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Complexity by Design: Why Hospital Buying Got So Slow · Zero Friction

• Ahmed Shahzad: Empathy, I think, is the heartbeat of healthcare when it's done well. But I also think if you can get to the love metric and you measure that and you show how your product is delivering to the clinical and experienced love metric into the financial love metric, and if you can reflect that every quarter or twice a year to a customer, you win. You absolutely win. If you don't think the healthcare system's using AI against you when you're walking in the door, you're crazy. Hey there, I'm Terry Kucholuches, founder of RevRX AI. We remove friction and architect revenue for med tech and consumer health practices. Welcome to Zero Friction. This is Terry Kuchraluchis, and today I have a can't miss episode with Todd Dunn. He's the founder and CEO of the Innovators Journey. And basically, you know, Todd and I came together on a call probably three or four weeks ago and really kind of discovered that we are both aligned around friction and removing frictions from the system. And so we want to talk about certain things today where we can help other leaders, whether they're in the healthcare side of the business or the provider side of the business, what they can do to remove friction from their particular systems. Todd has spent over a decade working on both sides of the fence. So he's been a medtech CEO. He's also spent a lot of time working for providers in their systems and their transformational areas. He's also been mentored by the Lake Clay Christensen. He's a Harvard thinker and was behind a book called The Innovator's Dilemma, and which has really kind of changed Todd's mindset. And he has his own book coming out. So that system is a part of a book called The Innovator's Journey. It's coming from Taylor and Francis, coming out in November. And so what we want to talk about today is I want to get Todd to give us a little background on himself, on how he got to where he's at, and then we'll talk about like systems, we'll talk about transformation. And we will talk about removing friction from the system. So Todd, welcome to the program. Glad to have you here today. Hey, good to see you. And thanks for the time, Terry. I'm that's I was really looking forward to this dialogue. A little bit about me, I'll be quick. Grew up in the deep south. My dad was an entrepreneur, owned his own businesses, started them. So I learned frugality and hard work from him. And he would always say, We get paid last, which I thought was really interesting, right? And so it made me fiscally mindful. Even when I was in large systems like GE or Advocate or Intermountain Healthcare, I've always been so mindful of being capitally efficient. Just don't waste money. I got my master's, my MBA actually in supply chain management, and spent the first half of my career really in an operating role between Cisco, McKesson, and Siemens. But when I got to GE, I was in an operating role in a software division that had a great partnership with Intermountain Healthcare. And during that time I got to I met Clay Christensen. I started reading Steve Blank's work out of, you know, his Four Steps to the Epiphany. And thought, ⁓ I kind of like this. And then I raised my hand one day at GE because I heard they're working on this innovation thing, Terry. And I emailed Beth Comstock at the time she was the chief marketing officer. I said, hey, I'm raising my hand. I want to be part of this. She said, well, it's really a volunteer job. So I was okay with it. had two roles at GE and through that work, eventually it developed into what became known as GE fastworks, their global innovation system. And I learned so much there because GE was like this the system darling, right? They spread the language, methods, behaviors, measures of Six Sigma around the world when everyone kind of struggled with it. And so I thought what a great learning opportunity. I left there when we spun that division out of GE to merge with Microsoft, joined Intermountain Healthcare. innovation role for a long time. Then I went to atrium slash advocate in an innovation role, took a year off, wrote the book that you mentioned. That was a lot of fun. Just really I just wanted to share what it was like inside of a company to try to create a transformation system. It's hard. But I wanted to be very practical, something within reach that you could do Monday. If you read the book over the weekend, you can go do something on Monday. And so I'm spending a lot of time now just not probably to the level that you are, but advising some med tech companies on how to really sell into healthcare systems, but also helping healthcare systems think through what is transformation, what should it look like now? I think we should be in version two dot ⁓ probably after the learnings from the last 10 years. Live in North Carolina now, love it. That's me, man. That's me. That's awesome. And, you know, I think what's amazing about your career is that you've spent time on both sides of the fence. And yeah, when we talk about our audience, whether they're CEOs, founders, or commercial leaders inside the med tech space, you've seen both sides. You've worked for the GMs, you've worked for the Siemens, you've worked for the McCassmans. These are monsters in the healthcare med tech sector. And then you've worked for some of the most innovative healthcare providers in the country with Inter Mountain and Atrium Health, who have really taken healthcare to a whole new level when it comes to transformation. So Talk to me about what have you learned from working on both sides of the fence. Man. That could probably be a book too. I I've learned, you know, I was a CEO of a med tech company. I'm gonna try to articulate this in a way that I think is really important. Systems that get you the clarity around the problem and context need to exist as ongoing efforts. I think you've framed it as a framework of how an organization needs to think. How that needs to behave, the tools that they use to guide those behaviors and thinking or to test their own thinking. And if you have a system, whether you're in a smaller med tech company or a large behemoth, it makes it a whole lot easier to make really informed decisions around what is your definition of transformation? How do you do it? And if you're a med tech company, how do you plug into that and resonate with a large health system that has at least a thousand things on their plate to do? That's One of my biggest insights was the need of a system. The other thing, and I go back to this book by Amy Edmondson, and it has just resonated with me forever. I think the name of her book is The Fearless Organization. If I remember, I should remember this. It's one I've read it a few times. But the psychological safety to speak up and question the status quo. Everybody needs the freedom to challenge the status quo. Because if they don't, just like seventy-four percent of those CEOs think their business is gonna be out in ten years, if you don't have a system that's coupled with the psychological safety of questioning the status quo, man, start playing them the ending of the music, right? And that I'm just a big believer in systems, established language. I'll give you a little number. It's fascinating. So when I started working for a large company, I wanted to get an understanding of how well they understood innovation. And so I decided to pick two questions. My first question was, if I were to ask a hundred leaders within this company their definition to write down their definition of business model and hand it to me, how many different answers would I get? And one of my fun colleagues, he said a hundred and two. And I said, Jeff, I'm only asking a hundred people. He said, Yeah, but I got a couple of doctors that'll force you to take two because they're gonna hedge their bets. I said, Okay, funny. Everyone told me that every answer would be different. And then I said, okay, in the last sixty days of those 100 leaders, how many of them have said or heard the term business model in a meeting? They said, ⁓ all of them. And so now you start to see the problem where there's a term being used because business models are the unit of competition, as you know, whether it's the portfolio of them or the individual one. And you have leaders talking about it, but they don't have the same definition. They don't have the same tools. They don't have the same approach to renovating, creating or eliminating business models. And you're like, okay, there's inherently the problem. To your point, they lack the framework, Terry. And little questions like that to me are great assessments of whether or not you have a transformation system in place. So then I'll close with this. Imagine going on the floor. I used to say, imagine I go on the floor. I'm on the fourth floor cardiac unit and I yell stat and I've got seven people, doctors, nurses, APPs, therapists, and everybody has a different definition of stat. Let's say the doctor thinks it's fifteen minutes. The nurse thinks it's one minute and I've got a patient who's coding and nobody's working together because definitionally they don't have the same clarity of how they can work together, that would never work in medicine. And so my point is it's the same with transformation in medicine. Whether you're a large McKesson or a GE, a med tech company or a healthcare provider, if you don't have a system with that unity around what transformation is, but then how do you do it? You have an episodic program versus building a DNA capability of transforming your company. And it could be a little company, 20 people. Doesn't matter. You gotta have it. You