Launch of *phil*osophies

I built a newsletter a system to accelerate your learning.

What is it?

It's a 2x/month delivery of contemplations and insights packaged up in a newsletter called, as you can see:

*phil*osophies

In its broadest, it's about work, life, and everything in between.

More specifically, it's about healthcare, startups, work, our minds, and the human condition.

Here's a visual:

This newsletter provides a foundation for me to vomit learn in public.

*phil*osophies is significant to me in two ways.

One - my mission in life is to expand my perspective, knowledge, understanding, and appreciation of the world. It's my true north.

Two - my aim here is to help you do the same; to embody a life of learning. To the extent that this content helps you to learn and thrive in your job and/or life, amazing. If not, eh, all good.

So what are you getting?

For now, you'll receive content every two weeks.

One email will include a series of articles - written by me - across healthcare, startups, work, our minds, and the human condition. It'll be a journal of contemplations, insights, observations, tips, etc.

Think of like an intellectual tik-tok.

The following email - two weeks later - will contain an easy-to-digest PDF summary of a book I’ve read.

Think of that one like Cliff notes. Or maybe Phil’s notes.

Or ... not.

Regardless, don't you sometimes think, "Ugh, I really want to read more!”?

Well lucky for you, I'm turning my book scribbles into easy-to-digest summaries so, essentially, you can!

Think of it like: I read, you learn.

I heard recently the average knowledge worker encounters 100,000 words/day!

My hope is for these monthly book summaries to serve as one of the highest points of leverage (defined as: impact divided by time commitment) that you consume online.

You can see the beginnings of the digital library here.

Why are you receiving this email?

Because you’re someone who I think will find value in this newsletter and/or tell me if it's whack (especially the puns and memes).

You have free reign at any point to unsubscribe and get off the ride.

(Pleaseeeeee don't...)

I also built a website. What do you need to know about that?

That website is here.

For now, it contains - in addition to the book summaries library - content related to digital health, customer success, and building teams & culture. It'll continue to evolve.

What you may find most interesting is a guide (or e-book, I don't know?) I wrote recently outlining 18 simple ways to get the best out of others.

If you’re not already thinking about how to elevate your work culture and those around you, you better start now.

I guarantee you’ll get at least one actionable takeaway to try this week.

Check it out below.

All that said, below is the first edition.

Keep in mind: for this one, I've included both a series of articles and the book summary. Moving forward, these will be sent in separate emails, two weeks apart.

Let me know what you think :)

With deep gratitude,

Phil

Reduced "weight" times

It’s time to pay attention to obesity.

Consider this: 4 in 10 adult Americans are considered obese. 40%!

We've tended to hold a simple story about obesity, viewing it as a result of lifestyle changes (e.g. lack of exercise, lack of clean diet, etc.).

There tends to be similar ideas around addiction and substance use disorders.

The idea being: you should do XYZ to stop being [obese, addicted, etc.]

You know, the ol' PicK yOurSeLf uP oFF yoUr bOOtStrapS rhetoric.

One, let's chill on that.

It's time to look at obesity and substance use disorders as biological disorders; as chronic conditions.

We don't put the same moral shaming around, say, diabetes or asthma. Our brains and stomachs aren't much different than our pancreas or lungs, after all.

It seems like we maybe are chillin' on it. In 2013, obesity officially become a "disease state". #progress.

And if it's more like a chronic condition, well, then why don't we treat it similarly to diabetes?

[Extravagant wrestling intro meme]

Enter GLP-1's.

It stands for Glucagon-like-peptide-1. They're new injectable drugs.

And early clinical trials are promising, to say the least.

In one clinical trial, 200 obese adolescents lost 15% of their body weight compared to the control group. In another, 58% of adults in the study lost more than 20% of their body weight!

GLP-1's appear to work on receptors in the stomach, resulting in:

• slower emptying of the stomach

• delayed digestion

• people feeling full faster and longer

And early studies show the drugs might work on receptors in the brain, resulting in people's brains:

• thinking about food less often

• loosening the link between food and reward

Back to the first part of the article, what if obesity, instead of being simply an effect of lack of exercise and clean diet, is itself also part of the cause? What if the presence of excess fat cells itself causes - in a sort of negative feedback loop - much of the stomach and brain pathways that these drugs are seeking to combat? In other words, once you gain weight, the weight itself acts as a barrier to losing it?

