Episode Thumbnail
Episode 14  |  35:57 min

Ask an HCP: A Candid Conversation with Dr. Wael Barsoum

Episode 14  |  35:57 min  |  11.23.2021

Ask an HCP: A Candid Conversation with Dr. Wael Barsoum

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This is a podcast episode titled, Ask an HCP: A Candid Conversation with Dr. Wael Barsoum. The summary for this episode is: <p>In today’s episode, we’re getting a firsthand progress report on the industry’s commercial transformation efforts from Dr. Wael Barsoum—a practicing orthopedic surgeon, the president and chief transformation officer of Health Outcomes Performance Co., and the former CEO of Cleveland Clinic Florida. Listen as he reflects on his best customer experiences as an HCP, unpacks the link between data-driven care and improved patient outcomes, and explores the shift to value-based care. And don’t miss “Wael Barsoum in Context,” where we discuss the life lesson that shaped his future in medicine, an alternate career in the courtroom and a fascinating miniseries to add to your watchlist.</p>
Takeaway 1 | 01:50 MIN
The importance of maintaining a true north as roles and responsibilities change
Takeaway 2 | 02:17 MIN
How we can use technology and AI to win against the global healthcare crisis
Takeaway 3 | 01:40 MIN
The transformation that Dr. Barsoum is leading at HOPCo.
Takeaway 4 | 01:32 MIN
Less art, more science: using data-driven care paths to optimize the patient experience
Takeaway 5 | 00:59 MIN
So, how are we doing? Dr. Barsoum grades pharma’s commercial transformation.
Takeaway 6 | 02:25 MIN
What can life sciences companies do to deliver an exceptional customer experience?
Takeaway 7 | 00:44 MIN
The fundamental link between data, customer-centricity and improved patient outcomes
Takeaway 8 | 02:05 MIN
How can life sciences companies best support a value-based healthcare model?
Takeaway 9 | 01:10 MIN
If the doctor couldn't doctor...what would he do?

In today’s episode, we’re getting a firsthand progress report on the industry’s commercial transformation efforts from Dr. Wael Barsoum—a practicing orthopedic surgeon, the president and chief transformation officer of Health Outcomes Performance Co., and the former CEO of Cleveland Clinic Florida. Listen as he reflects on his best customer experiences as an HCP, unpacks the link between data-driven care and improved patient outcomes, and explores the shift to value-based care. And don’t miss “Wael Barsoum in Context,” where we discuss the life lesson that shaped his future in medicine, an alternate career in the courtroom and a fascinating miniseries to add to your watchlist.

Guest Thumbnail
Dr. Wael Barsoum
President and Chief Transformation Officer at Healthcare Outcomes Performance Co.
Dr. Wael Barsoum is the President and Chief Transformation Officer for Healthcare Outcomes Performance Company. Prior to joining HOPCo last August, he was the CEO and President of Cleveland Clinic Florida. He is a practicing orthopedic surgeon, avid researcher and innovator and a proven healthcare leader.
Dr. Barsoum's LinkedIn

Wael Barsoum: We have to hold healthcare providers and healthcare sales people, I think to a higher level, right? You're not selling somebody a car. You're not selling them a new dishwasher. You're selling them something that affects their health, really their most valuable asset.

Clay Hausmann: I'm Clay Hausmann, chief revenue officer of Aktana and host of Contextual Intelligence. We have had many conversations on this podcast about the different ways that life science companies are using new technology to better support HCPs, but we have never had the opportunity to hear the perspective of a physician until today, to see if we are actually doing what we are meant to be doing. And that's why I'm so excited to introduce Dr. Wael Barsoum. In addition to being an orthopedic surgeon, he is also the president and chief transformation officer for Healthcare Outcomes Performance Company, and the former president and CEO of Cleveland Clinic, Florida. Wael, welcome to the podcast and thank you so much for joining us today.

Wael Barsoum: It's a real pleasure, Clay, to be with you and an honor, really, to be your first healthcare provider to be on the podcast. So thanks for having me.

