Scott Becker, McGuireWoods | The Window of Opportunity: Healthcare and PE Insights

Bluewave connects proactive business builders, including more than 500 of the world's leading private equity firms and thousands of companies to the very best service providers for their critical variable, on-point and on-time business needs.

So I'm very excited to be joined today by Scott Becker and Scott. For those of you who don't already know him, and I'm sure many of our listeners do, is an extremely well-known, not only attorney, but entrepreneur in two of the industries. That certainly matter very highly to many in this world. And it's the healthcare world and the private equity world and that intersection. And maybe just to set the stage before we jump in with Scott a little bit. I had a great call with him. Probably when I was just starting on the Bluewave journey and I was hoping he'd talk me out of it. But he encouraged me to stick with it. So, Scott, thank you so much for joining here today.

But the core of the business really revolves around hospitals and health systems, and really health it. But those are the two principal things, sort of Becker's healthcare. Founder publisher I still serve as publisher Chief Content officer. Jessica Cole, my partner in that business, is the CEO, has been the CEO for a long time now, just does a fantastic, fantastic job. And the law firm has several great partners that have really driven and grown the practice, and we overlap in the private equity practice. So a lot of work in the healthcare business has been around, originally in the legal side, helping hospitals and health systems, surgery center chains. But also private equity funds that invest in healthcare. And got deeply, deeply involved at that intersection of healthcare and private equity a long time ago. And again, like all these things, some of my colleagues and partners have taken it much further and much greater than I have. And we'll try to avoid mentioning too many people. But Jeff Cockrell, Amber Walsh, Holly Buckley and a variety of others have really driven that healthcare.

Private equity Intersection have done a fantastic job. But those are my two core worlds. My background graduated from Harvard Law School, if you wanted a fun fact about me. When I was a third year in law school, I was a teaching assistant for Moot Court and, for, you know, advising first-year students. In my first-year class. I had two brilliant students, one of which was future President Barack Obama. Another one was future law professor and brilliant, brilliant lawyer Eric Posner, the son of a famous judge.

And the fun fact about it is not so much that. I had them in my class, but the two of them were, and there's no fake humility here. The two of them were so much smarter than I was. That when I would explain things to the class, they would often jump in and articulate. I think this is what Scott means, this is Scott's point on that. But truly were so gracious and so bright, and so much better than me. That the class started to look like a Saturday night live skit where I would tee up the issue. And Barack and this gentleman, Eric Posner, would really explain what I meant. And they did so with such grace and such tremendous talent that I was like, that's it. But so that's a fun background fact from my Harvard law school days. But Sean, let me turn it back to you.

And you got to accept it. And it goes back to the flip side is you try and find your own niches where you could excel, where you're not competing against the whole world. But it's a fascinating world and there's always going to be people brighter, smarter, faster, more athletic, more this, more that, and it is what it is.

It's an acceptance that we all sort of come to at some point.

I was trying to build that brand and build a legal business around that. And then at some point into that journey, five, seven years into that journey. It was clear that this would have the potential to be a business in and of itself. And that was the point at which I started hiring a number of full-time people into that business. Trying to build on an editorial team, an events team, ultimately a sales team and a client management team. And of the 10 people I had hired, or so. And this will go back to one of the books we'll talk about later. A couple of those people were extraordinary, one in particular. And then ended up at some point sort of transitioning, sort of leadership on the commercial side. At first to that person. Jessica Cole. And then growing around that, and we really ended up about 10 years into it. So go back.

20-plus years ago, we expanded from surgery centers into hospitals and health systems, and into orthopedics and spine. And this is also one of the great lessons in so many things you have to. Both. You start with your own bias or perspective on what you think is going to be the thing. And then you have to keep your eyes open and follow things to double down on what works. So what happens is we grew into the next two areas. And Jessica and I had put together a strategy a long, long time ago. That we didn't want to be in 50 areas, but we needed to be in five to seven areas so that we weren't. You need to be in enough areas and deep enough that you could build out the team you want to build out.

