Preimplantation genetic testing has opened up a world of helping families have successful pregnancies. But when does the testing and selection of embryos go too far? In this episode of Inside Reproductive Health, Griffin talks to Dr. Jamie Metzl, author of Hacking Darwin: Genetic Engineering and the Future of Humanity. They discuss the implications of advanced technologies such as the future of embryo screening and gene-editing. More importantly, Dr. Metzl discusses the significance of understanding the coming technologies and how those in the fertility field can help prepare their patients and the rest of the world for these changes.
Why IVF Doctors Leave Their Practice: The Reasons Every REI Fellow and Practice Owner Should Know
Physicians with the letters, REI, after their names don’t come cheap.
“Any Fellows you can introduce us to?” I’m often asked at PCRS and ASRM (the Pacific Coast Reproductive Society and American Society for Reproductive Medicine annual meetings, for those not in the field).
“Third years?” I demur, “Nope, they’re all signed. Second years? What month is it? Nope, they’re signed too. I know some first years. Want to talk to them?”
“Yeah, I guess so,” the hiring physicians usually concede.
41 - Are Young REIs Entrepreneurial? One REI Fellow’s Vision for the Field, Eduardo Hariton, MD, MBA
The business of medicine is complicated and more often than not, the concept is split and managed by two people with different backgrounds and education. But what if they merged? On this episode of Inside Reproductive Health, Griffin talks to Dr. Eduardo Hariton, a clinical fellow at the University of California in San Francisco. While attending Harvard Medical School, Dr. Hariton also attended Harvard Business School, simultaneously earning his MBA. Griffin and Dr. Hariton discuss the merging of business and medicine and how new REIs can gain business skills while still focusing on what is important: the patient.
40 - Inside the Minds of Two Fertility Marketers, An Interview with Rob Taylor
There are lots of variables that make marketing to your patients a challenge. From age to regional differences, it isn’t an easy task and getting someone who understands both the world of marketing and the world of fertility can be beneficial. On this episode of Inside Reproductive Health, Griffin talks to Rob Taylor, owner of TD Media, another marketing firm helping fertility centers get results. They talk about trends they see in the world of fertility marketing, as well as some strategies that clinics, and physicians, can implement to increase their online presence, in turn, helping them reach their marketing goals.
39 - Can Geographic Location Have An Impact on Fertility Success? An Interview with Dr. Alex Quaas
But think of the differences across the world--it’s hard to fathom! On this episode of Inside Reproductive Health, Griffin Jones and Dr. Alex Quaas give us a glimpse into (literally) the world of fertility. Having practiced in numerous states and countries, Dr. Quaas shares his experiences, diving into the biggest differences in care he witnessed in Europe and here in the USA.
38 - Building Community: The Rise of Instagram Among REIs, Dr. Candice Perfetto
Growing your followers on social media can be challenging, especially when your niche is focused on fertility. On this episode of Inside Reproductive Health, Griffin Jones, founder of Fertility Bridge, talks to Dr. Candice Perfetto, a board-certified REI working in Houston, Texas. Dr. Perfetto has grown her following on Instagram to over 10,000 followers and has seen the effort carry over into her practice. She discusses why she got started on Instagram and how she uses social media to build relationships with other practitioners and patients, both near and far. You can find Candice on Instagram at @candiceperfettomd.
37 - Confessions of an IVF Marketer, An Interview with Griffin Jones
We’ve flipped the script on this episode of Inside Reproductive Health and interviewed our esteemed host, Griffin Jones! Stephanie Linder interviews Griffin, founder of Fertility Bridge, and learns the mission of Fertility Bridge and why he chose to help the field of fertility. Griffin also shares his thoughts on who is doing well and what clinics could be doing to reach more patients and make their mark on the field as a whole.
36 - Maintaining Clinic Culture Amidst Continental Growth: Is It Possible? An Interview with Michael Levy, MD
Deciding to expand your practice, either by acquisition or starting new, is an exciting time. But, adding new staff, physicians, and equity partners can come with a handful of problems. On this episode of Inside Reproductive Health, Griffin Jones, CEO of Fertility Bridge, talks to Dr. Michael Levy, IVF Director and President of Shady Grove Fertility. Shady Grove Fertility is the largest fertility group in America and has over 25 equity partners and almost 1000 employees. Griffin and Dr. Levy discuss the implication of having such a large staff base and just how they manage it, all while keeping the patient at the forefront of their culture.
