Healing from the Inside to the Outside - Interview with Justin Poulin

Justin Poulin is the founder, CEO, and host of four leading healthcare podcasts: Transmission Control, Power Supply, First Case, and Beyond Clean.

As a Hospital Healer, Justin works to highlight problems and promote solutions in key areas within the hospital, interviewing experts and providing thoughtful content that serves to build a strong community.

Learn about what Justin believes are the qualities all Hospital Healers should have, the key issues facing hospitals today, and his ideas on how to begin to solve some of these problems.

Before the interview, host Rich Palarea provides insight into the struggles of American hospitals.

Intro: 00:00

Rich Palarea: Welcome to Healing the Hospital Podcast. My name is Rich Palarea. On today's show, we have a seasoned voice and thought leader in the healthcare industry. Mr. Justin Poulin. I'm excited to get to our interview where we talk about healthcare workers having to do various things that don't take advantage of their talent and training. The potential death of the Just In Time supply chain and committing healthcare IT companies to mandatory open APIs for data exchange in their engagements among other things.

I read a discouraging article earlier this week from Healthcare Finance News, in which it stated that half of our hospitals will show negative margins in 2022. Did you get that? I said half the American Hospital Association and other hospital groups have requested that the Department of Health and Human Services distribute at least $24 billion.

That remained in the 178 billion COVID 19 Relief Fund meant for providers. The article cited the AHA as stating that hospitals have not seen a dime of federal funds to address the delta and Omicron variants, and that the American Rescue Plan largely funded hospitals only during the height of the pandemic.

The latest Kaufman Hall analysis backs. Their projections for the remainder of 2022 based on responses from 900 hospitals, shows that America's hospitals remain under severe financial pressure from labor costs, supply chain issues, and inflation. The range presented for change in operating margins was an optimistic 37% change to a pessimistic and whopping 133% change.

Lisa Goldstein, Senior Vice President for Kaufman Hall stated "Either way, hospitals will lose billions, and that one out of every two hospitals will show negative operating margins in 2022".

Okay. On to some brighter news, last week I attended the Health Enterprise Partners annual meeting in New York. The leadership at HEP always does a great job of pulling together a very informative and engaging meeting. This year was no exception. Dr. Kaveh Safavi, a senior director of Global Healthcare with Accenture, gave a fascinating talk on the future of work and healthcare, in which he touched on three big trends.

He said first, the nature of work is changing where demographics and economics are moving us to a human plus machine environment. Second, the meaning of work is changing. Dr. Safavi used the phrase "net better off", and that organizations who focus on intentionally creating this type of environment unlock human potential in any workforce model. And third, the place of work is changing from going to work, to working from everywhere.

I'm glad to report that healthcare is still chock full of innovators, solving big and worthwhile problems, and also investors with a good track record of creating value, looking for great companies to back. And now onto our discussion.

My guest today is Justin Poulin. He's the Vice President of Sales at Green Security and he is the CEO of Beyond Clean. He has over 20 years in the medical surgical industry, both as a registered nurse and a regional vice president of sales and operations. He's an active supporter and participant in AHRMM, which is the Association for Healthcare Resource and Materials Management and HSPA, which is the Healthcare Sterile Processing Association. Thank goodness they changed the title from IAHSMN and whatever it was before. And AORN, which is the Association of Perioperative Registered Nurses, having presented educational programs at various annual conferences. Near and dear to my heart, Justin is the host of several healthcare podcasts, including Beyond Clean Podcast, and I love the tagline "We fight dirty" which focuses on important topics, trends, innovations in sterile processing. His other podcast projects include First Case, which focuses on the operating room. Power Supply, which he co-host's with our friends, Garry Skinner and Hays Waldrop, focusing on purchasing and supply chain and Transmission Control, focusing on infection control.

Justin, you've accomplished a lot in a short time. Welcome to Healing the Hospital Podcast.

Justin Poulin: Rich, thanks for having me. And it is kind of, a funny switch of roles here because you've been a guest on the Power Supply podcast, which is how we know each other. A great interview that we had, talking about entrepreneurship and selling into the healthcare space.

Very successful episode for us on Power Supply. Really enjoyed that. And so now it's your turn to point the camera at me. Have me be in the interview, which is not a place I've spent a lot of time in over the last few years. I do a few interviews here and there, but usually I'm the one asking the questions.

