Can physicians be business people? It’s not a part of their medical training. And medical problem solving isn’t exactly like business problem solving. So is it even possible for successful physicians to be equally successful entrepreneurs?
On this episode of Inside Reproductive Health, Griffin talks to Dr. Francisco Arredondo, founder of RMA of Texas and author of his upcoming book, MedikalPreneur. Dr. Arredondo digs into a few concepts discussed in his book, focusing mainly on the similarities and differences between the traditional physician and the traditional entrepreneur. Listen to find out what it takes for physicians who wish to also be entrepreneurs in the fertility field to be successful in both endeavors.
Mentioned in this episode:
Range: Why Generalists Triumph in a Specialized World by David Epstein
Deep Work by Cal Newport
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
JONES 0:53
Today on Inside Reproductive Health, I'm joined by Dr. Francisco Arredondo who founded RMA of Texas in 2007. He grew that practice to be one of the state's largest and most experienced centers for fertility treatment. In 2018, his clinic joined forces with a group, he first exited at 51% equity, he then sold the rest of the equity in his group to start the sabbatical that he's on now, writing his book MedikalPreneur, which we're going to talk about. He has served as the CMO, the Chief Medical Officer for groups. He has served on the Medical Advisory Board for companies like Progyny. So he himself is an entrepreneur. He himself is a medical doctor. Now he's writing a book called MedikalPreneur, we're going to talk about the contents and that mission today, Dr. Arredondo, Paco, welcome to Inside Reproductive Health.
ARREDONDO 1:47
It's a pleasure to be here, so I'm ready to chat with you.
JONES 1:51
So I am happy to go into this with you because one of the things that you're passionate about is correcting the stereotype, I suppose, that doctors are not good entrepreneurs or not good business people. I'm not sure that it's a myth, but I'm also not sure that it's always fair. And so what is it that you're out to clarify?
ARREDONDO 2:19
Well, I think that there is this common talk that physician entrepreneurs is like an oxymoron. And obviously, it's not. And it's not for several reasons. In fact, I believe that the future physicians have the perfect hardware of the mind to become the best entrepreneurs and business people in the future for several reasons. So as you can see that the business is moving towards a way that is not only all about the money, it's actually solving a problem. And basically the money is the bypass product of the end. So the mentality of trying to help solve problems, help find solutions, it is already embedded in the spirit and the daily training of physicians. They just need a little bit of financial and business discipline that is something that is usually not taught in medical school. But if you think about it, of the skills that you're required to be an entrepreneur, a business person, they are very, very aligned and overlap a lot with physicians. Entrepreneurs and doctors both require impeccable judgment and learning from their mistakes. Both require a little bit of research and do trial and error and experimentation. Both deal with uncertainties. Both make decisions with imperfect information. Physicians and entrepreneurs need to know how to read patterns, how to anticipate events, how to question, to obtain the right answers. And because the skill the physicians have, always trying to do good, always trying to find solutions, and the money will come after that. In the 21st century, the hard work of the physician is perfect to flourish in business. And we just need to change, a little bit, the software of the mind. But I have no doubt that physicians will. And not all physicians need to be an entrepreneur. You only require a couple of them to really have an impact and have a change in their perception. You just need a few innovators to disrupt the whole system.
JONES 4:56
So you mentioned some of the commonalities that entrepreneurs and physicians have: making decisions quickly, incomplete information, doing so after trial and error, but those can be quite different. Can't they? I mean, there's some differences here, one of which is that the trial and error that physicians are working with have to do with labs and randomized control trials and approved procedures. And the trial and error that entrepreneurs are facing is the market, which changes every day. And by the time you do a randomized control trial with market study for a product, it could be irrelevant or replaced in the 18 months that it takes to launch it, which is very different from medicine. So what do you see the tension there?
ARREDONDO 5:47
Well, what I see there is, despite the fact that we think that physicians make decisions based on evidence based and scientific facts--there's a very nice article from Scientific American, I think it was like 2011 or something, that says that actually, the medical decisions with scientific evidence is only 30%. The great majority of the medical decisions are with no information at all. And I think that doing a small--if I understand your question correctly--doing a small trial and error in the business while it may take a little bit of time, you still will get to the bottom of the answer that you want. Can you clarify a little bit more of what the question that you want to ask?
