Volledige transcriptie van 26 - Dr. Brian Birch: Throwing Your Hat Over the Fence

the area and, you know, become in a you know a hospital administrator someplace else or leadership in some other organization outside of this area. do I just stay where I'm at and suffer for the next 20 years, which is not my not my personal or Chip Hart: Nope, no, no. Dr. Brian Birch: do I take the leap and decide to build something of my own? And ultimately it went from, you know, dreaming of what what I wanted a practice to look like, what I wanted care for my patients to look like, and ultimately what I wanted a enterprise organization to look like for the people working in that organization. and bearing those together and saying, okay, I think I I think I can do it. Obviously there's a lot of business planning involved to make sure you financially you can do it. And but ultimately decided that I think I could do it better. And and three years later I say I'm absolutely in. Chip Hart: Yeah. and you know I love that story, and you know that you it's funny, there's so many times where you've spoken about something and I was like, I was just about to read that book or you know, maybe I'll put it now, maybe I'll get to it, or or you know, you you reference something that I've I've found to be influential for years in my in my work. that Daniel book d Daniel Pink book about drive is something that really spoke to me when I read it because it really it really resonated with with me and and in fact I don't know if you were there but when I I did give a talk about it at Pediatric CEO and I think at PMI yeah Dr. Brian Birch: Yeah. Chip Hart: yeah it w it's you know it's autonomy, mastery and purpose. And I fe and and your identification of autonomy being important. is I think that is the that is the heartbeat of the the people you and I work with. You have all the purpose, you have all the mastery. Though and you just said during COVID, even without the autonomy that you would have liked to have had, you're still working for you know, in in a hospital system, in a healthcare system, you had a ton of purpose and a ton of mastery. Like you learn how to bring your this group through a through a an issue and you and you have a real purpose there. But it's the autonomy part that's missing and that's the difference between the independent practices and the the ones who aren't. Dr. Brian Birch: And I would argue my experience is that I wasn't able to fully master my craft because I didn't have autonomy. Like I I I'm a better pediatrician now because I have the autonomy than I ever was before because I didn't have that autonomy and that control over things that really matter for the care of my patients and my staff. and so I think that I think that's something that gets missed of these the the this is there's overlapping dependencies there. You you have to absolutely have a purpose, you know, first and foremost, you know, whether you call that mission, vision, and values. But if you, you know, and if you don't align with the the purpose of your organization or your the purpose of the organization is to make as much money as possible. you know, regardless of what their, you know, the mission is on their website, you know, that affects autonomy, but it also affects affects mastery, I would say as well. So I think they're they're interdependent of each other. And so even when people say, I don't have autonomy, but I'm I at least I have shared purpose and I at least I have shared mastery, I would argue back to say, without autonomy, are you really reaching your potential on on those other two facets? Chip Hart: Honestly, if I get hit by a car on the way to my one of my talks, I'm handing the slide deck to you or Katrina. You understand the stuff so well and you're able to ar articulate about it quickly. I think that you know, I meet and talk to people all the time who who I can tell know what you're talking about because they live it. It's part of their everyday world, but they've never they do it intuitively. And you also I don't know what what's the opposite of intuitive Dr. Brian Birch: Or Chip Hart: ex yeah, extuitively. I don't know. Like that just like you're also able to speak about it. And I th I think that's great. So you know here's your here's your practice forged out of a strong need to be autonomous and to your excellent point that you didn't really reach your capacity without that autonomy. So now that you're an independent practice Do you have some examples of the things that you're able to do or you think the things that give you great relief or satisfaction as a result of of being able to practice independently? Dr. Brian Birch: Yeah, I I you know, I think there's there's different things with patient care that I think I'm able to better. So and that's you know, I'm I did a recent seminar for or webinar for the AEP on care coordination for ADHD. And it was I have full autonomy on setting up how we do care coordination for ADHD. And it's you know, it it's different than anything else I've experienced before where we're doing more proactive care among our patients with ADHD. So it's, you know, we know within the first month or two. after school starts, that's a critical time to be checking