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Managing Pain Effectively Without Opioids with Amy Baxter, Founder & CEO at Pain Care Labs

Episode 426

Recommended Book:

Citizen of the Galaxy

Best Way to Contact Amy:

Linkedin

Mentioned Links:

Pain Care Labs

Buzzy helps

 

Managing Pain Effectively Without Opioids with Amy Baxter, Founder & CEO at Pain Care Labs transcript powered by Sonix—the best audio to text transcription service

Managing Pain Effectively Without Opioids with Amy Baxter, Founder & CEO at Pain Care Labs was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Saul Marquez:
Welcome back to the podcast. Today I am hosting a Dr. Amy Baxter. She's the founder and CEO of Pain Care Labs, founded in 2006 with the mission to eliminate unnecessary pain. She invented and patented VibraCool Vibrational Cryotherapy to treat tendinopathies and decreased opiate use. Her disruptive Buzzy device has been used to control needle pain for over 32 million needle procedures. Her oscillates technology has been confirmed and 30+ RCTs and was named "Industry Leader and Non-invasive Pain relief" by Frost and Sullivan. Dr. Baxter developed her nerve modulation pain reduction platform with a 1.1m grant from the NIH. She has received seven patents and a novel FDA five 10k indication for treating muscle and injection pain. She's been named a 2018 Health care Game changer, Health care transformer. Wall Street Journal idea person most innovative CEO the year among other awards. And by various well-known and credible media technology industry reporters. She's a top woman in Tech to Watch, and she's also been known for turning down Mark Cuban, Robert Herjavec and Mr. Wonderful on Shark Tank. So without further ado, I want to welcome you to the podcast. Amy, thanks for joining us.

Amy Baxter:
Thank you so much for having me. Sorry about all the Polish syllables in my background.

Saul Marquez:
It's all good. So tell me, I mean, what got you into health care?

Amy Baxter:
Well, I had always wanted to be a doctor. I mean, from age 4, sitting on the edge of the street hoping somebody would get hurt. So I could be the one there with bandaids and mercury chrome, which you are probably too young to remember. But I just wanted to be the one who could make a difference in a crisis. Not that I was hoping people would get hurt. But that started the interest in medical school and medicine. And as I morphed through the world of residency and fellowships, I identified that pain management was something I cared about. But it wasn't the primary goal for most physicians. So that brought me into the medical device sector.

Saul Marquez:
I love it. Now, you you did some great work up front and you guys were very efficient in the innovation that you did. I mean, you had a million dollars and you did a lot with that. A million dollars. Talk to us about that.

Amy Baxter:
Well, the actual reason that I got a grant was because as an academic studying pain, I had moved to Atlanta, Georgia, and I was no longer in an academic role. So I couldn't do an NIH grant or get funded to explore the technology that I had invented. And the technology was a very high frequency exploratory strain coupled with ice to block pain. I was using it for my kids, for their vaccines and for any kind of pain or boo boos or bumps. And I've gotten more and more agitated in the emergency department because there was so many there were so many children crying and screaming with needle pain. And I knew I had a device that would block it. But I also knew that I couldn't bring my prototype that I had sorted in my basement into the emergency department. And I also didn't know whether it was a placebo. You know, I had no idea whether it's just that my pain, my children believed in it because I told them it worked. So to get the grant in an academic setting, I had to form a company to qualify for a small business innovative research grant. A lot of medical device companies get funding to do research. But because I was a researcher, our initial studies were done really inexpensively. The Mayday Fund gave us our first grant to look at I.V. access and children and we did an adult study looking at calculation compared to cold spray. So the the 1.1 million from the NIH was really to establish in the population of kids getting vaccines that buzzy reduced pain. And in the course of that, we discovered that needle fear had increased about two hundred and fifty two percent. So we got a lot done with that grant. I think we really returned amazing value for the government's money. But one of the most interesting things was this additional discovery that there is a lot of people not accessing healthcare now because of a needle fear. So we went back into the data I published and figured out why needle fear is increasing. And because Buzzy has a very high effect size, it's very easy for a fellow who needs to publish to to look at it and study it. So every other study has been independent. People have been doing studies all over the world about our technology because it's cheap, it's reusable, it's low hanging fruit and it's really easy to leverage those early studies and that early brand into a lot more research.