JONES 6:46
So I mean, is it even a case like that, where you're making decisions, and maybe 30% of the time is based on the science that one might have before oneself, there's still 15 years of higher ed required to be an REI for example--four years undergrad, four years med school, four years residency, three year fellowship. Whereas I myself, I have a bachelor's degree from a state liberal arts school that I would blow my nose with. It has served me zero percent in my opinion in starting my business. My business has been informed by what clients are willing to spend money on, what benefits them, what their clients are willing to spend money on, how my people are motivated, how we're able to build systems. And I that has just been changing so quickly, and it's almost all been trial and error. And there are MBA tracks for people and I think that there is a utility for people that are going to be COOs and have that operational track or work for a place like Bain and McKenzie and do some sort of Harvard MBA level consulting, but some of the best business people in the world hardly have a high school diploma. Whereas every single physician has the licensure to practice medicine.
ARREDONDO 8:18
Yeah. I just don't know if what you're saying is that by having too much study will impair you to become a good business people. I don't agree with that. But what I would say is that everything that you mentioned there, and is basically the same process that physicians use for diagnosis. What does my customer want? Where do they want to go? And that's what we do. We try to diagnose the problem and then treat for it. And how do you diagnose the problem? By asking the proper questions and so on. Now since we have al; that embedded in our daily thinking, we just need to adopt it into the business. That is basically why I believe physicians are very well poised to become great entrepreneurs and business people. And let's make a distinction. The same skill set that you're required to be an entrepreneur is different than when you're required to be a business person. Because entrepreneurs start a business with an idea and develop it and idealize it and work through it. But that doesn't mean if you develop a product or a service that is innovation, that doesn't necessarily mean that you know how to handle the company. So, in fact, I know a lot of entrepreneurs that are horrible managers and horrible business people and vice versa. So I think that it's important to make the distinctions between an entrepreneur and a business manager or business person to make a company successful. So that's an important distinction.
JONES 10:18
And that is a good distinction. I'll give an example that might show where I see the tendency to be a successful physician betraying the tendency to be a successful entrepreneur. And so when we started working with clients and doing video for them, video is expensive, right? You can spend 10s and 10s of thousands of dollars on video if you wanted. And so I just wanted to test the concept with many of our clients at the time and just say, let's just do social media video. Let's just record something on the phone, edit it cheaply, just to put it out there to our community and to see how they react, get feedback from that and then we can invest in production later. And so many of our early clients were saying things like Griffin, I can't just take something that isn't gonna look the highest quality of production and put that on the internet. And that tendency to, I guess, for quality control, which is necessary in treating a patient, it can also betray things like, you know, having to micromanage every single social media post that people are going to spend 1.7 seconds looking at if you're lucky. And so, talk about that.
ARREDONDO 11:44
In your particular example, I think the important thing is to educate the physician and to say in our case in fertility, who is our current market? 25 to 45 years of age. A great majority of those are basically Generation Y and some Generation X. The advantage of what you propose to me about doing it with a phone is that you humanize the person. It's a natural conversation. If authenticity, it would change what the current consumer the current patient wants to see in doctors and professionals overall, they want to see authenticity. They want to see spontaneous conversations, and nothing can be achieved better than just the phone.
JONES 12:37
So that’s my argument of what the market wants. The market wants authenticity, the physician wants perfection.
