John Ray, Author at Business RadioX ® Page

To Your Health With Dr. Jim Morrow, Episode 18: 12 Flu Shot Myths

October 9, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow, Episode 18: 12 Flu Shot Myths

00:00 /

**Dr. Jim Morrow, Host, “To Your Health With Dr. Jim Morrow”**

To Your Health With Dr. Jim Morrow, Episode 18: 12 Flu Shot Myths

Flu season is coming! On this episode of “To Your Health with Dr. Jim Morrow,” Dr. Jim Morrow discusses the influenza virus and the 12 flu shot myths. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

Dr. Morrow’s Show Notes on Flu Shots

What is the Flu?

Influenza is a highly contagious airborne viral illness.
- The virus enters the respiratory tract cells of the host and, if not neutralized by antibodies, begins proliferating.
- The incubation period is 18 to 72 hours, but viral shedding may occur up to 24 hours before symptom onset and continue for five to 10 days.
- Influenza is typically uncomplicated and self-limited in otherwise healthy patients.
- However, severe complications, such as pneumonia, encephalitis, respiratory failure, multi-organ failure, and death, can occur.
- According to estimates from the World Health Organization, 3 to 5 million cases of severe influenza-related illness and 250,000 to 500,000 influenza-related deaths occur worldwide every year.

Diagnosis:
- Sudden onset of symptoms is a telltale sign of influenza.
- Common symptoms include
  - high fever,
  - headache,
  - sore throat,
  - myalgia,
  - cough,
  - rhinorrhea, and
  - fatigue

The CDC recommends that physicians diagnose influenza clinically and perform testing only in the limited situations.
- Several diagnostic tests for influenza are but negative results do not rule out influenza.
- Although many physicians use rapid influenza tests, clinical judgment should prevail, especially in view of the limitations of such tests.

Who should get vaccinated this season?

Everyone 6 months of age and older should get a flu vaccine every season with rare exception.
- Vaccination is particularly important for people who are at high risk of serious complications from influenza.
Flu vaccination has important benefits.
- It can reduce flu illnesses,
- doctors’ visits, and
- missed work and school due to flu,
- as well as prevent flu-related hospitalizations.
- Flu vaccine also has been shown to be life-saving in children.
- In fact, a 2017 studyshowed that flu vaccination can significantly reduce a child’s risk of dying from flu.
Different flu vaccines are approved for use in different groups of people.
- There are flu shots approved for use in children as young as 6 months of age
  - and flu shots approved for use in adults 65 years and older.
  - Flu shots also are recommended for use in pregnant women and people with chronic health conditions.
  - The nasal spray flu vaccine is approved for use in non-pregnant individuals, 2 years through 49 years of age.
  - People with some medical conditions should not receive the nasal spray flu vaccine.
- The most important thing is for all people 6 months and older to get a flu vaccine every year.
- Best time to get a flu shot is in October, so that it is in effect before the season gets into full force, and your immunity will last until the end of the season.

Making the Flu Vaccine: A Year-Round Effort

The job of producing a new vaccine for the next flu season starts well before the current flu season ends.
- For the FDA, it’s a year-round initiative.
The composition of vaccines for the prevention of other infectious diseases stays the same year after year.
- In contrast, flu viruses are constantly evolving.
- And the flu viruses that circulate causing disease in people, often change from one year to another.
- So, every year, there is a need for a new flu vaccine.
- To that end, FDA, World Health Organization (WHO), CDC, and other partners collaborate by collecting and reviewing data on the circulating strains of influenza from around the world to identify those likely to cause the most illness in the upcoming flu season.

In late February/early March — well before the new flu season begins — an FDA advisory committee reviews data about
- which flu viruses have caused disease in the past year,
- how the viruses are changing, and
- disease trends so they can recommend the three or four flu strains to include in the trivalent and quadrivalent influenza vaccines for the U.S in the upcoming flu season.
Once the strains are selected, vaccine manufacturers begin the manufacturing process to include the newly selected flu strains in their FDA-approved vaccines.
- The different flu virus strains are combined to formulate the vaccine into standard dosages.
- The vaccine is then filled into vials, syringes and, for the nasal vaccine, sprayers.
- Both egg-based and non-egg-based manufacturing methods for FDA-approved flu vaccines require high-tech processes and manufacturing facilities that have been inspected by the FDA.
- Vaccine manufacturers must submit applications to the FDA to include the new flu strains in their FDA-approved vaccines.
The FDA is also responsible for ensuring that released lots of influenza vaccines meet appropriate standards.
- Each vaccine undergoes quality control tests, including testing for sterility.
- Manufacturers submit the results of their testing, along with sample vials from each lot to the FDA for “lot release.”
- The FDA typically begins releasing lots of flu vaccines in late summer.
- Lot release can continue into early fall.
- Once lots are released, manufacturers distribute the vaccine throughout the United States for use by the public.
Flu seasons and severity are unpredictable.
- Annual vaccination is the best way to prevent the flu for people ages 6 months and older.
An annual immunization with flu vaccine is the most effective and safest way for most of us to reduce our risk of getting the flu and spreading it to others.
- When more people get vaccinated, it is less likely that the flu viruses will spread through a community, making us all healthier.

Myths About the Flu Shot

Myth #1: The flu is the same thing as a cold and it is harmless.
- It is common to confuse the flu with a cold.
  - Both have similar symptoms and often are treated with similar methods.
  - However, colds are mild and last longer.
  - The flu usually occurs suddenly and lasts 2 to 3 days. The flu also is contagious and can be dangerous.
- Symptoms of the flu include:
  - fever of 102°F or higher
  - chills and sweats
  - nausea and vomiting
  - muscle aches and headaches
  - chest pain
  - cough
  - stuffy nose
  - loss of appetite.

Myth #2: You can’t die from the flu.
- People who have severe cases of the flu or are high risk can die from the flu.
- High-risk people include:
  - Babies or children up to 4 years old.
  - Anyone 65 years of age or older.
  - Women who are pregnant, trying to get pregnant, or breastfeeding.
  - Anyone who has a low or weakened immune system.
  - Anyone who has a chronic health condition.
  - Anyone who lives in in a long-term care center.
- These people are at greater risk of having health problems that lead to death.
  - It is even more important that they receive an annual flu vaccine.
  - It helps prevent severe cases or problems related to flu.
  - It also lowers their chance of needing to go the hospital, which raises costs.
- If you aren’t high risk, you still should get a flu vaccine.
  - It protects everyone around you.
  - This is especially true if you work in health care or care for high-risk people.

Myth #3: You won’t get the flu if you get the flu vaccine.
- The flu vaccine helps to prevent the flu.
  - Every year, its purpose is to protect you from the main types of influenza.
  - However, you still can get the flu.
  - You could have been infected with the flu before you got the vaccine.
  - You also could get another type of flu that the vaccine does not cover.
  - Most likely, you will have a milder case than if you hadn’t gotten the shot.
- There are other things you can do to lower your risk of getting the flu.
  - These include:
    - Washing your hands often.
    - Covering your mouth when you sneeze and cough.
    - Using household cleaning spray to disinfect surfaces and objects.
    - Using hand sanitizer.
    - Washing laundry of sick people separate from other items.
    - Keeping your children, especially newborns, away from anyone who is sick.

Myth #4: You won’t get the flu if you take vitamin C.
- Vitamins cannot prevent the flu.
  - Using vitamin C can improve your immune system, but you can still get the flu.

Myth #5: The flu vaccine will give you the flu.
- You cannot get the flu from a flu shot.
  - This form of vaccine is made up of dead viruses that can’t infect you.
  - The nasal spray flu vaccine is made up of live, but weakened viruses.
  - The nasal spray vaccine is no longer recommended.
- You can’t get the flu, but you can have side effects.
  - The area of the shot could be red, sore, or swollen.
  - You also may have muscle aches, headaches, or a low fever for a short period of time.
  - These effects occur when your body responds to fight the new virus.
  - You also can have flu-like symptoms from other health issues, such as a bad cold.

Myth #6: You shouldn’t get the flu vaccine if you’re pregnant or breastfeeding.
- It is important to get the flu shot if you are pregnant, trying to get pregnant, or breastfeeding.
- The flu shot is safe for you and your baby.
- If you don’t get the flu shot and develop the flu, you could give it to your baby.
- Your doctor might prescribe antiviral medicine to help reduce symptoms. They also might suggest another form of feeding until you are better.

Myth #7: You shouldn’t get the flu vaccine if you have an egg allergy.
- The amount of egg allergen in the flu vaccine is very small.
- It is safe for people with egg allergies, even kids, to get the flu shot.
- Serious allergic reactions are rare.
- If you are at risk, doctors recommend getting the shot at your doctor’s office instead of a drugstore.
- This way, your doctor can monitor any potential reactions.

Myth #8: You don’t need to get the flu vaccine if you’re healthy.
- It is good to live a healthy lifestyle, but it can’t prevent the flu.
- It is an infection that spreads easily.
- Everyone over 6 months of age should get the flu vaccine, except for rare cases.

Myth #9: You shouldn’t get the flu shot if you’re sick or already have had the flu.
- It is okay to get the flu vaccine when you have a mild sickness.
- However, your doctor may suggest waiting until you’re better.
- It also is okay to get the flu shot if you have cancer.
- You still should get the flu shot if you’ve already had the flu. The flu vaccine protects you against several types of the virus.

Myth #10: You don’t need to get the flu vaccine every year.
- The flu is caused by the influenza virus, which can change from year to year.
- Because of this, the flu vaccine is adapted to protect against the main types of flu.
- You should get the flu vaccine every year at the beginning of the flu season.
- Flu season occurs in the colder months of year, typically October to May.

Myth #11: Getting the flu vaccine more than once a year will decrease your chance of getting the flu even more.
- There is no research that multiple flu vaccines will lower your chance of getting the flu.
- However, some kids or older adults may need two doses of the flu vaccine.
- This depends on your age and medical history.
- Talk to your doctor to see if you should receive two doses.

Myth #12: You should wait until later in the flu season to get the vaccine. Then you will be protected longer.
- The CDC recommends getting the flu vaccine as soon as it’s ready at the beginning of flu season.
- It can take up to 2 weeks for the your body to build protection against the flu.
- You should get the shot before the flu becomes more contagious.
- However, it still is better to get the flu shot late than not at all.

Sources: American Academy of Family Physicians and Center for Disease Control.

Family Business Radio, Episode 3: Cathy Hogan-Smith, Cachet Corporate Gift Services, and Brian Riggs, Foot Solutions Sandy Springs

October 8, 2019 by John Ray

Family Business Radio

Family Business Radio, Episode 3: Cathy Hogan-Smith, Cachet Corporate Gift Services, and Brian Riggs, Foot Solutions Sandy Springs

00:00 /

**Anthony Chen, Kathy Hogan-Smith, and Brian Riggs**

Family Business Radio, Episode 3: Cathy Hogan-Smith, Cachet Corporate Gifts, and Brian Riggs, Foot Solutions Sandy Springs

On this episode of “Family Business Radio,” host Anthony Chen welcomes Cathy Hogan-Smith, owner of Cachet Corporate Gift Services and Brian Riggs, general manager of Foot Solutions Sandy Springs. “Family Business Radio” is broadcast from the North Fulton Studio of Business RadioX® inside Renasant Bank in Alpharetta.

Cathy Hogan-Smith, Cachet Corporate Gift Services

Cachet Corporate Gift Services has been the go-to gift service for major corporations in Atlanta and nationally since Cathy Hogan-Smith started her business in 1997. Cathy is an expert in design and marketing. She has won numerous awards as a gift designer, writer and instructor/trainer in the gift industry. Her clients have included CNN, Cox Media Group, Turner Broadcasting System, Auto Trader, the Atlanta Braves, the Atlanta Falcons, Williams Sonoma and the Marriott Corporation. Cachet’s award-winning design team specializes in unique creations that feature delectable gourmet food and specialty gift items from around the world. Gifts are tailored to specific occasions or events and can include business logos. Cachet has provided gifts that fit with conventions, hotel room amenities, marketing, promotion and branding, grand openings, swag bags, celebrity or professional sporting events and much more.

For more information visit the Cachet Corporate Gift Services website. Cathy Hogan-Smith can be reached by email or text at 678-438-4486.

Brian Riggs, Foot Solutions

Brian Riggs is general manager of Foot Solutions in Sandy Springs. Each shoe at Foot Solutions must earn a place on their shelves, as employees undergo training in Pedorthics. Pedorthics is the biomechanical study of the foot and ankle, and how they affect the rest of the body. Foot Solutions can help prevent and relieve pain and discomfort. The retailer makes custom orthotics especially for you. They also have a variety of medical grade over the counter arch supports and orthotics that are already custom fitted. Each season, buyers for Foot Solutions Sandy Springs attend the world’s largest shoe show in Milan, Italy.

