"Screw Business As Usual" - Sir Richard Branson. . . . . Converting Medical Device Profits Into Financial Generosity.

I am on a plane 35,000 ft. above sea level as Africa disappears below me. I am completely exhausted but the memories of the past week are too fresh to sleep. I would bet that this is true for the five U.S. surgeons returning to their families as well. They are the true champions of this mission trip: 

1. Dr. Michael Wattenbarger, MD (Pediatric Spine Surgery; Shriner's Hospital for Children, Greenville, SC)

2. Dr. Joshua Miller, MD (Neurosurgery; Univ of Tennessee Medical Center, Knoxville, TN)

3. Dr. Adam Lewis, MD (Neurosurgery; Jackson Neurosurgery Clinic, Jackson, MS)

4. Dr. John Hicks, MD (Orthopedic Spine Surgery; EmergeOrtho/Blue Ridge Bone and Joint, Asheville/Hendersonville, NC) 

5. Dr. Tom Large, MD (Orthopedic Trauma Surgery; Mission Hospital, Asheville, NC)  

6. Dr. Greg Hoffman, CNIM (Neurophysiology, National Neuromonitoring Service, Jackson, MS

Together they performed 25+ complex surgeries (pediatric scoliosis, kyphosis, thoracic chordoma, TB infection, orthopedic trauma, vertebrectomy, corpectomy, etc...) in conditions that are too hard to describe. Each left his family and practice, and traveled 8,500 miles at their own expense in an effort to do something meaningful. All are extremely skilled at what they do but the humility that each one exuded as they served the staff at Mulago Hospital in Kampala, Uganda laid the foundation of all that will be done in the future. Well done gentleman. 

Each has recently experienced what is called "Vuja De", a phenomenon opposite "Deja Vu", which is seeing something that is old and familiar with a fresh new perspective, enabling one to gain new insights, and intended to flip the status quo to create something new.  

I learned that while in Africa, both Becker's Spine Review and WBIR, the NBC affiliate in Knoxville, TN ran short stories on the history, works, and purpose of On-Belay Medical. I am grateful for both and the timing could not have been more perfect.  On-Belay was founded in a Vuja De moment - and designed to flip the status quo and create something new. 

Victoria Hale, PhD, Chair Emeritus, The Institute for OneWorld Health and Founder of Medine360 says, "Business models are human creations, just as technology is. So we innovate the heck out of technology. Well, let's do it with business models too." 

Examples of creatively destructive business models of distribution are evident in markets all around us. Amazon, Apple, ITunes, Warby Parker, Uber, Tesla, SpaceX, Airbnb, etc, were all able to break through long lasting strongholds that existed between industries and their customers. The common thread is that each company provided their customers a measurable benefit and new way of doing business that did not exist before.  

We accept the status quo of the medical device supply model because it has always been done this way and it is all that we know. Effecting real change can seem impossible and changing would affect our "comfortable way". 

In the past, there were few medical device manufacturers and opposing devices could potentially have quality or ease of use concerns. However, today there is tremendous competition and medical devices within the spine and orthopedic space are very similar. If well trained medical device support is provided, the main difference of change is a new company name on the implant trays in the OR. But, as in any scenario that requires change, nothing changes until the pain of remaining the same is greater than the pain of change.    

Dr. Josh Miller, Neurosurgeon, University of TN Medical Center, has been working with On-Belay for several years and decided to measure the benefits of working with us. Like most, he was being supplied by some of the largest device manufacturers in the industry. (Screws, rods, plates, cages, biologics, etc...) The quality of selection that On-Belay provided had to be as good, or better, than the quality that he was currently using. 

At the end of the month (1 month) the financial benefit sent to the NCF (National Christian Foundation, and largest shareholder in On-Belay.) was calculated. Then, through his direction, the NCF converted those profits into 426 nights of shelter for homeless in Knoxville, supplied nearly 1,300 meals, and purchased enough water filters to provide safe drinking water in Uganda, Africa for 50 people for 10 - 20 years. The alternative? Provide sales commissions and profits to shareholders around the world... Any pain of change went away.

Adam Lowery, co-founder, method says "Business is the most powerful agent for positive change on the planet. But it's not business as we know it today. It is fundamentally and profoundly different. It is business redesigned."  On-Belay (a rock climbing term that means “one secured by another”) has an ownership model that is profoundly different – allowing us to convert medical device industry profits in to opportunities for financial generosity.

On-Belay surgeon customers are not financially compensated. The rewards surgeons enjoy here are different, and with no extra effort on their part. When surgeons understand that On-Belay not only exists, but is actually real, transparent, and honest, many surgeons prefer to work this way. Surgeons can involve themselves in the giving process and receive monthly company updates if they wish.  

Whether you are a surgeon that is motivated by curiosity, a stirred passion, or you just want to believe that On-Belay is real, we would love to connect with you. We have many surgeon customers that you can speak with. Talk with them, not us, and let them share their experiences with you.

Finally, I would like to extend a heartfelt "Thanks" to all of the suppliers that believe in and work in partnership with On-Belay. The instrumentation that you donated for the medical mission trip was put to great use and will carry on in our absence. Mulago Hospital surgeons are trained on your instrumentation and they will perform surgeries this week on patients that have been waiting for months, or years, for help. 

* One last thing. Thank you Sir Richard Branson for letting me borrow the name, and a few thoughts, from your great book, "Screw Business As Usual". I finished it on the way to Africa and enjoyed it very much.