This episode of Beyond the Deal features a conversation with Thoma Bravo Senior Partner A.J. Rohde, Thoma Bravo Senior Vice President Peter Hernandez, and NextGen Healthcare CEO David Sides.
AIR DATE:
July 10, 2025
LENGTH:
18:54
Transcript
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This podcast is for informational purposes only and does not constitute an advertisement. Views expressed are those of the individuals and not necessarily the views of Thoma Bravo or its affiliates. Thoma bravo funds generally hold interest in the companies discussed. This podcast should not be considered as an offer to solicit the purchase of any interest in any Thoma Bravo fund.
A.J. ROHDE:
Hi, I'm A.J. Rohde, Senior Partner at Tomo Bravo, and this is Beyond the Deal. Our bonus episode of Thoma Bravo’s Behind The Deal. I'm here with my main man, Peter Hernandez, Senior Vice President on my team at Thoma Bravo. And today we're also joined by the illustrious David Sides, CEO of NextGen Healthcare. Guys, welcome. Thank you for joining.
DAVID SIDES:
Thank you for having me AJ. Great to be here.
A.J. ROHDE:
Should be good fun as always.
DAVID SIDES:
This is a hard one to get on.
A.J. ROHDE:
It's a low bar. Yeah. Yeah.
DAVID SIDES:
I'm delighted to be invited.
A.J. ROHDE:
Having me here is a low bar. You should be doing it with Peter. But listen, first question, real simple. For those listeners who weren"t able to listen to last week"s Behind The Deal. Tell us a little bit about yourself and NextGen healthcare if you don"t mind.
DAVID SIDES:
So next I"ll start with NextGen health care is a health care IT company. We automate ambulatory practice of medicine. So think about — give an iPad to a physician and she can run her whole practice and even interacting with patients remotely. And I'm the CEO. Been in healthcare IT for 30 years and just love the space, especially the business of NextGen.
PETER HERNANDEZ:
And David, your family, if i'm not mistaken, has a bit of a history in healthcare as well. Can you talk a little bit about that and how you just got excited about the industry and what got you into healthcare IT?
DAVID SIDES:
So yeah, my grandfather is a physician in rural Missouri, which is basically like you're a physician back then, right? It was like, you didn't know if you're getting a car crash or a pregnancy. [laughs] You didn't know. And they came to your house, right? If it's off hours, they came to your house. My father"s a hematologist oncologist, so a blood cancer doctor, in a small town in Missouri where I grew up in the Boot Hill. And my brother"s a rheumatologist, a physician in the capital in Jefferson City. So I started pre-med. Right? And worked a summer as an orthopedic scrub. And it was kind of the same thing, like Deming"s definition of quality of no variance means you're doing the same thing every time. So like total knees are exciting at first, and then you're like, okay, another total knee every day, this would be a lot of total knees. So I kind of liked the technology side more. I was going to school at Berkeley doing a biophysics degree, and we were doing protein modeling and cryogenic experiments. And I was like, you know, I think the electronic technology side of this will be a place to go over time. Cause I just remember with my dad on Sunday nights, we’d go to the office and he’d be doing these huge stack of paper charts on the old dictaphone to try to get that done. I was like, “man, this is inefficient. There’s gotta be a better way. We’ve got a computer at home. Why is he not doing it on the computer?” And so there goes a 30 year career.
PETER HERNANDEZ:
Full circle.
A.J. ROHDE:
Yeah, that's funny. Here we are. Your leadership style. Describe it a little bit. What kind of winds your clock? How do you like to think about team building and talk maybe about the team you've assembled at NextGen today?
DAVID SIDES:
Yeah, so I mean, we have a great team. I think we lead the company with a lot of transparency. So I’ve run public companies, which it's good and bad of the transparency side, but I think overall it's a net positive. And I mean, good and bad net, right? You write an annual report and your competitors read it and really does say what you're doing. So you've got to be ahead of any of those strategies. But a lot of transparency. You know, run with the data. And then if you have transparency and a data managed mindset, right, it reduces the politics in the organization. let's just be focused on clients — client first — and that"ll show us the way instead of any kind of infighting that you see at large companies that I think is because you didn't set the right culture as a CEO at the top. And so we really focus on that. And Sri and I, you know, divide up parts of the country when we're going to see clients. What strategies are we working on? You know, what are we both driving so that it kind of gives people kind of a dual way to get things done. And very decentralized so people can do what they want and we’d rather they fail fast, right? So make a decision. If it's wrong, that's fine. We"ll just recover. That's better than being slow on making a decision.