Rich: Well, hopefully it works out to be fun for you Justin, I'm thrilled to have you here. We've spent a little bit of time over lunch as well, and I really enjoyed the time we spent talking about big problems, and that's really what we're focused on this show. Our mission for the past 10 years has been to eliminate the overcharges and inefficiencies in US hospitals and health systems, as people that are doing that, whether they're clinical caregivers or hospital executives.

Administrative staff or even passionate business leaders like you. We call them Hospital Healers here. So, my first question to you today is when you think about all the people you've worked with or interviewed on all the different shows and places you've been, is there somebody that fits that title of a Hospital Healer?

Can you paint a picture for the audience as to why?

Justin: Yeah. It would be really hard for me to single out any one person. I've had the pleasure of meeting just so many interesting people. We just did an interview for Power Supply that's going to be coming out probably before this podcast does, just in a couple of days with Joe Walsh.

That was an amazing interview around mentorship and really developing leaders in healthcare. And I think it's a theme that I could name several other guests, that have come out, whether it's Beyond Clean, First Case, Transmission Control. I could tell you my experience as a nurse, we didn't really get leadership training and in a lot of cases nurses are promoted because they have the skill set to be a really great nurse.

But as to be an effective manager or director or CNO and to be able to do that leadership and mentorship piece is kind of a different skill set and we don't always get trained on that. And I think that essentially when I think of a Hospital Healer, I'm looking at those kinds of gaps where there's just an obvious opportunity where we can help each other and heal within, right?

That's how a wound closes. It heals from the inside to the outside and then ultimately the presentation to the world is, that the wound is healed. And I kind of look at that in a metaphoric way for the hospital is when we look at some of the internal processes that are causing people to either not be satisfied in their jobs or to do work that, really could be through technology and they could be spending more time doing things that make them feel productive and fulfilled. I think this is really where the opportunity is. I know you and I have talked about that even in the context of your solution, but other ideas and movement. I would say in the industry it's hard to do that with clinician roles, but if you think about how clinicians enter billing or pick supplies, if you think about some of those activities or manage power levels, sometimes in certain cases when you think about that, those are not skills that are taking advantage of their clinical experience.

And that conversation can be extended to sterile processing and infection prevention as well. And I think anybody who looks at ways to really help people feel, the healers themselves feel, that they're actually healing and having that alignment. They're the ones that are doing some really great work, especially in today's environment.

Rich: I love the metaphor you just gave us of healing from the inside out. I think, you also talked about fulfillment. What does that mean when you think about what the hospitals are facing today? I know last time you and I talked about this was months ago when it was just kind of breaking news story that maybe there's going to be this situation. In the great resignation as they're calling it. And it's really going to start to impact the hospitals and now fast forward to where we are this afternoon. It really has, I just got back from an investor annual meeting around healthcare IT in New York where all they talked about for two days was the staffing shortage and how detrimental it's going to be.

And I think as it pertains to what we're doing at Kermit the moment that hospitals finally open their doors and people do come back for surgery. There's no shortage of demand. They're there. We just can't staff all the beds. And so, you think about that. What's happening in the areas that you specialize in some of the shows that you're doing in those courts?

You talk about what's happening on the staffing side right now, especially around sterile processing? Can you talk a little bit about that, if you will?

Justin: Yeah, I think training is also a key component to that. I'll set the table by saying we've been having that conversation about staffing for about a year and a half, and the first interview was one we did with a gentleman from a company called MZ and they were really highlighting that, and that's when I really started talking about it.

But to your point, it's come to fruition, it's really come to a head. You can't go to a trade show in any industry without this being one of the most prominent topics about how are we going to handle this? How are we going to tackle this? And when I look at, a lot of the conversations that we've had around the staffing crisis, it also relates that just as you said to like cases.

So there are a lot of hospitals that have returned to volumes in surgery that are the pre pandemic levels. The problem is it's not enough. Have you tried to make a healthcare appointment recently? Go to see a dentist? An eye doctor? I had something on my shoulder that I had removed today at the skin doctors.

And it took me three months to get in there to see the dermatologist. And they did a biopsy today, three months for something. And I've got a family history of skin cancer. Was concerned about it.

