How to Innovate Systems, Service Models and Products with Less with Geoffrey Gurtner, Professor & Vice Chair of Surgery at Stanford University

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How to Innovate Systems, Service Models and Products with Less with Geoffrey Gurtner, Professor & Vice Chair of Surgery at Stanford University

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

Welcome back once again to the outcomes racket podcast where we chat with today's most successful and inspiring health leaders. Today I have Dr. Jeffrey Gertner with us today to chat with a little bit about health care that maybe you're not used to. Different angle on surgery as well as reconstructive surgery and startups. Dr. Gertner has a wide array of experience. He is a professor and vice chairman of surgery at Stanford University, a plastic surgeon by trade and also research scientists. He has a lab that focuses on translational projects that are developed in the lab and are commercialized to improve patient care. He's also general partner at Tautona Group where they lead and the development of new technologies for aesthetics reconstruction, room care, surgical and biomaterial devices. And finally he's founder and director at Neodyne Biosciences where they're they're basically an evidence based company developing and commercializing innovative tissue repair devices to minimize scar formation. Restoring both function anesthetic appearance lab topics that are of interest to you. So super excited to have Jeffrey on the podcast. Thanks for joining us.

Thank you for inviting me I'm delighted to be here.

So Jeffrey anything that I left out in the intro that maybe you wanted to share with the listeners?

I think you covered most of the things that I do and it kind of them little bit guilty of a short attention span I found I'm a clinical medicine and have a lab and then also have tried to work in the private sector to bring you know new technologies and innovations to patients around the world.

And it's super important work that you do. So I'm excited to dive into some of that in the podcast today. Why don't we kick it off with you letting us know why health care like what got you in the health care to begin with?

Yeah it's a good question. I think I I again was looking at lots of different options growing up and certainly in college and medicine really stood out as I thought about it just because it had a piece of it that was business, piece of it that was more art than science. That piece that was science and that really seemed like for someone again who might be guilty of a short attention span. There were lots of different paths that you could travel as a physician and it seemed more like an adventure than a job. And so you know through process of elimination I kind of just decided that it was the exciting thing to go into and kind of have never looked back since.

That's awesome. And you've definitely done quite a bit in the time that you've been in the field. Jeffrey if you had to zoom in to hot topic that needs to be on leaders agendas listening today what would you say the hot topic is and how are you and your different organizations you're involved with approaching it?

Yeah I think you know just the the thing that struck me being an academic medicine in the private sector is just the real inertia of the medical system and the real challenges we have and not just in innovations in terms of therapeutics or devices but even in innovating changes in the systems and service models so that we can become more and more efficient and do more with less and just the natural frictional points that are kind of legacy parts of our medical system in the United States that are just really those kind of nimble innovation synthetically out here in Silicon Valley you see people disrupting gigantic industries left and right. And I don't think that's really possible in medicine because there are so many different stakeholders including the federal government that are involved in it. But you know it doesn't mean it's impossible and so I think just constantly thinking about how can we make the system better how we think about how to make the care of an individual patient better and trying to knock down those those barriers our least work within the system. I think it's kind of a job one for all of us what we're clinicians or scientists or entrepreneurs or executives or innovators. It's not a simple thing. So it has to be front of mind for us to be successful.

Yeah Jeffrey I think that's a great call-out and I feel like the leaders in healthcare that have been successful at moving the needle are the ones like you that decide on a vertical and they just stay hyper focus. Now I know you like the kid around about hey you know I got a short attention span. But the thing that you've done so well Jeffrey is honed in to your area of specialty. And I just love that you've done that and that's why you've gotten the results you've gotten. I love if you could just share with the listeners how you've created results and maybe some examples through one of your companies or your lab.