PETER HERNANDEZ:
Totally. When you're looking to add people to that culture that's so special, David, what's the number one thing that you look for to add to your team?
DAVID SIDES:
We look for are they fun? Right? Are they gonna fit the culture? Are they, you know, fast, smart, kind of no nonsense? Like if they"re keeping the vision and the clients first, then everything else will come through. You know, if they"re like, you know, slow or ask a bunch of dumb questions or whatever, you're like, all right, we don"t need more of that. We need someone who"s like —
A.J. ROHDE:
No pretense, no pretense,
DAVID SIDES:
Like, let's roll. It's all in
A.J. ROHDE:
The health care industry is — recruiting out of the industry for years was difficult in that regard because it's a very administrative hierarchical system. So people who grew up, come out in health care, they"re very used to these rigid processes that have fed the industry for a very long time. You found people that are industry — you know, spent most of their career in industry in a functional specialization role and brought a very entrepreneurial point of view to NextGen.
DAVID SIDES:
Yeah. Yeah. So no one"s really, you know, kind of ran a hospital or something like that, that would be kind of the worst for us because of all the administration and the slowness of operation. And we have people that have been in private equity backed companies so they understand the pace that we want to go at. And urgency. And if you think about when you're at a client site and you see people in the waiting room and it's like, heaven forbid the system"s down, you're like, man, we got to get that thing up. Like there are people, every minute there are people on the other end of this, millions of people, it's not even like just a few hundred thousands, millions of people. And so just driving that into the organization to be like, "that could be your family, that could be your mom, your dad, that's sitting there waiting because you didn't do this maintenance or didn't get this working right or wrote this piece of code that sucks". I mean, you can"t have that. You've got to have, like, a true passion around the people you're serving. And we're serving them through all these physicians who have really tough jobs, right? Every day, it's just, you never know what's happening. And a lot of demands and a lot of knowledge to keep up with.
PETER HERNANDEZ:
And you also do it entirely remotely. You know, I think that's one thing that's really important for our listeners. NextGen"s a fully remote company. Maybe talk a little bit about that. You guys didn't always used to be that way, but now you are. Like, some of the benefits of that, maybe some of the challenges too, just for our listeners.
DAVID SIDES:
I think everyone got their training during COVID. Right? We all got two years of operating remotely and —
A.J. ROHDE:
Sure did, especially in healthcare.
DAVID SIDES:
Yeah in healthcare and it's like, okay, why do we need to go back to these offices when we're already distributed? Let’s just be purposeful. And get together. Like we were together two weeks ago for our sales kickoff meeting. We brought clients in, met with our clients for two full days and spent all of our time, you know, either with our team members or clients. And it's just a great way to solve it because you're purposeful. It's not like, you know, people say, what happens to the water cooler? Well, we get the water cooler every month and when we get together and — either virtually in person and work through things.
A.J. ROHDE:
I always joke with you guys, even if you were in an office together, all living in the same city, you’d still be on the road 100 % the time seeing clients anyways.
DAVID SIDES:
Right.
A.J. ROHDE:
So it doesn"t really matter. And our investors ask us a lot, how do you think about companies that are in person versus remote? And I say, show me leadership and I"ll give you an answer to that. And you're a testament to that. Phenomenal leadership, remote company, no problem. In fact, probably accelerates pace of change.
DAVID SIDES:
Yeah, you don"t want people stuck in the office, right?
A.J. ROHDE:
Completely.
DAVID SIDES:
I mean, the answer to the question is out at the client site.
A.J. ROHDE:
Yeah. Get out on the trenches.
PETER HERNANDEZ:
And the bias to action it creates. Like I — one of the things that I've observed is because you get together monthly as a team, in person, somewhere, it's a force and function for those goals. You say, hey, guys, we're meeting today. Here"s all the things that we want to do. Next meeting, you're checking in. I think sometimes that can have, you can almost lose sight of it or it can dribble out and you guys use it as a forcing function to make progress. It's really impressive
A.J. ROHDE:
That's well said.
