DISCLAIMER: Today’s Advertiser helped make the production and delivery of this episode possible, for free, to you! But the themes expressed by the guests do not necessarily reflect the views of Inside Reproductive Health, nor of the Advertiser. The Advertiser does not have editorial control over the content of this episode, and the guest’s appearance is not an endorsement of the Advertiser.
The first 100 days are often the litmus test of leadership, and this week’s guest rose to the occasion.
Francisco Lobbosco, CEO of FutureLife, spent the first 100 days of his tenure hopping country to country, clinic to clinic, clinician to clinician while asking one set of questions. What he learned from his listening has created the blueprint for the future of FutureLife.
Tune in to hear Francisco reveal:
The questions he used to create his growth strategy.
How his first 100 days inspired FutureLife’s current mandate.
FutureLife’s 4-Pillars driving the company forward.
A clinic’s sweet spot for FutureLife acquisition [And the KPI’s they look for]
His philosophy on Quartile Growth
Some of the solutions FutureLife is implementing [Including a new CRM]
FutureLife’s growth trajectory [And if they’re expanding beyond the European continent in 2024]
Francisco Lobbosco
LinkedIn
Transcript
[00:00:00] Francisco Lobbosco: I took my first a hundred days to just go around and listen. But after that, I went through probably the key opinion, all the key opinion leaders that we have in the business in all 10 countries, and I started proposing changes. And to my surprise, they said yes to all of it. I think it's a matter of communication.
I think it's a matter of explaining what would happen if we were to do things differently. And most importantly, it's a matter of making sure that you don't mess up with the medical freedom that they have.
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Announcer: Today's advertiser helped make the production and delivery of this episode possible for free to you. But the themes expressed by the guests do not necessarily reflect the views of Inside Reproductive Health nor of the advertiser. The advertiser does not have editorial control over the content of this episode and the guest's appearance is not an endorsement of the advertiser.
[00:01:32] Griffin Jones: 45 clinics, 1500 employees, 450 physicians, according to their website, and he may have said 250 FTE docs, 55, 000 IVF cycles amounting to the second largest fertility clinic network on the continent of Europe. At least with regard to number of locations. That's according to our guest, the person that has found himself at the helm of this network.
The organization is Future Life. The CEO is Francisco Lobbosco. At time of recording, Francisco has been in his post for the last six months. He spent the first three and a half. Going from team to team, doc to doc, country to country, office to office, asking one set of questions. He tells us what those questions were.
He tells us the mandate that future life has come up with since those 100 days. He says he didn't propose any changes within those first 100 days, and since, all the changes that he proposed have been accepted. tried to dig into what those were and he tells us about future life's four strategic pillars.
Medical excellence, patients, associates, who we on this side of the pond would not just consider associate physicians, but associate physicians, partner physicians, embryologists, lab directors, all staff. All employees. Finally, growth. Francisco shares what puts a clinic in the sweet spot for future life to want to acquire.
He talks about which KPIs they're measuring, including but not limited to, take home baby rate, net promoter score, employee net promoter score. Francisco says that he's systems agnostic, but coding obsessed. I said, I don't know, man, we'll see how long that goes. They have seven EMRs. So I press him a little bit on that.
Are you really going to be able to keep seven EMRs? You're going to go down to one. What's that going to be like? What's your philosophy on that? And he shares his response. He shares his philosophy on quartile growth, which clinics and providers you focus on the bell curve. Francisco shares some of the solutions they're implementing now, including a new CRM, who that is and who they vetted from 17 options.
Will this be the promised child CRM? I don't know. I've been hurt before. And then I asked Francisco to conclude on trajectory of growth for future life. Are we going to see future life expand beyond. the European continent in 2024. Please enjoy all of these answers and more with Francisco Lobbosco, CEO of FutureLife.
Mr. Lobbosco, Francisco, welcome to the Inside Reproductive Health podcast.
[00:03:46] Francisco Lobbosco: Thank you, Griffin. It's a pleasure to be here today.
[00:03:48] Griffin Jones: It took me 200 some episodes, but I finally have the CEO of a European network. We've had Canada. India, the United States, the UK, but never mainland Europe. And you are our first, thank you for obliging us as we continue to grow the global audience.
[00:04:07] Francisco Lobbosco: My pleasure. I'll try to represent Europe in the best possible way.
[00:04:10] Griffin Jones: I hope so. You're the CEO of Future Life. That's been your job for the last six months as of this recording. And tell us a little bit about Future Life. Is it, in the, as far as the. network sizes of Europe, where do you all rank in terms of volume, in terms of doctor size, and maybe just a little bit of, background and I'll cover the rest of the background in the intro.
[00:04:35] Francisco Lobbosco: Yeah, sure. So we have 45 clinics, we're present in 10 countries. We are ranking number two in Europe in terms of locations. We do 55, 000 cycles a year, 2, 300 associates from which 350 are MDs, medical doctors, that's head count. 250 full time equivalents that could be, and we are very, proud to say that we are part of, helping this world, receiving a new baby every 45 minutes.
So that is probably our, best stat yet.
[00:05:08] Griffin Jones: You came from outside of the field. Tell us about how you found yourself in this post.
