MediSprout: Reclaiming the EHR from Venture Capital Control with Dr. Samant Virk and Ben Putland

This podcast episode of Therapists Unchained, hosted by Sivie Suckerman, features MediSprout founders Dr. Samant Virk and Ben Putland, who discuss their mission to provide an ethical technology alternative for mental health clinicians. Unlike venture-backed platforms that prioritize investor returns, their Electronic Health Record (EHR) system focuses on clinical integrity and data sovereignty. The founders explain how they self-fund their operations to avoid the predatory practices often seen in the industry, such as monetizing patient data or sudden price hikes. To ensure the software serves providers first, they established an independent clinical integrity board with veto power over features affecting patient care. Their long-term strategy includes building a nonprofit management services organization and an independent clearinghouse to protect the autonomy of private practices. Ultimately, the conversation highlights a shift toward transparent, practitioner-led infrastructure designed to reclaim power from large healthcare conglomerates.

MediSprout

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Dr. Samant Virk is Founder & CEO of MediSprout, a company focused on connecting doctors with their patients through innovative technology solutions. He is also a physician having practiced clinical medicine for almost 15 years, with a specialization in Neurology and Interventional Spine. Virk founded MediSprout' to help practitioners better connect with patients using its virtual video product, V2MD. Samant received his medical degree from St. George's University School of Medicine and lives in Rye, New York.

Ben Putland, Founder, Chief Operating Officer has spent 26 years growing businesses and building digital work that breaks new ground. He's helped global tech and entertainment brands — including Google, Meta, Spotify, Lucasfilm, and Disney — pull off genuine industry firsts. For Google, he led the team behind Google Outside, one of the first campaigns to turn live search data into out-of-home advertising that adapted to your location, the time of day, and what you were likely looking for. For Disney, he helped create the augmented-reality "Shadows" experience, which became the second most-shared ad of 2015 and drew more than 300 million views. Work like this has earned his teams some of the most prestigious awards in advertising. Originally from Cambridge in the UK, Benhas lived in five countries and has called New York home for the past twelve years. His 2019 exit came as COO of Grand Visual and managing director of its ad-tech spin-off QDOT, both acquired by Talon Outdoor that year. Since then he's served as COO of MediSprout, a healthcare innovation company, where he's tackling some of the sector's deepest problems with one goal in mind: making health equity a reality.

This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

Transcript

SPEAKER_02 0:07

Hi, everybody. My name is Civy Superman, and this is Therapist Unchained, a podcast hoping to educate, empower, and inspire mental health clinicians across the country facing the systems that we're facing in this ever-evolving mental health landscape. Today, I have two guests on the show, which is a first for this podcast. So we'll see how well I do with trying to navigate conversation with more than one person. And it's the first episode, I believe, where I have folks on the podcast who are not mental health clinicians, but have invested a lot of time and energy into helping support mental health clinicians. And I think it's it's going to be a very interesting conversation. So I have both Ben Putland and Sam Virk joining me today. Ben has spent 26 years growing businesses and building digital work that breaks new ground. He's helped global tech and entertainment brands, including Google, MetaSpotify, Lucasfilms and Disney. He and Sam, who is a non-practicing physician, have both worked to found a EHR called Medisprout, specific to mental health. Sam is a physician trained in neurology. He's got 15 years of clinical experience. And I just find it really fascinating for both of you. I mean, with Sam, obviously, there's a little bit more of a link, right? Sam, that you were in you worked in medical in healthcare versus Ben, where you have a background in tech. And so I'm super curious for each of you to kind of start by sharing where you started and how it led to this place. Number one, where you're collaborating with each other, you found each other, which I'm curious about, what that road looked like to create something like Medisprout, where you're trying to create a place where clinicians can tap in, but not through like a venture capital platform. I don't know who wants to start as far as trajectory. Ben Ben is pointing at Sam.

SPEAKER_00 2:09

I'll be the head of the sphere here. So thanks for the intro and thank you for having us, first of all. So we really appreciate being able to talk about this because we love what we're doing and we want to tell everybody about it because it's time that things change in healthcare. So I, you're right. I started as a physician, practiced for 15 years, kind of you live the everyday of just kind of all the challenges that clinicians, despite specialty, face in terms of just providing care to people. And my my world kind of in a very innocently, you know, took a transition into health technology. My own issues that I was having in my practice. I happen to have a practice where patients were coming to me from far distances. Uh, I started using video at that time, Skype, which, you know, talking about blowing it. Um I was like, that doesn't even exist anymore.

SPEAKER_02 2:56

They had an opportunity and they dropped the ball.

SPEAKER_00 2:59

They totally dropped the ball. Um, but tried to use Skype to just help my help the people I was taking care of. And um, with the challenges around regulation and privacy and HIPAA and all that, that got kind of a practice shut me down as far as using that video at that time, which was unheard of, do follow-up visits. So I just happened to be, you know, connected to the right people, friends who are in health tech or didn't know how to develop technology. And one of my friends just sitting over a beer one day was like, dude, let's just build something you can use then. Like, let's make something. So we built a telehealth solution. At that time, it was kind of going against the grain where everybody was focused on direct consumer telehealth, but we were trying to focus telehealth on continuity of care and improving the relationship. Anyway, but that's that's that's how my story in health tech got started. That kind of evolved over time, and I realized that providing care in an office or in an exam room or in a in a clinical setting is not the only way to help people. By developing better technology solutions where I was providing my perspective as a clinician, there was opportunity to still fulfill my personal mission to help people, which I wanted to do, and which is why I became a physician and a clinician, but I could use technology to do it. And especially seeing the challenges we had with tech and healthcare, I really was motivated to take that ball and run with it. And that evolved into our story. That telehealth story evolved into the story of Medisprout, which is this EHR we've been developing, which is also similar to the way we were going against Grand with the way we were developing telehealth. We are going against the Grand with the way that we are developing this new EHR. I'd love to get looking forward to getting into that story. But that's how I that's how I landed in this space.

SPEAKER_02 4:40

I'm curious, though, specifically, because you're specifically focusing on mental health, which I found I find really interesting. I mean, I understand there is some overlap with neurology and mental health, but and we said this before we recorded, it's not that you came from being a psychiatrist to doing this. You came from being a neurologist. I'm curious why mental health was the area that you really wanted to focus on.

