Joel Friedlaender: AI's Impact on Healthcare, Innovative Leadership Strategies, and Team Retention | GYC Podcast E278

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Unlock the future of healthcare with our latest Grow Your Clinic podcast episode, featuring Joel Friedlaender, founder of Cliniko. Ever wondered how artificial intelligence might transform your clinic's practices? Join us as Joel breaks down the real-world applications and challenges of generative AI tools in healthcare, pulling back the curtain on their potential benefits and significant pitfalls. From the intriguing yet flawed launch of Google Gemini (Bard) to the accuracy issues in AI-generated summaries, this episode promises to equip you with a nuanced understanding of AI's role in modern healthcare.

Joel doesn't just stop at the tech talk; he dives into innovative leadership and recruitment strategies that have set Cliniko apart. Hear firsthand how offering flexible work hours and fostering a culture of autonomy and purpose can lead to exceptional employee retention and engagement. Joel shares invaluable insights into how his team at Cliniko thrives, offering a refreshing perspective on leadership that transcends traditional hierarchical structures. These strategies aren't just theoretical; they have real-world applications that can help you build a motivated and committed team.

Then, we pivot to the promising realm of AI in telehealth and speech recognition. Imagine the possibilities of real-time subtitles for hearing-impaired patients or automated translation services. Joel offers a glimpse into the future, discussing how AI can handle tasks like patient follow-ups and off-hours calls. We also revisit the importance of team retention, exploring the substantial financial impact of losing valuable practitioners. From fostering friendships among remote team members to ethical marketing practices, Joel's journey with Cliniko is filled with lessons that can elevate your clinic's operations and team morale. Don't miss this chance to learn from a pioneer at the intersection of technology and healthcare.

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Transcript

Joel Friedlaender: 0:00

biggest technological revolution we've seen, maybe since the internet. It's just speaking absolute rubbish. It's telling people they should eat rocks every day. If you want the cheese to stick on your pizza, maybe try glue I might turn a bit of a blind eye here and use it because it sounds great.

Speaker 2: 0:14

So we just thought let's just get 30 this is the grow your clinic podcast from clinic mastery in other businesses.

Joel Friedlaender: 0:21

Anyway, how do we get creative to still attract great people? Try to give them a job that they couldn't get better elsewhere, because if they can get it better elsewhere, there's gonna be a temptation. Ai is at a point where it can automate stuff. It can do things fast, it can do things cheap, but probably not as well as-.

Ben Lynch: 0:38

Welcome to the Grow your Clinic podcast. My name is Ben Lynch. In this episode, I speak with Joel Friedlander, the owner and founder of Clinico, a patient management system that has been serving the allied healthcare industry significantly over the last 14 years and has a massive footprint here in Australia, the UK and now expanding across the globe. Talk integrating family into business, how to create a culture that retains talented team members I've had very few people ever leave the company. How do you recruit that talented team member even when you don't have a lot of time or money to do so, and the creative ways that they've had to do it over the years. And, of course, the place where we kick off the conversation AI, artificial intelligence. What is the state of the union as he sees it being in technology? All right, let's kick off this conversation with Joel. Let's start with AI. Yeah, it's all the rage at the moment. It seems a lot of platforms in the space are including AI. There are new AI tools that connect with Clinico. How are you thinking about this AI wave?

Joel Friedlaender: 1:55

I think it's really interesting. Obviously it's like rapidly developing and I'm always conscious every time I talk about it that like what I say today is relevant today and maybe not in four weeks or something uh, you never know. But it's both, like you know, biggest technological revolution we've seen, maybe since the internet, um, but also there's a lot of hype around it. Uh, maybe a bit of money behind it, a little bit of snake oil that goes with it. So I think it's a real mixed bag. There's like no question on the promise of it, but we're kind of only talking the hype and the upside and not really talking the reality of it or the efficacy or the accuracy or some of those things. So I think that, especially if we look at a healthcare focus, those areas need to come more under the microscope than maybe they do in other areas.

Ben Lynch: 2:47

So what have you found? Some of those downsides, because I think, yes, the upsides get a lot of PR, good PR. What are some of those downsides that you're considering? You've been immersed in it for a while.