Yeah sure. You know it all really starts when I started with patients and just as you go through your surgical training in my case you kind of have this illusion if you become very well trained you're going to be able to solve most of the problems for the patients that come into your office. And as you go through your training you realize there's just a lot of things that we really can't even address. There's a lot of things that aren't evidence base that we do to patients. And there's all these unintended consequences downstream and so my whole point of evolution has been relatively organic starting with "How can I do a better job for patients?" and then at a certain point you realize what we have to come up with new approaches for some of these things and that we do to the laboratory and you get to a certain point in your in the laboratory and actually that's where I was in 2005 when I was a professor at NYU and I had Art in Manhattan and had all these things that I thought were good ideas. I couldn't figure out how to get them into the real world. It just wasn't. It's not what Manhattan New York City is known for. It's not yet that time there was certainly not a med tech startup culture critical mass. I moved to Stanford figuring you know one place on the planet really knows how to innovate it's probably this area and realized pretty quickly that know all my great ideas were actually not very good ideas and they were certainly they were not good businesses in any case I learn that that final piece of what makes the idea, a good business and how it can have all the stars align and so it's just been you know unfortunately kind of just dogged persistence trying to figure out how to make a difference and how to advance the field of medicine that really has as kind of always motivated me. And you know I think again if you have that as your primary focus then I think it makes it easy to do things that maybe don't make a lot of sense like going out and you know as a surgeon and pitching ideas on Sand Hill Road to venture capitalists. That's actually how you learn. You learn by realizing that what you thought were ideas weren't good ideas. More importantly like what is a good idea and not in a vat. And then you can move forward. So you know it's a very simple motivation for me at least and that has kind of ended up you know there was never a strategic plan that I wanted to be an entrepreneur and became an entrepreneur out of necessity because that was the only way that I could see things that might impact patient care getting into the real world.

Now it's a winding road you know and it's pretty cool that you've taken it. You've been persistent with that and resilient for that matter and if you had to boil it down to the essence of what does make a good idea good business. What would you say the 1 or 2 things are?

I think you know for sure it has to me. For me at least it has to mean an unmet clinical need. I think there are arguably good businesses that are need two sorts of things. You know again you know we see it now we're kind of the immunotherapy for cancer. I mean obviously a great idea but if you don't really have the lens of a physician that's a great business. So now everybody is flowing into that sector but there's all these other areas of you know unmet clinical need that don't have investment and so trying to keep your eye on what you know and so as you alluded to I kind of focused on surgery reconstructive surgery plastic surgery as I know that area. You just have to find different ways to innovate. So I think remaining focused on the unmet clinical need believing you know I think the second piece is really really really being sure that your data is rock solid. So it's always easy to fall in love with your ideas and kid yourself and that's just a waste of everyone's time and money because you don't want to spend six or seven years worth of technology that you were aren't pretty sure it's going to work in the real world. And then I think being persistent and creative there's many paths to the top of the mountain and figuring out which way to go when you're not in the hottest sector, you're not in immunotherapy for answer. How do you foster innovation in those areas. I think sometimes requires just dogged persistence.

I think it's true and that's something that's hugely valuable and you as a leader Geoffrey and for the listeners that are in the middle of this process meaning to innovate to get their companies ahead to help patients to improve outcomes that dogged persistence is so key in what you're doing and take some inspiration from Geoffrey and his winding road and what you're doing it doesn't happen overnight. You've got to stay with it for the entire course. Geoffrey, you know just speaking of winding roads I feel like we learn a lot more from our setbacks than our successes. Can you share a setback that you had and what you learned from that particular setback?

Sure yes. But ten years ago started a company that was based on. Again you know really exciting technology that we've developed in our laboratory and it is really focused on novel ways to connect blood vessels. So that's mnemonic technologies and those kind of a classic example of that you know saying is, "It's not what you don't know that tricks up it's what you know for sure that just ain't so". As Mark Twain said and that we went into it with the knowledge that there were lots of it was a way to glue things to get real hallow tubes together. We went into it with the knowledge that there were lots of FDA approved adhesives on the market that were being used clinically and yet indications that we want to go into they were commercially available and so we assumed that the thing we didn't need to innovate on was the adhesive piece. And as we went in our core technology that enabled the using of adhesive to connect 2 hollow tubes worked extremely well. I mean it works great. What we found was that for certain applications these adhesives were really not good are not great they weren't perfect. They certainly weren't adequate for anastomosis. So you know that was kind of a real eye opener that you really need to question all assumptions. And again these were things that again had gone through FDA approval had multiple publications. And as you kind of get into the weeds of how does this actually work in patients realize that these were imperfect things and if we had known that ahead of time we would have certainly saved ourselves you know a lot of time and it would have changed kind of our assessment of the value proposition and also the risks of that thing. And so you know now as I look at projects I obviously look at every assumption not just the ones that incur risks.

No, that's such a great call-out. You know and there are a lot of things that we could get into and we assume and I think it's a great call-out. And I love the quote that you shared. It's what you know for sure. That is so that it really isn't us. I love that. And that was Mark Twain right?

