Managing Your Career - Are You Doing It or Just Letting Things Happen?
Patrick Jamnik is President of Episurf Medical, an orthopedic company who provides individualized technology for the treatment of painful joint injuries. In this episode Patrick shares why a company personal development plan may not be the best for your career, why you need to be a lifelong learner, how to seek out mentors and where to find them, what a mastermind group is and how it can benefit you, some of the things to do when importing a technology to the US, and what Episurf is doing to help an underserved orthopedic patient community.
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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! Most of us have seen the movie Forrest Gump. And we can picture the feather at the beginning and the end of the movie, gently moving on the breeze. With that iconic music playing in the background. We can also remember Tom Hanks as Forrest standing at Jenny's grave saying, I don't know if we each have a destiny, or for all just floating around accidental lake on a breeze. But I think maybe it's both. Maybe both is happening at the same time. We all have our own philosophies on life. And I'm certainly not going to try and change yours. But I believe that randomness does play a part. But I also believe that our plans rarely turn out exactly as we pictured them. And I know that you need to be prepared to take advantage when an opportunity is in front of you. Today's conversation evolves personal growth, and managing your career. A subject I that I absolutely know is important to all of us. Our guest today is Patrick Jamnik, President of Episurf Medical, an orthopedic company who provide individualized technology for the treatment of painful joint injuries. Patrick's background is in sales and marketing, but he has special knowledge in bringing technology developed outside of the US enter the US. Patrick also has a unique perspective on managing a career. In our conversation, we discuss why a company personal development plan may not be the best for your career, why you need to be a lifelong learner, seeking out mentors and where to find them. What a mastermind group is and how it can benefit you. Some of the things to do when importing a technology to the US. And what Episurf is doing to help an underserved orthopedic patient community. Here's our conversation. So Patrick, you're in a startup now, but you came from big ortho. Can you tell us a little bit about about your journey?
Patrick Jamnik 02:50
Sure. So my time in the medical device industry goes back to really goes back to the summers of 2002 and three, I started working for a distributorship of Zimmer, this is before Zimmer and Biomet were one company and I started doing all of the kind of back of the warehouse types of tasks putting instrument sets together running implants to hospitals on an emergency basis. And the first summer sort of turned into the second summer that was a more kind of structured and formal sales intern role. And that led into a full time position. When I when I graduated, and I was at Zimmer from 20 or 2005 to 2013 in a couple of different territories. During that time, I went back to business school at night. So it was Monday and Thursday nights for for three years. So I was sort of the the guy who would leave every day with the work bag on one shoulder and the school bag on on the other shoulder and they the schedule is kind of blend into to each other. I went back to business school, knowing that it was the right time for me personally, but not knowing exactly what I wanted to get out of it at the at the end of it. opportunistically during that time. One of the one of the classes that I took the professor happened to be on the board of directors at a sort of mid market orthopedic company. And I got along with him very well, I took his course we got along, we had good energy between the two of us. And ultimately, I ended up asking him who, you know, if there was anyone that he could recommend in the industry that I should get in touch with I knew that I wasn't going to stay in the strictly sales role that I was in for long term and wanted to just sort of expand my horizons a little bit. So he put me in touch with another board member that he worked well with and got along with and said, Listen, I think this is somebody that you should meet. I sure enjoy His company. And I think at the very least you could pick up a nice mentor and who knows what happens from these relationships down the road. And that relationship really kind of flourished. And sure enough, it's they always say no, it's not the person you know, it's the it's the next level connection. that, that tends to be the one that sort of unlocks thing. And, and in my case, that certainly came to be true because this gentleman that I was introduced to down the road became the CEO of a British based company called Stanmore implants and Stanmore was a an orthopedic oncology focused company that sort of dealt with, I guess, you could say, sort of the worst of the worst, but it was a company located outside of the US. And I was hired as one of the the initial team to sort of build the company's US market entry strategy we started with, with nothing, you know, we let's get some business cards, you know, really, really ground level things. So I stayed there for a couple of years. And we I guess you could say we caused enough sort of chaos and kicked up enough dust around us that we got noticed by one of the large incumbents, and we ended up being acquired by Stryker in 2016. So then, I stayed at Stryker for a couple of years after that, but even while I was at Stryker things went really well. And I appreciated all of my my time there back in a in a in a large organization. But once you at least for me, once you sort of get a taste of how things go working at a smaller company, and the pace and the energy and the dynamism that really exists there. You always kind of keep one eye out to sort of see what else is it what else is out there. So after a year in the cardiovascular field, which is a whole separate sort of journey of my my career, but but one that I would not trade for anything, even though the time wasn't terribly extensive. I went back and about a year ago joined a company called epi surf medical in leading their US market entry strategy leading all of their their US, leading all their US activities. Today, it's a company based in Sweden. So it's another one of these European companies looking to enter the enter the US market.
Patrick Kothe 06:53
So you started off on the bottom of the totem pole on the sales side, but you moved over into marketing kind of post education is that when you that's when you moved over into marketing, tell me about that transition?
