Insight to Action: Responding to the Challenges of Today’s SMBs

Renee Brotherton: Thank you so much for tuning us in. We're very excited about this. So as you all know, we're here in Austin with PeopleForceX, very excited to be here today. And this is actually in advance of next month's TriNet flagship event, which is PeopleForce, which will be in New York City, which we're really excited about, September 13th to the 15th. So I'm going to bring up our first guest, as we talk about how to make your business more resilient. Here we have Alex Clemente.

Welcome Alex.

Alex Clemente: Thank you.

Renee Brotherton: Alex. Give him a hand. Alex is a managing director of Harvard Business Review Analytic Services based in New York City. So thanks for coming out to Austin again. He's a founding managing director also of the Harvard Business Review Analytic Services. And he's an experienced intrapreneur with a history of demonstrated success in the publishing industry.

And he's also known for his thought leadership, content development and strategy, research methodology, analytics, digital strategy, and integrated marketing, customer relationship management and advertising sales. That's a lot.

Alex: Thank you. Thank you for the modest introduction.

Renee: Yes. How about that? Yeah. So next up, we have Dr. Aaron Ali. He's CEO and co-founder of MedtoMarket which is a valued TriNet customer and they're also based here in Austin. So Dr. Ali is a board-certified anesthesiologist and previous member of the U.S. Army Reserves. Thank you.

Dr. Ali: Thank you.

Renee: He previously served as a chief resident at the Duke University of Anesthesiology Residency Program, has served as a chief of anesthesia, chair physician peer review and secretary of Seton Northwest Hospital. In '06, he formed the Travis County Anesthesia Association, also known as TCAA and served as CEO. He has served as a consultant for Stryker in the Acute Pain Management Division.

So welcome, both of you.

Dr. Ali: Thank you.

Renee: Super exciting to be here and very excited to just hear a little bit more about the survey that we partnered with Harvard Business Review on. And Alex, you're going to just take us through some of the findings. If you haven't seen or heard about it previously, it's quite interesting. It's looking at how small and medium-sized businesses fared over the past 18 months. So, Alex I'm going to just let you take us through that.

I may just kind of stop along the way and just, you know, to hear a little bit about how this may be impacted or did it or how it relates to MedtoMarket and maybe other small businesses. So with that, why don't you just go ahead and just take it from here.

Alex: Great. Thank you so much. I want to thank TriNet for, not only for sponsoring this event, but also for sponsoring this body of research.

Renee: Yeah.

Alex: So I'll start with our survey objectives. First, we wanted to understand the notion of resiliency and agility and what that means for small and medium-sized businesses. We wanted to gauge the extent to which these SMBs were disrupted by the pandemic. And then we wanted to explore what their goals were prior to the outbreak and then after the outbreak to see how things may have changed or shifted.

And we also wanted to uncover challenges. There are always challenges. It's challenge du jour for most businesses, but things have changed a bit there as well. And lastly, wanted to identify and describe some best practices, some strategies and best practices that have successfully supported small and medium-sized business growth.

So, just real quickly talk about the methodology. This survey was conducted, actually this year. So well into the lifespan of the pandemic, it was a global survey, we had all of the major regions of the world represented. It was, as I stated before, small and mid-sized companies about 40-60 split respectively.

It was a very senior audience. They were either primarily senior or executive-level management or owners and partners of these smaller and mid-size businesses. It was cross-functional with the executive and general management, sales and marketing consulting were some of the biggest job functional responsibilities of our respondents.

And it was also a broad industry survey. So, you can see here the biggest industries were business and professional services, consulting, manufacturing and healthcare. And lastly, people that, everyone was screened into this survey based on being in a company with under 1,000 employees. Right, so first, we want to understand, you know, what the goals were, and this is sort of a business-as-usual kind of picture.

This was prior to the pandemic. And, you know, if we were to ask this question before 2020, and maybe a couple of years from now, this is pretty much what we would expect, is that organizations are looking to grow their customer base, they want to increase profitability. They want to enhance their customer experience, improve operational efficiency, improve product offerings and also improve talent.

As we all know, upskilling and training and recruiting people on some new job skills that have entered the businesses that we're in. So this next chart is a little busy. So I'll just explain.

This was asking these same respondents to identify what their goals were after the pandemic outbreak. And so, the prior to the pandemic is the orange and then for the future, the next 24 months in blue. And we can see growing customer base is still the biggest goal of organizations, although improving operational efficiency and also profitability.

As we know, things were challenged from a revenue perspective. So in that sense, you have to try to improve yourself financially with less revenue. Two things that actually popped up that are, I think, important, improving talent, upskilling and recruiting.

We'll talk about this a little about how most organizations you know had a physical presence but once the pandemic hit, it was immediately a digital presence is kind of what they needed to do. So there were some shortages in terms of talent that had those kinds of skills. And then also enhancing your customer experience, we all know customer expectations have changed.

And lastly, which is really what our theme’s about, and this is the one area where we saw the biggest increase of 12 points and that's improving agility and flexibility. And now just kind of looking at some general things of what happened. And so, nearly three-quarters of respondents said that they made changes to be able to respond to the disruption that was caused by the pandemic.

