For more information, visit matter.health and follow us on social:
Speaker 1: (00:11)
Hello, everyone. Welcome to matter's signature tales from the trenches series. My name's Steven Collins. I'm the CEO of matter. We are a healthcare technology incubator and an innovation hub with a mission to accelerate the pace of change of healthcares, uh, tales from the trenches is our longest standing series here. At matter, we're accomplished entrepreneurs share their journeys from how they got started to what they've learned along the way. And today will be joined by Aaron Bali. Who's the CEO and co-founder of carbon health. Uh, Aaron's a serial entrepreneur. He is a passion for human rights and it's become really his life's mission to address disparities in education and in healthcare to inspired him to start Emmi in 2010 and carbon health in 2015. Erin, thank you so much for joining us. We are really looking forward to hearing more about your journey and the promise of carbon health.
Speaker 1: (01:06)
Leading the conversation with Eren, is Dr. Suzette McKinney. She is a principal and director of life sciences at Sterling bay, and more importantly, she's a matter board member. Uh, Suzette has held a variety of public and private sector, healthcare leadership roles. She is a nationally recognized expert in emergency preparedness and response. Um, you may have seen her on CNN or NBC or ABC, or recognize her name from the wall street journal or the Chicago Tribune where she's been featured. Um, Suzette, thank you so much for, uh, joining us today and for leading this conversation and I'll, uh, turn it over to you now.
Speaker 2: (01:48)
Great. Thank you Steven, for having me today. Thanks to you also, thanks to the larger team at matter and Erin. Hello and welcome. It's wonderful to have the opportunity to, uh, speak with you today and learn more about your entrepreneurial journey. I think the first thing I would say is, you know, the tales from the trenches series is really designed to, you know, dig deep into one's personal story and their background. So that's what I'm hoping to do today through this conversation. So why don't we jump right in? And the first question that I'm going to ask is when did you first become interested in entrepreneurship?
Speaker 3: (02:30)
Uh, first of all, thank you much. SuElle for, uh, just having me here, give me the ion to this speak. Um, I did not grow up as in like within entrepreneurial mindset, to be honest because I, I was born in a small village in Southeast part of Turkey, essentially, 19 9%, the, my family, we were like farmers. So my, my mom was a teacher. She was, I think, first college educated person in our family. And I was very interested in mathematics kind of growing up. So that was essentially my ticket to, um, get out of the, the village and do some more interesting things. But, um, but I, I started in college. I thought I was going to be a mathematician, but when I was first started the college, I, the, our college supported double major. So instead of just studying mathematics, I studied computer science and mathematics together, and I was very interested in building things.
Speaker 3: (03:26)
And this was 2000 in Turkey where I had no idea what the startups are. Either had no idea like this company is tech companies like, um, she said they had no analogy. I didn't even know that the Amazon like, is that real company. I thought it was just somebody's website. Right? So, um, but second year in college, I did not own a personal computer. So I was just using the, the computers in the university labs. So were just kind of camping there. I was staying up till 2:00 AM every night. I was very interested in programming, like building things. Um, and I had to go for an internship over the summer. Um, and when we go to the internship, like we wouldn't have our computers because we have to now use the corporate computers, which are very kinda strictly guard that like, you cannot install anything.
Speaker 3: (04:13)
And I like listening to music. It's um, I built a browser based music player, uh, so that when I go to my internship with the company, we can, I can continue to listen to music. And this was 2001. So like the concept of building like reach media application was just like a nonexisting thing. Like, this is just rough when Napster was happening with Napster required you to install software, which means like it couldn't work running on, on the, my employers, um, computers. So, um, so, so the, so I build like a browser base tool from very little, like kind of simple components, and you could just make a playlist for yourself and you could add music. The music and I had to admit was not really copyright necessarily. So, uh, but so that was a very fun. And when I built it, I opened it to other people and it became used by so many people and the, the campus that the university to shut it down.
Speaker 3: (05:07)
So, but I kind of realized I just enjoyed building products, um, more than just academic nature of mathematics. So, and I think for last year in the college, I knew I was well to be, I want to be an entrepreneur again. I just didn't understand the Silicon and valley like venture fund, the technology entrepreneur concept. That that concept was just, I had no idea that it exists, but at this, in the last year of college, I said like, I wanna have a small company, maybe build products for people and sell it. So in, in very, very small scale, um, I, I decided last year and like before I graduated, I started my first company. And I think this is one of the things I just wanna want to understand is like here we are priv to like the understanding of large tech companies. You can start something, it'll be huge. You can be the next at ELAM Musk. Like Zerbo like that actually, like, at least when I was growing, I was not like, like IV nobody in my area, like even removed and knew that this was like an op, like this was a possibility.
Speaker 2: (06:06)
Sure. Wow. Well, you talk about liking to build things. Um, so let's, let's dig into that a little more. I mean, you, first company that you build, U Demi is one of the leading online learning platforms and you started that company in 2010 and it now offers more than a hundred thousand courses and serves 60 million students. Mm-hmm for our audience. I would inform them that the company went public last year with the large market cap. Well, what was the Genesis for you building that company?
Speaker 3: (06:39)
Yep. So, um, I, I, I started using actually a lot of early, like 2010 is a foremost our company in Silicon valley, but, um, it actually goes a little further in 2006, six. I attempted to build that company in Turkey first. Uh, the Genesis was my belief that in the future internet will, will become everybody's primary learning destination. So, and the reason I thought that way is because I grew up in this small village where my teacher wa my mom was the only teacher in the whole area, not just our village, like she was in the, the next, like for like 10 villages around, she was the only teacher she would rotate between classes. She would teach first grade, there is something and for 10 minutes and switch the second grade, there's third grade is fourth grade, fifth grade and come back. Right. So, so obviously it was not really the place you could get the bad, best education access education.