Clay Hausmann: Absolutely. Wael, I'd love to start our conversation today by talking about the topic of perspective and how it changes as you shift in roles in the same industry. And I come at this question a little bit personally, because in my career I started at agencies for the first 12 years and I thought I knew everything about what clients needed and then I became a client and I realized that I really did not know what I thought I knew previously. At Aktana we've recently created a revenue organization where sales, marketing, and alliances all work together and having spent my career in marketing, supporting sales teams and goals of all kinds, I thought I knew everything that sales teams needed. And I have since learned that, you know what, I did not know everything that was there to know and I've gained so many different valuable lessons in what's required there. I'm curious, in your experience, as you have transitioned between different roles as a practicing surgeon, a hospital administrator, a business executive in a variety of roles, how has your perspective changed and what have you learned across those different roles and vantage points?

Wael Barsoum: I try to live my life through the perspective of having a true north. I think if you apply that to healthcare, for me true north is keeping the patient at the center of care and really focusing on value in the healthcare system for that patient. When I talk about value, I talk about quality, access and cost. So as I'm look it something from a particular vantage point, your true north is still true north, right? Whether you're in Australia, whether you're at the equator, whether you're in Cleveland, Ohio, if you use a compass, true north is still true north. So I think from my perspective, as long as you have a clear true north, your perspective probably shouldn't change that much. So let me be a little more clear about that. So as a clinician, it becomes pretty easy. It's an easy decision when you're thinking about doing something and the patient is number one, first and foremost in your mind all the time. If you are running a healthcare system, and in my case, I had the distinct honor really of running an incredible healthcare system in Florida, part of the Cleveland Clinic, that's a nonprofit system that was focused, again, on community benefit. There is no challenge with making sure that you're constantly focused on the patient in that scenario. I didn't have investors that I had to answer to. I didn't have shareholders that I had to answer to and I recognize that's an important part of running a business. But fortunately for me, as a healthcare CEO in a nonprofit healthcare system, the perspective was completely the same as when I was the orthopedic surgeon taking care of the patient in the operating room. It never changed. And really, I think a lot of the credit for that goes to great places like the Cleveland Clinic that keep that focus the same. It's interesting now as president and chief transformation officer of a for- profit company in healthcare that runs, in many cases, hospital service line, specialty hospital, owns a hospital. We still talk about quality. We still talk about access. We still talk about cost all the time. So that true north has really stayed very much the same. So I would say that the difference in perspective maybe gives you an appreciation for things from a different viewpoint, but if you have a clear true north your ultimate goal and your ultimate outcome should still be the same. And in my case, that's keeping the patient at the center of the care, the focus, and always pushing towards improved quality, improved access and decreasing cost.

Clay Hausmann: One thing I'm curious to probe in on a little bit more. So for example, in my experience, I learned that the go- to- market process between marketing and sales and services and alliances is a lot like a relay race. You want the fastest runner at each leg, but you have to make sure those handoffs are as smooth and effortless as possible so that the overall machine or the overall team keeps moving as quickly as they can. That's what I learned the most and have learned is that those handoffs are critical. If you're just rewarding marketing for doing marketing things, and you're just evaluating and rewarding sales for doing their things, you may have the fastest legs, but you're not going to have the fastest team. Have you noticed in your differing views or your different vantage points, the importance of handoffs between different parts of the value chain in providing healthcare and what's critical to make sure they're successful?