Forty-two percent said they had difficulty adjusting their operations. And also, another 30% say that they're still having difficulty adjusting as they go forward. And this last one, 39%, is more promising, and that's that, these 39% believe that they have the resources now to be able to withstand future disruption.

And so, we want to know, well, how were you disrupted? And so, we looked at different functional areas, to say which ones, you know, had the most difficulty. And so, general employees, I think, you know, being number one, nearly two-thirds of respondents, that makes sense, because people, most people were basically sent home.

And now you were living where you were working. And there were certain challenges to your work life and your home life that came from that. Supply chain, obviously, a lot of supply chain was disrupted as different parts of the world were closing down. Trade and I think, border crossings and things like that. Sales and marketing.

As I mentioned, you know, you went from this kind of physical to a more digital way of doing things. Production, manufacturing and operations. Those are things where you can't do most of those jobs remotely. So those are people that have to be in the plant. And there were challenges for people just to do that. And then HR makes sense, because we see general employees at the top, and HR in charge of managing those people and what their needs are.

What's interesting is we said, well, what were some of the challenges that you faced when you wanted to try to adapt to this new way of doing business? And the number-one thing really stands out in a class by itself and that's the day-to-day workload really takes priority to being able to manage change.

We touched on this a little bit earlier, the lack of the right talent as more digital skills were required. And this next one should not be underestimated, I think, overwhelming workload to implement change. Change is difficult. And when we talk about, there's an expression that innovation is about 10% inspiration and 90% perspiration.

It really is hard work. It really is hard work to change. So keep that in mind. And then the lack of financial resources. There was stimulus money that was available, but still, organizations depending on which industry and what type of business you were running, some of them were really much more challenged than others.

And then also having the right processes. Obviously, things change and your business model and your operating model. And being able to kind of, you know, very skillfully kind of move into this other way of doing business is a challenge. Then in terms of which areas that they felt didn't really adjust well. So it's sort of a reverse question that we asked, supply chain and procurement.

There's been a lot written about that. So clearly, HR and talent management, people, I think people's expectations, workers’ expectations have changed as a result of this new world that we're working in. Product development was challenged, a lot of product development, a lot of innovation.

A lot of academics believe that it's still best to do across the table, eyeball to eyeball. And obviously, that wasn't something that was available for many organizations. Finance and accounting, you know, your revenue is plummeting so that becomes a challenge. And sales, marketing and PR, also having to now adjust to the changing expectations of customers.

Right, so we sort of just framed up the problem and now we're kind of look about, you know, at HBR our article method is, what's the problem? Why is it a problem? And then how do you fix it? And so now we're looking at how you fix it. So here's some of the things that organizations did.

First and foremost, the top two or more than half of respondents reassessing their work processes, and investing in digital tools and technology. One and two. Followed by researching new business and revenue models, investing in talent, improving employee experience.

When you're investing in talent that doesn't necessarily mean you're hiring new people, it can also mean you're training new people on new skills. Implementing new team structures, and lastly, improving the use of data and decision-making in business. And then in terms of investments. Technology was cited number one, and also kind of in a class by itself against things like sales and marketing, customer service and engagement, product development, and production and operations.

Renee: This is great. I want to just stop right there. Can we just go back to that last slide? Yeah, steps taken. So I just want to give a little bit, and Dr. Ali I want to pull you in on that one.

Dr. Ali: Sure.

Renee: Because I have some questions here. So we heard just kind of, you know, what we found through the survey, but the steps taken, I think this is a very interesting one. So I'm just going to give a little bit of background on MedtoMarket then I'd love for you to just kind of give us a little bit more information. So you have 32,000 square feet of medical training co-working facility, located in the St. Elmo District, in South Central Austin, correct?

Dr. Ali: That's correct.

Renee: And you were founded by practicing physicians. MedtoMarket's mission is to help medical innovators bridge the gap from concept to market under one roof. So you provide turnkey solutions in three different areas. You have, so MedtoMarket labs, M2M Labs, M2M Element Co-working and M2M Events. Can you just talk to us a little bit more about what you do here, I think is very...

Dr. Ali: Yeah, our business is quite unique. It's not your, we make hamburgers and that's it, right? In the world of medicine, what we concentrate on is taking people who are proceduralists. And I stay in my lane and I'm an anesthesiologist. I'm in the operating room all the time. So when I speak of physicians, nurses and surgical techs, these are people that are doing procedures, right?

So it's not the person writing a prescription for your high blood pressure. We want them to train like pro athletes. I use a lot of analogies to pro athletes and the military, just because that's my background and those kinds of things that I look at. The current status quo for medical training and innovation, I think is quite stagnant.

Once you're out of medical school, residency, fellowship, or a nurse is out of training, or a tech is out of training, we hit a flat plateau of training afterwards. So when we get in the "pros," it's nothing but get the 40 hours you need to get that year and hope it all works out. And then we go practice on you guys. Which I think if it's my kid or my grandmother going under the knife, I'd want that surgeon not to have just gone to a conference this weekend and learned about that brain tumor and how to take it out.

I'd rather he or she has gone and practiced this maybe on a real cadaveric specimen a few times, maybe 20 or 30 until they're really good at it, right? But the way we're trained is we get trained super hard, just like a college football player. But when a college football player comes out, if he's C minus—you would never heard of Tom Brady if he was a C minus quarterback right? But he's not, he's incredible.

