How Challenging Assignments and Brutally Honest Feedback Makes You Better
Dave Rosa is CEO of NeuroOne Medical Technologies, a company that has developed high-definition, minimally invasive diagnostic and treatment devices based on a unique thin film electrode technology, with an initial focus on epilepsy and the fast-growing neurostimulation market. In this episode he shares some times when tough feedback helped him grow as a leader, why taking the stretch assignment was the better choice, structuring a marketing group, key criteria when evaluating distribution options in a start-up company, and how NeuroOne is providing technology helpful to patients and clinicians.
Links from this episode:
Dave Rosa LinkedIn https://www.linkedin.com/in/daverosa/
NeuroOne Medical Technologies https://nmtc1.com/
Connect with Mastering Medical Device:
LinkedIn: https://www.linkedin.com/company/mastering-medical-device
Patrick Kothe LinkedIn: https://www.linkedin.com/in/patrick-kothe
Patrick Kothe Twitter: https://twitter.com/patrickkothe
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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.
[00:00:00] Pat Kothe: Welcome! Growth and development come from many different sources. But I found that I've grown the most from painful experiences. Failures, negative feedback, stretching into an area where I've been really uncomfortable. The pain actually forces me to be better. To learn from the experience. But also to embrace the pain as now, I know it's going to help me in the long run.
I think you're really going to enjoy this conversation with Dave Rosa, CEO of NeuroOne Medical Technologies, a company that's developed high definition, minimally invasive diagnostic and treatment devices. Based on a unique, thin film electrotechnology. Their initial focus is on epilepsy and the fast growing neurostimulation market. In his roles at CR Bard, Boston Scientific and St. Jude Medical, Dave has had some great mentors, and really nice responsibilities. In our conversation he shares some times when tough feedback helped him to grow as a leader, why taking the stretch assignment was the better choice, structuring a marketing group, key criteria when evaluating distribution options in a startup company, and how NeuroOne is providing technology helpful to patients and clinicians.
Here's our conversation.
So Dave, you've contributed to many companies in your career and you came up through the sales and marketing route. Is that a good place for somebody who's starting out their career in medical device?
[00:02:19] Dave Rosa: I think it's a great place to start. for me in particular, it was more of a requirement for the company that I was interested in working for. It was, Stryker Surgical at the time. And before you could move into any sort of marketing or say, senior management position, you had to start out in sales.
And I think it was actually, it was a little bit surprising to me at first, but of course I was, I think, 22 years old, at that time.
[00:02:48] Pat Kothe: why do you think they, they wanted you to start off in
[00:02:50] Dave Rosa: sales? Yeah. So they explained it very well. And, what they said was, look, before we put you in any position of decision making authority, you need to understand, the products, how they work, what's important to customers. So it, they felt it was the best training to prepare you for a senior management position. And, uh, to be honest with you, I appreciate it. I completely, after going into sales, completely understood because it took me a good six months to really get up to speed to, number one, learn how to sell, number two, understand what customers wanted, how the procedures were done, what the issues were, what problems we were trying to solve, and it really prepared me to move into a position of decision making authority.
Or what I was looking to get into was marketing at the time. So most of the companies, that I was even speaking to at the time were not interested in hiring me for a marketing position, which is what my MBA was in. They wanted me to start in sales and it was for that reason.
[00:03:57] Pat Kothe: And why medical device?
Why did you choose medical device?
[00:04:00] Dave Rosa: Device? I have always liked and been fascinated by the medical device field. And personally, I've had so many medical issues that I spent a lot of time researching things. When you're growing up, you're trying to figure out, really what you want to do.
And, and the things that I always seem to enjoy were helping people. And the second part was figuring out how to solve some of my own medical issues. So It was a good marriage and really after I graduated college, I spent a little bit of time outside the medical industry, but then really fought to get into it because, it was really my passion.
So you
[00:04:37] Pat Kothe: moved, from sales into marketing and then into management. Did you have a, a grand vision for your career? early on, or were just opportunities presented to you?
[00:04:49] Dave Rosa: I had a grand vision, but never, the vision never included me running a private company at some point or a public company at some point.
I knew I liked the, the strategic part of working in a company. I liked coming up with. determining, a strategy to grow a business, or, to really develop, technology. But I wouldn't say I ever thought, gosh, you know, by this age, I wanted to be in this role. I wanted to be in the senior management at some point, but not necessarily a CEO.
Your question of, did opportunities just present themselves? The answer is yes, but what I'll tell you is, I always focused, on the difficult businesses, uh, to get involved in, as opposed to the successful businesses. And really the reason why I did that was, I had a mentor of mine telling me that you're going to learn a lot more from solving problems than you are taking over businesses that are successful.
[00:05:51] Pat Kothe: yeah. And early in my sales career too, people would say you either want to follow the best sales rep or the worst sales rep, that middle of the road one is not where you want to go in. And the turnarounds are a lot of fun, a lot of work though.
[00:06:06] Dave Rosa: Yep. But, but it's where I think, you know, you, you really learn, how to solve problems and how to develop, a capability of, really making decisions and how to go about making decisions.
it's great to see, technologies or companies, become successful and try to duplicate that model. Every company's different, challenges are different, and I think it's in the, really, in the, jobs that you have that, you know, face, really severe challenges that you really grow as an individual, and, and I think your contributions, can be a lot greater through just dealing with issues, whether you're successful at resolving them or not.