[00:05:15] Francisco Lobbosco: So yes, so before, before coming here, I was in veterinary health and I was approached by a headhunter and I, do have a personal past connection with IBF and when, they call me and they started sharing this material, read material about the industry and the company, we at home together with Margot, my wife, we felt so passionate about it and they share, I think in total 500 pages.
And, we went through it, I think it took us two night and it became a topic of discussion on my wife is a marketeer and the journey and how many touch points do we have and is this a place where you would harmonize or not having 10 countries, it was a very good interview process and the funny thing about that interview process is that it was slightly different.
Because one of the shareholders invited me here to Prague, where I am today, where we have the head office, and instead of coming straight to the office, we stop up the Prague castle, which if you've never been in Prague, it's a beautiful, it's a beautiful scene, and we start walking towards the office, and that's a good 40, 45 minutes walk.
Through the, old Prague is fascinating. So I was already, fascinated about the scenery and then I arrived to the clinic and this is my first clinic visit ever. And, I go into the lab and I make a million questions around the way, but when I got into the laboratory, that's where I saw magic happening.
And I was just in time to see on the big screen an X ray process being carried out by one of our great embryologists. And I look at him as a. I, this is fascinating. What you guys are creating here, life is just fascinating. So I felt quite strong already in my first interview. And after, I think it was in total of nine interviews, I was lucky enough to be offered the job and I'm very pleased where I am today.
[00:07:13] Griffin Jones: What was in those 500 pages? Was it a sales pitch to you to come and be recruited? Was it their pro forma? Was it a mix of things? What was in those contents? It
[00:07:26] Francisco Lobbosco: was the BBs from past acquisitions. So Future Life is owned by main two shareholders, Hartenberg and CBC Capital Partners. And CBC entered last year or at the end of 2020, but I think they finalized the transaction in 22.
And therefore there was a lot of quite recent data for me to go through. And it was quite good really.
[00:07:49] Griffin Jones: What made it attractive as a business person, as a business leader that. said you could have gone to a few different companies and maybe been in the one, two or three spot, but you had this offer and you're looking at their history.
What made it attractive to you to where, what did you look at specifically and say, this is something that I can really be a part of?
[00:08:14] Francisco Lobbosco: A couple of things, but I will start with the most important one. as you just said, I had the opportunity working across. Different businesses, different industries, great companies, great experiences.
But none of them have the strong sense of purpose that future life has. And of course, this is not just exclusive to us here in future life. Of course, this is across every single clinic within the fertility space and every single person working at an IVF clinic. And I'm probably, you've been quite a long time in this space.
But Hey, let me remind you and everyone who've been part of this for a longer period of time. We are so lucky to be working where we are already. We are able to spend our days working on something that is truly amazing. Something that makes a huge difference to the world, really. And our job is to bring smiles to people's faces, to make their dreams come true.
And there is nothing more powerful than that.
[00:09:13] Griffin Jones: How about from a business perspective in terms of what growth potential did you see? What role, what did you see yourself being able to add?
[00:09:24] Francisco Lobbosco: it's a very good question. So here at Future Life we're quite lucky because the clinics that Hartenberg at the beginning and then CVC together with Hartenberg have been acquiring over the past years are very good clinics.
And I'm sure you will come to, what challenges do you face? this is one of them. The clinics are quite good. the medical outcomes are very strong. Financially, they are very successful. Wherever I went before, you always had a car crash, right? Something to turn around. In this particular case, when my 45, the worst thing I had is a single bidget.
it's fantastic financially speaking, so it's very difficult to come with new ideas when something's been working for such a long time, right? And let's not forget that you have the founders of the clinics, which are still present in most cases in our clinics, 99 percent of the cases. So engaging with them on saying, listen, I know what, brought you here over the last 20, 25 years is being great.
But what if we were to do things slightly different so as to maintain that medical side of the business, which, I believe in medical firm, but to give it a different tone to professionalize certain areas of the business, of the support centers, of the functions that are supporting you guys to deliver that highest quality of care possible, and there is, there are opportunities.
Outside Griffin, there are opportunities in the marketing area. There are opportunities on how we connect with our patients. we have, and we still have incredibly good, very strong, isolated clinics. we started last year to generate a community of clinics within FutureLive, but we are far away from where we want to be in the future.
And I think the synergies that 45 clinics can create, that's the goal in here. And from a business perspective. That's where really you can quantify the possibilities.
[00:11:17] Griffin Jones: It's interesting that sometimes the fact that it isn't a car crash on the PNL in many cases, in my view, is part of the reason why parts of the field haven't advanced that much because I said, why would I, our patients are getting pregnant or at least enough of them are, and we're doing great.
And lousiest social media presence or office space, or even if we are. Using paper and EMRs, we still have people coming out of the woodwork, offering us X multiple of EBITDA. We're still taking plenty of money home. We still have lots of people telling us that they love us. and I feel that's been the reason why the venture capital.
Was probably 10 years later than it would have been like 10 years ago, there was no venture capital. There was private equity. I don't want to say there was none. There was very little venture capital. I've really only started to see venture capital in the fertility space, three, four years. And I feel like we would have seen that 10, 12 years ago, if there was just more of a.
of, impetus to scale. Do, what's your view having been in here six months? Are you starting to see, is there any external force that you see starting to cause people to change more or is that external force still going to take some time to build?