35 - Gina Bartasi - Can a Direct Service Delivery Model Increase Access to Fertility Care?
Increasing access to care has always been a topic of discussion in the fertility field. On this episode of Inside Reproductive Health, CEO and Founder of Fertility Bridge, Griffin Jones, talks to Gina Bartasi, CEO of Kindbody, a women’s health company working to increase access by sending out mobile clinics to reach patients closer to home. They discuss ways that other clinics can meet their patients’ needs, as well as the importance of giving partners and team members positions that match their personality.
34 - How At Risk Are You as a Physician? Mitigating Liability In Your Practice: An Interview with Dr. Steven Katz
A malpractice case can be the end of an REI practice, and with IVF errors often making it into the news, the pressure to be perfect is high. Thankfully, technology aimed to reduce errors has grown. On this episode, Griffin talks to Dr. Stephen Katz, CEO and Founder of REI Protect, a company formed to provide risk management services and coverage for REI practices across the country. They discuss what can go wrong in an office or IVF lab, and, more importantly, how to protect your practice from errors.
33 - Building Consensus in a Multi-Partner Physician Practice: An Interview with Louis Weckstein, M.D.
Growing your practice is exciting and adding in new Physician Partners can mean a lot for both your business and your patients. But adding to your group of decision makers can be intimidating. In this episode, Griffin Jones talks to Dr. Louis Weckstein, Medical and IVF Director and Managing Partner at the Reproductive Science Center of the Bay Area in San Francisco. Dr. Weckstein discusses the importance of building consensus amongst Managing Physicians and three simple ways to help facilitate easier decision making.
32 - Marianne Kreiner - Remote Jobs Are on the Rise: Can REI Clinics Follow Suit Successfully
Working from home has become more and more prevalent across all industries and is starting to catch on in the field of fertility. But how can working from home be beneficial and successful for both employee and employer? On this episode, Griffin Jones talks to Marianne Kreiner, Chief Human Resources Office at Shady Grove Fertility. Together, they discuss how implementing telecommuting in your office can boost employee retention, the importance of building culture with those who work from home, and how to appropriately set up telecommuting employees while following labor regulations.
31 - Lindsay Fischer -Transparency Between REIs and Patients: Bridging an Emotional Disconnect
In this episode, Griffin talks with Lindsay Fischer, best-selling author, co-founder of the InfertileAF Summit, and a member of the Trying-To-Conceive Community. Jones and Fischer discuss the importance of honesty and meeting patients emotionally through their individual fertility journeys. Her unique perspective on the patient experience can help practices build stronger relationships and, in turn, the TTC community as a whole.
30 - Unpacking Diverse Family Building Paths: An Interview with Dr. Mark Leondires
The world of fertility has grown and changed as the needs of families has changed. And now more than ever before, there are different populations seeking fertility care. In this episode, Griffin talks to Dr. Mark Leondires, a board-certified REI and the founder of Gay Parents-to-Be, about the various paths of family-building and how fertility clinics can provide personalized care to those with differing goals and needs.
29 - What is shifting the entrepreneurial landscape for incoming REIs? Rhonda Zwingerman, MD
In this episode, Griffin hosts Dr. Rhonda Zwingerman, a fellow OB-GYN and REI at the Royal Surgeons of Canada and an assistant professor of OB-GYN at the University of Toronto. Jones and Dr. Zwingerman talk about the factors shifting the entrepreneurial landscape for incoming REIs including the funding of fertility treatments, the recruiting of REIs, and the risks involved. Tune in to find out more!
28 - Can IVF or Egg Freezing Vacations Abroad Reduce Stress or Financial Woes? An Interview with Joseph Davis, MD
In this episode, Griffin hosts Dr. Joseph Davis, a Reproductive Endocrinologist who saw the need for a fertility clinic in the Cayman Islands and brought his years of experience working in US clinics and his passion for global health policy to a country that never before had this field of medicine. Jones and Davis chat about the world of fertility past the borders of the United States, discussing not only the access to care issues in other countries, but also the traveling of patients from the US to other countries to seek more affordable options, find privacy, or simply relax during the process.
27 - Setting the Vision for Your Practice with Intentional Culture. An Interview with Angie Beltsos, MD
In this episode, Griffin Jones hosts Dr. Angeline Beltsos, CEO and Medical Director of Vios Fertility Institute as well as the founder of Midwest Reproductive Symposium International (MRSi). In the competitive climate of large fertility networks, Dr. Beltsos’ independent fertility center, Vios Fertility, has thrived, largely in part to implementing an intentional culture of transparency. Dr. Beltos discusses how Vios is built on three important pillars: an unparalleled patient experience, early scientific adaptation, and robust and dynamic culture that starts at the head of the team and trickles down.
