Designing for Health: Interview with Greg Aukerman [Podcast]

Show Notes:

[00:00] Intros

[03:00] Founding the Outcomes Institute

[04:20] The impact of a room placement

[07:30] Accidental versus intentional design in healthcare

[09:00] Fragmented systems

[12:30] Designing for outcomes

[14:50] Reimagining onboarding

[24:00] Fixing the relationship not just the device

[35:38] Greg’s favorite well-designed things

[38:23] Outros

Transcript:

Dr. Craig Joseph: Greg, welcome to the podcast. Where do we find you today?

Greg Aukerman: Thanks for having me. I am in my lovely home office in Cincinnati, Ohio.

Dr. Craig Joseph: Excellent, excellent. So, tell us, you're really into this kind of health care experience design. There's not a lot of people that that are into that that have done that. So, I'd like to hear about kind of how you got to where you are today.

Greg Aukerman: So, from an early age, I was labeled as gifted, which means I have wrestled with self-doubt my entire life. I have a bit of an odd background, and I've come very late to the world of health care in terms of my career. I cut my teeth in the retail space. I was a trainer and a lead for the Genius Bar for Apple. So, I was one of those people who can help fix phones and computers. And I got to lead a team with two other people, about 80 technicians. And it was one of the most formative experiences. And in, learning how to de-escalate, really any situation and always be able to care for the person right in front of me.

From there, I had a bit of a career in market research. It was qualitative market research, all very small-based size. So, if it was a consumer-packaged goods company or a pharmaceutical company, even if we were doing a study on, let's say, paper towels, we would spend 3 or 4 hours in your house learning about you and your life and the things that you're wrestling with. The idea there is that the better we understand a person and the different factors that they are dealing with, the better products we can design for them. From there, I got into a little bit of nonprofit work where I learned a whole lot about how to be kind of a Swiss Army knife in every situation and then moved into consulting. And in consulting, I really stayed in the areas where I was the most familiar. So, tech super packaged, good retail space, and those types of experiences. And then the combination of real-life fate and career fate kind of moves me in the healthcare space. And I fell in that pretty hard, in a good way. Several of my family members became sick with a number of things that they were dealing with, and I found myself at their bedside advocating for them and helping them navigate the healthcare system.

And at the same time, I had the opportunity to join some projects in a consulting firm where I got to work with healthcare institutions directly. And it was kind of this awakening

for me, where I realized that this background and creating experiences for people and caring for them face to face. And designing from their perspective, something that is empathic and resonant is something that I may be able to use to help health care. And I come from the lens and come from the perspective that there's a lot of really, really good things that are happening. And I wanted to pick up a tool and kind of pitch where I could, in the healthcare space. So that is a quick journey through the different experiences that kind of led me to where I am today, and trying to make an impact with my unique background in healthcare.

Dr. Craig Joseph: And to do that, you've started a new firm. So, tell us a little bit about it.

Greg Aukerman: So, whatever's inside of you is what comes out all the time unintentionally, intentionally, all the time. And I am here. And the reason that I jumped on board and started this company is to help care for people who care for others. And also, personally, it doesn't hurt being surrounded by smart people who share a common why of the impact they want to have, but disagree on how, because it creates some really sharp conversations and potentially some innovative ideas.

Dr. Craig Joseph: You and I met when I was in the audience at the American College of Healthcare Executives, and you gave a talk and shared a story about your mother. And she had a stroke, and I was moved, I think as much of the as the entire audience was. And, afterwards came up and said, I need to talk to you and try not to scare you off. And obviously, I was successful. I've not scared you off. Tell us what this, you know give us a summary of what happened to your mom and how it influenced you.

Greg Aukerman: A few years ago, my mom had a stroke, and I'm not going to bury the lead or anything like that. She's doing very, very well. Her recovery and the care that she received was phenomenal. And she's doing really, really well. But as it was happening, there's a lot of fear. There's a lot of questions, there's a lot of uncertainty. And when your family looks to you as a person who can most expertly navigate the health care system, you feel a lot of pressure that's there. And I think the part of the story that has really stuck with me is about intentional design of experience versus accidental design or experience or intentional care versus accidental care. And let me explain what I mean. So first of all, like I said, she had phenomenal care, really communicative staff, I really appreciate everyone who was involved in that. She got through the ED and was transferred to a neuro ICU. And when she got to her room, she was placed in a room where she's kind of in the corner next to the door, and her right side is up against the wall.

