Kristen Brokaw hosts this episode which features Andy Sutton, CEO of Kare Health & Wellness.

Andy and his wife, Keri Sutton, cofounded and grew a successful integrative health center. Andy’s background is in architecture as a project manager, and his wife is a nurse practitioner who serves as the chief medical officer of Kare Health & Wellness. At the clinic, Andy also oversees marketing, new staff hires and training.

Their clinic prioritizes developing and nurturing a strong culture amongst staff. Andy believes his staff’s cohesiveness and shared values has a downstream effect of benefiting patients and allowing their business to be more efficient, which is one of the keys to their success.

This episode belongs to the Evolution of Medicine’s Business of Functional Medicine series. Once a quarter, we bring you conversations that focus on the business and practice management side of functional medicine.

Check out the full recording to learn more about Andy’s approach to the following:

  • Developing a standardized staff training program
  • Staff hiring and fostering a team culture
  • Leveraging emotional appeal to acquire and retain patients
  • New patient onboarding
  • And much, much more!



Andy Sutton: So, yeah, that the whole group aspect of it, which is sometimes very scary. Again, going cash based instead of taking insurance. It’s one of those points for practices that seems scary, but once you figure out your niche and how you can incorporate it in, there’s some huge value again to the patient. Not only does it help you with your time management sometimes in an office, but being able to speak to 12 people about the same time versus bringing them all individually to do the same thing, right? Obviously, some advantages there, but the piece you miss sometimes one-on-one on those aspects is the community. And we’ve lost a bit of community just in today’s society where people are too caught up in their phones and social media and not real life. Nobody posts the bad stuff on social media that’s going on in their life, but we can bring them into a group, and they’ll open up and talk about it with each other, and sometimes just the talking about it does as much as any treatment that we’re going to put them on.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Kristen Brokaw: Hi Andy, I am here today with Andy Sutton of Kare Health & Wellness. Andy, why don’t you tell everybody a little bit about who you are and what your role is at Kare?

Andy Sutton: Yeah, so I guess I am one of the co-founders along with Carrie, but I kind of serve on the back end managing the business as the CEO. So, more the making sure the bright ideas, the big ideas, all get put together the right way and help us keep moving stuff forward.

Kristen Brokaw: So, when did you guys open Kare?

Andy Sutton: We opened Kare in late 2011. We took over a little small strip center space, a thousand square foot with a couple exam rooms, and Carrie and I decided this is what she wanted to do. And I became a front office person, and she became a provider. And that’s how we started it.

Kristen Brokaw: So, back in 2011. Okay. And what was her vision? Why did she want to start and, I guess, go out on her own and start this business?

Andy Sutton: Yeah, I think there were several factors. Originally, I think it was just kind of wanting to be an entrepreneur. Honestly, in 2011, she just wanted to do something different. But did she know if she wanted to do it as different as we are now? Probably not, honestly, because when she started the clinic, we were just still doing very traditional medicine, basic primary care services. So, nothing was really all that different other than we were independent and not associated with a large network. But then it pretty quickly through our own health journey became evident that we were just supposed to do something much different and quickly transitioned into more of an integrative and functional practice.

Kristen Brokaw: Yeah, I remember Carrie saying things like, “I was going through my own health journey.” And she’s definitely one that researches, so I started finding functional medicine and integrative medicine and looking into it and started changing her life and then going to some conferences and voila. So, when did you really… Did you accept insurance at the beginning?

Andy Sutton: We did, yeah, again, we were practicing very traditional. We were doing the whole insurance model, collecting very little, hoping to get paid on the backend by insurance, but we were very traditional in how we were doing it. Very old school. We had paper charts when we started, we were billing insurance, we were doing all the whole nine yards in the very beginning.

Kristen Brokaw: And then you make the transition, okay, we want to do more functional medicine. We’re going to run more fancy labs, et cetera. I’m assuming you move at some point. And when did you stop taking insurance? I’m curious about that.

Andy Sutton: Yeah, so, it took us a little while to make that commitment. Obviously, that’s a scary transition, I think, for a lot of practices to go out of the insurance model and into the cash-based model because it just feels like a big unknown, right? Insurance feels like a steady thing. You typically know what your reimbursements are going to be. And so, to transition out of that, you kind of feel like you’re dropping off a cliff a little bit, and you hope it goes well. And so, we probably made that transition… It’s probably been about six years now that we’ve finally transitioned completely away from insurance and a total cash-based system. At that point, we had moved into our current facility, although we didn’t have the entire building like we do now. But we had upgraded from about a thousand square feet to about 4,500 square feet at the time and decided it was time. Let’s get out of the insurance model. It was so restrictive on what we could do and very limiting to the patients as well when it came to the types of labs that we wanted to run to the amount of time we wanted to spend with our patients. And so, it was limiting what we could do for our patients and what our patients could do for themselves.

Kristen Brokaw: So, let’s go to where you’re starting to hire some employees. And who did you bring on? How many did you bring on? And tell us a little bit about the transition of adding employees. Because, currently, you have how many employees that work for you?

Andy Sutton: We’re sitting around 35 employees currently.

Kristen Brokaw: Okay, and how many providers?

Andy Sutton: Four total providers.

Kristen Brokaw: Okay. So, yeah, tell us about that journey of bringing people on and how that went.

Andy Sutton: Yeah, a lot of ups and downs, obviously, when you start having to bring on a team of people and trying to figure out the hiring process and what you’re looking for and how you’re ciphering through your candidates. And so, fairly quickly started to realize it wasn’t about a person’s resume as it was about the person. And so we tried to change our focus into let’s make sure we’re trying to hire the right people and then we’ll figure out the right position for them. And so that was really big for us even early on. And so we started to see our retention rates were better with our employees. Just the atmosphere, the culture was better. And that doesn’t happen overnight, obviously. I made it just sound like it happened really easy. There’s a lot of bumps and bruises along the way. You hire a lot of people that don’t work out.

