Latest / Becker’s Healthcare Podcast / Dr. Anthony Andre on Human Factors, AI and Designing Safer Healthcare Technology

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Dr. Anthony Andre on Human Factors, AI and Designing Safer Healthcare Technology · Becker’s Healthcare Podcast

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- There's a small circle of people who truly
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- For the agenda and event details,
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- visit beckershospitalreview.com
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- and click on the events tab in the
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- upper right.
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- This is Scott Becker with the Becker's Healthcare
0:54
- podcast. I am thrilled today to be joined
0:56
- by a brilliant
0:57
- leader. We're joined today by doctor Anthony Andre.
1:01
- And doctor Andre is the director of Interface
1:04
- Analysis
1:04
- Associates and just an absolutely brilliant person,
1:07
- in functional medicine in a whole bunch of
1:09
- different areas,
1:11
- robotics,
1:12
- a a a very,
1:13
- deep and brilliant person.
1:15
- Doctor Andre, Anthony, can you take a moment
1:18
- and introduce yourself
1:20
- and tell us a little bit about what
1:21
- you do?
1:23
- Yes. Thanks, Scott. So I my main occupation
1:27
- is I own, as you said, a consulting
1:30
- firm called Interface Analysis Associates,
1:33
- and we are a human factors consultancy
1:36
- that specializes
1:37
- in health care
1:39
- products and systems.
1:41
- We've been in business for thirty three years
1:43
- located in Saratoga, California.
1:47
- And
1:48
- what we do is we apply the behavioral
1:51
- science of human factors, which is a discipline
2:07
- And
2:10
- safer, and more satisfying
2:12
- for people to interact with.
2:14
- Talk for a second about sort of what
2:16
- I I really wanna know. I I've known
2:18
- you for a long time and a brilliant,
2:20
- brilliant person. So so I really wanna know
2:22
- first how you got into this? How did
2:24
- you end up in this area? I know
2:26
- you've always been literally brilliant.
2:28
- And then what is human factors and why
2:30
- are human factors why is this important to
2:33
- health care
2:34
- health care? And and what what does it
2:35
- mean
2:36
- for those of us that are not
2:39
- physicians,
2:40
- PhDs
2:41
- that haven't spent their life doing what you
2:43
- do? Talk about how you got into this.
2:45
- What does human factors mean
2:47
- and and and why is it important to
2:49
- health care?
2:50
- So I actually got into it by accident,
2:54
- as you know, with both of us at
2:55
- the University of Illinois.
2:58
- I switched majors.
3:00
- I was looking for,
3:02
- like, a general class to just buy time,
3:06
- to figure out what my next move was
3:08
- moving out of computer science and math.
3:11
- And I saw an abstract for a class
3:13
- in the psychology
3:14
- department
3:16
- about applying psychology
3:18
- to the design of products,
3:20
- and it was called human factor psychology.
3:22
- And I never heard of it, so if
3:24
- members of our audience have never heard of
3:26
- it, I completely understand.
3:29
- And that was in the fall of nineteen
3:31
- eighty four,
3:32
- and it's been my whole life ever since.
3:34
- I just caught the bug and fell in
3:37
- love with the discipline.
3:39
- And, you know, it's central to health care,
3:41
- and the easiest way I like to explain
3:43
- it
3:44
- is we seek health care
3:47
- to get better
3:49
- for positive outcomes,
3:51
- and the last thing we want health care
3:53
- to do to us when we seek it
3:56
- is to take steps backwards
3:58
- and actually get injured by health care.
4:01
- And so
4:03
- human factors
4:04
- professionals
4:05
- want
4:06
- people to get better through health care. We
4:09
- want the people who deliver health care to
4:12
- also be safe,
4:14
- have satisfying and usable experiences.
4:17
- And we're just really trying to match product
4:19
- design,
4:20
- not to the way people
4:22
- should behave
4:23
- or should view the world or should act,
4:26
- but the way people actually behave. So we
4:29
- consider
4:30
- the, you know, the human condition, warts and
4:33
- all, in designing systems to be compatible
4:37
- with human beings.
