Alan Roga Video.mp4: Audio automatically transcribed by Sonix

Alan Roga Video.mp4: this mp4 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

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

John Shufeldt:
Everybody. Welcome back to.

John Shufeldt:
Another episode of Entrepreneurs. I'm your host, John Shufeldt. Thanks for listening to another great edition of Entrepreneur to find out how to start a business and help secure your future. Go to John Shufeldt, md.com. Thanks for listening. As a physician, he has more than 25 years of experience in health care delivery, tech enabled service and healthcare. It. And he's done everything from start ups to to large cap public companies. Allen We'll talk about everything else, but with that, welcome.

Alan Roga:
Thank you so much for having me on, John. I'm looking forward to today.

John Shufeldt:
Yeah, we're gonna have fun. All right. So just to start, go over your background a little bit and go through the whole college, med school sort of thing, and then we'll dive into the entrepreneurial stuff.

Alan Roga:
Sure. So latchkey kid from New York, put myself through college in med school. Went to state school in New York at Stony Brook at Albany, and then med school at Stony Brook. Trained in emergency medicine. It's kind of a funny story, but probably my first entrepreneurial lesson was I was disappointed because I got into several very prestigious colleges and Ivies and wanted to go to a marquee branded school, but it wasn't economically feasible for my family. So I ended up going to state school and learned my first lesson in entrepreneurship in life, which is sometimes not getting what you want is a great stroke of luck. Because when I got to med school, my roommates were all from Yale and Harvard and Cornell and all the schools I wanted to go to, and we all graduated with the same MD, and I had about a fourth of the loans and debt that they have. So had. My first job, I trained in emergency medicine, worked at Northwell North Shore before it was Northwell and learned right away that I wasn't going to be a great employee. So picked up looking for sunshine and a Democratic air group and landed in Arizona. And the rest is the journey that I'm sure we'll get into now.

John Shufeldt:
When did you pick emergency medicine and why?

Alan Roga:
Yeah, I think emergency medicine is great for entrepreneurs. I did not go into medical school thinking I'd be an emergency medicine doc. I thought I would either do pediatrics or orthopedics, but I found that I loved the pace of emergency medicine. I didn't even know there was such a career as an E.R. doctor when I got to medical school. But one of my classmates said, I think you'd make a good E.R. doctor. Have you ever thought about this? And I said, What do you mean? He said, Well, you work shifts. It's fast paced. You got a lot of things going on at the same time. They said, It'll stimulate you the way I think you're made. And did my first rotation through the E.R. and I said I found my home. This makes tons of sense to me, enjoyed seeing the patients. And I think it also lends itself to entrepreneurship because as an Er doc, very quickly you have to get information, engage with the patient, impart empathy, skill and talent, convey that you are actually going to solve their issue and then move on. Make a decision with not always complete information. Sometimes it's not right. So you have to learn how to find your way out of some trouble and have that sticktoitiveness So, you know, much like yourself, I've encountered many E.R. docs that are extraordinarily talented entrepreneurs. I think the psyche, the sort of pace, the mentality serves itself very well for it. So I found that in med school and it's been a great journey. I miss patient care, but obviously career paths have taken me elsewhere.

John Shufeldt:
But it is funny though, because, you know, it's that whole sliding doors thing. Had you not gone into emergency medicine and myself as well always thought I'd be a surgeon growing up. Hard to imagine doing that with the rigors of orthopedics or demand or CT surgery because there's really no time to do much else, or so it seems.

Alan Roga:
Yeah, and I think that's probably one of the biggest challenges for physicians. I think the physicians actually really lend themselves very well to the business world and the entrepreneurial world. And I think that actually most physicians are unaware of how talented and valuable they are in the market. Like you, I actually did want to be a CT surgeon also, interestingly enough. So another commonality between us. Maybe there is a part two of entrepreneurship because I absolutely loved being in the Or. E.r. to me helped on the journey because I was able to phase out of shifts and build administrative skills and sort of a lot of capabilities that lent themselves to the business world. But I think physicians in general, you know, while I often wonder at times like Steve Jobs says, you live like moving forwards and you make sense of it, looking back, you sort of connect the dots. I think there is a lot of that in our world together as physician entrepreneurs. But whether you're an E.R. doctor, orthopedist, pediatrician, no matter what you do, that first transition in any of these journeys is tough because we're so used to and acclimated to This is who I am. And the change process and the transformation is really the challenge. I think for most of us, it's really not the skills, it's who I am is not necessarily what I do and sort of rebirthing yourself as an entrepreneur. And that whole hero's journey is pretty tough, especially when you put in so much time, energy and money as physicians have into their careers.