in and make sure that the kids are being successful, they're compliant with their medication. but being able to set up systems in place that allow my staff to care for patients independent of a face-to-face encounter with me, identify issues, and solve those issues, whether that's coming in and making a medication change, doing a telehealth visit, or just being like, well, how about you, how about you talk to the teacher about your IEP or 504 plan that's w that's in place and make sure that they're following it. I think from a but beyond just I think the care, it it comes as much about like I'm I I'm now able to care for my people the way that I want to care for them, the way that I myself wished I was cared for in other jobs and organizations. And so, you know, we we as a small, really small practice,

we we have a family a paid family leave program, you know. not anything that's in you know in Idaho is is required by by law by any means. but it was, you know, if I'm if if I'm gonna support all these families as they have kids in my practice, I need to support my employees as they have and grow their families as well. And so we've had one one staff member take advantage of that opportunity and we have two more that will be taking care of that opportunity coming forward and while it's there's you know, difficulties in trying to figure out how are we gonna balance the work of the practice, how are we gonna balance you know, the finances of of that. Ultimately, I'm looking at the long term and not looking at what that eight to twelve week time off looks like. I'm looking really at what's the what's that four year, 10 year time period that look like. Chip Hart: Yep. Okay. I'd I you make your answers too easy because normally people say stuff and I'll be like, well what about this? And I'm like Well one of one of the things that I think Dr. Brian Birch: Mm. Chip Hart: You and people like people we've already named. You and Katie and Katrina and Nelson and Christoph. One thing that you all have in common, besides all doing every one of you doing a massive amount of AEP volunteer work, is you all actually do things very deliberately. you're very conscious about what you where you're going and what you're doing. which is weird that I'm friends with any of you because I never do that. But the it's I I have to think about that. Why why am I stopping and saying this stuff? Because I haven't come up with what I'm r I'm talking about at CEO in a month. So I'm making a note right now. Deliberate. Right? That's that's me. Like we'd have to think about that later. But you're I mean you are one of the more deliberate conscious planners among the practices I know. Dr. Brian Birch: Yeah, and I think that doesn't come naturally to me. I think that's really Yeah. I think that's I mean I I I mean I had ADHD obviously my entire life, but never diagnosed until a year and half ago, right? Right. I mean I I I like to I mean I got finally I formally got diagnosed like a year and a half ago and it was it was, you know, after I'd started the practice. And but I I like to joke that in the setting of in in the setting of Somebody with ADHD that's really great at initiating projects or dreaming big or anything else. Like this practice was so important to me that I actually followed through on it. unmedicated, undiagnosed. that's that's quite an achievement right there, I would say. Chip Hart: Yeah, yeah, of course. Yeah. Dr. Brian Birch: I I would say I'm deliberate and intentional, but I think my my intentionality really just stems from knowing where I want to go. No but also knowing who I am and what and who the or organization enterprise is. And so it actually makes decision making really easy when you know who you are, you know who or what your organization is and stands

for and where you want to go. I think once you get those three pieces down, then decision making becomes really easy. And intentionality it looks like from the outside it's intentionality. you're intentionally planning this, you're intentionally doing this. But ultimately it's just like what What should we do as a clinic in this situation? I have a pa I have an MA who is pregnant. she's a great MA. We wanna support her. How can I support her in her life by providing paid family leave? And then you say, Yeah, do I wanna do it? Absolutely. Chip Hart: Does it fit my mission? Does it fit my values? Dr. Brian Birch: My mission, does it fix who I am? And then and then the challenge is just making it work. and you know, you do and that's where I I was part of a leadership development, a leadership development program through St. Luke's at one point. And one of the things I took away from there is when you come across a problem that has an answer, but the but getting there might be really, really hard, whether financially or anything else. it was there's an old, I guess, Scottish saying or something or Irish saying. It's like you throw your hat over the fence and then you just go get it. So it's like you essentially just say, This is where I I gotta get over that fence. I'm gonna put something of value across the fence, and then I'm gonna go figure out how to get there. And so you know, those sort of situations you just you throw your hat