Transcript: Annie Lamont, Oak HC/FT

The transcript from this week’s, MiB: Annie Lamont, Managing Partner of Oak HC/FT, is below.

You can stream and download our full conversation, including any podcast extras, on Apple Podcasts, Spotify, YouTube, and Bloomberg. All of our earlier podcasts on your favorite pod hosts can be found here.

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Barry Ritholtz: What can I say about this week’s Rockstar guest, Annie Lamont, incredible track record as a venture capitalist. She’s co-founder and managing partner of Oak, HCFT. I can’t list all her accolades because they’re just a hundred most influential people in healthcare. Forbes, Midas list five times top 100 venture capitalists according to CBE Insights, top VCs on the New York Times list, top 20 private equity power players, FinTech Finance 40. She has had 70 exits, zero O over the past 25 years, 15 IPOs. Just an incredible track record of investing primarily in the healthcare, but also the financial technology space. There’s surprising amounts of overlap in terms of access, outcomes, cost, speed, friction, especially those last three costs, speed and friction between the two. She’s also First Lady of Connecticut, married to governor Ned Lamont. She’s, she’s been doing VC work for, you know, 35, 40 years. And just as, as insightful as anyone in the world about those areas, especially healthcare. I found this conversation to be absolutely fascinating. I think you will also, with no further ado, my discussion with Oak HC/FT, Annie Lamont.

Annie Lamont: Thanks. Very great to be here.

Barry Ritholtz: I’ve been really excited for this conversation. You do so many interesting things, but let’s start with Oak Investment Partners. You were a GP there starting in 86 in HC Ventures. What led you to that part of your career?

Annie Lamont: Well, very early on, I got outta Stanford when Silicon Valley was really at the very beginning of Silicon Valley and joined something called Hambrick and Quis, which was boutique investment bank venture firms, or legendary at that time, like I was the 50th employee and really fell in love with venture from day one and working with entrepreneurs. I carry Steve Jobs bags on the Apple IPO Road show, my first three months there. Wow. On the first three months, we also took Genentech public, so I worked with two of the greatest entrepreneurs ever. I didn’t, I didn’t know at that, at that time. That was

Barry Ritholtz: My next question is, did you have any sense of who you were rubbing shoulders with, or it was just like fast moving blur?

Annie Lamont: I certainly, those two seemed ex like extraordinary people, and I extrapolated that to most entrepreneurs. I quickly learned they were two extraordinary individuals, but that was, it just got me hooked. I thought if I could just learn and be with people like this and not be the entrepreneur, but be the person that supported, helped, edited therapist, what, you know, whatever was required, I just wanted to spend the rest of my life with people who envision the world as it should be.

Barry Ritholtz:  And H&Q is known for a lot of their software, internet, hardware, technology. What led you over to the healthcare sector?

Annie Lamont: So, when I joined Oak, which was really just a couple of years out of, out of Stanford, we were founding Genzyme the year that I joined one of the, also very first biotech companies. And there was only one public software company at that point, and I wasn’t really interested in one of the 300 disc drive companies that were being created.

Barry Ritholtz:  Not, not an Iomega fan. I remember that one.

Annie Lamont: Just, yeah, they had done Seagates or the original Seagate shoe. And so I said, I, I wanna create my own space, you know, I wanna create my own expertise in an area that I could fundamentally be interested in. And that ended up being biotech and so focused on life sciences the first 15 years of my career. And back companies like Alexion, Cephalon, ies, a whole host of companies

00:04:18 [Speaker Changed] Were, were you anything healthcare or medical or biotech related at Stanford? What did you do on

00:04:24 [Speaker Changed] Graduate? No, I should have been a home bio major. Right. But I wasn’t, I had no idea how interested I was in the topic, but I became fascinated by it and educated myself and wish it would’ve been nice to have had the internet back then.

00:04:35 [Speaker Changed] But What, what’d you study at Stanford?

00:04:37 [Speaker Changed] I was a political science major, so of course that prepared me for my life with my husband ultimately. But I did have an interest in politics. But,

00:04:45 [Speaker Changed] But no technology? No, no engineering physics.

00:04:48 [Speaker Changed] No. I mean, everybody takes a computer science course at Stanford. Right. But,

00:04:51 [Speaker Changed] Huh, really interesting. So Oak Investment Partners, very sophisticated VC platform, going back to like the late seventies, I think is when they launched. Yeah, exactly. So when you joined them in the eighties, what did you, what did you focus on? What, what was, was it healthcare right out of the gate, or how did that transition take place from carrying Steve Jobs bags on the road show to focusing on healthcare?

00:05:20 [Speaker Changed] I think my, my interest, as I said, in, you know, we’d founded Genzyme, just intellectually interested in the area, but worked on, you know, some software companies back then, and then decided I really needed my own hook. Like the reality is in every career, you know, you should, you need to create your own expertise and your own special lane, and that was gonna be my lane. I wanted to differentiate myself from all the other engineers at, at Oak and do my own thing.

00:05:48 [Speaker Changed] Was, was that kind of a white sheet at that point? There wasn’t a lot of competition there. Yeah. White sheet. Yeah.

00:05:54 [Speaker Changed] Yeah. That was the other thing. There wasn’t any real competition at Oak. And in terms of the market, it was a new burgeoning area, and you didn’t have to be a PhD. You could hire PhDs to help you, right. Analyze these things.

00:06:07 [Speaker Changed] What, what was Oak’s core focus when you joined them? Was was healthcare something that had, they had no previously played in, or, or you essentially, did you stand up that sector at, at Oak? Yes.

00:06:19 [Speaker Changed] Yes.

00:06:20 [Speaker Changed] Huh. So what else were they investing in at the same time?

00:06:24 [Speaker Changed] Well, a lot of hardwares. I said a number of dis drive companies, pc, I mean, we did actually invest in Compact during that period. And so it was more PC hardware, telecom related.

00:06:39 [Speaker Changed] So clients, the LPs who come to Oak, were they just giving them cash to be allocated across all these different sectors? Or did people say, all right, I’ll try a little bit of healthcare and a little

00:06:50 [Speaker Changed] Bit. No, we always had, and we do have at Oak HCFT one Fund that everything, and, and we would choose the allocation,

00:06:57 [Speaker Changed] Huh. So that in investors are getting exposure to whatever you guys think has the, the most potential. Right. So you’re listed as a managing partner at Oak, as well as a managing partner and co-founder at Oak, HCFT. What’s the relationship between the two companies?

