Start here · First meeting with the search committee and leadership
Meeting game plan
Go in with one idea and one hook: 2 sentences, 3 engines, 1 enabler. Know five numbers cold. Make three asks. Listen more than you talk, and hedge anything the plan marks as unverified.
Source chips like Plan 7 open that business plan section. Slide 24 opens that deck slide (numbers match the 32-slide deck, version 3, Oct 14). Older versions are on the versions and change log page.
The memory hook: 2-3-1
If you remember one thing, remember the countdown. It uses the deck's own closing line and its own framework, so your words match what the committee sees on screen.
Complexity is our moat.
Continuity is our growth.
Door, Care, Data.
Grow the front door · Connected care · Discovery & data
AI makes it pay.
AI and lower cost to serve
"Door, Care, Data, and AI makes it pay." Behind the hook sit five numbers and three asks. Slide 10Slide 30
The pitch and the close
One-sentence pitch (open with it)
"Move this department from episodes of care to continuous relationships across a woman's lifespan: grow where competitors are thin, and make the AI UTHealth already paid for earn its keep."
Two-sentence close (end with it)
Complexity is our moat.
Continuity is our growth.
- Complexity: Level IV, The Fetal Center and the MFMU network. Only one other Houston program matches them, and Methodist cannot copy them quickly.
- Continuity: the postpartum year, midlife care and membership turn single visits into relationships that pay for themselves.
3 engines + 1 enabler
One line each, plus the single number to remember.
| Engine | In one line | Number to remember |
|---|---|---|
| 1. Grow the front door Plan 5Slides 12-14 |
A west Fort Bend satellite, the "UTHealth Signature" hybrid membership, and a Midlife & Pelvic Health Center. | +237%: Fulshear's growth in 5 years, at a $178K median income. That is why west Fort Bend goes first. |
| 2. Connected care Plan 2Slide 15 |
Own the postpartum year (remote BP plus cardio-obstetrics), perinatal mental health care, and a tele-MFM hub. Recurring monthly revenue. | 1 in 4: Texas pregnancy-related deaths that happen 43 days to 1 year after birth. Texas Medicaid now covers all 12 months. |
| 3. Discovery & data Plan 2Slide 18 |
Turn the research network into a Houston Perinatal Data Commons and prediction studies that bring grants and industry contracts. | The only one: McGovern is the only Texas institution in both the NICHD MFMU and Neonatal Research Networks. |
| Enabler: AI & cost to serve Plan 5Slide 21 |
Make AI already in place (Abridge, McWilliams School) pay, and lower cost per case (ERAS, OR supplies, visit redesign, safety). | Zero: there are no OB-specific AI billing codes. AI earns through capacity and coding accuracy, not new fees. |
Five numbers to know cold
Each one is checked against the plan text. All dollar figures are Estimate pro forma results, not actuals.
System includes Memorial Hermann's margin on deliveries and surgeries: -$1.49M / +$0.98M / +$3.59M in Years 1-3. Department-only (clinic) is -$2.54M / -$1.09M / +$0.22M. The 7,900 deliveries figure is undated; say "about". Plan 7
The three asks
What Dr. Sami needs from leadership. The plan says the department's share of the value "depends on three agreements": funds-flow, gainsharing or co-management, and MCO value-based contracts. Asks 1 and 2 cover those. Ask 3 gets the data to size them.
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Decision A funds-flow agreement with Memorial Hermann that credits downstream hospital margin, signed before any satellite lease.
Why: $3.37M of the $3.59M Year 3 total is downstream margin. Without it, the satellite clinic still loses -$0.56M in Year 3. Plan 8Plan 10Slide 12
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Decision Gainsharing or co-management with Memorial Hermann, plus value-based contracts with Medicaid MCOs, so the department shares the savings it creates.
Why: hospitals capture about $1.4-2.8M and payers about $0.3-0.9M of the savings. Without agreements, "the department does the work and partners keep the savings." Plan 6Slide 23
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Decision Access to actuals in the first 100 days: UT Physicians collections per wRVU, Memorial Hermann revenue per delivery and per case, current deliveries, cost per case and NTSV rates.
