Democratizing Surgery Part 1: What Verb Surgical is Creating

When the impossible is dreamed, it might just happen. Then a revolution is born.

I've always felt that as a marketer my role is to see what's going to happen, not what has happened.

I remember the day I read the news, and couldn't help but feel excitement.

As a marketing manager at Mazor Robotics, we were fighting the "surgical robotics" fight on the front lines against traditional surgery.

Then it happened. News that Johnson and Johnson's Ethicon partnered with Google's Verily Life Sciences to form a surgical robotics company.

The marriage of a surgical heavyweight with technology heavyweight will conceive something that few can imagine; a hybrid stronger than each parent.

That hybrid, is Verb Surgical.

Having two heavy weights like that join in the fight to evolve surgery only added momentum to what all the other companies were trying to accomplish.

My colleagues and I discussed what they could be working on, but eventually we just forgot about it and got back to fighting the good fight.

Months passed, and the jungle started to make more odd noises.

I pride myself on curiosity, and I couldn't help but go into it to see what I find.

What I found gave me goosebumps.

How Does Verb Define a "Robot"?

In a recent article, leadership from Verb Surgical made an observation of the current surgical robotic landscape:

Robotic surgery units available on the market right now are not technically “robots,”All that is is an extension of the physician’s eyes and hands.

According to Verb, a robot is supposed to tell surgeons valuable information to guide decisions and do some tasks automatically.

It will use Big Data, anatomical recognition software, and other features that are not available today.

However, what Verb's engineers are building goes deeper than just robotics.

Much deeper.

Verb wants to deliver a transformative technology, and the promise of advancing the standard of care lies in connecting all of the capabilities of this technology and others.

The vision of Verb's advanced robotics is to evolve surgery. In a recent statement, Verb's leadership stated:

Verb Surgical will look to implement a “transformative agenda’ in the field of robotics,” with the goal of “democratizing surgery,”

Actually, when you read between the lines, it's to start a revolution.

General Questions from a General Surgeon

"I don't understand what they mean by that".

That was my father's response to hearing Verb looking to "democratize surgery".

My father is the classic general surgeon.

He trained at the famous Cook County Hospital, which was a knife fighting club over the weekends in the seventies.

He then pursued private practice for over thirty five years in Texas.

Like most general surgeons his age, he's "retired" from surgery, but still works at the hospital as a medical director.

They don't really "retire". They just do less surgery, and eventually retire to do other work in medicine.

I explained to him that "democratizing surgery" was a focus on business model disruption and not just a technological disruption by just improving on existing robotic platforms.

Me: "They want to change the healthcare system overall," I explained.

Dad: "Ok, but how?"

Me:"Bring down cost of surgery and make it available everywhere, not just first-world places and big cities. Any surgeon anywhere will be able to do the complex cases that only a few can do today."

Dad:"What if they're not interested?"

Me: **Silence**

Me: "What do you mean? Why wouldn't they be?"

Dad:"Well, I remember when bariatric surgery came to our city. I was approached, and I thought it was great, but it wasn't something I was interested in doing."

Me: "What about something else that you were interested in eventually?"

Dad: "Well I remember the day we heard about Lap Chole. When we heard about it we just laughed and said "what the hell is that?!". We're not used to removing a gallbladder without opening the belly. Doing it through a small incision, with cameras?"

Dad: **Smiling** "But when we were told more about it over time, we understood. Then we saw a few surgeons starting to do it, and then it took off".

Surgeons, especially general surgeons, have traditionally been a conservative group when it comes to new technology.

Verb CEO Scott Huennekens admits that the path to adoption isn't always smooth.

"Any time you have an established market, there are friction points as it evolves".

Except Verb isn't inventing a platform for the current market.

They're inventing a new category.

What is this new category?

Surgery 4.0

In marketing and branding, it is vital to adhere to the laws, such as focus.

When you focus, you start to own a word in a prospect's mind.

When we hear "smart phone" we think Apple, and that is a huge advantage.

They didn't invent smartphones, but they found a way to own that code word in the mind of consumers.

"Smartphone" makes most people think "iPhone" which is code for "Apple".

Surgery 1.0 was open surgery.

Surgery 2.0 was the introduction of minimally invasive surgery.

Surgery 3.0 was the first generation of surgical robotics.

Surgery 4.0 is the enabling of a digital surgical platform coupled with robots.

This is where things start to get interesting.

Ripping a Hole into the Surgical Universe

According to Al and Laura Ries' famous work (22 Immutable Laws of Marketing and it's companion the 22 Immutable Laws of Branding), it is paramount that a company focuses on owning a word in a prospects mind through its brand.

The birth of a brand is usually accomplished through publicity, not advertising.

Today brands are born, not made.

A new brand should then adhere to the Law of Publicity by generating favorable publicity in the media. Otherwise, it will not have a chance in the marketplace.

Thus, a brand is birthed through the Law of Publicity.

Now once born, a brand will die unless kept alive with the Law of Advertising.

Publicity is a powerful tool, but sooner or later a brand outlives its publicity potential.

This process normally goes through two distinct phases:

Phase 1 involves the introduction of the category.

Phase 2 concerns the rise of the company that pioneered the new category. 

Verb Surgical is in Phase 1.

But what happens when you become so focused in a niche such as robotics? You start to go down the rabbit hole.

The wormhole, to be exact.

A wormhole or "Einstein-Rosen bridge" is a hypothetical topological feature that would fundamentally be a shortcut connecting two separate points in spacetime.

