How to Make Physician Education Your Most Effective Marketing Program
Dr. Aaron Ali and Dr. John Schlitt are experts in translating world-class physician education into customer loyalty. In this episode they discuss how to deliver educational experiences that allow clinicians to learn, practice and experiment, leading to better clinical outcomes, more efficient procedures and satisfied customers. Medical device companies benefit by getting closer to their customers by providing an invaluable and memorable experience. Their facility, MedtoMarket, blends a state-of-the-art bioskills lab, conference facilities and co-working space to provide an environment where innovation thrives.
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Episode Transcript
This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.
Patrick Kothe 00:31
Welcome. Today we're going to be talking about physician education. Now physician education has always been an important factor for the adoption of new medical devices. And in some cases, it's even a regulatory requirement. However, not all companies view education as a key marketing program to help drive sales, customer loyalty. And to to really identify and drive with the company brand is. Also how you educate depends on your product. Some are simple products, with simple training programs that you need while some are really quite complex, and require different training methods. But whatever your product is, the quality the educational experience for the doctor can really make a big difference on their opinion of your product, and of your company. Today, I'm happy to have Dr. Aaron Ali and Dr. John Schlitt join me to discuss physician education and their business which I think you're going to find fascinating med to market. It's one of the premier educational venues in the country. Through the years I've participated in a lot of different educational programs, wet labs, cadaver labs, skill courses, all kinds of different things. And I've seen all kinds of different venues from hotel rooms to basements to dedicated facilities. I can tell you that met the market is different. And I encourage you to look at their website, which I'll include in the show notes. Dr. Ali and Dr. schlitt are both practicing anesthesiologist in Austin, Texas. Dr. slit earned a chemical engineering degree from rice, his MD from UT Southwestern in Dallas, and completed his anesthesiology residency at Duke. Dr. Ali earned a biomedical science degree from Texas a&m, his MD from the University of Health Science Center at San Antonio and his anesthesiology residency also at Duke. I think you're really going to enjoy listening to their journeys as physicians, and also entrepreneurs. And I hope you think about how you how you can apply their message on education to your business. Here's our conversation. Dr. schlitt Dr. Ali, thanks for coming on the podcast.
Aaron Ali, MD 02:57
Thanks for having us.
John Schlitt, MD 02:58
Yeah, we appreciate it. Glad to be here.
Patrick Kothe 03:00
Great. So we're gonna dig pretty deep into innovation and physician education and the business that you founded and are developing. But to get things going. How did you find your way into into medicine? Dr. Ali, would you like to start with Alan?
Aaron Ali, MD 03:16
Oh, yeah, thanks for asking that. You know, it was funny when I was in undergrad at Texas a&m. I was actually an accounting finance double major all the way to the end of my sophomore year, so I had no intentions of going into medicine. I had two older brothers that had done the same thing and are graduating they were doing one was working at a bank and another one had a finance office. And my oldest brother called me up. He's like, I hate what I do. It's awful. You need to change tomorrow. You'd be a great doctor. My mother was a doctor. He's like, you know, you're a smart guy and a family you should definitely change and amazingly I took it to heart and walked into my counselor's office the next day and switched out of 60 hours of business. It's about 20 hours of premed. So I lost about 40 hours and found myself in a medicine but it was probably one of the best decisions I ever made. Just because I'm getting to do a lot of the things I wanted to do and that was business at first, but I'm doing and something I'm very passionate about that's medicine.
Patrick Kothe 04:11
And why anesthesiology
Aaron Ali, MD 04:14
you know when we were in med school and you get to your clinical rotations and you actually get to spend a month in ob and a month in cardiology and you get to kind of touch and feel everything. I enjoyed all the different sectors. pediatrics is awesome. cardiology was awesome. surgery was great. When I got the anesthesiology, I got to do every single one of those. So one day we would be putting in an epidural into laboring mother the next day we're doing heart surgery. The next day, we're running upstairs for person coding on the floor. It was fast paced, you got to do things in a very immediate way. If I want to change someone's blood pressure takes me about 30 seconds when my internal medicine buddies want to change someone's blood pressure takes them six weeks. So there's an immediate gratification involved in the fact that you get to touch all the different subspecialties of medicine. So that was very exciting. exciting to me,
Patrick Kothe 05:01
Dr. Schlitt, how did you find your way into medicine?
John Schlitt, MD 05:05
Yeah, interestingly, my story's somewhat similar to Aaron's in the fact that my route was a little bit circuitous. I grew up with two hard working blue collar parents who had always pushed for me to become some kind of professional, but didn't really have a strong feeling. One way or the other, I attended Rice University in Houston. And it was a strong engineering school. And I just thought at the time, let me get the strongest degree I can, which will give me the most options. So I was actually a chemical engineering, major rice, graduated with a BS in chemical engineering. And then, well, when a lot of my friends and peers were graduating a year ahead of me, the engineering degree actually did open up a lot of doors. And so at that time, the quote unquote, sexy jobs were jobs as investment bankers on Wall Street management consultants, for McKinsey, Bain BCG, and they loved the engineering skill set the way the engineers think. And so I actually applied for a job and took a job on Wall Street. As an oil and gas investment banker for Paine Webber spent some time actually doing that. And then when all my friends decided to go off to business school, I kind of had that itch similar to Aaron to do something that I might be a little bit more passionate about. And so I pivoted and applied to medical school, and decided to go that route at that time.
Patrick Kothe 06:29
And, and anesthesiology. What, what drew you there,
John Schlitt, MD 06:33
similar experience in medical school, you do all these rotations. And what I sort of realized early on is that I really enjoyed using my hands, I really enjoyed the procedurally oriented part of medicine. And ironically, what you learn when you spend time on a surgery rotation is, if your passion is surgery, you're really gonna only get to operate a couple of days a week, and you're gonna spend the rest of your time in the clinic, seeing patients to get them ready to have surgery. When you're an anesthesiologist, you're doing anesthesia, 24, seven. For me, the gratification element was the immediate gratification that Aaron speaks to, but also the gratification of getting to do what I what I'm passionate about every day, instead of just a couple of times a week. And then finally, you know, I've always enjoyed the quick decision making element of it and the calm under fire element of it. When things go wrong. We're like the pilots in the movies that people talk about, right we, we've got everybody's lives in our hands, and we've got to be calm and collected and go through their proper algorithms. I felt that that was something that I would be pretty good at. And hopefully it turns out I have
Patrick Kothe 07:42
great some some really different backgrounds to. So you're also both, I think, pretty entrepreneurial, both from a standpoint of business, as well as new businesses, organizing your business and practice management as well as new business. So Aaron, I believe that you have some experience in forming an anti seizure group. Tell me about that.
