Health Innovators
Health Innovators

Episode 102 · 1 year ago

Commercializing Med Devices in a Prehospital Setting w/ John Keane


John Keane considers himself a commercial strategy kind of guy - and with 35 product launches under his belt, we’re inclined to agree.

To reach that level of commercialization success, it takes a lot of expertise and an enviable ability to listen to stakeholders at every stage.

But he did it - and when he agreed to come on our show and talk to us about his experiences and insights around the med-tech and healthcare market, we were nothing short of thrilled.

Want to know why ego has no place in commercialization? Or how to avoid being the HIPPO in the room? Or why it’s never a failure if you’re learning something?

Pull up a seat and join us for John’s story!

Here are the show highlights: 

  • Talking to your customers makes the conversation easier (3:07)
  • Beware the HIPPO in the room (4:21)
  • Seek some input from outside the “box” (6:07)
  • It’s not failure, it’s learning (11:40)
  • How to navigate the tangled web of the healthcare market (30:05)
  • Why you need to leave your ego at the door when decision-making (39:58) 

Guest Bio 

John Keane is the Co-Founder, President and CEO of MindRhythm, a med-tech company focused on reducing stroke treatment times in the prehospital setting.

A medical device executive with three decades of experience developing and commercializing emerging medical technologies, John has been involved in more than 30 product launches.

His position in the healthcare community as a strategic leader and advisor to multiple companies helps drive his success in defining visions and positioning companies for dynamic gains.

If you’d like to reach John directly, you can find him on LinkedIn at John Keane, or you can email him at

You're listening to health innovators, a podcast and video show about the leaders, influencers and early adopters who are shaping the future of healthcare. I'm your host, Dr Roxy Movie. Welcome bow health innovators. On today's episode I'm sitting down with John Keene, who is the CO founder, president and CEO of mine, rhythm. Welcome to the show, John. Thanks, Dr Roxey, have to be here. Thanks for having me. Yeah, good to have you. So let's start off by jelling our audience a little bit about your background and what you've been innovating these days. Sure, I like to think of myself primarily as a commercial strategy person. I started out in pharmaceuticals, like many of us in Medtech did, a long time ago, and I found that I gravitated towards the newer products, new product launches, injectables and you know, once daily's and those types of things, and then I went from there into Medtech and over the past thirty years or so I've been involved in about thirty five product launchious every at every level, so at the sales rep level, the junior level, management, middle managements to your management. So I've sort of been exposed to what's needed, what works and what doesn't work. kind of an every at every and with the still believe that the most important part is the people in the field. HMM, okay, this is me more about that. Sorry. So I just with any company, whether it's a medical company or manufacturing company or consumer electronics, it doesn't it doesn't matter if somebody's not interacting with the customer in hearing what they want, what their needs are, what their work environment is like, it's really difficult to know what they need and to know what's right for them. And the moment that you get out of the field, and which is typically what happens when people go into management, I remember someone saying to me very early on what my managers said, the minute you leave the field you're no longer current. And he I learned from him. He was very good about listening to what his salespeople told him, what his clinical people told him, and and so he made better decisions and then it was something that I adopted the course of my career. That's great and that is it's so true that the closer we stay to the company, to the customer. I think that, you know, the more successful have, the more will be able to pivot and adapt and continue to deliver value on an ongoing basis when we stay close to the customer, not just this one time of launching something into the market. That's so true. And there are things that you you don't think of, that you wouldn't necessarily think about unless you're talking to customer. Just a simple example. You know, we're working with my current company. We're doing stroke triage and they don't the MST professionals don't have to any technology availables and they're only doing stroke assessments for patients. And I had someone say to me that the end of a long shift they're tired and they don't perform the assessment that with the same rigor at the end of the shift that they do at the beginning of the shift, which is something I wouldn't have thought of. Yeah, and it's just it came up in conversation yesterday. So it just made me think something I learned from talking to a customer twenty four hours ago. Yeah, and you know, being able to we talked. We talked about it as different topics but really all the same thing of like creating learning organizations where there's this cute continue as learning this continuous feedback loop that's in place to be able to pick up on those little nuances that could make a big difference. You're absolutely right, and the continuous nature of it is a very good point that you make in that if if someone were to visit an account, they get a snapshot of what's going on that particular day, at that particular moment in time. And the world is very dynamic, particularly in healthcare. These things change on a regular basis and it requires just constant interaction.