Joel Friedlaender: 2:59

Yeah. So if we're talking specifically generative AI and by that I mean AI that produces content, so the most common that people are looking at is the LLMs, the large language models, and they produce text. That's by far the most popular with like chat, gpt, and then you've got image generation as well, where there's like mid-journey stable diffusion tools like that as well. So if we talk generative AI, the interesting thing about it is like it's kind of it's a very complicated tool that has a simple premise, particularly the large language models, which is they're really just predicting text to give you. So if you use a large language model and you give it a prompt, it's got a lot of training from the internet, but what it basically does is say it's got a lot of training from the internet, but what it basically does is say what's the highest probability first word I'm going to give you. It gives it to you and then it looks at that again and says what's the highest probability next word I should give you, and it does, and it goes through the process to create some text. So maybe the term artificial intelligence is a little complimentary to it, because it's a sort of statistics and probability machine and it's just doing it based on all the knowledge it got off the internet. So it's not really smart, it's not really using reason, but the results can be quite magic because of the amount of training data that it's gotten. And sometimes we don't even know how it comes up with what it does because we don't exactly program it to do what it ends up doing. We give it a model and an architecture, we feed it a lot of data and it does its thing and it can be surprisingly good or surprisingly bad, and I guess on the bad front we've got things like hallucinations. So that's the term that's used for AI when it makes stuff up when it's not accurate.

Joel Friedlaender: 4:45

If anyone's been seeing Google Bard recently, it's kind of had a somewhat infamous launch because it's just speaking absolute rubbish. It's telling people they should eat rocks every day. Or if you want the cheese to stick on your pizza, maybe try glue. So we're seeing, particularly with Google Bard at the moment, moment, some of this, but all of them have it. You know, if you look at chat gpt the most used and you read their privacy policy, it basically says don't trust what our models will tell you. They could be factually inaccurate and they put that out there as a disclaimer. If you have a look also at chat, gpt and now they don't have anything particular for us in australia with the aust Australian privacy principles, but they do have ways you can be GDPR compliant with it, and that's for the European Union. So it's probably the most relevant to us if we're looking for healthcare and what they say to be GDPR compliant is don't put any sensitive information into it and don't put anything for anyone under the age of 14 into it, and that's a requirement if you're to be compliant. So you know it's a bit lesser talked about, but they're kind of steering people away from using it for sensitive information and the inaccuracies are definitely there.

Joel Friedlaender: 5:55

There was a recent study that I found is the most interesting. It was done by Princeton. There was the Allen AI Institute and a few others that got involved and they were evaluating the accuracy and effectiveness of AI in summarizing long text and the way they went about this was they actually used it to summarize nonfiction books. Sorry, not nonfiction fiction books. They did. They needed content that the AI didn't already know about, so they chose fiction books made in the last year that the AI has never seen before and it had it summarized, you know, the main stories, the main characters, things like this, and it did terribly so.

Joel Friedlaender: 6:35

Like ChatGPT4, for example, 80% of its summaries had factual inaccuracies or hallucinations in it and 60% had core omissions. So it might have left out a main character, a main story arc or something like this. So this is the bit where I say we're not so much talking about the effectiveness and accuracy of it yet, but we probably should, and I think we should when we start to look at. One of the most popular use cases in healthcare is to write your treatment notes for you or to do a report. And you know, probably anywhere else in the medical space we say there's a new tool, let's look at the evidence behind it and maybe in this space where, like there's a new tool, it's so compelling. So I hate to write my notes and I want to save time. I might turn a bit of a blind eye here and use it because it sounds great.

Ben Lynch: 7:22

In the Clinico survey that you did in 2021, I think it was. The stats were quite interesting that you had published on the website We'll link them to the show here that time management, admin tasks and writing notes seemed to come through in spades as people's biggest problem or challenge. And so to your point about a compelling proposition being able to write letters and reports with the assistance of AI. So then, what do you say to the clinics that are testing these products, considering these products? What, practically, apart from maybe consider the caution or maybe understand the terms? How do you see that playing out practically? Or maybe understand the terms like how do you see that playing out practically?

