How does a surgeon go from the operating room to a start-up? By pursuing her passion for filling the gaps in America’s healthcare system. Dr. Casey Means is a co-founder of Levels, a digital health company that combines glucose monitors with intelligence software to help you track and understand your data. Although no longer performing surgery, Dr. Means knows she’s helping more patients than ever – and giving users the power to make healthier choices. In this episode of Entreprenista, Dr. Means and host Stephanie Cartin talk about productivity tips for running your company remotely, how Levels raised $12 million from its first seed round, and why nutrition is the key to metabolic health.
4:53 – Following inflammation’s trail
Surprising clinical experiences pushed Dr.Means to search for the link between immune dysfunction and chronic inflammation.
“Why are people chronically inflamed? And why are we approaching this with surgery if this is fundamentally something that’s happening with the immune system, which is not really something you can surgically intervene on. Certainly, you can suck out pus out of a sinus, but it’s not necessarily doing anything for the underlying chronic inflammation. And so that’s really led me on this journey towards like, what are the key drivers of chronic inflammation? And it really comes down to exposure to things that our bodies see as a threat. And these things can be really anything that our body is exposed to. Processed, heavily refined foods we’re eating these days kinda look foreign to our bodies and it can signal the immune system to ramp up. What could that do for these ENT conditions? And then more broadly for the chronic health conditions that we’re seeing just rising at astronomical rates?”
8:38 – Mainstreaming a health game-changer
Levels combines continuous glucose monitoring and user-friendly data to take metabolic awareness public.
“Levels’ is bringing biowearables to the mainstream. So what we are is we are a company that pairs continuous glucose monitors, which are a wearable sensor that is actually monitoring internal biomarker glucose 24 hours a day, and pairing that with intelligent software that helps you interpret that continuous data stream and understand what it means. And why it is the way it is, and then helps you optimize it. So fundamentally our mission is to enable metabolic awareness and then metabolic optimization in our customers. And you know, metabolism is really foundational to our health and to all aspects of our health. And it really ties back to what we were talking about in the beginning, because so much of chronic inflammation is actually driven by metabolic dysfunction. And really the key substrate of metabolism is glucose.”
11:30 – Filling healthcare’s numbers gap
Don’t have a private doctor on call? Levels empowers patients to make data-driven health decisions on their own.
“A lot of the passion for me came from what we were talking about earlier with the idea of scaling innovative solutions in healthcare. I was sitting there in my practice knowing that I wanted to spend really hours with each patient helping them understand all aspects of their diet and lifestyle. And I just wanted to be there for them to really coach them through every one of those decisions we make every single day that ultimately generate our health. And you just can’t do that. And so how could we merge that specialized knowledge with some sort of other innovative solution to really get this to people, but have the individuals driving their own behavior change? Like how can we educate and empower people with their own personal data to actually make the decisions we have to make every single day and be inspired to make them and make them sustainably?”
14:30 – Finding your comrade-in-arms
Got some game-changing ideas? Share with your network – they might just lead you to your new co-founder.
“I put together this little pitch deck for myself, and I shared it around with my family and some close friends and said like, ‘what do you guys think about this and this?’ And my brother had seen this and then he was at an event actually overheard some people talking about this continuous glucose monitoring idea, and just kind of turned around and was like, you guys have to meet my sister, she’s talking about this exact same stuff. And so I had a phone call with Josh and it was just, we were just fireworks are going off intellectually. We were just really excited about the other’s vision, thinking about a lot of the same things. And then I flew down to the Bay Area, met with the team, and joined forces initially as a consultant and then as a co-founder. And so to me, that whole experience of meeting my co-founders was such a testament to how important it is to be stepping back in your career and reflecting on, you know, what are the pain points? How can you make things more efficient and then putting it down on paper and sharing it? To put your ideas down and share them with your close network and put yourself out there for opportunities like this, I think, to emerge.”
17:10 – Accelerating product development
Levels uses a focus on customer feedback to push out rapid app updates, new services, and sleeker UX.
“We are getting so much data and information from them about how to improve the product and just make it perfect for them. And we’ve actually put out about 400 versions of our app by now, within this year, and just iterated rapidly on it. And so that’s really been the product development process led by one of my co-founders David Flinner, who was a former senior Google product manager. And that’s been just really fun to see how dynamic and rapid it is. And then in conjunction with that, we’ve built out a telemedicine physician network, which is who we send our customers to, to be evaluated for the CGMs. We have a fulfillment portion of our business, which is a pharmacy that sends the product to customers. Of course, the packaging and. adhesive covers that go over the sensor that are branded. And that’s sort of all part of the product experience.”
23:28 – CGM’s social shareability
Part of Levels’ growing popularity? The appeal of sharing your diet insights, experimentation, and results with your virtual friends.
“There is really an amazing element of share-ability to glucose data because it’s visually appealing, it’s graph-based and score-based. There are so many surprises. We walk around our whole lives sort of trying to figure out what the right diet for us is and going on all these different diets and trial and error. And I don’t think very many of us can just say like, ‘Oh, I know that this type of eating plan is perfect for my body or I know that this breakfast is optimal for me’. But now for the first time ever people are using this product and they can say, ‘Oh, I actually know that oatmeal is a terrible breakfast choice for me, and I’m not going to eat it again’. So of course they want to share that they’ve been, you know, it’s fun to be like, ‘Oh my God, you guys, you know, oatmeal shot me up into pre-diabetic levels. Like I can’t eat this anymore, or I’m going to pair it tomorrow. I’m going to try it with a bunch of, you know, fiber and fat and nuts and chia seeds and see if it has any difference’. So it really lends itself to some amazing sharing, and so that really helped us gain more weight loss customers.”
28:38 – Thought-out content —> more traffic
Build better SEO by swapping cliche content for smart answers to your customer’s real questions.
“The focus I think really is to drive traffic and optimize it. I put my money in the basket of ‘let’s just put out really high-quality content that’s not out there and see what happens’. And actually, a lot of this was from taking a few online courses I had done about SEO and whatnot, but really actually this book that made a huge impression on me, called They Ask You Answer, which I would recommend to really any startup founder. Because I think these days, if you’re starting a company, you have to figure out Google and how to get people to your site organically. And a lot of that’s going to come from content and modeling. There’s no business that you can’t write awesome content about. And so that book, I would say it changed my life. Because it made me realize that like your customers have questions. If you answer them, they’ll come to your site. And you have to do it in a way that actually adds value to their life.”