[00:12:41] Francisco Lobbosco: I think you just described it really well.
And I think partially the drivers about having a very strong financial performance are there in terms of stopping development. However, I must say that I was personally very surprised. After my learning process, I took my first a hundred days to just go around and listen. But after that, I went through probably the key opinion, all the key opinion leaders that we have in the business in all 10 countries.
And I started proposing changes. And to my surprise, They said yes to all of it. I think it's a matter of communication. I think it's a matter of explaining what would happen if we were to do things differently and most importantly, it's a matter of making sure that you don't mess up with the medical freedom that they have.
And I'm very respectful of that. But when it comes to how can we improve at supporting the business from a finance, from a marketing, from an IT, from an HR perspective, I think there's a lot to improve there. Before we even get to the medical area from, a medical perspective, I have great advisor, so I don't need to get into that terrain.
[00:13:54] Griffin Jones: Did you propose any changes in those first 100 days?
[00:13:58] Francisco Lobbosco: Not in the first ones. no. So I am very respectful of. Coming into a new sector and so what I've done is I just went around, I visited every single clinic, I spent loads of hours talking to all our associates, not just the key opinion leaders in each of the clinics or the founders or the GMs, but I just, just wander around talking to.
Our embryologists, that's where I really enjoy spending my time if I visit a clinic in the lab. so talking to embryologists, learning, how they do things, talking to nurses, talking to the onboarding coordinators, even in the call center, I enjoy spending time because they want to know why they are calling us.
so I have a million questions on what I've done, which is something I always do. If I go around with my defined questionnaire and I just ask the question, the same question to different people within the same clinic. within different clinics, and then I go back and I ask the same question to the same person in different moments in time.
And what usually tend to happen is you get different answers and that helps you to make up your mind on assessing where the business is today and what do we think we need to do to improve the business and bring it to the next level.
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[00:16:16] Griffin Jones: I was hoping you were going to say you went in with a disguise like undercover boss with the glasses and the big fake plastic nose and the mustache underneath it. And see, you didn't undercover boss them. You went in and you had a questionnaire. What was on that questionnaire?
[00:16:32] Francisco Lobbosco: Why are you here? So that's my first question that I always ask when I go into a new place.
Why are you working here? So you usually start with, what's your name? What do you do? For how long have you been doing that? And why? Why are you with us for the last 10 years? Tell me what's different in this clinic versus the clinic next door. And to my surprise, our attrition rate is very, low. And people have, quite a lengthy period of time with us.
And therefore I'm fascinated to know, why do they stay? so that, that's my first question always, and you have so many different reasons. And that makes our job as a newly, my job as a new leader of a business slightly more difficult because you want to make sure you attach to the reasons that are keeping people happy and engaged and motivated.
But at the same time, you want to improve certain processes and SOPs and ways of working with an athlete. And therefore it's quite interesting when you ask the why are you here? It's never in this sector in particular, different to the prior businesses I worked for, perhaps. It's never about money, I'm still to get the answer saying they pay really well, which I think we do by the way, markets market rate.
But the point being is no one's here because of the money they're all here because of the patients and what they get to deliver for them, which is fascinating.
[00:17:54] Griffin Jones: Are you using that question to find out what processes can be changed or what you need to know before you change a process? So if you're finding out that, a number of people really like a specific person or, a really specific way of doing things that you take that into consideration when you're making a process change, or is that just to, is that for rapport building?
And then you start to get into more granular questions after that.
[00:18:23] Francisco Lobbosco: Yeah, but I don't take that question as the only question, to make up my mind. Of course, if someone tells me within a coordinator or the call center, right? So if I go into a call center and they have six people and I ask why you're here and everybody tells me my boss or the environment here is great.
I take that as a very good positive. So I try to learn what is that person doing to keep these people motivated and engaged and so on. But yes, the team, they usually gimme the team. The team is great. the team is great. and, then is, I get to help people and we are very, respectful about the quality of the service, the quality of the care that we provide.
So those are usually the two or three answers that I get. Within the very different versions of that.
[00:19:07] Griffin Jones: So that leads you after you 100 days to recommend changes and you said that they accepted all of the changes you proposed. What were they? So
[00:19:17] Francisco Lobbosco: listen, so I went on by having, let's say, one strong mandate.
Which was not imposed by anyone, but I could read it through my first a hundred days, future life from a medical perspective is very well positioned and our medical outcomes are it fantastic Francisco. Now, that don't touch that, right? So let's, make sure that whatever you don't mess up with the medical excellence that we're having in the business, because that is what describes us.
But then I went on and said, okay, so one of the things I'm asking is why are you here? And I'm getting different, views, all great views, all great answers. And especially when I go around clinics, the purpose is there. What I was missing was this little trick on asking the same question around support center and saying, why are you guys here?
And perhaps we were missing that, to verbalize the purpose, the mission, the vision, the values of importantly, the values of future life. So I went on and asked, why are we here? And then I went on and asked. What are we, setting ourselves to achieve? I, what our strategy is going to be in the next five years.
And then finally, how are we going to, just go through that strategy. So the why, the what and the how. So yeah. Quite simply after my a hundred days, the first thing I did is to grab, collect a number of associates across clinics, different roles, support center, different roles, and we set ourselves with support of a, of an agency to define the future life purpose.