Foot Solutions Sandy Springs is located at 6307B Roswell Road, Sandy Springs GA 30328. You can reach Brian Riggs by email or phone 404-252-8001. Also visit the Foot Solutions website

Anthony Chen, Host of “Family Business Radio”

This show is sponsored and brought to you by Anthony Chen with Lighthouse Financial Network. Securities and advisory services offered through Royal Alliance Associates, Inc. (RAA), member FINRA/SIPC. RAA is separately owned and other entities and/or marketing names, products or services referenced here are independent of RAA. The main office address is 575 Broadhollow Rd. Melville, NY 11747. You can reach Anthony at 631-465-9090 ext 5075 or by email at anthonychen@lfnllc.com.

Anthony Chen started his career in financial services with MetLife in Buffalo, NY in 2008. Born and raised in Elmhurst, Queens, he considers himself a full-blooded New Yorker while now enjoying his Atlanta, GA home. Specializing in family businesses and their owners, Anthony works to protect what is most important to them. From preserving to creating wealth, Anthony partners with CPAs and attorneys to help address all of the concerns and help clients achieve their goals. By using a combination of financial products ranging from life, disability, and long term care insurance to many investment options through Royal Alliance. Anthony looks to be the eyes and ears for his client’s financial foundation. In his spare time, Anthony is an avid long-distance runner.

Charles Gridley, Six Bridges Brewing, and Kathryn Woods, Confident Communications

October 8, 2019 by John Ray

North Fulton Business Radio

Charles Gridley, Six Bridges Brewing, and Kathryn Woods, Confident Communications

00:00 /

**John Ray, Kathryn Woods, Charles Gridley**

North Fulton Business Radio, Episode 169: Charles Gridley, Six Bridges Brewing, and Kathryn Woods, Confident Communications

Craft beer and improving our speaking abilities were just two of the topics covered in this edition of “North Fulton Business Radio” as we welcomed Charles Gridley, Six Bridges Brewing, and Kathryn Woods, Confident Communications. “North Fulton Business Radio” is hosted by John Ray and is broadcast from inside Renasant Bank in Alpharetta.

Charles Gridley, Six Bridges Brewing

Charles Gridley, along with his son Clay, are the co-owners of Six Bridges Brewing. They are Johns Creek’s first and only brewery and taproom. Opened in December, 2018, Six Bridges Brewing currently brews on a 30 BBL brewhouse and a 2 BBL pilot system. They’re dog and kid-friendly both outside and inside the taproom, and offer multiple TVs, video games, cornhole, board games, and of course, cold beer.

Six Bridges Brewing is located at 11455 Lakefield Drive, Suite 300, Johns Creek, GA 30097. To learn more, go to the Six Bridges Brewing website

Kathryn Woods, Confident Communications

Kathryn Woods founded Confident Communications in late 2016. Kathryn provides communication coaching and speaking training to show her clients how to amplify their voice in order to amplify their impact. As a recovering shy person, Kathryn understands firsthand the challenge that lacking confidence can present when communicating. This has led her on a lifelong journey to gain that confidence first for herself and then for her clients. Kathryn began her 20+ year career as a licensed certified speech language pathologist which is where helping people communicate more clearly became the focus of her work. Through customized coaching and training programs, Kathryn teaches her clients the simple tools and techniques they need to captivate their listeners, grow their business, and achieve their goals.

To find out more, go to the Confident Communications website.

“North Fulton Business Radio” is broadcast from the North Fulton studio of Business RadioX®, located inside Renasant Bank in Alpharetta. Renasant Bank has humble roots, starting in 1904 as a $100,000 bank in a Lee County, Mississippi, bakery. Since then, Renasant has grown to become one of the Southeast’s strongest financial institutions with approximately $12.9 billion in assets and more than 190 banking, lending, wealth management and financial services offices in Mississippi, Alabama, Tennessee, Georgia and Florida. All of Renasant’s success stems from each of their banker’s commitment to investing in their communities as a way of better understanding the people they serve. At Renasant Bank, they understand you because they work and live alongside you every day.

Melanie and Sebastian Flores, OctoGifts

October 4, 2019 by John Ray

North Fulton Business Radio

Melanie and Sebastian Flores, OctoGifts

00:00 /

“North Fulton Business Radio,” Episode 168: Melanie and Sebastian Flores, OctoGifts

On this edition of “North Fulton Business Radio,” host John Ray welcomes the show’s youngest guest to date, budding entrepreneur Sebastian Flores, age 13, who along with his mom Melanie are co-founders of OctoGifts. “North Fulton Business Radio” is broadcast from inside Renasant Bank in Alpharetta.

Melanie and Sebastian Flores, OctoGifts

OctoGifts celebrate love, friendship, and your inner child by offering candy dispensers and greeting cards that are fun to give and fun to keep. OctoGifts is the brainstorm of 13-year-old co-founder Sebastian Flores. At age 11, he decided to make a combination candy dispenser greeting card for a friend who loved sweets. With no luck in searching for how-to videos on YouTube, Sebastian realized he’d have to figure it out himself. After hours of experimenting, he had built a working machine out of items that he salvaged from the recycling bin, as well as his art supply stash. In January of 2019, he revisited this idea and redesigned his card in the shape of a heart for Valentine’s Day. His greeting cards sold out within hours on Etsy, and Sebastian knew that he was on to something. He pitched his creation at the 2019 Alpharetta Business Expo; served as an entrepreneurship panelist at the 2019 MantisEdu UNCF STEM summer camp at Clark Atlanta University; made the 2019 Atlanta Business Chronicle’s 25 under 25 list; and has been featured in numerous publications including the Alpharetta-Roswell Herald and the Forsyth County News. Sebastian lives in Alpharetta with his parents and older brother. He plans to become a mechanical engineer. His mother, Melanie, an OctoGifts co-founder, has a chemical engineering degree and formerly led a STEM coaching team that served early childhood educators.

For more information visit octogifts.com or email Sebastian and Melanie directly. You can also connect with OctoGifts on Facebook, Instagram and LinkedIn.

Alpharetta Tech Talk: Chris Smith, PRAXIS Technology Escrow, and Michael Anaya, DEVCON Detect, Inc.

October 3, 2019 by John Ray

Alpharetta Tech Talk

Alpharetta Tech Talk: Chris Smith, PRAXIS Technology Escrow, and Michael Anaya, DEVCON Detect, Inc.

00:00 /

**John Ray, Michael Anaya, and Chris Smith**

“Alpharetta Tech Talk,” Episode 1: Chris Smith, PRAXIS Technology Escrow, and Michael Anaya, DEVCON Detect, Inc.

The debut episode of “Alpharetta Tech Talk” features two great guests: Chris Smith, PRAXIS Technology Escrow, and Michael Anaya, DEVCON Detect, Inc. “Alpharetta Tech Talk” is broadcast from the North Fulton Business RadioX® studio inside Renasant Bank in Alpharetta.

Chris Smith, PRAXIS Technology Escrow

Chris Smith is the Founder and CEO of PRAXIS Technology Escrow. PRAXIS Technology Escrow offers automated software escrow protection for business critical software and SaaS applications. PRAXIS leveraged more than 20 years of industry experience to reinvent software escrow services because today, all businesses rely upon technology (on premise, cloud, mobile & more) for business critical functions which must continue even if the vendor fails. This is what inspired the PRAXIS team to envision the new technology escrow experience that removes the risks associated with relying upon technology regardless of the platform. The entire PRAXIS experience is designed to address needs from end to end, with customizable agreements, dedicated customer service, and best in class protections. Our goal is to allow businesses to effectively rely upon technology while knowing that their future is secure. Technology escrow services should both give you confidence and fit seamlessly into your business process.

For more information go to the PRAXIS Technology Escrow or call (800) 213-9802.

Michael Anaya, DEVCON Detect, Inc.

DEVCON Detect is where creative minds innovate a secure future. Third party JavaScript can open a window of intrusion for hackers to exploit your site and your audience. DEVCON provides Edge Security that protects websites from 3rd-Party JavaScript vulnerabilities, ad exploits, malware, data leakage, browser hijackers, form-jacking and unauthorized tracking by nation states.

Michael F. D. Anaya is a skilled, cybersecurity tactician with a wealth of knowledge in understanding both criminal and nation state actors. At the end of 2018, he became the Head of Global Cyber Investigations and Government Relations for DEVCON. He leads a team focused on investigating online ad theft on a global scale as well as facilitating interactions with the U.S. government and its investigative units. He specializes in untangling all the complex and sophisticated ways threat actors attempt to obfuscate their activity. Prior to joining the DEVCON family, he was a part of another stellar group of people. He started his career as a FBI Special Agent in Los Angeles, CA. There he addressed complex cyber matters, during which time he led numerous, expansive investigations including one that resulted in the first federal conviction of a US person for the use of a peer-to-peer botnet. He later was promoted to a leadership role in Atlanta, GA where he led a diverse group of Agents, Intel Analysts, and Computer Scientists in neutralizing nation state and criminal threats. He secured one of the highest performance standards given by the FBI for the entire Atlanta cyber program.

For more information, go to the DEVCON Detect website or contact Michael directly through LinkedIn.

About “Alpharetta Tech Talk”

“Alpharetta Tech Talk” is the radio show/podcast home of the burgeoning technology sector in Alpharetta and the surrounding GA 400, North Fulton, Roswell, Johns Creek, and South Forsyth area. We feature startup entrepreneurs, executives of larger enterprise companies, and other key technology players from a region with over 900 technology companies. “Alpharetta Tech Talk” is hosted by John Ray and originates from the North Fulton Business RadioX® studio inside Renasant Bank in Alpharetta.

Decision Vision Episode 34: How Do I Get an SBA Loan? – An Interview with Joy Manbeck, Vinings Bank

October 3, 2019 by John Ray

Decision Vision

Decision Vision Episode 34: How Do I Get an SBA Loan? – An Interview with Joy Manbeck, Vinings Bank

00:00 /

Decision Vision Episode 34: How Do I Get an SBA Loan? – An Interview with Joy Manbeck, Vinings Bank

What are the different loan options in the SBA loan program? How do I qualify? Joy Manbeck, a banking veteran with particular expertise in SBA lending, joins “Decision Vision” host Mike Blake to answer these questions and much more. “Decision Vision” is presented by Brady Ware & Company.

Joy Manbeck, Vinings Bank

Joy C. Manbeck is a Senior Vice President and Director of SBA Lending with Vinings Bank. Joy is an Atlanta native who has been in banking for over 35 years. For most of her career she has been in commercial and small business lending with several different Atlanta-based banking institutions. Her community and civic roles include 2019-2020 President of the Rotary Club of North Fulton, alumnus of Leadership North Fulton, board member of Capital Partners Certified Development Corporation, member of the Board of Trustees of Alpharetta First United Methodist Church, and volunteer youth leader at Alpharetta First United Methodist Church. Joy is a graduate of Georgia State University with a degree in Finance, and her hobbies include fitness, gardening and violin.

Vinings Bank was established in 2007 to offer something unique by combining community-based banking expertise with services that create an environment that encourages both growth and prosperity. They offer a full range of financial products and services including specialized deposit solutions for business checking, sophisticated lending options, and outstanding cash management services to help businesses thrive.

To contact Joy, you can email her directly or call (678) 710-2820.

Michael Blake, Brady Ware & Company

**Mike Blake, Host of “Decision Vision”**

Michael Blake is Host of the “Decision Vision” podcast series and a Director of Brady Ware & Company. Mike specializes in the valuation of intellectual property-driven firms, such as software firms, aerospace firms and professional services firms, most frequently in the capacity as a transaction advisor, helping clients obtain great outcomes from complex transaction opportunities. He is also a specialist in the appraisal of intellectual properties as stand-alone assets, such as software, trade secrets, and patents.

Mike has been a full-time business appraiser for 13 years with public accounting firms, boutique business appraisal firms, and an owner of his own firm. Prior to that, he spent 8 years in venture capital and investment banking, including transactions in the U.S., Israel, Russia, Ukraine, and Belarus.

Brady Ware & Company

Brady Ware & Company is a regional full-service accounting and advisory firm which helps businesses and entrepreneurs make visions a reality. Brady Ware services clients nationally from its offices in Alpharetta, GA; Columbus and Dayton, OH; and Richmond, IN. The firm is growth minded, committed to the regions in which they operate, and most importantly, they make significant investments in their people and service offerings to meet the changing financial needs of those they are privileged to serve. The firm is dedicated to providing results that make a difference for its clients.

Decision Vision Podcast Series

“Decision Vision” is a podcast covering topics and issues facing small business owners and connecting them with solutions from leading experts. This series is presented by Brady Ware & Company. If you are a decision maker for a small business, we’d love to hear from you. Contact us at decisionvision@bradyware.com and make sure to listen to every Thursday to the “Decision Vision” podcast. Past episodes of “Decision Vision” can be found here. “Decision Vision” is produced and broadcast by the North Fulton studio of Business RadioX®.