SPEAKER_00 5:06

Yeah, uh it's it's a great question. And I asked myself this, you know, um, when we started, and we learned a lot with the way we were doing our telesolution in terms of business strategy and your approach and everything. But it really comes down to where your heart is. And, you know, where my heart was, you know, I there's both professional and personal reasons why we chose mental health to do this. Personal reasons for a couple of family members who've dealt with mental health issues. I was very involved in a very personal way with one of them. And I saw the challenges with the barriers that technology was creating for them to get the care that they needed. And for provide, not from the provider's fault, but the providers were also facing the same challenges. And then when I was, I was looking from a professional standpoint, that's the personal standpoint. So I was really motivated to try to help there. From a professional standpoint, just looking across the various specialties of uh, just looking across the various specialties of care from neurology to you know everything from orthopedics, primary care uh to mental health. We just saw the mental health, we saw the crisis in mental health that was developing over uh, you know, from 2015 to 2020 and even before that and through post-COVID. And as we saw that crisis and the challenges mental health providers were facing to delivering care, to getting reimbursed, to all the frustrations that you that you all know, we said here's a place we can make a massive footprint and really kind of help change things.

SPEAKER_02 6:36

And I just want to say, as a mental health provider, that it almost made me a little of a clemp to like hear you say that because I to feel seen in that way, specifically, I think around someone who is a physician. It feels like we're like the little guys, kind of like screaming to be seen and heard. And hearing you say that just made me feel like, oh, okay, people are seeing this. Like you recognized the imbalances that we're facing. And so I just wanted to name that because I feel like sometimes we are we're kind of pushed to the side. And, you know, I mean, there's so many issues with healthcare right now. I'm not going to go into all of them, but I just wanted to name that because it feels good to be seen as a mental health clinician, right? It feels good to be seen from somebody on the outside who worked, like had to deal with it as a family member, but also the knowledge that you have as a provider, that you were seeing what's what's going on in our realm and that you were compelled to want to do something about it. So I just wanted to name that. And then Ben, you're come from a completely different world, which is very fascinating to me. And so I'm really curious on your trajectory, and Sam didn't mention this, and maybe you can kind of share how the two of you met too as part of that.

SPEAKER_03 7:56

My trajectory started out in the UK last century, post-uni, creating websites, getting into usability when usability wasn't even a thing. Did build all kinds of things digital and then you know, fast forward through a lot of that. It's great fun. The advertising and tech game, three martini lunches, and you know, Mad Men is is real, still live and kicking um in a lot of places. But it just wasn't really that fulfilling. I didn't really feel like I was contributing a lot to society. And after exiting a business that I brought over to the States um in 2019, the pandemic hit, time for change, and I wanted to help people. And a mutual friend introduced Sam and I, and like Medisprout was blowing up in the pandemic, the telehealth um, the telehealth product. And so we met, and Sam's like, I just want to help people, let me help you help people. The few other motivators were you know, my my mum's a social worker, so I was raised by a single mother social worker. My wife's just graduated Antioch in dance movement therapy, family marriage therapy. So, you know, it's it's something I've been around my whole life, and yeah, of course, friends friends have been in dark places, and I've seen that. So you know that that there's the motivation there, and rather than you know, building crazy advertising stunts or bits of technology that maybe don't have the best intentions, I thought well, let's let's put all that knowledge and skill into building something that could be really valuable and help people um in the long run. So and yeah, Sam and I hit it off in 2020 and the rest is history. Yeah, we we we we made the decision to pivot from pure telehealth and you get in get into the mental health space. We we as Sam said, we felt we could make a difference, and you know, we've really learned a lot in the last four or five years, and especially about the sector and and sort of led us to where we are today.

SPEAKER_02 10:20

And what's interesting as I'm hearing you talk about this, is I don't think it's a unique story for I mean, because it's what we're seeing, right? Where technology is infiltrating healthcare. And specifically in mental health, um, which is what I'm most familiar with, is these VC-backed platforms, these tech platforms coming in with a bunch of you know, capital investors coming in and doing that. And so I think from that lens, the story is on par with what we're seeing. What's interesting to me about what you're doing is that Ben, you reached out to me because you were at, if if folks haven't listened to the podcast, I work with an organization called the called Build Better Health and specifically the Mental Health Insurance Reform Task Force, which I will just call the task force if we talk about it because it's too many words. And I'm federal policy lead and Washington State lead with the task force or co-lead now for Washington State. And you were, Ben, you were at one of the task force meetings, and and I must have spoken and you reached out to me. And so this obviously I was intrigued because this isn't just and I pardon pardon the language, but like a tech bro wanting to like find a it didn't feel like it was like, ooh, how do I capitalize on mental health? Right. And I think part of that speaks to obviously working with you, Sam, as a physician, that there is a real clinical interest in this work. And it's not what we're seeing a lot of is that sort of exploitation. So I'm curious, and either one of you can talk. This is where I'm gonna have to figure out how to manage having two folks. As far as how you have been able to build what you've built so far, I know it's still under development, but you're not taking series A funding, whatever that means. That's just the first you, I think you explained to me, Ben, what that was. It's just the first round.

SPEAKER_03 12:18

Series A is typically when you've got greater than one million in recurring annual revenue.

SPEAKER_02 12:24

Okay. And you're looking at doing this in a different way. So I'm really curious, and I think our listeners are gonna be curious about that because my guess is people are listening to this with a little bit of suspicion, right? Like what what it what what what are you hoping to get out of this, right? Like what are you just gonna become another of what we're already seeing?

SPEAKER_03 12:42

Yeah, you can call me a tech bro. Um, I don't take offense, but I'd I'd probably reframe it a little bit. I think that that at Monica is uh for a specific group of people. I think there's plenty of people that work in technology that believe in doing good things and have values that align with you know your values and the values that people provide care. My mother installed those values in me. Um, so we are taking a different approach. It's 15 people doing this, it's our investment. So we're building a for-profit business. We've spoken to like thousands of therapists, and cost and price hiking was like the number one thing that we heard. And with knowing how to build efficient technology, take was hey, we can do this better for less.

