Ep13: From Record Players to EMR: How Dr. Robert Berke Revolutionized Medicine and Sales (Part 2)

Celeste Berke [00:00:00]:

And we are back on the Sales Edge podcast with Celeste. I'm here with doctor Robert Berke. If you didn't hear episode 1, stop right now and go listen to the previous episode where we covered all the things from Africa, Starting a business as an entrepreneur when you don't know what you're doing, the business lessons and the parallels in medicine and everyday life. PS, if you're almost 45 and you haven't gotten a colonoscopy, go get that as well. And my this is my dad, by way he was approached about a piece of technology, and I'm so excited for him to share the story because this is what many of us do. We have a piece of Technology, we think it's gonna be world changing. It can change businesses. He solves every problem that you have, and I wanna hear his story.

Celeste Berke [00:00:47]:

So take it away. 1999, some cowboy approached you.

Dr. Robert Berke [00:00:51]:

Well, it's, you know, actually, it was 2 brothers who were From Auburn, New York, which is pretty close to us here in in Western New York, had this product, then they brought and he said, we've got something for your practice, and we looked at it.

Celeste Berke [00:01:04]:

And what do you think at the time? Practice was what? 10, 15000 patients?

Dr. Robert Berke [00:01:10]:

No. But 75 100 patients.

Celeste Berke [00:01:12]:

75100. That time. Okay.

Dr. Robert Berke [00:01:14]:

Yeah. And I looked at it, and I said, this is too clunky. I mean, it was like it is you know, it's just like, alright. It it it just made no sense. But But

Celeste Berke [00:01:20]:

so at the time, you had gone from Handwriting, so you're Okay, Dolores. 75, 100 patients, handwritten

Dr. Robert Berke [00:01:27]:

We were 2 docs and Two physician assistants, I think. And we were, we had gone from handwriting our notes to Dictating that we we went to voice activated dictation, those didn't work very well, but then we went to dictation and someone, a lady in town, Was making a fortune on us, $40,000 a year on our practice alone, typing the notes out on sticky paper, which

Celeste Berke [00:01:55]:

we just stick

Dr. Robert Berke [00:01:56]:

into their chart.

Celeste Berke [00:01:57]:

Cut the different Peace is and put it in the chart.

Dr. Robert Berke [00:02:00]:

A paper chart. We had a a person doing that full time. And What do you what

Celeste Berke [00:02:04]:

do you do for a living? I cut out Sticky paper.

Dr. Robert Berke [00:02:09]:

But anyway but the nice thing was you could read the notes. They were legible, Which was a huge step forward. Okay? Because then then the patients were transferable from, provider to provider without you having to try to decipher the Hieroglyphics like the person who had done it before.

Celeste Berke [00:02:27]:

The individual for their whole life story again, which as a patient, I'm really annoyed.

Dr. Robert Berke [00:02:32]:

Mhmm. So I I saw this conference on computers and medicine in New York City, so I went and it was mainly about the large hospital systems And what computerizing them would mean. And one of the things which was eye opening was that it would cut down on medication errors in hospitals and just in the Extra dose of medicine that would be given to a patient who didn't need it, but that the order, because it was handwritten, wouldn't get taken off by the nurse For 5 hours, therefore the patient would get 1 more dose and didn't need it, and it would cost a hospital like, Beth Israel in New York City $1,000,000 a year in excess Dosing of medicine. Not that it was dangerous though it could be, but it it was that impactful. And I'm thinking to myself, well, this is, you know, And I had a friend a few years earlier who had been at one of the experimental programs in medicine. A guy named Weed had done it in Vermont and it was a touchscreen, actually. It was kinda unique for that time, but still, it was very early stuff. Well, about 6 months later, these cowboys came back again with this program.

Dr. Robert Berke [00:03:48]:

We looked at it and it was really a lot better. And we said, okay, let's go. And so we purchased

Celeste Berke [00:03:57]:

And what was the investment at the time?

Dr. Robert Berke [00:03:59]:

The investment was $120,000.

Celeste Berke [00:04:01]:

K. So we're talking a big investment. Right? But also a completely

Dr. Robert Berke [00:04:04]:

Oh, yeah. Yeah. That meant change

Celeste Berke [00:04:06]:

what your team was doing.

Dr. Robert Berke [00:04:09]:

Right. But that was software and hardware for everybody, meaning everybody was sitting in front of a screen and, You know, printers, the whole thing, prescription printers, you know, there was a lot of connectivity,

Celeste Berke [00:04:25]:

the wiring, the whole thing. 75 100 charts in your office as well.

Dr. Robert Berke [00:04:29]:

That's right. To to convert. Yeah. Yeah.