30:29 – DIY coordination in a remote world
Long-form documentation keeps the Levels team in sync, idea sharing from anywhere.
“In terms of communicating, we are very much a company focused on documentation and as much asynchronous work as we can do. Getting a bunch of people in a room without a lot of preparation for a meeting is very expensive and can often be kind of inefficient. If you have a thought, you write it down – and we like to favor long-form documents. So really strategy documents that lay out how we’re thinking about something, you know, pros and cons, background research, and then linking to other documents that are relevant. So for instance, this might be like a unit economics memo or a customer personas memo, or a total addressable market memo, or a company strategy memo, or product strategy. These are just like long documents. Then what happens is we actually send those to everyone on the team. Everyone has basically like a week or so to just read it and comment on it, thoroughly asynchronously in the document. So it ends up having comments, just like all over it. Lots of thoughts at the end. And then if we’d still need to have a meeting about it, we will, but it’s just there’s so, so much more context for that meeting. And so that’s really served us well.”
33:37 – The doctor is still in
For Dr. Means, the health-changing start-up means she’s treating more patients than ever – it’s simply happening outside the traditional practice framework.
“I do say though, and I really feel this to my core, that I’ve never felt more like a doctor than I have working at Levels. Even though I was seeing hundreds, if not thousands, of patients a year previously, I actually feel more like I’m stretching my doctor muscles than I ever have, and probably in somewhat different ways. And obviously, I’m not operating, but I feel like I’m taking this decade of training that I had and I’m using what I’ve distilled from that. And not only the experiences and the conclusion and the judgments that I made while I was there, but also an overview of the system problem that are limiting us from being healthy…And now I’m applying that every day into a product that I truly believe will actually be able to affect more people than I ever could as a physician. And it will also be able to help people proactively and to stay healthy and be empowered in their own health, as opposed to just reactively offering them surgery or offering them a bunch of medication.”
42:01- Goals for a system-wide change
Dr. Means is hoping Levels can help highlight the relationship between healthy choices and a broad range of widespread illnesses.
“A study that came out of North Carolina last year that looked at a huge population of people and found that 88% of people have at least one biomarker of metabolic dysfunction, whether that’s their cholesterol, their glucose levels, or their waist-to-hip ratios. So that’s just to me absolutely unacceptable, and it is almost entirely preventable and we’re just failing as a healthcare system in this regard. And I think that’s fundamental because we’re not approaching the fact that these are diseases based in daily choices, and we don’t actually approach these diseases in terms of helping people make better choices are actually changing their behavior. We’re very, very reactive. I also think that it’s a failing of the system that the average person isn’t thinking about their metabolic health until they get a diagnosis associated with metabolic disease. So we’ve got to be thinking about health more as a spectrum.”
43:01 – The anti-sugar soapbox
The Levels mission: broadcast the impact that stable blood sugar levels can have on America’s widespread diseases.
“What I think a lot of people don’t realize and what we’re really pushing in our education is that this idea of blood sugar regulation and metabolic function, this is something that actually underlies so many of these other symptoms and diseases that are so common. That many of us might be walking around with even now, when we’re otherwise healthy and not realize that it’s so linked to our glucose and our metabolism. And so we know that diabetes and obesity are associated with metabolic health, but I don’t think most people realize that Alzheimer’s, dementia, heart attacks, heart disease, fatty liver disease, chronic kidney disease. These are all things that are deeply rooted and in dysregulated glucose.”
49:26 – So you want to be a STEM start-up?
Take a step back, think bigger, and zero in on the problems that you can solve – and the people who can help.
“To me being an entrepreneur means stepping back frequently throughout your life and taking stock of what you’re doing and how you’re spending your time and really reflecting on what kind of impact you want to have on the world. Really looking at the world and saying, ‘What is interesting to me and what could be improved in the world and how could something that’s happening right now, sort of poorly and inefficiently be done better and be scaled? And how could I take my existing experiences and partner with other people to make that happen?’ And I think that’s, that’s really what it’s all at. That’s how it all starts is finding the pain points in the world, figuring out how you can impact it. Figuring out people who can help, you know, magnify you and your knowledge base and then, and then make it happen. But I think a lot of it does come from creating the space in your life to step back and think bigger.”
Dr. Casey Means: [00:00:00] You don’t necessarily realize, I think a lot of us think that our glucose levels is really just about what we eat and you mentioned the walking thing. It’s amazing how just taking a quick walk after meals can do so much for bringing our glucose levels down and we really try and bring that holistic perspective into the product. How can managing our stress? How can getting better sleep? How can moving and walking, how can changing our mealtimes? How can all of these things impact the ultimate readout of glucose? So I’m glad to hear he’s been enjoying those product features so far.
Stephanie Cartin: [00:00:31] We often hear that you are and what to eat, but in this episode with Dr. Casey Means, co-founder of Levels Health, we learned how your nutrition may be the most important key to achieving optimal health. Casey kicked off her career in medicine, being a head and neck surgeon and is now the co-founder of a digital health company that combines glucose monitors with intelligence software that helps you track and understand your data. She is passionate about educating her audience about the benefits of preventive healthcare and how tracking your glucose levels throughout the day can help you achieve metabolic optimization and live a longer and healthier life. She also shares helpful tips on how she approaches time management and leads a balanced life.
Coming up, you’ll hear how Casey discovered the gap in the health service of the immune system. How Levels has enabled Casey to reach more patients than she ever could as a surgeon. Her productivity tips for running your company remotely. How Casey’s company raised $12 million from its first seed round. Why you should seek feedback and advice from your investors. Why only 12% of the US population have a healthy metabolic function and what we can do to fix this. Why we should be concerned with the behavior of our metabolism? And finally, Casey’s best tips for achieving optimal work-life balance.
This is the Entreprenista Podcast presented by SocialFly. It’s the best business meeting you’ll ever have with must-hear, real life looks at how leading women in business are getting it done and what it takes to build and grow a successful company. It’s beyond the ground with no filters, no limits and plenty of surprises.
Casey, I am so excited to have a conversation with you today. We were introduced through a mutual entreprenista, Alexandra, who was on the podcast several months ago and I am so glad that she connected us because you have quite the story and journeys to share. So thank you so much for being here.
Dr. Casey Means: [00:03:16] Thank you so much for having me, Stephanie.
Stephanie Cartin: [00:03:18] Casey, you trained initially as a head and neck surgeon prior to launching this new business Levels. Can you share a little more about your background and how that led you to start this company?
