Technology Isn't the Product
Jack Bretcher, COO of PartnerMD, on running IT and operations from one seat, industrializing everything behind a concierge practice that is tripling in size, and why the phones and the scheduling stay human.
Key takeaways
- Technology is a tool, not the end game. Start from the business outcome and then open the toolbox, never the other way around.
- Scale smart: you are not ready for location three until unbiased metrics can tell you why location one works.
- After an acquisition, centralize membership billing, IT, finance, and HR. Leave scheduling and clinical workflows alone if they already work. Rule one is "don't break it."
- PartnerMD has deliberately held off on self-scheduling, chatbots, and call centers. Members pay to talk to a person, and after-hours calls ring a live physician.
- Every non-five-star score and every non-promoter routes in real time to the practice manager, operations, the COO, and the CEO. That loop closed last quarter at a 93 NPS.
- The one number he checks every morning is member terminations, the ultimate vote of confidence in a month-to-month relationship.
Most practices split technology and operations into two jobs and two org charts. Jack Bretcher runs both. He is Chief Operating Officer at PartnerMD, a concierge medicine practice headquartered in Richmond, Virginia, with roughly 12,000 members and thirty-some physicians before its most recent acquisition, and a plan to roughly triple from there.
He came to healthcare from e-commerce software and consulting, spent his first years at PartnerMD running only IT, and added operations once the systems side was stable. That sequence matters. By the time he inherited the operating side of the business, the infrastructure underneath it was already built.
“Technology is a tool. Technology is not the end game. The end game is providing an exceptional service.”
The duck on the pond
Concierge medicine sells a relationship, and you cannot mass-produce a relationship. So what do you industrialize?
Jack’s answer is everything the patient never sees. He calls it the duck on the pond: the calm, high-touch experience out front is only possible because of the furious paddling underneath, defined processes, cross-functional teams, and the tools that support them. Get that machinery right and the front-line team can spend its attention on the person who walked in feeling terrible.
“The core, the guts, are what you have to have in place and truly operationalized to excel on the high-touch piece. It’s not one or the other.”
Don’t scale until you know why location one works
PartnerMD wants to grow, and Jack is candid about what breaks when practices grow the wrong way. His phrase is “scale smart.” A team can be delivering exceptional care and still not be ready to expand, because nobody can point to unbiased metrics that explain the success.
“So many people think, I’m really successful in location one, and because we’re successful here, we can go to location three and four — without putting in the hard work to figure out why you are successful in location one.”
Acquisitions sharpen the point. You are buying a practice because it works, so the first rule is the one Jack has carried through every role in his career: don’t break it.
What gets centralized, and what stays separate
The centralization list is shorter than you might expect. Membership billing, IT infrastructure and support, finance, and HR are the services a ten-doctor practice usually does not have at scale, so absorbing them adds value without feeling like a takeover.
Scheduling and clinical workflows are a different story. PartnerMD acquired a practice on the same EHR about a year ago and still runs two separate instances of athenaOne. The practices are in different states, they schedule differently, and their workflows are slightly different. Merging them would buy cross-coverage the two groups do not need, so the tablespaces stay apart.
Where the automation line is drawn
Ask Jack where automation gives his team time back and he starts with where it does not. Self-scheduling looks like table stakes for a medical practice, but PartnerMD promises same-day or next-day acute appointments with no waiting, and delivering on that is more art than science, constant shuffling, blocking, and unblocking that a template with open slots cannot capture.
AI chatbots on the phone or in chat are off the list for the same reason.
“Our patients expect to talk to us. We are a high-touch business, and the live person on the other end of the phone is really important for us.”
Where automation is welcome is the asynchronous, back-office layer: texting for referral coordination and membership billing, with room for AI to route messages or answer basic questions inside those flows. The phone system does real work too, rolling calls between offices so a Greenville, South Carolina patient sees a local number on the callback, triage lines for urgent calls, and after-hours routing straight to a physician’s cell phone. No call centers. A five-doctor office runs with one person up front because coverage flexes across locations instead of adding a third of an FTE everywhere.
Real-time feedback and a 93 NPS
Ten years ago PartnerMD collected feedback on paper forms, like everyone else, and the volume was too small to mean anything. Seven or eight years ago they partnered with a startup, sitting across the conference table from the founders, to build a survey a patient could answer in ten seconds or ten minutes.