So they really push them but when he gets out in the pros, he's training every day, hard as can be. You wouldn't know Serena Williams, you wouldn't know Tiger Woods, if they got out of their colleges and they went flat. We get out of our colleges and our medical schools and we go flat. So that was the problem. So the solution is how can you create a turnkey infrastructure that's off campus? I love the universities.

I love the medical schools. I poke at them a little bit that they're a little bit behind the times that they need to move forward with technology. So we built a state-of-the-art medical innovation and training facility. We built an ecosystem. We wanted to involve everybody. We wanted to push the nurses, the doctors, the surgical techs, but we wanted to also push the entrepreneurs to bring them all into one facility that's neutral. We're the Switzerland of medical field.

Because if you ask UT, the University of Texas, if you can go on their campus and do something today, you're not going to get access. You're going to have to be a professor. So we're a very open facility and we've built what's called bio skills facility. So they're mock operating rooms. So physicians, nurses and techs will fly in from all around the world and practice a particular procedure. Now in the old days, you would stand in the hallway and I'd push a patient in and the surgeon would be at the scrub sink and a device manufacturer rep would teach them how to do the procedure right there at the scrub sink.

And the patients would see this and say, "Oh, my gosh, is my doctor just learning this right now?" And I'm like, time to push all the medicines and make then forget, right? But yeah, that's what was going on. But it wasn't so complex. But now you have robotic platforms, you actually sit in the corner, do the whole surgery. You may be mobile. And it's so complex, there's so much technology, that you really need to train over and over just like Tom Brady did, and Tiger Woods, or look at the military part, like our Navy SEAL teams.

I've got few buddies that used to be in the SEALs and that's all they did for that five minutes of action. Years and years and years of training, but we don't do that as doctors and I hate to scare you about it if you have surgery coming up. But, that's kind of the status quo, right? So we built this facility to go after that. But obviously, all the things that happened pre-pandemic, and post-pandemic and the things we're talking about today, really affected us and to be resilient and agile to get through all that.

Renee: Yeah. And persevere through right?

Dr. Ali: Oh, yeah.

Renee: Yeah. So, looking at just the steps and hearing, you know, what Alex was saying, what steps have you taken? I mean, just maybe like, pre and then during, and moving towards post, if you will.

Dr. Ali: Yeah, we formed the company back in 2011. So it's been 11 years and I call ourselves the 11-year startup, because we always push, we always pretend like it's our first day out there. I truly believe this about our company and I truly believe this about our healthcare is the most incredible asset you have there is a human being that shows up.

It's the employee that shows up in the morning, gets at the front desk, it's the employee that pushes them up at night. It's the physician or the nurse that shows up at five in the morning to take care of you. And so, we really focused on our employees, which was great, and the tough part about the pandemic, right? So now, we have the triple whammy, we, 95% of our people came in from out of town that brought in our revenue so now the airlines shut down.

So we had a 95% cut in revenues, but I didn't want to lay off a single person. So we all took a 25% pay cut. And we did some interesting things to get through it. But our human assets and the people we hired were our most important part. And now post-pandemic, I still think it's the same thing. Yes, we have a lot of technology that got driven into our business during the pandemic.

We did a lot of Zoom and workplace tech meetings that we had just one doctor.

Renee: So you used that technology investment.

Dr. Ali: Absolutely, the technology has helped out a great deal. So those are pretty important things for us pre and post to take steps to move forward.

Renee: So what about hybrid, though? Because it seems like, you know, a lot of what you're doing is in the facility. So you were...

Dr. Ali: Yeah, it's been tough because you have to kind of show up to do the surgery, right? You can't really do it from home yet. But they're moving that way, especially with the military. But what we did learn about some technologies, there's some VR helmets that we can put on and give to someone sitting in New York in their pajamas, and I watch a full surgery going on as if you're standing right there. And they can stop the surgeon and ask questions.

And they can move X-rays around and this and that. So you kind of feel like you're in a surgery. So that model, those things came out during the pandemic and we incorporate it.

Renee: So that goes to the technology investment that we're talking about. And that's just also like, kind of, I mean, everyone is pivoting right? That was the big word of what are you doing to pivot your business? But that's just like that. So are you still doing that, though?

Dr. Ali: It's still one of our options, right? I think there's a hunger to get back out there. Our med device companies all showed up in force all of a sudden when the pandemic started to slow down, but we certainly have all those options and they still get used. So it's great to have multiple options now.

Renee: Yeah. So those are some of the... so investment was in technology, steps taken, you just said, which ties in nicely to some of the stuff that we've done here too. So, interesting. Why don't you keep going with some of your stuff. I just wanted to kind of hit on that a little bit.

Alex: Thanks. So next, we wanted to ask what kinds of initiatives and undertakings in addition to investments and also in terms of these next two charts, looking at… so we touched on the ecosystem companies are we like to refer them as ecosystems. So you have employees and you have customers, which are two of the most important parts of your ecosystem.

So what were they doing to actually secure their people? And so on this chart, increasing flex work arrangements, probably hours as well factored into that in addition to where you're working from. Improving communications and expectations. I think a lot of people felt very disconnected from their organization. They probably were working with people in their teams on a day-to-day basis, but seeing other people in other departments and things like that, pretty much went away.