ARREDONDO 12:43
I think we have to educate it, because you have to define what are the set of values to say what is perfection? Perfection for whom? For you or for the customer? I have found physicians that are very open to this and especially the new younger physicians. And yes, we go to physicians that are more into the baby boomer generation that are going to be more difficult to persuade to tell them that this. But, you know, these are generalizations. I have found Baby Boomers that are much more flexible and open minded than a lot of Millennials. So obviously we're generalizing here, but as a rule, I think that the new consumer is looking to see authenticity, to see spontaneity. And I think that part of the duty of a seller of any service is to educate the consumer. I'm going to share with you this anecdote that I actually put in the book, in the MedikalPreneur book, which is the guy that enters into a Home Depot and says, Hey, do you have quarter inch drills? And the guy that works in the Home Depot looks at the customer and says, You don't need a quarter inch drill. You're looking for a quarter inch hole. He says Oh! And what do you need the hole for? Oh, I'm gonna put some wood and then I'm gonna put some screws in, I'm going to hang my frames in my room. Oh, you're looking to hang up frames? Well, here are the options. I have Velcro, I have this little device that you don't have to put a hole. I have this one that you put in the strip, you just make one little thing. I have the quarter inch drill and you can do that. And so actually, you know, the consumer in this particular case, your doctor that came here, they have an idea. They want to expand their sales and all this and they think they want to look more professional, but hey, they're all these options. There's the Velcro, there is this, there is that. So it is an important part for whoever's providing the service to also give options and to understand what is the ultimate need. The need was not the quarter inch drill, the need was to hang the frames. And I think we see this on a daily basis with our patients. And I've seen this in fertility--let's just talk about a little bit specific about fertility--it comes to me a 37 year old young lady and says, I want to get pregnant. I have not been able to get pregnant in one year. And you and I know that maybe I can, you know, if everything is normal, I can give her a little bit of Clomid and do an insemination. And if we're lucky, can 50% of the time, she will get pregnant and she will conceive. And guess what? You're a hero right now. But when she comes back as 39 or 40, and she wants her second baby, you're not going to be a hero because probably by then it's going to be much more difficult and you're not gonna achieve that in one or two inseminations. So the proper question at that time, you don't need a drill statement, it’s like how many children do you envision in your family? And if she at 37 tells me my ideal family is going to be three, I'm going to say, listen my friend, you need to do an IVF. Freeze some embryos, we'll do one transfer right now and actually, if you can pregnant, perfect. And then we have the other ones, and you can come back when you're 40 and we still have three or four normal embryos stored for you to maximize the chances of having those two or three kids. So once more, you know, it is the question. The question to try to obtain is what is the ultimate needs of your consumer? Does that make sense?
JONES 16:38
It makes perfect sense. We have to deal with this challenge very often because often when people approach me they have their marketing director or the practice manager approach me and they're just asking me questions like, How much does a website cost or what do you do for social media? Those are all things that we have done to help people, but the problems that we help with are things like getting a physician busy or helping to position for exit or helping to make a satellite office at capacity or improve IVF conversion rate or increase new patient volumes, etc. So I always try to find out what is the hole first. And until we agree on what is the hole, then we don't move forward. If they're just saying, hey, what kind of drill do you have? And I say, if you can't find a time and materials agency that's cheap and quick, you don't know how to use Google. This is what we help with. I'm going to help you figure out what to do for the hole because this is all we do. But it's a very good point. You tend to gravitate to this level of thinking and I remember the first time I met you, you were talking about going to New York City to do improv classes. So you have this, you have this bend towards entrepreneurship, towards creative thinking. I don't see it from so many physicians--not that I don't see it from anybody, I do really see creative entrepreneurship physicians in our field--but I don't see it from so many. Why do you suppose you tend to gravitate toward it more than other doctors who haven't embraced this entrepreneurial calling that you see?
ARREDONDO 18:14
I think that I have always been a very curious person. That's one thing. And I have always not tried to do what everybody does. I'm always a little bit thinking on the outlines, for good or for bad. And sometimes it's for bad and as an entrepreneur, you make mistakes. I would say that perhaps what gave me this orientation was that I had a group of--my parents would encourage me always to read outside medicine. My father was a big believer that what you gain in depth, you lose in width. And he said, it's much better to know a little bit about everything than to know a lot about something. And this is paradoxical because our universities are teaching you the country. Or you have to be the super, super specialists on these disciplines. But there's actually a very nice book that just came out, I think a couple years ago, and it's called Range. And how generalists will dominate the future of a super specialized world. Because the more you know about all the things, the more you can solve problems. That education of the past that gave you basics of ethics, basics of literature, basics of physics, basis of mathematics, that bachelor that gave you a solid basis for everything, then you can construct the house however you want it. So I think that to give you the answer, I think that it has always been my desire of reading things that have nothing to do with medicine. And the talks, you remember, I always talk about hybridization. You know, this is also that with physicians, sometimes--this is the bad part about the physicians--that sometimes we're hard headed, some of us. And we are set in the way of thinking. And we think that we cannot learn from other industries. And we can certainly learn. I mean, we don't have to reinvent the wheel. A lot of the things that we did in our practice to be creative, basically, I stole them from other industries. It was not--some of the things we created as a team, but a lot of the things that we did, we pilfered them from other industries. You know, Picasso used to say “Good artists copy, but great artists steal,” so you can steal a lot of ideas and apply them to your industry.