Wael Barsoum: Yeah, there's no doubt. I mean, so if you look at it from the care delivery perspective at the first level, which is a patient comes to the hospital and needs care, right? The handoffs that we do in the hospital from an emergency room to the attending doctor, from the attending physician to the specialist, from the specialist back to the primary care doctor, we know that's where things can fall through the cracks. And we know that's where disastrous outcomes can frequently come from. So there's a massive focus on those handoffs. It's no different in the healthcare business world, right. In the healthcare business world recognizing that maybe the marketing person is the equivalent of the endocrinologist and maybe the salesperson is the equivalent of the primary care doctor, and maybe the operation's person is the surgeon. They all have to communicate all the way down the line. Then if you can really take their level of expertise and apply it, in this case to the customer, and make sure that the customer doesn't see the baton fall, doesn't see anything fall through the cracks, then you've got a winning solution. So I think recognizing that healthcare is a team sport, Toby Cosgrove used to say that all the time, the past CEO of the Cleveland Clinic, he's absolutely right. You're not going to win a baseball game without a great pitcher and a great catcher and a great first baseman. You're just not going to, and you don't want that pitcher necessarily playing first base and you certainly don't want him catching, right? So you have to have the right people in the right role. And if each one of them performs at their maximum top of license, your very best that they can, then in the end, the customer, the patient ends up getting really the very best product or the best care possible.

Clay Hausmann: What role do you think technology plays in making sure those handoffs are smooth or the overall value chain and the healthcare process? Where can it be most beneficial? Where you've seen it be most beneficial in that transfer of information and knowledge?

Wael Barsoum: I would tell you that I'd be hard pressed to find a place where it wouldn't be absolutely transformational to healthcare. Look, we live in a world today and I'm just going to take this beyond the United States. We live in a world where 50% of the population of this planet does not have access to healthcare when they need it, 50%, right? We live in a world that has a massive shortage of healthcare providers. We have to depend more on the digital space, on the augmented reality, on artificial intelligence. I can clearly see a day where a patient in Uganda, where I took my family to do a medical mission two years ago, and people literally walked 20 miles to see a doctor for the first and probably the only time in their lives. It's incredible. I can see a day where maybe they enter into a little pod. They put their arm in a blood pressure cuff. The blood pressure cuff is taken autonomously. A little prick of their finger takes a little blood. It checks their blood sugar. Maybe they're a chem seven. Their hemoglobin gives them some basic information about their blood work. And maybe an avatar says, " Look, based on your blood pressure and your heart rate and your blood work..." And maybe even one day a genetic picture that says, " Based on your genetics, you are at risk for diabetes or you're at risk for heart disease." We would recommend again, using an AI protocol, a low fat diet, walking 20 minutes a day. Maybe on the other hand, it says you're at high risk for diabetes and not heart disease. Maybe you should be eating more protein and less carbohydrates, whatever. We don't have enough doctors and nurses and advanced practice providers to do that one- on- one with patients. We need technology to help further that. In the same way we can apply technology to the operations of the traditional healthcare system that we have today. Great example, look at supply chain, we're starting to do more and more just- in- time work with supply chain. It makes sense to nobody to have shelves filled with product that is in essence expiring every day. We should be producing what we use. We should have appropriate par levels and technology stacks will help us to do that more and more efficiently over time. So these are all things that come together that allow us, I believe, to put ourselves in a position to win when we talk about the global healthcare crisis that we have, which I think is very real.

Clay Hausmann: So you use the word transformation in there, I think once or twice. And that's obviously part of your title right now. So I'm curious, I want to spend a little time talking about your work at HOPCO. Do we call it HOPCO? Is that what it's called for short?

Wael Barsoum: Yep. HOPCO, Healthcare Outcomes Performance Company.

Clay Hausmann: And what does transformation mean in context of your role there? What are you transforming?