Speaker 3: (07:32)
Um, and I was very interested in mathematics, but really I did not have a lot to do with my mathematic interest. So, and this changed is always changed when I, I was a little bit older and my, um, so, um, , so my family, like we, we were living the village and over summers, we would actually work in a farm, just kinda make the ends meets because my, my father had the eight siblings and his parents died really early. So it was just really three siblings and like seven, seven or eight and uncles and aunts. Um, so over, over summer, we'd actually worked together in a farm, uh, with most of the time it was just pale and meat. And this was one year when we got some extra, like the, the produce became like larger than we thought. And we, I, my, my father had like disposed income for the first time.
Speaker 3: (08:24)
Right. So, and he's doing his goal was to kind of take everybody to a family vacation. Uh, and, but then I kinda lobby to kind of buy a computer instead. I'd never seen one, but I just knew it was like just the, the bridge to the rest of the world. So my mom convinced him. And so we bought a computer and intern Texas for a couple months. And like, at that point I realized, like I found all those IRC channels. Like if anybody remembers IRC here where people were discussing kind of more competitive mathematic problems. And I started self teaching, myself mathematics and long story short, I ended up winning the gold medal and turkeys nation met opioids and silver medal and international opioids, mostly like self teaching myself using whatever I could find online. And I'm not saying this just kind, kind of really brag about it.
Speaker 3: (09:12)
Um, but to me, like, it is critical to understand that billions of abuse of people in the world, like having access to intent or not like, can be a really binary, uh, drive like outcome. Right? So for me, like if I didn't have access to internet at that age, like none of those would happen because those things opened other doors for me. So especially even my personal like, experience, I kind of thought internet was not gonna be completely make everything equal for everybody. It, it was not gonna create like fully equity team, but I decided to have such, I had a chance to kind of create, um, portion for people to catch up. So, and I have a still in Turkey, I decided to build a product which would allow to teach online so that my goal was maybe one day, I dunno, hundreds of thousand of people teaching online on my website, so able was gonna have access to education.
Speaker 3: (10:04)
Initially, I thought it should be a free platform. So I started company in Turkey that didn't work. Uh, just, there was really no ecosystem in Turkey. Like not many people were online, honestly, even the bandwidth like technical infrastructure was not there. So we had to shut that down. And I moved to Silicon valley initially because we had borrowed some money to start a company. So the concept of raising funding, we just didn't exist that much either. So we had to borrow money to kinda start the company. So we had to just pay it back. So I came to Silicon valley to kind of take a job and pay, pay the debt back. And, and, but here I realized like that the whole world was very different. And in 2010, kind of, we restarted the company in Silicon valley. So my co-founder from Turkey came back, came to Silicon valley and we met another co-founder named Gianni. So Okta Gagan, and I, we just kind of restarted the company and this time, like, again, it was not easy. It still take, took us a long time to get it off the ground. But eventually we got some traction, we got some angel funding and company became a reality. So, but it was a, there was this like a four or five year that people don't know about the company system became, it became an official us company.
Speaker 2: (11:11)
I appreciate you sharing that story though, because I think it's important for all of us to understand that these types of things don't happen overnight. You know, there oftentimes can be quite a long period of, you know, blood, sweat, and sometimes maybe even tears to get to where you're trying to be. So you started out in education and then at some point you pivoted to healthcare and started carbon health. Tell us a little bit about what the inspiration was for starting carbon.
Speaker 3: (11:42)
Sure. So you gave me like eventually in 2015 or so it does, it was a sizeable company. It was definitely, it had escaped velocity. So I thought, I thought back then that like the right thing to do when the company, you get some success and you're an inexperienced founder, like I thought the right thing to do was really just finding new CEO to 50 company to next steps. Right. So, um, I, I stepped on and at the point I was, and, but I had this thought about healthcare being the, the probably even bigger problem when it comes to just giving people access to changing their lives. Um, I was always again interested, but I had, I had no idea where to start. And before I kind of stepped on, my mom had this disease called neuropsych, which essentially resulted in her entire body to have kind of stroke.
Speaker 3: (12:33)
Right. So, um, and I had to take a couple months of work, move to back to Turkey. My sister's a physician, she's an nuclear medicine specialist. So she had lined up a lot of specialists to get a check what was happening. And I was that, not that useful, to be honest. So, and I started observing them that, like my sister had printed out S of pages of documents from the EHRs. Like she printed out all the labs, she was highlighting everything. She printed some screenshots from the pet scans and MRIs. So cataloged them nicely categorize and put some notes around it. And we were going from specialist to specialist and I made the observation that like shit to do all this work, to organize the data because data, it was not really, the EHR did not really properly model the data in the first place.
Speaker 3: (13:24)
I kind of saw how bad the tooling tools that the doctors were using were mm-hmm . So I, I, being an engineer and designer, I actually sketched out, uh, some, made some sketches about how I would build an healthcare care platform if it was, if I was asked to do right. So I just made some sketches left it, there, went back to United States. My, my mom recovered. So honestly we didn't like pay too much more attention to it, but several years later, like I just came back to that, those sketches and said, somebody like doctors are, some of the doctors are probably most scarce resources of the world, right? So, uh, every single country has, is like a big invitation and they are being using horrible tools, essentially. We're optimizing Uber driver, like taxi drivers time a lot more than we optimize physician's time mm-hmm .