John Shufeldt:
It is funny, there was a neurosurgeon, well, actually he wasn't a neurosurgeon. He was from Harvard in March of his fourth year of medical school and dropped out and said, you know, I realized I didn't want to be a physician. I want to be a. And he dropped out of Harvard Medical School three months before graduation. Yeah, that took some large cojones to do that. I don't think I could have done that one. I think I would at least gut it out and said, you know, check the box. But I do agree with you that I think physicians don't think many of us realize this, but we're kind of born entrepreneurs. We have the skill set of we're generally resilient as hell. We don't mind hard work. We probably mostly pretty decent communicators. That's kind of three of the big boxes for entrepreneurs and.

Alan Roga:
I would wholeheartedly agree. And, you know, there's nothing that any of us really do that can't be learned. There's a lot of negatives in there. But like Aristotle says, we are we repetitively do, right. Excellence is a habit, not a virtue. I think all of the things that we do, whether you're a neurosurgeon or an entrepreneur, can be learned. It's whether you want to invest the time and energy to learn them. I became an entrepreneur unwittingly. Frankly, I'm a reluctant entrepreneur. It wasn't like I had this great vision for myself. When I started on this journey, I just felt like there was a better way to take care of patients. And the way to do that was through technology and entrepreneurship. And whether you're a fourth year new surgery or medical student or myself with a big mortgage for kids that were little and starting on a startup, it's always tough. But having that fortitude sticktoitiveness that's really the transition that gets you there, right? Everyone always says, you know, what are you most proud of? Like never quit.

John Shufeldt:
Yeah, yeah, yeah. Resilient as hell. So you moved out to Arizona. You were working at Scottsdale, as I recall, one of the docs of Scottsdale. So we're going to kind of across town, colleagues, How did you exit that or slow down on that and start going up on the entrepreneur? What was the impetus for that?

Alan Roga:
It's an interesting story, and I think like many, there are these catalyst moments in our lives. So my wife and I actually had some unfortunate personal circumstances with one of her pregnancies, and I almost left Scottsdale. Candidly. I just felt like there was potentially a better practice for me, but decided that the team and the group were investable. The people were just looking for leadership and better ways to do things. So I raised my hand in a meeting and I just said, What's the biggest problem we have? And I'm ready to fix it. And that really just started me on the path of where can I create value? What can I fix? So became department chairman, then started doing practice management work. You know, how do we do the financial part of running a practice and physician management and just start investing in leadership skills? And then the light bulb moment for me was in 2009 when even in Scottsdale, which is a fairly well off payer mix in area, 25% of our patients were going to collections and we were ruining people's lives. They couldn't afford the care that we were providing and charging someone $2,000 because their child had pinkeye and ended up in the Er because they couldn't get to see their primary care doctor through no fault of their own was not what I got into health care for. So it's very funny. I'm not a technologist and just was at a conference where they were talking about technology and they kept talking about technology and I had a bad debt report from the CFO and I showed how many people were sending collections and an urgent care business plan. I said, we just leverage technology.

Alan Roga:
We can get rid of a lot of the waste in this business model, get people closer to the doctor and reduce cost and improve outcomes and access. And this was before telemedicine was cool. I'm like, That could work. So I came back from that conference and I went to work in the E.R. on a Saturday night, and I took care of a mom who had a couple of kids who had colds. And I was raised by a single parent. They looked at the chart. I saw she had insurance. So I'm curious. You have insurance. You have a pediatrician. Why are you here? Your kids have colds. And she said, look, I'm a single mom. If I call my doctor, I get an appointment Friday. I have to miss work. My kids miss school. I can't afford that. And I said, But it's $2,000 a child. They have minor illnesses. She said, it's less than the copay for the child care that I'm going to have that I'm paying here today. And I said, Well, I've got this idea. What if I brought you me through computers? This is before we even had smartphones and I'm going to bring you an E.R. doctor. And I made it up. I said, I'll charge you $50. She said, I will go home and do that right now. So I went home and I woke up after my shift and I said to my wife, Hey, I got this idea to start this telemedicine thing and my wife will take a couple hours to match the shoes to the dress in 20 minutes. I said, That's a great idea. Let's go do it. And that was my path to entrepreneurship.

