In this episode of Beyond Consulting, sponsored by ECA Partners, we welcome Dr. Cliff Bleustein, a former PwC consultant and current Global President and CEO of AposHealth. Cliff joins us to share his journey as an MD and Professor to joining PwC and eventually leading AposHealth as their President and CEO.
The Beyond Consulting Podcast is hosted by Ken Kanara and co-hosted by Steven Haug. Steven leads this week’s episode.
Steven Haug: Welcome to Beyond Consulting. I’m your host, Steven Haug. Today we have the pleasure of speaking with Dr. Cliff Bleustein, Global President and CEO at AposHealth, and former management consultant from PwC. Before we dive into Cliff’s story, I want to take a moment to thank our sponsor, ECA Partners. ECA is a project staffing and executive search firm that focuses on private equity and former consultants. If you’re looking to grow your leadership team you can check them out by visiting eca-partners.com.
Cliff, welcome to Beyond Consulting.
Cliff Bleustein: Thank you for having me here, Steven.
Steven Haug: I’m really looking forward to our conversation here because your path after consulting, I would say, is just as exciting and interesting as your path before consulting. Tell us a little bit about earlier in your career. I’d love to hear about your start.
Cliff Bleustein: Yes, it certainly has been an interesting path to a startup environment. I started my career as a doctor. I went from medical school into residency, then during a surgical residency, I took two years to do a research fellowship. From my research fellowship I completed my training in urology and then went into private practice. In private practice we were in a pretty entrepreneurial group that owned and operated surgery centers. I really had the bug for understanding the business, and the business of healthcare, and how to grow it. I got my MBA while practicing as a urologist and from there, as a physician, one of the things that seemed to make a lot of sense was to really go on the path of consulting. I joined PricewaterhouseCoopers, first as a manager, and then got promoted up through the ranks. I did projects that ranged everywhere from documentation and coding within hospital environments to running the office of ambulatory services for a large healthcare organization in Kentucky, to international mergers, acquisition and bio cluster strategy internationally, all over the place. From there I went to Dell. I ran Dell’s global healthcare consulting practice with teams in the US, the UK, and the Middle East. I became Dell’s Chief Medical Officer. From there I left to be President and CEO of a public company called Computer Task Group. Then, after CTG, I joined a company called AposHealth, first as its Chief Medical Officer and US Head, and then about two and a half years ago as the Global CEO.
Steven Haug: Wow. That is quite a career. The transition from the medical field to the business field, I think, is very interesting. I’m curious about the motivation there. It sounds like you’re solving very interesting problems as an MD, and then also solving interesting problems as a consultant. Is the motivation there? Does it change in problem solving or is there something else that motivated that move?
Cliff Bleustein: I’ve been a lifelong learner and I find it very interesting and fascinating to continue to take my education or my learning to the next level. That’s one of the reasons why I’m also an adjunct professor at the Business School at NYU. I found that the business aspects of healthcare were fascinating and how, much of healthcare today is driven ultimately by how companies, physicians or practices, ultimately make money. I thought that learning about surgery centers, learning about laboratory services, learning about radiology within our own practice and how we were structuring the group to grow and expand into the healthcare environment was just really, really interesting. I wanted to see if there was a way for me to take my desire to ultimately have an impact on patients and delivering better care at a higher quality, could I have a better impact on running a business, or learning about a business, than I could as a surgeon.
Steven Haug: Good. That’s interesting. It makes a lot of sense, too, of course, those are large decisions there–going to medical school and making the transition out of there, but it sounds like you found quite a way to marry everything that you’re interested in these days.
I want to dive in and hear a bit more about your current organization and your role there. What are the goals of the company?
Cliff Bleustein: When I joined AposHealth five years ago, we really do have a mission to advance you know ultimately global health through the power of gait. Gait is really movement. This was a medical device company that was really founded in Israel. It was a technology that looks like a shoe, but is designed in a way to help people that have knee and back pain really get better, to improve their function and their pain complaints. We were in the process of growing in the US and, at the time, we needed to really think strategically around how we were going to scale the business, what the requirements were that we needed to meet in order to be successful.
