Duke Rohlen On How His Willingness To Pivot Lead Him To Build And Sell 5 Companies for $1.7 Billion

Unmessable Podcast

Serial entrepreneur and venture investor, Duke Rohlen grew up in Marin County, California where he dedicated a significant portion of his time to competitive sports. Duke’s dream was to be a world class tennis player, but after his knees gave out at the age of fourteen which forced him to get a number of surgeries, he had no other option but to pivot into other sports, mainly swimming, that would accommodate his physical impediments. Duke’s natural intensity and passion for adrenaline led him to start his first company, which was in the restaurant business at the tender age of 22 years old. Ironically, Duke is a very picky eater and doesn’t like many things, but in no way did that hold him back from sinking his teeth into the business side of things.

Within no time, the company grew to $20 Million in sales with more than nine locations and 500 employees. Since his experience in the food industry, he’s been on an entrepreneurial tear in building medical devices. Fast-forward to today, Duke built five MedTech companies which he exited for a combined value of $1.7 Billion, and he is not stopping here. His current venture Ajax, a holding company backed by KKR, one of the largest Private Equity firms in the world, invested in four promising companies that Duke leads. In this episode, Duke shares what’s been at the core of his repeated success and what has also been the most challenging thing to dial-in: company culture and team alignment, and how he sets his teams up for success.

In this episode you will learn about:

• • • Medtech companies
    • Leadership
    • Leadership Mistakes
    • Building a company
    • Exiting a company
    • Managing and scaling a team
    • Raising capital
    • Company Culture
    • Effective Communication

About Duke Rohlen:

Duke Rohlen serves as Founder, Chief Executive Officer and Director of Ajax Health, a KKR-backed enterprise that invests in and operates healthcare companies.

Over the last 15 years, Mr. Rohlen has raised over $400 million in equity financing and sold four medical device companies for a combined enterprise value of ~$1.7 billion.

In addition to his role at Ajax, Mr. Rohlen served as Co-founder, Chairman and CEO of EPIX Therapeutics (sold to Medtronic), and as Director of Entellus Medical (Sold to Stryker).

Prior to EPIX, Mr. Rohlen served as Co-founder, Chairman and CEO of Spirox, Inc. (sold to Entellus Medical) and Co-founder and CEO of CV Ingenuity (sold to Covidien, now Medtronic).

Before CV Ingenuity, Mr. Rohlen served in a variety of roles of increasing responsibility at FoxHollow Technologies prior to being named President. At FoxHollow, Mr. Rohlen helped drive annual sales to ~$200.0 million, helped the Company through an IPO, conceived of and structured a $300.0 million collaboration with Merck Pharmaceuticals, and ultimately led the sale of the company to EV3 (now Medtronic) for $780.0 million.

Prior to working at FoxHollow, Mr. Rohlen held senior management positions at two other medical technology companies and served as an Entrepreneur-in-Residence at the private equity firm, Alta Partners.

Mr. Rohlen presently serves as an Executive-in-Residence at Harvard Business School and as a board member for the United States Ski and Snowboard Association.

Mr. Rohlen received an M.B.A. from Harvard Business School and a B.A. from Stanford University.

Connect with Duke Rohlen:

Linkedin

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Full Transcription:

Duke: As a child, I would define my life as very active. From a really young age, we were raised to be on the move. We had a big family; we were seven kids.

Tanya: That’s Duke Rohlen, who raised over $400 million in financing for his companies, and sold five of them for a combined value of $1.7 billion. He now leads a number of medtech portfolio companies via Ajax that are backed by KKR, one of the largest private equity funds in the world.

Duke: And we had a mom who had more energy than she knew what to do with, and so we were always moving. That movement and that focus of activity is something that’s still with me today. I was a very, very active kid. I was studios. I studied really hard. I had really big ambitions. My goal was to be a world-class tennis player. My idol was a guy named Bjӧrn Borg, and I focused my entire life on trying to be Bjӧrn Borg. My life consisted of sports and study, for the most part.

Tanya: How often do you play tennis today?

Duke: I don’t play at all. One of the problems for me was I ended up having too much activity and my knees gave out when I was 14. I was a very, very highly-ranked competitive tennis player up until 14, and then my knees shut down and I ended up having a whole bunch of knee surgeries between the ages of 14 and 21, which effectively killed my tennis career but set me up for a life as a swimmer, which is what I still do to this day.