The problem is returning, and this was that whole concept, right? People said the return to normal when we return to normal. And now everybody's saying there is no return to the normal. It's finding our new path. But even just from a very singular metric of caseload volume, returning to normal is not enough. The backlog is there, which means that the wait times for people to get healthcare is still there.

We actually have to exceed prior volumes. And so what the workforce shortage does is it makes it very difficult for us to staff at that additional level. And when you tie it back to supply chain, everybody in supply chain understands this. They understand bottlenecks, backlog, and then the overwork or the increase in volume in production that has to happen for every minute that you're sitting in a bottleneck. And the pandemic, really, we should have called it the great bottleneck.

Rich: I'm glad we didn't, because I think a lot of people would've tried to steal that and use it from us. But I heard a lot of talk. I was out at National AHRMM conference this year in California. While it was great to be back in person with folks it wasn't as widely attended as it had in years past when probably you were a stalwart there.

One thing I heard that was very consistent in almost every single talk that was given by supply chain professionals, and you've been on those stages before, was resiliency. It was really interesting that they were talking about, you just mentioned, back to normal and I think we're wondering like what is normal?

And can we actually get back to what we originally had? And people are basically saying, no, I don't think that it's ever going to go back to the way it was. We have to figure out how to do more with less and how to be the answer in supply chain for everything that is happening, whether it's our own operating room or beyond that. All the hospitals came and descended upon these supply chain professionals and asked them to take over their own phantom ghost supply chains that were going on. So, I heard this topic of resiliency. What kinds of themes do you see changing in the areas that you work in?

Primarily in periop in sterile processing in supply chain that aren't going to go back the way they were before. And what kinds of things do supply chain professionals have to really pay attention to, especially if they want to make a hallmark and this is going to be their career, say for the next 10 years?

Justin: Yeah. It's interesting. I've gotten such a wide variety of answers on that. I mean, I can't tell you how many podcasts, whether it was the primary focus of the conversation or if it was just kind of built into the theme, but the idea that just in time is dead, Right? This was a strategy that was being used. Very widely. And then all of a sudden, because you know of the disruption in supply chain, we had to toss it out the window.

And then of course, then all of a sudden, I have this interview with Wade Blum and he tells us that no, just in time isn't dead. Just in time the way we did it is dead because we had just run it to the very extremes of its capability.

And so we had very little margin for error when the pandemic hit, but that in fact we can still do just in time. We just have to make some adjustments to the variables, such as lead time and we'll have to do a little bit better job of projecting volumes and working with suppliers in that manner. And so the theme that comes back to me is, the way to solve this is better data and I'll even throw it to Vin Matoso, who's one of the experts on the expert series for Power Supply. His whole conversation is around interoperability. For a long time, we had all of these standalone solutions and a lot of the solutions would just sell into one department of the hospital.

And you really have to look as a healthcare partner now at the enterprise level. And it's hard to do that as anybody who's coming new to the market or an existing business that's serving healthcare. Because what that means is slower sales cycles, because now you're engaging all these different end users.

But honestly, we do need to be interoperable because there's just so many things that happen that are manual effort that could easily be done by passing information freely from one solution to another. And so again, it really comes back to those silos, right? And then that's really how that worked.

And I think thematically we have as an industry and as suppliers, we really have to start thinking about how do we all work together and like really do that in earnest.

Rich: Yeah, I think there's this very delicate balance that we need to strike between innovation and where a lot of that stuff comes out of our small organizations like yours and mine, where we've seen the problem and in a niche way, we can address that problem and we can spend all of our time working on the niche problem, not at the enterprise level, but at the point solution.

And come up with something very powerful. That maybe it gets to scale, maybe it doesn't. But to look to the other providers of enterprise software the big names that we deal with in healthcare every single day. I feel like there's got to be something in the middle that comes to the market.

And we, as a capitalistic society kind of rule out the mid-market. We look for startup and innovation and very quickly we take all of that and we push it up to the enterprise through acquisition activity. And sometimes it makes its way to the market, sometimes it doesn't. But what we're missing is, it feels like, to me anyway, Justin, are the companies in the middle who are at $200 million, $300, $400 million in revenue and they're not public yet, and they don't have any desire sometimes to do that, but they're specializing in these enterprise solutions without being everything to everybody so that they can stay in sterile processing or they can stay in periop or they can stay in the bill only area where we provide a service but do it at scale.

And I wonder do you see a marketplace for that? Do you think about how we actually bridge that gap?

