May 14, 2024
Welcome to Perspectives, Leerink Partners’ signature podcast, where we share our insights and interview leaders across the industry to get their perspective on how they’re driving innovation. We’ll also be digging into the backstory to learn more about what has most influenced their success. Be sure to check out all episodes by Leerink Partners.
Sasha Kelemen: Welcome to the Leerink Perspectives podcast. My name is Sasha Kelemen and I’m your host for today. I’m a director at Leerink Partners where I lead our women’s health investment banking practice as well as our provider technology coverage. I’m joined here today by my close friend, Carine Carmy, who is founder and CEO of Origin, which is defining the category of women’s health, MSK, pelvic floor physical therapy. Carine, thanks for joining us today on the podcast.
Carine Carmy: Thank you so much for having me. It’s a pleasure.
Sasha Kelemen: Carine, why don’t you give our audience here a brief introduction of Origin and your role to set the stage for where we are today.
Carine Carmy: Sure. Well, thank you again for having me. Carine, co-founder and CEO at Origin. We are the leading provider of women’s health and pelvic floor physical therapy, and we deliver that care both in person, across clinics and multiple states. And then virtual care and nationwide in case anyone is listening, and they don’t know what their pelvic floor is, it is at the center of our body and it’s responsible for so much including bladder and bowel control, sexual function, holding up our organs, blood and lymphatic flow, much more. And yet we have not talked about or addressed these healthcare issues for various reasons, but that’s the broad overview.
Sasha Kelemen: Thank you. And look, we definitely want to spend some time today touching on the truly incredible and much needed work you’re doing at Origin. But first I want to level set the focus for today’s discussion. My number one priority here is really to get to know the person behind the c-suite title and company. Truly behind every leader, there’s an incredible past filled with unexpected twists, pivotal experiences, and I’m sure critical moments of truth. And importantly, your path to where you got today is not straight and narrow or typical, and we think that’s a really good thing. I have a thesis that in order for someone to truly persevere, it’s critical to identify one data point in common with a leader who has already made it so to speak. And by sharing your story, I hope this inspires the next generation of leaders to overcome new challenges and pursue innovations in healthcare that they otherwise may have viewed as unattainable. And so, with this backdrop, I’d like to just run through a very quick exercise to help our audience get to know you a little better. If you had to pick three identities to describe yourself outside of your formal role at Origin, what would they be and why?
Carine Carmy: Ooh, okay. I think one would be a creative. I am feeling the most inflow when I’m writing and kind of in just much more creative or even poetic head space. So that would be one. I would say the mover. I have a hard time sitting still. I need a workout every morning. I am just in constant flux both my mind and my body. And so, if my body can get moving faster, it’ll help all of me settle. So that would be the second. And then mother, I became a mom in 2022 to a beautiful daughter Carmel, and it’s been an incredibly formative experience.
Sasha Kelemen: I love it. Incredible. I love the perspective of creative and a poet and a mother and a mover. It’s very LA I would say and very much explains a lot, but I love it. So, let’s dive in a little bit and talk about maybe your early path. I’d love to learn a little more about your family how and where did you grow up? Did you have any siblings? What was that early childhood experience like? And did it really foster that creative spirit that you just talked about?
Carine Carmy: I grew up in LA. My parents moved here from Israel in the seventies, and I grew up with a brother. We now have a much bigger family, the modern American family. As my parents parted ways, I have more brothers and sisters, but that was our core growing up. And they were both also small business owners. My mom was a practicing architect. She had a studio in our home and my dad had a car business. And so, I was always around that kind of entrepreneurial hustle, which in some ways both attracted me to the business world, but also was daunting. I think if you see firsthand that immigrant small business mentality, it can be a lot and a lot of stress. And I was aware of that growing up. So that’s one piece we can come back to. But also, my mom having her studio in the house, our afterschool activities was me building models with her. She’d just basically give me foam core to play around with. And so, I was always in that kind of creative and building mode throughout my childhood.
Sasha Kelemen: So, did you think that you wanted to be an artist like your mom when you grew up, or were there particular paths that you were attracted to or thinking about as a potential career later on? How was that evolution given the two different role models you had in front of you here?