Visit Brady Ware & Company on social media:

LinkedIn: https://www.linkedin.com/company/brady-ware/

Facebook: https://www.facebook.com/bradywareCPAs/

Twitter: https://twitter.com/BradyWare

Instagram: https://www.instagram.com/bradywarecompany/

Show Transcript

Intro: [00:00:02] Welcome to Decision Vision, a podcast series focusing on critical business decisions, brought to you by Brady Ware & Company. Brady Ware is a regional, full-service, accounting and advisory firm that helps businesses and entrepreneurs make vision a reality.

Michael Blake: [00:00:21] And welcome to Decision Vision, a podcast giving you, the listener, clear vision to make great decisions. In each episode, we discuss the process of decision making on a different topic. Rather than making recommendations because everyone’s circumstances are different, we talk to subject matter experts about how they would recommend thinking about that decision.

Michael Blake: [00:00:39] My name is Mike Blake, and I’m your host for today’s program. I’m a Director at Brady Ware & Company, a full service accounting firm based in Dayton, Ohio, with offices in Dayton; Columbus, Ohio; Richmond, Indiana; and Alpharetta, Georgia, which is where we are recording today. Brady Ware is sponsoring this podcast. If you like this podcast, please subscribe on your favorite podcast aggregator, and please also consider leaving a review of the podcast as well.

Michael Blake: [00:01:04] Our topic today is, should I consider taking out an SBA loan? And I’m excited to cover this topic because although I don’t do a lot of stuff with banks, frankly, my skill set is more on the the equity side as a recovering venture capitalist and so forth, but I do—it is my belief that the SBA loan program is one of the least understood or most commonly misunderstood opportunities for small business finance out there. And frankly, it’s also—in spite of the fact that there are many outlets and many venues that are promoting the SBA program, it’s a program that not many people even know about. And if you’re a small business, and you’re looking at financing, if you’re looking at acquiring a small business, it might even be a franchise, if you don’t know about the SBA program, you really are leaving important options available to you off the table.

Michael Blake: [00:02:05] And like I said, I’m really not qualified to talk more than a very superficial level about the SBA program. So, if you’re a listener to the show, you know what’s coming next. I’ve brought in an expert who does know about the SBA program quite a bit. And here joining me is my pal, Joy Manbeck, who is a Senior Vice President and Director of SBA Lending with Vinings Bank.

Michael Blake: [00:02:32] And sort of funny story. Joy and I have known each other, I think, for 10-12 years or so, and we haven’t been in contact. We sort of all do our various things. Joy was off taking over corporate America, and I was probably in a gutter somewhere. But we happened to run into each other at an event where we had both recently joined our new companies as a mixer to my firm, Brady Ware, and her bank, Vinings Bank. And it turns out now that we are about 500 yards away from each other in terms of where our offices are; though, neither of us is actually ever there because are always on the road. But at least, theoretically, now, we’ve come together. And that’s kind of what got my wheels spinning about this particular topic.

Michael Blake: [00:03:14] So, Vinings Bank was established in 2007 to offer something unique by combining community-based banking expertise with services that create an environment that encourages both growth and prosperity. They offer a full range of financial products and services, including specialized deposit solutions for business checking, sophisticated lending options and outstanding cash management services to help businesses thrive.

Michael Blake: [00:03:36] Joining is an Atlanta native. Haven’t heard of any Atlanta natives left anymore. Has been in banking for over 35 years. She graduated from Georgia State University with a degree in Finance. And her hobbies include fitness, gardening, and violin. I did not know that. We’re going to have you on our band.

Joy Manbeck: [00:03:52] I would not at all.

Michael Blake: [00:03:53] We’ll do a Dexy’s Midnight Runner kind of cover situation there. She has a number of community and civic roles. She is a 2019-2020 President of the Rotary Club of North Fulton. She is an Alumnus of Leadership North Fulton. She is a Board Member of Capital Partners Certified Development Corporation, is on the board of trustees of Alpharetta United Methodist Church, and is a volunteer youth leader, also, with the Alpharetta United Methodist Church. Joy, thanks for coming on the program and somehow making time because you do a lot.

Joy Manbeck: [00:04:27] Well, thank you for having me. It’s an honor to be here.

Michael Blake: [00:04:29] People talk about banker’s hours, man. They have not met you. So, let’s get started. Let’s start with the very basics. What is a small business administration loan?

Joy Manbeck: [00:04:42] Well, an SBA loan, SBA was started in the 1950s to help businesses who were struggling with getting loans to help incent banks to make loans by guaranteeing a portion of the loan. So, 7-day loan, that’s the seven day program, it has a 75% SBA guarantee. And then, the bank takes the risk of the 25%, and then the SBA guarantees the 75. The bank makes the whole loan. And then, the government guarantees it.

Michael Blake: [00:05:15] So, why do companies consider taking out an SBA loan versus a more conventional financing instrument?

Joy Manbeck: [00:05:21] Well, several reasons. One is the longer terms. Financing equipment, usually, is over a 10-year period. No balloon payments. Real estate, we can finance over a 25-year period. Again, no balloon payments. And then, the amount down can be as little as 10%. Also, businesses that are special use like a daycare, gas station, car wash, they have a little bit more trouble in the conventional world getting financing. And so, SBA is, usually, a partner with those type businesses.

Michael Blake: [00:05:54] And so, you say, for example, a 10-year repayment period. In a more conventional loan, what do those repayment periods look like? Is it like a three to five-year or maybe even quicker?

Joy Manbeck: [00:06:05] Typically, usually three. At least, they’ll amortize them sometimes over 20 years if it’s real estate. 20-year amortization, three, five or seven-year call feature typically on those.

Michael Blake: [00:06:17] So, my understanding is that not all SBA loans are created equal. There’s actually a number of programs out there. So, can you highlight a few of those specific programs?

Joy Manbeck: [00:06:25] Certainly. As I mentioned, the seven day program a few minutes ago, these are eligible for any most small for-profit businesses. And it’s for a myriad of things. It could be to purchase real estate, construction, buying fixed assets, purchasing another business, starting a business, or working capital purposes. Seven day covers all of that. Then, you’ve got the SBA, what’s called a 504 program. And that’s only to buy real estate or fixed assets. And then, another one that’s become very popular is something called the cap line, C-A-P L-I-N-E. And that’s another 75% guarantee program up to $5 million, but it is an in an out line of credit.

Michael Blake: [00:07:09] Now, in the past, I think the SBA has also had so-called express loans. Is that right? Like for veterans, things of that nature. Do they still exist? Am I right? And if so, can you tell us about those?

Joy Manbeck: [00:07:20] They do. This is not something I have a lot of expertise in, but it’s a—an express loan would also be a line of credit. It would be a shorter term. And those loans are usually $350,000 and under.

Michael Blake: [00:07:31] Okay.

Joy Manbeck: [00:07:33] You have 50% guarantee on those.

Michael Blake: [00:07:35] So, for your needs, as long as you’re not trying to buy Apple, sounds like there’s potentially an SBA loan out there for somebody.

Joy Manbeck: [00:07:43] Absolutely.

Michael Blake: [00:07:44] So, what kinds of companies are good candidates for SBA loans? I assume there must be some that are kind of better than others.

Joy Manbeck: [00:07:53] Again, it’s for for-profit businesses. And basically, I mean, there are certain industries. Gambling, we can’t loan to. We can’t lend to finance companies. But pretty much anything, any for-profit business professionals. As I mentioned, car washes, restaurants, daycares, funeral homes, you name it.

Michael Blake: [00:08:15] And the SBA is actually a big source of franchise financing, right-

Joy Manbeck: [00:08:18] Absolutely.

Michael Blake: [00:08:18] Because it, actually, maintain—I think, it’s a pretty interesting list of the most successful franchise in terms of low failure rates, and then ones that are a little bit dicier-

Joy Manbeck: [00:08:27] Correct, yeah.

Michael Blake: [00:08:29] … for lack of a better term.

Joy Manbeck: [00:08:30] Right.

Michael Blake: [00:08:31] So, what about—the world I play in, as you know, is a lot of technology companies. Now, I presume that SBA is not a replacement for venture capital. There’s just not that kind of financing. But are there scenarios in which a technology or technology-driven company might also consider an SBA loan?

Joy Manbeck: [00:08:50] Oh, absolutely. And we loan to technology-driven companies quite a bit. So, they are totally eligible. Their terms are usually going to be—it’s usually for working capital purposes. So, if it’s permanent working capital, like a 10-year term, but the lines of credit are also good for those.

Michael Blake: [00:09:08] Okay. And then. you talked about companies that are not good candidates for SBA loans. You talked about casinos, I guess. Gaming is not going to be a good candidate.

Joy Manbeck: [00:09:18] That’s right.

Michael Blake: [00:09:21] I would assume a marijuana company is not going be a good candidate yet. That may change. But right now, we’re not there.

Joy Manbeck: [00:09:26] You’re right.

Michael Blake: [00:09:28] Finance companies. So, you don’t want people borrowing money from the SBA to, then, lend it out to somebody else. That’s not-

Joy Manbeck: [00:09:33] That’s absolutely right.

Michael Blake: [00:09:34] That’s not the goal of the program. Any other companies that, probably, come to your mind that they may not be great fits.

Joy Manbeck: [00:09:41] Not that are for-profit. Pretty much—I mean, if it’s legal, and if it’s not a finance company or a gambling company, typically it’s eligible.

Michael Blake: [00:09:53] Okay. So, I’d like to spend our time on the seven day loans because, I think, one, I’m not knowledgeable about real estate at all. I’m not even very good at monopolies. The 504 things have been great to me. But I think most of our listeners are more likely to be interested and candidates for the seven-day program. So, can you dive a little bit deeper into that? What does a seven-day loan look like? We talked about a 10-year term. Was it look like in terms of typical collateral coverage, interest rates, things of that nature?

Joy Manbeck: [00:10:23] Okay. Very good question. First of all, SBA gives us a set of regulations that we have to follow. But then, banks can use their own, I guess, credit guidelines. So, SBA is not a collateral lender. So, if the loan is not completely collateralized, andmost conventional lenders want their loans completely collateralized. So, that’s up to the lender if they want to make the loan with an SBA guarantee on it. However, if the loan is not fully collateralized, and the borrower has outside collateral, personal collateral, SBA does expect them to pledge it. So, that’s one advantage of getting an SBA loan. It does not have to be fully collateralized, but we are required to take available collateral. The other thing is cash flow. We’re gonna look at debt serviceability. SBA’s minimum debt serviceability is 1.15:1. We, as a bank, like to see 1.25:1.

Michael Blake: [00:11:22] And that, what’s that? What does that ratio mean?

Joy Manbeck: [00:11:24] That means that your cash flow available to cover the proposed debt service on-

Michael Blake: [00:11:29] Principal and interest.

Joy Manbeck: [00:11:30] Principal and interest.

Michael Blake: [00:11:30] Okay.

Joy Manbeck: [00:11:32] Absolutely. But again, that is up to the bank. That’s a guideline with SBA on the 1.15. So-

Michael Blake: [00:11:38] Okay.

Joy Manbeck: [00:11:38] … we can—our bank looks at loans globally. We’ll look at all the components and make a decision from there.

Michael Blake: [00:11:46] And what about interest rates? My understanding is, at least, the one point that used to be fixed to the prime rate, usually, 1% to 2% over prime. Is that accurate? Is that still true? What does that kind of look like?

Joy Manbeck: [00:11:58] Well, we offer—Vinings offer is a couple of options. And most banks don’t offer fixed rates. We occasionally do, especially on our real estate loans. They’re going to be probably in the mid to high sevens. And they’ll be fixed for the full 25-year term. Typically, most SBA lenders are going to loan over prime. It’s gonna be typically around prime and two. You can loan up to prime plus 2.75. And then, it’s adjustable usually on the calendar quarter.

Michael Blake: [00:12:27] Okay, which makes sense cause that’s usually when the Fed adjusts anyway. So, you’re kind of on the Fed’s calendar.

Joy Manbeck: [00:12:35] Absolutely.

Michael Blake: [00:12:36] So, the question I think a lot of people will ask and where I find that the greatest misunderstanding about the SBA program is that you hear SBA, you hear that it’s got the eagle on, it’s got the federal logo, and everything; and therefore, you think like Donald Trump is writing your check or a Washington-based loan.

Joy Manbeck: [00:12:58] Right.

Michael Blake: [00:13:00] That’s not actually the case, is it?

Joy Manbeck: [00:13:01] Not on seven days. On seven days, the bank makes the loan, and SBA guarantees it. So, your funds come from the bank. They’re guaranteed by SBA. And then, the borrower makes the payments directly to the bank, and the borrower communicates directly with the bank.

Michael Blake: [00:13:17] Now, you at Vinings Bank are preferred lender.

Joy Manbeck: [00:13:20] We are

Michael Blake: [00:13:20] As are other banks, but not all banks are. So, what does it take to become a preferred lender. And if I’m a borrower, why should that matter to me?