Speaker 3: (14:13)
And it just didn't make sense to, to me, I just said like, we, I should just be the better product tool for them. And then, and when I was kind of working on it, I realized there was a even bigger problem, which was that really the tools were bad, but also there were operational issues. There were other workflow stuff. Generally healthcare was a very complex operational service industry and it required a more technology centric approach to, uh, approach and was really disappointed me was there were all the startups show in the intersection of healthcare delivery and technology, but they were all trying to be healthcare provider for Google employees. Mm-hmm and nobody was really trying to like make healthcare better for the average average teacher, average retail employee, the more mass market population. So there was way too much emphasis on improving care for young affluent techies or like people like that, like not enough in like mass market services. And there were things like RO care solutions, which are obviously more mass market, but like, I was just really thinking about it just broad, like having physical locations, just more like a comprehensive care. So I thought, okay, the bigger idea was really building a extremely virtual integrated healthcare provider that can make healthcare like 10 times better for consumers without increasing the cost at all. So that, that just simple idea. Just I said, I realized was like a potentially, could be potentially one of the largest companies in the world.
Speaker 2: (15:36)
Sure. Wow. That's fascinating as well. Let's um, I mean, let's talk a little bit more about the success that carbon health has had and you know, what your vision is moving forward. So, so far for carbon health, you've raised more than 500 million so that you could scale the company mm-hmm , you now have more than 100 locations and what seems to be, you know, continuously growing fairly rapidly. And you've also acquired other companies like alerted that are working in the telehealth space, um, and, uh, steady health that's working in, in diabetes care. What's your vision for healthcare and Omnicare, uh, care, omnichannel care, I should say.
Speaker 3: (16:21)
Yeah. So division was really creating a healthcare provider that, that, that, that can create the blueprint for the future of healthcare. Okay. Cause we all have ideas about how healthcare's gonna happen in the future, but we are very far from it. Yeah. And for, for future of healthcare to happen, somebody has to lead the charge and do some of these things one or two decades before everybody else replicates. Right. So kinda part of the really broadest vision was like, let's just really figure out how let's really create blueprint for like healthcare's future. And we specifically wanted to start in the primary care side, could broadly primary care because most consumers, first decision in healthcare is a primary care or urgent care. In my mind is a part of primary care in my mind, not as a OUS health mental's health, these are all primary care.
Speaker 3: (17:12)
So we kinda want to start from there. Um, and we actually start really small. So we only raise couple million dollars. Um, and we, I brought together a physician engineer designer. It was me, we had a nurse who joined us as a first team, and then we rented an office space to work and we separated top of the office to be a clinic primary care clinic. Okay. Here we could be from scratch. We built a primary care clinic. And I actually, we did not use an ATO party EHR because I knew they were horrible. We said, we are gonna build everything from the ground up. I actually made four B to even look at other EHRs. So I said, we, we just, we, we have our clinicians and nurses and patients we'll just figure out everything from first principles. So we just, we worked for a very long time in a very small scale.
Speaker 3: (17:59)
I think in 2016, we started 17. We started having the same first patients in 2018, we partnered with a small urgent care chain in San Francisco to kinda do this on a larger scale, um, and became like more vertical integrated. But really we took at least three years optimizing the workflow, the, the providers, the medical staff, uh, patient experience. We just really kind of first wanted to prove that this is a, we can provide a better patient experience. Then we have to prove that we can do this while maintain an amazing provider experience. Then we had to prove that we can do both those things while having reasonable economics so that this is not a Philto because this company has a scale. So that has to be kind, it has to make enough margin from services so that we can kind grow this. So it, we took it is three years without really scaling that much.
Speaker 3: (18:50)
Right. So we just optimize, optimize kind. There is more money in that process, but like, it does a lot of like iterations. And by 2019, we finally got to a place where the core three things we' working like you took economics were working prior experience was working, patient experience was working. Then we just decided to scale open at more locations. So since 2019, we have been grow growing very fast. Like we had seven clinics in 2019. I think we got to something like 40 year after now we have 125. As of now we are adding three clinics per week, most, most weeks. So you'll probably get to, um, like 250 by the end of the year. So when we, by far the fastest growing healthcare provider, um, but part of it is because we took our time to optimize before we started scaling really sure.
Speaker 3: (19:39)
And really kind of acquisitions are just part of it, right? Because we don't see ourselves as a primary care network or urgent care network, to be honest, or like we do mental health as well. So we have a lot of different services, but like the more tactical vision was let's just build a, a 21st century version of Kaiser Permanente. That's really what you're trying to do. We'll have more broader set of services. We're starting from primary care, but PRI Kaiser's model is extremely heavy. It requires hospitals, insurance plans. It can only like work very small number of cities. It's really hard to replicate and distributed. This is what we are doing is we're trying to be at the primary care layer, which is nationwide. And then we are getting deeper and deeper as needed, but we don't have to do everything. We are also very open to partner with other other providers, right?
Speaker 3: (20:26)
So we partner with other providers with stand patients. Uh, we kind of integrate with them. So we health system partnerships. We have, um, like honestly other kind of platforms, but the idea is like to build a very, um, tightly integrated network of providers, which are really collaborating to provide care to the patient. And eventually we want to also take full risk on the patient's lower cost care. So, uh, we want to have partnership with the plans or even launch our own plan for individuals, but we, we, we do want to provide some of the services, service level services directly partner with other providers and really kind of capture the total economic and so that we can actually carry to clinical care without having to get permission from insurance companies.
Speaker 2: (21:08)
Sure. I love the way you describe your vision and how you've approached your work. I mean, what jumps out to me is that you're both a visionary and a disruptor. Yeah. But as competitive as healthcare is, and can be at times, you really understand the value of collaboration and how that collaboration can really seek to, um, maximally improve patient care. I think that's fantastic. So what does the future of carbon health look like? You know, talk to us about perhaps your, you know, speaking of collaborations and partnerships, what about your partnership with him and hers health, um, and how that seeks to improve the healthcare and partnership ecosystem?