know, it's really interesting comment, I think, that communication is usually the the main reason why people and teams succeed together and it's one of the main reasons why teams fail together. A hundred percent is being able to actually operate under common language and common understanding of that language. You use the word stat. You know, and that if there's five different meanings to the word stat, then that team is gonna have a hard time aligning on what the goal is, right? Mm-hmm. Just like if I say everything needs to be blue and there's five different shades of blue, I mean e everybody needs to understand what when X is said, this is what the common understanding is. So think about this, Terry, from a CFO perspective. Imagine you're the CEO and you walk into the CFO's office and you say, Hey, show me the annual planning calendar, please. And they don't have it. Or say, show me how we define what is a capital expense versus a non-capital expense. You go into her office and she doesn't have a clear definition that matches one of her direct reports. That would never happen. It never happens in the financial world. In the clinical world, there's sepsis across the entire company. There are ways to do things. And then you have this interesting thing called innovation, which I think is the verb. Transformation is the adjective or noun that you want. And there's like, wait a minute, you got the CFO rigor. You mentioned value analysis organizations earlier. They have templates, they have processes. You got the clinical world. And then all of a sudden you get this innovation transformation world and it's kind of hit and miss. It's episodic in a lot of places. And I just believe that you can have the same type of scientific rigor and math rigor in that world. that you have in the CFO world, that you have in the clinical world, that you have in value analysis committees, and the more you have it, the better off everybody's gonna be you know, you mentioned something called psychological safety. Mm-hmm. And I love this word because, you know, I think change is a scary word. Transformation is a very positive word. But when the minute you start talking about change, you know, it's it's a scary word for most people. And so we talk about psychological safety. You and I had talked about Any type of evolution or transformation that organizations are trying to create, there's always ten percent that will stand in the front of the line just because they love chaos and they love new things. And then there's ten percent that are gonna be at the back of the line that are never gonna change. And so that's twenty percent that you don't have to really worry about either way. But there's eighty percent standing in the middle. And they're thinking, Why, how much, what do I need to do, what's in it for me? You know, is it a good thing for me? Is it a bad thing for me? So talk to me about like systems that promote psychological safety and what type of attributes do they bring to the table? Because I think this is a really interesting concept, right? For any leader out there trying to move from position A to position B, to me, I guess psychological safety would be a component that you need to model into a program to get that transformation to actually occur. And how would I build that? How would I build psychological safety into a system? So psychological safety could be systemic, not like sporadic, but it could be a it could actually be an attribute that you could build into a system that would make it more consistent, more approachable, and more predictable for success. That's a great question. I want to attack it from two angles if I can. I believe in this concept that you need to reward. Give me a little southern levity, if you will. Coins in the couch and dollars in the dryer. You want teams to find coins in the couch and dollars in the dryer at scale constantly and always on. And I articulate why I think that's a psychological safety thing. Sometimes we reward the big wins too much and we make that the safest way to promote a career. But if you have a structured platform and system, I call the program Team SALT that has a structured way Of letting teams run challenges within their own team or with another team where they set their own destiny. It's like Dan Pink talked about mastery, autonomy, and purpose. But you got to put a system in place. It can't just be give me your good ideas. It still needs to follow the same logic of a problem with criteria and you fund it with time or money if it hits the criteria. And so there are platforms, a few of them out there. We did this at Intermouth and Healthcare. We eventually designed it. They called it My Voice. But where you give these teams the platform and the structure for questioning the status quo. And I could give you so many examples of where teams want the freedom to remove friction out of their day, like updating a database or something they hate doing, put a system in place that gives them the psychological safety and the freedom to go fix things without having to go to the hill. Because those are the coins in the couch and dollars in the dryer that if you add them up over time over and over again, you create A culture of psychological safety, and you start extracting time and money to reinvest somewhere else. I call it reinvestment innovation. And so that's one way you do it. The other way you can do it, there's so many, but let's say that your business model is your unit of competition. So a team solved challenge is about a process or something at the team level. It's smaller. You own it within the sphere of your criteria, your team, or with another team. You don't even need to know it. You just need to track it at the high level of the company. The other one is, I think, is, you're gonna laugh, maybe, is an activity I call an assumption burst. So goes back to medicine, diagnose before you prescribe. But let's say you're doing a business model transformation and you're using a business model canvas from Alex O's to Walter, you have the teams write down, we believe. Spend an hour writing down everything they believe. And then you design the test and the experiments. It's a scientific method brought to innovation transformation, but why? Like what causes me to be so passionate about it? If you make it part of a system that groups who want to renovate a business model or create a new one, they have to document their assumptions. You just made it safe for them to say, I'm not sure. And then They run the experiment which resonates in healthcare, right? The scientific method is the root of great progress that you mentioned earlier. So you bring the principles of medicine into the principles of innovation and transformation and it makes it safe. It's not safe to not diagnose if you're a doctor, which basically leads I'm not really sure, but I'm gonna run a lab. You need to do the same with innovation transformation. Those are two ways to do it. Create a structure. I call the program Team Solve. Challenges is the structure. It's an expectation. It's a behavior. It's in your goals. And then if you're going to create or build a new business or renovate one you have, you've got all these assumptions. And make it safe by making it part of the system for people to say, I know I have to go have evidence now, which intuitively you have to admit that you don't have it, but you got to make it safe. And that whole fail fast, fail cheap thing is a bunch of crap. You need to learn fast, learn cheap. And the way you do that is follow the scientific method. And that's all about writing down assumptions. That's the way I would do it. It just is it it goes back to what you've been talking about, Terry. The system will elicit the behavior. And if the system elicits the behavior over and over again, that behavior becomes an organizational capability. And that's why I believe transformation can be a capability, but not without a system. So let's talk about transformation opportunity and let's talk about The opportunities for healthcare systems. I mean, we're in the most I think the United States is one of the most innovative healthcare markets in the world in terms of leading innovation. And, you know, for years and years and years, most of the new technologies were developed here. Now outside the US regulatory authorities were a little faster to get things to market than the US. But most of that innovation was built here. ⁓ I think when I talk to other commercial leaders Whether they're small enterprise or large enterprise accounts, getting new technologies into these healthcare systems has has become a totally different game. Okay. And with the advent of value analysis committees and and listen, I totally am behind the fact that every healthcare system should have a governance system of what's coming in their doors and what's being used and what's on formulary and what is good for their patients. I mean, we are in healthcare. So There needs to be some framework that says this is a good thing or this is a fit or it's not a fit. However, it seems like it's over designed. It seems like it's overengineered. And it seems like it's designed with purposeful, intentful complexity to sort of slow down innovation and transformation in some ways. Can you talk to me a little bit about that? Complexity by design is what I like to call it. I agree with you and I understand it because I worked inside of a health system for so long. I was in a boardroom with a chief nursing officer and a chief operating officer eight years ago. And I asked this question Have we ever spent blown, lost five million dollars or more because we invested in something based on an assumption that we did not vet, either validate or