Sometimes, you got to put up with a bit of your culture not being the way you want it to be. And so you just have to find your way through that knowing that you ultimately have a goal that you’re trying to go towards and a culture that you want to create. And so we honestly did it person by person. And when we got somebody on board that we felt like was truly the right person for Kare, we made sure that we were doing the things for them as far as giving them additional opportunities, feeding into them as far as other educational experiences and training. And so, slowly you do that person by person and you get to a point where all of a sudden you step back and like, “Wow, we’ve got a team of solid people here who are the right people.”

And sometimes you get the right person, and you put them in the wrong spot. And so you start to have headaches and mistakes that are happening, and you have to step back and be like, “All right, we know this is the right person. What are we doing wrong?” As us as the leaders, what are we doing wrong? And often it’s that we have the right person, we’re just putting them in the wrong spot with the wrong responsibilities that aren’t great for them. And so, we got to make that transition so that we don’t lose a right person.

So, it’s been key for us is finding people who… And one of the things that you taught us even very early on in mentoring us a little bit early on was looking for people who got bought in at the heart level. So, they were passionate about what we did and what our mission was, and not being bought in at the wallet level when it was just about a paycheck. Because when it’s about a paycheck, you’re going to deal with people not showing up to work on time, people not living up to your standards or working up to your standards because they’re not in it for the right reasons. And you have to weed those people out and find the people who want to buy in at the heart level.

Kristen Brokaw: So, you keep mentioning culture, and I want to hear a little bit about maybe what your culture used to be like or what you always envisioned it to be because I know culture is huge at Kare. It’s our culture or you’re not going to fit here. So, let’s talk about maybe what it used to be and what it is now.

Andy Sutton: Yeah, it used to suck. Just to be raw and honest, the culture was horrible for a while as we’re trying to figure out how to grow. One of the part of our problem was just the growth rate was so fast and hiring so many people. I mean, we honestly feel like we are constantly in a hiring phase, and that’s just due to being blessed with a lot of growth and a lot of patients to take care of. And so, the culture piece came later, right? I mean, anybody out there who’s starting this fresh start with the culture first. It’ll make your life so much easier. But obviously, we learned the hard way that you need that culture in place, and we didn’t. So, yeah, again, more tough times sometimes when you don’t have the culture in place. And so, we had to start from the beginning with your basics, with mission statement and core values, but it also goes down to just how we treat each other in general, both as the employer and the employee.

And for us, we just really view ourselves as the owners and employers just as a part of the team. And so, we want to treat our employees the way we want them to treat us. And so, slowly, we had to develop our expectations for people. Really did that more through our core values and what Carrie and I’s vision was for how we treat patients from the very beginning, even when we were doing traditional medicine when we started, the sole focus was being patient centered. And so even as we went into functional medicine, again, obviously, functional medicine is… That’s part of the core values of functional medicine is being very patient centered. And so, we just wanted to drive that home a little bit more, but bringing our own personal morals and values into it as well as people. And so, we developed what our core values needed to be, and then we just started hammering those home with all of our people so that they truly live them out every single day when they come into the office.

Kristen Brokaw: So, let’s talk about your core values, like what it means to work there and what your vision and mission statements are. I’m just very curious about the whole thing.

Andy Sutton: Yeah. So, the mission statement, everybody gives me a hard time. They’re like, “So, could tell us your mission statement?” I can’t tell you it word for word because it got really lengthy, and I think a lot of people end up having that issue in business where they create this big long mission statement. We’ve quickly figured out how to create core values out of that. Here’s the things that are really more applicable day to day for people. And so, we started with servanthood as our first one. We really want to make sure that we and our people are serving our patients really well. Not only do we serve our patients, but we serve each other as our team. We’re always looking to help out and pick someone up when they’re having a bad day or know what our coworkers weaknesses are, that are our strengths, and how can we benefit and help them in that.

But we wanted to be good servants to everybody, but especially our patients when they came in. And that was everything from really wanted to try to know what the patient needed before they knew they needed it, whether it was a glass of water or whether it was a snack or whether they were just uncomfortable with the temperature in the room. Those types of things. We wanted to get down to the little details all the way down to quit serving things like coffee and water in plastic cups. We wanted to be a real glass, a real coffee mug. We wanted to feel the right way because it was like they were coming into our home. And someone doesn’t come into your home, and you give them a Dixie cup of water. You’re going to go get your nice glasses out of the cabinet, and you’re going to give them something that you would want to present to your friend.

And so, servanthood was really big for us. And really to drive that home, the phrase was, “It’s not about me.” And that’s how you become a servant is you take it away from you, and it’s always about the person in front of you that you’re trying to take care of. So, servanthood is where we started.

Passion was second for us. You’ve got to have a passion for this. And that goes back to being really bought in at the heart level for what we do in functional medicine, but being all in, right? Being all in, in what you’re doing is about being passionate. And it doesn’t matter whether you’re taking out the garbage or mopping the floor or starting an IV or just sitting and listening to a patient. You’re doing it all with passion because it’s all coming from the heart. So, that’s our second one.

