#33: How I Became a Venture Capitalist While Still Practicing Medicine feat. Marshall Kuremsky, MD

Welcome to the Passive Income MD Podcast, where we talk about creating your ideal life through multiple streams of income. I'm your host, Peter Kim. If you enjoy hearing about this stuff, make sure to hit subscribe so I can bring it to you every week. Now let's get on with the show.

Hey, everyone.

Today we have Marshall Koremsky. He's an orthopedic surgeon from North Carolina. He's just an awesome story of how he got involved with some really cool projects outside of medicine, and I'd love to have him share it with you in his own words. Hey, Marshall, how you doing?

Hey, Peter. Thanks for having me.

Yeah, I mean, it's really a pleasure to have you here. And I've gotten to know you over the last couple months, and you've just been doing some really cool, amazing things. And I'd love to have you kind of explain how that got started. But first, can you just tell us a little bit about yourself? And I mentioned you're an orthopedic surgeon, but tell us a little bit more about that.

Sure, sure. So I've got a wonderful family. Married, wife's a nurse, and currently taking care of our two wonderful daughters. They are 6 and 4. Got a couple of dogs as well. And so I think for me, everything starts with the family and trying to be the best dad and husband I can be. And I've got their support as well, even though you, me, and probably several of your viewers and members pulled in a lot of different directions. Right. And so if you're beating your head against the wall and you don't have home support, it is super tough. So I'm thankful for that. Originally from Pittsburgh, and I think you're from Baltimore, maybe.

Yeah, I won't hold that against you.

Don't worry. That's right. We can keep going. Yeah. And then college at uva. I'm a proud wahoo med school up in New York City. And then really part of my story, I've always wanted to be an orthopedic surgeon, like from the time I was 12 or 13 and singularly had my sights set on that in college and then in medical school was becoming an orthopedic surgeon and specifically doing sports medicine. So ended up doing my residency in Charlotte at Carolina's Medical center, which really had just a fantastic orthopedic program. And from there, really always wanted to spend some time with Dr. James Andrews, perhaps the most famous orthopedic surgeon and one that people know, particularly from espn. And so did two fellowships, hand and upper extremity first down in Birmingham, Alabama, followed by sports medicine and arthroscopic surgery, and then was lucky to find just a great job in a great city. I'm here in Raleigh, North Carolina, part of the Triangle. Been there for eight years now with a huge group, one of the six biggest orthopedic practices in the country. Wasn't always that way. When I started, it was, it was just the biggest group in the Triangle and now it's a huge statewide group. And so doing my clinical job here in medicine. And that's the background, obviously.

Kudos to you for getting, reaching your goals, kind of getting there. And you've done the typical physician journey where you kind of had your goals set on one thing. You went through training, you went through more training and more training and you got there. But today we're talking because you're doing things outside of medicine, like how do you get started in that stuff? I mean, let's talk about this whole path and people will start to understand where you got to and why you got there.

Sure. So I'm a partner at Loud Capital, which is a venture capital firm that they started in Columbus, Ohio, and there are two of us physicians there. Naveen Goyal is another physician and one of the co founders, anesthesiologists who actually just left clinical medicine as of the end of 2019, full time. Now for Loud, he likes to say I'm slowly behind him, but for me, this was kind of culminating a whole bunch of passions and interests. And interestingly, there were some things here that I didn't even know I was interested in. I, I have been so focused on doing orthopedic surgery and giving it everything I had because at least for me, that's what it took. It was nose to the grindstone and constantly studying, working hard and trying to be two steps ahead of everybody, literally to just claw my way there. Once I was there, I've been doing the same thing or chasing the same thing or living out this childhood dream for like 25 years. So Naveen and I, we go way back as groomsmen or a mutual friend in a wedding. This is like more than 10 years ago. So we first met, but we reconnected at this guy's 40th birthday party. And we were sitting around talking. You know, I said, what are you up to these days? Well, I'm an anesthesiologist. I've actually started this venture capital firm. And it literally, like one of those moments where you just have this epiphany. And I was spellbound. I could not get enough information at this one weekend I soaked up everything that he had to say. I had to Google Venture Capital when we took a break or something like that to kind of learn a little bit more about that and just said, this is it, this is my inspiration. There's a way.