SPEAKER_00 13:34

Yeah, people should be skeptical. And in healthcare, I think providers' practices they should ask harder questions to solutions that they're buying, that they're invest they're investing in, right? Who are you? Where do you come from? What do you stand for? Why are you and how are you making decisions, right? When I've gone through my journey, I've learned kind of what's behind the curtain here for tech health technology. And when you look behind the curtain, it's not bad people. They're not bad people. They're people that are out trying to do what they're supposed to do, right? And when you are a tech company that is funded by investors, that's just the reality of your circumstance. And when your reality of your circumstance is like that, you will be beholden to what those investors or those people want from you. That's just, again, not bad, not good, it's not judgment. That's just the reality of the background. To build tech costs a lot of money. Providers aren't doing this because they don't have time and getting the resources is difficult. So when we learned and understood this background, we said, we can do this differently. And we can do this using decision points that are very different from what other people have been doing. And that's what motivated us to start building an EHR rather than just some secondary solution, a scheduling tool or a notes tool or a XYZ tool. We said, let's just go to the heart of the matter, cut to the heart of the chase here. Let's build the thing that practices rely on and do it in the vision of how a provider and a practice wants it built to achieve their goals and not to achieve the, again, not judgment, to achieve the quarterly kind of goals of a spreadsheet that a health tech company is doing. And when you look at the background of health tech and how it has failed us, that's really what it comes down to is their decisions they're making are based on their financial needs, not on the clinical needs of us as practices. So we spent three years building the CHR, focused on talking to thousands of providers and learning what their goals and ambitions are. And that's in the philosophy of our website. So be you should be skeptical of what we're doing. But the proof's in the pudding, the HR is free. Um, we believe there's much greater value in solving actual problems that providers are facing rather than offering them a subscription model. So it's the beginning of a new journey.

SPEAKER_02 16:17

So I could already hear listeners. Well, if it's free, you said it was expensive to make. How is it getting paid for if it's free? And how have you been funding it at this point?

SPEAKER_00 16:26

Self-funded.

SPEAKER_02 16:28

Self-funded. What's the sustainability of that? Do you think? I mean, that's the first question that I come up with.

SPEAKER_03 16:34

So there is a commercial side to it. The core EHR is free. All of your scheduling, all your charting, all those basic things that you do every day, that's completely free. And it will be free for life. So if you're if you're doing in-person visits, it's free. There are paid for aspects of it. So we do unlimited video visits. That's that's expensive, right? To to run video um in HD, that's expensive. So $49 a month gives you unlimited video visits. But we'll give you four free video visits anyway, just to get you going. So if you want to start a private practice, by the time you're seeing, you know, you've got four patients if you're doing telehealth, then hey, 49 bucks a month is less than your cell phone. So we think that's reasonable. And then there's small transaction fees comparable to what all the other systems are taking, like 30 cents for a transaction, and then you know that the payment clearing houses take their percentage on top, but we're not we're not taking another percentage, we're not taking any points off your transactions. So it's a volume-based business. There's a million, there's a million mental health providers in the US, and we don't need like a huge, huge volume before we can cover our running costs. Like there is speculation, like there's investment that's gone in. Um, but we're in this for you know, we're talking decades that we want to be in this. It's like it's not like a quick turnaround, and that's the big difference between us to venture-backed businesses, as Sam was saying, like, we don't have a revenue target that we've got hit every month, right? So we're in a great place. We're lucky that we can do that, but what we've seen and what we're hearing is people feel they're being having money extracted from them because the prices keep going up for no apparent reason. So we wanted to solve that problem to help more people get into independent practice. There's, you know, we've all read the press, we all know what's going on with the marketplaces, um, you know, the D2C marketplaces. And we want to offer like a safe haven where therapists can have one less thing to worry about. You don't have to worry, we're not gonna suddenly sell it, we're not gonna suddenly jack the prices up, all the bait and switch stuff that's been going on, because we don't believe in that. Like, these aren't business practices that we believe in, and there's enough for everybody to think about when providing care. Like, let's just let's give you one less thing to worry about. That's that's the goal.

SPEAKER_02 19:39

And what comes up, because I I you know I put my clinician hat on of if I was listening to this podcast, I know a lot of the concerns that I'm seeing across the board that are specific to the like investor-based platforms, which is data. And I'm seeing a lot of panic from providers, from clinicians, mental health clinicians, where they're reading the fine print on these, on let's say it's simple practice. Did people know that on the simple practice thing it says X, Y, and Z? And now I'm worried about my data. So I'm curious about your view of being having all of that data and how you work with data, because I know that that's a huge concern right now. And my other question, kind of adjacent to that, is when you're self-funded as you are and you don't have, because I think this is something that clinicians were constantly like trying to figure out. It's so hard to compete with all the money being poured in to these other platforms, right? Like for individual clinicians, for instance, you know, seeing the rise of headway, rula, grow, all of these models that have taken over the algorithm where it's like the first thing now that pops up is headway when you're looking for a therapist. So it kind of pushes folks out who are not associated with that. So I'm curious, it's kind of a two, it's kind of two separate issues, but there's the data question, and then there's also the being small potatoes comparatively. How do you feel like you can really compete and get the word out? I mean, you're here, you're on the podcast, that's great. But how have you felt about being able to get the traction that you need to build up to the level where it is a sustainable, like long-term business model for you?

SPEAKER_03 21:21

It's hard. You know, we've been met with skepticism, and rightly so, when we when we said it's free. And and uh we've worked hard on the messaging around that, and we've developed a philosophy that we hope resonates with therapists.

SPEAKER_00 21:36

Yeah, as Ben said, it is hard. It's not easy to get the word out. Um, you know, we've been learning as we've been building about marketing, about how to how to get the word out. Uh, we've been creating relationships with with you and with state associations and places that providers, professional associations that providers have connection to. So I think it's gonna be it's gonna be word of mouth and And as we start generating revenue, we don't have to line other people's pockets with our revenue. We can spend that in marketing and in sales, right? We we, you know, from what we've understood and what we've learned, you can actually build a business by reinvesting your revenue into the business.

SPEAKER_01 22:16

What a novel concept.

