Episode 20: How Charlie Schadewald and his team at Wasatch Infusion are serving patients in Utah

Dylan McCabe: Welcome to the WeInfuse podcast. My name is Dylan McCabe. And each episode we give you a behind the scenes look at the infusion practice from multiple angles. And we’d like to try to interview key thought leaders in the infusion space, whether it’s providers or executives or nurses or whoever it might be. And in this particular episode, I sit down with Charlie Schadewald with Wasatch Infusion out in Utah. They have a thriving infusion practice. And the cool thing about this episode is Charlie was involved in starting this thing, building it from the ground up to a very large infusion center that does infusions, antibiotics, and even vitamins. So I think you’re really going to like this episode with Charlie, he’s the CEO of a Wasatch infusion. Let’s jump right into it. All right. And like I said, we have a special guest today, Charlie Schadewald with Wasatch Infusion. So Charlie, thanks for being on the show, man.

Charlie Schadewald: Thanks for having me.

Dylan McCabe: And like I said, the interesting thing about Charlie, he’s a real entrepreneurial guy. He’s the CEO of Wasatch infusion but he has been through them really launching and growing their infusion center and they actually offer multiple services. Unlike a lot of physician offices, they’re really branching out, trying to offer a lot of services to patients. And if you check out their website, you know it says right away at the top open 365 days a year. They’re just very, you know, crisp and clean with their marketing and their services and all that. So we’re really looking forward to it. To having him on the show and we’re interviewing him during the NICA conference, just like we did with Brian Nyquist. So Charlie, for those that don’t know about your infusion center and don’t know, you just kind of give like a little background on the story of Wasatch Infusion and how you guys started and what led you to this point.

Charlie Schadewald: Yeah. It’s a funny story and thank you for the introduction. Thanks for having me. It’s, you know, I’m just a serial entrepreneur. The oddity of this is that I have zero clinical experience at all. I don’t even know how to do phlebotomy. But you know, my background is in, you know, operational effectiveness, ERP systems, you know, paperless environments, high tech, history, and background. And so being able to walk into a business like this and help make it operationally more efficient and make it run better. And for some reason I sort of gravitate to complex things prior to this, I ran a managed service IT business. And so for me, there was a lot of megabytes and kilobytes and terabytes and teraflops and hardware and software and all the things that take to maintain an IT environment. And so when I got involved at Wasatch infusion to milligrams and kilograms, it wasn’t a far cry, right? Because it’s a very complex business. And so learning medicine and learning the biologics and the antibiotics and all the different infusible injectable medications, wasn’t very hard for me. I picked that up pretty quickly. So I came into Wasatch Infusion. I’ve been with them going on seven years now and you know, we’ve had, you know, phenomenal growth. I tell everybody, you know, half of entrepreneurship is a lot of hard work. The other half is, right place, right time, or luck if you want to call it that. So we’ve been really fortunate to be in this new expanding vertical market in healthcare that is so fast-growing and providing so much value to so many people, including the country, as we continue to try to lower healthcare costs. So it’s a great time and a great place to be, and we’re having a ball.

Dylan McCabe: That’s great. And so, and for, just for our listeners to understand your specific business model, are you guys an ambulatory infusion center or you provide our office with an infusion suite?

Charlie Schadewald: So we’re an ambulatory infusion center. That’s our model. We do have a medical director and then we hire nurse practitioners. Utah is a state where NPS can have total practice authority, right? So our medical director kind of keeps the MPS in check. Then we have our NPS below her and then we have RNs and then MA level, technicians that manage the floor at Wasatch Infusion.

Dylan McCabe: Got you. And then you guys infuse biologics, but you also infuse vitamins, is that right?

Charlie Schadewald: Yeah, we actually, about 40% of our business is biologics. The other 40% is antibiotic therapies and about 20%, I’d well–. 10% is vitamin IVs, hydration’s wellness. And then there’s another 10% carve-out where we do services to the community like PICC line insertions. We do dressing changes, port access. We do therapeutic phlebotomies if you know what those are, we’re pulling a lot of blood off of guys that are doing testosterone replacement therapy now, and their hematocrit levels are off the charts. So we take blood out of them. So we’re just kind of that comprehensive clinic, but don’t do anything that doesn’t involve a needle, right?