So to her from the bed, the left side is where all the people are. It's where the room is. It's where the activity is. And she had a stroke in the right side of her brain. So at that point she had a whole lot of difficulty, even acknowledging anything on the left side of her body. She couldn't see out of that size. She couldn't move out of that side. Nothing existed over there for her. And as people were coming in out of the room answering questions, checking on mom, checking on us, providing excellent care, somebody said in kind of an offhand comment, it's lucky that she was assigned to this room, because forcing her to acknowledge the left hand side of her body and the room and the space that she was in can help her heal. And that's a comment that stuck with me forever. Not only the fact that it was lucky that she was there, but that something as basic as where a person is in space or the room that they're assigned in a hospital could actually help. The healing process was kind of revolutionary, and I know that room assignments can be very, very challenging.

There's things like, you know throughput and staffing and all the different things that need to happen to get somebody a space in some of those spaces at a premium. But it made me start to ask the question internally, what were to happen if every decision that we make on patient's behalf, from not only the care they receive, but the places that they go, was done intentionally with their healing and their experience top of mind. That's a bit of the story that I told at ACA, and it's one of the ones that's kind of stuck with me and has shaped how I view my work, how I view healthcare, and the impact that I hope to have with some of the ideas that pop into this crazy brain of mine.

Dr. Craig Joseph: Intentionality really kind of goes through everything that is your work. I talked to people and I, we talked about design sometimes, and they said, well, I, I don't do designs. And I'm like, well, you do actually, you going to meetings and you've written emails. You actually do design. You just don't call it that. But a lot of what you do is accidental. Like, you didn't really think about it. And I think that I'm sure that comment that you got from that health care worker, was it just kind of just came out and just they left it and if you went to them and said, you know I kind of started a company a little bit based on some words that you said to that person, you could find that person, they would probably deny saying it, right.

They wouldn't have even remembered saying it was probably just some off comment. But it's the intentionality. So, can you give us some other examples of where a health care system or a hospital or clinician wasn't intentional in some of the design that they did, and the outcomes were maybe not bad, but not necessarily good?

Greg Aukerman: Happy to share a couple examples there. One that comes to mind immediately. And its lower stakes if you will. But you see it a lot. And I've seen it a lot in the organizations that I've got to, to work with. As primary care clinics, urgent care clinics, kind of that, that gray area, quick care clinic, start to move to, like, electronic check in. One of the things that you see specifically in the physical space and environment is there's no longer a human being that's there to help you check in for your appointment. And you go to a machine to help you check in, which is not inherently bad. And sometimes that can save a whole lot of time, especially pre-registering. It's like two taps and you're in and you're ready to go.

But what happens? Or the, the way that the environment kind of combines is that you are going into a space that was initially designed to have a person have an interaction with you. So you walk in and see the front desk of any of these places, and there's a sign that says, welcome, go here to check in, which to me, as a patient who might not understand, like what's happening, it's like, welcome, you're already wrong. Go away and go do something else. There's no one here to talk to you. Which can put you at a less than desirable mental state. You might. You're already coming in with a concern or maybe a fear. And now you're like, well, I've already screwed something up, and there's nobody to talk to, so I guess I have to figure this thing that happens a lot right now.

As the as the industry seems to be migrating towards these more automated checking things, the space, the physical space that they inhabit hasn't yet caught up. Another one. And this is this is a little bigger. And it's also much, much more complicated, is one that I got to witness again with a family member. The family member was having a seizure and, was there, got treatment to kind of relax and sleep, which was explained really, really well by the provider there that think about it like your bullet, your brain, blue screens like a computer and you need to reset it and it the sleep is the best thing you could possibly get. I love this. I thought it was a great analogy. It was clear it was in my language. Then we get into the area of unintentional design where family member is asleep in a bed and is surrounded by a number of devices and systems patient monitoring, infusion pumps, bed alarm, call button, all of them made by different companies and different brands.

