How To Eliminate Overwhelm and Frustration When You’re a Busy CEO

Having spent 20 years across various ‘busy’ roles from being medical doctor, senior corporate executive at Pfizer, technology entrepreneur and eventually in the CEO role my 3rd successive company, I’ve engaged with many fellow CEO’s and studied their behaviours in life and work. I found that the successful ones had some common traits and the ‘unsuccessful’ ones had some common traits too.

Success is defined by an individual, but for CEO’s or Political leaders this is also defined by their boss, shareholders, employees, customers or constituents. Nonetheless, CEO’s are constantly under pressure to meet targets, deal with crisis, fulfil multiple obligations and still be expected to lead a ‘healthy and normal’ personal and family life. As CEO’s understand their own ‘BS’ more deeply, they become more self-aware that their very own behaviours can exacerbate their current ‘crisis’. A CEO can be his or her own worst enemy.

Since I began coaching CEO’s over 8 years ago, I have learnt and taught several techniques to help them continue to pursue their careers at higher levels, whilst managing their responsibilities in their personal life. Often they even have difficulty connecting the relationship between the two worlds, which forms part of the problem.

1.   Quit

This is a perfectly legitimate option. For some CEO’s the pressure of the workload and circumstances surrounding their personal life require more time to be focused on the latter or risk causing irreparable damage to their health or family relationships. In such situations, quitting may appear to be the only option.

However, in some cases, this may also be a ‘get out clause’, used as an excuse for being unwilling to acknowledge one’s own mistakes or recognize how their own behaviours have contributed to their current negative circumstances. In these situations, the vicious cycle of frustration is likely to repeat in future roles.

2.   Be More Present

There is an accepted philosophy that ‘anxiety comes from living too much in the future’ and ‘depression comes from thinking too much about the past’. Busy CEO’s tend to be focused on the next thing even before the current task or interpersonal interaction has ended.

The focus is more on the clock, than on the person in-front of them. This gives an illusion of efficiency and speed, only to find later that subordinates haven’t really understood their instructions and made mistakes that need rework. The actual reason was because they weren’t communicated to in a patient and appropriate manner by their CEO.

The science of Mindfulness has now perpetuated the mainstream corporate and healthcare arena with companies like Google implementing programs for its ‘hypertalented, hyperactive’ employees, both young and old. The program has been such a great success that other Fortune 500 companies have adopted similar mindfulness practices with their own CEO’s and executives

3.   Change Your Expectations, Allow Another Reality

Many CEO’s are consummate achievers that have high expectations of themselves and therefore others. Frustration is an emotion that arises when those expectations are not met. For example, when you expect your CFO to complete the budget in 24 hours, but they can’t get it done on time. Or you expect to meet your annual company goals, but you fall short. Or perhaps you expect your password to work on your company and it doesn’t – all these situations give rise to frustrations.

A relief is felt when you change your expectations. I don’t mean lower them, I mean change them. Perhaps your CFO was being more thorough, and would deliver a more robust budget tomorrow. Perhaps falling short of your annual company goals provides you with a better business case to hire more talented staff. Perhaps your password error means your IT security has just been upgraded and you’ve just averted a major cyber-attack on your servers. Once CEO’s change their expectations and allow new realities to emerge, they can come out mentally stronger.

4.   Meditate

There are now hundreds of thousands of forms of meditations from a multitude of cultures. The benefits are espoused in traditional literature as well as modern science, and can help CEO’s manage overwhelm and stress over the long term. The body of evidence on medicine has exploded in recent years and MRI scans now even denser grey matter in the brains of frequent meditators. Personally, I have found the practice life-changing and allowed me to tap into greater creative thinking and problem-solving ability, as well as more focus and concentration. My initial time investment started at 5 minutes a day (on trains, planes and other ‘dead’ times) and I’ve worked upwards from there, to great effect.

5.   Find your Ikigai

The Japanese believe that every human being has a purpose or a higher calling, which they called their Ikigai. The French call it the ‘raison d’etre’ i.e reason to be. Regardless of race, religion, work status or nationality, having a clear purpose in life and connecting with the meaning of your work allows you to see beyond short term frustrations and bad days, and understand how they actually contribute to your personal growth, vision and mission.

CEO’s that connect with their Ikigai in an authentic manner don’t have to fake liking their job; they love their job and it shows. It shows to their employees, it shows to their customers and it shows to their shareholders. It allows them to tap into a deeper sense of fulfilment and commitment, that sees them through their business challenges and personal hardships.

The first step to finding your Ikigai is to simply answer 4 questions as genuinely as possible, and to find the intersection. The 4 questions are:

1.     What do you love doing?
2.     What does world need? (problem to solve)
3.     What can I get paid for? (how to monetize)
4.     What am I good at? (True Strengths)


The truth is that there are quick and easy solutions for CEO’s to minimize overwhelm and frustration in the short term (days to weeks). However, in order to achieve a higher level of performance in the long term (weeks to months to years), I often advise my clients that behavior change is an active process that requires more effort, but yields much greater more satisfying rewards in life, career and legacy.

10 Insights for Sustainable Healthcare in Australia from Sir Robert Naylor

Sir Robert Naylor and Avi

At a recent conference hosted by the Health Services Innovation group in Tasmania, I had the privilege of engaging with a few leading CEOs and researchers in healthcare. Whilst there were many highlights, Sir Robert Naylor, the CEO of  University College London Hospitals (UCLH) was outstanding in his insights.

UCLH has been ranked the 4th highest performing NHS Trust in the UK and a large part of that is due to its clinical and executive management approaches.

A few key points that he made:

1.  Payors in the UK i.e. government funding authorities are increasingly wanting to pay for value, rather than activity. This sentiment has been echoed in Australia as we are placing more thought on how Medicare can move toward a model of payment for outcomes, rather than activities.

2.  Providers need to focus on ‘transformation’ rather than ‘translation’. Sir Robert suggested that there is a need to form integrated systems along pathways; in order to this incremental changes is no longer good enough and patient pathways have to be viewed and changed as a whole.

3.  It is imperative to engage patients as active partners in their care. “Doctors need to change from being God to Guide”. We need to change the current archetypal image so patients have more ability to take responsibility for their care.

4.  Integration would be improve outcomes and reduce costs. The word “integration” is used often, but the word means different things to different stakeholders

5.  Sustainability is the “nirvana” that we are looking to achieve. In the UK, the healthcare system has 8% reduction in funding next year due to a “Cost improvement program”, while in Australia, stakeholders are complaining about 4% growth.

6.  Consumers and the public trust doctors, hence Sir Robert feels that we have to get the clinicians to communicate with the community. People want a good relationship with their GP, and GPs that understand patient’s concerns.

7.  He also encourages more clinical leadership in executive teams and encourages them to train in business and management skills. His Medical Directors manage the money, the people and the quality or care.

8.   Sir Robert observed that Australia is 5 years behind the UK in terms of the performance data currently published, which is not sufficiently meaningful for real change. Publishing league tables is good for improving transparency and performance; at UCLH they publish mortality rates down to doctor level. The 2013 Francis Report on failings in Mid-Staffordshire NHS Trust was a largely due to a lack of transparency – this is why league tables are very useful.

9.   The top priorities at UCLH are Patient Quality which includes:

·         Patient outcomes (is it going to make me better),

·         Patient Safety (is it safe for me),

·         Patient Experience (compliments/complaints)


These top priorities are put up on whiteboards on each ward, with top metrics updated daily e.g.. staff levels, infections rates. Each of his 9000 staff need to have these translated in a way that is meaningful to them, including janitorial staff.

10.  In terms of current thinking on innovation in the UK, a 5 year forward review by Simon Stevens suggested

  • Radical upgrade in prevention and public health
  • Break down barriers between GPs and public hospitals
  • New models of integrated care (Dalton Review)
  • Re-design emergency and urgent care

Sir Robert recommends tertiary health centers should focus only in a couple of areas of expertise where possible as it improves outcomes e.g. Cancer and Neurosciences. This is to establish critical mass, and involved UCLH giving up cardiac patients to other centres, but will dramatically improve mortality rates and build capability. He admires the Dutch system where they selected only 8 hospitals to treat complex chronic disease patients. Centralising services like stroke services has reduced mortality by 50%.

Transforming Consumer Experience in Healthcare

The healthcare ecosystem is becoming increasingly complex and consumer needs and expectations are escalating. The drive to create a more sustainable healthcare system means that industry players are forced to deliver new models of care whilst developing more sustainable business models under ever increasing budgetary conditions.  As cost cutting efforts reach diminishing returns, it has become obvious that the solution to this complex set of issues is to re-frame the problem, working back from patients and health consumers, and build models that deliver compelling experiences to consumers and superior health outcomes.

Last week, I held a webinar in collaboration with international consulting firm Palladium, and delivered insights on the healthcare system and future trends obtained from the Future Solutions in Australian Healthcare White Paper, an acclaimed research paper involving 21 thought leaders in Australian healthcare. If you missed it, please click on the video above to watch the recording.

It will identify where various sectors in healthcare have become siloed and focused on internal drivers, rather than focusing on patient and consumer demand drivers. New technologies for developing insights into experiences and narratives will be examined along with practical models for innovation to improve return on investment.  By the end of the session, you will have a clear step-by-step guideline to introduce consumer-focused transformation in your organisation.

Please do not hesitate to get in touch with me if you have any questions or would like to share your insights on this timely topic.

Is 2015 the ‘Year of Patient Experience’ for Australian healthcare?

As the Australian healthcare system continues to evolve, policies such as GP co-payments have raised controversy amongst patient groups. Indeed, when any complex system is looking to improve itself, a critical stakeholder from which feedback should be assessed is the end-user. However, when creating new policies we approach expert academics, industry bodies, doctors, nurses, practitioners, politicians and consultants, yet how often do we broadly consult healthcare’s end-user?

Thankfully, state health departments have more recently emphasised quality metrics linked to patient experience. Many of our public hospitals are now required to demonstrate that they are collecting and improving patient experience. However the system’s evolution in Australia is lagging behind the UK, where the National Health Service faced a more urgent crisis with the Mid-Staffordshire NHS Trust between 2009-10. At the time, overall care was found to be concerning and in several instances negligent. An £11million investigation of care in the Trust between 2005 – 09 led by Robert Francis, QC demonstrated major gaps between senior management and front line staff and patients.