00:07:15 [Speaker Changed] There is, there is no relationship. Oak Investment Partners is, wind is wound down effectively. I’m still there until the last company is, you know, exited. Just

00:07:25 [Speaker Changed] Waiting for a Right. Just waiting

00:07:26 [Speaker Changed] For the last, exactly. I have an obligation to those LPs in that, in that firm. But the reality is there is no relationship. We started O-K-H-C-F-T because we had had two practices, obviously in healthcare and FinTech. Andrew Adams and myself launched the firm and 10 years ago and really wanted to focus on sort of the new model of investing that wasn’t just Jedi Nights from, you know, 25 years ago, where it was just, you’re a good advisor and you don’t have a talent function, and you’re not, the, the model really changed to become a service entity to entrepreneurs, to support entrepreneurs. And it was always partnering with entrepreneurs in the past, but the reality is that it became a far more competitive world. You really needed to be deep in a specialty to differentiate yourself, and you needed to have things like, you know, tech support, talent support is enormous because it is all about people. We have five individuals that are just singularly focused on talent and attract, you know, attracting talent for our companies, and also introducing us to repeat entrepreneurs we haven’t invested in before.

00:08:32 [Speaker Changed] So you’ve used the phrase Jedi Knights in the past. Tell us a little bit what you mean by that. I get the sense the world of venture today is very different than the eighties and nineties.

00:08:45 [Speaker Changed] Very different. I think the Jedi Knights means that every, it’s just a group of individual. It’s a, it’s maybe a firm, but it’s a group of individuals that are sort of all out for themselves, just investing directly with entrepreneurs with no real overlap between anyone else in the firm and that entrepreneur. Whereas now, I would say like O-K-C-F-T is very much a team-based approach where we support the entrepreneur in a myriad of ways. Whatever they need, you know, we’ll, we will supply as a firm.

00:09:16 [Speaker Changed] And so, so some of the VC books and, and autobiographies and the, like, that I’ve read, kind of implied the early eighties and earlier days of venture was first they would write a check, and after they had been writing checks for a few years, they ended up having a bit of a network of other engineers and other venture funds and other entrepreneurs. And so people would plug into that network. It sounds like you’re describing something much more comprehensive and holistic than the venture of old servicing the entrepreneur. Put some flesh on those bones. How much service does Oak provide to the companies you work with besides funding?

00:10:02 [Speaker Changed] I think that, first of all, that you, we should just talk about that, the difference between a world where, sure. Everything, there was more mon, there was less capital and more entrepreneurs, right, in the early days. So the, the supply demand balance was such that there was a lot more power, I would say, with the money than with the entrepreneurs and the great entrepreneurs even

00:10:23 [Speaker Changed] Has that, has that.

00:10:24 [Speaker Changed] And I would say that’s flipped in this world, and that there are obviously many more entrepreneurs, but there’s also a lot more money in the industry. And so you really have to differentiate yourself. And I think that’s where this service model came in of support. That’s is how in part you differentiate yourself. And yes, it’s great relationships and great advice, but it’s also the wraparound of talent, which is huge, like recruiting and understanding that, you know, providing someone go to market advice at times exit, you know, really understanding the process in terms of exiting companies, introduce, you know, introductions, which is the importance of being deep in these two sectors. As you know, the customers, we know the customers intimately, we have great relationships with them broadly, and so we can help make the introductions as well as many of those customers end up being buyers of the companies. And so just understanding that life cycle and being completely connected to those communities is really, is hugely important.

00:11:30 [Speaker Changed] So that flipping of, of the power dynamics from the capital to the entrepreneur, does that have anything to do with companies now staying private for so much longer? That seems like there’s endless amounts of money around and, and no shortage of people willing to, to fund startups. How, how, how does that dynamic play out with all these companies just postponing IPOs for seemingly much longer than they used to?

00:11:59 [Speaker Changed] I think it’s less about postponing IPOs, although certainly some of the major, you know, some of the very large companies are, are doing that in order to realize full value. I would say that the IPO market is not as, you know, it is so cyclical, it’s just not, for example, it’s not friendly right now and it’s hard to get exits. So I would say in these two sectors, I mean, a stripe can go public anytime it wants. It is when to choose to go public, when it feels like the value’s there. And they’re in the best position from a profitability standpoint and growth perspective, the reality is most companies cannot go public. What has changed dramatically in the last 30 years is that companies could go public much earlier in their life cycle. Now, biotech, which we don’t, we don’t do anymore. We do all technology enabled software and services in healthcare.

00:12:59 And that, that pivot started in 2000 with Athena Health. The reality is, is the, it is not an exit to go public and with biotech, it’s just a funding mechanism, right? There’s a, it’s a public private world in biotech, the rest of the universe, you really have to be a more mature company. You have to be an over billion dollar market cap company to have to make any sense to go public. You know, there used to be companies that have a hundred and $200 million market caps that would go public, but it’s been, it’s been made much more difficult to be a public company. There are far fewer people that play with those companies. If you don’t have a large market cap, people don’t, the liquidity isn’t there. The dollars are so much larger going into these public companies that it, it’s just a, it’s a very different world than it was 30 years ago. But now we’ve created, in the private markets a sort of private public world. And I would say while 80% of our exits are through strategics, the financial, you know, PE world is our buyers for early stage companies, but we have to get them profitable. Huh.

00:14:08 [Speaker Changed] You know, it seems odd that markets are at all time highs at the same time. Not a friendly IPO market. I’m, I’m trying to remember the last time those two things happen at the same time, right? Like, you think back all time highs, late nineties, right? Red hot IPO market, red hot, even mid seventies before the financial crisis. Pretty robust. IPO market and then again venture and, and IPOs, right up and through the early part of the pandemic, you know, red Hot Market. This is my first example of all time highs in stocks, but not so much in IPO issuance.

00:14:47 [Speaker Changed] Right? But I think if you looked at the market, so much of it has been driven by the top seven com tech companies. So it’s a bit of a head fake. You’re now seeing rotation, right? In terms of other companies, right? Q3, yeah. You know, other companies now benefiting by the markets from being higher. But I think the reality is right now, we just have an overhang from, I certainly in my world, I can speak to healthcare and FinTech, a number of companies going public and then disappointing or valuation just being excessive compared to the maturity of the businesses. So I think there’s just a hangover from that, and people are going to invest in known entities that are already public at this point. And we still have a ways to go, I think, for some of those companies. Many of those smaller to midsize companies being valued in the marketplace and appropriately. So.

00:15:41 [Speaker Changed] Really interesting. So let’s talk a little bit about some of the companies that you guys have invested in. You were very early in some iconic names. You mentioned Athena. There’s also one Medical Village MD, devoted Health, quite a run of really big names. Tell us what led you to these companies? How, how are you so early, so often in companies that turned out to be, you know, big movers in the space?