Wael Barsoum: So in the healthcare world everybody loves this term, shifting from volume- based care to value- based care. It's like the hot sexy term now that everybody talks about, but the little secret behind it is, most people are terrified of shifting to a value- based care world. And you can't blame them. I mean, if you're a busy orthopedic surgeon, you're used to getting paid for every case that you do and you've made a good living, or you're a hospital that gets paid every time a patient gets admitted or readmitted, it's hard to imagine a scenario where a major change in how you get paid actually makes sense. So what our efforts are at HOPCO is essentially to help transform the delivery of musculoskeletal care so that in every single market that we're in the right patient's getting the right care with the right provider at the right time, in the right location every time. And how do we do that? We do that through the creation of value- based systems, partnering with the payers, with the hospitals, with the surgery center and with the providers so that everybody is incentivized to ensure that the patient gets the very best care. In the end there's savings associated with that. We like to incentivize the clinicians and the hospital systems and the ASCs. When they do the right thing, they get incentivized to do that. But at the same time, equally importantly, and maybe even more importantly, a portion of that savings goes right back to the insurance company, which then can go right back to the patient. How does it go back to the patient? It goes back to the patient in the form of a lower premium or maybe an expanded benefits package for the premium that they're paying. In the end that is part of the solution that I see, at least here in the United States, to delivering higher quality care for lower costs. We live in a country today that's spending almost 20% of our gross domestic product on the delivery of healthcare. That's simply too much. And we also live in a country where that number is going up about 4% a year. That's not sustainable. That outpaces the rest of inflation. So every year, if you're getting a 2% raise or a 3% raise at work and healthcare inflation is going up 4% every year, the math doesn't add up, right? It means that every household in the United States is spending more and more money on their healthcare. Not only that, we're also living in a country today where over 40% of Americans have high deductible insurance plans, right. And I'm sure people listening to your podcast are saying, " Yeah, that's me. I have a$ 4, 000 deductible, or I have the $5, 000 deductible." So those folks are becoming really smart consumers when it comes to their healthcare dollar because so much of it is now coming out of their pocket. So our goal is to transform markets so that those patients/ consumers can get the very best for their healthcare dollar in the market that they're in, when it comes to their musculoskeletal care.

Clay Hausmann: It makes perfect sense and it's such a worthy goal, such a large problem to solve. Because of how big that problem is, you won't fully transform it for quite a while. This is a long path to go down, but what are some of the early indicators that will make you feel like, " Okay, we're moving, we're having an impact here. We're moving things in the right direction. We're not done, but we have mile markers along the way of this path that tell us we're going the right way."

Wael Barsoum: I'll give you some very real examples of positive wins that we've had. In the Phoenix market we have a standing clinically integrated network that takes risk on tens of thousands of lives. Actually, at points it's taken risk on hundreds of thousands of lives. Starting in January we'll be taking risk on hundreds of thousands of new lives. Our history there is a consistent ability to save hundreds of dollars for every individual per year in a global sub- capitated risk product. Meaning that for the average patient, we may save$ 400 or$ 500 a year in annual spend. So that money then, a portion of it, goes back to the insurance company. A portion of it gets distributed to the providers, but most importantly, Clay, not only is there a savings, there is a consistent improvement in the quality of care and we see that through length of stay. We see that through mortality rates. We see that through complications reporting. We see that through hospital reported outcomes and patient reported outcomes tools that all of our patients are asked to participate in. So there's very clear objective data that shows that we can make a meaningful difference when we use peer review data driven clinical care paths. When we use transparent dashboards to help coach providers on what's the right thing to do for a patient every time, all the time. So the data's pretty clear that healthcare should be treated as a science and not an art. And I think in many ways we still treat it as an art. I mean, when you think about the amount of scrutiny and compliance the pharmaceutical industry goes through to get a vaccine approved or a new medication approved, and you think about the amount of scrutiny that the average doc might be expected to answer to when it comes to treatment of a specific patient, they're night and day, right? I mean, most of us as physicians we're really... people put their trust in us and we do what we think is the very best, but there's not a big brother looking over your shoulder and measuring all of your outcomes and telling you how you're performing and coaching you along the way. So I think this is an opportunity to take out some of that art and reintroduce some of the science to ensure that patients really are getting the best care all the time.

Clay Hausmann: I mean, I am inspired listening to you talk about what your mission is, what you're trying to do. I think, for myself and just about everyone who listens to this podcast, I'm guessing they are similarly inspired saying, okay, with what we're in business to do, you use the right, right, right kind of language. We use that as well by saying, get the right information through the right channel to the right HCP so that they can provide better patient care. And so we want nothing more than to be able to equip you to be as focused and successful in providing that care. So we're going to shift into what we'll call the report card session here, because you're our first healthcare provider, we spend to all this time talking about making sure that we provide you and others like you with the information you need at the right time with the right context. Now, I want to put that to the test a little bit and ask you to grade the process, the pharmaceutical companies, the med device companies and the technology providers like ourselves who are optimizing their communication process with you so that you are getting what you need. At a very high level, what kind of assessment or grade would you give that right now in terms of how it's performing versus where you'd like to see it?