Joy Manbeck: [00:13:28] Well, it’s huge for the borrower. First of all, to be able to qualify, you have to, in a 24-month period, have five loans that are approved by SBA on a direct basis. That means your bank approves them in our loan committee, and then we submit them to SBA, they underwrite them, and they are proven. So, once you’ve gotten to that five-limit approval of loans, then you can apply for preferred lender status, which means that you have the choice of once you approve the loan at the bank level, you can go ahead and just say it’s approved, and get your SBA loan number, and go move forward with closing.

Michael Blake: [00:14:02] And if you’re not a preferred lender, how does that differ?

Joy Manbeck: [00:14:05] It could take up to two to three weeks to get your loan approved with SBA, a lot longer.

Michael Blake: [00:14:10] And that point, I want to zero in on that a little bit-

Joy Manbeck: [00:14:14] Sure.

Michael Blake: [00:14:14] … because, again, one of the one reason that people, I think, shy away from SBA loans, when I say, “Think about the SBA,” they say, “How long is the government going to take to make a decision?” But in fact, the government, especially if it’s a preferred lender, is not making the decision at all, right? They’ve empowered the bank to do that.

Joy Manbeck: [00:14:32] That’s correct. I mean, and we do have to make sure that we do everything according to their regulations because we’re going to get audited eventually. And then, we’ve got to have everything as instructed. But we take care of that on our end. We do all the underwriting, but we underwrite them completely with SBA guidelines or regulations.

Michael Blake: [00:14:50] And so, the relationship is that the bank is lending the money and the US government is basically a guarantor-

Joy Manbeck: [00:14:56] That is correct.

Michael Blake: [00:14:56] … in case it doesn’t work out, basically.

Joy Manbeck: [00:14:58] Absolutely correct.

Michael Blake: [00:14:59] So, this may not be a fair question, but I just have to ask you. I mean, what happens if a loan does go bad?

Joy Manbeck: [00:15:07] Well, the first thing we do is try to work with the borrower. We try to get with them, find out what’s going on. Do they just need a payment deferment for a while, or are things turning around, or is this a case where the loan is just defaulting, and there’s nothing to be done? So, then, we begin to foreclose. We foreclose on whatever collateral is available. Then, if there’s a gap, then there’s always a guarantor on the loan, personal guarantor, at least, one, anybody, 20% and over as far as shareholder. They’re required to fully guarantee the loan. So, we will go to them, work with them, and try to resolve that gap. But if not, then we take further steps legally.

Michael Blake: [00:15:51] So, another point, one of the things I advise my clients who are asking about the SBA or talking about the SBA is that I think the SBA lenders do as good a job as any in trying to prevent a default, right?

Joy Manbeck: [00:16:07] Absolutely.

Michael Blake: [00:16:08] I think you get a lot more flexibility from an SBA lender than you do most conventional lenders because you really have no interest in foreclosing, unless there’s a gun to your head, basically, right?

Joy Manbeck: [00:16:18] That is absolutely—that’s the last thing we want to see.

Michael Blake: [00:16:20] And in that respect, it strikes a lot like student loans. I mean, you have to work hard-

Joy Manbeck: [00:16:25] Yes.

Michael Blake: [00:16:25] … to default on a student loan on an SBA. Is that—if your business has any chance at all of becoming solvent and repaying this thing in the future, there’s a lot of rope there, isn’t there?

Joy Manbeck: [00:16:38] There’s some. I mean, we can do it three payment principal and interest or principal deferment twice during the loan. But if the borrower defaults and is just not paying, then we have no choice-

Michael Blake: [00:16:52] Sure.

Joy Manbeck: [00:16:52] … but to foreclose.

Michael Blake: [00:16:52] That’s the way the world works, right?

Joy Manbeck: [00:16:55] Yeah, absolutely.

Michael Blake: [00:16:55] It’s not a grant. It’s not free money.

Joy Manbeck: [00:16:56] That’s right.

Michael Blake: [00:16:58] So, let’s say somebody now in earshot is interested, and wants to learn, and wants to maybe take a shot at SBA loan or pursue that, what does the application process look like?

Joy Manbeck: [00:17:08] Basically, we’re going to send them a list of the items we need. We’ll ask for always three years personal tax returns, three years business tax returns, current personal financial statement, current interim profit and loss statement balance sheet. If it’s a startup, we’re going to want two years of monthly cash projections and a good business plan, solid business plan. And then, depending on the company, whether we’ll ask for things like accounts payable aging, accounts receivable aging, just depends on the structure of the company. We’ll get things like resumes from the borrower, history of the company. We’ll go out and do site visits, meet with the borrower, and we do a lot of handholding with our borrowers.

Michael Blake: [00:17:50] I imagine because a lot of your borrowers aren’t necessarily financially sophisticated in the way they’re putting those projections, and you have to teach them the language of banking, I would imagine.

Joy Manbeck: [00:18:01] Sometimes, we do. Most times, I’ll encourage them to work with their CPAs. If they’re a startup business, and they haven’t had a lot of financial experience in the past, I will strongly suggest they sit down with their CPA and go through that projection process.

Michael Blake: [00:18:16] Okay, good. Now, I’ve seen cases where, also, on rare occasion, an SBA requires a third-party appraisal or valuation of the company to be done. When does that get triggered?

Joy Manbeck: [00:18:28] On a real estate appraisal, if the loan is over $250,000, then we’re going to require a real estate appraisal if that’s our collateral. And then, if you’re buying a business, then if the amount that you’re financing, that the bank is financing is over $250,000, we’re going to acquire a third-party business valuation.

Michael Blake: [00:18:49] Okay. And how long does that application process usually take?

Joy Manbeck: [00:18:56] If we’re gonna send a preferred lender, we’re gonna do it without having to submit it to SBA, typically—and I underwrite my—all of us at Vinings underwrite our own loans. And it takes me, usually, two to three days to underwrite a loan. Our committee meet once a week. And then, from there, we issue a commitment letter. Once the borrower accepts that, then we start ordering appraisals, we engage a closing attorney, and I tell people from start to finish, usually 45 to 60 days to close.

Michael Blake: [00:19:26] Okay. And that’s a lot faster. I think most people will appreciate it. Again, I think they’re used to certain kind of banking stereotypes, and they’re used to government stereotypes as well. But in reality, you most likely will receive funding through the SBA much more quicker than you will from a venture capitalist, right?

Joy Manbeck: [00:19:44] Absolutely.

Michael Blake: [00:19:45] VC is going to be a four to six-month exercise if it’s fast tracked.

Joy Manbeck: [00:19:49] Right, sure.

Michael Blake: [00:19:52] So, are there certain—are there any restrictions on what SBA funds borrowed can be used for?

Joy Manbeck: [00:20:02] There are—we can’t loan money to pay a borrower—give money back to a borrower. Say that they’ve bought a piece of property, and they contributed a certain amount into that property, we can’t loan money to give that money back to them. We can’t loan money to have somebody invest in a business. They can buy the business if they’re going to buy at 100%, but it can’t be for a partial investment. I’m trying to think of some other scenarios that go outside the realm.

Michael Blake: [00:20:33] Well, there’s one part that I think that I didn’t know. I knew you couldn’t borrow in order to buy minority interest, but I did not realize you couldn’t borrow if it’s a majority interest, only if you’re buying 100% percent.

Joy Manbeck: [00:20:45] That is correct. You can’t just buy in.

Michael Blake: [00:20:51] In your experience, where do you think most the funds get used?

Joy Manbeck: [00:20:55] Real estate.

Michael Blake: [00:20:57] Yeah.

Joy Manbeck: [00:20:57] Yeah, because those are gonna be those bigger loans. SBA goes up to—the loan can be up to $5 million. With their guarantee, $3.750 would be their portion. So, those are always, typically, going to be bigger loans, the real estate loans.

Michael Blake: [00:21:10] So, not all SBA loans are approved.

Joy Manbeck: [00:21:17] Correct.

Michael Blake: [00:21:17] Of course, you’d love to get them all through. Especially you, you would love to get them all through. But the reality is that there’s not 100% guaranteed promising.

Joy Manbeck: [00:21:22] Sure.

Michael Blake: [00:21:23] So, one, in your experience, what percentage of applications you think make it through where the loan is actually approved?

Joy Manbeck: [00:21:31] Most of mine, if they’re not going to make it, it’s gonna be a desk turned down. Meaning, I’m going to look at it and realize it’s not going to work. Most of them we take to loan committee are approved. And then, since we’re preferred lenders, we approve it at our bank, and we just get our SBA number. So, we don’t have a lot of turn-down scenarios.

Michael Blake: [00:21:53] Yeah. You make sure it doesn’t get to that process. I’m sure-

Joy Manbeck: [00:21:56] Try to.

Michael Blake: [00:21:56] I’m sure the borrowers appreciate that too, right?

Joy Manbeck: [00:21:58] Right.

Michael Blake: [00:21:59] Much rather a quick no-

Joy Manbeck: [00:22:00] Exactly.

Michael Blake: [00:22:00] … than a long maybe.

Joy Manbeck: [00:22:01] And we try to do that.

Michael Blake: [00:22:04] What are the most frequent reasons you find yourself at that desk level saying, “We have to take a pass on this for now?”

Joy Manbeck: [00:22:12] That’s a very good question. One would be inexperience of the borrower. Somebody wants to start a restaurant, but they’ve never even worked in a restaurant, or daycare, or whatever it’s gonna be. Another is cash flow. The cash flow, the historical cash flow of the company doesn’t show that it can service the loan. And sometimes, we’ll do a projection base. They they’re going to add another city to their company, or they’re going to add people, or whatever, then we’ll look at projections. Another would be that it’s way under-collateralized, and we’re taking too big a risk there. And then, another would be trends. Maybe the companies showed some negative trends over the past few years.

Michael Blake: [00:22:53] But the good news, I think, some of those can kind of be fixed, and they can be addressed proactively. You can’t necessarily fix your history, but you certainly can kind of rework the business, right?

Joy Manbeck: [00:23:04] Absolutely.

Michael Blake: [00:23:04] So, in a way, that can actually be a very educational process because you may be—you may, for a lot of these businesses, be the first kind of professional finance person that has looked at the business in that way. And that feedback can be very helpful, right?

Joy Manbeck: [00:23:18] Sure, absolutely.

Michael Blake: [00:23:18] So, have you ever had boomerangs where you’ve said, “Look, this isn’t ready to go now,” but maybe six months or a year later, they are ready, and you wind up being able to approve them?

Joy Manbeck: [00:23:26] We have. I’ve had a few of those in my history. But usually, they tend to go another avenue. But sometimes, they’ll be back.

Michael Blake: [00:23:36] So, you hinted this before, but it’s worth kind of focusing on. If if I’m an SBA borrower, particularly, I’ve never done something like that before, is it worth hiring an accountant or an attorney? Maybe both? Maybe somebody else that can to help me through that process?

Joy Manbeck: [00:23:53] I totally would. I mean, I mentioned earlier, a CPA to help you with the numbers, with your projections, and see what’s reasonable. Also, an attorney to walk you through getting your business opened with the State of Georgia and just advice. As far as contracts, they need to have someone look at a contract with them who has legal knowledge.

Michael Blake: [00:24:18] So, one—I’m going to get to a piece of advice I often tell my clients. Boy, I hope it’s right. And that piece of advice is that if you’re declined by one bank for an SBA loan, that doesn’t necessarily mean that every single bank’s going to decline it. Is there truth to that? If bank A declined it, maybe they might come to you, and you might view that differently. Is that a valid piece of—is that a valid thought?

Joy Manbeck: [00:24:49] It absolutely is. All lenders have their own guidelines. We all have to go by SBA regulations. But different lenders have different priorities, like where—we look at a loan globally. I mean, we’re going to look at all aspects of it. Other SBA lenders only want real estate, and they want coverage of 85% or whatever. And we—most of the SBA lenders in Atlanta know each other, and we know what each other will do that maybe our bank won’t do. And I referred a number of times somebody to another bank that might look at a loan that’s gotten low cash flow to debt service coverage or collateral is way off. But yes, I mean, those are bank guidelines, as long as you’re following SBA regs.

Michael Blake: [00:25:32] And it doesn’t mean somebody is right or wrong. It can just be a comfort level of the kind of business you’re in, right?

Joy Manbeck: [00:25:37] Exactly, absolutely.

Michael Blake: [00:25:38] So, let’s take you, for example. Are there certain kinds of businesses that you just feel like you just know really well and you can really get into them?

Joy Manbeck: [00:25:46] I do. Yeah, I become a car wash lender for one.

Michael Blake: [00:25:50] You mentioned that a couple of times, yeah?

Joy Manbeck: [00:25:52] Yeah. And restaurants, I’ve done a lot of restaurant lending, daycares. So, those are industries that are sort of my area of expertise. But we do really so many different industries. So, we don’t want to limit it-

Michael Blake: [00:26:04] Sure.

Joy Manbeck: [00:26:05] … ever, so.

Michael Blake: [00:26:06] Sure. Well, what do you—besides what we’ve talked about, are there any kind of other kind of misconceptions about SBA loans that you think that the audience ought to know about?