DAVID SIDES:
Yeah, otherwise you could go six months and something just kind of doesn"t get done. Where this is like, "hey, we met last month. Why is this not done?"
A.J. ROHDE:
Yeah. Yeah.
PETER HERNANDEZ:
And in that same vein about you guys working remotely, you've also been able to do — drive a great workplace for employees and at the same time have a ton of trust for your end customers. there's an award that you guys have won, like, four years in a row that you're one of the most trustworthy companies in America. Can you talk about that and how much that means to you and how you've made that a priority for the company?
DAVID SIDES:
Yeah, we're honored to win that award and hopefully keep winning it going forward in the future. It starts with transparency. you know, so being face up with the data on how we're doing and we use outcome key results. OKR is driven down to the person level. Now, we didn't have that when I got there. Individual, you know, "I've just started at NextGen in India or in the U.S. What am I supposed to do?" We didn't have that clarity of thought for them. Now we do. And so the data is everyone knows where we're playing and where they fit in, and that helps a lot with, you know, common purpose. And it also aligns people around which one of these are supporting which strategy and how important they are to driving results or outcomes for patients through our clients. So, you know, that kind of alignment really helps as you're moving the company forward. That everyone"s looking at the same data and knows what's required to get to success and what that looks like.
A.J. ROHDE:
Okay, now we're going to move to the fun part.
PETER HERNANDEZ:
Yeah.
DAVID SIDES:
Lets do it.
A.J. ROHDE:
One of the parts of the program where we do kind of a lightning round of Q &A. It's a little self reflective. It's always a little bit illuminating on people’s personal interests, you know, and personal history. So I"ll start. This will be a more benign one and then we’ll get into the fun ones in a second. What is something you wish someone would have told you or you would have known at the beginning of your career?
DAVID SIDES:
Well, kind of like trust the swing. Like this is all going to work out right? You don"t have to overdrive it. Like in my 30s, I bet I was like hell on wheels, you know, just so aggressive in my early 30s before kids and it's like once you have kids you have a lot more empathy, you know for delivering the same message but in a much better way. It's like, you know I bet if some of the people work for me in one of my 30s if they’re one of my children, right? it's like "You do this, this, and this", and then they"ll probably be crying like, "dad, why would we do that?" So I"d say bring some empathy forward. The kind that you learn with kids, if you bring that to the workplace, it actually makes you a more powerful leader to be vulnerable and be like, "hey, this is something I'm not good at, but you're good at it". You know, like "Sri, you're great at strategy. You do the strategy, and I"ll do some other things." Just before you kind of felt like I have to be great at everything, and you don’t. That's why you have a team
PETER HERNANDEZ:
A.J. It's a great question. I've got the same one for you.
A.J. ROHDE:
For me? Ok. There's this thing I think a lot about, which are one-way doors and two-way doors.And I've spent a lot of time, as I've gotten older, as an investor reflecting on that. You know, 99% of the decisions that you get to make all day long are two-way doors. You can always go back. And so what I’ve learned as I’ve gotten older is knowing when to know and to be really decisive quickly. All right, let’s get to it. Let’s go. Let's go. And there are also situations like in our business, Peter, it's we don"t make that many investments per year. Right? And those for our business are existential. And so in those decisions, you know, for me, who is a very synaptic, you know, quick thinking, quick action sort of person, having the temerity to slow, to be more methodical, to take an extra week to make an extra six phone calls, to bond and spend another day and a half with a prospective partner as a CEO. Like those things in an industry that has a very frenetic frenzied pace, just to say that's a one way door, right? That I can"t go back in that door and we're going to have a long relationship together and it's a billion dollars of equity. Like, let's make sure that decision is done right. So, not getting caught in the washing machine of the industry and recognizing when there are one way doors. And you know, you can never spend enough time thinking about the one way doors and the two way doors. I bet you most people spend too much time thinking about those. So it's really balancing the two.
PETER HERNANDEZ:
Yeah, it's interesting.
A.J. ROHDE:
Okay. Should we do the lightning round?
PETER HERNANDEZ:
Yeah, let's get into the fun stuff.
A.J. ROHDE:
All right, you start.