What about it? What about excited you?

You know what it was? It was the prospect of being a part sometimes, sometimes huge and sometimes just an important cogging the wheel of getting a business or series of businesses off the ground, being involved in companies that can make a huge impact. So as a physician, most of the time it's, it's one relationship at a time. Right. Like you're in a room and you're, you're talking. For me, I'm talking to somebody who's either got a problem or an injury or, or they need something changed. It's one on one and that's great. But I try to do the best I can with however many people that I see. When you have involvement in a company, especially from the grassroots level, when sometimes it's just past the idea stage and the napkin stage and they're trying to raise money or they're trying to get staff or they're trying to work on marketing and then you help them get somewhere big and this company does things that impact lots of other people. It's an incredible feeling to be able to say, you know what, I was there from the beginning. Like we helped usher them into who they are now. And yes, they've scaled and grown and become a household name. Like that's a dream for me because I've not been able to do that myself as the entrepreneur. I've tried a couple times, it hasn't worked out but you get to see how hard that is and what a real skill that takes in order to do that. So if you can help facilitate that for other people, it's just another way to get involved. And when you do things as a venture capitalist, you do that across a large. Well, you should at least we think do that across a large diversified blend of companies and some of them are going to succeed and do really awesome positive things and then you can touch lots of lives. So I think that's very cool.

Yeah. But when you first started and you met Naveen at this dinner, at this wedding party and I mean you didn't know much about it but something excited you about it. Right. And so what did you do with that kind of hope or that passion or whatever that was, that curiosity?

Sure. So first I said, you know, well, how can I get involved? And it started with me investing with the company and trying to. I believed in the concept. I believed in Loud Capital, and I believed in him. And, you know, I think it's fair to say that on the investor side, you have to believe in what you're doing with your money. Okay? If you just go on blind faith or if you haven't done your due diligence, if you haven't looked into this, that's foolish. And you may do that a time or two, but you shouldn't keep doing that, right? Well, I did that. I went home and I studied and I learned, and I asked for information and decks and stuff like that. And I said, I'm in. Like, I believe in this. I think this is going to work for the following reasons. A, B, and C. I said, okay, I have some liquid capital at this point in time, so I would like to be involved in that. And then from there, I started getting monthly newsletters. I started getting emails. I started texting and calling saying, what's going on with the company? How's such and such doing? Oh, well, we've got these updates, or they're doing this, or they've just grown. In the last four months, they've doubled. And I said, all right, I'd like to help. I'd like to be a part of this. But what can I offer you that would be useful? Because every time I talk to you, I hang up the phone, I tell my wife, like, this is crazy. This is super exciting, and I don't have. Nothing else really jazzes me to this extent. I'm sure you can relate to some of these feelings and emotions that I'm describing, but it was a whole new frontier for me of excitement, of passion. Totally raw, unbridled, and new. And so that's how I knew that I had stumbled upon something. And whether it was the circumstances of the meeting, I do not believe that that was an accident. All right? I absolutely believe that that was meant to be. Because, like you and others, I've had a lot of conversations with people about the business that they're in, the things they do, the things that are important to them or that they're passionate about. But this was the one that just stuck like it was it. And it just. Whenever. Whatever touch point it was, for me, it hit it. And so from there, I really haven't ever looked back. And I started getting involved, and that was really just almost like I just wanted to volunteer. I wanted to learn and get experience, but I wanted to be Helpful. So here I was an orthopedic surgeon and another physician in a different part of the country that was working on my own network and knew that there was room for major growth from there. It's just been a great relationship for both sides.

Yeah. I want to know like when you first said, look, I want to help, like what did they have you do? Because it's like again, you're an orthopedic surgeon, you know about something, about some business because obviously you're running your practice and you're doing these type of things. But like, what could you offer actually at that point?