According to Francis’ report “The Trust failed to listen to patients’ concerns, the board did not review the substance of complaints and incident reports were not given the necessary attention. The Trust’s board was found to be disconnected from what was actually happening in the hospital and chose to rely on apparently favourable performance reports by outside bodies such as the Healthcare Commission, rather than effective internal assessment and feedback from staff and patients.”

Following the outcomes of the investigation and the development of more patient-centred measures, the Prime Minister David Cameron said in 2012 – “I am determined to give patients a far greater voice within the NHS as a way of highlighting the best and worst of care within our hospitals. I want the NHS to put patient satisfaction at the heart of what they do and expect action to be taken at hospitals where patients and staff say standards are not good enough.”

Whilst we have yet to experience a similar crisis in Australia, CEO’s of health services and hospitals are still scratching their heads in determining the best strategies to collect, analyse and improve patient experience. In addition, the complexity of the data provides additional fodder to management meetings where budgets and priorities have to be allocated. Whilst patient experience data seems like an additional complication, it really should be seen as an important opportunity.

Patient feedback, when analysed well and actioned appropriately, provides important insights on how to deliver better outcomes and cost savings to a hospital through better targeting of projects and solutions. As demonstrated in the UK, alleviation of patient concerns in an early stage acts as an ‘early warning system’ that can reduce systemic errors and multi-million dollar lawsuits. There are also often many positive stories that can be effectively shared in the organisation to lift morale and staff engagement.

The ‘Future Solutions in Australian Healthcare White Paper’ noted that empowering consumers and listening to their feedback is one of the drivers of innovation in the healthcare system. The more ‘end-users’ are collectively involved in shifting the system forward, the greater the impetus for change – the same is true for any complex system.

Healthcare managers should consider a 4-step approach to improving patient experience. The first is to have a systematic strategy and data-gathering process – how you collect experiences and ask the questions is critical. The second is to analyse the data effectively to translate them into actionable insights – there are now ‘big data’ technologies available that can do faster and more effectively than analysts. The third is to action and implement changes through a cross-functional prioritisation process. Visibly demonstrate the results of feedback and management actions to drive culture change, motivation and results. Finally, monitor experience with performance to ensure that solutions are continuously aligned with patient needs.

A New Paradigm of Prevention and Wellness is Coming to Healthcare

It seems that almost every conversation about the ‘future of healthcare’ includes discussion around prevention and wellness strategies. Governments and industry are acutely aware that our current healthcare systems are geared towards “sick care” i.e. treating people when they are unwell, rather than “well care” i.e. keeping people as healthy and productive as they can be.

Whilst this is nobody’s fault, rather design by necessity, health leaders are realizing that the cost and resources required to treat sick populations could be better utilized if they were spent earlier in the disease spectrum, i.e. before people even became seriously unwell.

This is particularly true when dealing with patients with chronic disease, or who are occasionally referred to as “frequent flyers” of the health system.

I am personally not a huge fan of the term (because it implies frequency by choice), but I can see where it comes from. It is interesting to note that from available data, many government bodies and large healthcare organizations such as health insurers can specifically pinpoint who the “high users” of the system actually are, in particular the usage of hospital services.

Yet, the available evidence in the literature on prevention is quite disparate in the relative benefits of prevention programs. We know there is benefit, but we’re not quite sure how to implement them well in practice. Nonetheless, there are guidelines to help us such from the US Preventative Services Taskforce, Dept. of Health, Victoria, Australia  as well as advice of a diverse set of thought leaders in the Future Solutions White Paper.

Whilst defining the best way to tackle prevention is a complex problem, therein lies the opportunity for transformation.

I recently returned from a conference in Mexico, where I had ‘blue sky’ discussions with leaders from Google, Truven (top 2 healthcare data analytics company in the US), Seagate (global data storage company) and also Silicon Valley experts. It is clear that the use of “big data” plays a major role in identifying those at high risk of multiple co-morbidities.

However, what’s most interesting, is that in order to intervene at a level of prevention and wellness, we have to change behaviours, rather than prescribe treatments. We have to shift thoughts and emotions, rather than physical interventions.

This is a dramatic shift in thinking for current practitioners, administrators and providers in modern health system. Personally I think we could much better in changing behaviours, or more importantly, empowering people to change their own behaviours.

Yet marketing companies do this every day. They understand consumer psychology at a deep level, and are able to change mindsets about their products and services on a regular basis. Look at McDonalds, KFC and other fast food retailers.

This needs to be changed in healthcare, and it can change. New ‘big data’ and personalized health technologies such as Fitbit, Apple Health, ph360 and Pansensic  are able to tap into mental patterns and determine how to best communicate with a patient, in a way they understand.

The second big insight I gained from Mexico came in discussion with 3 doctors from the US who were huddled in a corner talking about how they had little idea about how to manage their own personal mental and emotional wellbeing, much less try to introduce it to their patients or the system as a whole.

As such, I am collecting feedback to determine the need for a specialized Personal Development program specifically for leaders in healthcare and wellness. If this is of interest, l’d love to hear your thoughts.

Til then, ‘Adios Amigos’ and choose to live your success, health and happiness.

Expert Lectures on Success Measurement in Health

It’s been a whistlestop tour for leading innovation expert Darrell Mann, who was in Australia to present several lectures on New Ways of Measuring Outcomes. Many thanks to Australian Hospitals and Healthcare Association and the NZ Trade and Enterprise for helping promote the events.

Darrell explained how deeper consumer insights allowed significant improvements to be achieved when hospitals in the UK redesigned services accordingly.  In other industries, Darrell’s methods have created billions of dollars in value to organizations such as Procter & Gamble, Siemens, NASA and Rolls Royce.

If you recall, the Future Solutions in Australian Healthcare White Paper called for the healthcare system to be more ‘consumer focussed’ and to align funding models to what’s most important for patients. Well, in order to achieve that, we firstly need to more accurate evidence on what consumers’ needs, thoughts and emotional barriers actually are, rather than make traditional assumptions about them!

Many organizations in healthcare are getting smarter by conducting consumer surveys or including consumer representatives on their expert panels or advisory boards. This is a good start, yet it can occasionally be challenging for even a team of experts to accurately predict the needs of tens of thousands of people without objective data from local users of the system.  Survey methodology can also often be biased, based on how the questions are asked and who actually responds to them (e.g. the ‘loudest’ voices are most often heard).

The most objective insights and innovative solutions therefore come from understanding the REAL VOICES and EXPERIENCES of front line staff and consumers, and translating that data into useful insights for better management decisions.

You can watch Darrell’s webinar on:

  1. How the UK’s National Health System has moved to measurement of patient’s experiences, using data from a national website
  2. Which types of surveys are better than others for gaining true consumer insights
  3. How to better use qualitative ‘big data’ to gain deep insights, some of which is ‘untapped goldmine’ in an organisation’s IT systems
  4. Case studies of how service pathways and consumer journeys were improved using these insights (and how some solutions didn’t cost very much at all!)
  5. The science behind Pansensic technology and its ability to assess consumer keywords and metaphors to uncover the hidden truth in consumer feedback
Darrell’s also given access to his slides on the second live lecture, which also covered learnings from industries outside healthcare. Feel free to share this with your colleagues.
In addition, Darrell has agreed to offer a trial run of Pansensic to analyse one sample qualitative dataset/survey for any organization in the Energesse community. Contact me on and we can set this up for you.
Finally, on a slightly lateral note, I occasionally get asked by high performing leaders such as doctors, CEO’s, senior executives on how to sustain high work rate and energy, while avoiding mental fatigue and burnout. As such, when I was invited to speak at the High Performance Health Summit, which is targeting 1 million online attendees over the next 3 weeks, I agreed to share my tools, knowledge and experience.
This talk is more for YOUR PERSONAL BENEFIT; it covers perspectives on work-life balance, achieving goals and maintaining long term high performance. It’s also free, and I’m confident the session can help you become a better leader. There is also a diversity of experts from other disciplines such as psychologists, executive coaches, health practitioners involved – pick whichever topic interests you. Register here
Our wellbeing is our own responsibility, so empower yourself with cutting-edge knowledge so you can walk the talk and be more authentic in how you serve others.

How do we BEGIN Developing New Services in Healthcare?

care patient
Times are evolving, and the recent debate and general lack of support around General Practitioner co-payments (see Australian Financial Review article)  indicate that policies derived by pure economic assessments can sometimes be unpopular in the real political world of healthcare. I have to admit, at first, the idea of a price signal may legitimately reduce consumption of GP services by “over-users”.

But after some thought and discussions with my network of doctors, Medicare Locals providers and healthcare experts, it was clear that this ‘GP tax’ as some are calling it, could actually harm those that need GP services most, such as the financially disadvantaged. It is also questionable whether “public overusage” really is one of the major root causes of rising costs in the system. Which is why I asked Darrell Mann, a world leading problem solver with the National Health Service in the UK to give us some ideas on better solutions to these system issues in 2 upcoming seminars.

It brought me to a discussion I have been having with many readers of the Future Solutions in Australian Healthcare White Paper. Most healthcare leaders and managers who read the Paper felt that its contents really resonated with them. But many had the question afterward “This is all great Avi, I agree with most of what is in the Paper, but what do we actually do next?”. This is not surprising, as if you go back a decade to research conducted by Rix et al, many reform issues are still topical and they’re root causes remain the same.

Basically, today’s leaders wanted to know how to implement the findings from the White Paper in future delivery of health services. This was particularly pertinent with organisations launching new healthcare services or even Medicare locals looking at restructuring their offerings into Primary Health Networks.

And so the common question is “where do we start with making a change”. My answer is always, it depends on your organisation BUT, like with any system change, always consider the VOICE of the end-user (consumer, patients, staff, etc) and make that the no. 1 thing you do. Get that intelligence around what their REAL NEEDS are (now and into the future), and use those insights for your services redesign and development of new offerings.