Tanya: Wow. Well, thank God that you were able to transfer into another passion because that would’ve been devastating otherwise.

Duke: It was tough for me, actually, when I was a child. My whole life was built into this concept of being a tennis player and being athletic. Especially in middle school, that was an important feature of who you were [02:36] capability, and then to be in a situation where I couldn’t do that and had to start completely fresh in a new sport as a freshman in high school was challenging. But it was interesting for me in that it helped me understand some of the realities that happen in life, which is that everything that you put forward and everything you’re trying to accomplish doesn’t always happen regardless of intent, and I had to learn that lesson as a 14-year-old and pick up something completely new, and it’s actually been something that stayed with me, the idea of pushing myself into new areas and trying to be better, even if those areas are areas that are really uncomfortable to me. Those are things that still go back to my childhood, that are ingrained in me from having that knee experience.

Tanya: That’s incredible. What happened at 22, where you transitioned into your first entrepreneurial adventure and launched a restaurant business?

Duke: Between 14 and 22, I went to high school and then I went to Stanford and knew in my heart that I wanted to do something of impact. I didn’t want to go and take a desk job; I didn’t feel like that was my calling. After college, when I graduated from Stanford, we were in a recession and all of the interesting investment banking jobs that I wanted to get weren’t realizable, and so I ended up getting rejected, I don’t know, 30, 35 times from investment banks. I didn’t really know how to go about getting a job and, quite frankly, probably wasn’t very qualified to get one of those jobs anyway; I was a History and Economics Major.

I decided to apply to law school as a default. I felt like, okay, if I can’t go into investment banking and have a career in finance, I should at least have a law degree. For everybody who doesn’t really have a path after college, law school doesn’t require a lot of business experience, and for me and maybe a bunch of others, it’s a default; it keeps you on a track but not really the right track for you, potentially. I applied to law school, was going to go to law school, and I ran into a friend of mine who was finishing up at Stanford Business School. He had been an investment banker, the job that I had wanted to get, and so he held an important role in my mind. I was like this guy’s really legit. He was going to start a company; in this case, it was a restaurant company.

Without any thought, I decided to abandon law school and try and see if I could convince him to let me join him as a partner in this restaurant concept, and so we did that. We opened up a restaurant and it turned out to be successful, and then we opened up nine more restaurants. We were successful in growing our company from a couple million to about 20 million, from zero employees to 500. It was a tremendous, tremendous learning experience in many ways, but one of the things it did do is it [05:44] sense of, okay, I want to be an entrepreneur. It enabled me to really understand that gut feeling that had allowed me to walk away from the structured path of law school and go towards an opportunity that was more entrepreneurial; it felt really right. From that experience, even though I didn’t want to be in the restaurant business for the rest of my life, I had this feeling that, okay, I can go and apply myself to an entrepreneurial endeavor and be successful at it and set my career in motion.

Tanya: So at 22 years old, starting a business and growing it to 20 million is incredible. What were some of your biggest challenges through that growth process?

Duke: There were so many challenges. First of all, I had never worked in a restaurant before. I had never managed a company. I had never done anything except for sports in school. I had to learn how to basically work in a company, and I also had to learn how to create things on my own, unlike a typical job, when you enter after college, where there’s a training program. We didn’t have a training program. The training program was figuring out how to start a company. One of the clear lessons for me was how do you fill up your time? How do you take something that doesn’t exist and make it into something that does exist, and how do you do that really well? For me, figuring out how to create and be innovative was a key lesson for me.

Third, I had to figure out how to lead. I was not a leader at that point. I had never done anything, again, in a structured business environment, and so I was very open to ideas and ways of leadership, and I made a lot of mistakes. I remember seeing on TV this really belligerent boss yelling at a person and I thought, okay, that’s a really good approach. This woman that he was yelling at seemed to be very, very influenced by his tone of voice. So I had this young, very nice girl who had done something probably very nominal, and I decided I was going to project my inter-belligerence on her. I remember feeling terrible after doing that, basically saying I don’t want to be that guy; I don’t want to be the person who leads that way. One of the things I had to do was figure out, okay, what is the right leader? Who do I want to represent as a leader? I did a ton of reading and really tried to surround myself with great people who could influence in the right way how to lead, and that was another thing I was not good at, and then I think I became a little bit better at.

