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FITM Extended Interview: Charlie DeCook · AHF Podcast

• 0:26
  Charlie DeCook: My name is Charlie DeCook.
• 0:27
  Charlie DeCook: I'm the president of Total Joint Specialist, a 17 surgeon Group here in Atlanta, Georgia.
• 0:32
  Charlie DeCook: I'm super excited to be on the AHF Podcast today.
• 0:37
  Joseph M. Schwab: So Charlie, you have an impressive, we'll, we'll say entrepreneurial track where you've uh, I think successfully exited seven companies.
• 0:47
  Joseph M. Schwab: Um, and I want to ask, as a busy surgeon.
• 0:50
  Joseph M. Schwab: How do you find the time and motivation to be a serial entrepreneur?
• 0:56
  Charlie DeCook: Uh, I think you have to create time.
• 0:59
  Charlie DeCook: You know, we, we go to what's most important in our lives.
• 1:03
  Charlie DeCook: And for me, the ability to create, uh, to create new markets, new products is the most exciting thing I do.
• 1:10
  Charlie DeCook: I mean, I'm, I like operating.
• 1:13
  Charlie DeCook: I've been a surgeon for a long time now and do lots and lots of surgeries.
• 1:18
  Charlie DeCook: To be honest with you, my main passion now is about, um, disrupting markets, creating new technologies.
• 1:25
  Charlie DeCook: Um, I think that's gonna be kind of my lasting legacy, is that, so I'm super focused on that right now.
• 1:32
  Charlie DeCook: To give you an idea of kind of how I divvy up my time.
• 1:36
  Charlie DeCook: I do about 1500 joints a year, but I do that all at about three days a week.
• 1:42
  Charlie DeCook: So, you know, a as you know, you know, efficiency is super important to me.
• 1:46
  Charlie DeCook: So I want to totally value the time I use and spend.
• 1:51
  Charlie DeCook: So I put all my clinical practice into three days a week, and then the rest of the time, I mean, weekends, nights, I mean, this is just what I love doing is learning from other founders.
• 2:03
  Charlie DeCook: Learning, uh, what's in the market and kind of developing new technologies, that's what really drives me.
• 2:10
  Joseph M. Schwab: Can you tell me a little bit about your first venture outside of your clinical practice?
• 2:15
  Joseph M. Schwab: How did you get involved in this?
• 2:18
  Charlie DeCook: Yeah, the first one, um, really wasn't my idea.
• 2:21
  Charlie DeCook: So the idea of surgical impaction came from a, a very dear friend that's actually become my real mentor in life, at least from an entrepreneur perspective.
• 2:33
  Charlie DeCook: They came to me with this idea that they had been working on for about six years already.
• 2:39
  Charlie DeCook: And, uh, really I just helped along the way.
• 2:43
  Charlie DeCook: Um, I, I found out that I was pretty good at storytelling and, uh, that storytelling really helped us sell the product.
• 2:52
  Charlie DeCook: Um, the product sold itself, but as you know.
• 2:56
  Charlie DeCook: You can't just have a good product.
• 2:58
  Charlie DeCook: So this one happened to be surgical impaction and uh, it was, uh, called Medical Enterprises and it eventually sold to Johnson and Johnson, I think maybe, gosh, I think seven or eight years ago now.
• 3:11
  Charlie DeCook: And it became what we all know now as concise.
• 3:16
  Charlie DeCook: Both Concise one and concise 2.0.
• 3:18
  Charlie DeCook: So, um, that was kind of the first real successful exit for me, um, was that product right.
• 3:28
  Joseph M. Schwab: Walk me through the DeCook filter.
• 3:31
  Joseph M. Schwab: So when an an early stage idea comes, uh, you know, comes to you, how do you determine if it achieves that sort of holy grail trifecta of easier, faster, better?
• 3:43
  Charlie DeCook: Ah, yeah.
• 3:45
  Charlie DeCook: Easier, faster, better.
• 3:46
  Charlie DeCook: Yeah.
• 3:46
  Charlie DeCook: The, the book that everybody knows is smarter, faster, better.
• 3:50
  Charlie DeCook: And, you know, I never was that smart, so I thought easier, made more sense to me.
• 3:54
  Charlie DeCook: Um, honestly, my filter has changed over the years.
• 3:58
  Charlie DeCook: I used to be so excited by so many products.
• 4:01
  Charlie DeCook: I mean, you'll hear Steve Jobs talk about this all the time, which is you have to have the discipline to say no to a lot of great ideas because there are just a ton of great ideas that surgeons have that engineers in our, in our medical device space have.
• 4:17
  Charlie DeCook: They're just fantastic ideas, but I think, you know, reality hits and you realize there's not really a market for it or nobody's gonna buy it.
• 4:26
  Charlie DeCook: So, uh, my filter has totally changed.
• 4:29
  Charlie DeCook: I would say yes to just about anything, you know, eight to 10 years ago.
• 4:32
  Charlie DeCook: And I'd just say, yeah, I'd love to help you with it.