00:16:12 [Speaker Changed] Well, I would say it started with Athena Health backing Jonathan Bush and the Park Brothers there, Todd and Eddie Park were then founded, Castlight, actually by Todd, and then, then devoted. So a lot of what we do are repeat entrepreneurs. Once you find a great entrepreneur, you develop a deep relationship with them, their friends, as well as business colleagues, and then you back them over and over again. And so we’ve done that very successfully over time. But it did start with a, that the whole tech enabled services approach in healthcare started with a Athena. And it started with our view that we really just wanted to invest in things that lowered cost, improved outcomes and patient experience in healthcare. Period. The end. Gimme,

00:16:57 [Speaker Changed] Gimme those three again. Lowered cost, improved outcomes and patient experiences. Yes. Well, that sounds like, you know, the holy grail, if you can do all three of those,

00:17:07 [Speaker Changed] So you don’t always do all three, but at least two of them. It, it really is a mission for us in trying to improve healthcare. And we started, Athena was the first cloud-based healthcare company, and we invested in them. And really it was just a rev cycle management company then, which was part of our thinking also around why we did payments and FinTech, A lot of overlap in the whole payments world in healthcare. But so, and then, and then it became an EHR electronic health record company seven years later actually. And so now they have one of the most important EHRs in, in the country in, in that space. But, but really it was just a, like pay doctors faster, better using technology. And so if you are looking at some of the newer companies, think Devoted, which is a, a fascinating company that’s focused on Medicare Advantage and is competing with all legacy companies. United, Humana, Elance, Anthem, the, if you think, if you look at what Devoted is doing, they have redesigned the entire tech stack. They’re using Gen AI in their function. They are a combination of a, a Village or Oak Street and an MA plan in meaning

00:18:28 [Speaker Changed] Explain that for,

00:18:29 [Speaker Changed] For the lay person, meaning that they’re actually, they have devoted medical group, which started as virtual, but as a network managing network of the care. ’cause you cannot, you cannot, as a health plan directly manage the cost of care. Cost of care is 85% of all healthcare. And so as a health plan, in order to manage care, you actually have to impart own the care. And so Devoted Medical Group starts with, you know, primary care docs, virtually wraparound services virtually as well as extending their network so that they can actually impact the quality and cost of care. So the, there, there really is nobody else effectively doing both being the NMA plan as well as being a source of managing the care. And so they’ve done that amazingly well. The fact that they have a modern tech stack that no one else has. Everybody else is riding off a 30 and 40-year-old legacy programs even. I mean, if you look at Epic just from the, you know, software side, I mean, that was originally based on mumps, you know, from the 19 wow. Seventies. So what’s exciting about Devoted is that you’re now seeing the impact of all of that, whereas MA plans all over the country are suffering and they’re actually excelling in this environment.

00:19:45 [Speaker Changed] So let’s talk a little bit about quality and cost. It seems like healthcare unique in the US business space has been so resistant to an end-to-end form of technology that improves quality, reduce costs like technology and computers and software seem to have improved productivity and lowered costs everywhere 20, 30 years ago. And it’s still compounding. Why has healthcare been such a challenge to build in basic technologies? Why are they still working on 30, 40- year-old legacy systems?

00:20:26 [Speaker Changed] Well, it’s a little, little like banking as like, as many of those are also working off of COBOL systems, but are now finally being, you know, reinvented, I would say healthcare, if you actually looked at most people who worked in, have worked in healthcare, there’s almost like a right brain left brain disconnect in that you’re either tech focused or, or healthcare focused. And I would say what’s happened the last decade is that you have a younger generation coming into the industry that are just naturally tech focused, right? Right. They’re tech savvy users. They’re a number of technologists that are now interested in healthcare. And so there’s been much more reinvention. I mean, I think not to, you know, talk about devoted too much, but the reality is is the CEO Eddie Park is a computer science major from Harvard, right? So that is, is like a different mentality.

00:21:16 And I would say if you, if you look at most healthcare companies, they just have not focused on that. And they haven’t, if you’re a hospital system in general, you’ve not been forced to be truly efficient HCA different story they have, but in most cases, they’ve implemented Epic or in some cases on the ambulatory side, maybe in Athena, but they are not tech, this is not their business. You know, their core business is delivering healthcare, and they really haven’t understood the power of tech. I do think what’s changing in the massive inflection point right now with Gen ai, you now have all this unstructured data that they, that is abundant in healthcare. And you now can take the that and have the power of that to change workflow, to change and support the doctors and nurses that are delivering care in a way that doesn’t require behavior change, but makes their lives easier. And that is gonna be a game changer.

00:22:19 [Speaker Changed] So, so I wanna put a little, it’s almost a cliche to say flesh on the bones. No, no pun intended. So I have my charts by Epic on my phone, and it’s the first app I’ve ever used where I could renew a prescription, I could set up an appointment, I can ask a doctor question. But literally six months ago, if I wanted a record before I put this on this phone, the doctor’s office would say, fax your request to us, right? Like, what’s a fax? I mean, really we’re still using 50-year-old technologies, but that seems to be in most of the medical profession. I know there’s some security concerns and some rules about what can and can’t be emailed, but faxes, I mean, they’re living in the 1970s. Is it, is it that far behind the curve for much of the medical care that’s

00:23:11 [Speaker Changed] Out there? Yes. Yes. Just even in New York City, just go to any doctor and you will find that they’re still faxing or handing you a piece of paper and they’re not integrated with their own hospital system that they may be affiliated with or have surgical privileges at. It is, it’s absolutely insane. My image, you know, images, I’m still carting around on discs or maybe, right. It’s, it’s crazy. No, the the amazing thing, and the problem with HIPAA is you, you’re right. Like you can’t do Zoom. You’re not supposed to do Zoom right

00:23:43 [Speaker Changed] As you, because it’s not secure, because

00:23:45 [Speaker Changed] It’s not, you don’t have hipaa, it’s not HIPAA compliant. You, what makes absolutely no sense is that a fax is considered secure,

00:23:53 [Speaker Changed] Right? It sits on the fax machine somewhere on for hours

00:23:56 [Speaker Changed] Until someone, anybody can see it, you know, the sanitation worker that night can, you know, like see the whole thing’s crazy so much for privacy and somehow, you know, your private email is not private enough. So,

00:24:07 [Speaker Changed] Yeah. So, so I mentioned MyCharts. Epic is still private, very large private company. Yes, there’s been some litigation because of antitrust concerns with them. How big is their penetration if so many offices are still, you know, faxing records around

00:24:26 [Speaker Changed] Their penetration is enormous and growing and I effectively, you know, Cerner is losing traction and losing clients every day, really. And yes, E Epic is, is owning that market,

00:24:43 [Speaker Changed] Is that because the software is so good? And I will tell you my experience with the app, you know, a 10 outta 10, but what else is happening behind the scenes that’s giving them such an advantage over everybody else?

00:24:57 [Speaker Changed] Well, I think Cerner lost its way in management a decade ago. Oh, really? A decade ago.