[00:06:48] Pat Kothe: So I'm going to ask you about two transitions. One transition is when you went from sales into marketing. And the other one was when you transitioned out of marketing into general management. What was that first transition like moving into marketing?
Was it, you said you, got an MBA. That was your area of interest. Was it what you expected it to be?
[00:07:08] Dave Rosa: Um, well, that's, that's a good question. No, it wasn't what I expected it to be, but I'm not sure that my expectations were right to begin with. I thought when you got into marketing that, you would go out, talk to the customer, find out what they wanted, work with R& D, to develop the product. But I always thought, that the most important thing was, to develop, the perfect product. We had to keep refining the product, until it met all the needs, solved all the challenges.
And that's probably a little bit of my technical background interfering with the, the business, learning. So I was surprised when, you know, there was a lot of pressure to, every three to six months get, get a new product out the door. and why that was so important to the business other than, we want to get a new product out the door.
But, there were a lot of reasons, and one was to maintain, if it was a competitive space, uh, or landscape, to really maintain or grow your ASP, because if you're working in an area that has competitors like most of us do, we're constantly, being challenged by companies reducing their price, or, leveraging other technologies to undercut,your pricing, So it's really important, which was not something I could appreciate it at the time. You want to have a product that meets all the needs, but it's not realistic. So you have to make a decision of this is good enough as it is, and we'll iterate from that to improve upon the technology to offer more features and use that as a, again, a strategy to help maintain your your margins, your pricing, or even grow them. So
[00:08:53] Pat Kothe: some companies have a product manager who's responsible for the upstream marketing or that product definition and moving a product through an R and D process, and then pass it off to the downstream people who do the product support and the sales, support and promotion with the product.
Some people have one person who does all of that. Other companies have downstream marketing people and upstream marketing people. What was your experience like?
[00:09:18] Dave Rosa: so it included both, but I can tell you that, when I joined and you were a product manager, you were responsible for everything upstream, downstream, and, uh, even in, in one of the companies that I was at, C. R. Bard, a large company. We were even responsible for marketing communications, so developing the strategy, coming up with the brochure, the concept. We might bring in a graphic designer, but we did everything. And then, uh, when I got to SciMed, and then it was acquired by Boston Scientific, it was the first time I had ever heard of anything, called upstream marketing, downstream marketing.
and really... That was back in 1997, I think, when, when I first heard that term, and now you, you hear it all the time. I'm not a big fan of it. I understand why companies gravitated to that. But there were also issues that, that came out of splitting that. So, you know, my philosophy is... Is that, I need to understand what's important to the customer. what, challenges the field sales, people are, are experiencing so, so I can, help, develop the best product with R& D that, that we can offer the market. I, you know, I always felt that if one person was just involved on the development side and the other one, uh, was, um, uh, strictly on the, um, promotional side, that there isn't always great communication in between those two groups. And at times, you know, everyone, you know, has their own little island that they want to protect, that the upstream, marketing people were not, in front of the customer or the salespeople as much as they needed to be.
And it's because the, you know, the downstream, marketing people felt that was, more their role. And then there was also issues, when we were trying to incorporate this early on at Boston Scientific with, really, a lack of enthusiasm from the upstream marketing group.
Because they felt, gosh, we did all the work to get this product out the door. And now, like, where's my, where's my congratulations? I'm, I'm kind of handing it off to the person who now gets to go on stage and, and more or less, get, get a lot of the credit for, the technology.
So there, there were issues with that. how do you reward the upstream, marketing person? How do you give them, accolades, for the work they did? There was always like this, I'll call it, um, well, I'll call it what it was, it was tension in between the two groups.
Uh, so personally, you know, I, I want the person. Who presents it to the sales force, being the person who went through, two years of finding out why the technology needed to be developed that way. Why, we didn't go a different direction than someone who was kind of, you know, hand it off the project when it was done.
So, you know, again, just my own philosophy. And in small companies, you don't really see that. You've got to be a jack of all trades for obvious reasons. Look, a lot of big companies have been successful, separating the two.
[00:12:37] Pat Kothe: Like you, I've came up through the sales and marketing side and run marketing departments and I've done it both ways and I've split it out upstream, downstream, then I've recombined it.
We see so much, change within large companies where they've got a lot of different divisions and they roll them up and, the sales organization is under, different product groups that are under one sales organization. Then they split them back out and then they come back.
Bottom line is there's no optimal way of doing this because if you're asking somebody to be an expert at upstream and downstream, that's all, that's a big ask. And the other thing is when you are focused on the product development, the sales team is going, Hey, what about me? We're out here selling this stuff.
We need more support than what we're getting. And when you're, focusing on the field and supporting a field, the R and D teams feel in the same way, where's my love here. So it is a really difficult thing when you get to be a larger company to have both responsibilities and have the right people in place and have enough time to devote to both.
So it's like I said, is there a right answer? Depends on where you are and where, what's your individual company needs. Ideally, you'd like to have somebody who has both skillsets, so you can emphasize one or the other, but it's a
[00:13:58] Dave Rosa: difficult thing to ask. I, I agree with that.
What big companies were doing at the time is they would take, a business segment, this is in the days when, one person was doing upstream and downstream, and they would start, cutting up the business segment saying you'll handle all the products that fit under this category, right?
Upstream, downstream. So I'll use angioplasty balloons as an example. You're handling everything that pertains to over the wire angioplasty balloons. And you over here are going to do everything that involves rapid exchange, balloon catheters. You know, products that are used in the same procedures, but sometimes based on preference or the procedure itself.