4:39
- You you you like and I and I
4:41
- love that. And and I'm gonna ask you
4:42
- two questions I'm gonna combine.
4:45
- As you work on health care products, you
4:47
- know, to to make sure, like, that's actually
4:49
- being used to how people use it, it's
4:50
- almost like so much of the AI today.
4:52
- It doesn't talk about how it should be
4:53
- used, but how people actually use the stuff
4:54
- to make it functional and usable.
4:57
- Talk for a second about
4:58
- both
5:00
- providers and clinic settings
5:02
- and and products used by patients at home.
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- You work on some of both. And and
5:06
- then talk a little bit about some of
5:08
- the things you've worked on in the last
5:09
- three decades,
5:10
- some of the products you've worked on,
5:12
- and and sort of the you know, where
5:13
- the input is on on your team. Because
5:15
- I think what you do is just fascinating.
5:18
- So
5:18
- we do products and systems both in health
5:21
- care settings and at home, but by, you
5:24
- know, by a large margin,
5:27
- the last decade, the trend is moving health
5:30
- care out of the health care setting. Right?
5:32
- We're sending people after surgery home the same
5:35
- day that used to stay in the hospital
5:37
- for a week.
5:39
- Drug delivery has completely moved
5:41
- to the home setting. People are injecting themselves,
5:44
- even infusing themselves
5:47
- themselves, etcetera.
5:49
- So, we do both,
5:51
- but health care the whole idea of health
5:53
- care is distributed,
5:55
- virtual,
5:56
- telehealth,
5:57
- moving health care, you know, out of health
5:59
- care facilities,
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- which creates kind of new challenges. Right? A
6:03
- lot of a lot of products, a lot
6:05
- of processes
6:06
- weren't designed to be done in the home.
6:08
- They were designed to be done in these
6:11
- clean, sterile, professional settings.
6:13
- And that's why human factors is now more
6:16
- important than ever.
6:18
- We've worked on such a variety of products.
6:21
- I wrote a little list down because it's
6:23
- literally over 2,000 products,
6:27
- dialysis
6:27
- machines,
6:29
- heart pumps and artificial hearts,
6:32
- remote patient monitoring systems,
6:34
- robotics devices for surgery, imaging,
6:38
- ultrasound machines.
6:40
- We once did a blood cooling machine.
6:43
- We designed,
6:44
- helped design a system that maps your eye
6:46
- for LASIK surgery.
6:48
- And so much of the key is that
6:50
- you design these so they actually fit into
6:52
- somebody's workflow and work well with them, So
6:55
- it's not awkward. It really works well with
6:57
- the clinician, well with the provider,
6:59
- well with the patient who's injecting themselves at
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- home or whatever they're doing. The idea
7:04
- is to make the ease of use so
7:06
- much more real and functional,
7:08
- You know? And and so when I talk
7:09
- about I'm I'm obviously
7:11
- was missing the point
7:13
- when I said
7:14
- functional medicine. This is more functional use in
7:17
- every way, like like, truly functional use for
7:20
- interacting with people, how they really interact. There's
7:22
- nothing worse than a product that's great, but
7:25
- it doesn't work well with you because it
7:27
- doesn't work well into your natural rhythm. So
7:28
- that's a lot of how you make this
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- work for clinicians, providers, individuals.
7:33
- Yes. You know, and another way I like
7:35
- to explain it is
7:37
- some great products have theoretical functionality.
7:40
- Like, we can all appreciate, like, if it
7:42
- really worked like that, if it really delivered
7:44
- that, there's a benefit,
7:46
- but that benefit is only realized through the
7:49
- user.
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- The user has to select the right setting,
7:53
- program
7:54
- the infusion pump correctly,
7:56
- you you know, use the product correctly.
7:59
- And so the ultimate functionality
8:02
- of a product
8:03
- is filtered through the lens of the user
8:06
- interaction, and it's that part of it
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- that
8:10
- my discipline
8:11
- is concerned with.
8:13
- And when you look at things from your
8:15
- perspective, I'm gonna ask you two questions again
8:17
- combined.