Dylan McCabe: Yeah, for sure. And so we get calls every week from people that want to start an infusion center or start a vitamin infusion center, or do the things you’re talking about. And you know, you mentioned those things and you make it sound simple, but tell us kind of how you started and how you grew to where you are now.

Charlie Schadewald: Yeah. So, you know, I didn’t invent this. I’m just–. I don’t think anybody really did, you know, it just kind of evolved out of either from a pharmacy or from a physician office with a need, or a hospital, you know, is where I think traditionally hospitals and oncology centers is where intravenous therapy came from. And so, you know, I didn’t invent this process, but we came in and we found a need. Wasatch actually started serving those Medicare patients who can’t get a reimbursement in the home particularly for antibiotic therapies. So that’s how the company was started. And we kind of just grew from there. We did our first biologic and went, these biologics are kind of cool and they’re safe for outpatient therapy. And, you know, let’s take those on, as we engage with the manufacturers and representatives and we started building our portfolio of products. And so you know, we were really diverse and that kind of bodes well for our model because we don’t write any of our own orders. We’re not assessing, we’re not prescribing diagnosing, we’re just taking referrals from our local physicians, MAs, nurses, case managers, hospitals, anybody that needs medication-infused into a patient provided it’s not heavy oncology or it’s not a narcotic or an opioid. So we don’t do morphine drips at Wasatch infusion. But those, you know, having a diverse portfolio of those therapies allows us to kind of ebb and flow. It allows us to fill in with the low-cost short infusions or injections all the way up to the higher cost long infusions or injections. And as the market shifts with biosimilars and generics and new products coming out, it allows us some flexibility in our business model that kind of buffers us a little bit. And going back to the point of being open 365 days a year, we, you know, that necessity is from those antibiotic patients that have to come into our physical space every day for sometimes 90 days patients will come in every single day and visit with us as we provide their antibiotic When they’re going through whatever treatment they’re going through. So it all works well for us. It’s very complicated. It’s very diverse, but it’s–. And we’ve seemed to figure it out, how to do it well.

Dylan McCabe: Yeah, it’s a lot of moving parts, but you guys clearly have a good process in place. So at what point did you, you know, doing biologics and antibiotics, that’s, you know, it’s pretty easy to bring that on board because these patients, the patient mix and what their needs are, but when did you start doing vitamin infusions and how did you attach that to your current business model?

Charlie Schadewald: You know, that’s just a little bit of a slippery slope because we, well we’re very much a mainstream medicine, FDA approved, you know, a medical clinic that provides safe outpatient therapy, just as safe, if not safer than another clinic or a hospital or oncology center. We wanted to serve that community that wanted to get those hydrations and vitamin IVs. So you know, we started down the road of doing all these wonky, you know Myers cocktails and, you know, all these other therapies, there were some, that was men’s and women’s libido cocktail. You could come in and get a couple’s infusion, right. And that started to create a patient, the diverse patient population, and a load of people and was starting to take away from our biologic and antibiotic business. So we put the brakes on that and we simplified our wellness IVs, what we call them you know, for our nurse practitioners that can do a brief assessment and prescribe something safe enough, like LR or NS or a vitamin IV. You know, we use FDA approved products. We use, you know, Baxter products for a vitamin IV for our banana bag. We’re not mixing cocktails from multidose vials. So I’m really cautious and careful to explain to people that we’re not snake oil salesmen. You know, we’re not concocting things from multidose files with, you know, an old handcart from the 18 hundreds that rolls into town and tells you we’re going to cure your major disease or disorder with some concoction we’ve created in the backroom and charge you a thousand dollars for it. Our wellness and vitamin IVs are, we charged like a hundred dollars for an NS infusion. And that includes all the, you know, Nordstrom like treatment that we have in our clinic, which is, you know, the private room and you get a blanket and you get snacks and drinks and you can watch TV. So for a hundred bucks, it’s a really good value. We don’t feel like we’re robbing people of their money for something as simple as a hydration or vitamin IV. But you do have to be careful. You know you want to validate what you’re doing with antibiotics. You want to validate that you’re doing the biologics and having those wellness IVs just kind of fills in, providing for some cash pay where we’re not billing insurance for those. And also gives our nurse practitioners a little bit of their licensing prowess to do a little bit of assessment and do some prescribing as well.