Joel Friedlaender: 8:05

Yeah. So I think there's two parts. One is the compliance side of it, so you need to make sure that you're compliant and not breaking any laws in doing so. Now there is ways to send healthcare information via these LLMs being compliant. So one example is, if you're using ChatGPT, you need to not do it via the ChatGPT application. You just download for free, and you need to not use a service that is directly connected to OpenAI's API, where the data's all going to OpenAI, even though it's not explicitly said that that's not compliant with the Australian privacy principles and I've looked into this quite a bit. All indications are it's probably not, but it doesn't need to be because for a software company that's using this tooling, they can host their own version of ChatGPT using Microsoft Azure, a hosting platform, and if they do, they do get a contained version of it and they're not sending the data to OpenAI. So if you're using something that's using ChatGPT specifically, then you want to make sure they're hosting their own version in Microsoft Azure rather than going directly to OpenAI's API, and it's pretty simple for a software side to do it. They should be doing that as a bare minimum. If they're using different services other popular ones like Anthropic Cloud, there's ways to be compliant using through AWS BedRock it's called which gives you again a similar type of service. So you just want to check a little bit to make sure they're doing it in a compliant way, mostly meeting the Australian privacy principles, and then you kind of got to go in with your eyes open. You've got to know that these things will hallucinate.

Joel Friedlaender: 9:40

So anytime we're talking note-taking, you need to review them. Now we have a bit of a disclaimer, like, oh, it's a draft and you review it and that's how we're all fine, but do you really review it every time? If you do two and they look fine, do you start getting complacent? I would recommend don't. And then the other thing that I think isn't spoken of enough is the emissions. So it's one thing to look for inaccuracies in what it's given, and they're probably easy to spot straight after a session, but will you notice the things that are omitted, like, let's say, we had a penicillin allergy or they've had a hip replacement or something significant that must be in those notes but gets omitted? That could be quite a problem. So when you're reviewing the notes, it's not just the inaccuracies but it's really looking for the emissions as well.

Ben Lynch: 10:26

And Clinico. You have a connected apps page on your website for tools like this that you connect with or they connect with you, so people can check that out. We'll link that up over here. How, then, are you, and collectively, as a team, thinking about AI within Clinico? What's your latest thinking in how you're applying it? Maybe, as a team, do you use it behind the scenes as a team for your own workload? And then also what comes from the client side for the product.

Joel Friedlaender: 10:58

Yeah. So on the note-taking stuff, we're actively not doing it. I don't feel comfortable with the state of AI for note-taking stuff. We're actively not doing it. Um, I don't feel comfortable with the state of ai for note-taking. Um, it's not that I think you can't do it well enough, but it would really take dedication from the people building it um to do so, and we wouldn't be able to put that dedication to one specific feature like this. So we're not doing the note-taking.

Joel Friedlaender: 11:20

There is other companies that do note-taking. I know a couple that have got traction at the moment is Patient Notes and Hybie, the two that I hear about a lot. I think one of them is connected with Clinico and the other one is starting to do so, so it'll be something that people can use as an integration. As far as how we use AI ourselves, it's very minimal at the moment. I would say as a philosophy, as a business, we care a lot for sort of quality and accuracy, maybe more than speed, and I still think AI is at a point where it can automate stuff, it can do things fast, it can do things cheap, but probably not as well as a capable person, and we're not really prepared for that sacrifice at this stage. So maybe we use it, like I've used it to reword the name of a talk that I'm giving it's quite good at that or we might use it to scrape and summarise some basic information. That's not terribly critical, but there's not a lot of places we're using it.

Joel Friedlaender: 12:18

In our business, you know, we explore and we experiment and mostly we decide no, based on the current outcomes. You know I've personally been experimenting a bit with, like github, copilot recently, which is a developer tool to help you write code, and it cost me more time than it gave me to use this thing. Now there's times where it was magic and it did something amazing and it saved me doing it, but for every one of those I wasted more time on the, you know, going down the wrong path than I gained from it. So I can't say that I'm like a huge fan and I say that we've been pretty immersed in AI for the last few months, at least as far as what we're doing in Clinico.

Joel Friedlaender: 13:00

We have a few places that we're trying to get it working in Clinico, because I do think if you can get AI working well, it's amazing, but it doesn't come out of the box and it requires some effort. So one example the first thing we started using it for and it's the least interesting thing is we started using it for some spam detection. If people are using Clinico maliciously, we can use it to detect some of that, and it's not an exciting use, but it was an accurate one. Another thing we're looking at at the moment is just some like document recognition to be able to read files you might import into Cliniko automatically with AI and convert that a bit and put it in for you. It's pretty good at image recognition, video recognition, reading text, things like that. So just trying to play to its strengths and probably not use it, I would say, in mission-critical areas and maybe a bit out of the medical side of it, at least for now.

