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Carla Fowler, MD, PhD

Thaxa

Carla Fowler, MD, PhD

Gabriel Flores  0:00  

Hello, everyone, and welcome to the shades of entrepreneurship. This is your host, Mr. Gabriel Flores. Today I am here with Karla Fowler, the Founder and Managing Director at faksa. Carla, how are we doing? I'm doing great, Gabriel. Thanks for having me. Because this is a unique, unique business kind of endeavor. This is actually about executive coaching and kind of actually helping support others. But we first we before we get in all that, let's introduce the world to Carla, Carla, give us a little background.


Carla Fowler, MD, PhD  0:31  

All right. Well, I grew up in the Seattle area, middle child of three kids. Andjust in terms of like, my background, and sort of career path, I was always into math and science, I think I really liked understanding how things worked. And I also have always been an athlete of sorts. I just really love movement. I love learning new skills. I did a year of like diving in the middle of everything. I mean, like, high dive low dive, you know, these are the things I just really always was very curious about whether it was a sport or even learning to do your multiplication tables, like how do you just learn how to do things? If you want to be good at something like how do you do that. So loved those new experiences. And so educationally, I went to Brown University, got a degree in Human Biology. And then ultimately, it was accepted to what was called a medical scientist training program. And that was the University of Washington. And basically, it is the double stuffed Oreo of like academic medicine and science. So you do like two years of med school, you go get a PhD in biological science, then you go back and you finish your clinical years of med school, and then you're off to residency. So took about nine years, I spent most of my 20s, either playing Ultimate Frisbee, or you know, cramming for tests or in the lab, like pulling all nighters in the lab. And so I went off to Stanford to do general surgery residency. And I'll tell you, within about the first year of what was going to be five, I made a dramatic pivot. And that was the moment when my executive coaching firm was founded. So that is not typically how people get into the industry that I am in. But that was sort of my pathway.


Gabriel Flores  2:37  

I love it. Now, before we get into that, I got to ask like, Okay, this is this is a very interesting, you're going down the general surgery. Now, for those folks at home, you kind of got to get through a lot of education before you even get to the residency of general surgery. So what what kind of made you decide that first year to pivot?


Carla Fowler, MD, PhD  2:55  

Well, I think the first thing that's really important is I always did stuff that I was interested in. And but maybe people will resonate with this. I'm interested in a lot of stuff. And in particular, I love challenging things. I love doing something hard trying to figure out how to do it. And I definitely picked surgery because it linked up somewhat with my research interests. So I was thinking I might be a transplant surgeon or potentially do surgical oncology. But ultimately, one of the things I really liked about surgery was that the surgeons have this knack and almost a requirement for seeing, owning, and then improving their choices. So the decision to operate on someone or not, is so binary. And a lot of medicine is not as binary as that, you know, you can give a medication, you can try it out, you can see if it works, you can see how someone tolerates it, it's not good, you stop. But in surgery, I mean, you're going to take them to the operating room, get them all set up and like cut into them. And that's a big deal. And I really liked what that meant about how surgeons had to think about decision making, and the choices. And usually you have imperfect data. And if there any entrepreneurs out there that are thinking to themselves, wow, that sounds like my life, you know, having to make what is a high stakes decision. With imperfect data. There are a ton of similarities and but that was what kind of brought me into surgery. And I really liked that. And I still love that it was a very high performing environment, where there were high stakes and lots of things to learn. But, you know, in in life, there are a lot of trade offs that we have to think about. And one of the biggest things is our time. And our work is one of the things that will ultimately take up the most time that we have. And if it wasn't clear for me sort of talking about the portfolio of things that I was doing growing up I think, for me, one of the important things was that I wanted a more multifaceted life. And that is not to say that one could not have that in surgery. But there are some brutal time equation elements for what's possible and what's not. And I think for me looking around, I could imagine being interested in something other than operating. But I couldn't imagine really focusing my life to go that deep on that one thing, without the ability to be an athlete outside of that, or do some of the other things I was interested in.


