Beyond Devices: Conversations with the Trailblazers Redefining Healthcare and Education
Michael Browers
Director @ Integer Holdings | MBA, Product Management | Medtech Cartoonist and Blogger | Creator of “The Unusual Side Effects” Comic | Author | Medtech Industry Insights at PulseOnDevices.com
As the holiday season approaches and 2024 draws to a close, I find myself reflecting on the remarkable Q&A interviews featured in Pulse on Devices this year. These conversations have showcased some of the most inspiring innovators, groundbreaking technologies, and compelling personal stories in the medtech world. From life-saving devices to transformative ideas, the leaders and visionaries we’ve highlighted are shaping the future of healthcare.
This year's lineup of Pulse on Devices Q&A features included Nestor Jaramillo Jr., CEO of Nuwellis, whose work with the Aquadex system is addressing fluid overload with precision and compassion; Aimee Garza of CoraVie Medical, whose pioneering circadian blood pressure monitor is transforming hypertension management; and Stu Brandon, who shared his entrepreneurial journey from sales rep to distributor, demonstrating adaptability and foresight in the orthopedic device market. We also explored a deeply personal and educational perspective with Fynisa Engler, author of Harry Can Hear, a children’s book that brings awareness to hearing loss and its impact on families and communities.
These stories reveal three key takeaways from this year’s interviews:
As we step into 2025, I am inspired by the unwavering dedication of these individuals and their commitment to transforming healthcare. Thank you for being part of this journey this year, and here’s to another year of innovation, impact, and progress in medtech!
Charting New Waters in Healthcare: A Q&A with Nestor Jaramillo Jr., CEO of Nuwellis
In the rapidly evolving landscape of healthcare, managing complex conditions like fluid overload requires not just innovative technology but visionary leadership. At the helm of Nuwellis, Inc., a pioneering medical device company, stands Nestor Jaramillo Jr., whose stewardship is guiding the firm into new frontiers of patient care. Nuwellis, renowned for its Aquadex system, has carved a niche in addressing the critical and often overlooked condition of fluid overload, which affects patients with heart failure, kidney disease, and other critical conditions. This technology stands out for its precision, safety, and adaptability to the unique needs of each patient, marking a significant advancement in medical treatment options.
Jaramillo, with his extensive background in the medical device and healthcare sectors, has been instrumental in driving Nuwellis’s mission forward. Under his leadership, the company has not only enhanced its flagship product but also expanded its reach to address the needs of pediatric patients and those requiring specialized care. His strategic vision encompasses a broad spectrum of healthcare needs, focusing on improving outcomes, reducing hospital stays, and, ultimately, lowering the costs associated with complex medical conditions.
As Nuwellis continues to innovate and expand its portfolio, the healthcare community watches closely. Jaramillo's approach to leadership—balancing innovation with practical application—serves as a beacon for the industry, highlighting how technology and compassion can come together to improve patient lives.
In this exclusive Q&A, Nestor Jaramillo Jr. discusses Nuwellis, the impact of its technologies on healthcare, and what the future holds for the company and the patients it serves. Join us as we delve into the insights of a leader who is not just shaping a company but also influencing the broader landscape of healthcare innovation.
What are the most common underlying health conditions that lead to fluid overload in patients?
When addressing common underlying health conditions and treatments, it's important to consider the wide range of challenges patients and healthcare providers face. For example, decompensated heart failure significantly affects a patient's health by causing the body to retain fluid, a situation often exacerbated by conditions like cardio renal syndrome. Initially, diuretics are the go-to treatment, but over time, their effectiveness can diminish, necessitating alternative methods for fluid removal. This condition is chronic and progressive, and without proper management, volume overload can accelerate disease progression.
Similarly, patients undergoing cardiac, trauma, or transplant surgery often receive substantial amounts of fluid during the procedure, which must then be carefully removed to prevent complications. The Aquadex system offers a tailored, gentle, and safe solution for fluid removal, addressing the needs of these patients effectively.
Transplant patients, particularly, face additional challenges with fluid retention due to the medications used to prevent organ rejection. Likewise, individuals with acute kidney injury (AKI), chronic kidney disease (CKD), including pediatric patients, and those with advanced liver disease often struggle with fluid removal. These groups may become resistant to diuretics, making traditional treatment methods less effective.
For those with advanced liver disease, a notable segment of the U.S. adult population, the situation is particularly pressing. Recent insights from a case series at Mt. Sinai in New York City have highlighted a promising application of aquapheresis within existing guidelines that doesn't require further FDA approval. This treatment has shown to significantly improve mobility and ICU recovery times without the complications often associated with other methods.