Patrick Jamnik 07:08
Sure. So it wasn't one that at the time was very, I can I can say this with with hindsight, it wasn't purposeful or deliberate, it wasn't sort of used to do sales. And now I want to do marketing, frankly, at a small company, the roles are very, they're very blended, and anyone who thinks that they are just, you know, just doing traditional marketing activities, or just doing traditional sales activities, particularly at a small company, those activities are very integrated. And as the you are, you're thinking about the sales process the entire time when you're in a marketing role. But really, for me, the the sort of move out of a field based sales job into a sort of a little bit more of a corporate atmosphere, or a little bit more of a, you know, not just an independent role was to get a broader, a broader business based background, I think, you know, marketing is sort of the, at least in most orthopedic companies, or med tech companies, marketing plays this very, very pivotal linchpin, that sort of bridges, r&d and sales. And they kind of work in both in both directions. And they can, you know, are used to and familiar with how the sales process works, generating demand working with the customers, but then at the same time taking some of that feedback, and being able to relay it and send it to the r&d department and work with the folks in r&d to meet the things that the customers are saying out in the in the field. And it was really that experience that that was really helpful. For me, a marketing role allowed me to get sort of conversational in a lot of different functional responsibilities within a larger medtech environment. So you're very quickly involved in conversations with r&d conversations with regulatory conversations with quality conversations with legal with finance, a lot of different departments that certainly as in a field based big company sales role, you're just not that interacted with a lot of those different departments that make the entire machine and ecosystem work.
Patrick Kothe 09:14
So you mentioned that you didn't really set out to do that. It was more of a discovery, once you were embedded in that spot is you had a whole lot to learn yet that you didn't know that you needed to meet it to learn. Tell me a little bit about your thought process in moving over into marketing and developing those things. Did you at that point? Did you know that there was so much that you didn't know? Or or is that something that you felt that you wanted to move towards?
Patrick Jamnik 09:48
In hindsight, I can say this now, I didn't know how much I didn't know. There are a lot of things that in a field based sales role, you know, You take for granted products get handed to you, they have the regulatory clearances behind them, they have all of the r&d work done, all of the bench testing is done. Some initial clinical studies might be done, the KOLs have been selected, all of the focus groups have been conducted, the brochures have been made, the sales tools have been created, it is up to the Salesforce to sort of take things, you know, take things and put them in, you know, run them run them into the endzone to use a football metaphor, but but I had, in hindsight, far, far too little knowledge and appreciation for everything else that kind of goes into getting a product ready to ready to be on the market.
Patrick Kothe 10:41
So let's go back into your into your sales experience in the first second. Because I'm also interested in in career development, and what's happening. So you're in a large company, you're in a sales role, and you have your annual performance reviews or your quarterly updates. And people always have developmental plans. So what do I need to do to develop myself? Or where do you see yourself moving into? What were those discussions? Like when you're on the sales side? Was it just teach me to sell better? Or was there anything to open up any of these things that you just mentioned?
Patrick Jamnik 11:20
Good question. And I think that the answer is will obviously be different for for everyone. But in my situation, at least, I was working at a large major distributorship independent distributor ship for a major manufacturer. So our distributors ship had exclusive rights within a given geographic within a geographic territory to sell the company's full portfolio of products. So your career options are frankly, somewhat limited, or I felt that they were my options were somewhat limited, there were certainly room for territory growth and management growth, but it always essentially was just more geographic oversight. And that was really the extent that was able to be offered to me, it's not a criticism of the distributorship, they're playing with the hand that they are, that they are dealt. But for me, it was just that was not something that was terribly appealing to just sort of have a smaller territory and then have it be a bigger territory, and then your sort of reward for a bigger territory is sort of more of the same, rather than more of different than in, in strictly sales roles. And that big companies, they are largely just, you know, sales roles. There's only so much more that you can be offered in terms of a diversity of responsibilities, you can be offered more territory and more geographical oversight. But, but if you want to get involved in other projects, especially at a big company, there always is going to be this tribalism and this sort of stay in your lane type of attitude that that that can persist. And a lot of these changes for me took place at the time that I had just been in business school. So every a couple of nights, every week, I was sitting around the table with people from a wide diversity of industries have backgrounds of different, you know, different jobs. So you really can get the imagination going, where you can see where there's there's other people, people that you would have considered your, you know, your academic colleagues, and they're engaged in, you know, in certain projects, or certain lines of work. And, for me, it just got my curiosity going more to, I need to explore what else is out there, I don't want to just, you know, go be an accountant or something totally different. I want to take my existing skill set and my existing experience, and how do I sort of harness that, and and make some sort of modest pivot into, you know, to build upon that, rather than just get more of the same type of experience.