Joy Manbeck: [00:26:19] In addition to the timing, if you work with the preferred lender, and there are other lenders that are what’s called GP, general participant, that can get the loans done efficiently. So, it’s not only at PLP lenders, but we can certainly get them done faster than the ones that aren’t PLP preferred lenders. The other thing is paperwork. Well, like I say, we do a lot of handholding. We try to complete as much of the paperwork as we can, our processing department. So, a lot of people shy away from it because they think it’s just gonna be tons of paperwork. So, that part, I think, in the past was more true than it is now.

Michael Blake: [00:26:57] I’m gonna go off the script a little bit because I thought of a question I can’t resist asking. You might not be able to answer. If you can’t, that’s fine. We’ll move on. But I’m curious, is there a favorite borrower that you’ve had that just took an SBA loan and just did fantastic things that sort of stands out? Maybe built a car wash empire or something like that?

Joy Manbeck: [00:27:18] It’s funny you should mention that because I learned—I did a 504 loan. That’s the loan that you can only do real estate and fixed assets. It was probably three years ago. He probably had 2.5 into the whole thing. Two years later, one of the big car wash franchises came and offered him $7.5 million for it. And so, now, we’re doing another one for him.

Michael Blake: [00:27:41] Wow!

Joy Manbeck: [00:27:42] Yeah.

Michael Blake: [00:27:42] I’d say he’s a good risk.

Joy Manbeck: [00:27:43] He is. They did everything right. So, good borrowers.

Michael Blake: [00:27:47] Well, this has been great. There’s a whole lot more knowledge that I know that you have. And if someone wants to think about working with you, and they’re getting the sense that I already know. I mean, you’re just a great person to work with.

Joy Manbeck: [00:27:58] Thank you.

Michael Blake: [00:27:59] So, if somebody wants to contact you to learn more about if an SBA loan is right for them or not right for them, how can they do that?

Joy Manbeck: [00:28:07] Probably the best thing is the e-mail address, which would just be jmanbeck@viningsbank.com. And I can spell that out if you’d like me to o-.

Michael Blake: [00:28:16] No, I think Vinings Bank, I think, is fairly self-explanatory.

Joy Manbeck: [00:28:20] Okay.

Michael Blake: [00:28:20] And if they can go the website, they’ll see the spelling. So-

Joy Manbeck: [00:28:22] Absolutely.

Michael Blake: [00:28:23] Okay. Well, that’s going to wrap it up for today’s program. I’d like to thank Joy Manbeck so much for joining us and sharing her expertise with us. We’ll be exploring a new topic each week. So, please tune in, so that when you’re faced with your next business decision, you have clear vision when making it. If you enjoy this podcast, please consider leaving a review with your favorite podcasts aggregator. It helps people find us, so that we can help them. Once again, this is Mike Blake. Our sponsor is Brady Ware & Company. And this has been the Decision Vision Podcast.

Jim Weber, ITB Partners

September 26, 2019 by John Ray

North Fulton Business Radio

Jim Weber, ITB Partners

00:00 /

“North Fulton Business Radio,” Episode 167: Jim Weber, ITB Partners

On this edition of “North Fulton Business Radio,” Jim Weber, managing partner of ITB Partners joins host John Ray to talk about his consortium of independent management consultants which serves start-ups to midcap companies and beyond. “North Fulton Business Radio” is broadcast from inside Renasant Bank in Alpharetta.

Jim Weber, ITB Partners

Jim Weber is Managing Director of ITB Partners, a consortium of independent management consultants providing high value-added solutions to your problems. ITB Partners helps business managers solve their problems by connecting them with high-quality independent management consultants. ITB’s consultants are experienced leaders, discipline experts, and project managers. Clients are publicly and privately owned mid-caps; private equity groups and their portfolio companies, start-ups, acquisitions, and turnarounds. The firm’s industry expertise ranges from consumer packaged goods and manufacturing to supply/chain, logistics, and the service sector. Additionally, they have depth in consumer services franchising, specifically restaurant, hospitality and retail. The core of the firm’s business is the belief that client success is paramount. This belief ensures that the focus is fixed on delivering a high-quality product. This client-focused approach is simple: Listen to understand the client’s needs analysis to provide insight; foster trust to forge a true business partnership; plan, implement and follow-through; and be accountable for results. ITB has a solid track record of success and long-term relationships with high repeat business. The firm’s referenced client list shows high client satisfaction. In addition, the consortium’s depth and breadth of skills, abilities, and experience includes more than 25 years in multi-industry environments, leadership positions in large multi-national organizations, as well as experience in building and leading successful businesses.

For more information visit itbpartners.com, or email Jim directly.

Decision Vision Episode 33: Should I Sell My Business? – An Interview with Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

September 26, 2019 by John Ray

Decision Vision

Decision Vision Episode 33: Should I Sell My Business? – An Interview with Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

00:00 /

Decision Vision Episode 33: Should I Sell My Business? – An Interview with Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

What should I be doing to be ready to sell my business when the right time comes? How do I know when that right time is? Find out answers to these questions and more as “Decision Vision” host Mike Blake interviews serial entrepreneur Ed Rieker, a successful seller of multiple businesses he founded. “Decision Vision” is presented by Brady Ware & Company.

Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

Ed Rieker is a serial entrepreneur and currently the CEO of the Avondale Innovation District. Ed was a founder or co-founder of four healthcare software companies. He navigated successful exits for three of these companies, as two were acquired by public companies and another by investors. The fourth is still running.

Two of these software companies were accepted into the Advanced Technology Development Center at Georgia Tech (ATDC), and one is an ATDC graduate.

Ed previously served as an ATDC Entrepreneur in Residence (4x) and an ATDC Executive in Residence (1x). He has served as a Venture Catalyst at ATDC between startups.

In 2004 Ed purchased an online community, built the business up and sold it to a public company in 2011. He has owned and operated a private coworking and technology incubator. Ed is an angel investor in various startups.

Ed was awarded patent #5,832,447 for an Automated System and Method for Providing Real-Time Verification of Health Insurance Eligibility (a co-inventor).

He is the owner and developer of Tudor Square, a community-oriented, quality, dinning, shopping and entertainment venue, supporting small independent business owners in downtown Avondale Estates, GA

Ed is currently the CEO of the Avondale Innovation District, located in downtown Avondale Estates, a place-based urban development designed specifically to support entrepreneurs and creative professionals, foster open innovation, attract and accelerate new business ventures.

Michael Blake, Brady Ware & Company

Brady Ware & Company

Decision Vision Podcast Series

Visit Brady Ware & Company on social media:

LinkedIn: https://www.linkedin.com/company/brady-ware/

Facebook: https://www.facebook.com/bradywareCPAs/

Twitter: https://twitter.com/BradyWare

Instagram: https://www.instagram.com/bradywarecompany/

Show Transcript

Intro: [00:00:02] Welcome to Decision Vision, a podcast series focusing on critical business decisions, brought to you by Brady Ware & Company. Brady Ware is a regional, full-service accounting and advisory firm that helps businesses and entrepreneurs make vision a reality.

Michael Blake: [00:00:21] And welcome to Decision Vision, a podcast giving you, the listener, clear vision to make great decisions. In each episode, we discuss the process of decision making on a different topic. Rather than making recommendations because everyone’s circumstances are different, we talk to subject matter experts of how they would recommend thinking about that decision.

Michael Blake: [00:00:39] My name is Mike Blake and I’m your host for today’s program. I’m a Director at Brady Ware & Company, a full-service accounting firm based in Dayton, Ohio, with offices in Dayton; Columbus, Ohio; Richmond, Indiana; and Alpharetta, Georgia, which is where we are recording today. Brady Ware is sponsoring this podcast. If you like this podcast, please subscribe and your favorite podcast aggregator. And please also consider leaving a review of the podcast as well.

Michael Blake: [00:01:03] So, today’s decision that we’re going to discuss is, should I consider selling my business? And for most people in business, there will never be a bigger decision you ever have to make in your life than whether when, how, and on what terms to sell your business. And selling a business is maybe even more challenging because most people only do it once in their life. There are a few people that are serial entrepreneurs, and we’re going to talk to one in a second, but most people, if they’ve had a good run, they sell their business, they get out, and then they go do something else, particularly if they happen to be good at leisure.

Michael Blake: [00:01:52] And the thing about selling a business, and I’ll be the first to admit this, even though I advise people on selling businesses, and I charge exorbitant fees for helping people do so, is that, actually, when you get right down, it’s not rocket science, but a lot of it isn’t necessarily intuitive. And the process of even wrestling with a decision on whether to sell a business is often such an emotionally entwined decision that has far reaching implications, even outside of the business itself that it can be very challenging to have a clear head when you’re approaching that decision.

Michael Blake: [00:02:33] And, generally speaking, in selling a business, there is no do over, right? Once you sort of sign those documents, and money comes out of escrow, and if you have that kind of business, the keys are turned over if it’s a virtual business, then all the the pass codes, passwords are handed over, that’s sort of it. So, if you have sellers or more, your only real recourse is to start new business and do better the next time.

Michael Blake: [00:02:54] So, it’s an important decision to get right. And it’s one that, like I said, you don’t really get a mulligan on this. And in trying to figure who’d be the best person to talk about this, I’m fortunate that a friend of mine actually is one of those few that has actually sold multiple businesses. So, he’s been through a few of these rodeos. And he hasn’t sold them for other people. They’re actually his businesses.

Michael Blake: [00:03:23] And so, without further doing introduce my pal, Ed Rieker, who has come all the way from Avondale Estates, which if you look at a map of Atlanta should be about a 10-minute drive. But the way our highways are set up at, it paces about an hour and a half. So, I really appreciate him coming into the studio today because he’s also got a 90-minute drive back.

Michael Blake: [00:03:47] But Ed has actually started and sold four businesses, at least, four of which I’m aware. He’ll correct me once he comes on. But he’s currently CEO of the Avondale Innovation District, an Avondale Estate Georgia. He is also the owner and principal of Tudor Square, a community-oriented quality dining, shopping, and entertainment venue supporting small independent business owners in downtown Avondale Estate Georgia.

Michael Blake: [00:04:10] He is the General Manager of the 151 Locust Fund One LLC, which is a fund established for the purpose of providing seed funding to Metro Atlanta technology startups. Ed was also the mayor of Avondale Estates for six years and is an adjunct faculty member in the Emory University Business School’s startup launch accelerator program. Ed Rieker, Your Honor, welcome to the program.

Ed Rieker: [00:04:33] Thanks, Mike. It’s a pleasure to be here.

Michael Blake: [00:04:36] So-

Ed Rieker: [00:04:37] By the way, I took a jet pack here, right.

Michael Blake: [00:04:39] Did you take a jet pack?

Ed Rieker: [00:04:40] Yeah.

Michael Blake: [00:04:40] I think that’s the best way to get here.

Ed Rieker: [00:04:42] 10 minutes.

Michael Blake: [00:04:42] Really?

Ed Rieker: [00:04:43] Yeah.

Michael Blake: [00:04:43] Now, thank God for Georgia Tech inventing that stuff, man.

Ed Rieker: [00:04:47] Absolutely.

Michael Blake: [00:04:47] So, let’s dive into it. There’s a lot of ground we can cover and hope we can cover all of it. Can you talk to us a little bit about the businesses that you have actually owned and sold?

Ed Rieker: [00:04:58] Absolutely. I’m mostly a software guy. So, the businesses that I’ve founded or co-founded were really about software, about the creation of value through pushing little buttons to make stuff happen. So, when I’ve had the privilege of being on some really great teams and also being able to cash out a few times. So, I started in 1988 when you weren’t born yet.

Michael Blake: [00:05:30] You silver-tongued devil.

Ed Rieker: [00:05:34] Absolutely. And so, what we did was we built a software system that actually worked with hospital systems and large systems to kind of get people in the hospital as quickly as possible. What it turned out to be really was a marketing thing. And so, we built that up, sold that to a group of investors in 1991. And then, I was a minority shareholder in that. I had an angel investor that had put money into that.

Ed Rieker: [00:06:09] Then, the next one, we also was in healthcare. I think once you get to be in a domain, you get to know people, they get to know you, you start to kind of build a reputation. So, health care’s been very, very good to me. And I’ve done four health care startups and sold three of those or two of those to public companies. And then, in 2004, I actually bought an online community, because I’m very interested in community and built-

Michael Blake: [00:06:37] Yes, you are.

Ed Rieker: [00:06:38] Yes, I am.

Michael Blake: [00:06:38] That’s definitely bring your MO.

Ed Rieker: [00:06:39] And both online and in the real world. And it’s just fascinating to see how people work together, and how they don’t work together, and what they need, and how it might be able to help. But we built that online community up and sold that to a public company in 2011. So, that’s kind of the story is the ability to build a solution, a tool that solves a problem, build a team, build it up.

Ed Rieker: [00:07:10] And then, the first one, I think you mentioned, was really difficult to sell because I was a minority shareholder. It was everything to me at the time. And when it got sold, it—here’s the thing though. When you—you talked about the escrow, the cash coming in, and you think about buying the yacht, but you missed a step. And that’s the part where you have to stick around for a little bit and deal with the new owners. So, that was the first time I had done that.