00:25:02 [Speaker Changed] So it just cre opened up the,

00:25:04 [Speaker Changed] It just opened up. There wasn’t, you know, it takes time to create all the different modules and all the different departments. So this is just a time game almost in that, you know, epic had a lot of time to create integrated software across all of these different departments. And, and because they got every academic medical institution in the country to effectively adopt them, you know, they, they’ve become a standard. And there, there is a danger in that, right? In terms of if you talk about a monopoly, they, they are going to have a growing monopoly in this market. They’re also, as you say, it’s, it’s a benefit. You know, their view is like Apple, they’re gonna be a walled garden and Right. That’ll be a benefit to the customer. And that’s then that’s okay. And certainly hospitals, you know, like it, and there’s a, a real benefit to it. I do think that issue is, I mean, we would never sue Epic for any of our small companies that are trying to interface with them. That isn’t the way we roll. But I do think that they’re, it’s a cautionary note about the amount of power they,

00:26:06 [Speaker Changed] That they have. They become the 800 pound gorilla in the space. Is that what’s happened?

00:26:08 [Speaker Changed] No, no question. And you as an innovator has to have privileges to link into that system,

00:26:15 [Speaker Changed] Right? So, so they were the disruptor and now like Apple was the disruptor and now they become the, the dominant player. So that’s why there’s some, some challenges. I I, I was kind of shocked when I saw the chatter about antitrust because literally it’s the first app that just works as a, as a patient, wait, I could do all these things, prescriptions, appointments, I could see X-rays, whatever. Wow. Nothing else has ever worked this well. They always send you to a website which opens up a different site. Like it, nothing really felt secure. This really does feel like a secure app. So, so does that create opportunities for other companies to come in and be in disrupt disruptors, or are are they sort of blocking the, the entranceway to new startups that want to compete in that same space? Right.

00:27:08 [Speaker Changed] Well, I think, you know, and let’s define the space, right? That is just for providers and hospital systems specifically. Not independent providers there. But you think about the way we think about healthcare in general, what we do in tech enabled software and solutions is we are, we’re treating pharma services, right? So pharma is a client, employers, payer employer market as a client and payers our clients beyond our customers of our companies, beyond just hospital systems. Actually the, this has been the hardest place to play. And where we’ve made the least number of investments, the fewest number of investments is in hospital systems because Epic owned it. And so it, you know, it’s been a sort of dangerous territory for a young innovator to go into. But there’s plenty of opportunity to have payer solutions to focus on provi, you know, creating companies that are value- based or focused on out, you know, how do we create better outcomes in Medicare, Medicaid, and commercial? That don’t mean that you’re competing in the hospital environment again, but back to gen ai, I think the reality is because of un the fact the power of our unstructured data, I think that there will be many more opportunities to be a disruptor in the hospital market. And I don’t think it’s certainly possible. My dream would be in a decade, 10 to 20 years that you wouldn’t, you wouldn’t need an epic because you, you would have the ability to integrate with all these solutions and using unstructured data across the hospital.

00:28:44 [Speaker Changed] So you guys aren’t necessarily an investor in hospital systems or hospitals, right? But when we look in the hospital space, there’s been a lot of private equity activity, there’s been a lot of consolidation, a ton of not-for-profit hospitals still carrying that moniker have been picked up by, for-profit private equity players. How do you look at the consolidation taking place in the hospital chain area? How does that affect how you think about software technology and, and integration?

00:29:16 [Speaker Changed] There will be more consolidation. It will mostly be done by not-for-profits. That is the vast majority of hospital systems now are part of not-for-profits, right? The private equity world, we consider ourselves venture capitalists or growth growth investors. Not pe but PE you know, has been, has bought several hospital systems, not all of it’s gone well, and I do feel there’s some backlash to that. You know, our goal is to reduce costs in healthcare and improve the patient experience. And you can’t really do that if you’re focused on owning hospitals. The reality is everything we wanna do is keep people out of hospitals. Like that’s the goal, right? Nobody wants to be in a hospital, nobody wants to die in a hospital. So everything that we wanna do is a better patient experience in the home. Right? Ambulatory surgery or in the home, outside of the hospital system.

00:30:15 And so that, that’s our goal and focus not being, not owning hospital systems. I will say I was on the board of HCA for a while, not as an investor, but an observer of the best hospital system in America. And if you think about that, that was a PE deal. It was done by a family, but multiple times, right? They went public, they went private, they went public again. And that is the best run hospital system in America as a for-profit. Really? Yes. That’s really the interesting run. The most efficient, great outcomes. The, and I, I think the way you’ve gotta look at this, not-for-profit hospital system, is that every, not-for- profit Hospital is a for-profit hospital because every decision is made by a for-profit doctor,

00:30:56 [Speaker Changed] Right? Somewhere along the line, someone is making a decision and obviously Yeah. That

00:31:01 [Speaker Changed] Impacts their income. Yeah. Right? So that you, there’s no such thing as a not-for-profit hospital in America. Truly.

00:31:08 [Speaker Changed] So, so what are the better known hospitals that HCA manages if, if I’m not familiar with HCA generally?

00:31:16 [Speaker Changed] Well, they’re gonna be brands, you know, there’s Baptist, there’s, they’re gonna be brands all over the country and they’re gonna be different in every market because they wanna be local. Right. You know, feel local. And so you wouldn’t necessarily know the brands. It’s gonna be Florida and it’s gonna be city by city and every hospital will have a different name.

00:31:33 [Speaker Changed] Like, I’ve been fortunate to not spend a whole lot of time in hospitals. Right. My experience at NYU Langone was kind of eyeopening. Well, first, you know, some, sometimes you get advice, Hey, go someplace that specializes in what you need. Yes. Yes. So they’ve seen every, every variant. Right. And even with that, I wasn’t prepared for what an amazing factory assembly line. And I mean that the most positive Yeah. Sense of it. It’s like, yeah, we do a million of these a day, whatever you have, it’s not a problem. We’ve seen, seen it, and it was true. They, they had it down to like, bing bang bing, you’re, you’re in and out. And it was really impressive to see. I’m just curious if that degree of competency, I think my whole copay for the whole experience was 50 bucks, which I guess just means my wife has good health insurance as a, probably as a New York teacher. But, but it was really impressive. I i is that specifically a function of one hospital or is that a broader management approach to the whole chain?

00:32:42 [Speaker Changed] New York does not allow for hospitals. Right, right. So you wouldn’t experience it in New York state.

00:32:49 [Speaker Changed] It did not feel like it was a not-for-profit. Yes. It, it felt like everything was structured to Yes. Get ’em in, get ’em out, move, move on to

00:32:57 [Speaker Changed] The next. No, we have, I’m, I’m New Yorkers are lucky in that they’ve got a somewhat competitive hospital environment and For sure and excellent care here. Right. So no, it’s not. And that’s, that is, I think if you sat in a boardroom of a, not-for-profit and a for-profit hospital, you’d be amazed how similar the conversations are. I

00:33:16 [Speaker Changed] Don’t doubt that. The same problems don’t doubt that. I don’t doubt that at all. How do you think about ha having sat on a board? How do you think about managing problem hospitals? I just got off the phone with a friend in Florida who jokingly said, you know, if you fall and break your leg in Florida, you don’t call an ambulance. You call a cab, you call an Uber to take you to the airport to fly up to New York. I think he was exaggerating a little bit, but that’s not the first time I’ve heard things

00:33:44 [Speaker Changed] Like that. I hear over and over again, people come take, you know, I’m from Connecticut and people come back to Connecticut, all that. They do their healthcare, they that here, Connecticut, maybe their or Northeast could be their second home. And maybe they’re domiciled now in Florida, but they come back for the hospital, the healthcare system.