Patrick Kothe 13:55
What's really interesting about that is, as you explained, you're working for a sales organization, and their needs are different than a company organization. So this, and if you're in a sales organization, within a company, it's still within that sales organization, you may be able to branch off into national accounts, or contracting, or people management, you know, moved to be a regional zone manager, national sales manager, but you're doing more of the sales function. That's what the development plan kind of looks like. But as an individual, we also have a responsibility to manage our own careers. And we have the responsibility to build a career pathway that may be different than what the company offers. So when you started to start to look at your experience within marketing, and it started to open up your eyes and the education that you went through and saw different people in different industries. Did you start to think differently about careers management,
Patrick Jamnik 15:02
I would say so and I think that's, that's probably the result of the kind of osmosis that you that you receive from just being around other people. And it was really the first time in my life that I witnessed other people actively managing their own careers. The field work is clearly you know, it's really, really important to a med tech organization, but it can be very isolated in terms of you have your own individual responsibilities, and you have, obviously, tons of customer interaction, but you are running your own little mini business where it can, you can go a long time without too much connection or too much too much work with your colleagues and even your colleagues are sort of just doing the exact same job as you in a slightly different geographical area. So there's not, there can be some little sales anecdotes that can be picked up. But it's not exactly it's not as if you are, you're part of a team and name but you're not a part of a team in terms of function and responsibility, where each person is bringing a unique skill set to the table that complements everyone. So I think, for me, the academic experience and this whole idea of like, should people go back and get an MBA or should they not that's a whole separate conversation. For me though it was a major sort of fork in the road moment in my my life and in my career. Because not only did I get to get exposure to people that for the first time in my career, I was getting exposure to people that had all sorts of skill sets that were not slightly, you know, that were not at all similar to mine, there were people who had almost, you know, 180 degree opposite skill sets, your friends are always your friends and your colleagues or your colleagues. But this sort of secondary network of people that are able to, you're able to get a fresh set of ears on an idea from and you hear them talking about how they manage their careers and talk to in deal with HR and how they, you know, think about their careers and longer term horizons, 510 15 year horizons, etc. At that time, for me, that was the first time that I had ever had those types of exposures on a, on a really frequent basis. Everything in the sales world is largely just, can I grow my business? If I grow my business? Can I have a you know, will I acquire more territory or just more responsibility within a given territory, but the work is very individualistic, for obvious reasons, as opposed to being collaborative.
Patrick Kothe 17:33
And the other thing about a career, and it's this kind of a push pull as well, if you have aspirations to move up or sideways, or do something different. The number one criteria that you have to pass is you have to be successful in your current endeavor. So, so you need to go deep in terms of your knowledge, and you need to be really successful in your current position, which, which means that you have to have deep learning about what you're doing and how to be successful. So having those sideways conversations with your peers about how to be your the best salesperson or the best marketing person, the best best engineer out there, that is really important. But you also have to start looking outside of your own realm as well. Did you? Did you find that to be a difficult thing to be able to go deep into yours and look, look out outside at the same time?
Patrick Jamnik 18:37
I think that I'm a relatively I'm a relatively affable and outgoing person. So meeting new people asking people for for help poking and prodding a little bit and asking someone, how did you do this? What were you thinking about along the way? Perhaps it's a sales background that makes me very sort of comfortable asking those those types of questions. But that, I guess, is probably something that has always come relatively naturally, to me, and it always helps to when you meet new new people that come from different backgrounds, they are just as interested oftentimes in what you're doing as you are in them. So, you know, an easy way to take interest in someone is when they take interest in you, it's quite easy to to reciprocate those, you know, that that level of curiosity with with whomever it might be that you're that you're speaking with.
Patrick Kothe 19:31
So, Patrick, you're you're president of a company now. So you know, everything at this point, there's nothing more that you can learn. Right,
Patrick Jamnik 19:37
right, right. Exactly. Yes, yes. Yeah.
Patrick Kothe 19:41
So let's talk about continual learning for a second because we all should be constantly, constantly learning. What are you doing right now, to continue to expand your capabilities.
Patrick Jamnik 19:53
As you said, Pat, it's always important to keep doors open to never be satisfied, you know, there's a there's a cut, like most people I'm sure I have, you know, I have a constant. You know, there's three books that I'm kind of reading at all at all different times about different, you know, different areas of business different biographies. I'm a big history reader, I always find that that that learning from the past unlocks all sorts of answers for the future. In the recent months, I've joined a medical device related mastermind group, which has been a terrific experience so far, in introducing me to new people with with somewhat different backgrounds, and we're able to bounce opinions and ideas off of each other. I think part of the way to continually be learning though, is you need to be a sort of this might be cliched, but this sort of perpetual curiosity, you need to always be thinking, what questions do I need to know what questions do I need to ask? And from whom do I need to ask those those questions? Because there is an enormous power of of multiplication when you when you can, you know, solicit feedback and get answers from from a diverse group of people. And that can be geographic diversity that can be background diversity, diversity can come from, from a variety of different sources. People love it, when you ask questions of of them, I can save you when the when the when you're looking at the other side of the coin. It's always great when you start some sort of conversation and people seem curious with what you're doing. They're asking questions they take an interest in, in who you are as a person and what it is that you're up to, so reciprocating, that, that that, that that attitude, I think is really, really important.
Patrick Kothe 21:44
So you mentioned a mastermind group. So masterminds is, is something that's been around for a long time is actually 100 years, I think, sort of back back in the 1920s. For any of you who have read the the old book by Napoleon Hill, Think and Grow Rich, I think Napoleon Hill was the one who coined this mastermind concept. And there are a lot of different mastermind groups. Tell me a little bit about your experience with mastermind and, and just kind of how its structured, and the leaders, how the group functions. And and tell me a little bit more about accountability there too. Yeah, sure.