Yup.

What a great quote. I'm gonna definitely have to look that one up after this and keep it in my in my quote arsenal. Because it's so true and a lot of and a lot of us in healthcare well and we mean well and we work hard and we're focused. Don't let these assumptions ruin your work. And the benefit that you could be providing the patients. Thanks for sharing that that's really insightful Geoffrey.

I'm sure. Yeah. And I think it's corollary is kind of why arrogance I think is a real, real negative for people that want to innovate because again assume that you know you know things are your confident you know things that I think you really have to have that can a learner's beginner's mind at all times to avoid essentially you know stepping into a pothole.

Love it. That's so true. So you walked us through sort of the some of the shadows with that company. Talk to us about one of the proudest leadership moments you've had to date.

Yes. So one of our one of my companies is Neodyne Biosciences and it's started actually when I was an intern at Mass General while working at the Boston Shriners Hospital in the 90s. Take care and burn patients and just realize again that was a situation where all the care is free. All technology was available and you just realized that these kids who had these terrible burns that literally were skin deep we could keep them alive. But you know their lives were immeasurably changed irreversibly changed just from that one moment. And there was nothing I could do as a surgeon. There is no technology that was out there that could change that. And so that kind of we embarked on a lifelong kind of project understand fibrosis and scar formation and really has been the focus of our laboratory. And you know one of the companies spun out of based on our understanding of one of the key determinants as a surgeon we know that mechanical forces are critically important in how a scar heals. We learn about these lines of minimal tension we're taught to orient our incisions so that they don't cross or that they are parallel to those lines with the clinical kind of anecdote that your scars will be better if you do that. And so there's you know again that that kind of thing that again was outside of surgical disciplines was not well embraced certainly when we started working on the mechanical environment how it changed fibrosis and scar formation. And to test that you know we actually did a human clinical trial with a little device that actually changed the mechanical environment and used incisions in humans and found that you could decrease the scar formation about you know 90 percent. Based on that. And originally we were just going to go and start screening drugs. But someone said Hey why don't we. We could use this device and people can make their c section scars or their knee replacement scars better and so we started a company that is Neodyne Biosciences is now and has treated basically using the experimental device it's now much slicker and has branding and all the rest of the stuff you need for commercial device. But it's true that 50000 patients are Serena Williams as kind of our our celebrity endorser. And you know it has made this reading those kind of testimonials on real self or different kind of social platforms seen how many different patients you know women who've had c sections and things like that is very gratifying and that's something that you kind of developed in your laboratory know has an impact on so many patients. But the journey is not over because obviously we feel that those sorts of devices don't help to earn patients and so we're now actually doing the thing with you know small molecules to block fibrosis for burns and so it's kind of again very gratifying that something where you saw an unmet need can impact and chip away out of it. And hopefully you know that pursue your career really change the game for fibrosis and scarring in a variety of different disease states.

What a great story Geoffrey. And it kind of all goes back to that beginning where you sort of you called it an illusion that you get the best training and you're going to be able to solve everything, you get out and you realize that that really isn't so. And sort of that that's the genesis of all the wonderful things that you've done and now you've uncovered a lot of Pathways to help this reconstructive scarring area. And you as you work to identify a solution for those kids with the Burn Burn kids. You're finding other things and you're sticking with your pursuit to find that need. What keeps you going man. Like what is it that that keeps you in the game. Because you could have given up a long time ago?

I just I think it's I mean I think that's why for me at least it's important for me to keep doing clinical medicine at some level and by far not the busiest surgeon but I still do surgery I still see patients and I think it just kind of rubs your nose in kind of how little we know every day. And for me it's those patients and just how do you move the ball down the field. How do we make things better. How you know in a hundred years how will medicine be different and hopefully better. I mean I expect it will be better through people just you know making incremental improvements all over the place. And I think now a lot of times especially as healthcare has become its own industry we can't put our blinders on and just go about our viewed generation or about this robot that are gaming the Preski any sister or whatever it is. And I think what you lose are what sometimes is lost is that holistic approach of hey we're trying to help one patient at a time by doing that we're going to advance medicine and by doing that, the world's going to be a better place. And so I think it's very I don't know exciting to be a part of. And you know just really for me it's I can't imagine not doing that I don't know when I would be that would have anywhere near the interest or urgency or meaning for lack of a better word than doing that and being part of that struggle and part of that that effort.