Expansion. Right. Geographical expansion, network expansion, showing and telling other people about loud capital and the things that we're doing because it's not a typical or traditional venture capital firm or PE or angel investing, we do things differently. We're there from start to finish. And some of the things we do involve being really hands on with the support. This is not just about a transferring of money from investors that have decided to raise with us that we then provide to companies. This is ongoing support, hands on kind of stuff. Where in first quarter of 2020, company A may really need a financial boost, help with marketing, and they need to be connected with some lawyers in order to advance their product. But by Q3 of 2020, company C might need networking help, they might need some infrastructure support and they might need to be connected with some other people that can help them with blockchain. And so we facilitate, we communicate, we keep in touch with companies and we see what they need and then we leverage our network, which continues to grow and it grows because you do good work with good people that you trust and, and that really is it. So if you have a lot of people that have different skill sets and backgrounds and then you're spread out across the country, that's how you can really do good, strong work together for the right purposes. Like, I'm super interested in some of the other stuff that folks on the team are doing that are not in parallel with what I'm doing. Because you never know when you're having a random conversation with somebody at work and they start talking about something that's important to them. You say, you know what, you may want to be in touch with Steve. Let me connect you with Steve. Nothing in it for me, you know, but that, that's how we do it. And what's interesting is that brick by brick, over time you can do some really powerful good things. You know, not everything works out and not everything wins when you stack wins together and you aggregate good people. I don't like. I'm just excited talking to you about it, man. Like, this is. This is my life. I enjoy these kind of things, connecting with people, networking, and many times you can't even see the growth. How can.

I mean, do you think this is something that almost any physician can get into? You know, what should they. Somebody, let's say they want to think about doing this kind of thing? I mean, do they feel like they need to have some sort of background in business or how does somebody kind of get into this stuff?

No. One of the nice things about this type of investing is you don't need an MBA or having spent some time on Wall street or things like that. I think you need a curiosity and an interest and a passion. Now, there are ways to get connected. People can reach out to us, for example, or to other companies, and certainly through some of our Facebook groups. We've got lots of. Lots of connections, but anybody could do it with the right skill set, time, interest, motivation. You don't even necessarily need personal capital to get started. You might need to raise some capital, but there are no barriers to entry. That's one of the nice things as well. So the way that I chose it, the way Naveen chose to do it was he started the company. Okay. The way that I choose to do it may resonate and speak with many more people or a broader sense of our physician community where people say, hey, you know what? Like, I don't know if I can take the big step, but I'm still interested in taking the small step. And what are ways that I can diversify my finances or how can I get involved? Or, you know, what are some alternative types of ways to be invested? Fundamentally, that's what we're doing. Right. This is an investment opportunity that I. And we are involved in and other people are involved in as well, because we want these companies to succeed. If and when they succeed, it's beneficial to all of us, for sure. Gotcha.

So it's simple matter of physicians saying, hey, I'm interested in this. It sounds appealing to me. I like the idea of it. So I just need to go out and talk to people and basically ask, how can I get involved? Is that what you're telling me?

Yeah, absolutely.

Now, what do you think have been some of the big challenges for you, like, throughout this whole process? I mean, I'm sure that. How about this? You're still practicing, right, As a physician, Is that right?

Yeah.

So how are you able to balance those things?

