Jon Lee, From Clinical Physical Therapist to Tech Entrepreneur

Speaker A: This is my journey Inspired One story at a time, a library of leaders was created. It began as a journey to learn. As time went on, it began to grow. All it needed was a platform. And this podcast was created to listen, to inspire, to share. I am a storyteller and this is my journey. Welcome to another episode of Profiles and Leadership. I'm your host, Steve Anderson and today our guest is John Lee. John is the co founder of Pickle, as well as a physical therapist. He's been featured by organizations such as NYU, the University of Oxford, WebPT, and the United nations, working with healthcare executives around the globe on workforce strategy and big data analytics. John holds an MBA from the University of Oxford in the UK and a DPT from Virginia Commonwealth University. He is also a board certified Orthopedic clinical specialist and Fellow of the American Academy of Orthopedic Manual Physical Therapists. So John, welcome to the program. It's great to have you on today.

Speaker B: Thanks so much for having me.

Speaker A: So let's just start a little, uh, with uh, context here. I always like to kind of get a feel for where people are from. So tell us a little bit about where you grew up, kind uh, of some of your early influences and uh, how you got to PT school and just kind of bring us up to date a little bit.

Speaker B: Absolutely. You know, I think like most young boys, I probably had a circuitous route in life. Um, I grew up in rural Virginia, split, ah, in time between there and New York City with my parents and grandparents. Um, my, uh, parents didn't formally go to college. So for us as immigrants, education was the way out. And in Asian families, usually it's doctor, lawyer or engineer. Those are only three choices. And for me, yeah, for me, like most young boys, I had a sports injury. Uh, I had a really good local mentor when I was going through middleswan High school who was a pt and that kind of gave me the love of the PT profession and figure out how I wanted to impact patients, uh, in my community, both in rural areas or in the city. Um, this brought me to undergrad at uva where I was an athletic trainer and then PT school at vcu. I, uh, went on to a residency and fellowship down in Houston with the Houston Methods System. Um, and then I practiced for almost 10 years in the Pacific Northwest. Uh, it's currently today in my day job I'm a PT who went to business school who learned data engineering. And most of my time today is spent working on big data analytics for healthcare organizations.

Speaker A: Okay, so how does a guy uh, that grew up in Virginia, uh, do residency in Texas, end up in the Pacific Northwest, in Portland, Oregon, I think, is where it was.

Speaker B: Honestly, it was, um, by accident. I don't know if you have this, but I find that when I speak to a lot of students or even young professionals in our industry today, they see you and they think you had this clear, linear line to where you wanted to be when you grew up or if you've ever grown up. And for me, it wasn't so clear. As I was going through vcu, I had a really powerful mentor named Shawn Soper, who was a professor at the time. She, um, was very active in apta, and I told her this dream I had about working with pro athletes. Right. I think at that time I was a student intern at vcu basketball. They were going through the shock of smart days, and really, I really loved that lifestyle. And she said, well, you know, I have some. Some connections at University of Pittsburgh, um, and you should speak to them. I spoke to them, and what they told me was, if your school doesn't support residency, now's probably a good time to be the first person, even though that might be tough. And understand that each residency has a different flavor based on the organization. Some orthopedic residencies are sports heavy. Some are hockey or football heavy. And kind of think about that as you're thinking about your decision. So for me, I was really enamored with the power of my hands. I thought human touch goes a long way to helping our patients get better. And so I chose the manual therapy route. Um, I looked for a residency that was led by a manual therapy fellow that was also affiliated with sports. Ended, uh, up with Toko Nguyen and his team down in Houston Methodist, and just had a great experience. And then, um, as I was finishing my residency and my fellowship down in Houston, um, direct access was getting bigger at that time, and I had realized that, number one, um, sideline travel for sports was maybe not something that I had loved in undergrad. And number two, um, direct access is really powerful, but it's got some restrictions from insurance at the time. So even if you could see a patient, well, insurance pay for it. And Oregon had this combination of really great direct access laws, really great reimbursement, and it was the headquarters of Nike. So it was a great place to get my start. Uh, work with high school, college pro athletes, meet agents and things like that. And so that's how a kid from Virginia ends up in Texas and in Portland.

Speaker A: Yeah, that's great. So tell us a Little bit about those early years as a young professional. Then you're coming in, you're working in a, I believe, was it a private practice or was it in a hospital system there in, in Portland? And, and uh, what kind of patients did you see and were you able to work with the caliber of patients, uh, you were hoping to.

Speaker B: Yeah, I was really fortunate. Where even to this day, you know, if I think back on some of the best jobs I've had in and out of healthcare, it's actually been private practice. And I think this aspect of being part of the community you live in and treat the people that you live with, um, was really powerful for me growing up in, in, in rural Virginia and in like the uh, Asian community in New York. And so for me, um, when I moved to Portland, I actually started with a private practice. It was run by a very, very smart fellow named Don diamond. Um, and I, there's another guy named um, Kent who took me under his wing and they were treating at this time, um, a lot of high school and college athletes. But um, had built this big beautiful facility with AstroTurf and basketball courts and everything. And we're really gearing up their sports. Sports side, um, When I got to Oregon I realized a couple of things very quickly as I was meeting more Asians and athletes was that um, number one athlete injuries in the pro level are often classified as workers comp. So there is a lot of benefit there for the clinic itself if you can get more workers compared to um, reimbursements. But also on top of that, um, building relationships with teams was really time consuming, especially as a young pt. Right. Like these guys are worth lots of money. So there's a barrier to entry by design. What I found uh, in that scenario was helping um, agents who were helping kids get ready for the draft before nil and all that stuff was actually a really great sweet spot because you learned a lot about high level athletes. But also as these athletes were then drafted and moved on to pro teams, you started building relationships with the teams. And so that's how I got my start in private practice. Um, that clinic ended up getting acquired, um, after a few years, um, and I went on to another area, uh, of care that's close to my heart. But those early days were so fun in terms of meeting new people and understanding what problems were and trying to figure out what I wanted out of my career and how I could help my community.