Aaron Ali, MD 08:07
Oh, gosh, it's been about 14 years ago, I was with a giant group and I moved here into town. And after seven years, that was not my place, I wanted to push the limits on certain things be a lot more entrepreneurial and, and my original group kind of wanted me to just show up in the you know, dress shirt and khakis put the proper fall and go home and you know, just do your job. So my wife and I actually started our own anesthesiology group and started kind of serving all the the smaller groups that couldn't hire a giant group to cover them, right. So we started picking up little places, I ended up at a surgery center where another gentleman myself built that practice up over a couple years and ended up being bought out by a large private equity group backed anesthesia group, kind of built groups, been with giant groups and enjoyed both facets of it. But I did learn quickly that I do enjoy being my own boss and not having a large group kind of tell me you know where and what to do and how to do it. But that's just my personality. That's who I am. And I love to kind of push the envelope a little bit and the guy that applied jump out of the plane first hoping that the parachute works, and I'll check it out later. That's always kind of been me. So it's been great to start your anaesthesia group and go through all the little things that you never think about because when you're with a big group, they take care of everything. You just need to show up for your scheduled time and do your thing. But there's a lot of nuances you learn a lot of business principles that you never thought about until you're actually running the show yourself.
Patrick Kothe 09:24
Was that your first entrepreneurial jump or or when you're a kid, did you have a lawn business or is this the first real entrepreneurial though
Aaron Ali, MD 09:33
I've I've been running little what I call gigs and projects and little startups all my life. I paid my way through Texas a&m by having a appliance Dolly business and what I could do is when the students would move in or out of their dorms a&m is a giant campus of the parking lot, maybe a half mile away from your dorm. I went and cornered the market on all the appliance dollies and Bryan college stations I had 40 appliance dollies and I parked it underneath the home. oak tree between the parking lot and the girls dormitory. And every mom and dad who walked by rented one out for 20 bucks an hour. So with 40 of them, I was making a killing every hour, the police loved me because the traffic was moving twice as fast. And I paid for four years of undergrad doing that. So I've always had little gigs like that I've always kind of forgot What's the need? And how can I provide a solution to that need? And I think that's just, you know, traveled with me to the point of starting multimillion dollar companies now and figuring out what the need is and what we can do to solve that problem. Wow, that's
Patrick Kothe 10:30
fantastic. What about you, john? Where did you catch the entrepreneurial bug?
John Schlitt, MD 10:35
No, I mean, I would honestly have to say for me, I mean, sure I cut lawns and did things, but I wasn't as passionate about it as, as Aaron was, you know, I did a lot of those gigs for fun. I mean, the greatest job I ever had, as a kid is a friend of mine and me, partnered with an ice cream truck company and rented an ice cream truck out of Boston and drove it to Cape Cod and, and work the cable summer, but that I think was more about his son and the girls at the time. For me, I think working on Wall Street as an investment banker, when you're when you're looking at these companies that are that are doing mergers and acquisitions, or you're getting ready to take a company public, as a junior banker, you go on these road shows, and you travel with the with the C suite around to the various brokerage offices selling the company. And so getting to spend time with those types of folks that started companies built companies getting to you know, share some intimate conversations with them over meals or on the road, really kind of got the fire burning for me. And so, coming out of investment banking, even though I was going into medicine, I knew I was always going to be interested in the quote unquote, business of medicine.
Patrick Kothe 11:46
So let's let's talk about your venture right now med to market. We'll get into the history in a minute. But as it sits right now, Aaron, you're the CEO of med to market? Could you explain to the audience what the mission of the company is? And what exactly you do? Sure, you know, our
Aaron Ali, MD 12:06
goal has always been to kind of disrupt traditional medical education, training innovation. When we first looked at it into the space the the sector was kind of owned by the universities, the hospitals, or people that didn't know anything about medicine, running that scene. And then you look at the clients who needed the medical training, the ability to train physicians, or do they have a medical device that they need to get out into the hands of physicians, there was no infrastructure behind it right, you have to find some hospital who'd be willing to give you their basement floor, and some Dungy looking room with very little service, which is the way we started our business at the beginning, we were out of it at an old Children's Hospital, that was the function not being used. And we were using the facility kind of as a PRN basis, and doing great, but what we wanted our vision wasn't there. But the goal was is to to build a flagship center where medical innovation, medical training, education, all those kind of things can come together and a private area. That's not the whole to a whole bunch of bureaucratic issues, or a lot of rules and regulations, those kinds of things. We wanted a very neutral kind of Switzerland place. And it took a while for us to find out what the perfect space was for us. You know, at first we were kind of a consulting group, we wanted to get in there and help people have access to the voice at a customer from physicians that they couldn't get ahold of you called john and I, we can get you a neurosurgeon within two hours to show up at your doorstep and look at a product, you go out on your own, it may take you months to find that neurosurgeon, right so we had that access and that ability to get to those people. But you know that that was the mission is to disrupt the traditional old fashioned, continued medical education and how devices roll down how physicians learned the newest devices and how they got trained on it. Just because we've had many devices put to us, where we looked at and thought their curriculum was pretty weak. The way they taught was pretty weak. JOHN ended up on a great circuit teaching a lot of advanced procedures. I did a little bit with him at one time, but we saw that ability that we were great teachers, but the infrastructure wasn't there. The model wasn't presented. Well, the docks were put into these pretty weak little places, like a tiny motel six would be to the Four Seasons approach. And we really wanted to take that four seasons approach and that's what we ended up doing with our venture with met the market.
Patrick Kothe 14:24
So what is the facility look like? what services are you providing?