The requirement that mattered was visibility. Any score that is not a five out of five, and any response that is not a promoter, automatically goes to the practice manager, to the head of operations, to Jack, and to the CEO.
“If there’s something that’s not right, we’re reaching out to the patient. Even if it was just a nit. That patient feels heard, and if it’s something we can change, or it’s a training opportunity with our team, we act on it.”
Five-point ratings all land around 4.9, which is why Jack prefers NPS: it is harsh enough to flag the office sitting at 91. PartnerMD finished its last quarter at 93.
The vendor story is its own lesson. When two or three tools can solve a problem, PartnerMD picks the company it can grow with and influence, a partner, not a product.
Where athenaOne still falls short
Jack has been on athenaOne for close to fifteen years and calls it the right decision then and now. He is enthusiastic about what the platform is doing for physicians: native ambient documentation, summarization inside the chart, and broader access to clinical data, all aimed at giving doctors time back with patients rather than time in the EMR.
His one criticism is the same drum he was beating at strategic forums a decade ago: the patient portal. It has improved, but not to the level a concierge practice needs, which forces third-party tools, two logins, and split data. Consumer technology and wearables are moving far faster than the patient-facing side of the EHR, and the opportunity to combine wearable data with clinical data is, in his words, huge.
The metric he checks every morning
Lightning round. Most overrated tool in healthcare tech? AI as the cure for everything, powerful when applied thoughtfully, a problem when you expect it to do all the work.
The number he checks first each day: terminations. Members leaving the practice. In a month-to-month relationship, retention is the clearest signal of whether the value delivered matches the price charged.
And the sentence he finished, “in concierge medicine you can automate almost anything except”, landed on patient experience, with a story from a member at his gym.
“Jack, you guys want me to use the portal. I pay you guys a lot of money to talk to people.”
That is the whole episode in one line. Build the machinery so the paddling disappears under the surface, and never let the tool get between the patient and the person they came to see.
Transcript
Read the full transcript
the lessons we learned early is you gotta scale smart. So, you know, organic growth, you know, even even if you have teams that are running in and delivering exceptional care, unless you can look at unbiased metrics and unbiased processes to understand why that's happening, you're not ready to scale.
And I think so many people think that okay, I've you know, I'm really successful in location one. And because we're successful here, we can go to location three and four without putting in the hard work to figure out why are you successful in location one.
Welcome to the Pretty Good AI podcast. I'm Kevin Henrikson, co-founder of Pretty Good AI. We make voice agents for healthcare. Every episode, I sit down with operators that are actually running healthcare: practice owner, executives, the people behind the front desk and the EHR to get specific about what's working, what's breaking, and where technology actually helps. No hype, no hand waving, just how the work gets done.
Let's get into it.
Today's guest, Jack Bretcher, COO of PartnerMD, is really doing concierge at scale. And I think as sort of a health, kind of quantitative health nut for years, I've wore all the trackers, have my CGM, you know, really have tried to take health as a priority. And I think the idea of concierge medicine being able to encapsulate more of that and helping folks understand that journey. And so I'm excited to talk to Jack today.
And really just how Jack sees this idea of technology and sort of operations blended together as one really uniform sort of capability that allows them. to sort of deliver this really exceedingly high MPS score that we're going to talk more about. So let's get into it.
Jack Welcome to the show.
Thanks Kevin. Glad to be here.
Well, you've got one of the most unusual jobs in healthcare, kinda you run IT and operations where I think a lot of practices split that in two.
So let's start there. I mean, what is it like sort of running both, you know, operations and IT it when a lot of companies of of your scale and sort of approach keep that separate?
Yeah, it it's interesting. I actually I had the you know the I guess the good fortune of when I joined PartnerMD, I ran technology, just technology. so and you know, I spent the first couple years kind of digging into infrastructure and everything, you know, kind of all IT, if you will, both infrastructure applications, process people, all of that part of IT. And you know, was able to spend that time to to try to understand where you know where the gaps were, where the shortcomings were, where we wanted to go as a company and how we needed to evolve that part of the business. and then when I jumped over and you know, I say I should say jumped over, when I added operations to my team, I had a actually a pretty solid IT team and infrastructure.