In summary, fluid management in patients with these conditions presents a complex challenge that requires innovative solutions like Aquadex. This approach not only offers a safe and gentle option for fluid removal but also has the potential to significantly improve the quality of life and outcomes for patients facing these serious health issues.
How does Nuwellis' technology specifically help patients with such underlying health conditions?
Aquadex SmartFlow Ultrafiltration is a cutting-edge treatment that empowers both physicians and clinicians to tailor the process of excess fluid removal to the specific needs of the patient. This personalized approach is not only gentle and safe but also critically attentive to the complexity of the patient's health condition. By customizing fluid removal, we can avoid sudden hemodynamic shifts—those changes that might adversely affect blood pressure. Moreover, it supports the kidneys' vital role in filtering and removing fluid from the body, an essential function for maintaining health.
Fluid retention occurs in three main areas of the body: the intravascular space (within the blood vessels), the interstitial space (between cells), and the intracellular space (inside the cells). The Aquadex system is designed to efficiently remove fluid from the intravascular space, which in turn allows fluid from the other two spaces to naturally migrate back into the intravascular space for removal. This process ensures a balanced and effective approach to fluid management.
Key to this system is our innovative sensor technology, notably the Hematocrit Sensor. This tool enables clinicians to accurately monitor the rate at which plasma refills in the blood vessels. By doing so, it ensures that only the appropriate amount of fluid is removed during each therapeutic session. This precision not only maximizes the effectiveness of the treatment but also upholds the highest standards of patient safety and comfort.
What are the benefits of using Nuwellis' Aquedex SmartFlow technology over traditional fluid management methods?
Aquadex therapy represents a highly personalized and precise method for fluid removal, functioning similarly to an advanced mechanical diuretic. This innovative approach allows for the gentle and safe extraction of excess fluid, tailored to the unique needs of each patient. Unlike traditional medication, which requires time to administer and observe its effects, Aquadex therapy offers immediate start and stop capabilities. This instant adaptability means clinicians can observe fluid removal in real-time, just seconds after the therapy begins, contrasting significantly with the hours or even days it can take to assess the effectiveness of medication.
One of the standout features of Aquadex is its ability to be finely adjusted on the fly, aligning perfectly with the patient's fluid removal goals related to both volume and weight. This level of precision is challenging to achieve with conventional medications. The system operates with two pumps: one to circulate the blood through the device and another to extract fluid from the blood. Remarkably, the ultrafiltrate pump, responsible for fluid removal, can be deactivated while the blood continues to circulate, ensuring the integrity of the circuit is maintained without interruption.
Aquadex distinguishes itself from more aggressive fluid removal methods, such as Continuous Renal Replacement Therapy (CRRT), by having less blood within the circuit and employing only two adjustable pumps. This setup allows the system to operate at a slower, more controlled pace, which significantly reduces inflammation of blood cells. Inflammation is a critical factor that can prompt the body to retain fluid, counteracting the objective of fluid removal technologies. By minimizing this response, Aquadex not only effectively removes excess fluid but also supports the overall well-being of the patient, making it a compassionate choice in fluid management.
Can you elaborate on how Nuwellis' technology integrates into a patient’s overall treatment plan?
Incorporating technology into a patient's comprehensive treatment plan can markedly enhance outcomes, particularly when it comes to managing fluid overload. Evidence has shown that utilizing Aquadex technology early in the treatment process, especially for those patients who are resistant to diuretics, can lead to significant improvements. These include shorter hospital stays and a decrease in both readmissions and rehospitalizations, ultimately contributing to better patient outcomes and reduced healthcare costs.
For patients dealing with chronic volume overload, the stakes are particularly high. Each subsequent hospitalization can significantly increase their risk of mortality. By integrating Aquadex into their treatment regimen, healthcare providers can offer a more proactive approach to managing this condition. This not only helps in mitigating the immediate health risks associated with volume overload but also plays a crucial role in improving the long-term survival prospects of these patients. Through such strategic integration, Aquadex stands out as a valuable tool in the ongoing effort to deliver high-quality, cost-effective healthcare.
What are the future developments Nuwellis is working on to enhance care for patients with fluid overload?