All those companies and brands are staffed by brilliant people that create these products that can help deliver care. But the combination of all these different brands with their own ideas of patient experience and the journey that the patient and the provider take and using the equipment are not integrated. And the way that that showed up for this particular family member is that under sedation, they woke up three different times by alarms. One of those alarms connected to a central monitoring system that talks back to a nurses’ station. And it was able to be deactivated and addressed to other ones, weren't they weren't integrated, they weren't connected. They had a different sound by a different company. And they actually woke this person up three times. And all of them were false positives. Now, in the grand scheme of things, is that huge? Is that really going to affect someone's care journey? I don't know probably not. It's alarms. And you want to pay attention to things that the designers and the providers say are things to observe or concerns to have when one of these alarms go off. But the integration of the system and getting these things to talk to each other and thinking through what it means to put a patient in a room that has, you know 11 different companies putting together these devices that are supposed to help not only the care team, but the patient itself that can produce some less than optimal outcomes in that health care setting.

Dr. Craig Joseph: You mentioned one kind of reimagining of the hospital space. What can hospitals or health care systems do to kind of start thinking about being more innovative in their design of their physical spaces?

Greg Aukerman: I wish it was a simple answer. But it is. I think it's a complicated response to that question, and it's determining what are the outcomes that you want to deliver. And if the outcome that you want to deliver is that every decision that we make. I'm making this up as we go. Every decision that you make is designed and will benefit the patient's recovery. Let's say that the thing that you want to do or, I believe, I'm not going to say the name even though I want to brag on them. I believe there's a healthcare network out west that recently said that one of the outcomes that they want to do is that every step they want to remove as much fear, angst, and anxiety as possible.

Those are goals that you or outcomes that you can design around. So if you as an organization with leadership buy in from the top to the bottom, say everything that we were going to do is going to be to benefit the care and rehabilitation of the patient, or everything that we're going to do is going to reduce fear and anxiety. There's a number of changes or decisions that need to be made and all the supporting systems. So how rooms are assigned, how different floors are staffed, the types of decisions that are given to a patient and the types of choices that they have, the types of interactions, all level up to that outcome that you want to see. That's where the real work comes in. It's determining and aligning the organization behind that outcome that they want to focus everything towards. And then making every system, every part of the organization, every different entity that makes up the whole hospital, or the whole hospital network focused and driving towards that one decision. And it's big and it's scary.

And you can use words like transformation and that's really, really freaky. But it can start with small things, and it doesn't have to be, you know some of the giant and sweeping. But to say out loud, like this organization did out west, that we want to reduce fear and anxiety right now, we can take some steps towards it and see if we can get some momentum.

Dr. Craig Joseph: So, kind of again, kind of getting back to intentionality and thinking through from the from the patient's perspective, you know what can I do to kind of minimize fear and anxiety? Let's pivot a little bit, but off fear and anxiety and talk about onboarding. And we'll start with onboarding employees, which is something that you've done. Certainly, there's excitement there. You're starting a new job. There's a lot of fear and anxiety there, too. Should be, and it's a new place. And you don't understand the culture, and you don't know anyone and all of that. So, did you help clients with overhauling their employee onboarding process? And then after this, we'll talk about how that is applicable for health care.

Greg Aukerman: I may use examples inside and outside of health care as we kind of talk through this. Onboarding is interesting because you're right, there's a whole lot of potential. There is an individual and an organization that have said yes to going on this journey together, and we have to figure out how we're going to make it happen. And sometimes, specifically in the healthcare space, that initial onboarding experience can be incredibly overwhelming. Or it could be dry. Let me explain what I mean by that. I have a couple of friends that are onboarding in different health care organizations. Right now, there's a lot to learn not only about how things are done, but also different things can be done in terms of compliance and regulatory requirements to make sure that they're able to do the jobs that are there.