8:18
- How do you define success in what you
8:20
- do with customers, with people that are developing
8:23
- products, developing
8:24
- instruments and and ideas?
8:26
- And then
8:27
- where does AI have the greatest potential
8:29
- to help here, to help with what you're
8:31
- doing and to expedite maybe what you're doing?
8:35
- So I've always had,
8:38
- two key definitions
8:39
- to success in my business.
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- The first is, easy one, you know, to
8:45
- express
8:45
- that
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- me and my staff are all about making
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- products safer, more usable,
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- more satisfying
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- than when they were introduced to us. You
8:56
- know? So they come into us, and they
8:58
- have to leave in a better state.
9:01
- So, you know, that's
9:03
- our most important success criteria.
9:06
- But the other one that we've really,
9:09
- championed over the last thirty years
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- is
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- navigating the FDA and the regulatory
9:15
- process
9:16
- to help put that now usable product on
9:19
- the market.
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- So we're very proud of the dozens of
9:24
- product approvals
9:26
- that we've helped,
9:28
- obtain on behalf of our clients over the
9:30
- last thirty three years.
9:33
- That's amazing. Amazing. And where is AI gonna
9:35
- help in this area?
9:36
- And and how important is it to have
9:38
- the human in the loop in driving the
9:40
- AI to get the solutions that really work
9:42
- to to discipline and execute through these things?
9:45
- Yeah. So we're doing a lot of AI
9:47
- driven products now,
9:49
- and I liken it to the decision support
9:53
- and automation movements I was involved in in
9:56
- the nineties in the aerospace
9:58
- industry and a little later, you know, in
10:00
- the automotive industry, you know, like we see
10:02
- in,
10:03
- you know, autopilot,
10:05
- like, systems like in Teslas, etcetera.
10:08
- And,
10:09
- you know, AI as an aid
10:11
- to humans
10:13
- has great promise.
10:14
- It could suggest a diagnosis
10:16
- after being trained on a million trials.
10:19
- It could suggest treatment. It could aggregate the
10:22
- spirit data, etcetera.
10:24
- It has great promise, but I think
10:27
- AI should not lead the process. It should
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- be a tool to the human.
10:31
- It should be
10:33
- a partner to the human,
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- but we shouldn't let it run away and
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- replace humans
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- quite
10:40
- yet. And, but I'm very excited. We just
10:43
- finished,
10:44
- a study of an AI
10:47
- assisted,
10:48
- ultrasound,
10:50
- product that, you know, helps you detect where
10:52
- the tumors are. Why not use AI for
10:54
- that instead of having a physician look at
10:57
- it? Maybe maybe make a wrong
10:59
- diagnosis
11:00
- on a ambiguous
11:02
- ultrasound scan.
11:04
- And and let me ask you this question.
11:06
- One of the greatest human success or behavioral
11:10
- success
11:11
- inventions of all time was, of course, the
11:13
- iPhone where Steve Jobs saw differently than the
11:16
- rest of us how you could use the
11:17
- phone screen and work with the phone screen
11:19
- in a way that people didn't envision that
11:21
- would work so well with sort of human
11:23
- factors, with the human piece of it.
11:26
- Is health organizations spend billions of new technology?
11:29
- What separates those organizations that see this right?
11:32
- I mean, we see it so much in
11:33
- the use of new technology, not so human
11:36
- factors, but if it's easy to use,
11:38
- systems and providers and good institutions really start
11:40
- to use it. If it's not easy to
11:42
- use and doesn't work with them, you almost
11:44
- don't get a second chance with it.
11:46
- When systems organizations are doing this well and
11:49
- successfully
11:50
- implementing
11:51
- new devices and software,
11:53
- what separates those that succeed with that versus
11:55
- those that struggle with adoption and clinician acceptance?
11:59
- I think there's three things.
12:02
- And the first will sound self serving, but,
12:04
- you know, it goes back to Steve Jobs'
12:06
- example.
12:07
- It's hiring
12:09
- human factors and design professionals,
12:13
- and not just letting the people wearing suits
12:16
- control the purchase decisions.