So then what happens is you have multiple marketing people dealing with... salespeople for really the same category of products. And that also, annoys the salespeople and, they want to deal with one person, right? and,
[00:14:55] Pat Kothe: and, and we didn't, we're not even talking about the physicians who want to deal with one person too, because you're developing an over the wire system and a rapid exchange system is basically talking to the same docs, right?
[00:15:05] Dave Rosa: Absolutely. Uh, uh, agree completely.
[00:15:09] Pat Kothe: Let's kind of, um, move to that other transition we were talking about, you moved out of marketing, you learned a tremendous amount, through that, and then you moved into, a general management or VP level position. Tell me about that transition.
[00:15:23] Dave Rosa: Yeah, that was, um, tough, although I didn't think it was tough.
So managing people, is probably, I would say, the greatest challenge. For me, learning a technology has always been, you know, I'm fascinated by science. But managing people, who maybe, approach things a different way, than you do was eye opening to me. So I'll tell you a quick story, that made me, that really changed, at least my perspective.
I was at, Boston Scientific. I think it was actually still Scimed at the time. And, I found out that I had an opportunity to move up, into management. Actually before I moved into management, One day, this consultant showed up and, so the president of the division had hired this guy, unbeknownst to the people he was working with, he was really there to assess talent that was not in management yet.
And, what we were told was, he's going to help you, you know, become better at what you do, make better decisions. But really what he was doing, because the company was growing so fast, was... he was going back to the president saying, look, out of these 20 people, that you have me working with, these three people are people that I think could quickly step into a leadership role because they were growing so fast. They didn't want to hire from the outside, but they had to, more quickly develop, their, people internally. For the,
for
[00:16:51] Pat Kothe: the listeners, Scimed was an extremely successful company in the angioplasty area in the early days and developing some great technology for, the angioplasty procedure. Very aggressive group, but a very talented group of people and a lot of great, great medical device people,spent time at Scimed.
[00:17:14] Dave Rosa: Yeah. it's, it really spawned a generation of people that have gone out and either taken leadership roles and private companies, public companies.
really an amazing company. and I really. And that's where I learned most of the things that I've applied really since then. But in this case, I, so I worked with, this consultant. It was probably for between six and nine months. And he came up to me one day and,he said to me, he said, Rosa, I think you're a smart guy.
I like the way you assess things. I would tend to do what you recommend to do in the business. But the problem is, is that you leave a lot of dead bodies along the way. Wow. And, uh, you know, I'm a guy from Philadelphia. Like, what are you talking about? I leave a lot of dead bodies, right?
I'm very direct. That's the way people on the East Coast are in the Northeast. And if you're screwing up, I tell you, you're screwing up, but you're, but you're a job. That's what you should be doing, but you're in
[00:18:19] Pat Kothe: Minneapolis and the Minnesota nice culture is a little bit different than the
[00:18:23] Dave Rosa: East coast.
So, I mean, in my world, it was, and even, prior to that, when I was at a Stryker, even though they were based out of Kalamazoo, that was the most aggressive company that I ever worked for. Just the way they did things, it was at a whole different level, so a personality like mine fit, fit very well, really into their portfolio of, let's just say employees, and what they were looking for.
So, you know, when he said that, I was like, what are you talking about? He's like, you know. Um, you know, it's good that you have an opinion and, that you have a good understanding of the business and where it needs to go, but it's a painful process, Dave, and you will never be successful, if this is, you know, the way you do things.
and he said something to me that, people have said to me, or just in passing have said, is there's a lot of different ways to get to the finish line, right? There's your way. Which, if you were like me back then was kind of like, this is the only way, right.
The way I'm doing it is the right way. but, you know, the, the, the comment was, let people take a different way if it gets them to the same destination. That, that you're, you want to get to, how old were you?
[00:19:41] Pat Kothe: How old were you at the time? Where were you
[00:19:44] Dave Rosa: in your career? Okay, so that was 1997, and I was born in 64, so I was 33 years old.
[00:19:52] Pat Kothe: And you knew everything at 33. I know. I knew everything at 33
[00:19:56] Dave Rosa: now I knew everything at 20 . Uh, so , so yeah, I mean. You know, it was, honestly, it was probably so clear to everyone else. But the only person it wasn't clear to, was me. So, you know, I kind of thought about that, and I still thought,you know, look, um, you know, my formula works, so, uh, but, you know, as, as time went by, I think early on, the reputation, my reputation was, he's this, hard nosed guy, and, very demanding, and...
Uh, and I think, you know, I still am that way, but I don't, I don't approach things the way I did back then, which is it has to be my way.Everybody's got a different style and again, if we can, achieve the same goal, and it's a different way, you know, who cares?
And I, and I think that comes more. with maturity and age and, back then it was a complete shock. So that was one of the big things that, shocked me, in terms of moving into, a senior leadership position that you need to change the way you approach people or, you're going to be working by yourself and probably somewhere else.
What's
[00:21:08] Pat Kothe: interesting to me about that is you'd been in companies for 10 years at that point, 23 to 33, you've been, you've had several managers do that and it took an outside consultant to come in and give you that feedback. All of your managers could have given you that feedback throughout that and they didn't.
Why?
[00:21:32] Dave Rosa: Well, um, when I was at C. R. Bard, my manager was exactly like that. I would sit down with him and take him through a, a product launch and the strategy and he would sit there, and this is a true story, he would look at my brochure, right? and I'm more of like, the strategy is what's important here.