Wael Barsoum: So I would tell you that today it's a lot better than it was when I first trained and first went into medicine. So I started my training in residency about 25 years ago. I've been out in practice for 20 years and I would say it used to be probably a D- and today it's probably a B +...maybe even better than a B +. The main reason I would say that, Clay, that it's been such a change is because more and more of what is shared with clinicians today is good objective clinical data. I think that the implant world and the pharmaceutical world have gotten better at reporting data transparently and I would also say that I think most clinicians have gotten better at asking the right questions and therefore demanding better information when they're learning about a drug or learning about an implant and running the value equation in their own minds.

Clay Hausmann: So that's great to hear. How about in the last, say five to seven years, have you been able to, as the end audience, who are hopefully the beneficiary of a lot of this new technology, the AI and the machine learning, have you noticed better alignment in terms of the messages you receive? Meaning, if a rep calls on you on a Tuesday, you get an email on a Thursday, you attend an event the following week, that there is consistency in alignment there? Is it appropriate to your areas of focus and where you are? Have you seen that sort of targeting the same way you might experience it in your e- retail shopping experience, where you're fed personalization and you're fed recommendations? That's a lot of the model that this industry is seeking to provide, that you get information that is directly relevant to you and it comes through channels that you prefer. We know that you prefer to do your own research and to do it by visiting websites, or you do it through social media platforms or no, you don't, you still prefer the in- person rep visit. Have you felt the impact of that?

Wael Barsoum: Yeah, I would say that I have and I would suspect that most of my colleagues probably feel the same way. I think the customizability of how you might have a relationship with a rep is certainly attractive. I mean, to your point, some folks want to have in- person visits and learn more and be able to have a two- way conversation and exchange information. Other folks might, if I'm at the American academy of orthopedic surgeons and there's something that I'm clearly interested in, we wear a badge, they scan the badge, they'll just send us the information. So I think all of that's very helpful. I would tell you probably the one thing that I'm not a huge fan of is the mass emails that are just not necessarily focused on what somebody might be interested in and you buy a list of emails and you just send out to 50, 000 people the same message. I can't imagine that's terribly cost beneficial for the companies on the other side of it. So I like the customizability, the ability to personalize it, to be able to be pretty clear about what you're interested in and what you're not interested in and then get the information for what you're interested in, and candidly, I think that's probably a win- win for both sides of the equation.

Clay Hausmann: Can you think of, and I'll put you on the spot a little bit, without naming any names could you describe the characteristics of a relationship you've had with a pharmaceutical or med device company in the past that you particularly valued and what was so helpful about the way in which they communicated with you, the way they supported you, the way they operated? Does something come to mind as a best practice? " Boy, if I could replicate that experience that I had with company X, my life would be so much easier and I'd have so much time to focus on what I'm really here to do."

Wael Barsoum: I can give you a great example. So probably 15 years ago, I was minding my own business, doing my hip and knee replacements at the Cleveland Clinic up in Cleveland and thinking I was the greatest surgeon in the world. Every surgeon, by the way, thinks that. It's normal. It's probably a good thing. I had a rep that came in and he said, " Hey, can I introduce you to our surgical navigation system for total knee replacements?" And I said, " Surgical, now why in the world would I need a surgical navigation system?" Right? I mean, I'm a great surgeon. My outcomes, everybody thinks their outcomes are the best until they actually start measuring their outcomes and realize that people have complications and not everybody is delighted with their outcome.

Clay Hausmann: They're trying to sell a GPS system to a driver. We all think we know-

Wael Barsoum: Yeah, exactly.

Clay Hausmann: ...where we're going.