Why is future life here? What's our vision of the world? What's our mission? And most importantly, what are our values? And obviously, we have clinics, as I said to you, that were quite independent, and they are still independent for many years, very successfully. And some of those clinics have strong statements in place.
And my purpose is not to, my mission is not to change those statements. But to have a united voice on future life and why is future life here to drive that core identity. So we've done that. And actually, I'm not sure when this podcast is going to go live, but I'm flying to Barcelona tomorrow to the first global leadership summit, where we're going to introduce those.
Those statements to everyone and to all our leaders in clinics and then obviously we're going to introduce the strategy and the strategy as you can imagine is something that together with my management team tapping into the medical advisory board tapping into some key opinion leaders from country we developed and we put on a paper and that strategy went through my supervisory board of course in june and that was approved and now we're going to introduce you introduce the strategy into the future life society again at the end of this week And then it's how we're going to go through that strategy and what is important for us to achieve.
And this question of why do we have a group? What is group going to do different than the clinics were doing until now independently? That's a very important question that needs answering quite fast. The synergies that we will have a group, those roles and responsibilities between, okay, clinics are doing this.
Fantastic. How can groups support the clinics on, being better at that, at that quality of care? How can we help the clinicians in particular, the EMTs, the embryologists, the nurses to have more time with patients instead of having, non value added activities or non value added time.
So that's the purpose of group. And that's what we're setting here to achieve through the how. And finally, would you say a finish? It's all about, as I said earlier, to keeping that medical excellence in place. And therefore we introduced literally two months ago, our medical advisory board to the CEO, which are 10 of our 10 of our great associates, medical doctors, embryologists.
And we get together once a month and they have three different topics in the agenda that they need to help us drive. so yeah, so I'll pause here for a minute because I think I gave you a lot there.
[00:23:19] Griffin Jones: Was there no medical advisory before, board before? Was every clinic just operating with their own medical director?
[00:23:28] Francisco Lobbosco: So there was a scientific advisory board before, which was great, but I think we were missing parts of what I'm expecting the medical advisory board to do. So when in the medical advisory board, you have three areas that we predefined. So scientific research, now it's part of the medical advisory board.
We have education that it was perhaps not tackled before. And then the third one is what I call the business drivers. And that could be procurement, could be total reward strategy for the business, could be M& A, could be no thanks, right?
[00:23:59] Griffin Jones: So you're involving them in the comprehensive growth strategy of the company.
Tell us what about what, does that strategy look like? You talked about some of the questions and I want to start asking those questions is to see what answers are in place thus far here. By the time this podcast episode comes out, you will have already shared that strategy with, you will have already released that strategy.
So it won't be news, but for the sake of. context of the conversation, tell us about what it, what is this strategy for the next year?
[00:24:33] Francisco Lobbosco: Yeah. So we have four main strategic pillars. So we have medical excellence, we have our associates, we have our patients and we have growth. So those are our four pillars. In addition to the four pillars, if you were to think about a house, the typical house that you see in business.
You'll have the foundations and for me, the foundations are to make sure that we have the right reporting timely and accurate, and let's make sure we go through to have the right digital tools in place, right? I think there was an episode a few weeks ago that you guys, published it was fantastic.
I certainly enjoy it, but for us is to start the journey on this digital transformation, what are the basic initiatives that we want to land across the whole of future life? So those are the foundations. From a financial reporting and from our digital infrastructure. And at the end of it, as an outcome of it, we'll have our financial performance.
Okay. So we want to make sure that we have a strong and predictable results over the years up to 2027, but that's the outcome. And I'm convinced, as I always say to my team, that if we were to have strong success rates or medical outcomes, as we currently have on a strong patient satisfaction, the financials will come.
That's a matter of time, but I've seen places where actually financials are really good and patient satisfaction is poor or the medical outcomes are poor and that in the long term will take a toll. So for me, it's incredibly important that we stick with those medical outcomes being very high and patient satisfaction being very high.
I gave you the four pillars. So again, medical excellence, patients, associates, and growth. And within each of the pillars, what you have is a strategy. So medical excellence, our strategy is quite simple. Enable a quality and patient safety culture focusing on improved outcomes. Every strategy has a goal and a way to measure the goal, and then we'll have building blocks within those strategy pillars, right?
So again, medical excellence, for example, you have quality leadership, transparency, learning, and safety culture, advanced data usage, and clinical standard and outcomes. And then at the end of it, what is going to be our 2024 corporate objective? Because we wanna set this five year roadmap, but with milestones that we are set to achieve over the upcoming, midterm, short term, midterm and long term.
so that's how we set the strategy.
[00:27:01] Griffin Jones: This might just be my own ignorance. Why is medical excellence its own pillar as opposed to it just being the. It being the result of the providers and patients pillars, I
[00:27:14] Francisco Lobbosco: think it needs attention by itself. I think obviously when we talk about associates, we're talking in general about our, I think this is where you're going.
So we talk about associates. We're talking about clinical associates in general. When we talk about patients, it's the outcome, it's how happy they are is by the outcome of the medical excellence. When we're talking about growth is organic growth and inorganic growth. And there are cross.