It’s an interesting company because we’re now FDA cleared for knee osteoarthritis, we started to get insurance coverage with multiple different payers, we’ve expanded to have delivery at our partner locations in multiple states: New York, New Jersey, Pennsylvania, Massachusetts, California, and we’re starting to really get a major adoption across multiple different provider groups. It’s an exciting time to be at a startup. It’s an exciting time to be growing and healthcare is an exciting place to be.
Steven Haug: Whenever it comes to startups, I would say some of the types of businesses that perhaps have the highest barrier to entry are maybe manufacturing, because the infrastructure you need to produce goods, and then healthcare, for perhaps regulatory reasons. You found a way to try and tackle both of those with one company. Did you step in, or how large was the company whenever you stepped in and what were some of the major hurdles on day one?
Cliff Bleustein: The hurdles for any healthcare startup are enormous. Healthcare payers by the very nature have a tendency to be very conservative, often requiring a significant research base before they’re comfortable moving ahead with any new solution, and it doesn’t matter if that’s a medical device or drug. Ultimately, adoption is very, very slow. It takes time to convince payers, to convince physicians, and to convince patients that your product works. so I think the challenge is for any startup company are extraordinary I think you need to think about all of the different constituents that ultimately can be impacted by your company and by your advice and start focusing on making it easy for people to get to “Yes,” which is ultimately what you want to do.
Steven Haug: Tell us a bit more about clear about the product.
Cliff Bleustein: It is a shoe-like device which has two pods that sit underneath the specially made, in-built rails on the bottom of the shoe. Then, what we basically do is two different things. The first is that we are able to offload a joint by placing these convect pods underneath the shoe, based upon our algorithms and our training material, in a way to offload the joint. By offloading a joint you immediately get rid of the pain complaints that an individual has and allow them to regain a more normal walking pattern. Then, with the convexity of the pods, that helps to retrain the muscles in the new walking pattern so that when you take the device off, a patient remembers what it was like to walk with it on. Over time, we’re able to change the way people walk or their gait patterns to be a healthier walking pattern that has better function and less pain, and it does it through, really, treatment at home. All the patient needs to do is wear it for up to about an hour a day while they’re doing their normal activities. It’s relatively easy to do, it has a high compliance rate, and it is amazingly effective, which is one of the brilliances of its simplicity. Many times when solutions look simple people have a hard time believing that it works, but many times the best solutions are simple in their very nature.
Steven Haug: Very good. Well, that that is very exciting. Is this something that would be prescribed by physicians or providers?
Cliff Bleustein: Yes, we’re FDA cleared for knee osteoarthritis, of which the FDA clearance had a prescription. For the most part, physical therapists are recommending it, orthopedic surgeons, sports medicine doctors, pharmacologists, and primary care providers are prescribing it.
Steven Haug: Okay, so there are folks out there using your product right now.
Cliff Bleustein: Yes, we’ve sold more than 110,000 of these things globally.
Steven Haug: Okay, wow. That is really exciting. Is the United states the largest market?
Cliff Bleustein: Right now the United States is the largest market.
Steven Haug: Good, well, I think this is an endlessly fascinating discussion to learn more about the product itself, but of course, I want to hear about how consulting has played into your career. Can you tell us a bit about the decision to leave consulting? Whenever you joined consulting, did you plan on staying in it for your career, or did you always plan to build that toolkit and then moving into startups?
Cliff Bleustein: Consulting is an incredible place to be. I thought, when I was leaving medicine, that there could be no better profession than for me to go into than consulting, just for the reason you said. Ultimately, as a consultant, you develop a very strong toolkit based upon the projects, the clients, and the locations that that you’ve been to. Over time you build that at a very accelerated pace because you’re seeing multiple different iterations of whatever area you happen to be focusing on. It’s an amazing way to very rapidly develop skills that are pretty broad-based. It’s interesting and fascinating as can be. I could think of no better job to have than as a consultant. You get to deal with people, you get to learn new things on a daily basis, you get to do research to try and find more and interesting and creative solutions to really challenging problems. It was a wonderful career with which to learn and I’ve been very lucky to have experiences not only within the US, but actually global in nature.