Speaker A: Yeah. So why did you, if you don't mind me asking, why did you leave, uh, the, the practice Once it got acquired, was it just different in some way?

Speaker B: It's more of a personal story. Um, so, um, what I found through my personal life is that a lot of the patients that fall through the cracks, um, tend to have some sort of circumstance that we don't understand. Right. Maybe I'm homeless and I'm panhandling for bus fare, or maybe I don't speak the language, or maybe I don't know, access my, my healthcare plans, resources or things like that. And for me, the reason why I got into PT as a teenager was because I wanted to work in sports. But I remember during that time when I was working in that sports field, I kept having this thought of was this everything that I have always wanted to do. And I remembered that the reason why I got into healthcare as a kid was because I wanted to help people that looked like my dad or looked like my grandma. Right? And I had forgotten that as I went through puberty and went through the luster of going through pro sports and things like that. And once I got there, I realized sports was fun, but it's just the edge of what we can do with our white kids. And for me, uh, after that acquisition, I made the decision actually to go into Medicaid. And so I went into a very large Medicaid center in Portland. Um, was seeing a lot of homeless, uninsured, drug addicted oncology patients. And for me, I felt that after sports it was really important to me to help people in my community who maybe came from similar backgrounds or tougher backgrounds maybe I had experienced growing up.

Speaker A: Yeah, what an experience. I mean, I can't think of two opposite, different worlds. Right. I mean you're looking at the pro sports, high money, high pressure. You know, uh, these people are well taken care of and you might even argue or babied a little bit to the uh, population that uh, doesn't have any money. Uh, people forget about and they're often, uh, ignored. So, uh, what a stark contrast. But uh, wow, I'm sure you saw some real big differences there. Or do you think it's similar approach, just different, uh, circumstances?

Speaker B: I mean even today I, you know, I lead a tech company, but there's one patient that just I, I can't ever forget.

Speaker A: Right.

Speaker B: And I think when you're going to PT school, maybe you think, oh, that NBA player or that NFL player, I always remember, but those often aren't the ones that like kind of shake your, your root of identity. Right. I remember I had this patient who was a part time worker at Nike she was, like, working for an agency, and she was a manual laborer. She was the person who, who would take the air insoles and then inspect them and move them down the line. Right. Move them down the production line. And she came in with overuse shoulder pain, classical rotator cuff tear, uh, labral tear type thing. But what was really challenging about her was she had radicular pain beyond her elbow. Right. And she also only spoke Spanish, so I had like, rudimentary Spanish when I was living in Texas. It's very challenging, but trying to work through that, that navigation. Right. Ultimately, what happened with this patient was her pain. Even though her imaging was positive, her pain was actually coming from something else. Literally the day before she came to see me, her son had been taken by immigration. This. This is. This was in 2018, 2017. Right. So it's before all the stuff we're going through now. Correct. But for her, that trauma and stress of watching her son being taken away fed to this chronic regional pain syndrome, um, hypersensitivity pain. Right. What's fascinating for her is once I realized this and worked on working with the hospital to get her community social work services and things like that, her pain actually went away. And I think about this all the time because we think about biopsychosocial model and, you know, what it means to, To. To be a member of our community and to help patients and help. Help people we care about. And that story, even now, as I'm developing virtual products, I take that as kind of my origin story for listen to the user, listen to the customer, kind of these bedside MANNER Things that PTs are great at, understanding why someone's really seeing you. Is it really a musculoskeletal issue or something deeper?

Speaker A: Yeah. Yeah. Wow, that's an. It's an amazing story. And I, I think it's a. It's a great lesson. As you just said, there's a. You know, we have to treat the person as a whole and what they're going through at home and the stresses and, you know, it just exacerbates everything. And so, uh, if you don't take that into consideration, a similar condition is going to present two different ways, depending on, um, you know, what's going on at home and what's going on in their personal life. Yeah, really interesting. Okay, so now you're, uh, you doing that for a while, and then I think Covid hits and, uh, uh, what happens now?

Speaker B: Yeah, Covid was an intense period in time for society. Right. I think for providers, for the patients, for Our loved ones. And I think sometimes on the back end that we forget just how crazy that first wave was. So I'm working in this community health setting, um, very at risk patients in a Medicaid facility. And Covid happens, a large number of my patients are going to chemo at the same time. Right? And so you're thrust into this situation where my patients are dying, right? Like, and it was so early, we didn't even know about contact precautions, like, are you wearing gloves? Did I wash my hands enough? Uh, all these types of things that, you know, that fear of those early days of COVID was like very palpable, right? And that really impacted me because for me, it really made me try to figure out, one, why I got my white coat and two, how do I go from 20 patients a day to a million people or more? Because I think PT and healthcare is very challenging, it's very noble. But when you have a global pandemic killing millions of people at, ah, a very high rate, it's like, how can we do more? And why do we enter healthcare in the first place? So for me, where my pivot happens is I remember it was April or May 2020. It was, it was at, uh, towards the end of the first wave. And I remember coming home from work and I remember just turning on the news and I saw that it was a ticker on CNN or Fox News or something said, Oxford's announces first COVID vaccine initiative. Right? I think they had gotten 2 billion pounds from a bunch of sources to make the versus colored vaccine. And something like went off in my head. I remember there was like two distinct questions I had. I said, number one, are the people developing vaccines, have they seen patients before? Right. And number two, if the World Health Organization is predicting three to five years at best to get out of COVID and we had just started, what can we do to speed this up? Because every day that goes by is another impact on the patient or a family or a provider or things like that. If we're thinking about this time period, it's April, May 2020, it's like pretty late in the school year. I made this decision that I wanted to go and find a way to go make vaccines. And, and I figured that if I went back to school at the place I was building the vaccine, maybe I could figure something out. The challenge there is, it's a different country. We as Americans, we know about Stanford and we know about MIT and we know about Harvard, but Oxford and Cambridge is a whole different level in terms of culture. In terms of prestige and just how they carry themselves and the scope of how they see the world. And so me as a PT, the only degree left in May 2020, when school starts in the fall, was business school. And so I didn't actually look to leave clinic. I accidentally ended up in business school as the only degree left that I got accepted into to then fulfill this bigger mission at some point of like, how do I help the world get us out of the pandemic?