Celeste Berke [00:04:32]:

We I know this team who's

Dr. Robert Berke [00:04:34]:

been Yes. As you were you're yes. Yes. Yes. Yes. I know. Well, ultimately we did the conversion and then these charts, 75100 of them had to be mothballed for, If they were a kid 20 years, if they were a person x number of years, just safety, and we can brought that data in slowly, But that was $120,000 which we had anticipated we would pay back in 4 years. Well, what we didn't understand was that we were 2 to 3 weeks behind in accounts billable because of the paper charts.

Dr. Robert Berke [00:05:21]:

That shrunk To 2 to 3 days. Okay? We paid the 120,000 off In 6 months. Because it shrunk our receivables down. Like, we had just Cash sitting out there Right. That sat out there for months because of the delay in billing, and suddenly it it came in. And so The thing paid for itself. And then we started to find that there were problems with the system, And we would call these people up, it'd be fixed the next day. Call it up, they'd be fixed the next day.

Dr. Robert Berke [00:06:03]:

And then they started asking us, look, when you find yourself, please let us know. Can you be a beta site for us because like obviously and they said you know we we load 3. Every month we start 3 practices. One goes like this, 1 goes like this, and 1 goes like this, and you guys are going like this, and we were just flying and We just kept, you know, going and going and going, and ultimately, you know, we're 20 4 years later on the same system, we're still they tried to poach some of our people because we were giving them so much information on how to run the thing That they, you know, are calling us for advice and everything else, and now everybody is using stuff that we've built in. That wasn't me. It was just all of us We had built, and this is some of what getting back to that adaptive entrepreneurism, what I instilled in my staff What I said, if you see something that isn't working for you at the clerical level or at the nursing level or at the billing level, don't sit there and keep your mouth shut. Say something And let's look at how you can help improve the system because that is the way you have this continuous improvement, a A learning, environment, and it's a learning, business. And you're constantly and and Even today, we're doing the same thing.

Dr. Robert Berke [00:07:26]:

Yeah. We continue to do that. And actually, there are parts of that system now that we built for them in a sense. Told them, look, You've gotta do this because of that whole story about who gets a colonoscopy, who gets a a pap smear. If you come into the office, the first screen I see Tells me what you're missing.

Celeste Berke [00:07:44]:

What's missing?

Dr. Robert Berke [00:07:45]:

Well, yes. But what's missing is also what's missing with respect Getting back to what we talked about in the last session, I think it was the last time we chatted, about the incentives That we get reimbursed for for getting people to do. It's all in there. No matter what you want, you can put in there their birthday, You know that it it it lights up that it's their birthday today or this week. I mean, you can put in whatever you want. And we just kept feeding, and we can now do that in our own system and and tailor it to whatever want, but we also keep telling them about enhancements. Anyway

Celeste Berke [00:08:21]:

And that is what's commonly known today as EMR, electronic medical records. So when most of us, unless unless you're in a super rural area, are going to the doctor, they're on the screen. And you've also

Dr. Robert Berke [00:08:35]:

But wait a minute. So then

Celeste Berke [00:08:38]:

Yes. Now you've been active.

Dr. Robert Berke [00:08:41]:

We've realized that There is a every every cloud has a silver lining, but every silver lining also has a cloud. And what we found was Patients were complaining they weren't complaining about their prescriptions being sent in or being printed off and we finally came very quickly to Them directly going to the pharmacy without any paper or anything like that, but what they were complaining about was the doctors sitting there like this all day, you know, and not making eye contact. And it's a problem with your date entry.

Celeste Berke [00:09:12]:

What they were saying or people like me. Right?

Dr. Robert Berke [00:09:15]:

You are, you can't date entry, Especially a guy like me who doesn't type very well can't enter everything they're saying so they come in next time and they say, you know, we talked about this and it wasn't in the old record because I was too busy talk because they were talking also about this and this and this and this. So this wasn't our system, but someone we knew Had dev devised a scribe system. Now people have used scribes, you know, before, and the scribes come into the room with you and sit there quietly like a mouse in the corner and are typing while you're

Celeste Berke [00:09:49]:

talking to him. Stenographer. Right?

Dr. Robert Berke [00:09:52]:

Yes. A little obtrusive, I would say. And also, you know, another person in the room And

Celeste Berke [00:09:57]:

now you wanna talk about the colonoscopy I need? Like, Cannot know.

Dr. Robert Berke [00:10:01]:

Or or I I I am talking about my wife who's in and I'm having a where, you know, and I can't you know? Yeah. So we we developed a system where the scribe isn't in the room. I wear a headset And there's a screen in the room which the patient can see, their note is being done, but also I can and the scribe's sitting at home And it's mirroring her it's an iPad that is mirroring her computer on my screen, Not my computer screen, which is sitting on my desk in the office, and I'm sitting here having a conversation with her just like I'm having one with you, face to face And everything that is being talked about is being data entry.