Applications that were largely migrated or or implemented at that point. So I had a really good team, really good people and process and technology in place on the IT side, which allowed me to kind of jump over and then really kind of you know go through a lot of that same exercises on the on the operation side. So you know it it it was timing had a lot to do with it, you know, again, having having that time purely on IT. And then you know, honestly, I think my my back. lends itself well to operations. I'm a process kind of guy and
Yeah.
I think of that as a big part of what I do day in and day out from an operations perspective.
I like it. Cool. I mean, concierge kind of as a business, I mean, you're really selling like relationships, right? And it's hard to like, you know, sort of mass produce that. So as you all have scaled, you know, what do you sort of industrialize versus like what is sort of that relationship piece that you decide you know needs to be kind of personal and unique?
the core the the guts are what you have to have in place and and truly operationalized to excel on the high touch piece.
So it's not a one or or another thing. It's you know it's kind of like the duck on the pond, if you will. You know, that massive paddling under the water is all the time that you invest in, you know, how you've defined your processes, how you work together as you know, cross-functionally as as teams, as the tools you you put in place to support your teams. And then that gives you the ability to focus on those high touch pieces. And then, you know, in you know, both both from a an application of it, how do how do we provide a better experience for our patients? you know you think about our business. You know, we have you know, half the time people are coming in on their worst days. I mean they feel like crap. and how they show up is different for everybody, but we want them to feel welcome and embraced when when they come in. And and part of that is you know having systems in place for that, but also product is having an amazing team that is that is invested in providing that type of an experience for the patient.
Yeah, so you sort of take the admin work away so that they can really focus on that unique sort of personalized piece when that comes in makes sense. e-commerce software kind of is your background consulting. Like, you know, what did those worlds teach you that like, you know, kind of the lifelong healthcare only operators maybe never saw or learned?
You know, I think my biggest takeaway and this is probably more for the IT focused people, is technology's a tool. And it you know, technology is not the end game. you know, the end game is is providing a an exceptional service, Or or with consulting. I mean if with the consulting the you know my my kind of edict with consulting Was that you know we we are here to understand what you want to achieve from a business perspective. And then we will look at our toolbox and figure out are there tools that we have that can help you do that. Versus a lot of people unfortunately look at that the other way around and say, I you know, I have a hammer and a screwdriver, and regardless of what I find, I'm gonna use that hammer and screwdriver to solve your problems.
Yeah.
No, we've all seen that go wrong a bunch of different ways.
Absolutely.
I mean, partner MD's goal is, you know, to to roughly triple. I think you guys have said, like, hey, I mean, you're you're in the business to grow, right? Like you're not saying, Hey, we're just gonna run this thing, you guys wanna grow. You know, from your sort of operating seat, like what do you expect or what have you seen as the things that break as you sort of go through these sort of waves of scaling?
Yeah, it depends how you scale.
I mean I I think the the the lessons we learned early is you gotta scale smart. So, you know, organic growth, you know, even even if you have teams that are running in and delivering exceptional care, unless you can look at unbiased metrics and unbiased processes to understand why that's happening, you're not ready to scale.
And I think so many people think that okay, I've you know, I'm really successful in location one. And because we're successful here, we can go to location three and four without putting in the hard work to figure out why are you successful in location one. why are you successful and why aren't you successful? Much like we look at you know, kind of at the roll up level, but at the individual location, you know, if if you you tell me you're doing well in an office, why is that?
It truly is being able to answer those questions and be able to understand how you take and pick that up and you you replicate that either in a new location, you know, which has its its own challenges in you know into itself, but also through acquisition. I mean acquisition brings a whole new set of challenges as well because you you have existing people and process there that they're you know we're we're Requiring another practice because they're successful. We're not we're typically not going out and acquiring a practice that's failed. you know, and my number one goal in every role that I've had in my career is don't break it.
So figuring out how do you start to bring together your processes and and their processes in a way that A doesn't seem like you know we we are the the mothership taking you over and create a lot of resentment in the organization, but also then don't break the good stuff that's working in in the in the location or in the groups of locations, whatever it may be.