00:34:01 [Speaker Changed] How does a system that has that sort of reputation, how do they address that? It, it seems like, oh, in Florida

00:34:07 [Speaker Changed] You,

00:34:08 [Speaker Changed] You would think that they have lots of people who were older. They do, they should be really good

00:34:13 [Speaker Changed] At this. They should be really good.

00:34:16 [Speaker Changed] It’s a, it’s just a, you know, it’s just a, I’m just musing, but it just seems like I mentioned to somebody, I was speaking to you and they’re like, find out why Florida hospitals are not good. Like, I don’t think she invests in hospitals,

00:34:30 [Speaker Changed] But, well I, you know, and I think there’s, there’s just a long history, frankly, of doctors going to ho to Florida to, there’s been a culture of like making money there, you know? And the more specialists you have, the more it’s, it’s amazing. The more specialists you have, more surgeries, the more things to get done. Right. And so I just don’t think they have the same tradition of quality that other states have had or their Northeast has had. So I can’t, obviously they’re good HCA hospitals in Florida, but for some reason the whole ethos there has not been the same in general.

00:35:05 [Speaker Changed] So I’m kind of intrigued by a couple of things you’ve said about wanting to improve outcomes, reduce costs, and enhance experiences. And you talk about five levers of change that the fund looks at. And, and, and let’s go through all of these. Access, outcome, cost, speed and friction. That, that sounds like everybody’s combined headache in healthcare. Right? Tell us a little bit about those five levers.

00:35:39 [Speaker Changed] Well, access, I think we all learned a lot about that during covid. I, right, there is, there is differential access and it’s not just minority or city based. Obviously rural, the rural environment is very challenging, right? A little

00:35:53 [Speaker Changed] Bit of a healthcare desert in some places

00:35:54 [Speaker Changed] It’s healthcare desert. You’ve got pharmacies closing, you have hospitals that are a year and a, you know, an hour and a half away from people. You have challenged hospital systems, I would say in suburbia and, and urban environments. Hospitals are actually doing quite well in making fair amount of money, but in rural, far more challenged. So that, that is something that we’re actually addressing in one of our companies called Main Street, which is focused on, it’s a Oak Street, maybe Village MD for the rural environment, but with a different business model. And the point is for them to actually own everything in those environments except for acute care hospital and try to keep people as much as possible outta the hospital, but provide a broader set of care opportunities to those in rural environments.

00:36:46 [Speaker Changed] So I, I have a vivid recollection of a television show called Northern Exposure. They wanted more doctors in Alaska. So the state of Alaska would pay for your medical school, but you had agree to practice there for five years. It seems amazing that in the United States in 2024, there are healthcare deserts. Why haven’t states, and I know this is not your expertise, but it seems like states should have addressed this a long time ago. How is it possible in a modern era you could be two hours away from an emergency room? It it’s unthinkable, at least in the Tri-state area. It’s hard to imagine. Yeah,

00:37:24 [Speaker Changed] No, I agree. I the fact that they should be in setting primary care, paying for people’s medical school that will go into primary care and go to rural markets. And there are some that are doing that. I think about virtualization though, because of one of the aspects of a Main Street or some other models we have Care Bridge is that virtual care and wraparound care, so much of this actually can be done virtually. You can have specialists in a network that don’t, you know, on call, your best oncologist from MSK in New York City can be advising people in rural environments. Right.

00:37:56 [Speaker Changed] Memorial Sloan Kettering you’re

00:37:57 [Speaker Changed] Referring to. Yes. Memorial Sloan Kettering. Exactly.

00:37:59 [Speaker Changed] So, so what’s the difference between virtual and wraparound? How, how do they differ?

00:38:03 [Speaker Changed] Well, I think wraparound may mean that you have a connectivity locally, plus you have virtual care that extends what is available locally. But wraparound could be, you have, in Cambridge’s case, you’re, you’re managing what we call dual eligibles, which are those who have Medicaid and Medicare. They’re the sickest of the sick that are in long-term services, home-based services. So they’re in the home generally. They’re sick enough to have a caregiver and who’s either a family member or a caregiver who’s hired to help them out. And, and then you’re supplying, you know, nurses and ma and others that will, they get to know these patients, but all virtually. But they end up, you know, developing a relationship with the caregivers that have a, you know, we have an iPad in the home with a button, essentially you think, you know, like the 9 1 1 button where you hit the button as opposed to all of a sudden for every issue sending that patient to the emergency room.

00:39:02 Right. Which is wildly expensive. Right. And not constructive. ’cause often they get admitted and you know, and then all of a sudden you have a $30,000 expense. The reality is that button is going to a nurse that’s on, you know, on call or in a call center for a care bridge and or a main street that’s taking care of that individual and, and actually knows the long, knows the medical records has gotten developed, a relationship with the caregiver and the patient so they can walk through what are the issue Is this a mental health crisis, which is, you know, often is, or get ahead of some of the challenges of wound that gets taken care of as opposed to in the er, you know, by somebody going to the home or getting them to another facility. So these are the things that, it’s just like longitudinal care management of individuals and the chronically ill are those that end up in the hospital most often.

00:39:55 [Speaker Changed] And, and you mentioned Care Bridge, that’s a company. You, you have an investment in it, it seems so obvious. How do we get better outcomes and less expensive cost by intervening before they end up in an emergency room Again, how, how has this not taken place before? Is that, is that what Care Bridge’s core

00:40:14 [Speaker Changed] Business is? Yes. Yes. And yes. They, they manage the sickest of the sick chronically ill in the home that are in, that are dual eligibles. And that is what they do. They develop a relationship, they wrap around, but they, it’s all about, part of this is financial alignment. They have contracts with the health plans to take care of these individuals. They get paid, basically they have full responsibility for the cost of care for these individuals. So they’re highly incented to take good care of them, you know, the quality

00:40:40 [Speaker Changed] And preempt those emergency

00:40:41 [Speaker Changed] Rooms and preem, those emergencies. The rooms, the two most expensive things in healthcare are rising hospital costs, which are up like 20% this year. Right. And drug costs. So if you can manage drug compliance better, and most importantly, the easiest but not easy thing to do is to keep people out of the hospital appropriately. Nobody wants to be at a hospital. I mean, this is the thing, I I always, hospitals always talk about utilization management. You’re keeping people outta the hospital. Well that’s actually our job is do preventative care and keep people from using the most expensive resource in America.