Looking ahead in the realm of fluid overload management, innovation remains a key driver in enhancing patient care, particularly through advanced sensor technology. At the forefront of this innovation is our Hematocrit sensor, a pioneering feature that's integrated directly into the Aquadex system's console pump. This unique design allows clinicians to monitor and assess a patient's condition in real-time during ultrafiltration therapy, a capability that sets Aquadex apart from CRRT (Continuous Renal Replacement Therapy) machines, which require an external sensor for similar assessments. Additionally, Aquadex stands out by measuring SV02 levels, offering an innovative feature not standard in other systems, thereby providing a more comprehensive view of the patient's status.
Nuwellis is not only focused on sensor technology but also on improving venous access. We are thrilled to share that we've received FDA clearance for our new, shorter version delc catheter. This advancement offers additional options for clinicians, ensuring more comfortable and tailored access to the patient's bloodstream across various body types, enhancing the overall treatment experience.
Furthermore, Nuwellis is at the forefront of developing a state-of-the-art pediatric CRRT machine. This groundbreaking device is designed to offer physicians a superior option for managing fluid removal and dialysis in the pediatric population, especially for those young patients who are born with absent or underdeveloped kidneys. Our aim is to provide a lifeline for these children, sustaining them until a transplant becomes available or other surgical interventions can be pursued. Through these innovations, Nuwellis is dedicated to expanding treatment possibilities and improving the lives of patients across all ages with fluid management needs.
Learn more about Nuwellis:
Revolutionizing Cardiovascular Health: A Conversation with Aimee Garza of CoraVie Medical
In an exclusive Q&A session, Aimee Garza , the Founder and CEO of Minnesota-based startup CoraVie MEDICAL, shares insights into her visionary journey in the medtech industry. Garza's leadership has been pivotal in developing CoraVie Medical's innovative circadian blood pressure monitor, a device representing not just an advancement in medical technology, but a potential paradigm shift in cardiovascular health management.
Based in Minneapolis, MN, CoraVie Medical is at the forefront of the battle against cardiovascular disease, the leading cause of death globally. The company's cutting-edge technology is designed to inform treatment decisions and monitor therapy effectiveness, epitomizing a dynamic approach to cardiovascular health management and enhancing patient-clinician communication.
CoraVie Medical has made significant strides in a relatively short period, securing both equity investments and non-dilutive funding, including a grant from the National Science Foundation. These achievements highlight the promising potential of their blood pressure monitoring solution.
The company has also collaborated with major university research centers to expand and validate the applications of its technology, underscoring its commitment to healthcare innovation and excellence.
In this conversation, Aimee Garza explores the origins of CoraVie Medical, the motivation behind their groundbreaking blood pressure monitor, and the challenges and triumphs encountered along the way. This discussion offers an opportunity to discover the story of CoraVie Medical under Garza's inspired leadership and learn how their novel approach is reshaping healthcare standards and improving patient care.
Would you describe CoraVie's subcutaneous blood pressure monitor and how your technology aids in the management of uncontrolled hypertension?
Our fundamental mission is to empower people worldwide with actionable insights that when acted upon, will slow, and possibly prevent, the progression of cardiovascular disease. Our insertable circadian blood pressure management solution transforms the paradigm for how dangerous blood pressures are monitored and detected.? Through CoraVie’s unmatched accuracy and predictive analytics we will prevent dangerous hypertension-related emergencies like strokes.
Hypertension Crises (or blood pressures above 180/120mmHg that require urgent care) occur in 1-2% of the population and require emergency care to prevent organ damage.? CoraVie offers physicians early and accurate detection of these events.
We are genuinely enthusiastic about these advancements.
I understand. On a personal note, I believe that's fantastic. You might have come across my LinkedIn post about my mother-in-law, Roza, and her battle with uncontrolled hypertension, leading to her untimely passing. Had she still been with us, she would have been an ideal candidate for the technology that CoraVie is developing.
I’m sorry to hear about your mother-in-law.? It is indeed tragic. Reflecting on my early days at CoraVie, I shared Wanda's story, who at just 46, suffered a hemorrhagic stroke due to uncontrolled blood pressure. This left her with severe physical, emotional, and financial hardships, affecting her for many years. Such a situation could have been avoided. Hypertension crises can become emergencies that cause damage to critical organs, such as strokes impacting the brain, acute renal failure affecting the kidneys, and acute myocardial infarctions and heart failure concerning the heart.
These serious situations highlight the importance of not underestimating blood pressure issues. When people think 'blood pressure monitoring', they often envision buying a basic cuff from a pharmacy. However, relying on consumer health and wellness devices like a Fitbit or a wrist-worn device to capture the infrequent and sudden onset of critical health issues is risky due to the sporadic and likely infrequent measurements and potential data inaccuracies. Many of these devices have not been validated, are not calibrated, and are often not trusted by physicians to be accurate.