Saul Marquez:
Well, that's awesome. I mean, you guys, you found a way to validate and and to get it out there. Now you guys have have some traction. Tell us about what you're seeing out there. What do you think health leaders need to be thinking about? And maybe you want to take this question from a perspective of a med device innovator, or maybe you want to take it from the perspective of those that are purchasing your devices?

Amy Baxter:
Well, I think that the from from a med device innovator, what I see coming from both sides of the care spectrum is that not just high deductible health care plans, but also patients fear of the economy and the economics of being hurt are really driving people away from traditional Western medicine, but also towards self care and their own interventions. I think that the paradigm we have set up through our payer system is that if you are prescribed a pill, you are on it for an indeterminate amount of time. And the cost of goods from making that pill or that injection is negligible pnce the research has been done. So the profit margins on pills are huge and they're paid for by the government. So it's got a huge bias for anyone who's got insurance to take them. The medical devices have the same rigor, but they are not in general reimbursed. The cost of goods is never gonna get down to pennies and patients expect them to last forever. So currently we have really biased the system towards pharma and the pendulum that is swinging. Is that because those medications are becoming so expensive and because they're not being completely reimbursed, patients are moving towards other solutions. And for physical problems you really need physical solutions. So to promote movement and to promote pain relief, I think that there is a tendency that patients are going to start taking this into their own hands and that probably for physical relief and for pain. And psychologically, having your own power over pain with an over-the-counter device, I think is the way that this system is going to move, regardless of whether payers catch up quickly or slowly.

Saul Marquez:
Yeah, it's an interesting thought, Amy. And you see this happening, too, with the large emergence of digital therapeutic options, too, you know?

Amy Baxter:
You know, this is a really interesting point you bring up, Saul, because we are designing products for ourselves. And if you look at the people working for digital therapeutics companies, we are way over on one end of the bell curve. I think that a place that's being missed in this digital revolution is that the general health and the patients we want to take care of, they know they're fat. They know they don't exercise enough. They know they don't eat well enough. Digital therapeutics are not a solution that they want to go to. They don't need more information. What they need is something that is simple that they're not afraid of. And that works on contact. So it's easy to believe in it. But I think that the lesson of cartooning yesterday that had pills and surgery and this really long line waiting for it and lifestyle change, nobody was in line for that. So I think that the promise of digital therapeutics was to help people change lifestyles. And it's not really the the audience that is going to listen to that kind of information. We've got to figure out how to meet patients where they are.

Saul Marquez:
Yeah, yeah, I know. That's a very interesting thought. And I have a picture of that cartoon you just illustrated. Kind of funny, but it's the reality, right.. I mean, it is kind of what we're faced with. People are looking for the magic pill. The thing they could insert to make life better. It's that they sort of easy route, quote unquote.

Amy Baxter:
So we've set up our healthcare system with a paradigm level of one problem equals one solution. And particularly when it comes to pain, there is really nothing that will reduce pain more than about 30 to 40 percent. So that has to be a multi-modal approach to solving the problem. And we're not set up in that paradigm. But I think that as going to traditional healthcare becomes more expensive, more and more people are turning to multiple solutions. But a lot of them are not evidence based. So you've got people using essential oils and taking supplements that have no basis, in fact, and doing all sorts of things that are not actually going to help. But at least it is changing the paradigm of empowering the patients and having them try multiple different things simultaneously, which probably is going to be the right answer, at least when it comes to pain.

Saul Marquez:
So give us an example of how you guys are doing this differently. How does your technology work?