Our third one is integrity. And integrity is, gosh, probably a really important one in every industry. But in healthcare… I think in traditional medicine, there’s so much integrity that feels lost in traditional medicine. And so for us doing something different than traditional, we had to have integrity in there. And we needed people who didn’t just show integrity here, but it was just a part of their fabric. It’s what they do outside of here and their family and their friends and their community. It just is them. So, for us, integrity for people is all about doing what’s right when no one’s even looking, making sure you’re doing the right thing, even if you’re tired and you’re exhausted at the end of the day. And you could cut a corner, and you don’t do it because that’s just not who we are. We’re going to do it with integrity.

Our fourth one is compassion. So, again, when you’re dealing with patients in health care where compassion is used a lot, and it’s a term that sometimes loses its meaning because it’s just used too much. But compassion for us is about truly hearing our patients and what they’re saying and not discounting them, not discounting their story, their journey, where they’ve been, what they’ve been through. But we want to truly show compassion and know that we got them, right? We got you. Whatever it is you’re going through, we’re here, and we got you. And that’s how we’re going to show our compassion to them.

And then our last one is excellence. And gosh, that again goes to everything back to whether you’re taking out the trash or mopping the floor, taking care of a patient. You’re always showing excellence. And this was one that when we talk about this to people, they’re like, “Wow, you want us to be excellent all the time?” Sometimes that’s hard. We’re all still human. And so, we had to break it down for people. You’re not always going to be at your best. You’re not always going to feel a hundred percent. You can’t always leave your baggage at the door when you come to the office.

But when you’re here, we want you to give the absolute best you can possibly give in that moment. And that is excellence. We always shoot for perfection. And there’s a quote out there about perfection’s not attainable, but when you genuinely pursue perfection, you will achieve excellence. And so, that’s where we go. We’re always teaching you how to do everything perfectly, knowing that that’s not possible. But in trying to do it perfectly, we can always do it with excellence.

So, those are our five core values that we kind of try to drive home with every employee. We are constantly keeping it present in their minds. We talk about it on a weekly basis. And those are the things… It’s that language and culture that we created internally that everybody holds each other accountable according to that language that we have in place. And that’s where we saw our culture really completely turnover from something that was very negative—and people didn’t like to work here, people were frustrated with the way things went here—to a culture where people generally love to come in here and work.

And the people that we hire in come in and like, “Oh my gosh, I’ve worked so many places. I’ve never worked any place that has this kind of environment.” And so, that’s rewarding for us to have spent the hard work and tried to develop that culture, but we also know truly it’s a daily thing that we have to continually work on to make sure the culture stays where we want it to be.

Kristen Brokaw: That is excellent. I mean, wow, that is so impressive. Yes. So, you’re saying you weren’t always there, but now these core values are part of your DNA, and so anyone who works there understands, like it’s an understood thing, that this is how it goes here. We are servants. We have integrity. We have compassion. Is that what you’re saying?

Andy Sutton: Yeah. And it’s how you police it. If someone’s not living up to one of those standards, it’s easy to go back to them and say, “Hey, this is our core value. We have to operate this way. And if you can’t operate this way, well, then it’s just not the spot for you.” We didn’t get the right person if you’re not willing to operate by these standard core values. We don’t think they’re hard. They’re not difficult. They’re absolutely easy for the right person. And so, it’s a good way, when you hold that standard there, now that we have them. Before when we didn’t have them, it seemed impossible, right? Impossible to get to that spot where you have these core values in this culture to uphold.

And now that they’re in place, and they work so well, it’s like we will go to the ends of the earth to make sure nobody tears it down. And if one person starts to want to be counter to that culture, we got to get rid of them, right? You just can’t be here. You can’t tear down all the hard work that everybody puts in on a daily basis to tear down an environment that we all love being in.

Kristen Brokaw: That is really impressive. I got to give it to you. So, let’s shift gears here for a second. I know how you guys operate your business, and you truly operate your medical practice like a business, and not everyone does this. So, let’s talk about that. You started to realize over time, like, “It’s not all on Carrie and myself.” You guys can’t run everything. So, maybe you had your office manager. Well, tell us about the transition where you realized we can’t even just put this on the shoulders of the office manager, and you started to separate things out into team leads. And so, tell us about that journey and how well that works for your practice.

Andy Sutton: Sure. Yeah. I think we’ve been able to be, fortunately, a part of groups that have helped this. You’ve been a part of a lot of those and helped us as well through masterminds and things like that. But I think in a lot of independent practices, especially in the functional and integrative world, the providers try to do it all. I mean, they are running the business. They’re seeing the patients. They’re checking the accounting on the back end. They’re taking care of the books. They’re taking care of the product ordering and the supplies, and you see it in offices you go to. They literally work themselves to death, and so, they don’t grow. They get stagnant because you only have so many hours in the day. You can only do so much. And so, as we were growing, we were at that spot. We were just burned out.

You’re literally burning the candle at both ends. And so, slowly, we started to hire people. We brought an office manager in. We went through a few office managers, again, not having the right person. Until we finally got one, and Heather’s became our office manager, who is now our COO of our company. But, again, we found the right person who was truly bought in at the heart level. And anybody who meets Heather knows that she truly… If you cut her, she bleeds Kare blood. That’s just who she is. And so, we had a good person on board to build off of. But then, again, as it grows, as you said, the three of us… We don’t have enough time to manage this many people to do it effectively.

And something that people don’t know about, especially about Carrie, she is constantly thinking. She’s very innovative. She wants to grow the brand of functional medicine as big as she can possibly do it. And so, that means constant growth, constantly adding new services, new innovative procedures, which means we’ve got to hire more people. And so, the team grows, and as the team grows, again, one person can only manage so many people, so many services, so many things.

And so, as we’ve seen that to develop from a clinic to also an infusion center, to a diagnostic center, to a COVID treatment center, a full retail center with all of our nutraceuticals and supplements, that’s so much to try to manage and care. We started again as we got the right people on board looking at, okay, what are their strengths and how can we utilize them better so that we continue to grow and to offload from Carrie and Heather and myself and the burden that we were trying to carry.