Why: every pro forma input is an assumption, to be replaced before any capital decision. Plan 11Plan 9Slide 27
If there is time: approval to start recruiting in month 1 (urogynecology, cardio-OB, menopause-certified clinicians, pelvic floor PTs). These searches take the longest. Slide 29
Meeting flow
Opening: the first 2 minutes
- Thank the committee.
- Frame it: "This is not a list of what the department already does well. It is where I would take it next, and how each move pays for itself." Slide 1
- Give the one-sentence pitch.
- Name the foundation with respect: The Fetal Center, the MFMU site, Level IV at Memorial Hermann-TMC. Slide 4
- Invite correction: "I built this from public sources. Where I have something wrong, please correct me."
- Signpost: why now, the market, competition, three engines and one enabler, the economics, the first 100 days.
The middle
- Walk the 2-3-1. For each engine: what it is, its one number, what it needs.
- Slow down on the economics slide. Say "system" and "department" every time. Slide 24
- Name the risks before they do. Slide 25
The close: last 2 minutes
- The two sentences: "Complexity is our moat. Continuity is our growth."
- The three asks, in one breath each.
- "The first 100 days are for listening and baselines. I would not change anything I have not measured." Slide 27
- Open for questions.
Time budget (60-minute slot)
| Part | Slides | Minutes | Running |
|---|---|---|---|
| Opening: title, thesis, why now, strengths | 1-4 | 5.5 | 5.5 |
| Market and competition | 5-9 | 10 | 15.5 |
| Framework and portfolio | 10-11 | 3 | 18.5 |
| Engine 1: Front door | 12-14 | 7 | 25.5 |
| Engine 2: Connected care | 15-17 | 5 | 30.5 |
| Engine 3: Discovery & data | 18-20 | 4 | 34.5 |
| Enabler: AI and cost to serve | 21-23 | 5.5 | 40 |
| Economics: profit, risks, funding | 24-26 | 4.5 | 44.5 |
| Execution: roadmap, scorecard, people | 27-29 | 3.5 | 48 |
| Close | 30 | 1 | 49 |
| Questions and discussion | Appendix 31-32 if asked | 11 | 60 |
Minutes are the deck's own per-slide plan (the data-min values), which add up to 49. The deck timer runs to 60:00. The title-slide notes say "about 45 minutes", so aim for 45 and give the rest to questions. Press T in the deck to start the timer; it shows whether you are ahead or behind.
1 minute: frame and pitch. 3 minutes: the 2-3-1. 2 minutes: the five numbers. 2 minutes: the three asks. The rest: listen-first questions.
Suggested cuts if running long: TAM/SAM/SOM (6), revenue stack (16), prevention (20), scorecard (28). Keep: built on strength (4), profitability (24), close (30).
Listen first: questions to ask them
The plan's first 100 days open with a listening tour, and its "assumptions to replace" list says what to learn. Asking these shows the homework and lets them correct the plan. Pick three for who is in the room. Plan 9Plan 11
Department leadership and the committee
- AskHow does the referral pathway for women over 60 with incontinence work today: volumes, completion, outcomes?
- AskIs the department using the Abridge scribe today? What AI projects are already under way?
- AskIs there a cardio-obstetrics or menopause clinic under another name?
- AskWhat would make the first three years a success in your eyes?
Memorial Hermann and finance
- AskHow are funds-flow terms with Memorial Hermann set up today? Is there appetite for a joint venture or co-management?
- AskWhat are UT Physicians OB/GYN collections per wRVU, and the payer mix by site?
- AskWhat is Memorial Hermann's net revenue per delivery and per gyn case?
Clinical operations
- AskWhat are current deliveries at MH-TMC and LBJ, and current Fetal Center volume?
- AskDo MH-TMC and LBJ already run ERAS for cesarean and gyn surgery? What are current NTSV cesarean rates?
- AskHow is the OB/GYN liability premium set under the UT System plan today?
Faculty and residents
- AskWhat slows faculty down most today?
- AskWhat would you protect at all costs as the department changes?