Speaker A: Wow, that's a big leap. I mean, uh, you know, from a physical therapist perspective, you know, you're, of course, you're at a doctor level health professional, yet, you know, dealing with COVID which is not. Not something you'd really think about, you know, in physical therapy terms as, you know, the day to day, it moved you in a way that, uh, is really interesting. So, uh, so you enroll to go get into the MBA program at Oxford and get accepted. And, um, so you head for England.

Speaker B: Yeah, that time period of my life was really intense. I remember I got accepted and I had 60 days to get my visa, which most Americans, I didn't know what a visa was. I had to like, Google that. I was like, what is a visa? And then, like, figure out how to get to a foreign country and what about all my stuff? So I remember in a span of 60 days, I sold my house, I sold my cars, I sold every living thing I owned. Uh, I drove 6700 miles to Virginia to drop my dog off of my mom's house, processed my visa while I was driving across the country, paid the school sight unseen. I thought it was a Nigerian prince scam. Because I remember so vividly, when I spoke to admissions, they said, oh, by the way, we've never accepted a physio into Oxford in the last thousand years. And I was just like, but I got in. Is this real? And so I'm paying them more house money. And like, I didn't actually see the school until I got off the plane and took the train, took the tube an hour to Oxford. That was the first time I saw a school.

Speaker A: Right.

Speaker B: Um, but yeah, it wasn't a clear path. I can't even lie to you and say I had it all thought out. I just. I think Covid affects a lot of people. And coming from pt, I think we have a lot of weight on patient interactions. And I just. I wanted to figure out how to do something more.

Speaker A: Okay, now you have this first class education from Oxford University. You got an mba. Uh, now you decide, what am I going to do with this. So what do you do?

Speaker B: Yeah, uh, again, just getting lucky. I think. One thing I tell students, whether they're post professional students like PTs going to business school or nurses going to MHA or even PT students going to PT school is don't underestimate the power of being a student. Every good leader out there has been where you've been. And if they're a good leader, they haven't forgotten what that feels like. And what that means is at that point in their lives, they reached out to someone for guidance and for help, right? So for me, what was really important at that point was I reached out to a bunch of people I had never met before, like, probably spammy. And I was just honest and I said, hey, I'm a pt, worked on the front lines, I'm here at Oxford and business school. I want to make a difference. I don't know how to do it, but you've done something in some way that I have 15 minutes of your time and you just tell me how you did it in the problem you were solving and, and gather that information to figure out what you want to do. Now this is all happening in the context of Oxford, which is a one year mba, not two years. So like imagine never opening a spreadsheet before. And then I'm sitting in accounting class of like these venture capitalists and private equity guys and knights and arms dealers and like all these crazy smart people, right? I'm just like, what's a credit, what's a debit? Like very, very basic fundamentals, right? So for me, learning all that in a compressed timeframe was tough. And for me, when I finished, when I graduated, I actually went on to management consulting, um, in big pharma, um, as well as consulting for the United nations for some digital health initiatives they were working on in developing, um, nations. So for me that was really great because the consulting is a whole nother rat race. It was a great finishing school, I guess, in terms of all the skills I had started to acquire in business school. But then the tech side, the infrastructure side and the policy side, that opportunity allowed me to understand how software is built, understand how funding circulates, understand what system constrictions look like. Because like, for example, a problem that we were dealing with at the UN was if telehealth requires 5G and I only have 2G Internet in Burundi, how, uh, does that work? It doesn't, right? Or if I am a Portuguese company hiring American doctors to treat patients in uh, like Zimbabwe, what happens if the patient Gets hurt. Where's jurisdiction? Like all these, like, little things that we don't think about as we're just trying to make sure our patients get care.

Speaker A: Yeah, that's, that's amazing. So did you feel like during that time when you're doing this work now, did you feel like you were leaving the profession of physical therapy? Did you feel like you were leaving it behind and doing something different? Or did you feel like you're just bringing physical therapy into another aspect of having health, that maybe it hadn't been exposed to physical therapy before, but maybe this was a bridge to get there?

Speaker B: Definitely the latter. And you know, I thought about this a lot. A couple, a couple different stories come to mind. I think the first one was that, uh, even today, like when I, someone introduces me or I introduce myself to someone, I still classify myself as a physical therapist. I think going to business school or going to Oxford, like for me that was a way for me to figure out how to take my PT identity and, and expand that impact. Right. What I found was that a lot of people treated me differently because I had MBA or. Cause I went to Oxford or whatever. But like, for me, I was still doing the same things and asking the same questions I asked as a pt. I was just asking them in a different language that these other parties could understand. Right. And so I remember the day that the World Health Organization announced Covid was over. I remember so vividly about three months before that, some of my friends in the Yen were saying, hey, just, just so you know, summer 2023 looks like Covid might be paused, changed, announcement, something, right? And so when they announced with the World Health Organization, I remember I quit my job that day in Big Pharma. And it was not because of my job, was that, uh, I, my coworkers are great. I worked for a great consultancy called Idea Pharma. I learned a lot from design thinking and finance from them. But for me, as like a pt, I didn't become a PT ultimately to develop drugs for a living. I wanted to try it during this moment of need and see where it went. And for me, I never really lost that PT identity. And so it was time for me to move on personally once Covid was over.