Carine Carmy: I was never that good at the visual arts, so I would make projects that would fall apart. So that was a pretty clear no for me, I wanted to be president when I grew up and now, I would definitely not want to be president of the United States. I think I was always just following different threads of what was role modeled to me both in the home, but then beyond that, I think one through line though for me was always writing. I started entering writing competitions when I was a kid, which I didn’t even know was a thing until my mom encouraged me to do it. And I didn’t expect writing to necessarily be a career path, although at some point I thought I wanted to be a journalist, but I did know that for me, communication was always so powerful and so critical and just kind of made me feel alive in whatever way that would take shape.
Sasha Kelemen: I love that so much, especially the idea of writing, storytelling, sharing a perspective. Curious what kind of writing that you preferred. What was your specialty?
Carine Carmy: When I was growing up, I liked to write both poetry but then also fiction, which is daunting for me now. I don’t think I’ve touched fiction in more than 10 years, but I love to read fiction and I love stories, but then it was all about kind of world building.
Sasha Kelemen: World building, which I think is a lot of what you’re doing now, which we’ll get to in a little bit. And you mentioned various role models. Who are some people that you looked up to and what were some characteristics that were appealing to you or interesting as you were thinking about where you wanted to spend your time in the world as you got older?
Carine Carmy: I wish my memory for the specific people were more clear from childhood. Obviously, I think teachers that I was around had a really pivotal role in my life. I grew up in a very small school. I went to the same school from kindergarten through high school. And so, I had this beautiful community that I was a part of always and felt really safe and held there. And so, I think the teachers in that environment were really a big part of that and helping us follow those paths. So, I’d say that was one really, my parents are probably two of the biggest role models in my life for different reasons. But I think the leap of faith that it takes to leave your homeland and come to a new place and then reroute and build a life that’s vibrant and connected I think is so inspiring. Not only were we growing up with our immediate family, but there was always so much community around us. And so that was really important for me. And even as I think about company building, how do we make it feel more like a community? And I think in women’s health, it does take a village to change this industry. And so that’s been a critical value for me as well. And then one piece of my childhood is that I grew up in a Jewish home and that was always kind of a value system that ran through. And so, whether that was the rabbi I had growing up or just even the structures around that kind of the values of our personal responsibility to shape the world around us was always really critical for me too.
Sasha Kelemen: That’s super interesting and especially ties back to the idea of having different identities, especially as the daughter of immigrants learning to straddle multiple cultures as well as growing up in a home where both parents are really much finding their own vocation and path on either creative side or otherwise. It sounds like a really potentially productive environment to nurture interesting ideas and potential paths forward. Where did you go to school? What did you study? Was it communications marketing as you mentioned in terms of your focus on creative writing, and did you really know that would be your focus from the beginning or did you kind of change perspectives over time?
Carine Carmy: So, I wrote my whole college essay around wanting to be a journalist, and then I went to UPenn undergrad, and I showed up and I was like, okay, we’re going to go down the business path. I get it now. And I think that was always in me too. I was quite strong at math growing up. I didn’t end up applying to Wharton, which I think was good for me so I could have a little bit more of a balanced liberal arts education. But I was really lucky. I don’t think my parents understood what east coast ivy league schools meant or what doors that opened for me. And I had a college counselor who helped guide me through that and also the financial assistance required to do that. But I got in early to Penn and kind of on a whim went and showed up and moved across the country and discovered the popped collar for the first time. And I was like, “what is this place and who are these east coast people?” So, it was a bit of a culture shock, but I really am so grateful for that education. I studied economics and then I minored in political science, and it was a fascinating worldview for me for a few reasons. One, on the philosophy of business within the econ school versus the business school, I got to kind of look at the lenses of business and economics and macroeconomics a little bit differently. And so, I’m really grateful for that. It was also right around the time where behavioral economics and rational choice theory was rational choice theory was being questioned and behavioral economics and Dan Ariely and that whole field was taking off. And I remember asking some of my professors about it, I’m like, “this sounds more interesting and more real life.” And they would tell me, “wait until you’re a PhD to ask those questions.” So, then I realized that was not the path I wanted to pursue, but I still feel really grateful for that education and frankly, the doors that opened for me and just the worldview of being in a completely different environment.