Now this might seem as self-explanatory as a class on “Restructuring 101”. However, from my experience, that this first step is often poorly executed, leading to many ongoing system issues and here’s why:

  1. Lack of time, money, resources, and/or expertise result in hurried decisions – we often miss talking to the end-users of our services and ironically, it actually costs the system more afterward.
  2. Instead of doing the neccessary end-user research, we instead use the opinion of experts, and occassionally consumer representatives. Whilst this is valid, there can sometimes be a gap between what management experts think and what it is really occurring at the front line. Despite their best efforts, it is also unrealistic to expect that a handful of consumer representatives can adequately voice the multiple perspectives of thousands or even millions of people.
  3. When populations need are assessed, they are often extrapolated from secondary data sources and public health studies. Whilst this gives a “big picture view on needs”, they rarely provide the necessary accuracy that comes from speaking to actual local consumers of the service.
  4. In cases where consumer surveys are conducted, it can often include the more vocal “public champions” or those who show up based on the financial incentives provided. This ‘gifting bias’ can cause misrepresentation of the true needs of consumers.
So…. is there are better way? Well, thankfully yes, and that is what Darrell Mann will be speaking about. Darrell will be talking about his strategies working with underperforming hospitals and local health systems in the UK. He will explain how the initial analysis of the problem (ie. Problem Definition stage) is the key to developing the right solution for a healthcare product of service.


He will also explain how the use of new technologies (Pansensic) and “BIG DATA” is changing how we obtain more accurate end-user insights in developing new systems, and will provide examples from healthcare and other industries.


Don’t miss this unique opportunity to hear from Darrell in his short trip to Australia. Here are the details of his two seminars, which are FREE for the Energesse community of healthcare leaders.


Live Event 1 – Online Webinar

Topic:   “Measuring Success in Healthcare” followed by Q & A
Date:     Thursday, 23rd October 2014
Time:     7pm – 8pm
Register here for the webinar

This live online presentation will focus on how outcomes and major issues in the National Health Services (NHS UK) are measured using patient and staff experiences. It will also describe how latest technologies are being utilized to measure success in these areas. There will be time for Q & A with the audience on the webinar.

Live Event 2 – Seminar in Sydney

Topic:   “New Methodology in Consumer and Patient Understanding” followed by Networking
Date:     Monday, 27th October 2014
Time:     9am Registration for 9.30am start. Concludes 11am
Venue:   Sydney CBD, to be confirmed

This event is catered for individuals involved in market research, consumer analytics, employee experiences and patient understanding. Darrell will cover the latest methodologies used in measuring the ‘intangibles’ which includes developing solutions from opinions and experiences. His cutting-edge technology platform, PanSensic, will be covered in more detail. This technology is now being used across multiple industries worldwide. Spaces are free of charge but limited.

These are special events tailored for your needs so you have plenty of time to ask questions.

If you have any questions, please contact Olivia at or 02 8091 0918.

Dr. Avi on Getting Raw: Bridging the Gap between the Wellness and Medical Industry

In this interview with Richard Marc Toutounji, Dr. Avi speaks about bridging the gap between the wellness industry and medical industry. Dr.  Avi also speaks about being a business owner, having a passion for your business and how to build your brand within the market place.

Below is a breakdown of what is in this video:
0.33 Richard introduces Dr Avi Ratnanesan.
1.08 Dr Avi shares his experience with biotech companies.
3.02 Bridging the gap between wellness industry and medical industry.
5.05 Researching the market place with your wellness business.
5.45 Passion vs Skill.
7.07 Valuing your time and strategy in business.
9.50 Building your brand in the market place.
11.30 Finding a niche.
14.12 Personal Training and Health Care.
18.55 Mastermind Program for fitness professionals.
20.23 Strategy importance.
22.21 Problems and solutions.
25.40 Mindset and behavioural change.

Richard:           Welcome to Getting Raw, it’s Richard Marc Toutounji, and it’s been awhile since our last episode that I had, but today I think we would kickstart the series again. I got a really special guest here today. I’ve got Dr Avi. Welcome doctor.

Dr. Avi:            Nice to see you Richard.

Richard:           I usually call you Avi, so it’s Dr Avi, the official name and title. Dr Avi, you’re a medical doctor, is that correct?

Dr. Avi:            That’s right, I was trained as a medical doctor and I trained in the UK, in England, and then came to Australia probably about 14/15 years ago, and worked in the medical system in Australia as well.

Richard:           This is the first time we’ve had a medical doctor on the show, and you are probably wondering, “Why we got a medical doctor on a Getting Raw series, when we are talking about business and strategy, and fitness, and everything to do with wellness.” Dr Avi, you are responsible for pretty much working with billion dollar companies as their strategist, is that correct?

Dr. Avi:            Correct, that’s right. After my stint in medicine, I did an MBA in Master’s in Business Administration. I got into the biotech scene initially. I worked with biotech companies, and then subsequently worked at Pfizer, which was the largest pharmaceutical company in the industry. Initially my role was more looking after the development of new medicine. It was actually Viagra.

Richard:           Viagra?

Dr. Avi:            Yes, that’s right.

Richard:           You brought Viagra to Australia?

Dr. Avi:            No, Viagra was already in Australia, and doing well. My role at the time was really to look at the science behind Viagra and see what else we can do with Viagra, and get through different populations. It was actually my role to also approve any marketing and advertising for Viagra in Australia, so I needed to get my signature before we add some…

Richard:           That’s also doing tricky advertising as well to get that as well.

Dr. Avi:            That’s right. It’s certainly was edgy. Some people say it was a hard job. Some people don’t get that joke. I learnt a lot because obviously managing Viagra, things were in the newspaper all the time. You always get the statement that the company spokesperson denied this or include that, and I was the company’s spokesperson.

Richard:           You were the company’s spokesperson?

Dr. Avi:            Yeah, back in the time. Then I transitioned more into the business world. As I grew my way through the company, I ended up advising the CEO on strategies and innovations. How do we plan the business side?

Richard:           That’s what I really want to get you on the show today because you are strategizing, not just small businesses, not million dollar, billion dollar companies here… I really wanted to understand the lessons and the techniques that you gave to those companies that are multinationals, and how it’s actually working within smaller startups. Particularly now I know you are getting in the space of wellness, so bridging the gap between wellness and medical.

Dr. Avi:            Yes.

Richard:           I am really interested in that because we all know that the best referrals come from your doctors and so forth. People will say, “Hey, you need to get fit and you need to exercise. I am really interested in that to see how we can actually work with you. I never actually come across someone of your caliber that could be talking about such a topic. Before we’ve had a lot of fitness entrepreneurs on the show, a lot of fitness people in the industry. It’s like, how do we bridge that gap? How do we really do that gap?

Dr. Avi:            It’s really important, wellness, entrepreneurship, entrepreneurship in the health and wellness space. What is that? A bit about my background. After I did the role at Pfizer and did pretty well at it, actually then went to start my own companies from absolute scratch.

Initially there were even areas outside of healthcare, but then after a couple of years I realized I wanted to get back into healthcare, but looked at it from not just a modern medicine perspective, but look at it from the wellness perspective, because currently I think in Australia, we’ve got this division between sick care and well care. We tend to think of our doctors and our hospitals as sick care, and we tend to think of our personal therapists, our alternative health Allied health or our fitness project as wellness and wellness care. Never the two shall meet.

Richard:           Sick and well.

Dr. Avi:            Yeah, sick and well. Whereas that really isn’t how it should be. It really is about a combined approach that’s the best to treat the person as a whole. From an individual perspective, if Richard you want to look after your healthcare, wouldn’t you love it if you have your personal trainer talking to, your doctor talking to you, alternative health therapist, and it was all in one system, right?

Richard:           Yeah.

Dr. Avi:            That would be the best solution for you, but as an industry, as providers of healthcare, we are still quite separated. We don’t really talk together.

Richard:           Most definitely. You go to a doctor when you are sick, and you go to the gym when you are well, then if you are sick you are not hitting the wellness part of it.

Dr. Avi:            Yeah, absolutely. Now here is the thing, if you are a wellness professional or if you are a personal trainer, a fitness coach, even if you are a gym owner, you are starting to think of yourself, “How do I reach more people? How do I get into working with the healthcare side of things?” That’s where you need to be a good business. We know from some of the statics and we look at some of the stats within the industry, some stats say that up to 75 percent of startup wellness businesses failed within the first 18 months.

Richard:           I can believe that.

peaker 2:         It’s a really high failure rate. The reason for that is multiple. Sometimes people don’t realize or don’t fully appreciate why they got into the industry in the first place. A lot of people get into the industry because of heart, the passion for health, and really want to help people with their help.

Richard:           Yeah, the experience something and they want to do it again to somebody else.

Dr. Avi:            Absolutely, and that’s such a great story. It’s a very genuine motivation. Passion will only get you so far. After awhile you need skills and you need business skills in order to help you grow your client base and see more people, because you do need to generate revenue.

Richard:           I like that, business skills. That’s all it’s all about. You are going to have the skills, but you need the actual business skills to go to the next step after that.

Dr. Avi:            Absolutely. To keep yourself sustainable. Some of the mistakes that often people in startup say, “Okay, I’ll do this for free or I’ll train you for free or I’ll undercharge.” Because you are trying to get your way into the market. In some cases that can work, but sometime that’s a win lose situation, where the client wins because they are not paying much, but you lose as a business owner.

Richard:           Because you are not getting paid.

Dr. Avi:            You’ve got to find that balance, and that really comes from valuing yourself first and foremost. It comes from having that sense of, “I value myself and my services and what I can deliver…”

Richard:           I think that’s a big problem within the industry. We are not valuing ourselves or time, because we are selling our time, and it’s also as I said, a doctor or a practitioner, they are selling their time, we need to sell our time as trainers, as gym owners, or as practitioners. It’s the same concept, right?

Dr. Avi:            Absolutely. Valuing your time is fundamental because that’s really were your revenue comes from as a personal trainer. The second thing is then having the right strategy around how you approach the market. You got to think about, “Who are the kind of people that I actually want to help?” A lot of people scatter themselves across many different segments. You might decide, “I want to train men, I want to train women, I want to train kids,” and really scatter yourself a bit too much. Such that when people think of you, you are not clearly positioned in the market.

Richard:           You can pretty much say everything we ask…for male and females between 18 and 65. It’s too broad, right?

Dr. Avi:            Yes, absolutely. Really, whether you are a massive gym owner and owns a chain of gyms, or whether you are an initial startup, business strategy is really important because that determines your long term future. If you are an individual personal trainer, you need to think about who it is you want to serve in the world, who is it you really really want to help. When you find that type of person, then focus on helping those kinds of people, because that’s when you get the joy from your work, that’s when your value builds up, as you learn about specific segments of the market.

As you learn about, say you prefer working with kids for example, you will learn the details of differences of working with children, compared to working with adults.

Richard:           You be the specialist in that area, so like surgeon become a specialist in a certain body part, you turn that the same to the concept.