Patrick Jamnik 22:27
So backup a handful of months ago, probably four or five, maybe even six months ago, I responded to, you know, a modern day classified ad, I guess you could, you could say it was a post on LinkedIn, saying, you know, if anyone is interested, my an organization that I'm sort of found, and this is by a gentleman named Eric Anderson, who put this first this first LinkedIn post out, who said, you know, myself and a friend of mine named Stuart Brand, and we are starting a medical device related mastermind group that will be run through a program called the medical Sales RX program. And the they were, you know, seeking input, I don't think they knew at the time, would there be interest or who would be interested, what types of people would be interested in what they would hope to get out of the group, but I responded, these were not people that I knew. But I said, you know, this looks interesting, I had known about mastermind, groups never had participated in one but I had known about mastermind groups. And when, when the idea of an industry related one came onto my radar screen, I said, Well, that's worth a, that's certainly worth responding to, to this, I would at the very least like to like to learn more. So myself and Eric and Stu, we had a number of discussions, and we talked through a lot of different things about you know, who the group is for, maybe perhaps, or maybe importantly, who the group is not for and, and what people hope to get out of the Get out of the group. So we, there's 10 of us in this particular group, my understanding is that there will be subsequent groups, my group in particular is 10 different 10 Different people we meet every other Wednesday at 5am Central, and we meet for an hour every, every time and the meetings are, the meetings are structured, where you can almost think of them as sort of a first half and second half, the the first half of each of each meeting will usually open with a conversation around different sort of wins that everyone has, you know, things that people just sort of want to share with over the last couple of, of weeks. And then right now, for example, we're all reading the same book book called who not how every other week we we have a chunk of the book that basically we are, you know, kind of talking about and still will send out questions ahead of time to the whole group to get everyone's thought process journeying about something related to the book and then we're all sort of have a conversation around that. And then the second half of the meeting is usually the time for one individual to be in the sort of hot quote unquote hot seat where that person for that ticular session or meeting will bring something to the group, where they are talking about whatever it is that's on their mind a challenge that they're a challenge that they're facing professional or personal. And one of the fun things about this group is there is a lot of blending of the two, it is not just a, you know, let's get down to business and talk numbers types of things. And it is not just, you know, personal matters, there's a, there's an absolute blending, and everyone is interested in helping each other, both professionally. And personally, the there's a term that gets used a lot like your personal board of directors and I have already used this, this board of directors to bounce a number of different ideas off of both as a group and with a couple of different individuals privately, nothing related to really the day to day activities of my day job, so to say but, but career related things or or industry related, you know, industry related things, we're always you know, we're all always thinking of these kind of random ideas that just pop into your head. And you know, you've got a group of people that you can call to bounce ideas off of and say, Well, I think I'm onto something here. But But I also feel like I'm I'm 25% away from the actual idea helped me to help me fill in the blank. So it's been a wonderful experience. So so far. Now part of that probably, I'm sure is the is the guys that organized the group that they were deliberate and considerate of, of sort of the group's construction, for lack of a better term, and they knew that there, there were certain personality types that would do better and do worse in this type of atmosphere. So they get a lot of credit for, for the group's construction because very, very quickly, you know, we are all becoming very fast friends. And there are, you know, there are multiple sort of in person meetups that we're all planning to do. And you can really see this spinning into something much, much larger, I think, than people may have even intended, because the the atmosphere amongst the entire group is really, really strong, and everyone is really there to, to help each other. And I think there's, it's that mentality of if you're sort of in a giving mode first, you'll you'll end up receiving much, much more over the long horizon. It's not just, you know, a kumbaya spirit, though there isn't accountability to the group. And people will ask, Well, wait a minute, two weeks ago, you said this, what happened or you know, those types of things, and nobody forget, you know, people don't, don't forget, while we are becoming fast friends, we are there to push each other and sort of stretch each other as well. And I have myself already been, you know, sort of pulled and stretched into areas that are that make me you know, slightly uncomfortable, I guess you could say, you know, I could say and, and that's good. That's, that's, I come out better as a result of that. And I'm personally doing things that I had thought about doing, but you need a little bit of incur either encouragement or, or someone to just come off and sort of just push you off the ledge because they know you know how to swim those, you know that that type of analogy. So it's been a, it's been a wonderful, wonderful experience so far.
Patrick Kothe 28:09
So sometimes we know that we need need a push, and go looking for it. Sometimes we're in, in a meat grinder, so to speak, and there's all we can do to keep our head above above water. And to continue to chip away at at the job. Did you find yourself that you were in one of those those real learning modes, when that LinkedIn post came across you? Or is that something that's been brewing in you for a while?
Patrick Jamnik 28:42
I don't know that there was I don't think that there was anything unique about the day or whatever. But for a long time, I had probably had a whole series of unconnected and scattered yet related thoughts in my head that this back to some of the things that we were discussing earlier, this this industry can be at times very, very isolating, especially when you are in field based roles. And I know this firsthand, as the lone us employee for European for a European company, the the emails and messages, they're all They're very active in the morning and all of a sudden by noon, you know, you know there's you can have a lot of time to think sometimes the pace of activity certainly is different. Because so many sales roles traditionally have been either 100% commission based or largely commission based that causes a an independent spirit that is largely good, but if left totally unconstrained can produce a certain type of profile where everyone thinks that everything that they have ever achieved in their career is due largely due only to their own individual success and you know, the logo on the business card did nothing and that's just not the case. And the more that you get out there and spend time with other people and hear other people's stories, you realize this is an incredible industry with some really, really incredible people and unique backgrounds. And everybody has something collectively to add to each other. There is a power in in numbers and learning from others. I wouldn't have been able to articulate that six months ago, but I think I can now and I think a handful of experiences that I've had largely related to this mastermind group have helped form or calcify some of those, some of those those thoughts.