Ben Lynch: 13:54

It's a great perspective and a different one, perhaps from what we're seeing and hearing a lot through social channels etc. You spoke to the point about capable humans and Clinico, from what I know, has a unique way. You have a unique way of recruiting capable humans and building a culture where it's incredibly sticky. As I understand it, high retention. I realize we're speaking here with clinic owners who have some different elements, some different contexts. There's still some fundamentals. I'd love to unpack that a little bit more with you. I saw you recruiting right at the moment, maybe for an operations manager. So take us into the world of recruitment and your philosophy. You have quite a few philosophies that you like to practice. What does recruitment look like for Clinico?

Joel Friedlaender: 14:50

Yeah, I think that one of the challenges we always had, especially early on, when we were much smaller and much less resource lower salaries we could afford to pay and things like that is how do we get creative to still attract great people? Because if you don't put a lot of effort into your recruitment, your applicant pool will reflect that it really requires higher than normal effort to get the right people applying and then to be able to go through and work out just who those people are in that package.

Ben Lynch: 15:21

And just to interrupt, what were some of those creative things you did back in the day when you didn't have the resources, because I know plenty of folks watching or listening and going. Yeah, I don't have a massive budget or a lot of time perhaps, so what were some of the creative things or messages you would share with others?

Joel Friedlaender: 15:38

Yeah. So things we did is our team still does it. Our team worked a 30-hour work week but at full-time pay, and that was probably the biggest thing we did for a couple of reasons, but one of the biggest was recruitment. We knew that that was going to be compelling to people, that, even if you know maybe we're not offering the same salary as others, the ability to work 30 hours, have much better work-life balance, is going to resonate with a lot of people and we're going to be no worse off for it. And maybe it's a little bit different, you know, for healthcare practitioners with billable hours.

Joel Friedlaender: 16:08

But in a creative field what you get done in 30 hours or 40 hours might be a bit of a moot point. If you're productive, you probably get enough done in 30 hours, even more than someone else does in 40 in a productive environment. So we just thought let's just get 30 really good hours out of people and we're probably beating what they put in in other businesses anyway. And it's great for recruitment. We have unlimited annual leave so we're not tracking it. People take what they want, with the only exception saying minimum four weeks a year just to make sure that people take enough. We don't have hierarchy or managers in the business. We're not doing performance reviews, we don't have things like this, which, for really capable people that crave autonomy, can be quite an appealing perk in its own right. So it was trying to look for the soft things that didn't necessarily cost us money but would be appealing and have our job stand out against other jobs.

Ben Lynch: 17:02

So then someone listening in goes, especially in a healthcare setting couldn't offer unlimited leave in that example, because of billable hours being important for it being sustainable for them. But maybe on one element of that is that people saying, well, do you get people that take it a little bit too far? You know, give them an inch, they'll take a mile, kind of thing. How?

Joel Friedlaender: 17:29

does that?

Ben Lynch: 17:31

maybe self-police, or how does the culture support? You know people doing some honest work as well. How have you set that up?

Joel Friedlaender: 17:40

So I'd say two parts to it. One is we do do a fair bit to try and help on that front and I'll go through it. But the other is we've probably had one or two people over the time that did take advantage of it. But you know, we've been going 14 years, we're a team of 55 now and one or two people I would say what an acceptable cost to run the business how we do, like easy. That's no problem for me.

Joel Friedlaender: 18:04

But as far as people not taking advantage, I think they've just got to want good for your business. I think that people have to care about the business they're working in. They need to see the purpose of it. They need to really, truly believe that if this business doing well is like good for me, good for the world, good for something, so that it's actually achieving something real for them, and they should like the people they work with, they should just feel good all about it, that they're intrinsically motivated to want it to do well and to do their bit towards it and maybe even making sure people are really aware that they do make a difference. So sometimes it can be easy to think you're just one small piece and whether you turn up each day or not doesn't really matter, and I think trying to just build awareness around. You know, the impact or the result of a business is just the accumulation of all the people in it. So, like each single person, especially in a small company, what you turn up every day and do is what the business achieves.

Ben Lynch: 19:00

How do you let people know that or know that they're feeling that if, say, you don't do reviews, where perhaps that might be a formalized structure to be able to celebrate someone's progress or contribution, how do you make the team feel that?

Joel Friedlaender: 19:14

I think part of it is transparency, so having people really see the big picture in the company and understanding the impacts of things. So you know people like in our company, they can see our revenue, they can see what things are costing us, they can see our growth, all these kind of things, so they see the big picture of the company, they can watch the impact of projects and things that have made an effect on it, and I think also just having like some true responsibility. So stripping away the managerial level means you really know why you're doing the work you're doing. If you're doing work to achieve a KPI or to satisfy a requirement from your manager, that's different to you know helping a patient get better or improve marketing in the business so that the business actually brings in more patients and all the practitioners are busier and earning better. And you know, once you actually get to work towards the real goal and not some maybe more arbitrary goals in the middle, I think you see the purpose and feel it a lot better.