It's, you know, the brochure is kind of like along for the ride, but he always wanted to change something because it was never, what anyone did was never perfect or the way it should be done. So he would, he would look at my brochure and he would say, what Pantone color is the background on that?
And I would say, I don't know what Pantone color is. Uh, I think, I think you need to change that to a lighter shade. Bring the, uh, Pantone color chart here and let me take a look at it. So he was always tweaking something, and it was so annoying, and I was doing the same thing, when I went into management, but I didn't think it was annoying, to the point where I started putting in the launch documents, or the brochures, misspelled words.
And I'm very anal about spelling and, proper spelling and grammar. and he would be excited because he would find a mistake, but he caught on one day. He's like, you did this on purpose. You're gaming the system. But I had worked in the Northeast, um, cause I, you know, being from Philadelphia, that's where my early jobs were.
And my bosses were the same way. So I had never seen any other way other than they tell you exactly what you think. It's usually painful and it doesn't bother you because, that's more the culture there. It's when I got out of that, that environment that, you know, that I, met people, like you said, Minnesota nice, a whole different culture that was very different from where I first started.
[00:23:25] Pat Kothe: So that's one of the major lessons I take it that, that you learned is you've got to be a little bit more open, forgiving to other people's styles. Were there, Were there some other lessons that you learned, through that growing up period, so to speak, and development period that, that really became.
foundations of how you manage today.
[00:23:50] Dave Rosa: Yeah. I would say the biggest one that was more, I would say from a managing people's standpoint. and this one also, influenced that as well. Uh, so it's a story again at Boston Scientific. I always felt that one of my strengths where is, we're having good instincts.
now it doesn't mean that, I didn't ask anybody their opinion, but my instincts have always been very good and ultimately. you're going to grab data and the data could swing you one way or another most of the time. I mean, sometimes it's clear cut. Uh, and you're going to have to make a decision, and in those cases, I rely on my instincts, and I'm right more than I'm wrong.
So, I was running the intravascular ultrasound business, which was a disaster at Boston Scientific. Salespeople didn't want to sell it. The company, after they bought it, really didn't even want the technology. The guy they brought in to run the business lasted two months, and they got rid of him. It was losing money.
They were being sued by the FTC. Hewlett Packard was suing them. You know, they were losing money, in terms of sales. And I had an opportunity to work in the stent business, which was booming. It's one of those businesses where, you know, without me, um, it might've done better, um, or, or the ultrasound business.
And I sat down with the president at the time, Mike Berman, smartest man, um, I've ever met, uh, and Mike said to me, listen, and by the way, he was from New York, division president in Minnesota. His story was he was so rough around the edges when he was a product manager in the company, that his boss, uh, that they had put him on a plan, they were going to fire him because, he was just rubbing people the wrong way, but I connected with him because he was from the same part of the world as I was. So he said to me, here's the deal. This business has a lot of problems. It's never going to be a billion dollar business. What I want out of this is I want to get it profitable, I want to clean up all the problems, and that's what I want. That, that we will consider, to be successful. and he said, look, if things get worse, then you'll get fired. But that's, and he said it just that way. So I said, okay, and it's one of those jobs that, I thought, my friends thought I was crazy, but I thought, I've never been involved, and had to go through a lawsuit by the FTC or, any company, all these problems, salespeople don't want it, it was a disaster, but I thought, Um, I'm going to learn a lot from this and the bar is so low here that I don't know that it can get much worse really than it is.
So I, I, I took the job and, you know, the business started getting better, after about nine months to a year. and then it got to a point where, you know, we hit this low again in terms of sales. I won't go into all the details, but what we would do every quarter is we would have a business review, at the division where the products were manufactured.
And it was the division president, so Mike was there, the heads of sales, marketing, manufacturing, all the respective, departments. And you would get up there, I would get up there in this role, because I was responsible for Ultrasound, the business, and I would give an overview.
Where sales are, what's happening, why, what we're doing to address some of the issues. So I got up there one day, and um, Mike said to me, you know, I'm looking at these numbers, they're flat, um, to declining, and I think, uh, you know, that people are using it less. And I said to him, I don't think that at all. I think the, uh, the, because, uh, the company made a change in how the products were sold, what they did was, they said, because ultrasound involved capital equipment, we're going to hire, uh, well first we had our own separate group selling it, and then there was a decision made to combine, to have the sales rep sell everything.
Now if you're a disposable sales rep, who's used to selling a product, and getting a sale minutes after they, get done their presentation and then having to sell capital equipment for a product that gets used sparingly. That's not exciting.And I was very against it because I thought nobody's going to sell my product. They're going to make all their money in stents. And to be honest with you, I wouldn't have if I was them either. So I said, the people, you know, our top 20 customers are using the product just as much, if not more.
It's everyone else who relies on a sales rep, a dedicated sales rep, to come in, set up the equipment, show them how to use it. Because it's not used regularly, and there weren't these ultrasound specialists. The reps were, in essence, filling that void. And now that you've taken that away, and there's no specialists, the people that, that aren't real believers, but occasional users, are not going to use the product.
Takes too long to set up. They don't know what they're looking at. and, I'll never forget this. He said to me, Oh, really? He said, that's not what I think, so show me your data. And at that point, I kind of like froze, like, what do you mean, show me, you know, your data? And I remember looking down, it was a U shaped room, and to the far right, closest to me, was my direct, uh, boss.