Sasha Kelemen: It sounds like that was probably the first time you were sort of taking a path somewhat similar to your parents in that you left your home, smaller school, smaller safe environment, went to the east coast to a much larger school and institution, potentially got exposed to different diverse perspectives and value systems. Was there anything that you were really surprised by during your time at Penn and anything that potentially made you extra curious whether inside the classroom or it could be someone you met or an extracurricular activity?
Carine Carmy: It’s a really good question. I think more of the big awakening surprises happened a little bit later in life, but I think I’m just so grateful for how luck can play into success. I remember this is less about school, but I walked into that whole industry of consulting and banking, and they come on college campuses and do recruiting and would’ve never been exposed to that world and that door that opened up several other doors in my life that got me here. And it was really kind of this combination of luck, curiosity, asking questions, and then a lot of grit and hard work and preparing that kind of got me through there. And so, I just feel grateful that you can be in those places and that gets exposed to you. And then it also, I think creates a really deep awareness of the inequity that can happen when you don’t have those doors open for you as well. I actually did my economic thesis on intergenerational income mobility and just the stagnancy that was so obvious, I think, and it’s still so obvious to so many of us, but I think when you’re in an environment like Penn can be hard to actually see firsthand. And so, I think I’ve been trying to live since then in this duality of both the gift of privilege and what that can mean and what that can do if you use that to open doors for others, but also the reality that our world is not a fair and equal place.
Sasha Kelemen: Could not be truer words. And so, you packaged that together and decided to go into consulting after Penn. Is that right?
Carine Carmy: In retrospect it sounds like a perfect story. I was really looking for a way to pay off my loans I have, and I’m like, “great, this job is going to have a good starting salary and I can live in New York and go out a ton and have fun.” And I spent all my savings in my twenties, it was really fun. But I also graduated college in 2008, so right into the recession, and that was incredibly formative to be having my job protected while 20% of the firm I joined was laid off. And so, that reality check that there’s not as much security or permanence as you always would like there to be.
Sasha Kelemen: So, knowing that perspective, what kind of projects did you work on or what kind of clients did you have exposure to in your role in consulting? When did you decide it was the time to transition to try something new? And then what did you do after that?
Carine Carmy: Yeah, I had two mainstreams of work I got to focus on. One was in healthcare, and so I got to work with really large multinational healthcare companies on everything pharma drug launches to health system understanding. So, it gave me this incredible insight into the underbelly of the healthcare system, which has obviously been very helpful as I’ve progressed in my career. And then I was also part of a group called Marketspace, which was focused on digital, and that was when digital was capital D. And there was digital strategies and companies were figuring out what that would mean and what is social media and how do I build my e-commerce business. And it was really early days, and I think my heart was actually more in that team and that kind of work around innovation. I’ll never forget, I was sitting next to one of my colleagues and he showed me this video that came out of the MIT Media Lab by Patty Mays, and it was called The Sixth Sense, and it was basically, imagine wearing a camera connected to device today, but it was so eye-opening to me. I was just like, “okay, I need to work in innovation. It’s over.” And so that was the beginning of that path for me. And in 2009, our digital media practice was spinning out and I said, “I want to go work with you all.” So I joined three partners and it was the three of them and me, and we started a boutique consulting firm that was called Marketspace Next. So, if Monitor was in the 50,000 feet in the air view advising companies, this was call it 10,000 feet. And so, I got to spend a lot of time with really incredible businesses building out their digital strategies, everything from healthcare to e-commerce and everything in between. And I did that for a period of time, but then I ultimately hit the wall where I realized you can be in your early twenties as a consultant and that can be a career path, but I had a deeper entrepreneurial itch. And also, I had never really done anything hands-on before, and it was time for me to cut the cloth or whatever that saying is.