Dr. Casey Means: [00:03:30] Yeah. Yeah. It has been a very interesting journey to digital health and prevention medicine by way of surgery.
Yeah. So I started that out as a head and neck surgery resident and that is essentially treating surgically the conditions of the your nose and throat. So you can pick up think of things like sinusitis and ear infections, vocal cord polyps, Hashimoto’s thyroiditis, even head and neck cancers and skin cancers of the head and neck and things like that.
And I was about four and a half years into my training as a head and neck surgeon and realizing that so many of the conditions I was seeing were inflammatory in nature. So all of them ended in ‘itis’, which is the suffix that usually means inflammatory. So the sinusitis, thyroiditis, and it got me thinking, why are so many of these patients chronically inflamed? Why are we seeing so many health conditions in ENT, but also more broadly in our healthcare, in healthcare in general, that are inflammatory in nature. We’re learning more and more that conditions like diabetes, obesity, heart disease, Alzheimer’s. A lot of these involve upregulation of the immune system. And it got me really scratching my head thinking, first of all, why are people so chronically inflamed and why are we approaching this with surgery? If this is fundamentally something that’s happening with the immune system, which is not really something you can surgically intervene on. Certainly you can suck out pus out of a sinus, but that’s not necessarily doing anything for the underlying chronic inflammation. And so that’s really led me on this journey towards, what are the key drivers of chronic inflammation? And it really comes down to exposures, things that our body sees, that it sees as a threat and these things can be really anything that our body is exposed to. So foods. A lot of the processed, heavily refined foods we’re eating these days look foreign to our bodies and it can signal the immune system to wrap up. Processed sugar, processed, grains, pesticides, other preservatives that are put in foods. And then of course, toxins in our food, water and air, chronic stress is an inflammatory signal to the body, sleep deprivation can cause the body to become inflamed, even sedentariness, so not moving a lot. The body doesn’t like that and it can be signaled as a threat.
Stephanie Cartin: [00:05:41] I need to stand up right now and do my stress squats mid episode.
Dr. Casey Means: [00:05:46] But it was really fascinating to step back after really being so entrenched in surgery and think, “What could we possibly be doing with patients to really counsel them on this and help them build a set of lifestyle behaviors and nutritional behaviors that ultimately keep this threat signal in their body down? What could that do for these ENT conditions? And then more broadly for the chronic health conditions that we’re seeing just rising at astronomical rates?” And so ultimately this journey actually really led me towards moving away from surgery. I became really laser focused on how do we actually keep people out of the operating room?
There’s a lot of wonderful surgeons out there, but there’s not a lot of MDs who are specifically focusing on how do we keep people super healthy at scale. And scaling really is the piece that got me moving towards digital health because I can have a conversation with a patient one-on-one and dive really into their diet, really dive super deeply into their diet and lifestyle and help create a comprehensive plan for them that helps move them in the right direction. But that’s a one-on-one conversation and that is, while it’s really valuable, it’s not scalable. I can maybe do 20, 30, 40 of those a week. To do it well, you have to spend a lot of time. Our system isn’t really built for that. And really to help someone move in the right direction, what I want to do is to be on someone’s shoulder 24 hours a day saying, “Oh, now’s a good time to walk.” “Now is a good time to stretch.” “You should probably go to bed now.” “Don’t eat that refined, processed sugar cookie.” Help with all these hundreds of micro decisions throughout the day. And so that really pushed me to thinking, “How can we scale behavior change modalities?” Because we have to change behavior to change the conditions in the body that generate good health. And so really digital health was an exciting avenue to explore there. We have our phones on us. We have our computers with us all the time. Literally, 24 hours a day it’s usually within a few feet of us. So how can we leverage this to motivate the sustainable behavior change that we need to be healthy in a big way. And so that’s where I’m at now and that’s the journey for me from in the OR to working with amazing software engineers and entrepreneurs to build tools that empower individuals to make the choices we have to make to be healthy.
Stephanie Cartin: [00:08:00] Can you share in layman’s terms exactly what Levels is? So for our listeners who have not heard of your product before, what is it, how does it work and then I have so many more questions for you about how you launched this.
Dr. Casey Means: [00:08:15] Absolutely! So Levels is bringing biowearables to the mainstream. So what we are is we are a company that pairs continuous glucose monitors, which are a wearable sensor that is actually monitoring an internal biomarker, glucose, 24 hours a day and pairing that with intelligent software that helps you interpret that continuous data stream and understand what it means and why it is the way it is and then help you optimize it.
So fundamentally our mission is to enable metabolic awareness and then metabolic optimization in our customers. And metabolism is really foundational to our health and to all aspects of our health and it really ties back to what we were talking about in the beginning because so much of chronic inflammation is actually driven by metabolic dysfunction. And really the key substrate of metabolism is glucose. Just backing up like what metabolism is. It’s how we generate energy in our bodies from substrates like glucose and fat and if our metabolism is running smoothly, we have good energy, we have clear mind, we have good memory, we have good athletic performance, we’re feeling good, we’re thriving. And right now we have virtually no insight into that in our bodies. We might have a yearly physical where we get a fasting glucose check or a cholesterol check or we can weigh ourselves each morning and get a sense of whether we’re storing fat or not, but we just don’t have any way to track it in real time. And these days, that’s really what we want. We’ve got our wearables for sleep. We’ve got our wearables for fitness. We even have now wearables for stress with HRV monitoring, but we’ve never had a wearable for nutrition and for understanding whether the foods we’re eating and the things we’re doing each day are affecting our metabolism in a positive or a negative way. And so now we can finally measure that and we’re leveraging this amazing technology, continuous glucose monitors to really bring it to all as the first nutrition biowearable.
Stephanie Cartin: [00:10:11] That is so amazing. Can you share more about how this idea actually came to be and how you met and connected with your co-founders and made it a reality?
Dr. Casey Means: [00:10:21] Yeah. Absolutely! A lot of the passion for me came from what we were talking about earlier with the idea of scaling innovative solutions in healthcare. I was sitting there in my practice knowing that I wanted to spend really hours with each patient, helping them understand all aspects of their diet and lifestyle and I just wanted to be there for them to really coach them through every one of those decisions we make every single day that ultimately generate our health. And you just can’t do that. And so how could we merge that knowledge, that specialized knowledge with some other innovative solution to really get this to people, but have the individuals driving their own behavior change. How can we educate and empower people with their own personal data to actually make the decisions we have to make every single day and be inspired to make them and make them sustainably that are going to generate the conditions in the body that lead to health.
