Flipping the Switch: How an Entrepreneurial Mindset Can Spark Innovation in Public Health Ramon Llamas - Founder, Switch/Health, LLC

Ramon Llamas is a social entrepreneur and blogger that’s focused on leveraging innovation to improve health outcomes. His mission is to change how society currently views health, with a particular interest in empowering individuals to become more proactive about their quality of life.

As Founder, Consultant, and Writer at Switch/Health, LLC, Ramon works with non-profit organizations and early-stage startups in public health, healthcare, and social services on business and program development, organizational strategy, and strategic partnerships. He also is the Author of the Switch/Health blog & writer on Medium.com, where he shares stories and reflects on health and well-being as the complex beast that it is. The content of each post incorporates many factors that directly and indirectly influence health outcomes, with an overall purpose to educate and empower (and hopefully entertain).

We sat down over food at Motorco, a local bar & music hall, to discuss Ramon’s path to becoming a public health professional, the obstacles he’s had to overcome, and his advice for aspiring Arc Benders.

What initially inspired you to make a difference and what path did you follow? 

My career path in public health unfolded in somewhat of a weird way.  I was studying abroad in Italy in my fourth year of college (I graduated in 5 years), and when I came back from Italy, I had missed my registration window and was forced to sign-up for a handful of random classes. I was a pre-med major and I was ironically only able to register for one of my pre-med major requirements that semester. I took a range of classes, including an introduction to public health and Italian. That first class in public health completely changed my perspective.  It challenged me to think outside of the traditional pre-med focus on cells and the individual, to a broader sociological focus on population health.  I became way more fascinated in how people interacted with their physical and social environments than understanding the intricacies of cellular metabolism and studying for the MCAT.

After I graduated, I got a job as a health educator focused on preventing substance use and abuse in high school students. I was engaged in communities presenting to high school students and a number of stakeholders and I stuck it out for a year, but I got so frustrated with my managers because they were so ingrained in the status quo.  They felt that there was only one correct way to approach the problem we were trying to solve.  They had secure grant funding from the county and didn’t want to change things at all.  Personally, if I see something that needs to be improved or can be improved, I want to be able to make a change.

At that point, I decided to enroll in graduate school for a Master’s degree in Public Health (MPH). It was probably not the most mature way to go about it.  In hindsight, I wish I had gotten more job experience to have known exactly what I wanted to do…but instead, I went to graduate school after a frustrating experience at my first job. It was an expensive lesson to learn.

In graduate school, my focus was health education and health promotion, but I quickly discovered that those classes didn’t stimulate and engage me. Thankfully, one of my professors who taught one of the required classes, U.S. Healthcare Delivery, was young, motivating, and thought-provoking.  He shared various articles that highlighted issues that weren’t really being talked about – the price of healthcare services compared to other countries, tort reform, and healthcare spending compared to other sectors, among others. I took another course he taught in Comparative Healthcare Systems around the same time healthcare reform debates and election 2008 were heating up and it reinforced my interest in health policy. After the election, a couple of classmates and I made the trek Washington, D.C. to watch the Inauguration in January 2008, and I accepted an internship in D.C. later that summer. That professor changed the course of my career towards issues that I was truly passionate about.

My experience as an intern in the summer of 2008 influenced me to move to D.C. so I could focus on health policy issues on the national level.  I moved right after I graduated in August 2009 and took a job with a national non-profit organization that addresses health disparities through community outreach, advocacy, and health policy. Through that job, I got more experience in engaging key stakeholders including legislators and how the skill of community organizing. Living in D.C. was really inspiring and motivating. However, I eventually ran into the same frustrations I had with my first job out of college around innovation.  While this non-profit was more forward thinking, it still wasn’t as open to making changes as quickly as I’d hoped.

The big question I kept asking was – why aren’t we more innovative?

I knew I was looking for a change, so I decided to take an opportunity with the federal government, in part because I was looking for stability. Initially I worked on an employee wellness program supporting Veterans Affairs employees across the country as part of a division of the U.S. Department of Health & Human Services. Our goal was to provide employees with integrative health coaching by phone. Our division’s funding was non-appropriated, so we were an independently operating business within the government charging other agencies for services that they would have otherwise contracted to private sector companies. In my opinion, the division oversold and under-delivered. We had a team of 10 people and we were tasked with supporting approximately 300,000 employees. While we were going to do a phased-in approach of bringing on one region at a time, it just didn’t add up, even if it was virtual.

After that program, I spent the next three years working on another project in the federal government where I managed a health and wellness program for employees at HHS headquarters.  Our program served over 3,000 employees with an on-site health clinic, mental health counselor, and fitness center.  Additionally, I was responsible for the health education and health promotion side of things as well as overall coordination of the team. We had a very a holistic approach and it was very innovative from the federal government, primarily because it was President Obama’s goal to bring best practices in health & wellness from the private sector for public sector employees.