Patrick Kothe 30:35
Well, like you, I'm learning a lot from the people that I'm having conversations with on this podcast, it's a really good way for me to establish relation new relationships, and to learn a lot about what different people do. Your experience with the mastermind is, is a unique one. And that not only are you learning but you're putting things in practice and the accountability piece. So there's not one way for everybody to do things. Some people have informal mentors that they meet with constantly. Some people have formal mentors that they meet with constantly. Some people have a wide group of individuals who they can call on or call on them. Some people get involved more intimately, like you are with with a mastermind group where where it's going to be together, and who knows how long it's going to stay together. But it could could stay together for a long period of time, or it could, you know, flame out at some point in time or somebody has needs that they want want to move on. But to me, the key is, are you continuing to grow? Are you continuing to learn Are you purposely doing something to make yourself grow.
Patrick Jamnik 31:50
And to me, Pat, the mastermind group fits a perfect kind of niche or a perfect kind of gap, where it sort of falls in between traditional mentorship and your friends. And they you know, I say we've all have our friends, of course, your friends are, you know, they're the ones who will lie down and traffic for you. And a lot of your even if they're professional friends, they probably are professional friends, because you have had the same experience as you you work colleagues at this company. So conversely, a mentor, and I have my own mentors, and I serve as mentors to others. I would encourage everyone listening to how both, you know, to play both of those roles in their career. But it's just it's inherent that in traditional mentor mentee relationships, there's usually a power dynamic at play, not not in a bad way, but in a way that the mentee is typically very aware of not wanting to sort of overuse or abuse the relationship. That's something that that I know that I personally think about. So the mastermind group for me fits that spot in between sort of your your mentor and your friend, where I wouldn't expect people in my mastermind group to defend me at all costs or to you know, sort of lie down in traffic for me to use the phrase that I was using before. At the same time, I can I can rely upon and contact people in my mastermind group with a frequency and about a range of topics that would you know, probably not be, you know, it would be a little bit too informal, sometimes to approach what is what are traditionally sort of mentor mentee types of relationships.
Patrick Kothe 33:27
I want to switch gears for a second and go back to something that that we started to talk about. And that was, you're now inside a startup company in the US and you're launching, preparing to launch a product in the US. But what you mentioned earlier, as you've done this a few times before, as you've brought something into the US. And when I think about careers and managing a career, we we want to we want to master certain things, we want to be really good at certain things. And that kind of carves out our own uniqueness. There's not a whole lot of people who who have carved out a space that says I'm good at taking products from an international company and bringing them into the US. There's a lot of companies outside the US. A lot of products are developed in us and then you launch them outside. So we search for for people that way. But there's seems to be less that are international companies that come into the US and need to launch in the US. So talk to me a little bit about what it takes to bring a new medical device into the US and being that first person that an international company contacts it says, Hey, Patrick, can you give us a hand here? We need some help and launch and into the US?
Patrick Jamnik 34:48
Sure. What I think is the first thing that I think is really important, or at least is something that that I have always looked for and like you said, I've done this a couple of times I've made the decision three different times in my career to join startup like companies. And each time, except for in a couple of cases, the CEO who had, you know, a wide variety of responsibilities, I was blown us employee at the time that I was that I was hired, I think the one of the first things that I look for that is really important is does the company itself, everyone is going to say our product is the best, everyone should use our product because of product, attribute, A, B, or C. But there needs to be, especially because you are, quote, unquote, foreign, I mean, you literally are a foreign based company. But because of that there is some sort of emotional trust that will need to be built up with customers, that isn't sort of an extra hurdle that a foreign based manufacturer will have to clear as, as opposed to when to a domestic company, or certainly your kind of household bulge bracket brand brand names. So I think it's really important that the company itself have a compelling narrative around the company, how was it founded? For what reason? What's the corporate culture like, because ultimately, getting your first handful of of customers, you need to sort of almost put your arm around them metaphorically, and convince them, Hey, come on this journey with us. And they need to be bought in and attached to not just the not just the product itself, but they need to feel, you know, bought in, we got to remember our customers, all of our customers are certainly orthopedic surgeons, they need to take new products that they find interesting, take them to the hospital, put them through the value analysis committees, you know, go out on a little bit of a limb for this particular product in this particular this particular company. So,
Patrick Kothe 36:47
Patrick, I'm thinking about you have clinical data, clinical study that comes from outside the United States, and you use that clinical data inside the United States. There's more skeptical skepticism with with that data. Compare that to bringing a product in Is it a much higher degree of skepticism? Or is it about the same amount of skepticism?
Patrick Jamnik 37:15
You mean, comparing the like the data to the product? Yes.
Patrick Kothe 37:18
So if you're, if you're if you're trying to use clinical data from outside the US versus bringing a whole new product inside?