I think the nature in terms of trying to figure out what to do next is to some extent happenstance, which happens in many people’s careers. I was reaching out to my network and when I was reaching out to my network I was actually looking for a guest speaker for one of my classes and they ultimately said, “There’s a position open at Dell to be a Global Head of Healthcare Consulting, is that something that you’re interested in?” Timing is everything in life and it sounded like it would be a fascinating job to be able to go and manage a consultancy, own a profit and loss center, and actually, ultimately, be responsible for delivering revenue for a company, and doing it at scale, seemed like a really interesting opportunity which I was lucky enough to take. Even in that role it was still in and around consulting, really until I got to CTG, where I was running a public company.
Steven Haug: The public company path, and then to the startup world there. What was that decision like?
Cliff Bleustein: A recruiter came and said, “Hey, listen. There’s an interesting role at a public company. Do you want to learn more about it?” I was looking to scale healthcare and figure out a way that the healthcare systems could work to deliver quality and outcomes to many more people than I could ever do as a surgeon. Each step that I was taking along the way was really thinking about is there a way that we could potentially have greater impact on individuals in the healthcare system and I thought that there was going to be another opportunity to be able to do that. I think, when you’re working for larger corporations there are always challenges and constraints within that, but to some extent, I felt like I was getting farther and farther from the direct care and management of patients and being able to have a direct impact. After CTG, that was one of the things that attracted me to the startup world, which is an ability to really grow a solution that could have more of a direct impact on patients than some of the consulting and other work that I had been doing.
Steven Haug: It’s exciting to hear the motivation there, as well. That was something I was curious about. I imagine that there’s a strong passion for the medical world, given your background there. As a physician, I expect that you were able to see the results of your efforts in real time and right in front of you, effectively. I was curious if you were able to scratch that itch as a leader in the startup world.
Cliff Bleustein: Yes. Whatever you want to do, you have to be passionate about it. Ultimately, everyone has a certain skill set that they develop over time, but if you don’t enjoy doing what you’re doing, if you’re not having fun, if you’re not intellectually stimulated, or stimulated with other values within the company, mission, or outcomes, it’s going to be a challenge for you to be successful. It’s important for you to do something that every morning you wake up and you get excited that you’re doing it.
Steven Haug: You’ve been a leader in the startup world for a while now. What are some of the key traits that a leader in a startup organization should have?
Cliff Bleustein: You need to be able to innovate quickly, be comfortable making decisions with incomplete information, be comfortable encouraging your teams to take ownership of the different aspects that they’re doing, and to fail fast. Many things that you do in the startup environment look wonderful on paper, and then when you get into executing on them you realize that it wasn’t so great. You have to be able to acknowledge that something isn’t working out and be willing to make some adjustments and try new things. I think the speed with which a startup works has to be very, very fast, so you’re often making many decisions every single day around what direction you want the company to take and you’re making adjustments at a much faster clip than you would do in in a more structured environment of either a consultancy or a larger firm. You need agility. You need comfort with making decisions in an environment where you don’t have all the answers, you just have incomplete information. You have to be comfortable with failure and understand that a lot of things that you’re going to try aren’t going to work. You need to be comfortable hearing “no,” all day, every day and not let it phase you, because the barriers you have across everything is really hard. You will hear “no” a lot, and you need to be able to take that as a drive and say, “Okay, maybe it’s ‘no’ for today, but it’s not ‘no’ forever,” and continue to move forward.
Steven Haug: Are there other former management consultants on your leadership team?
Cliff Bleustein: Yes, one of our operations individuals is also a former management consultant, but I’m a firm believer that in a startup environment you need diverse groups of individuals that have different political views, different worldviews, different backgrounds, different previous jobs, and education base. The more diverse you can make your team, the more people you have in the room to try and help you think through really challenging problems.
Innovation is hard and in order to really find some of the best solutions, you need a team of people from diverse backgrounds where they’re comfortable speaking up and saying, “Hey, listen, have we thought about doing it differently?” At whatever level they are, they know that whatever comment they make is going to be taken seriously and heard. What we often find in this type of an environment is that one person’s idea is not the right one, two people’s ideas usually aren’t the right one, and whatever the team comes up with, ultimately, is a better solution than anyone would have come up with alone. One of my mentors used to say that “No one is smarter than everyone,” and that was sort of the mentality of trying to get a team together to try and tackle difficult issues.
Steven Haug: Looking back at your career, from the story that you’ve told us, you’ve been able to capitalize on opportunities to build your career to where it is today. Is there anything that you would have done differently looking back, or, if you could do it again?