But one of the things that perhaps. We did not have Griffin and I think we were very lucky on the way we've been acquiring over the last couple of years is this minimum medical and minimum lab standards across future life. But whilst we go on and on in this journey of, inviting more clinics to be part of the future life family, we need to make sure we have those minimum standards ready because, high quality clinics.
It's great, but are we going to have the same number of high quality clinics in five times across Europe that we're going to, go on and pursue to join us? Maybe not. So let's make sure we set the minimum standards right now. And I want the medical pillar to be a reminder for us of what we're trying to achieve all day long, doesn't matter the size, it doesn't matter the financial outcomes that is a pillar, the medical outcomes are a pillar for us.
[00:28:31] Griffin Jones: And when you say associates, I want to make sure we're using the words correctly, because in the U. S., associate would mean an employed physician. It typically would not mean an embryologist or a lab director. It also would be different from a partner physician. in Europe, does associate refer to all clinicians and all scientists?
[00:28:52] Francisco Lobbosco: All employees, from a receptionist to, the chief medical officer, everyone is an associate, but it's just terminology.
[00:29:01] Griffin Jones: So then on the growth side, what do you plan to implement for the growth pillar? So you have a couple of things, right?
[00:29:09] Francisco Lobbosco: So you have. Organic growth and inorganic growth, and obviously from developments that we've seen lately, inorganic growth is very important.
So perhaps I should start there. We have a great team, a great MNA team that they go out and source and talk to the best clinics in Europe about future life. With my arrival, the first thing we did is we put minimum requirements of clinics that we want to pursue, right? We want to have a conversation with.
And those minimum requirements could be as simple as, size of the total clinic, number of medical doctors, the size of the lab and potential capacity for, number of cycles, success rates. So by setting the minimum requirements, then our M& A team actually had what we call clinics within the sweet spot.
and then we go on and proceed the discussion with them. So inorganic is incredibly important. And then of course you have organic, we have organic coming from, a couple of building blocks. Productivity, you'll have synergies and you'll have advanced data usage, which is linked to probably productivity.
so productivity for us is not to push more work to our doctors or our nurses or our embryologists, but to understand how can we help them to have more air time with our patients. What is it that they are doing that perhaps these non valued activities, can we reduce them? Can we help them to reduce them?
I think you were pointing out into paperless before, I think you were referring to that, that, that's one of the drivers, right? So how much time are you spending on daily basis on printing forms and filling them out and in that are not required by law because every country is Understanding how we can help our clinicians and productivity is incredibly important.
And then understanding how we can leverage the group synergies across all our clinics is also very important. And then data, when, I came here in April, we, didn't have a very automated way of getting data, frankly speaking. And I think the team have, done a great effort over the last six months.
And now we have daily. Insights that are reporting for every single clinic that we have operational marketing and medical data coming, in an automated way, accurate way to us that then we share back because that's the intention. So every member of clinic leadership teams will be able to see not only their numbers, their dashboards in ways that they haven't done until now, but also they will be able to see what the others are doing.
Because the intention here is to share best practice. So if I'm struggling in an area of my business and I see that clinic A is doing fantastically well, we are actually pushing clinic B to call clinic A to see what they are doing. So data, has been incredibly important, but also we have. One of the most modern in, in, in house, lab facilities here in Proud, and we want to benefit from it.
We have one of the strongest marketing teams that we are building as we are speaking. So we want to make sure that we provide support to the clinics from a marketing point of view. Education, I talked about it before. We have a meat bank, right? So we want to make sure that we, prioritize our future life clinics when it comes to the donor material and so on.
[00:32:27] Griffin Jones: I want to dig into a bunch of these. I'm deciding which one to go first into. Let's talk about the insights because you're getting operational marketing, medical data every day. What are some of those KPIs that you're looking at every day?
[00:32:40] Francisco Lobbosco: Yeah, very good question. So we started getting the data only a couple of weeks ago, and again, if you were to ask me about the challenges that I'm facing, these are challenges that I faced also in my prior positions where I went from having not much visibility and just reports that were manual into automated, and accurate reports.
And the risk with that, Griffin, is that you are overflowing the organization with data and KPIs and reports and so on. So it's just at the kick of a button distance for us to have loads of KPIs. So answering your question, I am a big fan, not us, us from many years ago to have a maximum of five things we really want to push.
So if you're a part of a leadership team, probably you're looking at the many, KPIs, which is great, but up to five is what you should push and reward for. and as you can imagine, deciding which five we're going to publish is quite an interesting discussion. And I'm quite open about the discussion and I want my executive team to have a say about it.
So we're actually looking into it, but of course, I'm not going to lie to you. So coming back to that strategy, right? So I talked to you about the four pillars and I talked about our digital journey, so most probably we will end up with at least one KPI for each of the pillars to be consistent with what we're saying that we want to achieve.
Now, if you want to dive into a particular pillar, of course, you will have loads of data, right? So I guess the first KPIs that come to mind, and again, with the caveat of this hasn't been decided yet with between me and my management team, NPS, patient related, take home baby rate, medical excellence related, EMPs, Associates related.
And then I had two more, one related to demand creation and one related to operational excellence. But those are still under discussion.
[00:34:42] Griffin Jones: So those acronyms for those listening, NPS is net promoter score. EMPS I'm guessing is employment engagement score. what does that stand for?