And you know from people have asked me over the years. You know, how have you come up with your sales strategies, your marketing strategies? Like well, it's not that hard. You talk to your customers, telling you what they want. They'll tell you what they like, tell you what they don't like and having worked with, you know, surgeons for years and years, they're not shy about offering their opinions. So it's a pretty easy place to start. Well, I think it's brilliant. It's brilliant to go. You know what, I really come to the conclusion that I don't have to have the answers. Makes it easier, doesn't it? Like why are all so many people fighting to have the answers when they could just let that go and ask the customer. You know, it's funny because we're joking about this, but on a serious note, I've noticed that over the year sitting in and management meetings, mmm to me one of the biggest barriers to coming up with a good product design or a good study designer or whatever is somebody wanting their own voice heard. And Look, we all have of opinions, we all have ideas and we want to share them. We want to be treated with respect and when people to listen, sure, but it really should start with what is the right thing to to what is the customer want? What is Proper Study Group interactions in a input from the team, and too often when I see decisions made that aren't right, it's made by somebody who wanted a decision that was theirs, that didn't have enough specific knowledge to been able to make the right decisions just because they don't have the information. So it's something I try to avoid. You know, we call that. I say we, I didn't make this up, but they the term is hippo, the highest paid a part highest paid person's opinion. And what is it? I mean don't. I've never heard that, but boy is that true. There's so many teams, so many companies that companies that have a hippo in the room, and I'm and I always say like and if you don't know who the hippo is, look in the mirror, because it might be you. That's so true. You know, especially, as you know, as consultants, as visors, as CEOS and Co founders, you know lot, very often people won't contest our point of view and just kind of acquiesce to whatever it is our vision, our strategies and tactics are, and so you know that's never going to be a successful bath. That's a good point. I try to and it's hard sometimes because when people report to you, they feel that chain of command and that there. It's not okay, and I'll I'll tell people it's okay to tell me you disagree with me, just I mean, you could be nice about it, to tell me I'm dog. Yeah, but you know, if you have enough, if you have another idea, if you got an idea that's better than what's there, you're improving the situation, you're making the company better. In making the product that are you're helping patients. So that should be expressed and I do think that in many companies there's a culture where people feel afraid to share their opinions because it's their livelihood, that dont want to lose their job. So, but that's it's counterproductition. Yeah, I really like what you're saying, is that you know we can have this expertise internally, but you know we're going to maybe be more successful when we are seeking input from outside of the company, outside of the four walls, on a regular basis. Yeah, it's it's such an important thing to do and I've worked with companies where they don't seek input. They design a medical product without seeking input from medical people, which just seems to me as fundamentally not smart. And so I can recall a conversation and requirements discussion. For those in the call it don't know what this is. When you're designing a device, it has requirements that have to be in it, and one of the things that we had for this particular monitor that's going to be used in an operating room was that the cord would have to withstand five hundred pounds weight being rolled over it, and the team was like, how oft it is five hundred pounds of way can to get rolled over this chord and I'm like in an operating room in a hospital. I don't... least once a day, and they couldn't believe it, you know. But you know, you have to be again, you have to be in the environment to know. Yeah, yeah, absolutely, that type of shadowing to is even different than, you know, just asking people what they think about something. We have some conversations here on the show about the difference between, you know, seeking input from customers and really gathering these new insights about, well, what are they trying to accomplish, versus asking them, well, what do you want, because they can't like you know, we often use the steve jobs example. If you to ask customers what do they want, not very many people would have said, well, you know what I want, I want to ipod, I want a thousand songs in my pocket. We're thinking that revolutionary, but there are still ways to be able to facilitate that conversation with the customers, to be able to figure out what they're trying to accomplish, what job are they trying to do, and still be able to come up with revolutionary ways to be able to address that. That's very well said and I don't think thought about it in that fashion before we had a call today. Internally we're we're making a product design decision and essentially one of the components of it was should this be disposable a reusable? And my experience with disposables and reusables is most customers say they want reusables but they don't like them when they get them. And so you have it available and then nobody ends up using and and they throw them out. They get upset at they're spending more money. And See, phrasing the conversation, how you put it, what are you trying to accomplish versus? What do you want? If you say what do you want or going to say we want to use reusable do you really in an ambulance at two o'clock in the morning a newer when it's raining? And I think so. And that's that's probably a better way to have the conversation where you can guide them down the pathway of what you're trying to do, getting that input, but making sure that the input is is qualified in some manner. Yeah, yeah, you know, it's usually to your point is that there's a big difference when we're asking someone would you, would you buy? Would you like this, you know, is this something that you would use? And then in okay, like how much would you pay for it? And Oh, no, I won't pay for it. Right, I would use it, but I don't want to buy it. I'm not going to give you my money for it. Interesting thing with respect money found in fundraising. All of our investors thought that we didn't have a product price high enough. All of our customers that we had our prices product price too high. So I notice that the people who think that the pricing on things is too lower the people who stand to make money off of a higher price. The people think it's too higher the ones up to pay for it. So funny how that goes and and that, to me, is a great use case for this type of qualitative market research that we are doing with customers to be able to create a business case. So you know, if you're talking with investors and you're saying, well, we disagree, or you know, this is the price where we think it should be, in your kind of coming up with a different scenario to kind of back up that decision, that's very different than actually, if you've got like interviews, videos of customers saying what they will pay. Right that's going to be so much more powerful feedback that people can't contest. It's a lot more difficult to robut both for ourselves as whether those advisors or investors are having that conversation, like when you're hearing directly from the customers. Now it's really easy to adjust pricing in the board room. You just change it on a spreadsheet. You see your margins gool up, you see her revenue school like this is the direction we should be going. If they don't buy it, your revenues in zero, and so it. Yeah, totally so. Yeah. I had this, you know, experience personally where I was pricing something really...