Wael Barsoum: That's right. Why would I need that? So that was really my view. And I said, " It's kind of intriguing. It seems like a fancy toy. And it's probably pretty expensive. I'm not really interested." He said, " Well, let me get you some data and I'll come back and go over that with you. I'm a fairly scientific guy. I like to do clinical research and basic science research." And he did, he came back about a week later with all kinds of really compelling data that I was taken aback on. I'll give you an example. 14% of patients with total knee replacements today are not entirely satisfied with their outcome, 14%. That's one out of every seven people, one out of every eight people. I was shocked to hear that number, but it, as it turns out, it's true. He said, " You know, a big part of that reason is because of malalignment or because of soft tissue imbalance." Again, today, this is all second nature to us, but 15 years ago that wasn't so much second nature to us. So I said, " You know, maybe you're right. Maybe there is an opportunity. Let me talk to a couple surgeons that have used this. Let me see what they say." So he connected me with a couple pretty academic surgeons that were collecting data. I asked them what their results were. They actually shared their results with me. I said, "Hey, this is pretty compelling." So for the right patients, I started using that system and it made a very real difference for those patients. In my hands it was higher risk patients or patients with deformity that that made a big difference for and now that's transferred for me with the use of robotics in total hip and total knee replacement. So there's no doubt that for me, my personalization with the rep in this case was, " Show me the data. If you have real objective data, then I'm all ears. If it's anecdotal, I don't want to hear it." Now I'll give you another example of a case that was the opposite of that. Somebody came and said, " Hey, here's something that you can squirt into a wound and it will decrease hematomas and decrease bleeding." I said, " Oh, that sounds pretty intriguing. That's a big challenge for us. Do you have any data on this?" He said, " As a matter of fact, I do." He literally opened a brochure and in the brochure, there were two knees. " Here's one that we injected it in, and here's one that we didn't inject it in." I said, " You've got to be kidding. That's really your example?" And he said, " Yeah, it's pretty compelling, isn't it?" I said, " It's not compelling at all. You've got an N of 1 in each group. That's not compelling to me." So again, I think you have to know your customer and know what's going to drive them. But most of all, I think if I'm on the selling side for the pharmaceutical company or the medical device company, I think you still need a true north. And that true north has to be, is this, in fact, the best option for this patient? We have to hold healthcare providers and healthcare sales people, I think to a higher level, right? You're not selling somebody a car. You're not selling them a new dishwasher. You're selling them something that affects their health, really their most valuable asset. So we've got to hold ourselves to a higher level of responsibility. So the data has to be clean. It's got to be pure. It's got to be honest. And I think that's really the key.

Clay Hausmann: I want to ask you because you mentioned it earlier around the value- based healthcare, as opposed to volume- based and obviously at its definition level, it's the ambition that we should all have for the healthcare system, that it's based on patient outcomes, that it's based on efficiency and not on process or on volume. How do you think as we move, hopefully, towards a system that is built that way, a lot of the things that we've talked about here, how can the relationship between a medical device or a pharmaceutical company with someone like you help mirror that or match to that to be able to support that mission?

Wael Barsoum: I think it's a couple of things. I think it's number one. I mean, I think most medical device companies today recognize that getting paid a premium for something is harder and harder to get. So focus on the products that have not yet adequately filled a niche. So what do I mean by that? Total hip replacement is an operation that has incredibly high success rates. Cataract surgery is an operation that has incredibly high success rates, right? We're probably not going to make cataracts much better than they are today until you can get to the point where you don't need to remove a cataract or you don't need to place a lens, but today the lenses work pretty well, and the removal of the cataract works pretty well. It's the highest value operation that CMS pays for. The second highest is total hip replacement, same kind of thing. So those are areas where maybe we could spend less R& D dollars and put more R& D dollars in the areas where we haven't quite solved those problems. So putting the R& D dollars in something like robotics, as opposed to a new piece of plastic, to me, is pretty exciting in terms of driving towards that value equation. The second thing I would think about is for those products that are working well, how can we get the cost down, right? I understand that if you're a publicly traded company you have a legal obligation to return shareholder value. I get that, but how can we return shareholder value by maybe bringing down the cost of manufacturing, bringing down the cost of packaging, sterilization, delivery, and then still maintain margin, but bring down the overall cost of the product? And there are companies that are thinking about that and are focused on that. I think the real solution is to say, how can we genuinely get the cost of goods down, maximize outcomes and do it for the lowest price possible? And again, I'm excited because there are clearly companies out there that are committed to doing that.