And, there is a challenge, I think, also in terms of managing people in this kind of remote kind of network. Next was to be able to better collaborate. So better collaboration tools and technology. It's kind of like what you touched on Aaron, if people are going to be working remotely, you have to give them the same tools and capabilities that will allow them to perform their job at the same level that they did when they were inside, in the building.

Training and upskilling. Again, a lot of it has to do with the kind of digital platform, everything kind of moving to the digital platform and making sure everybody can work that way. And lastly, employee engagement and retention. One thing I do want to say about this is, you know, your employees are, you probably have some intellectual property and certainly that's one of your biggest assets.

But apart from that, your people, that's your biggest asset. And we write about employee engagement. But there's a nuance, and that is employee engagement is actually taken from the lens of the employer. And in this situation, I think what I can recommend going forward is to think about what we call employee experience and that's actually looking at the job through the lens of the employee.

And a lot of times, you know, companies don't even think that way. But you have to also turn it around. It's not just about am I getting my pound of flesh out of my people? It's like, what value are they actually getting working for this organization?

Renee: So that's an interesting point. So just in the news yesterday, and then widely today, was a report around monitoring employees digitally.

Alex: Digitally monitoring.

Renee: Yes.

Alex: In the New York Times, on the first page yesterday.

Renee: Yeah, exactly. So it's kind of an interesting... And they talk about like, the larger companies are doing that. But I'd love to hear your thoughts on that. And I don't know if any of you folks read about that. But it's quite interesting.

Alex: I'm not a fan of it. I think the reality is, we put a lot of expectations on people. The one, I'll just say the word secret, I was going to use another term, but the secret of the pandemic was that companies were incredibly productive. The level of productivity that came out of companies during the pandemic was just, it was astronomical, in terms of what you might have expected.

And it was all based on the fact that people were working, they were working constantly, they were working harder. This kind of gets back to this monitoring thing, is a lot of organizations felt that anybody that was working from home, it was only a contingency, you know, now it's more permanent. But as a contingency, there was always a suspicion that if you're working from home, you know, you're probably goofing off half the time. You're probably not working.

What's unfortunate about this particular tool is that it's monitoring people sitting at their computer, clacking away. And, you know, if you measure intensity by people sitting at their desk or sitting at their computer, I think you've gotten it all wrong.

Renee: Yeah, I agree. And maybe that's not where you need to be, investing your technology.

Alex: And it's trust. What it really means is you have to trust your people, so that they can trust you back. And I think that's the thing. That's the problem I have with it.

Renee: Yeah. That's interesting. And then also, I think it's just kind of looking at the foundational level, the culture of the company.

Alex: Correct.

Renee: Is that what you want? Is that what you want for your people? I mean, the fact that you actually did you know, 25% pay cuts across the board, so nobody had to lose their job, like, awesome on that one, that everybody actually took it and was willing to do that. That's fantastic. So nobody had to lose their job. It's things like that. It's just changes like that, that makes a real difference.

Alex: But we had a lot of, you know, thoughts and discussions about what do we do when we send our employees home. Are we still getting the same out of them? And it's a valid concern. But I think at the end of the day, if you brought these employees on because they're highly talented individuals that are a true asset, if they can pull it off in three hours at home while they're sitting by the pool versus eight hours in my office, go do it by the pool.

I think it's fantastic.

Renee: I agree. I think it's also right reminding folks, you know, take your time off.

Alex: Yes.

Renee: Shut down. You know, it's just I think that just kind of finding that balance. And I think that small, big, all companies, all individuals like working had a hard time just trying to find the balance. And it seems like and, Alex, I want you to talk a little bit about this as we continue, like, what's ahead? I mean, because that's something, it's really, folks are on all of the time. I know, you know, we're all guilty for that.

And it's just kind of like, you know, it was really funny. Somebody said to me, "What do I say? Do I put that I'm out of the office that I'm working out of my home office? What do I?" And it's just like you're out of the office, you're fine. But it's just really kind of shifting the mindset if you're remote and you were always in the office, you know. So anyhow, this is...

Alex: Yeah. So the next thing was really looking at the other part of the ecosystem, which are the customers. And the customers, active listening to customers is something that, you know, companies should be doing all the time. But it makes sense that you kind of put that at the top of the list. Also looking at product and service innovation, we know that customers' wants and needs changed as a result of the pandemic.

And it was being able to be sensitive to those changes and doing whatever tweaks in your product or your service. Improving and then improving customer service. Again, it's, you're no longer doing, if we're talking about retail, you're no longer doing face to face, or even in B2B, you know, where you have a sales force goes out and calls on people. They're no longer doing anything face to face. They're doing it 100% digital, sometimes not even speaking to anybody, or if they are speaking, we're all, you know, big head on the screen to each other.

You know, so that's important and then also improving your marketing capabilities. You know, the shift to digital, the one interest, it's a double-edged sword that organizations weren't as comfortable doing it. But you know, and felt that like they were losing something by not being able to engage face to face.

The reality is, whatever you do digital, it's 100% trackable and so much of what... if you want to know the way big companies think and how smaller and mid-size companies compete with big companies, they're all about data. They're all about data, two things, data and automation. Well three things, behavioral science, that's the third thing. So you really do need to get better with data if you're not strong with data.