Justin: Not the way we're structured in terms of sourcing. If you really think about it, the sourcing strategy is, it creates competition, right? If you go into an RFP, you're essentially pitted against your competitors, which for that little niche makes sort of sense. But it creates a similar kind of vibe in just the way that we contract for services instead of this collaborative environment.

And so one thing that I started thinking about, I think maybe six weeks ago, I started kind of offering this suggestion up where I think that as part of contracting, and especially as IT, you're not going to get away from having an IT contract in the next five years. I don't care what your solution is that goes into the hospital, you're not going to get away from IT sourcing because if your solution can't interface with the enterprise resource management platform, you're going to be dead in the water.

You are , because that's the solution, is how do we remove the humans that are simply transferring information from one silo to another. Now the problem is exactly how you outlined it. Either we have this very new to market, early entry. Disruptive. Maybe somebody left a company and had a ton of knowledge, but all of a sudden they're more nimble.

They can do all this innovative stuff, and then obviously the model is often to sell to the bigger ones. Not everybody, as you outline nicely there, but a lot of times that's the thing is like, come do something innovative, do something disruptive, really beneficial, and then get bought by a larger player. I think they should be writing into their IT contracts that they will not contract with a company unless they are willing to provide an open API for the exchange of necessary information.

And I get you want to protect it as a business. You don't want to just be offering up any aspects of information, but anything that is really truly applicable in sort of an information exchange with another partner that hospital or that health system has, it should be written into the contract that you, in good faith will operate as a partner and a collaborator for the health system to choose the solutions that are going to do the best for them, and then essentially play nice in the sandbox by offering up an exchange of information that allows them to take these "widgets" as we've heard and fit them together into something that's a beautiful mosaic.

Rich: I love that idea. I've never heard anybody articulate it in such a direct way and in a powerful way where you're saying you're suggesting contract language. It's something that binds the parties and we're going to set up the agreement from the get go that we all know where we're going. And I love the way that could play out because it really fits with the altruistic notion of healthcare and taking care of the population. And the counter to that or the antithesis of that is being super capitalistic and protective about our little fiefdoms, right?

And so how will we actually work together? How will we put one solution together with one solution and have it in aggregate more than just one plus one being two. And I love that idea. I wonder too if there's a way for hospitals and health systems to and they're being inundated with offers and opportunities.

I heard your friend Hays Waldrop tell me when we were together last week in Nashville, the onslaught of emails that are coming to a hospital and how many of these just don't even get opened anymore. It's very difficult to reach a decision maker. What kinds of things have you done that have put your solutions or put solutions that you really like in front of decision makers, where otherwise they probably would've stepped right over it? It was a really good thing and maybe they trusted you to bring something to them, but they're really glad they stopped for just one extra moment and looked and listened to that because it changed everything for them. Do you have an example?

Justin: Yeah. In this case I'd probably point to Green Security. And, sometimes it's just a matter of timing. Honestly, Rich, you can't force something to be important to somebody that it's not. But the reason I'll use this as an example. It's not always your time. Just because you have the right idea, many times you're ahead of it.

I can even tell you before I do the Green Security example, that when I started my Boston Celtics podcast in 2004, which was just a pastime while I was working as a nurse, little did I know it would become my career and a combination of my entrepreneurial spirit and podcasting and nursing experience I had not that vision.

But when I did it, I remember the play by play announcer, who's Emmy Award winning and over 30 years as a broadcaster. He told me, he said, I just think you're way early to this. It's awesome what you're doing, but I think you're way early. And he was absolutely correct. It took 10 years before podcasting finally took off, I was way ahead of it.

That happens in a lot of scenarios and I would say Green Security was as well. Our president and founder, Sean Fitzgibbon said we need to be able to manage all non-employees in one platform, not a siloed platform that only sells vendor credentialing in a supply chain, the facilities and construction contractors in event of emergency, you should know who's in the building.

And what about patient and family visitors? Really only children's hospitals were doing that prior to the pandemic. And so, we would go around and we would talk about this and people got the idea. But when it came to committing resources, and this is why I tie into timing, when it came to committing resources a lot of times it was just viewed on as well, we don't want to do the whole thing.