invalidate. The CNO leaned back, that's too painful to talk about. The COO said it's not have we ever, it's how many times have we done it? And if you do the math If you blew five million dollars and you had a ten percent margin, which no health system does, Mayo just bragged about eight point three. Right. So or didn't brag about it, they reported it. But they should be proud of it. But at ten percent, you just blew fifty million dollars in revenue to cover up five million dollars. And so then you think, how many knee procedures or heart procedures did we have to do to Bring in fifty million dollars to waste on your bad idea. Okay. And so I think the complexity is there to stop that is to be so cautious because losing a dollar costs you twenty in a five percent margin perspective. And I think that's why, to your point, it's intentional complexity to make sure they're de-risking every element of spending an extra dollar that they can because they've been burned so many times and it's it's just burned into their memories. And that's why I'm empathetic to it and I understand it. And it's also why I tell med tech companies, vet your assumptions about what you think the financials are, the problems are, the friction is for the health system. Don't put the burden on them. You need to do everything you can to understand every bit of that. So that you can navigate the complexity more effectively. Yeah, that's a really good point. And and I would say even five percent is generous for most healthcare systems in terms of returns. Most of them are two, three percent. It's brutal. So think about that five percent, you blew five million, you had to generate a hundred million in revenue. And then Terry, you dive into this and you you see the Affordable Care Act is gonna pull back some of the extra Medicaid payments. Payers aren't giving you increases in payments that outrun inflation. So you literally almost can't make up the loss. Right. And you got to put a mechanism in place that stops the losses. And I think that's why you've got these committees that are so and they're multiple committees to your point. I think that's why they're place. You know, so the message back to innovators of technology and introducers of new technology would be have your economic model ready. And have have your pure understanding of what friction you're doing to remove costs from the not just generating new procedures, but possibly what are you doing to take costs out of the system? And then more importantly, how do you take risk out of the introduction of the new technology for them? Because the one thing I heard you say was so wise. You know, the risk, the risk removing risk is because they don't have margin of error. They really don't have margin of error. And so their risk tolerance is almost zero, which is why there's such complexity to create the maze to get things in the door. So that's really a good a good a good thought process on when you're introducing new technology, taking risk out of the equation for the buyer. Again, you and I earlier talked about there's different perspectives of the table of there's a seller's perspective and a buyer's perspective. And you know, if you're not selling with empathy, you're not selling with a buyer's perspective. You're selling what's good for you and the company. You're selling features, you're selling benefits, you're selling speed, you're selling deals, you're sp you know. But on the other side is is what are you doing to bring value to the end user or the system or the patient or the stakeholder who's gonna benefit from the technology? Man, that Terry, you're so right. That and this is where I'll just be candid. There's been a lot of talk. This is I think this is relevant. There's been a lot of talk about private equity and hedge fund money in healthcare. Mm-hmm. Right? There are two camps. It's talk. It's real. I mean, it's it's it's there. There's there are two camps, people who think it's horrible for healthcare and people who think it's can be good. When I think about these med tech companies selling into healthcare, I think one of the key friction points, and you mentioned it risk, empathy toward the customer. whether you're taking cost out or you're improving revenue because you've improved the procedure, now they can do more of them without burdening the doctor even more. One of the frictions is the lack of understanding of a lot of venture firms and P or hedge fund firms on that complexity that you brought up. And it may be tying it together in an odd way, but if you're if you have a CEO of a company, of a med tech company. And you tell that CEO, we want that enterprise deal closed in six months, nine months. And that CEO comes back and tells you this process is eighteen to twenty four months and you need to fund it accordingly. And here's the path to it. If you don't accept that as an investor, you're probably gonna have a really rough time building a company in today's healthcare system. Because to your point, Terry, the complexity of de risking a decision, which is what I really think value analysis is for. It's a really key point and it needs to be there. If you don't figure out the whole path of a company from selling to solving to actual check and you think about it, you've got to let your CEO and your team have the psychological safety to tell you about the complexity of the healthcare system. And you can't just wish it to be six months or nine months because it's not going to be unless you're absolutely lucky. But it goes to that whole process. You got to have the clinical proof that it works. You got to have the economic proof that it works. But you got to have another angle on this. The health systems have to believe that you're going to be stable enough for them to invest their time and money that you'll be around in three to five years. This is not just about a one shot thing and yeah, it's a great product. Nah. With all the consolidation, the health system has to believe that you're going to be around and it goes all the way back to your board. If your board's putting so much pressure that you're trying to convert these accounts too fast, then these health systems are gonna get nervous and they're gonna say, wait a minute, is this company gonna be able to handle something to ⁓ the size that I, you know, that we are? You know this from your days at Abbott. You know, you talk about integrating some of these small companies. Once you integrate them, a big health system is more confident in them because Abbott's behind them. Right. It's a that that whole process to your point, that's all part of the complexity of selling into health systems. And I think early stage companies need to map out the complexity of decision making. How how do these smaller companies partner with large healthcare systems when they do truly have innovation and they can bring something to the table, but they, you know, just like they're asking for other investors and money to for for finding ways to bring that value, are there ways for healthcare systems to invest in technologies too in a way that like, you know, if they see benefit in it, like where they become a stakeholder too? Yeah. A l a number of these health systems have investment funds. And those investment funds will only invest if they believe it's a clinical and business problem together that they can solve for. Then they will invest. And there's nothing better than that, by the way. Getting a strategic on your cap table that believes in the problem and will talk about it publicly for you and with you is fantastic. And then the question becomes, what do I have to do to create that type of an alliance? And I think one of the most brilliant thinkers in the world is a guy named Michael Watkins. He wrote the first ninety days, Master Your Next Move. And in Master Your Next Move, he talks about this thing of relationships versus alliances. So I think a relationship can get you in the door. It can get you into a dialogue with the health system. An alliance around the problem clinically and financially can get you to a cell. And so at some point you have to realize that the relationship just buys you getting in. But if you don't have it, you probably never will. If you violate it, you'll get kicked out. It's I mean, it's a sacred thing, right? Because it's this currency of trust. But you have to create an alliance with the system. And so is there a code that the health system can use to pull all of the data where you can point to their problem? You sometimes you can buy definitive health care data. I'm not a I I prefer the health system pull their own data. Sure. But to your point, you have to create an alliance with the health system and never get caught in the mistaken thing that one doctor, like a chief medical officer, can get you to a check. Like you can't. I wrote this thing called the Seven Deadly Sins of Healthcare Startups. I wrote it eleven years ago. Some of it's still kind of true, but it's more complex now. But who do you need to get an alliance with? You brought up one of the most critical ones, the value analysis team. And then you gotta go through clinical governance, you gotta go through clinical appropriateness, you've gotta go through IT governance. Yeah. Right? And so how do you create an alliance with those committees? And so I think what if I were a medical device company earlier, I would ask that question. If you never worked in a health system, you need to learn how decisions are made, which committees are involved, what criteria do they use, and then shape your offering to help the health system went hard. So so Critical. And I mean, you know, you talked about it earlier, right? I mean, you understand this stuff. You were you get it. And helps small companies really need to understand it. And big c health systems also need a playbook of how to engage the external world. Tell you a fun story. I love talking to you about it. When I was at Intermountain, I oversaw the healthcare transformation lab there. And our CFO, Bert Zimmerley, brilliant guy. Such an innovative CFO's. Just a rare, rare guy. I was in his conference room office one day and my boss was there, Mark Propes, great CIO. And Bert looks at me and he says, Hey, do you have a process for how you work with these smaller s companies and how you make decisions? I said, Yeah, I do. And he said, You do? I Yeah, sure do. Do you wanna see it? He said, Yes, I do. 