Tanya: When you say really lead in the right way, what does that mean?

Duke: Leadership is an art. There’s no finish line to leadership. What leadership comes down to, in my opinion, is motivating a group of people to share a common vision and work really hard to realize that common vision. When you think about motivating groups and the different personalities that are within those groups and dealing with all of the personal issues that are in the different personalities which are in those groups, it’s a very complex organism; it’s very challenging to figure out how to lead.

To me, what I’ve always found is leading with the end in mind. This is what we’re trying to accomplish. How do we get everybody, irrespective of your differences, to go in that direction? The way I ended up doing it is I ended up figuring out what each person’s role was within that objective, within the goal of trying to reach that vision, and making sure that they could articulate with clarity what that goal was. Every person, be it the busboy or the waitress, knew exactly what their role was and felt that their role was contributing to a bigger picture of what we were trying to accomplish, and it worked! Even though I was really young, I think everybody maybe felt that we were trying to do something bigger than ourselves, and that collective vision and sharing that vision is what ended up allowing us, in my opinion, to be successful in getting a lot of people to do really good things.

It was never about the money. No, it was more about – we had this incredibly interesting company with lots of young people, and everybody was betting against us because the average age in our company was 24.

Tanya: Wow.

Duke: Yeah, we were all in it together and there really was no hierarchy. It was like, hey, everybody has their role, let’s nail this role and do something that all of the adults – again, we thought we were young – were not able to do, and that common vision was really empowering for a lot of the companies. I think the testament to that is when we sold the company, it ended up going bankrupt within six months because the collective vision was no longer shared, and the ‘us against the world’ mentality that we had cultivated went away. It’s a really powerful lesson for me in making sure that everybody buys into a vision.

Tanya: That is a very powerful lesson. You went from the restaurant business to medtech.

Duke: Yeah, which is a strange job.

Tanya: Yeah.

Duke: One of the things I learned in the restaurant business is that I didn’t like the restaurant business. I love managing people, and I love leading, and I love finance, but I didn’t love food. In fact, I’m allergic to most foods; I don’t eat onions, mushrooms, garlic, celery. I mean, it’s crazy how little I eat.

Tanya: Wow.

Duke: I was fascinated by the idea of growing companies and in Silicon Valley at the time, it was burgeon. We had Yahoo and [12:15], all these companies that were starting. I caught the bug and I figured that I didn’t want to go into technology because technology was not directly connected to people. I really wanted to be involved with people, both on the leadership side and on the product side. I thought, gosh, it’d be really interesting to go into medical devices because your developing technologies that treat people.

So I went back to Harvard Business School and focused entirely on learning the healthcare business. Then when I jumped out of Harvard Business School after graduating, I went into the healthcare world. Again, I probably wouldn’t have been able to do that had I not had the experiences of being 14 and being at the top of a tennis game, and then having to jump ship and go into swimming, and then be successful at swimming, or jump into a restaurant business at 22 and not having worked in a restaurant and be successful at that. The confidence that came from having to pivot in a new direction made me feel confident that I could pivot into healthcare and be successful. Looking back on it, it was probably naive in many ways and the odds were stacked against me, but I had those experiences that gave me the confidence that I could probably do it and went full board into it.

Tanya: Yeah. Fast forward, you’ve built five companies, exited five companies, and have a total combined value of $1.7 billion of exits under your belt, so I would say that didn’t turn out so bad.

Duke: Yeah, and it’s funny. I hear those numbers and it seems to me that, wow, that would be a successful person, but I don’t feel successful. I actually feel like we have so much more to accomplish. When I say ‘we,’ it’s all these people I work with. The benefit of being the CEO is you get all the credit, but the challenge of being the CEO is that you also take all the blame. One of the things that gives me an enormous amount of confidence is that we have incredible teams that all can get around, as I said earlier, shared vision, and we’re able to accomplish things that are really hard to accomplish because of that. So it sounds good hearing it, but it’s been such a process that each one of these is like a child that you’re raising and then they go on and grow up and become mature products, or in the case of children, mature adults. You don’t really feel like, oh, my god, I totally succeeded with my kid and I’m a success. You feel like, gosh, I want those to continue to grow, and I want the technologies and the companies to continue to grow as well.

Tanya: Yeah, absolutely. What is your definition of success?