Celeste Berke [00:10:50]:

The problem for all of you who are in sales and are trying to draw Awesome correlations here. When we talk about a tech product or, like, selling whatever your widget is, it wasn't that the notes weren't getting put in. That's an annoyance, right, to the doctor and also who's ever looking at the chart. The problem that you can't just fix immediately. Right? It's this overarching became customer satisfaction. Right? The potential

Dr. Robert Berke [00:11:13]:

I exactly

Celeste Berke [00:11:14]:

lose patients because they felt like the doctor wasn't engaged with them because the doctor's too busy trying to catch every word. And if you're like my dad, who I told him 20 years ago to learn how to type, and he never did. Like, he pecks on the computer. Right? We're not we're not as as exactly efficient in getting those

Dr. Robert Berke [00:11:33]:

notes. But but I can tell you even today well, first of all, there there's more to this story. But Because it only costs it only the cost of that scribe is 1 and a half patients a day more, which I can Easily see because I'm not sitting there doing this or going back to my office and spending 20 minutes typing in a note that I'm trying to remember or being up half the night trying to type All the notes that I never did, which is a common complaint that doctors have who don't have, you know, don't have this kind of system, They've taken all kinds of work home. I don't take any work home. My notes are done when I leave the office. I go for a run, I go for a bike ride, that's what I do. I mean, hey, Why not? So anyway, it's 1 and a half So

Celeste Berke [00:12:18]:

your quality of life has improved as well.

Dr. Robert Berke [00:12:21]:

There there is the other issue. Quality of life, I've gained quality of life. And if you ask your sister, the doctor, she's part of a 40,000 Female doctor Facebook group. Biggest complaint? Quality of life. Go home, I'm sitting for hours dealing with stuff that I couldn't deal with the office. We figured it out. Plus, the patients love it because I'm sitting there talking to them. I'm spending time quality time with them.

Dr. Robert Berke [00:12:53]:

I it's like they've got a real live person with them And I've got a whiteboard. I can draw them little diagrams, or I can say to my scribe, can you go out on Google and bring me in a picture of a knee? I wanna show I wanna show the patient how this knee works and where the problem is. I mean, it's it's it's like this whole thing. Or can you bring up that, The x-ray or that x-ray report, let's talk Mhmm. It's or your last labs. Look, this cholesterol level, yeah, don't worry about it. It's this you know, it's It's it's and I can order their orders, their x rays, their referrals, their while we're talking, And it's all done. And so we've done 3 things there, made my life much More simple and my quality of life that much better, which is really important.

Dr. Robert Berke [00:13:46]:

We're seeing a lot of doctors screwing off because they just don't want to deal with it anymore. It's It's so cumbersome and and like Yeah. Odious, you don't even wanna do it anymore and a lot of them are just selling out, you know, And then the second thing is it's made the patient's level of satisfaction that much better. And so you and you're more efficient. There it is. Yeah. You solved

Celeste Berke [00:14:11]:

All of it.

Dr. Robert Berke [00:14:12]:

The major the major

Celeste Berke [00:14:14]:

is sitting at home. They have a remote life at home, so You're able to hire other people who also have better quality of life. They're sitting at home, right, with

Dr. Robert Berke [00:14:24]:

Exactly. Don't have to get dressed up. Don't have to die. You know, the cost Clothing, oh, yeah, it's fine. Feed the cat, do whatever, you know, it's it's I've known, but it it there are a number of layers from a business point of view To employee satisfaction, physician satisfaction, patient satisfaction, but the most important Is efficiency. And this that we're doing has really been a quantum leap in efficiency. So remember I talked about We shrunk accounts receivable to 2 to 3 to 4 days. Same day, next day.

Dr. Robert Berke [00:15:05]:

Same day, next day. 30 day, you know, like stuff that's out there 30 days Is the majority of our billing. I mean, that's totally incredible. And we do our own billing because again, it is another business Thing that we learned, you you can, you know, shop out your billing at 7% or whatever it is, there's some cost. Yeah, but they don't care, it's your billing, you know? My people, every penny, every this and they're still same day and they're like you know, they drive you nuts because you haven't you gotta put this in or that, but We have control of it and these are the things you learn and every people we talk, oh, I got it out and I'm unhappy because I, You know claims, you know, they they a claim gets denied which happens frequently. I we know 1 organization, they stick them in a drawer. You know? It's too little, it's $35 or whatever else I say. They got a drawer full of, Well, once you get to the 3rd or 4th drawer full of $35 or $50, you know, it's real money.