Deeper and deeper into a funnel to the very end point, and you've now torn a wormhole into the surgical universe.

The question now is this; What is coming out the other end?

The Surgical Robotics Market

Intuitive Surgical gave rise to the robotic world and owns the word "surgical robot" in our minds.

Intuitive Surgical’s da Vinci surgical robot was a major innovation, making surgeons more precise and dexterous.

Other companies came out into the surgical robotics world and owned their own code words.

When I say "robotic spine surgery", surgeons associate that with Mazor Robotics.

With their second generation system "Mazor X" out on the market, they are further expanding their presence in the market and the minds of surgeons.

Even though Globus, Brainlab, and Medtech Surgical have robotic spine systems, Mazor owns that code word today.

Marketing is not a battle of products, but a battle of perceptions in the mind of your prospects.

Companies are not just battling for marketshare, they're also waging war to own marketshare in the mind of surgeons.

So the surgical robotics category looks like this today:

(Note* If you don't see your company here, then your marketing department needs to do a better job getting into my mind)

Verb Surgical has some work to do in order to grow to the size that Intuitive Surgical is at and the market share they own.

Unless they don't do that.

Leading a New Revolution

The nature of revolutions is that they destroy the perfect and enable the impossible. - Seth Godin

When discussing changing the surgical landscape, Verb CEO Scott Huennekens stated

"And robotics is only part of that. I think Intuitive defines itself as a robotics company. We're not a robotics company".

A decade or two ago, our industry was rewarded for even the slightest improvements in technology.

Surgeons gladly took on the discomfort of trying “the new thing” as long as it kept the promise of better patient care.

Hospitals complied and paid the high prices with large margins.

Times have changed, and unfortunately, it’s not just about better outcomes. That’s expected.

Reduced costs must be part of the equation, otherwise, adoption by medical teams and hospital leadership is a stretch.

But it can't stop there.

Verb is trying to do something big.

Changing the healthcare system overall is a dangerous journey to embark on.

What does that mean? How do you go about doing that?

Andy Rachleff (cofounder of Benchmark Capital, and now the founding CEO of Wealthfront) once shared a powerful insight:

I know a lot of companies that failed due to lack of focus. I can’t think of one that failed because they were too focused.

Verb aims to bring down the cost of surgery, empowering all surgeons with access to technology to perform the most complex surgery, and making it available across the world.

This all starts with a focus or a base offering to the market.

In the process, surgery will be "democratized".

Something like that is impossible.

Until it's not.

And that's how revolutions get started.

Here's what I feel can happen, and selfishly what I hope happens.

LAW of ADVERTISING-PHASE 1: The Birth of a New Category

So if Verb Surgical isn't a robotics company, what are they? They have a robot, and that's what everyone is waiting to see in a few years.

However, to lead a revolution and democratize surgery, it requires a violent step into a liberated future.

That violent step is on the other side of the surgical robotic universe, into a liberated future of digital surgery.

Phase 1 involves the introduction of the category.

Verb will be a coercive midwife to the birth of surgical democracy that is still ambiguous to surgeons, most of whom have the same response my father did.

However these are the ambiguities that we, our culture, my generation, continue to embrace, believing in ‘revolutions’.

LAW of ADVERTISING-PHASE 2: Leader of the New Surgical World

If done properly by educating the market and seeding the minds of surgeons, the resonance of Verb's launch in a few years will be felt throughout the surgical universe.

This isn't going to be the same as introducing a procedure like Lap Chole with a few surgeons adopting and others following suit.

This requires a more complex approach, one that markets to the subconscious before the conscious mind is even introduced to anything.

With enough force in the tear they created, the market will vacuum, drawing other robotic companies into the new category.

Those who do not evolve and adapt will be subject to economic Darwinism and will die off.

Remember what happened to Blockbuster and Hollywood Video when Netflix came out?

Phase 2 concerns the rise of the company that pioneered the new category. 

(I'm not completely against being vain, so to pay homage to medicine and the naming of theories after oneself, we can call this the "Khateeb Category Wormhole")

As other companies come through the wormhole to the other side, this will push the category pioneer up the adoption curve by validating the category.

We saw this with Intuitive Surgical in surgical robotics.

Netflix, the iPhone, or other technologies aren't any different.

By laying the subconscious groundwork from now, Verb will have massive momentum going into their launch a few years from now.

Once they've successfully done this, they now reap the benefits of The Law of the Word.

The Verb brand should strive to own a word in the mind of the consumer.

Once a word is precisely associated with a brand, it is almost impossible for a competitor to create some stronger associations.

If you want to build a brand, you must focus your branding efforts on owning a word in the prospect’s mind.

A word that nobody else owns. 

"The most beautiful thing we can experience is the mysterious. It is the source of all true art and science." - Albert Einstein

Read Part 2 of this wildly popular series here:

Democratizing Surgery Part 2: How Verb is Provoking a Surgical Revolution

Disclaimer

This is a personal LinkedIn blog. The opinions expressed here represent my own and not those of my employer or any other company.

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Omar M. Khateeb is an unorthodox and innovative marketing leader with a background in science and medicine. 

He publishes an article a week on LinkedIn, drawing from various sources.

His interests reside in sales psychology, neuromarketing, and self-development practices. He often reads 2-3 books a week and combines concepts to execute strategies in new ways.

Check out his virtual bookshelf here to find your next great read, and connect with him on LinkedIn, Twitter, or SnapChat.