And so that was really what inspired me, I would say. And to me, metabolic health was just the thing we had to focus on and start with for a few reasons. One is that we’re fortunate that this technology, the hardware for glucose monitoring already existed. And so this is an interesting part of the story, which is that – We were looking at the landscape, should we create a hardware? Should we develop a new type of tracking tool to inspire behavior change like a new Fitbit or something like that, but more focused on metabolism. And that’s a really, that’s a long process and it’s a great process, but the reality is there’s already a technology out there, the CGMs. The thing is these were only being used in diabetic populations. So these are FDA approved wearable devices that you just stick on the back of your arm. I have mine on right now, but they’re only being used as a treatment tool for really medication management in diabetic populations. But given what we know now about the fact that Type 2 diabetes is a largely preventable condition and really actually getting on top of our glucose levels far, far earlier in our lifetimes and keeping them stable early on can not only help us ward off disease in the future, but can actually up-level all aspects of our lives now. Really the thought was, “Okay. Let’s take this existing hardware, expand the market and then build a software overlay that’s going to make it as useful as possible to people.” So that’s what drove the vision of the company and I was so fortunate to really serendipitously meet my co-founders and I have four co-founders and they are all just a highly technical bunch. We have the person who really was the force behind the start of the company was Josh Clemente, who’s an aerospace engineer actually, who was at SpaceX for many years. And he was a CrossFit instructor while he was also at SpaceX super fit, ripped guy and he had learned about CGMs and learned about how monitoring glucose was important for actually fitness endurance.
So he started actually pricking his finger a bunch and saw that his glucose was actually really high even though he was super fit. And he was like, “Oh, that’s curious. I thought I was so healthy because I look great and I’ve got muscles and all this stuff.” But he ended up becoming obsessed with checking his glucose because he was like, “This is not normal. This is too high.” And ended up picking his finger 50 times a day at a point and essentially was creating his own continuous glucose monitor. And he then asked his primary care doctor to give him one and the doctor said, “No. You’re not diabetic. I’m not giving you a CGM.” And he said, “But I need to fix this now. I don’t want to become diabetic.” And so he ended up actually – A friend of his, who was a surgical resident prescribed him one and he put it on and he realized he was essentially in the pre-diabetic range and worked to optimize it. And then that was his journey.
And so anyways, we got connected oddly through my brother and this was a fun serendipitous linkup, which is that I was thinking a lot about this behavior change stuff in my own practice and I was so interested in solving this issue that I actually put together my own little pitch deck, just to really prototype my ideas of how I thought we could use digital health and lab data to really be a biofeedback tool for patients for behavior change. I put together this little pitch deck for myself and I shared it around with my family and some close friends and said, “What do you guys think about this? Is this interesting? And my brother had seen this and then he was at an event and he’s a founder of a company in Silicon Valley and actually overheard some people talking about this continuous glucose monitoring idea, and just turned around. It was like, “You guys have to meet my sister. She’s talking about this exact same stuff.” And so we actually – I had a phone call with Josh and it was just, we were just – Fireworks were going off intellectually. We were just really excited about the other’s vision. It was thinking about a lot of the same things. And then I flew down to the Bay area, met with the team and joined forces initially as a consultant and then as a co-founder. And so to me, that whole experience of meeting my co-founders was such a testament to how important it is to be stepping back in your career and reflecting on, what are the pain points? How can you make things more efficient? And then putting it down on paper and sharing it. You’ve got to put your ideas down and share them with your close network and put yourself out there for opportunities like this, I think, to emerge. And so that was really a big takeaway for me, in terms of just personal development. This was a result of me taking that risk and then really beautiful things came from it.
Stephanie Cartin: [00:15:24] I’d love to know how long was the product development phase.
Dr. Casey Means: [00:15:27] Yeah. So I would say we’re actually still in the product development phase. We are prelaunch at this point and we’re still in a closed beta program. So we came together in summer of last year, around August, so we have been around for about just over a year and we started testing our beta version of the app that is paired with the continuous glucose monitor in about January. We had about a thousand customers go through that, go through the month long Levels program, which is what we offer right now. And so just to step back, when you become a Levels customer, you get access to a physician consultation for these prescription-only continuous glucose monitor devices and then if you’re approved for a prescription you’re sent two continuous glucose monitors, which each last 14 days on the arm, so that’s a month worth of sensors and then access to the software. So that’s the program, the metabolic awareness program that we offer. So we’ve had about a thousand customers go to that program and with each of them, they go through midpoint calls, final calls. We are getting so much data and information from them about how to improve the product and just make it perfect for them. And we’ve actually put out about 400 versions of our app by now, within this year and just iterated rapidly on it. And so that’s really been the product development process led by one of my co-founders, David Flinner, who was a former senior Google product manager.
And that’s been just really fun to see how dynamic and rapid it is. And then in conjunction with that, we’ve built out a telemedicine physician network, which is who we send our customers to, to be evaluated for the CGMs. We have a fulfillment portion of our business, which is a pharmacy that sends the product to customers. Of course, the packaging and adhesive covers that go over the sensor that are branded and then – So that’s all part of the product experience.
Stephanie Cartin: [00:17:07] Coming up, you’ll hear which communities have already been drawn to Levels and how Casey manages to communicate and work efficiently with four co-founders.
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Courtney Spritzer: [00:18:49] When you were ready to hire, who were your first key hires?
Dr. Casey Means: [00:18:53] So our first key hire was Mike DiDonato, who is our head of customer success. And I think this was such a critical hire for us because it really – We are a product company who is building the product that is going to help our customers. And we wanted to hear every piece of feedback from our customers and make it just an absolutely beautiful experience for them from the beginning. And Mike is who makes that process completely seamless. And at the beginning, a lot of this was very hyper-manual and what has really been the trajectory of the past year is how do we take these hyper-manual, customer-facing processes that Mike does so well and actually automate them. And so Mike has just been basically just the Jack of all trades and making the customer experience great. But as we’ve grown and as we’ve expanded our team more with operational capacity and more engineers, we’ve been able to take those pieces that we’ve learned from what the customers needed from Mike and actually build them into the product.