It's A great question. So there's no burnout here, no burnout here. Sleep less, exercise more, eat better. Be good to your family, give them the time that they need and decide what's really important and meaningful in your life. I don't think it's any accident like what's going on with me as I'm looking at this different career and pathway. I've become a better version of myself. I really have. And that is something that every one of us should strive to do. But it's easier said than done, right? It is hard to look at and identify your weaknesses and the things and to give up some things that might be luxuries or comforts. So for me, I have made sacrifices in how I spend my, my free time. And that's not always good because you can't get good at what I'm trying to do if you aren't willing to put in the time and effort. So you got to do it, you got to suck it up. It won't happen on its own or just by me wishing for or talking about it. So it's boots on the ground, it's phone calls late at night, it's connecting constantly. It's keeping my head on a swivel to see how I can help other people because that is actually the easiest thing. And then people trust you because they understand that you are constantly looking at it from your perspective. So I do the important things for myself, but I do a lot less for myself just because it would be fun or that would be, that would be cool. And that's the point that I'm at right now. I've got the time and the energy and the passion to do it. So I've got to act on it because it won't always be there. And we look at today's current landscape and obviously the coronavirus and what's going on, that might be a once in a lifetime thing, it might be a couple times lifetime. But what it has taught me is you need to be nimble, need to be flexible, need to be thinking outside the box. And one can never be too diversified or creative or insulated, you know. So here I've got a whole other network aside from my W2 paying job as a physician, where I've got people I can count on, I can lean on. I've done good work for them. I feel like I have a network of people that have chosen to come in and invest with loud that I've brought in. I also feel like I am now aware of other people that I could invest with too, that might be useful in order to spread out some of my asset allocation that's good for my family. And in the end, I'm having a ton of fun. Like, there's a different side of me that just glows with an energy when I get a win, when I do something good. And it's usually just involves helping somebody, right? Like, either I connect them with somebody or I bring them in to one of our funds, or I meet somebody and I just listen to them. It helps me think, all right, what could I do that would be better for me or my family? Or what do I want to be in five years? And I really never thought that way.

That's amazing. What do you wish you knew when you first started this whole thing that you know now that might have helped this journey either through a shortcut or helped you, you know, kind of navigate.

It a little bit easier? Well, I think if I hadn't gone straight through the educational path to being a physician, I probably would have done something in law or business or finance that would have given me a heads up in terms of maybe learning the vocabulary or the language. And having some of that experience under my belt may have played a role early on. But you can narrow that gap rather quickly because first of all, a lot of this content is now available online. You can learn the things that are taught in school. And, you know, if you want to be a physician at some point in time, you probably need like exposure to anatomy class and the cadaver, right? And you just simply need to learn how to talk to a patient, how to do an exam. So that part's hard to learn online. But for a lot of these other core disciplines that are out there in different professions, you can get a curriculum online and you can self teach if you have the motivation and the interest to do so. So I've done that to learn the terminology, learn the language, realize I don't need an MBA to do this, that some of the other skills are super more important, right? You need people skills, you need to be communicator, know how to listen. You have a good head on your shoulders. You need to be able to size people up. You'd be able to know a good opportunity from a bad one, the one you want to gravitate toward and the one you need to walk away from fast. And those kind of life skills you can learn. I fully believe you can learn them if you already have developed them. And a lot of physicians have. Okay, so that's why there are some parallels between alternative Investing. I think you've written about this. Between the parallels of physicians and those that are in PE or venture capitalists, you need some certain common skill sets in order to succeed and make quick decisions. And so while it would have given me an early advantage, I've spent time trying to make up for that now. So otherwise I'm super happy just taking it week to week and learning cool stuff. And that's actually part of the fun.

Yeah, that's amazing. I mean, what kind of impact, you mentioned family earlier on. What kind of impact do you think it's going to make or have made on your family life? Because that's such a big part for you.

It is. So it takes some time away. I've learned how to, I sleep efficiently. It's almost like being a resident again. Right. Like you just when it's your time to sleep, you better. You know, there's a lot of time for some social media or doing some other stuff. So I take the time when I can get it. What this could mean is that hopefully my kids see a guy who works at the stuff in his life all the time, his family, his poor golf game, you know, trying to be a good father and give them, whether it's it's 10 hours of time on a weekend or two hours on a weeknight, good quality time for me that you're a lifelong learner and you don't have to be the smartest person, you just have if you care the most, it's going to take you super far. It's going to take you really far and to be passionate about things. So there are ways that I hope that they are not only actively but passively learning from me. And then I believe that this has been a very, very significant thing for us financially too, to be involved in. Because if you're associated with a good company, doing good work, regardless of what the industry is, for us, it's loud capital and the financial sector, then yeah, I think ultimately this will probably change things for us in a way that I didn't even know about five years ago. So that'll be good too.