12:18
- People that really can
12:21
- figure out what people need even if the
12:24
- end user can't voice that themselves.
12:27
- That was the key to Steve Jobs.
12:30
- Secondly,
12:31
- again, don't get too in love with that
12:33
- the technology
12:34
- alone.
12:35
- Think
12:36
- about how clinicians, nurses,
12:40
- patients would actually use the technology and how
12:43
- well it will fit their workflow or how
12:45
- well they can adapt to a new workflow.
12:49
- And the final thing that's really missing
12:52
- and is a big part of my field,
12:54
- admittedly,
12:55
- my business
12:56
- isn't focused on this, but many I have
12:59
- many friends in the field who do, and
13:01
- that is
13:02
- health care provider safety and usability. In other
13:05
- words, everyone thinks about patient safety,
13:08
- but you wouldn't believe the earned injury rates
13:11
- for surgeons,
13:13
- for nurses,
13:14
- for even just hospital
13:16
- personnel, etcetera.
13:18
- And I don't think hospitals think enough about
13:21
- the impact of a given product or system
13:24
- on their own employees
13:26
- who have to then use that system.
13:29
- Thank you. And and talk for a second
13:31
- about this issue of,
13:33
- you you know, some people are big on
13:36
- surveying
13:37
- people
13:38
- and and trying to get their sense of
13:39
- how they use things, how they look at
13:40
- things, versus some people are so engaged in
13:44
- so seeing how they use them and do
13:45
- things.
13:46
- Talk about that because I've always found that
13:48
- surveys
13:49
- so often are so not useful.
13:52
- But how much is the use of surveys
13:53
- in this versus being so engaged
13:56
- that you really could see in part in
13:58
- communication, of course, with the client what the
14:00
- patient or the physician or the clinician needs.
14:03
- Talk about that. It's like
14:05
- and any thoughts on that? Surveys versus Yeah.
14:07
- I've got a lot of thoughts on that.
14:09
- Yeah. I teach a class about that topic.
14:11
- So people get confused when they hear human
14:14
- factors professionals
14:16
- say, you know, we're all about human centered
14:18
- design,
14:19
- and they run with that, and they say,
14:20
- let's go talk to the user.
14:22
- You know, there's that famous
14:24
- Henry Ford quote. If I ask people, you
14:27
- know, what they wanted, they would have said
14:29
- a faster horse. Right? They couldn't have said,
14:31
- I want a car because they couldn't have
14:33
- envisioned the technology.
14:36
- So you do wanna hear from people, but
14:39
- the best designs come from a trained
14:43
- observer. It's not just what people do or
14:45
- say.
14:46
- It's that getting filtered through someone who is
14:49
- an expert
14:51
- and interpreting
14:52
- user data into a design.
14:55
- And so I agree. I there's,
14:58
- voice of the customer
15:00
- has been an abused concept, I think, in
15:02
- society,
15:03
- and and taken too literally does not lead
15:06
- to effective designs.
15:08
- Thank you. No. I think that's exactly been
15:11
- my experience. So I I love your thoughts
15:13
- on it. You spent a lot of time
15:15
- as editor in chief of the journal
15:18
- Human Factors in Health Care. You're also the
15:20
- founder of the International Symposium on Human Factors
15:23
- in Ergonomics in Health Care, and were recently
15:26
- recognized one of the 10 most impactful
15:29
- experts in this in in the world, quite
15:31
- frankly, or to watch.
15:33
- What drove you, doctor Andre, to become a
15:36
- thought leader in this discipline? And and and
15:38
- I know you said you got so excited
15:40
- about it early on in the class, and
15:41
- I think that just is an amazing gift.
15:43
- But what drove you to have this kind
15:45
- of drive and discipline around this? It's a
15:47
- it's a remarkable thing.
15:49
- Well, I I fell in love with human
15:51
- factors as a discipline.
15:53
- In my early career, I applied it to
15:55
- aerospace,
15:57
- computer,
15:58
- products,
15:59
- software.
16:00
- I was in on the beginning of of
16:02
- the web.