Speaker A: Yeah, it brings up a good point. I've argued this point in the past as well. I personally think that physical therapists do make great leaders because of how we, uh, perceive things and how we problem solve things and how we ask questions and how we build relationships with patients and all those things. And they're easily transferable to the business world. It's always perplexed me a little bit of how little PTs are in healthcare systems in the higher management executive levels, where, you know, there's all kinds of physicians and nurses and other, uh, you know, other professions, but, you know, very few physical therapists. So I agree with you. I think it's, it's, you know, you can take those skills that you've learned and developed and do more than, you know, putting hands on a patient, treating them. You can expand that further. So, uh, uh, thanks for sharing that story. So you quit your job. So what do you do now?

Speaker B: Yeah, so, uh, I'm in the UK and, uh, I did what anybody would do. I went to my two starters for two smartest friends with a crazy idea, and I said, hey, we're gonna start a company together. And that's how the genesis story of Pickle is. Basically, I went into my two smartest friends and said, hey, let's, let's, let's try this out. Um, one thing that always stuck with me when I was working in the hospital system was how expensive alternative alternatives to care were and how much that impacted the outcomes of a patient. Right? So there's like standard examples. If you ignore a, uh, bed sore, maybe it'll turn into something worse. Right? But I'm talking about, like getting actually seen by a clinician. I remember during COVID you know, you had the rise of travel staffing firms and external recruiters, and these are really, really expensive. What I learned that time was a lot of that cost is pulled from the operational budget mid year. Right? So you have less resources for your staff. Ultimately, you have less resources for your patients. And what I realized was if there's a way to identify really good companies, really good practice orgs, could we supply them with the tools that every travel agency wish they had, right. To understand who is in my area, how many patients I have, and what can I do to make sure my patients get seen? Because at the end of the day, healthcare doesn't work without providers. We spent a lot of time in the last 20 years focusing on patient flow, but really, provider intelligence and understanding our workforce is a big gap we have across all of healthcare. Like, I'm not aware of any company that can tell you besides us, how many licensed physical therapists there are per zip code in America type thing. But if you're thinking about these care gaps that you have, if you don't even know how much care you can provide on a population health level, how can you think about solutions to help your patients get more care. Especially considering we have the aging of America and also we have all these developmental delays from pediatric care from COVID Right. We're really at this kind of crisis point here. And the final thing I'll add is, uh, there's like one data point I remember seeing that just blew my mind. According to the census, by 2030, 2/3 of all healthcare professionals will be Gen Z or Young Atlantis. This is not like a passing tide. This is a wholesale shift in generations. And this, uh, group right now across all the healthcare service lines are under a combination of 10 times more debt than before, but also 10 times longer to hire than it took 10 years ago. Right? So imagine this scenario. You're a physical therapist. You're 24 years old, you have 200, 250 grand in debt. Okay? The average time to hire in physical therapy is 12 to 15 months, depending on your setting and depending on your resources. Right. The average human tolerance for a bad situation is six months. And then I need to figure out something else. So you have these kids who are under price pressure, like debt pressure. They take the highest paying job or travel job or something and there's nothing wrong with that, right? But at six months, you start to get burnt out. Maybe you're thinking, maybe I wanted to try something new. You start looking for a job, it takes you two or three months. You start this for two or three months, which is a quarter into the hiring life cycle and you lose hope. So what happens? You become a real estate agent. Right. Or you do something else and we lose your talents for society from a healthcare perspective. And so ultimately speaking the workforce intelligence and understand workforce also has an input to attrition.

Speaker A: Right.

Speaker B: And making our industry more resilient. Because if people aren't able to switch different to different roles or different situations based on, uh, how their lives change, we run the risk of losing them out of profession totally. And I think that's been born time and time again in each year's annual report.

Speaker A: So for those listening that have never heard of Pickle before, just give us a summary. What does the company do? Uh, what are you trying to solve and how do you do that?

Speaker B: Yeah. So Pickle is a data engineering company that builds workforce intelligence. We map and catalog every medical care organization, every provider, every specialty, things like that, to have a golden record or a phone book of what our professions can do under very granular level, pt, ot, rn, things like that. Most people use Pickle for either, like mergers and acquisitions, like if I'm going to Buy this clinic. Do I build it or buy it? Well, there's 10 therapists within 100 miles. I better buy that clinic because I can't fill it. Or they think about ways to redistribute their resources for recruiting, staffing and retention. For example, if I can't find any women's health therapist, I'm going to offer women's health certification as an employment bonus. Right. Because I know I need that service. But you can't really make that decision on how to support your people if you don't know how many people there are in the first place.

Speaker A: Mhm. So, okay, so, uh, you find. I guess what I'm trying to say is I've been around a long time and as long as I can remember, people in management or ownership of healthcare and physical therapy companies are always like, you know, we can't find enough people. We just can't find enough people. And so the question is, is there not enough people or do we just not know how to find the people we need? And uh, it sounds like your program helps people identify who's out there and maybe they're looking for a change.

Speaker B: Yeah. The best analogy I can give is Google Maps, right? Let's say you're going out to dinner with your family, right? You open up Google Maps. Google Maps shows you all the restaurants in the area, reviews, ratings, things like that. Now imagine that for clinicians and for medical care organizations where you could actually see and plot in real time who exists where and how many. Up to 99% accuracy. 99% coverage, uh, of the workforce itself. Right. Because ultimately speaking, whether you choose to use that information for recruiting or to open your own practice or open another location, it's all fundamentally the same data, right? We can't really make strategies on how to best manage our volume patient load without taking into account the people that are providing that care. Right. And so this goes back to your question of, uh, is the shortage really a shortage? Absolutely. What I think is unknown at this point is how much improvement can we make in the lives of patients and patient care gaps if we optimize the system, in addition to creating new supply? Right. We can always open more PT schools, train more PT schools. Right. But until that happens from a regulatory perspective or education perspective or things like that, how far can we push optimizing our efficiency within the physical therapy system? And I don't mean like seeing more patients. What I mean is how do we take the talents of our people and distribute them and keep them with us? Keep them with us as an industry.