Dr. Avi:            Absolutely right. It’s lot of fun being a generalist and working in different areas, but if you find that you really want to build greater value all the time, going that specialized route, maybe for 80 percent of your client, is a very good way to go, because then that builds value and you then build them in yourself, your expertise and you are able to charge more, then you can become a more successful-

Richard:           I like that concept. I’ve heard that before, but you explain it in a very different way, with if it’s something coming out alive when you really want to help that particular market, that’s when you become that specialist in your field. What you are also doing is saying okay, when you are a specialist in that field, teaming up with other specialists in different healthcare sector, is that correct?

Dr. Avi:            Yeah. Right now the industry is saturated. We know that. We have more personal trainers now and gyms that we ever had.

Richard:           Yeah. We have more gyms and trainers, exactly.

Dr. Avi:            Which is a good thing, in a lot of ways because we are helping the greater population. On the flip side, if you are a business owner, then you’ve got to say, “Well, how do I actually penetrate this saturated market?” That’s why this specialize comes into place. Now, hand in hand with building your expertise, is building your brand.

Richard:           I understand.

Dr. Avi:            As you build your expertise, you then know need to figure out, “How do I now build my brand within the marketplace? I do I get it out there? How do I communicate my brand?” That’s why things like good marketing principles like having a decent website the represents who you are, who you target, the way you communicate and close the sales call, because it is a sales call at the end of the day. Having that conversation is so important. How do you stuck to the conversation with somebody in your marketing world. Do you go, “Okay, I do this, this, and this, but I can also do this and I can also do that.” How does that seem to the customer when you say you can do all these things?

Richard:           I like that. It’s very interesting you say that. You are coming from non-fitness industry as well, which I may had, which is really I think probably the value asset idea, because you are coming from a medical background. That is what you do as specialist, and each person is calling for a specialist task. It’s almost like, can we duplicate that, what’s been successful done over the years, into a fitness wellness market.

Dr. Avi:            I think that’s certainly, from my point of view, I think that’s certainly a way to go right now, because the market is saturated. Because there are more and more personal trainers out there. It really just depend on where you are. If you are in a location where there is absolutely no personal trainers at all, then sure, be generalized, but if you are in a market where things are saturated, there’s lots of personal trainers, there’s lots of group training etc, etc, really try and find a niche that you can go into, where it’s with people you love working with.

Richard:           I think that’s the key. People you love working with is probably a very big key that we are talking about.

Dr. Avi:            Yeah, absolutely. Business is tough and helping people in healthcare is tough, because you are really dealing with their problems. You’ve got problems and they’ve got problems, so you are around problems all the time. What keeps you going? A few things keep you going, your personal inner motivation, satisfaction, your happiness and fulfillment. Ultimately that’s what keeps you going.

If you do something that you love doing, you will keep going because you are motivated and you feel fulfilled every day of your life.

Richard:           That brings up my next question. You’ve come from a medical background and now at the moment, you are actually helping wellness specialists, personal trainers, gym owners, in that wellness sector, actually work on their business. Why did you make the switch for? What’s the story of you making that switch? Why are you still in the hospital, prescribing medication?

Dr. Avi:            It’s a very good question. The reason was, I really got out of full-time about 15 years ago. I found that after practicing for about two years as a doctor full-time, and then I went part time for another two more years, I found that one-on-one care for me, there was something bigger, there was something missing. I did it for a couple of years. I didn’t really know what it was at the time. I left, actually I took some time off. I took about nine months, where I didn’t do anything.

Richard:           You did a gap?

Dr. Avi:            I did the gap yeah, which is an unusual thing to do, but I really took time to think what is it that I love doing. What I found, I started reading the financial review and business news and things like that, and said, “This is really interesting. I actually really enjoy this stuff, and I want to learn more.” I did that the only way I know how to do that, which is go back to university, because I already spent five years in university.

Richard:           Go back there again.

Dr. Avi:            I’ll just go back there again. I was a sucker for punishment when I went and do that. I did a master’s in business administration. It was a two year course, and I did it 16 months. Fast tracking. I got on the dean’s honor roll, so I was with distinction as well, a distinction student, and I was working part time as a doctor as well, to pay for … I felt, yep, this is absolutely what I love doing, but I didn’t want to just go purely into business. I was still passionate about healthcare, I was still passionate about helping people and helping them have better lives, saving them from illness, and preventing illness, so that’s where personal training comes in.

I said, how can I bring the too together? How can I bring the business side and the healthcare side together? We know that in the wellness space, you have to get paid. There is no Medicare here. You’ve got to go out and get clients and get paid. You’ve got to earn a living.

Richard:           Wouldn’t we just like to swap the medicare kind of thing to a personal trainer? (laughs)

Dr. Avi:            That’s the thing, but we still have to get that credit card. We still have to have those skills. We want to help people yes, but we also still need to get paid. On the flip side, on the hospital care on the GP side, you’ve got patients coming through the doors sometimes. In fact, sometimes you wish you had less patients, but the problem there is bringing the cost down, because the cost of healthcare is too much at the moment. We need to look at ways of bringing cost down.

Depending on the side aspect … That’s an economic issue. It’s a major economic issue, and so again, having that business mindset, helps that side of things as well.

Richard:           You hit it on the head, the cost of healthcare is huge. How are you getting the attention of governments and politicians out there to really say, “Hey, this needs more attention”? Is it happening? Will it happen? Do you think it’s big enough to happen right now?

Dr. Avi:            I think the situation is, everyone is acutely aware. Everybody, the government is acutely aware, the treasurer is acutely aware. He’s scratching his head now, smashing all his subordinates, saying, “We’ve go to find a way to bring healthcare cost down,” so everybody is acutely aware of the problem, and trying different solutions out there.

One of the things I am working on at the moment, is speaking to the top 20 senior leaders in government, business of healthcare, helping to understand what’s the integrative approach to solving this problem. How can we stop working in silos and working as a pharmaceutical industry, as a health insurance industry, as a wellness industry, fitness industry, and how can we start working together. In order to prevent chronic disease, a lot of the issues around the cost of healthcare, comes from our aging population. A lot of us will see or coach people that are 40 plus, who are starting to get those chronic diseases and multiple illness, and multiple injuries.

We are starting to see all those things come through. That is a big burden of the cost. If we can prevent that, if we can keep people fitter, healthier, for longer periods of time, not only will they be more productive to society, they will actually avoid a lot of these chronic diseases that are costing the healthcare system a lot of money at the moment.

Here is where the big opportunity is for the fitness and wellness professional industry, to work towards helping prevent these sorts of diseases.

Richard:           This is just one sector of the many of the wellness stuff that you are working with at the moment?

Dr. Avi:            Absolutely.

Richard:           You’ve got a bit of a big job on your hands I think.

Dr. Avi:            Yeah, I love a big challenge. Don’t we love a challenge? We all love a challenge. I think even for fitness professionals and trainers, don’t you just love those clients that are challenging you all the time, in a way, to not just improve how you train them, but forcing you to be creative, while this person is not responding for this exercise regime or “I’m going to bring some toys in next time.” I’ve got my personal trainer and she’ll try different things. Say, “Okay, this time let’s just focus on some of the stretching this time, it’s boxing this time, let’s try a bit of some yoga techniques. When you get that challenge, that’s what forces you to think of new ways of doing things.

Richard:           I think it’s big need. It definitely make sense as well in the marketplace. I know right now, I guess to start getting that focus into changing the mindsets of the fitness industry, the personal trainer, the gym owners and so forth. I know you are doing a lot of coaching, a lot of programs for that industry specifically to try align them into wellness industry, which I think is actually great. I don’t think anybody is doing that in this industry.

They are pretty much saying, hey if you are a business owner and you want to grow your business, you are an entrepreneur or you want to take your business to past the million dollar mark or million to 10 million dollars, you’ve got the skillset because you’ve obviously gone from the billion dollar companies, and you are working all the way through. What does those sort of programs involve? I know you are working with a few people in the industry, but you are working with the people that are thinking differently as well, not just, hey, I want to get 10 sessions or 20 sessions. You are really trying to think that business skyrocket as fast. Tell me quickly about that.

Dr. Avi:            Generally I work in a number of different ways. I’ve got a mastermind group program, which is a regular weekly coaching call. That’s in a group setting. What that does is, I help, let’s say you are a fitness professional, wellness professional, I help you grow your business by giving you advise on a weekly basis, making sure you hit those weekly goals that you set for yourself, but also helping you think different to everybody else that’s in the market.

Richard:           I like that. I think that’s the key, is thinking differently.

Dr. Avi:            Absolutely. As you said, if you are just trying to get more clients, there’s only so far you can go.

Richard:           Time is money.

Dr. Avi:            Time is money and there is so many hours in a day, and you can burn yourself out, because even if you work with six clients a day, can you really work with six clients a day for five days a week? I don’t think you can. You might be able to in the short term, but not a long term. You need to think of different ways of earning revenue. Can you create products? Can you create services? Can you tap into partnerships with other businesses? So you have more passive streams of income.

Look at Michele Bridges for example, she’s your classic case of someone who’s built her profile over a period of time. She still works with clients, but she’s got products, she’s on a TV show. She’s got other services that she endorses. She’s partnered with schools. These are the ways that you can leverage some of your expertise within the marketplace, to create other streams of income. That’s the real thing that a lot of people don’t think about. This is where having good strategy at an early stage, comes in.

Richard:           Having a good strategy and having a good team will able to give you that strategy, that’s thinking differently and that’s come from a different … Somewhere totally different, which is, … I know we had a couple conversations and it’s taking a while to understand your concepts as well because you are coming from a different concept. It’s still even so valuable because it is a different model of hey, not fitness. You are coming from a different sector, which is I think is very powerful.

Dr. Avi:            Thanks for saying that. I think the other opportunity, particularly if you look at gym owners who are owning businesses that are say, 1 million to 10 million or want to go from 10 million to a 100 million, then they hear the opportunities to look at how do we get into other sectors? How do we partner with the sick care side of things? How do we work with hospitals? How do we work in other areas of the health industry, even health insurance companies for example, to form this greater partnership and reach a broader number of people.

That’s where we need to think outside of the box, just like Steven Johnson when he created … Everybody’s got an iPhone right now, and when the iPhone first came out, people said, “What is this thing? This is not really a phone anymore. This a complete different innovation. This is completely different, but look at how popular it’s become. The same with you. If you are delivering health and wellness at the moment, what are you doing that’s different? What are you doing that’s outside of the box?