Ed Rieker: [00:07:46] And what happened was, is they kind of put me in a room and ignored me for a while. And then, I watched them kind of do what they wanted to do. So, you can’t make decisions anymore because you’ve sold it. You’re exactly right. But normally, once you sell it, especially like a software business, any other business, you’re gonna be there for a while to watch that transition. So, that can be a difficult thing. And over the years, I’ve been able to kind of look at the idea of building with the end in mind, which is to sell it, so.

Michael Blake: [00:08:24] Now, what was that transition like? I mean, I know you personally. I don’t see you as a very good employee.

Ed Rieker: [00:08:34] I’m a horrible-

Michael Blake: [00:08:34] And I mean that with all the love I could possibly muster.

Ed Rieker: [00:08:37] Yes, absolutely. I know.

Michael Blake: [00:08:38] But I consider myself, and my firm will tell you, I’m a terrible employee.

Ed Rieker: [00:08:42] Right, yeah. I’m a terrible employee. I will admit that. And I think the first time I sold, I was also a terrible seller because I was so emotionally involved and so focused on what I thought was right for the business, but I didn’t have any say anymore. I didn’t have any vote anymore. So, it becomes very difficult to hang around and see people do things that you probably don’t agree with.

Ed Rieker: [00:09:13] And, also, remember, the alignment I had with the sellers was they had the money, they had an idea of what they thought they wanted to do, and I really didn’t know on that well. And when you start to kind of see the team change and see kind of what they think is right, it can be very difficult for a seller to kind of be in that world. Most of the time, after you sell something, if you look at the statistics, the CEO goes bye-bye about six months, the old CEO.

Michael Blake: [00:09:48] I was going to ask you about that because most sales I’ve seen if the CEO is asked to remain at all, it’s a two to three-year period.

Ed Rieker: [00:09:57] Right.

Michael Blake: [00:09:57] But I don’t think most CEOs actually wind up serving out that term.

Ed Rieker: [00:10:01] They’re usually gone in six months. And that’s the thing you have to learn about in terms of selling. There’s things like earn-outs. So, when you get to the part where you agree on what the value is and what the terms are, part of that term can be the offer of, “Oh, we’ll double the what we’re buying you for if you’ll stay and hit these metrics.” And normally that’s kind of phantom money. That’s really hard to do because you don’t have control over how to reach those metrics anymore.

Michael Blake: [00:10:33] Right. I mean, the special sauce that you brought is now not being used anymore. It’s just sitting in the refrigerator with the label on it saying, “Add special sauce.”

Ed Rieker: [00:10:41] Right. You’re lucky if it’s in the fridge.

Michael Blake: [00:10:46] Right. I can’t shake this vision. I mean, having sort of been put in a room, you sort of watch everybody do the thing with the business after you’ve sold that, and you just sort of have to be at peace with your powerlessness by doing that.

Ed Rieker: [00:11:00] Yeah, and I wasn’t. I absolutely wasn’t. I mean, I think I was probably a bad seller at that point because I looked around, and it wasn’t going in the direction and as well as I thought it could go. And so, I didn’t really stay for the whole six months. I kind of bugged out of there because I had other things to do.

Michael Blake: [00:11:24] Yeah.

Ed Rieker: [00:11:24] Yeah.

Michael Blake: [00:11:26] Your experience of that sounds like my experience parenting a teenager.

Ed Rieker: [00:11:31] Yeah.

Michael Blake: [00:11:32] You watch it, but there’s only so much impact you can ultimately have. It’s sort of it’s just going to happen. So, how long did you own those businesses before selling them?

Ed Rieker: [00:11:42] So, I’m looking at my notes here, and I think ’88 and ’91. So, what’s the math? That’s three years. So, I probably worked on that a little bit longer than that. So, probably looks like the average is three to four years.

Michael Blake: [00:11:56] Okay.

Ed Rieker: [00:11:57] Yeah.

Michael Blake: [00:11:57] That’s not particularly long. Even in venture capital, that’s a fairly quick turnaround.

Ed Rieker: [00:12:02] Well, I like small teams and early stage stuff. And so, I like building it up to a certain point. And one of the things, I think, that if you’re a business owner of any kind of type, what you want to see is that every six months or so, the phone rings and somebody says, “Hey, I’m thinking about doing business with you or transaction with you.” And it evolves in this sort of, “Hey, we’re thinking about buying you.” If you’re not getting that call every six months or that activity every six months, then I feel like there’s something wrong with your business-

Michael Blake: [00:12:38] Huh!

Ed Rieker: [00:12:40] … because that’s one of the key indicators that you’re on to demand is that you get these situations where maybe you’re serving a large customer. and they say, “Well, maybe we should buy you instead of being a customer.” So, you want to kind of see those things happen every six months. If that’s not happening, then there’s something wrong with the business.

Michael Blake: [00:13:01] I’m gonna go off the script because I think that is insightful point that I want to explore a little bit more because I would not have thought of that in a million years, but I think I got it. So, let me tell what I think I get, and you tell me why I’m wrong. And what I think I get is people want to buy you because they notice you, and they’re making an impact, and you’re so important, they can’t afford to not you being available at some point down the road.

Ed Rieker: [00:13:31] Yeah, absolutely.

Michael Blake: [00:13:32] Right?

Ed Rieker: [00:13:32] And it’s the noticed part and the can’t live without you part that drives the price up. It could be a strategic or a technology acquisition. And most of the stuff that we did was a technology acquisition because we had found a pocket somewhere in health care that we were serving. And it was important enough to a large corporation that instead of building it, they would try to buy it. And that’s exactly kind of what you’re looking at.

Michael Blake: [00:14:01] So, that’s interesting. So, kind of a bullet point is a lot of business owners will tell me that they get annoyed they get offers to potentially buy and sell. They don’t want to do that. But in a way, if you’re getting those calls, even if they’re not particularly serious, the fact that you’re on somebody’s radar screen means you’re doing something right-

Ed Rieker: [00:14:19] Yeah, that’s correct.

Michael Blake: [00:14:19] … in terms of the market.

Ed Rieker: [00:14:20] And every once in a while, you actually want to follow through with those calls because that’s a great way to to create a valuation for yourself, to kind of figure out, you’re in that business, you’d be a great advisor to call. And it [crosstalk]-

Michael Blake: [00:14:32] “Hey, thank you, Ed.”

Ed Rieker: [00:14:34] … product placement. Was that on the script or?

Michael Blake: [00:14:38] It should have been.

Ed Rieker: [00:14:39] It should have been.

Michael Blake: [00:14:39] It should have. My marketing department is, right now, tearing their hair out, saying, “Why do you make everybody say that?” So, you said that you’re a bad seller when you sold that first business.

Ed Rieker: [00:14:50] Absolutely, yeah.

Michael Blake: [00:14:51] And part of that was because you’re a minority shareholder, so you couldn’t really drive the bus. You could almost sort of grab the steering wheel every once in a while. By sale four, in what way were you a better seller? Were you a better seller?

Ed Rieker: [00:15:03] Well, absolutely, yeah. What happened is that I was so emotionally attached to the first one. It’s not the same thing, and it’s probably a really bad analogy, but it’s like selling your baby or selling one of the things that you love, a family member. It just really was—I was that emotionally attached to it. And then, after I went through that, when I realized that perhaps my career, if I could call it a career, would be building and selling companies. I began to think about it in a different way that the actual in-game was to sell it and to sell it successfully. And by successfully, it meant that they were happy, I was happy, there was a good outcome for both of us, and that the transition part was actually part of building the business that I was able to transition out of the business to be able to go do the next thing.

Michael Blake: [00:16:02] So, the transition was organic. And in fact, they should stick somebody else having to stay with the buyers instead of you.

Ed Rieker: [00:16:08] Absolutely.

Michael Blake: [00:16:08] Right?

Ed Rieker: [00:16:09] Absolutely. So, that’s the process, then, is to build a team, so that I was dispensable. And actually they didn’t—why should we keep that guy?

Michael Blake: [00:16:19] Now, I’m curious. And I may be all wet here, but I’m curious if, also, the financial dynamic changes. When you sell your first business, I suspect but do not know that that was a lifestyle changing event for you.

Ed Rieker: [00:16:37] I would say the first one wasn’t.

Michael Blake: [00:16:39] Okay.

Ed Rieker: [00:16:39] When you start getting into the second and third, because the first two, I had to have angel investing to build the business up.

Michael Blake: [00:16:47] Yeah.

Ed Rieker: [00:16:48] Everything else was out of my own pocket, self-funded.

Michael Blake: [00:16:52] Okay.

Ed Rieker: [00:16:52] And the reason for that is that I found out in the way that I work is that I am able to risk my money, but not so much somebody else’s. I’m more careful with other people’s money, so that it hindered the ability for me to actually do the kind of the on-the-edge things that I wanted to do. I can do that with my own money but not necessarily with someone else’s.

Michael Blake: [00:17:18] I can understand that. And I’ve long thought, even though the standard playbook for startup entrepreneurs is hit up friends and family, right? On the other hand, that can lead to some very awkward Thanksgiving dinner conversations if things don’t go great.

Ed Rieker: [00:17:36] Absolutely.

Michael Blake: [00:17:37] Right?

Ed Rieker: [00:17:37] And the first one was what I would consider friend who had resources that actually funded the first one. And, of course, we don’t talk anymore. So-

Michael Blake: [00:17:50] Okay.

Ed Rieker: [00:17:50] Exactly right.

Michael Blake: [00:17:51] Yeah. So, that is a risk.

Ed Rieker: [00:17:52] Yeah, that’s the risk. Yeah.

Michael Blake: [00:17:55] So, it sounds to me like—well, I’m gonna ask the question for this. That’s why I have you here. To what extent were these sales planned versus opportunistic? They sound like a hybrid to me, kind of.

Ed Rieker: [00:18:07] Well, I think the first one was opportunistic because I really didn’t understand. I mean, I was an idiot on the first one. I really was. And I had a deep desire to create something, and a desire to perhaps bring that into the world and make it bigger. And what I didn’t understand was that through my immaturity, I was not a really good boss. Not only not a good employee, but not a good boss. And so, I think that having that sale hit me and all the emotional stuff that went with that, just reconsider a lot of stuff. At least, I did. And then, as I built teams that actually were the core of the success, you can’t be successful without a great team. I’m just really fortunate to have people that were able to help me, and teach me, and gather the things that we needed to be successful that we’re able to build these businesses up and sell them. So, I think I avoided your question. I am not sure I-

Michael Blake: [00:19:20] No, I think you, eventually, got around the answer.

Ed Rieker: [00:19:23] Yes.

Michael Blake: [00:19:23] Yeah. So, a common thread here is that all of your business is sold within two to three years or so. What did those businesses look like? What did they have in common that made them salable at that three-year period? Why do you—I’m sure it wasn’t luck.

Ed Rieker: [00:19:42] Well, yeah, it is luck. I mean, it’s—there’s a thing called the lucky bus that drives around. And if you’re standing out on the street, and the lucky bus stops in, and they say you’re ready to go, you got your bags packed, and you have your bags packed, and you’re ready to go, you can hop on the bus. And the bags packed is actually the work to be done, the job to be done. If the lucky bus stops, and they say you get your bags packed, and you go, “No, no, wait a minute, I’ll go finish packing,” when you come back out, the bus is gonna be gone.

Ed Rieker: [00:20:18] So, the idea I think we had going forward after the first one was to kind of always be in the way of a larger company. How could we—imagine this giant that’s walking or stumbling around. How can we annoy them enough that they’ll look down, and pick us up, and go, “Oh, yeah. This looks tasty. I’ll eat it.” That was the idea. So, what we did was we developed ways to deploy software and ideas in the world, so that we wound up in front of a large corporate entity that we knew eventually would probably want to do what we were doing, but they weren’t fast enough to be able to do it. And so, they would say, “Okay. Well, it’s just cheaper for us to kind of scoop this up and go with it.”

Michael Blake: [00:21:12] So, what that tells me is that your approach has been always be prepared to be opportunistic.

Ed Rieker: [00:21:18] Yes.

Michael Blake: [00:21:18] Right?

Ed Rieker: [00:21:19] So, yeah, to sell. Right. And to sell. And one of the things I would encourage entrepreneurs and CEOs to do is there’s a thing called due diligence, which is very exciting. And it’s even more exciting if it’s a public company because when they want to buy you, they really come and look at everything.

Michael Blake: [00:21:38] It’s basically a product logical exam without the anesthetic or-

Ed Rieker: [00:21:42] Yeah, yeah.

Michael Blake: [00:21:46] Just leave it-

Ed Rieker: [00:21:46] Yeah, yeah. And at last, not seconds, but hours and days. Yeah, absolutely.

Michael Blake: [00:21:51] Just to make it extra fun.