Aaron Ali, MD 14:29
So we have a 32,000 square foot facility here in southeast Austin. It's an industrial flex building. I love it because you pull up it's a very clean looking place. We have physicians that walk in through the front door and they stop. And they actually step back out because they think they're at the wrong place. It looks more like the Google office, right? It's got beautiful leather couches. It's got a bar there. It's got an event center. It's got a gorgeous saltwater aquarium we walk it doesn't look anything like a training facility, because they're used to going into basements and shoddy little places that don't really cater to them. But the facility was built around the core business of bio skills and bio skills, in essence is a human cadaver. So someone who's willed their body to science is there on a surgical table and you have surgeons, medical device reps, engineers, executives, around this categoric specimen, and now you have multiple opportunities, you're able to train the device rep on how to sell to the physician, because the physician standing right across the table from you, the physician gets to practice for the first time with this device. I can't tell you how many times I'm pushing a patient into the operating room and I hear the surgeon at the scrub sink, talking to the device rep on how do I use this product? Exactly. And the patient looks at me going is this my doctor's first time using this product. And here I am pushing medicine. So they forget that they asked that question. And so that's the core of our business is to allow all those different vectors to be able to communicate in a very open and certainly less stressful environments that you're not worrying about a live patient, we add an event center, which helps to kind of support the idea that 200 physicians fly into town, we have a large auditorium that they go into and give those lectures and have that appropriate place. When they want to break out we have a part of our Events Center, it's a nice lobby and bar and place to eat. The other division that we have, along with our Events Center and our vital skills is our co working division. So those three divisions hold our company together, we added the CO working because we felt that a lot of the smaller entrepreneurs and smaller groups and those groups that aren't making 10s of 20. And millions of dollars already needed that infrastructure to a place that they can office without signing a 10 year lease, you know, they're just on 12 month memberships, right? They can leave anytime they can leave within a month or two, we're not going to hold a contract and take eight months of money from them. They have beautiful offices, they could share all the amenities. They don't have to go out and do all the investment of purchasing or buying or renovating the office building. And so having that turnkey solution for them, putting them in the same infrastructure that allows those resources for them to use in our labs, and then an event center to be able to cater to their physicians or whoever they're selling to is a very unique space that I'm going to tell you there's nothing like this in the United States. We're all three of those elements have been put together. Certainly there's co working certainly there's labs, and certainly there's event centers, but the way we put it together for the healthcare sector, I think is an incredible nation. We're very excited about it.
Patrick Kothe 17:19
Great. Hey, john, let's go back a little bit. So you guys are practicing in the in the same practice? When did you start to learn that there was a need out there? How long ago? Did you guys did this idea start to germinate?
John Schlitt, MD 17:35
No, that's that's an excellent question. And for me, it really goes all the way back to the very beginning of my journey as a as a true medical professional. So when I graduated training, as Aaron alluded to, I think part of the reason what we do now is so important is as I graduated training, I knew there was a need for me to continue training and or help train others, Erin and I actually had the opportunity to train together at Duke. And one of the areas that that we were really well trained in was something called regional anesthesia. So when a patient's undergoing an orthopedic procedure, we know how to inject numbing medicine around the nerves that feed the extremity they're having surgery on to numb that extremity to really minimize the pain and speed up the recovery. And so early on in my professional career, I started teaching regional anesthesia courses for the large medical device companies. And I would travel around the country teaching these courses on weekends and nights to other physicians who hadn't quite acquired the skills to to adopt the techniques and or the new technologies that were coming out. And as I was teaching these courses, a few things really resonated with me, Aaron hit on the first one, which was I'm scanning live patients and or doing work on cadavers, in hotel lobbies, where we're trying to take traditional hotel event space and turn it into professional medical space. And so that was number one. But number two, which I think is even more important, and both important for the medical device companies. And the physicians that might listen to this podcast are I quickly learned that in this space, my personal belief is that education is marketing. And what I mean by that is if you're a medical device company and you launch a device, the fastest way to gain loyalty from a group of physicians is not to advertise or make commercials, or give them colorful brochures, it is to it is to teach them it is to it is to help them gain additional skills that will set them up to have more successful practices than they otherwise would have. And so if if education is done well and done properly in the right environment and the right atmosphere, and a physician adopts your piece of technology, they're going to stay loyal to that technology for years, because you've enabled that skill set that they didn't otherwise have. And so once sort of, I put those two and two together in my mind. And Aaron and I started talking about the gaps that we knew existed in that space, we kind of knew that something like med market had to be built at some point.
Patrick Kothe 20:29
Were you guys looking at it from a physician standpoint, or from a company standpoint? Or both?
Aaron Ali, MD 20:36
I would say we're looking at it from both perspectives. I think one of the the unique qualities that john and i have always kind of had is the ability to look at it from multiple different perspectives, right? Because if you look at it from the doctors perspective, only, you missed about 70% of it, right? Because people skip over the circulating nurse in the room, or the surgical tech was going to put this device together in the background, or the supply manager is going to figure out how he's going to store this, or how much ahead that they need to purchase things, right. And the insurance companies that are gonna end up paying for some of this stuff, right? So there's so many different perspectives. And it's one of the little things that I always said is this 360 approach, right? If you look at it from just your five degrees of perspective, you've missed most of the area there in front of us. So we try to put ourselves in multiple different positions. So I think as we've done that, it's worked out quite well, because the physician walks into this place, and they say, Wow, you did it exactly the way I want it. A device rep walks in and says, Wow, you did it exactly the way I would have built it. And on and on and on. We hear that from multiple different specialties, different groups. And so I think that's been one of the very nice successful traits that we've kind of implemented into all our business that's that's made things go the way it has,
Patrick Kothe 21:46
what exactly is involved? What is in the facility? What materials are there? What imaging is there? What are all the services that you're bringing into one location?
Aaron Ali, MD 21:59
Sure, that's great question. Look, when I look back at our FF and E budget, our fixtures, furniture and equipment budget is multi millions of dollars, you know, so if you think of a CRM, a CRM runs around $150,000 to purchase, we have six of them. So you've already hit almost a million dollars just in CRM. So you surgical tables run 15 to $20,000, we have 21 real operating room lights, so you actually raise your hand above, you actually grabbed the or light and actually move it just like you would in the operating room. I've been to other bio skills facilities where they have a lamp, you know, something they bought at Home Depot, and they're trying to play that as a surgical light. Our training Bay has 19 operating room lights in there. And that's enough to be able to put almost 100 people in there with 19 stations, which means each station has a cadaver and a surgical table in the back table and all the equipment necessary. We're Texas anatomical board certified, meaning we have to hit certain requirements that we have to meet. To make sure that everything is well secured, everything's well taken care of our training Bay has 17 ventilation exchanges per hour. From chemicals, there's different smells, if you want to get that stuff out. So when someone throws a mom and pop shop up in some strip center and doesn't put into all these things into account, that really bothers me, one of the motivating factors to keep on building what we do. Our audio visual is incredible. You know, we have the ability to stream from any room in the building to another room in the building. I think one of the best examples is we had about 100 army physicians here at our facility. And they did a surprise visit and a surprise visit while everybody was in the auditorium. With these two giant projector screens. The astronaut who was on the International Space Station came up alive, floating inside the International Space Station and through Houston and Mission Control had a live q&a with our army Dr. Sharon underground in our in our building. So the fact that we've been able to touch out in that space and do a an SSH zoom call out an astronaut tells you that you know we really put a lot of thought into building this facility. It has the capabilities of if there was some type of terrible disaster where the hospitals were inundated and their operating rooms renovated. We could run 21 operating rooms here if we needed to, and even run an ICU here if we needed to. We got looked at when COVID was getting really nasty and we were wondering where we're going to put overflow from isssues the MS groups came in here and looked at everything and we were actually set to do that. So the facility is almost turnkey to do surgeries if you just roll into anesthesia machines and some oxygen tanks, we're ready to go so all the equipment you can ever imagine that's at a hospital is here but they're not all the supportive you know event centers and bars and the kitchen area and all that kind of stuff. It just becomes a really turnkey solution. You know it's sometimes I almost kit about the fact that we're almost like wedding planners, right? We have everything for you the whole entire venues and the flowers will be there this and that. It's the same thing here. Our clients want the same thing. They want a turnkey solution. Here's what I want. Here's how many people are coming. And the beauty is we can supply everything they've they've asked for and we could have meet those and Am
Patrick Kothe 25:01
john Aaron did a great job and explaining all of the different equipment and how it's how it's laid out within the facility? Why is it important from a training standpoint that a B is as lifelike as possible?