Sasha Kelemen: And so, what did you do after that and was there a moment that made you decide today’s the right time, or now is the right time for me to pivot and try something new?
Carine Carmy: I don’t think I’ve ever shared this part of the story, but I was living in Brooklyn and two of the partners were in Boston. I was often alone, and I realized after a bad breakup, I was like, “okay, I need to work around people.” So, it was really a personal kind of catalyst at the time and coupled with this kind of deep knowing that this was not the career path, but I wanted to share that. I think it’s so important that in retrospect, it always feels like this linear story. And sometimes ironically, a breakup can put you on a career path. But I did try to start a company with a couple friends, and it swerved into something not successful. And so that was a great learning experience though. And then I started trying to break into the startup world at the time, and that was when the New York tech meetup was still a thing, and it was only a couple thousand people and the New York tech community was really intimate, and it was really hard for me. I applied and got rejected from dozens of jobs, and I knew I had skills, but it was really hard for I think someone to take a leap on a consultant versus someone who had already been operational. And so, I ultimately got excited by 3D printing after reading an economist article and going down a rabbit hole, and I wrote a blog post about it and I sent it to the CEO of a company called Shapeways, which was really early stage then is now a public company. And I said like, “Hey, I know it doesn’t look like I know what I’m doing but hire me to be your marketer and I promise you it’ll be a good decision.” And he took a leap of faith on me, and that was the beginning of kind the startup path for me.
Sasha Kelemen: I love that so much. So, you proactively wrote a blog post or thesis essentially and just sent it through to I guess the key decision maker there. Most people I don’t think have the audacity to do that and kind of go out their way and advocate for themselves. I think especially women, people of color or others with potentially non-traditional backgrounds tend to shy away from doing that. So, kudos to you for putting yourself out there. You joined Shapeways to lead their marketing efforts. Did you have any direct reports? Walk me through what the organization was like in the early days.
Carine Carmy: In the very early days, it was fewer than 20 people across multiple geographies. So, it’s a very small team. I was the only marketer, and I was just me to start. And I had a couple peers that I was working with. I remember my first week they said, “okay, great, you’re going to go to Dutch Design Week and man the booth or woman the booth.” And so I was in the trenches, the doer. I quickly grew in my role and became director and then VP of marketing and then over time oversaw our marketing and community and e-commerce teams and worked with our sales team as well. And I was really lucky to have a leader and Pete the founder who saw potential in me and gave me that seat at the table. And it was an incredibly formative experience. The industry was just explosively taking off at that time. It was the renaissance of 3D printing, and we had incredible VCs around the table from Union Square Ventures and Andreessen Horowitz and Lux Capital. And so, I just got a very fast training ground in startup culture in rapid growth and what makes success, but also some of the challenges with that for sure.
Sasha Kelemen: It sounds like at Shapeways, I think the CEO you mentioned was potentially a really transformative manager or sponsor for you during that experience. But were there others that sort of helped shape your journey and potentially mobility to come in as director and get promoted to VP and then ultimately lead that team?
Carine Carmy: Definitely. I mean, I think another one of the co-founders, Marlene, was really supportive. And I think especially for me as a young woman around the table and then a very close friend of mine now, Justine Truby who was leading our operations, she was much more senior than me, and so we’re actually frankly all the other VPs around the table. But she would really help coach me through especially board dynamics leadership, team dynamics that were really new to me. She was the first person to teach me what upspeak meant when people turned questions, and I didn’t even know that I was doing it. And she just said, “Carine banish this from how you speak because it’s really undermining the quality of your work, you’re undermining yourself by doing that.” So that was really helpful for me just to have some trusted, real talk from peers who were much more seasoned than me at the time. And then I also had access to an incredible coach just for one session, Jerry Colonna, who is the founder of Reboot, which is an incredible coaching program. And through him I got the most helpful advice, which was, you have a seat at the table, it’s your job to sit in it. Which I think for me at the time, I didn’t realize we had some imposter syndrome going on. I was like, “yeah, you’re right. I need to sit in this chair even if I’m 10 years younger or this is my first time in this role.”
