I recently went one-on-one with Jeremy Shiner, founder and CEO of Myriad Systems.
Adam: Thanks again for taking the time to share your advice. First things first, though, I am sure readers would love to learn more about you. How did you get here? What experiences, failures, setbacks, or challenges have been most instrumental to your growth?
Jeremy: Adam, thank you for having me. It’s such a pleasure to speak to you today. Like everyone, I have had ups and downs in my professional career. Traversing these goes beyond what you learn on the job. I find we learn how to carry ourselves through difficult stretches far before receiving our first W-2. Sports taught me a lot about pushing through adversity, long before I had a job. I came up playing sports night and day and ended up playing football at a small college in D.C. During that time, I fractured my spine, which was a major setback my sophomore year. I was told I would never play again, but I made it back the following season. That experience taught me a lot about perseverance and pushing through difficult situations. Talent and where you start are not nearly as important as where you end up.
In business, I got an early window into healthcare payments through my father’s work. He built one of the early companies in the space, partnering directly with Visa and MasterCard, and grew it into a leading processor. I didn’t inherit a title. I spent years learning about practice management and how healthcare systems operate from the ground up. As the industry changed with DSOs, MSOs, and new investors entering the space, we had to adapt while staying focused on private healthcare. Eventually I left to start my own company, walking away from an existing book of business to build something new. We developed an all-in-one system for medical practices, and perseverance and adaptability have guided me ever since.
Adam: How did you come up with your business idea and know it was worth pursuing? What advice do you have for others on how to come up with and test business ideas?
Jeremy: The idea came from being hands-on in the field and talking to people who use these systems, doctors, office managers, and billers. A real problem kept showing up. For me, ideas come from identifying a need or a gap and filling it. The need was that doctors kept saying they have too many systems, the systems do not talk to each other, they spend too much money, and patients are not paying. So, I took my core competency of patient payments and the psychology of patient payments and built an infrastructure around that, following the encounter end to end starting from marketing, to scheduling, to treatment estimates, clinical documentation, claims, remittance, and post-remittance balances, plus all communications, referrals, prescriptions, and everything in between.
What I would say to anybody thinking of an idea is not to consider ideas in a vacuum. Get out there and talk to key stakeholders in the industry and get their opinions, not just investors, not just MBAs, not just people behind a desk, but the people you will eventually be selling the solution to. If they do not get excited by it, it is probably not the right idea to pursue. The idea was tested early by pitching it to clients years before it existed. Their response was consistent: they said, “I would use that, call me when you have it.” That is when it became clear there was something worth building.
Adam: What are the key steps you have taken to grow your business? What advice do you have for others on how to take their businesses to the next level?
Jeremy: From my perspective, growth breaks down into two verticals. The first is internal: build a team with skill sets that complement yours, so the business isn’t limited by what any one person can do. The second is organic growth, which is turning your existing users into advocates. Prove the concept, get the word out on how you do business and how you treat people, and let referrals follow. Especially in healthcare, among other fields, but in healthcare especially, you need to start getting the word out of how you do business and how you treat people and work in those referrals.
So, if you need to bifurcate, or break down where to focus, it is building the right team around you and building the right client base that is going to become advocates for your business or the right client partners. Keep clients at the center of every major decision. It sounds simple, but it is genuinely hard to do when investors, competitors, and a hundred other priorities are pulling your attention. The businesses that last are usually the ones that never lost sight of why their customers chose them in the first place.
Adam: What are your best sales and marketing tips?
Jeremy: My best sales and marketing tips are to understand your audience. To listen to the message from their perspective, and to speak the message and focus on how it is impacting them, not how it makes you feel or you look. So, try to never be “me-centric.” Always look at the audience and ask: what are they thinking or feeling? What are their existing beliefs? Instead of trying to change their beliefs, align what you are doing with their existing beliefs and their existing needs. And that is when you really have synergy, that is when you really have connection, and that is when you can really grow together.
Adam: What are the most important trends in technology that leaders should be aware of and understand? What should they understand about them?