And so, yeah, we started to develop a structure within the business like you would see in a more like a traditional health system. So, you’ve got Carrie and myself and Heather kind of at the top as your chiefs, if you will, as the chief medical officer, CEO and COO. And then we developed a level of directors below us. And so, we have a director of clinical services, a director of operations. We have a director of patient education and staff development. And so, those people then kind of have more focused areas that they’re responsible for, which allows them not to be overwhelmed. It gives us a singular person to go to for those areas of our business to say, “Hey, what are we working on? What do we need to improve on?” Or “Hey, we see an issue here.” So, it’s easier to address those problems.

It also gives the people below them somebody to go to then bring their issues, their problems, their successes back to us. So, it keeps a good line of communication open there. And then below those directors, they have their own managers. So, we have an infusion manager, clinic managers. We have infusion assistant managers, clinic assistant managers. We’ve got diagnostic managers in our labs. And so, we just trickle that down into each department with managers, assistant managers and leads who can really take on their portion of our business and take ownership in it.

And those are their babies, and they help us uphold our standards, our core values, our standard operating procedures. That’s what they do within their department, and that’s their focus. And as they have issues, again, they trickle it up that chain. We don’t like it to be a hierarchy. We don’t like that word because, again, we’re all about stepping in and doing whatever’s needed, wherever it’s needed.

It doesn’t matter what your title is. But as far as the flow of business and how it operates, in order for it to grow, you’ve got to have structure. And you’ve got to have people who can manage in specific areas, who can put blinders on and say, “No, this is my focus. I’m going to do this really well, and I’ll collaborate with these other people when I need to, but I got to make sure my piece of this is working efficiently so that everything else works.” And then we can step back from a bird’s eye view up here and see how everything’s doing globally as we get reports from all of those areas.

And so, it allows us to still manage and operate the business as a whole, but we don’t have to make every single decision that has to happen in order for us to operate on a daily or even weekly basis. So, that structure has been honestly a lifesaver. It’s allowed us to continue to grow at the pace that we’ve been used to growing for the last decade. And honestly, it’s that structure we feel like is setting us up to take whatever that next phase is for our business, which we hope is even bigger and grander than anybody’s ever imagined.

Kristen Brokaw: Andy, that’s so impressive. I’m sure to people listening, they’re going to say, “Now, what was that director again?” So, again, I just want to say 30, 35 employees, some may think that’s not that big, if they have a big practice. Some may think that’s a ton of employees, right? What is so interesting is there’s really this organizational chart that allows each person to have onus of something that’s theirs. It seems like everything now is clear for them. It’s not just… You got to go to that one person who’s already overwhelmed, “Oh, I don’t want to go to them because I’m nervous, because they’re doing inventory and I know they’ve got to do payroll next, and I really just need to know if we can do this one thing.” And you kind of eliminate all of that. How long have you been running the business with this type of infrastructure?

Andy Sutton: We’ve been with that full structure for about two years. And again, as you said, some people would say, “Wow, that’s a lot of structure for 35 employees.” Seems like a lot of chiefs and fewer Indians in that sense. But for us, it wasn’t just about where we are right now, but it’s about where we want to go in the future. And so, we feel like we needed to put the infrastructure in place now so that it’s there. And we can tweak it. We can mold it. We can figure out what works and what doesn’t work. So, in that next phase, as we continue to grow, that structure’s already there, and we don’t go through the roadblocks that we’ve had in the past.

As you said, it’s like, well, we’ve got a frontline person who has a simple question, needs a simple answer, but the only person that can answer it is Carrie. Well, Carrie’s in a patient’s room. We know from the time she gets here to the time she leaves, and then at night, she’s doing her research and her studying. And she’s doing her charting. And so that question that seems so simple that literally takes five minutes to answer, would take two weeks to get the answer, right? Well, that’s affecting patient care. Because that answer probably needed to go back to a patient at some point.

And so, it was going completely against what we’re here for, which was to be patient centered. And so, to be able to divide this up and as you said, allow people to really narrow in and focus on what was their responsibility and what their duties and give them somebody to go to who does have the ability and authority to make that answer more directly to them and has the time to do it just made the flow of the business so much better. And again, it wasn’t about what made our lives easier, it was about what made this better for the patients. And this structure by far makes our patients, as far as their communication and their experience, it just takes it through the roof.

Kristen Brokaw: So, let’s talk about… You mentioned a few of those roles. Let’s talk about what some of those roles are just briefly and what they oversee and how often are you meeting with your, say, the lead managers, et cetera, and just what you kind of pour into to everyone.

Andy Sutton: Sure. Yeah. So, starting from the top, take that a little bit backwards, so Carrie and I and Heather, who’s our COO, and then all of our directors, and then even our front-end manager. So, our infusion manager and our clinic manager, we consider that our executive team. And so, that’s kind of our close-knit circle, if you will, when it comes to big business ideas, bigger issues that need to be talked about or worked through within interdepartmentally. And so, we meet every other week. We have a set meeting that we meet on Wednesday mornings every other week just to go through these big things that are out there. What are big projects that we’re working on? What are things down the road in the future that we’ve been working on getting input? Or “Hey, you guys have been working with a lab company. Where are we at with that? What information are you getting that helps us make bigger and broader decisions?”