General questions, not from the plan's list. They support the plan's "people and culture" point. Slide 29
Likely tough questions, with short answers
Each answer comes from the plan's own risk and mitigation text. Agree with the fair part first, then answer.
"Your satellite clinic loses money."
Yes, on its own. The clinic is -$0.56M in Year 3 at $95 per wRVU; it breaks even near $106. It is a system investment: with Memorial Hermann's downstream margin it turns positive in Year 2 and reaches about +$2.0M in Year 3 (about +$1.0M on a conservative benchmark). So no lease before the funds-flow agreement, and the second site is stage-gated.
"Houston Methodist will outspend you."
They are excellent: #7 in U.S. News OB/GYN, about 14,000 births, a new $10M OB/GYN fund. But their top maternal level is Level III, and public sources show no academic MFM division (their MFM comes through affiliated groups) and no menopause program. We compete on complexity, the postpartum year, midlife and data. We do not fight on suburban low-risk births or next year's ranking. We move first on MFM outreach and offer partnership on transfers.
"The payer mix will sink this."
Texas has the highest uninsured rate in the country (16.7%), and Medicaid pays for about half of births. That is why the plan cross-subsidizes: commercial and Medicare growth in the suburbs and midlife, Medicaid-paid services in the postpartum year, mission care at TMC and LBJ. We pick commercial-heavy corridors, use UT Physicians actuals, and hold a go/no-go at the Year 1 review.
"AI-drafted notes are an upcoding risk."
Agreed. The goal is accurate coding, not more coding. AI-drafted notes get compliance audit sampling, and we track E/M distribution against benchmark. No prediction model goes live without a silent trial first, under SAFE center governance. There are no OB-specific AI codes, so AI pays through capacity and accuracy.
"A paid membership at a public academic center looks inequitable."
It is a hybrid. Insurance is still billed for covered care; the fee covers only non-covered services like access, navigation and longer counseling. Compliance reviews it for Medicare and Medicaid members, and the university approves the fees. A fixed share of membership margin funds the postpartum year program at LBJ. It starts inside an existing site with $0.5M of capital.
"Why menopause? Baylor already has a Menopause Center."
Demand is coming back: in November 2025 the FDA moved to remove the boxed warnings for heart disease, breast cancer and dementia on hormone therapy. About 38% of women over 60 have incontinence, and only about a quarter seek care. We do not copy Baylor. We differentiate on reach across the Memorial Hermann network and on integration: continence, menopause, bone and heart risk in one place.
"What if Memorial Hermann says no to funds-flow?"
Then the satellite waits. Build-outs start only after partner agreements are signed, and the department's own capital at risk is limited to Horizon 1 programs. Remote BP, collaborative care, coding integrity and cost work can start in existing space.
"What about fertility, or how does this fit with McWilliams?"
Fertility: partner first; there is a 13-site incumbent. Own oncofertility counseling and referral (Texas HB 1649 makes it insured demand), and decide on REI (build, buy or partner) in years 3-5. McWilliams: not new AI research. Wire the tools UTHealth already paid for to outcomes, and give the AI centers prospective validation in diverse patients.
What not to say
Hedge these: the plan marks them unverified or estimated
Use one of three phrases: "As I understand it...", "From public sources, we found no...", or "My estimate, to replace with your actuals."
- UnverifiedThe 60+ incontinence referral pathway. Known only from the briefing; nothing public. Say "as I understand it" and ask how it works. Plan 2
- UnverifiedWhether OB/GYN uses Abridge today. The UT System agreement is real; department use is not confirmed. Plan 2
- UnverifiedVolumes. About 7,900 deliveries is undated. Fetal Center volume is 200-250 on one page and 150-200 on another. The cost section's ~8,000 deliveries and 60-80 faculty are not confirmed. Plan 2Plan 6
- UnverifiedTexas Medicaid rates for connected care. Texas Medicaid pays home BP monitoring as S9110 + 99091 with prior auth (not the Medicare RPM codes) and has covered collaborative care since 2022, but the rates, and whether pregnancy hypertension qualifies, are not confirmed. Dollar amounts in the deck are 2026 Medicare national. Plan 5Slide 16
- UnverifiedWhether ERAS already runs at MH-TMC and LBJ. If it does, those savings are partly banked. Plan 6
- Public sources onlyCompetitor gaps ("no academic MFM division", "no menopause program") are absence findings. Say "we found no public..." Plan 4
- EstimateEvery pro forma input: $95 per wRVU, $12K hospital revenue per delivery, 30% hospital margin, member ramp. Plan 11
Avoid these
- AvoidCriticizing what exists. The deck's line is "I will not pitch what this department already does well." Slide 4
- AvoidAdding cost savings to the profit totals, or calling them department money. They are reported separately.