Speaker A: Mhm. Yeah. Interesting. So I have to ask you, uh, Pickle, how, what's with the name? How did you pick Pickle for the name of your company?

Speaker B: This is a great story. I wish I thought of it didn't. When we started this, when we first realized that the generational shift in healthcare age, we created an experiment, we made a job board, we created some career material and we went viral on TikTok. That's where all the young people live. I think in six months we actually got almost 100,000 healthcare professionals out, uh, of TikTok to apply to jobs on Pickle. What we did was he picked a thousand of them and we interviewed them and we asked them the same basic five questions. Right. How are you feeling about your decision to be a healthcare professional? What was your journey to get here? What are your goals for your career? What problems do you see with achieving that goal? The last question is really illuminative. Right. The word pick kept coming back up. I wish I could pick how I grew my career. I wish I could pick how I knew who a good employer was. I wish I could pick the way I impacted my patients might be pick, pick, pick, pick, pick. The young people, while, you know, they've gone through a tough time with multiple economic downturns and things like that, still have this like hope and this belief that I am just so appreciative of that there can be a better way. Right. If I'm real about the constraints to get there. And so after hearing Pick thousands of times, decided to check out the trademark office, see if anyone trademarked it. No one did. And so that's how we became Pickle. They came from the clinicians.

Speaker A: Yeah. Interesting. That's a great story. So you said that you approached your two best friends and you're in the bio, we know that you're a co founder. So uh, these two friends that help you form this company and build this company, what backgrounds do they come from?

Speaker B: Yeah, so at Pickle, we're a founder, we're a minority led, women led company. So I'm a minority Asian. My other, ah, two co founders, um, one is male from Mexico and one is female from the Philippines. And so this is really, really cool for me in the sense that they, they experience healthcare in different contexts around the world. We have different reactions to the same staffing stresses we have here in the US but on top of that, my technical co founder from Mexico, he's an AI engineer. Right. My other, uh, co founder from the Philippines, she is a growth Marketer, finance person. What's fascinating is all three of our families came through healthcare. They have their own immigrant stories, Filipino nurses, Latino nurse practitioners. Like they've seen it and they've done it. Right. So for me I was really fat, I was really lucky, where I got three people, two people I trusted who saw a similar problem or a similar problem that I'm seeing, but also were strong in the places where I was not as strong. Like I am decently technical, I could code a script, but like to make an end to end deployable AI infrastructure, not something that I could do. Right. But to have a friend who does that and you trust and who understands the healthcare context is really cool.

Speaker A: So let's say that I'm a business owner and I hire you, uh, you know, work with Pickle. I have, you know, 20 or 30, uh, facilities and I want to find staff and keep my staffing strong and consistent. How does Pickle help me do that?

Speaker B: Yeah, great question. Customers usually fall into two buckets, right? The first bucket is my existing processes are working and I'm looking to add another process to it. I'm hiring great for my student internships. You know, I'm hiring great from my uh, community community fairs. I'm looking for another tool to latch on to drive more clinicians into our door to be aware of what we do for our community. Right. I just need some more top of funnel support. I need more people to make what I'm doing even better. The other side is actually even more fascinating. The other side of the customers are uh, business owners who are looking to enable their top staff. Right. The typical recruiter in healthcare today spends 20 to 25 hours per week Googling people. What these customers are looking for is I have this recruiter who's been doing it for so long they're really good, but I need to make sure that they're doing more valuable work versus Googling or researching or things like that. So in that case, they use Pickle to automate all the research and identification to allow their best people to focus on building relationships with the clinicians who can see their patients versus I'm going to go to state licensure board or I'm going to google the school and do all these little research tasks that should be automated to enable our people to focus on building relationships with clinicians and patients.

Speaker A: So is this just a one way system? You just explained it really well. If I'm a business owner, how that's going to help me find the people that I need to grow my business and continue, uh, success. Does it go the other way too? If I'm a clinician, if I'm a physical therapist or uh, a nurse, can I use it in a way to go in the other direction too? To find the place I really want to be in the dream job?

Speaker B: Even better. Company policy. We offer three hours a week of free career consulting for any clinician. All they have to do is go to our website, click, reach out, contact. Everybody with a medical license will get at least 30 minutes of free career coaching. Because at the end of the day, until you bring the companies and the people together, uh, our patients are going to suffer. So we don't have a platform for clinicians. We actually go directly to them and help them with things. Especially for the ones who maybe don't have the financial resources to pay for a career coach or things like that.

Speaker A: Yeah, yeah. That's interesting. You have a, you know when entrepreneurs come up with business ideas and they go into it, a lot of times people think about what it could be and it's like, oh, here's a great idea and then you do some research. And uh, well, I was about a year late or you know, someone else is doing this, or someone else is way down the road or whatever. It appears that you've got onto something that no one else is doing. So I guess my question is if it's been, been an issue for so long and been on everyone's minds, why has it taken so long for somebody like you to come and deal with this problem head on?

Speaker B: Great question. I wouldn't say there aren't other people doing this. I just feel like other people haven't approached a problem that we have. One thing that I learned from business school is like competition is good. You never want to be the company that is Blue Ocean. No competitors, Right. Because either your assessment is incomplete or your idea may not be repeatable in value. Right. So other our competitors or our analogs would be like recruiting and staffing firms or like LinkedIn recruiter or things like that. Right. We're bundled into this HR kind of HR tech recruiting staffing space. What's interesting though is number one, going after a place where there are competitors is really good, but doing it a bit differently I think is where we succeeded. I think there's an AI sticker on everything right now and I think people maybe misunderstand or fear what AI actually is. AI is a decision making process based on assumptions from certain amounts of data. It's literally a decision tree. It's stats, right? The challenge there is that everyone had been trying to build more AI tools to read the dirty data, because no one's really had the idea or execution ability to build the database itself. If you think about it, if you have this database like we have of all the medical care organizations and providers and et cetera, all at once, this in itself is insanely valuable because this then allows our AI talent to build custom tools on top of this database. So really what happens is if it's crap in and you try to optimize good out, you're always constricted. For us, we decided to take the harder route and fix the crap in to give us a clean output.