So that was really so key and just at the end of the day, we are building something that we want to delight our customers and also just really achieve our mission, which is to help people gain metabolic optimization. And so he’s just been absolutely integral in being the interface between the customer and then our further product development
Stephanie Cartin: [00:20:08] I have to share. So when we first connected, when was that? Two months ago now, three months ago, I shared that my husband is on his health and weight loss journey right now and you offered to allow him to be part of the beta test program and he has absolutely loved his experience getting to test this product and has learned so much about how his body has been processing foods. He’s getting alerts, realizing that maybe he should go for a walk before he eats something or a certain food that he thought was really great for him is actually really spiking his blood sugar levels. And then he’s been on the phone with your team sharing feedback based on his experience. So I’ve gotten to see this firsthand, which has been super exciting.
Dr. Casey Means: [00:20:52] That’s so great to hear and really highlights, I think, some of the nuances of glucose monitoring that I don’t think people necessarily realize. I think a lot of us think that our glucose level is really just about what we eat and you mentioned the walking thing. It’s amazing how just taking a quick walk after meals can do so much for bringing our glucose levels down and we really try and bring that holistic perspective into the product, how can managing our stress, how can getting better sleep, how can moving and walking, how can changing our mealtimes, how can all of these things impact the ultimate readout of glucose? So I’m glad to hear he’s been enjoying those product features so far.
Courtney Spritzer: [00:21:31] How were you able to get your initial testers for the product? Outside of stephanie’s husband.
Stephanie Cartin: [00:21:39] There was already a long wait list.
Dr. Casey Means: [00:21:41] Yeah. So yeah. Currently we’re at a 40,000 person waitlist. Yeah. 8,000 in October, so far. So it’s been amazing and initially, a lot of the people we brought on were, of course, in our network. It was people who knew about our vision and wanted to be a part of the early testing. A lot of the silicon Valley entrepreneurs and biohacker types and fitness enthusiasts and whatnot. And then, things just really started taking off on their own and I think a lot of it had to do with social media. So right up your guys’ alley. There is really an amazing element of shareability to glucose data because it’s visually appealing, it’s graph- based and score-based and it’s also, there are so many surprises and we walk around our whole lives trying to figure out what the right diet for us is and going on all these different diets and trial and error and I don’t think very many of us can just say, “Oh, I know that this type of eating plan is perfect for my body.” Or, “I know that this breakfast is optimal for me.” But now for the first time ever people are using this product and they can say, “Oh, I actually know that oatmeal is a terrible breakfast choice for me and I’m not going to eat it again.” So of course they want to share that. It’s fun to be like, “Oh my God, you guys, oatmeal shot me up into pre-diabetic levels. I can’t eat this anymore.” Or, “Tomorrow I’m going to try it with a bunch of fiber and fat and nuts and chia seeds and see if it has any difference.” So it really lends itself to some amazing sharing and and so that really helped us gain more waitlist customers. And then I think there were just some other segments of the population who have really been desperate for this type of technology who came out of the woodwork when they heard that this was starting to happen.
And so I think the segments that are most notable are Because the longevity enthusiasts and the biohackers and the tech people, , all that was pretty in our network and easy sell. But then there were these other segments that were so interesting. So one was the fitness community. We got outreach from well over 10 pro sports teams in the first couple months who have really wanted to understand glucose for performance, fueling and recovery for athletes. And these teams, I’ve been amazed. They have these really brilliant nutrition scientists who work on these proteins now who are out there looking at what types of new technologies are out there and how they can potentially work to improve performance.
And then the second community is the weight loss community. There’s been a lot of interesting books that have come out over the last several years, notably Jason Fung’s “The Obesity Code, “The Diabetes Code”, Mark Hyman’s “Blood Sugar Solution”, Ben Bikman’s “Why We Get Sick” and these talk really deep in detail about how weight loss is not just about this calorie in calorie out model, but it’s actually , hormonal . If we keep our glucose high, it means that we’re keeping our insulin high and insulin blocks fat burning And so to really unlock the power of fat burning you’ve got to get insulin down which means you’ve got to get glucose down. But of course these are hard things to measure , So that community has been following these types of authors who are just all over it , I want a glucose monitor. I want to track it I want to bring it down and I want it , And so we ran a few small pilots early on with people in the weight loss community and saw some really , incredible results with that , So that was , some of the groups that were , the early evangelists And then I’d say the third is the keto community These are people who are low carb adoptive type people They eat a very very low carb diet , and they’re tracking their ketones usually with a blood finger prick but to be able to actually see your glucose levels and keep your glucose down that’s essentially , – You can assume that if you’re keeping your glucose levels low and stable you’re going to be generating ketones which is a product of fat burning So you keep the glucose low you start tapping into fat burning you produce a ketones So in terms of personalizing , a ketogenic diet it’s just so fun ,
So we got very fortunate in a lot of these communities , hearing about us and then just , going big , on social media , And then I think , aside from social the really , big driver of organic interest was through our blog and our content strategy We invested heavily in putting up really high quality content about why a non-diabetic, otherwise healthy person should care about glucose highly scientifically referenced articles written by many of our medical advisors myself and others, athletes and we actually saw an increase in organic search as a percentage of total visitors to our site from 5% to 30% over just a few months, and search terms like glucose and , healthy glucose levels and Levels , We were way down in the rankings and went up to , three, four, , five for these search rankings within just a few months of putting out really high quality content So Google , knew that there was something good there , in the sense that people were spending a lot of time on page and this and that and we just started seeing a lot of inbound organic search traffic So that was one of the most interesting things to me about the past year is learning so much about the SEO side and being the head of our content operation at Levels, just really seeing how that could be a marketing channel That is just so powerful
Courtney Spritzer: [00:26:34] What was your initial , social media and SEO strategy?