across the fence. Chip Hart: Yeah, throw your hat over the fence and Dr. Brian Birch: And then and then you gotta go get it. Chip Hart: That is that is you know, you're an example of what you're talking about that's relevant to us is my clients who decided that they were gonna f you know, first of all, they were gonna go after the COVID vaccine. They were gonna get it. And then they were gonna vaccinate adults, and then they were gonna do Bay Fortis. And the practices I worked with who said, I'm gonna order as much Bay Fortis as I can and then figure out how do you get paid. Those practices People don't like to talk about it, but those practices made money. And I mean, besides the fact that they saved lives, all right, they saved lives. They don't even know necessarily know whose lives they saved, all right. But they they were having huge, profound, positive impact on their communities, and they did it before they figured out. And I and the practices who didn't see the opportunity, the practices who said, Well, I'm gonna wait and let everyone else give COVID vaccine, They're the ones who like this year, I've I'm an increasing number of practices I know say, Yeah, I'm not carrying COVID this year. There just isn't much demand. And I'm like, how come I have another practice like in your town or in your county that has plenty of demand? You didn't you didn't create the demand. You didn't continue the bond with your patients to remind them of the importance of these things. you know, you you know, you're not doing a flu clinic this year? Hmm. Dr. Brian Birch: I mean la I mean we expected, you know, and nationally we saw reductions in flu vaccines, you know, you know, last year, you know, or two years ago to last year, our clinic increased our rates of flu vaccinations by ten percent. and it was because we did right clip weekends, we did broadcast it, we did remove the barriers for everybody that wanted. And every visit we were like, Do you want the flu vaccine today? And you know, of course people say no. but a lot of people say, Well, what do you think? Should we get it? And it's like, yeah, absolutely. You know, I got it. Yes. My kids got it. you know, you know, yes, that's why I'm offering Chip Hart: Do it again right in front of you if you Dr. Brian Birch: Yeah. Yeah. Yeah. So I think that I think that's, you know, I think that you you you have to be strategic and and not get over your skis too far over your skis on everything. But I think if you know who you are, you know what you want, then you pick those things that are that are core to that. you throw your hat over the fence and and you get at it and that, you know, I think vaccinations is and vaccines is one of those things. Chip Hart: I think it's interesting you you just threw out a very Idaho and Vermont expression right there, like getting out over your skis. For those of you in the south, he's talking about snow skis. All right. When I talk to my friends elsewhere who are like, you're going snow skiing? Like, no, that's skiing. It existed long before water skiing. anyway. okay, so When did you realize that you wanted to become a pediatrician? When did you decide to become a pediatrician? Dr. Brian Birch: Yeah, I think it was probably between my undergrad and medical school. and Chip Hart: That's one that's maybe the only answer I haven't gotten. I've gotten from I was born to be a pediatrician to it was my last rotation. Yeah. Dr. Brian Birch: I like to a story. I think when I was I think when I was six, I asked my parents what you know what my pastor made, you know, as far as you know working, you know, what he made. And they said, probably about the same as your dad. My dad was a carpenter at Boeing, you know, kind of blue collar, there for almost his entire life career. and it's like, okay, that's you know, my parents obviously do fine. that's that sounds good. and they were like, well, yeah. So I'm like, well, I'm thinking either between between being a pastor or or being a a a doctor. And I would say these are, you know, two kind of male figures that were instrumental in my life, my pediatrician and my my pastor. mind you, I was six, and so they said, that's really interesting. They went and t they went and told the pastor and they were like, that's fantastic. you know. And then shortly after I found out the pastor didn't only work on Sundays. and so I I kind of I kinda X that out after that point. but I would say, you know, I was always interested in medicine. I o I think my drive for