SPEAKER_00 22:18

You don't have to spend it to pay other people and then, you know, to meet certain goals. So, you know, it is it's different. It is different. And we, but from everything that we've seen, we know that this is possible. I mean, the best and the biggest part of it is there's a desire for this in the community. The more we learn, the more we realize. I mean, the two latest examples over the past couple months are, you know, Alma and Aetna and the simple practice data issue, which we're talking about data, and I can touch on that. It just keeps increasing everybody's frustration. And because we're modeled differently, because we our um our philosophy is different, uh, we don't anticipate having those issues. And I think, you know, you can spend a lot, we can spend a lot of time talking about why we're different with this and how are we going to do that, and how are we going to do, you know, how are we going to do fill in the blank? I think the idea here is we believe we can build a very successful business, which we are trying to do. We are trying to build a business, right? Yeah. We believe that business can be built on good values and good ethics that align with caring for people and helping people. Those two things are not mutually exclusive. They can exist and they can coexist and they can actually grow each other and be symbiotic. Today, it is the opposite. The technology that we use does not work in a symbiotic way with promoting relationships, promoting care, helping clinicians, helping patients. It use it undercuts what their objectives are. So it just begins with a really simple idea. You can build a really great business and help people at the same time. And I think the fact that we're not beholden to certain entities and the fact that we've been doing this for three years, if that's not belief enough for people to think that we're committed to this, then you know you can keep watching and we will keep and we'll keep going. Um, I think this next year is going to be uh a really interesting one for us. We just putting the first product into the market, uh, which is for private pay practices, and we're about to put our insurance model into the market as well. So that's the clearinghouse.

SPEAKER_02 24:38

Because when we spoke at the pre-interview, you're also building your own clearinghouse, which is a whole nother. I was like, I didn't even know you could. I mean, obviously people do it, but that blew my mind that you were doing that.

SPEAKER_00 24:50

There's there's um, so I'll touch on the data piece you spoke on uh asked about a second ago, and I'll touch on the clearinghouse. So the data piece, we again it goes back to the same philosophy. We don't need to monetize data to make money. We can use data, we everyone's opted out. No one's like opted in. You know, let me give let me contrast it. We don't view data as a revenue stream, we view data as a way to improve the way that practices operate and that our business operates, which where we're not monetizing it. We will allow practices to use the data that they generate to improve their own business and the way that they're providing care. So whereas EHRs today view data as monetary opportunities because that's what they're that's what they are. That's what that's cloudy.

SPEAKER_02 25:48

Say that again, Ben.

SPEAKER_03 25:50

Cloud feudalists. It's uh command capital. It's like a new concept that uh a very well-known economist came up with. Yannis, I can't remember his surname, Greek guy. He was the uh Greek finance minister during the the massive crash of Greece in 2000. Um like the extraction of money from data. Um, and that's what everyone, like all of the you know, the hyperscalers have been really good at doing, and that's what everybody else has like jumped on that bandwagon. It's like there's money in data, but we want to we want to be a counterplay to that. Like let's let's utilize data to create value, to improve outcomes, share insights, and advance the field rather than just selling data and using it to target target ads or you know, use it for bad purposes.

SPEAKER_02 26:51

Yeah, and I'm glad that you're you know the reason I asked it obviously is because of what you you know what you're both saying is that that is the model right now that a lot of these uh companies are using as an it's like always like how much money can we extract from the system? And you're seeing that as another opportunity to make more money for their investors. And because you don't have investors, as you said, you're not looking to line anybody's pockets. You want to reinvest in it. I'm also curious because we're seeing more and more AI integration in EHRs and just everywhere. And some, and I don't want to misspeak because I may not be accurate, but I feel like some EHRs are now requiring some sort of AI component that is just going to be agreed upon that you just kind of have to agree upon to participate. Like I've also heard like simple practice now is requiring biometrics or something. Stuff is just kind of going off the rails with all of this. So I'm curious. I did check out MetaSprout, Medisprout, just so folks know. I I created a free account and I was poking around in there. I'm curious if you see that as a necessary in moving forward or how you're feeling about the integration of AI into EHRs and if it's something that you're considering, or like where you both stand on that at this point.

SPEAKER_03 28:16

We already have an AI component. Like voice activated notes. We've got a dedicated practice assistant app where you can either transcribe the whole visit or you can just dictate notes and it will, you know, usual story, it will generate soap, gurp, burp, whatever acronym of note format you want.

SPEAKER_02 28:38

Oh, like a DAP note or a SOAP note. Yeah, yeah.

SPEAKER_03 28:40

All the all the usual suspects. But what we've done is we've said everyone is opted out. Like the patient and the provider are opted out by default. So it requires consent from both parties before that functional work.

SPEAKER_02 28:58

Okay.

SPEAKER_03 28:58

Right? That we believe in opt-in is it's gotta, you know, you've got to choose. I think there's this isn't going away, right? And there's already people that are customers that have demand for it, they want to use it. So if there's demand, you want to do it, but if you can do it in a more ethical way, then that's great. Do we need biometrics? Not the last time I checked, and and one of the things that we've put together, and you know, for any of your listeners that want to get involved, we've put a clinical integrity board together. Oh, and that clinical integrity board has veto power over things that affect clinical judgment. So if we were to suddenly say, Oh yeah, let's do biometrics, we've got to put that to the board and the board gets a casting vote. And maybe they come back and they say, Yeah, but, or they say no. And our goal is to start publishing these results to offer another layer of transparency, but importantly, it gives therapists a seat at the table of a tech company. I was just at the NASW event and it had all of the leadership from the trade organizations. And that was the only common thing that I really heard was we need a seat at the table. Well, we're offering that. You can sign up, you can participate, and we want that engagement because we think that will help build trust as well when your peers are involved in making decisions that affect clinical judgment. So that's something that we're actively doing. Don't think anyone else has that. They've probably got they've definitely got therapists on staff, but they're paid and they probably don't have veto power.

SPEAKER_02 30:53

Well, and I you're right. Like if you're an employee of some of an EHR as a therapist, let's say, you're beholden to your employer. You're being, you're like, you you followed the rules of the employer. What it sounds like, what you're doing differently is you're creating an independent board that is specifically around clinical integrity. They're not on payroll, and it's really about you wanting that objective input from actual clinicians to help inform the work that you're doing. And Ben, you said I don't think anybody else is doing that. You're right. I mean, from what I know, nobody else is doing that at all. And I also just very quickly want to make a note to the audience that we recognize Ben is having some audio issues. And I would just want to name that because um I'm hoping folks will be able to understand Ben's bringing up some great points, but I don't want to stop the conversation. And I'm hoping that uh folks will just be patient with the audio and do your best to be able to take in what Ben is saying. But this does feel really different to me. And I really appreciate the thoughtfulness that you're both bringing to this. And honestly, I would say humility that you're bringing to it. Because I think that when you start a business and you have ownership over something, there can be like a power thing that can kind of take place. And what it feels like to me is that of course, you want to make money. This is your business. I get it. Like that's I mean, I'm a small recruit practice owner. Of course, I want to make a living doing this. I don't know, you know, like that is part of why I'm doing it. But the int the clinical, and I even love the name of the board, the clinical integrity, like what a great name. It really feels like there's an investment in doing this the right way, in being transparent. And it also sounds like you're planning to kind of study or like use some of the data at least to advance some research in this area. Is that accurate?