John Shufeldt:
No kidding. That is amazing. You should find that woman up and call her up and thank her. Imagine if she would have said there is no way in hell I'm seeing you over the Internet.

Alan Roga:
Yeah, and you know what? It might not have happened, but, you know, between myself and yourself and a few others, like the telemedicine field was born, Right? And if it weren't for the grit that we all had. What happened during Covid might have been very different without virtual care and all those battles we fought early on to make it happen, because back then no one wanted telemedicine.

John Shufeldt:
It was funny. I was pulling into I'll never forget this too. Like, I don't know, United Health Care, I think for a meeting and I'm treating this person who's a long haul close friend, who owns a massive long haul truck business and me and had the contract and we didn't have that many physicians. And I had, of course, 30 state licenses. And she is driving in Seattle area and she's showing me her hemorrhoid as she's driving on her laptop. And I just remember going, God, what what have I done? Like what my life's come to. But I called in a prescription of steroid cream or something at the next place. She was stopping with this huge 18 Wheeler she was driving. So part of me was thinking, like, that's kind of badass. And part of me is thinking, God, I never want to see that visual again.

Alan Roga:
Yeah. Yeah.

Alan Roga:
I was like, you one of the first physicians doing telemedicine, and I think I saw our first five patients and one of the patients had a bartholin cyst. So immediately I called the attorney and I said, Look, it's not porn, but I'm used to having someone in the room with me to chaperone. And now we're doing it virtually. How does this work? And of course, the turns like it's okay, you're documented it, but those were the things we had to figure out early on through this, right?

John Shufeldt:
Yeah, it was really funny. So, okay, so you grew your telemedicine business from what month in 2009?

Alan Roga:
March of 2009.

John Shufeldt:
Wow, that is badass. Okay, so I started in October 2010, right after leaving Nexcare. Okay, so you started in March 2009, and then when did you sell to the big dog? Teladoc?

Alan Roga:
Yeah, June of 2015. Wow. So we were doing our series B Round and Teladoc had gotten wind of it and we weren't actively looking for acquisition. But, you know, for the entrepreneurs on the line, a lot of times acquisitions occur during a financing and like every good deal, it fell apart twice, came back together. And actually there's a very funny story there if you'd like me to share with your audience. So we had board members we had taken in capital, and one of my board members was adamant that he did not want to sell at all. He wanted to stop. Doctors should grow to $100 million company and have this massive exit. I said, Well, look, Teladoc's going public and they're the market leader. And I think there's a very good opportunity for us. He was adamant and my other board member wanted to do the deal. So we were going to meet with the CEO of Teladoc in Chicago. And I had this great vision in my head of we all get together and everyone will be a happy family and it snows. It's March of 2015. It snows. So there's no commercial flights out of New York. And the CEO said, look, I can't meet you guys. So my other board member had a plane and he said, Let's go meet the one who doesn't want to do the deal and we'll talk to him and we'll all fly to New York together. So we flew to the Midwest and he said, You guys do what you want, but I'm not doing this deal. And now I still had to go to New York to meet with the Teladoc CEO to try to warm it up.

Alan Roga:
Deal didn't get any better. But anyway, we had a board call and then I'd be in Chicago the next day to meet with venture capitalists because if this didn't come together, we still had to raise financing. So we had a board call in the airport and everybody's emotionally involved. Finally, I said, Look, you have to say thumbs up or thumbs down. And if you don't do this deal, realize that any investor who loses any bit of money less than they would have received from the Teledoc deal, I'm going to let them know that you're not doing your fiduciary responsibility as a board member, right, because you're acting in your own self-interest. So now it's a heated discussion and we finally accepted the deal. I don't drink that much, but in a period of period of about 36 hours, I had flown from Phoenix to Wisconsin, Wisconsin to New York, New York to Ohio, Ohio to Chicago, Chicago back to Phoenix got upgraded to first, and the flight attendant said, Can I get you anything? And I said, Bourbon until I pass out. So that's what it took to get the deal done. And then actually, the only thing that would have prevented the deal was if Teladoc didn't go public. And the Texas Medical Board, of course, as you know, had some. So Teladoc, we actually had to sue the Texas Medical Board, including the seventh time the members were sued personally for violating antitrust provisions, and then they acquiesced. And the IPO happened because absent that, we might not have gone public. So that's the kind of stuff that, you know, everyone has these visions of entrepreneurship being all glory and you just got beat out.

