to my own business to modify its processes? Its, behaviors where I would be thinking like a customer that is now afraid to step into my physical bricks and mortar facility and may want to be doing more work from home or getting those goods and services delivered to their home as opposed to having to step out  into the public.   If everything went away, and this was a pandemic that was completely eliminated and everybody's vaccinated, I still see it taking years for things to get back to normal.

So, anybody who's businesses are sensitive to a month, two, three months or even six months, fourth of a drop in revenues. They need to modify or are they like, these won't exist for three to six months. 

Steve Wells: [00:16:53] Specifically to healthcare and healthcare delivery, you mentioned you didn't use where telemedicine, but remote examinations and those types of things.

How do you think that's going to affect the health care delivery and how do you think the specific doctor or practitioner needs to think about their personal life and maybe even their personal finances? 

Michael Varenbut: [00:17:13] I think every clinician has to look at their own practice and modify it too include virtual care and start thinking about the types of visits that they would typically see patients in person for and ask themselves the question, can this be done remotely. Do I really need to be in the same room with a patient or can I do this? Through telemedicine. So, if you think of psychiatrist, as an example, there is very few.

There are very few benefits for a psychiatrist to be in the same room. If you have high quality virtual teleconferencing, that's a huge difference. So that psychiatrists now might not need to have an office at all. They don't need staff.  If you're a dentist, for example, way more difficult.

If you're a surgeon that does a lot of procedures and you're hands on, you will not be able to do the procedures themselves virtually, but at least you could do the assessments. A lot of the preop, the postop follow-up visits, you would have to ask yourself every visit that I have scheduled the patient for before that would be in person, can I do this virtually? I think the bigger, the bigger challenge is going to become, more with the payers in the system of reimbursement.  Will, the reimbursement remains the same for virtual care as it is for in person care. And that's never been tested because that's never been the case.

The payers will have to get their heads around, can we afford to reimburse at the same level as we were before, where the whole economic structure of the service delivery has changed. 

Steve Wells: [00:18:50] You read my mind, I was thinking, reimbursement and maybe even some regulatory changes are going to have to be made.

Even education, you know, how you train the next group of healthcare providers might really be very different as well. 

Michael Varenbut: [00:19:06] Absolutely. So, continuing medical education or continuing education courses, seminars where the, the, the mainstay of, of physician education, where you'd sit in a room with a thousand physicians and you'd have a course for a day or two that's gone. You don't really need to do it that way. You could sit in your own home and learn just as well, and listened to a lecture being given by an expert who is sitting in their own home.

But think of that change of infrastructure to all the companies that are providing continuing education, they're gone. Or they need to modify themselves to be able to provide virtual events and virtual conferencing and virtual education. As far as regulatory changes, where virtual care or telemedicine platforms were not approved by regulators unless they had very specific, security, and HIPAA compliance and patient, compliance, put into it. As of about a month ago, the local regulators said, forget about it. We don't care how you do virtual care.

You can use the phone. That would never be allowed in the past because that wasn't deemed secure enough to have a patient doctor exchange. They've removed the barriers because otherwise there would be insufficient platforms to deliver the care. So, platforms like Zoom or Skype or FaceTime, were not approved originally.

That completely changed where now the local regulators said, use whatever platform you wish. We don't care as long as you deliver the care. And locally here, they've also put in fee codes that make it equally reimbursable. Whether you see the patient virtually or in person. And that's been put in place just during the COVID-19 pandemic right now, but nobody really knows how that's going to change post pandemic. I think it's going to be very difficult for them to go back to say, that was nice, but now we're going to just scrap it all. And virtual care is no longer reimbursable because then that will put the onus back on the patient and then the patient would have to put the onus back on potential insurance companies or somebody else's was splitting the bill, or have to modify that whole process altogether. So, I think it's here to stay, but what we're going to see a lot of changes, over the next 6, 12, 24 months of how virtual care and telemedicine in general is going to morph. 

Jeffrey Feldberg: [00:21:26] Michael, you raised a lot of interesting questions and some insights, and I also know that you're fresh off the heels of a book that you wrote for doctors dealing with finances and money.  I think it'd be fair to say that if you ask the general public, when it comes to money and doctors, most of the general public would say, well, all doctors are zillionaires, which is just like saying every person who's in business is a gazillionaire.

Some doctors who are, have done very well in some doctors who haven't done as well.  As we enter into this new world, maybe you can educate them on what it's going to be like for them now as patients in this new world with the doctors.