Dylan McCabe: Wow. I think it’s great. I mean, I’ve heard from multiple people that when they started doing those kinds of treatments for wellness, it dramatically improved their, what’s the phrase, just their health, you know, their daily health. Because in addition to the biologics or the antibiotics they needed, had some more needs. And so it’s, I like what you said though because we get a lot of calls at WeInfuse because if you type in infusion center software or how to start an infusion center or whatever or just because of Google, we show up typically number one. So we get these calls from people that want to start these vitamin infusion clinics, but that’s where they want to start. And they don’t have any clinical background as far as having a clinical setting. And so they’re just looking at the dollar signs and that is what they want to do. They want to have these cocktails and they’re getting these IV bags and they’re mixing all these different elements. And they want to show up at, you know, concert venues and sell hydration for 150, 200 bucks a pop or sell vitamins for, you know, $400 infusion or whatever. And it just sounds a little out of control. So I love what you guys are doing, where you’re really trying to do something that’s honest and good for the patient and depending on the patient’s needs. So out of all that, what would you say today is your main area of expertise at Wasatch Infusion?

Charlie Schadewald: I want to touch on a point, you just, mentioned, this is really timely since we’re sitting here at the NICA conference and you know, we have to give a plug for endorsing that we just published those minimum standards, right? So for anybody out there listening that is trying to open up a medspa or a vitamin IV bar, or, you know, wants to just buy bags of fluids and slam them in patients and make a quick buck of cash. They really need to engage in NICA and realize that, you know, normal saline is considered a medication, right? It’s got an NDC code it’s regulated by the FDA. You can’t buy it at Walmart. There’s a reason for that because if you’re not careful, even with NS if you’re infusing it to the wrong person, you can really hurt somebody. So, you know, that’s what I would caution is this is not a really easy business that you can do in a popup shop, you know or a roadside taco stand. You really have to understand what you’re doing. You have to understand your local regulations and your local licensing and your health department rules and regulations, including OSHA and DAPL, and everything else. Those are really important things to look at because this isn’t jump in and just start swimming business, or you’ll end up in trouble. So, you know, again, another plug for NICA, look at those minimum standards of infusion. There’s plenty of help out there for people like me and other people that want to grow this industry, want to provide help for the community, want to provide help for our country, and the people that need these therapies. And if you do it right, it’s a really fun thing to do, but it’s a lot of hard work and you have to do it right.

Dylan McCabe: That’s a great point. Yeah. I’m glad you made that plug. And for those listening, if I don’t mention at the end of the podcast, you can check out the NICA website at infusioncenter.org, and they’ll have those minimum standards of excellence on the website available on their website for free. And they’re also going to be giving a lot of resources that you can look into as well and learn about how to start an infusion center, just a network of different resources that you would want to tap into. And that leads to the next point, which is, you know, let’s switch gears and let’s talk about one of the biggest challenges you can face in this kind of setting.

Charlie Schadewald: The biggest challenges are that you have to realize you’re–. It’s a medical business, right? And there’s nothing more challenging in America than medical business, except maybe rocket science because of all the different regulators, all the different rules you have to follow, the biggest challenges are and know your rules and do the right thing for your patients. Especially if you’re going to take government plans, you know if you’re not familiar with your local CMS contractor. You know, out in Utah Noridian we’re in jurisdiction F, you have to follow all the rules, restrictions, guidelines. If you’re specifically going to take government plans and, you know, and then commercial payers are no exception. You know, you have to follow the rules, you have to understand what your contracts are, what the regulations are, what the rules are. And there’s a lot of them. And I think that’s, you know, some of the barriers to entry for a lot of people is the fear of man, I’m going to get into this thing. And if I don’t know what I’m doing, I could get in trouble. And that’s absolutely a true statement. Most of us that have gotten into this have gotten caught with our pants down one way or another because we just didn’t know. But the information’s out there, you got to search for it and you got to know. Have a good legal counsel you know, provide a good service and do the right thing. And you’ll be fine because there’s plenty of support, especially now with NICA. And with, you know, with software and companies like we infused where you guys are expertise in this space. You know, that’s a really good place to go is to pair up with the people that have done it, that know it, understand the processes, the procedures, the protocols, and the way to run a practice effectively.

Dylan McCabe: Yes. So no need to reinvent the wheel.

Charlie Schadewald: No.

Dylan McCabe: It’s already people that have learned through the school, hard knocks out what to do, what not to do.