26 - Passing the IVF Lab Torch: Is the Reluctance to Do So Causing Scarcity? An Interview with Shaun Reed
In this episode, host Griffin Jones chats with embryologist Shaun Reed. As the Embryology Technical Supervisor at Utah Fertility Center, Reed offers a unique perspective on one of the more mysterious parts of any fertility clinic: the lab. Jones and Reed discuss the future of embryology, the differences between millennials and the generations that came before, and Reed’s concerns about the lack of interest in innovation.
25 - Buy-in: Necessary for Successful Implementation of an EMR System? An Interview with Nicole Koczanowicz
In this episode, Griffin Jones hosts Nicole Koczanowicz, the Vice President of Artisan Medical Solutions. Koczanowicz’s focus on adoption and adaptation of Artisan’s EMR program to every practice has set Artisan apart. Jones and Koczanowicz have an honest conversation about the delicate dance between a practice fully adopting a necessary change, to the EMR team adapting to the individual needs and workflow of each practice. After all, Wall Street and Silicon Valley both want your patients, but there is a plan, if you are willing to take action.
Fertility Company Profile: The New Marketplace for IVF Patient Acquisition
Consolidation.
If you had to reduce the water-cooler talk of our field to one topic, it would be exactly this: the consolidation of IVF centers, fertility pharmacies, brokers, genetics companies and others, purchased with private equity money.
I wrote about these players, and the collective unease about them, in 2018. I have talked about it on the IRH podcast with guests such as doctors John Storment and David Sable. I hear the apprehensions and I share some of them.
Are we capable of betraying our patients’ best interest because of obligations to financial stakeholders?
That’s a very sound concern for the delivery of fertility care. Furthermore, it’s very likely that there are examples wherein this concern is justified.
I own Fertility Bridge outright, 100%. I often make decisions based on what I want for the relationships of our clients and employees. If I had to answer to many different shareholders, we would likely do things very differently.
Conversely, I also see examples where this pressure disrupts the status quo and forces innovation and efficiency when we have to compete to earn patients’ selection. Sometimes, the independent centers with the least competition are the least likely to invest in patient experience and team culture.
Either way, I do not see the consolidation of REI practice groups as the single greatest disruption coming to the field. Not by a long shot. In 2018, I also wrote that technological revolution dwarfs any disruption caused by the sale of IVF practice ownership to private equity.
While others are looking to Wall Street, I have my eye on Silicon Valley.
Consider it this way:
The independent REI practice is the local, 100 room hotel.
They’re worried about the Marriott building a 1,200 room, mid-rise on the waterfront.
I’m worried about AirBnB.
One view looks at larger and more dominant competitors in the same marketplace. I’m looking at a whole new marketplace.
The model for the delivery of healthcare, including fertility care, has become too estranged from the conveniences that patients are used to when researching, considering, receiving, purchasing, and evaluating goods and services as consumers.
Our patients under age 30 have conceivably never called by phone to invite a friend over, break up with a significant other, or even order food. Yet, for virtually every fertility center, there is ultimately no other way to schedule a new patient visit.
Please take my next admonition as commentary on the mechanics of patient relations and not on providers’ devotion to service; I know the depth and sincerity of so many practitioners’ vocations.
We’ve been too slow to adapt and have grown out of touch with our patient demographic. For some, it’s already too late.
I don’t envision large fertility groups or boutique REI practices going away, but another class is emerging to capture the middle, the entry, and everything around.
There is a wide opening to provide the user experience of patient acquisition and patient retention that the current demographic demands. With the right application, and/or scaled acquisition strategy, one or two platforms can become the gateway through which patients enter. Many companies are jockeying for that position. Some of them may win, or the winner may not yet be in the marketplace. The extent to which they’re able to scale is the degree of leverage they have over providers.
Put frankly, someone is building a better mouse trap than you have so they can sell (who would have been) your own patients back to you.
Many have tried and not (yet) succeeded, but it would be hubris to think that others won’t.
Here are some of these players now, and what they’re up to.
Important disclaimer: Neither I, nor Fertility Bridge, have a direct commercial relationship with these companies at time of writing, though we certainly may in the future. No information in this article comes from conversations that I have had with the executives of these companies. This profile is not a revelation of insider knowledge. Rather, it is a curated synopsis of public information. My observations and opinions are exactly those, based on information that has been publicly released by these companies or covered in the press.