And as we see here, the last one, which is really increased customer data and analytics, it's what? Five on the list. I would argue that it should be higher. And then I think I have a summary chart. So we can continue with the panel Q&A. So just some key takeaways from the report that we just published.

The pandemic underscored the importance of resiliency for small and mid-sized businesses. And our recommendation is to focus on efficiency enablers. We saw the day-to-day workload is the biggest impediment to resiliency. You know, the question is, does it have to be? Is day-to-day workload, can it become less daunting?

And perhaps it can be if you can implement more efficient work processes. The second point was technology can maybe be a major facilitator. So tech was cited as the number-one investment that these organizations were making. And the way big companies think is to automate the mundane and liberate people to do more strategic work.

Identify what opportunities are out there, increasing customer experience, pressures do bring more challenges, but they say that there's also the flip side of that is they also provide more business opportunities based on the insights that you get out of that. And the last two words, savvy and nimble. When you talk about small companies, you can, you know, it's common to say, "Well, they don't have the bureaucracy, they don't have the red tape of big organizations, and they can be more nimble."

But that's the question to all of you is, are you nimble? Can you be more nimble? And lastly, building a workforce for the future. We need to identify the skills, you know, what you did five years ago isn't what you're going to be doing five years from now. So, you know, look to the future, identify what those skills are, retrain your people, and hire those where you need those competencies and you don't have them.

Renee: Yeah, very good. So just, you know, from the time that we did the survey, now, more has happened, right? And it continues to happen. So as we kind of look to, say, maybe the next 12 months, what are you seeing there?

Alex: Well, there's a couple of sort of macro things. Certainly, there's, I was quite kind of surprised to see this, as I'm sure some of you were a couple of weeks ago, when we saw that we were back to practically full employment. We're back at record employment and that means there's going to be a talent shortage. So that's number one.

Number two at the same time, we have a very uncertain economic outlook. You know, there were a lot of signs saying it's going to be a recession, whether it is one, I mean, it kind of was one for a couple of quarters, but things seem to have kind of picked up a bit. So those are sort of the macro things that are going on. When we talk about hybrid, as you know, we thought about that, as I said, originally working from home was a contingency, then it became a way of life.

We thought it was a temporary way of life. But now we're starting to see, including my own company, Harvard Business Review, where we're only reporting to work one or two days, or I should say, reporting to the office, get that right. Two days a week. And if I could get that job for two days a week, I would sign up for it tomorrow, but now you're working five days.

Renee: Question. How many folks in this room are working hybrid or fully remote?

Yeah, so majority, seems, maybe.

Alex: Yeah, and my comment about hybrid is, it's still sort of a work in progress. You know, we can get better at it. You know, we shifted to this platform, if you will, this digital platform. And for some people, it was really just, you know, in terms of technology, it was just duplicating, it was kind of a lift and shift. But the opportunity, both from a technological standpoint, but also from a work process standpoint, can you redesign on that platform now?

Are there new applications that you can create using this technology that you had to invest in that make you more productive, make you more efficient? The same thing with how people are working. I think that that human aspect of it is something that companies maybe aren't paying enough attention to.

You know, when we talk about this, the three sides of value in an organization you have, and I think probably the latter part of the 20th century was all about shareholder value. And I think the last 20 years, certainly, if you picked up a copy of Harvard Business Review, customer value, is what we've been writing about.

It's kind of funny, we write about it like it's a new topic. But in the last two years, I think what happened was the pandemic, kind of moved the spotlight over to employees, and there's employee value, which is actually the third part of that triangle. And I think companies for the first time, and we've seen this in a lot of the research that we've done, have become much more focused on their people.

Renee: Rightfully so.

Alex: Yeah. the health, the safety, the security of their people, not just for the short term, but also for the long term. And I'm hopeful that that trend will continue and not when COVID finally subsides. You know, we forget and we just go back to being, you know, evil employers or whatever. But the truth is, your people are your biggest asset, as I said previously, I think.

So as we look to the next 12 months, I think you have to check in with them. I think their health, mental health is something that's been very stigmatized. It certainly doesn't have the same levels of coverage that other medical care does. I think paying attention, checking in with your employees, really getting their pulse, making sure that this new work arrangement is actually working for them.

And particularly the little things, to look at the all the little things that people do and make sure that they're not sending you a signal. It could be a weak signal, but they may be sending you a signal that it's not right. "You know, what I'm doing right now isn't really working for me."

Renee: Yeah, pay attention. Dr. Ali, what do you think about like, what is MedtoMarket doing differently that maybe you just wouldn't even imagine that you'd be doing? Say, you know, two and half years ago?

Dr. Ali: Yeah, we've looked at every single facet of our company and the different divisions and being able to, a lot of the things Alex was saying about incorporating efficiencies and technology. And, you know, we got the triple whammy, because not only did we get stopped by having our customers coming in, less people were donating their bodies to science because of COVID.

And then the whole PPE debacle. We need gowns and gloves and masks to do our job. So we had three things hit us all at once. So, when we will look at that all together, we look forward now is we need to have a lot more support around us. So we've reached out to other labs sort of like us to try to build a whole consortium across the U.S. and create those kinds of efficiencies and enablers. We've looked at our revenue lines and try to make more revenue lines and produce more ways of kind of moving forward.