So for those who are thinking about kind of following in your footsteps, we've mentioned some practical tips for them. But do you have a number one tip that you can leave with people?

Reach out. First and foremost, reach out. So establish a connection through whatever network it takes for you is the most important thing. And be open minded. Sometimes the answer or the pathway may not be obvious at first. It may involve doing A and B in order to get to C, that's a little bit how it was for me. This wasn't necessarily the goal. I was just incredibly enthusiastic and drawn to learning more about this, that it was natural for me to say, what do you need? Like, if I can help you and the companies that you're supporting, then that's a good thing, right? Because I invested with you and I never thought of it as, wow, this is actually like a second job for me, which is what it's become. You know, be hungry, reach out, trust your network, and if you don't have one, find a good network. So that's the most important thing is that there are, especially in a physician community, there are a ton of leaders out there and a ton of people who are showing what you can do. With the right bandwidth, the right energy and the right interest, you can leverage your medical degree, you can do things. And there's a whole bunch of people out there that are trying to show you it's not. Well, if you just do A, B and C, then you're going to be me or you're going to end up with such and such title. Unfortunately, it's not that cookie cutter, but it is a pathway towards getting maybe some of your hopes and dreams. And then another thing I found myself thinking about prior to today with you is if you can do things to stimulate or generate passive income for yourself, if you can diversify your, your time, your energy, and listen, let's be honest, your finances, somehow you may actually be able to circle back and find the fire again or get more enjoyment out of your job as a physician. If it becomes less, I've heard people say, transactional or less focused about the money or being bitter about the way things are going with insurance companies or hospitals or the state or the government, you can sort of get rejuvenated into why many of us went into this in the first place. Now, just conversations I've had with physicians, I keep hearing things like this, or if I read stuff on your site or in your blog, like, a lot of people, they're tired or they're weary or they're burdened by debt or they're wondering. And you almost feel like, where's the joy? Like, I went in this because I kept breaking bones as a kid and I was in my orthopedic surgeon's office, like all the time. I was always in a cast and I was like, this dude's pretty nice. Like, he's always putting up X rays on the board and he takes my cast off himself with a cast on. He doesn't hurt me with that. And I kind of leave there good as new again. And I thought to myself, that's a pretty nice way to do it. His waiting room was always full of people who were either hurt or already better. It was a very interesting kind of, kind of way to look at it. And you know, it's nice to be able to do that whether you're doing that as a physician or, or you're doing that in some other industry. But it's nice to be able to help people and to do it the right way for the right reasons. I'm blessed because I currently am doing that with two totally different companies. I feel like I'm helping people for the right reasons as opposed to selfish or I don't really feel good about what I'm doing. And I know not everybody can say that, but I sleep good at night knowing that I'm. I'm in good company.

Well said, man. I couldn't have said it any better. So how can people reach you if they want to find out more? Just get more information from you about you or Loud Capital. What's the best way?

Well, that's good. So email's fine. I respond marshallowd vc, that's Loud L O U D V like Victor, C like Charlie or Venture Capital. And then we have a physician specific website which is simply Physician vc. Again, Physician V like Venture C like Capital. And on there it prompts you to enter some information and you can put that you came to us through Peter Kim or through Passive Income Maryland. It allows you to look at some of our investor decks as well. But that way it'll trigger a way for me to contact you. But if you haven't heard from me within a day or two, please send another email because respond pretty quickly. So I'd love for people to reach out. Also, our general webpage is loud VC www.loud.vc and yeah, that'd be good.

Absolutely. Cool. Everybody check it out. Thanks so much. Enjoy the show. Let me know by dropping a review in the podcast app you're listening to us in. And if you haven't already, make sure to hit subscribe. Are you part of our community yet? Join thousands of physicians who are also on this journey to creating their ideal lives through multiple streams of income. You can join us on our Facebook group Passive Income Docs and you can always learn more at our website, passiveincomemd.

Com.

Thanks again for allowing me to be a part of your journey. See you next time.