00:41:16 [Speaker Changed] And, and I it’s always astonishing to, when you read, I think medical errors are the third most common cause of, of fatalities in the United States. That’s a stunning number. Right. And I guess why no one, none of us really wanna be in a hospital unless we,

00:41:32 [Speaker Changed] No, it’s dangerous to be in a hospital. You don’t want It’s dangerous. It is dangerous. Think about the infection rate, right. In a hospital. Right. Huh. Sort staff. And yes, it’s, it is actually dangerous to be in a hospital. So there better be a good reason to be there.

00:41:45 [Speaker Changed] So, so we talk about access, outcome, I’m kind of intrigued by the focus on cost, speed and friction. ’cause all three of those seem to apply to both healthcare and financial technology. Yes, absolutely. You mentioned they both live on old legacy systems. They’re not nearly as cutting edge as they should be. I is that how you ended up being both a healthcare and a FinTech investor?

00:42:10 [Speaker Changed] Certainly between insurance and payments and, you know, RevCycle, we thought it was in 2002 an obvious place to go. And having gone into biotech early and then tech enabled, you know, software using, you know, leveraging the internet in healthcare early, I just felt like payments and FinTech, I wanted to be early. Like that was an area you could just tell the tailwinds were there. And so we came in 2002 before anybody knew what FinTech was. And we were focused initially on the sort of prepaid underbanked market and

00:42:43 [Speaker Changed] Prepaid underbanked under

00:42:45 [Speaker Changed] Market. I got that under being 60. At that time, 60 million people in America did not have checking accounts or credit or debit cards. Amazing. Right. And think about what you can’t do. Okay. And you had the, had the advent of the internet. You couldn’t buy things online. You couldn’t reserve a hotel room, you couldn’t rent a car. Like all these things that change your life. So by investing in NetSpend, which is one of the first prepaid debit cards, people could actually do those things. They could buy online, they could reserve a hotel room, they could rent a car. I mean, these are game changing things to someone. So that was exciting because we were changing people’s lives and giving them access, you know, democratizing, you know, credit effectively.

00:43:30 [Speaker Changed] So, so it’s interesting you started in FinTech in 2002. ’cause I recall former Fed chairman Paul Volcker said only half in Jess. And I want to say it was 20 11, 20 12, you know, what innovation is there in the financial space other than the ATM? Nothing’s happened. And it seems like that really isn’t true. There’s been a ton of innovation in the financial space. Te tell us some of the other FinTech investments you’ve made

00:44:02 [Speaker Changed] More recently and fraud. Just think about fraud as being an area of constant, constant battle. Constant constant battle. Right? Arms race. It is an arms race. And well, even more so when you think about what happened was in the payments world, you had card present, right? You’re, you’re swiping at the p the point of sale. And then we had the internet come along and they get virtualization of payments then fraud exploded from, right? And now with, you know, gen AI and obviously deep fakes, you have person not present. So you’ve got a whole different level of fraud that is being experienced right now. Right. Where somebody’s mimicking your voice for a call. Right?

00:44:44 [Speaker Changed] Ju literally just had this conversation yesterday with my head of compliance. It was a, I don’t remember if it was Gizmoto or one of those sites that talks about the fake calls you’re getting supposedly from Google, who will never really call you, assume any phone call you’re getting right. Is a fake. But the AI agent on the other side sounds so realistic. Always ask them to sing a song. And, and that was, that was the solution. An AI app will sing it until, or whatever silly thing you ask, right. But it just seems like the ability to impersonate people is just getting better and better. Who’s gonna win this arms race? Yeah.

00:45:30 [Speaker Changed] Well I think it’s just gonna be a continual battle of, they’ll create new ways to, to implement fraud and then we’ll create solutions against that fraud. And so it is, I think we’ll be a perpetual and continual battle. We have companies like Feed Eye and prove that are, you know, focused on that area. And it could be

00:45:50 [Speaker Changed] Feed Eye focuses on risk management and and combating fraud.

00:45:55 [Speaker Changed] Combating fraud for Yes. And prove is that, you know, when you get the, the pin and you’re, you’re putting, you’re doing sort of double authentication. They’re the ones that are integrated in the operating system of phones and effectively are giving you that number, that pin when you’re typing in that second number to authorize a transaction. So, so we have a number of companies, probably seven or eight in that space. Other companies that do, if you think about the Amer America and where we are here in terms of credit payments, think of it, LA latam is two decades behind us. And so we are seeing a number of opportunities in FinTech and Latin America,

00:46:40 [Speaker Changed] Two decades behind.

00:46:41 [Speaker Changed] Yeah. Two decades behind, which actually will probably be an advantage. And they will leapfrog us because they don’t have these,

00:46:47 [Speaker Changed] They’ll start from scratch.

00:46:48 [Speaker Changed] They’ll start from scratch and, and scratch. And if you look at Brazil, they’ve created something called picks, which they built for $2 million, which is amazing by their central bank. And it’s real time payments and effectively it’s a protocol and effectively allows bank to bank authentication. So if you think about a CH and your cash account to somebody else’s ca it is incredibly complicated in the US to do an a CH transfer your bank account to another bank account. Right. There’s this takes, you know, forever

00:47:20 [Speaker Changed] I, I, I wanted to address that. I grabbed my phone and I’m opening the folder with the FinTech apps on it. So Venmo is the easiest thing in the world to use, right. Just to send money to someone else. Right. But I did something in South America in Columbia, I had an old truck rebuilt in Columbia and I was using Remitly and World Remit to send, as long as it was less than $10,000 at a time internationally, it was like click, click, click, done. Right. Right. That was an unthinkable nightmare. I don’t know, five years ago, 10 years ago. I’m, I’m looking at the TD and the Schwab app, I’m looking at the chase. I I mean just the amount of things you could do on your phone. So it a, it feels like the innovation certainly has,

00:48:12 [Speaker Changed] The innovation from the consumer experience is there. It’s ironic though because if you think about Venmo, everything runs on on the credit card rails right now. Right? That’s right. I mean that’s actually what’s happening on the visa rails, the MasterCard rails or mx. Then the reality

00:48:25 [Speaker Changed] Is, is that because that’s so secure

00:48:27 [Speaker Changed] Or well it secure and it exists. Right. And it’s easy. Yeah. So I mean, think about Apple, right? They run on, you’re, you’re putting your credit card in for Apple Pay, right?

00:48:35 [Speaker Changed] You’re time putting your debit card in for take the subway Apple Pay every time I just drop the phone on it. And that’s right. If that goes right through the, the credit card. So

00:48:41 [Speaker Changed] That’s, if you think about lat, that’s an expensive option. Yeah. And so what they’ve done in LAT is created a pretty friction free visa like rails, but cheaper, very cheap, like cents, pennies, like virtually no cost. So that is then that is probably taken like 40% of credit card and debit card transactions.