Clay Hausmann: One quick selfish aside, we're, at Aktana, that's obviously a big part of our mission because we feel like if we can help the pharmaceutical or medical device company lower their costs of their commercial process, if they don't waste a lot of dollars sending you information that you didn't ask for, or sending it through a channel that you don't prefer, but we're much more targeted, then they can recoup those savings and pass it through in the overall cost of goods. And that's obviously what we're trying to achieve here. All right. So as much as I've enjoyed this conversation so far, we are going to pivot into Wael Barsoum in context, which is a bit of a personal deep dive into your influences and your interests. If you are amenable to that, we'll shift there.

Wael Barsoum: I'm happy to.

Clay Hausmann: All right. Great. Well, the first question we ask, who has been an influence on your career that might surprise us?

Wael Barsoum: The person may not surprise you, but why might surprise you? So the easy answer is my dad, because my dad's a doctor and I've been going in the operating room with him and observing surgeries probably since I was in the fourth grade.

Clay Hausmann: Wow.

Wael Barsoum: But probably the biggest influence in my career, interestingly enough, is my mom. So when I was a little kid, I was maybe eight or nine years old and still embarrassed by this, but I was picking on another kid. I was picking on him. I was making fun of him. He was a short chubby kid and I was teasing him about it. And my mom pulled me aside one day and she said, " You should never, ever, ever tease anybody because of how they look." I said, " Well, why mom?" She said, " Because every human being is made in the image of God and everybody deserves to be treated respectfully." I've taken that with me for, I'm now 52 years old. So from when she said it's probably, I guess it's been 45 years. And when my pager would go off at three o'clock in the morning and I was just absolutely exhausted, I never had a hard time drawing the clear connection between the pager going off and a real human being that needed my help. So it was like a gift for me because it never became a burden. Even if you were tired, even if you hadn't slept, it was, for me, a service to another human being. So that I would say has been the biggest influence on my life. It always keeps me upbeat.

Clay Hausmann: What a wonderful lesson, what a wonderful story. Thank you for sharing that. Okay. My second question, if money was not a factor, what career would you most like to pursue other than the one you're currently in?

Wael Barsoum: It's a tough question for me because I'm one of those people that loves a little bit of everything, to be honest with you. I thought it'd be really cool to be a trial lawyer, but I don't want to be one of those guys that spends a bunch of time writing briefs. I want to be the Perry Mason, the guy in the courtroom, like, " Hey, you can't handle the truth."

Clay Hausmann: You're just brought in for that.

Wael Barsoum: Exactly.

Clay Hausmann: Let the other people do the long hours of the paperwork.

Wael Barsoum: I don't want to do that.

Clay Hausmann: I just want to cross examine.

Wael Barsoum: Right. I don't want legal pads and stuff. I want to converse with you and then get you to confess on the stand. That to me would be super exciting. The other thing that I think would be the coolest job in the world and I'm sure people will think I'm crazy for saying this would be to be the president of the United States. I think that is just so cool. I love negotiating. I love trying to bring consensus to things. I love different perspectives, although I think today, not to get overly political, I think we have too many extreme perspectives, but I do like that ability to bring people together and try to find commonality as opposed to divisiveness. So those would probably be the two things I'd be most excited about.

Clay Hausmann: I think for your first job, I might have a better answer for you. Don't have to be a lawyer. You just be an actor on Law and Order and then you can just do.

Wael Barsoum: There you go.