So even though we had some success in the vendor credentialing realm, I would say the adoption of the contractor modules that we were building out was really low. And then this past February, all of a sudden CMS comes out with, you need to be able to report on any bodies covid vaccination status that enters your building and that includes landscapers who walk in the front door to go to the cafeteria and all of a sudden it was our time.

And I could tell you we signed on six accounts last week because we have a proven model for managing that population. While just about everybody in the marketplace was still a little bit more siloed in their solutions and not looking at it as enterprise, but the enterprise nature. of it slows the sales cycle. So it's a dilemma in a way from a business decision, but we did the right thing and then when it was our time, we were positioned very well to have a lot of success.

Rich: Yeah. We talked about this a little bit when I had a conversation with you as a guest on Power Supply about longevity and staying power and the kind of sticktuitiveness, it's not just dumb luck that you guys just happened into the timing where you needed to be able to report on the landscaper's covid vaccination status.

It was, and I'll say it this way, Justin, I think it was because you had the foresight to take a long tail on this, and you were okay and you were patient with how long it was taking you or not you, how long it was taking the market to catch up to where you were and when the messaging finally arrived. You were prudent.

You had enough money in the bank, you had enough people who were still passionate about the solution, and you were ready to come with an answer. And I think about that as kind of a model for, people will say, well, you just got lucky, didn't you? You had some legislation that came down and you had the benefit of that and not everybody gets to ride that wave. And I'll turn back around and say to anybody who wants to challenge that, No, it's good business planning that got you there. We don't have a crystal ball but the prudent person, the prudent business owner's going to be ready for just about anything.

And I think being small is the hallmark of being able to be nimble and kind of pivot and go in any direction you need to. That's what really attracts me to this type of an approach where innovation comes out of startups. We can maybe get it to scale, maybe 50 employees, but I really hesitate about going the other side of that unless I'm part of a much larger organization, because I don't want to lose that nimbleness. I don't want to lose that ability to just look at my crystal ball today, and if the weather changes, hey, you and I are going, right?

Justin: Why did you become an entrepreneur? It was to have that control and flexibility and I'm in agreement, I definitely enjoy having a lot of decision making ability, that's not for everybody. I think it's really important to characterize that, that it's our personality types that match. That approach and that mentality it suits us for that environment. Because it isn't for everybody, but I get a lot of satisfaction out of it. For me personally and I know we share this, just based on the nature of many of our conversations, we get the satisfaction of the discomfort. Of having to solve a problem that hasn't been solvable. Instead of putting our hands up and saying, It is what it is, we're living through it, and we'll get out to the other side and things will evolve on their own. In a lot of ways, we're not afraid to jump into that fray and say, I'll just try to figure out how to solve this, because honestly, that to me is fun.

Trying to solve the problems is what I enjoy and I don't know that it always works in a marriage, but it certainly works in business.

Rich: Well, you and I are in the right place in healthcare. I feel like, and you might agree, you find lots of rocks in the field and you turn over any one of them, there's a problem to solve.

There's no shortage of problems to solve. No shortage of places to innovate. I'm so glad that we had a chance to talk today and catch up. I think it's been great for our listeners. And by the way, would you just kind of roll through if they want to get more information on what you're doing and where to find you?

How can they do that?

Justin: The easiest way is to just go on LinkedIn and make a connection request with me. All the companies, all four media brands, Beyond Clean, First Case, Power Supply, Transmission Control are there, as well as Green Security. And you can get over to our websites just by clicking onto those links or see a lot of the social media content we create.

And then email wise, you can reach me at justin@beyondclean.net or you can reach me at Justinp@greensecurityllc.com. Those are the easiest ways. But I love LinkedIn. I believe in the power of LinkedIn. I believe in building a true culture and community in our industries that can really be a source of pride.

And I'll just say this after speaking with two folks from the Young Professionals group with AHRMM that are going to be on a future podcast. They used a term to me that I thought was really important. And it was they want to make supply chain, healthcare supply chain, a destination career. And I feel that way about sterile processing.

I feel that way about the operating room and I honestly feel like LinkedIn is our path to reconnecting these communities and creating that sense of pride and culture. And I'll add one last thing. It's really big picture. It's so big picture that two weeks ago we released the very first ever musical album dedicated to sterile processing on the Beyond Clean channel.

When I say culture, that's what I'm really talking about.

Rich: That's awesome. I can attest to the fact that Justin, you and just a handful of other people who I really admire and follow on LinkedIn are doing a terrific job with not just using the platform to get your message out, but really enhancing the whole community.