Ed Rieker: [00:21:52] Yeah, extra fun. So, what I learned after the first one was to create. And I’ll make it simple, like these little paper boxes that you put files in. So, when you’re doing things, like you have a contract, you have an employment agreement, or you have anything that’s paper that’s important that they’re going to look at later on, you just make a second copy and throw it in that box. And you know when the due diligence comes around, you can just go point at that box, and go, “All the stuff you want is in that box.” And it makes it a lot easier because when they do come and do due diligence, if you’re not ready, you’ve got to go through all your files and find this stuff. And it’s really time consuming.

Michael Blake: [00:22:34] And distracting.

Ed Rieker: [00:22:35] And distracting.

Michael Blake: [00:22:36] Right?

Ed Rieker: [00:22:36] Yes.

Michael Blake: [00:22:36] And, also, I gotta believe, and I’ve always advised clients about—on this, so I hope I’m right, there’s something to be said for making yourself easy to buy.

Ed Rieker: [00:22:49] Absolutely.

Michael Blake: [00:22:50] It doesn’t necessarily make you more or less valuable-

Ed Rieker: [00:22:52] Right.

Michael Blake: [00:22:52] … but just offering that path of least resistance.

Ed Rieker: [00:22:56] Well, what can happen is that, for instance, when you talked about opportunity, one of the purchases that was made on one of the software companies was that the public company had actually issued some bonds. So, they had gotten some cash, and they had a timeline when they had to spend that cash. So, you know.

Michael Blake: [00:23:17] So, that the government-

Ed Rieker: [00:23:19] Absolutely. We’ve got a budget to buy stuff. Let’s go buy stuff. And that’s somebody’s job to be done is to do an M&A.

Michael Blake: [00:23:26] Yeah.

Ed Rieker: [00:23:26] So, somebody at a corporate office is absolutely getting bonuses and pay on buying companies. So, there’s actually people that do that, and they have goals, and they have responsibilities. So, if they had this money, they had to spend by a certain time. So, it gave us a couple of things. It gave us the upper limit of the purchase. It gave us the timing. And then, we kind of—that gives you a leverage that perhaps they might not know that you know and helps you in the negotiations. So, you got to make sure that when you’re getting bought that you’re paying attention to those kind of things.

Michael Blake: [00:24:10] Boy, that’s interesting. That’s a a blog post I’ve been aching to write. But you’re right, there is sort of this moral hazard on the buy side when companies have a dedicated business development from an acquisition perspective or corporate development function, right?

Ed Rieker: [00:24:27] Right.

Michael Blake: [00:24:28] Those are people who are judged based on how much stuff they buy.

Ed Rieker: [00:24:31] Yeah.

Michael Blake: [00:24:32] And often, whether or not it’s a good acquisition or not, there’s so much turnover. Those people aren’t around-

Ed Rieker: [00:24:36] Yeah.

Michael Blake: [00:24:37] … whether it’s a good deal or not, right? And although the prudent thing to do, because we have a pro deal bias, the prudent thing to do may be to walk away from a deal. Nobody ever gets interviewed on Bloomberg or on The Wall Street Journal for someone who walked away from a deal.

Ed Rieker: [00:24:54] That’s correct.

Michael Blake: [00:24:55] It’s never happened.

Ed Rieker: [00:24:56] Yeah, yeah.

Michael Blake: [00:24:56] Right?

Ed Rieker: [00:24:58] Yeah.

Michael Blake: [00:24:58] So, if you are being approached by someone that’s got that corporate development function, they need wins.

Ed Rieker: [00:25:04] Yeah. They need wins.

Michael Blake: [00:25:04] They just do.

Ed Rieker: [00:25:04] And they need certain dollar ranges that they’re buying in. There are certain ways that they’re buying in terms of how they model their transactions. So, cash, stock, earnouts, what happens to the founders, what happens to the team. All those things are consideration. A lot of us think about the buyout as being, “Oh, it’s a certain dollar amount,” but there’s a lot of nuance that you can create for yourself and your team that you can do in a deal.

Michael Blake: [00:25:35] And I don’t know if you’ve been in this situation because your model for building and selling a business has been so focused on a venture capital type model, but I am going to throw it out there anyway. And that is, are there signs out there where an owner needs to think about actively selling a business as opposed to being opportunistic that you can think of, or maybe you’ve experienced it where we’re at a point now where it’s really time for this business to sell, or it’s time for me to get out, or some combination? Is that something you can speak to?

Ed Rieker: [00:26:07] Yeah, sure. I think that that’s an interesting thing that happens. There’s cycles that we see. We’re in a happy time right now. It’s not going to continue to be a happy time. And that’s just the way the market works.

Michael Blake: [00:26:21] Yeah.

Ed Rieker: [00:26:22] So, I own some commercial real estate now. Now, I’m thinking about it’s time to sell because I think we’re in a pretty good place in the market. And I think that’s also true of a business. There could be things going on with the team, there could be things that you know about the technology and perhaps where it’s going that you may want to try to cash out. So, absolutely. I think an example for that for me was that 2008 was the precursor to a horrible 2009. And we had the online community, and there was a company that was rolling communities up. And they had approached us about selling the year before, and we said no because we were still—revenues were rising, and we were still building things. And I was of a mindset that, “Oh, this is going to continue and go up next year.” And the guy that was wanting to buy us, we’re on the phone, and he’s literally screaming at me on the phone saying, “Take the cash, take the cash, I’ll pay all cash.” And I’m saying, “No, I think we’ll be worth more next year.” Well, guess what? We weren’t worth more.

Michael Blake: [00:27:44] It didn’t work out.

Ed Rieker: [00:27:45] It didn’t work out. It went down, and it took us a couple more years to sell it.

Michael Blake: [00:27:49] Huh! Okay.

Ed Rieker: [00:27:51] Yeah.

Michael Blake: [00:27:51] So, when you sold your businesses, were these do-it-yourself jobs, or did you kind of put a team around you to help you?

Ed Rieker: [00:27:58] Well, the team part is the CPA and, also, we used the same legal team to do the sell part. The deal structure, the first one, I was a minority shareholder in. And so, I wasn’t as involved in that and progressively got more involved in the other ones and pretty much full on. I think the idea is that you agree on a face to face, usually. You kind of agree with the principles. This is the price, the terms, what happens to the team, what happens to you? Then, you kind of wind up with maybe a one page or a page and a half. And then-

Michael Blake: [00:28:42] It’s called a term sheet-

Ed Rieker: [00:28:43] Yeah, yeah, yes.

Michael Blake: [00:28:43] … for those of us in the audience.

Ed Rieker: [00:28:44] Term sheet.

Michael Blake: [00:28:44] Yeah, term sheet.

Ed Rieker: [00:28:45] Thank you. I knew there was a name for that. And then, what happens is that two pages turns into 30 or 50 pages of mind-numbing legalese fees and schedules.

Michael Blake: [00:28:58] Oh, boy, you’re not kidding.

Ed Rieker: [00:28:59] Yeah. And so, that’s-.

Michael Blake: [00:29:00] Except, it’s only one of the most important decisions in your life, so you have to read it.

Ed Rieker: [00:29:04] You have to read it. And you have to have a team that can interpret it for you. And you have to have, both on the financial side and on the legal side, someone to make sure that what you think is happening in your head is actually what’s in the document. That’s the most important thing. It’s like you can look at the documents, and you can see what the outcome will be if certain things happen. I got tripped up once by one word in a document that was part of an earnout. And, it costs a big bucket of money because we interpreted that word differently than what it actually meant. And that was one word in probably a 40-page document.

Michael Blake: [00:29:53] Whew!

Ed Rieker: [00:29:54] Ouch.

Michael Blake: [00:29:54] Yeah.

Ed Rieker: [00:29:55] And so—yeah, but unless you make those mistakes and see them, you can’t learn from them, so.

Michael Blake: [00:30:01] Well, yeah. And exactly why I think you have such a fascinating and valuable perspective because you’ve had the opportunity to make those mistakes live to fight another day, right? And like you said, most people don’t see four transaction. They don’t see four sales.

Ed Rieker: [00:30:17] Right.

Michael Blake: [00:30:17] We’ll see one.

Ed Rieker: [00:30:18] Yeah. I’ve been lucky. Absolutely.

Michael Blake: [00:30:21] So, at any point, as you were considering a sale, were you concerned over what would happen the day after, what would you happen to you the day after you wake up, all of a sudden, there’s no office you have to be in?

Ed Rieker: [00:30:35] Well, that there was never a no office to be in. There is always a time you have to stay with the business. And after the first one, I was able to say, “All right. I know my job to be done in the world is to start them and to sell them.” So, I know when the new people come in, I want to underpromise and overdeliver. But I also want to have a team in place to where the business really doesn’t need me. My job was to think about the really big things. And so, usually, by the time the deal was done or even before that, I would be envisioning the next thing that I would be building. And that’s always been the case is that, “Okay. I know it’s time to sell because I’m thinking about something else.”

Michael Blake: [00:31:22] Did you ever find that being involved in a sale was kind of an emotional roller coaster?

Ed Rieker: [00:31:28] It’s absolutely an emotional roller coaster all the time. And remember, this idea of kind of looking at every six months, someone calls you, and they say, “Hey, maybe we should do a deal.” Well, I would do those to see kind of what the value is, to see how prepared I was, to see if our story was right, and to see if it was a real deal. And sometimes, there are corporations that want to really go to school on you. So, they’ll say, “Hey, we’re interested in buying you.” And you go, “Oh, that’s exciting. Come on in. I’ll tell you everything.”

Michael Blake: [00:32:01] Right.

Ed Rieker: [00:32:03] And then, they go, “Oh, we’ve decided to build it ourselves. Thanks.”

Michael Blake: [00:32:05] You’re totally catfished.

Ed Rieker: [00:32:07] Yeah-

Michael Blake: [00:32:07] Basically.

Ed Rieker: [00:32:07] Absolutely. So, you have to know at what point when you go, “Oh, these guys are going to school,” and then you just kind of shut it down. So, I’ve had those experiences where I’m like, “Oh, okay. Yeah. No, I’m not going to show you that. Thanks.”

Michael Blake: [00:32:26] And how about within? I mean, in my experiences, most deals are called off, at least, once before they ultimately happen.

Ed Rieker: [00:32:36] Yeah, absolutely.

Michael Blake: [00:32:36] Right?

Ed Rieker: [00:32:37] Yeah.

Michael Blake: [00:32:37] And how do you kind of stick with that and keep a level head as opposed to just setting up a YouTube video of yourself taking a baseball bat to a roomful of computers and file cabinets or maybe you do that, and that’s how you sort of keep your head on straight?

Ed Rieker: [00:32:51] Right. That’s-

Michael Blake: [00:32:52] How do you manage that?

Ed Rieker: [00:32:53] That’s why glassware is always in danger when you’re around me. So, please don’t bring me glassware. I think the idea is to isolate it from the team and compartmentalize it in your brand because what can happen, I’ve seen this with teams, where the CEO gets excited about a sale, and they move off the mark of what they’re trying to do with growing the business. And these things can take six months, a year. It can take that long to find out it’s a folly. So, if you’re get pulled off growing the business, what happens is your business dips. So, your next sell gets delayed because you’ve got to build that back up. So, the idea is isolate it from the team until you actually have a term sheet that looks real, and looks doable, and maybe even the first draft of the purchase agreement. And then, make sure that while you’re doing that, you’re continually serving the business.

Michael Blake: [00:33:54] And that’s another great reason to sort of have your due—basically build your due diligence package as you go along-

Ed Rieker: [00:34:00] Absolutely.

Michael Blake: [00:34:00] … because, then, you don’t have to bring your team in.

Ed Rieker: [00:34:02] Yeah.

Michael Blake: [00:34:04] And there’s no sort of smoking gun.

Ed Rieker: [00:34:05] Right.

Michael Blake: [00:34:06] If you’ve hired people that are smart, you start to ask for documents, all of a sudden, they’ll realize that’s why.

Ed Rieker: [00:34:11] Yeah.

Michael Blake: [00:34:12] Right? But if all of a sudden, you just have this box, you just say, “Here,” then that gives you the option-

Ed Rieker: [00:34:17] Right.

Michael Blake: [00:34:17] … to be able to let more-

Ed Rieker: [00:34:17] If you’re walking around saying, “Can you sign this employment agreement really quickly?” yeah, it’s a little late.

Michael Blake: [00:34:24] Yeah. My lawyer will be back to you with some thoughts on what I’d like in order to sign that agreement.

Ed Rieker: [00:34:32] Yes.

Michael Blake: [00:34:32] And some of the other side to that too is deals die a thousand deaths, but, also, deals are never done until they’re done. And I think I’ve seen, as you’ve probably seen it too, is plenty of businesses die while they’re up for sale-

Ed Rieker: [00:34:52] Yeah.

Michael Blake: [00:34:53] … because the process of selling a business really becomes a full-time job.

Ed Rieker: [00:34:56] Right.