John Shufeldt:
Yeah, I'll tell you another time. But we have so much similarities in that path. And I'd forgotten about Texas and Teladoc. But you're right, they were based out of Texas and they were getting just raked over the coals by Texas Medical Board.

Alan Roga:
And it was all personal. It was two people that just from Teladoc and the medical board that never got along. And once cooler heads got involved, we became great friends and we wrote phenomenal legislation and we championed for the people of the state of Texas to have telemedicine and now telemedicine. Texas is a great state for telemedicine and everybody's friends. But if it weren't for that, we might not have had certainly Teladoc public, all the other companies, the great growth that the industry has had. And those are the little stories about how markets get made.

John Shufeldt:
Yeah, with a lot of gray hair. Okay, so now you've gone from this scrappy startup dude to now you're a corporate suit. How was that for you? Because I don't think I could do that because I know the story a little bit. And when you were telling me the story before, I'm like, okay, there is no way in hell I could have done that. So how did you do it.

Alan Roga:
You know, with a great CEO at Teladoc? So before we did the acquisition and the CEO, Jason Gorevic, who's a good friend and an excellent CEO, I said, look, you're the acquisition was basically for stat doctors to be the health system division said, I will deliver. If you do a couple of things, resource me appropriately, make sure that we have this maintained as a separate segment. And if you leave me alone a little bit to do what we need to do because this is a startup inside of a larger organization and we had phenomenal success for the first three years, and then the corporate dynamics took over and analysts and earnings calls. But for the first three years after the acquisition, as a young public company was probably about as much fun as I've ever had professionally, because at every entrepreneur's dream you didn't have to raise capital. I didn't have to manage a board and got to really be resourced to have the freedom and just singular focus of creating value for clients and for the company.

John Shufeldt:
Yeah, that had to be really a wild ride. Okay, so how long did you stay there for?

Alan Roga:
I stayed until 2020. Again, like most entrepreneurs, you sort of look for opportunities. So what happened was Covid comes in 2020 and the CEO calls me and said, Look, I want you to go run clinical operations. Said, You speak doctor, you speak technology. And so now I inherit 40,000 doctors and 13 million virtual care visits. And then I became really a corporate kind of person because I had my own little company inside of Teladoc, and we got through it. It was tough for everybody during Covid, but during that time we all saw what happened to George Floyd, and health equity came to light and I said, I don't really know anything about this space. I trained in New York, in the Bronx, and I'm an inner city kid and I lived in an ethnically diverse neighborhood. I said I didn't really know there was such a thing. So I reached out to everybody who would speak to me about health equity, and I said, Look, I've got all these doctors, all these patients, I need to learn something about this. I found that health care is not equitable in the United States, much to my surprise.

Alan Roga:
And I figured if someone like me who cares and practiced for many years was unaware of all of the disparities and specifically the clinical bias in health care, said, I think this is a problem that matters. And I think that's the foundational principle for most entrepreneurs, which is we find problems that we think matter in the world. And you gather together a group of people who are like minded that believe this problem is worth fixing, and you align everybody with the appropriate incentives, whether it's equity and cash value in that response or social value or professional value, you gather your team and then you go conquer the world. And health equity has got some great tailwinds and solid regulatory tailwinds. And so a market forming, much like I saw with telemedicine, I said this space I want to be in, so left my very comfortable, cushy public company job, which was still hard to now do another startup. And the thing I can share with you is that I remember the pain of the early stages, but like most things we tend to forget.

John Shufeldt:
I think it's probably like childbirth now. God knows I've not had kids. It just seems like, Oh, it wasn't so bad. And they're like, Are you kidding me?

Alan Roga:
Childbirth totally agree. Equate companies to exactly like your children. When you have your startup, you have an idea. And your baby is going to be president or be a professional athlete and be perfect. And then the baby's born and not perfect and you're up at night a lot and you can't really leave it with too many people. And really, you're changing diapers most of the time and you're cleaning poop and pee and you're really not having that much fun early on. And then, you know, they go to kindergarten and they put their backpack on and they're kind of cute. And then they go to high school and they become rambunctious teenagers. And then you give them away at the wedding and you hope for grandkids. So we've just graduated from diapers and taken our baby steps as toddlers. But it's exactly right. I look at that as the life cycle of an entrepreneur. Very similar to your children. Totally.