So, onboarding, like what we talked about a little bit ago, can be modified based on the outcome that you want to see. So, for example, a health care network that I had the opportunity to work with, their initial onboarding experience was really dictated by the need to ensure that new hires met regulatory requirements. How that manifested is that their first day on the job was eight hours remotely in front of a computer doing regulatory training, and that was for operational staff, for clinical staff, it was for everybody. And while it is important, believe me, I am. I'm not going after making sure that you are certified and meet regulations and things like that, it did not create an inspiring experience for people who have said yes to a journey on delivering care, and that is what we worked to pivot regulation and making sure that these courses are taken are important.

But it might not be so important that you need to do it on the very first day. So, we put together a kind of an overview of what the first year can look like on the job for operational teams and providers and things like that. And it starts with the first day. That is really all about connecting your why. So why did you say yes to this journey within healthcare or within, practicing medicine of this organization and how do you connect to the why of that organization. So, we did things like, be able to we were able to create some initial videos to give people an understanding of why they were there. We had more discussion-based ideas. We have a chance for them to start thinking about the moments that they create with patients or with their team members. We had some visible executives come in to provide a little bit of time to answer questions, tell a little bit of their story and their why, all to create this really, really memorable first day where you got to feel a little bit of appreciation and connection to the organization, as opposed to just kind of checking some boxes.

From there, we had a number of things that we put together from onboarding kits that were boxes that would either be waiting for somebody at the facility or be sent to their house that had not only the typical things like, hospital swag, coffee mugs, things like that. But also, something that has a little bit of flavor from the book. So locally roasted coffee or candy from areas that surround the hospitals just to reinforce that idea that this is a place that not only cares for people but is also active in the community. And there's parts of that community that are there with you. We put together, kind of by quarter, a deep dive into each individual value of the hospital, values and mission and things like that, I think are incredibly important, but only as so far as they are embodied and understood otherwise, they're just words on a wall. We wanted to make sure that those were internalized and contextualized. So, if this is one of our values, how does it come to life for me as a Nurse Practitioner, how does it come to life for me as somebody who works in environmental services? So, we had quarterly dives into those.

We had cohorts that met with new hires, so they had a chance to develop some relationship on day one and through that first week, and then had a chance to continue to grow that relationship throughout. And it was really wildly successful. And it was one of those things that I like to work, in the work that I do as. Yeah, we're going to work with you, we're going to co-create with you, and then we're going to be able to hand that over so that you can run it. And one of the most rewarding things for me, aside from the feedback from new hires, was that, “hey, this was awesome. I felt seen, I felt known, and I felt valued from day one”, where some of the like learning and development trainers who used to do the eight hours of regulatory training that are now leading these experiences where people have a chance to explore their values. And it was a great transfer to say.

Dr. Craig Joseph: So how does one kind of take that? And we were talking about how that's actually true of almost any employer. Right. Your experience was with a health care system but could be valid for anyone. How can a health care system pivot from thinking about onboarding employees to onboarding patients? So, we're not going to make the patients watch videos, although sometimes we do. But usually, it's on the on their way out, not on the on their way.

Greg Aukerman: Yet I have got to brag on them, and we can use them or not. But Cincinnati Children's oh my gosh I'm a huge fan. And for having children who experience procedures, some of those procedure videos are top notch. Is it reduces some of the anxiety. And that's amazing. Those videos, great bad actors? Not so much. But how do we onboard patients and their families? Like, I love this question. Intersects something that I believe and that the company that I co-founded kind of works to create. And this may be a little bit weird. This answer may be weird, but you're going to come with me on this journey, and I swear it's going to be great. The thinking that informs it is connected to the idea of missionaries.

And let me explain what I mean. When you think about missionaries, you can think about religious missionaries or folks that maybe work for the peace Corps, or maybe even habitat for humanity. These are people who believe they have something of value, and they go to a place that needs that value that they have, or they think need the value that they have, and they are willing to learn local language, local customs, local culture to fit in and provide something that has value and a service for the folks that are around them. In that example, those missionaries that are going out are doing all the code switching. They are learning all new things. They are taking on all the responsibility to figure out how to navigate that place that they are going to. When you think about people coming to a health care organization, that equation is flipped completely. The missionary at that point is the patient and the patient's family.