Ben Lynch: 20:12

So with no managers, then do you see yourself as a leader and, if so, how would you characterize your evolution and journey over the 14 years as being the leader of Clinico and creating a culture like this?

Joel Friedlaender: 20:31

It's changed quite a lot, but I wouldn't say necessarily like with intention. I think I just like naturally get pulled in different directions and work in different ways and adapt. Like you know, I'm so confident I couldn't do the job I do today 14 years ago when I started it. There's so much learning along the way, uh, so that it's never a big jump. You know, if I was to look at a business the size we have now, it'd be too daunting, but it was never a big leap. It was always those small incremental uh jumps along the way that felt manageable. But I still think like I don't know, I could never define the like what I even do each day or my role, because it's just like still, I think you feel a lot of gaps when you're the person where ultimately you're responsible for things. So you know, you try to put people in place to handle all the different things, but in the end you're still the gap filler at the end.

Ben Lynch: 21:22

We'll have to talk about the octopus status. It's like one head, many arms and different things, and sometimes a lot of it sucks. Yeah, clarifying the vision, setting the vision where are we going? You are helping shape the future of the allied healthcare industry. How do you talk about that and look at the future of allied health over the coming years?

Joel Friedlaender: 22:00

It's tricky, I think you know we obviously touched on a lot of it, but AI is the hot topic for everyone and what impacts is that going to have throughout the field is hard to say, but I think that we take, you know, a serious responsibility in that vein. You know we have a significant portion of the market in Australia and in some other countries as well. So what we build into Clinico gets used. I always think of it. For example, if we're going to put a report into Clinico that gives you some metrics and information, people are going to use it and people are going to trust that report and assume it's a good idea to listen to those metrics. So there's a real responsibility of what do we put in there, because that's going to shape some behaviour down the path. So, definitely, you know we're much more considered we. You know we're much more considered we. You know things have to get past an initial barrier to be able to get considered and get released. Before and maybe in the earlier days it was much easier just to be responsive to everything, be like yes, we want it. Yes, we want it, we will put these things in. But you know we have approximately 100,000 people use the system every day and it comes with a feeling of responsibility to do right and to say, all right, if we put something in, we can't take it back. It's going to be there a long time. What's this doing to the behavior of clinics that are using Clinica and how confident are we? So you know we're more careful in the decision making and cognizant on it, and I think also you know we've just got to get things right. We've got to make sure features work without bugs. The quality's got to be there, the performance has got to be there, the security has to be there. It puts a different onus on releasing something, but you know where we're moving in the future.

Joel Friedlaender: 23:38

I always thought that telehealth is still, you know, for many modalities at least, going to get bigger. It certainly had a massive jump through COVID and we've seen a lot of residual use of telehealth since COVID but maybe more drop-offs than I would have expected as well after that time. So it's still heavily used through Clinico and we didn't have it at all before, but it hasn't maintained a level that I thought it might still keep up. But I think that's also because we're quite heavily skewed to manual therapy and, you know, even though it can be desirable for telehealth for a number of benefits to the practitioner in the business very hard to put your hands on someone through it. So I think you know that was inevitable on that front and I think we're just yet to see what AI looks like in the healthcare setting properly.

Joel Friedlaender: 24:25

Will the automatic note-taking get good enough? Will people be happy with the lack of privacy that goes with that? You know, if we look at the fact that there's a microphone in the room usually recording the whole session, so now all your personal conversation and, you know, medical conversation all goes into the summary at the end. Does it change the way treatments work a little bit, where now you're a bit more careful what you talk to your practitioner about? Is your practitioner going to start narrating what they do with their hands because they want the microphone to pick it up and summarise the treatment?

Joel Friedlaender: 24:59

We kind of don't yet know what impact the notes part will have or what other things that we'll have. You know, will we start to see effectively your medical copilot while you're writing your treatment notes and you start to note a bit of soreness here or a bit of something here and it pops up and says have you considered diabetes, for example, which might be a terrible example, because you probably don't diagnose diabetes from soreness? Maybe you do. It's not my space, but will we have some kind of co-pilot there? You know, google brought out I think it's GeminiMed, they called it which was a real healthcare focused AI agent, and maybe you'll have that and maybe that will get good enough at one point to be a little mentor in your room, you know, helping you out. I'm not sure.