Now for sure. I appreciate you sharing that. Yeah it's definitely true, right? Listeners, we're in this together and there's no one person is going to be able to solve all of healthcare's problems. So think of it as as a collective work and keep yourself in the game. You're not the only one struggling to get these solutions out there. You have other Brethren and sisters out there doing the work like Dr. Geoffrey Gurtner. So tell us about an exciting project our focus that you're working on today Jeffrey?

Sure. You know again we're not only working on the process of fibrosis and scar formation but we're working on the the flip side of that coin which is you know core healing like in diabetes and aging and so we have lots of really interesting projects in the laboratory at Stanford we're fortunate enough that started a large clinical trials unit and our wound care center where we're actually able you know very rapidly. Look at what works and try to you know bring in an ethical responsible way bring new treatments to the market. So we're very excited about you know one of our projects that potentially can prevent wounds from occurring not just heal them faster and so we're we're gearing up for kind of initial clinical experience but that's you know I think an exciting and exciting effort and you know is kind of the flip side of the fibrosis and scar formation issue.

Fascinating love that you're super focused on that and you know what. I know that your work will continue to yield benefits to patients that need it so keep up the awesome work. Getting close to the end here. Geoffrey, let's pretend you and I are building a healthcare leadership course on what it takes to be successful in medicine today. The 101 of Dr. Geoffrey Gurtner we're in our right at a syllabus. I've got four questions for you. Lightning round style and then will conclude the syllabus with a book that you recommend for the listeners, you ready?

Yup.

What's the best way to improve healthcare outcomes?

I think to always keep your eye on the big picture of we're in this to advance the care of an individual patient and to progress medicine?

What's the biggest mistake or pitfall to avoid?

I think expecting the future to be like the past to expect good things that worked in the 80s and 90s are going to be the way the health care system broadly writ is going to be for the next 50 years.

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

I think it started off by talking about the inertia and the friction that exists in virtually every vertical and horizontally across the whole system and I think although it's difficult to be nimble to always try to be nimble and have one of your aspirational goals to be nimble and you know rapidly changing organization that is not a hold into the past. And you know legacy sorts of systems.

Love that. What's one area of focus that should drive everything in a health care organization?

I think the patient you know just always whether you're a scientist, whether you're a practitioner, whether you're an executive thinking about improving the care of patients either by developing new technologies by providing the existing evidence base standard of care in the most efficient way possible. I think making a patient. I think sometimes we get tripped up with the you know the different billing in compliance and everything else. I think that patients should always be front of mind for every one.

Love that. What book would you recommend to the listeners?

So it's kind of an old one and I actually just had my 15 year old son read it and he responded well to and I thought he might just say boy this is really really outdated. So Zen and the art motorcycle maintenance is I think a great book because it kind of on the one hand is very very pragmatic it's the story of a father and son. And he expands from that sort of story into the big philosophical questions that have that humanity is pondered since antiquity of what is the meaningful life. What's the good life and you know at a really high level. So for me it's if you kind of are looking for meaning and that has practical implications I think it's a great book.

Love that recommendation. Folks if you want to get all of the transcripts, shownotes, links to the book, Zen and the Art of Motorcycle Maintenance and all the other things that we discussed today just go to outcomesrocket.health/gurtner, G U R T N E R, and you'll find all that there. Geoffrey, this has been a blast I've really enjoyed the conversation. I'd love if you could just share a closing thought. And then the best place for the listeners could follow you or get in touch with you.

So I think you just always keep the patient in mind whenever you do and be persistent and avoid arrogance not because arrogance is a bad thing. Arrogance is impedes your ability to be successful. And I'm on LinkedIn and Twitter and Facebook. So just as Geoffrey, G E O F F R E Y, Gurtner, G U R T N E R, and happy to continue in the conversation.

Love it Geoffrey. Hey this has been a pleasure. Appreciate you carving out some time with us and looking forward to staying in touch.

Thanks again for interviewing me. Appreciate it.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.

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Recommended Book:

Zen and the Art of Motorcycle Maintenance: An Inquiry into Values

Best Way to Contact Geoffrey:

LinkedIn: Geoffrey Gurtner

Twitter: @GeoffreyGurtner

Facebook: Geoffrey C. Gurtner

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