They have to understand the new language. When they get into this health care situation, they have to understand the customs, the expectations, the barriers, the code switching that they need to have coming into a place where they think they are going to receive value as opposed to give value. And it is underlined by this idea and this reality that they're not super jazzed to be there because they may be scared, they don't know what the answer is, or they may be hurt. And they may have a whole lot of fear underlying it. So, thinking more like a missionary, is what kind of drives what patient onboarding can look like. And what I mean by that is, if you think about, a person who is new to your healthcare network or maybe just new to your clinic if you're in private practice or things like that, thinking about what do they need to know to succeed? What do they need to know to communicate their concerns properly? And some of the things that that we have seen work in the past is being really, really clear about the types of questions and the language that you use when someone comes in for the first time, or when they fill out a request for an appointment online to get at not only the chief concern that's bringing them in or their biggest concern, but what else is going on inside those beautiful brains of theirs?

What are they concerned about? What do they have questions about? So that you are taking some of the cognitive load off of that patient or that patient's family and taking it on yourself by thinking through those interactions and those types of onboarding experiences. You don't want them to be a missionary. You want them to come to you feeling at ease and ready to receive care that you're ready.

Dr. Craig Joseph: I feel like a lot of it is similar to, what you learned and kind of developed at Apple. And you teased us. It was a tease a little bit, a little bit ago, you teased us that you were a genius and helped train other geniuses. I'm curious. One of the things that you talked about when we were preparing for this conversation was the idea of fixing the relationship, not just the device that when someone comes in for help, it's not just the fixing of the device, it's the whole relationship. So how what does that mean? I have some ideas, but what does what does that mean in reality?

Greg Aukerman: What it means in reality specifically from the point of view that that I got to expose to, while I worked for Apple is that the device is always secondary to the relationship and the trust that you can develop with the person. Some of those interactions are intense. Some of them are, you know business leaders who need to get a file. Some of them are I just lost all my photos and this person is no longer with us to, you know I'm late for a meeting and there's a whole lot of emotion that is tied into these devices that we use to run our lives, run our social circles, run our businesses. And though the devices can and do break from time to time. And so sometimes software can get buggy and it needs to be, fixed. The most important thing to do in any interaction is to repair the relationship with the person standing right in front, and it's to get to what is the thing that is driving their concern. At its core, it's easy to say, hey, you have a broken iPhone. Here's a new iPhone. Or hey, you spilled some coffee in your laptop. It doesn't turn on anymore. We can get that fixed for you. What takes time and focus and attention and a little bit of art science is being able to empathize with the person who's right in front of you. And there's a couple of mindsets and frameworks that Apple uses and trains in order to kind of focus and refocus what that interaction can look like, which I'll talk about in a second.

But the one thing that I will add before we go there is when it comes to onboarding, at least when I did this at, a while ago, I'm not going to say exactly how long, because I don't want to talk about how old I am and why I have gray hair. But the onboarding process for people who are doing tech support is three weeks of training, two weeks were interpersonal interaction and one week was tech was technical training. You fix anything with, within a week of technical training? But it takes a while to kind of understand the art, the science, the interpersonal action. With that in mind, one of the mindsets that has stuck with me that was trained by Apple is this idea that anyone who ever shows up in front of you have three jobs to do with them, and they are to acknowledge a line and assure the three A's acknowledge, align assure Or if you want to talk about it in Cool Genius Bar, speak from the mid. Whenever I worked there, it was like, I feel your work cool. And what that means is anybody who comes in, you want to acknowledge the concern that they have, you want to make sure that they are seen, that they are heard, that you understand what they're there to fix.