At the end of the day, I mean, you just can't have the kind of talent you want if you have too small a business. So we had an imperative to grow, but we didn't want to 20 different lines, we wanted to be deep in five or seven lines. So we thought orthopedics and spine, which is a very close parallel and connected to surgery centers, would be our growth area. And it grew great. But hospitals and health systems ended up exploding in growth.

In hindsight, it's clear as to why. But it's one of those things about listening, understanding and following what you're doing, understanding your own business to be able to then grow it to the next level. And I'll tell you, so many things in life are not about brilliance, they're about at least being able to follow the cues. When I first started with surgery centers, people say, Oh my god, that was brilliant that you got into surgery centers so early, and the reality is it wasn't so brilliant. I was testing three different areas. The other ones were cardiovascular and disease management and surgery centers, and the attention that we got, the opportunities we got, kept on coming in in surgery centers.

And it wasn't that I was so willing to pick surgery centers, it was more I was able to pay attention. That was the one that was going great. And sort of knowing your own business, following it yourself. And doubling down on that area is how we ended up really growing out. The surgery center side, first as one of our verticals, and then hospitals and health systems, orthopedics and spine. But again, a lot of it is not brilliant, it's following what's working and doubling down on it as a constant business imperative and theory around business. Sean, let me turn it back to you before I just keep on taking up all your time.

And his whole notion was that Napoleon wasn't a great X's and O's type general. What he was was amazing at seeing moments of opportunity where they would just open and then seizing those exactly when they saw it. Double down and go and get it when these small windows of opportunities open, because they close equally quickly. And so it reminds me a lot of that, where you saw this opportunity and you went and you took it. And so, you know, in different verticals within your business.

Before it was a popular area, it was just a growing, crazy growth area. So great fun to build a legal practice around, great fun to build an experience route. Then we saw at one point and it wasn't by, it wasn't by. Most things are not by design, they sort of happen to you, when you see them, then you see them. The digital media business, you know, starting a digital media business 20 years ago, 30 years ago, ended up being really smart.

But it wasn't smart. We were competing with Modern Healthcare, one of the great print magazines in healthcare, a magnificent print publication, great great magazine. Still, and we couldn't win against them in print. It just I was funding myself, we couldn't afford to. They were sending out to 30, 60,000 people an issue every week. We couldn't play that game.

And I had editorial members, team members that were like, we have to beat them in print, and it was just by necessity. We couldn't do that, but it was seeing the opportunity. And obviously, starting a digital media company 20 years ago was fantastic. Where, if you started today, there was so much noise, so many different players, so many different participants. That to sort of find a spot in the digital audience today is more challenging than when we started it. You know, 20 plus years ago, I mean, we started the company 30 years ago, but really doubled down on digital 20 plus years ago.

And even to personalize it. I spent a fair bit of my career investing when I was in private equity, in healthcare data businesses. And Becker's healthcare is, and was then kind of standard reading for anyone who hoped to be serving or being in the healthcare systems and centers world. And so, to your credit, you've built something that really matters and is kind of a cornerstone in those industries.

On the labor side, there are looming and huge, daunting shortages of physicians and nurses, physicians in the specialty area, the primary care area. We've got about a million physicians for 330 million plus people in our country. The numbers, it's just a math problem, those numbers just don't work. Even as much as we supplement technology with AI, with everything else, we need more physicians.

Anybody who needs a specialist knows it's harder and harder to find a specialist without knowing somebody. And that's a horrible situation to be in for a whole bunch of different reasons, not the least of which is health equity and access and everything else. So we've got this huge shortages of physicians, we've got increasing proliferation of a lot of different players in healthcare. You've got the CVS, the Walgreens, the Amazons, all trying to hire doctors at a time when there's not enough doctors.

You've got Optum, which is a part of UnitedHealthcare, has become the largest employer of doctors in the country. You've got hospitals and health systems that need more and more doctors. You've got some percentage of business that's being driven by private equity-driven specialty platforms and physician platforms that are hiring doctors. There's just not enough doctors to go around at the end of the day to meet all the needs out there. Anesthesia is a great example.