TBD.

One of my major takeaways from studying nutritional science in college was: for every study saying food X is good and follows ABC pathway in the body, another future study finds that food X is bad and actually follows DEF pathway. It's hard to keep track. And we're often wrong.

Either way, our actions are driven so much by the chemical wiring in our brain and the thoughts it produces. (I'm not gonna dive deep into thoughts, will-power, free-will - that's maybe for another edition - but it is relevant.)

With these GLP-1 drugs, we're barreling toward a world where obesity drugs will be as prevalent as high blood pressure meds.

A world where we could obtain, essentially, the benefits of gastric bypass surgery without the surgery.

The billion dollar question is gonna be: how are these drugs distributed?

From your doctor? Maybe, though over half of millennials don't have one.

One place I'm looking is the direct-to-consumer (D2C) subscription model.

We've already seen, for example, a D2C company called Calibrate spin out of Redesign Health in 2020. They offer a year-long "metabolic reset" - essentially, access to GLP-1 drugs + video coaching.

They received $100M in funding in August 2021 and appear to be seeking to enter the B2B route ("Hey self-insured employer, we can reduce your costs and help your employees get and feel way healthier. Cover our costs on behalf of your employees. Come on down, you won't regret it!").

And literally last week, Ro, another D2C company - perhaps known for their initial focus on men's hair loss and erectile dysfunction; you know, the topics men lead with at dinner parties - announced their new weight loss program.

I'm fascinated to see how the distribution of these new drugs plays out.

[Tangent: check out Nikhil's on-point article about Ro on his Out-of-Pocket Health blog.]

Interestingly, the initial hypothesis around GLP-1's focused on diabetes, yet we stumbled into a break-through for a different condition. The same thing happened with Viagra (and many other common medications). #accidents

(I didn't anticipate a Viagra sighting in the essay number one but here. we. are)

Good lesson to stay open-minded and not be so narrow with the range of outcomes you're assessing for.

If you want to learn more, here’s a phenomenal podcast episode highlighting the promise of GLP-1 drugs.

Startups / Sam Altman

Sam Altman is the founder of OpenAI, the company behind Chat-GPT.

I’ve followed Sam for a few years now (weird flex). And also, not like followed followed, though I am pumped for the new season of You.

Recently, I watched a 2018 talk Sam gave on succeeding as a startup.

His #1 takeaway?

80% of building a successful startup is building a product so good that people say to their friends, “you HAVE to check this out”.

That's basically the sales and marketing playbook.

In terms of Chat-GPT, safe to say: Check.

A few other insights he shares:

• the product needs to be easy to understand (we too often hind behind jargon and generalization)

• it should capitalize on an exponentially increasing market

• it should capitalize on a real trend - which is when a small number of people use a new product a lot, compared to a fake trend when it's used by many people, but only a tiny bit.

Also, his two favorite phrases to hear from fellow employees within a startup?

“We’ll figure it out.” and “I’ve got it.”

Seems like the optimal attitude to embody at work and in life.

Three minor notes on Chat-GPT:

1. it’s incredible what happens when transformative tools become fully accessible by the general public. It’s a massive enough obstacle to create the damn tech, let alone to distribute so that everyone can leverage it. Transformative stuff.

2. what / who is "an expert" in today's world? Dunno. Expertise is overrated, anyways.

3. be careful not to confuse the last two articles. A GPT-1 isn't (yet) an injectable AI drug.

Features ... commonly lost in translation

A company needs to position its features in a way that resonates.

In the startup world, I often hear, “sell on value, not on features.”

I’ve (finally) discovered a useful framework to do so, from a book on product positioning called Obviously Awesome:

I love the simplicity of asking, “What does this feature enable for your customer?” to highlight the benefit.

Check out the full roadmap below to ensure you’re positioning your product(s) optimally.