Speaker 3: (21:52)
Yeah. So when we think about the next like five, 10 years for carbon, like again, technically geographic expansion, we are going to become the first nationwide primary care network. But, and when I say primary care again, it includes urgent care, brochure care, like someone who got more services and chronic care management is an important part of it. That's why we be, be acquired steady health. And we now like actually last week, this week, uh, announced the carbon diabetes program, which integrates continues glucose monitoring and all other channels. So literally geographically expansion is the first thing we are doing in parallel. We are trying to create a much more comprehensive primary care solution, which we call omnichannel care. What we call Omnicell care is really meeting the patients where they need to get care and always holding the, their hand throughout the process. So if you come to our clinics and wanna join our primary care panels, but you have diabetes and hypertension, and maybe you have a anxiety problem, right?
Speaker 3: (22:47)
So we don't want to just kinda say, okay, this is out of our scope. Just go find somebody else. But instead of due is like for diabetes program, if you're eligible, we give a, put a continuous glucose monitoring sensor on your arm. We figure out how to get, you can reimbursed for that. And then we are actually oversee your care. You go home, you open our, you, you open your patient application and log your meals. And other symptoms you're seeing such as a very comprehensive program, which has virtual in person hardware, like all those different modalities. And we are trying to think integrate them so well that you almost never worry about what's next mm-hmm . So that that's an example type of thing that we do everything inside carbon, which we, this is what we call Omni mission healthcare, but no matter what we do, we are never gonna manage all due care for everybody, right?
Speaker 3: (23:35)
So we have to just pick our battles. So internally we are more focused internally on primary care, urgent care, and just chronic chronic care management, especially for diabetes, um, hypertension, and two, three other kind of chronic conditions and mental health, right? So you're just providing, building those services directly, this, the service expansion. But simultaneously we are trying to partner with other healthcare providers to create a more seamless experience for our patients. And this comes in couple forms. So one part of it is we partner with health systems for really acute care, right? So we had partnership with Stanford healthcare freight that we announced last week, John Muir, prime health. We partnered with north bay health. So, and we are actually adding these partners very quickly and we build deeper integrations with them. So when our patients need a transplant or like orthopedic surgery, they can be very seamlessly channeled back there.
Speaker 3: (24:25)
And then we can just get their medical records back to carbon. So, but there's the other side of the, the table is when we are the escalation point for most virtual care companies. So if you use HIMS and hers and you to see a provider in person, they do not do that. They're like real good at the virtual, like their service times such as they send patients to us. And we have a nice kind of care collaboration. And this is very important because everybody talks about how interpretability was broken in traditional healthcare system. But the reality is digital companies, digital healthcare providers have not done better. Digital healthcare providers are just as disjointed as traditional healthcare providers. And because we are building all those really expensive physical infrastructure, one of the things we said is like, it doesn't make sense for everybody had to, to build the same physical infrastructure, because it's very expensive. All these different virtual care companies, all the remote patient monitoring companies, all the, uh, home diagnostic companies, when they need physical access, they can use our physical footprint. And we, we software during companies, we can actually connect with their systems easily, right. So essentially that is like started him and her. But, uh, there are gonna be a lot more companies where we become the, uh, in, we become the physical access network that they can easily integrate with.
Speaker 2: (25:47)
Sure, sure. Well, you know, when we started this program today, Steven and his opening remarks talk about matter and matter being in health, a healthcare incubator, and I'm sure that the large majority of our audience today are healthcare entrepreneurs. So I want to, you know, focus a little bit now on, you know, just your thoughts around, uh, entrepreneurial, uh, entrepreneurialism, I would say. Um, so I guess the first question I would ask is what do you think, um, is the biggest entrepreneurial mistake you've made and how do you make sure that you don't repeat some of your past mistakes that you've seen in your entrepreneurial journey thus far?
Speaker 3: (26:33)
Yeah, I would say there are a lot of them in different stages of my, uh, career. So when I first started UDI in Turkey, the biggest mistake we, I was making was confusing. What is technical hard as an engineer to what important? Sure. So we first started using me with a live education platform mm-hmm and I thought that was a feature, but that was part, even though there were a lot of signals saying otherwise, partially because building a live classroom tool was just more technological and difficult, right? So I think in healthcare, this happens all the time. People are trying to build some, so when they have a hard problem, they think it means a solution has to be some like really complex software. But the reality often, like the most practical solutions are like SMS integrations or like some really simple things. It just happens to be the right time, right place like integrated right way to the care.
Speaker 3: (27:27)
So it's really just separating difficult problem solving like importance is very critical. So that was when I was really just started my first company. And, um, one of the other things I learned when I was doing Udimi was important lesson is that you ha you cannot think of product and distribution as two different things. You just have to design distribution into product from day one. Like, so that means like, you have to understand if you're building a solution, how are you gonna distribute it? And sometimes when distribution is very challenging, what you have to do is understand what distribution channels are viable and really think about what kind of product you could build that actually integrated, like that actually matches the distribution. And sometimes actually even go the other way. Because as an example, a lot of healthcare entrepreneurs are building solutions that they just had to sell to large issues companies or hospital systems mm-hmm , and that's really, really difficult.
Speaker 3: (28:27)
There's a pilot talent healthcare, a lot of companies die before they get out of pilot. Right. So that's very difficult. So, and that's like, like, if you have to do that, for sure, you just have to have four or five years of runway, a lot of stamina, because you're gonna go through a really slow process that that distribution channel is, is difficult unless you happen to some unfair advantage, like maybe, maybe you were the CEO of Providence health and like, you know, everybody like, like that might be the first situation, but for normal entrepreneur, that's just not gonna be the case. So you just have to understand in healthcare, like how are we going to distribute the general solution? And you have to understand what makes your solution is easier to distribute. And you have to be able to be that way. The reason we chose primary care, even though primary care is not one of the most expensive parts of healthcare was because I want to get a lot of patients by providing amazing customer experience.