Gabriel Flores  5:32  

You know, one of the things you mentioned, in regards to like surgery, and I think this is it's very true for a lot of listeners here is imperfections and possible to obtain, right. And in surgery in healthcare in general, I think for the last couple of years, there's been some distrust in the healthcare world for various reasons. And I think it's important for individuals understand health care, we're not trying to make the perfect choice, we're trying to make the best choice possible because we don't know what the perfect choice is. Your your anatomy may react differently to some medications and others, your body may react differently to surgery, you may not be ready for a transplant, you know, and these are things out and providers constantly are having to go through and back through things called tumor boards for the oncology world in particular, right? You know, if you're a surgical oncologist, you're going through a tumor board, there's a general surgeon, there's a surgical oncologist, radiation, pulmonology, imaging, all these providers talking about just you so. So entrepreneurs, when you're out there thinking about, you know, perfection, and you're seeing the social media channels that are perfectly curated to spark an interest. There's probably a lot of money in marketing behind those perfectly curated, you know, things so, so kind of dispel the notion that perfection is obtainable. Because it's not try to do what's best, you know, whatever the best outcome is. And that's even true in business. And same thing we do in healthcare, right, we would try to find what's the best possible outcome, not the perfect outcome, because we're unsure what the perfect is. But we're certainly trying to aim as close to perfection is possible. Now. Now, one of the things you mentioned, you know, that kind of helped spark this new business, let's talk about what is your company.


Carla Fowler, MD, PhD  7:14  

So Thaxa is an elite level executive coaching firm. And it was born out of both my passion for loving these high performing environments, loving thinking about performance, I'm thinking that that was actually something that I could stay interested in for a lifetime. So that piece, and then I think a second piece of me is just that, I love the pursuit of things. And the truth is, I believe everyone loves being good at things. I think we let a lot of things get in the way, or talk ourselves out of it or all of these things. But I think all of us feel great when we feel like we're performing at our best. And I just have this empathy or this desire to like give that to other people to help other people figure out what's going to work for them, particularly when they're doing these really challenging things where the feedback loops aren't perfect. You get imperfect data, perfection is not obtainable. I just thought, I think I had been coaching for about two decades in formally in the sense of that's just how I think about the world. And I love to help people around me. So 10 years ago, was sort of the formal start of backset as a concept. And I really built it around kind of tying into my scientific background, this idea that actually, we have science and knowledge about this stuff. And also the idea that most people who go into coaching actually don't have my background. And so in that sense, I love combining sort of a different lens, a different background in a new industry, to see what happened to build something great. That's different than what's already out there. So that was sort of the inspiration for taxa as a concept. And so


Gabriel Flores  9:03  

how, what what is that you're like, kind of aha moment, you know, you're going through general surgery residency, and decide, you know, what, this is not the career path and you should be going down executive coaching is a career path I should be doing.


Carla Fowler, MD, PhD  9:15  

I don't think I had exactly the sort of niche of like, oh, it's executive coaching. But what I will say is, I think I, when you're starting to think about like, Okay, this thing is not my thing, then, you know, you sort of have to decide like, Okay, well, what's, what's not a good fit about it? And in some ways, the high performance stuff was a great fit, but I realized I needed more autonomy. I wanted to have control of my time, because in the performance world, one of the things that I think is most important is how do we use our time to how do we think about our time how do we use our time really potently? And also how do we feel about it? And I think one of the other things I definitely noticed was, I was So under slept, I mean, I was an intern, I was a surgical intern, I was so under slept. And we know like that. Sleep deprivation is really terrible for our brains and our health. And it actually took me about three months of catching up on sleep before I felt like I had a creative thought, again, to be perfectly honest, like a non necessity, like do this, do this, do this kind of thought. And, and so I think, you know, you start to notice these things, and then you start to say, Okay, I need a different plan. And I actually had an attending who I looked up to, and I respected, very kind person who surprised me one day very early and said, Carla, what's your plan? And I think I said something like, oh, Allah, Allah, Allah, like, I'm going to transplant surgery, blah, blah, blah. And he was like, no, he's like, what's your plan? He's like, my plan is to build an app, I want to be more independent, so that I can operate when and where I want, like, more or less like the plan to sort of get out, right. And when someone you look up to ask you that question, you start to think like, oh, I need a plan. Like, I need to actually think about whether or not this is going to work. And so that was actually pretty good advice for me. And nine months later, I had figured out that I was sort of moving forwards, I, you know, made sure they had plenty of notice. And a really wonderful friend took the spot that I had, and is a fabulous surgeon. And then I knew that I wanted to do some kind of coaching to work on it with performance science, and to really integrate those two things into a firm. So those are some of the moments, some of the key things that said, Okay, it's not this, but it is about performance, and it is about working with people. So


Gabriel Flores  11:55  

yeah, I like it. In fact, shout out to the fabulous friend, that's a surgeon. If you're looking for a role, please look me up at OHSU. I'm happy to always chat with surgeons that are looking for some positions in the healthcare world because we're always looking for some new surgeons. Now how so let's talk about that a little bit. Like how did you how did you financially? Is this your first first is this your first entrepreneurial endeavor?