Duke: You know, I’ve run five of these healthcare companies and each company has been beset with thousands and thousands of failures, failures all over the place. My idea of success is taking the failures and the lessons that we’ve learned from interacting in these companies and pushing forward into new companies. My vision of success would be to create the perfect company, a beautiful company where there’s harmony among the employees, where there’s a shared vision. The endpoint of what we’re trying to accomplish is something that really changes healthcare and changes the way that patients are treated, and then benefited from the treatment, and doing it in a way where all of the mistakes that we’ve made are avoided. The irony is that you’ll never reach that endpoint, just like you never really fail because each failure helps you become better at not failing. You never really get to success either, and I think that if you get to the point where you think you’re successful, you should check out because you’re no longer relevant. Nobody is ever successful, in my opinion.

Tanya: I agree. Do you think that you’ll ever reach a point and say, “Wow! I feel successful!”

Duke: I remember when I started the restaurants; one of the greatest feelings I ever had was the day we opened the restaurant, I was walking down the street and inside my mind, I just felt like, “My god, I did it. I started a company,” and that might’ve been the most successful I’ve ever felt because it was setting me up on a path to something that felt right. From an endpoint, will I ever feel successful? I think I’ll feel proud, and I think I’ll feel that we’ve done great things. I think each one of these companies has done tremendous things.

Our technologies have been used in over 10,000 patients and that’s a really gratifying feeling, but the most gratifying feeling for me is working with other people and allowing them to feel good about themselves by creating environments where people really feel confident in their contribution to a collective. There’s nothing better than sharing success with a team, and more importantly than that, for me at this point in my life, is seeing people that were at entry-level jobs become much more senior and much more responsible and feel great about their career. I don’t know if I’ll ever feel completely like I’m a success, I don’t think I’m hardwired that way, but I feel definitely proud of the contribution I’ve made to our industry.

Tanya: Yeah. Creating five companies, selling them, and having an impact in the lives of 10,000 patients – not to mention creating all that shareholder value – is incredible. Just going back to sort of the toughest moments, what has been the toughest thing that you’ve ever had to deal with as a leader?

Duke: I think the most challenging areas of anybody have to do with interpersonal communication and being in situations where people don’t feel that their integrity is being honored or their persistence and hard work is being valued, and that erodes confidence. I’ve always felt that when you combine integrity, which is accountability, and the idea of doing things that you stand up for with persistence – and persistence is not doing something in the short-term and quitting; persistence is doing it for years and years and years. When you combine those two things, you should get confidence. You need to be in an environment where integrity plus persistence yields confidence. If you have an environment where that’s not the case, then no matter how successful the company is, people are not going to feel confident and it’s going to create a really, really bad organization. I’ll give you an example.

When I was in my first company, we had a very split organization. We had half the company that just wanted to sell the company and the other half of the company wanted to innovate and grow the company, and that split created a schism in that organization, and there was a lot of malice, and there’s a lot of frustration between the two sectors of the organization. I was stuck because we had this company that was, from the public standpoint, very successful. It was public and we were well-traded from a value standpoint, but in my opinion, the company was going to fail, based on the internal division. The decision that was ultimately reached was, okay, we’re going to have to take people that had been generally responsible for creating something that’s of tremendous value, and we’re going to have to say you either get on this new bus of what we’re going to do, or you get off.

That was a very, very challenging thing because these people had worked hard. They had been working with integrity. They had persistence. They had confidence in what they were doing. For whatever reason, they felt that the path of the company was different than the path that I envisioned, and [21:07] I had to let those people go. That’s probably the hardest thing I’ve ever had to deal with. I’ve made sure going forward that, from inception when I started the company, the vision of what we’re trying to accomplish and the endpoint is clear. The endpoint can change obviously but people sign up, and there’s a personal contract between me and the employees that says, hey, if we all collectively do our jobs, and if we are on the same page, we’ll get to this endpoint. I’ve learned from that and made sure that we – I am hyper, hyper-vigilant to make sure that we don’t have that divisiveness within our organizations again.

Tanya: Yes, the culture is a huge driver for results that end up ultimately being produced. If the consensus is divided, you get a huge hiccup. What is your practice having learned that and having subsequently built a number of different – and exited a number of different companies? How do you avoid that and how do you set your culture from the onset?