Michael Blake: [00:34:57] And it can very easily distract you from actually running your business to the point where maybe a deal just doesn’t happen because it doesn’t happen, or I’ve seen—I’ve even seen it where the business has deteriorated so much during the due diligence process that it’s just no longer the valuable asset that prompted the initial proposal to buy in the first place.

Ed Rieker: [00:35:17] Yeah, absolutely.

Michael Blake: [00:35:18] Right?

Ed Rieker: [00:35:19] That’s correct, yeah.

Michael Blake: [00:35:20] And that’s why it’s important, I guess, to have those advisors and have that due diligence ready to go because you’ve got to just accept that it’s two full-time jobs.

Ed Rieker: [00:35:29] Yeah. It’s the exact same thing as raising capital, only you’re selling the business. It’s the same kind of process. And so, when you’re raising institutional money, you’re also doing the same kind of things, and it’s the same kind of roller coaster, but it’s the end game.

Michael Blake: [00:35:49] And I’ll share with you a secret that I tell my buy side clients.

Ed Rieker: [00:35:53] Oh, a secret?

Michael Blake: [00:35:53] Yeah, a secret is that many sellers, if they’ve never sold a business before, they start to get what I call Costa Rica syndrome-

Ed Rieker: [00:36:05] Yeah.

Michael Blake: [00:36:06] … which means that mentally, the second they think that those dollars are coming in-

Ed Rieker: [00:36:11] Yeah.

Michael Blake: [00:36:12] … they’re already halfway to their condo in Costa Rica.

Ed Rieker: [00:36:16] Yeah, absolutely.

Michael Blake: [00:36:17] Right?

Ed Rieker: [00:36:17] Yeah.

Michael Blake: [00:36:18] And once they’re there, the buyer acquires extraordinary leverage.

Ed Rieker: [00:36:24] Absolutely.

Michael Blake: [00:36:25] Right?

Ed Rieker: [00:36:25] Yeah.

Michael Blake: [00:36:25] And even for [indiscernible], let’s say that initially talked about a $10 million purchase price, well, in our due diligence, really, I only want to pay seven.

Ed Rieker: [00:36:34] Yeah.

Michael Blake: [00:36:35] Right? And if the seller has exposed themselves where the business is going to be hard to recover but, also, mentally-

Ed Rieker: [00:36:43] Yeah.

Michael Blake: [00:36:43] … they have to now say—they have to get back from their tropical paradise.

Ed Rieker: [00:36:48] Yeah.

Michael Blake: [00:36:49] Right? And cocktail drinks and so forth. They come back. They don’t want to do that. Now, they’re just looking at that $3 million difference as a number. But, well, I still got $7 million left. Just let me do this, so I can go to my Costa Rica.

Ed Rieker: [00:37:04] Right.

Michael Blake: [00:37:04] Right?

Ed Rieker: [00:37:04] Yeah.

Michael Blake: [00:37:04] And I think it confers a tremendous amount of leverage-

Ed Rieker: [00:37:09] Yeah.

Michael Blake: [00:37:09] … for the buyer.

Ed Rieker: [00:37:11] Yeah. I’ve had stuff happen at closing or right before closing where a buyer will come back and say, “Well, maybe we should do this,” and you have to be prepared to say no.

Michael Blake: [00:37:23] Yeah.

Ed Rieker: [00:37:24] You have to be able to say, “You know what? That’s okay. We’ll pass.”

Michael Blake: [00:37:29] Yeah, that’s right.

Ed Rieker: [00:37:30] So-

Michael Blake: [00:37:30] If you can’t walk away from a deal of any kind, you’re not negotiating. You’re just asking.

Ed Rieker: [00:37:36] Yeah. And that’s the part about the business. If your business is solid enough that you can say no, that’s a great business to have because that means there’s gonna be another buyer. And also, you always want to have a horse race, even if it’s a pretend horse. So, that-

Michael Blake: [00:37:55] The stalking horse.

Ed Rieker: [00:37:56] Yes. So, that when you’re winding up with a single buyer, there’s always this other entity that perhaps might pay more, or do quicker, or be kinder to your employees, that sort of thing. So, a one-buyer deal is really no fun.

Michael Blake: [00:38:12] Well, and even by setting yourself up the way that you’ve described, the other horse is you, as yourself, right?

Ed Rieker: [00:38:19] Right, yeah, you can stick around.

Michael Blake: [00:38:19] I can always not sell.

Ed Rieker: [00:38:21] Yeah.

Michael Blake: [00:38:22] And because I’m the idea person and not the operational person, my lifestyle is still okay.

Ed Rieker: [00:38:30] Yeah.

Michael Blake: [00:38:30] Right? And we’ll just sort of reset and wait for the next person. And that makes you pretty much impervious to the Costa Rica syndrome.

Ed Rieker: [00:38:40] Yeah.

Michael Blake: [00:38:40] And nothing against Costa Rica. I could have just as easily said Tahiti, but a friend of mine-

Ed Rieker: [00:38:44] Yeah, or Macon, Georgia.

Michael Blake: [00:38:46] Or Macon, Georgia, yeah.

Ed Rieker: [00:38:46] Absolutely.

Michael Blake: [00:38:46] But a friend—one of my clients sold a business, went down to Costa Rica, and they love it, so.

Ed Rieker: [00:38:51] Yeah.

Michael Blake: [00:38:53] Well, this has been great. We’re sort of running out of time here, but there’s a lot of ground that could be covered. If somebody is kind of thinking about maybe selling their own business, could they contact you for a little bit of advice?

Ed Rieker: [00:39:04] Sure, absolutely. Yeah.

Michael Blake: [00:39:05] How will be the best way for them to do that?

Ed Rieker: [00:39:07] Send me an email, ed@softlinc.com. S-O-F-T-L-I-N-C dot com.

Michael Blake: [00:39:14] Okay.

Ed Rieker: [00:39:15] Or call Mike. Yeah.

Michael Blake: [00:39:17] There you go. But Ed might be free. I know that I’m not.

Ed Rieker: [00:39:21] Yeah.

Michael Blake: [00:39:22] So, that’s gonna wrap it up for today’s program. I’d like to thank Ed Rieker so much for joining us and sharing his expertise with us. We’ll be exploring a new topic each week. So, please tune in, so that when you’re faced with your next business decision, you have clear vision when making it. If you enjoy this podcast, please consider leaving a review with your favorite podcast aggregator. It helps people find us, so that we can help them. Once again, this is Mike Blake. Our sponsor is Brady Ware & Company. And this has been the Decision Vision Podcast.

To Your Health With Dr. Jim Morrow: Episode 17, Testosterone

September 25, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 17, Testosterone

00:00 /

To Your Health With Dr. Jim Morrow: Episode 17, Testosterone

How do men and women know if they have low testosterone levels? What are the symptoms of low testosterone levels due to aging, as well as other causes? Dr. Jim Morrow answers these questions and more on this edition of “To Your Health.” “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

Dr. Morrow’s Show Notes on Testosterone

Physiology of Testosterone and Causes of Hypogonadism in Males

Testosterone is produced by the testes.
Decreased production of testosterone by testes in men is categorized as hypogonadism.
Primary hypogonadism is the failure of the testes to produce sufficient testosterone.

Testosterone Therapy

Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians.
There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone.
- Physicians should not measure testosterone levels unless a patient has signs and symptoms of hypogonadism, such as loss of body hair, sexual dysfunction, hot flashes, or gynecomastia.
- The U.S. Food and Drug Administration clarified in 2015 that prescribing testosterone for low testosterone levels due to aging constitutes off-label use.
- Depressed mood, fatigue, decreased strength, and a decreased sense of vitality are less specific to male hypogonadism.
- Testosterone therapy should be initiated only after two morning total serum testosterone measurements show decreased levels, and all patients should be counseled on the potential risks and benefits before starting therapy.
- Male hypogonadism should be diagnosed only if there are signs or symptoms of hypogonadism and total serum testosterone levels are low on at least two occasions.
- Potential benefits of therapy include
  - increased libido,
  - improved sexual function,
  - improved mood and well-being, and
  - increased muscle mass and bone density;
  - however, there is little or mixed evidence confirming clinically significant benefits.
- The U.S. Food and Drug Administration warns that testosterone therapy may increase the risk of cardiovascular complications.
  - Other possible risks include
    - rising prostate-specific antigen levels,
    - worsening lower urinary tract symptoms,
    - polycythemia, and
    - increased risk of venous thromboembolism.
    - Patients receiving testosterone therapy should be monitored to ensure testosterone levels rise appropriately, clinical improvement occurs, and no complications develop.
    - Testosterone therapy may also be used to treat hypoactive sexual desire disorder in postmenopausal women and to produce physical male sex characteristics in female-to-male transgender patients.

Monitoring of Men on Testosterone Therapy

Men receiving testosterone therapy should be monitored regularly for adverse effects and to ensure normalization of serum testosterone level.
Before initiation of testosterone therapy, testing should include:
- a complete blood count to measure hematocrit, and
- a PSA test to detect preexisting prostate cancer.
Patients should be reevaluated for therapeutic response and adverse effects three to six months after initiation of treatment, including:
- a repeat testosterone measurement,
- complete blood count,
- and PSA test.
Reevaluation needs to be performed regularly.
An increase in hematocrit to greater than 54% should lead to
- cessation of treatment,
- lowering of the dose, or
- change to a lower-risk formulation.
An increase in PSA of greater than 1.4 ng per mL (1.4 mcg per L) over 12 months or an abnormal digital rectal examination result should prompt referral to a urologist.

Testosterone Therapy in Women

In women, testosterone is produced by the ovaries and adrenal glands, and by conversion of proandrogens in peripheral tissues.
Levels decrease gradually starting in the 20s or 30s.
There is no abrupt decrease during menopause, with the exception of surgical menopause.
Testosterone is also converted to estrogen by aromatases in many tissues; therefore, testosterone is an important source of estrogen in postmenopausal women.
Testosterone deficiency in women may be associated with problems with sexual function, mood, cognition, and body composition.
A comprehensive meta-analysis of post-menopausal women found improvement in sexual function with testosterone therapy.
There was no evidence of improvement in
- anxiety,
- mood,
- body weight or mass, or
- bone density.
- Subsequently, a consensus statement released by several major organizations, including the Endocrine Society and American College of Obstetricians and Gynecologists, supported the use of testosterone therapy for hypoactive sexual desire disorder in postmenopausal women but not for any other indication.
- Of note, there are no FDA-approved products for testosterone therapy in women, and no formulations are readily available in the United States that provide the recommended treatment dosage for women (300 mcg per day), necessitating the use of compounding pharmacies.

To Your Health With Dr. Jim Morrow, Episode 18: 12 Flu Shot Myths

About Morrow Family Medicine and Dr. Jim Morrow

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Morrow’s Show Notes on Flu Shots

What is the Flu?

Who should get vaccinated this season?

Making the Flu Vaccine: A Year-Round Effort

Myths About the Flu Shot

Family Business Radio, Episode 3: Cathy Hogan-Smith, Cachet Corporate Gifts, and Brian Riggs, Foot Solutions Sandy Springs

Cathy Hogan-Smith, Cachet Corporate Gift Services

Brian Riggs, Foot Solutions

Anthony Chen, Host of “Family Business Radio”

North Fulton Business Radio, Episode 169: Charles Gridley, Six Bridges Brewing, and Kathryn Woods, Confident Communications

Charles Gridley, Six Bridges Brewing

Kathryn Woods, Confident Communications

“North Fulton Business Radio,” Episode 168: Melanie and Sebastian Flores, OctoGifts

Melanie and Sebastian Flores, OctoGifts

“Alpharetta Tech Talk,” Episode 1: Chris Smith, PRAXIS Technology Escrow, and Michael Anaya, DEVCON Detect, Inc.

Chris Smith, PRAXIS Technology Escrow

Michael Anaya, DEVCON Detect, Inc.

About “Alpharetta Tech Talk”

Decision Vision Episode 34: How Do I Get an SBA Loan? – An Interview with Joy Manbeck, Vinings Bank

Joy Manbeck, Vinings Bank

Michael Blake, Brady Ware & Company

Brady Ware & Company

Decision Vision Podcast Series

Visit Brady Ware & Company on social media:

Show Transcript

“North Fulton Business Radio,” Episode 167: Jim Weber, ITB Partners

Jim Weber, ITB Partners

Decision Vision Episode 33: Should I Sell My Business? – An Interview with Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

Ed Rieker, Serial Entrepreneur and CEO, Avondale Innovation District

Michael Blake, Brady Ware & Company

Brady Ware & Company

Decision Vision Podcast Series

Visit Brady Ware & Company on social media:

Show Transcript

To Your Health With Dr. Jim Morrow: Episode 17, Testosterone

About Morrow Family Medicine and Dr. Jim Morrow

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Morrow’s Show Notes on Testosterone

Physiology of Testosterone and Causes of Hypogonadism in Males

Testosterone Therapy

Monitoring of Men on Testosterone Therapy

Testosterone Therapy in Women

Our Mission

Sponsor a Show

Partner With Us

Connect with us