At CoraVie, we have developed remarkable technology with the precision of intra-arterial blood pressure, the gold standard in healthcare. Our patented technique ensures unparalleled accuracy and the ability to automatically monitor consistently over day and night, crucial in managing serious health conditions.
How does the device provide actionable insights for patients and healthcare providers?
I have a few thoughts regarding the importance of actionable insights and what we do at CoraVie. Currently, doctors are dissatisfied with the tools available to them to capture actionable out-of-office insights. Can a physician trust the data provided by a patient? Often, the answer is no. Factors like patient anxiety, exemplified by white coat syndrome, can lead to falsely elevated blood pressure readings, not reflecting the true values.
Errors in patient measurement techniques add to the problem. Even well-educated and capable individuals may not execute all steps correctly for accurate blood pressure measurement. Additionally, as I mentioned previously, the market is flooded with non-standard, non-validated, and non-calibrated home blood pressure monitoring systems. A study in Australia estimated that over 90% of blood pressure monitors sold online are inaccurate.
Combining all these factors, if a doctor receives patient self-measured data, the chances of trusting this data are quite low. Therefore, clinical decisions are often delayed and therapy suboptimal, leaving patients at risk.
CoraVie is directly addressing the need for clinical accuracy. It’s important to emphasize the need for clinical accuracy, especially when we’re talking about hypertension emergencies because it is fundamental for accurate risk prediction.? CoraVie is a direct measure of the blood vessel, and highly accurate.? Because we are a direct, accurate data source, we can further magnify the insights by incorporating predictive analytics and artificial intelligence.? This ensures that when it signals the need for care, it is indeed a legitimate alert.
Not to get too far into the future, but there is an emerging trend for circadian, day and night monitoring to identify patient risk, inform medication half-life, and personalized medicine based on a true blood pressure profile. CoraVie is the only solution that can automatically monitor over day and night to create a blood pressure profile, assess blood pressure variability and nocturnal hypertension.? A single point-in-time measurement will no longer be sufficient.? To draw an analogy- one would not expect a carbon monoxide detector or a fire alarm to only check for an issue once each day.? Another relevant analogy is the introduction of continuous glucose monitoring in diabetes management. Continuous glucose monitors significantly enhanced the outcomes for diabetic patients. It's unrealistic to rely on single-point measurements taken hours or days apart and expect a linear understanding of a patient’s health between these points.
What have been the key milestones for CoraVie Medical since its founding?
I’m so excited for the team of experts advising CoraVie to get us to our next milestones!? We recently had a technology advisory meeting that gave confidence in our ability to deliver a miniaturized fully insertable solution.
In terms of our progress, the feasibility work on our unique sensor technology has been pivotal. We have proven that our approach is not only reliable but also feasible, marking a major milestone. Reflecting on the past few years, our journey has transitioned from being heavily research-focused on technology innovation to now being a largely engineering undertaking. We now understand how to transform our invention into a commercially viable product.
Being immersed in the day-to-day details can sometimes obscure the appreciation of our progress. Our timing has been impeccably aligned to technology advancements to deliver an insertable device that can accurately derive intra-arterial blood pressure, representing a significant leap forward.
How does CoraVie address the issue of patient monitoring fatigue? What role does patient compliance play in the effectiveness of your device?
It's worth emphasizing: patient compliance is a crucial issue, and CoraVie has gained deep insights into this. Having interviewed over 300 physicians, patients, and economic stakeholders, we've clearly identified unmet needs, one of which is patient compliance, especially regarding long-term therapy or monitoring adherence.
The reality is stark: patient compliance, especially for ongoing tasks like blood pressure monitoring, is abysmally low. Asking a patient to measure their blood pressure twice a day, with multiple readings each time, and to continue this indefinitely, is a daunting request. The regimen's complexity – avoiding coffee, maintaining posture, etc. – further complicates compliance.
It ultimately boils down to human behavior.? Despite knowing the benefits and the risks, such as the likelihood of a stroke, many of us neglect to take our medication or monitor our blood pressure routinely per doctor’s orders. This is especially challenging when there is no ”trigger” (or symptom) that tells us, “hey, you’re feeling a little off today, maybe you should take your blood pressure”. This isn’t about blaming the patients; it’s an acknowledgment of human behavior. Consequently, doctors often do not receive the necessary data to inform clinical decisions.