In the weeks in between those meetings, our frontline managers are meeting with their department team. So, our director of operations is getting with our front office manager and all of our front office rooms. Our patient care coordinators who handle our front desk. Our new patient care coordinators who handle every new patient inquiry as far as getting in their information, their paperwork, and just taking care of everything that they need to become a patient. And so, they’re meeting to talk about, “Hey, what’s happening on the front end? What’s the front line issues you guys are dealing with? What are your wins?” First of all, we don’t allow our meetings to be complaining sessions. We talk about, “What are our wins? What are things that are going well?”

Let’s have our wins for the week or for the last couple weeks. And then what are things that you’re running up against that are keeping you from doing your job the best you could possibly do it? And that’s where we’re going to focus, and that’s where they get to give their feedback. It’s their line of communication. So, they have a way to share their ideas, their frustrations, their issues. And then obviously, there’s always things that we’re passing down from our executive team meetings that need to go into those meetings to, say, “Hey, here’s something new that’s coming down the road. Let’s make sure you guys are up to speed on that. Here’s a new product that we’re going to carry. Here’s a new service. Oh, hey, we got a new provider that’s coming in. Here’s a little bit about them.” And so, we can past that information back and forth.

Our director of clinical services and our clinic manager, they do the same thing with all their clinic team, the diagnostic team, the lab team gets incorporated into that. So, they do that meeting while our front office girls are doing their meeting. And so, that gives them the ability to break up into smaller groups, digest information that’s coming out. And again, just kind of share, “Hey, what are your wins? What are your successes? And not your frustrations, but what are your opportunities for improvement? And how do we pass those back up?” And again, some of those things they can discuss it in their meeting, and the managers in that meeting have the ability to say, “Hey, you know what? That’s a great idea. Let’s implement that. Let’s start that next week, and let’s see how that goes.”

Other ideas just are bigger than that. They involve too many things, too many moving parts, but it goes on their list. And then they bring that to our meeting the very next week with our executive team and say, “Hey, my girls had some ideas I’d like to talk about that they think could make things better for them.” And so, those ideas get talked about. And the great thing is we always make sure… People know that not every idea can be acted upon.

Not every suggestion can be put into place, but we listen to every single one of them, just like we listen to every patient that comes in and every complaint that they have. It’s the same process for us. We want to actively listen to it. And in doing so, we have to make sure that we still give feedback back whether we’re going to implement that idea or not, we need to at least thank them for the idea, or we need to explain to them why we can’t implement it so that they understand. Because if people understand the why as to why you’re doing something or the why as to why you’re not doing something, there’s buy-in either way.

But if you don’t explain the why, it’s just, “Oh, well, they never listen to our ideas.” Or, “Oh, they’re just putting more work on us. They just want us to do more because they are implementing this idea that someone else had.” But when you can understand the why about it, everybody buys into it because it’s still about being patient-centered and what we do. And that’s usually where your why goes back to, “Hey, we’re going to implement this new process, this new procedure, and here’s why.” It makes this more efficient on this end, that more efficient on that end, which translates to a better experience for our patient. And when you can explain the why, people are like, “Oh yeah, okay, great. We’re all in.” Because that’s what we’re all here about is about what we can do for our patients.

Kristen Brokaw: Yes. And I think something else that needs to be said, and maybe I didn’t say this earlier, is that your practice is the type of practice that not every single person coming… Because you have an infusion center as well. So, not every single person has seen a per se provider. They may just be coming in to get their prescriptions of their IVs. You know what I’m saying? So, you offer those kinds of services. So, it really does make sense that everybody has to be on board to, like you said, the values. Because they’re not always seeing someone at the top.

Andy Sutton: Yeah, for sure. I mean, Carrie talks about her IV team and what we call our functional healing center, which is our IV therapy area. But that team is Carrie’s eyes and ears for her patients. So, Carrie will see that patient, and she’s going to prescribe some IVs that are a part of their treatment process. And so, they may be coming in every week, every other week, but Carrie may not see them for another four months physically in here for a provider visit, but they’re in here every week or every other week with our IV girls getting their treatments. And so, they are Carrie’s eyes and ears as to what’s going on with the patient. So, they’re critical to the care that they get as well as when they come in just to buy supplements. So, again, those eyes and ears from our girls who are around the supplement area and knowing what people are coming in to buy or questions that they have.

Or patients will come in and say, “Hey, I was taking this, but I don’t think it’s doing anything for me.” Or, “Hey, it’s making me feel really weird like this.” They all know that, “Hey, well, I’m not the provider. I don’t take care of the patient, or I’m not a nurse, so I don’t really address that.” But they know to absorb that information and make sure they get it to the right person. So, that person can be like, “Oh, hey, I just got a message that so-and-so’s not doing well on that supplement we put them on. Hey, I need to make sure my nurse calls them. Let’s adjust them, and let’s put them on this different supplement.” Let’s not wait three months till they come back for a visit. Let’s make them better now. Let’s get it fixed right now. We don’t have to wait.

And so it’s the same with the IVs. If someone’s not tolerating an IV really well or if there’s just other things going on in their world, I mean, we know that people’s lives are busy. Stress creates a lot of chronic illness that we see in the office and somebody’s coming in just for their routine treatment and they come in, and we find out that a family member passed away or they had to move, right? Or they lost a job. We want to know about those things because all of that stuff is affecting their health and affecting them getting better and getting well. And so, our team is just really well-trained to first of all, be very active listeners. That’s part of what we do. That’s part of being compassionate. One of our core values is that we truly listen to what people are saying, and we’re picking up those little things, both good and bad.