PETER HERNANDEZ:
David, we know you're a little bit of an avid motorcyclist. Harley versus BMW? On the bike.
DAVID SIDES:
Harley, right? I've ridden a Harley since I was 16. So American made, it's a classic.
A.J. ROHDE:
Love it.
PETER HERNANDEZ:
And on that same, maybe a follow up to that, I think you've spent a lot of time on Harley"s, if i'm not mistaken. Can you tell us the longest ride that you've done? When was it and what was it for —
A.J. ROHDE:
I know the answer to this one
DAVID SIDES:
Well, it was a couple years ago. The backstory is almost more interesting. So my dad, when he got to be 80, we used to ride. Everyone with the Sides last name, my brother, my dad, my uncle, his son, would get together and ride every year on motorcycles for a weekend. And when my dad turned 80, he said, "All right, I think I'm going to quit riding the Harley at 80". We're like, "Oh, you know, why would you give up so early?" And he was going to sell the bike. And I'm like, "You can"t sell the bike. I'm going to buy the bike." And so whatever quote he got from the dealer, I paid him and rode it from Missouri all the way to Connecticut in 24 hours. So 1,100 miles. Which is this — you get this award called the Iron Butt Award. You have to, like, take a picture of the gas station and the mileage every time you hit a gas station. ‘Cause you know, they can kind of tell how fast you're going too.
A.J. ROHDE:
The funny thing is you were doing that as we were getting to know you.
DAVID SIDES:
Yeah.
A.J. ROHDE:
And that was the very first discussion I ever had. You're like, "Hey, can we talk over the weekend — catch up over the weekend? I got a quick question over the weekend. Can you talk?" You're like, "Actually, I'm going to be out on this 24-hour ride."
PETER HERNANDEZ:
Sorry, I'm coming from St. Louis to New York.
A.J. ROHDE:
Yeah, I said, Peter, just up the umbrella policy and our assumption of the model you know.
DAVID SIDES:
Yeah. Well, you can talk on those things now. Now you can call me and you wouldn"t even know.
A.J. ROHDE:
You can. Isn't that funny? Yeah. It's wild.
DAVID SIDES:
Great.
A.J. ROHDE:
Obviously, you're a huge skier, as am I, and we bonded quite a bit over that over the years on that. What is your favorite mountain in general? And what is your favorite mountain to go off piste as well?
DAVID SIDES:
My favorite mountain in general is Aspen Highland. That ball when you get off the lift and you go up a cat and you walk up this razor’s edge.
A.J. ROHDE:
Yep.
DAVID SIDES:
And then you basically have to jump to get into the ball. You go off this precipice like 10, 15 feet like your first — that first jump — you either make it or you don"t. It determines the whole day. So if you hit it and make the first turn, all is good. You hit it and miss, you're searching for skis like one of my buddies did. So that's my favorite. Off-piste, I was skiing in Chamonix one time. When off-piste, ended up at —
A.J. ROHDE:
Everything"s off-piste there.
DAVID SIDES:
Yeah, and there was a restaurant and it said open and there was like a black lab standing in front. I was like, "How can this be open? Like, I haven’t seen one person down this thing because it was so gnarly." So I pull up. And this woman’s there who runs the place and she's like, "You want lunch?" I'm like, "Yeah." She's like, "All I have is Coq au vin." I'm like, "Great, that’d be good." And she's like, "And you want a glass of wine?" I'm like, "No, I mean, you see the skiing out there?" And she's like, “No, come on, you have to have a glass of wine". She's like, "We’ll sit here and have one together." And so she poured two glasses and we had this conversation. It was great in my decent French. And at the end, she says, "Oh, could you take my daughter to school?" And I'm thinking, "This is a bad idea." Like, she lives on the mountain? I mean, in this remote place? So we get outside, and there's a deck. And her daughter’s a snowboarder. And I put on my skis. And I'm just waiting for her to go. She gets on the picnic table, puts on the snowboard, and jumps off the deck. And I was like, "Man, it's going to be tough".
A.J. ROHDE:
Boarding to school every day. That's a pretty good life.
DAVID SIDES:
And so I follow her down. We're going through the trees, through some kind of crazy creek, like as fast as I can do. I'm sure my heart rate’s like 200 the whole time. We get to the bottom and she's like, "à bientôt! Merci!" And I'm like, oh my gosh. I had to go back to the hotel and rest for two days to recover.