Charlie Schadewald: And that’s a great point is, you know, we don’t have some magic sauce. There’s, we’re not doing anything that’s secret that I hold close to the vest and I’m not going to tell anybody my secret, because I’m making a bunch of money out in Salt Lake with an infusion center. First of all, I’m not making a bunch of money because it’s a lot of work and it’s low margin. But it’s not really, you know, there’s no secret to it. You just have to jump in. It’s a lot of hard work, a lot of stress, a lot of headaches, but it can be really rewarding like any hard work can, so you really want to do it, jump in and all the answers are out there.

Dylan McCabe: For sure. That’s a good point. And so what you guys have been through so far, I mean, is there some point or maybe a process where you had kind of a light bulb moment and decided Wow, we really need to focus on this or we really need to make this our core issue or core goal.

Charlie Schadewald: I don’t know if there was necessarily a light bulb moment, you know. With this kind of stuff, it’s a slow rub, you know, it takes it’s—. You know, over time you just kind of mold yourself and your business into, you know and to what you want to make it. I think the biologic was an interesting transition, right? To doing biologics alongside antibiotics and then understanding those medications. You know, for us we’ve never been too proud to work hard for five bucks, you know. And I guess, you know, the thing we do, our mantra at Wasatch Infusion is do the right thing, you know, and if we don’t do it right the first time we do it very right, the second time, you know. I’m not a religious man, but I’m a firm believer that if you help your fellow man, it comes back to you tenfold. And that’s happened to us so many times, you know. If you’re just in this for the money, it’s not going to be rewarding enough than understanding what you’re providing for your community. You know, it’s a bit of a cottage business in Utah we’re called Wasatch Infusion because that’s what our mountains are. And everybody’s familiar with Wasatch. And we won’t change our name because we’re serving our local community by lowering healthcare costs, providing a higher level of service, and being faster and more efficient than the competition. But you know, just doing the right thing is what’s really important. We’ve taken uninsured, we’ve taken underinsured, you know people always worry about the hospital just sends me all their crappy patients. Well bring them on, we’ll take the crappy patients because for every crappy patient you’re doing something good for someone and another one will follow and it comes back to you, so.

Dylan McCabe: Yeah, so typically when, anytime I interview somebody that is, has a really large practice or a successful business, it always shines through that they’re really passionate about the patients and it’s the same with you guys. And, but that–. So that passion and that energy drives you to do all these great things and have a successful business and a successful patient experience as well. So thanks for highlighting that.

Charlie Schadewald: Have you ever taken your doctor like a gift? Ever, showed up at your doctor’s office and thanked him for diagnosing my knee. Here’s a Christmas basket.

Dylan McCabe: Can’t say that I have, no.

Charlie Schadewald: Never have I but at Wasatch Infusion you should see our conference room at Christmas time. The patients bring–. They make cookies for us and they bring snacks and flowers. And it’s crazy how appreciative our patients are. And that’s when it, you know, it brings tears. I sit up at our company meetings and I read the letters from people and I start crying and my employees laugh at me, you know because I’m up there bawling because Martha sent us this heartfelt letter, how we’re saving her life. And as I mean, that’s pretty powerful stuff.

Dylan McCabe: That’s awesome. And a lot of people don’t realize that. When they’re looking at–. You don’t think it’s specifically people looking at starting an infusion center, they don’t realize how much you get to know these patients. Especially, they’re coming in once a week, once a month, or for 30 days at a time, you really get to know them. And that’s a powerful connection.

Charlie Schadewald: Yeah, the antibiotic patients like I’m telling you some of those come in every day for like 90 days. They’re diabetic and they’ve got foot ulcers and they’re losing their feet and it’s a scary time for them. And they’re seeing seven different people. They’re seeing their podiatrist and their general practitioner, and they’re going to hyperbaric treatments and they’re seeing wound care and their infectious disease. And then they’re coming to Wasatch Infusion and these people are just struggling to get through life every day. And we’re one-stop on their train to saving their feet, you know, and we celebrate, you know, Thanksgiving and Christmas and new years with them. Because they come in every day for 90 days and you can see the progression and you know, it’s sad to see, but it’s pretty heartwarming when you can help them, so.

Dylan McCabe: That’s great. Well, tell us about everything you guys have going on. Tell us about something that you’re most excited about right now with Wasatch infusion.