As we've increased sites of care dramatically, we're looking at a 30 shortage of anesthesiologists. This is just an incredibly challenging situation.

That's just an example, anecdotal, but across the board, lots of different challenges. You've got more and more people that can't get to their doctor when they want to get to their doctor, you've got more and more people. Reverting back to ERs again, just a lot of different trends. One of the last points I'll make about the private equity healthcare world is, and this is the same as any business that relies on leverage. Some is.

This has become more challenging from a cashflow perspective, as the cost of leverage has gone up. That's put a little bit of softening on the deal environment for private equity. Because you're looking at if you're borrowing $100 million, for example, that used to be at 6 7, now that's at 10 12, and it depends what business you're in. Whether the margins are strong enough for that extra $5 million, $6 million in interest a year, or whatever the number is. It has a real impact on the profitability of deals, the ability to keep on investing and doubling down on deals. And just the amount of free cashflow that can be generated when interest rates are that much higher. So those are challenging issues in healthcare, and they're challenging in everything, but they're particularly challenging in areas that are in high-margin areas.

There's even higher demand than they can serve. But you can't just grow anesthesiologists, and so you think about that. And this is a really unique period that usually don't correlate with each other over economic periods. How are healthcare providers overcoming it, or can they overcome particularly scarcity and inflation, co-mingled at the same time?

So they're trying to bring those things down. But in general, it just is a tougher margin business than it was a few years ago. I mean, government now is 50 plus of pay. It used to be a business where you were cross-subsidized by commercial payers. Commercial payers make up a smaller part of the equation.

And the commercial payers are stronger and have more negotiating leverage than they've ever had. I mean, four of the largest top 20 companies in America by revenues are four of the largest payers, so UnitedHealthcare CVs are fifth and sixth. They go back and forth in terms of who are the largest companies by revenues in America. Right after Walmart, Amazon, Apple, et cetera, and ExxonMobil. Depending on what's going on with oil prices that year.

And then Cigna and Elevance are also two of the largest top 20 companies by revenues in the country. And there's just there's, you know, more and more. The big payers are able to sort of have a little bit more control, like Medicare and Medicaid does, over reimbursement. Now. The flip side is, there's just not enough doctors to go around, so we've got this challenge of this tremendous scarcity of physicians. That's going to get a lot worse over the next several years, I'm afraid.

You know, if you're a radiologist 10 years ago, you would look at every slide, you know, every cell, and say, is that you know cancer or not? And then they put, you know, the robots, and they're working side by side. Now, you know, the systems can reconcile the easy stuff, and and the radiologists spend time where their, you know, superpowers are needed most. So what's your thoughts on that? In terms of, you know, this is probably playing forward 10 years versus, you know, one year.

And two, a lot of those jobs are relatively lower wage jobs, where the turnover was tremendous and so the quality of efforts became more challenging. And you've got places that have 1,500 employees, they can get down to 1,000 employees with using AI and those 1,000 employees. As you just said, much more triage on the more challenging cases, of places where there's money to be recovered and so forth. And I think you'll see more and more of that.

I mean, everybody's still trying to figure out where it's going to play into the physician's sort of diagnosis and treatment role, you know, I mean, we've got a totally different issue, which is medical school is still designed pre-internet. And so we turn out doctors that are very well-trained. But at a tremendous cost to those doctors, tremendous cost to the system and tremendous debt, too. I mean, tremendous cost, physically and mentally, as well as cost. And a specialist isn't out of school until they're in their early 30s, and a huge percentage of them are part-time, by 40 or 50..

So you've got this horribly inefficient medical school program and residency training program, and so forth. That is a challenge, too. But this makes technology improvement, education improvement, and there's a lot of vested interest that slows some of those things down.

I don't think you could ever turn them over to the robots, at least in our visible future. So I think that's a great point and maybe turn in the page here a bit. I'd love to get your perspective on what's going on in Washington, D.C. What's going on? Particularly as it relates to the private equity industry and the perceived role that's occurring.

