“Culture is set and reset every day. It's about the decisions that people are making and what you value. It’s done in action and not by words. It’s reflected by who you hire and who you don't hire.”
Amit Shah is the Chief Clinical Operations Officer at Virta Health, a tech company that has reached a $2B valuation by creating a new method for diabetes care and is on track to reverse diabetes in 100 million people. Prior to the role with Virta, Amit held numerous operations roles including being the Market Leader & VP Operations of Everside Health which recently filed for an IPO. Amit received his MSE at the University of Michigan and his MBA from Stanford University.
You got your MBA at Stanford – Tell us about that experience and the role it has played in your career?
Overall, it was a really powerful experience. And I think that the thing that made it very powerful was, first and foremost, all of the people that I met. I met really incredible, thoughtful people that came from different walks of life and that have shaped my thinking over the years. It was also really helpful that I had two diverse work experiences before business school - one as a consultant and then one as a co-founder of a startup. Business school helped me build a better business toolkit and a better personal toolkit also.
Was there one key philosophy or lesson you learned there?
Stanford focuses a lot on leadership development. One of the things that they really try to encourage is leading from a place of authenticity. While I did take classes in accounting and all the things you’d normally expect from a practical skill perspective, the biggest lesson I learned was around the importance of people. One of the CEO quotes I heard at Stanford that still rings true for me today is “People don't care how much you know until they know how much you care.” And that just continues to be true in my experience. When you're dealing with people, which in business you generally are, it's about how you treat people. You’ve held quite a few operation roles.
What got you interested in operations? Is it something you set out to be involved in early on?
My undergrad degree was actually in Industrial and Operations Engineering, so there's operations in my degree--I feel like it was predestined. I like organization and systems. I have a systematic way that I organize the bottles for Sameera (Amit’s newborn) so that in the middle of the night when I go downstairs I can get what I need for her in my sleepy stupor. It’s always been part of my mindset and how I'm wired. I enjoy deep problem solving and coming up with systematic solutions to solve problems, and that's really what ops is about.
You’re now the Chief Clinical Operations Officer at Virta Health. Tell us about Virta Health and what the company is solving for.
What Virta does is completely unique. I had worked in health care for about five years before I joined Virta and my first reaction when I heard about Virta was “No, I don't think that’s real.” The reason for that reaction was that Virta claimed to reverse type two diabetes, without using drugs or surgery. When I joined, the term “diabetes reversal” did not exist; the American Diabetes Association called diabetes a “chronic and irreversible disease.” But after seeing the truly transformation patient outcomes from Virta’s clinical trial and speaking with the team about the treatment, I knew diabetes reversal was poised to become the norm very soon. And what's really incredible to me-- is that, just four years later, it's no longer a crazy idea. As Virta grows, so just awareness around diabetes reversal and the power of this treatment. The American Diabetes Association has even cited our peer-reviewed clinical papers in the latest standards of care, citing a carb-restricted diet as the first line therapy for diabetes. It’s such a huge win. And not just a huge win for Virta but a win for science and the way we’re approaching this problem. Diabetes is one of the biggest epidemics in America and is one of the largest categories in health spending. In fact, it’s estimated that around 55% of what we spend on health care in our country is metabolic disease related. Virta offers a solution that not only works, it’s super scalable as well.
What makes Virta’s approach so unique?
There are really two things –
The first one is the nutrition therapy. The nutrition science is decades old and proven to work in reversing diabetes by getting blood sugar under control, and that's what I just referenced that the American Diabetes Association talked about. It's a low carb, moderate protein, and high fat nutritional approach that we work with our patients to personalize. But that alone is just part of the solution.
The second area is Care Delivery which I think is equally, if not more important, than just the nutritional approach-- our continuous remote care platform. We function as a virtual metabolic health clinic. The virtual piece means that we're delivering all of our care completely remotely via a smartphone app. The patients are actually engaging with our care team numerous times a day, submitting biomarkers, messaging, accessing content, interacting with an online community, etc. The metabolic health clinic part means that we're delivering full patient care, keeping patients safe while de-prescribing medications, often on a daily or weekly basis. It's the service that you would get in a brick and mortar clinic, but on steroids because it's in your pocket. It's absolutely life-changing for our patients.
One of your goals is to reverse Type two diabetes in 100 million people by 2025? To achieve that, comes significant scale – how do you achieve such scale?
It's an important question and a hard one to answer. The main thing for me is how can we safely and sustainably scale our treatment. There are a couple of key aspects to that – There’s the technology aspect. I'm spending some percentage of my time partnering with our technology leader and talking about what pieces of our care can be automated or augmented with tech.
The second big piece of our care delivery is around people. Scaling people involves having clinicians onboard and they have to understand how the systems work. We have to recruit, hire, and train. We need to have metrics and we need to have a management infrastructure that works. That’s my job.
The other thing I’d be remiss if I didn’t mention as it’s the base of all of this is the mission and the culture.
The mission is meant to be set. You set the mission and then build a strategy that is aligned with that mission. Hopefully the mission stays intact for 10 or 20 years. Then the strategy is set and hopefully that's good for 6 to 12 months. Whereas culture is set and reset every day, 10 times a day. It's about the decisions that people are making and what you value. It’s done in action and not by words. It’s reflected by who you hire and who you don't hire. It’s so important because as you scale a company as fast as we have, your processes will lag, and your product will lag. You can't always anticipate what's happening so you're reliant on people and the micro decisions they make on a daily basis when they don’t have clear direction. That's culture.