Speaker 3: (29:22)
Right. That was gonna be the, our edge. If I build, if we built a neurology service, it wouldn'em work because consumers may don't make a lot of neurology decisions. They, they pick their primary care doctor and put a primary care. Doctor refers 'em to neurologist most of the time. Right. And most of the time also there's the coverage were limited. So they don't even have a lot of options, right. So it's not a, if you want to win by providing better customer experience, you just have to pick something which is a consumer decision so that you can go right. So like, we really change like how we start at tackling based on where we think like our strength can brings distribution. Right? So I think this is essentially enough. Think about distribution, essentially team about distribution after product is, is the biggest mistake. And, and in current rate, if you look at serial entrepreneurs, people who have success, certain, multiple successful points, that's the biggest difference between what they do. And not first timers is like, they know distribution has to happen. So they think about it before even they can finalize the details of their product.
Speaker 2: (30:22)
Right. You talk a lot about, um, starting out in Turkey, um, clearly you're very proud of your Turkish heritage. I am interested in hearing about your experience coming from Turkey to the United States. Has, uh, do you think that perhaps being an immigrant has made it harder to build a business here or does it not make a difference?
Speaker 3: (30:46)
Yeah, look, it, certain of makes it harder. And I, uh, uh, like there are, it was definitely intimidating experience to be in another country. You very don't speak the language as well as everybody else. Uh, you're an accent. Uh, you also just kinda hard to like Chi chat with other people and you feel less confident in the room. So that was definitely, uh, a friction. But on the other hand, I just don't want to undermine that like United States with all its faults is still, it's still something not to, uh, take it for granted, right? At least as an entrepreneur, even though it was harder than probably somebody who was, who grew up in the United States, it was possible in reality, in Turkey's a lot harder to start a successful company if you're not already coming from wealth. Right. So a lot more of the tech companies in Turkey were actually start until recently were started by people who are already like major business owners and families who, which can control the country and major of the country. The world actually works that way. So, so I would say, yes, it's not perfect there, immigrants do a lot more challenges that maybe natives people who are born here don't experience. But also, as I said, it is, it is not impossible, so it's difficult, but not impossible. So I still essentially appreciate the opportunity I was given. Um, so while still trying to make it better for like easier for the next, next, next entrepreneur
Speaker 2: (32:13)
Mm-hmm well, what advice do you have for entrepreneurs that are listening in today or perhaps those that are just starting out?
Speaker 3: (32:22)
Yeah, there is a lot, but I would say there is the reality of the role like that they have to face as early as possible because it is unfortunately not fair, right? So everybody starts in a different angle and if they, your jobs, your experience, honestly, even your family relationships, all those things do kind of influence things and they give advantages to kind of certain people. But on the other hand, it's not a, like, it's not a human, right? Like this is not, you are not expect like the not everybody's gonna have a very successful large scale tech company. So this is one of the things where like, look, there are certainty things that you have to just assume that you deserve, right? Like everybody, I think, deserves accessible healthcare, good education and setting childcare has universally accessible. So there are some of this things are which we has to be humanized, but starting companies always gonna be extremely competitive and over, and some other people are gonna be ahead of you.
Speaker 3: (33:28)
So I think, I think it's important to understand like your strengths and weaknesses, and really be realistic and realize that like your chances of success is not very high, but it's also not zero. So I would say like for me, like just, I spent lost a lot more time, not understanding what was possible and being kind of, I intimidated from everybody else, which feel, felt like it was easy. Things were easier for them. They knew how to talk. They knew how to pitch their ideas. And they had like friends who could help them. So, um, but I think just kind of facing the reality is like, is what it is I'm just gonna make the best out of. It was probably, um, uh, my thing and one of the tactical things I was gonna say is I would suggest, is always try to build connections like partners, especially our starting your first company, having couple co-founders very important. So like, this is a very difficult thing to do. It's also very hard to face alone. So, and again, everybody other people might have it easier, but like you just have to kind of do whatever you can to, to make it easier for you as well.
Speaker 2: (34:36)
Yeah. I think that that's really great advice. One of the things that I always tell some of my young mentees is that you really can't compare yourself to others and you have to resist those feelings of intimidation, although it can be very difficult to do so. So I appreciate you saying that today because I think that, uh, the entrepreneurs that are listening in on today's discussion, you know, that's very valuable information and, and Sage advice for them. So I appreciate you saying that. So now, you know, we've talked a lot about business. I want to switch and, you know, talk more about Aaron and Aaron as a person and the things that you do for yourself. So, um, one question I guess, more serious, and then I'll go to a more, less serious or a less serious question, you know, what do you do every day? Yeah. You think that contributes to your success.
Speaker 3: (35:32)
So I think, I mean, let, make sure, introduce myself a little bit more in, in personal life. Right. So yeah. I have three little kids right now, so I have twins who are three and a half years old and a two and a half year old. So it's, it's pretty busy at Tom. It kind of feels like a zoo sometimes so, and I have, I'm very close my family. So when I look at really just myself, I, I had always some really simple goals in the life, right. When I was a child, I just wanted to be a good son to my parents, like, so, and I grew up, I wanted to be, I got married. I wanted to be a good husband. I, uh, started companies. I wanted to be a good boss. Like I'm a father and I, I want to be a good, good, like good, good, uh, good dad.