(whispers: you're probably not)

While you're busy tryin' to fit in, I'mma stand out

[If you know the name of the song (w/o using Google), holler at me]

It's hard as shit to stand out when applying to a job.

I talked with a founder the other day who said they’re specifically NOT posting a crucial opening because “Well, we'll probably get 400 applicants and have to navigate through all that. We'd rather just see if anyone knows anybody."

Just like l'm more likely to actually buy a BBQ sauce if I’m given 3 options as opposed to 400, I guess the same is true with selecting a candidate. ("the paradox of choice")

So the question is: how do you stand out among 400 applicants and/or how can you figure out a way around the traffic?

Seems like the best way around the traffic is to become someone's recommendation.

I don't have the answers, but I am trying a bunch of shit:

• creating and sharing content - talks, guides, website, etc.

• re-connecting with colleagues (you, maybe!? sup.)

• trying to build as wide of a connection base as possible

One approach that's worked, too: reach out to who you think the hiring manager is and express interest.

I leveraged this approach to secure an initial conversation with a company focused on tech-enabled addiction treatment - an idea I'm becoming increasingly interested in.

Example LinkedIn outreach:

Hi [name], I know I'm reaching out out of the blue. I've been following [company] for awhile now and saw the [role] open up that I think I'd be a perfect fit for. For context, I got my MHA from Ohio State, and then spent 6 years at a B2B SaaS healthcare startup. I ended up managing a team of 8 enterprise CSM's. My areas of interest are healthcare, startups, and our minds. Related to your company's mission, outside of work, I've recently read "Drunk", "Meaning of Anxiety, and "In the Realm of Hungry Ghosts." Might you be open to chatting about the open role? If there's someone else at [company] you recommend I connect with, just let me know.

Obviously that was most specific to that company, but hopefully you get the gist.

Where will it land? Who knows.

Regardless, I'm continually searching for ways to stand out. What's worked for you? Lemme know.

Goodhart's law

Ever hear of it?

Its premise is: as soon as a measure becomes a goal, it ceases to be a good measure.

Why? Because we'll manipulate it.

We humans are oh so clever, creative, and goal-striving.

We'll game it to the point where either the measure becomes useless or, actually, it backfires completely.

The classic example goes as follows:

Hundreds of years ago, a government faced an increasing crisis of venomous snakes around town and, in enlisting the help of the community, offered money for each dead snake.

So what happened?

The village proceeded to breed the damn snakes, kill them, and exchange them for $tacks.

People cashing in on the system.

Is it really thaaaat different in present society?

Maybe a stretch but take a quick peek at medicine, for example.

Goals and systems go hand-in-hand.

What system and targets have we set up for billing?

Simply put, doctors submit CPT codes (a language for medical billing) to insurance companies following their patient encounters. The system we've designed is, basically:

• more complex the encounter -> the higher the code -> the higher the reimbursement

That system, with its set of procedures and goals - created by humans - is just as prone to being gamed as any.

In fact, you can see the debate going on in the Medicare Advantage space. We're seeing higher codes.

The key question is: are patients really sicker or are visits being up-coded?

It'll be interesting to see how it plays out in healthcare, but more broadly, it's a lesson in being wildly aware of:

• what systems are you building?

• what measures/goals are you setting & putting in the spotlight?

• where could resulting behaviors actually go off the rails relative to your intentions?

The line between maximizing and manipulating has always been - and will always be - flimsy AF.

Be aware of it and perhaps loosen your grip on those metrics by, say, 20%.

I know what you're thinking: goodhart's law? more like badhart's law.

For sure.

A milli - a lesson on exponential growth

It's hard for us to wrap our minds around exponential increases.

$1M vs $1B? Sure, a billion is way more but how much more?

Try this:

(assume "now" = February 1st, 2023)

• 1M seconds from now = February 12th, 2023

• 1B seconds from now = October 19th, 2054

In other words, you:

• hit the 1M second mark at 11 days old

• hit the 1B second mark at 31 years old.

And the exponential increases are wild, too. You:

• hit the 5M second mark at 55 days old

• hit the 5B second mark at 155 years old (RIP)

(Remind me again why we need billionaires!?)

How long is "now"?

The Waking Up App has changed my life.