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JONES 22:59
Let's explore the idea a little bit more because if we were just taking this at face value, I think this is something that you and I would really disagree on. My tendency is to say that I think for most people, the universities are crap because they're far too generalist, particularly with regard to undergraduates. And the success that we've had, have been from being specialists. The reason why I'm able to negotiate the way I am, the reason why I'm able to have the results for clients is because I'm not really worth much to a dermatologist. I'm not worth much to a restaurant owner as a marketer or many other different types of businesses. We’ve all gone into this depth. The point you're making, though, about the value that a generalist can bring in a specialized society, I think someone named Cal Newport has identified where we're both right. Are you familiar with Cal Newport at all?
ARREDONDO 23:59
No, actually. I'm not, no.
JONES 24:02
He wrote a book called Deep Work. And so especially for the Millennials listening, I recommend listening to it. Cal Newport’s book is Deep Work. But one of the things that he talks about, Paco, is being so specialized in one vertical, and then also being really well-rounded. So going really deep in something and then having the Renaissance experience to add to it. I think both are critical.
ARREDONDO 24:30
Obviously, I cannot agree with you more. I think that we do not disagree. We agree. You obviously need something to focus your work, but you're required that wide knowledge in order to solve the new problems of other things and thinking totally outside of what you are. You know, I don't know if you know this, but, Nobel prizes, the great majority of them, you are much more likely to be a Nobel Prize [winner] if you play an instrument, if you actually are very prone to acting and into a lot of the performance arts. People don't know that having this wide variety of knowledge is so super important. And other people call it alternating rhythms, which is basically to never lose perspective of the big picture, but be able to focus on the details. So is that balance that requires to be very specialized, but also having a lot of knowledge. But what I'm saying is unfortunately, in a lot of our medical fields, the stuff is, Oh, you have to know about medicine and information. You have to know about OB/GYN, who cares about the kidneys, or you have to know about reproduction, and who cares about deliveries, it's only this. Now. I mean, our body is totally interconnected and interconnected with the society. So you really yes, you need to know about this of reproduction, but you need to see the big picture. And I think that sometimes, not always, some of us physicians lack that universal view, and focus on the--we get lost into the leaves and the trees and forget the forest.
JONES 26:29
And I could see being, especially a sub-specialist physician, one's tendency to err on that side of being too deep in the vertical and not wide enough to be well-rounded. And I'm seeing a lot of people come out of college or even people my age now in their mid 30s, and I just think you don't have any specific skills. Sure,you've traveled the world and you've worked for a few different companies, but you don't have deep enough skills to charge a price premium for whatever it is that you want to do. And so I tend to see the challenge on the other side, but it's a good point that one can err on either side. And it is good to be deep in one and wide in general.
ARREDONDO 27:22
And remember what we were talking about is how to be good entrepreneurs. So for solving specifically the problem of this particular patient, yes, you're required to be much more into the depth the great majority of times. But to solve problems of a group or to develop a business, you require a little bit of a broader knowledge. This is the same example about the difference in medicine between clinical medicine and public health. Sometimes the measures that you do for the individual patient are totally opposed to public health. You put millions and millions of dollars into heart transplant, but those millions of dollars, you can put them on a preventive task and you save much more lives. But if you're the person that has the need of the heart transplant, you want the heart transplant. But if you look at the group or the whole population, it’s better to invest it in preventive things instead of one heart transplant. Does that make sense?
JONES 28:34
It makes sense. So you're talking about the mentality that physicians need to become good leaders and entrepreneurs, what are some of the specific steps that physicians should take if they want to become visionaries for their organization?