Carla Fowler, MD, PhD  12:17  

Well, technically, my first entrepreneurial endeavor was a card business that I sold out of a wagon when I was


Gabriel Flores  12:23  

like, eight gotta hear about this. 


Unknown Speaker  12:26  

Oh well, I mean, there's not much to tell, except that I already had an understanding of like, it's good to go in an industry where you can have a high margin product. I think my mom was appalled at what I had said I was going to charge for these greeting cards. I was shortly that was probably like a two afternoon business. Oh, well,


Gabriel Flores  12:46  

nobody's like handmade cards that you made. Yeah, totally. Yeah. And just cruise wagon.


Carla Fowler, MD, PhD  12:52  

Uh huh. That's a glitter sparkles.


Gabriel Flores  12:55  

That's just hustling that's just, grassroot hustling right there. Now, what about financing? How did you kind of start the finance rallies, just kind of grassroot efforts Daksa.


Carla Fowler, MD, PhD  13:05  

So I self funded. And a big piece of that, that was fortunate was I, my training had been a funded program. So I didn't have student debt, which is was just a huge gift for me. So that was very helpful. And one of the things when you think about self funding, and how I thought about self funding was it was really an investment in myself, and building the career that I could see lasting, you know, the next 40 years. And something that I would love that would have a lot of optionality to take it where I wanted to go, and then it was a platform. And so that was something worth investing in. Certainly coaching doesn't have the same kinds of capital types of things, you might need to start a different kind of business. So yeah, that's how I find it.


Gabriel Flores  13:55  

So let's, let's kind of talk about the because obviously, you have to scale up your business, right, you have to get new clientele. How did you get your first client? How did you kind of begin to? How did you create the business essentially?


Carla Fowler, MD, PhD  14:09  

Well, I got my wagon, and I put some weight actually, I, you know, the way I started and got my first clients and also just gathered a lot of data and learning because again, they don't teach you to sell in medical school, they don't teach you a lot about running a business or setting up a business. And so I hustled and did a ton of networking. And this was helpful for a couple of reasons. Number one, like I was coming back to Seattle from Palo Alto, and so just kind of reestablishing myself in the community. One important thing I think about coaching is that it perhaps not unlike other types of service providers, but it is a business where trust is really important and the sense Have like knowing a person is important, particularly if you are newer, and haven't been coaching for as long. And so I think networking was really helpful for me. And when I say networking, I really just mean relationship building, I had coffee with many, many people, and I'm very interested in people. And I'm interested in what they're up to, what their goals are. And as a part of that, you get to share what are you doing, you know, what is your business, but it really was, I want to be very clear, there was very little like, go to large gathering, do the business card swap out, it was very much like build relationships. If there are organizations you're interested in joining them, be a part of them, so that people just get a sense of who you are as a person. Because then the idea of like working one on one with you becomes much more tangible. And there's a little bit of that baseline trust there, when someone realizes that actually they do want to coach or need a coach, they have someone to call, even if it's not me, they have a starting point.


Gabriel Flores  16:06  

Yeah, let's talk about that. You know, I think I've had a lot of highs, I've highlighted this many of times, the importance of networking. For us, you know, being a new entrepreneur, what would you how important, would you say networking has been to your success thus far,