John Schlitt, MD 25:16
That's a great question. And before I really dive in to that, I'd actually like to add a little bit to some of Aaron's comments, I think, while the equipment and the infrastructure is is important, I think what's what's equally important, again, when you look at it through both lenses, the physician lens and the medical device company lens, are the level of services. And what I mean by that is, if you take a real step back and look at this industry, as a business, it's a very fragmented industry where there is not a set series of standards for the types of services and the types of equipment that need to exist in places like this. And Aaron alluded to this earlier, but we early on made a decision that we wanted to have a four seasons approach. So not only is the equipment, I believe, top notch, but the level of service. And what I mean by that is small examples. A cadaver, if they want to operate in the abdomen, can't be frozen, it has to be thought some cadavers need to have an MRI before they get worked on, some need to have a CAT scan before they get worked on, there needs to be certain pieces of equipment that need to be able to be shipped in. We've got trucking bays where trucks can back in. So we, so we make sure we have the appropriate equipment. So the equipment is important. But I also think that the level of services is is equally important. To get back to your original question, the reason it's so important to be lifelike. And I'm sure we're gonna get to the future, as you alluded to earlier, but but in the current environment. First of all, as a physician, there are certain things that need to be done on real tissue. So not only when you're suturing, or you're manipulating layers of tissue, right, you know, in physician terms, when you're doing surgery, you've got, you've got sub Q, you've got skin, you've got subcutaneous fat, you've got layers of muscle, you've got to you've got bone, you've got ligament, you've got tendon, you're often inserting medical devices into one, if not many of these structures, you've got to get the feel of what it feels like for a screw to lock in place. Or you've got to get the feel for what it feels like to create a pocket to insert your device between the proper muscle layer, there really are no training aids that are going to completely mimic that feeling. And then truthfully, it comes back to confidence, right? If you've got an older physician learning a new technique, or a young physician trying to improve technique, there is nothing that's going to inspire confidence in bringing what you're learning to the real operating room, then practicing it on real human tissue.
Patrick Kothe 27:59
Aaron, training not only involves the physician, but it also involves the staff. Because you've got a team of people that are performing an operation, Do you often get just the physician? Or do you have the team attending as well?
Aaron Ali, MD 28:19
That's a great question. You're spot on. You know, when you're in an operating room, it's not just the surgeon, the surgical tech can be just as important as candid device rep, or the circulating nurse and anybody else that's involved in the actual touching and feeling of the surgery. I love to do analogies, sports. Drew Brees is who he is, and incredible quarterbacks are who they are. But if their offensive line stinks, you'd never hear of them. Right, they would just get sacked all the time. It's the same thing here. If you don't have good staff around you, your surgeries will be mediocre at best. One of the things in programs that we've tried to push really hard, you know, our business tends to lean towards the medical device companies. But we're starting kind of a new campaign by pushing towards the hospitals and saying, send your entire surgical team, send your orthopedic surgeon, your surgical tech, your circulating nurse your device rep bring them all here as a team of five or seven. And let's do your surgery over and over until you're so good at it. That now you can do four total knees in a day instead of three. One of the things john and i think remember a long time ago was the golden room, there was this operating room it was called the Golden room and the golden room, everybody got paid better. Everybody got kind of patted on the back a little bit more because that was the best surgical tech, the best surgeon, the best anesthesiologist, the best everybody, right? That was the best of the best. There's a Top Gun room in essence, but we don't train that way. Unfortunately, there's a cost to sending five or six people from your hospital and you lose them for that day and they come in here and train but the costs associated versus a return on your investment. It's it's a no brainer. And so we don't see as much as team showing up. We do see a lot of device reps and their surgeons showing up but that's 1/3 of the group, right and so one of the projects that we're really hoping to push is, even with the insurance companies, you should pay to have these people flown in for part of their medical education, to make them that much better. If if half the team is good, and the other half thinks, you still have a mediocre room, and you're gonna have a mediocre case, you're gonna have a mediocre outcome. And unless you have someone incredibly stellar in there, that can really motivate the team. And I've seen some stellar surgeons that can truly motivate their team. But I promise you that surgeon shows up in the morning says, if I don't have Susie's, my surgical tech today, I'm not doing cases here. And john will back me up on that, that there are surgeons that demand that surgical tech is a no, that's the best surgical tech. But guess who surgeon B gets, he or she does not get the best surgical tech, they get the second best. And so that's one of the things we would love to push harder is to bring your whole team in here make every surgical tech in every room. Phenomenal, just like the surgeon should mean just like you're circulating nurses and on and on.
Patrick Kothe 30:55
So let's talk about your customers for a second. You alluded to the fact that medical device companies are your customers were also hospitals or your customers as well talk a little bit more about who the medical device companies are, and and how you got started with them.