CONSUMER APPS:
GLOW
The tech-forward platform for serves fertility patients and connects them with clinics by providing:
Glow- Ovulation and fertility tracker
- Includes:
Fertility Calendar
Daily health log
Health insights
App syncs with partners app
Glow Nurture - Pregnancy app
Glow Baby - Baby Tracker
Eve by Glow- period tracker and sex tips
Glow Fertility is segmented into a direct-to-consumer programs and a separate employee benefits program.
Direct-to-consumer programs:
Glow predicts ovulation patterns and fertility probability based on user data inputs and supports women with services such as egg freezing and IVF. In addition to helping clients navigate the process of getting pregnant, Glow also facilitates access to healthcare providers (with whom the Glow team negotiates discounts to reduce the financial burden of historically expensive fertility treatments).Employee benefits program:
On the employer side, the Glow Fertility Program negotiates contracts between employers and fertility care providers.
Millions of women input data on menstrual periods, doctor visits, sleep habits, sexual activity, and birth control (in addition to over 35 additional basal health data points), and Glow has all of that data.
Although Glow does not publicly share the full details behind it’s business model, the firm charges businesses for the employee benefits program, and is also able to charge a fee for facilitating access to services from preferred healthcare providers. Glow also offers women personalized consultations through its direct-to-consumer channel, offering one free session before converting to a charge for service model.
History and Funding:
Launched in 2013 by Max Levchin (co-founder of Paypal)
Glow originally spun out of PayPal Co-Founder and CTO Max Levchin’s business incubator, HVF.
According to Crunchbase, Glow has raised over $23 million in venture capital, $17 million of which was raised in a 2014 Series B round that included Founders Fund and Andreessen Horowtiz, reports Vox.
EMPLOYEE BENEFITS:
CARROT
Carrot is a startup out of Y Combinator working with employers to offer fertility care like egg-freezing and in vitro fertilization (IVF) as a workplace benefit.
Provides affordable options for those struggling with infertility by partnering with employers to add coverage for fertility services. They offer customizable plans to employers to include varying levels of fertility coverage at a sliding, per-employee dollar amount.
Founded by:
Tammy Sun, CEO
Dr. Asima Ahmad, Medicine
Juli Insinger, Growth
Arun Venkatesan, Engineering
Funding:
Total funding: $15.2 million
According to CrunchBase, Carrot has raised $15.2 million over four rounds, one angel, two seeds, and a series A. Their lead investors have been UnCork Capital with 3.6 million and CRV with $11.5 million.
Their family planning concierge, which reports to provide members with caring, live guidance, and support at every stage of the journey.
Help for members maximize existing benefits.
Access to preferred pricing at top clinics and pharmacies.
Access to customized fertility payment options.
Nubundle offers its products as a voluntary employee benefit, limiting the costs to employers. Employers pay a flat annual admin fee.
Founders
Chris D'Cruz
John Ciasulli
Total funding: $1.5 million
In a seed round, NuBundle raised $1.5 million from three investors led by Lightbank.
STORK CLUB
Family/fertility benefit suites for companies.
In 2018, Stork Club expanded their core offering by introducing a comprehensive suite of Flexible Family Benefits that include both Fertility and Parental programs designed for large enterprises.
Stork Club advertises to be the only enterprise-ready family benefits provider designed for self-funded employers. They process claims and pay providers directly, letting your team focus on more important goals.
They have employee-facing web and mobile apps to help employers on-board, manage, and validate new programs with vetted provider partners.
Founder, CEO: Jeni Mayorskaya
Early Stork Club investors and advisers include key employees from LinkedIn, One Medical, and Facebook .
They appear to be funded by slow ventures, but it is unknown how much money they have raised.
PROGYNY
Right now, Progyny is the fertility benefits company.
They provide fertility solutions for self-insured employers.
Some may remember, Fertility Authority, the consumer facing company and fertility clinic review platform that negotiated reproductive health benefits. The company changed its name to Progyny in 2015 after acquiring, or being acquired by, Menlo Park-based Auxogyn, the inventor of Eeva. They quickly sprinted ahead to lead the race of fertility benefits broker.
In my opinion, this is a one-horse race at the moment, with their young, new competitors looking to be the person who can disrupt their early lead as Lyft did to Uber.