We don’t want to just pick up on the bad things that are happening in the world. We want to pick up on the good things as well and make sure we’re conveying that to our team and not just convey it to our team. So, we try to do little things like writing cards. So, we have people on staff who we just say, “Hey, I need a card for this person because their daughters graduating college next week, or their son’s getting married next month. Can we circulate a card and everybody’s going to sign it, we’re going to hand write them a note.” Like, “Hey, congrats. We hope the day goes great for you guys.” So, it’s not always about a sympathy note when someone passes away, but it’s about celebrating their victories as well as their defeats in life. But it takes everybody having an active listening ear as to what’s going on with our patients.

And again, we want our staff to know, it doesn’t matter whether you’re just checking people in and checking people out or getting them scheduled or talking to them on the phone. That’s just as important as the provider sitting in their room with them. And getting people to understand that is not easy. Sometimes they just feel like, well, I don’t really have a role and my patient’s getting better, or the people here getting better. I just take their information, and I check them in, and I call them to remind them of their appointment. All of that is so critical to them getting better. If we don’t remind them of their appointment and they don’t show, we can’t get them better if we don’t get the proper paperwork filled out correctly from them, our nurses and our medical team don’t have the paperwork that they need to treat the patient.

So, it prolongs their success. And so those are things that we have to reiterate to our team that it doesn’t matter what your role is, you’re all a part of our patients getting better. So, when we get a success story, we have to share that even with our new patient care coordinator who may not have even talked to this patient in the last six months, because that’s how long they’ve been here. But our new patient care coordinator who got them started, who got them introduced to our practice the right way, is just as vital to their success as the provider who’s been treating them for the last six months.

Kristen Brokaw: Yes. That’s said so well that they need to realize that they’re sometimes the very first impression that an office or that a patient will have of this office, and how critical they are. Yes. That’s awesome. You guys have done an amazing job at growing. Where are you headed?

Andy Sutton: Wow, that’s a great question as you know.

Kristen Brokaw: I’m sorry.

Andy Sutton: Because sometimes we don’t even know where we’re headed, right? I think that’s something that we’ve learned through the years is that we have a plan. We have a vision of where we’re going and where we’re headed. We know that that vision sometimes flips on a dime depending on what opportunities happen, what’s thrown your way. But we are currently in the process of trying to develop a truly full integrative medical center, not just a clinic. And that’s going to take a lot, a lot, a lot, a lot of hard work, a lot of relentlessness probably to see that through. But again, we feel like we’ve developed the base and the culture that we need. We’ve got the right people on board to make something like that happen. But not only is it important for us, for our community here in the Springfield area, in the southwest Missouri area to do that.

As you know, we treat literally patients from all over the country. We have people coming from literally all over the world at this point. We have Canada, Saudi Arabia, Mexico, we’ve got people coming in because we’ve just been able to establish something here that people can’t find elsewhere. And so not only is it a benefit to our local community, and we want to build it for them, but we want to continue to expand on what people globally are looking for right now in trying to find a more natural, holistic approach to healthcare, trying to find outside-of-the-box alternatives to treatment and to their healthcare no matter what their issue is, whether they’re just trying to live a more vital life, they’re fairly healthy, and they just want to stay healthy. They want to live that long life, find the fountain of youth, if you will, to those people who are dealing with severe chronic illnesses, anything from cancer to ALS to Lyme disease to whatever it might be.

They’re looking for a place that they can go and actually get answers and find hope. And I’m surprised that’s the first time I’ve used the word hope in everything that we’ve talked about, but that’s a big… It’s not a core value of ours that just truly is our heart. We feel like we have to provide hope in the healthcare world where so many people feel like there’s a hopeless part of society right now. Everybody lost a lot of hope in our healthcare systems, especially through COVID, unfortunately. And so, we feel like that’s something that we have to do is a lot of people come to us in that spot where they literally just feel like they’ve done everything. They’ve seen everybody, and they’re hopeless. And so, for us, it’s about providing a place that provides hope to them if nothing else. And what’s cool about that is you’ve been in our clinic, and so you’ve seen, as you walk off the elevator on our second floor, we created this huge freestanding sign that is hope.

It has our icon as the O, our icon is round for those that don’t know. But it’s amazing how many people we have come through our new patient orientation and we give them a tour of the building just so that they can see what they’re getting into. And we literally have people walk off the elevator and will burst into tears because they’re looking for a place that’s going to give hope, and they literally walk out and there’s a sign right in front of them that says hope. And so, for us, that’s huge. That just tells us that we’re headed in the right direction with it. And hopefully with that next phase of what we’re going to be able to do with offering even more services for people, more opportunities, more options for those things that people are just struggling to find, we want to be able to bring them all under one roof.

And it’s one location that people can come to for truly all of their healthcare needs. From the one-day old to the hundred plus old, whatever it is, whatever your needs are, this is where you can come to get it. And you don’t have to live right here in Springfield. We wish everybody had one of these in their back door, but the reality is we know that they don’t. And so, our goal is… The next phase is to create something that truly hasn’t been created in the States at this point. And we want to be the first to do it, and maybe it becomes something that can be replicated at that point and give more access to more people to do those types of things.

Kristen Brokaw: Oh, wow. That is so inspiring. You know, I would like to finish there, but I want to bring something up because you just mentioned it. You said when patients in the new patient orientation, they see that sign that says hope. The one thing I would love for you to tell everybody is how you do new patients.

Andy Sutton: Oh, wow. Yeah. So, that’s something that’s transformed a lot through our practice, which is vital and key to what we do. To be honest with you, when we started, we did it just like everybody else. Someone’s interested in being a patient, they call you up and you put them on the schedule and they become a new patient. They walk in the door, they have zero expectations of what they’re getting into. They don’t know what the facility looks like. So, you always have a bit of anxiety. I mean, anytime any of us go to a doctor’s office for the first time, we’ve never been there, admittedly, we all have a little bit of anxiety about what’s behind the next door, what’s this going to be like? And we know for what we do, it’s different. And we do things very different.