...high and not selling it very often and then changed it to where I actually went much lower than what I had wanted and was kind of so, instead of going high and going no sales, no sales, no sales, need to drop it, no sales, going low and going sales, but they said yes, too quick. Okay, now I'm going to increase it a little bit. Okay, so I'm still getting sales, but they still said yes, too quick, and then all of a sudden you get to that point where you're like no, they they're taking a little bit longer time and you kind of figure out where your sweet spot is on pricing, but you're still building sales along the way, as opposed to going so high it's like, okay, no sales for months because I'm too high. Well, that's, you know, that's market research without a nets. Right, right, exactly. But that's also you know, that willingness to adapt is a really, really important skill in really in life, but in business in particular. Your willingness to say, okay, Oh, I'm not selling anything in the price is probably too high and then let's just take do a radical reset. Oh maybe the price is too low, and then eventually found where you needed to be. Yep, for the through the willingness to change, and your point about the hippo another characteristic. There's, you know, our ignorance brings us to a mistake and our arrogance keeps us in that mistake. That's good. Not My original line. It's been applied to be quite a bit, but it's just for our viewers and listeners to chime into. It is the type of thing where, I think, because how we're brought up in our education system. It's we reward being correct and we punish being incorrect. When you're doing something new, you're not incorrect, you're learning. And so if you do something and it's not working out right and you adapt and you have a little bit of success, that's a that's an evolutionary pathway and to me I view that is a very positive development. So I don't ever feel like, Oh, cheezs we did something and it was wrong and now we got to fix it. I feel like, okay, we learned what not to do, now we'll try something new and and I think the entrance parent about that. It can be so powerful because it really demonstrates that there is no ego and that you are really open to learning and that you are adaptive. And so often I see innovators, especially startups, you know, one to present themselves to investors or potential customers as they've got it all figured out. You know, they kind of mapped point a to point B with three steps in between, and they've just been plugging their way and without being really candid about what's going on and in really thinking that that's actually going to lead to more success. But it's not true. It's not reality. And so if we were more vulnerable and more transparent about those learning opportunities, I think we'd have more trust and more credibility and end up being more on a path of success instead of trying to fake like everything's just been perfect. I completely agree with that. In the beginning it could be very difficult because the answer to virtually everything is, I don't know right. Right. It's so because it's you know, it's you start out with an idea on a cocktail mapped in, and it's you need to prove a number of things. But I do think this is this was my first foray into fund raising and you know product launches, design, what needs to happen the FDA and all of the strategy and all that. I've done that for a long time, but fundraising was very new and you like it, you want to just keep doing it. Well, now that it's done, I like it. A couple months ago and maybe not so much, but today's a good day. I started out not liking it and I ended up liking it quite a bit, and I not liking it for the obvious reasons. Right. I moved to I moved into the uncomfortable. I moved into an area where I didn't have expertise and...