- AvoidCounting connected-care revenue in the base case. It is upside until Texas Medicaid rates are confirmed.
- AvoidSaying "concierge" without "hybrid" and "mission pairing" in the same breath.
- AvoidPitching "AI research." Pitch AI tied to revenue and capacity.
- AvoidPromising a U.S. News jump or a fight for suburban low-risk births. Both are on the "do not fight" list. Slide 9
- AvoidTalking about approaching Methodist-affiliated hospitals before Memorial Hermann is aligned. The deck notes flag this as political. Slide 17
- AvoidMixing "system" and "department" numbers in one sentence.
Before you walk in
- Replace "[Candidate Name], MD" on the deck title slide and the business plan cover. As of Oct 14, both still show the placeholder.
- Read Dr. Sami's feedback on the deck and check the deck reflects it.
- Rehearse once with the deck timer (T). Aim for 45 minutes of slides.
- Test presenter view (P) and fullscreen (F) on the meeting laptop and projector.
- Say the hook out loud: "2 sentences, 3 engines, 1 enabler. Door, Care, Data, and AI makes it pay."
- Pick three listen-first questions for who will be in the room.
- Print the one-card below, and plan sections 1 and 7 (executive summary and financial plan).
One-card summary
Fits on one printed page. Printing the whole page puts this card on its own page at the end.
Women's Health, Continuously: meeting one-card
"Move this department from episodes of care to continuous relationships across a woman's lifespan: grow where competitors are thin, and make the AI UTHealth already paid for earn its keep."
The hook: 2-3-1
- 2 sentences: Complexity is our moat. Continuity is our growth.
- 3 engines: Front door · Connected care · Discovery & data
- 1 enabler: AI and lower cost to serve
- "Door, Care, Data, and AI makes it pay."
Five numbers (estimates)
- ~$3.1M capital: 1.6 + 0.5 + 1.0
- Year 2 system-positive (+$0.98M) only with MH funds-flow
- +$3.59M Y3 system; conservative ~+$2.5M; dept-only +$0.22M
- $2.4-7.2M/yr savings, all parties; most to hospitals
- Level IV + ~7,900 deliveries (Methodist: Level III)
Three asks
- Funds-flow with Memorial Hermann, before any lease
- Gainsharing or co-management; MCO value-based contracts
- Actuals in the first 100 days
Flow (60 min: 49 slides + 11 Q&A)
- Open, 2 min: thank, frame, pitch, respect, invite correction
- Middle: 2-3-1, then economics, then risks
- Close, 2 min: two sentences, three asks, "listen and baseline first"
Tough questions, one line each
- Satellite loses money: system investment; no lease before funds-flow
- Methodist: their ceiling is Level III; compete on complexity, postpartum, midlife, data
- Payer mix: cross-subsidy; commercial-heavy corridors; Y1 go/no-go
- AI upcoding: audit sampling; silent trials; SAFE governance
- Membership equity: hybrid, still bills insurance; margin funds postpartum year at LBJ
Listen first (pick 3)
- How does the 60+ pathway work today?
- Is Abridge in use in OB/GYN?
- How are MH funds-flow terms set up?
- Collections per wRVU and payer mix by site?
- ERAS in place? Current NTSV rates?
Hedge words
- "As I understand it..." (60+ pathway, Abridge use) · "From public sources, we found no..." (competitor gaps) · "My estimate, to replace with your actuals" (pro forma inputs, Medicaid rates, volumes)