And so I'd be curious, why are regulators getting engaged, where are they getting it right and wrong? Et cetera? Specifically as it relates to private equities role investing in this part of the economy.

So relatively small amounts of the big scheme of things. I mean, you have two things that happen. With Washington attacking private equity periodically, you have a very visible blow up where a private equity funded firm had been way over leveraged. And ends up, you know, in financial trouble. But that's not unique to private equity, we get plenty of households that get upside down without anything to do with private equity.

I mean, it just is the way of, if you have too much debt, we always say, you know, categorically, debt kills nations, families and companies, and so people overdo debt. They end up in trouble periodically, and it is part of the private equity toolbook to use debt now. Whether that's a Washington issue that they should get involved in or not, who knows?

I mean, the second thing that happens is we get to periodically where healthcare is, you know, talked about very much. So. As it's 18 19 of the economy, we spend more on it in our country than many other nations do. We don't necessarily get better outcomes in other nations. So people look at that and then it becomes sort of a tangent to that. To go after the private equity funds. And part of the thing that's happened in D..C.

Is, you know, the Medicare advantage thing is a great example of this, and I'll go onto the thought in a second. Medicare advantage is something that is now more than 50 of Medicare is in Medicare Advantage. The stats The stats on Medicare advantage generally show it's more expensive versus less expensive. It's not necessarily better care, hospitals and health systems, depending on where they're at. Like it or hate it. But it gives them less control over the patient population and more control of the Medicare Advantage Plan.

What happened with Medicare advantage? President Trump ended up being pro-medicare advantage, and this just goes to political power in Washington, we're going to talk about in a second. President Biden started off being anti-medicare advantage. He came out originally as anti-medicare advantage. And then what's happened is the insurance companies are so powerful in our country, and they're more powerful than ever.

I mean, we mentioned it a moment ago that four of the 20 largest companies by revenue in the country, right up there with, you know, Apple and Walmart and Amazon are four of the biggest payers. So so many dollars for those payers, and those payers, you know, somehow, or another, the D...C. crowd got to President Biden, President Biden turned his position. 180, became very pro-medicare advantage.

Now we're at a spot where Medicare advantage is more than half of all Medicare patients. And the data, at least so far, shows it's more expensive versus less expensive. Now, whether somebody could, you know, people are always talking about, well, we're going to bend the cost curve at some time in the future. I don't necessarily see that. You get more rationing, you get more control of where people can go.

But are we really bending the cost curve? Not so much. But we do have incredibly powerful insurance companies and it is what it is, but what happens is the insurance companies, you know, and it's not so much like there are real problems to solve. In D..C. We don't have doctors and nurses.

Let's focus there, you know? But it's easy to go after P.E. funds, it's hard to go after insurance companies because they're so powerful, the P..E.

Funds are multiple different levels, of course, but mostly at the end of the day. Insurance companies are incredibly well-connected in D.

C.

And private equity ones are not that poorly connected either, so they end up sooner or later generally fending through most of these things. Pretty much okay.

So they don't use their words, they don't explain what they're doing. They all just try to keep their heads down because they don't want to get whacked on the head by whomever's got the club. At the time. And today, you know, most of the people still think about this industry, you know, through the lens of a 1980s movie with Michael Douglas and Charlie Sheen. And so that's something that gets them in a lot of trouble over time.

And the first thing they said, it's, as you said earlier, it's a pretty small part of the healthcare system in terms of where they're playing. And it's, you know, 4 of the hospitals, 11 of the nursing homes. And then what they said is, we looked at all the data, we looked at the outcomes. And if you look at everything, the cost of their care, their patient satisfaction, their staffing levels, the quality of care. They're all kind of materially the same as everyone else. And so it's hard to kind of, like, throw them under the bus because they're not necessarily better, but they're not worse than others. And then, you know, coming across a study by, you know, the thing that they said they are doing, and what an NIH study said is, well. What private equity is doing is they're actually bringing care to lower income and underserved populations and rural areas where healthcare doesn't exist. Because that's kind of what private equity does is. They look for opportunities where there's white space and they go there.