Yeah, how do you I mean on that I think it's a great example because I'm sure you've centralized like for your own practice, like certain things, like hey, we do coding the same way or we run, you know, w wellness visits the same way. Like where else are you sort of finding things that, you know, you can kind of keep the same or share across these multiple locations, whether they're ones you're running today or new ones you're adding, so you can continue to add patients revenue with kind of out adding like that back office staff, you know, each time.
Yeah, I th there there's a core set of services that we have purely from a you know concierge medicine medical practice perspective. and they're the types of things that are typically the you know, I say the easier things. I say that and we're not doing it across all of it in our most recent acquisition, but you know, they're typically the things that are easier to to centralize. It's your it's your medical it's your membership billing, it's your IT infrastructure, IT support, it's finance, it's HR. 'Cause you know, in unless you're going out and acquiring a a company of similar size. I mean we're, you know, before our last acquisition we were about twelve thousand twelve thousand members and thirty some docs. So we had you know, we're not a big company, but we have some scale that unless we have some solid systems and process in place, we're not gonna be able to, you know, we're we're not gonna be able to run the business. So when you you you go and acquire a a a company that is, you know, maybe ten docs, you know, they they typically aren't gonna have a lot of that infrastructure in place. So that's probably your your easiest kind of easiest place to go in. and add value without feeling that they're trying to
Yeah.
that we're trying to force them to do things differently. You know, you
Yeah.
you know, in in and that's not always black or white. I mean as as an example, you know, you know, our electronic medical record, we we're on the same electronic medical record as the company that we, you know, that that we acquired a year or so ago, but we haven't brought them together because it just didn't make sense. We are.
Yes, you're still running two table spaces in athena or whatever.
Yeah.
We are.
And and and I don't know that we will in the short term bring together because they work well together. If if we were in the same state, in the same general area, I think there would be a more of a a a motivation to do that for cross coverage, but because they're in a completely separate state and they they schedule differently, you know, they they their workflows are slightly different. it just makes sense to kind of keep it separate.
Yeah, I mean the the state thing's always interesting, credentialing, insurance, reimbursements, like all those things that sort of are gonna be different. But I mean, you touched on scheduling. I mean, for a concierge practice, right? It's really, you know, how do you phone scheduling kind of after hours access? That's kind of the product, right? It's like, you know, other than the annual wellness things where people are kind of coming
Mm-hmm.
in on their regular thing, it's like, how do I access you and how do I sort of get access to care?
Like, where does automation around that stuff give your team time back? And where are you like, Hey man, this is just something we're not gonna like automate?
Yeah, that's a great question because there are so many opportunities to automate on scheduling, on you know, AI bots to help with, you know, whether it's chat or phone or you know, even even kind of normal operations, referrals and things like that. We've chosen not to go down those roads. You know, our patients expect to talk to us. I think at some point in the future we will we will certainly look at that it as a great example of self-scheduling.
You know, you you you would think from a medical practice perspective, the self-scheduling is table stakes. You know, you you have to do it. But but no,
Yeah. Surprisingly not.
but when yeah, when you look at how we schedule, there's there's a lot of art and and there's more art than science in there. You know, because we we make a promise to our patients the same day next day, acute care pa acute care appointments, no waiting.
But to do that and to be able to get everybody in to be seen, it's not as simple as we have a template that has X number of open slots and we open it up to the public or not to the public, to our members to schedule. There's a there's a lot of of shuffling and moving around and blocking and unblocking and all of that there. So we've that that's something we probably will will not automate. And then you know, as as far as you know, chat bot AI chatbots to respond. Our patients want to talk to us.
Yeah.
Yeah, we're we'll we're we're starting to look a little that a a little bit from a texting. We're start to we're we've done some texting in the area of referral coordination and membership billing just because it's it's easier to to get in touch with them to be more asynchronous in terms in terms of the communication there. and and we'll we'll expand that more into other parts of the business. I think there are some opportunities there to use, you know, some kind of AI type of of response in inside of those where it's looking for whether it's routing or where it's providing some basic answers. But we are a high touch business and you know, and you know the the the live person on the other end of the phone is is really important for us.
Yeah, I mean, like I said, members pay a premium precisely, you know, kind of for that human attention in a business like yours. When you do sort of roll out new tech, or maybe just looking at the people, like how do you staff that today? Like how many people sit at a front desk? You know, so let's say you have an office with X providers, let's c let's just pick a number five.