Being cash-based is very different. Being functional medicine is very different. There’s a lot expected of the patient. They have to take some ownership in this as well. And so, we were getting a little frustrated with people who would come in as a new patient, and we didn’t have a process for them. They just came in, they saw a provider, and they were a little shocked by how much it cost because it was cash based. And then, oh, they had to do labs and oh, wow, well, that’s different. And that’s sometimes cash-based, sometimes insurance, and still is. But there was just so many unknowns for people, and nutraceuticals, like supplements, oral supplementation, that’s huge for us as well. All of these things were foreign to people. And so, what we would find is that people would come to us for one or two visits, and not everybody, but there was a chunk of people who then fell off.

They wouldn’t come back. And as we would start to reach out to these people, it was, “Man, I can’t afford it. I wasn’t prepared for that piece, or I wasn’t prepared for the lifestyle changes I was going to have to make to do this. Man, I just can’t give up my 12 pack of Mountain Dew. I just can’t do that right now.” And that’s fine. We get it. It’s life. We all have those crutches that we fall back to, and you got to be in the right frame of mind if you’re ready to give up some of those things. And some people aren’t. And so, as we heard those things we’re like, “Wow, we’ve got to find a way that we can lay out the expectations for people.” We’ve got to tell them who we are, what we are, and why we do things the way that we do. They need to know that.

And first off, it was to inform people, but second of all, it was to allow people to say without any money out of their pocket to say, “Yeah, I’m not ready for this. This isn’t the right place for me.” Which sounds crazy. You’re turning away business. We could have just scheduled them, brought them in, and made a few bucks off of them, and oh, if they don’t come back later, well, we still made a few bucks off of them, right? But that’s not where we are. We’re about getting people better. We’re not about the finances of the business. We’re about how do we actually get people better. If you just get people better, the business side takes care of itself. You don’t have to worry about that piece. And so, we implemented through an idea of group visits. I don’t know who would’ve given us that idea necessarily, but it kind of stemmed from that idea.

If you could put a group of people together and you can fill them with good information and let them make informed decisions, good things tend to happen from that. And so, we implemented a group new patient orientation. And so, when people now call us and they want to know about Kare, they want to know about how being a patient. Right now, we have three girls who are new patient coordinators. That’s all they do. They answer the phone for new patients, they talk to them about who we are. They try to answer all their upfront questions, and then they get them scheduled for an orientation. It’s completely free. We do two a week. One is done in person in the office, one’s done virtually. We started that obviously during COVID. And we found that just works sometimes for people. It’s just easier for them.

They can honestly sometimes be on the job somewhere, but they can pull us up and they can listen to the orientation. We still prefer in person. We feel like it’s the best and the most successful. But in today’s world, we needed other options. But the whole goal of that is… And Heather, who is our chief operating officer, who’s been with us a long time, actually, she started as a receptionist for us. She left us for a period of time, came back as our office manager, and we’ve just moved her up and empowered her. But she does this for us because when we first did this, Carrie and I did, we did every single one of them every week. And again, it came to that point where it’s like, “Wow, we just have so much.” Not that it wasn’t worth our time, but it was just one of those other things we had to try to fit in.

And we felt like we’re not doing it to the best of our ability. We’re not doing it with excellence with everything else on our plate. And so, we’re like, “Okay, who else can do this? Well, it’s Heather.” Anybody that knows Heather again knows that she can speak about Kare better than anybody, so probably does it better than Carrie and I sometimes because she does it with such passion. So, she does those for us, and she just downloads to people like, “This is who we are. This is how we operate. Here’s what you can expect, but here’s what we’re also going to expect of you.” And we lay it all out from the amount of time they’re going to spend with us in their visits to the amount of money they may spend. We try to give them an idea, a ballpark. Here’s what it may cost for a visit, and here’s may what your labs can generally cost.

But just to give people everything that they need to know. And then at that point, let them decide, “Hey, yeah, I think this is the right thing for me. I want to go ahead and get scheduled. I want to get on board to see a provider.” Or, “Hey, you know what…” And we have plenty of people who say, “Yeah, you know what? I can’t do this for whatever reason.” Maybe it’s finance. I can’t tell you how many people will say, “Hey, I’m just not prepared for this yet financially, but I’m going to be back.” And at first we thought, “Oh yeah, that’s an easy way to get out of it.” Right? What’s amazing is how many of those people come back and they’re like, “Okay, I’ve been putting my money away. I’ve been adding more to my HSA. I’ve just been putting more into my savings account. I want to get started now, right? Because I want to do this. I just needed to be in a better place to do it.”

And again, those are things that tell us we’re doing it the right way because these people needed to get prepared for this. Or those people who say, “Man, I’m going through a stressful time in my life. I can’t give up my three liters of Mountain Dew that I drink every single day.” Right? We’re like, “Oh, you’re killing yourself, but we get it.” But then they come back to us later and they’re like, “Hey, I’m in a better spot. I’m into my new job.” Or whatever that was unsettling for them. “Now I’m in a better spot. My mindset’s better. Now I’m ready to take this on.” And so, we feel really good about those people, and we feel just fine with the people who say, “Yeah, broader vision, you guys just aren’t for me. I’m going to go do this somewhere else.”

That’s great. We didn’t waste any of their time. We didn’t waste any of their money. And honestly, we didn’t waste any of our time on those people and not being able to get them better. We want people who are invested in their health and truly want to make a change to better themselves. Because when you get someone who’s already in that mindset, the sky’s the limit on where you can take them. It doesn’t matter how sick they come to us, if they’re in that mindset, there’s so much you can do with those people to get them better. So, that’s where new patient orientation came from. It takes maybe an hour, hour and 15 minutes on the in person when they get a full tour of the building, so they see everything. And so, it’s just really cool for those people to come and see it.