Richard:           Yeah. How are you being different every other turner out there, every other 24 hour club out there. How is that different? I think that’s very interested topic of conversation. Before you leave, I want to get you giving us three problems that you see from an outsider in the fitness industry, for issues that we are doing wrong within the fitness industry. Do you have three?

Dr. Avi:            I could point three out, but if I am going to give the problem, I am also going to give solutions. Let’s talk about different areas of the market. Let’s look at individual personal trainers. I think the problems that individual personal trainers have is that you are limited in your time, in what your time limit is. You can get burnt out very quickly. One of the things to to think about as an individual personal trainer, and owning a business is, what can I do different?

The problem is I am limited in my time. The solution to that is, you’ve got to think about business strategies. Think of yourself as a business, firstly. Having that mindset, and the solution is, “How do I build my skills on the business side of things?” Because I need those skills, and secondly, what can I do that’s different to other personal trainers? What are the products and services can I offer that are going to help me generate long term revenue, that’s not going to rely on my time.

Richard:           Great, I like that.

Dr. Avi:            Does that make sense?

Richard:           Makes perfect sense.

Dr. Avi:            If you are a larger gym owner, let’s say you are own an individual gym, again it really depends on the area that you are in. If you are in a saturated area, again, I would say niche in your market. What is that niche that are currently catered for? How can I understand the problems of that niche market in the health and fitness and describe it better than they can? Once you get to that layer, you are no longer a gym. You provide all the different aspects of health and fitness for that market more than as a gym. You become part of their lives.

One big opportunity there, is going online. Having that engagement, not just inside the gym, but how do I serve people-

Richard:           Everybody can see what you do, instead of having to come inside the gym.

Dr. Avi:            That’s right, and how can you offer them information outside of the gym. Let’s say you come to the gym three times a week, but you are still interested in health information. Why can’t you be the provider of that information. Why can’t you get some personal trainers to-

Richard:           I think that’s a very good element.., and that obviously comes down to your blogging, your video content, things like that… Providing your content.

Dr. Avi:            Absolutely. Providing content, going digital..

Richard:           Be the authority in your space.

Dr. Avi:            Be the authority in your space. That’s another key thing. Then we talk about the big problem for the bigger end of town. We’ve got the larger gyms and franchises. What are some of the challenges there? Again, in some of those areas, you’ve been in the market for many, many years. You’ve got these replicable scalable models, how else can you grow. You can go international and do all those things.

I feel there still big opportunities to look at partnering with the sick care side of town. The doctors, the hospitals, health insurance companies, and look at partnerships in those areas, because those are ways in which you can add joint value. The problems that you are solving, somebody else in the healthcare industry is also trying to solve them.

Richard:           Doctors are always full and there’s always waiting rooms. There’s a waiting room lined of people. It’s crazy, a market is there, isn’t it?

Dr. Avi:            Yeah.

Richard:           Just bridging that gap.

Dr. Avi:            Absolutely. I think the other thing is just also not looking … This is for the entire spectrum of healthcare professionals, is no just thinking of yourself as treating the body, because to treat the body and treat the physical, first you’ve got to treat the mind, you’ve got to change behaviors, so really get good a learning how to change people’s behaviors, because you are not just treating your physicality, firstly you are treating behavior patterns. Only when people change their behavior patterns that they change their physicality.

Richard:           I like it. That’s a good point to leave off of. I think it’s an exciting time for the fitness industry. It’s a very exciting time because there is so much room for growth and there’s so much room for those [up raiser 00:26: 04] maybe are getting a little stale and I need to take that next level. I think you are the person to have a chat with when you are at that position and you are not too sure where to go.

Before you leave, just tell us where we can find more information. I will put some links on the website, but where could everybody find some information about you?

Dr. Avi:            Very easy way to go is go to my website, I am open to have a conversation with people. I offer free initial mentoring conversation. I am very happy to do that with people if they reach out with me. Always willing to help people in this industry.

Richard:           Thank you so much for your time. I think there’s a lot of passion in this conversation, and there’s a lot of growth that can happen. It’s about just aligning yourself up with the right people. Thank you so much. Until next time. I’ll see you later on Getting Raw. Thanks guys.

Dr. Avi:            Thank you.

Dr. Avi at the 11th Annual Future of the Pharmaceutical Benefits Scheme Summit 2014

Innovation and Healthcare System Reform

Thanks very much. That’s a little bit of all bio there. Essentially, I’m at a company called Energesse . We’re a consultancy in the healthcare and wellness space. We consult companies mainly in Australia, but also healthcare organizations in the UK and US. A little bit about what we’re going to talk about today, the title is Innovation and Healthcare Reforms. Obviously, with a lot of changes going in, we focus a lot in the last day and a half in the problems and the challenges. I’m really going to take different attack, and talk more about the potential solutions that our organizations can implement.

The takeaway that I want to leave you with, by the end of the day, is that you have 1 or 2 tips that you’re able to implement in your organizations literally tomorrow. This presentation, this come with a warning, because I’m going to be very controversial. Most of you probably disagree with what I have to say, but that’s fine. That’s the nature of a lot of presentations so far, but I’d like to keep it a little bit exciting. If you’re easily offended, probably you’re best to leave, because there some of things I’m going to say are pretty out there.

Moving on, what are we going to cover? Firstly, I’m going to talk a bit about managing the PBS and patient care in the healthcare ecosystem. I call it an ecosystem, because it’s a bit broader, and it’s quite an interdependent system. I’m also going to take the conversation up a level. We really have been focusing on the PBS quite a lot in the last day and that’s the nature of this conference. We really have to look at our pharmaceuticals and the PBS in the context of the boarder healthcare system. I’m really going to talk big picture today.

We’re going to talk a little bit about our systems centricity, how we are focused on creating solutions, and solve problems within the system. Sometimes we forget about the growing patient needs. We’re looking at a lot of patient needs today as a static picture, that’s not actually true. Patient needs and expectations are changing. They want more they want better health care. We’re going to look at how innovation can be used to solve some of these problems. I’m going to give you a few tips on process on how innovating your companies, so that you can go ahead and do this pretty much straight away.

I’m going to talk a little bit about the future trends. That’s not just trends in Australia, but trends globally. When we look at the Australian healthcare system, it really does limit a lot of what’s going in the UK. It takes elements from the US. Certainly when it comes to science, we’re always going to US healthcare conferences, and getting our knowledge from there. Let’s look at some of the trends that are happening there, and what you can do in the organizations today. Finally I’m going to talk about a white paper that Energesse is developing with 20 of the top healthcare leaders in Australia. It’s called Future Solutions in Australian Healthcare. I’ll take about that at the end as well.

Then we’ll have some time for QA, if we’re lucky. I really want to tailor this presentation to what you guys actually want. I just want to get an understanding of which sub-sectors of health care you can’t be working. If you can just get a show of hands. How many people currently work in pharmacy? How many people work in pharmaceutical companies? All right, so we’ve got a few there. We have a few more volunteers that just joined. How many industry bodies?

Research and academia? All right, so we’ve got 2. How many people in other? Quite a lot out there. I know about legal. We’ve got research, market research. What else have we go? Healthcare system.

Audience:        Direct clinical care.

Audience2:      Personal health

Direct clinical care. I think I’ve got some pointers for you guys as well. Let’s see how it goes. Anyone else in the other category?

Broader health, fantastic. I’ve got some for you as well. I think we’ve got it covered. If you don’t mind, just a little bit on my background, because you’ve then understand why I’ve got all these wacky ideas. I started my career as a doctor. I worked as a doctor in the UK. I trained in the medical system over there. Worked for the National Health Service. Then I came to Australia, and I worked for the health system here. I worked in private healthcare syste, and I worked in public as well. I’ve got experience across different healthcare systems in different countries, and also public and private.

I then got to the industry, I did an MBA. I got into industry. I worked initially for a company called Sorono, in medical affairs. Then went on to join a company called Pfizer, as one of the medical directors. I work in research and development, clinical developing, clinical trials. I was involved in registry in products. I was involved in reimbursing products, such as Champix, and marketing products such as Viagra, etcetera, all the hundred million dollar.

At that time Pfizer was turning over a billion dollars a year. It’s not that big anymore. To answer one of the questions earlier, Have we seen a reduction in staff across pharmaceutical industries? Absolutely. At Pfizer I think we had 400 or so plus sales force. I know it’s about 150 people now. In the time that I was there, we completely got rid of the whole clinical research team. We have no clinical research team in house in anymore. Certainly the industry has experienced a world of changes since I left, and that was 2010.

I then went on to a lead industry for a while, doing things in technology, owning companies in that space. Then coming back to healthcare, because I find that’s really where my heart is. My heart is around helping people with their health and wellbeing, which is why our organization really has a vision of helping a million people in the health and wellbeing around the world. We did spend some time working in the holistic health space, and looking at other areas of healthcare that are assigned to emerge.

What we found is some of these things are traditional Chinese medicine, meditation. There’s a growing evidence based for them. In fact the Australian Heart Association actual cited meditation as one of the solutions for heart disease, or preventing the progression of heart disease. That’s meditation, not medication, which is very interesting. We spend some time in that area as well. If you think I have a bias, yes. I have a bias across the whole lot of healthcare, and looking at various different solutions for various different conditions.

It really helped me redefine what healthcare is all about. Healthcare, medicine alone isn’t necessarily health. I did say that this is going to be controversial. Medicine is not necessarily health. Just law is not necessarily justice. There is a difference. Medicine is a sub-sector of health. Sometimes, when we get focused on medicines alone, we lose sight of the broader picture of the value that we can add back into the healthcare system. We lose sight of the value that we can add back to patients. That’s one of the key points here.

What is healthcare really? Healthcare is the maintenance and restoration of the health of the individual’s body and mind. The maintenance being prevention. We forget a lot about that. We focus on treatment quite a lot. Healthcare really is a combination of both, and is also body and mind. Often we really focus on the physicality, the physical outcomes of healthcare, but we forget about the mind. We forget about the rule of the mind. A lot of this stuff may not relate to your professional point of view, but it may relate to you from a very personal point of view.

What is the healthcare ecosystem actually look like. We talked a lot about PBS, but I just want to give you a broader picture of what the healthcare system actually is. Once you understand what’s going on in the whole system, you’ll then understand why some of the things are happening the PBS, and the nature of some of changes that are actually going on. When we look at the entire healthcare ecosystem … Firstly, we’ve got the biggest funders. We’ve got federal government on one hand. Between federal and state, we spend about $140 billion in the Australian healthcare system.