And I remember looking at him, he had this little mustache, and he was, he was twirling this mustache, he was sweating, and when I saw that, I'm like, you know, I... I think I'm in trouble here. So I said to him, like, I don't have any data, but again, you know, I thought my instincts, you know, were dead on. Uh, I said, but you know, this is what I think.
And he said, okay, um, uh, he goes, what, what time is it? It's 11 o'clock. You have one hour to go back. Um, and he said, you said the top 20 customers, right? And I didn't know where this was going at the time. And I said, yeah, the top 20 customers. And he said, well, uh, is it fair to say that you think the business could be even growing there?
I said, yeah, top 20 customers. I do. Give me a number, you know, 10%, 20%. Now, if I was smart, I would have said, yeah, the lowest number that he gave. But I said, no, I think they're up at least 15 percent in the top 20 customers. And he said, okay, you got one hour, call, call back at the home office and get ahold of finance.
I want to see the top 20 customers with, uh, you know, where they were a year ago, where they are today. You can sit down now. That's when I started to sweat. and I'll, I'll preface this by saying, up to that point, all my presentations, over the course of the first year plus had gone very well because things, were improving.
So I get on the phone, I'll fast forward, we get the data, and I'm literally sitting there with a calculator, you know, what, you know, what, what are we doing here? What are we doing there? ultimately. the business, I think it was like 27 point something percent growth in the top 20 accounts. and it was probably even the top 30 accounts, but after that it was just a nosedive.
So now, I'm a sore winner, right? And Mike Berman's the smartest man on the planet, you know, in my opinion. And I'm right, and he's wrong. So, um, it's 12 o'clock, and I'm, by the way, my chair is right next to his. So, um, and he's not even acknowledging me. And I have sweat pouring down my face. And so at 12 o'clock, he says, okay, we're, we're going to take a break.
Uh, so what's the results, Dave said, you know, business is up 27, you know, point whatever percent he goes, okay, you know, now we're going to take a break. And, and, you know, this was my moment of glory and this is what I get. I don't get a. You're right, uh, you know, congratulations, nothing. It's like, let's go to lunch.
So at the end of the day, I'm sitting in the room, and I'm really mentally exhausted from that whole exercise. And, uh, the door, I hear the doors open behind me, and, you know, this person puts a hand on my shoulder, and I turn, and it's Mike Berman. And he said to me, Dave, I want to talk to you about something.
And I said, okay. He said, listen, I think you're a talented guy. I think you have a good head on your shoulders, he said, but, don't ever come to me and tell me what you think, because I don't care what you think. if I have to approve something, that's based on your opinion versus my opinion, I'm going to pick my opinion over your opinion 100 percent of the time.
If you've got data to show me, to make your argument, to convince me of what you want to do, I'm going to go with what you want to do, because I do have confidence in you. But he said, never come to me and tell me what you think without having, done the homework. That was a turning point for me because then I said to myself, yeah, I'm not that smart where, um, you know, I can kind of ignore, uh, you know, what, uh, the exercise of going out there and finding what the real answer is before I develop an opinion.
I skipped a step is what I did. Now, my argument was, I've been out there working with customers and this is what they were telling me, which was true, but I never checked the numbers to see if it supported that. So that, that taught me a lesson of like, I can't just go in there, you know, and, and say like, yeah, my, my gut tells me this and that's what we're doing without at least going through the exercise of having something to support that.
[00:33:59] Pat Kothe: Fascinating story. And, and really, you know, what a lesson I've, I've got a, I've got a Berman story myself. So, so, so for, again, for the listeners that don't know, don't know Mike Berman, Mike, you know, he really made a tremendous name for himself at SciMed and, and when Boston Scientific bought, ended up to be, you know, be a CEO of, of Boston Scientific from what I understand now, Mike is, is involved on, on, on the investment side of things and, and, and doing things with, uh, uh, investing in, in, in different companies.
Thank I was, uh, in marketing, uh, marketing diagnostic, uh, catheters in, in the cath lab for, for Mallinckrodt Medical. And I got a call from somebody, Hey, you know, Scimed's looking for, you know, somebody looking to build a diagnostic, uh, uh, catheter, uh, uh, company in cardiology? You want to go talk to 'em? So I did. I went up, I went up to Minneapolis and talked to, you know, Danny Sullivan and, and, and, and the, and the group up there.
and I, yeah. And the other people in marketing and, and, uh, uh, sitting across from, from Berman, it was a Saturday morning, a ton of snow on the ground up there, January, February, whatever in Minneapolis. And, and Mike asked me a question. he said, okay, if, if you showed up here on Monday, your first day on the job and there was nobody here to greet you, everyone was.
Kind of tied up, you, you're on your own. What do you do? What do you do those first couple of days? And I had been living in the diagnostic Cardiology catheter market for a while. So to me, I knew well like you I had these instincts and I said I, I would go down to R& D and I'd start talking to the R& D folks, about capabilities and what to do. And I saw on Berman's face, you kind of went kind of blank. And at that point I knew what I had done. Um, but I didn't, I didn't backtrack, you know, the correct answer to that question is I'm going to go out and do it with the customers.
I'm gonna go talk to the customers. Same thing. Data. I need to have data in here and the place you get data is from your customers, but because of my own ego or, curse of knowledge or whatever you want to call it, I knew. And he taught me basically the same lesson that he taught you.mine was in an interview, which was a little, you know, less, uh, stressful than you with a job on the line.