16:03
- But once I fell in love with the
16:05
- application to health care,
16:07
- I really
16:09
- had a drive
16:10
- to build a community,
16:12
- with that same interest.
16:15
- So I'm really passionate about the opportunity for
16:18
- my field of human factors to make a
16:20
- difference,
16:21
- and I actually see no greater application
16:24
- of human factors than in health care.
16:26
- And I wanted to motivate my colleagues to
16:29
- apply their amazing skills to this domain.
16:32
- I wanted to encourage students and young professionals
16:36
- to enter health care human factors,
16:38
- and I realized that
16:40
- I had to I had to help form
16:42
- that community.
16:44
- So that's why I started,
16:46
- the conference in 2012.
16:49
- I tried to be a thought leader
16:51
- and a mentor
16:53
- and and then started the journal,
16:55
- in 2018,
16:57
- I think. And
16:59
- I just want as many human factors professionals
17:02
- as possible
17:03
- to get hooked on
17:05
- health care human factors. And, you know, saving
17:08
- lives
17:09
- is not a bad way to make a
17:10
- living.
17:11
- I I think that's remarkable. I'm gonna ask
17:13
- I'm gonna flip you to a different question.
17:15
- One of the great athletes that I knew
17:17
- growing up, and I'm wondering if there's help
17:19
- that he can get, is is a guy
17:20
- named Kenneth Andre.
17:22
- And Kenneth Andre was a great athlete, but
17:25
- for the life of him, he has a
17:27
- hard time swinging a golf club how it
17:29
- should be swung. Does that mean that he
17:31
- needs human factors
17:33
- advice,
17:34
- or can they design a golf club taking
17:37
- into account the wild athletic swing that he
17:40
- has? Is that doable?
17:42
- You know,
17:43
- there are limitations
17:44
- to even human factor science, and I think
17:47
- my brother's golf swing would probably,
17:51
- extend beyond those limitations.
17:53
- Maybe AI and robotics and some other future
17:56
- technology can help him,
17:58
- but for now, you know, I think we're
18:00
- just stuck with, you know,
18:02
- who he is and how well he plays.
18:05
- No. He is he is a remarkable athlete,
18:07
- but it is sometimes shocking to see that
18:09
- remarkable, an athlete,
18:10
- struggle with the design of the of the
18:12
- the golf club today even with the technological
18:15
- advances.
18:16
- Anthony, doctor Angel, let me ask you another
18:18
- question. You you've lost a recent article,
18:21
- on this famous case about the nurse convicted
18:24
- of doing the wrong medication to a patient
18:26
- that led to an untimely death.
18:29
- How are there key lessons that health care
18:31
- facilities should learn from that case, from, you
18:34
- know, those types of issues?
18:36
- Talk about that for a second.
18:38
- Yeah. It's a really interesting case that everyone
18:40
- should read about, and and it's the case
18:42
- of a nurse at Vanderbilt
18:45
- Hospital called Redonda Vaught.
18:48
- And the way and it's also a showcase
18:51
- of human factors. So the way the world
18:53
- looked at it and the courts
18:55
- is she gave someone the wrong medication and
18:58
- that person died.
18:59
- So they're sitting at what we call the
19:01
- sharp end of the accident and saying, well,
19:03
- that's, you know, cause and effect. Right?
19:06
- The way human factors person looks at an
19:09
- accident like that is we say, wait a
19:11
- second. Yeah. That's the final act, but what
19:15
- allowed that to happen? Right? What allowed her
19:18
- to give the wrong medication?
19:20
- And when we analyze the case, we found
19:24
- seven to 10 factors that all worked against
19:27
- her delivering the right medication.
19:30
- Things like she was a roaming nurse that
19:33
- day. She wasn't dedicated
19:35
- to the department that she was asked to
19:37
- help out in, and in fact, she had
19:39
- never
19:40
- been in that particular department
19:43
- ever before.
19:45
- Things like work shifts and fatigue.
19:48
- She also had
19:49
- to mentor
19:51
- an assistant that day. In other words, she
19:53
- was she had a shadow, you know, like,
19:55
- bring your child to school,
19:57
- to work day that was with her demanding
20:00
- some of her attention.