Carla Fowler, MD, PhD  16:23  

it was very important to my success. That being said, I think there are different, there are different methods of building a business. And it kind of depends what the business is, my business is very humanistic. And so in that sense, I think that you need to give people a chance to get to know you. And for me, when I looked at kind of a pipeline, and the idea of building a clientele, it just made the most sense to do that in person. I also think, again, part of the desire to go into coaching are some strengths around just having a conversation listening, you know, being able to do that. And so I'm actually an introvert, but one on one conversations are really my sweet spot. And so for me, networking made a ton of sense, assuming I was doing coffee by coffee and not, you know, large ballroom filled with people. So that made a lot of sense for me and for my business. Other ways that people do go about it is they share themselves, and they share their ideas through blogging, or some other types of channels like that. And I think that can be effective. You know, I looked at what I thought I would most enjoy doing and what I thought would be most effective. And for me, it was like don't start blogging right now. In fact, I didn't know social media for the first 10 years of my practice. And, and that was fine, because you need to be out doing stuff. You don't necessarily need to be doing what everyone else is doing. As long as what you're doing is effective.


Gabriel Flores  18:01  

Yeah, yeah. That's a great point. In fact, you mentioned you're an introvert, how what advice would you give to other introverts because there's a lot of entrepreneurs, extroverts and introverts? Are, there's no kind of dissemination of that regard. Now, what would what advice would you give? Like, what are some things that you did to kind of overcome this? Because you're kind of going out and meeting with people and you're kind of putting yourself out there to grow your business? What advice would you give another introvert that might be thinking of becoming an entrepreneur?


Carla Fowler, MD, PhD  18:31  

I would say it's okay, if you're terrified. I mean, like the first time I was out, trying to sort of pitch my concept and how I was working. It wasn't just sort of bread and butter, executive coaching. And so I was trying to explain it. And you know, you have all these ideas about what other people are thinking, but I just say, keep going, get started. Don't worry, if you feel terrified, you will only get better. And also remember, everyone else is terrified to Oh, yes, everyone, we are so soul centered on our own insecurities. And so that's just helpful to remember. But I, I really, so in my practice, one of the things I'll talk about is like 9090 90, the most important thing about the 9090 90 is number one, get started that will put you in the top 10% Like because 90% of people often just don't get started on what they're doing. Second, 90, keep going. So even after you have a terrible coffee, or whatever it is, like I just I had scheduled them, I forced myself to send the emails, do the outreach, and I was like, You need to go to that coffee. And you go and then you have some great coffees, you know, some in the middle. And the truth is, you just gotta keep going. And then the last 90, is you need to then start to think about okay, how can I improve this a little bit? What was confusing about my pitch to that last person or what were the questions they asked and what can I learn about, you know, what's working effectively and what's not based on what If they asked about or what their concerns were, and so that last 90 is all about then looping or iterating. And just making a little bit of improvement every time. And this is more or less, how great stuff happens. I think sometimes we think, Oh, no, someone's just talented. It just happens. The truth is, this is a very effective way of improving, and it's how most improvement actually happens.


Gabriel Flores  20:26  

Yeah, it's that's so so true. So folks at home, you know, I know a lot of people know, I do a lot of public speaking, I probably been public speaking now for a little over 15 years. And I have definitely been on some times where I'm like, I should stop speaking in public because I've just bombed this. I forgot the presentation. And I should have stopped right there. But I continued to go. And you know, to your point, Carla, what I was really focusing on is how do I continuously improve how to continue to provide value back to the listeners that are attending these presentations. And now this year, I would say over the last two years, in particular, maybe three, you know, this, this 15 years now, this last three, I think people are probably realizing, Oh, I've been a public speaker, but actually been doing it for, you know, 12 years before this. It's just the last three years that it's finally being, you know, grabbing traction, that people are actually reaching out to me and offering me, you know, honorariums and flying me out to different locations, to speak on things that I've have experience in, you know, I'm not just, you know, pardon my French, I'm not pulling shit out of my ass, like I'm speaking on things I'm an expert in. If you want to talk about healthcare strategy in health care outreach, you want to talk about building a program using referral volume or claims data, come talk to me, you want to talk to me about reading a podcast, come talk to me, if you want to talk to me about remodeling a bathroom, I will help you and I will never remodel it again, though, because the work sucks. But but you know, there's but then there's other things I just can't teach about, you know, if you want to learn how to bake, I can't, I can't help you. I burn water. I'm not even sure how it's possible. But I do it. You know, and so there's just some things in but to your point, Carla, none of this happens overnight. It's it's take some time, it's okay to be fearful of new things. But at the end of the day, the only way you're going to grow professionally is you have to get outside of your comfort zone. That's the where the real growth happens. I equate it to actually traveling outside the country, if you've ever traveled outside the country, I've done a few different trips outside the country, in the sense of being completely lost when you enter a new country is actually quite gratifying, in the end, because you grow so much because of that trip, because you're gonna have to figure out how to get food, you're gonna have to figure out where you're going to say, but you don't know that language, right, but you're gonna have to learn it, you're gonna have to learn things on the fly. And that's why I think I always encourage folks to travel outside of the country, because that's where you begin to grow a lot. You get to learn other ethnicities, you get other cultures, but personally, yourself, you also grow because you put yourself in situations that you're not normally used to. Right. And it's just the experience piece. Now, what would you say, you know, you're you're you mentioned, you're an introvert, you're networking, what has been difficult about starting this business and your perspective?