You are then going to align with them to make sure that they understand that you've got this together. We've got this, and we're going to find a solution. We're going to get this thing fixed regardless of what it is. And then the final is the assurance is that this is the path that we're going to go on together. The thing that's really nice about mindsets like that and that can transfer, I think, to health care really well. And quick caveat I understand that replacing an iPhone is much simpler than providing medical care for individuals. So, I'm not going there. But the thing that's really nice about those mindsets is that even in high pressure, high emotional, high stress interactions, it's easy to reach back and go, I have no idea what to do here, but I do know that I'm supposed to acknowledge the concerns, align with them, and assure them that we have a path forward so when the mind is kind of hijacked by the brain getting into fight or flight mode, little easy to remember, deeply implanted things like those three A's, tend to stick around so that you can make decisions and find some clarity and find a way forward and de-escalate situations. From that training that you receive.

Dr. Craig Joseph: I think it's very relatable to what we do in health care. From what you're talking about, from a customer service perspective. And it's not the technology, it's the relationship. You mentioned a patient transport team at a, at a large teaching hospital, and you did some work there. And I was fascinated when you were telling this story about how you kind of took something that was, wasn't really perceived as being a net positive, made it into something that was, you know much better.

Greg Aukerman: We were brought into this patient transport department to help solve a couple of team culture and kind of team internal brand issues that they were running into where, this patient transport department was working at this large academic medical center that, like, larger, lots of large academic medical centers are old in terms of this structure. Because of that, there are constant renovations which trickle down to and on to the outcome of those reservations is it takes a long time to get somebody somewhere on a stretcher when half your elevators don't work. That is just one of the outcomes that they were dealing with. And because of that, they were receiving some of the brunt of the ire of not only the patients, but also some of the people who are working within the institution. So that was one of the things that they were dealing with. And the other was this idea that they were always onboarding, constantly onboarding where they had trouble keeping people in the team long term.

So we went in to do a little bit of exploration to kind of find out some of the why behind, what was going on with the institution, and what was going on with the team and provide some recommendations on how they may change some of those, factors that were leading to the outcomes that were a little bit less than desirable for the people on the team, those folks that really so, on the kind of team brand and how they were being treated, what we discovered is that, yes, there were some, factors that were causing them to provide some service that may be less than ideal when it came to the perspective of people at the hospital and patients that are there. There's also a communication outage, and a little bit of an outage around the vision of what they wanted to do, that they had this idea and this, kind of saying that was kind of just words on a wall that we are the heart of this hospital. We are that we move people from place to place to receive treatment. And they didn't feel like that. They used a couple other choice words for anatomy of what they felt like, and so they needed to kind of reset those, those expectations internally and start to more proactively communicate, with their partners and with patients what's going on and not in the way to place blame.

But if you show up to a situation and you're like, hey, sorry, we're a little bit late, this is what's going on, I'm happy to be here. Now, if you have any questions, as we get you to where you need to go, and reinforce in that communication, was really, really helpful when it came to something that they could operationalize really quickly. It was something as simple as if you're late, communicate, easy to put in mind, easy to enact, and make decisions based on it. If you were running late and those were one of the things practically that, started to catch on the other onboarding is, is a little bit more interesting and I think a little bit more, exciting. What we discovered, and this is not technically abnormal. There was a, medical device company that I got to work with where they were experiencing the same thing in their sales team, where they were constantly onboarding. No one was staying at work. When you looked at it from a little bit more macro lens and you're saying, okay, why are people leaving?

And more importantly, after they left, where are they going? They're not leaving the organization. They weren't leaving this medical center. They weren't leaving the medical device company. They were moving on to other things. What was discovered is that training and patient transport. And in this other example, sales was the doorway into these institutions. So instead of thinking about, all the time and resources that they felt were wasted in onboarding these people, it required a shift in mindset to say, all right, not we are not a place that struggles with retention. We are a launchpad. When someone comes in here, start the clock, because within two years they're going to be on to the next thing. What can we do to give them the best experience possible to prepare them with the institutional knowledge that they need to navigate, these organizations so that they can take all the goodness that they learned in patient transport about how to care for people and empathize with people and communicate with people and be on vision, or how we talk about our products and how we represent our brand to the world. In the case of medical device, how do we take those skills and cascade them throughout the organization? Because we know we are launching people forward. And if that's a design criteria to go back to talking about experience design that you are going to onboard people, you're going to have them for less than 24 months and you're going to onboard them again, it causes a whole different set of decisions to be made when it comes to maximizing that time and maximizing the investment and then the individual.