SPEAKER_00 32:52

Yeah, 100%. I think it, you know, to boil it down is what's the cart and what's the horse, right? You know, for us, the horse is clinical care. And we think there's plenty of financial benefits for everybody, including us as a business, if you address the needs of clinical care. As opposed to the traditional way of developing tech, has unfortunately been the opposite. It's been what are the financial objectives and how do we accommodate clinical care to achieve those financial objectives? So it's just time to view it differently, and that's what we're trying to advocate for. And as it relates to AI, it's the same thing. It's we're viewing AI through the needs of advancing clinical care and not through the needs of how can we use AI to generate a new revenue stream? That's the difference. And an example of that is how we're doing notes, like Ben mentioned, right? There's the ability to just transcribe the whole, the traditional way that people are applying it is just the slapstick method of, hey, we'll record the whole visit and we'll create an AI note for you, right? We thought a little bit deeper about it. We said, wait, well, where's the art in this? Where's the where's the clinical judgment in this? Are we just going to have slapstick form AI notes created for all these patients where you can't differentiate them? So we said, why don't we do this? Why don't we let the clinician still dictate an open-ended, you know, two, three, four, five minute discussion of how they think the visit went. And in that, from that, let AI take that and turn that into the note. Right.

SPEAKER_02 34:36

And I love that because with the data piece, that whole transcribing everything, because as a therapist, I'm not a I'm not a tech person. Like I, I, I'm, I'm not an expert in this stuff. And so when there's this full transcription of everything, it's like, where is that living? How is how is it being used? Like, is PHI being compromised in some way? Um, have I read all the fine print? Do I even understand the fine print that I did read as far as what this actually means and how this data is going to be used? Because it's all in legal ease. And so this, which, and maybe other things are doing this, but I've never heard this, where the clinician can just kind of summarize and give their take on a session. And instead of it literally listening in and transcribing everything that was said, that just feels safer to me in so many ways.

SPEAKER_00 35:31

Yeah. And the and the clinician can give their artistic, if you will, bent on how the visit actually went from their perspective, not from the AI perspective, who suddenly becomes the artist. Right. Like, and again, it just takes one extra, that's the difference between clinical care leading the way versus a financial decision leading the way. And when you apply that philosophy and that approach throughout the technology, those subtle differences start to add up. And they result in what we're hoping are going to be a product that actually advocates for the needs of practices.

SPEAKER_03 36:10

The other side of this is HIPAA is what we all know about and you know, we're bound to. Um, but HIPAA is dated. Policy can never keep up with tech, right? That that's we're we're still um, I think we're still using laws from the 1970s to regulate email, for example. So, you know, like come on. If you think about what's going on in that therapy room, people are people are saying some really deep stuff, and that isn't really what HIPAA was designed for. So I think people rightly should be concerned with having that data stored. Like, does it store for eternity? Or can we delete that straight after the session? That's something we're looking at right now. Like we we we had a lot of feedback around um people are scared, providers are scared of that suddenly coming back. So, oh, there's a full transcription of what was said in the room, and my EHR that I've got today has got a record of that, and then what happens if they got bought out by a payer who then wanted to go and do clawbacks? Like, think of those scenarios of like what could happen in the external environment around like transfer, transferring ownership of that data. So like those are real concerns that people should have, they're concerns that we have. Um, and so yeah, we want to we want to do things that give people confidence in using the tool because the tool is good, right? Like if we can all save time and effort, that's good because I can have more time to do the things I enjoy or spend time with my family. So we all believe in those things, but we need the confidence that it isn't gonna come back and be used against us.

SPEAKER_02 38:01

Yeah. And I think that there's two different kinds of realms happening here. As I'm hearing you talk, there's so there are, you know, like the simple practices and therapy notes and sessions, which is one that I think people tend to appreciate more than uh, especially simple practice. And then you have the VC platforms like Headway, who have their own integrated EHR, but they are different than what you're doing, right? Because they're acting as a management services organization where they're handling billing and credentialing and doing all of those things. And I'm wondering with the shift in that, and I see it's funny because I've been noticing that simple practice ads are it tells me that they're scared of Headway because they're like, we're gonna start having helping you credential, right? There's I I'm like, ooh, they're losing business to Hedway. That was my first thought when I started seeing that they're offering credentialing, is that they're afraid they're losing business to Hedway because Edway has an integrated EHR and they do they're an MSO, et cetera. How do you feel like you're gonna fit into that and compete with that? And does that impact sort of your long-term strategy of what you see Medisprout becoming as it as it continues to grow?

SPEAKER_00 39:16

We've we've been thinking about all these things. So the headway and alma evolution has been really interesting, simple practice also. And I think the common thread between simple practice and alma and headway and you know, uh therapy, nest and all all of these, all the other, all the EHRs is kind of what we were speaking about earlier is who are they beholden to and how are they making decisions? And I think that uh the MSO idea is it's great in theory, uh, meaning practices need that administrative help. I think that some of that administrative help, you know, again, the question to ask is who are you and where is this coming from? Right? Like, okay, you're lending out a helping hand to me, but why are you helping me? And what what is your what is your goal of helping me? Right, you gotta ask those questions, right? Um, and when you look at Headway and you look at Alma, and it is the insurance companies who are their investors. And once once they have a hold, what what are their decisions going to be? And it's very easy to get like just, oh, it's not gonna impact me. Like this is just a it looks like a really great company, and everyone's talking about them and they're being marketed. And look how many people are investing in them, and they must they must be out to do good, right? And you know, I think the lesson my mother once taught me was just because someone has money doesn't make them a good person.

SPEAKER_01 40:39

Like, right?