Carla Fowler, MD, PhD  23:23  

I would say the thing that was probably the most difficult was making that transition from, I'll just call them systems. So like, if you want to become a doctor, I mean, there are well laid train tracks. I mean, it's not easy, you got to work for it. But like,


Gabriel Flores  23:38  

gotta make a little bit because we have to make doctors like just saying it's too much.


Carla Fowler, MD, PhD  23:43  

But like, it's pretty well defined, like, what's the bar you need to meet? What do you need to do? What's the next step? How do you do that? And I would say that growing up, I was very good within a system. So it's like, tell me what the parameters or the constraints are at home are going to be measured. Okay, great. And then I would figure out how I was going to do that. So one of the hardest things that I think is really, and this is true of all entrepreneurship is when you maybe take that leap from a system into saying, I am this system, whatever systems I make for myself, I will have, and whatever I define explicitly will give me more clarity, but I have to do all of that. There's no kind of outside party that's really going to do that. And so I think I'm a person who could see all the different things that maybe I should be good at, or that I should be doing more of or this or that. And so I think one of the challenges for me, and I would argue one of the challenges for most of my clients really comes back to defining explicitly, what do you want to have happen? What is the result you're trying to produce? And then secondly, what is most important for that? I call this the brutal This is the brutal focus of access. So that's one of my principles of performance is, what if you think you have to be good at everything, if everything has to be perfect, it slows you down. And also, it generally means that your time gets soaked up with a bunch of stuff that may or may not be important, but the really important stuff then doesn't get above threshold, you can't invest enough in it to really be successful at those things. And so, I am not, I don't somehow have magic, you know, other than my, that my clients don't have, I have to do it, it is a thing I continually have to do. And I think it's one of the best things that entrepreneurs can do is to continue to think about and focus. What is it I want, whether it's in a particular conversation or negotiation, or sort of more the meta arc of your company?


Gabriel Flores  25:50  

Yeah. What would you say? Has? Or would you say there's any, anything been easy about this process about starting your own business?


Carla Fowler, MD, PhD  26:00  

I think I have a lot of enthusiasm and a natural curiosity for people. And I just love highperformance. And I could talk about it all day. And so I think for me, the spark and the desire that is what produces the value for clients was always there, that that pert was not going to be hard. I've gotten better. I've worked to improve that. So not just rely on kind of whatever natural talent I have, but really say No, how do you hone this as a profession? How do you make it better, but that came pretty naturally, I think. And so that's probably, and I think if you're going to design your own business, find that thing, because you don't there will be things that will be a slog, and you might as well build it around something that has enough of that fuel, I call it like the clean energy. It's like the solar power, the wind power versus like, filling yourself with coal or gasoline. Gasoline will take you there cold will take you there. But it's got a lot of byproducts that are really not that great.


Gabriel Flores  27:03  

And you know, one of the things you mentioned was your enthusiasm and I can I can see it over the the interview right now. I'm like, I'm holding myself back from recruiting you back to surgical oncology right now. Like we come back to Sir junk we'll take you want to do some liver transplants. Oh, goodness. Now, what would you say? What would what would you say kind of keeps you up at night as a small business owner currently?