Speaker 3: (36:21)
So I actually have never, like just wanted too much, actually I'm relatively happy with where I am. Like, I mean, in a very good position, but even when I wasn't, like I was generally was like, thinking of was like, what I have thats like is actually privilege. Like I grew up in a village with very little access to most things, but also I had the privilege of like really supporting kind of close family relationship. We have, we have a very large family, I have 55 cousins. So I grew up with a lot of like support, like from cousins and you never feel alone. Right. So, um, it is, um, like the, I think like in a day to day, like I, between kids and business, there's really not much free time. So I, I play all the games. Like I, um, Tuesdays and Friday nights after the kids go to sleep, like we play games, a couple friends, like, but other time that like, I really don't have much, uh, I'm doing. Um, and anyway, like for me, just like the, between the, my family, the kids, uh, that's actually kind of what just interests me. And then the business interest is like kind of nice compliment to that.
Speaker 2: (37:25)
Sure. Well, I was going to ask what you do for fun, but I think you've answered that. So maybe what's, what's your favorite activity with your kids? I mean, obviously they're very small. They have lots of energy I'm sure. Yeah. And you've already said that sometimes it can feel a little bit like a zoo. So what's your favorite activity to do with the kids?
Speaker 3: (37:45)
I, I, I love going to beach with them, so we, they actually moved to Southern California because the beaches a lot nicer and everyone's now working remotely, so they love waters. Um, they just wanna walk around then. It's kind of interesting for me because I grew up in the mountains. Like I was probably nine hours away from the nearest beach. So I, I don't think I'd seen, I'd been to a beach I can until I was probably 14, 15 years old. So, and I always kind of like wanted my kids to grow up in a beach town. So like, that was like a kind of Unal dream for me. So now the kids are in a beach town and like, um, like that, that's kind of my, my favorite activities, like when they're in the war enjoying and were with them. Um, but I, I personally like playing GA like games. Like I would, if I was not doing anything and I was single, I'd probably be playing 10 hours of games every day. And I had to like specific part, like stop that and just limited to only a couple hours per week.
Speaker 2: (38:39)
Yes. You know, uh, it's funny that you mention that because I actually like to play games too, and there's this one very old video game that I love to play from the 1980s. And for some reason, all of my friends want to challenge me. Yeah. In playing this game, the game is called Gallagher. It's sort of like a, a spaceship, you know, and the spaceship has to kill the alien ships that are coming down from the sky. But, um, it's, you know, a lot of people don't understand gaming and video games, but it's really a great release and lots of fun and you know, kind of an escape. Yeah. So Aaron, if you could give any advice or say anything to your 20 year old self at this point, reflecting on all of your experiences and everything that you've been through, both in business and just in life, what would you tell 20 year old? Aaron?
Speaker 3: (39:35)
Yeah. I would tell him that there are all those people, like you look at as kind of idols or like very successful people. Like you see him on TV is like celebrities, another dimension. I was playing a lot of chip and chess. So, uh, for me like grand master, like Casper was the person probably I would want to meet the most if I was like 20 year old, so, or like a child. So, but just realizing pretty much all of my other humans. Like they actually, like, if you meet any celebrity, you always get disappointed. So like, like if you, I, I, I guarantee all this, like people here, if they meet like Musk or Jeff they'll realize like this, like they're are less smart than they thought they would be like. So, uh, I mean, they're smart, but like they just everybody's human. Some people are like, there's really not much. There's just too much like auto scope. I think sometimes when we just look at these people and kind of think too much about them, it kinda makes them feel further from us. And we actually do not find the energy to try to reach there. So, um, but really just number one would be like, everybody's a human nobody's like as strong as like invincible that they kind of look from from a TV screen or whatever screen you seeing them.
Speaker 2: (40:53)
So what is your hope for your children? If your children come to you one day and say we are interested in going into business, what would you say to them in response?
Speaker 3: (41:03)
I really want my kids to just find like, things that are passionate about right. And sure. Just have the ability to follow them. If they have a passion that could be a business. And that would be awesome. I I'd be very happy about it, but if they have passion towards like music or arts and other stuff, I, I, or like politics, I would be just hap as happy if anything, like, I mean, I've started companies, but I still let's say. And the other people, like, I always thought wanted to be like better at like visual arts. Like I always wanted to make a movie. Like if you ask me my dream was still like being a director, so which I haven't been able to teach you. So, and I think that a lot of, a lot of success or interesting past in life is, is not, it's not that linear actually. I think like the, if anything that we are over, over promoting this whole entrepreneurship concept is like, that's not, I think the benefit of entrepreneurship is when you success also comes money and like resources and everything. So that's nice. But like, other than that, I don't think that's actually necessarily that much better than being an academician or artists or scientist. Like as long as you can let that just interest you.
Speaker 2: (42:14)
Yeah. Well we, um, so we've talked quite a bit today. I, I feel like we have, I have, I should say monopolized the conversation. So I would remind our audience members that if they have questions that they'd like to ask today to feel free, to go ahead and drop those in the chat we have just under 15 minutes left in our time today. But Erin, I think at this point I would open it up to you. What, what would you like to talk about? Or is there anything else that you'd like us to know about Erin that we haven't talked about today?
Speaker 3: (42:48)
Yeah, so I think a lot of people look at me. I started coming in education space, which became fairly successful, uh, and healthcare, it is becoming success successful, but I think there's actually an illusion of size. So yes, we did raise a lot of money and we have a large team and everything, but still there a lot more ahead of us. We have to, it should be because before I can call ourselves success. So, so, um, and these things all start really small. I think this is really finding, uh, just a small thing that, that interests you, that you become good at. Uh, and some other people want to kinda use your product for that actually is the starting point and actually took turn massive thing. Like we, I never thought we was gonna be as big as it is today. So I thought it was gonna be useful for some people, but didn't really kind appreciate the size it could get.