And then is there any centralization there, or is that all location specific in your guys' business? And then for after hours, does that change? Like, do you have humans that are
Yeah it's yeah it's
arming those after hours?
Yeah, it's it's a little bit of both. You know, so a at five doc office we'll probably have one person sitting up front, but we yeah, we we use our phone system to help roll phones to provide coverage as well. So you know, our office here in in Richmond, Virginia, we have I think fifteen docs in this office, we're able to roll other Offices in here and you know and show up, it's you know, a call coming from Greenville, South Carolina, and to be able to push out a number for Greenville, South Carolina when we call the call the patient back. So we do have some rollover where we use the technology to to support that.
We have triage lines that if something is urgent, it it it rings a triage line on our our nurses, so they get dealt with immediately.
And and again, because of the infrastructure that we've built, we're able to to flex that as it makes
Yeah.
sense. that way we're you know it's it's less rigid that we don't have need to you know put a you know one and a third FTEs in a location which we both know is isn't something you can do. you
Yeah.
know, so it gives it gives us that that level of of flexibility. And then from an off and and after hours perspective, it again we we leverage our our telecom infrastructure to roll to we have docs, you know, d typically during the week our docs take their own call on the weekends it rolls to a doc on call and we have you know our our you know in a via phone system that we're able to route all of that to the to the appropriate dock, find the coverage, push it out to cell phones, We don't use any call centers. It goes to it goes to a live person answering the phone, a live physician answering the phone after hours.
Some yeah.
Yeah, very cool. And I think that I think that goes a lot to like sort of your MPS and sort of, you know, as we shift a little bit into just thinking about feedback. Like I think one of the things I read is you guys like had this crazy impact in feedback volume where you got a lot more feedback, and then you know, crazy, like then MPS is like in the high 90s, right? And so tell us a little bit about that and like and how you collected all that feedback, like what channels did you get it in, And then, you know, I think you had an interesting view on like, you know, it's not yet perfect. And so how do you work backwards from sort of understanding what are the opportunities?
Yeah, yeah, it's an it's an interesting journey. I mean if you go back ten years ago we were probably you know, we had little forms in the office like everybody else did and you got a handful of feedback and it you know, and it it was pretty meaningless because your volume based upon your patient volume was so small. we have implemented a platform probably seven, eight years ago. and we and we looked at a handful of it. a company called Feed Trail. and I'll never forget we're sitting in our conference room here across from the founders and one of their you know their venture capital investors and and talking about what we wanted to do and how they wanted to build the company. And it it kind of speaks to So I'll I'll come back to the to the the feedback, but it it it speaks to how we engage with technology partners. You know, we really look for that that partner and not a a product. You know, so if if there are two or three options out there to to solve to two or three technology options to solve a problem, you know, all things being somewhat equal, we will look at the company really hard.
And and is there is this a company that we can grow with and we can have some level of influence with. That is that is really, really important to us. And that's what we found in Feed Trail at the And and their promise to to us and our in our ask to them is you know, we want to create something where our patients can give us can can take ten seconds out of their day to give us feedback.
Or they can take 10 minutes and write us a book. And they were able to not only provide the tool to do that, but pro but provide the the the expertise in terms of how to craft those types of surveys to be able to flex in those ways and to be able to gather that feedback.
The other requirement we had is we wanted to have near real-time visibility when when things weren't going right.
So if you think about you coming into a doctor's office and and and again our promise to our our patients is basically minimal if any waiting in the lobby. And you s you come in and for whatever reason you're sitting there, you know, ten minutes, which is a a huge amount of time for our patients. And you get back to the exam room and You know, you may have to wait five more minutes for the doc to come in and you get you know, everything beyond that grows great. And we get a feedback saying, doc's amazing, nurse is amazing, you know, your your wait time, you know, was a three out of five and not a five out of five. the way the kind of the way we're we're structured is we have a practice manager that's that's oversees each of the offices and they roll up to a person on my team that's that oversees all the practices. a comment that we want to have to provide visibility to everybody, or it's a score that's not a five out of five.