Amazingly, during the pandemic, we lost only 10% of total revenues, even though we had 95% hit against us with our regular line of business because we pivoted. And I think that's the agility part we talked about, right? And the resilience you know, my favorite encyclopedia is YouTube. So, just looking around...

Renee: We're all on there.

Dr. Ali: I know, right? Where you fix your sink.

But you know, I looked up the word resiliency, what YouTubers say about it and honestly, you can't be resilient unless you've failed, right? If you had the perfect life, then you have zero resiliency, because you've never had a bad day, you've never had a challenge. You've never failed and no one's kicked you in your ass. And you've had it great. I'd sign up for that program, if they give it to me, but I don't think it's out there, right?

But the resiliency to get through what we did over those years really gave us some introspection to look and sit down in some of our board meetings and say, "Wow, how do we make it through that? What did we do right? And what did we screw up on?" And so, we talk about those things very open, you know, from the C-level down to the custodian, we have everybody come to the board meeting. It's pretty fun. And so I think having that full open transparency and being able to talk to everybody.

Now, we're a smaller company, and we don't have 1,000 people in there. So it'll be a little harder for the bigger groups. But those were the things that I think really helped us get through it all.

Renee: Yeah, that's great. So your customers are medical manufacturers, medical folks, hospitals.

Dr. Ali: So it's interesting, you would think that the physicians would be our customers and the nurses and techs, but they don't pay a single dollar to come into our facility and use the place and have all the cadaver specimens out. The medical device manufacturers, the big giant blue chip customers that you see the commercials on TV all the time, they're the ones that pay for the physicians to fly in and nurses and everybody to fly in and put them up in the hotels and pay for the cadaver labs and those kind of things.

But it's interesting to me that, why do the hospital systems not pay for their most valuable assets to go get trained? Right? Because like, I go back to sports analogies, they spend all their money on their valuable assets, that's their players, right? You put all your time and effort into that. So hospital systems, insurance companies, they pay zero for these people flying. So it would be an interesting paradigm shift to get those people involved in the training of their most valuable assets and that's their people.

Renee: Yeah. You have a very unique business model. I have to say, I mean, the fact that, because you actually, and I want to make sure that I'm getting terminology correct. But you procure the cadavers for folks to come in with, is that right? Am I saying it proper?

Dr. Ali: No.

Renee: Because I think that there's another term that you use that I may not...

Dr. Ali: Well, we talked about the Willed Body Program. So in the state of Texas, if you want to donate your body to science versus, "If I get in a car accident, you can have my kidney, liver, cornea." All that kind of stuff, one’s a living tissue, the other one's a nonliving. So the nonliving part is called a Willed Body Program and you would donate your body to science.

And so as a physician, you know, we learn when we're in gross anatomy, every single person that was there on those tables were people that donated their bodies to science and we would never have learned the things we did to get to this point without that. So we have a lot of dignity and respect for those people that have willed their bodies to science. And so it's an incredible piece of medicine that is kind of that spooky side that people don't talk about, right?

You know, and it's weird, because in my building, I have 40 specimens, cadavers in there. And my kids think that's kind of weird. My sons always make fun of me. But at the end of the day, who's going to train you, if you don't get the real training? Simulators are great. Technology is great. Plastic specimens are great, but at the end of the day, real human tissue is incredible to work with.

And so we are very respectful of that and, you know, we make sure that at the end, we've completed the cycle. We do actually cremate and bring the remains back to the family so they can actually have a burial. So it's kind of a special thing. And it's a very odd business, right? Like I said, I don't flip hamburgers, I don't do this and that, but we're training in the future of tomorrow and the people that are going to take care of you guys in the operating room.

So it's fun for me because at the end of the day, I know I'm doing something great for patient care. And it's the right way and the right thing to do.

Renee: Great. Thank you and the fact that you're like local when you're here joining the states, right?

So we're going to go ahead and open it up for questions now. So I don't know if there's folks here that have questions or online, I think we're going to be taking some. All right, this gentleman right here. All right.

Audience member 1: You mentioned a remote work situation, and a lot of folks transitioned away during the pandemic, the height of it. Did you in your survey determine how many would be transitioning back? I mean, did you assess any of those numbers are going either staying remote or going hybrid or then going full time back?

Alex: Yeah, it wasn't I mean, it's a great question. It wasn't one that we included actually in it because that was just one part of the whole. And we have a certain limit to the number of questions. But I think we've seen, we know how Elon Musk feels about it. There are some companies that are mandating that people come back to the office.

But I think what I'm hearing, generally speaking, is that we are going to have some kind of a hybrid way of doing business going forward.

Renee: Thank you. Any other? Here we go. And I think we're taking questions online as well, right? Okay.

Audience member 2: Hi guys.

Renee: Hello.

Audience member 2: And lady. Kivon Roberson,- Services of Hope out of Dallas, Texas. And we have a small office in Amarillo. And it's great to see this. And this model in this survey in the for-profit arena. The nonprofit, unfortunately, we had the reverse problem. We had a growing customer base once COVID hit. We had plenty of resources as far as dollars and cents, because federal government, local governments were investing.

