S2 E4: Marcus Whitney on Furthering Innovation and Equity in Healthcare
As a healthcare entrepreneur and advisor, Marcus Whitney gets to use his own experience with technology and mental health to advance the healthcare field. So what does he think will it take to bring forward-thinking innovation and racial equity to behavioral health?
Marcus: Hey, my name is Marcus Whitney, entrepreneur, healthcare innovator, and investor.
David: Hi, Marcus. Thank you so much for being with us here at the Mental Health Marketing Conference in Nashville. Thank you for being here.
Marcus: Thanks for having me.
David: All right. We’ll start with your story. Introduce us to your background. I know you grew up in Brooklyn in the ’80s. Could you paint a picture of that for us?
Marcus: Yes. I was born in 1975. I spent my entire childhood in Brooklyn, New York, which was awesome. It is a great place to grow up. You get to meet all different types of people, learn all different types of cultures, which is super cool. I think it’s also just a very ambitious place. You learn a lot about having big goals and working hard. My parents both worked extremely hard. I was lucky to have a grandmother who was alive until about 12 years old. When I would come home from school, she would be the one to take care of me because my mom worked in a department store called B. Altman in Manhattan. She couldn’t get home until 6:00 PM, 7:00 PM at night. My dad always worked nights. He was a correction officer for the city of New York, working in the jail system. He might be at Rikers Island on any given night. He worked nights and so he slept during the days. It was quite a great childhood man. I grew up on an awesome block in East Nashville, East Flatbush, sorry.
David: Now you’re in East Nashville.
Marcus: Yes, that’s right. That was the full part of the area. Now I work in East Nashville, live in Wedgewood-Houston. I’ve been in Nashville for 19 years. In-between New York and Nashville was a really interesting window of discovery for me. I went to the University of Virginia for architecture, ended up dropping out, becoming a hip-hop musician. I did that for four or five years, traveling up and down the eastern coast and landed ultimately in Atlanta. That’s when my life really turned up. I met my ex-wife, we started a family. About a year after the family started, moved to Nashville in the year 2000. That’s the beginning.
David: I know where the focus here is mental health, here at this conference today. Talk us through the journey of mental health. How do you remember being introduced to that? What were your views of that and maybe how they changed?
Marcus: I have no real remembrance of mental health as a child. When I say child, I mean, all the way through my teenage years. I would say probably my first real encounters around this entire umbrella and I won’t even call it behavioral health, mental health, but just disorders. The idea of disorders really hit when both of my boys started to get labeled as ADHD. We started having to go through that whole world. We’re now on the other side of that. It’s not clear whether or not those were appropriate diagnoses or not. That was really when I started becoming way more aware of it. Obviously, there was the societal awareness of it. For the last five years, I’ve been very involved in healthcare and healthcare innovation. It’s an everyday thing for me now.
David: In other conversations I’ve had, I know the topic of mental health among people of color, minority communities has come up. You’re talking about lack of access, stigmas, misunderstanding. How do you view that? How have you seen that play out? How do you think that could be improved?
Marcus: Well, I definitely think that there are different cultural realities from a convention perspective that different cultures have. I think in the African American community, there’s a fairly interesting relationship with the healthcare system broadly. I think that it is an institution in America that has not really served the African American population very well. There are so many instances where instead of mental health and behavioral health services, we deal with the criminal justice system. I’m not making big leaps here, I’m talking about basic stuff. I think that the overall distrust that African Americans have, which is very justified based on history, extends itself into many of the institutions that this country has and the healthcare system is one of them and the behavioral health, mental health, community are subsets of that.
David: Even like, if it doesn’t go to the criminal justice side, even getting access to care, getting access to quality care, provider bias when you’re in care, it seems like there’s just so many factors at play.
Marcus: Yes, for sure. If the people that you see don’t understand your cultural context, then there’s an issue there. There’s a lot there.
David: Is it just education? The healthcare industry needs more education about that or what? What’s that?