'Cause r remember he wanted me to be capitally efficient. And I said, Well, when do you want it? One of the greatest Statements ever in my career. He said, Isn't your office about 50 feet that way? I said, Yeah. He said, Well, if you have it, go send it to me now. I was like, ooh. So I walked to my office, emailed it to him. It was 43 lines. The first one I sent was 43 lines. That thing's almost 10 pages now. But here's my point: you need a playbook for how this works in a system. Because if not, you have this onslaught of all these early stage companies. If you don't have a problem list that you're trying to solve as an organization, if you don't have rules of engagement, first question is, do we have a contract with a large company that prevents us from working with this company? Just ask the question. Don't hope. Just ask the question. If the answer is yes, go to the next one. But you need a checklist that shows that you govern the onslaught because you're right. There's so many great innovative companies, but if you don't have a playbook for how you engage the external world as a large system, you're disappointing the market. And you're wasting internal time and money trying to field all of ⁓ Well, your framework. Well, and it's all about having, you know, there's a lot of remarkable technology out there that never gets seen because it listen, most small companies don't have the knowledge, number one. And number two, the bandwidth. I mean, just the work and the effort that goes into that value analysis committee process and dealing with eight ⁓ point four different stakeholders on every new technology offering. Yeah. You know, takes its own sales process by stakeholder. So, you know, it used to be, you know, I remember in the days when I first got into medical device sales, I literally would call a doctor, he'd say, bring it in, and I'd go to the hospital the next day and I might check in or I might not check in. I might go right to the OR or the CAF lab and bring my bag in and ⁓ use one, two, three, four, five, ten different things during the procedure, fill out my my invoice and have the the cath lab manager or the OR supervisor sign the paperwork, walk it down to procurement and collect the PO and I'd be on my way, right? Yeah. And and today, you know, you you can't get into a hospital system without going through a rep tracks machine. You can't go into an OR OR without getting a red hat put on your head. You can't, you know And that's if you just get through the value analysis committee process. But now you have That's right. Now you have not only a clinical stakeholder, you have a department stakeholder, you have procurement, you have finance, you have legal. If it's software, you're gonna be dealing with IT. If it's software, you're gonna be dealing with IT security. You know, you're gonna might be dealing with you know, some sort of chief medical officer or nursing officer, depending on what your product lines are. You have department heads. Then you have staff and stakeholders who, you know, training and all this stuff that that comes into new technology decisions. Small companies, that's a tough road to host. Let's just be like really, really real about that. That's a that's a big burden. And going back to some of our earlier conversation was, you know, the GPO framework might actually have you know, a pathway for that, that again, most small companies don't want to give up anything on the pricing side and go to a GPO. But if there are innovation and new technology categories that GPOs can support and make it easy for hospital systems to adopt, that might be an interesting angle to take. So tell me a little bit more about that opportunity. That's a great question, Terry. When I think about a company, an image always comes to mind for me. Alex Osterwalter, one of the he's been one of Thinkers50 for years, created this concept called a business model canvas. And so I think through the structure of a business model canvas and in two elements of that. There's what's your get, keep and grow strategy, how do you get customers, keep them grow? But there's also this other really interesting one that's related. What's your channel to those customers? And to your point, early stage companies often worry about the tax of a vision or a premiere. 3% tax, 5% tax, whatever it is. But I would remind them that's a channel because within Visiant, for instance, they have a breakthrough innovation category. Premier has something that they call very similar to that, to where you submit your product into their process, and they have customers who sit on their committees and review these technologies and they'll give it a stamp of a breakthrough innovation or not. But let's say that you get it and it's a breakthrough. Well, you just got the credibility of Visiant, what are they in sixty something percent of the hospitals now and premieres probably right there? But that's a process and a committee that you don't get to present to, by the way, is you give their representative your content, you teach them about it, and they represent it for you. And so there's really this interesting currency of credibility that if you can make it through that. And they say, yeah, this is a breakthrough innovation. Then by the way, in like in September, Visiant has a day at their annual conference to where your product will get highlighted. And the reason that I offer is your question provoked it, is that don't overlook the credibility of a rigorous process that could stamp you as an innovative product. And then all of a sudden that GPO becomes your channel, a five percent cost channel to I mean, look, man, hiring salespeople, you know, is really difficult. And if you can use a channel to get into dialogues that only cost you five percent when you sell something, I mean it's free until you sell something. And so I just think you can't overlook that in today's world because a lot of these large companies are he quotes kind of outsourcing a lot of their work to Visiant or Premier just to say, okay, what should we even look at? Let's only look at Vizyant's breakthrough innovation technologies this year. You just quieted all the friction for a health system by going to visit Premier. I don't know if the research group has it quite that way, but I know advocates process is incredibly rigorous. They partner with Premier with their GPO. And of course HP G man, if your board thinks you're gonna make it through HP G in a year, you're you're bored smoking something. Yeah. And by the way, HCA reminds me of Hemingway's book, Old Man in the Sea, I think is what it was. You know To where he goes out and he catches this really large fish and it gets eaten by the time he gets back. And you think why not just stay close to the shore and catch some brim? Right and everybody wants HCA, but I would argue probably a bad place to start because they're so big, they're so complex. And to your point, can you really handle them? You gotta be very careful as an early stage company who you handle. reason I bring that up is a lot of those companies that use the GPO like a premiere or Visiant are sometimes a little bit smaller. Sometimes and it could open up a channel to where you can start building an economic model an argument that you could use to go to the bigger ones. You just have a really clear strategy on what your get, keep and grow approach is. Not just gonna burn money. And they all and they all have different, you know, sort of value offerings to technology and suppliers, right? And I think You know, HDG and HCA has always been looked at as the most vertically compliant organization. You know, once you got in, then it was a really good thing for you because then you're on a formulary that has a standard of care initiative and that makes it very, very appealing versus sometimes these other systems are a little less vertically integrated. They have a little more flexibility around what they can use when they use it, type of thing. And so I think but to your point. using these channels as and guilty as charged, you know, not wanting to go take things to the GPO because, you know, you didn't really understand the value proposition very well. Most small companies don't want to use a GPO because theoretically, historically, they've not offered a lot of value in terms of being able to do anything for you. Okay. Like I mean, really make it happen. That's the one thing about HPG and HCA is that once you're there, they tend to push for you. Right. They then they try to to perform on that basis. Where the other GPOs get things on formulary and and a an allow choice. Right. And that's kind of where, you know, unless you have the infrastructure to do it. But most companies today, I think this is what's really going to resonate with today's leadership. If it's if they can take anything from our conversation today, here's what I'd like them to walk is understanding that the GPO may not be it's going to get you to the other side. But the door will be open and allow you to get to the other side