I said things and, you know, got schooled quite a bit because I didn't know certain terminology. I had to learn them. So that's that's uncomfortable. I also didn't like it because I love strategy. I love but you know, coming up with the commercial strategy and the design. It's what I've done for so long. It's fun. Yeah, and you know, I was told in knowing certain terms by my colleagues. You know, your jobs to keep the gas in the gas tank and you really are going to spend a lot of your time raising money. And of course, during Covid it was more challenging and at first I was like I's taken me away for something I really like doing and I had to get used to trusting the people around me take on some of those things. And so there was like an inflection point where I sort of developed a certain level of knowledge and skills with the fund raising and got used to handing off some of these things to other really qualified people that have worked with over the years and I've seen them growing their careers and now it's like, Oh, I've got good people that can do this. It doesn't have to be big, good, I can sleep tonight. It's you know, it's ended up working out quite a bit and now that the rays is over I get to go back to some of that stuff. But or yeah, it's really the primary role and just, you know, how do we get comfortable with it? Is just do it right and do what you're doing it. Yeah, wait, yeah, the first time you run a fifty yards or throw a football or pick up the guitar, you're not going to be good at it. So let's play the drums. or you see the drums behind me? So, but I can't remember picking up a drumstick because I was so young the first time I did that. All drummers show like this. Yask any drummer. We why did you start playing the drums? I don't know. I just thought it's going to play the drums. Every drummer as a picture of themselves with with wooden spoons hitting the pots and pans and okay, mom my dad's kitchen. So make well. It's just more than just doing it for a long, long time. HMM. But drums you never get good. So tell us a little bit more about mine. Rhythm and what you're innovating there and kind of where you are in this innovation or commercial process. So mind rhythm is a company. Right now we're focused specifically on stroke triosh and I'll cover a little bit about that, because there isn't even in the medical world, even in neuro there's not really a lot of knowledge with respect what goes on prehospital. So there you can basically have three types of strokes. You can have a hemorrhagic stroke, which is bleed. Nothing they right now. There's nothing they can really do for that other than lower your blood pressure and evacuate in certain situations. If you're having in a schemic stroke, that's a that's a clock and it's if you have a part attack, you're having a clock heart. That clock goes to your brain. If you goes to a small blood vessel, you have a small vessel inclusion stroke. If you have a large vessel seclusion stroke, it's a big clock in a big vessel. For small vessels, they treat them with a drug. With large vessels, there's only three hundred places in the country that can treat that and you have to go to one of those hospitals in order to have them go in and take the clot out of your head. Yep, and it's such a it's such an important technology that it's a difference between getting treated in walking out of the hospital two days later or being potentially in a nursing home for thirty years permanently disabled, like not move it half your body. So it's a it's really a binary situation. And so right now in the US there's no way to tell what type of strokes somebody's having. So they're going to the hospital, they scan them, they determine the stroke and then they transfer them. So takes hours to get treat and then it causes permanent disability. So we've developed a device that can identify that for the paramedics in ninety seconds in a Amulans, so they can say large vessel pluition stroke, they need to go those. I'm in Boston, so they need to go to mass general, bringing women's Beth Israel, one of those hospitals. In San Francisco you'd go to UCSF. And the more rural you get in your communities, the longer the transport times, and in outside the US it's significantly worse. It could be four or five hours... Ireland to a hospital can treat you by then you know you're dead. Yeah, so that's what that's what we're aiming to solve. We are the device works. We have to publish papers, but we're most companies would take those papers and get FDA clearance. Now, YEP, we chose not to do that. This is based my own experience. I find that nobody will use medical technology, new medical technology, unless you prove beyond a shadow of doubt that it works, and then you have to prove it's better than what they have. In our case, they don't have anythings. Also, so we what happens is comple pause there for a second. In your case, what they don't have an option. So we're feeling something that doesn't exist right now. Yeah, so if it's a brain tumor and you have a new way of removing brain tumors, while they have open resection, they have radiation therapy, they have laser treatments, chemo, all different things you can use. With us, nothing exists. So that part of the pathway is actually easier for us, because the paramedics want what we have. But in general there's resistance to using new things. It's very difficult, as you know, to get new medical technology adopted AAY. So, in as in a startup situation without this proof, we're doing an ambulance based trial right now to show that it works in the environment where it will be used. We're doing it in Metro Detroit through way in state. And short of that, I don't believe we will have the support to change state policies because most of these practices of where to take patients are determined by state protocol. They're not going to change state protocols without evidence based medicine. Yep. So that's what we're doing. A typical scenario and network for companies that have done this. They try to get the product to move for as little money as possible, which means no FDA trial or limited trial get out. Then they hire sales force, which is very expensive, and then they go across the country. They don't sell anything and then you can over the head and say why aren't you selling? So we're not. I think the reason I'm so sensitive to that is I was in that role so often. I was the VP of sales, which is, you know, it's the bulls eye position. You get blamed for everybody else's mistakes. It's so I just I was like, we're not going to do that, and it's helpful because I work with people who are very experienced, so they've seen the same thing. And then one of my colleagues is a neurologist, so he's focused on stroke as a position. He doesn't want to put something onto the market that isn't fully bettered in the environment just because it's his reputation. So we're all in alignment on that. And so we are pre FDA. We just submitted our FDA presub about an hour ago. I don't suppress people. Yeah, so, like we, we spend a lot of time on it because they're we didn't even understand the prehospital situation. And defining the problem is very important, because we don't define the problem correctly, the solution isn't going to be viewed as valuable as it actually is. I mean, there's a literally a lifesaving, in life altering product, and so we don't define that. You know, that's on us. Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy and DNACOM backslash kit. So one of the things...