Marcus: Well, the reason why I said there’s a lot there is because at the foundation of it all is equity, which is not necessarily something that’s just about mental health or behavioral health, it’s about power, and making sure that in every environment where every person is, there are people there that could be advocates for them, that can anticipate the challenges that they would have and design solutions for them. The conversation is pretty inadequate, do you know what I’m saying? That’s fine. Ultimately, you have to have equal representation and equal distribution of power commensurate with the population. We don’t have that in this country. There’s always going to be a deficit of appropriate care for many people when the power structure doesn’t reflect them. When I say it doesn’t reflect them, I mean it doesn’t understand them. I can’t understand what a woman needs experientially. I can empathize with it, I can want to understand, but I don’t understand.
David: It’s just never going to be at the same level.
Marcus: I’m never going to know what it’s like biologically. You have to have women in power who understand that at an experiential level to be able to design solutions that women need. There’s no difference between that and African Americans or Native Americans or any other demographic group. That’s why the equity in the power dynamic is so key to actually solving– That’s the fundamental problem.
David: It takes time.
Marcus: Yes. That takes a lot of time. That’s a completely different discussion.[music]
David: Zooming out, looking at even bigger picture, what’s one thing that you wish the culture at large in America understood better about mental health?
Marcus: I will say, I think we’re coming a long way. We’re getting much, much better about it. Understanding that mental health is just health. Understanding the brain, understanding emotions, understanding chemicals, understanding hormones, and understanding that there’s no “right way for a human being to exist.” We’re coming a long way. Understanding our relationships with chemical dependency and self-medication. We’re coming a long way in all of these different aspects, I think. Unfortunately, it takes some disasters in order to drive that. The opioid situation is bringing awareness to that. Unfortunately, other previous chemical dependency disasters that didn’t affect white people didn’t-
David: Didn’t break through to that level.
Marcus: -didn’t break through, yes. [crosstalk] When was growing up in New York, man, crack was crazy. It was seen as a drug problem. Now, opioids are really driving this conversation about mental health in a different way. I think that it’s coming a long way. I made a choice 11 months ago to stop drinking for health reasons. It’s been awesome. That along with exercises put me in a position to be able to start meditating daily and to be able to change my diet and be able to focus on sleep. I just see all these things as being connected. I think it is important to focus on mental health, but I think there’s massive connectivity between mental health and physical health and environmental health and-
David: Community connection.
Marcus: -community connection and occupational well-being. This stuff is so connected. It’s so, so, so, so connected. I think we don’t have an integrated healthcare system and so we have mental health and behavioral health over here, and we have acute care over here and surgical over here and nutrition over here, and they’re not coordinated and they don’t look at the whole person. That’s unfortunate.
David: Let’s shift to looking at some of the work you’ve been doing in the healthcare space. About 10 years ago, you made the jump-in with Jumpstart Foundry which specifically works with startup companies in healthcare. What led to you making that jump and why healthcare?
Marcus: Yes. I said, in 2000, I was waiting tables and trying to take care of small and growing family living in a week-to-week hotel. The way I got out of that was by teaching myself how to code. I started in 2001 my- basically, let’s call it a 10-year career as a technologist. I went from like a junior developer to a Chief Technology Officer/entrepreneur over the course of 10 years. Right around 2008, I met my partner Vic Gatto, who was a venture capitalist. 2009, he and I and a group of others folks started Jumpstart Foundry.
It actually didn’t start with a focus on healthcare, it was just broadly early-stage companies, usually with a technology lens on it. We did that from 2009 to 2014, investing in 45 companies. Of those 45 companies, 20% of them were healthcare companies, and they far outperformed the other 80% in terms of money raised, in terms of survivability, in terms of jobs created. We realized a lot of that had to do with the fact that Nashville is a healthcare town and so we had this incredible wealth of assets here in terms of human capital, investors who understood the healthcare business, they could follow on and invest in those companies.
David: That’s a good point. Once the ecosystem is in place, it’s easier.
Marcus: Correct. In 2015, we made the move to make Jumpstart exclusively a health and wellness-based venture business, where we’re now the most active investor in the country in healthcare companies. We invest in a little over 20 a year. Then we also created Health:Further in 2015, which started as an event around healthcare innovation and grew from 650 attendees to shy of 2000 last year. Last year, we made the decision to turn off the event and turn on a strategic advisory business. We built quite a network, we learned a lot about the state of healthcare across the country and where it was all going.