[00:36:39] Dave Rosa: Yeah. I, I, you know, I have so many stories like that with, with him. We could do a whole interview just, based on that, but, I have to say that, And I've told him this personally, I'm like, the only reason why I feel like I got to where I did, in terms of role, is because of a lot of the things that he taught me, either directly or indirectly, just from being around him, and, he's not the only one, but he certainly, at a younger age, when I was at a younger age, he certainly, changed my way, my approach, my way of doing things, and thinking about things, that I had never really considered before.
And I think, part of that is, as the business was getting better, I was gaining more confidence in myself. And I think that's a dangerous thing. Because, I think when you start feeling like, Oh, I got this figured out. I know what I'm doing. people are telling me I'm doing well.
You feel like, maybe I don't need to do that because I know what's going on. everything's going fine. and Mike, again, that's probably something I would have done, to someone in a group before this consultant talked to me, but that was Mike, and I really responded better, I think, to people who kind of slapped me hard and said, hey, Mike, thank you.
Shut up, listen, and, uh, you know, uh, don't, don't do what you did before.
[00:37:59] Pat Kothe: There's a difference between the, the person who says, you know, slaps you and said, shut up, listen, and then they take it out on you, versus using it as a teaching
[00:38:09] Dave Rosa: opportunity. Yeah. And Mike always, he wasn't there to try to embarrass anybody.
But boy, he would teach you some tough lessons. I saw him do it many times.
[00:38:19] Pat Kothe: Great learning lessons. Thanks for sharing some of these things because, as we grow in our careers, in my estimation, the most valuable things that happen to us are when somebody sits us down and says, what you're doing is wrong.
You need to change. there's something about, about you that, no one, if no one's ever told you this before, shame on them. But I'm telling you this because in order for you to grow and build your career, you need to know this. And there's so many people who just go along to get along and don't have those hard conversations because they're, they're thinking maybe they're going to tick somebody off. I don't want to have that position open, we'll just sweep that under the rug because 90 percent of what that person does is good. And there's 10 percent that isn't, let me just take the 90 percent and put the 10 percent in the closet when that 10 percent could hold that person back from, promotions from a career, because that 10 percent is so toxic to the next job.
[00:39:25] Dave Rosa: So let's move, move from that into what you're doing right now, because you, as you said, you built a tremendous amount of. of knowledge on how to grow companies. And you went from big companies into small companies.
[00:39:39] Pat Kothe: So let's talk about NeuroOne Medical Technologies and what you're doing there. what's the problem that you're, that you're solving? what is the clinical situation, that NeuroOne is tackling?
[00:39:51] Dave Rosa: NeuroOne's a company that, that's developed and commercialized what I'll call a platform. Everybody likes talking about their technologies as a platform. And, I really feel that this is a platform. The problem when I was investigating this area, which I didn't have, it's actually one of the things that attracted me to this space because I had never worked in it before.
So I knew I would definitely learn, a lot from it and I have. But the issues were... Initially, very invasive, morbid type procedures, you know, removing the top part of a person's skull, and then removing, brain tissue that was causing issues, think of it like atrial fibrillation where you've got, heart tissue that's causing, complications for a patient.
This is just, different organ in the brain doing the same thing. I remember talking to a doctor at the Mayo Clinic saying, oh, do you use a catheter to destroy that or, cryotherapy? And he said to me, what are you talking about? We use a scalpel. Um, and I thought, wow, this is such a barbaric space.
You know, the brain, you know, fascinating organ. And, I kind of, uh, expected that, technology would be where it was. It would be comparable to the cardiovascular industry. Because. I really saw a correlation between what we had done in the cardiovascular side with companies I had been with to, to what needed to be done in the brain.
What I saw in NeuroOne was a technology that could be used to perform, multiple, not procedures, but multiple applications. And what I mean by that is there's a diagnostic aspect. like trying to find the problematic area in the brain. So there were surgeries dedicated to just doing that.
And then a patient would get sent home. They would have to come back and get scheduled for another surgical procedure where they had to go back into the brain and then, remove the tissue. and there weren't very good ways to really identify if the procedure was successful, because if you're dealing in epilepsy, it's is the patient having a seizure, and then, there are other procedures where they place devices in the brain or even other parts of the body to stimulate tissue therapeutically, but all these required additional procedures.
And what I saw was spawned out of, the Mayo Clinic and the University of Wisconsin was. The device that had the capabilities of being placed less invasively because of how thin it was, but also being able to perform both the diagnostic and therapeutic function. As a patient, less invasive, minimally invasive, non invasive, that's what everyone wants.
But also, no one wants to go in for multiple surgeries to begin with. But if there was a way to combine the diagnostic and therapeutic, part into one procedure, not only could we reduce the number of complications, just based on reducing the number of surgeries, but people should, should only have to, uh, go through a hospital stay once instead of twice or maybe three times.
And there's also a cost element there. The ability to save the healthcare system some dollars as well. So I looked at it as, the patient wins, the hospital doesn't have to eat up eight hours, for a diagnostic procedure, another eight hours, they could do more procedures, because capacity is not very good in, in these neurosurgical procedures, just because of how long they take.
And I saw an opportunity there and, you know, so my vision was, to take this one platform and expand it not just for diagnostic purposes, but also to address the therapeutic side using the same device. And, uh, that's kind of the path that we've taken, and mine was a stepped approach.