...that I see often, and I'm not saying that this is the case with you, I just kind of want to explore this, is that I'll see innovators come up with solutions to problems that their target audience doesn't know exists or is not looking to solve. And that doesn't necessarily mean that that's a dead end business or a dead in innovation. It just means that there is a very different strategy to commercialize something like that when you're in a very mature problem market or the how do we say that? The the problem is very mature. Right the market all is very familiar with the problem. They just trying to choose between a and the new thing or versus. When there's IT's a very immature problem. Market like we don't even there's a population that doesn't even know they have this problem. So as you think through that, you know kind of tell us what you've encountered or how what's the strategy for being able to educate the market about this particular problem and kind of elevating it as a priority for them to seek to solve it. So what you just asked a question that I'm going to answer this in a different way than you phrase the question because you're the first person who's ever brought this topic up and it's such an important topic to me. I tell everybody the single biggest thing that you can have with the new medical technology is to have a technology that has a known problem and they don't have a solution for that. They actually want Yep, and you almost never have those things right you you either have something that they have a they have another solution for, and now you're what was the old thing? Who moved my cheese? You know, you're changing. You're changing what they have to be exactly. They don't. They don't want it. They have something new, they have to learn something. They don't think it's problem. You know, I work with transfusions, which is a huge problem. Nobody thought it was a problem. Yep, and I've actually tried to convey this to our investors because we actually have this situation. We have a product that's a huge problem. The situation's huge problem is really well known and everybody wants it, and so I probably should be careful, since you're according this, because my investors will read this or they'll they'll watch this the we like, John, you're not selling much. You said that everybody wanted this, but in I've never experienced this with anything I've worked with before. I've had people tried to buy this from us in prototype for and I'm like, I don't look good owner of it. Can we just do it right? And I'm not saying this to like push this, you know on the podcast I'm saying this is literally I was shocked when I encountered this. I was expecting. You know, I have this joke. A friend of mine sent me a picture of the world's first anisthesia machine which is in the medical museum in Paris and it was my clinical person. She sent me a picture and she said look, the world's first Anisthesian machine, and I said in ten minutes later the world's first anti thesiologist said, what do I need a machine for? That's the resistance to new technology. So I was my expectation, as always, to have that resistance. In our case. We don't have that. We have the exact opposite. We've got a problem that we benefit everybody because the places that are doing these surgeries, you know, the hospital makes a lot of money, the patients benefit, the patients that can't the hospitals that can't treat they don't want those patients coming to their hospital right and the amulance crews don't like dropping off people at the wrong hospital where they know that they're not going to get good care. So everybody benefits. where I think we're going to have our challenges is actually a unique situation for us, which is at the state level. HMM, because these are all policy driven practices. State of Massachusetts, where I live, they they designated that all strokes go to the closest stroke center. There are two types of stroke centers, primary stroke centers, comprehensive stroke centers. Only the comprehensives can treat these big, big strokes. So most patients end up going to a primary stroke center. They get scanned, if they have a small stroke, they...