Patrick Jamnik 37:27
Sure, the data is oftentimes met quite skeptically as you, as you say, for for no real reason. Sometimes other than, you know, well, we do things differently here. And you can push and push and ask, Well, what do you do differently, and sometimes, you know, the answers will will vary in how good they are. But ultimately, with any foreign company, there usually will be connections into the US from outside of the US base. So the the most active customers that you might have in Europe or in Asia, they will have friends in the in the US and bridging those friendships is a really, really critical first step, because whoever sort of let's think of if we think of data, you need to, to make unassailable the people writing the papers, for example, and they need to be thought of as you know, I have the highest level of of credibility. Well, some of the places where those people will be thought of the highest are from you know, the existing peers that they have a lot of well known surgeons, certainly the what I'll call the paper publishing class of surgeons, they see each other at international conferences, sometimes they even collaborate on on products and but they have a certain that there's a lot of friendships that get developed over the years and taking your existing users outside of the US. And being very deliberate and upfront about asking them who their friends are, is a really, really critical first step, and then going and meeting with those friends in the US and building some immediate credibility all well, I know Dr. XYZ in France, or in Germany, or wherever. And, you know, I've operated with him before and he's of the utmost, you know, he's of the highest quality, you know, the highest quality, it builds credibility, and then all of a sudden, now your data is sort of emotionally accepted with your first sort of group of us users. Another thing that I think is really, really important bringing European companies over is you need to be very deliberate about asking for warm introductions and understanding the power of warm introductions from from physician to physician and especially that that first sort of level across the ocean, those across the ocean, warm introductions, will go a long, long way into sort of getting you established because one of the first things that if you go and just ask what you know, we'll call the median surgeon just to sort of generic surgeon in any any place they want to say, Well, who else is using it? That question always comes up who else is using us and what they're looking for? Is you know, names that they names that they know now names that they that they trust. So you can't just give them usually, well, there's these guys in Germany, there's these guys in France that will sound foreign that will feel foreign, that will feel like it's an extra level of risk for for them. But once you can sort of use those warm introductions across the ocean, now you have a bit of emotional buy in from a from a group of surgeons in the US. And then you need to be very, very deliberate about asking for those surgeons. Okay, who else can we go talk to? Who else? Should we go talk to? Who else do you think would would like to learn more about this product? Or like to review this paper or talk more more about this?
Patrick Kothe 40:35
So the companies that are coming to you, are they are they coming for launch? Are they establishing companies in the US as their regulatory issues that they're trying to get through quality issues? How does how does that work? Are you just a distribution center? Or are what are these companies coming to to do in the US,
Patrick Jamnik 40:58
in my personal experience, it has always been largely centered around commercial activity activity. So the company will have had a product for perhaps for a number of years, they will have had outside of the US business, they will probably have a real good grasp of the market access strategies for the US, you know, they'll know how to what Well, we think this is a PMA product, we think this is a 510 K product. Nobody has ever called me and asked for like a specific, you know, regulatory strategy or something like that.
Patrick Kothe 41:31
So they're not running regulatory through you, they're still running the regulatory process, through the home office in whatever country, they're at least
Patrick Jamnik 41:41
at least initially. Now, over time, those responsibilities or the oversight usually at a smaller company, it's a combination of in house capabilities, and outside consultants, over time, those relationships for sometimes just obvious timezone, and you know, those types of reasons over time, once there is like someone like myself established and on the ground and working for the company, the management of some of those outside relationships, especially if they are US based, they can that will start to transfer over over time. So it's the regulatory strategy will usually be not, not in, you know, not carved in stone, but there'll be a pretty good idea of how different products are going to be able to be accessed into the market. Patrick,
Patrick Kothe 42:25
are you setting up a legal entity in the US?
Patrick Jamnik 42:28
I never have. Usually there's that has been set up in the in the past, it's usually it's a frankly, it's a pretty simple thing to do. It's something that everybody will have to do. There's importation rules that if someone doesn't realize that they will have to, to do that. But if you're going to hire a US employee, as an actual employee, of course, they will need to have a legal entity that they are working for, for tax reasons and such. So I personally have never been involved in the establishment of a legal entity. But usually there's a border, as you know, CEO from across the ocean that is that no, that is knows that much and is able to get those, you know, one or two of those fundamental things in place right away now importation strategies and ideas and tactics and how that all works. That's something that I've certainly been, you know, I've got every story in the book on on how that that goes, because that comes much later. That's, you know, that's, it's good news, when you when you're ready to talk about, okay, how do we import this product, because you're sitting on a regulatory clearance or approval, and you really, you know, now you're really getting in the more of the final stages towards taking this out to the market.
Patrick Kothe 43:34
So your function, as you described it really as market introduction, preparing the market for market introduction. And it may come fast, it could be a 510 K device, or it may come over a period of time if you've got to get a PMA device. So it's it's establishing those relationships longer term.
Patrick Jamnik 43:55
That's right, you, you can do a lot of the the sort of tilling of the soil and preparing of the soil ahead of time and just, frankly, just boots on the ground, getting out there talking to people, introducing the company introducing yourself explaining who you are up to breaking down some of those barriers that when it comes time for a sales specific type of conversation that might be more Product Center, that you know, you are not having to describe well, who is this company? What is it that you that you do you've you've sort of you've built some sort of level of trust up ahead of time.