Now we're seeing the very opposite happen now. We're seeing the fact that the dollars are starting to shrink. We're also seeing the fact that our customer base is starting to shrink also. It should be shrinking, but it's not shrinking as fast as we'd like to, because people aren't going back to work. Lisa and I were having that conversation earlier today. And we're trying to see how we manage that. Because while I love being the president and chief operating officer of a nonprofit I do not like our business model.

And I want to look at what's happening on the for-profit side and be able to make those things transparent to the nonprofit side. So I would love, number one, to see you do a survey like this for the nonprofits. And number two, Aaron, I applaud you for what you're doing here in East Austin. I went to Houston Cillessen. So glad to see you operate here in Austin.

Dr. Ali: Thank you, sir.

Renee: Thank you.

Alex: I'm sorry, I didn't quite get the question part of that.

Audience member 2: The question is this, what would you recommend for nonprofits operating?

Alex: Oh, what would I recommend? Yeah, I mean, I think it's wonderful. I actually work for a nonprofit, Harvard University, well, an affiliate of Harvard University. I think that when, because I think a lot of the problems that are being solved are not being solved by government, they're being solved through partnerships. So I see the private sector, as companies talk a lot about their ESG, which is environment, society and governance and the rules that they're creating.

Some of it’s been a little bit hijacked by marketing, but the reality is more and more companies talk about this need to actually invest in their communities. So my, and believe me, I'm not an expert in these models, but I would think that if we think of government, and as you pointed out, you know, they're declining funding, if not completely shutting off funding.

I think that there's certainly the individual donors and things like that, but I feel that there are private sector that have bigger resources. And I think if you're able to partner in your market with some of the biggest employers in your market… you know, there's a great quote by Jamsetji Tata, Tata Corporation, which is an Indian company.

And I know I'm going to mutilate this, but it was, in so many words, what he said was that the company has to focus on the community, because without the community, there is no company. And he said that in like 1860. So it's not a new concept. And it can be applied.

So I think if you could apply it through partnership, that would be my suggestion.

Dr. Ali: And I like what he said about the partnership. You know, one of the things we try to do, even though we're a for profit companies, we're trying to create the largest Central Texas STEM program for high schoolers, right?

Renee: That's great.

Dr. Ali: Now, I don't have $5 million to bring in 3,000 high school students 10 times a year through our facility and do everything we can. But I can go talk to Valero Oil and I can go talk to HEB, our biggest grocery producer here in Texas and get them to foot the bill. So there are ways to find those partners out there that can see that as a PR thing for them and be a part of this incredible movement.

So the things you guys have done and did in the past and will do in the future is always important. It doesn't end just because the pandemic ended or the funding ends. I think you still wave that flag and you make sure that if it's government funding that was saving you then you just move that funding to someone else, and you find... the same thing we had to do right? Our revenues were coming from this group, they went bye-bye, we have to find a different way of creating revenues, right?

So I think we face a lot of the same challenges whether you're for-profit or nonprofit. At the end of the day, you still have to solve something, create a solution, execute on it. And you guys are doing that. So that's where my focus would be, though I'm not a nonprofit guy and I have you know, it's the best guess I can give you.

Renee: Very good. Other questions. Anyone? Any questions online that are coming in? All right, so, well, I guess I mean, we're going to give some time back if we don't have additional questions.

Oh, here's one. Okay, here they come online. Welcome virtual questions.

Audience member 3: Hello.

Renee: Hello.

Audience member 3: Over the years, it's always been great to read HBR and the case studies. You can learn a lot, you know? So, obviously, we've seen supply chain efficiencies over the years. We've seen management changes over the years. But what do you think is the opportunity if we could get this right, with resiliency, investing in people? You know, is it that hard?

Or, you know, really what really could be the outcome if we got this right?

Alex: I think that companies could be wildly more successful if they got it right. But as we said, as we saw here, in this study, day-to-day responsibilities, in particularly small and medium-sized businesses, I think it's more of a challenge for them. Because, you know, big companies can have very specialized innovation, you know, teams they can put into an organization that are just there to invent stuff and to come up with new processes, but smaller companies...

The other thing that's a challenge for smaller companies is that there are fewer sort of specific roles. And there are people that probably wear multiple hats in smaller companies as well. So it's kind of harder for them to kind of put, you know, to put their day job over there for a while and focus on innovation.

I think, when we talk about being resilient, we look at it in terms of probably solving customer problems is really the net result is what you're trying to do to be able to respond to customers quickly to solve their problems quickly.

There's also this notion, and they're sort of competing arguments about predictive analytics, that if I use the data, I know when somebody is able, you know, is going to be willing to make a purchase. There's sort of an argument against that as well, since all data is historical, you don't really... you can't really…

But anyway, those are kinds of things that organizations are looking at. I think if you understand that, we're, you know, being resilient is doing things differently and giving people time and space to do that. It's not inexpensive. It is a commitment that organizations have to make. And some way, somehow, if you can make the day-to-day stuff less demanding through better processes, through automation and technology, so that people can focus on the strategic goals and new directions for the company, then I think you can actually seize that opportunity.

Renee: Yeah, I just want to say, though, I think, and I understand what you're saying about larger companies having larger, you know, groups that can actually... but I actually think that small and medium-sized businesses, and we've found this out, have been the most resilient through the pandemic.

Alex: Right.