SPEAKER_00 40:42

Like you can't just, you know, you know, believe it. So I think the as we've been digesting that, we've been thinking about potentially, you know, setting up our own MSO, a nonprofit MSO that is attached to the free EHR so that we can actually empower, I think the the thing we've been missing in healthcare is the community of clinicians that acts as a whole to advocate for what they need, right? I think no one has done that. And I think if we rally everybody around a common philosophy and common idea and common goals that everyone believes in and are being brought, you know, brought to to them by people, which we hope can be us, who are honest and and uh and open and willing to do good, that MSO structure is something that could that could actually offer them that helping hand that is not tied to investors.

SPEAKER_02 41:41

Yeah. Because if it's if it's a nonprofit model, which again is a really interesting approach to it, similar to the having that clinical integrity board, then having a board, because if you're a nonprofit, you have to have a board who I would assume would involve clinicians as well. I think it's a really interesting model because I think that this is what people have been hungry for. And one of the main like points of my podcast is I want people to be hearing that this stuff is happening. Because what I see is everybody's kind of in their silos trying to reinvent the wheel by themselves. And we're up against the big guns here. So we can't be super precious about our little project if we really want to compete. And because we have some issue with our name being at the top of something. I would love for people to hear about what you're doing. And I actually introduced you, Ben, to somebody else I know who's doing something very similar to what you're doing. And I was like, you two should talk to each other about what you're doing and how you're both doing it. Because I think that my hope is that people will see these opportunities to come together because we're so fragmented as clinicians, which is a whole nother issue that I have because we have mental health counselors, you've got marriage and family therapists, you've got clinical social workers, we all have our own associations, we have our guild protectionism. We already have all these silos. And I think people feel the reason people join these companies like Headway is because they're overwhelmed and they don't, they don't know how to build their own infrastructure to do it. So when I hear folks like you stepping forward and saying, All right, how do we compete with the big dogs without turning into them ourselves? We can we can have the same model is not the right word, but but do the same thing, but do it in a way that leads with integrity and with the clinician first approach. Uh and also that's a great way to build trust because a lot of us now are really skeptical of everything just because of what what we've seen happen.

SPEAKER_03 43:43

And we should be. Let's look at some other sectors. I mean, if even if we look at physical health, like in the last 20 years, physical health, independence have gone down. I don't, I can't remember. I think I think it's like from 60% to Like 38% of the market is owned by independent practitioners. Care equity or care outcomes have gone down and costs have gone up, right? That's the direct result of consolidation. So if we don't want the same thing to happen, and what what we're seeing is, you know, we watch the external environment a lot, you know, that's those are the signals that we're looking for in the external environment to see what's doing. We need to build a moat, right? We need a moat around independent practices. And we see Medisprout as one part of that moat. You know, we've got other people that we're meeting and collaborating with who are going to build other parts of that moat, be it a payroll system, be it a CRM, be it a referral mechanism. Like we what we need is we need to have an ecosystem which protects independence. Because I've got a driver's license, but what what I'm seeing is there's now other license that I've got. But what I'm seeing is independent practices provide better care, they have the ability to be more niche, um, they're not just cookie-cutter, and people aren't under pressure. And I know what the pressure is, and kind of going back to what you were saying about simple practices ads, yeah, they were bought out in 2024, right?

SPEAKER_02 45:28

Um, engaged for the second time, I think for the second time.

SPEAKER_03 45:31

Well, and this is what happens, right? This is the trajectory of private equity. So they bought they got bought out in 2024. So what's happening now is they the Vista equity partners are pushing for growth, growth, growth, growth, right? That's why they're selling financial products, that's why they're putting the price up. They need to see growth. And they're on their goal is to exit and cash out and make a big, hefty sum. I've been on the uh receiving end of being bought out, and I've had I've felt the pressure to make the quarterly numbers. Um, fortunately, I only had to do it for a year. It's you know, it's super hard, it isn't fun. Most people don't achieve it, the earnout part. It's like something like five percent. But you know, if you hey, word to everyone, if you're gonna sell your practice, don't take an earn-out deal. So you gotta buy me out entirely now. That that would be my recommendation on that. So if we can if we can build this moat and have a collective in our own ecosystem of ethical businesses that aren't out just to like scale and exit, then we can really protect independent practices. And so that's we we want to be a part of that. If there's other people doing the same thing, great. That tells us that there's massive demand. Like if you're just doing it yourself, it's not a great signal. But if there's two or three people trying to do the same thing, that's great. And then it also means there's competition within that, but you know, as Sam said, you you need to look under the hood, you need to understand who's behind that curtain, who's who's pulling the strings, who's who's pushing people to behave in certain ways.

SPEAKER_02 47:28

Mm-hmm. Yeah, and there's not necessarily a one-size-fits-all approach to EHR, right? So, because I'm I've been planning to have that other person on my show as well to talk about her plans for the EHR that she's building. And so I think that there's room at the table for everybody because you know, maybe there's one geared towards solo independent practices where that's all that you really need. And maybe there's another one that's more geared towards a group practice, like what I have, or maybe there's one that's geared towards a group that also has prescribers, right? So there's there's first of all, there's I think 1.2 million of us. So there's plenty of us to go around. There's a market for it. Yeah. And the thing that I really am trying to really, I want to kind of push it into people's heads is that I think in this field, we've operated from a scarcity mindset for so long that people clutch on to things. Like, and I think there's just this fear. So I'm all about take a breath. You don't need to be so precious about your idea because we need all of it. Totally. We need all of it. Yeah. All of us, you know, I think that there tends to or there can be this sense of competition. And sure, healthy competition is fine. But if we want to stand up to these tech platforms, we have to put that aside and honor each other for what we're bringing to the table and that we're vetting for integrity and that we will support each other, even if we're trying to reach the same people, that we're stronger together and we can lift each other up. And whereas my product may not be right for these people, hey, they might be right for you. And I'm happy to let those people know hey, there's this other organization that actually I think will better meet your needs than what I'm doing. And I think that's how we have to be thinking about this, which is why I want to amplify even people that are doing the same thing as each other, because I think there's room for all of it.

SPEAKER_03 49:34

It's I've got a real world example of when that happened. When I came to the US, I was the only company doing what we were doing. And it wasn't until another company doing what we were doing in the UK came to the US that we started gaining traction because it created a market. So, you know, we were we were competitors. The guy that did it were best of friends because we knew each other back in the UK. They're like, oh, we're both in New York. So that was great. And like that's what created a market. Sorry, Sam, you were gonna say something.

SPEAKER_00 50:06

I was gonna say the exact same thing without the concrete example.