Sasha Kelemen: You obviously at some point decided, okay, the next step for me is something different. Was that Origin, was it another step to getting to where you are? Talk me through kind of the early idea generation for the current business.
Carine Carmy: I actually went, was at Shapeways for about four years, and then I moved to San Francisco and helped launch a business called Amino, which is in the digital healthcare space with an incredible founder, David Vivero, who’s a great friend and mentor of mine. But it was towards the tail end of my time at Amino when I decided to really take a step back and look at what was going on in my life. On a personal note, this was before Covid, when you still had to fly for work when you didn’t live in the place where you were working. I was flying between San Francisco and LA every single week, and it got so intense that I actually developed Vertigo every time I flew. I was like, “okay, my body is telling me this is not what I should be doing”. And we were also at a point in the business where it made sense for me to kind of shift roles. We had fully pivoted from B2C to B2B, and I kind of led the team through that change. But I think you get to that point where you say, “is the life trade off worth the benefits of the work?” And for me at that time, I decided to take a step back and I did what my immigrant parents thought was insane and I quit my job, no job lined up and was still supporting the team as an advisor, but really decided to say, “let me take a beat. I’ve been working nonstop since I graduated college at 21. I’m like, it’s time to just breathe and figure out what’s next.” And I think one of the root decisions or reasons behind that was kind of feeling out of alignment with intuition and with what was really making me happy. And I think this probably happens to a lot of people in their thirties and forties, but you get to that point where you’ve been on one rollercoaster and you realize you’re on the wrong ride and you’re like, “okay, how do I jump midair and this other place I want to be.”
Sasha Kelemen: Hopefully land somewhere.
Carine Carmy: Exactly. So, it was really daunting. I spent a lot of money on a coach without income, which was also a crazy thing for my parents, but it was the best investment I made and I’m so grateful to her, Bristol, for that work. But I think you just had to unwind and reroute in yourself. And for me, that’s so important, both theoretically as an individual, but also as I think about what we’re building at Origin, I think that a lot of people, and especially women, we’ve been out of alignment because of the societal pressures that are thrown against us at various points in our lives. And for me, that had to do with my healthcare and how I was not necessarily supporting my health in the right way and also the decisions I was making at work. But I see with so many of our patients, just this lack of understanding of our own bodies and how that can translate into things beyond our body. If we are not rooted in ourselves, it becomes so much harder to just be present in the world and to actually recognize the signals that are coming at us when they’re either to our benefit or not. It’s our job as leaders to get clear on who we are, what we believe, what our vision is, so that we can either take that information as feedback and adapt to it or just take it as information that we don’t always have to respond to.
Sasha Kelemen: So, as you were going through that self-reflection process, and it sounds I think a lot easier said than done, as you noted, right? Very much an investment in yourself and being comfortable with the ambiguity of what is next or what am I doing now? Especially since so much of our identities are often tied to our profession or our careers, if you thought about how to get back into realignment, who am I? What am I meant to do? Or what is really my vocation? Did you think you were going to start your own business, your own entrepreneurship journey, like your parents, or were you really trying to just get back to who is Carine and how do I move forward from here?
Carine Carmy: I had these two very distinct paths. One was let me go back into the tech startup world and take a great job as a VP marketing, CMO, whatever, and make some great money and have that very comfortable life or go down this crazy entrepreneurial path that I’m on right now. And I ended up putting a piece of paper together, which was just the criteria for what I wanted my life to look like, not what the job would be, but what that experience would feel like. I just started filtering everything that was coming my way or that I was exploring through that. The only thing that met my criteria is what is now Origin. And had you told me at the time I’d be starting a location based, but also virtual, a healthcare company in the services world in pelvic health, once you start to get that’s that piece around alignment, if you know what you’re looking for, it becomes incredibly obvious even if that thing is not what you always thought it would be. And I also really credit my co-founder, Nona, who’s an old friend of mine for partnering with me on this discovery of what is now Origin. And we started to really uncover the industry and the opportunity and the massive white space and just the unmet need that was so obvious that once you see it, you can’t unsee it. And I think that’s really kind of the vision of starting a company.