We also felt like the starter pistol had been fired on the next version of the healthcare business with changes that were happening in Washington, DC along with changes happening in the free market that everyone is seeing now. Those changes are lots of public companies and healthcare were going private. There were big consolidations like CVS and Aetna. Then you had really, really big consumer companies coming into the healthcare space. That’s Walmart, that’s Amazon, that’s Apple, that’s Google.
All that stuff basically came to a head last year, and we were like, “Events are cool, but we could be a lot more effective if we were more nimble, more agile.” We’ve been operating like that for the last year and to good success.
David: I like what you said about the starter pistol going off for this new way, this new generation of healthcare. I know you’ve talked about some of the big companies coming in, different things happening in Washington. What will that new health market look like in your view?
Marcus: Well, behavioral health is a big part of it. There’s a growing recognition that many of the issues we’ve been trying to solve with just drugs or the criminal justice system or not solving at all and then having downstream physical health ramifications are really behavioral health issues and can be dealt with therapy or community engagement-
David: On the front end.
Marcus: -on the front end. That’s right. You’re seeing more and more opportunities just in reimbursable dollars coming up in behavioral health. When reimbursable dollars show up, that’s when the acute care system starts to say, “Okay, there’s opportunity here.” I think that’s one big thing. I think large self-insured employers are also a really interesting area. If you think about it, we have a generally speaking, pretty low unemployment rate in the country right now. People, when they think about the jobs that they take, it’s not just about salary, it’s also about benefits.
We’ve worked our way into a system where, as an employer, part of how you compensate people is through health insurance as part of the package. They buy these packages en masse. When you really think about who is the actual customer in this country for healthcare, largely, the free market customer is large employers, and the largest of those are the self-insured employers where they’re taking on all the risk. It’s like they’re the backstop for everything. I think you’re going to see a lot of innovation coming out of large self-insured employers.
When we talk about Walmart, we talked about Amazon, they’re large consumer players, but really what’s motivating them is their employee base. They have a growing employee base. They’re spending a lot of money on the healthcare for that employee base. They know they’re not getting their money’s worth. The employee satisfaction is low, the missed days from work. There’s real labor implications here for not having good healthcare opportunities. I think we’re going to see a lot of activism and a lot of new market solutions coming from the self-insured employer market.
David: Do you think those companies like Walmart or whoever will drive some of that?
Marcus: Yes. When you look at what Amazon launched first, it’s a solution for their employees. The things they’re doing are starting with their employees, and then they’re gonna roll these things out to the greater market. Also, I think they’re going to offer them to other large employers to compete with the existing brokers. These consumer-oriented companies, they’re great because they’ve been living on the mobile phone for the last 5 to 10 years.
David: They are not afraid of the innovation.
Marcus: No, they lean into it. Innovation is their oxygen, in fact. I think that’s what’s so cool and why I use the starter pistol analogy for the last 12 months.
David: They have the experience and the capital to make something happen.
Marcus: Absolutely, and the desire. I mean, I think the other thing that people need to understand is that healthcare is 18% of GDP and growing. It’s the largest segment of the gross domestic product. It’s a massive market opportunity. These are publicly traded companies. Their fiduciary duty is to find new market opportunities and capture market share. Healthcare is the big, untapped market. They’ve ravaged the advertising market, they’re ravaging the retail market. What markets can they go after next? Healthcare is massive.
David: Something that I’ve heard in other conversations is that the healthcare industry historically has been more afraid of that innovation. They’ve been lagging behind, I guess. Why do you think that is and what’s it going to take to get them up to speed? Is it going to be things like this, shift like this?
Marcus: They are that way for very good reasons. It’s basic economics, it’s incentives. We don’t give healthcare systems enough credit. Healthcare systems are high-reliability systems which means, the enemy is variability and the stakes are really, really high. They’re not that high in consumer stuff. If a package doesn’t get delivered or gets botched or something, you’re mad about it, but it’s not like life or death, and you can’t get a malpractice suit as a result of it. The healthcare industry has optimized for high reliability. They’re significantly penalized when they have variability in their systems.