John Shufeldt:
You know, it's funny. Another similarity, I went out and worked on a Native American reservation 90 miles to the east of Phoenix. And at the same probably aha moment that wait, what do you mean? We're treating people differently here? Because I've been in inner city Doc for ever and for so naive and stupid that there was inequities in health care based upon race and bias. And it literally was eye opening for me and I was literally embarrassed. It's the fifth largest city in the country, and we're treating people as if they're in a third world and we're 90 miles from Phoenix. How is that fair? So when I heard what you were doing, of course, we kind of reconnected. So tell folks what TruLite is, because I think it's very remarkable.

Alan Roga:
Yeah, sure. And by the way, if you're Native American in America, disparities are everywhere. If you're Native American, you actually will live longer in the Congo than you will in America. Yeah. Which is unbelievable in the wealthiest country in the world that these things happen. But, you know, as I start studying the space, I found there are disparities race, gender orientation, zip code. We talk about race based medicine, but white Americans in rural America have worse outcomes than a black American in inner city Detroit. So they're disparities everywhere in the United States. The second thing I learned about studying the space is that social determinants of health and cultural bias training are admirable, foundational elements. But they are not moving the needle on outcomes or cost. In fact, it's getting worse. And if you look at a chronic illness, it's over $5,000 a year more for a black or Latin person to be treated for the same exact illness. So that's a problem that costs the US health system almost $1 trillion a year. So large market problems that matter. And so the third thing that we found is we were studying it is this clinical bias in health care, whether it is practitioner related as examples in the literature. If you're not white, you get about half the pain medicine. And if you're white or the tools we use like formulas that will race correct, or we also during Covid about pulse ox and underestimates oxygen levels, we've known that for three decades and we're still not doing anything about it or studies and research that lack diversity in their trials. So Albuterol being the most commonly used med works well in the in the white population, but may not work as well in the diverse population because 97% of the clinical trials are in the white population.

Alan Roga:
What we've done is built a tool as a clinically integrated workflow tool that essentially grabs patient data and runs it through a knowledge base where we've built the largest health equity clinical science database to find where care may be being impacted because of race, gender orientation, zip code, and we make it clinically actionable to point of care. So directly inside the electronic record. When a patient presents, we can expose where there are tools, research, science, treatment that may be impacting the patient's care inadvertently. Because this is at a system level. It's not that clinicians go to work, do a bad job. In fact, the most dedicated professionals, in my opinion in the world are clinicians, doctors, nurses, care coordinators. It's that systemically we've got an issue. So at the point of care, we're providing clinical recommendations to the care teams and to the patient. We follow up with a health equity coach, which is a best practice in this space to create patient advocacy and reduce readmissions and improve compliance and actually promote some health related social needs in the local areas and then nudging people to keep it actionable. So it's a SaaS model integrated into the EHRs. We'll expand it to payers and employers because this is a big issue. And interestingly enough, I've talked to my colleagues internationally. They're the same issues internationally as well, especially in the Westernized countries like England, France, Germany, where they're seeing the same disparities in outcomes that we're having in the US. So that's TruLite health in a nutshell. Wow.

John Shufeldt:
So give a concrete example. You're working in in Scottsdale and you have a 75 year old heavyset black woman come in who may have a history of diabetes and hypertension. How do the nudges work?

Alan Roga:
Yeah, so let's pick an easy one like asthma, just to keep singularly focused on one disease, to not confuse the folks who are listening. So if they come see me and you're in the E.R., an urgent care center in 75 and wheezing, probably get a prescription for albuterol, maybe a treatment or two and go home. But it's a massive missed opportunity. So as examples. What we know is pulmonary function tests actually race, Correct. 10 to 20% of your black actually says that a black lung doesn't work as well as a white lung. So pulmonary function tests race, correct? Not just in the black population, but in the Asian population. Pulse oximetry on the wrist makes oxygen levels. Albuterol may not work as well in the diverse population and getting in other components like air quality index. Are they near a physician underserved area? So with Trudy, a platform pulmonary function, removing the race correction formula shows actually the lungs are more impaired and she needs more aggressive treatment. Pulse oximetry underestimates it, and ABG actually shows that she's hypoxic. And in addition to albuterol, corticosteroids would be warranted because single dose therapy is often not enough and air quality index is poor. Health related social needs need to be reinforced through coaching. So absent truly the platform, just getting albuterol versus pulse ox corrections, corticosteroids coaching, statistically that patient is 3 to 5 times more likely to end up in the air and be hospitalized.

