100 accurate all the time, of course, other tv weather forecasters cheat just a little bit. They over predict rain. Here is why. If they are right and it rains, they are accurate. If it doesnt rain, nobody cares they said it would. They just go enjoy the day. Keep that in mind as you hear one in three economists surveyed by the National Association of business economics says the u. S. Economy will be in recession by 2021. That jumps to three in four if you extend the guess out to the end of 2021, which is why i brought the rain analogy. You only remember the people who failed to predict the storm. Its safer to say its going to happen. Its possible those economists are hedging their bets by predicting recession. That said, lets talk about what Silicon Valley needs to do just in case. I thought we would get in touch with the partner at emergence capital. Smart guy who is some of the big money behind one of the most successful ipos of 2019, zoom video. He has been through booms and busts before. I asked him here to help us play out the idea of a change in the forecast. Joined by christina cnbc, troy wolferton. Whats your feeling as everyone begins to worry ever so slightly . My prediction is the market is not going to be where it is today. Things are going to look different. Were going to deal with them. I come from argentina. I had to deal with a lot of recovery and busts and bubbles of any sort. Were going to be fine. Especially for what we do, Venture Capital. We dont care that much about the short term. Were investing and partnering with entrepreneurs, thinking that theyre going to build Great Companies the next decade. As long as we keep focus on building value long term, were going to be fine. Do you see entrepreneurs thinking recession is coming, maybe sales wont be so good next year, lets raise a bigger round than we would have done otherwise to get through the next couple of years as they perceive as potentially rocky . We do. Were seeing a lot of that, entrepreneurs raising a lot of money just trying to prepare in case something happens. Thats also a line with a lot of Venture Capital firms that have raised a lot of money and need to deploy that capital. Thats also fuelling that bubble where theres a ton of capital, entrepreneurs want to raise, and this is a great time for them to raise. The possibility of a recession, is that affecting timing in terms of when Companies Plan to go out in an ipo . I think its going to affect the focus on actual growth and profitability. So far, they are seeing an over emphasis at growth at any cost. Companies are loosing a lot of money. Theres no line in sight for them becoming profitable. Thats going to change in we head in the direction of a recession, because Retail Investors are looking for profitability or a path to profitability. Is there some conversation that people are having in the Venture Capital world about this . Is this something more that sticks to the cnbc and newscasts discussion . There is a conversation. When the market adjusts, a lot of companies are going to have trouble raising capital. So then if an investor unique for those companies to be able to raise capital, and if you believe theres going to be a challenge in the future, you focus on companies that are doubling down on profitability and healthy growth. Does this make it a harder time to be im speaking generally a seed stage investor . You dont know who is going to come in behind you. A series b or c can say, i will let it work itself out. I will come in at the right time. I feel it will make it hard for consumer focused investors. When urine veyou are investing consumer companies, you are building the community and you hope you can monetize it. Onthe other end, for firms like ours where we are investing in enterprise companies, theres real revenue. Companies like zoom, you talk about zoom, people are not going to get rid of. Theyre going to double down on Video Conferencing because theyre going to travel less. Those enterprise focus company will have an advantage if the market starts correcting. How about the valuations which have been extremely frothy for the past two years . Could a recession bring those down to potentially more normal levels given where the companies are actually at today . Is that a good tlihing for investors . They are going to come down. Its been crazy land for a while, especially in later stages. When you think about companies burning a lot of capital and the market becoming a little more cautious, valuations are going to come down. Yeah, thats a good thing. Thats going to encourage the entire community to focus on companies that are building real businesses. You touched on this before. One of the things that has been marked about this particular period has been how much Silicon Valley has been awash in cash. How much do you think that that changes if we do enter into a do downturn . What impact is a recession going to have on the massive amounts of cash we have seen flooding into the valley. We talk to enterprise companies. We ask them about revenue and customers. Once we start double clicking into revenue, we notice a lot are selling into other venturebacked companies. Its this cycle where were Funding Companies that are buying products from other venturebacked companies. That creates a sense that the revenues are going up. Its going to come