Aaron Ali, MD 31:11
Our very first bio skills lab we ever did, and correct me if I'm wrong, john was a cell. We did a inguinal hernia mesh bio skills lab. We had never done a bio skills lab in our life. john and i are actually moving cadavers around by ourselves down in the basement trying to get it upstairs onto the operating table and get everything set up. And, you know, we didn't have a lab director, it was it was us. And we quickly found out exactly what the device reps were looking for. And they were looking for, like I said, the infrastructure, the ability to put this stuff on this event, because it mattered a lot to them. Because if they're flying in their surgeon from New York, and you did a crappy lab, that's a cell you're not going to make and you lost a lot of money. So we quickly understood that our device companies, our biggest clients, they're the ones that have the product. They're the ones that put 10s or 20s of millions of dollars in to get that product to the FDA and do their clinical trials. And so this means a lot and this is the last mile bringing in that physician into that operating room with that bio skills lab that teach them how to use this product and grow that confidence that we keep on alluding to that if you have that confidence and education is marketing, it's a win win for everybody in the room. So the device companies have always been our number one clients but you know, we train every ms personnel here in Austin, Texas, every single paramedic and EMF provider here in Austin, Texas has been through our building and as intubated chest tubes, cut legs off for amputations, done all sorts of things. We've had military personnel coming here we've had Navy SEAL teams come through here. We've even had the ATF and FBI look at us as a training facility. So our customers are there's a lot of different sectors we can go through. But the core business tends to be around a medical device. You know, the Giants the strikers, Abbott's Medtronic, those kind of groups. They're pulling and rolling out innovations, almost on a monthly basis. There was a wall street journal article a few years back about their industry of rolling out new products runs into 30 to 50 billion. That's just getting the products out. But then the training, and the infrastructure needed is another 30 to 50 billion. So there's a lot of money in the sector that's being spent, we just hope to be able to use it efficiently. Drive costs down and train the dogs who really need the training along with the rest of their staff.
Patrick Kothe 33:24
JOHN, are most of the company's orthopedic companies, or do you have a wide range of different companies?
John Schlitt, MD 33:31
Yeah, I would say if you if you broke down by by segment, I would say orthopedics and spine probably make up our largest two segments. Quickly. Behind them are some of the chronic pain companies that do a lot of implantable stimulators and do non invasive spine procedures. And then probably I would say the fourth largest maybe cardiovascular type devices in again, implantable pacemakers. icds things that that don't necessarily require pulsatile blood flow, right. And that's, that's one of the reasons this is fun for Aaron and I because, again, you got to understand the nuances. We talked about real tissue earlier. And it's critical that some devices actually require pulsatile blood flow, we can we can take our cadavers and hook up non pulsatile blood flow and actually have volume circulating through the circulatory system. But But we can't we can't currently do pulsatile blood flow and get the heart to eject in a pole style fashion. And then the only other thing I'd like to add to Aaron's comments earlier is while these these large clients certainly make up the majority of what we do, our passion around the CO working in in the innovation lead us to partner with people that are working to bring new devices to market as entrepreneurs themselves so we a lot of our co workers and clients find their way to co working because a everything Aaron said earlier about the Affordable space but be x To the lab and the innovative atmosphere. So we have a scrub tech school that utilizes the lab, and trains alongside some of these large medical device companies. And what better experience for a scrub tech whose training What a wonderful job in today's economy, but you get experience working in the lab, which is right next door. And then a lot of our startup companies are drawn to our space, because they want to utilize the lab. And so we found some really creative ways to make sure that we take care of our large cap clients, so to speak, but still have have plenty of time attention in detail to our entrepreneurs and in some of our schools. And actually, in certain scenarios, blend them together so that they both reap the benefits of what's going on in the lab.
Patrick Kothe 35:47
So you guys are not an accelerator or incubator, you're you have co working space. Is that accurate?
Aaron Ali, MD 35:54
Yeah, I would, I would definitely would not call us an accelerator and incubator. That's a great topic you just brought up, we've worked and talked to lots of incubators and accelerators. And I think where we found ourselves in that space is, once you have gone to the university and accelerated created your business, you have your C Corp done and you have your idea and you've done your minimal viable product. And maybe you have some revenue generated, we're happy to take those companies as they graduate, in essence, from that space, into a, okay, we're with the big boys now we actually have to get revenues, we got to get in front of doctors, we got to train them how to use the product. We're past a lot of the r&d though we do have groups here that are still doing research and development on their products, or their past the FDA. Or even if they're close to getting past the FDA, we can help them with that. So we find ourselves as a next step in that, you know, that difficult process of going from light bulb idea to you just got acquired by a giant medical device company. We don't accelerate and incubate here, per se. But what we do is offer our clients a few different options, your option can be you have an office here, you walk into the front door, your way, that means that hey, Carrie, when you go about your business, do your day. Option B is my doors always open, you want to sit down for five minutes and chat about things and ask them questions. Come on, and no one's gonna charge you anything. We're happy to, you know, introduce you to people and get you going. And then option C is guys, we're not really sure what we're doing here, we really need some help, and some consulting help. We'd love to put men to market on our board of directors, help guide us, help us introduce us to funding, get us in front of people, that kind of stuff. We may even give them office space for free for a few months. But what we don't want to become is kind of like a security service, we're providing them all the money to exist, that's not our job, their job is to get to that position and be able to fund and take care of themselves. Our job is to elevate them and get them to the next step in the process. Because we know how difficult and how cumbersome The road is to success and the medical device world the medical innovation world.
Patrick Kothe 38:00
So Aaron, you went from a customer to now in the sales business a little bit. So you're you're out there getting customers with medical device, device companies, so kind of switched? What was the thing that you learn the most, when when you switch from being customer to salesperson?