yourself where the door is not going to be shut. And so finding ways to befriend and create value for these GPOs with these new technology offerings where you can make them look good as well might be a really interesting pathway and and not to have this previous known notion of don't want to go there because I'm just giving away my money. All right. Cause that's the thought process. And At the end of the day, you're gonna you're gonna end up discounting anyhow. So you're gonna end up giving away the money regardless. So do it in a way where you're actually getting some value for it and maybe you can you can make that value analysis committee process a little more efficient or efficient. Yeah, it's great advice, Terry. What is interesting to me now compared to maybe ten years ago is to your point, these GPOs are part of the system and they're becoming more intertwined. I mean, even look at Vizions like quality scores and all the things they do now. They've expanded their tentacles into health systems very effectively in the design of a really good exchange of value. And so to some degree, you just have to accept that that's the way it is now. And then you almost ask the flip side of the question. There are two ways to think about this. You brought up something where they worry about the five percent tax, but you give a pricing schedule through Visiant or through Premier, right? You say, okay, if you buy zero to ten, it's this price or up to a thousand, it's that price. So you kind of set it in a way that could protect you and you can build in that five percent fee somehow and you'll be fine. But then if I were to ask you, say, hey Terry, if Visiant could help you sell five million dollars a year of your device or your solution, would you be willing to pay them after the fact that they brought the money in? Would you be willing to pay them three percent of that? And you'd be like, ⁓ bro, really? Like that. Yeah. Every day. You would pay it. And so I think it's the mindset of it is not what they're taking from you. Because if you just look at an align item in an Excel spreadsheet, they're taking something from you. But if you zoom out to your business model and you think about what are the channels, how do I get eyes on my product in a credible way? And how do I get, keep and grow without having a really expensive channel, I think they're I really think they're a great value to smaller companies. That's my experience. And it really sounds like that's a really interesting pathway. I think so. Let's pivot on a conversation here. Let's pivot on a topic. So let's talk about like the pace at which hospitals actually buy. And let's talk about you've been in I mean, you're in the boardroom, you're a CEO. What's it like on the other side when you're watching these companies struggle? Like, you know, and they're burning cash and you know, you're you're trying to like you finally have spent all your money getting something to market, by the way. Yeah. Right. So you've you've spent money on innovating an idea. You spent money on developing a product from a manufacturing perspective. You spent money going through a regulatory process and now you're you're there. You're there. Okay. And now now the run rates aren't happening the way we wrote it up on the PowerPoint deck. And you know, and cash is burning, the capital's burning. What happens? Tell me like what happens when that clock and that cash start looking at each other. Stress levels go up a magnitude of 20x. It's rotten. I think a lot of times companies are built on assumptions. I'll go back to that argument. We believe that if we do this, it'll work. And then I say, okay, do you really have to build it? I'm going to give you I think maybe a story may illustrate this. When I was at Intermountain Healthcare, a nurse came to the transformation lab, and this is right before I joined the transformation lab. And said, we need a watch or something to remind us to wash our hands. And so what do you think the engineers in the transformation lab did? They were there to innovate. So they built a watch. Built a watch. 3D printed, most amazing watch you've ever seen. It was smart watch before watches were smart. It knew if you had washed your hands in the right way, that chip had been chain trained, and so they built a watch. And then of course there was a financial analysis that said, ⁓ look at how many nurses there are, how many watches we could sell. Damn. And so then you sit around and you say, hmm, what has to hold true for the watch to actually deliver clean hands? And so we got in this room, this little this little circle. And I decided to use some of the learning that Steve Blank had taught me. He's a father of the lean startup movement. Came up with this concept, a leap of faith assumption. What has to hold true? And so I asked the team, I said, Hey, look, I'm kind of new to the project, but what has to hold true for the watch to deliver value? And so the engineer's like, Gotta be waterproof. Yeah. Someone said has to tell time? Yeah, maybe. Has to change colors when you've washed your hands, blah, blah. It's like, I don't think that's it. Like, what do you mean? I actually believe they gotta wear the watch. The leap of faith assumption is they have to wear the watch. The other leap of faith assumption is that they are allowed to wear the watch. So in OR, a NICU, a PICU, any type of ICU, you can't wear jewelry, right? Right. The reason I bring up the story is that in the early formation of a company, You really need to do the assumption burst because you may make it through FDA, but FDA doesn't build a business, it just builds approval. And so vet those assumptions that you actually believe, especially behavior assumptions, context assumptions. Write those down, vet them, and you might not have to spend any money. We never had to build a watch. We didn't have to spend thirty minutes building a watch if we were to just walk the halls, which is what we did. Four different hospitals watched, walked the halls. Nobody the young nurses didn't wear watches. the guy who ran the hospital wouldn't buy the watches and in areas you couldn't wear the watches. And so I think that example is something that organizations need to think about. But now when you get to the point, let's say you're you got a great product, I sat in a room in Charlotte four years ago with the CFO's right hand person and it was a capital allocation meeting. And I was blown away 'cause I'd sat in a number of those and I looked at the request, Harry. I was like, My w how are we going to get through this? And my buddy said, We're not We can't get through it. So what you mean? He said, Todd, by the time we get down about 20 lines, we're going to be out of money. And so there was this whole prioritization process and they ran out of money. Why do I share the story? Early stage companies worry so much about who they're competing with. That's the wrong way to think about the world. You don't I don't care if you're competing with Medtronic. I I don't care. What you're competing against is the allocation of time and money inside of a system. You may be competing competing against them buying new ambulances. You may be competing against them hiring nurses. And so what you have to figure out is or whatever whatever's happening, right? Like Exactly, Terry. So when the the reason that I shared is you asked me like what's the perspective? I've been the CEO of a med tech company and I've sat inside those meetings. And so you have to have this ruthless focus on articulating your value that's so clear. that you could win out over a new ambulance, a new helicopter, whatever other requests are coming in, and then you got attention units you're competing with. And so if you don't frame it to the clinical problem that you talk about and the business problem and how you make it safe to buy, you really have to think like a system thinks versus thinking like a startup. ⁓ we're going to sell this, we're going to exit for $200 million. Stop thinking that way. Document how the system thinks and then Pray to God that your board believes you. And what's the best way? I have I have my thoughts on this, but so now we're sitting here trying to create the value proposition stakeholders. Yeah. But there's many things that come in front of before you even begin to do your value proposition, before you do your proposal, before you align my product does here's your five problems and here's my five solutions, and they all line up, right? Right. Yeah. What do great innovators of technology and these startup companies need to do before that even happens? Is it a discovery process? Is it like landscaping? Like what do they do to take inventory of all the things that are necessary to be to help you be successful when it comes to the value alignment meeting? Like who do you talk to? When do you talk to them? What what types of information should you be seeking out that put you in a position to be successful. You worked with Abbott. You know this. Because even your question alluded to it a little bit. So I had the fortune of knowing Clay Christensen. And I remember he told me one day and he and a his brilliant partner in crime and thinking, a guy Bobby Mesta, said think about the movie. The reason that I say that is that if you don't understand the friction in context that is caused by the absence of your product. Like why do current solutions fail? Well, what friction is caused because you're not there? The current products do what? I believe that you have to be able to articulate the problem in context in a way that the people who will eventually use your product in context would agree with, and the people who would buy it would agree with it. And so you've