...get treated there. If they're having a large stroke, they get transferred. In Massachusetts, they the community hospitals got upset when they designated primary stroke centers. Is the places that all stroke patients would go to. So the response by the state was to designate every hospital as a primary stroke center. So it's not a good response. It's so the we're work it. We're doing a pilot project with one of the MS companies to change state practice. That's where I think we're going to run into our challenge and that is unique. I've never work with anything as before. What about being the term that you use as prehospital? So that's something that I don't come across very often as well. Is is is that considered kind of a prevention solution, you know, in are there any things that we need to be a that you need to be aware of or we need to be aware of when we're thinking about prehospital solutions? So it's a good question and I've spent my entire career working in the hospital and Free Hospital is the term that they use. The hospital people use as the care that takes place before the patient gets to the hospital. You'll hear like in cardiac arrest, that's a neurological injury, but the the the lifesaving behavior, takes place before they get to the hospital. So they'll always say we need to affect prehospital care. So that's a commonly used term in the EMS world. Okay, so to your point, there there isn't a lot that goes on prehospital because there isn't a lot of technology that the paramedics and emts, they live in the special world by themselves, right. So they they have defibrillators, they've got EKG, they have entitled Celt and I pull sex SVENTRY. That is their entire technological armamentarium. Yeah, everything else is a one call, unknown situation. Assess this in a chaotic environment is not an easy job. Yeah, so you can see why they have embraced technology like ours, because they're like okay, they go, we have something, you know, and so they there isn't a lot of technology. Since there's not a lot of technology there are a lot of companies making things and there aren't a lot of in therefore, the there's not a lot of fdiregulatory stuff. There's not reimbursement associated with it. It's it's all its own world. And then the ems world is also very different because you have public companies, private companies, hospital o companies and then fire departments, and they all did all in then midflight and they're all taking care of the same patient group but in a different way. So it's it's I've never worked with it before, but I was fortunate enough I worked for Resolt for a while. I'm soul was. There's also a major manufacturer of defibrillator so a big portion of their sales for spends time strictly any UMASS infect some of the people on the soul team have helped me with me, helped our company, but with specific introductions and with gaining an understanding of what's really essentially a very different environment than the hospital in Romor. Sure, yeah, I can see that. And we might actually be a hybrid because we might actually be purchased by the hospital then given to the amulance companies. There's a business model for that. There are specific medicare rules pertaining to it. You know, you kit, it's not a kick back. You can't give it to him in exchange for patients, but it's true. Yeah, so you know, you got to be careful of doing something like that in there. So there are guidelines associated with it. But it makes sense. The hospitals making the money off the patient. The ambulance company is it's costing them money to buy this technology to rout them to the correct hospital. They're willing to do it, but the real financial beneficiary is the hospital in the insurance company. Yes, just another example the complexities of commercializing and in a nation and healthcare, with all...