Carla Fowler, MD, PhD  27:28  

I'll be honest, um, I sleep pretty well, I have this like aura ring that tracks my sleep. I like a champion sleeper. Like I can't nap. I can't nap at all during the day. I sleep at night very well. But I think the bigger point to your question is that honestly, compared to surgery, like compared to like, the one year I spent as an intern, like, there just aren't things. Like I don't wake up in the middle of the night worried that my patient is dying, and I'll just be honest, are worried that Deming is going to call me in the middle of the night and be like, Why did you do X, Y, and Z. And I think that, you know, that's not to say I don't have worries, it doesn't mean that I don't sort of like have something in for separate on it. But I think one of the things that really helps me is just that perspective of saying, like, gosh, at the end of the day, like I get sick in the middle of the night, I can go to the hospital, like there is amazing people there to take care of me. And in my business, there isn't really anything that's life or death. And you know, we do the best we can. And sure there will be decisions or things that don't turn out well. But in the grand scheme of things. There, there aren't things that are kind of like career ending or life ending or like those big, big things. And you know, I say that, who knows, I may just not have discovered them yet. But I also find it's not generally very productive for me to like, worry or per separate about that you kind of got to take things as they come. And I think this is very true for the entrepreneurs out there that there could be a lot of like you're spinning or basically like energy that you put out that's not productive, just worrying versus if something needs a plan. Or if something if there's some homework you could do to figure something out, so you wouldn't worry about it. Awesome, do that. But there's some things that are unknowable, there's some things are just going to be uncertain and no amount of research are going to take care of that for you. And that's why another one of my like, principles is we got to learn to relish the uncertainty, and even to have a sense of like, fun about it. I don't that's the right word, but because the uncertainty is also where things can surprise and delight us and it's also where the opportunity is, and we have to take that Risk for yet might not turn out how we want. But our lives will often feel a lot more flat. If we're unwilling to take that risk, whether it's to grow and how that networking coffee, if it's to start that business, that is the thing that you see that no one else sees. But you know, it can be great. Like, Yeah, makes sense.


Gabriel Flores  30:20  

No, and it's a great point. Because, you know, health care provides such a unique perspective on life. And the fortunes that I think people that aren't in, you know, have that experience, probably don't really understand it as much, maybe people that have like a Life Index experience, maybe somebody's gone through cancer or things like that nature, they can definitely relate. But, you know, I've interviewed a lot of entrepreneurs, and there are times, you know, I think you nailed it Carly's like, understanding that this is not a life or death situation. Money is gonna come and go, even if you I've had some entrepreneurs on the show that have been dead broke, and they've risen through the fire, like a phoenix. And I think that's kind of what entrepreneurship is, right is kind of continuing to grind through the grid, understanding that none of this is going to be easy, and everything can be taken away in a heartbeat. But the, it's the grind that we aim for, right? The continuously evolving door of what's going to change next, how can we continuously improve because I think that's what truly human beings are, at their best is when they're innovating, is when they're actually getting together. They're talking, they're creating ideas. I mean, look at what the pandemic did. Well, if you really look at what the pandemic did, and was the vaccine that they created, the the science, and the perfect storm that went behind the crate that really is quite unique. And so it really is kind of a unique perspective, you know, in the healthcare world, to be able to have that perspective than getting into the business world. How would you say, do you use do you see some similarities in healthcare and being an entrepreneur? Or do you see some different patients? Or is it pretty different?


Carla Fowler, MD, PhD  32:04  

I actually see a lot of similarities between between science. I'm actually gonna pause us just for a minute. Is that okay? I'm so sorry. You said you edited I realize like, I'm in Wyoming. And it's very dry. I know. I was just like, my lip, my lip is bleeding. Okay, suddenly was like, Oh, God, is it like running down my face? No, I didn't even know. Sorry. Okay. Okay, great. You want to ask your question again? Or I can just hop in for your question. Okay. Um, I do see some similarities, particularly between science and that kind of thinking. So when I did my PhD, it was like, immunology, it was lab science. And, but I see that the kind of thinking that my MIT pushed me to do, like, I would come in and say, Hey, I'm gonna run this experiment, this experiment. And you'd be like, Carla, why are you doing that? Like, what? Not as a rhetorical question, but like, what? What is it that you hope to learn? Why are you Why do you want to know that? Why would it be important to know that would the field value that? And so this idea, it's very similar to when an entrepreneur is like, I have this product I want to make this product is always really important to ask, why is that the product? Like, what is it in the market? That that does? Will the market value it in the same way that I'm sure, like, there are lots of things we could like fix or this or that, but like, really thinking about how valuable is that solution? How big is the problem, in fact, and I just see a lot of similarities between sort of the scientific method, where you think through you make a hypothesis, you try and figure out how to test it, and how to keep moving forwards. Ideally, you know, lab stuff isn't cheap. So similarly, how do you test it as cheaply as possible? And I think it's very similar to the sort of entrepreneurial saying, Okay, how do we have a hypothesis? How do we test it the market, maybe with an MVP, something, just get data? Figure it out? Yeah. And so I think that part is really similar to science. I think the medicine piece, the biggest parallel, I continue to think about is that like, see, own and improve your choices. And I think this is such an empowering thing, as an entrepreneur where you're making the choices, you don't have a boss who's making the choices for you. But it's really important to see like, Okay, I choose this over this, I choose this over this. There are trade offs. Let's see how it goes. I'm gonna learn from that, you know, at the end of the day, I'm responsible and that's actually a very empowering place to be. Yeah, that's very true and I can improve.