building relationships with kids and families was really well modeled by my own pediatrician growing up, Dr. Gagoris. and and then In college, I started volunteering for a nonprofit organization that worked with kids and families with HIV. was and did an internship with them for a year, kind of really focused on more of the psychosocial aspects of care for families and with that background, and started shadowing a PEED's ID doctor so and just really loved that and actually thought that I so went into medical school thinking I would do something like pediatric infectious disease and kind of continue that. passion for working with these kids and families with HIV. found out during a lot of during medical school residency where I I think most doctors are A-type personalities. The PEEDs ID doctors are A plus plus plus plus plus and I really I was never clearly that that that plus plus so so that kind of morphed a little bit through through medical school, but it was always it was always pediatrics, I think from day one of starting medical school. It was just what what direction and it wavered from rural medicine in, you know, northern Idaho to PQ care, hospice care, and ultimately general pediatrics. Chip Hart: So yeah, I d I think as I said, we've I've I've heard so many variations of when people decided. Yours is yours is quite unique. I I I think that that's interesting. All right, so as a pediatrician right now, all right, what is keeping you up at night? Dr. Brian Birch: Not a lot. I mean there's always there's always the things that you can't predict that are coming that may come down. you can't worry about those because you don't know what it's gonna be. so I I don't let that that really keep me up. I think for me, you know, talking about you know who who I am, who we are as an as an organization enterprise, and where we wanna go. I think the the one that's that third piece is where I would say I'm probably evaluating and reevaluating. When I opened up the clinic, I had a pretty good idea of a growth mentality of, you know, potentially multiple locations, having having this growth mentality of of, you know, more is better. and I think I'm now coming to a, you know, three three plus years in to say is that is that actually what I want. not only from me myself personally, or and you know, but is that also what I think is best for the organization and for the community and and that's where I think I'm probably that's the thing that's keeping me up at night is is looking at okay, is there alternatives to just growing big yeah as it relates to where where we're going as an organization. Chip Hart: What it okay, again, that's a really interesting answer. So when you think about alternatives to growing big that are satisfying, what what occurs to you? What's an option? Dr. Brian Birch: Yeah, so I think so I'll wind it back a little bit and just give a little more detail. So when I opened or before I opened, I I built a plan and it probably comes from

some of my project management program development background of saying I I built the clinic with a vision of what I wanted it to look like when I left, when I retired. And what is that and actually building a succession plan into that as I'm leaving from before I even opened up. and then from that twenty twenty five year time period, what is what does ten years look like? What does five years look like? And then what is, you know, one year, you know, then what's a one year goal in between? So coming up on the five years, it was like, Hey, if we're gonna grow into what I want it to be in twenty twenty five years, at five years I would be opening up a second location. Well, three years out from that, it's like, five that that I'm a year and a half away from doing that. Right. And so it's kind of where the the rubber meets the road. and so, you know, one the one idea is growing big to, you know, a five to seven location area and having kind of, you know, formal structure as far as like executive team, et cetera, et cetera. Chip Hart: You and I have talked about some of those options. Dr. Brian Birch: Yeah. but I think the the the but the the alternative I think is is saying during this time rather than adding growth in the sense of of physical growth, more more providers or more locations, can you actually look at adding depth and and and quality? So you know, you look at some of the you know, it's it's I don't think I'll stay stagnant in a way. but it's like do I do I wanna grow in the sense of physical growth more locations or do I want to grow in the depth and the depth of services we provide. So integrate Chip Hart: Specialty words. Dr. Brian Birch: Rated mental behavioral health, care coordination, those sort of things. And I think that's and and those two things may not aren't necessarily mutually exclusive, but it's it's kind of Chip Hart: Say why not both? Why not both? Dr. Brian Birch: And I think it absolutely can be both. but it it also comes down to what do I want for myself personally as well? you know, do I wanna step back from patient care in order to build and scale and grow? Do I or do I feel like I wanna stay in in the owner operator realm in the business term of you're seeing patients and you're running the business? or do I try to balance the two while, you know, having you know, an executive operations person, et cetera, that can help with that growth. I think it there's there's lots of different ways of doing it. It's just ultimately trying to marry what what I want from my own personal life, and what brings me joy, which is a lot of things. that's the ADHD. and but also with what with having that intentionality in in where we're going. Chip Hart: Ugh. All right, so do you ha I I'm curious, do you have a vision for what your succession plan looks like? Dr. Brian Birch: I do, yeah. I can I'm happy to share it. So Yep. Chip Hart: Please, I'm I'm curious if this this is the number one topic in this business, you know what I mean?