from every direction. Its going to make those come down. I dont know how much things are going to come down. Theyre going to come down a lot. The other one i worry about is the consumer oriented companies. I dont mean to pick on door dash. Its the easy one to think of. When every is very busy, to have services that bring you food and pick up your dry cleaning and walk your dog become invaluable. I use those things all the time. If nobody is going to work, theres no chance any of those companies are useful in any way, shape or form. I think those are the canaries in the coal mine are those Services Companies that provide these things. Its only 10 delivery. I havent got a job. I think those are the you dont worry about that in enterprise. You can see that would be the earliest to go. Definitely. Those are the ones that are going to be in more trouble. However, i also think that when it comes to those consumer behaviors, people are changing the way they are buying goods and services. Even though you might feel that getting food delivered, its happening because people dont have time, i think people are getting used to that. People are not buying cars. They are not driving. I think that thats here to stay. What i feel is going to happen is that people are going to focus a lot more on companies that are profitable, at least economics profitable. If you are growing, you invest a lot of capital. That extra customer that you bring in is profitable. I have only a minute left. I will hog the last question. If im an entrepreneur, give me some advice. We dont know whats going to happen. Thats where we started this with, we simply dont know. Sometimes talking about a recession is the wrong thing to do, because it could bring it on. That said, in this point where we seem to be at least discussing it and i am a young company, what should i be thinking . Whats the advice . Do what you love doing. Regardless of the outcome. Odds are against you. You need to be able to enjoy the journey. Do it with passion, work super hard seven days a week. Hope for the best. We appreciate you being here. Up next, sorting good doctors from, well, not so good with a fellow who told the president of the United States what to do. Welcome back. One of the buzz words is quantifiable. How do we turn something into numbers, make big data out of it . Its not always easy. Can you take, for instance, a talented and knowledgeable doctor and somehow quantify his talent . A good demeanor and skill as a clinician, make that mathematical. Its one of the challenges programmers face as they take it up at grand rounds, a Company Offering patients recommendations on second opinions, offering corporations ways to save on Employee Health care. Wade chambers is the chief technology officer. He is the head of engineering at twitter formerly where he was key in making that Company Money through advertising. Thanks for being with us. Happy to be here. You do lots of things. How do you quantify a doctor . The obvious thing is, he went to Harvard Med School or she went to med school. But i can do that. Theres different data that we use to be able to understand the pattern that is out there from claims to see whats the rate of reinfection or readmission to Association Data that helps us understand where they studied, may have done some time in a hospital and understand who they also Practice Medicine with. That counts into what theyre going to be able to do. Theres more data out there thats available other than schooling and experience. There is. Its really one of those things that in the last ten years has changed significantly. If you think about ten years ago, the system of choice was a manila folder for health care records. With the high tech act in 2009, part of that was to provide electronic access to records. Now were starting to get to deeper clinical information on each and every one of the patients. As we start to get access to that, we can do more and more Machine Learning and Data Sciences associated with it. Some physicians i know will redisist any attempt to say thi doctor is better than another one because some will say, i take on riskier cases. I take on patients who have many chronic illnesses. Therefore, i might have a higher rate of fatalities than the doctor down the street that doesnt do that risky work. How do you build that into your equations . Certainly. Part of that should show up in the data itself. If you are taking on riskier patients, there should be a history of more issues associated with those types of patients. Theres going to be more diagnoses that have been involved, more interactions with doctors that they have had to see. So over time, you should be able to see that the riskiest patients go to these physicians and they have Better Outcomes than others that might not. It reminds me a bit of teachers. Teachers often resist net ranking system saying, listen, i dont mind competing for the top spot, but you have to understand, all of these different other sources issues that are in my particular school. I was going to ask, from a high level, what are some of the most interesting information that has come out of the data you have been able to collect and study . Lets see. Some of the things we find is over 60 of people who engage in back surgery, thats probably not the thing thats going to help the most. There are other