Gabriel Flores  34:57  

You know, one of the things you know, Carl, I'm sure you're very Whereas this is a, it's kind of a pretty normal phrase in the surgical world, especially in the academic world is see one do one teach one, you know, and that's very true in the entrepreneurship world as well as you see something, right, and then you're gonna go do it, you're gonna test it either as a consumer or as a business owner. And then you're gonna teach people how to use it, or teach people the value of it, right. And that's, that's kind of where he kind of created. But to be honest with you, if you have to teach somebody too much of the value of something, then maybe it's probably not valuable, right? If you're, if you're teaching too much, they might just be valuable to yourself. So just kind of be mindful of that. Now, Carla, how do you grow your brand? You know, you're, you're an executive coach. So how do you actually grow your brand?


Carla Fowler, MD, PhD  35:42  

So I mean, this is always a work in progress, right? Like you start when you're small. And I started in Seattle, and I primarily had clients were local, I saw them in person. And now I'm kind of in I don't know, I always say, like, expects a 2.0, or expects a three point. But I had had moved even before the pandemic, to this idea of working with clients remotely. So I had some people I saw in person, I was already doing virtual coaching, and then the pandemic hit, and I switched everyone to virtual coaching, and then started really expanding kind of my reach nationally. And, you know, part part of that is about the business. But the piece that I'm really embarking on now is about the ideas from the business, because I love one on one coaching, I will probably always do some of that. But there is, you know, you can scale that so far I have, you know, limited, I have the same amount of time that everybody else has. And so what's really important for me around impact is a little more about that brand, and maybe even more so the ideas with the brand. So what are the principles of performance that really help people and that, you know, can land and have some value, even without the one on one coaching to really personalize it and do that dialoguing, what is helpful to people and and that has much more scalability to it. And that excites me in terms of like, where I'm going next. And also just how many people can I reach. And so, you know, in that sense, everyone I talk to whether or not they choose to work with me as a coach is a moment to really expand that brand. And I take a good amount of time with all potential clients to just have that conversation. And, but there's also sort of, again, part of my brand is being able to share some ideas on podcasts, with gracious hosts, like yourself, and have great conversations about it, you know, not a lecture, but just really dialogue about what's useful.


Gabriel Flores  37:47  

Very true. Now, what would you say you've been working with some clients now for some time, what would you say are some either common questions that they're asking, or maybe common mistakes that they make?