...these multisided markets and the tangled web we weave. One of the guys who's on our board is a longtime friend of mine actually through music, Kyle York, and he he specializes in tech. He sold his company to Oracle a few years back and he's running a tech fun and he's always like your world is so difficult. Your product actually has to work before you get it onto the market, and not just work, but work better than anything else. That's our market exactly. He's like. He's like, you know, with with software, you can just make something, put it up and then work on it while it's out there. And it's just healthcurse. Health is challenging, but it's it's rewarding, it's worth it, it's a nice place to be. So so you've got a pretty interesting lineup of investors, sorry, not investors, advisors that are part of your advisory team or Advisory Council. Some pretty big hitters. They just kind of share with our audience. You know how that came about? I mean most people are trying to figure out how do they get the best advisors that put them in the right position, whether it's going to be introductions, funding, strategic guidance, whatever that's going to, you know, be. But how did you get access to these folks? And, you know, is that making a difference for you and your company? So I would say the unique situation that I had, MMM is probably was really instrumental for me being able to complete the race as a first time doing this with not a lot of contacts. So some of this won't really be transferable because it's kind of luck. My colleague, way a Dr Smith, is that he's a very wellknown neurologist at a very it's the UCSF is the top rank, the top neurology department in the United States and he's a director at the department. He was instrumental in the original thrown back to me trials, the ones that the technology for treating these large strokes. So he's very well known and he's in San Francisco. So he so he's helped a lot of people. He's taken tore of family members who are grateful, and there's he does a lot of research. So he is a number of contacts. My other colleague, Paul is, he's been an entrepreneur for a number of years. So he has his level of contacts of people that we could talk to. And then I had my own, you know, much pewer contact, but I had my own group of people that I that were in my network. And so what I found is, I mean that's a really eat that's a really good head start to have if you if you're if you've never done fund racing and it's like Oh, John, you know, let me introduce you to the inventor of robotic surgery and sure, okay, I'll talk to him and you know, let me, let me introduce you to the inventor of view too, but it's a lot easier to talk to those people when you get personal introductions to the so a lot of it was that, and so that's just lucky. I just kind of lucky because I had known Dr Smith from my previous companies and we have a good relationship. So, you know, the career does feed into it, but that accesses I wouldn't have had on my own. The pause for there for a second because you said kind of lucky, but you know, kind of I had this prior relationship that led to these other things. I think what's important, like a good takeaway for our audience here, is that, you know, those relationships that were cultivating early in our career are usually like lifetime customers or life time there's a lifetime of value associated with that relationship. So it's not going to be just that one company that we worked with them and then kind of we moved on. And I mean they'll be those people that they will be the other people where you deliver incredible value and you really cultivate a strong relationship and those people will be either your customers in the future for your next five or ten businesses, or they'll be part of your network that can... it that's leading you to future customers, and so I think, you know, that's one of the threads that I think that I pick up on that maybe most innovators don't even articulate, is that as you're moving through your career, you know, those formidable relationships just continue to pay off because you're delivering value. You doin the right thing, even maybe when it's not always the best financial thing, but you're doing the right thing and delivering value and they just become incredible for our careers. It's very well said. I think I hesitated there when I said it was it was lucky, and I my hesitation was exactly what you referring to, because right I would you know I wanted to acknowledge the fact that it wasn't. I am grateful to be in this environment where I was able to be introduced to those people, but at the same time, I think for for all of us where we're at in life, a lot of times can be attributed to what we've done previously, and so it's not just the things that worked out that contribute. The things that don't work out also learned too, and so you know, and so I went from various VPS of sales roles. So I have a whole network of people that I know when I need a sales team I'll have a good group of people. Yeah, I have the strategy and everything else, but I also had roles where I was speaking to investors before I was doing this. So each one of these things prepares us for our next role. Yeah, and I think to your point, if if you engage with people and in genuine and authentic way treat people with respect, you do cultivate relationships over the years and eventually the combination of different skills and hard work and things that worked and things that didn't work can lead to something that these last few years of my life have been. They've taken a lot of commitment on my part because when you start a company or not taking a salary of any type, and you know, we had no money and my previous company went out of business and there was a lot of turmoil and I involved in the drum company as well, and so I had a lot of cash outflows and a lot of risk that I was taking on. Yeah, and you know, nobody sees that part of it right. They say seem like about it either, but act like that doesn't exist. So it was just like a strategically made this decision and everything was great. I had this big payout of my last GIG. That's, you know, funded me for now. But you know, I mean just fake it until you become it and without being real about what what this life is really like. Absolutely. I said to my cousin, who's a good friend and he's an investor in the company. He's a actually lawyer for a MEDTECH firm. When we're not talking about music and cars, we talked about talk about Medtech and he said, you know, I don't. It takes a lot of courage to doing to do what you're doing and, you know, not taking a salary, starting a company from scratch, not knowing where it's going to go. And I said, you know, I've reached a I've always wanted to do this and I've wanted to have a team in place of people with a similar philosophy and a similar life you that I have. I will either all get along really well or we'll be at each other stroll. It's but we'll find out. And but I've always wanted to do it. If I don't take this chance at this point in my life, you know, with what I'm able to do, then I just I don't I think I'm not living courageously. And so I'm saying that because for the last few years, I'm on a personal I will have been like, is it really so smart to live so gurrageously? Right, things are starting to come together now. Write. The companies starting to have some success and we're moving forward and like I wake up in the morning and I have to be awake for a few minutes to be like, oh no, no, there's no major crisis of dealing with today. Things are things are going well, it's smooth, and which is not to say they won't be, you know, after you coming on tomorrow or something else, but it...