Dr. Brian Birch: So I think when you I think when you think of traditional succession planning, you think of just a f there's a few options out there. There is succession planning, which is you retire and your business deteriorates and and goes away. Right. You're owner operator, single person, nobody to take over. We've seen that a lot happen in our area here of independent practices really in the last three years where it's like the owner operator was, Hey, I'm done. I'm retiring and whoosh open one day, close the next, or gradually going out, whether whether intended or force for medical or personal reasons. I think the the second option you look at the second option you look at at finding somebody to take over the practice, particularly if you're small, you find one person, they take over the practice and they kind of carry on and you try to find a mini me of yourself that you can grow, develop and they they carry it on. And then I think the third option really that people look at is, you know, you know, is selling, you know, whether it's PE or or hospital systems. what I've thought about if I'm a bigger organization is actually having an executive board transitioning the organization to a B corporation, so a benefit corporation that you know, much like PCC is in a sense of the, you know, It's not now just about profits and how much margin you can make. It's what's what's the benefit that the enterprise is is providing its community and making decisions specifically around that. I think that's naturally something that all pediatricians do, whether it's formal in their business structure or not. But but I think it it moves away some of the some of the temptations that might be out there in the future when a founder is no longer involved in the day to day operations of the organization. And ultimately my my vision for if a larger organization is is having half of the organization owned by the physicians that are working in the organization and half of the organization owned by the employees. and that executive team board is a 50-50 mix of employee and physician owners. and if they're and the you know, the B core officer in that structure would be a tie-breaking vote. in in the sense of the physicians want to give themselves a twenty percent raise and they want to give a ten percent pay cut to all the employees. You know, you know, things that aren't going to be best great for the enterprise, things that aren't great for the community. The B Corps officer then helps break ties in those situations. And not saying that it's always going to be physicians against employees. That's not the intent, but it it really balances that executive Chip Hart: Structure. Dr. Brian Birch: And so ultimately that's kind of that's kind of the vision. I I just I don't see that structure working in a small practice. It has you have to have at least some substantive mass of an organization in order for that to work. Chip Hart: So you would so in fr with your present circumstance you would need to increase in size, but I mean by the way, that as I said earlier, you remain, you know, one of the more deliberate, if not the the most deliberate, person I work with. And the fact that you've you know, you can name some of these things already, that should that should tell us a lot. and as you know, yes you're talking about something that is very much parallels the PC C process. so just keep an eye. If you just if I'm happy in a year or two then you should be going around again. If I'm not happy then then you then you know. all right so As a pediatrician, what's exciting you? What's what's what's what are we expect are you expecting to see in the future that you're in you're looking forward to that's that's that's exciting, cool, interesting, fun? Dr. Brian Birch: Yeah, I mean I think there's there's a just so much opportunity out there, I think, for pediatrics to to innovate and innovate in a way that large, you know, pr large organizations can't. you know, when I opened up my practice three years ago, I s I started with an AI virtual scribe. so day one opening had virtual scribe, you know, used a used a product, third party software that was, you know, first to market, really expensive. But I really felt like that was the way that was coming and now and now it's fully integrated in PCC and you know, I'd say even better, you know, three years later fully integrated, better PCCs implemented it better than that first to market third party was and any really any other third party that I've used. I think Yes, Chip Hart: Well more securely. Dr. Brian Birch: and definitely more securely. But I think it I think that for I think that there's a lot of there's a lot of options. And there's a lot of potential for small practices to be successful. I was at a recent conference, non medical, about small business operations and you know, I really kinda was was on my soapbox a little bit about we're moving away, I think, in in our culture around an attention economy. It's not just how many clicks you get on Instagram, it's not how many followers you have on TikTok. we're We're really moving to a relationship based authenticity economy. And so with that comes a responsibility. And I Chip Hart: I hope so. Dr. Brian Birch: hope so too. I hope so too. But I think but I I think you're seeing a lot of that coming along as it's now more it's more authenticity based and relationship based than just attention. And I think that's that's that's the superpowers of small pediatric practices. is is authentic relationships. They don't. Chip Hart: This is the thing that the P E guys don't understand. The relationships don't are not just something you can buy and sell and move. Dr. Brian Birch: I think that's I think there's value in that. I think there's there's you know, there's some risk though as we see integration of AI and and different things of of losing that authenticity. And so I think there's challenges that and people will make