Dr. Robert Berke [00:16:16]:

And we go after we have the the flexibility to go after everything that we can get paid and very efficiently. Yeah. We may overdo it. You know? Maybe there's a certain point at which you just gotta walk away from it, but it it's These are and and I this whole just is life experience. You

Celeste Berke [00:16:35]:

know? I've never been in this place. So where I struggle I mean, a lot of my Fellow comrades on sales struggle is whenever you get into organizations, you see problems. You see impacts. You see things that are broken. You talk To reps, you talk to individuals that work in there. Right? They're dissatisfied. They don't have training. They don't have all of this stuff.

Celeste Berke [00:16:57]:

And for me, especially in the industry I came from. I saw it all the time where it's people have arrived at this position. But why do I continue to invest or be innovative, like, when I'm collecting a paycheck, and I think you're a perfect example of and I'd love to hear from you. You're still at a place where you've could have retired 10, 13 ish years ago, and you're still showing up, but you're still driving innovation. Like, you brought in EOS for your business.

Dr. Robert Berke [00:17:28]:

Right. Right.

Celeste Berke [00:17:30]:

Where where does that come from?

Dr. Robert Berke [00:17:32]:

Oh, that that was one of my partners came across it and thought that one of the things that we lacked, Even though we had all this going on was that it wasn't organized enough in the sense of structured in the way we problem solve. And EOS did, it was fairly expensive, but the training taught us a structured approach to meeting and to Setting goals, rocks as they call them, big goals and then littler goals and whatever else, year rocks, Smaller pebbles or or 3 month and who's responsible, and who takes ownership and has to report. And our meetings at every level, providers, owners, clerical, billing, nurses, they all have their own Meetings, L10s they're called, and it's only an hour and it's very structured And everybody pipes up, you know, and if there's a problem, it's listed, we choose the top 3, go through them, And everybody's got a you know, everybody queues in as to what they think and we come up with solutions. And, yeah, A growing learning organization has to continuously improve and can't just sit there Like what you're describing and collect a paycheck. As soon as you have people just sitting there collecting a paycheck and not actively looking Every time, every day seeing something that they think could be done better. I I can remember One of our people who wasn't computer literate. I mean, like, you know, a lot of our people never had you know, this was a few years ago, suddenly chiming in and saying, well, you know, I Click this thing and and suddenly I saw you could do this. Yeah.

Dr. Robert Berke [00:19:30]:

But this was what was happening early on. We, you know, we had this tool, but It had all the bells and whistles which no one knew how to and someone would hit a button and, oh my god, you can do this. And recently, we were all complaining about Because we're the bottom of the funnel being family practice, and in most parts now in the United States, There are regional they're called RIOS, regional health information organizations, where you can get all the data you want on wherever you go. You know if you were to go to Denver, some small community hospital in Denver, somewhere else, a clinic, all that information comes back to your primary care doctor. Wait. Can you imagine the amount of stuff that comes in every day? And someone said, well, you know, a lot of this stuff we don't even have to do. It's the patient's in hospital, all these are the in hospital labs. You don't need to look at them.

Dr. Robert Berke [00:20:23]:

But we're all complaining, we have hundreds of these. And he says, well, you know, if you do this, you can collect them all and just close them. I and none of us know how to do that and this, You know, again, it's just again, people just not being afraid to touch a button here or to and find some new way to do something that everybody benefits from. Saves you 10 clicks. Saves you this. Saves you that. I mean, it's all and it's all just goes on and on.

Celeste Berke [00:20:49]:

You've built an organization that isn't just like the lumpen pro proletariat. Right? Who are just it's like everybody has buy in because everybody knows, Like, your mission, your vision, the problems that you're solving, basically, that you're out there to do no harm and also to do good in the Community, right, that stems from how you first started the practice as a very community focused

Dr. Robert Berke [00:21:16]:

Mhmm. They they it's getting hard right now it's getting very hard because of, staffing. I mean, all the bigger institutions are Starving for staff so they're offering a these huge bonuses, you know, that that we can't compete with. All we can compete with is the fact that we have a group, A core group of x number of employees who carry enough to show up every day because they enjoy being there, and they're part of An organization that cares about them and and also wants to hear from them on, you know, what they think about Improving Right. How we do our work.

Celeste Berke [00:21:53]:

They're not just improving

Dr. Robert Berke [00:21:54]:

their work. Yeah. And that's about all you can do. It's it's really hard Staffing wise, you know, everybody's complaining, but everybody's complaining everywhere about it. A, the younger staff Don't seem to have the same stick to it ness that the older timers have, you know, who just understand that you show up every day and you do your work and you You're part of something that's actually quite enjoyable. Younger ones I mean it's really every industry is complaining about Finding people who, you know, won't jump for a dollar more an hour somewhere else. Right. You know, not realizing that, Yeah.

Dr. Robert Berke [00:22:34]:

You're gonna be asked to do more things and to maybe, you know, whatever else. And anyway.