got to spend you mentioned the word discovery. Be an archaeologist of the problem. I almost think about it as painstorming. So many early stage companies get into brainstorming. Throw that away for a little while and just go search for friction. Go search for the friction in context and then the friction in the PL caused by the friction in context. Because right, you know this your your the podcast is just so ar articulated so well. Friction, friction radiates. Friction radiates for burnout, friction radiates on the P and L. And so go understand that friction and design your product and your business model to remove it. If you do that homework really, really well and you're willing to hear things you don't want to hear but that are true and facts, you're gonna be far ahead. Versus just believing your idea is gonna solve a problem that nobody really believes. Well, it's a difference between, you know, ha having a hammer and running around looking for a nail, right? Yeah. Or or having a toolbox and actually You know, understanding what your your your client needs. And I use a framework, and I actually have built it into my AI systems for discovery processes for a sales process. And I use Keenan, which is gap selling methodology, which is all around understanding what the gap is. And so where is the pain? Where is the friction? ⁓ where is the coming from? And not even talking about product in that. Like that really is truly just taking inventory of, you know, from a healthcare perspective, patient care, patient process, workflow, financial implications, you know, human resource allocation, whether it's training, whether it's time, whether it's room turnover efficiency, all these things to get that played into that and having the right framework and understanding to ask the right questions to Put the customer in a psychological mindset, by the way, to be open with you as well. Because you also have to get them to admit there is pain. And most people don't like to admit psychologically that they have pain. Correct. Right? So you have to build a framework, you have to build a process, you have to be intuitive and asking and and bring empathy, not just questions to the table. But I understand that must be really painful. That must be really hard. I can understand why that's a challenge. Right. Using that type of language provides freedom, more freedom for the for the customer to actually outline for you what is really going on. Because if you walk away from the meeting getting false information, your alignment's never gonna hit. Like your value and your pain point, they're gonna get the value analysis committee and be like, that's really not a pain point. And you're s and you spent all this time trying to align to this and this and this and this, and all of a sudden they're not hitting. Right. So That discovery process to me is the biggest part of actually aligning the value down the road. And if you don't do the discovery, I promise you, you're never gonna align on the value and it's never gonna connect anywhere. And by the way, now you have to do it eight or four times because you have eight point four stakeholders, by the way. Right. You know what's interesting that you bring up made me think about a two concepts. A concept of why versus what in the way we ask questions. The second concept of this notion of a love metric. So one of my favorite books is from a guy named Chris Voss. Never split the difference. Exactly. I use his methodology as well. Love his book. Yeah. And in some of his writings, whether it's in the book or I read his post, he talks about the problem of asking someone why. And so for instance, why do you do it that way? If I were to ask you why did you choose to move to Florida? What's your first word typically when someone asks you why? It puts you in a defensive mechanism number one. So you're you're playing. There go. You play you say because. As soon as someone says because typically their dukes are up, man. They're in defensive mode to your point. But if I were to say, hey, it's cool you moved to Florida, what led you to the decision? What criteria did you use? What were you considering when you did that? Then you're gonna start talking and what you said made me think about this. You get in deep dialogue with them. And that's where you wanna be, because that's where the learning is. And don't be scared of that. And then you almost have to say, well, what would be good about that? And the what would be good about that question leads you to the concept that a dear friend of mine taught me. His name is Roy Rosen, called a love metric. If we did this perfectly, this product worked perfectly for you, what would you love to have changed? And they may say, Well, but no, I didn't leave a device in a body, or they may say, Well, I would know that they're Stitches are not gonna get infected. Whatever it is, I would love that. And then we would say, Well, what would be good about that? Versus asking why is that important? What would be good about that? What would the measure of that be? What would that change for you once you leave the hospital? Well, I would get to go to my kids' soccer games on time. The reason that I bring this up is you bring up this word empathy. Empathy, I think, is the heartbeat of healthcare when it's done well. But I also think if you can get to the love metric. And you measure that and you show how your product is delivering to the clinical and experienced love metric into the financial love metric. And if you can reflect that every quarter or twice a year to a customer, you win. You absolutely win and you'll create word of mouth. But the generic measures that we use today, man, they just don't work that well. And so to your point, go to the context and learn it so deeply that you know the language, the friction. You gotta go see it. Right? Because movement in an OR, you've been in an OR, you've watched people get frustrated and they didn't say a word. And you're like, hey, what what just frustrated you? Cause you saw it. And then you got to ask the five what's, not the five whys. And get alignment on the love metric. If our company delivers to you, what would you love to have changed? You get those metrics, you're like, okay, we can commit to those. Bingo. It takes time, it takes a patient, board. But if you do it, you have longevity and then I think you'll get an exit with a Medtronic, an Abbott, a J and J. But without that unique approach, you kind of just a you're another person on a long list trying to get money and attention from a health system and there's nothing unique about you. In the gap is the love metric. That's a good point. In the gap there is a love metric. Yeah, right. 'Cause something's like hey, that you gotta close the gap. How do you close it? You gotta give me something that I would love because the gap is I'm here, I wanna be there, but Current state versus future state, right? So you have current state versus future state. And that love metric is somewhere in the middle where if I could do this, would you love that? Right? Kind of element. That would close your gap. That would close your gap. Because sometimes a love metric is born out of understanding the friction. Takes too much time. Well, how much is too much time? Well, what would you love? I would love it if I could do it in two minutes. Okay. I mean if you I I I like how you frame it, Jerry. If you get in the dialogue long enough, empathetically get in the dialogue. You can learn what you need to learn to serve your customer and when. The fundamentals of that will never go away. Authentically empathetic too is one thing, you know. It can't be can't be viewed as scripted. It can't be viewed as like, you know, they're just going through their list of questions for me. You really have to kind of, you know, take a challenger's mindset of truly understanding the problem before you even walk in the door, right? Yeah. In some way. So you can frame your conversation, have some sort of element of which takes intelligence, you know, and I think this is like for me, I use AI every day. I don't think most sales organizations are doing this. So there's a couple things that you mentioned. So I use Keenan's Gap methodology for my discovery framework. Right. Okay. I also use Voss, I use Jet Blunt, and I use another guy named Claf. And I program all that into my communication processes as well. And basically the types of conversations that I'm having with my customers. The AI will actually pull out that relevance of that methodology and neuroscience and plug it into the communication piece and build these frameworks for that. And so, like the whole game point plan is like if you're not using AI through these processes as well, you and I are talking about like how to use your brain a little bit, but like using AI to create an intelligence framework for yourself. Using AI to build consistency. around that framework and build a system with AI, right? Plugging it into your communication channels and actually plugging your AI in and teaching AI how to use these methodologies with your customers because they are effective. You don't have to remember to use them anymore. You just tell the AI what you want out of it and it interprets the communication, the process, and it builds it in a framework where then you have to use your mind too. You have to look at it. You have to scrub it. You have to make it your own. But it's there. Because I'm going to go on another avenue. If you don't think the healthcare system's using AI against you when you're walking in the door, you're crazy. They ⁓ they already know what doctors are using what when they're using it. They are all day long. They've already laid up the competitive