ARREDONDO 28:50
Well, we covered one of them, which is to try to read about things that are totally unrelated to medicine. That would be one of the first steps. The second one is to understand when are you acting as a physician? And when you are acting as a leader. It is not the same. The software of the mind that you're required to be a physician is different than the one to become a leader of a group. For example, physicians, when they ask questions, and they say, Did you take your medication? And there’s always a skeptical physician, he didn't take the medication, let me see the bottle to see if she's lying, you know? You're always suspicious of your information, right? If you transmit that skepticism, and if you don't trust in your team, it’s not going to happen. So you have to know that the skills to become a physician, while they overlap to be an entrepreneur, as I mentioned, to be a manager, it's a total different ball game. So in a sense, you require skills to be a physician, to be an entrepreneur, and to be a business manager, which are different. Those fn the business manager, I would say that is trust that is building up with time. I remember once reading about Socrates that they asked him, What are the types of respect? And people in a position of leadership required the respect of the people to say, Hey, we're going to go this way and say, Yeah, you know, that makes sense. Let's go this way! And there's two ways only to obtain respect. One is through fear and another one is through law. You respect the people that you're afraid of. And if you're very afraid, you are very respectful, you won’t do anything that he or she doesn't say. But guess what? The moment that person's around, the respect goes away. If the respect is out of law, it will always be there because they are afraid of failing you. They're afraid of not really rising to the level that you are expecting them to do. So you have to build up that skill. And physicians sometimes were very critical, Hey you didn’t take your medication! You're not supposed to stand up here, you're not supposed to get out of the house, you're not supposed to be eating that on the diet. So if you all have that critical mind that a lot of the physicians do have, that we are sort of like disease-oriented, instead of health-oriented, you need to know that to be a visionary, you need to go from the critical to the hopeful. You have to say Hey, we are in trouble right now, but we can get there. How are we going to get there? We're going to get there in this way. So I think that is some of the skills that you require to be a visionary.
JONES 32:05
And this need to build a team to be a leader and a visionary, that can be something that I sometimes see as a point of tension where I think the entrepreneur is the leader. And sometimes I see physicians that I perceive just wanting to be employees of their own practice. And one of the biggest tendencies I see in the difference between these two groups is how they manage their teams. And the second group, the folks that just want to be employees of their own practice, they will leave people that have no business being in the organization in their seats for years and years, even if they're no good for the health of the organization because they don't want to get back into doing that role, meaning the business owner, the physician doesn't want to get back to doing that role. Where in my company, if somebody can't play nice with the other girls and boys, I don't care how good they are, and I don't care if it drags me back into the day-to-day for a little bit, they're gone. Because I need that culture and that's something that I don't see many physicians doing unless they're really cognizant of that leadership piece.
ARREDONDO 33:25
Yeah, I think that not everybody in any profession can be an entrepreneur and not every entrepreneur can be a business person. So you have to be very honest with yourself, where do you feel comfortable and where do you want to be? Maybe you're not comfortable, but you want to develop it because you want to be there so that's okay. So in order to answer the--I think that you nailed it on the point of the team. No company is anything without a team. And for that, I'm going to share with you Paco’s 5 Hs. I don't know if I have always shared those with you or not, but when we hire people, we began by saying exactly what you said, which is, I don't want the best embryologist, I don't want the best doctors, I don't want the best nurses. I want the right ones, not the best ones. And sometimes the best one is the right one. But not always. If you have created a philosophy in a company that is towards low cost or great customer experience, and those people don't have the mind for that, even if they are the best on what they do, ain’t going to work. So that's the first thing. So for that I have the 5 Hs of Paco. One, you want people to be hungry, a go-getter, a person that does not stop at anything that when you tell them you can't he or she's gonna say Oh yeah? Watch me. That kind of attitude, the hunger. Two, that they are humble. Humble means that they can listen. They can accept they're wrong, they're willing to learn. They know that the team is more important than themselves, that humbleness is required. The third one is human skills. That you are able to listen, to empathize, to smile, to say, good morning, to identify with your coworker--Hey, I see that you're sad, is there anything I can help you with? I don't want to know but I just want to help you out with it. So those kind of human skills of listening, smiling, empathizing, collaborating--all those things are essential. The fourth one would be honesty. That goes without saying. You have to be honest, that nobody is going to try to get an advantage of you and get advantage of the team and we quiz the morale of everybody. And the last one and not least of the Hs is happy. You want positive people. You want people that can take a joke and say a joke and defuse tension with the jokes, and be happy and be positive. And you know, we are all humans and if you have a bad day, take the day off! It's fine. But in general, you want happy people. So those are the five Hs that we really require in our companies to be successful.
JONES 36:38
Happy is the one that I might see physicians betray a lot or, or I guess often enough, maybe a lot isn't fair, but I see it betrayed often. And then there's almost--when that happens, there's almost always a couple people either in nursing management or office management that are not happy. And creativity is just stifled throughout the rest of the organization and they want to make some changes and it happens at a glacial pace and it happens with resistance because they don't have those people in place.