How do you create the right culture where your people are making the right micro decisions because of the culture you’ve built?
First and foremost, it’s how you show up and how you make decisions as a leader. That speaks volumes. If I went in every day and I said, “What's most important is patient care,” and then I never looked at what our patient care was like or read our patient feedback then my actions wouldn’t align with my statements. In reality, the first email in my inbox is feedback from patients and I read them. That’s how I start my day. I then try to provide specific feedback to individuals, whether it's a coach or an enrollment advisor based on that patient feedback.
The second part of it is directness and talking about it. You have to state what matters to you as sometimes your actions are not seen by everyone especially as organizations grow in size.
Then the third thing that I found works really well is to celebrate when you see it a lot. So we have a process on the operations team for teammates to recognize other teammates for living our core values. And I take that seriously. I personally hand write a note and send people a thank you for living our core values.
Beyond culture, how do you know whether your teams are on track and performing well?
We work together to develop a shared understanding of what the output should be. We then work back and figure out what input metrics impact the output. We track the input and the output metrics and do a lot of testing to figure out how to improve.
There are always areas that are hard to track. I feel pretty strong about this – there’s always a measure. If you care about it, you can measure it.
You’ve worked with some great leaders throughout your career – was there a particular leadership trait that really stuck out to you?
One leadership trait that has really stuck with me is how a leader made me feel cared for as a person. I felt like, at the end of the day, they cared about my work and they really cared about me. I think that's an important quality in a leader. A second trait I really appreciate is being honest with feedback. I’ve worked with leaders who don’t tell you how you’re doing because it's hard. It's hard to tell someone you care about them when they're not doing something right. I think that the people that take the time to have that conversation, which is hard in the moment, but is valuable in the long run shows you how much they care. As a young leader, I’m sure it’s easy to have imposter syndrome at times and feel like you need to fake it until you make it.
How have you dealt with that given the authentic leadership lessons you learned at Stanford?
I would encourage people not to fake it until you make it, but rather to work super hard. It depends on what your goal is, but if your goal is over the long term to be a trusted leader in an organization, then faking it till you make it is just not going to get you there. The way to get there is to consistently prioritize what's best for the business and put yourself in the position to be able to make those tradeoffs and go the way of the business. Over time you'll realize that good organizations don’t value faking it. What happens in reality is that leadership continues to give you more and more responsibility because they say “Every time I give something to Person X, they do what's best for the company, with as low of ego as possible, and it gets done. I can count on it. So we're going to keep giving things to Person X until all of a sudden that person is doing everything!”
Is there anything you’ve done in your career that you think was critical in getting you to where you are today?
I have to start with saying that I won the genetic lottery--my parents are great people that cared about me which set me up for success. I also have a super supportive partner and wife. I'm even more conscious of that in 2021, as I reflect on bias and systemic racism, and see that not everyone is fortunate to have been born with or developed that kind of support system. It wouldn't be fair for me to not start with that.
The things that I did, that I can point to is, I did work hard every step of the way. If I say I’m going to do something, I’ll try my darndest to do it. The second thing is I have tried to be really kind to people along the way. I am more and more conscious of the fact that you get what you give in the world and I try to give out some kindness. I’ve still had to make hard decisions that impacted people's lives. I just don’t take any of that lightly. I think there's a way to do it with respect and kindness.
The third thing I would say is I've tried to put the needs of the team in the business above my own. In making decisions, I really do try to reflect on what's best for the team, what's best for the business, and start with that.
Is there anything you’ve done on a consistent basis that you’ve found to be really helpful as well?
This goes back to being an operations person where anything I do has to have some level of consistency. There’s quite a few things so I’ll mention just a few - One of the things I do is I have a To-Do list and I actually use it all the time.
It’s odd to say this helped my career but it really has - I have a pretty consistent workout routine and when I go workout, I also meditate and combine it all together to create some sense of balance.
Another great practice that I've already talked about is I like to start every morning with patient feedback or customer feedback. That's a practice that I've built into my life and as long as I work here or at any company that serves customers, I'm going to do that.
Your wife is the CTO of Guild Education, another fast-growing tech company and you both just became parents with your first child. What’s your advice to parents in the workplace that also have demanding jobs?
I’m a little too early on this to give advice but I am taking all advice!
One of the things that we are really trying to do is work as a team. We try to talk about what's going on. Talk about the challenges and the problems. We try to set consistent routines to take decision making out of the day to day such as “Our workdays are going to start at x time and end at x time.” It takes complexity and variability out of it. Obviously, things come up but then we communicate around it.
Any favorite books?
Good to Great by Jim Collins is a classic.
Values to Action by Harry Baxter
I love The Wright Brothers biography by David McCullough. It was just so inspiring, and I often think to myself, “How did these bike shop owners figure out how to fly?”
Shoe Dog by Phil Knight
The Hard Thing About Hard Things by Ben Horowitz
Working Backwards by Colin Bryar and Bill Carr
“If you want to build a ship, don’t drum up the men to gather wood, divide the work, and give orders. Instead, teach them to yearn for the vast and endless sea.” Antoine de Saint-Exupéry