Patrick Kothe 44:30
So let's talk about your company. Let's talk about epi serve. And what you guys what problem are you trying to solve? Going back to
Patrick Jamnik 44:39
what I mentioned about about it being important or in my view as being important to have for the company to have a compelling story outside of just the products? We've got a great, really compelling story we were founded by an orthopedic surgeon in Sweden from the Karolinska Institute in Stockholm who founded the company off of a problem that he experienced with his own Knee he started to experience pain in his own knee, he very quick quickly was able to do a little bit of self diagnosis and realize that every logical or likely solution available to him at that time represented probably some degree of either under treatment or over treatment compared to the the problem that he that he actually faced. And that's where this, a lot of this this language that we use around what we call the gap patient in orthopedics, these sort of middle aged patients between about age 40 and 60, that tend to be a little bit too old for a lot of the kind of biologic processes that work well on on younger patients to really take hold, but at the same time, or too young, that they very, you know, they oftentimes don't have, they don't have levels of disease and degeneration that warrant these end stage types of procedures like arthroplasty, knee replacement, or Arthur desus, and ankle fusion or a toe fusion, these these types of things. So what we do and we make is we make personalized mini metal implants that are used to treat specific spots of damage or specific defects in the articular cartilage of knees and ankles. The analogy that I use is that of a dental analogy. So when you go to the dentist, if there's a problem in your tooth, they'll tell you, Well, you have a specific spot of decay, we can fix it right now with a cavity filling restoration. And we can send you sort of on your on your way. And okay, fine. What if I do nothing is one of the questions that you might ask when they'll say, Well, it's not going to get any better, it's going to continue to decay. And at some point we'll have to put a crown on your tooth and a crown is essentially just you know, capping of the of the tooth, that's like a knee replacement, basically the knees, the knee is damaged to the to the point where it cannot just be fixed. You can't just go in and fix both meniscus fix the ACL repair all the articular cartilage get the alignment back straight, etc, etc. The knee needs to be replaced, it needs to have essentially a cap put on it. So what we are what we sort of, you know, I think represent is something much more along the lines of a cavity. So we using a proprietary MRI protocol, we receive a series of images from from patients, and we create personalized implants to sort of fix those individual defects. So we customize the surface to make sure that the articular geometry is restored to to that of its pre diseased state or its pre defected state, we provide a series of sort of suite of personalized instruments. So the surgeon use, you know, it's exact surgery where we are shipping sort of a dictionary sized box of implants and instruments into a hospital or surgery center ahead of time, everything is sterile, Upon arrival, everything gets used once the implant goes in, the instruments get used once and then discarded, there's no reprocessing, there's no you know, back and forth with the trays, there's no running to sterile processing the night before to make sure your trays are in order or picking things up and moving them around afterwards. So it's a pretty, pretty streamlined and, and pretty novel approach we've got, we've got our own, you know, work ahead of us from a regulatory standpoint, and the company has done a lot of clinical work already in Europe. But we've got we've got a lot of work to do still. But it's really, really, it's a company that's really, really exciting. And I was excited to join because there are so many kind of big picture narratives that I see going on within orthopedics, whether they be the personalization, you see companies left and right talking about personalization, this combination of hardware and software and how we take the images that we get, and we produce these really kind of aesthetically appealing reports to the surgeon that allows them to see exactly what's going on in the knee and exactly where the damaged spa exists. And then combining that with a hardware solution. So some of these kinds of hardware software types of solutions. And then this emphasis on clinical data, like I said the company because I think we were surgeon or because we were surgeon founded, we've always had such a strong emphasis on clinical data, it was not some sort of like nice to have, we'll get to that when we when we get to two was really a foundational fundamental kind of element of of building the company. And as a result, we're now starting to bear the fruit of that because we have so much I've got so much information to provide when when surgeons look at us and they're trying to figure out you know how to use us or you know, how we fit into their on treatments.
Patrick Kothe 49:33
So Patrick has a custom device and an international company. Are you setting up manufacturing in the US or is it something that's going to be shipped back and forth as well?
Patrick Jamnik 49:44
Sure. So right now we are importing everything from Europe into the into the US over time, it would not surprise me at all if we ended up getting a domestic supply chain. Some of the reason we can't do that just yet some of it pertains to the European regulations and this, this transition from MDD to MDR. And what European companies are able to do while they're in that sort of transition type of phase. So right now, everything is produced abroad and imported in. And then over time, though, I would expect that with the appropriate volumes for there to be a sort of, you know, complimentary supply chain set up here.
Patrick Kothe 50:26
So there's a lot of a lot of different knee, knee prosthesis that are out there a lot of different devices that have gone through the agencies before, but I don't know if there's been anything like this before has there?
Patrick Jamnik 50:42
No, well, there, there has been one a number of years ago, and we think that we've substantially improved upon that we think that was sort of a, you know, that was a really good idea at the time that the technology was just not not ready to go at that time. And through modern imaging and manufacturing methods and techniques, we think we're able to really fine tune that. But But I think but you're you're right, Pat, that when you say I don't think there's been something like this before, we don't think there there hasn't we very much consider ourselves category creators. That's an ambitious task as a company to take on. But it is how we we feel that there is a spot in the market between what have traditionally been thought of as either sports medicine or joint replacement products, and a lot of those categories kind of stem from the way that surgeons go through their own educational experiences, and through the residency programs and into fellowship programs. But as a result of that the sort of middle aged patient has been, you know, a little bit under focused on historically, and we hope to change that over time and sort of, you know, carve our own spot into the continuum of care.
Patrick Kothe 51:49
So the way that you described the market, there's someone who had something similar, yet there isn't. So that kind of leads me back to what is the regulatory pathway for for a device like this?