Amy Baxter:
Sure. So what we're doing is using a specific frequency that has only really been documented in the last 10 years, why it works, but we use very specific observatory frequency. So we've got a mechanical stimulation that's just put on top of the skin and we do it through unique thermal packs. Because if you're going to be administering intense vibration through the skin, you need to have the thermal packs transmit it. So we've got ice packs free, solid and hot packs of free solid. And the that's the the nuts and bolts of it. The physiology, what it's doing is rather like tens units, except that what tells you that you're trying to do is just stimulate the motion nerves that inhibit pain. Like when you bunker elbow, you rub your elbow and you don't feel the pain, you feel the rubbing or you burn your finger, you stick it under cold water. You don't feel the pain that works all over the body. It works for any kind of sharp, acute or injury pain. But tends units are only stimulating two of the four mechanical receptors. And they're also not using the frequencies that we now know are the most effective for decreasing pain, particularly in joints and in post surgery. So the receptor that's most effective and necessary for pain inhibition is called simian core muscle. And it really is only in 2017 that Dan Holland's published what frequency and why that this simian is the one that's most important for pain relief. So mechanical receptors respond best to mechanical stimulation. You know, it makes more sense. The body is designed to respond to this kind of a a touch stimulus. So the data's been about two to three times more effective, intense units for relieving pain, because that's really how the body is designed to inhibit pain.

Saul Marquez:
Love it. Love it. Pretty cool. And folks, the technology is is accessible. It's over the counter. It's not very expensive, reusable. So if you got pain. Check out the devices that Amy offers as an option for you. So so as as you've taken. So how long have you been doing this for, Amy?

Amy Baxter:
You know, I came up with the idea and filed the first patents in 2006. And that was really, again, so that I could then embark on getting the NIH grant. We got that in 2008. We launched Buzzy. The needle pain device available at Buzzyhelps.com launched it in 2009. So it's been 10 years. The opioid part of this journey started about three years ago and I've been practicing medicine the whole time. And my intent was not to create a company that would take over the world. My intent was to provide the device. Someone would buy it and I'd keep practicing and doing academics. But my first mistake was thinking that people cared about needle pain. And if you're in medicine, you don't mind needles. So if you have to have an abstract empathy for health care and pain to really care about needles, it's become more of a big deal in the past decade, some through the advocacy and the research that we've done demonstrating that it's impacting vaccination and health care and anti vax sentiment. But the other part was I really wanted to disrupt the way that medical device sales and distribution were done. We got a lot of offers for investment early on if we would make the technology disposable. And I had no interest in making patients who had a chronic disease like diabetes or we're having to go through IVF pay over and over to use Buzzy to block the needle pain. But the the misunderstanding that I had was that it really is almost impossible to get medical device companies to want to distribute products that are that are going to last forever. You don't want to have a reasonable device. The interesting change in focus and the reason I quit practicing medicine three years ago is that one of my colleagues had been an opioid recovery for two decades and had to have a knee replacement. And he had put off getting the surgery because he didn't want to take any opioids and didn't know if you could tolerate the pain afterwards. So he used our device to not take any opioids after surgery. And that was when I realized that there was probably a greater calling than the trench warfare in the emergency department. So I focused full time on on trying to understand the opioid crisis. Where'd it come from? And the nature of pain itself.

Saul Marquez:
So what would you say is one of your most exciting experiences to date since the last three years?