It's been the same thing from what you share with me offline. What's been happening with doctor's offices and clinics. Where do you see that going and what should we expect as a general public, as patients, it doesn't matter what country you're in because you could be in the same country, but you have different local regulations.

But I think some things are just going to be universal across the board. So, what advice would you give? 

Michael Varenbut: [00:22:31] So, lots of great questions. Again. So, the reason for the book was, really my own sense of frustration of, of over 30 years of running a business, running a medical business, one that I was largely not ready for an educated for did not. We're not given the proper tools through my own medical training. The title of the book, The Myth of the Rich Canadian Doctor, was a collaboration with  an American general surgeon who felt the same way, and that there is a myth amongst both physicians and the public that as soon as you get your MD, you’re a gazillionaire, you're going to be financially independent and you don't need to worry about it. You don't need to do anything, which is a complete fallacy because most physicians, most medical school programs, even today, do not educate physicians on anything other than medicine.  The realization that every physician is really a small business is a really vital one because physicians that don't have any business acumen, background or good advice are likely going to make a myriad of mistakes. And we see that all the time. Physicians are a very easy target for all sorts of bad investments, bad advice, all sorts of scammers. because are a trusting bunch and we don't have. Anything to go by.

And I think it's really important for physicians to realize that early, but also for anybody that wishes to work with physicians. And that was the premise of the book, was really to educate physicians for them to do their own, their own assessment, really their own physical on the state of their financial knowledge and acumen to find out where they have gaps and what they can do with those gaps, but also to educate professionals, financial advisors, insurance brokers, so on that wished to work with clients or have physician clients to really better understand what, what it means to be a physician. 

There's a lot of room for both, public education to really understand how the healthcare system works. Who pays for what? I'm understanding that physicians run small businesses and when a pandemic such as this hits that they're affected just as much and sometimes more if they can't open their office and they still have rents to pay and staff to support.

Steve Wells: [00:24:54] You know, we talk at Deep Wealth sometimes about trying to make your business pandemic proof and, and, a physician is a small business or a large business, even though they're professionals as are. People like lawyers, architects. you know, there can be all kinds of people who, have a business.

But they're reliant, as you said, on that client customer, patient base coming in and those expenses don't go away. What advice do you give the physician, which might be similar to other professions on how do they help themselves become pandemic proof?  

Michael Varenbut: [00:25:29] For physicians specifically, I think they need to. Put away their medical hat and just think, put on their business hat and try to understand what are the ins and outs of their business, how do they generate their revenue and what would happen if they couldn't generate that revenue for a month or two or three or six in the traditional way that they did before?

And look for other opportunities to generate revenue such as virtual care as an example. And they also have to look at the flip side of their, of their income statement and look at their expenses Where are they spending their dollars? So they're big buckets like rent and payroll and a whole slew of other miscellaneous. So they need to think as they're getting into business and whether they're starting a new business or joining an existing business, looking at all those expenses and trying to be smart about whether it's, you know, getting advice on signing a proper lease with some provisions for things like pandemics, which most of us have never even thought about. Looking at things like business interruption insurance. Most physicians do not have business interruption insurance, or most policies don't cover pandemics. They may cover a flood or a fire. 

If I have 10 employees and I need to lay them off. How do I deal and navigate through that, but thinking about it in advance so that I can have contracts in place, provisions in place, get some decent advice, look at every expense that's coming out, and look at a variety of new income opportunities that would pandemic proof me as an example.

If I couldn't perform the surgery that I typically do, or I couldn't perform the in-person assessment that I would do. What else could I do? How could I pivot? There's a great example just recently that, that came up was, you know, dermatology, which is a very, very touchy feely, very visual specialty.

You have to see the skin to be able to make a diagnosis. . You know, 99% of the services were delivered in person, but through a pandemic, most dermatologic conditions are deemed non-emergent, so they can wait. But at the same time, dermatology is very conducive to virtual care. All you need is high quality equipment, and you can make the exact same diagnosis that you could in person most of the time.

There are some conditions that you still need to do biopsies and so on. But had most dermatologists thought about that. Beforehand, they would have been better prepared to deal with this pandemic. Now, most of the dermatology offices are closed. Their expenses continue, the rents need to be paid, which are then parlayed down the road to the landlords and then the lenders, and all the staff had to be laid off. So, there's lots of medical staff that are sitting at home, potentially in jurisdictions that have some unemployment insurance but others that don't. I think every physician would be smart to sit down and think of what happens if tomorrow everything changes, which is what we've seen.