Duke: Culture, again is a dynamic thing. We are now at the stage where we can attract some really, really qualified and confident people, and qualified and competent people doesn’t mean that they have to be the most experienced. They have to have a core phenotype that reminds me of the 22-year-old Duke Rohlen, where I had this vision and this passion to do something entrepreneurial. I try and balance an organization where you have people who have the tremendous skill sets with people that just have incredible vigor and the desire to do something. I think that’s part of it. Combining and creating a healthy, happy environment where you have experience with – maybe less experience but more vigor is valuable.

The second thing, I really believe that if you calcify, if you don’t surround yourself with new ideas, you’re going to break. You’re not going to be successful. Part of figuring out what the team looks like and what the culture is is creating a culture that’s based on ideas and execution, not just ideas, but ideas and execution. Ideas need to come from everybody. Ideas need to come from the young [23:49]. I learn a ton from my kids, about things that I should know, or I would learn a ton from people that talk about ideas. Incorporating all of those ideas, the young and the old, into an organization creates a vitality that people want to be part of.

I think the most important thing for success is having a company’s culture which is really strong. If you don’t have the company’s culture, people hate it and nobody wants to stay. I really feel like rewarding confidence, rewarding innovation and making it something where every idea is considered and open is in the approach that I choose to take. You have to balance that. You can’t just be an idea company. You have to balance that with hardcore execution. I think ideas plus execution are what have given us some level of success.

Tanya: Yes, no, absolutely, and I’m sure having done this multiple, multiple times, you get to learn so much about what works and what doesn’t. Aside from just the experience that you’ve had in building and selling companies, what is at the core of your leadership growth? How do you fuel your growth?

Duke: To me, I want to learn and I’m fascinated by humanity. I’m fascinated by what makes people move. I’m really drawn to understanding the motivations of people, what is their quest for love, for power, for meaning, vantage, salvation, things that give them a sense of who they are. I look for understanding these basic human drivers, and when I understand these human drivers, I learned. I learned that if you can understand what’s really motivating somebody and drive them to an opportunity to fulfill that motivation within the construct of a company, it’s very powerful. What motivates me is understanding human motivation, understanding what makes people want to go above and beyond the salary to be great. I love that.

I’m also an athletic freak, so I swim all the time and I love doing hard things. I love the challenge of a 5,000-yard set where you’re 500 yards into it and you have 4,500 yards left on a really tight interval, and you’ve got to train your mind to get over that hump and complete it. I’m really drawn to, from a personal standpoint, challenging myself to do really hard things, and challenging my companies to do really hard things. Selling a company for $350 million doesn’t happen very much, but I know we can do it, and I know we can do it if we persist, if we continue to push forward and don’t quit. There’s a part of me that’s fascinated by people that can overcome like the mind over matter that can overcome the challenges, be it physical or corporate, that tend to get in the way of less successful people and don’t get in the way of the really successful. I’m fascinated by stories of people that do that and I try and incorporate that into my own living.

Tanya: As you are talking about your passion to figure out what motivates people, have you noticed any commonalities? I mean, you’ve employed thousands of people at this point. Is there one common thread that motivates people or is it really different for each individual?

Duke: I really feel people want to be respected and treated fairly. Those are two things that don’t have to do with money and don’t have to do with returns. They have to do with feeling good about themselves. One of the things I’ve – if you can build a career for people or help build a career, help shape an opportunity for someone where they can develop skill sets, and not just technical skill sets but emotional and mental skill sets where they can feel confident in themselves, you’re going to succeed. For me, it’s figuring out how to do that. It’s figuring out how to create an environment where people can feel confident.

I would say the common denominator is it’s never money. It’s so interesting. Everybody says, okay, I want to go make money. Yeah, money is a very interesting byproduct, but money – if you were to somebody who feels confident and completely capable in their job, okay, you only have to work 30 or 40 hours a week and at the end of this year, you’re going to make 5 million bucks. I would hope that every single one of the people that have worked for says I’m not going to take that easy path. I’m going to go and I’m going to flex my muscle because I can. That’s what we’re really trying to get people to do, is to flex their muscle. If you can create an environment where that happens, it’s really rewarding.

One quick story, when we had ACT, which is my – I think my third company, we had an offer to sell that company. We took that offer and that offer came with a certain amount of money upfront and then a big back end. The money upfront was enough to basically give everybody in the company an ability to retire and have $2 million to $5 million in the bank. The company’s technology failed and so I sat down with the company. I said, “Do you guys want to move forward and try and win by coming up with a technology that will actually transcend the current standard of care? Or do you want to sit back and just take this upfront payment and call it a day?” Every single person in the company raised their hand and said, “We don’t want to win by failing. We don’t want to take this money and not have a product to go forward with.”