We’ve got a PBS there which is one way of paying for healthcare. We’ve mentioned that’s about 0.6% of GVP, which got Medicare, which funds a lot of services, the doctors etcetera. State government largely funds hospitals that’s about $42 billing with the spend. Then we’ve got health insurance companies represented on the bank. Again, we’ve got 11 million people in Australia that have private health insurance. Again, that funds a lot of healthcare. We’ve got work cover, which we forget about, which also covers a lot of employee benefits in health care.

Then we’ve got things like exercise and nutrition. We tend to forget about the rule of exercise and nutrition, particularly when we starting talking about medicines. When we talk about clinical outcomes around medicines, we start to forget about how important exercise and nutrition actually plays a role in the results that which is in practice. We’ve got age care, and then we’ve got a research in academia, again, represented here. We’ve got our medical professionals, we’ve got about 70,000 across the GP and specialist in this country. Pharmacist, we talked about that Got about 5,250 pharmacist. Steven, was I correct 5,250?

About that plus and minus 3. And about 65,000 employees. That gives you an idea of scale of the ecosystem. Then we’ve got all the nurses, the allied health professionals, the occupational therapist, the physios, all play a role in the maintenance and prevention. We’ve got the alternative health space. That’s a $4 billion industry in this country. We offered 30,000 employees. Fair size for a country like this. We’ve got complementary medicines, which we’ll talk about. We’ve got the pharmaceutical industry, and medicines in there. Then we’ve got the not for profit sector.

The interesting thing about the not for profit sector is that it very often addresses the gaps. The areas where the not for profit organizations are not able to fill, the not for profit raise money from the public to provide healthcare services in those areas as well. Why am I telling you all this? When we start to talk about that we don’t have enough money to do stuff, and we don’t have enough money to create solutions, the reality is if you look at the entire ecosystem, there’s a lot of money around different areas. We can be creative about how we work with other areas with the healthcare ecosystem. We can find some amazing solutions for this person. 23 million of the Australian population, which is really at the center of this ecosystem.

The beautiful thing about the healthcare ecosystem in this country is that the principal of health care is universal health care. We really believe in that. We really want to give everyone in this country very good access. Not just the medicines, but to health care. That’s a wonderful principle, and we forget about the privilege we have working in the system under hat guiding principle.

The other thing that we tend to forget is when changes happen in on par of healthcare, it affects many different parts of healthcare. Brendan talked about this. When we reduced the amount of funding to the PBS, for example, then we reduce the amount of funding available to pharmaceutical companies. The drug industry will reduce the funding available to pharmacy, for example. What happens then, or pharmaceutical companies are not able to fund research. We’ve certain seen that. We know that they fund a degree of education for medical professionals.

What happens then is that those benefits, access to pharmacy, for example. Patients have less access, potentially expertise station have less expertise from the doctors. There is a flaw on impact for whatever change you make in the industry to a stake holder. Very often, we tend to forget the flow on impact. Not only do we forget the flow on impacts to the patients, we also tend to forget the flaw on impacts to all the other stakeholders in the industry. I forgot to mention devices and diagnostic, which is a very important piece.

One thing I want to take from any falsely changing intervention that you’re looking to make in the organization. Think about the flaw and impacts to other stakeholders. When you start thinking that way, you actually start looking at the potential opportunities within the ecosystem to collaborate with other stakeholders to achieve the outcome that you want. We talked a lot about this, a we’ve all talked about the points of trying to have it on cost versus benefits to patient. That’s also about cost centric system versus the patient centric system.

I want to tell you a bit of a story. I recently had an opportunity to go to a specialist consultation with my Dad. My Dad is 69 years old. He’s got a number of illnesses. He’s got diabetes, he’s got asthma, he’s got heart disease. Very rare for me, despite being a doctor, the first time I actually went to the see a specialist with him, and be with him for that consultation. In that consultation … My dad’s a very intelligent man. He’s a dentist. He’s the president of the World Dental Federation. He knows his stuff when it comes to medicines.

In that consultation, he was there sitting with the specialist. The specialist said to him … Asked his history. He was able to relay his history. Then he said, “What medications are you on?” My Dad started rattling off. It became a bit of a challenge, because he was on many medications, he couldn’t actually tell the specialist what was going on. This is a real situation here. An intelligent person, with certain amount of medications, and he was having a real challenge doing that. I felt quite guilty, because.. some preparation for him, and help him with that side of things, but I couldn’t do that.

After we went for that consultation, we came back home. I said, “Look dad, let me help you with this situation. Let’s just look at all the medication that you currently own at the moment.” They said okay. I said, where do you keep it? He said, “Okay, I’ve got some here.” He’s got all his puffers,he’s got his tablets, all this other stuff. I said, “Let’s get all that stuff up.” I said “Okay, we got some there as well in the fridge.” I went to the fridge, searched all the medication. Let’s get all of it out. Then my mom came in. She said there’s medication upstairs as well, in the fridge up stairs. Oh, really?

I go upstairs and collect all those medications and bring it down. Here we’ve got this massive pile of medications. I look at all that stuff. I go, “Wow, there’s a lot of stuff” I went through the medication. The first thing I did. I just checked expiry dates. There was 52 medications in total, more puffers, creams, tablets, all that sort of stuff, accumulated over the years. 26 had already expired. Straight away, that’s half of it. He said, “No, I’d still use that.” I said it’s expired 4 years ago. You got to get rid of it immediately. Then I take the rest of the medicines, there’s 26 left. Out of 26, 13 were not for him anymore, not indicated for him anymore. Their even substituted with some other medication.

He was still mixing the stuff up. This is an intelligent man, who’s got a very good sense of size and knowledge in medication, but that is the real situation of someone who’s 66, 67, 68 in the management of medicines. A very real situation. What I did, I helped him develop a drug chart, and then that was something again that he could take to future consultants, and have a bit more systematic approach to his health. Why am I saying this? The reason is this. When I heard about the home medication review, and before we talked about in John Jackson. I thought, what a fantastic thing.

These are real opportunity for pharmacy can evolve in this area, because not everyone has got a son who’s a doctor, that will come to specialist consultation. That’s not the problem, this is a real world situation. I look at the fact that we’re capping things like home medication review, and things like that. I really don’t see the sense of it. I really see that this huge opportunity for us to, not just increase the funding, but also use it rationally. These are real problems in terms of the quality use of medicines.

We keep talking about access to new medicines, but a lot better ways they can use current medicines, so that patients get the benefit. Normally, as I mentioned, the needs of patients is not static. We’re taking a snapshot right now, and say that the cost of healthcare is this. Let’s just keep it was it is. The needs of patients are changing. We know patients want better service from the doctors. They tell us, “We don’t want better doctors. We want nice doctors.” They’ve said that in medical curriculum are changing.

Even our selection process has changed. They want access to different choice of therapies. $4 billion industry in this country, 30,000 professionals, they’re going that way. They want to prevent this stuff. They want the complementary medicines. They want more information, they are seeking more information. I think I mentioned Dr. Google yesterday. The world’s most famous medical practitioner, Dr. Google.

It’s not only that, what’s really interesting is that patients are actually going to another source of information that they rely very heavily on, and that’s Dr. Blogger. Healthcare bloggers are actually not just influencing the way the information gave about medicines, but also how they use their medicines. Patients actually go into a blogger, seeing what medications they take, and then decided on whether I’m going to continue that medicine or not, based on the information of a stranger that they’ve read about online.

You got to say to yourself, “Well this is absolutely ridiculous. How can I do that?” Why not they listen to me? Why listen to me, I’m the doctor. I’m the pharmacist. I’m the one who’s giving them advise. Why their changing the behavior. We’ve got to understand the relationship and the connection that patients have with that blogger. That blogger is going through a similar condition, a similar illness. The stories that they tell resonates with the patients that have this illness. Ultimately, people want that, you want that. That’s what you want. That’s what you want from your healthcare provider, and you’re not getting that.

It’s only when you don’t get that, you go to someone who’s a stranger online and get that information. This is a very real trend. We talked about patients wanting continued access to medicines, pharmacy. Then one thing, all the other stuff around exercise and nutrition to help them with their wellbeing as well. What are the current challenges? We’ve seen lots of graphs, charts, etcetera. I’ve intentionally taken out all my graphs and charts for the very reason that you have very intelligent people present you with enough numbers, and graphs, and charts. You know the facts.

The way I see it is this. Hear what the challenges are in the current healthcare system. Number 1, we still have a system that does not really give us equitable care. There’s still an inequity of access to healthcare in different parts of this country. That for me, universal healthcare system is still the biggest challenge. Delivery is fragmented. If you go to a hospital, you get cared in the hospital. You can then go to your GP, you get a certain level of care, you get a specialist. There’s still not that great sense of communication and coordination between different parts.

You’ve only experienced this. You got one doctor, one GP, you got to tell your story all over again. You go to another GP, you got to tell your story all over again. We still have a very fragmented healthcare system. I just want to ask a question there. How many people have filled out their eHealth record? Show up hands. Fantastic. Leaders of healthcare, and we haven’t filled out our eHealth record. Here’s the thing. We’ve got to walk the talk. You seriously have to, because it’s all well and good to come up and talk about how bad your government is treating us this day and the other. eHealth records are a very good thing. They absolutely help solve the problem around this fragmented delivery of care.

Enormous amount of efficiencies and a great opportunity for pharmacy as well. I filled out my eHealth record. I did because of… thing is a very good idea. Again, this is an area that patients need helping. They do need help to be reminded, fill out your eHealth record. Come into pharmacy and do it. We’ll help you do that. Huge opportunity to work together with initiative that government is doing, and solved a lot of the issues in healthcare

Rising cost, we talked about it. Don’t spend about $140 billion. Many different figures has been shown. I think this is the only number that I’m putting in this presentation. It’s one of the figure I’ve got with 9.4% of GVP. It seems to be the going rate in an OECD country or developed nation for good healthcare system. If you look at countries like the United States, it’s 17.7%. $3.7 trillion being spent on healthcare. It’s completely unsustainable. Whereas this, as we say, seems to be the going way.

The reason people aren’t going to tell you, and reason governments never going to tell you that things are going okay is this. They want you to continue to find efficiency. They want you to continue to change. They want you to continue to adapt. They want you to continue to improve, so you continue to deliver the best service that you can to patients. While they’re looking for that reassurance, and it’s fantastic that community pharmacy aggrievance exist that 5 year of assurance. I don’t think that’s actually going to happen.