Sasha Kelemen: That resonates with me so much in terms of alignment, figuring out what you want and don’t want. I went through actually a similar exercise, I think you described it a lot more eloquently, of identifying what are things that I need versus what I want both professionally and personally, and what are potential career paths or types of lifestyles that fit both. And I think it’s important to figure out need and want are two different things as well as what you don’t want. That kind of helps you provides guide rails for how to move forward and how to make sense of this often chaotic or confusing world. Talk to me about how did you find your co-founder? You mentioned you’re friends from a prior life. It’s obviously a big transition and I often find that finding the right co-founder can make or break any business regardless of the idea, the tam, the technology or product. What was that experience like and potentially how has that relationship with your co-founder involved over time?
Carine Carmy: It’s such an important question and I do think that so much of what we do at work is who we work with that defines whether it’s your co-founder or your peers, your manager. And so, I think choosing the who is maybe oftentimes more important than what. I have the benefit of having a deep long history with my co-founder as friends, we weren’t best friends, which I think makes it easier. We’ve known each other for a long time, and I’d actually started talking to her husband about working together on a business a couple years prior. We have very complimentary skills, what would it be like to work together? But we rolled out a few businesses over those years and then Origin was the first one that I think met all of our criteria in boxes and checked those. What was interesting for us was even though we knew each other socially, we started working on the business before we all decided to make this our full-time vocation. And during that period is I think when you could also build a lot of trust, which is how are the micro decisions being made around ownership and equity or how do we actually work together on a day-to-day basis and do we want to be spending 12 hours a day together? So those types of things where it became increasingly clear, this quote I heard recently about motivation and this idea that sometimes you think you need motivation to start something, but other times it’s actually in the thing, in doing that you get the motivation. And I think the same is true of relationships in it is when you start to actually understand what is the quality here.
Sasha Kelemen: So, you and Nona, and it sounds like her husband talked through or brainstorm multiple ideas over the years and you landed on origin. So, talk me through how or why you decided this is it, this is what I want to focus on. And then also very curious about the origin of Origin. How did you pick the name?
Carine Carmy: Oh, good question. Just to start on the why, I think it’s incredibly rare to be able to identify and see an opportunity that impacts so many people. One in three women have pelvic floor disfunction, one in nine men. It’s probably more because we’re underreporting these issues. So, to be able to work on a problem that is so prevalent and is so widespread but is not tackled yet is pretty wild. And I think for the marketer and storyteller in me to be able to help shape the way that we interact with the healthcare system and our expectations of the healthcare system as women just felt like a gift. I was like, “okay, well this is the biggest and most fun challenge I get to work on maybe in my career, but at least for now.” And so that was incredibly motivating and from a naming standpoint, we battled around a lot of names. But I think for us, the beauty of Origin is that there’s a freshness and a beginning quality towards it. And I think a lot of our patients, myself included, if it’s not around pregnancy, if it’s about going through menopause or going through a different healthcare issue, there’s a beautiful new beginning that can happen with every time we heal ourselves and then grow from there. And we wanted to kind of tap into that energy. And the pelvic floor is the center of where life comes from. So, there’s a little bit of a literal meaning too.
Sasha Kelemen: You’ve been as a co-founder and CEO a number of years now obviously you have gone through a global pandemic on the other side of pandemic, you’re now seeing patients nationally as you mentioned in clinic as well as virtually. I imagine there’s been a lot of changes in the business and the team over that evolution. So, can you maybe first just start off in what were the early days? And then that, if you take us a few steps forwards a few years forward, how has that sort of evolved a little bit since then?