Aaron Ali, MD 38:20
I think one of the most important things as, as any physician will probably support me on this is you got to check your ego a little bit. You know, you used to be the doc in the room. But now you're the sales rep in the room in essence, right? Listen, it obviously helps to walk in a room and have an MD behind your name as the person selling the concept and the idea because you've got credibility, you've been there 20 years plus, and you know what you're talking about, you're not some Joe Schmo that said I can do this. You know, I've always, hopefully check my ego through the years. But it's easy for me to be passionate about a concept and an idea. And a lot of times in medicine when you're the doctor. The passionate part is when you're talking to your patient, and you're you know, you're trying to sue their fears you're trying to get them through this rough moment because they're not coming to see you because it's a great day. Usually something's not you know, perfect here in their world. So as as a salesperson or on the other side. My passion now is truly about our baby that we started here, right? This this company's is our thing this is this is one we didn't walk into become partners four years down the line that someone else started 30 years ahead of us. This is our baby, every single cushion or rug or wall that's been painted here was paid by us or we put our butts on the line with our 401k to pay for it. So the passion involved in standing in front of a group and selling yourself is actually pretty fun. It also, you know, puts a little stress on you that if we screw this up, we could be losing a lot of money. And so when we did a lot of investor pitches at the very beginning, that was me selling my entire everything, my soul, my passion, my expertise and I'm standing in front of some very sharp family offices or private investors. To invest in multiple different successful organizations, and they're hammering me with questions that I've never had before, you know, there's a lot of p&l this and cash flow that I'm thinking, Oh crap, I didn't get that in biology, you know. So it's difficult, but we're at the level we're at, because we can learn things pretty quickly. And we can, we can try to understand things. And I can spend some time in front of YouTube and understand cash flows a little bit better. But you're really selling yourself and your passion. So for me, that's, that's natural. I've always been, I've always enjoyed that I've always got a big kick out of sitting in front of a group of people that I've got to convince them that my idea here is worth anything. And so yeah, I had some door slammed on me, I had some people within like, 10 minutes of my picture, like you'd go ahead and stop. And I was like, really, like, not interested at all. And I mean, it was like, you know, tail between your legs walking out of that restaurant and feeling like a dum dum. But at the same time, I had other people saying, that's the most incredible idea for I Why hasn't anybody done this before. And I love that line is why hasn't ever been anybody ever thought about this idea. And I think that's what we pride ourselves on is we love to push that envelope a little bit and into little areas that most people wouldn't venture into, because they're comfortable. As a physician, showing up to the office, doing your thing, making your money, going home and doing your thing,
John Schlitt, MD 41:14
I'd get bored. That's all I was doing. And my wife hates it. But this is this is me, I love it. And I don't mind selling myself on the other side and being that salesperson. Yeah, but I'll tell you that one thing that Aaron has to get used to is as a physician, when you're working with device companies, you're used to hearing Yes, a whole lot. And then when you flip to the other side, you got to get used to here know, a whole lot. And I think that's the biggest change.
Aaron Ali, MD 41:38
Totally agree with that. Because like I said, we've got knows where you're like he or she just say no to me. But yeah, right, you're on the other side now. So you will definitely get your notes.
Patrick Kothe 41:49
So let's talk about medical device company. So there's somebody who's coming out with with a new hip, knee, whatever, and they want to utilize your facility for training. What happens? Do they bring their own equipment? Do they bring their own teachers? How does it How does it work?
Aaron Ali, MD 42:07
We haven't alluded to this directly yet, you know, we've talked about the infrastructure being amazing. We've talked about the service. Honestly, what really makes this business is I've got some of the most incredible employees in the world. They're here till 11. At night, they're here Saturdays and Sundays, doing these labs, because a lot of these device companies want to come on Friday, Saturdays and Sundays. Our lab director, Paul, I don't think has had a weekend off in the last nine weekends in a row. And he's got a baby doing about two months, this can't be done without, you know, the right employees and the right people. And they have, they all have ownership in the company. I want them to walk by and pick up a piece of trash on the ground and feel like this is their place to write. When a group wants to, you know, set up a bio skills lab with us or an event with us. We have a lab director, we have an events director, we have a Chief Operating Officer too. And so everybody gets involved. So you you call us and say, Hey, Stryker, and I want to do a robotic platform, total knee replacement, I want to have 20 surgeons fly in, I've got 20 of my own staff, I need, you know, 10 stations, and they start to go through that. So we have a form, in essence, that walks us through every question, you know, what day how many days are going to be or how many people once you go through this nice exhaustive form, it allows us to pretty much take that data and we become so slick at it that within Gosh, two hours, we can come back with an invoice to them and say that quote and say this is what it's going to cost. Here's everything we have, there are some specialty items, obviously, we don't carry the million dollar robots, you need to, you know, fly those in UPS and FedEx into the back. And then we find out the gray zone equipment, right? Do you guys have this? You know, retract? Or do you have this and that's we go through this because we know we've done so many of these labs. Now. We know the little things that are mess, because the worst thing that could ever happen is everybody shows up. And there's some silly retractor that you don't have in the surgery can't occur now. So you just spent the $100,000. And you brought in all these people and flown all these people in, and the labs a complete failure because you're missing something. So we spend a lot of time two weeks before to make sure every bit of that equipment is correct. And every piece of it is done right. And then we help them out with where to stay for hotels, where to go for dinners. That's where our events coordinator director takes in, and then how we cater all their food. And so it's literally a turnkey solution. We go through all these questions to make sure every single thing is answered. But I think where we become the Four Seasons is we ask questions that they don't think about, Hey, you know, you said this, but we would recommend you do this because we've done enough of these where that didn't get the ROI you're looking for from your physician. We've seen physicians come in to kind of shake your head about that technique. We highly suggest this technique. And a lot of them take our advice from us and you know, like you're asking what kind of feedback do we get from the physicians and our clients as they tell us I've never been to a place like this. This is the absolute best place I've done the bowel skills labs all across the US. And I don't know what it is about you guys, but it's perfect. But I know what it is, it's the whole entire package of the right employees, the right instruments, the right equipment, the attention to detail in providing a true four seasons infrastructure, right, you walk into somewhere, you're like, wow, this place is awesome. All those things make the difference. And so, but that process oriented, you know, manner of an intake form, going through all the steps, making sure everything is going to be perfect, just like setting up a wedding, you got to have the right rows and the right color, whatever it is, you want, we do the same thing here.
Patrick Kothe 45:34
The facility is is one piece and the people that are there, but the bride and groom are a big part of that, too. So when companies come in, I'm sure some companies do it better than other companies do the education better. What do the good companies do?
Aaron Ali, MD 45:51
Well, I think they take that four seasons approach. Also, I think they look at the entire project or lab or event from A to Z, you know, they don't leave anything to chance. They're not hoping this person gets it, right, they double check everything, you know, sometimes we kind of are like, man, so and so's calling again. But that's great, because that keeps us on our toes to make sure everything's done. Right. So, you know, like I said, they're spending a lot of money flying 20 physicians and put them in a hotel, taking them out to dinner, stuff they don't even do in our building, before they even get her. They've already dropped, cost $100,000 get these people here. So these are big ticket items. And so they're just as concerned about it as we are. And so they have their own medical education coordinators, and they have people that work very nicely in parallel with our coordinators and our directors. But when they see how much of the responsibility we take off of them, and how easy it is, it's almost like your concierge, I got this, I got you set up before o'clock today, you're going to go climb this little mountain or whatever. Same thing here. We got this, we understand it. Sure. Please ask your questions, feel very comfortable that when you get here, you're going to notice, you've got a lot more free time to yourself to actually go and chat up with your physicians get to know them. Focus on them versus is the cadaver position correctly, where's that one piece of equipment we needed? Because for them, you know, like I said, their return on their investment as their physician has to walk out of here. educated, confident and happy. If you can't get those three things, and even one of them is missing. You probably missed out on an opportunity to bring in your product to that hospital system.