In my timing, 10 years ago or 7 years ago when I first joined the pharmaceutical industry, we were still stalking about finding certainty. Now, I come back and hear what’s going on, we’re still looking for certainty. You’re not going to get it. The best thing you can do is innovate, and adapt, and create your own business models..Aging population, we talked about the aging population, chronic disease and services, people like my dad. I’m putting a burden on the healthcare system, but with that, we’re actually are victims of our own success.

Let me explain what I mean. Cancer used to be a terminal disease. We had cancer, and many different types of cancer used to die very quickly. It’s now become a chronic disease, because of medications that we provide, we help people stay alive for much longer, and live a better quality of life. As such, in many different conditions, we now have a growing proportion of people with chronic disease. That puts a different kind of burden on the healthcare system.

A very big issues in our healthcare system is the inefficient allocation of resources. We are allocating resources … I’d say we spend on certain amount on state, we spend a certain amount on federal government spent. Again, we don’t have that coordination across the 2. We work in silos. Talking about the PBS, as good as it might be, is stuck in a silo. That’s the reason I decided to bringing up a big picture today, because I’m really very passionate about working across the silos and getting better efficiency across the silos of healthcare. We do have the power to do that.

The other thing that we focus on is very short-term measures. Again, whether some of the other people have talked about . When we’re looking at the healthcare the moment, we’re looking at cost, we’re not looking at value. We’re not looking at overall health outcomes. Can someone tell me what is a good health outcome for Australian Healthcare, what’s our target? What’s the goal of Australian healthcare for the next 5 years? I don’t know one. I don’t think any of you do. If we don’t have a goal, how are we going to get there? If we don’t have a goal for health outcomes in this country, how are going to get there?

That really is a big question. We have a goal for cost, but we don’t have a goal for return on investment, every other organization does. We need a vision, and we need strategy, we need goals. We can work towards them. Every stakeholder have talked to cluster healthcare ecosystem wants to work with better healthcare ecosystem, but we don’t know what the goal is. We focus on very short-term measures. They’re not real world measures. We look at hospital waiting times, for example. When I heard about the hospital waiting time issues, where people wait too long for healthcare services in this country.

What do we do? When you go to emergency,no more long hospital waiting times, now it’s going to be 4 hours max. You’re not going to wait longer than 4 hours in a hospital emergency waiting room. What happens? I know because I’ve talked to emergency doctors. Here’s what happens. Patients come in, within 4 hours, we get you into the emergency department. This time we’re not going to treat you. Before you we actually try to treat … The staff won’t treat you, we’ll just ship you off within 4 hours onto another ward, like a short-stay ward, or something else.

We’re really passing on to fix this short-term measure that we’ve implemented within the system. We really need to be looking at long-term outcomes in the PBS, we have to look at those outcomes, and in other areas of healthcare as well. If we keep training like this, we get some political wins, but we’re actually not getting any real wins in the healthcare system. Then we’ve got a system that’s really focused on disease rather than prevention, and really not looking at rook cause. A lot of people coming with stress.

A doctor, unfortunately, only has a certain amount of time to deal with stress. We’re not really getting to the root cause of it. We know that stress then goes on to cause cardiovascular disease. There’s implications and other sort of diseases as well. We’ve got a system that’s really focusing when people are sick. We’ve got a sick care system. What we need to have is a well care system, address people when people are sick, but also when they’re well. Why is this important? Look at how you manage your car at the moment.

You look at your car engine. Do always fix your car when it has a problem, or do you also take it for regular servicing to prevent it from having the problem? Similar when you to your dentist. Your dentist recommends you got to a dentist every 6 months to prevent any serious issues from happening. That will prevent any serious issues. Whereas in our system, we’re actually fixing the problem after the problem has already occurred, rather than trying to prevent problem. We really need to shift the focus of the system away from just disease alone, but more to the wellbeing and preventive side.

Albert Einstein have said, “Problems cannot be solved by the same level of thinking that created it.” The journey that we’ve got to so far has come from a way of thinking, a way that we’ve thought about our healthcare system. For us to move forward, to advance the healthcare system, we need a completely different way of thinking. Einstein used the word consciousness. In healthcare it would be health consciousness. We need a different way of thinking about our healthcare in order for us to move forward.

What is innovation all about? People get confused about innovation. The thing is, innovation is the next smart phone. It’s not necessarily a new smart phone. Innovation is that … I’ll keep the definition very simple. It’s something that’s new, is different, involves change or a form, and it creates value. You actually get improve health outcomes. You ought to get reduced mobility, reduced mortality, you reduce cost, or you generate revenue if you’re a for profit organization. Who do we doing innovation for? The stakeholders, either patients, or consumers, service providers, or the healthcare users.

At anyways you can involve anything, you can involve services, you can involve products. Often we talk about innovation, we talk about the next thing block buster drug, not necessarily the case. Particularly now that we’re not getting as many as blockbuster drugs that we need to innovate and how we got those drugs paid for but he ecosystem. While processes policies structured in business models.

Here’s a real thing about when we innovate, when we do something different. We tend to forget this side of things. When we innovate, there’s a lot of confusion, that can be anger, that can frustration, because there’s a big change that we’re not used to. We’re going out of our comfort zone. Instead you want to see the tone, and listen to the tone of all the speakers at this conference and a lot of people in healthcare, we see that. We see a little bit of anger, we see some frustration, we see a lot of these things happening amongst the medical practitioners, amongst industry, and so and so forth.

In this state leadership, and very often when you make some very big decisions. Typically, like in US, if I’m going universal healthcare, a lot of mistakes can happen. That happens with innovations, get used to it. What we said is best practice before is no longer best practice in the future. You can just imagine, what you’re currently doing is best practice, and you know for years, and years, and years, this is the best way to do it. Then someone comes along and says to you, “Hey, actually what you’re doing right now is wrong. There’s a better way to do it.” How do you feel about it? That’s the challenge a lot of you are going through right now in the healthcare system.

Ultimately what we’re looking for is a win-win. The win for the industry, win for practitioners, and win for patients. We’ve got to hold that as a guiding principle. Sometimes it’s a win-lose-win. One industry wins, patients win, but one part of the industry loses. That’s the reality of how it’s working today. Ultimately, I only considered the patient needs, everything else then comes out to evolution. What are some of the potential solution going forward? What are some of the things that you can take away, and use it in your organizations? I’m pretty much trained to go out on a limb here, and say here’s what we see as some of the future trends that are happening in the healthcare industry across the western world. He want to adopt some of these things, and think about how these might relate to the organization by all means.

First things is, first look within. If you’re now looking for a solution to some of the challenges you’re having, payment models. How do convince government better? How do we look at faster registration processes? The first thing I’d say is first look within. Very often, and studies have shown that the best ideas often come from our own customers. That’s one potential solution. Our suppliers, so people within the value chain. The shareholders within our organization as well as our employees.

Here’s a very strong source of ideas for solution. What is it I’m going to see happening? We’re going to see a huge expansion of integrated care models. I talked about a bit eHealth system. Any system that’s going to allow greater coordination of access between hospitals patients. This might be pharmaceutical companies. It might be medical practitioners as well. We’re going to see an expansion there. Government’s investing in that. They’re going to invest more in that space. We’re going to look at how specialist can get access to patients in the community. We’re going to look at how GPs can get that access to patients, and so on and so forth.

Integrated care is definitely going to be the way forward. We’re also going to see greater localized community care. We’ve already heard and think about how Medicare locals may not be around much longer. I think that probably will be true. I see a great amount of merit in having very localize systems of provisioned, of care that cater to local communities. You might have seen an area where higher levels of aboriginal population, then they had different sorts of needs, to areas in Eastern suburbs of Sydney.

When we have localized care, we have better quality of care. However, having said that, government have said they’re going to change the structure around how they deliver it. The great opportunity here is that, here’s a place that pharmacy can interact with, here’s a place where we can interact within healthcare systems better with community. I think the idea or the principle of a localized unicare system is the definitely the way we want to go. We want to push more services out of busy hospitals and more into the community, absolutely.

We’re going to see a lot of workforce innovation. If we look at the running cost of hospital’s about $25 billion, while 70% of that is starting cost. We’re really going to see how we can change staffing cost within the healthcare system, so we got to see a few things. Devolution, we talked about. The federal government, moving responsibilities away from fed government over to state government. That’s to remove duplication, and so state government have more flexibility. I believe that’s going to help it.

The other thing we’ve got to see is delegation. If you don’t get force delegation, I suggest you look at delegation. That is moving roles from the highly paid workers to lower paid workers. You might have specialist that… institute talk about moving endoscopies from specialist getting paid $250,000 to nurse practitioners that are paid about $60-70,00. That is a reality that could happen. I think really we are going to look at moving the workforce away from busy general practices or into pharmacies, such as task like vaccination for example, preventive health checks. I think a lot of that can be moved away from the more higher paid areas into the more lower paid areas within those efficiencies.

Outsourcing can be very controversial when you talk about government jobs, but absolutely necessary. What do I mean by outsourcing? There’s almost selling work over agencies or sending it over overseas, where you get lower cost and efficiencies. Is that even possible? Absolutely. Already happening now. A lot of your x-rays, when you go to a private sector are being outsourced and being read by specialist in India that cost maybe 20%-30% if what specialist would it for here. They’re even being done after hours, so you get greater access there.

These processes of an outsourcing are actually being done. If we live in a globalized world, which we do, you really want to be looking at how you can do that, particularly for your back end processes, such as accounting, IT , etcetera, a lot of ways of which you can do that in the organization. I’m really keen to see, and I think we will see greater concept to collaboration. We do a lot of work in the pharmaceutical industry, or in clinical research still. We do a lot of work around advocacy. We do a lot of work within the community. Same with health insurance, same pharmacy, that even pharmacy reserves $10 million in research funding.

I think the precious of a tightened healthcare budget is actually going to force us to look outside, and look in other sub-sectors of healthcare economies of scale. That’s really going to happen. I think it’s going to be a very strong thing. I think it’s going to be very positive thing, because we’re going to have much better ideas working with other sub-sectors of healthcare. I don’t think we do it enough at the moment. I think there’s real opportunities for health insurance companies, pharmaceutical companies, pharmacy, and other stakeholders work outside of each other to gain those efficiencies. I think that’s going to be a real thing, we’re going to see more of that.