Carla Fowler, MD, PhD  37:58  

Great question. So we kind of talked a little bit about some to start. But really, I think most of us have either a pile of stuff we got to do. Or we have a dream, we have like a fantasy about some outcome that we want. But we don't necessarily have a plan, or the way to connect the dots to get there. And so I think that points to this common mistake of not defining or asking ourselves, what do we want? What is the outcome we want? And there are a lot of reasons why with this gets trained out of us, like, you know, or we get the I should want this, but I don't want that. So I just want to think about what I want, or it's a practice that sometimes just sort of goes away for us. But it's really important, because everything else flows then from there. So the second thing is that even if we say okay, what do I want, and we actually kind of defined that explicitly, we have to ask ourselves, what is actually most important to get in there. And I can use myself as an example. So I did no social media, no blogging, no social media, no content production, for the first 10 years of my practice. And I think there were a lot of people early on, were like, oh, you should do a blog, you should do this, you should do that. And certainly plenty of coaches had blogs have this. But I looked at really what was essential. And I said, What is essential is I need to continue to improve my method, like people need to get value from it doesn't matter how great at marketing I am if I'm not actually producing something great for my customers. So that was number one. And number two, it was you need to figure out how to talk about what you do, and how to really build a sales pipeline to have clients and that might never involve social media or online marketing. And so I really focused on those things I really focused at Learning sort of how to pitch how to talk about my business, how to make it clear that it might address people's needs, the challenges they were facing. And so that's just using myself as an example. But there, you can imagine all the things that I could have been doing that could have taken other time, we really focused on those things. And, and they were, they were levers that could drive me in the direction that I wanted to go. And so it was effective. So I think that is, the first mistake is we don't really, again, brutally focus and say, whether it's a health goal, whether it's a business goal, to say what really is the driver towards that. And with the knowledge, there's gonna be so many other things, people are doing so many things you think you should do, or all of that, but to really actually say, what drives that? And how could I actually eliminate a lot of the other stuff? So I think that's one, that's probably my top top mistake there. There are others, and I'm happy to talk about them. But I think that is the biggest one to drive home.


Gabriel Flores  41:06  

Nice. Now, where do you see tax in the next five years?


Carla Fowler, MD, PhD  41:11  

That's a great question. I see having more of a footprint in this idea space, maybe we'll call that leadership, whatever it is, because I love the stuff that I'm working on with clients. And the ideas have evolved and just have grown and developed. And I think they're really useful. And I love being the spark that changes something for someone, whether they hear it on a podcast, or they read it in an essay or something like that. So obviously, my focus was not on that for the first 10 years. And I suspect there will be a lot more of that over the next 10 years.


Gabriel Flores  41:49  

Nice. Now what for folks that are interested in learning more about you maybe learning more about faksa? How can they find Carla? How can they find taxa online? Are you on social yet?


Carla Fowler, MD, PhD  42:01  

I'm on so you heard it here.


Gabriel Flores  42:04  

We are breaking news, baby. Love it.


Carla Fowler, MD, PhD  42:09  

Oh my gosh. So a great way to learn more about my coaching is that my website baxa.com. that's T H A XA. And you can message me through this site, particularly if you would like to have a conversation about what coaching might look like. I'm happy to talk a little more about my process, and about people's goals for that. And so, but there's also just more information about my coaching in general. And for listeners of the podcast, one of the things I love to do is just whenever you're looking for a coach, sometimes that process can feel sort of ambiguous, and like how do I start? How do I find a good coach. So I actually have a download that I created that's just about what are some of the common mistakes that can happen when you're looking for a coach and how to avoid them. So how to run a good process, how to think about it, how to think about what you want out of coaching. So I will put that up, we'll make sure the welcome page has that


Gabriel Flores  43:04  

perfect. And then again, so for folks that are listening, you can also find this information on the shades of entrepreneurship newsletter, so please make sure to subscribe to the newsletter. It will also be on the blog post. So I'll make sure I'll have this information on the blog posts will also have the links on the website episode. So again, there's gonna be a lot of information on the on the websites. Now what about your social channels? It's the any social media locations that can find you.


Carla Fowler, MD, PhD  43:29  

Yes, so LinkedIn is probably the best place. And that's it Carla dash Fowler. And so you can follow me there. I this is where I post, like when I'm on a podcast, that's where that goes. And so it's a great place. Also, if you just want to hear more about performance science, like we talked a lot about business today. There's lots of interesting things I love to talk about also just in other realms of performance, and so and even in the nonprofit space, so there's good stuff that you can find there.


Gabriel Flores  44:00  

Awesome. Carla Fowler, the Founder and Managing Director of faksa of Lee, Executive Coach, thank you so much for attending, being on the show. really did have a appreciate the conversation. I'm telling you, I'm going to try to pick I'm still going to try to get you to come back to surgery at some point.


Carla Fowler, MD, PhD  44:18  

But it's such a compliment.


Gabriel Flores  44:22  

Thank you again so much for being on the show. For those listen, you can follow me at the seeds of E on all the social channels. You can also link up with me on LinkedIn at Mr. Gabriel Flores. Other than that, thank you for listening and have a great night 


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