Cliff Bleustein: Somebody once told me, a long time ago, that if you go through your life and your career and you use the “what if” calculation that you usually lose that game because you envision the other option as being something much better than it probably would have played out to be. Having said that, I think one of the lessons I wish I would have learned earlier on in my career is the power of the network and that it’s important to build your network unselfishly. Many people are building their networks in more of a transactional model. What I would say is that the more you reach out to other people to try and find out how you can help them, the better off you are, and the sooner you start that in your career, the better your lifelong outlook is going to be. Ultimately, even if it doesn’t come back around to help you in any meaningful way, you can at least feel good that you’ve paid forward with other individuals. I think the network is often how people find their next opportunity. The network is often how you find opportunities at the current company that you’re in, and the broader the base of the people that you know of without your network, the more people you can tap into to try and help you think through problems or challenges as you go forward. My advice, in terms of what I’ve learned in my career, is network is king and the only thing that you need to do within the network is build it unselfishly. I think that that’s a hard lesson to learn and I wish I would have learned that earlier on in my career.
I think the other thing, when I look back on my career, is you have to be comfortable taking risks. You will not be successful at everything that you do and that’s okay. Most people that you look at who are successful can tell you about spectacular failures that they’ve had in their career. The question isn’t are you going to fail at some point or make one bad decision or one bad call or do one bad project, the question is how do you recover from it and how do you think through what you’re going to do next now that something didn’t work out right. How are you going to pick yourself up from that trough, because there are peaks and valleys in consulting. There are peaks and valleys in business, and there are certainly peaks and valleys for individuals.
Steven Haug: That’s really helpful advice, Cliff. I think a lot of our audience is made-up of folks who are currently consultants thinking about their next move. I think the idea that they should lean on the network that they’ve built in consulting and then try to expand that is very helpful advice. Is there anything else that you would tell a consultant who perhaps is looking to move into an industry or into a company where they feel that they can have a real positive impact
Cliff Bleustein: Yes, I think one of the important things is don’t chase the title. Look for a role and an opportunity that you think is going to be interesting and exciting and that will ultimately help your career long term. Be humble about where your career is and what your skill set is and be willing to take what, externally, may be considered a step back in order to move forward. I think those are hard lessons to learn. I think you know a lot of people get hung up on titles, but when I worked at Dell my boss was a vice president but he’s running a multibillion dollar business unit, that arguably, he could have been a Fortune 1000 CEO, but his title was Vice President. Take titles with a grain of salt. Look for the role that you want, think about your career path and what are the skills you need to take it to the next level. Be comfortable taking a role that other people are going to say is a step back, because, ultimately, many of those step backs may be for a short period of time, but the rest of your skill set will allow you to accelerate faster from that role than others who are typically in it.
Steven Haug: When you made the jump from consulting, were there any gaps in your skill set that you quickly learned about?
Cliff Bleustein: Yes, there are always gaps. No one is successful on their own. I’ve been very lucky and fortunate to have coaches and mentors all along. I think one of the most important things to learn is it’s okay to say you don’t know, it’s okay to say, “I need help,” and the important thing is to try and recognize the areas that you have that are gaps and quickly fill them with other people who can complement you in a way that that those gaps aren’t gaps anymore. I’m still learning every day and there’s still areas we can always improve on. The answer is yes, there are always gaps. You’re always learning and the truth is the challenges that get pushed upon you are often not the ones that you ever expect. They’re often more like Black Swan events like COVID that radically change the way you have to think about you know the world and how things are going to move forward.
Steven Haug: That’s interesting. What are some of the major hurdles you’ve faced as a leader in your current organization and tell us a bit about how you’ve overcome those.
Cliff Bleustein: I think the biggest hurdle that you have in the startup is that one of the resources that you often need is capital, of which is always in short supply. You never have enough capital to do all of the things that you want. One of the biggest challenges you have as a leader is trying to figure out what’s the right balance. Where do you put every single dollar when there’s a never ending demand for more people, more technology, more resources, more marketing, you name it, there’s always a need for more of it. One of the biggest challenges is how do you prioritize and how do you get the focus that you need in order to get the company to grow.