What could I do? How do I pivot? What could I change so that I can survive? 

Jeffrey Feldberg: [00:28:24] Michael with wearing two hats now let's combine them as a business owner and as a physician. So, if I'm a business owner and I need to stay in business, and perhaps I've, I've been able to reduce my physical footprint, but I still have staff, I have employees, I have a physical space that I need to operate out of.

How do I keep my people healthy? How can I keep my myself healthy? And although this episode isn't meant to dive into all of the health issues, there's just been a lot of misinformation that I've found has been put out there. So from your perspective, and by no means are we saying that this is a prescription for people to follow it's simply your opinion that you're putting out there what would just be some best practices to, physically and emotionally keeping the business owners healthy and safe as well as their employees. 

Michael Varenbut: [00:29:17] Advice like washing hands, can you ever imagine a physician not washing their hands in between every patient?

But I think perhaps now it really behooves us to think about it twice and spend more time on those very basic disinfection procedures and processes and hand washing in between patients. Not congregating patients in waiting rooms like sardines. So, issues with scheduling, and, general office procedures, personal protective equipment.

Should physicians be wearing a mask going forward with every patient interaction? And there's lots of lots of experts that say, yeah, that makes perfect sense. We wear gloves. We wouldn't dare, perform certain examinations without gloves. Maybe we shouldn't be wearing gloves all the time.

And the same thing with staff. You know, barriers like we've seen being put up between patients and staff at reception desks. Should those barriers remain, and, help us to protect our staff from patients constantly standing above them, coughing, breathing, sneezing onto them so that we can keep our staff healthy.

 Let's say it's a family physician used to work in their office nine to five, five days a week in person requiring that physical space within their clinic.

It's very easy to, to fathom now where two physicians could share that office and share that time schedule where a physician would spend a half a day in, in the office seeing their patient. Physically, and then they could spend the other half from home performing virtual care as long as they can satisfy their patient's needs when they're at home another physician can be in their space. So, you can theoretically imagine that the office that used to be 3,000 square feet could now be 2,000 square feet or 1,500 square feet, that would reduce the expenses on the physician side. Most landlords wouldn't like it, but it would work itself out, over time.

And you can see the same thing happening in other entities as well. Law firms really need full floors with everybody working in the same place or accountants? A lot of the work can be done remotely. And I think that's where we're going to be seeing a lot of the changes is that it's going to be very difficult to go back to where we were.

Because we're going to experience the fact that we survived and we pivoted and we changed and it worked just as well, and everybody came out of it. Certain professions, certain aspects be it medical and nonmedical, entities are going to need to change and they will change and continue to remain that way going forward.

Steve Wells: [00:31:48] What's very interesting about the healthcare and medical community is I think if, if they make changes and do things, they could be the pioneers for many of the practices that you've outlined, like you're talking about dermatology. And you know, if, if a patient could get some kind of high definition camera and in the right situation, either at home or some remote location, not in the office, the doctor could make an examination.

I know Jeffrey and I built an online learning company, and it was a decade ago. Back then, online learning wasn't really accepted. It wasn't commonplace. And we were able to build a simulated, program for, a master's or a doctorate in physical therapy, that previously they had hired patients and they would simulate a disease and then they would diagnose it.

When we built the simulator, the. The peoples that were in education said, oh no, this is not going to be as good. Well, it ended up being, the simulator was really more accurate and ended up being a better educational tool than hiring actors at. Some were good, some were not bad, and it was expensive.

And so, then the, the online simulation became the standard way to operate in the classroom. So, and that's an example of a healthcare. So, you really bring up some really, really very interesting, topics and that technology might be one of the answers. 

Michael Varenbut: [00:33:06] I agree with you. I think Steven and Jeffrey you were pioneers 10 years ago and had more industries and professionals taken your advice back then. And implemented changes to their processes and behaviors, I think we would have potentially been in a much better place. Why does classroom education need to be in person? Virtual education works just as well. 

Going back to the medical point that you made, there's, there's no reason why patients cannot become bigger components of their own healthcare, with simple modifications with technology that already exists. There's a company called Cloud DX that has a whole suite of peripherals that patients can have in their own home, be it at home in nursing homes or whatever, where you can gather information that typically you would have to go to the physician's office for things like blood pressure.

Checking somebody's blood pressure is not rocket science or heart rate or oxygen saturation. We're doing an ECG and we're seeing companies coming up on almost on a daily basis that are providing peripherals and devices to enable virtual care. And I think that's where things are going. Historically you had to have a diabetic come into your office every month for a pinprick to check their blood sugar.