...takes a lot of effort and it takes a lot of belief in yourself. I mean, I'm describing my role in particular, but the people in my team, it's the same thing. They're taking a chance. They could be at you know, I have people who are working that could be at these they've come from large mettech companies with big salaries and yeah, for when keys and security and everything else, and they're taking a chance on this. And that's our team, or the team of people who believe in what they're doing, who want to contribute, make a difference on this planet and do well. And you know, sure we want to grow the company and make lots of money or sell the company and profit from now. Sure we all want to do that, but I think the primary motivation for everybody is getting up in the morning and doing something that they think is worthwhile and working in an environment where we all we admire each other and we work together as a team and we have fun. Yeah, definitely everybody's taken a risk right in looking out for the reward on the back end of that. So, as we kind of just start to wrap up here, John, I want to give you just another opportunity to say, okay, if you kind of like think back to your experience with mine, rhythm and and maybe this most recent, you know, seed endeavor, or maybe it's even going further back and some other commercialization experiences and product launches that you've had. Are there any other lessons learned that we haven't touched on that you just want to make sure that you share with our audience, who's alsos in the trenches doing different things at different stages. But any other wisdom yet you want to share with them. So I think the lesson I story I tell all the time is I learned. I didn't know it. I learned virtually most of everything I learned about business I learned growing up because my dad owned his own business. So my whole life was kind of an involuntary NBA. Course he would ask me questions. I've learned. You know, I can. I can recall one. I'm sitting at Massachusetts General Parking Lot in my hockey equipment. You know, he stopped there on the way to a game and he's got this customer situation's running it by me. He's like now, how would you handle us? I'm like wait, how old are you? I was ten, ten years old. I've no idea. So he would grill these things into me and so, I mean, it's it's just I it's just a vivid memory, but my whole life was like that. And the thing he always said to me, which I think is we've covered part of this, but the first part of it was he said reserve your judgment. You should get all of the information you can possibly get before you make a decision. Get get input from everybody that you work with, all of the different stakeholders, your customers, competitors, wherever you can get it, get information and and be neutral about it. Don't bring your own ego and emotion into your decision making. In question everything. Then when you make a decision, make it and if it doesn't work, adapt. Yeah, and I think if you apply that philosophy pretty much to anything, it's going to work. By the way, he wasn't so open to when I said questioned him. Right, right, right, he's like a player question business things. He was, he's he's great with that. What did he do in his career? He actually he owned a medical company, but it wasn't mettech like we think of it. He owned medical record company and so his his business model was different because he was dealing with the people in medical records, in the hospital information chain, and he actually one of the things that he did that I thought should have taken off that never did, Yep, was he tried to partner with all the electronic medical record companies when we were moving over to the electronic medical record. He said physicians don't like looking at computer screens, they like holding these charts and if you design this without using the way these charts are, yeah,...'re going to design and nobody would bite on it. And look what we have now. We have things we got to click back for things to find something and then they weren't designed with the end user. Yeah, so we're all electronic at this point, but, and I thought it was a bit eavy about it, it's not an efficient workflow necessarily. Yeah. So, so I was always in hospitals, you know, I was always go with him to hospitals, but it you know, the medical side of it. He was never into the medicine. He came up through the paper industry, right, right, the business part of it. Yeah, exactly. Yeah, okay, okay. So how to folks get Ahold of you? If anybody wants to learn more about mine rhythm or just connect with you after the show? Well, there's always the easy ways, right Linkedin, and just check with me on Linkedin. I'm pretty open to whoever connect with me. There's contact at mind rhythm, which will eventually get to me, or you could just email me at mind rather. It's just John Dot keen at mind rhythmcom and and reach out. I'm I tend to be pretty responsive. My background and sales is just you know, I just say to people in the dumbest person in the room, but I'll return your phone call, and so I do get pulled in a lot of different directions. So if it takes me a bit to get back sometimes, I apologize. Bear with me. I tried to try to be responsive. If if I don't you and your picking me a second time, I'm not going to be offended. So isn't that the world we live in today? Please don't anyone take it personal. You need to reach out at least three times exactly. Be Fair. Well, thank you so much. It was such a great conversation, so much wisdom that you shared with our audience today. I know that they will find it very valuable. Oh thanks. There was a lot of fun. I appreciate you inviting me on it. Had A good time and hopefully people get something out of it. Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who shared the show with friends and colleagues, see you on the next episode of Health Innovators.

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