Everybody turned down the money and we ended up going back to the drawing board and coming up with a new technology. That new technology ended up becoming EPIX that we sold for $350 million. They were not driven by the money even though the money would have changed their lives. They were driven by an opportunity based on their capabilities to develop a technology that, in all of our minds, would really change the status quo and make the world a better place for people suffering from this disease. To me, that’s the power of – that’s the commonality that I see across the people that have worked for us, a real drive to do something above and beyond just make money.

Tanya: Yeah, people are driven by impact for the most part as the impact that they can make. The highest expression of human beings is to give back. It’s to do something that’s bigger than themselves and it’s amazing. What I hear when you say the commonalities and what people are driven by is really you stand from a place where you look to see how you can elevate your team and the people around you. That is what creates this desire and competence and environment that people really feel empowered to reach for the stars.

Duke: I like that. I mean, I haven’t thought of it that way, but I would say you are right, which is, I have really high expectations and really high standards. We’re not a touchy-feely company. We work really, really hard and we don’t do it in Google offices. We don’t have ping-pong tables and we don’t have lounge chairs and pods we can go sleep. Several of my companies have started in windowless buildings where the rent is cheap. What we do have is a shared vision. I don’t think any of the ping-pong mentality, Silicon Valley lifestyle stuff matters. I think what matters is understanding that if we develop something, it’s going to change a person’s life. It’s going to make someone better.

I see that firsthand. My wife, three years ago, ended up having a stroke. She was like 40 years old and had a stroke. Fortunately, she’s a 100% now better. It really struck a chord with me, which was listen, this is not about money. This is not about realizing returns. This is about taking technology and making it so good that it can go into a person’s brain, so that all of the loved ones, and in that case it was me, all of the loved ones that are sitting out in the waiting room can feel that the technology is going to hopefully change their lives or make their lives better or prevent them from being very, very sick.

From that lesson, it changed my perception. It is 100% about doing something for the world, not about doing something for a return on equity. Return on equity’s great, I love the fact that we saw $1.7 billion in the company. I love the fact that we’ve generated 10x returns from our investors, but what I really love is, when I walk into a hospital and see our catheter or a technology that we’ve developed being put into a human so that that human can go out and see their parents, or their brothers, or their sisters, or their wives and know that they’re okay because of it. That’s what’s really powerful. That is the message that we as healthcare people really get to embrace and we really leverage in terms of creating great cultures.

Tanya: Duke, I’m inspired. I mean, I couldn’t agree more. That’s incredible. If you were to rewind back 10 years and give yourself one piece of advice, what would you tell yourself?

Duke: It’s a really good question. I would tell myself to have confidence that if you work really hard and if you surround yourself with really good people and persist, meaning persist through the hard times which inevitably happened, that you’re going to come out on the other end. A lot of times when you’re young, you don’t envision a future of success. You are so surrounded by obstacles because you don’t really know anything at that point. It’s hard to anticipate that if you do the right thing and if you stay with it, good things will happen. I would really say, have the confidence in yourself.

One last story, I remember when we sold one of our companies, there was a CEO who was really a lot older than me and had been successful and was backed by big private equity guys. We were doing sort of a merger. I remember feeling like okay, I feel like I’m better than this guy from a leadership standpoint, but he’s clearly the better guy because he’s run big companies and he knows what he’s doing. I remember feeling like okay, you know what? We just got to move over and let this guy take it. Well, this guy took it and he completely destroyed the organization. When we sold that restaurant company to the more seasoned restaurant group, they destroyed it.

I think the message that I would send to myself is trust your gut. When you’re faced with that path of do I go to law school which doesn’t really feel right or do I jump into the restaurant business, jump into the restaurant business. Or if you’re going to sell your company you go, should I sell this company or should I merge it and continue to run it and fight for that because I really feel confident, fight for that, because you are probably better than you might give yourself credit for. I think I was better than I gave myself credit for back then, and I hope that I would be able to exercise that confidence and make those different decisions now.

Tanya: Yeah, so the importance of really listening to your gut, above all the social cues and ranks and experience is really listening to yourself.