I think the titling of budgets in this space is a good thing, because it’s actually going force for this to happen. How many of you are on Facebook? Show of hands? How many people are on LinkedIn? Great, okay. We’ve got a handful of percentage of people that are on social media platforms. It’s not just social media platforms, it’s just the whole digital revolution. Healthcare is particularly bad at utilizing the digital technology. We keep talking about how we don’t have enough funds to do a lot of these things, marketing space. A lot of this stuff is of a tiny fraction of what we’re standing on right now. We just haven’t been forced to look that way.

There’s a great degree of adoption. There’s a great degree of adoption by professionals in phase. We’re not using these platforms as well as we can be. Absolutely not. There’s a lot of opportunity for your organization, to do your current jobs, and do what is needed. Patient sector engagement, they look for healthcare information here, and they’re not getting enough from credible sources like you guys. There’s a lot of opportunity to spend more time investing in how to use this more effectively.

The other key thing about social media platforms is that we know that public health education works. The biggest healthcare challenge in this country, obesity related conditions, alcohol related conditions, and smoking related conditions. Costs are about $70 billion, those three things alone. They’re all behavioral in way, if you look at the essence of what they are. We know how public information works, or we looked at things like melanoma skin cancer. The rates have dropped by 10%. The Slip Slop Slap has all been working over the last 10 years or so. Again, here’s this huge opportunity, use this platforms now and adapt for the future.

We looked at personalized health information technology as well. People want to get more personalized with their healthcare. We’re seeing a lot more wearable tech. These things are like wristbands. How many people heard of the Fuel Wristband by Nike? It measure the amount of steps that you take. It get very effective, can be used for conditions like obesity. Apps that we can have on our smart phones measure food calorie intake, etcetera. A lot of these things are really coming to the full.

We talked about personalized medicines. I won’t cover that anymore, because personalized medicines really talk about genetics and how we can target some genes that predispose as certain diseases in order to influence health and wellbeing. We don’t talk so much about personalized health. What do I mean by personalized health? Where technology starting to come out and we’re inviting some companies in the states around the area of personalized health. Then these technologies that actually going to look at epigenetics.

Epigenetic is how the environment is currently affecting your healthcare. What do I mean by environment? That sis the food that you eat, the light exposure that you get, the people that you’re around, the amount of stress that you have, and how much you, as an individual, can actually experience before you produce disease. That comes from measuring things like arm length, leg length. The don’t even have to do your DNA sample anymore. They can just take a bit of a history, look at your cultural origin, and measure some things about you, before coming to personalize heath. This is what we’re going to see moving forward.

I’ll run through it rest of it.. We’re going to see more on the space of integrated I’ve talked a bit about that, traditional Chinese medicine are better. Countries like India, and China, and 2 billion people can’t be wrong. There could be something in it. The reason is, particularly in western countries have all these data in English. We discount the fact that they actually work. We really need to look at that. Again, do a multi practitioner consultations. The system really needs to adjust so that you can see your doctor, your pharmacist all at the same time, and get reimbursed for it as well.

We talked about pricing and value of healthcare. They key important here is how do we measure success? If we don’t have a goal, how do we know which way we’re going? We talked about innovative payment models. I do have an opinion on this about free healthcare systems, and that comes from really talking to a lot of doctors. When I say to them, “who are your best patients?” They said private patients. I said why. “Because they’re paying for the service”

When we think about end game, what the end game here? The end game for us is we want to help people get the best healthcare and value your own healthcare. They get that, and they feel like that. We know a lot of psychology comes from that when they pay for something. I’m not saying everybody should pay. People who can’t afford, they shouldn’t pay. We should have those protection they just in place. I don’t think that paying a little bit for your healthcare is necessarily a bad thing.

We talked about leadership thinking for the future. I think we all got to change the way we think, particularly in leaders. We’re all leaders in this room. I really do think we’ve got to stop looking at it from a patch protection way. How can I protect may patch more? Look at the best patient outcomes, and how can it work with other sectors of healthcare to deliver those outcome. I think that’s the big thing. Very important, the soft stuff and relationships to a degree would lost the trust. Some sectors of healthcare have lost the trust of public.

I think that relationship with the public really needs to be restored. Great transparency is required. One of the reasons we’re recording tonight is so we could put it out there and just have that conversation with people about what we discussed in these rooms, so people are actually aware of what’s going on. I think the public needs to know what we do in these sectors of industry. They don’t know enough. They’re not educated enough in this space. Particularly, we need to rebuild that culture of trust.

It sounds like a soft thing. Trust, a bit airy-fairy, it’s a big kumbaya, but we know the economics of trust is this. When you have greater trust in the system, you increase fee and you reduced cost. When you have 2 parties doing business together, transacting together, and there’s a high degree of trust, that transaction appears much faster, and the cost of that transaction also is reduced. There’s a lot of things that you can do to improve trust. I suggest you read a book by Stephen Covey, called the Speed of Trust. It’s a very good powerful book. It’s a global best-seller. It really talks about active things that you can just increase trust in the organization.

Finally, I’ll just cut short on the future solutions for Australian healthcare. We’re involved in developing a whitepaper for all the future solutions for Australian healthcare which interviews 20 of the top leaders, CEO of Australian healthcare. We expect that this can be launched at the future of Medicare Summit in August. In order to get updates for that, all you have to do is just go to this website, and subscribe to that to get an update for when the paper will be released.

Currently we’ve got Professor Ian Frazer, these are people who have committed. Professor Ian Frazer, Professor Stephen Leeder, Dr. Martin Cross, Chairman, Medicines Australia, a few pharmaceutical CEOs, a couple of health insurance. Mr. George Savvides, John Bronger form the pharmaceutical society, Dwayne Crombie from Medibank BUPA, and also for not for profit. And we’re continuing to get that data. That’s really going to give us, one-on-one interviews with all these leaders who said to us “Here’s what we think needs to happen moving forward.”

That’s pretty much it from me. I just want to need some of the contact details if you want to get in touch. If you’d like to find out exactly when is white paper comes, just send and sms with your email address to that number and you we’ll let you know when that happens. That’s pretty much it for me. I hope that was useful for you. I hope that you were able to take just 1 or 2 things that you’d be able to implement in your organization tomorrow. Thank you.



Do you have the ‘Entrepreneur’s Curse’??

In my role, I help CEO’s and Entrepreneurs in the Healthcare and Wellness industry, often when times are very rough. In some cases their companies are financially cash strapped and they are almost broke.

For the CEO’s of larger companies, stress management is just as important as strategy management, and so I help them in both of these areas.

However, for the smaller organisations, I note a very similar behaviour pattern or condition that I have noted several times in the past. In fact, it’s a condition that I have also been afflicted with in the past.

The condition is called the ‘Entrepreneur’s Curse’.

To understand this curse, first you have to understand the mindset of an entrepreneur. An entrepreneur is often someone that is optimistic and full of bright ideas. A true entrepreneur has the courage to take some of these ideas and turn them into viable businesses.

However, what happens very often is one of two things:

1. Before Business no. 1 becomes a success, the entrepreneur has already started working on business no. 2 (and possibly even business no. 3)

2. Within business no. 2, the entrepreneur has already dedicated his or her limited time to a multitude of projects, tasks and activities, all of which are ‘good ideas’ to him or her, but do not necessarily align the with cash flow requirements of the business

3. The entrepreneur has spent so much developing new ideas (the exciting stuff), that he or she has not focussed on the MOST IMPORTANT AREAS OF FOCUS and developed that ONE BUSINESS to become the greatest source of income and success.

In short, the entrepreneur has spread himself or herself too thin, to point that the business never really succeeds and occasionally reaches a point of failure of bankruptcy.

In effect, this curse is actually a ‘blessing’ or ‘gift’ as the ability to continuously generate great ideas is a special ability to be cherished. However it does have a major downside if it is not checked.

In the last few weeks, I have particularly come across several entrepreneurs that are experiencing this ‘curse’.

One entrepreneur in particular had experienced a repeated set of failures, from office supplies, to property failures and subsequently wanted to start a range of healthcare products.

In most circumstances, while I strongly encourage greater entrepreneurship in the wellness industry, in this case
I actually advised him not to do it. It would have made his problems (and his debt) even larger and he needed to focus on more near term business growth opportunities.

Here’s the thing – if you haven’t learnt your lessons from past failures, the universe will keep hitting you over the head with the same lessons until you learn them!

Everyone has a unique set of stories and business experiences when they come to me and its important to identify what an entrepreneur really wants in their business and in life, before providing advice of any kind. So here’s a few pieces of general advice if you think you may be suffering from the healthcare ‘entrepreneur’s curse’.

1. It still surprises me how many business owners, particularly in healthcare, have not set themselves a financial goal. One tip I can provide here, is make sure you have set financial targets that are aligned with your business values as well as how you truly define success and happiness in life.

So many start up entrepreneurs want to create a business dollar company, yet very few actually do. If you have set a big goal – great, but ask yourself – does it really have to be a billion dollars?

Start with a more short term goal and work your way up from there. Your financial goals will help you determine a more focussed strategy for your health business.

2. Get OBJECTIVE advice on how your personal performance and business style affects your business. There is a tendency to rely on friends or family or occasionally, one-off advisors and whilst this can be helpful, solving these issues, especially when the business is in financial trouble, requires more intense support.

In my experience, a solid Advisory Board can help but more importantly I have found regular business coaching or mentoring to make the most difference. The reason for this is that entrepreneurs can get distracted VERY QUICKLY, even daily, and such there needs to be that sounding board to be there as regular as possible to get this back on track.

A good coach can save you millions and help make you millions, depending on the size of your business. Therefore I strongly recommend paying for a professional that is willing to accompany you on your business journey long term.

3. Finally, I would also strongly recommend mapping out all your projects , major tasks and activities on a simple project mapping tool like Basecamp (hyperlink to

It is incredibly insightful to observe how many projects & activities you may be currently in, what may bring you short term revenue and which are the longer term options, in order to strike the right balance for your cash flow forecasts.

I recall conducting this exercise with Energesse and at one point we found that we were way overcommitted on the number of initiatives that we were involved with and actually ended up scrapping or holding off half of them!!

So, in summary know that your entrepreneur’s curse is also your gift. However, be sure that if you want to help as many people as possible with your healthcare and wellness organisation, then you need to be AWARE of how you are managing these sides of yourself and how it affects your business.

When was one time when you experienced the ‘Entrepreneur’s curse’?