types of care that we can get them into that actually will improve their outcome at a reduced cost where they actually get better. Instead of surgery . Instead of surgery. There are other classes that are along those lines. Hysterectomies are one of those things that also, there are i think its something around 30 that there are better ways of being able to provide a better outcome for the women who might engage in that. I actually talked to walmart about this. They have so many employees having spine surgeries thats very painful and expensive but not very efficacious. Data is showing they will go as far as to buy a hotel room in another state and fly out an employee first class to see a better doctor who might tell them not to get a spine surgery. Is that the kind of extreme measures you are seeing across a number of large employers that you work with . We see that a lot. Sometimes its not even try story. My brother is battling cirrhosis of the live. Has an infected gallbladder. He has been dealing with this for some period of time. His ability to get to the hospital and back, he has three kids, and he is trying to help raise his kids while he is dealing with this. The ability to get people around, the ability to do housework, things along those lines, that can become challenging. One of the things we have done recently is with uber, to help people get from point a to point b. Bigger, more extreme things are moving going to a different state to get the quality of care you need. We can help the experts going to make the biggest difference. The great part is we find that when you get qlity health care, it costs less, not more. We looked up you service comcast, the parent company. I didnt know that. There are so many different here is a big problem they have. There are so many Different Things off nerd ered in my bene package. How do you get that out to the customer . We provide this service for free through walmart, through comcast, through United Airlines or whatever. How do you get that attention from your patient . Thats a challenge. I think that during open enrollment, one of the things is help educate. You have this great benefit through grand rounds that if you encounter something, we can help get you the right expert. We can help you move through that. All the way down to, who is the best physician that i could be seeing today . True story. One of our employees went through and looked up their physician. Come to find out, the physician recommends surgery six times higher than all other physicians in the local area. Just that data point allows him to understand how to do things better. When we can help employees understand that they have this benefit, then they can start to go find out where should i go . Who is the best physician for me to see right now based on my specific history, based on myne . I want to pivot to im going to show people at home a picture of you and president reagan in the oval office. You are how old . I must have been 19 years old. What was your job in the white house . I was administrative specialist and graphic specialist. You worked in the underground war room . I worked the swas roituation room. Quite a bit in the Old Executive Office building quite a bit. I was moving back and forth between those two areas. Putting together graphics for the president of the United States . Back then it was kind of low tech. High tech was just starting to happen. I have seen pictures of the situation room. In the movies, theres radar and lots of beeping sounds. In reality, its just a Conference Room . Theres a few different areas associated with it. Theres a Conference Room. Theres a radar room with beeping . I can neither confirm nor deny that. Its pretty high tech. Theres a lot of experts doing really Amazing Things and doing it with incredible precision. One last question about the situation room. The current president wants very Little Information presented very quickly. In your years of presenting very Important Information to very important people, what was the key thing you learned about creating what would later become powerpoint, i suppose . How do you tell president reagan, this is the important thing you need to know in a graphic . What have you learned about that . Simple is better. The more that you can take a lot of information and try and present it in a very simple way, the more it can be understood and acted upon. Wade chambers, cto of ground rounds,twitter. Thanks for having me. We will be back in just a minute. Welcome back. I have often said the real strength of this show is not the guests, its the reporters. We use different reporters to bring you a variety of perspectives, from the New York Times and San Francisco chronicle to Fortune Magazine and npr radio and so on. This week, its Business Insider and cnbc. Troy used to work at the mercury news. Christina can top him on that, since her first appearance, she has worked for in order, venture beep, reuters, fast company and now cnbc. Shes kicking butt at cnbc. Christina constantly breaking stories and exclusives on her beat. The latest article is just out, examining the trouble that may be brewing at apple as employees debate what apples goals should be. I found it fascinating that one of the big fights at apple health according to your exclusive report is that theres a group that doesnt think theyre