00:49:04 [Speaker Changed] Really? Yeah. And, and wasn’t there a couple of things done over cell phones in, in parts of Africa where Yes, they didn’t have a credit card system and just, you know, necessity being the mother invention came up with some things. So my question is are, are all of these various things secure or you know, what is the challenge building the next generation? What’s gonna replace,

00:49:29 [Speaker Changed] Yeah, I

00:49:29 [Speaker Changed] Think it will, will anything replace credit cards?

00:49:32 [Speaker Changed] Well, I think realtime payments will replace credit cards, but you are gonna build costs on top of it. Because if you’re talking about large B2B payments, right? You’re still gonna be talking about something that need and even larger B2C payments, right? There is more fraud capability that needs an identity authentication capabilities that need to be built on top of it. There will be great opportunities for companies to, for us to invest in that will create B2B opportunities on top of picks and on top of other infrastructures that are being built in latam or India or, or Africa.

00:50:06 [Speaker Changed] Huh. Really, really kind of fascinating. So given these two areas that you focus on and the track record you guys have put up, I, I just wanted to mention again, you were named one of the top 10 venture firms of, of 2024 and a, a number of other accolades last year. How does this affect the deal flow you see in the companies you look at, do you have your own space and and that’s what you drill into? Or are, are you guys a little broader thinking about a, a variety of different types of companies.

00:50:43 [Speaker Changed] We, for example, we are FinTech very broadly. That is e-commerce infrastructure. It’s, you know, it’s fraud and identity. It is payments, it is general infrastructure. So it’s fairly broad in terms of how we look at it. I think the, as we think about opportunity in the sector, think of us as starting things or backing an entrepreneur who has started something. ’cause we have a whole thematic approach to an area. And I’ll, I’ll talk about something we just did all the way up to a classic a, b, C round, right? And, and we’ll even do an occasional buyout or two where we think there’s huge growth opportunities if we invest in the tech portion of it. So something we did recently, I think is, is emblematic of, of what we’re doing more lately with the 2 billion, our most recent fund was 2 billion. And we backed the individual, Dave Clark out of Amazon, who built the, for 22 years, built all the supply and logistics chain at Amazon and he brought his chief scientific officer and a number of people from Amazon and others who that he’s worked with.

00:51:58 And I think when we announced this company, 1200 people that day submitted resumes. Wow. To them it was, it was extraordinary. It speaks to his reputation. And the idea is that we will build Gen a, a gen AI software, native AI software platform that will incorporate some of the supply chain software boutique, best of breed software systems that are out there that constitute the supply chain. Because if you are an Amazon or someone else, you’re working with 20 different vendors to complete your supply chain. And the reality is you really want that integrated in one infrastructure. And so their plan is to basically build a supply chain infrastructure

00:52:41 [Speaker Changed] End to end one company

00:52:42 [Speaker Changed] From, and

00:52:43 [Speaker Changed] Software from when it leaves this place to, it ends up that place and all the quantitative metrics and tracking and everything that goes with it. Huh. Really, really

00:52:52 [Speaker Changed] Interesting. And so we committed a hundred million to that. Oh,

00:52:54 [Speaker Changed] No kidding? Yeah. Oh, so that’s you, you’re pretty, that sounds like a pretty big bet. Yeah,

00:52:59 [Speaker Changed] We’re all in. But yes, we’re doing more of the a hundred million plus investments, 70 million investments. ’cause we want concentrated bets in the areas that are most exciting to us with the best entrepreneurs.

00:53:11 [Speaker Changed] So I only have you for another 10 or 15 minutes And, and before I get to my favorite questions, I ask all of my guests, I gotta throw a curve ball at you. Okay. Which is, you know, normally at this point in a conversation with a, a vc we talk about you’ve had 70 exits and 15 IPOs and, but you are also the first lady of Connecticut. You’re married to Ned Lamont, the governor of Connecticut. Kind of an unusual role for First ladies being a vc. Tell us how you juggle these two roles. It’s, it’s, you are the first VC I’ve spoken to who’s also in a state house.

00:53:54 [Speaker Changed] Right. It is unusual. The great news is that there is no expectation for the first lady of Connecticut either. There is no established role. And so I’m really just a partner to my husband as I would be in terms of just their support and guidance. But I do campaign with him. I go on weekend, you know, on weekends we, we do things together. But he’s very much running the state of Connecticut. Well, I am doing my thing, you know, during the week and then we come together in Connecticut and Greenwich during the weekend. But it’s been, I mean, it’s fascinating. He loves the job. It’s, I, you know, I’m biased, but I think he’s done a great job for Connecticut as a businessman himself, but somebody who has a, you know, his social conscience. So it’s been fun to watch ’cause he does love the job and

00:54:48 [Speaker Changed] Huh, really, really interesting. All right, let’s jump to our favorite questions that we ask all our guests. Starting with, since, since you mentioned you like to spend the weekends with your, your husband, the governor. What do you guys do on the weekends? What, what are you watching listening? What’s keeping you entertained? Right.

00:55:06 [Speaker Changed] What’s keeping Yukon basketball? I can’t wait to have it back. So women and men are gonna be amazing this year. So, and they, I have been obviously the, the men have won two years in a row.

00:55:17 [Speaker Changed] Huskies have a great team. They’ve been, they’ve been winning for a long time. Amazing. And the women’s team has done really well also the

00:55:24 [Speaker Changed] Past few years. Gino is incredible. I mean, the fact that they had five injured players and, and got into the, basically the final four was incredible. So between Gino Orama and Dan Hurley, two of the best coaches in the country. So that’s been super fun. We go to games and we, and we watch on weekends, but we’re, we’re, I don’t know, I don’t know if I’m an athlete, but I love sports and we love sports. We play golf and tennis and hike and it’s being out ski and being outside as much as possible. And he watches and you know, he’s been a long suffering Jets fan. We’re hoping the Jets are back. And I happen to be a Packers fan being from Wisconsin. So we

00:56:02 [Speaker Changed] Really Interesting. Tell us about your early mentors who helped shape your career. Yeah,

00:56:08 [Speaker Changed] There was an individual, Jerry Gallagher, I’m from Wisconsin. He was from Minnesota and he ran for a prior firm. He ran the retail investing and was a brilliant investor. I mean, he was somebody at Donaldson de l and Jen Ret in the early days. He was the retail analyst and he actually invented the same store sales metric.

00:56:32 [Speaker Changed] Oh, no kidding.