That's gone. What is the point of that? They can sit at home, have a glucometer that can be smart and interact with an app. And that information could be downloaded or accessed by the physician, really saving the patient and the physician countless hours and potential exposure to infectious agents.

Jeffrey Feldberg: [00:34:47] Michael, as we begin to wrap things up here, there's one thing that you said that resonates and you said, and I quote, we survived, pivoted, and changed.

And such simple words that have a big meaning. And it, it's just interesting how it takes a pandemic to really open up the flood Gates of a different way of thinking in a different way of doing things. And you've outlined for us how hopefully healthcare can continue the charge of changing society as we know it, in terms of how we interact with each other. 

If you could look back, call it a year ago, even two or three years ago, what would you have done differently and what should business owners as we look forward, be doing differently, in your opinion, to pandemic proof their business and keeping themselves and their employees and their communities, health and, and being safe?

Michael Varenbut: [00:35:49] We're always great with retrospect. We are always good at looking back and saying we should have, could have, but didn't. I think this pandemic took everybody by surprise, but it should be a lesson for us that there are going to be future pandemics and future events that may not be pandemics, but maybe other, other sources of significant seismic changes and stressors. So, we need to really bulletproof or pandemic or, incident proof all our businesses by sitting down and considering some of those items that we talked about before because I think it's going to become the norm.

This is not going to be a one-off pandemic that we'll all survive and, and nothing else is going to happen. There are a lot of people that are predicting that this is going to become commonplace, where, you know, we're expanding the population. There's lots of poverty. we're using antibiotics, very freely causing increased resistance.

I think we need to be cognizant of, of possible future pandemics. Environmental changes, global warming, and the implications of each one of those possible events, but really looking internally and looking at our own businesses or our own little microcosms and thinking about what could happen, what do I need to do to prevent it from happening?

Or if it does happen, am I ready for it? 

Steve Wells: [00:37:09] Things happen in nature and things get stressed and the stress makes them stronger. In those situations, we may not be able to predict everything that's going to happen. In fact, I know we won't, but what we can do is when we are challenged, try to use that as a way to improve and adapt for the better. And it may be, who knows, this pandemic may make the healthcare system cheaper, more accessible, maybe the quality gets better, it’ll be very interesting to see what happens. 

Michael Varenbut: [00:37:40] I completely agree. This is, to me, a real time, live experiment of survival of the fittest for the business environment.

The strong will survive, but those that survive are going to be stronger because they would have weeded out a lot of the competition.

There's going to be a lot more grass on the Savannah if there's fewer of us eating it. But as far as health care, again, hard to know. will it be cheaper perhaps? There are a lot of different players that, survived from healthcare. One thing is for certain, as we're seeing more money being invested in healthcare startups.

Healthcare companies have been more resilient. pharmaceuticals have had, more resilience. and I think the vast majority of us realize that we really, we can't achieve anything if we're not healthy. So it's worthwhile putting a lot of time and effort and money into the healthcare system to ensure that it's robust and affordable and accessible to everyone so that we can. Survive into the future. 

Jeffrey Feldberg: [00:38:41] Last question for you is, knowing what you know, if you could only do one thing as we look to the new tomorrow, whatever that is, whatever that's going to be, wherever that's going to take us, what would that one thing be?

Michael Varenbut: [00:38:55] I'll answer it more on a financial rather than healthcare because I think of, of have done everything that I think I could do to ensure my own and my family's optimal health. Financially. I think we would all be better off to have a larger. dearest, nest egg of, of cash so that we can withstand, six months, a year, two years’ worth of zero income, and having a nest egg that we can rely on that is completely secure that is risk proof that we don't need to worry about market economies, pressures, pandemics. but something that we can rely on and, and sleep well at night knowing that it's there if something happens. 

Jeffrey Feldberg: [00:39:43] Well said. And on that note, Michael, as we look to wrap things up here, if people want to see what you're up to or find you out there in social media space, where's the best place that they can find you? 

Michael Varenbut: [00:39:57] Easiest is on LinkedIn, just under my name, Dr. Michael Varenbut.  Happy to provide my email and phone number to anybody that, would like to connect. 

Jeffrey Feldberg: [00:40:05] Michael, a big thank you for sharing your insights and your time with us today.

Michael Varenbut: [00:40:11] It was my pleasure. Thank you for involving me and for inviting me to speak. 

Steve Wells: [00:40:15] Thanks, Michael.