Dr. Casey Means: [00:26:38] Yeah So I would say up front from the content perspective , our North Star is to reverse the trend of metabolic dysfunction and we understand that to do that , people have to know why it matters then they have to care . So education was of paramount importance to us and it could not be fluff , Very early on I ,differentiated between what I would call a content marketing strategy and , a really editorial , journalistic science writing strategy. , Content marketing being more – Putting out content that is really search engine optimized to drive traffic towards your site which may have some good pearls in there and whatnot but the focus I think really is to drive traffic and optimize it versus , I put my money in the basket of, , “Let’s just put out really high quality content that’s not out there and , see what happens” And actually a lot of this was from taking a few , online courses I had done about SEO and whatnot but really actually this book that made a huge impression on me called “They Ask, You Answer” which I would recommend to really , any startup founder because I think these days , if you’re starting a company , you have to figure out Google and , how to get people to your site organically and a lot of that’s going to come from content and modeling There’s no business that you can’t write awesome content about And so that book , I would say it changed my life because it made me realize that , your customers have questions . If you answer them they’ll come to your site , and you have to do it in a way that actually , adds value to their life and in doing that you not only increase , your search ranking in organic traffic but you build trust with your customer , So that was really influential to me and was , the beginning of our SEO strategy
Stephanie Cartin: [00:28:08] So I have a question about how you manage your relationship with four co-founders. How you all stay efficient and communicate? Do you have any secrets there ,
Dr. Casey Means: [00:28:18] Yeah. It’s a great question I don’t think there’s one right answer to it but I can certainly share how we do it at Levels And this is very much driven by my CEO Sam Corcos, who is really one of the most brilliant systems thinkers I’ve ever met in my whole life , We have been a remote company since the beginning so we were never intended to have an office We always were remote So when COVID hit we were , just , ready to go , Literally not a single thing changed for our company except that we became even more evangelical about glucose because we found out with COVID that metabolic dysfunction was one of the key predictors of mortality and morbidity in the disease . So it specially made us feel like we were on the right mission But in terms of communicating we are very much a company focused on documentation and as much asynchronous work as we can do. Getting a bunch of people in a room without a lot of preparation for a meeting is very expensive and can often I think, be , inefficient . And so we are – Essentially if you have a thought you write it down and we like to favor long form documents So really strategy documents that lay out how we’re thinking about something , pros and cons background research and then linking to other documents that are relevant So for instance , this might be like a unit economics memo or a customer personas memo or a total addressable market memo or a company strategy memo or , our product strategy These are just , long documents and then what happens is we actually send those to everyone on the team Initially it was just the co-founders, and everyone has basically like a week or so , to just read it and comment on it thoroughly, asynchronously in the document So it ends up having comments just , all over it . Lots of thoughts at the end And then if we’d still need to have a meeting about it we will. But it’s just there’s so so much more context for that meeting , So that’s really served us well So long form documentation is just massive and we actually hire very much now for people who are interested , in focusing on strategic thinking and , on really , written thought as a way to communicate , on a remote team . Basically if it’s not written down we find that it often just gets, it gets lost We actually document every single one of our meeting notes We use a program called Notion for that So if you have a phone call , there’s a meeting note about it That’s been extremely helpful All meeting notes have action items and then tags for anyone who it would be relevant to. We of course use Slack but that’s mostly, we consider that really an open loop form of communication ,It’s not permanent It’s not our source of truth at the company It’s just a way to , communicate throughout the day ,
Yeah , So Notion , Slack of course , all the Google platforms are some of our main ones And then everyone on the company uses Superhuman for email because , it’s really just an efficient way to triage emails , and projects . And there’s , a few other key programs that we use but those have been quite helpful for us
Courtney Spritzer: [00:30:57] I got to check out Superhuman and Notion , I’m a stickler about taking notes and making sure everything is documented and , everyone is on the same page because we’re all moving so fast
Stephanie Cartin: [00:31:07] ,Courtney I will give you my feedback on Superhuman . I had my onboarding today that actually got cut short There wasn’t enough time to finish They only scheduled a half hour So when I’m fully onboarded next week I’ll give you my full review
Courtney Spritzer: [00:31:19] Yep Put it in writing
Stephanie Cartin: [00:31:21] You got to get Notion first
I want to know , how has this venture into , running a startup been different from , being a medical doctor ? And I know you had your own practice and having your own practice , does require you to put on , your business hat but how is this experience different , from what you’ve done before
Dr. Casey Means: [00:31:40] Yeah. , It is different , in a lot of ways I do say though and I really feel this to my core that I’ve never felt more like a doctor than I have working at Levels. Even though I was seeing , hundreds if not thousands of patients a year previously I actually feel more like I’m stretching , my doctor muscles than I ever have and probably in somewhat different ways and obviously I’m not operating , but I feel like I’m taking this , decade of training that I had and , I’m using what I’ve distilled from that and , not only the experiences and the conclusion and the judgments that I made while I was there and also a overview of the systems problem that are limiting us from being healthy in our company and , was able to distill that . And now I’m applying that every day into a product that I truly believe will actually be able to affect more people than I ever could as a physician And it will also be able to help people proactively , to stay healthy and be empowered in their own health as opposed to just reactively offering them a surgery or offering them a bunch of , medication ,
It’s just funny though I thought it was like “Oh am I going to miss the clinical practice Am I going to – ? , I still do see patients actually , part time I do Yeah Because I love it And , it’s just so wonderful to work with people and , both jobs inform each other so well. , But I just really love , the way that this is a way to apply medical training , in a different and I think highly scalable way I think one of the big practical differences is that in surgery in medicine you really know what your priorities are each day You have a list of patients that you’re seeing and then at the end of the day , every single chart note needs to be signed All the referrals and the prescriptions have to be sent . You have to do all your billing , and then you’re done And it’s very much like you know exactly what your success criteria are , for the day And I think that’s very different at a startup It’s just you are wearing so many different hats , I’m a , SEO marketing person. I’m a content writer . I’m managing our advisory board I’m , on podcasts. I’m doing , the clinical product development just so many different things And so I really do think there’s a whole different level of prioritization And so it does, , I think require you to step back , each day and week and say “You know what ? What at this company can really only I do Where can I add unique value and , what can I do that is going to drive the business forward , as usefully as possible this week?” , And really really focus , on that because there’s just so much to do , and I think prioritization and thinking about leverage I think, is really important in a way , that wasn’t actually there , in my day-to-day medical career. And a lot of the prioritization and figuring out how to leverage your skills I think a lot of that comes down to actually saying no and having really good communication , with colleagues So figuring out what are the right things to focus on and then where do you actually just have to very clearly communicate that you’re not able to and then just making sure that your team is aligned , with those choices. , That would be the main thing
Stephanie Cartin: [00:34:25] I know that you raised money for this venture Can you share some of the tips for fundraising Because a lot of our listeners are thinking about raising money, , are in the process of that right now and would love to hear some advice