Carine Carmy: While the dynamics of the market has changed a lot, ironically maybe with the exception of the virtual care model, our vision has actually remained really steadfast. And so, it’s been interesting to kind of see that through line. We partnered with a local clinical team in our early days, there was a practice in Los Angeles called Bebe Physical Therapy, and they were one of the only in-network practices for women’s health and pelvic floor PT in Southern California. And so, we said, let’s actually start to learn about this industry. And that’s how we both, Nona and I got exposed to the really big opportunity and that practice owner was actually leaving the business moving to Mexico, and there was a big question mark of what was going to happen to Bebe PT. We actually partnered with that local team and that was the genesis of Origin. And so, my first office was a desk I shared with five PTs and the story of a strip mall in Santa Monica. And that was how we started. And I’d say the first kind of year and a half was like that really actually just getting into the nuts and bolts of the business, not wanting to change too much until we really understood what our big vision was going to be and the role of technology. I like to joke that the first thing I did that was really value add was introduce Gmail to the team because they were still on paper. So, there was a lot of just basic small business work to do. But obviously this was the beginning of the platform, and the clinical team was so incredible and so early days was humbling to say the least. Then Covid happened. And so, we were actually in the middle of building out our first branded clinic called Origin in 2020 when the pandemic hit, it was a 4,000 square foot space. So, it was also the biggest space we’ve ever had and learned a lot about not going too big in the future, but incredibly terrifying and challenging. I’d say the silver lining was that this was the first time that virtual care was being reimbursed for by payers for physical therapy. So, for other models of care, they had adopted virtual way earlier for PT, it wasn’t actually done yet. And so, we were able to save the business and keep our lights on virtually for a period of time. And what was so exciting to me was actually to see how well it was working for our patients that so much of what we do is education and therapeutic exercise. And so, we ended up building kind of a secondary parallel path business of virtual care alongside our clinics when we reopened. Flash forward in 2023, we launched virtual care across the country after we piloted over those few years, and we have now clinics in multiple states as well. And so really are kind of continuing to expand with the core philosophy in mind.
Sasha Kelemen: Incredible progress, especially in the middle of a pandemic, totally pivoting the business model and expanding, I think that is ultimately what separates the companies that survive and make it’s, can you pivot and really find that product market fit very quickly. But I presume that some of those challenges or surprises you may or may not have agreed with your co-founder or other leadership team. How did you corral others to align on a certain perspective that you may have or were there situations where you as a leader had to agree to disagree to move the business forward? Can you just talk to me a little bit about how you handled some of that potential conflict and then ultimate resolutions to move the business forward?
Carine Carmy: You know, it’s really interesting for a business like ours is that we have the business team and then we have the parallel path clinical team and our teams are actually distinct legally and structurally. And that’s so important because you want to be able to protect patient care and a businessperson should never be driving patient care. But I’d actually say that that’s worked to our advantage and that having those different hats around the table creates a really healthy tension and dynamic around decision-making. To be honest, I’m not sure that there’s been fundamental disagreement on direction, but there’s definitely been a ton of stress as you think about Covid having to furlough people for a period of time, macroeconomic conditions, and then operating, taking insurance in an industry where, and in a time when healthcare burnout is so high. And so I think it’s less of a disagreement, but I think the challenge and the navigation that we continue to have is we have this really positive and aspirational big vision both for what we’re going to do in the world, but how we’re going to create a company that doesn’t look like traditional PT, where you tend to have very high degrees of burnout among clinicians. So, you have this big vision, but then the details of how you operationalize that and how quickly you can get there and the frustrations that happen when there’s dissonance between who you want to be and who you are today. I think that’s the tension that we live in as a leadership team and as a company. And I think it’s our job to navigate those moments where we’re not where we want to be yet, and we have to own up to that reality for our team.
Sasha Kelemen: Knowing you, you’re always one that likes an extra challenge, and you always wear multiple hats. And so, you get through at least the more challenging part of the pandemic, you pivot and then you take on a new leadership role as a mother. I know you and I are both actually on maternity leave at the same time. You were a rock to me getting through that period, and I can imagine it was, I always think that CEO and co-founders who are also mothers are really just superhuman juggling multiple hats. How has your either leadership style or perspective of being a founder and CEO changed now that you are a mother?
