I had the pleasure of interviewing Joseph Krainin, M.D., Founder of SingularSleep, the first ever “virtual” sleep center. Joseph Krainin is a telemedicine thought leader, Fellow of the American Academy of Sleep Medicine (AASM), winner of the 2017 Innovision award for technology integration, named a 2017 MedCity News-AARP “50+ Innovation” leader.
Thank you so much for doing this with us! What is your “backstory”?
I am double board-certified in sleep medicine and neurology. Sleep disorders are my passion. Prior to starting a telemedicine company, I had diverse career experience having worked in private practice, academic medicine and in the private sector. In the authoritarian world of traditional medicine, I had always felt somewhat like a round peg in a square hole. Medical school and post-graduate training are a lot more like the military and trade schools than non-medical people would imagine. You are taught to do things and think about things a certain way. There is intense social pressure within the community to practice in a way that does not rock the boat. This group-think culture is undoubtedly contributing to the death spiral of health care economics in this country. I was always the guy who was saying, “Look we could do this so much better if we did it this way…” and no one cared. I knew there was a better way to manage sleep apnea, one that was more patient-centric and efficient. Finally, the frustration with the system built to a breaking point and I decided that it’s time for the rubber to meet the road — I had to go for it and see if my ideas were worth a shit.
Can you share the funniest or most interesting story that happened to you since you began leading your company?
When we launched the website on Veteran’s Day 2015, I was racked with anxiety. Most physicians have several layers of branding armor surrounding them — the clinics, hospitals, medical centers where they practice, their departments etc. By hitting that launch button, I was really putting myself out there naked in a very public way. There was no getting around that this was my brainchild and there was no one else to blame if it failed. You read stories about websites that are not prepared for the onslaught of customers and the servers crash. This was not the case with Singular Sleep. I remember a high level of tension in the early days, was this going to work or be a complete bust? Days went by with no orders. Finally, our office manager called me and told me that we had our first sale — some blessed soul had ordered a white noise generator! When she called, I was out on a walk, trying to clear my head of the negative chatter, and I remember this feeling of elation washing over me. After I hung up the phone, I remember that I did a Rocky-style fist pump and thought to myself, “This is really going to work!” Later that day I did some calculations and realized that, with the drop-ship fee, we actually lost money on that transaction. The team and I still laugh about this.
What do you think makes your company stand out? Can you share a story?
A superior “virtual” team. Doing telemedicine right can be very tricky. We aim to not only preserve but improve upon the typical patient-doctor and clinic-doctor relationship that people are used to. We run on time. If I am three minutes late entering a consultation, I am profusely apologetic. We follow through. We know how valuable patients’ time is and we respect it. There has somehow been a creep where patients accept terrible customer service in medicine, as if it is somehow part-and-parcel to the whole experience. One patient came to us who knew that he had a big problem with sleep apnea but was extremely claustrophobic so he had sat on it for years because he didn’t think he could tolerate a CPAP mask. Our associates carefully worked with him to find an unobtrusive mask that was comfortable for him and I had him do a series of exercises to desensitize himself to the therapy. Our team then monitored his treatment remotely, slowly increasing his pressure over several weeks, and checking in on him routinely. In this way, we were able to build him up to an effective treatment pressure that he could tolerate. Once he got there, he was amazed at the outcome — he really didn’t think he could do it — and how much the treatment changed his quality of life.
Are you working on any new or exciting projects now?
We have a new pediatric sleep medicine program. The impetus for rolling this out was that wait times for in-lab pediatric sleep studies can be prohibitively long — over three months in some parts of the country. Approximately three percent of children in the United States have sleep apnea. Do the math and this is way too many kids not getting the care they need in a timely fashion. Pediatric home sleep apnea tests are controversial. The AASM has come out against them. Personally, I feel that this decision was based on a protectionist money-related agenda and not science, as pediatric in-lab sleep studies have been a “saving grace” for sleep labs. As reimbursement for adult sleep studies has declined, causing many labs to shutter their doors, pediatric sleep study reimbursement has remained lucrative. The American Academy of Pediatrics has recommended home testing as an alternative to in-lab testing when in-lab testing is unavailable. We use the one system that the FDA has approved for testing in children as young as two years. We are also initiating a revolutionary program to allow patients to obtain custom oral appliances for sleep apnea, a common but expensive CPAP alternative for obstructive sleep apnea, without ever having to visit a dentist. We “cut out the middleman” and, like our other programs, the patient is able to do everything from home. We are able to offer a premium, custom oral appliance at a much lower price point than if the patient went the traditional route and got it from a dentist.
What advice would you give to other CEOs or founders to help their employees to thrive?
Reward them financially but also psychically. Encouragement, praise, recognition all go a long way.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are?
I have several real-life mentors and several virtual mentors. My father was a great touchstone for the hustle and drive needed to start a new business. Michael Morton, a local businessman and HBS grad who lived in my neighborhood, and Brandon Welch, a Charleston-area telemedicine pioneer in his own right, were instrumental in helping me develop the first principals that gave Singular Sleep a solid foundation. Peter Thiel’s book “Zero to One” and “The E-Myth Revisited” by Michael Gerber were instrumental in shaping my vision for the company.
How have you used your success to bring goodness to the world?
The great thing about practicing medicine is that helping people is intrinsic to what you’re doing. We provide affordable, convenient products and services to help people diagnose and treat sleep apnea, a medical disorder that can rob them of their quality of life and health. The improvements in wellness that I am able to help my patients achieve are truly inspiring.
Can you share the top five ways that technology is changing the experience of going to the doctor.
A) A new version of house calls — practices like Singular Sleep can now evaluate and manage patients from the place of their choosing.
B) Big Data — we obtain tremendous amounts of data remotely from “smart” CPAP machines that can be used to achieve better compliance with therapy and better outcomes; remote data acquisition is having impacts on other fields like cardiology and neurology
C) Digitized records — the days of paper charts overflowing with doctors’ notes are over; in the near future expect technology to deliver a personalized database of your records that will synch across all health care facilities and providers — kind of like an “Evernote” for your medical records
D) Virtual reality — this will become an essential tool for medical training; imagine your surgeon perfecting the latest technique with VR instead of practicing on you
E) Robotics — just like robots have revolutionized manufacturing, they will certainly be a game-changer in medicine. The days of the robot “doc in a box” from Prometheus are on the horizon.
Can you please give us your favorite “Life Lesson Quote”?
“We all do no end of feeling, and we mistake it for thinking.” — Mark Twain.
Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this :-)
Peter Thiel. He is the ultimate renegade. I have profound respect for his capacious intellect and refusal to bend it to today’s social pressure of virtue signaling.