John Schlitt, MD 47:24
Yeah, but I'd back it up even a step further. Bad to answer that. And I'd say it starts with the with the inner belief of the company of a concept that we talked about earlier, which is education is marketing. It's finding the right medical education coordinator in a world where you know, regulatory and getting through the FDA, and r&d and engineering are so critical. In many companies that medical education budget is not as important internally, as it is in other places. So the companies that I feel, do it best, give equal amount of attention to that medical education staff that medical education budget, and and really do internally believe that education is marketing. And I think it starts with that fundamental belief and then extends into everything Aaron talked about earlier.
Patrick Kothe 48:17
Bringing people in Austin is convenient for some not convenient for others, more local training, maybe more appropriate for other other locations in the country. So let's talk about the future and see about what you guys have planned for possible expansion. Is this something that you you've you've thought about? Is it something that is interesting to you?
Aaron Ali, MD 48:43
It's definitely a discussion point we have lots of times our goal has always been to take this fragmented industry that's run either pretty well or pretty poorly, and tried to really set forward a gold standard. And I think we've done a very good job here with the limited budget and the investors we brought in and the things we instituted here at our flagship location in Austin. But now knowing what we know, and having almost 10 years of experience under our belt, the appropriate step for us this to scale, is to build two to three more of these flagships across the US and correct geographical locations that can kind of cover the East Coast, the West Coast and kind of the Midwest areas. And so there's certainly cities we're already looking at there certainly organizations and private equity groups and investment bankers we're talking to right now. multiple ways of going by we can build another shop and do what we do and continue to grow our business and, and just do this for the next 1520 years. My goal and vision that I see is to really go out there and and reset the standards and get rid of some of these, you know, poorly run bio skills labs that don't really understand why they're in that business except to make $1 find somebody other ones that have the same principles as we do, and either roll them up together with us, or kind of united in essence, and really set up a true gold standard in a very elite standard of this is the way in the US, we educate our physicians, once they're out of their residency and fellowships, this is how we innovate. This is how we bring new devices to market. And truly push that envelope once again, and I know I've said that phrase a few times. But it's so true, because I hate status quo, I can't stand it, I'm always going to do everything I can to change it to make it better. And the beauty is, is every single thing our Corporation does today, tomorrow, a year from now, or 10 years from now, it comes back at the very end to one tiny little line that paint points back to the patient. Everything we do here is going to benefit you as a patient when you're sitting on that operating table. Period. Yes, I'd love to exit out $100 million. Yes, this man, yes, I'd like to have 20 these around the world. But the cool thing that I can always sleep on when I go home very comfortably is what I did today is going to help out some grandmother, some teachers, some firefighter that may be in the operating room or at a clinic or a hospital. So you know, the drive to scale is definitely there, that's definitely in our future, the drive to try to roll up this industry and set up even higher standards than what's out there is definitely a driver for us. So I'm excited about what the next two to three years are going to bring him out. And it's always interesting. It's sometimes a little stressful. But that's the beauty of entrepreneurship. Right.
John Schlitt, MD 51:29
And you know what I would add to that, which I agree with there. And I think we clearly want to scale as we do. So I think when you look to the future, that the two components that we're lacking today that I think will be incorporated into this space, are data and technology. Right? And so you could spend an entire podcast on the data, right? I mean, is it us sitting down with our clients that we spent 10 years working with and saying, Okay, let's look at where all your physicians are around the country? Where do we need to scale to to host your national labs, your regional labs, make it convenient for everyone, and sign multi lab contracts. That's one set of data. But then even internally while you're doing labs, collecting data on surgeon efficiency, on, you know, knowledge of the rep on on likely conversion to your device, based on the surgeon's experience. So we believe that data is going to be integral both internally and externally to our future. And then technology. I mean, we certainly need to be aware of it. I don't foresee tissue being eliminated completely in the near future. But certainly, you've got to be aware of VR and simulation and know that, that those will play a role at some point in enhancing education. And and to me that that still goes back to data, right? Is it? Is it you know, how many categories total knees using the robot does a surgeon need to be proficient or do one more in a day than he was doing a year ago? So that the operating room is more efficient at the hospital? And that surgeons getting a significant return on investment? Or how many does he need to do using VR and then supplemented with tissue in order to achieve the same milestone? You know, and so I think we realized that data and technology are going to play a role. And we're enthusiastic about both and continue to stay abreast of both of those. And we look forward to incorporating them into into our future structure as well.
Patrick Kothe 53:36
Virtual reality has certainly gotten a lot of press over the past several years. Do you guys consider yourself to be a bio skills lab or an education
Aaron Ali, MD 53:47
platform? That's a great question. You know, it always depends on which client I'm talking to, if it's my clients that are all about bio skills are verbal skills, the education is always a part of it right? When I'd speak to non medical people Hey, Aaron, what is that med market thing? You know, I kind of push more on innovation you know, we're pushing the envelope of training like Top Gun pilots to bring in technologies a lot of dogs haven't touched yet mess with yet you know that scene in James Bond with James Bond gets taken down accused live and Q has all the fancy gadgets and the pen that explodes or the car that can you know, fly pretty much. That's what this is. This is a James Bond lamp or physicians for device companies. This is an opportunity for you to come in here and do things that you just can't go do in the hospital. You can't mess around with stuff like that in the hospital, we get a live human being on the table. But here we have a lot more leeway to do things so when I explain it to them like that, they're like okay, I get it so you're just like you can do just about anything and then you can train people and you do the coolest things and you can you can try things that you would never try at the hospital. Absolutely. You know we we can throw firecrackers that the the military guys training to just simulate noise around them while they're trying to put a chest tube in because that's the environment there. Going to be head, right. So you know, they always say, you know, train like you're going to be when you're out on the field. So we do the same thing here, we try to put you under the same stresses and the same pressures. And so we try to mimic the most realistic environment possible. So a lot of different ways to describe what we do. And a lot of different faces when I'm talking to different clients. But at the end of the day, it's it's, it's an incredible, incredible innovative center where you can train you can design you can develop and you can sell,
Patrick Kothe 55:27
is VR a competitor? Or is VR, a tool that you're going to use to train?