Our retention rate is probably 98% of people who go through that schedule and become patients. You’re not really turning away that many people. And the great thing about that is they’re buying in with all the knowledge and not just on a whim, “Hey, oh, I saw your ad. I thought I would call you because I need this or I need that.” And so, it’s been huge for our practice. So, anybody out there who’s trying to figure out, “Gosh, how do we do this different?” Take the time. Yes, it takes time. Yes, it’s free. But in the long run, that investment in those patients… It will change your business and it will change the lives of those patients.

Kristen Brokaw: Oh, that’s said so perfectly. And you guys even do some group visits in your practice, and that’s such a great way to get them used to the idea of group visits is the fact that their first encounter with you was a group orientation.

Andy Sutton: Right. Yeah. I mean, the group thing is always… As you know, it’s a hard thing sometimes for people to want to do, but what you find is that community education piece that happens even on our orientations, right? Heather has each person just kind of, as much as they’re comfortable with, just share why they’re there. Why did you come to Kare? What are you looking for? And some people don’t want to share anything, but other people will dive into everything and becomes a quick little session with them. But what you’ll find is that other people sitting around the table when someone talks is like, “Oh, man, I thought I was alone. I thought I was the only one dealing with these frustrations with these health issues. But Susie over there on the other side of the table, just went into this spill about, oh my gosh, I can relate to her. I can relate to her. Now I’m not alone. And if she’s here doing this, by God, I’m here doing this.”

And the same thing happens in our group visits, we do a lot of them for specialty lab reviews or SLRs. So, people who have gotten similar labs like food testing for one, to bring them into a group and talk about what this looks like and what the lifestyle changes might be. As people start talking amongst themselves, they’ll find that, “Oh, hey, this person’s really struggling with how to get gluten out of their diet.” Well, this person over here knew that they were gluten sensitive, and for the last two years, they’ve been developing their diet that way. And they start sharing, “Oh, hey, let’s share your email, or give me your phone number. I’m going to text you some recipes.” And so, what you find is that the community aspect of it almost does more than what we’re doing for them sometimes, because they connect to other people in similar situations who already have some answers that sometimes we didn’t even have. And we’re like, “Oh, that’s right. Somebody get me a notepad.”

Kristen Brokaw: A writer downer.

Andy Sutton: That’s a writer downer. Because we got to pass that on to an expert. So, yeah, that the whole group aspect of it, which is sometimes very scary. Again, going cash based instead of taking insurance. It’s one of those points for practices that seems scary, but once you figure out your niche and how you can incorporate it in, there’s some huge value again to the patient. Not only does it help you with your time management sometimes in an office, but being able to speak to 12 people about the same time versus bringing them all individually to do the same thing, right? Obviously, some advantages there, but the piece you miss sometimes one-on-one on those aspects is the community. And we’ve lost a bit of community just in today’s society where people are too caught up in their phones and social media and not real life. Nobody posts the bad stuff on social media that’s going on in their life, but we can bring them into a group, and they’ll open up and talk about it with each other, and sometimes just the talking about it does as much as any treatment that we’re going to put them on.

Kristen Brokaw: Wow. Andy, I am so inspired after this time with you today, so if there was any one last nugget looking into a crystal ball for people listening on, oh, I’ve got all this business stuff. Is there anything you would say to them?

Andy Sutton: Wow. Probably a lot of things are pertinent, but probably I think having a relentless style about you. I think that’s important. That’s something that Carrie and I have really embraced is how to be relentless. Anytime you’re going to be… And I think we may have learned this from you or maybe something that you told to us at one point, but people who are trying to do big things can’t expect to have small problems. That just doesn’t work that way. People who want to have small problems stay in their comfort zone. They keep it safe because they don’t want to deal with a big problem. But if you really are wanting to build something and you want to do something bigger than yourself, and you want to truly help as many people as you can, that’s doing something big. And if you’re going to do something big, you’re going to face big obstacles.

You’re going to face big problems. And when you can change your mindset to that and realize that’s a part of the process, and you just have to be relentless, right? None of those things can stop you from what your ultimate vision is. It doesn’t matter how bad the day goes or how bad the week is or how enormous that problem is that gets thrown your way. At the end of the day, you got to step back and just say, “Look, we’re relentless.” Right? And if we’re facing a big problem, that means we’re doing big things, and so bring on the big problems because we’re going to do big things. So, yeah, I think just for other people out there who are… Everybody faces it. If you’re running a business, you’re facing problems, right? Whether it’s employees, whether it’s just cash flow, whatever it is, you face problems. Don’t steer away from the big problems. Just know if you’re facing a big problem, that means there’s something big in store, and you’re headed in the right direction.

Kristen Brokaw: Hallelujah. Amen. That was awesome. Thank you so much for your time today, Andy. And what is the name of your clinic so that people can find you?

Andy Sutton: It is Kare Health & Wellness. K A R E. Don’t spell it with a C. Kare Health & Wellness. We are in Springfield, Missouri. Our website is kare-health.com. Tons of information on there. We love sharing. We love helping out other independent practices, whether it’s doing the same thing that we’re doing or it’s someone out there trying to bake goodies without gluten and dairy, whatever it is, but somebody that’s trying to do something in this same niche field, we love trying to help people out. So, look us up. If there’s anything that we can do to help out, we would love to do it.

Kristen Brokaw: Thank you so much.

James Maskell: Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening, and we’ll see you next time.

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