SPEAKER_02 50:12

See, that's why you two work together. Great minds like a light. You'll be finishing each other's sentences soon.

SPEAKER_03 50:17

Oh, we do sometimes. Yes.

SPEAKER_02 50:19

And I, you know, when you were talking about the payroll thing, that's somebody else. I know I connected them with you, Ben. Somebody else reached out to me who is trying to build something called a PEO, which I had never heard of. And then I started going down that rabbit hole. Like, what is this? I didn't even know this was an option. And I'm a little confused by it, but uh, she's gonna be she's gonna be coming up and gonna talk us through that piece. But it's all these components that I see people identifying, right? Where there's the EHR piece, right? Then there's the MSO piece, then there's the like HR administrative burden of, let's say, having a group practice, because you know, I'm a small group practice center. So of course I'm very intrigued about that piece because I can't compete with Headway. I mean, also we're different and we're different things. They're 1099. I'm a W-2 employer, I take care of my employees, but the infrastructure, as you both have talked about, you know, and with HIPAA compliance, with technology, everything has gotten to be so much. And then you have small practices where we don't have the revenue to fully like embrace all of this stuff or to manage all of it. And it can feel really overwhelming. And then the price points continuously go up around it. Our reimbursement rates do not go up. And it feels like the little person in this gets screwed because we just don't have the same revenue and power to feel like we can we can do all of this ourselves. I mean, some of us are crazy like myself and are like, I'm gonna do this, I'm gonna put something scrappy together and I'm gonna make this work. But like what you're doing and and what um Don, who's gonna be on the show, this creating the systems to help us be able to compete in like it's almost like a consortium, right? Like, how do we share resources? Can we create a consortium of these businesses that are emerging where we can cross-pollinate and come together to support the whole the whole system being lifted up?

SPEAKER_00 52:29

I think that it goes to something we've spoken about is just the basic concept that today in healthcare, this model where practices and providers, right, all the services that that they use, right, whether it's technology, whether it's insurance, whether it's whatever maybe script writing, it's flipped upside down, meaning those services are actually dependent on us, but somehow it's been structured where they've made us dependent on on the on them, right? And that those businesses don't exist if you don't see a client or somebody doesn't see a patient, or like they don't they don't have a business. And I think there's a mechanism to leverage that capability. So not to take advantage of them necessarily, but just to say, hey, listen, like we need better, and we're gonna let you know what we need rather than you telling us what we should be using. And I think that our approach with cost structure with the HR, with the way that we want to set up claims with a nonprofit MSO, it sets the stage for that to be possible. It aligns with the interests of clinicians who should we believe will want to use what we're providing. But then we can then leverage that capability then to push back and to say, listen, we need rather than Aetna saying we're cutting your rates, saying, Hey, Aetna, we need a better rate. Or, you know, whether it's malpractice or whether it's, you know, fill in the blank. It has taken steps, but I think that's where we're trying to get to is so that we can kind of reclaim what's right. It's just the right, it's just the right thing to do.

SPEAKER_02 54:07

Mm-hmm. And clinicians obviously don't, honestly, a lot of the time, not everybody, but don't have the technical knowledge a lot of the time, or the bandwidth, or the funding, or anything. Because we're just trying to survive. So we feel beholden, like you said, like it is flipped because we don't have the infrastructure ourselves to like we're we have to use a clearinghouse. So we it kind of does take our power away because we have to, we're we're beholden to these systems if we want to get paid to, you know, file claims and stuff. But you're a hundred percent right. And I'm curious that feels like a really big job to create a clearinghouse. But it's also, I love it because it's taking ownership of yet another large piece of the puzzle, which I love. So I'm curious about the clearinghouse piece, but I Ben, what what did you want to say? I don't want to interrupt you.

SPEAKER_03 55:02

I'm just gonna say, I think generally it's not just in the mental behavioral healthcare sector, like every sector could benefit from ethical infrastructure that isn't trying to overly monetize or commoditize the service. Like we we hope like there's more people doing other things in other sectors, and if we win a good market share, then it will be detrimental to the people that we don't believe are behaving very ethically, right? It's like together we're stronger, like, and we really are like you back us, we're backing you. You know, it's like all of those small like it's great, just one person private practice. Great, come on, Paul, we've got you, we'll transfer all your data, take care of you. We're not gonna suddenly sell out. That's all that needs to happen. People just need to take the action. Ask yourself, how would you feel after you'd got out of that bad relationship? Like, because it's kind of what it is, right? It's not a good relationship that you're in. So, yeah, I just think I think conceptually, like I just love the idea of ethical infrastructure, right? If I had more bandwidth and more resources, I'd be like thinking, okay, how could I, you know, how could I have our own data center or our own LLM or you know, take take it up a notch. We're building what we're building, but it could be be a lot more. And it's it's it's why also why we're like, okay, well, let's let's do the clearinghouse. Let's get into the clearinghouse.

SPEAKER_02 56:42

Um that just sounds I also don't understand how it all works, but that sounds big because you don't hear about people starting clearinghouses. At least I don't.

SPEAKER_03 56:51

The genesis for it, if you like, was we're like, okay, we've got to do an insurer. 70, 80% of the market takes at least one insurer. So if we don't have that, we can't compete. So we look at what's out there, and you know, we we'd still have to build so much infrastructure, even to do it. At which point we're like, ah, let's just build it. Let's just build it. Because in the long run, that's a bigger moat for us. That that makes our moat harder to breach.

SPEAKER_02 57:22

100%. Because like I think it's Optimum United owns a clearinghouse themselves, Change Healthcare. And I'm assuming you're both familiar with the big data, the hacking situation that, you know, I knew I was running a clinical director slash group practice owner consultation group while this was going on. And one of the practice owners that was in that group was like, Well, I'm able to make payroll this month, but not sure what's going to happen next month. And so when you have like a company like Optim United now owning, again, that vertical consolidation, owning change healthcare, and they mess up, it's the clinicians holding the bag. It's the group practice owners holding the bag. It's another place where they have all the power and we have no say. So I think it's brilliant that you're looking at all those components instead of just tapping into Office Ally or tapping into Trizetto or Availity or whatever it is, and saying, you know, instead of tapping into somebody else's thing who have their own investors or whatever, we're gonna do it ourselves and try to make this ethical all the way around, where we're not reliant upon any of these huge conglomerates and we can figure out how to build it ourselves. So I applaud that because it feels, I mean, I'm a clinician, I'm not a tech person. So to me, it feels like that feels crazy. But Ben, I know this is definitely in your realm, right? And then you have the clinical eye for it, Sam, as well as around how all of that works. So I just major props to you for taking all of this on.