Celeste Berke [00:22:42]:

Yeah. So I wanna talk briefly before we close our to close this out. I wrote an article. I actually I should send it to you. Last week when I was pacing at night, you know, it was 9, 10 o'clock at night. I hadn't written my weekly newsletter. And then I thought, like, let me channel my dad. What would he tell me? When times are tough, when so we're seeing really low quota attainment from reps out there.

Celeste Berke [00:23:08]:

Company is not making their numbers, right, year end projections not being great. And, also, If you're not closing deals, that's tough on your mindset. It's also difficult because sometimes you have 1 shot. Right? You have 1 call, and if you flub the call, you don't get a do over. And so my article about the advice that you give me before you go into anything. Right? A speaking engagement, a webinar, right to stand there and piss ice water.

Dr. Robert Berke [00:23:41]:

And I Exactly.

Celeste Berke [00:23:43]:

And I wanna hear about a tough if you have to look back on your life, the toughest, most Challenging moment that you've had. Tell us that story because I'm assuming you took a step back to piss ice water before.

Dr. Robert Berke [00:23:59]:

Well, first of all, that that came from I was playing football in college and it was my I was the 2nd stringer on the varsity team in college, and before our 1st game Thursday night, I came to practice and the coach pulled me aside. He was an old pro, you know, who I played and he pulled me aside and said, son, you're on Saturday, the guy ahead of you, Linebacker. I blew his knee out last night in practice. So you know what you have to do, we've talked about all the cues you see when things happen, But you have to when the play starts, do nothing but stand there and piss ice water. And I looked at him like, what's he talking about? And he said, stand there and take a moment to look at what's going on and you'll know exactly what to do. If you don't take that moment, You're just gonna do something and it may not be the right it may be the right thing, it may not be, and you can avoid that by just Taking it taking that one second. And that's been for my whole life, that's been, like, really important In the operating room, in the delivery room, in life in general, just nothing happens that fast. You know, it it does, but if you listen to the and I'm gonna use a sports analogy here.

Dr. Robert Berke [00:25:22]:

The guys talking in a game watching a pro game and they're talking about Wayne Gretzky in hockey or Tom Brady or, You know or or Michael Jordan. For them, when it starts, everything slows down for them. They see the field. They see they they just see in almost in slow motion What has to be done? Well, everybody else is just, you know, they have that ability and everybody has that ability if you take the, If you learn that one thing, which is just take a breath and then do what you have to do. So I'm sitting there one day in the delivery room and this lady and I are having a, you know, chat, she's a ski instructor and she's pushing out her 1st baby, and Yeah. We're happy and we're just talking, you know, and she pushes out this baby, beautiful baby, and then I'm waiting and she delivers her placenta along with the uterus attached to Which is not a good thing. No, that's called a, you know, a a cuvalier uterus, the uterus comes out Inside out at you. And it's really not good because it means the placenta's stuck on and you there's a lot of bad things happening.

Dr. Robert Berke [00:26:35]:

And I'm just sitting there and I I kind of take a moment, I say to the nurse, call down to the OR, you know, call me another doctor, I need someone to look after the baby. And then we take her down to the OR and, you know, I I I have a surgeon come in because this is requires a little procedure which I was, I mean, I've never seen this before, though I know exactly what it is. And afterwards, the nurse says to me, You are so calm, like, why why is you know, like how could you just sit there? And I'm my heart's going about 200, you know, but I'm sitting there, you know, And the woman says to me afterwards, you know, I knew there was something wrong because you stopped telling me jokes, you know, but otherwise, you know, But you have to kind of stand there and piss ice water sometimes and just do what you have to do once you see what you have to do. Anyway

Celeste Berke [00:27:26]:

And you did the same thing a couple of years ago with the guy at the gym whose whose heart

Dr. Robert Berke [00:27:31]:

Oh, yeah. Yeah. Of course. Yeah. I I teach spin class, And this guy I know is in spin, and he comes in, you know, he's not spinning with us, but he was swimming. He comes in, and this guy Sits on a bike and, you know, we don't care, and he spins and then he leaves. And then the class ends and everybody leaves, and I stopped for a minute to use the little bathroom because there was an old school room. And I walked down the hall and I see he's sitting on the couch but he's kinda and I figure he's joking and I walk over and I realize he's Had a cardiac arrest and I give him a thump on the chest which does nothing, it's an old fashioned kind of, And then I go scuttling down the hall in my in my bike shoes, run into the, you know, the and I say to the person at the desk, I need the AED.