And so are you seeing anything in terms of that regard, like just bringing it to different spots, maybe that your large healthcare system you don't want to serve? Rural Kentucky.

But, you know, it's another piece of the puzzle of trying to figure out other ways to solve America's healthcare challenges. And so whether the venture capital funding of all kinds of different initiatives, the private equity investment in companies that already have some profits or some revenues. But either way, it's a critical part of the ecosystem of trying to figure out what can work and what won't work. And like anything else, there's winners and losers in that world as well, you know, people that do it really well, people that don't.

And so, you know, a lot of what they're doing is 100 selfish. They're trying to generate returns on behalf of investors, many of which are pension funds, many of which are, you know, very wealthy families. And they're bringing healthcare to different places out of selfishness because they want to generate returns, but within that selfishness, there's actually some altruistic outcomes. And I think you see some of that in different areas where people aren't served and they're finding ways to overcome. To go around and go below, because that's where opportunities haven't been before, to generate selfish but good returns and outcomes for other people.

And so I think it's like, with everything, we tend to polarize the world. And you raise a lot of good points of, you know, the truth usually lies somewhere in between.

And how would you recommend entrepreneurs consider that path as well?

Wanted to de-risk some, take some money off the table to make sure my family was safe. Make sure I can get my kids all through college. And one at med school and other stuff right now, and all those kinds of things. And at the same time, we wanted more freedom to grow the company, and so for us, private equity ended up being a good answer, and every founder has. I think most founders have somewhat of a love-hate relationship with private equity, which is a whole other discussion. But when you go into this, with looking at a private equity transaction, like three or four pieces of advice, you have to sort of know what you're trying to accomplish.

You know, we were trying to de-risk and grow, so we sort of knew what we were trying to accomplish. We didn't have a need to do anything with a desire to, which is a far better place to be. Second is, as you go through anything that you're going to do, you got to make sure the core business keeps on running well. There's nothing worse than getting yourself wholly involved in a process and having the company go in the wrong direction.

You have to double down. You end up with multiple full-time jobs during that period of time. Make sure the company is going great. We're going through a process. Third, you probably almost always need a good investment bank, a good advisor, et cetera, et cetera. People don't realize how much better they know the business in that world than you do.

I was a lawyer by background, a CPA, a Harvard lawyer and practicing lawyer in doing this. And I was blown away by the difference in understanding of the market that the investment bankers had than I had. You think you know a lot, but you don't have any idea how much you don't know. The people on the other side of the transaction do this completely for a living. You're doing it once or twice, or three times in your life. You might be doing it as an advisor to others, but it's very different doing it for your own company, your own business.

So you need a great advisor. Fourth, you have to understand how you're going to manage the company going forward. For us, Jessica Cole, our CEO, is still in charge. Our private equity fund, we ended up with a private equity fund that good people that we trusted.

No private equity fund is perfect, but overall good people to work with. And so you really look at when you're doing a transaction, how are you going to look at the people afterwards? They line up with you in terms of your personality, what you're trying to do, what you're trying to accomplish, and it's never perfect, but it's been, in the big scheme of things. Really good is the offer of the value that you're looking for. It doesn't have to be the perfect offer, but it's got to be a rational offer.

The third is, can they close? will they close? Do you trust that they'll do what you want them to do and get from point A to point B in the deal? Fourth is, are you relatively aligned on management going forward and what it's going to look like going forward? A number of those kinds of issues.

And then fifth is if you're not used to having debt. If you bring in a private equity partner, you're going to probably have to get used to managing a company with some debt on it. And I know, for me and my partner, who's now CEO and president, and really the leader of the company. That was a real experience, learning to live with a lot of debt when we had no debt forever. But it also gave us freedom to double down on. Some of the things that were working great were economic. We might not have felt as free to do so beforehand. So having a private equity partner, like anything, it has to be a good partner, people that you'd live with.