Dr. Casey Means: [00:34:38] Yeah. , We’re still very early, so , I’ll share what I can for sure but we , actually just closed our seed round a couple of days ago and so , we just closed a 12 million dollar round led by A16z and we’re so excited to partner with them and just really excited to use that money to drive the product forward and just build the most amazing customer experience that we can, scale our operational capacity and also build out our clinical research efforts , with our academic partners So we’re very very excited about that And I would say , our CEO Sam, really led the fundraising efforts , and I think he did it just really brilliantly And I think a lot of it came down to having a ton of respect for , his network and really leaning on the network to help us through the process So I’ll just give , some really , practical things , that I saw happen So yeah We had a network of about 70 or 80 angel investors who had been , early funders of the company and we actually reach out to them all the time for advice and for feedback , I mentioned these long form documents that we often write and share amongst the company . We actually share those all external We’re a radically transparent company about what we’re doing and we are really confident in how we’re executing and aren’t really worried about , what other people hear or know as much as I think many other companies are. We really feel , like we’re going to rise together not only with other people in this area and other companies , but just , with our network And so we would send many of our strategy documents to our angel investor network and just get extensive feedback on that type of stuff So everything was just like very very refined in terms of how we were thinking about things By the time we went into the fundraise there had been a lot of eyes on what we were doing and there was pretty much an answer to every possible question any investor could have asked So the way these meetings , went was , we’d be connected with , some type of investment firm and have some calls and they’d have a number of questions and we would really follow up with , five to 10 or more , documents of how we’re thinking through , these things And we got a lot of feedback , that was extremely helpful I think we showed up prepared We know , what we think about things and we’ve thought through really every angle of a lot of these issues And when we didn’t we reached out to our network for help and for input , So it was , amazingly a team sport , this fundraise and I just would , ask people to consider that. , I think sometimes we think like , “Oh we’d get an investor or the angel investors something and then we just ,want them to stay out We don’t want them to , meddle in our stuff but I actually feel very very differently about that . I think the more that , we can play as a big team , the better that we’re going to do And so that would be my biggest takeaway , from the fundraise is respect your network and ask for help and totally be in , a growth learn mindset every step of the way and write things down and share it with people I think at the end of the day the investors want to feel confident that , you know what you’re doing You’ve thought about it You are mature , and comprehensive and so anything you can do , to show up prepared in that way I think is good
Stephanie Cartin: [00:37:41] That’s such great advice Up next the state of metabolic dysfunction in America and why we have to think of health as more of a spectrum Hey entreprenistas I am so excited to announce the launch of the new Entreprenista website We listened to what you’re looking for and have created a resource for each of you that goes beyond each episode of our podcast so you can continue to discover the best women-led brands, products and services to help your business grow . We will be featuring more stories from female , business leaders and we’ll publish exclusive content and interviews on the website to continue to provide you with as much value as possible Be sure to check out our Entreprenista shop filled with branded merchandise and our Entreprenista picks featuring discounts and special offers from your favorite female-led brands. We’ve created a special coupon code just for you for our launch for all Entreprenista swag. Use code podcast10 at checkout We can’t wait to hear what you think and thank you so much for being part of our community Head on over to entreprenista.com to start exploring and use code podcast10 at checkout
Courtney Spritzer: [00:38:57] Casey you have already accomplished so much in this business and , what seems like such a short time What is the ultimate vision for levels
Dr. Casey Means: [00:39:04] So the North Star of our company is to eliminate preventable metabolic dysfunction in the United States Right now we have 88% of Americans in this country with some sign of metabolic dysfunction . Only 12% of people in the US are what we would consider perfectly metabolically healthy and this , actually comes from a study that came out of University of North Carolina last year , that looked at a huge population of people and found that 88% of people have at least one biomarker of metabolic dysfunction whether that’s their cholesterol their glucose levels or their waist to hip ratios . So that’s just – To me , it’s absolutely unacceptable and it is almost entirely preventable and we’re just failing as a healthcare system in this regard and I think that’s fundamentally because we’re not approaching the fact that these are diseases based in daily choices and we don’t actually approach these diseases in terms of helping people make better choices or actually changing their behavior We’re very very reactive I also think that it’s a failing of the system that we – The average person isn’t thinking about their metabolic health until they get a diagnosis associated with metabolic disease So we’ve got to be thinking about health more as a spectrum . And if we can get people to really start thinking about where they are on this spectrum in the continuum of health and disease and realize that every single day they have the choice of where they want to move on that spectrum, , I think that’s a win. And then give them the tools to actually do it in a way , that is very achievable .
So that’s our ultimate goal is to make a massive dent , in this epidemic What I think a lot of people don’t realize and what we’re really pushing in our education is that this idea of blood sugar regulation and metabolic function , is something that actually underlies so many of these other symptoms and diseases that are so common that many of us might be walking around with even now when we’re otherwise healthy, and not realize that it’s so linked to our glucose and our metabolism , Overtly we know that diabetes and obesity are associated with metabolic health but I don’t think most people realize that Alzheimer’s dementia and heart attacks and heart disease and fatty liver disease chronic kidney disease – These are all things that are deeply rooted , in dysregulated glucose. In addition some sort of really unusual things that people aren’t aware of that fertility the leading cause of , infertility in the United States polycystic ovarian syndrome is a metabolic condition and when we actually can control our blood sugar levels the symptoms get radically better very quickly for many women with PCOS. Erectile dysfunction closely linked to blood sugar dysregulation acne depression anxiety chronic pain chronic fatigue, all of these can be related to how the body is processing glucose .
And it makes sense because if glucose is a primary form of energy in our body when we’re not regulating well that can actually impact any cell in the body, any system in the body. We need these fundamental pathways of energy production to be efficient And so it’s not just fighting diabetes it’s not just fighting obesity . It’s actually helping people reclaim a foundational pathway of health in the body so that all aspects , of our life and our current symptoms our current wellness and then our future health can be improved and I just really think it’s the lowest hanging fruit in terms of high value health care right now and it’s got to be approached through a behavioral framework ,
So that’s where we see Levels going and filling that niche ,
Courtney Spritzer: [00:42:10] I will definitely be a customer I love , getting all sorts of tests probably done them all So I’ll definitely be signing up I’d love to know more about how you manage running a startup and your personal life . How do you find time and balance for yourself
Dr. Casey Means: [00:42:29] Yeah. , It’s a daily sort of dance I would say and , no two days , look the same What I know for me to be true, is that I have to have the four pillars of health of personal health to be strong for me to be a good leader . And that means that I have to have my food really on point I have to get enough sleep for me personally That’s on my Fitbit or my devices. It means seven and a half hours of time asleep which usually means I’m in bed for eight and a half hours It means I need to be moving and exercise So ,I try and sweat every day . That’s my goal. , It doesn’t necessarily happen every day but , if I can at least break a sweat through some physical activity I’m happy and then stress management, so just making sure that , – If I’m stressed the first thing I do is breathe and make sure I’m doing that and I just keep it simple . So it’s not like an hour of meditation It’s not like I have to get a half hour of working out every day but I pretty much make sure all those things are covered , I think the food and the sleep both do you end up taking time , You could say time away , from the business , I will really be ruthless about those things I will not skimp , or compromise on food because to me it has such a direct relationship to how I show up as a teammate and a leader and a creative thinker and a systems thinker I just can’t do my job , if my food is all over the place.