The longer the monitoring duration, the greater the likelihood that 'monitoring fatigue' sets in, diminishing the likelihood of obtaining reliable data for physician decision-making. CoraVie addresses this critical issue head-on. Our solution tackles patient monitoring fatigue, compliance challenges, and the self-awareness of measurements, eliminating concerns about inaccuracies due to patient behavior. Our tiny, subcutaneously inserted, fully automatic device revolutionizes patient monitoring.? CoraVie is the only solution that fully addresses patient self-monitoring challenges to automatically deliver accurate insights to the doctor.
What has been the most surprising finding in your journey with CoraVie?
Reflecting on your question, I realize there isn't just one thing that has surprised me the most: it's a multitude of factors.
I confirmed my own resilience and drive.? If someone had detailed all the hurdles and 'bumps in the road' I would encounter from day one, I might have hesitated to start this company. The sheer effort and persistence required are immense, and I'm grateful I didn't let initial doubts or discouragement deter me. Overcoming these challenges has taught me that success is not a straight path; it's filled with ups and downs. I've embraced and mostly enjoyed these fluctuations. And perhaps there's a part of me that's motivated by a desire to prove doubters wrong.
Another revelation has been the power of networking and a great team. Early in this journey, I reached out to my connections, and the response was overwhelmingly positive. The support and willingness to help from my network of friends and acquaintances, who understand what it takes to start a company, has been astounding. I was expecting to run into a highly competitive and opaque environment; instead, I found a community eager to lend a hand, because they have “been there” and know it takes.
And I have found a team that shares CoraVie’s values and behaviors and sees the vision to prevent the progression of cardiovascular disease.? I’m humbled every day to know these team players and build something great together.
Let me pose a question that naturally follows from our discussion. Considering the challenges and 'bumps in the road' you've encountered and overcome, if I had asked you three years ago about your aspirations for where you'd be in your journey today, would you say you're on track, or perhaps even ahead of where you hoped to be? I'm curious because, despite the obstacles, it doesn't seem like your progress has been significantly hindered compared to your expectations. However, I don't want to make assumptions. Could you share your perspective on this?
Reflecting on my initial expectations, I realize they were naive. Everyone says it will take longer than expected, and I didn’t appreciate the amount of research and invention that still needed to occur. For instance, when I applied for our first grant with the National Science Foundation, Pat Dillon, an invaluable resource in Minnesota for those considering grants, seemed amused by the optimism in my roadmap. I remember thinking that the entire process—from submitting the grant application to receiving funding—could take a year, a duration in which I assumed my project would already be completed. However, the process took its time, and the funding turned out to be immensely helpful when it arrived.
Now, I'm eager to accelerate our efforts to kick off the development of our product for early human feasibility, which is exciting. Our most recent challenge has been the 2023 venture capital markets.? It has been a little bit of a slog raising capital to get to early human studies. This has slowed our progress as we work to extend our cash.? But I am optimistic for 2024!
How does CoraVie contribute to the global conversation on hypertension management?
As for the global conversation on hypertension management, I hope I have partially demonstrated to you already how CoraVie contributes to enabling improved hypertension management. ? We're not just developing technology; we're actively participating in and shaping the discourse on effective hypertension management, bringing unique and innovative solutions to the table.
For decades, people have explored this area, but I believe we are now at the forefront, particularly in the way we're addressing hypertension through measurement and enabling sound decision-making for patients in need. Our approach is genuinely transformative and has the potential to revolutionize how blood pressure monitoring is perceived and implemented.
We are , and will continue to engage with the right advisors and societies, such as the American Heart Association and their Hypertension Council, to align with groups that understand and set guidelines. The American Medical Association is another key organization in this context. Building robust evidence is crucial, especially from the perspective of an implantable medical device. We must meet regulatory and clinical standards and demonstrate clinical and economic outcomes to secure reimbursement from governments or payers.
This high bar we're aiming for is essential in building the evidence necessary to drive adoption and change the standard of care to align with what we're doing. We are diligently following all these processes to achieve our goals. I'm really excited about this journey, despite knowing it will be a long one, and I'm enthusiastic about the potential we have to dramatically alter the way blood pressure is managed and understood.
What are the long-term goals of CoraVie Medical in the medical device industry?
Staying focused on our overarching vision is crucial, especially given the tendency to get mired in day-to-day operations and short-term milestones. Certainly, our long-term goals are ambitious, given the vast potential of our technology. CoraVie, with its name reflecting its French and Spanish roots—'Vie' meaning 'life' in French, and 'Cora' derived from 'Corazon', Spanish for 'heart'—is deeply committed to its vision of preventing the progression of cardiovascular diseases.