Duke: That’s right and trusting yourself.

Tanya: Trusting yourself, right.

Duke: Trusting yourself only comes from failing a lot and persisting through that failure. It’s like when you’re doing that 5,000-yard swim set and you’re like, Jesus, I don’t want to do another 4,500 yards, I’m only 500 in, fight through that and finish 5,000 yards. By doing that, you gain confidence that you can do it again. Similarly, by putting yourself in tough situations and overcoming the challenges of those tough situations, you get confidence. You don’t get confidence by taking the easy way out. You get confidence by busting through hard barriers and not giving up. I agree. It’s literally gaining confidence in yourself that allows you to make the decisions to go into the restaurant business versus a law school path.

Tanya: I love what you say, which is a struggle with whatever you’re doing long enough to get good at it. Don’t expect to be good at it from the get-go. Know that through that journey it’s going to be painful but if you stick through it, you’ll get there. It’s brilliant.

Duke: It is so simple.

Tanya: Yeah, it’s so simple.

Duke: It’s so true but most people quit. I have to say one more thing too, which is everybody talks about Gladwell’s idea of 10,000 hours, 10,000 hours of tennis or 10,000 hours of swimming or 10,000 hours to paint a picture. I would encourage people to think about 10,000 hours of self-development. Think about if you focus on concerted disciplined hours towards being the best leader, or being the best communicator, or being the best parent, or whatever it is that motivates you or drives your boat. Think about that as opposed to a skill set because I think one of the things that’s [39:27] it is the idea of self-development.

At the end of the day, robots are going to do a lot of stuff that humans do, but what you can never get away from is leadership and interacting with people. You might as well spend your 10,000 hours getting to be a great leader and a great communicator with people. I think that you’ll find that if you do that in addition to the technical jobs, you’ll end up with a very, very rich and rewarding skill set that translates to career.

Tanya: Brilliant, brilliantly said. What are you doing now with Ajax?

Duke: We’re doing four new companies. We’re buying two companies out of Germany that are in the atrial fibrillation space. We’re doing a company with a guy who has worked for me twice that’s in the autism space. It’s a tremendously interesting company. Then we’re doing a roll-up in the veterinary space. We’re busy. The common denominator is that these companies are all run by people that I know and trust that started out at lower levels and through sort of sheer drive and persistence are bigger now and in leadership positions. I’m able to do a lot of these things because I have tremendous people around me who I trust and who trust themselves. There’s more to come from Ajax. One of the things my wife said, “When are you going to stop?” I don’t envision a scenario where I stop because I feel like I’m getting – I’m still learning so much, but I’m getting a little bit better than I was 20 years ago. It’s fun to be better than worse, so I’m continuing to move forward.

Tanya: Absolutely. Now I have to ask you because since you are involved in four companies, how do you manage your time? How have you figured out to pick things to work on and sort of edit? What’s your strategy?

Duke: We invest an enormous amount of time in people, in people who become really good. We focus a lot on communication. We focus a lot on leadership as you’ve heard in this podcast. We focus a lot on setting goals and defining the vision. What I do is I empower or I try to empower people to envision a scenario where they’re running a company for me. The way I’m able to do it is I have people that have worked for me, like the autism company is run by a guy who worked for me before. The two companies in Germany are run by guys that have worked for me before. The vet roll-up’s being run by a guy who worked for me before.

What I do is I really spend a lot of time with those guys or women. We have women too obviously. They learn the things that are important to me and I feel like the things that are important to me have translated to values. For better or for worse, we’re going to continue along that approach and I empower. I don’t want to do their jobs. I give them an enormous amount of leeway within a framework to succeed and to fail and to make it work. It enables me to be very hands-off from an execution standpoint and very hands-on from a strategy and value creation standpoint, which is what I love. I also care a lot obviously about creating the cultures within these organizations. I spent a lot of time doing that. It’s really a hands-off approach that allows people that I trust to go forward in their careers.

Tanya: Brilliant, brilliant. How do people get in touch with you if they want to say hi?

Duke: They want to say hi, they get in touch with me via probably my email, which is drohlen, R-O-H-L-E-N @ajaxhealth.com.

Tanya: Amazing. Duke, thank you so much for being on the show and sharing the incredible insights that you’ve accumulated over all of your businesses.

Duke: Tanya, thank you. I really appreciate the opportunity.