Jeremy: The trend is that technology is being commoditized and is more accessible. Online platforms have shifted from locked-down subscription models to ecosystems where people can come in. With AI and the speed of building new technology, traditional software solutions are being more accessible. Gatekeeping will become harder. The shift is moving from a software-as-a-service model to a service-as-software model, where you must prove the value you bring to a business day in and day out on a recurring basis. You need to show how you are reducing costs, driving revenue, or creating measurable value, whether through AI, payment systems, billing, or other inelastic services.
Having software or an interface is no longer enough. Businesses will measure software spend directly against ongoing value and outcomes. This has been happening over the last decade, but AI is accelerating it, being added to everything to show continued value and reduce manual work in measurable ways. You need to quantify continuous value to compete in the new age of software and technology. Things like a backend with HIPAA compliance, cybersecurity, and infrastructure that insulates the core business. You are going to need to consolidate and bundle services to make it worth it.
Adam: In your experience, what are the defining qualities of an effective leader? How can leaders and aspiring leaders take their leadership skills to the next level?
Jeremy: When you cut past the ego and the spotlight, where some younger people think leadership is about attention and glory, effective leaders are really servants. They have deep empathy and real care for the people they lead, and a nagging sense of responsibility to get them where they need to be.
To take leadership to the next level, you have to shift the questions you are asking. Stop asking, “What can you all do to make me look good?” which a lot of young leaders fall into. Instead ask, “What can I do to make you look good? What can I do to make you perform better? What can I do to make you excel?”
The more people you help excel, the more you grow as a leader. You might not always get the credit or the immediate glory, but you build your leadership through the success of others. It is an indirect relationship. The best leaders understand that their role is to make other people better and remove the obstacles that stand in their way. When you focus on the needs and success of the people you lead, the impact you create becomes much bigger than anything you could achieve alone.
Adam: What is your best advice on building, leading, and managing teams?
Jeremy: Start with the right people. Skills can be developed, but character and work ethic are much harder to teach. I look for people who are curious, take ownership of problems, and care about the mission beyond their role. Hire slowly and deliberately early on because every hire shapes the culture in a compounding way. Once you have the right team, there are two main tenets I follow.
First, lead by example. Act the way you want others to act. Show at least a high-level understanding of their work and appreciation for what they do.
Second, spot check routinely. Do not just rely on reports. Get into the work, talk to clients, and see what is actually happening. That gives you better insight to guide improvement.
I also think it is important to keep balance between technology and the human element. In an AI-heavy company, it is easy to let technology replace judgment or connection. The most successful teams are the ones in which technology increases team productivity.
Adam: What are your three best tips applicable to entrepreneurs, executives, and civic leaders?
Jeremy: I’d say perseverance is key. You are going to meet challenges, and successful people overcome challenges. People who do not reach their goals often give up before they get there, so it is a matter of time and perseverance.
Second, be open-minded. Just because you saw things one way at one time does not mean the situation has not changed or that your perspective cannot evolve.
And third, be collaborative. Nobody can do it alone. You need strong people who complement your strengths in your corner to succeed in any facet, whether it is entrepreneurial or otherwise.
Adam: What is the single best piece of advice you have ever received?
Jeremy: Never do anything that will make it difficult to put your head on the pillow that night.
Adam: Is there anything else you would like to share?
Jeremy: Yes, I think the most important thing I would leave people with is that healthcare in this country is at an inflection point. The financial pressures on independent practices have never been greater, but at the same time, the tools available to help them compete are more powerful than ever. What excites me is that a small private practice can now operate with the efficiency and sophistication of a much larger system if they have the right technology partners. I deeply believe that preserving private healthcare is worth the effort. The best doctors in the world deserve to stay in business doing what they love.
Where there is demand, there will be a resurgence, and overall people want more personal, provider-led experiences in healthcare. And that is where we believe the biggest growth in the next decade in healthcare will be. The message is simple: if we support independent practices with the right tools, patients get better care, with hands-on service, more time spent with patients, and more focus on overall wellness.