Speaker 3: (43:43)
And also it just could also be a lot larger than it is today. Right. So, um, and like everybody just kind of goes through very similar emotions, really. Just like there's a lot of failures and, uh, ups and downs, we gave up and on em, me ideas exactly. Four times, like four times we just said, this is not working and we just stopped working on it. And we just came back because there was a voice internally, which, which was saying there is still something we just haven't been able to execute it every, but we thought the underlying idea wasn't bad. Right. So we just came back to it and eventually just found a way to make it work. So it, it, again, what, what looks like success doesn't look as smooth as it looks from the outside, but also I want to able those like hustle porn concept either. It doesn't have to feel like dread either. It is just usually mixed of like, oh, I did this thing, which is working awesome. It's for fun. Some other days you realize something's not working. So it's just a mix of ups and down. It's not, it's not a pure, hostile and torture that you have to kinda suffer through or no, it's just some like really roll zero road. It's just really in between.
Speaker 2: (44:49)
Sure. So the questions are starting to roll in, but one of them that's related to what you just said was, you know, was there ever a point in time, you know, when you talk about starting over with U Demi, was there ever a point in time where you lost motivation? And if so, how did you overcome that?
Speaker 3: (45:06)
Yeah, that happens pretty frequently, I assume, uh, as a founder. And, uh, the first thing is if you're doing it for the first time, you just need co-founders when your motivation is done, you need someone to lift you out. Right. So that's actually very critical. Uh, and as I was starting carbon, like my wife also became like support there. Like whenever I feel done, she's always kind of kinda being, being able to like lift me up. So that's one, the second thing is you want to take what you want to do from idea to reality as soon as possible, because the more it becomes a reality is harder to, to get demotivated. I, you, up, you just a session, want to increase the chance, decrease the chance that you are gonna give up because you are always gonna have more lower motivation. You just have to not give up.
Speaker 2: (45:56)
Speaker 3: (45:56)
I, I have a ability to like marriage as an institution is still useful because a relationship is hard to hard, easy to give up on. Sometimes marriage makes it a little bit harder to give up. So I, I think that's just main value of marriage is like, it just makes separation one, like one tiny bit more difficult, which is actually useful because marriages go up like relationships have good and bad moments, right? So it's similarly, like your journey is gonna have bad moments. You just want to be at some structure to, to just make quitting a slightly more expensive. And you have like real users of a product. For example, it's just like, that's the type of thing that makes quitting harder.
Speaker 2: (46:33)
Sure. So what about, um, incumbents in healthcare, for example, payers, you talk a lot about the patient experience and just improving the level of care and the, uh, provision of care. So what should incumbents in healthcare do differently?
Speaker 3: (46:52)
So I believe healthcare has a lot of issues, but it's not because people in healthcare are evil to honest, if anything, the over overestimates how much evil there is in large companies. Like for example, issues, companies get the most criticism. They're still made of a lot of people who are trying to do the right thing. And, um, and similar to like health systems PBMs. Like, so I think there's a lot more like, I actually believe a lot of the healthcare problems root cause is just, is just the most difficult, most complicated service industry, right? You cost far more competence, far more, uh, optimization efficiency than any other industry. It's also consuming a very expensive resource. And the reality is like we have an IMB and talent. Like we have very much talent, very much. We have too much talent that goes to optimizing ads. Right?
Speaker 3: (47:47)
If you look at the world of advertising technologies that bay, like people who are very smart, that working there all the time, just really just optimizing something that doesn't have a lot of society impact, right. Mm-hmm and healthcare traditionally, hasn't received a lot of just like the talent that can actually make things better. Right. Especially in technology and design, like those type of principles. I think really the key thing is just like being able to attract more talent into the healthcare and try to like work together to improve things. That's what everybody else does. And what we are trying to to do is in carbon is just like a small scale of it. Like we have very strong mix of engineers, physicians, designers, legal, like operations, people just really working together to kind fix the problem in our, our, our landscape.
Speaker 2: (48:31)
So in optimizing talent and increasing talent, does carbon recruit, uh, primary care physicians?
Speaker 3: (48:39)
Yeah, look, we, we have, I mean, we have more than 4,000 people, majority of them work in our clinics. So they are primary care clinicians, urgent care, uh, like nurses, medical assistants, front desk, people, some customer support building. Like there's a lot of actually major companies in some sort like service industry. And actually that's one thing I like about carbon is like, my job is like we are creating jobs practically. Even one day we'll have millions of employees. So, and these are good jobs. These are the jobs that are able to lift people out like power to rose over fast. Right. Um, like one thing I really enjoy is like we have front desk jobs, which are kind of lowest, obviously like most like entry level jobs in our whole, uh, in most of the company and some of those early front desk folks, we have, we were attend the company for five years now.
Speaker 3: (49:29)
They're like regional directors, like overseeing 200 people. They have a very good job. Right. So it is, I think is I like the kind of job creation aspect of it. It's also very, uh, diverse, like a very diversified job. Like we have like our, the diversity of our employees, both in corporate teams and headquarters, like, and the clinic teams pretty much align with the, like our, our patients. Right. So, um, like I think have 7% women, 6% of all, all managers of women, uh, like we care, we do care about diversity quite a bit. So yeah. So it is a lot of different jobs. But then on the other end, we also like designers and engineers and machine specialists and operational efficiency people. So it's like a nice mix of clinical and technology people coming together.
Speaker 2: (50:12)
So did you always do this direct hire or did you start out as a marketplace?
Speaker 3: (50:17)
Uh, I thought maybe we would be marketplace the first year of the company. Uh, but then we opened one clinic just so that we can control it better. Okay. And get better feedback. But then we realized like, so marketplace idea was not a great idea. So we kind of wanted to be extremely worth take great test.