Or NPS that's you know it's it's not a promoter that automatically goes to the practice manager, goes to, you know, Bonnie on my team goes to me and goes to Zach, our CEO. So we we look at that stuff real time So that's that's been really effective over the years, and we've seen you know, NPS is a is a great measure. you probably want to look at MPS because our ratings on our one to five scale, they're all 4.9 something. You
Yeah.
know, and then and and you can pat yourself on the back all day long. But when you have an MPS because of the the way the NPS is calculated, you see your other office is maybe in ninety-one, you know, that that raises a flag right there. mean we've we finished our last quarter at a ninety-three NPS.
Incredible.
Yeah. And and and it's because of all of those things. It's because it you know, we're looking at it, we're you know, and if there's something that's not ready, we're walk reaching out to the patient. Even if it even if it was just a a knit, you know, we're reaching out, that patient feel feels heard. And if it's something we can change or it's a a training opportunity with our team, you know, we we act on it.
Yeah. I think it's cool that you're looking at it in the moment because if you think about like the so many little interactions that are good and bad, you never ever know like which one does it tie back to.
it and it's also, you know, if if you think yourself on on the patient side of that, if if you come in and and you waited an extra, you know, five minutes and and you know and scored a four versus a five, you wouldn't expect to get a call from the practice manager. But you may spin on that when you get our marketing materials and say it's it says minimal to no waiting. It's like, Yeah, but it's not really. But being able to have that conversation with the patient and say, I understand that things didn't go perfectly, you know, you know Let's talk about it, you know, if there's something w you know, that solves a ton of a ton of issues downstream.
Switching gears a little bit, I mean, you to you've talked publicly about athena and like, you know, you guys are now you have two instances of it, you know, you used to have one. But like, how do you think about that as being critical to your vision I'm sure as you think about MPS, it's like, hey, you're you're not a hundred yet. There's still some people that aren't marking them all fives. how do you think about that and sort of the the sort of core kind of EHR
You know, I think so when I joined going on fifteen years ago now, you know, we were on a different EMR
Yeah.
looked at a couple of different EMRs and ended up with athena. And I think that was the right decision then. I think that's the the right decision today. I think athena does a good job evolving their platform both from a a both from an overall platform perspective but also from a physician workflow and a technology perspective. which is yeah that that coupled with their marketplace and being able to provide a foundation or you know APIs that third parties can can use to extend functionality. So in general I think you know athena has done done a good job, continues to do a good job. I've you know, some level of line of sight into what they're what they're doing. Just I'm one of their their advocates, so I I'm a you know obviously a supporter of them. but some of the things they're doing in the AI space I think is are are really, really interesting. and I think they're doing them for the right reasons. They're doing it to save physician time, which is which is a lot of our focus. You know, we we want to we realize that there's physician burnout is a is is a real thing.
And the the more that we can do to make the the docs more efficient to give them time back in the day. You think about our you know our value prop to our our docs, it's it's providing time with patients. Not to pr not providing time in your EMR to do your documentation, it's providing time with patients. So the more we can the more that we can support that and some of the things that athena's doing with their you know, own native ambient, some of the summarization tools they're doing on on in you know inside of athena, some of the you know just basic, you know, being able to query, but also them having better access to all of the clinical data inside the chart. We've we've done this with a number of different partners with with mixed results, but having a core to the platform and having yeah, them having the ability to access the information More broadly and more efficiency efficiency kind of place in our benefit. Now, on the flip side of that, where I'd love Athenian to spend more time is from a patient experience and a patient portal perspective. And that's a drum, you know, if there's one criticism I I have, I I used to go to their strategic forums when they used to pull us together once a year. And that is a drum we all were beating, and that was ten year, you know, probably close to ten years ago.
Portal has gotten better. but unfortunately what it it's it's not, in my opinion, to the level that needs to be. And because of that, we we have to look at third parties, which is less than ideal. It's less than ideal from a from a a clinical provider workflow perspective. It's less than ideal from a patient perspective because you have two different log ones and you you access different data on each one of them. but it's it's kind of where it's kind of where we are. That that whole piece of technology is is advancing or evolving it at a at a pace much faster than what athena is doing from a a patient-facing perspective. And and I I get why. I mean they they are a revenue cycle management company. They you know in and the way you optimize for that is you optimize the patient experience and the patient workflow. Which again back to my earlier point in in terms of physician burnout is is absolutely the right thing to do. I just wish that they were able to Move faster on their their patient portal pieces of it. Especially as you look at kind of where that technology is going with the integration of wearables data and not not only the integration of the wearables data, but the the the analytics and the automations and the the work the the combination of that wearables data with the clinical data and the insights that be can be gleaned from that, I think it's a huge opportunity area.