Ben Lynch: 25:42

Do you have a sense or even a desire for where AI can be most beneficial for clinics? Moving forward, you've immersed yourself in it, you've made some comments around note-taking and report writing and where it will sit, some of the security reasons, but do you have an ideal state? This is where I think you know, with the right parameters, ai could be deployed and add tremendous value to clinics and patients.

Joel Friedlaender: 26:13

Ultimately, yeah, I think letter writing is one that it should be good at because it's so good at natural language. So it should be able to say here's my treatment notes. Give me a summary letter to a doctor that describes all of this. And maybe we can achieve it well enough now with enough effort or, if not, with the coming models, because the thing is you can build on AI now and then the next model comes out. Now you'll have to do a whole lot of retesting, but maybe that is all you needed to get the sort of quality that you want from it. So I think letter writing for sure is an obvious one.

Joel Friedlaender: 26:44

I think speech recognition is still really compelling. I could say in telehealth, for example, it's very good at speech recognition. It could put subtitles on the screen while you're talking, so if there's someone with hearing impairment, it could be automatically transcribing. It can just as easily do it in a different language. If you've got a patient of a different language you know and you're unable to communicate normally, all of a sudden maybe it just automatically translates and subtitles in any language for you during the session. And I think that's places where it's already pretty good and it would just be the effort to implement. I think we might see it come up in data reporting where you could use some natural language to query information in your system.

Ben Lynch: 27:26

We will return to the episode in just a moment, but since Joel mentioned reports in Clinico, it's time we talk about Ali. You can head to aliclinicscom and test out our new software for free for 30 days. Ali connects directly with your Cliniko account to automatically sync reports so that you can see visually and clearly the performance of any therapist or location and you can easily share it with your team so that they take greater ownership and responsibility over their own performance and caseload. If you're joining me here on YouTube, you'll be able to see my screen. We're looking at a fictitious character, toby Wheelwright, and reviewing his utilization.

Ben Lynch: 28:14

We can see the green line represents the target that you've set specifically for Toby. The purple line represents the actual performance, which is just below the target. What this means is that at our next mentoring session we can have a really thoughtful conversation about how we support Toby to boost his utilization with a more ideal caseload the people he loves to treat and serve. We can then track that over time to see whether the actions that we committed to are making the meaningful and measurable changes for his utilization and satisfaction in his role. Ali enables you to share these data points with your team very easily so that they can take ownership in their role and you can test it free for 30 days. All right, let's head back to the podcast with.

Joel Friedlaender: 29:02

Joel. And then the big next step that everyone sort of talks about is AI agents that are taking actions. So it's one thing to you know, be retrieving data, but maybe we can have some agents that are doing things automatically as well, like automatically contacting patients for a particular reason. Maybe we have it answering phone calls, although I'm not yet convinced that that's going to be a nice experience. Maybe it gets better. I think we'll see it in these places, whether it gets great for it or not, because it can be a money saver and health clinics do run lean and they're small businesses and perhaps, you know, for answering your phone, maybe it's not as good as a receptionist, but you don't have a receptionist from 5pm till 9am. And is the AI agent better than the phone ringing out? Probably, I still say probably, not certainly. So there's some spaces. I could see it in the probably not too distant future.

Ben Lynch: 29:55

So you're thinking about AI, using AI in varying degrees with Clinico, but you mentioned, really from a product decision making, a lot of responsibility that you feel with so many people using it. Can you share you know as of today, how do you go about making product decisions, whether it is to include AI or roll out a new you know report? What does that look like within the team as to how you make decisions?

Joel Friedlaender: 30:27

So a number of people in our team will get involved in it. We have people in our team that have been in the space. So we have practitioners that have joined our team. We have an ex-practice manager in our team, so we have some good core knowledge of people that have been clinical customers in the past or in other systems as well, and been in the field. So we have that internal knowledge. And then, because our team has been around so long, you know we have quite a few people that have been in our business for 10 plus years, people that have just been immersed in the healthcare space and the tech space for so long. We have a pretty good feel for it as well. So for the most part, you know it's internal judgment, but of course we can reach out to certain places where we want some extra opinions. You know I've done so in your clinic mastery community, where I'll reach out there and we'll do that as well when we feel like we don't quite have enough internally.