Dr. Robert Berke [00:28:16]:

I need you to call 911, then I kick open the door to the the locker room, and I say I need some help. Who comes out but another doctor and a minister? I figured I got the guy covered either way here. We go down, you know, CPR, shock him 5 times, the guy's still alive. Again, you have to just, you know but Difficult times? Yeah. I remember the most difficult time in my life, I'm talking medically, Was as a public health officer in 1997. We had an HIV spreader in our community, And we had been looking at the case for a while, figured out who this guy was, And we figured it out because one of my folks had interviewed him in jail and about 6 months earlier and he said, I don't give an f what you You're telling me about me being HIV positive. Well, I'll go out and do whatever I want, and she had put it in her notes somewhere. And after about six Cases that we came across that young girls who were HIV positive, she came to me and said, I think it's this guy, And we had another 6 cases come in and we had to Ultimately expose him publicly because the local superior court judge said you've gotta do this.

Dr. Robert Berke [00:29:41]:

This guy's a danger. And there was a a I was talking to the state health department on Friday night, October 24th, 1997 at 5 o'clock in the afternoon with someone from the CDC and I'm sitting in my office and they're giving me this, Well, you know, you could, you know, just whatever. We can't help you very much on this, and it sounded Someone sawing the limb, the branch that I was on a little closer to the trunk, you know, like, I could hear the and it was a very lonely kinda weekend. You know, I remember taking Your brother John to a football game. The John Elway and the Broncos were there, and I'm sitting in this at the Bills Stadium with 80,000 people. And I knew Monday morning we were gonna have a press conference and announce this, and it was the loneliest place I've ever been in my life With 80,000 people with me knowing, like, what I knew about what we were gonna do. And Monday morning, 10 o'clock in the morning, We have a room our our our meeting room is full of, people from, you know, Erie, you know, And local news people and I kind of do the announcement that, you know, this is the guy. We had a poster of him and everything else, and We didn't know where he was, and we had, you know, we had a problem.

Dr. Robert Berke [00:31:04]:

I walked out and the, guy from Erie who I knew, you know, he's a stringer for the new Erie News said to me, doc, you don't know how big a story this is, and I said, yeah, you know, we're we're just doing it. Well, by 2 in the afternoon, Dan Rather's person was sitting across, or Raheema Ellis was sitting across me grilling me as to, you know, What did I know about who it was? And by that time, I did know who it was and I knew where he was. He was he had already been imprisoned in Rikers Island for something else, A drive by shooting or something crazy, you know? And so we had him, but I couldn't divulge that. But, oh, boy, that was like 2 weeks of absolute craziness. Oh, god. Was that that was just That was tough. That was tough.

Celeste Berke [00:31:51]:

Yeah. I remember seeing you on TV. I was a freshman in college watching for my

Dr. Robert Berke [00:31:56]:

I remember my my friend from Australia sending me a note saying he saw me on TV as well. I mean, it was that crazy. It was that big a story. And it went on for

Celeste Berke [00:32:06]:

Yes. The special victims unit. Law and Order special victims unit was episode

Dr. Robert Berke [00:32:11]:

And about it. Well, they and the big trucks With the the, you know, the the antennae were outside for 10 days, and suddenly they were gone because the nanny gate story broke in off Long I or off in Boston somewhere. And we were

Celeste Berke [00:32:25]:

Done.

Dr. Robert Berke [00:32:25]:

Suddenly no one was around. It was done. And and, yeah, it's like that, you know? It's like, you know, have you heard anything about Ukraine lately? No. Because it's all Gaza now. You know, if they just do this, the story moves but but those are oh, that would And the Friday night where I was my partner had called me up and said, could you come over and Chat with me. So I went and I stopped at his house, and he said, I'm thinking of leaving the practice. It's just too busy for me. You know? Like, he could've waited, you know, a day or 2.

Dr. Robert Berke [00:32:57]:

Like, he knew what was So this is I came home and I told my wife, and my wife said, well, what's the third thing that happened? Like, happened in threes, you know, like but anyway, we that was tough. That that was and then I was by myself

Celeste Berke [00:33:10]:

Yeah.

Dr. Robert Berke [00:33:11]:

Because he left and the other guy I had hired Left pretty soon and so I was by myself. Yeah. And then then thing but things turned around and things now we have 4 offices, 100 employees, 17,000 patients have merged once with a a hospital practice. And here's this business story if you want a business story in medicine. We looked at this hospital practice. Hospitals don't run family practice very well. They they run hospitals. And so they were losing $800,000 a year Because no show rate was 30%, and they were paying all his staff and, you know, it was just not good.

Dr. Robert Berke [00:33:51]:

And so we went and said, we will take it over for you. You'll lose the total cost. The revenues don't matter because you're losing $800,000 a year. You will net Not lose $800,000 a year, and you'll continue to get all well, it was even better than that because it was a hospital run practice. They're a special category. Labs are part of the fee they get. Well, you know, so you order x rays, labs, they they don't get anything for it. Now we own the practice, they get all the labs And the x rays, and it's all additional charges they can do, plus we were sending all our labs to an outside lab, and we said we'll send you all our labs, Which was couple of $1,000,000 worth of laboratory business.