Speaker A: Just in thinking of it very elementary, I'm thinking as a clinician, I'm in a system that I don't even know I'm in. In other words, you know, it's not something I signed up for or filled out a subscription for or. Or I'm in. You just go out and do the work and somehow you find out people's locations and their, you know, their resumes kind of, in a way, and their experience, and you have this in a database. So I, as a, as a physical therapist, may not even know that I'm in your system. Is that accurate?

Speaker B: Um, yes and no. So what the way to think about Pickle is we just take public information and look at it through a healthcare lens. Right. It's not like we're like, cracking systems or anything like that. It's all public. It's all stuff that recruiters would Google anyway. Right. What really bothered me as I was going through those, like, thousand clinician interviews was one particular problem that I, uh, still experience, which is why am I getting a text message for a home health role in Idaho? I have never lived in Idaho. I've never done home health. Again, inappropriate data leads to bad targeting from whatever recruiting firm or whatever it is.

Speaker A: Right.

Speaker B: But the other problem that kept coming up that I also hate is like, resumes. I've been practicing for at this point, almost 14 years. Right. Why do you need a resume? You have my license number, my license verification, you have my board certifications. You have all this other stuff. Let's just talk to see if I like your organization or if you think I could be valuable to your organization. I think cutting out all the faff of. Sorry, faf is a British term. Cutting out all the fluff for, um, like, roles that aren't in your area or don't help you grow as an individual is a really positive externality out of this, because at the end of the day, I don't want to receive more text messages from Idaho, but if someone sends me a LinkedIn message inviting me out for a cup of coffee at the clinic down the street, I would definitely take some free coffee.

Speaker A: Yeah. Uh, yeah, that's great. So I think I've heard you say this before in some of our previous conversations, but I think you might have just answered it. But, you know, you say that healthcare recruiting is really run on broken infrastructure. So, um, what you're trying to do now is just trying to put these pieces together. So it's a, it's a linear, systematic approach as opposed to here and there and everywhere right now.

Speaker B: Yeah, the data problem is like very deep. I mean, even insurers have trouble with this. Like, when's the last time you try to access your insurance plan to find an in network provider?

Speaker A: Mhm.

Speaker B: Right. This is all workforce data too, for patients. Right. And just like this, we have a shortage, but our system can be optimized to prevent some of those negative impacts from that shortage. Right. Adding more talent to the shortage is an option, but that doesn't mean we can neglect improving what we already have as an industry.

Speaker A: So we have a common friend in Chris Hoekstra. And, uh, Chris worked with me and I always thought he was one of the most brilliant guys that have been around and is just so. Approaches things so intellectually and so sound. And he just, he just, he so impressed me. So he told me, you know, that I need to talk to John Lee, because, uh, he said he's even a bigger nerd than I am. So, uh, how did you meet, uh, uh, Chris, uh, Hoekstra. And, um, tell me a little bit about that relationship.

Speaker B: Chris is very kind. Chris is one of like the six or seven people I've met in my life that made me rethink what data was and how we use data in healthcare. Just like point blank. And I'll tell you what I mean, um, when I was first getting out of business school, I spoke to my mom, and my mom was telling me, as she told me since I was a kid, that one, john, you're not that smart. Two, someone older or smarter than you has had the same problem and figured out and written a book about it. So why are you being so stuck up and not just asking them how they did it or what to learn? And that's like, really stuck with me, right? And I reached out to a bunch of people in industry that I looked out, like I looked up to, and Chris is one of them. Um, Chris is also a manual therapy fellow, but he also has PhD in Informatics. Right. Informatics is kind of like the 90s way of saying software development. Right. Statistics. And so I got connected with him and that first conversation, two things stood out to me. Number one was information as data, and number two, how to flip between the two, information and data in terms of specific problems that he was seeing at his organization. So it's not about the tools we have, it's not about the data we have. It's about how we take what's available and restructure it in a way that optimizes the outcome. Right. In many ways, it was the first time I'd heard someone both fluent in clinical and technical talk talk about building software. Like building a plan of care. Right. Because we do the same things when we're going through our post op acl, gather data, we analyze, we draw regressions in our head against the mean, we iterate, we add, uh, new steps, we add new phases. It's the same, it's similar process in software. But I had not made that connection until he actually said like, think of it this way.

Speaker A: So you start a business that's hard enough itself, you got a great idea, you've got the right people on board, now you got to raise money. I think you bootstrapped this whole thing and, and now you're starting to raise some money and whatever. So how do you do that? And how do you know how to do that?

Speaker B: You don't. Ah, uh, man. Um, so like when I was living in Europe, I was really lucky where I got to sit on the other side of the table with some VC funds and things like that, like helping them decide who to invest in.

Speaker A: Right.

Speaker B: And that world is different than what we're used to in clinical care for different incentives, different people. For us, uh, at Pickle, I feel really lucky because we were able to start our company from people in our industry. We actually, actually declined a lot of VC term sheets and things like that. I went to people I looked up to in the industry, you know, people like who had built EMR systems or who had scaled practice organizations and says, hey, I'm interpreting this problem. I saw during COVID this way. What are you seeing? Is this real in terms of how you're seeing this in your clinic in Pomona, California? Right. And what's interesting is I was doing this information gathering and that's when I learned one, that the problem is huge and relates to data. But two, we were so blessed to have Leaders in PT and rehab ask us if they could back us. Right. So for us, like, that first, first, second, third investment was like, pretty challenging. Trying to figure out what, what you're doing and what you're trying to build. But after that, we, we've been fortunate where we had. People came to us and said, I believe in you. You have these results. I think the problem is much bigger, just like you say, and how can I be a part of this? And so I got lucky.