landscape of your technology versus the other five. And they already know the benefits across the board. They know the market shares. They know the preferences. And you're walking in to I wouldn't even say I I used to say like as a device supplier, we used to walk into gunfights with a knife, right? Now I think we're walking into not just we're you're walking into an artillery battle with a knife these days. And if you're not using AI to elevate yourself around intelligence of what's happening in their world and intelligence to actually helping you frame what's going on and actually testing yourself versus your competitors, by the way. Mm-hmm. Like, you know, saying, if I were the customer looking at this company and I used X, Y, and Z, you can actually use AI to say, This is what they're going to actually say about you. Yeah. You what you boy, what you're talking about now, I believe that med tech companies you're gonna shoot me for this, maybe. Maybe not. I believe what you just mentioned is a service that med tech companies should hire. And the reason that I say it is that's so comprehensive. And if it gives you a direction and it doesn't work out, hey, I can do even do a pre-mortem. You could say, hey, we did this, it didn't work, tell me why. And it has this incredible ability to analyze tens of thousands of factors in ten minutes. As I think about startups, med tech companies to your point, if I ever did it over again, I would look for someone like you who I could say, Hey, look, I really need to build a branding, communication, and marketing function. But I can't hire a quarter of million dollar marketer and I can't hire 10 salespeople for 200 grand because I have to be capitally efficient. What should I do? And I think that that service is, you know, you're gonna arm 10 salespeople who could support five companies, all supported by AI who understand the context of, say, Venus Access or something to do with a heart. To me, that's the new model or sh it's that model should really become far more prevalent with med tech companies than trying to hire the old traditional sales get on an airplane type model all the time. Like, yeah, you were like the artillery thing, man. You're fighting you're fighting surveillance. Mm-hmm. Man. I mean I know of a company, Terry, that hired twenty something salespeople. Now think about the expense of twenty something salespeople who are all probably demand a base starting of a hundred and fifty. To go with an early stage company. So you're burning at least three million more. Way more. Plus benefits and they're flying thirty percent on top for benefits and expenses. And then add travel. It's even worse. Like I know someone the other day that flew from Tampa to Augustus and spent fifteen hundred bucks. But you think, okay, so that activity still needs to be done. Branding, marketing, communications, it still needs to be done. But now what's the new way of doing it that prevents you from burning money and time that doesn't need to be burned, but getting to an insight way faster than you ever could. Sub agents, you know, if you're using Claudia, you develop out sub agents or whatever. But I I I think you're I think you're spot on and right onto something that I mean you clearly know the industry incredibly well, but rethink your get keep and grow strategy and rethink it in the way that you're rethinking it. I think that's the future of med tech companies. And I think investors are going to savvy up to this pretty quick. It's hard though, 'cause healthcare is a always been a human to human connection and it's you know, it's it's hard to let go of, you know, the days in the OR when you were representing, but you know, the mere fact is there's a couple of things happening in the market. One is it's virtual meetings are easier to have, number one. Number two is the new buyer does not appreciate human to human connection the way a millennial or a Gen Z buyer does today either. So These guys want asynchronous relationships. They'd rather learn on YouTube. They'd rather learn eighty percent of today's buyer journey is done eighty percent digitally and twenty percent human contact. Twenty years ago, it was literally flipped. And so, you know, they don't prefer people. Okay. They prefer to learn on YouTube. They prefer to learn on an app. They prefer to do things differently. And so The bottom line is for these medical device companies, you have to figure out where to be, when to be, and how to be where your buyer wants you to be, when how they want you to be. And that is harder today than ever, ever, ever before. You said something that made me I remember this movie so much. I was in an O R when I worked for Atrium. And this wonderful nurse, Christine Sisk, she has her doctor now, Dr. Sisk, hosted me to go into these ORs so I could go learn. I wanted to go see how hemodynamics was managed. And I was an internal guy. Remind I I led innovation there. I was an internal guy. So I'm in what I call the bunker. It's at the head of the bed where all the anesthesiologists sit and watch everything about you. And I'm at the head of the bed and there's an open heart. Double valve replacement. Hearts on bypass. Dr. Skipper, a wonderful human, looks up at me, said, Who are you? I said, I'm Todd Dunn. He said, I don't want to be rude, but what are you doing in my OR? And I said, Doctor Skipper, I work for the company. Christine hosted me. I'm just here to learn. I'm here to observe. I'm not here to talk. And he said, Okay, I'm glad you came by to learn. He said, feel free to ask me questions, no problem. But I went into four other ORs that day. Every single lead physician asked me what I was doing and this goes back to your point. The old way of going into ORs and just walking in and thinking you're gonna get to observe when you're a early stage company or an outsider. People forget it's sacred and I think it's getting more sacred because the onslaught of requests that these doctors and nurses have from all these companies. I think they just want to be in their OR and do their job. I really do. Skipper was nice enough to me, but to your point, hey, go learn about it on YouTube. Get on a video, learn to ask really good questions to try to put together the movie without thinking you need to go in a sacred space and learn it. That's hard. But I would also say I think, Terry. That healthcare systems need to have people dedicated to doing ethnographic research on behalf of the company. Meaning your job is to spend time in the ORs for the next two weeks. You're in the ORs full time learning. You're a mouse in a corner. You're recording, you're writing down, and you're learning the friction in the OR or in the transition to the floor, and you're going to come back and unpack it. And then we're gonna have a problem list of things we're gonna solve for and we're gonna go to the market and we're gonna go find the answer. And so then you you put this you you put this kind of control in place, but to what you're saying, like the Kenan and all of that, that's the future of where this is going. Healthcare systems are gonna get more insular, and if you don't do what you're saying, Terry, they're gonna be a bunch of dead med tech companies along the way that use the old model. That's a shame 'cause there's a there's a lot of great technology out there that's just getting stuck, you know? Yeah. And by the way, think about like if let's say I call Jesse Terry, I got this med device company. Dude, I don't have money to hire ten salespeople to cover the regions. Or if I just break the company into four regions, I don't have ⁓ and I can't find them anyway because the really good ones are making great money and I can't hire ⁓ away. Can you help me develop out branding, communication, and marketing strategy? And give me the insights that I need to do to shape my business model for a dime on a dollar compared to doing that. And you would probably say, Yeah, I can do that. Right. How much time you just save me? Well, it's and you build consistent patterns and you know, but I just know that there's a lot of things in today's marketplace where, you know, venture capital and private equity want to come in and g and offer tens of millions of dollars. And there's certain stages when both owners aren't ready to go take that on. I mean, they don't want to become They don't want to become employees of another organization at that point. They they they started a company because they wanted to be a founder and an entrepreneur and they wanted to to run the show. And so, you know, but then there's that there's this gap being created today with money where, you know, if you need five or six million dollars, that's probably the hardest chunk of change to go find. Because it's not growth capital, it's test capital. Right. And and and the reason that I separate the two to greatest term by It's a really great term. It's test capital because you're still trying to test how you build out a scalable, repeatable, profitable business model. Yeah. And to your point, twenty million is growth capital, typically. Right. Now maybe when you get into some of these therapeutics, it's you're still doing heavy, heavy research. But test capital needs to be the most capital efficient money that's out there. And if you're hiring salespeople for quarter of a million dollars a year and they're out in an airplane testing for you when a sub agent could do homework on the entire world for you in thirty minutes. And and find you people with the right here's the other thing too is it can actually find, you know, people with intent. Like it it it finds buyers with intent. There's so many signals in the marketplace that you can now use AI to say, these group of people are