missteps. You know, I was talking about, you know, people doing cold calls in businesses for and using AI to help them target their target audience with AI cold calls and you know, kind of made me start thinking about well. If I were to use AI in mind communication with my patients, like that would just ruin the authenticity. you know. And so, you know, being really intentional and careful about how you're using different technologies so that's not eroding the relationship, not eroding the the authenticity. I, you gave the somebody's like, I don't know if I believe you and I'm like, okay, so imagine you have a loss in your family and you get a text message from your best friend that was obviously AI generated. How would you feel? You'd be like you. you Chip Hart: You know? Exactly. Dr. Brian Birch: know, you know, and that's and that's what we want to avoid. And so but I think there's a lot of potential, and it's not just AI, I think I think there's a lot of potential coming for how we build relationships, how we build that authenticity and people seeking that out. I think the the marketing difficulty will be how do you tell people you're the you're what they're looking for. you know, you are the auth you're not the the Walmart of of medical care. you are that that real authentic relationship based care that they're that they're seeking. Chip Hart: I think well, you I think that one thing that pediatricians do without well they do like they breathe is they tell stories. so when you say that difficulty will be how how do you how do you communicate that to people, I think intuitively, as a group of people, you're going to excel at that. All right. You're re- and because you're selling relationships. You are particularly good at selling relationships one at a time, one one mom at a time in an exam room. I do think, of course, there's a lot of room for for us to tell the pediatric narrative better. It because the one part of about the pediatric narrative that is hard to tell. It's not hard to tell, but it's hard to get people to have it sink in. Is that is the is the value of preventive care. Because if you do your job right, people don't notice. Like that's the you're the offensive line of Of medicine. And they only they only know notice when you're do when something goes wrong and even when it's not your fault. And that's a that's a tough story to tell, that part. It's just 'cause human nature's not good at understanding risk and r return. We're just not. but Dr. Brian Birch: But I think but I think it answered. I think there's there's value in painting the picture of what what does a world look like without preventative care? What does a world look like without the pediatrician, without that trust. and I think to your point, yeah, the the value of preventative care and sometimes the value of the pediatrician isn't really f isn't really felt when it's done well. it's definitely not seen when it it's done well. but when it's done wrong, it's it's felt and it and I think people will start feeling, you know, as as there's that some of that erosion there, they'll start feeling like something's missing in the care that my child is getting or the care that I'm getting and we'll go trying to find those answers. At least I help. Chip Hart: Yep, I I I really like your answer. Actually 'cause I I'm just thinking like I've gotta bring your answer back me 'cause you know the users conference next year is about telling stories. That's our theme. And so I'm like Dr. Brian Birch: Yeah happy to know that my wife is one of the keynote speakers, so Chip Hart: Exact that's called volleyball. I went like this and you just do that. And the I've gotta yeah, I'm gonna think about that some more. Anyway, okay, I have two more questions. All right. First, well it's really three, but it's two segments. first, if you could give yourself advice, if you could go back to yourself twenty years ago and give yourself advice, what would it be? What would you tell yourself? Dr. Brian Birch: I mean, I think a a variation of this is what would you do differently? and I think the answer to that would be nothing. I think my time in the healthcare system helped me recognize and grow in ways that I wouldn't have grown if I just went out and opened up my own practice from the beginning. I think the advice that I'd probably give myself though would be just, you know, trust trust yourself, trust your instincts. but keep keep your eye on who you are. and and what you wanna and where you wanna go. very just vision directed. But I think I don't think I would change my journey at all for all the ups and downs and even the bad things. I think I would I've you know we all we all