Dr. Robert Berke [00:34:39]:

So they ended up not losing $800,000, getting Our labs getting the extra reimbursement, you know, and the headache was gone. And we doubled our practice overnight, Which was a bit crazy and was a lot of work and was but in and they were using a a computer and they were using another software which was just Garbage. It was awful. And so we merged that into ours, and all those patients to ours, and it was just a A win win for everybody, and so it doubled the size of our practice. And it it was, you know, a lot of, work, but Fascinating. You know? Fascinating business deal. And I knew immediately looking at what at how what they were doing that the deal was The best for both of us, you know?

Celeste Berke [00:35:32]:

So as you move on into a new phase of your life, No Ironman training. You've written your stories to books out there that you've self published.

Dr. Robert Berke [00:35:45]:

3.

Celeste Berke [00:35:46]:

3? 3.

Dr. Robert Berke [00:35:47]:

Yes. I did. Poor poor lost mom. Oh. Your your niece's lost, doll in the park. Yes. I just did that.

Celeste Berke [00:35:54]:

Okay. Yeah. Yeah. I haven't seen

Dr. Robert Berke [00:35:56]:

Your your daughter will get one at Christmas time. I have Okay. Okay. For her.

Celeste Berke [00:36:00]:

What advice do you have 2 salespeople or people like myself. Right? Mid career. Days are tough. The dip seems to sometimes keep going down.

Dr. Robert Berke [00:36:11]:

Mhmm.

Celeste Berke [00:36:13]:

Before it inches up slowly.

Dr. Robert Berke [00:36:17]:

Well, first of all, don't try to sell people what They don't want. You've gotta look at where their where where the hurt point is. This last story, I knew what the hurt point was, and Give them a a a way to solve that because solving that for them is Probably what's stuck in their crawl. And they either are just avoiding it or, you know, just ignoring it or whatever else or they can't figure out a way Out of it. Telling them that they're gonna earn more money or this or that or whatever else. EOS, you know, they told us we were gonna improve our income by so much. The issue wasn't that for us. The issue for us was better organization, better better ways to to look at our problems and deal with them, you an organized fashion.

Dr. Robert Berke [00:37:08]:

Well, same thing. Sometimes, you know, telling people this is the best thing since sliced bread isn't what They need what they need is maybe to solve a problem that they're just that they don't even recognize or that they've recognized but just can't deal with. And and and it may improve things other than the bottom line, but it may improve their They're they're they're much like the little headset, you know, a lot of different things. My my my my ability to go out and ride my bike, You know, patient getting a person looking at them. I had a long conversation the other night with a doc who I was talking to about scribes. He does not use 1, But he says, yeah. You know what? You're right because I have to go back to my office and I have to do my notes, Yeah. Like, again.

Celeste Berke [00:37:56]:

This is a whole new business center for you.

Dr. Robert Berke [00:37:59]:

Yeah. Yeah. Yeah. I know. I know.

Celeste Berke [00:38:02]:

Add it to the list. Add it to the list. Yeah. Of course. Alright. So we're gonna stand and piss ice water. Look for the problems.

Dr. Robert Berke [00:38:12]:

Right. And look for the efficiencies more than because the efficiencies will then translate into financial, you know, improvement. But Don't immediately go when you're selling to what they're gonna you know, how much more they're gonna make, you know. Oh, it's just gonna you're gonna make 10% more, or you're gonna do this or do that. They hear this all the time. What you really want to do for them is give them sometimes intangibles, and sometimes Solve a problem that you see in their system that they don't fully appreciate. And

Celeste Berke [00:38:52]:

Yeah.

Dr. Robert Berke [00:38:52]:

It's,

Celeste Berke [00:38:53]:

Totally. I'm I'm with you there. Alright. So if you tuned into the 1st episode, You heard about my dad's time in Africa. As we wrap up, I'd love for you to tell the listeners oh,

Dr. Robert Berke [00:39:07]:

One Okay. It's empty.

Celeste Berke [00:39:10]:

Of your most favorite memories from Africa. Like, something that we wouldn't Think of today that you got to see us.

Dr. Robert Berke [00:39:20]:

This is a funny story. You know? First of all, I'm fluent in pidgin English, which is what I had to use when I was there. It's the because Cameroon has 400 different languages, they all speak pidgin which is a It's a lingua franca, the pidgin in West Africa is English based, but it has a lot of words mixed in, you know, and so I'm having A party at my house for my midwives. I would bring them in and they would have a a 2 day, you know, seminar in our, you know, in our office, and then I don't have to come to my house.

Celeste Berke [00:39:55]:

Lived, just so people understood, like, you lived in the city, but then you would Travel

Dr. Robert Berke [00:39:59]:

Well, a city a city. I lived in a city of 40,000, which means 30,000 kids and 10,000 adults.