00:56:33 [Speaker Changed] If you can imagine, people were just saying, oh, that company’s growing a hundred percent a year. They didn’t know if they’d added a hundred stores, you know, double the number stores. But yeah, so he actually invented that. He joined us and invested in, well it was a filings basement, whole Foods, Amazon, I Whole Foods, which we sold Amazon, Dick’s Sporting Goods, office Depot. It was just a PF Chang, Jamba Juice, I mean just a unbelievable track record, the best retail investor in the country. And he taught me a ton. So he was the first person when I was 27 years of age who said to me, you’re focused on the idea. You’re not focused on the CEO enough. You’re not focused on the people. Like you have got to raise your bar on CEOs. And, and of course it’s of course it’s, I mean it’s so obvious it’s all about the people, but I think people, you do get enamored with trends, secular trends and ideas.

00:57:31 And ultimately it’s, it was the most important advice anybody ever gave me because it’s, it’s all about the CEO at the end of the day and the team they can attract and how they treat people. It’s, and, and I think it was very much golden rule. You know, he was, some might have considered Jerry Old Fashioned but the reality is that that old fashioned message just cycles back and every crazy cycle we have with entrepreneurs, and that is, you know, just obviously do the right thing and, you know, and treat people like you’d like to be treated and be kind, and yet, you know, be, be direct and be tough.

00:58:04 [Speaker Changed] I, I don’t remember which VC it was that said the same thing that you just said about backing the, the team and the, the entrepreneur, not the idea, but to drive the point home. Hey, each of these companies that have had a successful exit, they’ve pivoted five times. And however it works out. Right? It’s never the initial idea. Right. It’s always the person. And I never really thought about that until

00:58:30 [Speaker Changed] A hundred percent Right. It,

00:58:31 [Speaker Changed] It, it’s, if if you’re betting on the idea, you’re, you’re three iterations away from where it’s gonna end up. Right?

00:58:38 [Speaker Changed] Yeah. And the, and the general idea and secular trend may be right, but actually the business model’s wrong. So getting the business model is so right is, is so critical.

00:58:49 [Speaker Changed] Hmm. Really, really interesting. Let’s talk about books. What are some of your favorites? What, what are you reading right now?

00:58:56 [Speaker Changed] Well, original favorite was To Kill a Mockingbird. And I would say that that like influenced my sense of social justice. And then it’s probably the Robert Massey books. And, you know, I’ve never been to Russia, but I’ve been fascinated by, you know, Peter, the Great Nicholas and Alexandra Catherine the great. I mean, one, it, it’s, so, if you look at what’s going on in Russia now, same exact, like you understand cultures, right? I mean, it’s sort of like understanding history and cult. They don’t, it doesn’t change that much, right? I mean, it is a, it is a, that is a country that understands suffering and likes autocrats, basically, you know, and

00:59:32 [Speaker Changed] Strong leaders. Seems not a coincidence. Right?

00:59:34 [Speaker Changed] Yeah, yeah. Yeah. Not a coincidence. So, yeah. And then recently the Money Trap written by a friend of mine, Aoke Soma is a fascinating book. He was the head of SoftBank during the crazy period that in North America. Oh, really? Yeah. And he actually had never written a book. He went to the creative writing program, got his visa, and was able to stay in America, went to the creative writing program in New York City and, and wrote this book, and it’s absolutely beautifully written and it’s fascinating. So I I highly recommend

01:00:04 [Speaker Changed] It. Money Trap. I’m gonna, I’m gonna put that on my list. Yeah. If, if you’re, you mentioned books about Russian. I know you’re talking more historically if you haven’t read, read Notice by Bill

01:00:16 [Speaker Changed] Brower. I did. I I know Bill and yes, I read it.
01:00:18 [Speaker Changed] Oh, you do? Yeah. Astonishing.

01:00:20 [Speaker Changed] Unbelievable. Yeah.

01:00:21 [Speaker Changed] It, it, it’s, it reads like it’s fiction and it’s such a page turner. Yeah. All right. Our final two questions. What sort of advice would you give a recent college grad interested in a career in either venture investing, healthcare, FinTech? What would, would you, how would you advise them?

01:00:41 [Speaker Changed] They have to go work inside companies, and they should go work in a startup in an early stage company and maybe mid stage, and definitely a larger legacy company because they need to understand business. I mean, when I read the New York Times business section now, I think these people have never been in business. And I, and obviously Bloomberg specializes in it, right? And so has a lot of reporters that deeply understand it and respect it. But I think that you can’t write about something you don’t, haven’t actually lived at all and truly understand what is, they’re obviously things that are very flawed in business, and it’s often, particularly in the early stage, extremely chaotic. But it is what drives our economy, which provides jobs for people and employs people and allows them to pay their bills and support all our great social programs. So it’s important to understand.

01:01:36 [Speaker Changed] And our final question, what do you know about the world of investing today? You wish you knew back in the 1980s when you were first getting started?

01:01:44 [Speaker Changed] It’s an interesting question because I, you know, and maybe because I have a Teflon memory, but I feel like I only remember the good things. I think, you know, knowing that large secular changes are the most important thing that drive investment waves and Right. And, and ultimately build great companies, just focusing on those. But I feel like I ended up actually doing that. Well, you know, picking the secular wave that made sense and getting ahead of it, but not too far ahead of it. I was

01:02:16 [Speaker Changed] Gonna say you did that well, but you were, you were also early in a lot of big secular trends.

01:02:21 [Speaker Changed] Yeah. So I would say, I I, that ended up working out well, you can’t be too, being too early is the killer, right? Right. In investing. So that worked out well. But I, I would say I, you know, in general, I don’t sweat the small stuff, you know, get the large things right and the rest of it will take care of itself. So I I, I would only caution those that are starting out now in the investing world, or frankly in any career, to just you, you all those things that seem so important that are so small during the day. Like, just remember that, you know, think about yourself 40 years from now. Like what’s gonna matter? What will have mattered to you? What will have mattered to your success? And just focus on those things. And don’t focus on all of the petty small things that have may gone wrong or the people around you, you know, and then otherwise, just like stay away from toxic people and make sure you carefully work with people you love and respect. And I think in general, I’ve done that, but I think there are times where I would’ve walked away. I would’ve started K-H-C-F-T so much sooner, and that would be like the one change in my career that I would’ve made. Huh. Really

01:03:30 [Speaker Changed] Interesting. Thank you, Annie, for being so generous with your time. We have been speaking with Annie Lamont, co-founder and managing partner at Oak, HCFT. If you enjoy this conversation, well be sure and look up any of the previous 500 discussions we’ve had over the past 10 plus years. You can find those at Bloomberg, iTunes, Spotify, YouTube, wherever you find your favorite podcasts. And be sure and check out my new short form podcast at the Money Conversations with experts about your money, earning it, spending it, and most importantly, investing it at the money in the Masters in Business Feed, or wherever you find your favorite podcasts. I would be remiss if I did not thank the crack team that helps me put these conversations together each week. Anna Luke is my producer, Sean Russo is my head of research. Steve Gonzalez is my audio engineer. Sage Bauman is the head of all podcasts at Bloomberg. I’m Barry Riol. You’ve been listening to Masters in Business on Bloomberg Radio.

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