John Shufeldt:
Yeah, they'll be back. How many bounce back did you see with Maddox? Come back in. That's interesting. Wow. That is a very cool process. So I know you were out raising money for TruLite. Has it changed at all since you were raising money for Stat Doc? Is the process the same? Are you better at it now? Is it less painful?

Alan Roga:
Yeah, certainly we get better with time. So I think the process I'm better at. But as you know, and for those who may be listening, really your number one factor for being able to capital raise is market timing, right? It's really dependent on the market dynamics. And 2022 has been a rough year for most venture and M&A work because 2020 and 2021 were pretty frothy. So we had some unnatural multiples and valuation metrics that were in play. And then a lot of the venture capitalists have been hurt by it because companies can't exceed the hurdle rate, so they're winding them up. So I actually just read from Pittsburgh it was something like 46% less venture deals done in 23 than in 21. Thankfully, we got our round done, which is a great testament to the company. It's never easy for those who may have never done it before. Typically you have to have at least 30 venture meetings to get your one term sheet. You just have to have continue on that grid. I've got some interesting tips for any physician entrepreneurs that we may want to get to, but let me stop on the capital part and see.

John Shufeldt:
So that was my next question. I know how hard it is, and you're fortunate because now you have some cachet. You've already done it. You've had an exit, you've got a great team behind you. You're much easier to invest in than you probably were with stat docs. What are the tips you have? Because most people won't be in your shoes. They'll be your shoes that step back.

Alan Roga:
Right as you probably get as well. And I'm happy to do as well. Physicians who want to be entrepreneurs tend to find us at times, right? They're looking for mentors. They're looking for guidance. And when I first started on this journey and it's now my third startup or even fourth, if you're depending on you look at it. I thought it would all be about your product, your idea, your solution, and it's not. So I formulated some level my six questions for the would be entrepreneur. So sometimes the docs will find me. I'll actually send it to them. If they answer it, I'll talk about it with them because you always think it's about your product, your solution. It's not. So my first question is always, Is it a business or a hobby? Right? Nobody is interested in your hobby. Your business is a serious endeavor. It requires capital, it requires commitment, it requires conviction. So is it a business or a hobby? My second question is always, What's your source of capital? Are you the deep pocket person? Are you going to mortgage your house or you have a wealthy uncle? All the dumb things. By the way, I've done all those things. Don't always recommend it, but that's what we do, right? Because that's how we think. Then the next question is what's your next source of capital? Because it always takes longer. It never goes as planned. It's always going to be more expensive. So are you going to go out there and raise a financing or not? My fourth question is, are you comfortable being uncomfortable? Because by its very nature, you are going to have to learn things that not only you've never done before, but probably nobody's done before, like when you founded Nexcare and you did Me.

Alan Roga:
And I mean, these were transformational organizations that you had to learn how to do some things. You can take pieces from other businesses, but ultimately you have to assimilate them away. They have been done before. My fifth question is always, is your spouse significant other or somebody on board that's going to rub your back and tell you it's going to be okay even when you don't believe it? Because you have to have somebody that believes in you. And my last question is always make sure you want to go swimming, because the second you jump in this lake, there's only two options. You swim to the other side of success or you drown while you're trying. There's no I change my mind and I'm going to go back to clinical care or do something else. When you take that first dollar, that first client, that first product, it's real. So those are my six. I always ask them that some answer them. I asked myself these same six before I did TruLite business as a hobby. How am I going to fund it? How am my next source of capital? Is my wife on board? Am I sure I want to go swimming? I asked all these same questions.

John Shufeldt:
I love those questions. Let's go over them again. All right. So business or hobby? Because a lot of people I've got this great idea, but then you're really press into it and they're like, well, probably more of a hobby. What's your source of capital? Because I just talked to a physician who I think she only put in like $4,000 to this business. Yeah, it's a cool business, but 4000 doesn't cut much.