Aaron Ali, MD 55:35
I would think it's just going to be another, you know, tool, another piece into our armament as we go forward. You know, it's something we're going to have to definitely incorporate in and we've already got groups coming in and, and discussing with us, you know, how can we use this? And how can we do that we actually are using some of the are already. So we're always looking at the next step ahead to augmented, you know, haptics in the VRC can actually feel the different tissues as you push the needle through those kinds of things. So there's a lot of really cool technologies out there that we're already looking to, to try to partner up with different organizations. So definitely will be a part of our future, too.
John Schlitt, MD 56:11
Yeah. You know, Pat, I agree with Aaron's comments. And to add to them, you know, I think while you know, traditional medical device bio skills is not going to go away. I mean, one of the things that we find that that we not only get asked to help do, but as to really push the envelope on is curriculum building. And I alluded to it a little bit earlier with the data, right? I mean, is it for VR sessions and three kind of Eric sessions? Is it six VR sessions and two categoric sessions? Is it you know, how many chest tubes to the paramedics need to place to be proficient? How many times can they simulate it, and then do it on real tissue to be proficient? So I think as we look to maximize our space as a business, right, we want to be as busy as possible with as high a margin contribution on those days as possible. Education and curriculum building will always be a significant part of what we do. Even if the device companies come in on Friday, Saturdays and Sundays. We're building curricula and partnering with people on Mondays Tuesdays, Wednesdays and Thursdays to try to figure out how to take care of that patient, as Aaron alluded to, and make people as proficient as possible. Again, what that core belief that education is marketing, right, I mean, those paramedics that leave here that feel like their first pass intubation technique is significantly better than it was before they came here. That's a good, that's a game changer for that guy, or for the surgeon, that added one more case during his day. And so that will always be a significant part of what we do.
Patrick Kothe 57:40
You guys have unique perspective, and that your clinicians as well as entrepreneurs, there's some things that you think people in within the medical device industry really need to focus in on to help train their customers.
Aaron Ali, MD 57:56
I think, from experience, and what I've seen in the operating room, the best medical device reps can almost substitute into the surgery and be almost a surgeon, I've seen some that can actually literally tell the surgeon, I wouldn't do that, I would do this. So truly having a passion for your specialty. If you're an orthopedic spine person, you need to almost know how to do the surgery. And that's why we push with a lot of these medical device groups is sending your sales reps without the doctors but maybe their Proctor and actually have them put the spinal cord stimulator in. So one of our device groups does a great job, they actually have the reps, put this spinal cord stimulator and put the leads and make the pocket. These are guys that have never cut skin open to make a pocket. But once they start to understand and put themselves in the shoes of the surgeon and know what why is that complex, why is that taking the longest there, then they can walk them through it. So you really, really, really need to try to put yourself in a position of I'm almost like the surgeon, and I can almost tell the surgeon what to do. Because if you're going to be in that position, the times where the doctors gonna look at you and say, What do I do next. And so if you want to sell and you want to be the number one sales rep and your device company, you've got to be that person, because that's the exact surgeons, pick those device reps, and they become best friends with them. And obviously, you've got to have the personality and all that to deal with the stress and dealing with Doc's all the time, but they look at you as their right hand person. And if you're that person, you've got the most successful business in the world, you're gonna you're gonna crush it at all times with these physicians in the operating room. Yeah, what
John Schlitt, MD 59:33
I would add to that is even even outside the sales space, don't be afraid to to always ask questions and continue to learn. And what I mean by that is some of the simplest and most nuanced things make make the the largest difference. So you know, when when you're training, a lot of times what a company will do is they'll they'll have what Aaron and I call, you know, one or a few big caol is key opinion leaders. And those companies really zero in on focus on what those kayo ELLs think and make decisions based on the feedback they're getting from those kayo ELLs. But if you if you go beyond those ko ELLs and you engage with your physician customers in training opportunities, and you ask questions, you may find that the 90% of your clients like the handle if it was tilted 10 degrees more this way. And that is a game changer to your device coming off the shelf. And then the other part of asking questions that I think is critical as healthcare is ever changing, right, we are living in a world of bundled care initiatives, where we're now working on decreasing length of stays, and decreasing costs and maintaining quality. And the economics of healthcare are always changing. So continuing the understand the economic environment and the economic drivers of healthcare, you know, the day where if a physician a slammed his fist on the table and said, I'm only going to use this device, or I'm leaving and going somewhere else, those days are disappearing. Now you've got large hospital systems negotiating with vendors. So you've really got to find ways to differentiate yourself. And really understand that economic equation of quality over cost, your device really has to either improve or maintain quality while decreasing costs. And if you continue to learn and continue to learn about the environment, and continue to ask questions and staying engaged, I think it'll just set you up for future success.
Patrick Kothe 1:01:36
I just love understanding what's inside the minds of physicians, especially when they become entrepreneurs, and start to see things from a different perspective, our perspective. So a few of my takeaways. First, education is marketing, that was really the theme of this whole conversation and the basis for their business. Education is marketing. But I'll tell you this, bad education is not good marketing, good education, equals good marketing. So you really have to do it correctly in order for it to pay off for you. So it has to be done right. The other thing is, every product doesn't require the same level of education, if you got a simple device, a cadaver lab may not be the way to go. But education of a different manner, can be just as effective for you. Even though it's not the full blown cadaver type of situation, just do it right. The second point was they both looked to find the need, and then define what the solution is based on that need. And that started from an appliance Dolly business at a&m or an ice cream ice cream truck on Cape Cod. And then, you know, kind of leading through anesthesia practice and starting starting in a seizure practices, and making sure that the needs were met, they're all the way to leading them to med to market and really looking at education from the visit physician standpoint, but also talking to companies and understanding what their needs were. And they're not stopping, you know, with with the establishment of the business. You're heard, how they continue to learn and how they continue to innovate based on the feedback that they're getting from the companies as well as the physicians that are coming through their training training courses. The last thing is john Schlitz had some very interesting things to say when he said, help them gain skills that will set them up to have more successful practices. So I think we have to look at ourselves. We're not only selling devices, but we're selling technologies that can help physicians be more successful in building their practice. So it's a different level of sales, a different level of marketing. When you step away from I'm just selling my product to you, too. I am helping you build your business. Thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast on Apple podcast, Spotify, or wherever you get your podcasts. Also, please spread the word and tell a friend or two to listen to the mastering medical device podcast. As interviews like today's can help you become a more effective medical device leader. Work hard. Be kind