Charlie Schadewald: You know, I think we’re most excited about just our growth and expansion. You know, we’ve kind of planted our seat in Utah and we’re, you know, planning two more locations in the state here shortly. So we’ll be up to four locations. Currently, we have two and there’s these little bedroom communities like there are just about any state where we can really provide a higher level of service to planting infusion chairs. We’ve centralized our model really well, where we do everything for one central intake. We do all our Prius, our insurance verification, and all their collections and denials and all that work from one main office. And so we really have the opportunity to drop infusion chairs anywhere we want. We can put two chairs in a tiny community. We can put 10 chairs in a big community and manage it pretty effectively so that’s a, it takes a long time to get that infrastructure and the process and the technology and the communication and the proper people in place to be able to have, you know, that launching point where you can be successful with additional locations. And we’re right at that precipice now. Where we’re about ready to jump off at the hang glider and just, you know, sail away. So we’re excited about that. I’m really excited about what’s going on here with everything, with NICA, with WeInfuse, with all the people that are coming to this conference this weekend. I mean, this is crazy. This is our first conference. We’re having hundreds and hundreds of people and dozens of vendors visit us. And you know, everybody knows that the pipeline for biologics is so big that there’s not enough chairs in America to support the onslaught of medications that need to get in patients. And breaking down the barriers of access to treatment is what we’re all about. So our relationship with manufacturers and payers and the community of patients and the medical community is phenomenal. So the more we can voice what we’re all about to Capitol Hill, to those payers, to the manufacturers, and to the general public, we can’t scream loud enough how valuable this vertical space is right now. So, anybody that’s out there that’s passionate about infusion, stay passionate, be part of this system and help us grow this thing. Because it’s going to be a really cool ride for the next five to 10 years in this vertical.

Dylan McCabe: Definitely and I mean, at the time of the recording of this podcast, we haven’t even officially started the conference, but the last couple of days have been amazing. And it’s great, you know, just to all the people that are passionate about infusion all in one place. And I mean, it’s just been such a good time of networking and connecting and building synergy. Well, we could talk about this for another hour.

Charlie Schadewald: We could talk all day.

Dylan McCabe: We sure could and we will be talking all week, but what’s one parting piece of advice? And I’m thinking specifically for people who want to start an infusion center, what’s one parting piece of advice you would have for them?

Charlie Schadewald: If I were to start an infusion center like this, boy that’s tough. I think you really do have to really understand the market. I think engaging with the proper people like NICA or you guys at we infuse because you can’t do any business today without software. Right? So I think if I was just an entrepreneur like I am, and I was looking at this vertical and I wanted to figure out how to get in it. That would probably be the first place I would look is to guys like you, like at, WeInfuse and I’d say, Hey, you know. Which is why you’re getting all the phone calls, right. You know it, they’re going to call you and go all right, I know I need to push buttons to get this done and your software can help me do it. And then you guys have the expertise and understanding the product market, the product line. So I’d probably start there. But boy, make sure you have a passion for it, make sure you know your local laws, rules, and regulations, and get yourself a good counsel for that. You know, that’s always important.

Dylan McCabe: Well, great advice. And Charlie, thanks so much for being on the show. We’ve got a lot to learn for those of you that want to connect with Charlie. You can find him on LinkedIn it’s Charlie Schadewald, and you can find him on LinkedIn or do a search for Wasatch Infusion. You can see their great website and really see what they offer. So anyway, thanks again for being on the show.

Charlie Schadewald: Yeah, thanks. Appreciate it, Dylan.

Dylan McCabe: Alright, that concludes the interview with Charlie. So glad he and I could get together at the NICA conference. And I hope you guys got a lot of value out of that. Like I said, you can definitely connect with Charlie on LinkedIn, and if you haven’t done so already head over to weinfuse.com. You can check out our blog with some of the latest insights in the infusion practice or the infusion center. And if you’re in an infusion practice now and would like to learn more about our workflow solution, the software solution we provide, be sure to request a demo on our website, just go to weinfuse.com and there will be multiple places there where you can request a demo either myself or one of the other account executives will schedule a discovery call with you and learn more about your workflow and see if we can bring the latest technology to simplify your infusion practice. Guys, this Dylan McCabe with the we infused podcast. Thanks and I will catch you in the next episode.