And what I mean by that is that I want it to be stable in terms of the glucose, so if I’m swinging up and down with my glucose because I’m eating a bunch of processed snacks , my mood is going to be up and down, my memory is going to be foggy, my cognitive performance is going to be off, I’m not able to sleep as well So that’s just for me that’s a non-negotiable. I focus a lot on fiber, trying to get 50 to 75 grams of fiber a day because for me microbiome , our gut microbiome or what make the majority of the neurotransmitters in our body – so if they’re not fed well I’m not thinking well. Our gut microbiome is tightly linked to our mental health and so , it’s just critical for me to make sure I’m getting fiber which means not eating processed foods and really eating more whole foods which means I’m actually spending time each day preparing food and then really focusing on Omega-3s .
That’s another big one for me Omega-3s are what makeup our brain cell linings and if we – Omega-3s are , the healthy type of fat that we like to think about anti-inflammatory but these things come in , chia seeds flax seeds walnuts and fatty fish Whereas the Omega-6s which are not great for brain health and are pro-inflammatory that’s the stuff you’re going to see in , processed seed oils and eggs and chicken and beef that are poorly raised and things like that . So I’m just really focused on fiber, Omega-3, low-glycemic and then lots and lots of micronutrients from lots of vegetables And to me that is actually , 100% necessary to be a founder of a company , To me , it’s intricately linked. I’m of course biased because my medical practice is focused on food as medicine . So I think about I , care a lot about this but it’s all going towards the same mission, so I see it as part of my job actually
Courtney Spritzer: [00:45:20] Are you taking on new patients virtually because I want to work with you
Stephanie Cartin: [00:45:24] I know Can you please give us your grocery store list I think that’s my biggest challenge Because I want to do all the things that you’re sharing but then I go to the grocery store and I just freeze because I don’t even know where to start, so –
Dr. Casey Means: [00:45:37] Yeah. , One plug I have to put in. , I think this has been really helpful for my patients but there’s a company called Daily Harvest and actually founded by an entreprenista. I don’t know she’s been on ,but, Rachel Drori, and they , basically fill all the criteria that I just talked about , They have harvest bowls. , They’re frozen food that come in compostable containers and they’re super filling and they have all the things I just talked about and , for patients who are just , too busy to do any of this or for me when I am too busy to do this I just am like Daily Harvest. I’ll order a 26 pack and sometimes I’ll do that for , a week because I just don’t have the time but it’s not compromising at all And of course I’m , not supported by their company at all or anything , It’s the only food company I’ve found that is , organic and ,truly meets all the criteria that , I think are really important to mental and physical health . And it’s all plant-based which is cool
Courtney Spritzer: [00:46:25] Casey, what does being an entreprenista mean to you
Dr. Casey Means: [00:46:28] To me being an entreprenista means , stepping back frequently , throughout your life , and taking stock of what you’re doing and how you’re spending your time and really reflecting on , what kind of impact , you want to have on the world . Really , looking at the world and saying , what is interesting to me and what could be improved in the world and how could something that’s happening right now , poorly and inefficiently, be done better and be scaled and how could I take my existing experiences and partner with other people to make that happen And I think , that’s really what it’s all That’s how it all starts is , finding the pain points in the world figuring out how you can impact it, figuring out people who can help , magnify you and your knowledge base , and then make it happen But I think a lot of it does come from creating the space in your life to step back and think bigger . And that means to me getting out of the hustle and bustle of how the world wants us to be living , glued to our phones glued to our email, moving so so fast and really taking intentional time to step back And even if you’re not stepping back and actively reflecting at least giving your time your brain time for some of that processing. I think that is the first step . It’s just hard to just , really jump into a project if you haven’t had that space to really consolidate be creatively degenerative, ,reflect , So that’s really , what it has meant to me and I think the foundation is where all , the good stuff comes from ,
Stephanie Cartin: [00:47:51] I have learned so much from you in this conversation and I am so glad you took the time to sit down and share your story and journey not just with myself and Courtney but our entire audience who I know is just craving so much of this information that you’ve just shared So thank you so much , for sharing your story and journey We can’t wait to continue to follow you and follow Levels Where can everyone find you on social, find the website sign up , to be a user once it becomes available for everyone?
Dr. Casey Means: [00:48:20] Yes Absolutely! , Thank you so much for having me on. It is so great to chat with you Stephanie and Courtney and I am so grateful to be , in the Entreprenista community , It’s an amazing , group of women that you guys support
And so to find us you can come to www.levelshealth.com You can sign up for the waitlist there and as we grow in scale which we’ll be doing rapidly because of our new , – closing our seed round. We’ll be moving fast and we’ll try and process people as quickly as we can from the waitlist. We anticipate a launch in Q1 of 2021 where people can , just come to the website and sign up and purchase the product So stay tuned for that. To find more if you’re interested in finding out more about metabolic health and how this relates To you and your life I’d check out the levels blog which is levelshealth.com/blog And you can follow us on Twitter and Instagram levels which is super fun to follow because like all our beta customers are putting up experiments that they’ve done and what they’ve learned And it’s just it’s really awesome to see people’s Individual responses to food and activities And then for me personally I’m at Dr Casey’s kitchen on Instagram and Twitter Dr CaseysKitchen and I put up a ton about plant-based nutrition and metabolic health and how to keep your glucose stable even if you’re eating all plants
So we would love to hear from you guys.
Dr. Caroline Leaf: [00:49:32] Thank you Casey so much. I’m Stephanie and I’m Courtney and this is the best business meeting we’ve ever had.
Stephanie Cartin: [00:49:40] You can connect with us @socialflyny.com and follow us on Instagram @entreprenistas. Check out all our latest episodes @entreprenistapodcast.com. Thanks for listening.