[00:34:53] Francisco Lobbosco: Yeah.
[00:34:54] Griffin Jones: Employee net Promoter score.
Oh, okay. Oh, ENP. Okay. Yeah. So you got your NPS for patients and your ENPS Got it. Correct. And, then you talked to, you told us that initially this data wasn't being gathered and, or at least wasn't automated. Maybe it was being gathered, maybe it was here or there, and Correct. It was gathered.
[00:35:12] Francisco Lobbosco: But in a manual basis. So now it's a lot easier to access that data and to make decisions based on the data. But as something new, you may get overwhelmed. but that's where we are today. And we're incredibly happy with what the team, as I said, have achieved over the last six months. And now is what we're going to do with that.
And, this is the fun part of it.
[00:35:32] Griffin Jones: What did you do to automate that data intake?
[00:35:38] Francisco Lobbosco: We made it a topic, we made it a recurrent daily topic. Of course, we hire an external consultant to help us with it. So we have a number of EMRs in this, in the business. We don't have a single EMR. We have a number of them.
[00:35:52] Griffin Jones: and, that sounds horrible. I've never met one person that likes their EMR. Yeah. I've met people that like their EMR better than other ones. And they like the people that make the EMR and because they do their best, but I've never met. someone that's this is 100 percent my favorite thing to use ever, and you have multiple EMRs.
is that going to be something that, stays over time? Or how do you get, how do you get multiple EMRs to equate into one source of truth?
[00:36:25] Francisco Lobbosco: Yeah, great timing for a great question because I just came this morning out of a management team meeting where we allocated 60 minutes to that discussion.
and listen, so one thing I learned years ago is that I am system agnostic. But I am coding obsessed. So if I can take the data in the right way out of an EMR and my medical doctors, nurses, embryologists, coordinators are happy with the system, but we can tap into it and generate these definitions, equal definitions in the cloud, and then just, spread the insights across.
I'm happy with that. But obviously as we expand the question is how many do you want to have? Because every new clinic most probably will come with their own EMR. So there's a decision to be made there. But so far we are okay with the seven EMRs we're having. and especially because as I said, this, this third party consultant company help us to tap into every single one of them.
And now we have access to the insights that again, it's not just for us at management here at group level, but we're cascading that down for, the clinics to make decisions as well.
[00:37:41] Griffin Jones: So I've seen all three approaches with regard to when you acquire a number of clinics and then you adopt different EMRs, or they have different EMRs, I've seen the approach of everybody, you can keep your EMR, decide for yourself, we're going to make a recommendation of what EMR we should use, and here's our SOP, but you decide if you're going to implement it or not, and then I've also seen, and probably even more recently, we're going to all go to this EMR.
This is the way it is for everybody in the network. This is what we're doing. It sounds like right now you're choosing the approach of one of the first two. why not make everybody, you said your system's agnostic. I get that. But even from a coding obsessed perspective, doesn't it? I feel like I would, I just know there's going to be some pain in your.
In the future of this isn't coding the right way because they're not actually coding equivalents in these systems. And, especially when you see one group having a low NPS because of their EMR and another group having a higher NPS because they really like their EMR. So why are you not going with the third option now?
Not the right time for sure.
[00:38:51] Francisco Lobbosco: I think we have other priorities. I think the current DMR systems that we have in place give us what we need today. And again, for every decision, every initiative that we implement and we create a group level, most probably it will have repercussions at the clinical level.
And what I do not like to do is to overwhelm the clinics with projects that then will have an impact on the way we treat our patients. And changing EMRs, as or developing EMRs, you need to tap into that, you need to work with clinical associates. And I think today is not the right time for it, but I'm not saying no for the future, but I think today is not the right time.
[00:39:33] Griffin Jones: So you're getting these insights and not just the KPIs in the form of insights, but you're getting wisdom in the sense of asking the questions, what can be. Removed in order to add more value, what non value added activities can go? What can we do to give more time back to our associates? You're a smart guy.
You've been asking these questions for a hundred days. I assume you have a couple of, answers by this point. what are a couple of those things that you can do to remove non value added activities for associates?
[00:40:09] Francisco Lobbosco: Yeah. And I think every clinic is different and every, the starting point for every single clinic is very different, right?
So with data now we can see, volumes going through productivity metrics going through, and as I said, you can sit on daily basis or intraday if you wanted to. And if you see a clinic that is, I'm a big fan of quartile and everything, right? So you have in a regular bell curve, you'll have Q1 two, three, and four.
So if you think about the quartile one and two, they are below average. So you wanna bring them to average, right? So you'll probably get a better impact from doing the, a bigger impact from doing that than pushing Q4 into, the 98 to the 99%. And as I said, every clinic is different. But there's one thing that I learned, which is my MDs, our MDs, our nurses, our embryologists are flat out is they're not playing Tetris in their consultation rooms.
And therefore, if they're delivering a lower productivity levels than the clinic next door within future life, that means that they're probably doing something else that the other clinic is not doing. And in most ca, in 99.9% of the cases. The MDs are looking at us saying, help me because I want to see more patients, but I have to do all these things that are stopping from, they are stopping me from seeing more patients.