20:02
- And
20:03
- there's a lot been written about the drug
20:06
- delivery system
20:08
- or the drug cart they're called
20:11
- that she had to go to to get
20:13
- the drug
20:14
- that
20:16
- had problems where when you enter the first
20:18
- few letters, it would suggest the drug.
20:22
- And there's a difference between entering the drug
20:25
- name, the brand name, and the generic name,
20:27
- and you could end up with a different
20:29
- drug
20:30
- given the way you approach that machine. So
20:32
- that machine has a an a dangerous user
20:36
- interface design. And we called out all these
20:39
- other factors that really allowed the accident to
20:42
- happen,
20:44
- And we call that, like, a systems approach.
20:47
- It's also referred to in the literature as
20:50
- a just culture,
20:51
- which is combining individual
20:53
- responsibility
20:55
- with system improvements in a hospital
20:58
- that make medication errors and medical errors less
21:01
- likely.
21:03
- I love that. I think that's so important
21:05
- because it really takes a different look at
21:06
- the person who has, you know, really been
21:09
- in trouble for this when there's so many
21:10
- things that led to that problem
21:13
- that go beyond that her own human action.
21:16
- Let me ask you a totally different question,
21:18
- and and and I'll ask you this around
21:21
- two different things. You've built a practice, this
21:23
- great business over three decades.
21:25
- You know, there's two questions there. Any advice
21:28
- for others building businesses?
21:30
- And second, if you had to buy shoes
21:32
- in the Chicagoland
21:33
- area
21:34
- for a woman, where do you buy shoes
21:37
- in Chicago for a woman?
21:39
- Alright.
21:40
- So first answer,
21:43
- and I'm gonna reference your book, which, you
21:45
- know, I read recently,
21:48
- and not just because we're talking. I love
21:50
- the book.
21:51
- You know, it was it was a trip
21:52
- down memory lane. Right? Because you and I
21:54
- both started small businesses
21:57
- mainly on our own. You know, we had
21:58
- partners at different times, etcetera.
22:01
- And I I really recognize some of the
22:03
- lessons you lived and learned.
22:05
- What I really loved about your book was
22:08
- your central theme that you kept coming back
22:10
- to about being comfortable in your skin and
22:13
- doing what comes natural to you. So many
22:16
- times you're like, you know, you could do
22:18
- it this way and people have been successful.
22:20
- That just wasn't my style,
22:23
- and I didn't go that route. And I
22:25
- I love that. There's a lot to learn
22:27
- in your book. It's so funny you say
22:28
- this. It took me a long time to
22:30
- get there because as you're growing a business
22:31
- and doing things a certain way, you think
22:33
- that that's the way to do that. Then
22:35
- as you get older, more mature, you see,
22:36
- like, well, that guy did a fantastic job
22:38
- or that woman, and they did it in
22:40
- a very different way. You know? And so
22:42
- it's really it was an education for me,
22:44
- though. It wasn't like it wasn't it wasn't
22:46
- obvious to me, but it takes a certain
22:48
- amount of, like, you know,
22:50
- growing up to see, like, there's a lot
22:52
- of different ways to do it. This is
22:53
- just how I happen to do it. But
22:54
- but I love that. I love that. Because
22:55
- one of my favorite thoughts that's evolved with
22:57
- me over the years
22:58
- is, oh, because I used to teach a
23:00
- class on business development, and then I was
23:02
- like, oh, I am missing a whole different
23:04
- way that other people have done it really
23:05
- successfully too and better. But but thank you
23:08
- for that. Thank you. I really appreciate that.
23:09
- But go on. Keep on going. Sounds like
23:11
- that. Well, I mean, I I kinda followed
23:12
- the same way. I mean, you know, it's
23:14
- like a blend. You should learn from the
23:16
- way other people do it and maybe, like,
23:18
- adopt,
23:19
- but, ultimately,
23:22
- you gotta be passionate
23:23
- and run
23:24
- with, you know, your true self being,
23:28
- and that leads to great businesses. That's what
23:30
- you did, and I like to think that's
23:32
- what I did. And then, you know, for
23:34
- me,
23:35
- staying small
23:36
- enough to never bait and switch was a
23:38
- key business quality. In other words, I do
23:41
- all the selling for my company.