Ben Lynch: 31:15

Not quite built into the product but on the Clinigo website. One collaboration we had was the cost of losing a practitioner. You remember that when you presented it at our event many years ago. Just seeing the dollar impact We'll link that to the show here it was quite confronting. But I guess the point of that message was how do you retain team members? You were kind of offering a counter to the always hiring approach. What if you were able to retain your team members? And by seeing the very shocking dollar amount that it actually costs was pretty big. How do you think about retention within the Clinico team? You've had great retention, as I understand it, within your team. What are some of the things that you feel helped set up the Clinico team for a long length of tenure and a really engaged career?

Joel Friedlaender: 32:11

Yeah, so we've had. Now we've been going 14 years. Like I said, we were 55 people. We've had three choose to leave in that time 55 people, we've had three choose to leave, uh, in that time.

Joel Friedlaender: 32:24

Um, and I I think, like you know, the the most basic summary is try to give them a job that they couldn't get better elsewhere, because if they can get it better elsewhere, there's going to be a temptation. So I think you really want to know that you're offering the best thing possible to them. For us, the reduced hours is certainly part of it. I think the real flexibility we offer, you know we don't have such set work hours. People are choosing when they want to work and they get to. You know, I'd say we're particularly family friendly business. So people that work in our company and have kids probably know their kids better than people working in most other businesses and that's like a gift you never get back that time in most other businesses and that's like a gift you never get back that time. So I think that those parts of it play a big role. I think that no managers plays a role. I do think there's job satisfaction, for you know the autonomy that comes with it and the purpose for what you're doing. I think that our business strives for more than just some profits, is big for people in the team.

Joel Friedlaender: 33:17

We do donate 2% of our subscription revenue to charity. We've been doing to Beyond the Orphanage, I think, for almost 10 years. We've been doing for Sea Shepherd more significantly over the last few years, and they're causes that are important to people in our team and they know that the success of the business is causing other things to go well, not just our own pockets. We've managed now I'm not sure the total number, but we've been able to give millions towards these charities since we've been running. So I think all of these things combine.

Joel Friedlaender: 33:49

And then also we, like you know, really try to help foster friendships with the team and people in the team, like so many of them, are just like great friends with others in the team, travel to see each other. You know, because we're a remote company and we do that with meetups and social channels in our Slack that we use. And you know, sometimes we'll attend some conferences, either to exhibit or otherwise, and we'll get some people together there. It's like a little mini meetup and that as well, like when you work with people you really like and they're your friends. It makes a difference too.

Ben Lynch: 34:22

You've been doing more conferences by the looks recently a new booth. I've seen plenty on the social media looking really sharp and obviously with COVID we had sort of the downturn in in-person conferences. I guess what's spurred on that additional presence? And what are you hearing from people on the ground floor when you do get out?

Joel Friedlaender: 34:43

A bit of it's some pettiness towards other places you could do advertising. So I'm not so keen on giving Google our money or we don't spend anything with Facebook or Meta anymore. So we really try to make more ethical choices in our marketing spend and when we go to these conferences we're giving the money to the associations which effectively is going through to the members, so it feels like a better place to do marketing spend. It's marketing spend spend. It helps in our business, but it also helps our customers as well, which is quite nice. And then we found just numerous benefits for turning up to these conferences. The the original idea was obviously marketing, branding, exposure, get new customers. But in starting to do them, I think, like what we would have considered, the side benefits maybe even become the main benefits. And that's like you know.

Joel Friedlaender: 35:31

I attend a lot of these conferences myself and been able to stand there and just talk to customers, talk to potential customers and hear what they need, what goes well, what doesn't go well. It's like the best focus group I could get and I find it invaluable for getting a feel for what people really want the system to do or what their pain points are, and that alone might make these conferences worth it. Like I mentioned, we get our team together for it. So it's just a nice chance to get five or so members for our team together, stay together for a few days, you know, have some dinners out, do things like this some nice bonding in the team. And then I think also, you know people do appreciate when you turn up to their events. They don't have to come looking for us. They're there anyway for their conference and we'll come to them and be available. And you know we go there not to sell but just to be present and answer questions and be there for what they want.

Joel Friedlaender: 36:31

And are you noticing a trend at the moment with what people do want and what they're coming to talking about. I don't know if it's anything new. There's certain glaring omissions we have that we are looking to address right now. Probably our easy number one is with our intake forms. Uh, people need those going directly into the record, so we're on to it. So I think more there's. There's some obvious stuff that we know to get going on and it's been, uh, you know it's pretty consistent what things are most popular with most people. Um, but we're we're like hot on it now. We've just hired six developers over the last six months and we are like raring to go on some of these things.