Speaker A: Yeah, that's great. So how long ago did the company start? Um, we're recording this on April 22nd. It's going to be published, uh, a little bit later in the year as, as the process goes. But just give us an idea of how this company has grown and, and how it's scaled and, and where do you think you're headed?

Speaker B: Absolutely. So like I said, uh, Covid ended in August 2023. Right. So that's when I ended.

Speaker A: Yeah.

Speaker B: So I guess that would be the genesis. Um, took about a year to build a job board, interview a thousand people, figure out what was going on in our young people. And then we actually released our first product in August of 2025. Right. So it took about a year of research and then a year, ah, a year since we've, we've launched. I think to date, we support almost 3,500 clinics across the US in the last six months. I think what's really fascinating is we haven't spent any money on advertising. What's been happening is that just like me going to executives in my network and saying, what are you seeing with our people? People are coming to us and saying, what are you seeing? Across the industry, we actually don't really sell to customers. I have all our people say, any clinic owner, any size, they want 15 minutes, um, to learn from us. We will give it to them. And a lot of these conversations happen about what are you seeing in your market, like, what are your goals for growth and things like that. And if pickle's a solution, great. But I think the first step is just creating this community or creating this kind of like, learning system where we can ask each other across pt, ot, et cetera, what's working, what's not from the bottoms up to also augment what Apta AOTA is doing for the top down in their analyses.

Speaker A: It seems like a lot, you know, we talked about this earlier, but if you could also find a way, and you said there's a starting way because you talk to people and you counsel anybody who's willing to, you know, contact you. I hear a lot of pts that the two things, one is they want to look at some non clinical PT professional career steps. And the second thing I see is I want to be with an organization like X, but they don't know where X is, they don't know how to find it. And as we talked about before, the traditional way to look for a job is you reply to an ad or, or you go to indeed. Or you do whatever and it goes down this deep dark hole. And you know, half the time no one ever even. You have no idea if anybody got it. There's no response. It's just, it's like shooting in the dark. And so I uh, think if you can also help professionals find their place to be. Uh, is that part, is that part of your, is that part of the mission of the company as well? Or do you think that's uh, for someone else to solve?

Speaker B: Great question. One of our core values at Pickle is the future of healthcare will be determined by its workforce.

Speaker A: Mhm.

Speaker B: Right. Very broad, kind of ambiguous. It goes back to the heart of healthcare is important to society because it's the people who operate in it. Right. There are other tools, digital health and stuff which is all augments human ability. But really right now at least healthcare is a human driven function. I find the non clinical versus clinical split to be so interesting. Um, 20 years ago if you were to own your own clinic or you would be VP of ops at a scaling platform company that technically is a non clinical role. Right. Like if I am VP of ops at select physical therapy or something like that. But today it's almost like, oh, I need to be in a startup or a digital health company to be non clinical. It's like truly a lot of our profession. I think Larry Ben said 30% of our FTEs right now are non clinical.

Speaker A: Right.

Speaker B: Executives who aren't treating and things like that. I think this is like a really interesting thing to think about because I think non clinical kind of is just a buzzword.

Speaker A: Right.

Speaker B: What I think about is am I going into direct patient care or supporting direct patient care? Right. Whether that's uh, executive or digital health or whatnot. Right. And I find that there's always two questions I like to ask folks who are thinking about this jump from a clinical to a non clinical role. The first question is are you running towards something or running away from something? Right. Are you running away from a bad situation or are you running to this opportunity to automate musculoskeletal care? I Think digging into that is really, really important. Because if you're running from something and especially to an opportunity that is not set up for your success, that is even worse for you. Right. Because you need to be successful for us as nursery to keep you and keep your skills and talents within healthcare. Right. So are you running from something or to something?

Speaker A: Yeah.

Speaker B: And the second question I ask is, what do you think is the biggest barrier to getting this new role and succeeding in it? Right. Most of the answers I get are a bit vague. It's like, oh, I just need an opportunity. It's like, yeah, but an opportunity to do what? I find that it comes down to two main factors. The first factor is tool familiarity. Are you familiar with these tools in this new role?

Speaker A: Right.

Speaker B: Because you need to translate your clinical skill into this role. So like can you use Excel? Right. If you're going to management consulting, I know you understand healthcare, but can you tell that story to people who don't understand healthcare through their, their model, through their, uh, channel of spreadsheets? Right. So when you go to new role, can you, can you use the tools? Right. And the second one is, can you speak the language? Yeah, because there's a being able to translate what you saw into like a large org and how other people on that org aren't clinical. You're gonna be able to have to tell that, that problem in many different languages. And so for me, I think tools and lexicon are probably the two biggest things that people are asking to take risks on from employers. I think it's good to know that up front because you can prepare for that.

Speaker A: It's a really great point because I think that we have these biases for a long time. I would say our profession looked at someone who went to PT school and treated patients and then went into a non clinical role as somehow doing something bad. In our profession, we're losing a practitioner, we're losing a clinician. But you made a point earlier, like if I can only treat 10 or 15 or 20 patients a day, and uh, that's how many over a year, how many people can I really impact? Whereas if I go into a non clinical role, is there something that I could do that could leverage that where I'm having my talents affect a much broader base which could be positive. So there's that to think about. I also think that as physical therapists. Well, I'll give you a good example. This podcast, when I started this podcast nine years ago, because of my contacts and who I knew and who I asked to be uh, you know, everyone was either, uh, a physical therapist or within healthcare. And then over time it kind of became 50, 50 between PT and healthcare, and then the other 50% was business. And as I've gone on, I'm still a physical therapist, I still come from that background. But now this podcast is almost 10 to 1, if not even bigger business to PT or healthcare. Why? I think because all those things that we talk about leadership wise and what we do is translates easily to the business world. So we shouldn't try and put them in. This is healthcare and this is business. It's the same. And I think we can learn so much by just expanding our knowledge of that and trying to do things that, um, you know, bring our talents to other business related entities because I think it's really valuable.