Amy Baxter:
Since, you know, I have this funny feeling like when you're finishing a puzzle and it's 2:00 in the morning, but you've got a corner of it that you're so close to finishing. And so you had this agitation that you can't go to sleep until you finish it. So I feel like a lot of the last three years has been dominated by this agitation of finally understanding the science. I put in for another SBIR NIH grant and the research I did the last two years of 2018 coincided with a book being published about the physiology and pain relief and recovery and rehabilitation of with the vibratory therapies. And I think it sounds nerdy, but that was the most exciting thing was reading this book. And all the second have everything I've been studying for the past 15 years coalesce into a chapter by Ranjini Adul. I mean just it was like, wow, I understand. I understand how this works. I understand how to to make it better. And I understand why this is is a really effective, specific pain reliever. So the the testimonials we've gotten have been the most emotional. People who were on opioids, who had not been able to get off of them, that used our vibral device. People that were crying in pain and couldn't go to sleep and then tried it and felt like angels singing. You know, we've had a lot of really moving testimonials. But I think that the most exciting thing is just understanding what to do with this new physiology and how to implement it.

Saul Marquez:
Love it. Yeah. It's exciting. You're helping people. And out of all the things that you're up to now and you're in it full time for the last three years, what would you say is an exciting, the most exciting project you're working on?

Amy Baxter:
We're actually looking at and I've applied for reimbursement. I realize that we can't get this to the people who need it unless we have the regulatory component and the reimbursement in mind. And the exciting thing is to realize that the slow growth when we didn't really advertise or not salespeople, we just were accumulating all of the data that was coming in about our technology with Buzzy that has established this really firm base from which to now get reimbursement to legitimately explain why this physiology is twice as effective as tens and two to get it where it needs to be. So I think that the the excitement of figuring out how the system works best to help patients and being able to work within that structure, that's that's satisfying.

Saul Marquez:
Yeah, that's awesome. And. And so you've got traction. And now it's about getting that reimbursement to get it to the next level.

Amy Baxter:
Getting the reimbursement or, you know, we get Shaquille O'Neal to decide that icy hot is not his favorite brand and he wants to move up the divide recall. It's always this this balance between pursuing traditional channels and talking to orthopedic surgery departments and having people stopped by recall for post stop versus. Maybe we'll be on Ellen and then everybody can get it more or more directly. But it's. But, yeah, it's fun.

Saul Marquez:
Love it. Keep keep up the awesome work, Amy. You never know. You just keep keep consistent. Focus is follow on course until success. And I think that's what you've been doing for the last 10 years. So there's no doubt in my mind you'll figure out that that thing or that moment where it'll take you to to the whole country.

Amy Baxter:
We're in 27 countries. It's just a matter of depth of penetration versus breath the penetration. And up until the opioid crisis, we were content to have. No sales people, people just read the articles in the medical literature in hospitals and then told their patients to get a Buzzy. Now that we've got a much broader reason for this, I'm really focusing on helping patients directly while we try the other, you know, into to get into hospitals and to get better known in the physical therapy world. But giving patients options to have power over pain before surgery. We've created some pre surgery pain plans, and these pre pain plans incorporate what I've learned over the past, particularly five years, magnesium and long acting… and exparel is one of the brand names that get get long acting pain relief from surgery, start taking anti inflammatory ease and the pain reduces. Magnesium is great because it decreases the amount of opiodis you need. Also realizing which surgeries you don't even need to have opioids for telling people how to use by recall for surgeries. You know, one thing people don't realize is that for wisdom tooth surgery, this also came out in December of 2018. 5.8% of young adults who got opioids for their wisdom tooth had a diagnosis of opioid use disorder within one year, compared to zero point four percent of people who didn't. So age matched same situations. So it's it's simply prescribing the opioids that is leading a lot of people to become addicted. So giving people options so that they can avoid them, if not entirely, just get a prescription for three to use or throw away or four to fill and flush if they don't use them. But I think that that sort of cohesive pain plan is also something that's really exciting me.

Saul Marquez:
Love that. Yeah. So you already got the breath. Now it's time for the depth.

Amy Baxter:
Yeah.

Saul Marquez:
Amy. So so on. It's time for the Lightning Round. So we got a lightning round, followed by a book that you recommend to the listeners. You ready for that?

Amy Baxter:
Yep.

Saul Marquez:
All right. What's the best way to improve health care outcomes?

Amy Baxter:
Listen to patients and meet them where they are.