And then I think the other thing that was interesting is this notion of like, you know, how do you make the patient feel that technology? And it sounds like, you you You have to build around that to make the patient feel like, you know, consumer technology runs crazy fast, right? We have these iPhones and you know, the
Yeah.
the the apps that are out there and the things that people see. And and then and then I think wearables being another place where it's like, you know, I've got like my whoop and my aura, and you grab all this data, you know, or CGM. And it's kind of cool when you take that, your blood test, and then your, you know, a month or two of wearable data and lay those together, and then maybe your weight on the scale and it can
Yeah, yeah.
tell you some pretty interesting things. It's and and it's funny, like I'm curious where you guys fit on this, like from a practice perspective. Like I've taken, like, you know, one of these crazy like 200 panel blood tests to my doctor. And you
as as if I, yeah, absolutely.
show it to them. And some of them are like, whoa, I've never seen this before, like in this level, because they just don't have this kind of this isn't the way traditional medicine was grown up with you would do like, you need a lipid test, or you do a couple of things and you give them the 200. And so I'm curious, like.
Where are you guys on that spectrum of like how how deep are you going on your blood panels versus some of these sort of consumer, you know, the hundred bucks a year, three hundred bucks a year kind of thing, dollar a day as function says, to like pr giving that full level of panel and then how used to your docs are either dealing with that versus like you guys running it yourself? And where do you sit on that as a, you know, relatively high tier sort of concierge approach?
Mm-hmm. Yeah, I I think there's a couple answers to that. I think it it our our our our general philosophy with that, and and the and this is true both with like what function's doing as well as a number of other both national and and and local organizations are doing it. my my the way the way I with the way I think about them is is a bit of a shotgun approach. We're we're gonna throw a ton of things you know, pr we're gonna provide access to a ton of of tests, of which maybe thirty percent apply to your your particular situation. So we take a much more more focused approach. We have access to all of the same tests. So you know function basically uses uses quest to do tests.
Quest, yeah.
for both Quest and and for Lab Core and we look at the patient and see what's most appropriate for the patient and our docs are all very well versed in in in what those tests are, both kind of what the core tests are would be part of our physical, part of our executive physical, or if there's tests that are done for quest what they what they are. as well. We also have access to all of the other more advanced technology. function just acquired Ezra for full body MRI.
That's right, yeah.
We also have access to Ezra here in in Self Our Markets. We have access to Prenovo for their full body MRI. yeah the difference is we don't see full body MRI is a one size fits all for everybody.
And we don't all we don't necessarily look at as it for everybody it needs to be done in a vacuum. It it may be appropriate for certain people in certain situations. You may want to you want you may wanna for a certain cohort combine that with gallery. And and I'm I'm not a clinical person, so you know take this for what it's worth. This is Jack's opinion of of how these tests
Right.
can be applied and in the conversations that we've had internally. But it is is a it's much more of a customized approach to what's right for the patient. versus the mass market approach that we're going to give you access to, you know, a hundred and fifty different, you know, biomarkers through through blood tests and give you access to full body MRI and and all these other things and give you you know kind of an AI interpreted results of of what that means for you. where we take it is what are the right tests for you and your situation. We you know we We understand and we review those results and then we take the next action and the next action and the next action to continue down a path for longevity for where where you want to be. So we we we provide that that you know the the the the guide for that versus just the test.
And and and I think it's funny, like I because I've both Pernovo and Ezra, and like you take it to some doctors and they're like, Man, we hate these because it you know, any little shadow or blip generates an office visit that's unreasonable. Yeah. Yeah, yeah.