Founded in 2008 as Fertility Authority, became Progyny in 2015
CEO: David Schlanger
Headquarters are located in New York, New York
Funding:
Total funding: $99.5 million in ten rounds from six investors, as documented by CrunchBase,
Who led the rounds has not been released.
Though we do know they raised $15 million in a new round in 2016.
THE FINANCIERS
Now this group is different. They’re not a new wave of tech companies launched from or by Silicon Valley serial entrepreneurs. However, by default, they do serve as lead generation and another entry point for patient acquisition from which they can bring new patients to fertility centers.
Also, I speculate a potential scenario in which one or more of these companies are acquired for easier, quicker, and more expansive entry into the fertility field.
Think about it. Many of these companies have an outdated user experience and some of the founders may be ready to cash out of the game rather than reinvest and overhaul. Again, this is Griffin Jones putting his Jim Kramer hat on and being purely speculative.
WIN Fertility:
Maybe they belong in the employer benefit group, but a few things set them apart:
They have been in the field for two decades.
WIN offers benefits through employers and affordable options for treatment through practices for those without insurance or for those who have exhausted their insurance benefits.
WIN integrates with national and regional insurance carriers, as well as the nation’s largest pharmacy benefit managers to procure fertility services. WIN patients are qualified prior to fertility treatment.
Available 24 hours a day, 7 days a week, WIN’s Nurse Care Managers guide patients through every step of their fertility journey.
Originally founded as an independent women’s health management company
Founded in 2000
President and CEO: Roger Shedlin
Attain Fertility
ATTAIN FERTILITY:
Attain makes themselves known for being the original multi-cycle plan provider. They offer bundled IVF cycle plans, called Multi-Cycle Discount Programs, that include multiple IVF cycles for a one-time, discounted fixed fee.
Being owned by IntegraMed they are affiliated with 40 practices, 130 locations, and more than 180 Reproductive Endocrinologists in their US wide network.
Some patients qualify for their Multi-Cycle Discount Program + REFUND. This offers patients who meet certain criteria the potential of getting a refund if their IVF cycles are unsuccessful.
$15.4 million
Founded by Pam Schuman
ARC Fertility
ARC says they are the access point to the “nation’s largest network” of fertility professionals and offer innovative financing options.
More specifically, ARC offers fertility treatment packages, refund guarantees, and finance options to people living with infertility.
Value proposition to clinics and/or patients:
Largest network
Most trusted
Doesn’t own/operate clinics -> looking out of patients best interest
ARC’s fertility care packages can be bundled with medication and genetic testing services and bundle the cost of services into one monthly payment.
History:
ARC was founded by David Adamson, MD.
THE WILDCARD
Fertility IQ
The most comprehensive review platform for fertility specialists and fertility clinics.
With FertilityIQ, prospective patients search by location or by a specific doctor or clinic name. Doctor profiles are detailed with aggregated metrics including communication quality, degree of individual attention, responsiveness, and overall recommendation. Patients’ summarize their experiences with doctors and clinics -- from the doctor’s approach to diagnosis and treatment protocols, to the nursing staff’s level of organization, to the competence of the clinic billing department.
History and Funding:
The founders of Fertility IQ, Jake and Deborah Anderson-Bialis, say they will never take marketing dollars from clinics. Rather than seek capital from outside investors, the couple decided early on to self-fund FertilityIQ.
Founded in 2015, went live in 2016
One of my clients once told me that they were weary of Fertility IQ because they thought they were building a mousetrap and they didn’t know what it was. I’m not weary because I believe Jake and Deborah have built their platform from an authentic ethos and are serving the market in a genuine and desperately needed way. Where the mousetrap will lead, I have no idea but it’s already a darn good one. Fertility IQ offers the best user experience for fertility clinic selection and has some of the best consumer generated data in the field.
Conclusion:
Up to now, I have presented private equity backed consolidation and venture capital backed innovation as two separate phenomena, though they certainly don’t have to be. What will happen when the largest fertility networks, their parent companies, or private equity firms, acquire the largest scale platforms for patient acquisition, financing, distribution etc? Vise versa?
Resilient businesses survive revolution and later thrive because they adapt to capitalize from these disruptive forces rather than be replaced by them. There is more opportunity for the independent REI practice than there has ever been before, but it isn’t coming from doing business the same old way. It requires new strategy, paying close attention to the new players in the market, and using them for their benefit.
If you would like help in adapting to these forces and benefiting from the disruption rather than being pained by it, learn more about how to implement the Fertility Marketing System.