Saul Marquez:
What's the biggest mistake or pitfall to avoid?

Amy Baxter:
Don't design for yourself. Realize that most people in health care are on one very small end of the bell curve and we have to realize where we are and understand where our patients are to effectively deliver outcomes.

Saul Marquez:
How do you stay relevant as an organization despite constant change?

Amy Baxter:
Giving people power over pain is always going to be relevant.

Saul Marquez:
And what focus area drives your organization?

Amy Baxter:
Our mission and passion is to eliminate unnecessary pain. And we see where pain does not have to be. And we see consequences from poorly treated pain. And we know that we're making a difference every day.

Saul Marquez:
What would you say is your number one health habit?

Amy Baxter:
Wow, that's an interesting lightning round question. Loving people when I feel. Like, I'm taking care of somebody or I feel like I want to show somebody that they're loved. Or I do something that makes somebody else better. Then I have less of an impulse to have bad health habits personally. And it makes me excited to exercise and to eat well. If I'm if I'm feeling benevolent to the world, it makes it much easier to take care of myself.

Saul Marquez:
Love that. That's a beautiful one. Good question. Thank you. And then the last one here to lighten around is what is your number one success habit?

Amy Baxter:
Like Elon Musk said, you can't change the world unless you're willing to put in 80 hours a week. And so my success habit is being relentless.

Saul Marquez:
Relentless is key. Resilient, relentless. You wouldn't be here still after ten years, Amy, if you weren't.

Amy Baxter:
That's true. But that could be stubborn as well, though. So there are different ways to describe the same side of the coin.

Saul Marquez:
Fine line, right? Yes. What book would you recommend to the listeners?

Amy Baxter:
All right. My grandfather is Robert A. Heinlein, a science fiction author. And I think that Citizen of the Galaxy is a tremendously moral book for anyone who is in business and anyone who is on one end of the gifted side of the bell curve through either circumstance or intellect or opportunity or accident of geography of birth. But I think that citizen of the galaxy brings really tangible philosophies that can make the world better if everybody read it. It's cool.

Saul Marquez:
Yeah. And did you see your grandfather wrote it?

Amy Baxter:
Yes. He I. It's a long story, but my I adopted a science fiction author when I was 12 who had no children. So I had been steeped in science fiction all the way up to there. And I certainly was steeped after they adopted me. But.

Saul Marquez:
I love it.

Amy Baxter:
Yeah, definitely trajectory changing.

Saul Marquez:
Such a great recommendation, folks. You could get all the resources we've discussed today on outcomesrocket.health in the search bar type in Amy Baxter. You'll find all of our discussion there, full transcript, short notes. Links to the book Amy has recommended and more. Amy, this has been a blast. I love if you could just leave us with a closing thought and then the best place where the listeners could continue the conversation.

Amy Baxter:
Sure. So it takes courage and dedication to evaluate new sciences and innovations in the new way to get things done. I don't think that innovation is a solution. Innovation is figuring out how to get other people to adopt a solution. And when it's something that is new or challenging, you really have to be willing to dig in and understand it, to be able to express it and explain it to change other people's behavior. And we are new and challenging and and work and an idea worth spreading.

Saul Marquez:
Love it. And if the folks want to continue the conversation with you, what's the best way for them to do that?

Amy Baxter:
Sure. So they can go on to paincarelabs.com or buzzyhelps.com or even by… And we have a contact and an info site. And so info@paincarelabs.com. Will get to my inbox just about directly. Also, LinkedIn with me. Reach out to me. I'm not as much a Twitter person, but LinkedIn is a pretty consistent haunt for me.

Saul Marquez:
I love it. Folks, take Amy up on that invitation. Dr. Amy Baxter, make that connection. That's what it's all about. So, Amy, just want to say thank you so much for making the time for us and we're wishing you the best.

Amy Baxter:
Thank you so much. It's been delightful. I appreciate you doing this.

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