So let's develop the diagnostic piece first, and then the combination piece for, ablation, meaning destroying the tissue as well as being able to, monitor the area or find the problematic area. And then, stimulation being, the next piece upon that. and really, that's where we are today.
We've got two, approved product families, that are being sold by Zimmer Biomet, who's, our distribution partner. And our first combination diagnostic therapeutic device is sitting at the FDA right now. We've already had an initial set of questions. We're going to be responding to those shortly.
And I envision that sometime in, late Q1 next year, we'll be in a position to launch that. and, there's always curveballs that get thrown along the way. Things that, again, that could lead you down a different path, have you change your strategy that you didn't see coming.
And one of the things that we are excited about is, the ability to use this same technology to not only deliver drugs into the brain, But also,evaluate the, effectiveness, of those gene therapies or drugs in the brain as, as we're delivering them. We're having discussions with, biotech, biopharma companies, to use, a device like ours in their clinical trials as a way of developing objective performance criteria to demonstrate to FDA the efficacy of the therapy.
So it's a little bit of a, a different, application, but, the beauty of it is that today. what we're doing to resolve issues, especially with epilepsy, is to burn tissue, destroy tissue in the brain. And I think the future will be to put a device like ours into the brain into one or two spots, and without destroying any brain tissue, delivering gene therapy, to address these conditions.
So I think we're, we're well positioned today, but we also have a platform that, can really, be the next frontier. in terms of, treating these conditions using gene therapy.
[00:45:52] Pat Kothe: Can you describe the device, the size, how it gets placed? what the procedure is, whether it's permanent or temporary?
[00:46:01] Dave Rosa: Sure. It really varies since we're involved in a number of different applications. But we have, I said two product families that are cleared for diagnostics. One is, film, based technology. So think of, a piece of paper, something that's as thin as that, that you can roll up,and one of our platforms is for spinal cord stimulation.
And our goal is to deliver it through a needle that doctors use today, to deliver pain injections in the patients. So instead of having to make any kind of incision, we can put a larger device in, because of how flexible it is, just through the center of a needle. Obviously that's percutaneous, which would be, phenomenal if we could do that in, in all these applications.
Some of them, though, require the device to be placed in a focal point or a specific point, in the brain or somewhere else in the body. So different devices, that look like thin wires. They're about 8 millimeters in diameter. So they get placed directly, much deeper into the brain. but they're used to do the same thing.
and that is record what's happening in the area. So those, are placed using, typically using a robot. This is why Zimmer Biomet, our distributor, was interested in us. They have a robotic platform that will drill the hole into the skull and, those holes are, the depth, the trajectory of the electrode are all pre programmed in based on where the, neurologist and neurosurgeon, want to place the device.
So they'll predetermine a rough area of where they think the problems are and then the devices will get placed to a very specific depth and angle, so that they get to the area they need. So the less invasive platform is, a millimeter hole in the skull. The more invasive platform is you remove a piece of bone from the skull, to place the device.
Most of the procedures today are being done, with, drilling tiny holes,into the brain. So that's the way they're placed in the spine. It'll be percutaneously through a needle. So depending upon the application, it'll really determine the method of insertion, but we have a clear advantage because our technology is so thin and so flexible that we can put it in, advance it through small holes, as opposed to having to, for example, remove the entire top part of the skull.
[00:48:36] Pat Kothe: So you've got different products, different applications. You've, partnered with,Zimmer Biomet on, on one application. What does your go to market strategy look like in general? Is it, partner with other companies? Is it, go direct? What does it look like in
[00:48:51] Dave Rosa: general? Yeah, that's an excellent question. And it's, it really depends, on the company that I've run and what the situation is. In this particular case, my goal was for the diagnostic only products was to find a partner, a strategic partner.
And the reason for that is the market was relatively small for that. Where the market becomes much larger is in these combination devices that are not just diagnosing problem areas, but then providing the therapy. That's where the revenue is much greater and the businesses get much more interesting. So my plan was find a partner that has an existing sales force where there's some synergies, which was Zimmer Biomet.
Utilize their sales force because all of our competitors for the diagnostic only application are small private companies. And Zimmer obviously sells a lot more devices than just this robot and these procedures. Even if the devices were equal, and we had no advantage, Zimmer would have an advantage in terms of sheer number of people in the field, as well as the ability to leverage other technologies to get the electrode business.
But my plan, beyond that was... to go direct, where the markets are much larger. The other benefit of, of having a strategic partner, especially when you're just starting, and you're a, I don't care really if you're a public or private company, is really validation of what you're doing.
I think most people think of early stage companies as well, these companies they don't have the resources. They don't have the know how that larger companies have. The risk is greater, right? Will they ever get clearance of their device? Did they do development properly? So there's all these, stereotypes, I think, of smaller companies.
And if you're able, to get, an investment or an agreement. successfully with a large strategic, it validates what you're doing in a sense to the investor and in his mind, maybe reduces the risk associated with making an investment in you. So that reason, as well as the market being small and me not believing that, financially, it made sense to add all that overhead for such a smaller market is the reason why, I developed a partnership or was lucky to get a partnership with Zimmer.
As time goes by, again, I said, sometimes you think you're going to go left and you go right. what we're doing has become a lot more synergistic with, some other strategic companies and Zimmer is one of them. So it's not just them kind of evaluating the company based on this diagnostic technology.