Renee: Very much so, with just kind of shifting operations how they need to. And it's been awesome to see. And it's amazing. I mean, and I know at TriNet, we're just thrilled to be able to serve these customers. But it's amazing some of the stories that we have with what folks have done, just to adjust to the world, you know, that's happening. I mean, we applaud them every day because of this.

And maybe they're not as large as some of you know, the bigger-name companies, but they have found a way and they have just been incredibly, the perseverance and just the resiliency, it's been amazing. And that's what we do a lot with what we're celebrating. I think the survey has showed a lot.

And I just think that in itself, I mean, that is amazing. And it's something that we've seen and I do understand what you're saying around, you know, some of the larger companies have other you know, like, it's but...some of the biggest innovators around are the small and medium-sized businesses and it's just awesome to see.

Alex: Yeah. I mean, I would concur with that. I think that because it's more of a life and death issue for smaller companies. There's a school of thought that if you innovate in a sort of crisis mode that you'll get to whatever that, you know, destination that you're hoping for. The other thing that was interesting that I didn't point out is that in the sort of pre and post-pandemic research that we've done with large organizations, growing customers wasn't at the top of the list. And particularly once the pandemic hit, they were way more focused on two things that they refer to, one was business continuity, just kind of secure what business you're used to having, and then becoming more agile and flexible.

Customers actually took a... it was almost like they knew that the customers weren't going to be as valuable to them during this period so they needed to kind of work on other things. But to your point, smaller companies they stayed focused as we saw in this...

Renee: Yeah. Have to protect the base, right?

Alex: Yes.

Renee: I mean, their customer base.

Alex: Absolutely.

Renee: That was something, it's like you didn't want to lose anything there. And, like, growth while important and new customers, but it was just really understanding what's going on with the business to be able to move forward with whatever was going to happen. Because right, we just kind of didn't know.

So great. Any other questions? Thanks, Alex. Yes?

Audience member 4: What resiliency parameters are most important and necessary to grow small business through a recession?

Alex: I can take a stab at that. We talk about in this study, agility and resiliency. Agility is a part of resiliency. I think that agility is the fact that you can shift to a different platform, a different direction. And you can do that in real time. That's part of being resilient, I think maintaining also the kind of speed at which you function, prior to, you know, the pandemic, or whatever the event might be.

And the fact that you can operate at that same speed, I think that's part of being resilient also.

Renee: Yeah. I also think it goes back to culture. I'd say I think velocity is very important and being able to persevere with whatever's coming. But I think it's just really understanding foundationally what the company stands for, and really establishing the culture. Because ultimately, I mean, you're going to, as you look to attract and retain employees, it's all about the culture of the company.

You're going to look at a company and say, "Wow, it's really great." And you start talking to folks and you get a feeling right away about what the culture is. So you have to know that, you have to establish that and clearly communicate that as well.

Dr. Ali: And I think on top of it, you know, part of resiliency is life ain't fair. And during a recession, the recession is happening to everybody, right? So it's not like it's just happening to me, not to you. So everybody's in the same boat, when you hit a recession, or, you know, the mortgage rates go up or this goes. I mean, everybody's got to be able to move and pivot.

But I think the number one key thing that helped us out and I think helped many companies out is quick, immediate action and doing something about it, and not complaining about it. Because you can always look at the past for experience to help you out. You can always look at the future where you want to be, but people forget about spending enough time right now in the present, right? Like, let's get together, let's figure this out.

Let's do it and execute a plan. And I think recession or not, that's how you stay successful.

Renee: Agree. I think those are great words to end on. I think that we're wrapping up. We have a couple minutes. Wait, did we have one more question? Yeah, go ahead.

Audience member 5: This is for Dr. Ali. Have you seen a turn in employee engagement since making some of the decisions you made during the pandemic?

Dr. Ali: A turn?

Audience member 5: A turn in employee engagement.

Dr. Ali: I mean, look, we're always very engaged because we're a smaller group, We really got pretty close during pandemic, because we had to do everything and anything to make sure the company stayed alive. So our engagement of our employees, I think, probably doubled or tripled. And when what we did and how together we were, even though we took on the hybrid points where people are at home, working out of the house.

But I think, it's kind of one of those things, we're in a small boat and it's got a hole in it. And if we don't all ladle the water out, we're all going down together. And I think that's the incredible feel about small or medium businesses. If you work for a giant organization, a multi-billion-dollar blue chip, you don't get that feeling if you're at home, if you're middle management or someone that just worked for them.

But for us, it really engaged everybody. But it also allowed us to look for incredible talent that felt and thought the way we did.

Renee: All right, well, look at we are at the top of the hour it looks like. And so I want to thank all of you for joining us here today. We're clearly not finished here in person. We actually have a networking event after this. So please stay, we have some great music from DJ Mike Greco out in New York City here with us. And just, yeah, it'd be great to talk to some of you all. But we definitely want to thank you all virtually who have tuned in with us today.

And I want to thank you very much again, Dr. Ali. Alex, again, of course, the study and it's been very helpful, informational. And I think there's a way that you can actually download this study right?

Alex: Yeah, absolutely.

Renee: On our website. Meri, right? So you can go to TriNet.com and get more information and download the actual study that you've seen here today. So thank you all again for attending. Thank you two.