Patrick Jamnik 52:01
Yeah, sure. So it depends on country. You know, it depends on really which country you're talking about. If you're talking about for the US, then it becomes which product are you talking about. And usually that comes back to working with the FDA and figuring out what predicate devices exist if there's a 510 K pathway available, and we have some products in the pipeline where 510 k will be appropriate one of those we hope to have, within just a couple of months. Now. We have other products that we've got IDE studies that have already be gone because there is no appropriate predicate device and therefore, you know, we need to, you know, to do more clinical work and ultimately fill in and file a PMA for so it really depends product by product. anatomic location by anatomic location. And there's no one clear answer for for that, that question is probably not we were hoping to
Patrick Kothe 52:49
hear no, no, it always is it you know, you always have different different applications based on the unique situation for each one of them. What areas of the body you guys focusing on, you've talked about knees as its shoulders as it hips, you know, what areas of the body?
Patrick Jamnik 53:05
Yep, so the knee product is the one that we've had out for the, for the longest, we've had an ankle product and the tailless that has been available for a couple of years now that was designed in combination with Nick Van Dyck, who's one of the the most preeminent Foot and Ankle surgeons around the world, we have that product in Europe as well also. So knee ankle, we have a toe product that we're in various spots of the r&d process on right now. So it's everything it's been knee, knee, downward on the body or the knee and distal, so knee, ankle, and tibia so far, we've gotten approached by other companies or certainly by surgeons on on a shoulder idea. We've never taken something like that all the way through into a into a business plan yet but but it very much is a platform technology that could be applied to a number of different a number of different anatomic locations. I think the hip would be one of the more difficult ones but knee and ankle today, toe in the future. And we'll see. But there's lots of opportunities down the road.
Patrick Kothe 54:06
Oh, very interesting, Patrick, I mean, talking about that gap patient and what's needed for that gap patient and having a solution for that is really a great addition to the tool set that orthopedic surgeons are going to need.
Patrick Jamnik 54:21
Yeah, as soon as you talk about the gap patient, everyone sort of just in conversations, everyone knows what a lot of people say that's me. I am one of those. I am one of those. I am one of those people
Patrick Kothe 54:33
Well, this has really been a nice conversation we we've gotten gotten a lot I really enjoyed the the career part of it as well as what you're doing and how you're growing as well. So to kind of sum this up, I'd like to ask if if you've got someone who is at the beginning stages of their career and the first third of their career. What kind of advice would you have for those people in terms of managing their career,
Patrick Jamnik 55:02
I think the first thing that I would do is, I would certainly recommend that everyone try to seek out mentorship from, it's important to have a good relationship with your boss, but I would try to seek out mentorship from within your industry, but outside of your company, and it will be difficult to just, you know, go contact a direct competitor for for obvious reasons. But we have platforms LinkedIn specifically that are available to us now to sort of try to find 20 years ago, you would say, Well, who are these people that I could, you know, you wouldn't even know you know, you really wouldn't know who just to start it would have been a game of telephone trying to bridge different connections today, it is much, much easier than then before. And I would really encourage people who are just starting off to find at least one but But ideally, a handful of of mentors that they can call occasionally don't overuse, or don't abuse the relationship, but that they can call and seek guidance for on what they think of are our you know, next best, next best steps, that's that's one recommendation to I would be, I would recommend for people to be pretty intentional about where they you know, where they want to go, that can always change, new things come up new, new experiences are had. But you, you need to have a really good idea of where you're, you know, where you would like to be in order to sort of work your way, work your way backwards. And I think too often people when it comes to their career, hopefully they're not, but I've seen it too many times to count where people are, they're just sort of winging it a little bit. And they're just sort of hoping that Well, I can just do a good enough job that I will stand out enough. And I will just automatically get that that recognition. And they see examples where that has worked out, but they don't see all the times when that didn't work out. And they're not thinking about the percentages of how likely something like that is to actually play out.
Patrick Kothe 56:55
I was particularly interested in sharing this conversation with you. Patrick is thoughtful and introspective. And I suspect when he talked about his early career experience of floating around like that feather in Forrest Gump, it was similar to most of us. But he pivoted. And I think that that really made all the difference to him. I've heard from many of you, with questions about career moves, timing, how to prepare for it, and how to manage through difficult situations in your career. By the way, thanks for reaching out. And please continue to send me questions like that and comments. We're going to be exploring these questions, and also how to better manage your career, and upcoming episodes. A few of my takeaways from this conversation with Patrick first, learning didn't stop when he was promoted, or when he earned his MBA, he continues to to learn, there's so much so much that you can pick up. If you think you know it all and stop learning Well, welcome to the end of your career. So just never stop learning. The second thing was learn from people outside your normal group, Patrick talked about having your own friends, and that's great, but their experiences are very similar to yours. So you got to get outside of that comfort zone and meet new people and, and those people are gonna have different experiences. And those are the things that you're going to be learning from. So make sure that you expand out your group of advisors and people that that you listened to. And finally develop a unique skill set. Patrick is an expert at importing products in the US. That actually makes them more desirable that he has that in addition to his sales and marketing expertise. He has something else that's pretty unique. So the question is, what's your unique skill set? You may be great at one thing, but what are some of the other things that make you thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast wherever you get your podcasts. Also, please spread the word until 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