grow from those those those missteps and we all grow from from those experiences. but at at the moment, sometimes you don't even see that until you're on the other side and It's sure nice being on the other side. Chip Hart: Right, right. I've yet, by the way, I've yet to have anyone say I would have become a PCC client sooner. No one ever says it. In your case, you know you could you could like Dr. Brian Birch: I couldn't say that I signed with PCC before I even signed a lease. I knew I was gonna be with PCC before I had a location or a name. maybe I had a name. Chip Hart: I think you had a name, but that was about it. but you definitely hadn't even told your exist that your then existing employers. all right, so you ready? I don't know if you and I have you and I have ha had these questions before. This is a new addition to the podcast, but I should have done it from the beginning. Ready? So just my only prep is don't pay attention to the premise. There are no rules to the answer. It's not though it's not w there's no wrong answer. It what's important is why. Right. So the zombie apocalypse is happening and the zombies are coming. You just know that your end is imminent. That's all that's important. what is the last thing you have to drink if you can have

anything? Dr. Brian Birch: I'd probably say a good IPA. Chip Hart: I mean there's nothing wrong with that. Not the first thing you'd have to drink today. I mean the first the last thing the last thing, okay. Do you have a particular IPA in mind? What's your dream IPA? What what was your favorite? Dr. Brian Birch: So I like there's a brewery out in Astoria called Fort George. it's where Astoria's where the Goonies were was filmed. And they do they have their basic IPAs and stuff, but they have a very robust circulating collaborate collaborations. and I would say about ninety five percent of them are amazing and great. And five percent you you're glad they only bought maybe one or one or two. Yep. but so I like the variety. It's not one where I I would say, it's exactly this one. It's just like, Yeah, give me a give me a six pack of different IPA collabs that they done and I'll sit there and watch the sunset as the zombies approach. Chip Hart: That's I'm I'm I'm on their website right now and I'm like, ooh, I have not had these guys. I don't think I'm what do you know? Anyway, all right, so number two, as you're having this final IPA, your Sony Walkman has enough battery to listen to one last song. Alright. What is the song that you go out with? Dr. Brian Birch: I think I'd probably say closing time. Chip Hart: Okay. All right. Just Dr. Brian Birch: That's the it's the end, right? Chip Hart: It's the end. Yep. All right. It it w I will tell you we've heard a answers everything from Fanta and hot chocolate to propofol a propofol cocktail. we've heard we've heard Elvis, we've heard opera, well certain opera pieces. it's it's really part of part of well, first of all, if you're sitting around, these conversation the conversation about this can go on for like An hour and a half. But the it's really interesting to see what triggers people's nostalgia. That's the that's the thing that like you you learn you learn what was pop what was top forty or what was popular when someone was sixteen is really half half of the answer. I think we just did, in fact. So anyway. All right, those th those are good. I like your answers. Just just save them. All right. You you never know. and you're allowed to change them later if you see me again. I gonna see you in like a month? Or no, like six weeks, five weeks? Dr. Brian Birch: A week and see. Chip Hart: it's NC. I was I I was thinking NCE was the pediatric CEO date. Yeah, I'm I'm gonna see you next week. Dr. Brian Birch: Yeah, so next week for NCE. So there's a bunch of stuff going on by soap I'm have kinda taken a back seat, but I'll be around and I have two talks I'm giving. Chip Hart: That's right, you might be the incoming chair. Dr. Brian Birch: I am the incoming chair. So yep. So I don't I'm not involved in the planning of this year's NCE. the the great team's been doing a fantastic job planning that, but I have I have some incoming responsibilities. and then unfortunately I will be in Mexico at a friend's wedding during pediatric CEO this year. So as much as I would have put that on the top of my list, the pre-planned friend's wedding, I will I will make sure that they're aware are aware of how disgusted I am that they're getting married during Pete CEO. Chip Hart: Yeah, well hey, just so you know, there I think there's about to be a virtual option which will allow you to watch the event later. So Dr. Brian Birch: Nice. Okay, I'll I'll take a look at that. Chip Hart: Yep. So Dr. Brian Birch: Bre breaking news. Chip Hart: breaking news. You heard it here first. well Dr. Birch, thank you. As always, that was as that was enlightening. All my conversations with you are. I appreciate it. I will see you next week and then I will see you are you going to PMI? Dr. Brian Birch: Hopefully. Yep. Okay. I still have that one on the calendar. Chip Hart: Okay. All right. Well, I'm sure I'll be seeing you and you know you know where the s P C C suite is at every event. So come on up. But thank you very much, I appreciate it. Dr. Brian Birch: Awesome. Have a great day. Appreciate it.