I've been fortunate that I've got a magnificent CEO partner in the leadership of the company. The company's gone great since we brought in private equity several years back. That helps a lot, too, because it avoids a lot of the tensions between private equity and management that you can't have. Because we've had a great, great leadership team Jessica, Katie, Abby, Emma, Scott, Jones, a whole lot of people, Margo, a whole ton of people. Editorial leadership, too, Laura, Molly, Mackenzie, Brian. A lot of people that have really driven things well since, and so that's helped a lot.

Haley and Allie, too, on the sales side, driven a lot of the sales team. But there's just a lot of like. Things have gone well. So it makes it a lot easier to manage the relationship. You know, imperfect, but overall, it's been a real plus for us.

It's like they're always bringing in like an extra interim CFO to help with the load, because it will crush your CFO, no matter who they are. And then number two, what I really liked you thinking about is bringing in good advisors. When I was on the other side, where I would see people really go off the rails. Is their friend, who is a real estate attorney, is their deal attorney, and they didn't want to use an investment banker. Or they got someone who wasn't a good fit. You know that they met at a cocktail hour at the Country club, and then, you know, so bring in. I love how you pointed out, bring in really good people. They'll be worth their weight in gold, literally and figuratively, to get through that process.

And then third, I think the thing that was really, really insightful that anyone will benefit from is this whole concept of alignment. You know, make sure before you slip on rings, you know you're aligned with your future partners. Because it turns into a marriage that's going to, you know, last quite some time. If it's, you know, whether successful or not. And so thank you for that advice, I think it's really, really helpful.

Are they perfect? No, but they're very good people, we trust them and they're very, very good people and they've been great partners.

I mean, in the big scheme of things, you know, it's always challenging as a founder, when you turn over control, this is always a complicated thing for founders. Whether you know, most people recognize that at some point, that that's a complicated transition, same as any leader who transitions power. Some, those are complicated emotional, financial, et cetera things. But in the big scheme of things, they've been wonderful partners. And it was a but it was a great. It was a good process.

And we had sort of been through a pretty hardcore. We knew some people connected to them too. But, to your point, there's nothing worse than when somebody says to me, You know, I know this guy from my club, he does this stuff, I mean, as opposed to like. And we did.

What everybody should do is. We went through an interview process with several investment bankers, we found out the right of this banker was with the private equity funds that we came down to. We did a ton of different checks of people that had worked with them, trying to understand it. I mean, you have to do that diligence on your side to make sure you know at the end of the day. As long as you get what you expect to get, it's fine, but if you do a deal with somebody and they're very different after you do a deal, no good, you know, but but. But as long as you understood, like, and you always learn when you do this, you know, you always learn things that you would have known before.

But as long as you're dealing with good people, you sort of figure it out.

And you're, you're, you know, you're, you're starting to date. It's like, don't, don't, don't marry the first person you go on a date with. Like, you know, go around and meet people and learn things and calibrate in your mind. And then and then, just like in a marriage every day, it's not going to be perfect. And I'm sure my wife will very fairly tell you that. Most of the time, I'm pretty good, but a lot of times I'm just a total pain in the neck. That would be like, how I, you know, I, I process, you know, our conversation in my mind.

So maybe as a as a great little transition here, I'd I'd love, you know, no doubt you've collected, you have collected a lot of wisdom and takeaways and things you've read. And one of the things I, you know, I think we both would agree, is, you know, people we know who are really interesting and successful. They. They read a lot and often share books with each other. And and, and and learn from the wisdom and mistakes and opportunities and insights of others. So, Scott, I'd be really curious to see what's one of maybe your favorite books that you've read over time, and you know, some of the takeaways that you'd share?

If you put the right teams in place, the right people into place, so so, I. I'm a huge fan of Jim Collins thoughts around that. He was the most articulate on the concept and it resonated with what I was doing back in the day in the law firm, in the media company. Which is trying to build great teams of people and keep those people and double down on those people. And so I love that concept. We think so much about businesses doubling down on great clients, great people, great niches, those three concepts.