Carine Carmy: One, thank you also for responding to my messages late at night, which is later for you than for me. I had a very hard transition into motherhood, to be honest. I think I had a lot of resistance. I was obviously so thrilled about being able to have a child and start a family, but the kind of identity shift hit me really hard, it took me some time. And so, I think there was a bit of kind of the darkness that happens in the beginning for some moms, and I definitely experienced that. That was really hard and humbling and I think potentially also helped me connect to other people on our team more in those moments because I think until that point, I had been kind of this source of endless optimism and when you go through these hard times yourself, you’re like, “okay, well let’s actually talk about the edges and live in that a bit more.” So, I think it probably helped me just be a more well-rounded human overall for our team, I’d say is one thing. The second is, there’s this truism about working parents in general around you have to get much more focused and with your time, that’s been true for me. But I think my big shift in the last 6 to 12 months has been how do I get even more clear and direct? Because when you’re not clear and direct as a leader, that creates cycles of challenge for your team. I see that with my daughter too. You need to have boundaries and you have to have also places for play. And so, I think getting really clear has been my north star so that I can lead the team through what is always going to be a rapid pace of change and flux given the environment we’re in as a business.
Sasha Kelemen: What are things that you do to get really clear as a leader? Similarly goes back to getting realigned that we talked about earlier. What are some things that have worked well for you to potentially get realigned during these moments of transition or moments of change?
Carine Carmy: So, there’s a few things. I think there’s one, how do you just manage your own stress levels and mental health? Because if you don’t do that, then there’s no clarity because it’s all covered in gunk. I have to work out every day or at least move every day or I can’t flow through that energy. So, there’s some level of movement. I try to meditate every morning. I also try to journal even for five minutes in the morning. It just kind of really helps me get into just much more clear headspace before the rest of the day piles on. I also started doing a weekly practice at the end of the week where I just reflect on the week around what matters most and what have I learned. And that muscle of just having that internal dialogue I think has been really helpful for me to process. And so those are kind of some of my internal tools and processes. And then I think coming into conversations either with my co-founders or leadership team or the board or even peers with more intentionality. So how do you take those five minutes before the meeting to make sure you’re really clear on what you’re trying to get out of that? It’s really just a ton of micro practices that just help kind of shifting you back towards what is probably known to you. But if you don’t get the clutter out of the way, then it’s hard to see.
Sasha Kelemen: I think it’s a really great way to summarize as well, what a leadership journey, a career path professional development is. It’s a number of micro paths, small steps that are usually not linear, even though we would all prefer them to be. Usually there’s potholes or twists and we have to learn how to get back off our feet, what have we learned from the experience, and then reassess and move forward. I think that really rings true. And I think the word that I would describe that as hearing your journey is really resilience and self-awareness. And I think it’s an incredible quality that we don’t often see, and it can be really challenging to find the time to set and reassess. And so, I think I may have to actually borrow some of those suggestions for my life. So, thank you. One last question for you here is looking back at what you’ve accomplished so far today, and I have no doubt, and I’m so excited to see the future and what you’ll be able to accomplish, both as a leader, as a mom, a creative, and someone always in movement. But if you had a piece of advice to give to either your younger self or perhaps your daughter, what is something that you would share?
Carine Carmy: I actually got this advice from Nona a few years ago. I’ll use the PC podcast friendly version of this without the language, but she said, “Carine, you’re your best when you give less blank about everything else, just declutter.” And I think there’s this connotation around the word selfish or self-centered, especially for women. And what I’ve realized over the last couple of years is that the more we center on what makes us feel good and is in alignment, and obviously there’s limits to that, but we just over orient towards others in ways that actually detract from your own health and space and time. And I think the more that I’ve just rerouted on what’s actually true and right for me, it’s been net positive for everyone around me. And so, I think just giving yourself the grace to be selfish, even in ways that feel indulgent and obviously get the feedback if you’re taking it too far. But I imagine for a lot of leaders, a lot of women, we’re not taking those steps and we end up feeling depleted more often than we feel cup full.
Sasha Kelemen: Carine, thank you so much for sharing your perspectives and your experience with us here on the podcast. It’s been an absolute pleasure to have you.
Carine Carmy: Thank you so much. It was a pleasure.
Thank you for listening to this episode of our Perspectives podcast. If you are interested in participating in future podcasts or would like to learn more about Leerink Partners, please email us at info@leerink.com.