They're seeing us make progress in the therapeutic area and other areas like drug delivery, deep brain stimulation. So then, you get to a point where the market today, the financial markets today, are just a disaster compared to where they were, when I started. So then you have to start thinking about, maybe, uh, should partner with them as well, given the cost of capital, and what's happening in the markets.
So right now we're going down a parallel path of having discussions with strategics about our, combination, this first combination diagnostic therapeutic device versus doing it, ourselves through distributors and direct salespeople. The advantage we have in this is that there's not many hospitals that do these procedures.
So a lot of companies will have, 100, 100 plus reps. there's 30, 40 centers that do the bulk of these procedures. So if you just focused on that, it wouldn't be out of the question to, to do this and, try to handle this directly. Ultimately, what we'll decide in the upcoming months is what makes more sense.
Does it make more sense toform an additional relationship, whether it's with Zimmer or someone else, or do it alone? A year ago, people thought that things would be easing up in the financial markets. I think they're actually still getting worse, and I don't know that any of us can predict when things are going to settle down. You know, You have to take away all those, because they're all important factors.
[00:53:11] Pat Kothe: Given our earlier discussion about having the data to support making the decisions, I'm sure you and your team have got the data, and going to use that to help drive these strategic decisions.
So good luck on this company, you're already in the marketplace. There's other products that are coming. good luck as you start to really get, get this thing rolling. I do have one, one final question for you. And it comes back to our earlier discussion on careers and I'm sure you get a lot of people come to you and say, Hey, you've been really successful in building a great.
medical device career. What should I be doing? What should I be doing so that I've got a full career, set out ahead of me? What are a couple of things that you talk to people about that are asking for
[00:53:56] Dave Rosa: advice? Again, I'll steal a little bit from what I did. My attitude was look for a role where, you can learn.
And it doesn't mean that you can't learn in successful businesses, but, what you need to learn is to be able to make decisions, for things that are, going to be tough decisions that you have to make. And you learn those by moving into roles that, have challenges, obvious challenges.
So my thing is learn as much as you can and do not shy away, look for the jobs that are challenging because you're going to learn a lot more. The second is to learn as much as you can outside of your area of expertise. Um, so if, you know, If my background's marketing, and I want to get into, uh, management, senior management, spend time with people and finance in the company that you're with.
Spend time with, people in R& D. Learn as much as you can about what's important to them, how they approach things, so that you can at least be competent in having a discussion, and in understanding how they approach it. Ultimately, you're going to want to surround yourself with people that are experts in areas that you're not.
But learn as much as you can. Very early in my career, I had a, a head of R& D come up to me in this company, and he said, Dave, explain to me, I don't understand, why my R& D guys really like working with you. You're, you know, in the evil empire of marketing. Like, what, what are you doing different?
And I wasn't doing anything different, but I had an engineering background, and I could understand what they were talking about. I could understand what their issues were. I was no expert in it. But the bottom line was they were able to communicate me on their wavelength as opposed to me talking to them from a marketing only perspective.
And I think that's important because it gains credibility with people in other departments that you're going to be working with. And I think that also, helps your career because, again, in that situation, I didn't even know that these R& D or this R& D group. had a positive, vibe for me and my interaction.
So, you know, if your goal is to move higher up into senior levels, try to learn as much as you can, develop relationships as best as you can, with people in other areas, not because human nature is if you're in marketing, you talk to the marketing guys and you're friends with the marketing guys, you socialize with the marketing guys.
And, that's important too, but I think it's important to also, spread yourself, into other areas as well. The other thing, and I tell this to my, children all the time, don't listen to all the noise around you. There's going to be more people in your life that are going to tell you you're not smart enough. You're not good enough. It could be out of jealousy. It could be because they really believe that, but if you're going to be successful, you got to believe in yourself, and you got to block out all the noise because there's going to be a lot of it. And if you let that influence you. You'll never be successful.
and then the last thing is, don't give up if your dream is to, to work in R& D the rest of your life at, at a senior level, middle level, whatever. keep pursuing it, keep learning and don't quit. There's going to be roadblocks all along the way. and you can't let that get in the way of, you accomplishing what you set out to accomplish.
[00:57:32] Pat Kothe: I'm drawn to people who are open about their experiences. Good and bad. And willing to share because they know it's going to help others. Dave's one of those people. And I hope you enjoyed the conversation as much as I did. A few of my takeaways. First. Brutal feedback. If you're on the younger end of the spectrum and no one's given you any, seek it out. You're not perfect. That feedback's going to help you get better. Surround yourself with people, who aren't afraid to tell it like it is and tell it, like they see it.
if you're a little further in your career, remember you're not all that.
Make sure that you're open to listening for that feedback. And if you see someone. And you think that feedback can help them find a way to do it. Step out there, give somebody a, uh, basically a hand. And how they can be better.
The second thing was marketing department roles. And I enjoyed the conversation of upstream downstream combo roles because I've lived through it. But whether you're in marketing or any other department be deliberate about how you design your department, because there are things that you need. But then there's also internal ex external customers.
And what do they need? And then what are the talents of your people and where are their interests?
And it kind of leads into the last point and that's stretch assignments. Dave could have taken the easier, more successful product lines. But he chose harder ones. He chose opportunities where he could grow. And in those, those opportunities you end up with high risk, high reward.
He talked about, you know, Uh, how it could have been high risk, high reward, but he's being viewed by the people as a problem solver. We've got a real issue here. Can someone step up and take it on. Not only can help the company, but help you use stretch and grow.
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