We're beginning with key markets and patient groups where we believe we can make a significant impact. However, our technology paves the way for a platform capable of enabling multiple opportunities.
Looking to the future, we envision integrating blood pressure and other hemodynamic data with implantable therapies to deliver closed-loop systems.
In the future we will utilize artificial intelligence and combine accurate, prospective clinical insights with broader population health data, enhancing personalization in medicine and improving overall population health.
The future is one where patient care is enhanced, where the information we provide not only informs but also motivates better health behaviors to prevent cardiovascular diseases.
Explore CoraVie's revolutionary approach to blood pressure monitoring and its impact on patient outcomes by visiting their website:
From Sales Rep to Distribution Entrepreneur: Unveiling the Journey of Stu Brandon in Orthopedic Sales and Distribution
In this Q&A, I have the pleasure of featuring Stu Brandon, a respected medical device leader and change agent at ASCdx. In this insightful interview, Stu shares his inspiring journey from being a sales representative for big orthopedic companies to founding his own distribution company. He sheds light on the challenges he faced during this transition and how he overcame them, as well as his approach to selecting the right products and brands to distribute.
Additionally, Stu delves into his success stories and memorable experiences, showcasing the boundless possibilities within the orthopedic industry. He concludes by sharing his vision for the future of orthopedic sales and distribution, emphasizing the importance of flexibility, innovation, and strong customer relationships. Join me as we delve into Stu Brandon's remarkable story and gain valuable insights into the evolving landscape of medical device sales and distribution.
What inspired you to transition from a sales rep for big orthopedic companies to founding your own distribution company?
For me, it was a familiar tale shared by most of the sales representatives from major orthopedic companies. Over the years, our selling prices had been steadily declining, and in order to maintain profits for shareholders, the company had started reducing commission rates. Consequently, we experienced a period where average selling prices dropped due to contracting, while commission rates were slashed for consecutive years. As a result, our commissions decreased by forty percent over a couple of years. This is a common situation faced by everyone in our industry.
Even small companies are not immune to the decline in average selling prices. However, they may be more willing to pay higher rates since they are not market leaders. In my specific situation, I also faced the challenge of operating within a limited geographical area. Therefore, I recognized that in order to adapt and stay competitive, I needed to explore opportunities beyond the large orthopedic company I was employed by.
Can you tell us about some of the challenges you faced in making this transition, and how you overcame them?
The initial challenge I faced was navigating the restrictions of my previous employment agreement, particularly regarding non-compete clauses. While the enforceability of such clauses varies across different states, it is common for companies to include non-solicitation agreements to limit soliciting business from existing customers after leaving. Overcoming these contractual limitations became a top priority and posed a significant challenge.
Prior to that, I had to meticulously develop a plan for transitioning from my previous role to pursue my own business venture. This required thorough planning and strategic considerations in order to build a solid customer base. It's important to note that even if I had a successful track record as a representative, it did not guarantee immediate customer support for my personal endeavor. However, I recognized the potential for finding new clients who were open to exploring alternative options. Engaging in thoughtful discussions about the future and how my services could benefit them became crucial as I approached potential customers. Establishing these connections and expanding my customer base was a challenging aspect of achieving the freedom to operate and devising a successful business strategy.
How do you determine which products and brands to distribute through your companies, and what criteria do you use in making these decisions?
This has become one of my favorite aspects of my work. Ironically, I have undergone personal changes along the way. To provide some context, when I left the big orthopedic company, I initially believed that I needed to find a total joint company to replace what I had, along with potentially adding a trauma or sports medicine company depending on my sales focus. However, my experience has taught me that there are numerous exceptional products and small companies to collaborate with. Now, it has become much easier for me to determine which companies I want to partner with. If there is a product that one of my customers desires, I have the flexibility to pick up that product line. Additionally, when I come across unique technologies or new developments, I engage in conversations with my customers before reaching out to the company. This helps me gauge their interest and determine if it aligns with their needs. If there is no demand for a particular product in my area, I may choose not to pursue it, even if it is an excellent product. My philosophy is rooted in being strategic about the products I choose to represent.
Early on, when I had the freedom to choose any product at the American Academy of Orthopedic Surgeons conference in 2019, I experienced what I now refer to as "shiny object syndrome." I found myself wandering through the exhibit hall, thinking, "That's cool! I'm sure I could sell that to someone!" However, upon reflection, I realized that many of those opportunities would have been distractions, potentially taking me outside my usual business scope. It would have been purely driven by the possibility of making a sale, rather than considering the long-term implications.