Not only has it taught me what mediation actually is and given me tools to pay more attention to my experience, it's completely reframed what thoughts even are.

One talk, exploring the “now” of our experience, stood out recently.

Here’s what's shared:

Wild.

BTW - I’m able to gift a free month of the app. Holler if you’re interested.

Free agents

I love sports. Actually, more precisely, I can tell you where ~98% of NBA players went to college. My friends get a kick out of it. They did recently stump me with former Knick legend Steve Novak. Damnit.

Anyways, Mark Cuban - who is only slightly more of a tech, sports, and healthcare(!) success story than I am - made a profound point on a podcast with Adam Grant.

The gist was: the notion of a "career" is over. In today's society, we're all always free agents. When we join a company, we really ought to consider it as a 1-year deal.

This resonated even before all these massive companies laid off thousands.

This idea almost certainly wouldn't have landed in, say, post-WWII into the mid-90's - a period where security, "safe" professions, pensions, longevity at a company, etc. were of highest value.

Now? shit lands.

What does it mean in a world where we're, at least mentally, signing 1-year deals?

It means valuing variety, "starting over", and lateral moves.

It means building relationships and connections that transcend a particular moment-in-time at a particular company.

It means the new connection you make is just as likely to help you land your next-next job - or even the one after that - as long as you nurture and value the relationship. And that could be in just a few years.

It means everyone around you is, subtlety, never not looking.

(And, in a remote world, it's never been easier to "take a call" or have visibility into new opportunities.)

Rebuttal question is probably: "well, how does it look to others if, for example, if I have a couple of 1-year stints under my belt?"

While sure, right this second, traditional HR peeps will likely view that as a red flag, a few other thoughts in my head are:

• The # of businesses launched each year continues to increase (5.4M in 2021; 3.5M in 2018 for example) -> more opportunities

• Moving forward, if it becomes more normal -> it won't stand out in a negative light as much.

  • If we lived in a country where all states got rid of non-competes, maybe that'd normalize (FTC proposed a rule to ban it 3 weeks ago)

• Could argue it's just as much the company's role to keep you as it is for you to "stay loyal" to them -> "well, neither of those 3 were optimal fits because ABC"

• If this approach resonates with you, you won't want to work at a place or for someone who views it negatively -> embracing it may actually help you find a place that your values line up with and then stay longer

Downside? Maybe you won't take as much of an interest in the long-term interests of the company. Also, maybe this would be yet another example of our generation exhibiting commitment issues?

Regardless, it's fun to play with.

P.S. / fun fact: Mark Cuban and I both attended Emma Kaufmann Camp in Morgantown, WV as a kid and then both worked there years after attending.

P.P.S / fun fact: Mark Cuban only owns 1 more NBA team than you.

Fake healthcare idea of the month

Apple launches an Apple a day prevention program aimed at providing its users, especially those with Apple Watches, a curated program of daily and yearly preventive activities to complete.

Orrrrr actually, instead, how about Instacart Health launches an Apple a day program alongside their work with Partnership for a Healthier America? It seems they're trying to get a bunch of fresh fruit into the households that need it most. That = healthcare.

Side note: I've implemented my own an Apple a day. It's a low tech approach. It consists of eating a honeycrisp apple (+ Teddie's peanut butter) almost nightly. I'm obsessed. It's one of my top foods on the if you were stranded in a desert question. It's basically the dessert I don't feel shitty for eating. <- now there's a tagline!

(Check it out, mom, I got desert v. dessert right.)

Book Summary - Four Thousand Weeks

What's the most important book I read in 2022? Yo, great q, great q.

But, for real, it's this one. ^^

Premise:

• We humans have a ton of whacky ideas about time and it twists us up in many ways

• It opened my eyes to what we get wrong, the negative impact it's having on us (hint: simmering angst, anyone?), and wtf we need to do to course-correct

Snag the key insights, takeaways, and actions below.

Talk to me, Goose

If you made it this far, can you:

1. Reply to me and tell me what resonated / what you enjoyed most

2. Forward to a pal? It only takes 20 seconds and this newsletter took hella longer than that!

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-Phil