interested in what you're doing, right? Which then allows you to engage with some sort of phone call or email and then allows you to qualify on the phone and allows you to have conversations. Focuses. And so that you're not wasting okay, there's there's the fifteen hundred dollar, you know, flight from Tampa to Augusta, by the way, you probably have to go to Atlanta to do it. So you're probably spending six hours, like, you know, one hour to drive the airport, an hour to wait at the airport, you know, an hour to fly and then another hour to wait and then another hour and then a and then a rental car you'd burn a whole day to Like, you know, that's a trip that you might even go like it's a better for me to even drive, right? So like you've it's not just the money that you spent, but you've actually burnt time that you'll never get back in the world again, by the way. So that's the one that's the one yeah thing asset in the world that you cannot actually buy is time. It's once it's buried, it's gone, it's done, right? Gone. Yeah, you just it man, what you're saying, I'm just keep thinking through the model. You're redesigning business models. It I mean, I tell you this company, twenty something salespeople, it blew so much money. And and these are good people, right? I mean that that the sad thing about these are good people who are trying so hard to sell something. But imagine that company could have had five part time people armed with the insights of AI subagents telling them, You should probably call that group in Spokane, Washington. They just posted something about their interest in this. Here's the person, call them. I mean, you're like you're literally laser targeting, you're guiding the missile in. And I that's the way to do it because if not, you're really scattering so much money and time and you're just hoping that one of these things will land for you, but you I think about your measure. You're probably gonna have a great measure for this. The cost of customer acquisition. Yeah. I mean you you're gonna have a measure that says your old way used to cost you half a million, new way's gonna cost you fifty grand in five months. But you You're yeah, love that model that you're talking about. It's got my brain turning. But you can find people who are interested in this topic, but AI can find it for you. It can every day. It it does every day. It doesn't my business anyhow. You should all you should have this service for s med tech companies. Well, that's kinda what I do. I mean, that's part of what I do is I bring AI to med tech companies every day from an architecture perspective. But there's this new concept that I I think there's just talking to a lot of early stage companies that I know are struggling for like what do I need what do I need to do to get this thing to market? They have approval. They have approval and they don't have the money to go hire twenty or thirty people. They just don't. And don't. And you gotta go figure out and like one's not gonna get it done. And you know, it's just like you've gotta figure out where how can you go hire a partner. It's gonna help you get it done, that knows the industry, not just the clinical side, but the business side, the GCO side, the value analysis committee side. I mean, there's all these complexities that get thrown in front of these small companies. And it's not just friction, it's inertia too. It's a it's there's just all sorts of, you know, things you've gotta plow through that it's hard to be an early stage company. It's easier to listen. Making the product and g and getting the idea and going to a manufacturer and getting it through the FDA used to be the hard part, okay? Not anymore. Not anymore. Like that is actually the easier part of the whole equation. The hardest part is now I have approved now. Now what? You know what's interesting, Terry? That part is so known now. Like I mean, I even think AI could help speed that up. But of course it can. It's known. Like, yep, these suppliers in China do this, these suppliers in Costa Rica that you can find it. Here's the FDA book. You know it. Like, ⁓ but now how do I sell it? How do I GTM go to market? It's a big thing. It's a big thing. It is so hard. I love that, man. That's so brilliant. I mean, you're gonna have some companies are gonna win because you help them. And they're gonna and you know, part of it is you're gonna buy them runway too. I mean, money runs out. It runs out faster than most startups think it'll run out. But if you could buy them six months because they didn't have to hire a big sales team, think about what you can do in six months now with that type of ⁓ of a digital team helping a really sharp person. So you take one fractional salesperson and you turn them into a team of 10. Or or just work with GPOs and get value analysis committee processes started without a sales team yet. And that way you're not you mean, you know, because what you're going to deal with at a certain point in time is, you know, you can use data that says, okay, here's the the 10 markets I should go after because these are where the procedures exist. Whether you use definitive data or IQVIA data or Med Scout or you know EQ at EMD, they all have data that says, here's where I should go. Here's where not only from a hospital perspective, it'll tell you the doctor percentages of It's mind blowing. Like, you know, who does what? So you can actually landscape everything out on paper. You can build your game plan, you can build a communication plan, you can digitally start engaging today. Right. Yeah. And then and then when you are ready to go, you've already mapped out a great deal of that process. You still have a lot of work to do, but at least you've got it mapped out and you can execute against it. So anyhow. So many deviating, but like I I just it's great. Any great dialogue. Well, any other things today as we're kind of like wrapping things up here, Todd, what would be what would be one piece of advice you would give to a founder or a CE of a med tech company? Bringing something to market that truly has impactful value to a healthcare provider system. What's the one piece of advice? May I give two? You can ha I'll give you one extra one, sure. Really understand if you have a board, or even if you don't have a board, really understand the profile of who will be on the board. I cannot overemphasize the importance of that for your company and for your lifestyle. If your board wants to meet with you every day, your board chair, you're probably in the wrong spot with the wrong board. Cause that means they don't trust you. Don't trust you, get out. The second thing I would say is exactly what you alluded to. Get a plan in place so that you can know if it's working or not. Because if you're just working your butt off and you don't have a plan that you can look at to see if you can refine or alter along the way, you don't really know if you're getting better as a company or not. Third thing I would say, I'll stop with three, is rethink the models. See search out expertise like yours. Cause as a CEO, your your job is not to hire people, your job is to grow the company. And so rethink methods of go to market, get keep and grow, channels, but reach out to really rethink models based on where the world is today versus where maybe you want it to be or where it was even two years ago. I would say rethink the model in the most capital and time efficient way that you possibly can and test those models first. That's what I would do. Love that. And that's a mic drop, guys, on Todd Dunn as he finishes up the podcast. I do have one more question for you, but it's a personal question. And so if current day Todd could go back to 22 year old Todd coming out of college. All right. And I'm only gonna give you one here. So you don't get two and you don't get three. You're just gonna get one answer. You can give younger Todd one piece of advice, whether it's professional, personal, financial, whatever it might be. What would that one piece of advice be? Do a better job of patiently harnessing your irascible attitude toward the status quo. Say that again. Be patient, harnessing your irascible attitude toward the status quo. Be patient. Be patient as you're trying to make things happen, right? Yeah. Yep. Don't get frustrated. Stay true. Stay on the code. Take a little longer. You kept harding hitting on it. It really brought to mind. Change takes time. Stay irascible with the status quo. It's the only way the world gets better. But also, take a big breath. Be patient with it. If you think it's going to take three years, be okay if it takes you five. Well, Todd, thank you so much. What a great man. Day. I can't wait. I think we're gonna get three episodes out of this one. So I appreciate you being on and it was a lot of fun. And I I really truly am better off after this conversation than when we started it. So thank you. Me too. You man, you've got my brain cranking. I wanna if we can find time over the next month about what you're doing inside of AI around those agents to find those insights. What you said is like, yeah, I can find people who care about what you're doing. Mm-hmm. Go like what? I'd love to learn more for you because I've got I'm working on something interesting. And what you said is like, bing, man, do that. Med tech companies need what you're doing. I'm just telling you. It's that's the hardest damn thing about a med tech company. Is where do I target? What's my go to market? Efficiently as I can, as fast as I can, without hiring a bunch of people. Yeah. Good for you, man. Way to go. Good to see you. Good to see you too, Todd. Thank you. Hey, thanks for the time, man. 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