Currently, I have potential customers with whom I am not yet doing business. I engage with them in discussions about various offerings to assess if there is a suitable fit for their needs. The most enjoyable aspect for me is the freedom to approach someone I don't currently work with, and it is perfectly acceptable for them to decline if it doesn't align with their interests. That's perfectly fine; it just means it's not the right fit for them. The relationships I have developed with many of these individuals involve a desire for me to continue bringing them new opportunities. Instead of being solely associated with one company, repeatedly pushing the same product, I understand the value of providing them with diverse options. I also acknowledge that there may be companies that do not wish for me to represent their products, and I respect that. However, this does not limit me, as there is no shortage of excellent products available for me to consider.
Can you share any success stories or particularly memorable experiences from your time working as a sales rep or running your own distribution companies?
The more I distance myself from the big companies, the more enthusiastic I become about the possibilities within our industry. Let me share an example: during one transition, I encountered a situation involving a small company and a surgeon who was leaving his group to relocate from northern Illinois to Tennessee. I approached the company and suggested, "I believe this surgeon who is moving to Tennessee could be an excellent fit for your company." To my surprise, the regional manager responded, "Stu, I would love for you to introduce us to him. If he wants to pursue our products, we want YOU to take care of him." This completely blew my mind. How could I manage business both in northern Illinois and Tennessee? However, as I discovered, surgeons are embracing a different mindset as our market evolves. In orthopedics, anything is possible.
As a result, I now find myself traveling to Tennessee multiple times a month to collaborate with my friend who relocated from northern Illinois. This is something I never imagined was feasible. Consequently, my company has expanded its operations to include Illinois, Minnesota, Wisconsin, South Carolina, Alabama, and Tennessee. This experience has opened up a whole new perspective for me. I have transitioned from thinking narrowly about the confined boundaries of doing medical device sales within a small, predetermined region. I have realized that if there are individuals who wish to do business with you, there are ways to facilitate those connections within our industry. However, it requires a different mindset from both the representative/distributor side and the surgeon side. Many people within our industry anticipate forthcoming changes, and it is advantageous to proactively embrace those changes rather than waiting for them to be imposed upon us.
What do you see as the future of orthopedic sales and distribution, and how do you plan to stay ahead of the curve?
The key to staying ahead of the curve is maintaining flexibility. One significant advantage my company possesses is the absence of non-compete agreements with the companies we represent. While we work with numerous companies that we appreciate, this flexibility enables us to adapt to the changing and evolving market, as well as the shifting wants and needs of surgeons.
For instance, as more surgical cases transition from hospitals to ambulatory surgery centers (ASCs), surgeons' preferences and requirements can differ from what they were a year ago, and they will likely differ even more in the next five years. By having the freedom to act as consultants to physicians, we can provide unparalleled support to our group. If a surgery center approaches us and expresses their struggles with finding quality products that do not compromise reimbursement for specific cases, we are liberated to explore various options on their behalf. We can thoroughly investigate what's available in the market and present them with a range of alternatives in every product category they currently utilize. This approach empowers them to avoid being solely dependent on one vendor and maintain autonomy in their decision-making process.
Learn more about ASCdx:
Hearing Harry's Story: A Journey of Understanding and Acceptance in 'Harry Can Hear'
In this issue of Pulse on Devices, I am delighted to spotlight "Harry Can Hear" by Fynisa Engler, a touching and insightful children's book on hearing loss. This story resonates deeply with families like mine, who have experienced the journey of a child diagnosed with hearing loss and adapting to life with hearing aids. The book beautifully captures Harry's transformation across various settings—home, school, and everyday places like ice cream shops—mirroring the experiences of many children like our son Jayce. It's a heartwarming and educational read, offering both understanding and hope to families navigating similar paths.
Following my deep personal connection to "Harry Can Hear," I am thrilled to share this special Q&A with author Fynisa Engler. After sharing how her book profoundly impacted our family, especially our son Jayce's journey with hearing loss and hearing aids, Fynisa graciously agreed to discuss her work and its influence. This conversation delves into the heart of her storytelling, the insights she brings to children's literature on medical themes, and the profound effect such narratives can have on families like ours.
As a parent of a child who has hearing loss and benefits from hearing aids your book really resonated with my family, how did you ensure such accuracy in portraying hearing loss in a child?
I am glad to know my book connected with your family. I wrote “Harry Can Hear” based on my background as a pediatric audiology assistant and cochlear implant coordinator. I have worked with children of all ages and in all stages of their hearing aid journey. I was able to pull from my knowledge along with these experiences to develop a story that maintained accuracy while keeping the process simple for kids to understand.