And Jim Collins was probably the most articulate. About getting the right people with you and sorting out people is more important than anything, and we had some real hard times in doing so. I mean, when I took a very young leader and put her in charge of the 10 20 people I had hired already, there was a lot of rebellion to that. But but this was somebody who's outperforming everybody and we put her in charge like 20 years ago. And probably half my people quit within a month or two because they were like, I'm not working for that young woman.

I'm just not doing it, you know? And those were men and women that were just sort of like that, just couldn't see it. But what happens is we then sorted out, people, built a great team, great leadership in all different areas. And we often talk about, we talk about often, the three phases of an entrepreneur.

And I'll just touch on this for one second, 30 seconds. First phase is you're doing everything yourself, sort of, you're the chief bottle, washer, cook everything, you're doing everything. The second phase, you're hiring lots of people, but they're honestly better than you.

And you could still leverage yourself, you still get to a certain spot by hiring lots of other people that are starting to fill out positions and you could grow. But the third phase of an entrepreneur is when you've hired people in every key role. Who's better than how you could do it yourself? And this is when companies can grow on top of companies and can grow at a different level. Because it's no longer reliant upon a top-down vision of the founder, it's now lots of people self-actualizing and growing and thriving.

So if you do those three phases of an entrepreneur, Jim Collins. He might never have articulated that, but he articulated a lot about both leadership and about the importance of building teams. That's one book, the second book I'll point to is a recent book I've been reading or finished recently. A doctor, Peter, Attia, and Peter writes a book called Outlive. And so one of the things and you and I are probably on the same vintage. I'm probably a little bit older. But if you're going to talk about, one thing I would tell my younger self is, how do you make physical and mental health a priority for life?

You know that, like, I tell my children, they got to be constructive adults and they've got to make sure they maintain themselves as physically and mentally healthy. And whether it's the nutrition and the exercise and the other things. There are so many things that you can do that are so important to your longevity. Both as a professional, because you see people as they keep themselves. I'm one of these people who's in good shape, not great shape. I can never quite get to that perfect spot where I'd like to be. But it is what it is and it's a struggle for me. It's a war to stay in reasonably good shape. But you're so much healthier and more effective professionally, and you're so much healthier personally.

And Peter Atiyah Dr. Atiyah talked about this concept of lifespan versus healthspan. And the concept is you might live to 85, but if your body and mind is going at 75, your last 10 years of life are often going to be horrible. So he talks about trying to get healthspan, your health to match up as well as possible with your longevity and your lifespan. And I think the concept is a brilliant concept.

And he talks about the four different big causes of death and deterioration. And how you sort of fight those with nutrition, with exercise, with taking care of yourself mentally, all those kinds of things. So I think this. So. Those are two books outlived by Peter Atiyah, and then Good to Great, and the different series of books by James Collins that probably continue to resonate with me. You know, both one more recently, but it's something we think about all the time, and one more, longevity wise, that I've talked about. Reverences, the Jim Collins books.

And I think, if you could read that, that's 80 of your MBA right there, don't spend the money.

And so it's getting businesses and doing something in its early form and then getting to customers as soon as possible. And they'll help you refine it versus letting perfection be the enemy of really, really good. And then the next book that we give out to everyone is Who moved my cheese? Which is this great parable about mice navigating through life and dealing with change in your lives. And then the last one is one that I just came up with, was recommended to someone else, that I just gave everyone a team. And it'll be one of the five books we're going forward, which is called The Boy, The Mole, The Fox and the Horse. And it is this really, really great book about life and change, and fear and togetherness. And navigating through scary things and coming out the other side better, and realizing that life's a journey, not a destination.

And it's a children's book, but I love it, so those are the five that we give out. But I'm always looking for others, and one book I will absolutely read probably this week is Outlive. Because my doctor is telling me I need to up my game for the very same things. It's like, listen, do you want to be on a glide path into your older years, or do you want to come roaring in?

And let's just say I'm on a glide path right now.

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Onward.