Celeste Berke [00:40:07]:

But you would then travel out to the bush part

Dr. Robert Berke [00:40:10]:

Oh, yes. Oh, yeah. I had 27 I had 27 health centers that were out 45 kilometers by dirt road here or there. And so once a year we would bring them in, the midwives in, because they were out there in the, you know, outpost, A cement block, nicely built buildings, but, you know, bring them in and give them some education and, you know, also just give them a chance to share a little bit with each other. And then I would have them to my house, mine, we would cook a meal for them, you know, so there were 15 or 20 of them at a time. We would, you know, my cook my my cook, John, would cook meal for them, and they would all eat before they got there because they all knew that, You know, food in my house. I wasn't gonna fill them up. It's very funny.

Dr. Robert Berke [00:40:53]:

But anyway and we would talk a little bit and and then I remember I was playing some music for them on this battery run Phillips record player, and I had all these records, you know, Freedom's Clearwater Revival, all these, you know, old 70 eights, you know, whatever else, Lyle piece, you know. And one of the midwives said to me, doctor, how do they gum that gum Glue, yeah, in pigeon gum. How do they gum that sound to that disc? Fascinating. Fascinating. And I'm looking at this, and I'm thinking, how do they do that? You know? It it's a a very sophisticated process, And here we are, you know, just you know? And and she's asking me how they glue that sound on, which was, like, fascinating. You know? And then I had a phone in my house and I could the phones, very, very rudimentary. If you're lucky, you could get a line out somewhere, but it was hard because there's only a couple of lines in the whole town. And I remember one of my midwives asking me, You know, about phones in Canada, and I said, I can dial 10 numbers, talk to anybody in the world, basically.

Dr. Robert Berke [00:42:15]:

And she looked at me, and she says, white men, you own too much. Meaning, like, you people are, like, from Mars. You know? And and that was now, of course, in Africa. Everybody's got a cell phone and everything else. This was in 1971, you know, or 72, you know? It was a long time ago, but, like, we didn't realize, You know, like, just yeah. I said, you know, those are memories. You know? I have many others, but that that is fascinating. Yeah.

Celeste Berke [00:42:44]:

Mhmm. Well, I appreciate you sharing that. It's for those listening, you know, an unlikely we We often don't think about medicine and how that translates to sales, and there's a lot of parallels with talking to patients about their problems I'm rooting through that and trying to figure out, okay. What's the root cause and what do I what's really important that has to be addressed here? You address it all in one setting? Do you are you able to? Do you have to send them out someplace else? And we face that, but we often forget There's this human side to just life and the greater good and doing things to help other people just because we're

Dr. Robert Berke [00:43:26]:

Right. Right. And and it's hard and the hardest thing sometimes is leaving you leaving it all at the office, you know, And coming home and just, you know, not I mean, that's sometimes very difficult, especially when you've had a day where you've Dealt with some very difficult things in people who've had some serious issues. You know, it it's you have to learn To to just it's you can't take it with you. It's, you know, it's not your problem in a sense. You're you're there to help, but You can't it'll lead you up. You know? And it's it's hard. It's hard.

Dr. Robert Berke [00:44:03]:

Yeah. Yeah.

Celeste Berke [00:44:04]:

Well, I appreciate your time. Individuals can Follow you on LinkedIn, but hopefully soon more stories coming if you launch podcast or you write another book or who knows what you're doing, consulting work, helping practices.

Dr. Robert Berke [00:44:19]:

Oh, I have. I've talked to you already. I have, I I'm Interest I've got stories, you know?

Celeste Berke [00:44:26]:

Yes. And you're a great storyteller as well, so

Dr. Robert Berke [00:44:29]:

I Well, I've got Stories you know, one of the books that I wrote was Tales My Patients Told Me, and it it you can't believe some of the stories people have, You know?

Celeste Berke [00:44:39]:

Right. But you take the time you take the time to listen.

Dr. Robert Berke [00:44:43]:

Oh, yeah. Yeah. Yeah. Fascinating.

Celeste Berke [00:44:45]:

Is awesome, which is why you're, like, the mayor of where where I go

Dr. Robert Berke [00:44:49]:

No. I'm not. I'm no. Not at all.

Celeste Berke [00:44:51]:

I mean, everybody knows you. We're when you go places, you're Well

Dr. Robert Berke [00:44:55]:

And I've delivered 1200 of them, so, yeah, usually that ties you into a fairly large number of them in a small town. You know? Yeah.

Celeste Berke [00:45:03]:

Definitely. Well, thank you all for tuning in to this edition. Appreciate you sharing your time with me, dad. Always love chatting with you because we don't live close to one another. Thank you listeners. Stay tuned for next week's episode.