The kinds of things that you put out there are very thoughtful, they're timely, they're informative. I frequently like, comment, and share what you're putting out there because I think it's a value to my community as well. And so thank you for sticking with that. And I'm going to go check out the album now. I'm really excited about that.

Rich: So, I thought that was a really good interview. I think one of the things I took away from that, that was interesting in listening to Justin's comments about the technology play, he said something like we have all these different point solutions that have come about and everybody kind of has their own set of data.

And what he was saying was, he doesn't see how that's going to be a theme much longer. Hospitals are going to have to, by way of contract language is what he said, in to their contracts that they're going to force these vendors to be able to share the data. We hear all this stuff as you and I work together every day about interoperability and how important all that stuff is.

I wonder, you handle all the sales for Kermit, you manage the national sales force. You handle all the different channels. You meet with customers all the time what do you think about that? Can you just react to what he had to say about, can you imagine us being compelled to do that?

And I mean, I can see a benefit for it, but how would it work commercially?

Tom: Sure. I don't think it's a big step for hospitals to go in that direction. I mean, you and I have reviewed contracts plenty of times. And oftentimes they're very clear that the data that we're sharing with you is our data.

So I think for them to take another step forward and say that we need to determine how that data is shared and we need to put that requirement on you to work with the systems that we've invested in so that data doesn't get locked up into your ecosystem there.

When I was listening to Justin it really reminded me that we need to listen to our clients and whether they understand what the art of the possible is in certain times because we know the data well, we know what we've done to transform it. What we may not know is the downstream effect that it could have in really saving them the time, energy and quite frankly, we marvel at some of the manual efforts that are going on at these hospitals. I just think that we really need to open our ears and open up the conversation with our clients to understand how can this impact downstream your efforts in becoming more efficient.

So there's just way too many things going on in the hospital environment today that is quite frankly, being managed by 20 year old technology and 20 year old process.

Rich: I think you're right. I think when you think about all the different things that a hospital deals with when it comes to technology, they're a little bit behind the curve as far as other industries.

They're kind of being forced to adopt this stuff on the fly. And all they have to compare it to is what you said, 20, 30 year old systems. I mean, Legacy systems AS400. We're now in the cloud, with what we're doing at Kermit, which is very futuristic.

They don't really understand how can you stand this up in a week. It takes months to do this in other places. Yeah, So I totally agree with you. I think it's you know how to take them on that journey and what's the message going to be?

Tom: Indeed. And it oftentimes it's the big players that throw up the biggest barriers, the ones that really don't have much to worry about.

They're entrenched in the hospital system. They've got high transaction costs. In other words, no one's flipping out of that system without a 1, 2, 3 year effort. Sometimes it's those firms that are the most resistant to allowing us to interface with them and push data into their systems.

Without naming names, there's a lot of pay to play in getting into someone's environment that really isn't for the benefit of the hospital. It really isn't for the benefit of their clients. It's sort of an unnecessary barrier that they throw up.

I think firms like us are more than willing to jump into that environment and share what we can. Because it's kind of the cost of doing business. But the bigger firms, the bigger EMR and ERP suppliers often need to break down some of the barriers that they have to even allow that to facilitate that process.

Rich: Yeah. Thanks, Tom, for helping us put a bow on this episode of Healing The Hospital Podcast. I also want to thank Justin Poulin for being here today. Be sure to check out his podcast and send him a connection request on LinkedIn.

And also to stay up to date with everything that is the Healing the Hospital podcast please follow us on LinkedIn and YouTube. These links and more are in the show notes, and we want to bring the stories of Hospital Healers changing things for the better. So, if you'd like to nominate a Hospital Healer to be featured in a future episode, visit kermitppi.com/healingthehospital and submit the contact form there.

And if you're enjoying The Healing The Hospital podcast, be sure to subscribe so that you never miss an episode. And leave us a five star rating wherever you listen to your podcasts. Thank you for spending part of your day with us and for listening to this episode of Healing the Hospital Podcast. I've been your host, Rich Palarea, and I'll see you next time.

Healing the Hospital is a Kermit podcast. To learn more about Kermit, your implant spend management experts, visit www.kermitppi.com.

Healing from the Inside to the Outside - Interview with Justin Poulin

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