Steven Haug: Do you have general advice to give folks if they’re leading a startup, of how much time to spend fundraising, versus growing their team, versus working on the product?
Cliff Bleustein: Most leaders that I know of in startups spend their time focusing on the areas that seems to be the biggest fire drill at that time. I think the hardest part of running a startup is pushing enough or delegating enough to the rest of the team and making sure that they’re going to step up, so I think that your time as a leader is always inevitably spread thin. Startups require everyone to get their hands dirty. Everyone has to do work and there’s nothing that I’m not willing to do that we’re asking our teams to do. I think the answer is, you need to find the right balance between managing your board/investors, you need to have time to make sure that the product is going from a strategic perspective in the right direction, you need to be monitoring and tracking your sales and cash and everything else on the finance side, and you need to inspire your team to take their game to whatever level that they can. Hopefully, you’re at an organization like ours that’s mission driven. We know that we’re having a huge impact on our patient populations and we see it every day when we hear the patient testimonials about how we’ve changed their lives, so that drives a lot of the people at our company, but the leader has to create a vision that allows everyone to want to work their best, to want to be inspired, and take the game to a whole other level.
Steven Haug: How many employees are there at AposHealth right now?
Cliff Bleustein: We have roughly 60 employees, globally.
Steven Haug: 6-0?
Cliff Bleustein: 6-0.
Steven Haug: And globally, how many folks are in the United States?
Cliff Bleustein: About 2/3 of them, roughly.
Steven Haug: Is there an office or is your entire team dispersed?
Cliff Bleustein: We have a corporate headquarters in New York, we have a headquarters in London, we have the global company in Tel Aviv, but most of our teams are, even though we have offices, even before COVID were remote. There’s a balance between being in-person and being with clients. I think ultimately, even before COVID, we found that one or two days a week was sufficient for the teams to get together to meet, collaborate, and innovate, and the rest of their time was focused, really, on patients and our clients.
Steven Haug: For a medical device startup, how is your company structured between sales people, operations people, those sort of buckets?
Cliff Bleustein: About roughly one-third of our individuals have sales-related roles. About a third are back office, and about another 10 to 15% are clinicians. The rest have various roles that often spread between some of the different buckets. What you find in a startup is that, unlike many corporate structures where you have someone that only does account management, someone that only does network development or sales, someone that only does marketing, someone that only does finance or operations, in a startup, more often than not, depending upon your stage, people have multiple functions.
Steven Haug: Hmm. That’s a good point. Here at ECA Partners, we have a healthcare practice where we help our clients find executives for their leadership teams in the healthcare world. Oftentimes what our clients are looking for in their candidates are I’d say at least two things. One thing is that candidates need to care about the mission, just to fit into the culture and to be effective employees. They need to care about what they’re doing. Number two is that they need to be able to work in ambiguous environments. Is there anything else that you look for whenever you are interviewing or evaluating candidates for your team?
Cliff Bleustein: Yes, I like someone who’s agile, who is able to be given one job description this week and then two or three months later a different job description and is okay. I want someone who has had to deal with disappointment on a regular basis and knows how to work through it and have that drive them in a positive way instead of it being demoralizing. I like people who, to some extent, have had failures in the past and have managed to work their way through it because it demonstrates a certain amount of resiliency that you need to have in the environment. I want people who are able to think differently, be tolerant of other ideas, appreciate a constant feedback, and are data-driven. Everything in our company has a number to it, a key performance measurement, a quality outcome score. We think it’s very important that our data and analytics capabilities are pretty strong to help us drive behavior, so you want people who are lifelong learners and actually like to use data and think about data and have it drive their own performance.
Steven Haug: That’s great. Cliff, this has been really interesting. I really enjoyed hearing your story and I think a lot of the wisdom that you have shared with us is going to be extremely helpful to the folks listening today. Before we wrap up, is there anything else you’d like to leave our audience with?
Cliff Bleustein: It’s important to continue to keep your skill sets up. Be lifelong learners. Be agile. Don’t take yourself too seriously and understand that there are going to be disappointments for the company, and probably for you individually, and push your way through it.
Steven Haug: Cliff, it’s been a pleasure talking with you today. Thanks so much for joining us on Beyond Consulting.
Cliff Bleustein: Thank you for having me, I appreciate it. Thanks Steven.