Speaker 2: (50:33)
Sure. Uh, one of the questions that our audience, uh, members would like to know is how do you increase, um, utilization of your platform at carbon?
Speaker 3: (50:43)
Yeah. I mean, that's the most like financially difficult problems. So cuz when you create physical locations, uh, there's a lot of fixed investments. Like you have to, you have rent, you build able to clinic which costs money and then you hire people who are gonna work that no matter how many patients they see. So the, the thing that you have to, you cannot fail on is bringing enough patients to the clinics to make the immuno clinics work. Right. Because they, when first open clinics all are losing money, you just have to get turned them profitable as fast as possible. So it means like we just have to be really good at customer exhibition, patient acquisition, very good retention, probably retentions our strongest suit. So we have really good at keeping our patients like and making them loyal, uh, repeat rates. uh, all those things just have to kinda optimize patient experience. Um, I mean utilizations again like that, that's the most difficult problem.
Speaker 2: (51:34)
Sure. I think another very important area that entrepreneurs frequently wanna hear about, um, not only how you manage your business, but also just as a leader, how do you prioritize important decisions? How do you evaluate your success? I imagine, you know, you develop a suite of KPIs or other measures that would, in your opinion indicate success, but, but how do you do that? How do you prioritize those things?
Speaker 3: (52:00)
Yeah. So I have a fairly unique V wonders and probably, uh, disagrees with majority of technology world. So I, I come from computer science, mathematics, I'm I'm, I'm sufficient at technical, right? So let me put it that way, but I don't believe there's any data in my process that can give you the right decisions. I actually lean very heavily into hiring people, which I thought think generally cares about the business, not the business, but the general cares about what they do and really like putting them in the position of insights and really make like trust in their intuition. Like I'm a far more intuition, heavy person than a typical entrepreneur. I look at data always with some amount of skepticism, right? So look movies every for forever, there are good movies and there are bad movies, but we still, still don't have a metric which tells whether movies good or not.
Speaker 3: (52:54)
Right. There are ratings on IMDB and RO tomatoes, there's box, office numbers and all those other numbers. None of them are perfect. Right. So we, we understand like, just because there's good and bad, doesn't always mean that you can find a clear metric. So like we do find metrics, but I, I broadly I don't run the company with numbers. I come run the company by really just like hiring the right people and just a lot of, kind of a lot of back and forth conversations to figure out where we are going. And the number one video I set up drafted for the company is if you go to our website, um, it's called, uh, assume karma exists. This idea that this car business is. And if you do the right thing consistently for a long time, you're gonna be rewarded more significantly than if you're just optimize for short term. And you, and the key to the idea is there is like you, you won't know how it's gonna come back, but you just to believe it that it's just gonna come back because, because it does in practice, you do the right thing consistently. Does your work like you get rewards eventually?
Speaker 2: (53:55)
Sure. Well, in the last few minutes that we have, you know, I wanna go back to, you know, Aaron, the entrepreneur who came to the us from Turkey. Um, so many of our audience members have put in the chat, how much they've enjoyed, just hearing about your personal story and your family and your background. And so I guess in our final couple of minutes, um, talk to us about your, uh, uh, continuing or remaining connections to Turkey. Um, do you still have business connections in Turkey? Is that a part of your business? Uh, do you have a team there?
Speaker 3: (54:34)
Yes. So I, I have a, I have, I had, I have both, you demand carbon have sizeable teams in Turkey. So I think at carbon we have 25 people or so we'll probably get to couple hundred eventually. Uh, so I always like building a team because hiring, especially like engineering talent is very difficult. So wherever you have competitive advantage for hiring, you have to utilize this. So I, we do have competitive advantage in Turkey. Um, I think, uh, so I also go there pretty frequently. Uh, we're actually building a new house so that I can go with there with my kids because now our family is too big to fit our in our parents house. So cause all me and my sisters are all kids. Uh, so building a new house. Um, yeah, so it is like I've I go to my village and actually I don't like to go to Turkey and like spend time in like vacation towns. I spend it a amount of time in my hometown, still pretty close with me lot. My family member, like family relatives. Uh, so yeah, I, I, I do want also my kids, if I'm, I'm lucky on my kids will have some connection. Yeah. Like one of my peers is that they're not gonna have a strong connection and maybe they will want, they want, want to go, but I really hope it'll go the other ways.
Speaker 2: (55:40)
Yeah. And I imagine you also get a great deal of inspiration from being around your family, your extended family, and also in the village where you grew up. So very, very quickly, if you can tell us mm-hmm um, what's the next problem you think you will try to solve for?
Speaker 3: (55:57)
So healthcare is a big problem. So I think it's gonna take a while. So honestly, I don't think there's no like timeline for me because this, like I'm going to be working at carbon for foresee future. Sure. Um, but the, one of the other area that I, that interests me personally is like consumer robotics. Mm-hmm to whether we can, I think robotics field is way behind where it should be. And, uh, I think software was the biggest bottleneck in the past, which has actually been extorting really quickly. So anyway, if I was not doing healthcare, I would do robotics, uh, um, today. But again, healthcare is so big and I don't think there's any kind of schedule there for me. Sure.
Speaker 2: (56:40)
Well, Aaron, thank you so much. This has been such an amazing discussion today. It was certainly my pleasure, not only to meet you, but to have the opportunity to just engage in this conversation with you. Um, so I really appreciate it on behalf of matter and the entire audience watching and listening in today. I just want to say, thank you. Thank you so much for being so open and honest with us and with that, Aaron, thank you so much.
Speaker 3: (57:09)
Thank was a great conversation,
Speaker 2: (57:15)