Clay Hausmann: You just do all the cross examining. You don't have to do any of the work. So on the flip side, what profession would you most not want to pursue, no matter what it paid?

Wael Barsoum: I don't know. I mean, honestly, I'm an odd guy and I can find something good in just about anything. I mean, I guess I wouldn't want to clean a sewer, right? That'd be a pretty lousy job. I have a very sensitive, sensitive spell-

Clay Hausmann: There you go.

Wael Barsoum: ...so not to be disrespectful to sewer cleaners, but I wouldn't be up for that one.

Clay Hausmann: That wouldn't be for you. What is the best book, film or show you've enjoyed recently and why?

Wael Barsoum: I just finished watching Billion Dollar Code, which is really pretty cool. It's a Netflix miniseries and it's about how Google Earth was started and how disruptive it was. It was actually started by group of programmers in Germany, working with Deutsche Telekom. They started a company called Terravision and essentially wrote all the code that Google ended up allegedly stealing from them. And they never made a penny off of it. But it's just a fascinating show about corporate espionage, about what a group of really committed people that initially had no resources were able to pull off through grit, through intelligence, through hard work and through innovation. It's really pretty fascinating.

Clay Hausmann: I tell you, I get so much out of the business part of the interviews here, but also I have compiled the longest list of content that I want to go consume. I will look that up for sure. You're at a family gathering and your eight year old niece asks you what you do for a living. What do you tell her?

Wael Barsoum: I tell her I care of people. The first answer is, I'm a doctor and I still do practice medicine. I just yesterday did surgery, but I'm very lucky in that whether I'm in the operating room or whether I'm on the business side of HOPCO, I genuinely believe that I'm making a difference for people when it comes to their musculoskeletal health. And that, to me is, is awesome.

Clay Hausmann: I would imagine, given what you said about you like to dabble, you like to find interest in a lot of different things, this role that you have, where you're able to still be a practicing surgeon, but also have a really interesting business and societal challenge that you're tackling, this has got to be heaven for you in terms of having that mix.

Wael Barsoum: It is. I love it. It's great. Every day I pinch myself that have the greatest job in the world.

Clay Hausmann: All right. So your ultimate dinner party for four, who is in attendance and what are you serving?

Wael Barsoum: I'll tell you what I'm serving. That's an easy one. Who is in attendance will probably surprise you because I'm sure people come up with great names like Socrates, Jesus, Plato. I don't know, Abraham Lincoln.

Clay Hausmann: I will tell you, we have gotten a broad range of answers to this from just my immediate family, having dinner and watching a movie to historical figures to everything in between. It's been fascinating.

Wael Barsoum: Is that right? Well, good. That makes me feel better then. So what I would eat for sure, if price and calories and health are no object, okay. I'm definitely a long boned rib- eye kind of guy. So I'd go with a big steak, medium rare, mashed potatoes, strawberry shortcake for dessert, French onion soup for appetizer. I would go to town, Clay. I don't think I'd leave one nibble on the plate. As far as the people, I'm a friends and family guy. I mean, there's nobody that I enjoy more than friends and family. I'm a very lucky guy. I mean, I get invited out to dinners all the time and for me, I can usually find pleasure and joy in just about anybody that I'm sitting around a table with. I love eating with people. I love doing business around a meal. I love getting to know people around a meal. So the dinner table for me is absolutely awesome. But I mean, if I could have dinner with Jesus, that would be awesome.

Clay Hausmann: Oh, my goodness. Fantastic. Well, this has been inspiring. It's been very informational. It's been enjoyable. I cannot thank you enough for coming on. It's been a real pleasure.

Wael Barsoum: It's really been my pleasure and an honor. So thank you so much and thanks for what you're doing in healthcare.

Clay Hausmann: That's it for this episode of Contextual Intelligence. I'm your host Clay Hausmann and you can find all our episodes on Apple podcasts, Stitcher, Spotify, or wherever you get your podcasts. And please leave us a review or a comment or a question or all the above so we can make sure that this podcast brings the proper context to your work. Thanks everybody for joining us.

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