SPEAKER_00 58:54

It has to do with um who we want to be, and and it was just too foundational to when we looked at what it was going to, what it what our world and life would be like with Claims MD integration, or you know, it was like it just felt like we were compromising what our philosophy was. Um so if we want true change, you got to go to the heart of the matter. And and claims is where the heart of one of the pieces that's the heart of the matter, how how these how these practices generate revenue. And then it comes to del how do we deliver value to a practice, right? Right now, it doesn't there's no nobody's defined what value an EHR actually has delivered to practices. There's been no evidence, like my $100 a month subscription is actually worth it or not. I I don't know. Like there's so what we're trying to say is by building a clearinghouse is the is the way that we will generate revenue, but we want to do that in a way where we're saying, hey, here's a value that you will get. And you can only do that if we build it ourselves. You know, you you want to pay per claim, but you'll understand that what you're getting is as good or better than what you're paying today, but you're getting a lot more value for it.

SPEAKER_02 1:00:07

And you're getting uh something grounded in integrity. And the which it matters to me.

SPEAKER_03 1:00:13

Yes, both. The other side of it is the unit cost of every transaction. So if we were to piggyback off someone else, then we've got to pay those fees and then we've got to mark those fees up and pass that on. And so you've got the fiscal aspect of it, but the bit that you the the the reference you made to change healthcare, like there's no resilience. So they if they go down, we go down. Like at least if we build it, we can fail gracefully. Like, oh okay, we like we could route some traffic back through here, some through there. Tech that doesn't invest in failing gracefully and having redundancy is bad technology, like it costs more, but you know, when it goes wrong, your reputation, your reputation really gets damaged. So yeah, you've got to think about those things. Like, how do I fail gracefully? Because there will be failures.

SPEAKER_02 1:01:12

Like And you have more at stake than Optimum United because they're like a gazillion dollar and they don't really care. They don't care if practices go under. They they really don't care. And whereas if you're serving a certain community, you do care. You absolutely care if something that you do causes practices to fail. It's a it's a bigger hit for you than it is for United, who they probably love it because then the money gets to sit in their bank account longer before they pay it out.

SPEAKER_03 1:01:39

Yeah.

SPEAKER_02 1:01:39

And they can earn more interest on it.

SPEAKER_03 1:01:41

Play on the FX overnight.

SPEAKER_02 1:01:43

Exactly. Exactly. I'm just kind of looking at our time here, and I feel like I could continue this conversation for a long time because I think what you're offering is really tuned in to the core things that a lot of clinicians have felt really powerless over. The EHR stuff, the AI stuff, the data stuff, MSO, like the headway stuff, clearinghouse stuff. And I, it's just so nice to see people coming from the right place in this and building something from a place of integrity that is, you know, because I when I met with you two, whenever that was a couple of weeks ago, to kind of get to know you, what you were doing, I hit you with some pretty like hit pretty hard. Like, why should people trust you? Because there's so much mistrust right now. People aren't sure. And the humility that I saw and the willingness to like field those questions, and I think that's where we started talking about your idea for that nonprofit, and maybe it had already existed, but that there was a lot of thought about gaining trust and being part of a community instead of cashing in on a community. So I just wanted to say that.

SPEAKER_00 1:02:54

Appreciate that. Yeah, we do appreciate that.

SPEAKER_02 1:02:58

And I would love closing thoughts from each of you, just sort of like, you know, what you want people to walk away with, or if there's something that you didn't get to say that you really want to make sure gets hit. I want to like kind of leave the closing to both of you to wrap us up for today.

SPEAKER_03 1:03:12

We welcome the hard questions. We you can reach us, like reach us through the website. You can book time with us. We're happy to speak to everyone one-on-one. We wanna, we want to extend that offer. We're just getting started and we're here to help.

SPEAKER_02 1:03:26

Thank you. Sam?

SPEAKER_00 1:03:27

Yeah, there's a lot, there's a lot happened over the past three plus years as we've been building. Um, as we're as we're just you know putting this into people's hands now. I think uh we're just looking to help, as Ben said. We just um we wanna we want to change, we don't want to just provide another EHR. We want to change the way people view technology. Um, and we know that's gonna take time for people to trust who we are. Um but we're looking but we're looking forward to doing that because you know, very personal, healthcare is really important to me. I think that it's something that is beyond just the business of care. I think it goes to societal issues. I think it means people, you know, feeling good about how their families are taken care of, about who they are as people, about their communities. And we're just not doing enough, regardless of mental health or not, to making people feel like the most essential part of their life, their health, is something that people aren't taking advantage of, right? It's time to change that. It's time to create something that focuses on the humanity of care and not just the business of care. And those two things can coexist. We we have to start doing this. I think it's it goes deeper than just a business model. It goes to helping who we are as a society. And that's really where we're coming from. So if there's a reason that you want to believe that there's deeper thought in this, that's what it is.

SPEAKER_02 1:04:48

I love it. And I just appreciate both of you so much. Ben, you're the one that reached down and made contact with me. And I really appreciate you doing so and being interested in what I'm doing as well, because I think that that's important that we're that we're supporting each other and seeing where all of us fit into this bigger picture. And just so folks know, in the show notes, there will be information about both Sam and Ben, what MediSprout is, how to learn more about it, how to connect with them, all of that stuff will be in the show notes so that you can look into this yourself and see if it's something that you're interested in participating in. Like Ben said, you can feel free to reach out to them to set up a meeting if you have further questions. And I just very much appreciate your time today and your interest in being on the podcast. And I want to thank all my listeners. I want to let folks know that in the past month, this podcast is starting to really blow up. And I'm really, really, really grateful for all of you that are sharing and liking and subscribing. The numbers so far, today is June 24th. The numbers so far for June are almost double where we've been. So I can see that people are sharing the podcast. We have now hit, I think, 640 cities across the world with this podcast that would not be possible without each and every one of you. So deep gratitude to all of you that are supporting the podcast and sharing it with your networks. Thank you so much for listening. Again, my name is Civy Suckerman, and this is Therapist Unchained.