When you think about what kind of organization would you build for high reliability, it’s not going to be an innovative organization. It’s going to be a highly-effective operational organization. They just don’t have that DNA in place. They haven’t been incentivized to do that. The problem is that the system that we have today was designed and built to solve problems of the previous 75 years. If you look 75 years back, what were the biggest causes of death? Famine, plague. Do you know what I mean? It was a completely different world, like disease, and when say disease, I don’t mean cancer. Cancer is proving to be very difficult.
I’m talking about like the measles, polio. You know what I mean? Stuff that we’ve virtually eradicated. I mean, polio is almost gone. Those are massive, massive successes of this healthcare system. Life expectancy has gone up more than a decade. That’s a massive benefit of this healthcare system. Yes, I mean, I think you have to look at that and say it’s been successful. Now the future problems are chronic care and behavioral and mental health. This healthcare system has no ability to deal with those things. You need innovation now, they haven’t been designed for it. They haven’t been incentivized for it.
They’re now going to face competition for it. That’s some really tough position to be in. Those market forces are exactly why we stopped throwing events and we started rolling up our sleeves and working with systems because they actually need help. Quite frankly, in America, we don’t really want them to go under, we want to put pressure on them to change and improve, but we don’t want our healthcare infrastructure to go under because there’s lots of implications for that, that are not good.
David: Now they’re gonna have to face that.
Marcus: Yes, there’s no question, you have to face it now.
David: For a listener, who might want to dive in even deeper on this mental health, innovation in healthcare, what would be a book or resource that you’d recommend to them?
Marcus: Actually, there’s a book called Mind Hacking Happiness. I did the audiobook version of it. It’s kind of hokey, but it’s also right.
David: It’s practical?
Marcus: Yes, pretty practical. I do think mindset plays a really, really big role in the opportunity for you to have good mental health. That, for me, has been a really, really big shift. My ability to process these things and remain happy has largely come from being able to put a little bit of a buffer between the emotions I’m feeling and myself, and be able to give those emotions space to occur and not necessarily respond to them, but to also respect them and try to understand what they’re trying to tell me. Those are things that this book– There’s a lot of other books like this, The Untethered Soulis another one.
I do think we have to do some amount of work on our own. We can’t completely rely on external support for our well-being. We have to do things on our own. Those are a couple of books. They both have very similar messages, but one is like much more spiritual-minded. The other one is kind of hokey and silly. Mind Hacking Happinessis kind of hokey and silly, but those are two books that have been helpful for me.
David: Absolutely, yes. Just to wrap up with this last question. What would be a favorite piece of advice, something that’s meant a lot to you that you’d like to leave listeners with?
Marcus: Three words, mood follows action. That’s been really, really helpful for me because I feel like when you’re in a bad mood, one of the most difficult things to do is to take the action to get out of the bad mood and people who don’t necessarily understand that mood follows action will be waiting for their mood to change before they can take action, and you have to find the strength and the courage and the bravery to take the action in spite of the mood that you’re in because your mood is not the leading indicator.
It’s the trailing indicator of your actions and your activities. When you’re in a funky place, one of the most important things you can do is take an action. If you’re feeling down, go exercise. Do you know what I’m saying? There’s just so many chemicals that we’re learning about every day that are playing a role in the moods that we have. Sometimes you just need some exercise. Sometimes you just need a water. Sometimes you just need to get some sleep, but a lot of times, there’s a physical and physiological action to take to impact your mood in a positive way.
Maybe you’re hungry, and you just need to go eat something, you know. Mood follows action has been really helpful for me. It’s been empowering for me to not feel under the weight of my moods and feel like I need to reach for some external thing like alcohol or something like that, and to say, “No, I have the things within me that I need to at least improve this scenario, what are those things and get better at trying to build a practice around those actions so that I can maintain the mood that I want for the long term.”
David: Marcus Whitney is the co-founder and co-owner of healthcare advisory firm, Health:Further, healthcare investment firm, Jumpstart Foundry, and Major League Soccer Team, Nashville SC. Check out his podcast, Marcus Whitney’s Audio Universe and see what else he’s up to at marcuswhitney.com.