23:43
- You know, I'm kind of the figurehead.
23:45
- I never wanted people, like, to, like, come
23:48
- to me. I write a proposal. They hire
23:51
- my company, and they never hear from me
23:52
- again. So I kept my company small enough
23:56
- to be intimately involved in every project,
23:59
- and my customers
24:01
- really recognize that.
24:04
- I know. I love that. I love that.
24:05
- And I always felt in the law practice,
24:07
- once I got a couple people away from
24:09
- the core client that I was that I
24:11
- was never as effective, that it it was
24:14
- and I I love that. And so I
24:15
- always made the effort to be within
24:17
- one to two people of the client so
24:19
- that I wasn't so far away from it.
24:20
- But I hate that when you sell one
24:22
- thing and the client gets a very different
24:23
- thing. I love that point as well. Yeah.
24:26
- I and I read that in your book.
24:27
- And then my final thing I've always been
24:30
- committed to is selling success instead of services.
24:34
- And what I mean by that is,
24:37
- some clients come to us, you know, and
24:39
- they ultimately wanna get,
24:41
- FDA approval and and get on the market
24:43
- with a medical product
24:44
- device or drug delivery device.
24:47
- And we see a pathway that's really fast
24:49
- for them given maybe because their device is
24:52
- already on the market, and they're kind of
24:54
- a copy of something that's been previously approved.
24:58
- And I always sell them the fat the
25:00
- easier pathway. And sometimes they're like, wow. You
25:03
- know? You know? This could be over in
25:04
- two weeks. You're not gonna make any money.
25:07
- You know, other people wanted us to do
25:09
- a year long project, this and that. And
25:11
- I'm like, you know what?
25:13
- If I put you on the market, you're
25:15
- gonna tell 10 people about us,
25:18
- and give referrals to us because we treated
25:20
- you right,
25:21
- and, we were focused on your success. And
25:24
- that has paid off for me,
25:27
- since day one in 1993.
25:30
- Fascinating and fantastic. I've loved watching your professional
25:33
- career evolve. It's remarkable to watch.
25:37
- I don't know if you're gonna dodge the
25:38
- question on Lori's shoes. You can't really watch
25:40
- it. Gonna come to that. That was gonna
25:42
- be my grand finale.
25:45
- But jump into that if you don't mind.
25:47
- Alright. Yeah. It's not just shoes. It's shoes,
25:50
- clothing,
25:51
- accessories. You should follow Lori's shoes and my
25:54
- sister-in-law,
25:56
- Lori on Facebook.
25:59
- They have stores in the suburbs. They're classic
26:02
- original store on Armitage.
26:05
- It's a family business. My brother Brian's involved,
26:08
- their son, Matt.
26:10
- And, it's it's one of you know, we're
26:12
- talking about small business owners. Your book about
26:15
- growing a business,
26:17
- I mean, to be honest, Laurie could have
26:19
- written the book and me and you take
26:20
- a back seat because she created an amazing
26:23
- business
26:24
- that's still thriving today.
26:27
- Remarkable.
26:28
- I I'm gonna ask you
26:30
- I I won't do this. You know, what
26:32
- I what I'd really like to ask you
26:33
- is to give you an update on all
26:35
- the Andres, but I won't force you to
26:36
- walk through it on the entire podcast.
26:39
- But, doctor Andres, what a pleasure to visit
26:42
- with you.
26:44
- We're we're the biggest fans of what you
26:46
- do and of you. Thank you so much
26:47
- for joining us today on the Becker's Healthcare
26:49
- podcast. What a pleasure to visit with you.
26:51
- Thank you. It's great to see and talk
26:53
- to you again. It's been so long.
26:55
- Brings back childhood memories, and,
26:58
- congrats on the,
27:00
- the empire you've built and and the information
27:03
- dissemination you pride provide the health care community.
27:07
- It it's invaluable.