And it changes how people regard your part of the organization. Man, you want somebody really, good in this next in where you're hiring from, you should look at sales. You should look at patient transport because they know what they're doing there. And they have people that are ready for what's next.

Dr. Craig Joseph: These are folks that are working throughout the hospital like they're not on one department. You know you mentioned neuro ICU. You know you could be in the ICU for decades, actually, as a nurse or a neurologist. And you know how that plays functions backwards and forwards. But it may be a little bit about the emergency department and a tiny, tiny bit about the floor because you have to send patients there. But other than that, you have no clue how the place runs, and you need not have a clue because that's outside of a outside of your world. But transport, they go everywhere and they do everything, and they have to deal with all kinds of different personalities. That's great. And they kind of acknowledge that, hey, it's not bad that we're constantly hiring and putting people in this position. It's actually good because they're not leaving the organization. They're going on to greater, bigger and better things. And that certainly would be an incentive for a lot of folks who think about, well, I don't want to do this for 20 years. Well, statistically speaking, you're not. Well, I was going to say we've run out of time.

And, before we let you go, there's a lot that we need to digest of everything that you said. So much, so much good stuff and learning there. But before I let you go, we always like to ask the same question. We like to talk about design. Are there 1 or 2 things that are so well designed in your life that they bring you joy whenever you interact with them?

Greg Aukerman: Might be a little odd, but for me, it's my bicycle. There is a YouTuber who his name is James Thomas, Bike Fit James, and I've never met him in real life. I hope to, but he is really into the measurements and how a person interacts with a bicycle. And that, if it is too long or too short or too tall or things like that, it can cause you all sorts of muscle issues and tendon issues that may or may not be related to the part that needs to be moved in. Anything in the chain of human motion can cause all sorts of issues. And the reason that I kind of follow this guy, and the reason I think my bike is the most well designed thing that I interact with on a daily basis, is he once said, and this is another thing that stuck with me, humans can absorb an incredible amount of dysfunction, which means that, you can ride a bike that doesn't fit you for hundreds of miles. It's been said it's one of the most efficient methods of transport that we've ever designed. As a species. And once you have it dialed in, where it fits the length of your legs, the length of your arm, the length of your torso, the size of your head, which actually plays a role in In Balance and Gravity. It feels incredible.

It feels incredible to have that dysfunction removed. And the bike, I think, is the most well-designed thing that I have. And that thinking goes directly into everything we talked about today. Humans can absorb an incredible amount of dysfunction. We're very, very good at it. Whether it's physical dysfunction or mental dysfunction or organizational dysfunction. But when it's removed and when things are designed to fit us perfectly, it's a pretty incredible and special thing that we feel. And the type of work that we do, or the type of miles that we ride, can increase exponentially.

Dr. Craig Joseph: Having ridden bad bikes before. Yeah, man. Kind of need a mentor guru to help you size that bike and to make those adjustments and to tell you it's worth putting money into this aspect, but not worth money putting money into that aspect. You're not going to get the benefit out of it. Awesome. All right. And do you want to give a shout out to is there a particular bike, brand or company that you love?

Greg Aukerman: I never thought I would actually do this. I'm going to quote this James Thomas guy, who I've never met, but is a guru. His whole thing is fit first, buy later. Who cares what the brand is? Figure out what fits you. That's going to bring you the least amount of function, the most amount of pleasure and joy, and go buy that.

Dr. Craig Joseph: That is great advice. Greg Aukerman, thank you so much. This was great. We learned so much, or at least I did, really appreciate it. Look forward to watching your company grow and expand. Do great things and we'll have you back after you've got more experiences of cool things to share with us.

Greg Aukerman: I'll be more than happy to. Thanks so much for having me on. I really appreciate the opportunity.