Alan Roga:
It's not like commitment. Well, may not be. I mean, if 4000. Look, it's a lot of money.

Speaker3:
Yeah, but I understand.

Alan Roga:
But you're going to have to go find some more.

John Shufeldt:
A lot more. Yeah. So that next question is great and very prescient and then the comfortable being uncomfortable. You know, it's funny. I think a lot of physicians probably are not like that because generally we're relatively comfortable. We've got decent careers. We've got a path to an exit, even if the path is 30 years long. So the comfortable being uncomfortable, maybe that's an thing because we kind of live in that uncomfortable world. Making life and death decisions with imperfect information. And then as your significant other on board. Another great question. Then finally, if you're going to jump into the water, you better start swimming because if you're not comfortable, you're screwed.

Alan Roga:
Yeah, make sure. And the other thing I always think is pretty funny. People think of entrepreneurs as these crazy risk takers and fly by the seat of their pants people. Most entrepreneurs I've met are actually pretty conservative investors. You know, we decide to invest in ourselves because we believe in our own abilities instead of in 2008 nine, when we all saw the stock market and housing market crash, 401 became 201 KS. I said, Look, I'll bet on myself. And the funny thing is, is my kids will always joke about like, Dad, there's no way you can have a technology company again because they have to help me with the iPhone and the TV. And I said, I don't have to know how to write the lines of code. I just have to understand the process of how to build technology. But they constantly are making fun of me. Like there's no way you can have a tech company so uncomfortable being uncomfortable. I'm now the third or fourth time a healthcare tech CEO who I couldn't even tell you a line of code, but it's kind of like graffiti. I know when the process is working and what it looks like, and I know how to assemble the team and I know how to put it all together and I know how to measure them and assess them. But I don't actually have to write the code. And much like you talk about capital raising, I never raised capital before. These are all skills that we can learn. You just have to decide are you ready to invest in yourself and ask for help? Was fortunate enough to have great mentors and you know, you'd be a great mentor to any entrepreneur out there with your skills. So find a few people that have done it before. Learn from them. It's not rocket science. Any physician has the skills to do this.

John Shufeldt:
I totally agree. Well, what final piece of advice do you have, Alan, to the would be entrepreneurs out there?

Alan Roga:
You can't teach passion or fake it. We are all very blessed on this line. I always felt like being a physician was a blessed career. In fact, I think it limited my success as an administrative leader because as as a poor kid from New York, I'm like, You make a good living. You're always going to have a job. You get to take care of people in their most vulnerable moments. I mean, this is truly a gift, but some level, it's sort of impacted me that way. So everyone is very blessed on your audience. They have a lot of skills and to whom much is given, much is expected. So very talented people find something that you think you can do to make the world a little bit better and go for it. Because when the day is on earth or over, we don't want those ghosts of what might have been around us. So find something you're passionate and it's your responsibility to go do that, whether it's tech or patient care. If you see an opportunity, go for it.

John Shufeldt:
Yeah. Or painting or anything that you can do to improve the world. There's this quote, The definition of hell is on your deathbed. You'll meet the person you could have become. And I've had this experience where early in my career where I know the guy was experiencing that as he was dying because I was watching his face and I'm like, I will be damned if that's going to be me. I'm going to slide in sideways yelling, Holy shit, what a ride. Because I do not want to lay on my deathbed and meet that person. So your advice was sage, So thank you.

Alan Roga:
Oh, thank you, John. And none. None of that's going to happen to you. But it's.

Speaker3:
Scary. Yeah.

Alan Roga:
Yeah, it's scary. There's concerns. It's all noise in your head. At the end of the day, everybody on this line can earn a living, can feed their families, Like, find something that you think matters, be passionate about it, and play the game to win.

John Shufeldt:
And go for it. Amen. Well, thanks, Alan. This has been phenomenal. I'll have everything in the show notes, including ways to contact you and your LinkedIn profile. Thanks for taking the time. Had a blast.

Alan Roga:
Same here, John. Always enjoy our time. Thanks for the opportunity and I enjoyed this this a lot fun.

John Shufeldt:
My pleasure. And good luck with TruLite. I'm going to be a passionate investor in it, so thanks for the opportunity. Thanks for listening to another great edition of Entrepreneur to find out how to start a business and help secure your future, go to John Shufelt Webmd.com. Thanks for listening.

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