A.J. ROHDE:
After your glass of wine too. Yeah, yeah.
PETER HERNANDEZ:
That's pretty good. Maybe switching gears a little bit, getting off the skis and talking music. Maybe one for you and for AJ. Grateful Dead, or Rush?
DAVID SIDES:
Oh Grateful Dead. All the time.
A.J. ROHDE:
Obviously, you know the answer for me. It's Rush. And yet we still get along somehow.
PETER HERNANDEZ:
Somehow.
DAVID SIDES:
You gotta come to a show with me. We"ll have a great time.
A.J. ROHDE:
Didn't you just see them at the Sphere?
DAVID SIDES:
Yeah, some of the Sphere at the Capco. Oh, it was great. Have you guys been to the Sphere? it's all, the whole thing’s —
A.J. ROHDE:
Magical.
DAVID SIDES:
Basically just pixels everywhere. And great music, of course. You got your little dance going AJ. What are you dancing with?
PETER HERNANDEZ:
This is when I leave the podcast. I don't know if I want to see either of these dance moves.
DAVID SIDES:
What's your favorite Peter?
PETER HERNANDEZ:
You know I'm a country music fan.
A.J. ROHDE:
There you go.
PETER HERNANDEZ:
I spent a lot of time in Nashville. So I've been into Luke Combs lately. Thomas Rhett.
A.J. ROHDE:
My kids love Morgan Wallen.
PETER HERNANDEZ:
Morgan Wallen is great. He's coming to Miami soon. I'm going to try to see him.
A.J. ROHDE:
Cal vs. Stanford.
DAVID SIDES:
Oh Cal. I went to Cal.
A.J. ROHDE:
Easy. How about sports?
PETER HERNANDEZ:
Sports, yeah. Let’s see. Well, you were a rower, I think, coming up, David, like, crew versus football?
DAVID SIDES:
I mean, crew. And that's another reason, no Stanford. I beat Stanford every race for four years. There wasn't a national championship, Pac 10, anything we ever lost. I had so many Stanford shirts, I used them to like wax my car. [laughs]
A.J. ROHDE:
They didn't take that well. How about you? Crew or football?
PETER HERNANDEZ:
Oh football. I'm football through and through. I grew up left guard and defensive tackle so I"ll take —
A.J. ROHDE:
In 100 degree humidity in Central Florida.
PETER HERNANDEZ:
Yeah, exactly.
DAVID SIDES:
What about you, A.J.?
A.J. ROHDE:
I'm a tennis player, as you guys know, so I don"t have a dog in either of those fights, nor am I built for either of those endeavors. [laughs] But yeah. No less competitive, as you guys well know. But yeah, tennis is my sport. Racket sports.
DAVID SIDES:
That's awesome.
MUSIC IN
A.J. ROHDE:
So guys, thank you so much for doing this. It's a really special moment for me personally. A, to have you on the first podcast.
PETER HERNANDEZ:
Yeah, thanks for having me on.
A.J. ROHDE:
And to be your partner, honestly, over the last 15 months has been one of the joys of my professional career. And seeing what the art of the possible is on a company that I may have overlooked over the years and the potential to drive real value over time in a company like that, it's so important to remember management is the key to that solution. And you are the reason we're here and you're the reason we have been so successful and you're the reason we want to stay in this investment for a long time. So thank you for being our partner, for being our friend. Thank you to Mark Bischoff, our chairman, for being our — you know, he can"t be here today — but for helping all this as well —
PETER HERNANDEZ:
And the broader team too.
A.J. ROHDE:
The whole broader team. Noah, Henderson —
PETER HERNANDEZ:
Matt Jacobs, George Sotelo. We have a really great team top to bottom
A.J. ROHDE:
Tony Palladino, obviously your whole executive team Ari
DAVID SIDES:
Sri and James.
A.J. ROHDE:
So thank you guys so much. It’s really been a joy today.
DAVID SIDES:
It’s been super fun. Thank you guys.
ORLANDO BRAVO:
Behind the Deal is brought to you by Thoma Bravo in partnership with Audacy’s Pineapple Street Studios. Join us next week for more stories behind the deal. Thanks for listening.
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