Speaker B: I'll end with a story. Um, so there's this guy in New York, his name is Vadim Gourdin. He is the godfather of digital health in New York. Every early stage founder, whether you're a clinician or not, needs to know this guy exists. Okay? He has worked with funds, he led NYU's incubator. He's like, been in that game. He's also built medical devices as a founder before. He's a mentor of mine. And I remember having this conversation with him. We're talking about the ivory tower syndrome in healthcare where physicians and surgeons are at the top. And then pts, for whatever reason, sometimes we feel like we're less than adequate because we're not top of the pyramid. And this kind of bleeds into other things in life that we may be thinking about doing. And he told me something really profound. He said, john, at this point in my life, I've worked over a thousand companies. The best clinical founders I found are actually the rehab associates and the nurses, right? Not the physician, not the surgeons. I said, why is that? He said, honestly, I think it has to do with chain of command, right? I think nurses and rehab professionals know that they are part of a larger team so they're more collaborative, especially during the grimy early days of starting a company, right? Because the first year is always ugly. Like, it's hard to build a business, right? It's not easy. And I took this away with me, like, this is a guy who is the king of New York. And he's telling us, like, not only are PTs good enough, we need more of you, whether that's in clinic or not. And for somebody who's invested in all these companies, I have never forgotten that.

Speaker A: Yeah, it's a great story. Well, John, in anticipation of our discussion today, what haven't I asked you or what haven't we covered that you want to be sure and get started the program?

Speaker B: Yeah. The one thing I, I'll go back to that I want, I want to think about is this census data about the generational shift in healthcare. Right. Our workforce is changing and this has happened cyclically. Every 10 or 20 years, the, the pendulum swings between patient flow and provider flow challenges. Right. But what we have not seen before is this level of debt and how that impacts the decision making of our young people who we need for the future of healthcare. So the one thing I want everyone to know is that the future of healthcare will be determined by his workforce. Specifically, it's young people. Right. And if we can't support them, if we can't get on the same page with them, we may not survive.

Speaker A: Good point. Well, at this time in the interview, I always ask my guests the same common question, and that question is in relation to leadership. What is a pearl of wisdom that you could leave us with today?

Speaker B: Yeah, I heard this saying yesterday, which stuck with me. Um, culture is what you tolerate, not what you tell people to do. So if you're in your orb and you tell people, carry yourself this way, carry yourself this way, that's not actually culture. Culture is the unsaid things that you tolerate, whether positive or negative. I myself am processing this thought. It's very deep. Um, it came from a friend of mine who works, um, who works at PT Solutions. And I myself am processing this, but I think it's very profound.

Speaker A: Well, and that brings to the point too, maybe the final question of our interview today here is, uh, so what kind of a company are you building? How many employees do you have now? How many do you think you're going to bring in? And uh, do you look for more of that, uh, tech nerdy type, or are you looking for more of the, uh, uh, the professional health care person to join the company?

Speaker B: Um, great question. So our team is smaller than 10 and we're global. I've got, I've got staff in Europe, ah, South America, got staff in Asia, et cetera. We've been a pretty lean team globally. My requirement is, regardless of your background, you have to be somewhat technical, right? If you, you've got to understand what a PRD is like a product requirements document. You've got to at least understand or try to learn how to build a database or how to manipulate data. Um, for us right now, because we're growing so fast, I, I Don't really care where you came from, but I want your values to align with ours. And bare minimum, I want to know that what your starting foundation is from a technical standpoint, because we are a data engineering company. And then from there I will set you up for success. I would love it if you were a PTRN or OT or pta. I would love that. Right. Because that's context I can't give to my engineers. But at the same time, you have to be able to talk to my engineers.

Speaker A: Yeah, good point. Well, John, this has been a real pleasure. It's, uh, fascinating what you're doing and it sounds like it's got some great start going here. And uh, as I've said, I've know a lot of people and I've heard the buzz around from people saying this is what we've needed for so long and I think this guy's got it and, and we're headed in the right direction. So, uh, cheers to you for bringing that forward and, and wish you all the success. And uh, it sounds like a really great thing. And, and you know, who knows, uh, it could be huge.

Speaker B: I appreciate that. And if any, anyone listening, ask questions about careers or staffing or even like, resources, you, uh, can find me on LinkedIn at JohnLee PT J O N L E E P T Like, especially if you have clinical practice experience and you're looking for just someone to share ideas with, please let me know because I have struggled with that question so many times in my career. Who from a place where I've been can help me in the place I want to go?

Speaker A: And, uh, it's great advice. I mean, people know you, I others have gone through this crazy world that we live in and the willingness to ask questions, willingness to admit you don't know all the answers, the willingness to ask for help, the willingness to work a network that you have, I think all helps you get to where you want to be. And it's not linear. You can't say, I'm going to start here and I'm going to end there. You just never know who you're going to talk to that's going to spark the next step, uh, flame or give you an idea that you never had before, or give or introduce you to somebody that's going to change your world. So I agree that that's the way to go.

Speaker B: Pay it forward.

Speaker A: Yeah. Well, thanks so much for your time. It's, it's been a pleasure, as I said, and, uh, wish you the best of luck. And now that you're living back in the Pacific Northwest in the Seattle area. I hope to see you, you know, uh, down the road one of these days. Uh, maybe have coffee sometime. And let's keep the conversation going.

Speaker B: Absolutely. Thanks so much for having me.

Speaker A: Okay, Take care.

Speaker B: Bye.

Speaker A: Bye. Thank you for listening to another episode of Profiles and Leadership. To listen to all my interviews, subscribe to Profiles and Leadership with Steve Anderson on Apple, Podcasts, itunes, and many other popular podcast platforms. Some of these interviews are on video, and you can search YouTube for profiles and Leadership with Steve Anderson. You you can also access the entire library of interviews on my website, orange.coaching.com and that is orangetheword.coaching.com and go to the media center and click on Podcasts or Video Gallery. You can also enter the website from pilpodcast.com.

Speaker B: Sam.