doing enough. I can see that in Silicon Valley, that you had gathered all these smart people together at apple of all places, you say, all right, what are we doing sfl a . We will figure out how your heart beat works when you are jogging. I can see people would be frustrated. Its a hard and weird problem to have if you are apple. You could do absolutely anything in health care. If you think about being a patient in the system, it doesnt really work very well. Theres so many things wrong with it from the lack of transparency that a company like grant rounds that we talked to is trying to fix to just endless issues with inefficiency. If you are an apple employee, you want to do big and bold things. I spent about a year and a half talking to all sorts of people internally and externally about this. What came up was just we could be think about the ipad technology, Wallet Technology and apple pay. How do we apply that to health . We could be doing virtual consults. Its modest and inemental. Theres been cool stuff thats come out of the team. I dont think it goes far enough. Were talking about two to three year bill cycles. You may not see the fruits of your labor for a long time. What is the pushback from Apple Management . Why have they been resistant to some of the more ambitious things that the employees wanted to do . I think part is just there isnt really a visionary leader right now who runs health. I learned through this reporting that there are hundreds of people who work on that team, which is way more than i had thought. Thats surprising. Theres so svp for health. There are a number of vps and three people who report to the coo, jeff williams, that are in control of health in some way. Theyre doing slightly Different Things, whether its software or hardware or some clinics that apple is working on for its employees. There isnt that one person at the company saying, this is what were going to do, here is the tenyear big grand vision that we can get excited about, how is how we work to get there. That surprises me. Apple obviously, was known for leadership, they have an infinite pocketbook. They have cache, were apple, work for us. We will pay you an absurd amount of money. You do what you want but you have a visionary. You have three vicepresident s. Not necessarily i want to change the world through health. We havent seen that yet. I think like you said, so many things are possible. Theres also risks. Theres liability. Other companies, whether its microsoft or google have failed in health care. There was a couple of high profile disasters from both those companies. Apple is probably looking at this space and saying, we need to be very slow and very cautious and we dont want an equifax breach. Imagine what that would do. Disaster. They are thinking, what can we do that is low risk and does move the needle for some people . It sounds like having covered apple for years, it almost sounds like theres this difference between the way apple has tended to operate, which is that each years iphone has some incremental new thing that gets added. Every so often theres one revolutionary product. But every year after that its an incremental change. Its one new thing that they add. Theres a difference between that mentality, incrementally improve our product, and this mentality of we need to have a lot of breakthroughs. We need to tackle big problems. Absolutely. One thing that did come up is apple last year released an electrocardiogram that is part of the apple watch. Thats intended to monitor the hearts rhythm. That is going for wellness more into the medical sphere. Employees wanted to actually completely do Something Different from apples playbook. We launch the products at these big events and invite the press and make a big deal. They instead wanted to have a small group of medical doctors in a room asking questions. Is this safe . How does it work . Can i recommend it to my patients . That didnt go down the way that those people wanted it to. I think thats a clash that you are going to see with the medical culture that wants to do things in the way that health care does things and the tech culture that comes from that very secretive apple place where its we make splashy announcements when were ready. Your coverage on cnbc is just second to none. Its constant scoops and exclusives. We appreciate you joining us. I recommend you watch. Well be back in just a minute. Thats our show for this week. Thanks to my guests and thank you for making us part of your sunday morning. Announcer when you see this symbol you know youre watching television thats educational and informational. The more you know on nbc. Lauren im Lauren Thompson and get in ready position because the champion within starts right now. Today, how the achievements of her older sisters made Aaliyah Powell a champion. Sharron and i know for a fact that she could definitely come away with that gold, be an olympic champion. Lauren then, a young golfer uses her talents to help save a mans life. Avery cancer treatments are really expensive and i said, hey, dad, weve got to do something. Lauren and later, surfs up in the 2020 tokyo games and we hang with the first olympic surfers. Courtney theres just a different dynamic that an olympics brings and i know surfings ready for the olympics
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