Ben Lynch: 37:03

That's fantastic. You spoke before about family and being very family inclusive. How do you manage your work from a home destination, home office? How have you, over the years, managed the dynamic with raising a family and being a business owner? That is such a common thread for listeners for our community is starting a family, expanding a family, integrating family into what they do. What are some of the things that you've found personally quite useful and maybe also, by extension, the Clinico team have found useful in integrating family?

Joel Friedlaender: 37:40

I think for myself personally, like you, just can't afford to be ineffective or not productive when you have time to work, because your time becomes more precious. You've got set hours in the day that you want to spend for work, for personal activity, for family. So you can't go into work and you know have five hours to get done and spend 10 hours doing it. It just won't, won't work. So you need to get really self-reflective on when you're productive and when you're not. And if you're not maybe you can walk away and do some of those other things that you need to get done and then come back to it, rather than kind of procrastinating and staring at your screen.

Joel Friedlaender: 38:14

When it's your own business there's no credit given for sitting there. You know there there's no benefit that you say that you can computer nine to five or something like this. It's only what you get done. So I think you become much more protective of your time and your productivity and a bit focused to do it. You know I have the benefit of having a separate office to the house, but I think you need some space away. You need some uninterrupted space to be able to get in the zone and get productive and then you know, if there can be flexibility in the work, I think that could be advantageous. You know, I find, you know, often I'll do a few hours work once my kids are asleep and I'll do some hours in the day and I can do some time for health and fitness during the day and just work it out with some flexibility that fits like a family schedule, not just my own.

Ben Lynch: 39:03

I like that sort of flexibility in how you've set things up. I know myself as well that there've been many years getting to know the Wiggles particularly well in between as a bit of a break. But I love that point about being effective when you are at work, when you are doing the things, whether that's from a home office or in the clinic, wherever that might be, for those that are listening in that's a great point.

Joel Friedlaender: 39:29

And I think you almost have like some more accountability with it. Like previously you're kind of accountable to your business but you could throw more hours at it. But now, like if I come out here and I waste my time and I've got to do more work at night, like that's costing my kids, so you have a better reason to be really disciplined with it.

Ben Lynch: 39:46

It's a great point costing your kids that goes straight to the heart, and also the accountability. That's a really great way to think about it and frame it, because I think you can just keep adding to the to-do list. It's continuing to grow, so you can always say, well, I need to work a little bit more. So, yeah, great, great distinctions. Joel, we've gone in a number of different directions, from product making decisions, leadership, culture, retention, recruitment, family, ai, thank you. Thank you for sharing uh. This is. We've had a couple of podcasts now together over the years you were commenting before about uh. We've been doing this a while. We'll keep doing it. No doubt there'll be a future episode as well to check in on all the progress that you're making. Um, and we're excited as well to have our new product alley connecting to clinico and really be a practitioner support hub using some of the Clinico reports that you've developed over the years ultimately translates into better patient care. So, yes, we are continuing to be more connected, which is really cool.

Joel Friedlaender: 40:51

Yeah, it's great and I think always people are really starting to embrace more connected apps. Now I know some years ago there was some resistance and they're like it should all be in one place, but I think that people really came around to the idea that, like no one system is going to do all these bits so well I know that we cannot dedicate to a reporting engine, like someone, that that's their sole focus. So it really seems like there's been a change in mindset and appreciation of it and those kind of you know, like Ellie, this kind of thing that lets people do a lot more has been really good.

Ben Lynch: 41:22

Yeah, that's awesome. Well, thanks so much For those tuning in. You can catch all the show notes on our website, clinicmasterycom. And come check us out on YouTube and watch. If you're also subscribed to our podcast on the traditional listeners like Apple and Google fantastic, come over to YouTube and check out the channel. Listeners like Apple and Google Fantastic, come over to YouTube and check out the channel Joel. Thank you and we'll see you on another episode sometime in the future.

Joel Friedlaender: 41:48

Thank you.

Speaker 2: 41:51

Thanks for tuning in to the Grow your Clinic podcast. To find out more about past episodes or how we can help you, head to wwwclinicmasterycom. Forward slash podcast and please remember to rate and review us on your podcast player of choice. See you on the next episode.