Yes. Well and and and that and that's the complaint of a lot of the docs is that and you you don't want to create that anxiety in your patients where you see something that actually the same with genetic testing. I mean, you know, for for you know, genetic testing inside of our practice, we require counseling before testing. for for a number of reasons. You know, from a from an insurance perspective, you know, you can you you can ex you can find something through genetic testing that may preclude you from getting certain insurance. Not all insurances are covered by Gina, you know, which is the the the you know government, you know, I fear I'd say g genet genetic testing, whatever that says you can't use these tests to not provide insurance. but also to to coach and one there may be something that's found that we just don't know what it is yet and you know, not to freak you out, you know, but here here are the things we should be looking at because there are you know, there there are clear paths forward for those types of things.
Cool. As we wrap towards the end here, a couple of quick questions, like just lightning round kind of model. what would you say is the most overrated tool in tech right now for healthcare?
that's a great question.
I would say I I'm gonna answer this talking up both sides of my mouth.
Yeah.
I I think it is AI as as the cure for everything. I think AI used appropriately and in in certain I don't say narrow but you know thoughtful ways inside of your practice is really powerful. Thinking it does everything for you I think is is a problem.
hundred percent agree on that. number one number you check every morning.
terminations, people leaving our practice. You know, we set goals on an annual basis and and we spend a lot of time and it it speaks to patient experience. It it is a indicator to see how well are we doing delivering value to our patients, how well are we doing in terms of providing exceptional patient experience, how w you know, in in the the price that we charge versus the product that we deliver, how well are we doing against that.
I love that. I mean, it's funny as we built our business, we only do month to month, no long term contracts for the same reason, which is like there's no stronger vote of somebody, you know, voting with their dollars every month to come back or voting
Absolutely.
with that service.
and if you think about a lot of things we talked about are the things to support that.
So if we see that moving in the wrong direction, we you know it's it's unfortunately it's a you know it's a bit of a lagging indicator, but it gives us an indication that some of the things that we're doing, we we really need to refocus. Either we're not doing it well or we're doing the wrong things.
Yeah, I love it. Last one, finish this sentence. in concierge medicine you can automate almost anything except
patient experience. It is it is it's interesting. I I I go to a a gym around the corner at the university here and one of the people in the gym is a member of the was a member of the gym he's unfortunately since passed passed away but he he made a comment to me that says like Jack you guys want me to use the portal. I pay you guys a lot of money to talk to people. And and I think that's what we need to keep in the back of our mind. You know the the tools and the technology are there but some people just are not gonna use it and we are you know, we as a business, you know, make our you know we we we provide value every day in those human interactions.
It's like you want technology to be there to support the sort of provider and patient experience and not sort of prevent that from being the the main thing that, you know, healthcare's all about.
Absolutely.
Absolutely. Technology is a tool.
I love it. Jack, where can people find you if they want to learn more or chat with you? Or also just, you know, if they want to sign up and investigate partner MD?
Yeah, I mean yeah, partner MD is simple. We're at partnermd.com. and I'm on I'm on LinkedIn. So I'm easy to find. Jack Bretcher, just search for me on LinkedIn.
Awesome. I'll put it in the show notes as well. Jack, this was great. I
Exactly.
mean, most people treat tech and operations as different jobs. And so to see this and sort of all come together is really why it's just the best version of you know, how how you'd bring this together. So thank you so much for taking the time.
Absolutely. great conversation.
That was Jack Bretcher. An honest look at how you industrialize everything behind a concierge practice. So the relationship out front can actually scale.
A couple things that stood out to me. The duck on the pond, you know, all that paddling underneath, the process, the systems, the cross-functional work, and that what earns you the right to be high touch where it matters. This technology is a tool, not the end game. Start with the business outcome, then pick the tool, never the hammer looking for a nail. Scale smart. You're not ready for location three until unbiased metrics tell you why location one works. And on acquisitions, rule number one, don't break it.
Partner over product. They pick vendors that can sit across the table from them and grow with them. The same reason we're month to month. Earn your business every month. Feedback in real time, right? The non-five score, the non-promoter pings, the practice manager, all the way to the CEO. That's how you finish a quarter like Jack with a 93 MPS. The number he checks every morning, member terminations. Churn is that ultimate vote of confidence in your business or in your practice.
You can automate almost anything except that patient experience. You know, as he said, I pay you guys a lot of money to talk to people.
That's the show. If you got something you can use, follow along and send it to one operator who needs it. I'm Kevin Henriksen from Pretty Good AI. See you next time.
Transcribed from the episode recording, with names and spellings corrected.