ARREDONDO 37:16
I think you're totally right. I'll tell you a quick anecdote when we started the first practice, 13-14 years ago and time was our biggest valuable asset. I think it comes all from the leadership. What happened at that time is I went through all the list of the 250 Ob/GYNs that were in San Antonio, which is where we opened the first practice, and I personally visited every single one of the OB/GYNs knocking at the door of the practice. And at that time, I did introduce myself and just have my suit and theirs and have my tag and people thought I was a drug rep or something, and I would just sit calmly and then finally met the doctor, offer the services, and established a conversation, but one of the things that I observed is that when the front desk was very nice, the doctor was super nice. When the front desk was not a nice person, I felt it correlated with an R or .9 or something like that with the doctor. So it's all from leadership, the people below you will be the reflection of the leadership. That's basically what it is.
JONES 38:32
I remember the same thing from when I first started in the field when I was cold calling people because I didn't know anyone yet, the people that would treat me nice were the ones that had really good cultures. There's a saying that says that you can tell how a society is by how they treat the lowliest of their society like prisoners, but you can tell how an organization is by how they treat the lowliest of the people they interface with, which would be the salespeople back then. And I think that's a really good point. So these are skills that people have to have. Looking for them can make someone a good leader. So what would you advise to someone that is finishing up their training? And I'm thinking of someone that is maybe either just out of fellowship or was an associate someplace, but they're up to their eyeballs in debt still. They probably got a quarter million dollars in debt, maybe half a mil. And now what do you recommend for people--because it's hard to be-- There's a scale of entrepreneurs, right? Some really are okay with debt and some aren't. I'm a person that I'm really not okay with debt. It makes me very uncomfortable. I've had zero, but you have people that by virtue of their training or coming out with big heaps of debt, how do you advise them?
ARREDONDO 39:59
Well, I think you’re asking a person that might be totally progressive, crazy, and liberal in a lot of the handling of the company, but in the finances, I'm extremely conservative. And I tell you or share with you that the great majority of all the new companies that we developed, we developed with no debt, basically with our own earnings. We did have some debt and I feel more comfortable in getting there then than we used to, but which is not necessarily good or bad is just what it is. The American culture of entrepreneurship is always with debt. So you have to get used to that. But specifically to your question, this is an individual, and as you well said the average physician finishes or starts practicing being an REI around 32 or 33 years of age and they accumulated 250-300 grand, which is a lot of money. It’s a lot of money. And I would say that the best way is to try to pay it off right away and when you start practicing if you practice right away in a group or for a company or something, I would say my recommendation will be to when your dollar comes in, 25 cents of those do not belong to you. 25 cents of that dollar that comes to you, does not belong to you and goes to pay everything. Because if you want to be in a position where you want to become an entrepreneur and you want to embark on a risk-taking position, you're required not to add up to your already own debt that you have. So if you can tighten the belt for a couple of years and try to minimize the debt that you have, which will require--and this is a difficult position to be in--and I'll be back the big back the marshmallow test, which you probably are familiar with. But it is the first three years, four years, you’re tempted because you've been for so many years, the prime of going out with your friends and you've been focusing on your career and now, you may have a baby, and you want to relax, and take a vacation, and go and experience life, basically. But are you familiar with the marshmallow test from Stanford in the 60s?
JONES 42:39
No.
ARREDONDO 42:41
Actually, so it's so simple. They put three and four year old kids and they sat with cameras and they were in the room by themselves.
JONES 42:47
Okay, yep.
ARREDONDO 42:47
And they put the marshmallow--
JONES 42:49
The delayed gratification test.
ARREDONDO 42:50
Correct. Yes. So if we come back and if you have not touched the marshmallow, will give you two. Well, those kiddos did--they followed them for like 20 years and they did much better when they were able to hold on the gratification. So I would say that to those physicians, you know, it's going to be two, three years where you really hold your gratification of being a physician. But in the long run it’s gonna pay off because now you're going to be able to do what you want. Let's face it, we're very lucky. Our field is very good. There is a lot of money in our field, they pay very well. And it is a specialty that no matter what happens in the market, there will always be jobs for us and good paid jobs because fertility-- You can postpone having your new home or your new car, but if you're 35-36 and you can’;t have a baby, you cannot postpone that you have to do it now. So we're lucky.
JONES 43:59
Dr. Francisco Arredondo, Paco, thank you so much for coming on Inside Reproductive Health.
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You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.