And I think that's, the area that is very different clinic by clinic. So if you ask me for an answer now, I don't have an answer. I have many answers and they're very particular to the countries, to the clinics. There's some legislation in some places where everything has to be paper based. So it's quite different clinic by clinic.
[00:41:50] Griffin Jones: That brings me to, it's jumping ahead to a question about the EU in terms of, I'm sure there's some things that are, standard across the board, but then I imagine that there are many differences country to country. And, what's it like navigating those differences? What stood out to you in terms of particularities between different governance?
[00:42:12] Francisco Lobbosco: yeah, it is different, but one of the things I experienced here that I didn't experience in my past experiences is fertility tourism, and therefore patients are willing to actually move to the next clinic in the next country to access whatever they cannot access at home. And that is one of the biggest things that here at Future Life we need to start leveraging.
And, that referral within our own family is something that is missing. It's something that is going to drive growth as we were talking about growth earlier, definitely. But most importantly, something that our patients are asking for, because if in clinic A, I come to clinic A because I heard great things about clinic A.
But you cannot treat me because I'm a single man, for example, where can I go? Or, a homosexual cop, where can I go? we can definitely help you here and here and here and here, and we'll, make it happen for you. So that is one of the biggest benefits from having this community of Canine Excel across 10 countries that we think, I think we need to leverage a
[00:43:15] Griffin Jones: And that's helpful in having a lot of this data aggregated and having the, teams working together too, because then you can build that infrastructure of, it's not just, Oh, I think our clinic over here does that.
It's, we have, let's take you over to the portfolio and let's see where. Where you're going to be able to be helped on the solution side of the elements,
[00:43:41] Francisco Lobbosco: sorry to jump in, but one of the elements I think is close to your heart as well as we're implementing a common CRM system across every single clinic.
And that actually will help us as well with that transition and to offer, the right treatment for, all patients across independently on the borders.
[00:43:59] Griffin Jones: Is it a CRM we would know like a HubSpot or a Salesforce, or is it a different kind of CRM? Creation.
[00:44:04] Francisco Lobbosco: I'm not sure if you heard about it. I'm not familiar with them.
[00:44:08] Griffin Jones: And how did you vet them? They're based out of London. The CRM topic is, interesting to me because the reason why. I don't advise most small clinics to do it is because it's just too much work. The bigger groups have found a way to make Salesforce work and the big networks, but it's still not what I would want.
If I had my druthers, I would want a CRM that fully integrates within EMR because otherwise there's just too much duplicate work. So how did you vet this solution?
[00:44:40] Francisco Lobbosco: So we obviously have lots of requirements at the moment of selection. We worked very collaboratively between the digital team, the operations team and the marketing team, because everybody has a say on what, what conditions we want to drive out of a CRM.
and we started with, I think it was 17 potential options. We went through meeting each of them, making sure that they could. Cope with our requirements, different to what it may sound. Our requirements are, is it going to be simple to use? Am I going to get just, what I need? I don't need a Ferrari to drive through the streets of Prague.
I need something that would take me from A to B. Is that going to take me from A to B? But potentially having the potential to go to C if I wanted to go to C after. So we were quite picky on our requirements. And, some of the names you mentioned there were. Definitely within the top five of our consideration, but in the end, we decide for creation, which I think they are based out of London.
[00:45:41] Griffin Jones: Do you plan to use it just for patients, new patient sourcing? Do you also plan to use it for referral providers? Because I've seen CRMs used both ways, where you use it as like the digital CRM, the marketing CRM, but also as the sales CRM for referring providers. How do you plan to use it?
[00:46:00] Francisco Lobbosco: there's a phase one for sure on phase one is to make sure that we use it for marketing purposes, but we have the, what I was saying, let's go from A to B and then potentially let's go for C.
can you take me to C? these guys can take us to C and C is precisely what you're saying. I think eventually there are some functionality sitting in the EMR that potentially can go to the CRM. It's becoming a bit technical. Definitely it's a second phase of the project.
[00:46:27] Griffin Jones: Maybe we stick with the growth theme For the last couple minutes of our conversation, you mentioned you've identified a sweet spot.
Some of those clinics might in this, in your sweet spot, might be listening and maybe future life is a good partner for them. Tell us a little bit. More about who's your sweet spot of clinic to come into your portfolio.
[00:46:52] Francisco Lobbosco: first of all, we are very keen on having reputable clinics, right? So we're not in the business of turning around clinics from a medical point of view, we just trust our medical community in every clinic that we acquire, and we believe that they're up to the quality that we want to be proud of offering.
Answering your question, it will depend. And the reason why it will depend is because if we're talking about a new country, probably you want to go with a clinic that is slightly larger, that if you want to go into a country where we already have presence and we have a half clinic, as we call it, because from a half clinic, you can provide certain services as a great marketing team, as a great IT team, and so on, which is what we do, Again, it depends on the country, but if we were to enter a new country, we'll be looking into a clinic that, does around, as a minimum 600 pickups a year. We'll be looking into is there succession planning? I, do I have four or five at least FTEs in place? I'm talking about medical doctors.
What about the founder? How important is the figure of the founder? Is there succession for the founder? How is it being managed from a support perspective? can we utilize those great resources coming from the support functions in that clinic that we are acquiring to potentially expanding within that country, relying on the marketing individual that sits in that particular clinic or the finance individual that sits in that particular clinic.