The challenge, though, was our limits on financial incentives for public employees, which was only $50 annually.  In contrast, private sector financial incentives were up to 1-month of insurance premiums, which were often $250-$300 to start – a lot of money and could get people signed up quickly.  So, we had a much harder time getting buy-in from people to sign-up and we had to do a lot of work from the ground-up.  Our team engaged employees, built relationships, and participated alongside them.  I was there for almost four years.  But yet again, I became more aware of the issue with status quo… our team would propose innovative solutions based on employee feedback and specific needs, but they would unfortunately get lost in bureaucracy and were never implemented.

Tell me a bit about your work are how it’s helping to make a positive impact?  

Today, I am a freelance consultant in public health. Switch/Health, LLC’s clients are non-profit organizations and early-stage startups. My work focuses primarily on business development and strategic partnerships. That’s my day job and it allows me to not only choose the projects I work on, but also gives me some creative freedom to push the envelope sometimes with regards to new approaches.

One of the reasons that non-profit organizations struggle with hiring employees with innovative or business skill sets is cost – they can’t afford competitive salaries for top talent. The benefit for me working as a consultant is that there is lower risk for the organizations I work with.  They can invest in a short-term project with me and if they like it, we can keep working together.  If not, we can part ways.

Most, if not all of a non-profit organization’s income is from grant funding, but the ROI on writing a grant is minimal.  Grant funding doesn’t make sense from a financial sustainability perspective. I thrive in helping non-profit organizations diversify their funding streams.  For example, cultivating relationships with private donors and corporate sponsors are strategies that we explore, as well as selling their expertise as a service (e.g. consulting, training, capacity building, etc.) to a variety of potential clients.

I’ve also come to realize that public-private partnerships are more common that I initially thought.

When you’re in school for public health, you often graduate with a black and white mentality that the private sector is “bad” and the public sector is “good.” But when you start working, you realize that everything is a shade of gray.  I’ve met people working in the pharmaceutical industry in corporate social responsibility initiatives that are truly inspired and making positive impact and I’ve also met people working in non-profit organizations that are morally corrupt. At the end of the day, it’s about the people rather than the industry.

I’m also trying to develop a startup on the side, Hungr, which is an app that delivers tailored recipes for people with chronic conditions. We’re focused on providing it as a B2B solution.

I enjoy my work because the non-profit organizations I work with don’t have the expertise or appropriate staff in place to think in an entrepreneurial way. Also, they usually have processes in place to keep them thinking with the same mindset. But I’m working hard to change that!

Where are you at with the app?

I am pre-funded and looking for an angel investor and applying for accelerator programs. I have a team around me, but we’re stuck on creating the MVP (minimum viable product). I’ve been focused on interviewing potential clients, specifically to understand what they need before we finish developing the technology. I’m applying for a Techstars/MetLife accelerator, which would be 3-months of learning, mentorship, and incubation in the field of “insuretech”

I believe we can save insurance companies like MetLife money in two ways:

  1. Since their customers are buying life insurance – if we improve health outcomes and extend their customers’ lives, they are paying out less in claims.
  2. We can also help them with their employee population. If we improve their health, they are spending less in healthcare costs.

I also have a blog, Switch/Health, which I started with the intention of supporting the field of public health by connecting the dots. I organized my content in such a way that you can learn from a variety of sectors, and apply the ideas and best practices across sectors in public health and healthcare. From there, I started a series, “Public Health in Action,” where I interview interesting people and feature their work on local impact. The interviews also highlight health disparities and social determinants of health in their local area, and recommendations on how they could be addressed.

What are the biggest obstacles you’ve had to overcome thus far?

From the viewpoint of starting a business, the biggest obstacle for me has been having to retrain my mind to learn again. I was in the government for approximately four-and-a-half years. I had to learn a lot in the beginning of my projects while working in the government, but after that initial few months, it became a routine and maintenance.

I also had to learn how to be comfortable with not having a stable income and that I always need to be selling myself. I had to figure it all out – how can I sell? What service am I selling? Who can I sell to? That’s definitely a different mindset to be in. As an employee, I had the security that I was going to get paid on a consistent basis. Now, I always have to be aware of where my next paycheck is coming from and have a constant urgency of developing a pipeline for the upcoming months.

When I quit my job, I didn’t have anything lined up. After a 3-month vacation, I started talking to mentors, former colleagues, and professional contacts in my network and they started connecting me with work opportunities.

No one can teach you how to be an entrepreneur – you have to learn it the hard way – by doing it.

What advice do you have for people that want to change the world or pursue their passion?

Pick something that you’re willing to fight for, because it’s not easy. Everything around you will point to staying put and resisting change, so you have to pick something that you’re willing to commit to. That’s the biggest thing: the commitment to fight for the long haul.

Also, sometimes it takes a while to figure out your path and that’s ok. I always had an interest in health disparities and health equity, but it took me time to realize that I wanted to work in public health. Take the time to figure out what direction you want to go and invest in figuring out what your unique talent is.

To learn more about Ramon, checkout his website, follow him on Medium.com, follow him on twitter @RandomRPL, or connect with him on Linkedin.