How does "Harry Can Hear" differ from other books about hearing loss?
In crafting “Harry Can Hear,” my aim was not just to provide representation for children with hearing devices but also to enlighten kids unfamiliar with hearing aids that those who use them are just like any other children. Many books often focus solely on one perspective, and I wanted to bridge that gap.
What do you hope parents and educators take away from the book?
I would like for parents and educators to gain a deeper understanding of hearing loss and exhibit more patience towards related behaviors. Drawing from my experience with dyslexia, my childhood behaviors might have appeared lazy and anxious, and I wish for educators to look beyond surface behaviors to comprehend the underlying cause, as illustrated in Harry’s case with hearing loss.
How did you balance educational content with an engaging story?
While writing, my focus was on the universal dislike kids have for missing out. This resonates with the reality that children with hearing loss often miss out on parts of conversations. Through Harry, who is oblivious to what he's missing, the story weaves in the diagnostic process many kids experience at school or at the doctors office. Readers get to witness Harry's day once more, gaining insight into everything happening, with a delightful twist awaiting them at the end.
What resources would you recommend for families dealing with hearing loss?
For school aged children I would recommend that the family have close contact with the school to make sure their child is receiving all the necessary accommodations such as preferential seating, visual aids, speech therapy, and an FM system to name a few.
For family resources I’d recommend visiting:
Hands and Voices at:
A.G. Bell at:
How do you see technology changing the future of hearing aids?
Hearing aid technology is extremely complex. While some may perceive it as simply amplifying sounds, the reality is more complex. Tailoring to factors like low and/or high frequency loss as well as the extent of the hearing loss requires unique programming for each individual. The advancement enabling hearing aids to automatically adapt to different environments, distinguishing between quiet and noisy settings, is remarkable. I anticipate further enhancements in hearing aid clarity over time.
What’s your advice for parents discussing hearing loss with their children?
Consider comparing it to eyeglasses, as many children are familiar with them. Glasses enhance vision, and similarly, hearing aids improve auditory perception. As the child matures, educating them about their hearing aids becomes crucial, enabling self advocacy and fostering comfort with the device.
How do you think Harry's story can change perceptions about hearing aids?
It is my hope that “Harry Can Hear” can spread awareness about hearing aids to educate children by fostering an understanding that a child wearing hearing aids is similar to them, just requiring a bit of assistance to hear better.
What are the misconceptions about hearing loss that you aim to address?
The main misconception I aim to address is that the person with hearing loss just simply isn’t paying attention. What the reader can take away from “Harry Can Hear” is that this isn’t the case, Harry didn’t want to miss out on all he did at school and home. And he definitely didn’t want his ice cream to be plain.
Can you share an experience of reader feedback that impacted you?
A parent reported that their child did not want to wear her hearing aids because they made her feel different. After reading “Harry Can Hear” she felt encouraged and didn’t want to miss out on important things like Harry did before his hearing aids.
Purchase Harry Can Hear on Amazon!
A Dose of Humor: Announcing My New Book, Laughing Through the Pain
As we wrap up this issue of Pulse on Devices, I’m thrilled to share some personal news—earlier this month, I published my new book, Laughing Through the Pain: The Unusual Side Effects! This project has been a labor of love, blending my fascination with the quirks of modern healthcare and my passion for finding humor in unexpected places.
In Laughing Through the Pain, I take readers on a journey through the often-absurd world of medicine. From baffling waiting room dynamics to the maze of insurance paperwork, awkward doctor encounters, and the (sometimes dangerous) allure of DIY remedies, the book offers a lighthearted take on the experiences that frustrate us all but also bring us together. Through anecdotes and lively cartoons, I explore how laughter can truly be the best medicine.
I’m incredibly grateful to everyone who has supported this journey—whether through encouragement, feedback, or simply sharing a laugh along the way. If you’ve ever had to decipher cryptic medical advice, waited endlessly in a sterile clinic, or laughed to keep from crying at your latest bill, I hope you’ll find something to relate to in these pages.
Your Voice in Healthcare: Connect with Pulse on Devices
I am always on the lookout for the next big story in medtech and healthcare. If you're a leader in these fields with insights on technology advancements, inspiring stories, or suggestions for future features, I'd love to hear from you! Reach out to me through LinkedIn or email me at [email protected] to share your ideas and be a part of our dynamic newsletter. Let's collaborate to keep our community informed and at the forefront of innovation.