We're looking for certain minimum square footage or square meters. Obviously we're looking into. EVDA as a consideration, because based on turnover EVDA, if the clinic has opportunities or not financially speaking, but that is usually the last consideration for us is all about success rates, which are in general here in Europe, they are published.
And therefore you can see the medical excellence or the medical quality that clinic has to offer. And then we send our teams out there. We send our operators, we send our chief medical officer. So we have one in West New York, one in Central Europe. They go and see the clinic and they come with a report.
And usually I'm also going out, seeing the clinic meeting, meeting the people that will potentially partner with us. Oh, in most cases, we don't acquire a hundred percent because we like them to have skin in the game and to continue with us partnering and so on. So therefore that partnership and the quality of the partnership is incredibly important for us.
[00:49:18] Griffin Jones: all right, so you're not taking 100 percent stake in, are you taking a majority stake in most of the clinics?
[00:49:24] Francisco Lobbosco: Yes. Yes, definitely. and again, we're open for, a hundred percents, but in general, people are very proud. Founders are really proud of what they built and they want to keep going, which is great for us.
They want to keep going, but we better support from a digital perspective, but support from a finance perspective, from a marketing perspective, and that's what we can offer.
[00:49:45] Griffin Jones: The pick, when you said 600 pickups, I wasn't familiar with that term. Does that refer to ag retrievals? Is that referred to? Yes. Okay.
So at a minimum, you're talking about not the smallest. I would say the, where it starts to become a mid sized practice as opposed to a small practice. Do you have the opportunity in the year to place docs in, to have docs go from some countries to other countries? Like in the U S one of the biggest challenges for single doc.
groups is that it's hard to get other docs to come to that area if they're in a small market. There's at least one group in the U. S. that I know of that has been taking advantage of it. They have bought a couple of these single doc groups because they can take some of their docs and fly them out there for a week or two at a time and batch cycles.
Do you have the opportunity to do that in the year or does the regulation between countries prohibit that?
[00:50:41] Francisco Lobbosco: It depends on the country, we do have examples, we, have Hans who was working in Spain now, he's the chief medical officer for, reprimanding Ireland. we have Tomas in Slovakia coming from Czechia.
So we do have examples, it's just, it is a bit more complicated to, to have that freedom of movement when it comes to doctors, but definitely it's an area that we need to explore a little bit better, especially when it comes to embryologists.
[00:51:08] Griffin Jones: That could be its whole episode in of its own talking about being able to use a bank of embryologists, and there's a lot of questions that I haven't asked you that I will be happy to ask you bringing you back onto the show.
With Growth is international. In your near horizon, now that we're seeing, we, saw the East Asian cohort by Indira and IVF, we see ginseng fertility own HRC in California. We saw care in the UK for the first time, make an acquisition in the United States. And in the end of 22, are we, should we expect to see future life moving beyond the continent in 2024,
[00:51:52] Francisco Lobbosco: so we see many opportunities in Europe for us to continue looking at.
Also, we need to remind ourselves, especially that ourselves here at future life, that we're a new team with loads of initiatives being carried out as we speak. So focusing on the 45 plus the ones that will come from Europe next year, probably is the right thing. With that being said, we're always looking at what the market has to offer.
And, definitely the U S is a, is a market that, is attractive from different considerations, definitely other parts of the world as well. So I'm not saying no to it. I'm just conscious that we are incredibly busy at this precise moment. Delivering what we have to deliver here in Europe.
We also see opportunities for expanding here in Europe as well.
[00:52:45] Griffin Jones: Francisco, it's been a pleasure talking with you. I want to give you the floor to conclude with your vision for growth, your vision for why, what we need to do to help the people of, why we're here. The floor is yours.
[00:53:00] Francisco Lobbosco: thank you. I think I really enjoyed the conversation, perhaps just as a final thought from my end, which is something I said to my team quite often, I know that people like you, Griffin, most of your listeners, if not all, have been in this sector in this space for quite some time.
And you're very familiar with it. Sometimes it's good to have someone external coming, reminding us. On how powerful it is to work that you guys do on a daily basis. And I'm talking about everyone working in clinics, right? So this goes for everyone working in a clinic, MDs, embryologists, nurses, receptionists, coordinators.
It's just fascinating what you guys do on a daily basis. your job is to put smiles on people's faces. So my last words would be encouraging you to continue going. I think what you're doing helps the sector in particular, for everyone else out there, just keep going. I think we, or you in particular, are changing the world one way at a time.
So big thank you from my end.
[00:54:02] Griffin Jones: you have helped with the impetus for more international content because I think it was earlier this year, maybe end of 22 when you first messaged me and said, I'm coming into the space and I'm, using your media to, to learn more about it. I said, Oh, maybe we should start creating more international content.
So you're among. among the reasons why we're expanding coverage for the global audience. and I'm thankful to those people that, that send me notes like that. And I echo your sentiments for people, because I'm not a clinician. I've, barely passed high school biology and, I often forget to, to sometimes stand back and say the same things that you just have.
So Francisco Lobbosco, thank you for saying it. Thank you for saying it on the Inside Reproductive Health Podcast. Thank you, Griffin.
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