• 4:34
  Charlie DeCook: Let's develop it.
• 4:35
  Charlie DeCook: Let's bring it to market.
• 4:37
  Charlie DeCook: Now I'm super, super selective and it's really based on the market and where I think the market's going, right?
• 4:44
  Charlie DeCook: If it's not ai, if it's not robotics in some way, then I'm really not interested.
• 4:53
  Charlie DeCook: Um, you know, the.
• 4:56
  Charlie DeCook: The market, not just a medical device, but obviously the entire world is going to this AI and robotic space.
• 5:03
  Charlie DeCook: And if it is not touching one of those two things, then we probably shouldn't be doing it.
• 5:09
  Charlie DeCook: So, uh, it's, that's my filter now.
• 5:12
  Charlie DeCook: I mean, if it's not AI related or if it's not, um, somehow related to, uh, a robot, then I'm not that interested.
• 5:21
  Joseph M. Schwab: So you also emphasize that innovations, or you've emphasized in the past that innovations drive greater value.
• 5:29
  Joseph M. Schwab: They have to drive greater value for patients and, and healthcare.
• 5:32
  Joseph M. Schwab: And how do you, uh, when you're looking at these new technologies, ai, robotics, whatever you're looking at.
• 5:38
  Joseph M. Schwab: How do you weigh improved patient outcomes against, we'll say commercial necessity and cost?
• 5:47
  Charlie DeCook: Yeah, well, I think probably surgical impactor is the best example of this, where I think people get the wrong idea.
• 5:54
  Charlie DeCook: When we were developing the impact, or there's a lot of people and academic people saying, Hey, listen, you have to prove out that this thing creates less fractures, that it does this or that, or look at ergonomics or things like that.
• 6:07
  Charlie DeCook: And they took a very appropriate, uh, stance, which is, Hey, you need lots of research to prove out these things.
• 6:14
  Charlie DeCook: But we knew fundamentally the reason why surgical impaction would be adopted.
• 6:19
  Charlie DeCook: It's'cause frankly, it made it simpler for the surgeon.
• 6:24
  Charlie DeCook: It's, it may not ever prove out that it's better for the patient.
• 6:28
  Charlie DeCook: As long as it, as long as it proves out that it's at least as good as using what we've been using for 3000 years, which is a, you know, a mallet or a hammer, then I'm good with it.
• 6:39
  Charlie DeCook: So I think this idea of bringing value to the patient is great.
• 6:44
  Charlie DeCook: Oftentimes when you bring a product to market, even successful products, other products that we sold that have become successful.
• 6:52
  Charlie DeCook: Even when you do that, it's hard to ever prove out it does any better to a patient.
• 6:57
  Charlie DeCook: Let's take for exa example, first generation robots.
• 7:01
  Charlie DeCook: Look at all the money that is spent on first generation robots in the hip and knee space, and there's been never any conclusive evidence that does squat to help the patient one bit, right?
• 7:14
  Charlie DeCook: It's all been about capitalism, market share.
• 7:18
  Charlie DeCook: That's what it's truly been about.
• 7:20
  Charlie DeCook: Now, do I think in the future, do I think robots are going to help patients?
• 7:26
  Charlie DeCook: I do, but that process takes forever.
• 7:30
  Charlie DeCook: You know, it just takes so long to prove these things out, right?
• 7:33
  Charlie DeCook: We're eventually gonna prove out that a robot does better than manual instruments for a hip or for a knee, because we're gonna eventually know where the target is.
• 7:43
  Charlie DeCook: We all know that robots hit a target better than we can manually, even with the fluoroscopy and anterior approach, but that just takes a long time to prove out.
• 7:52
  Charlie DeCook: It's same with the overall cost, structure and value, right?
• 7:57
  Charlie DeCook: People always freak out about the cost of a particular technology early in in the lifecycle, and I never really worry about that.
• 8:05
  Charlie DeCook: I always think back to when my dad bought his first.
• 8:09
  Charlie DeCook: Flat screen TV and it was like$10,000.
• 8:12
  Charlie DeCook: I mean, it was ridiculous in like late eighties, early nineties, right?
• 8:16
  Charlie DeCook: He was willing to spend$10,000 on the stupid tv.
• 8:21
  Charlie DeCook: Right.
• 8:21
  Charlie DeCook: And what do we get'em for now?
• 8:22
  Charlie DeCook: I mean, we can give'em for like$400 on Amazon.
• 8:26
  Charlie DeCook: Right.
• 8:26
  Charlie DeCook: So the great thing about, uh, Adam Smith taught us about the invisible hand of capitalism, which is it eventually pushes competition to the point where those, the value will find itself.
• 8:40
  Charlie DeCook: So always when I start with a product, I always start with a big vision.
• 8:44
  Charlie DeCook: And those other market pressures will work itself out like finding, um.
• 8:49
  Charlie DeCook: The right thing for the patient.
• 8:51
  Charlie DeCook: Finding the overall value, that stuff eventually works itself out in the market.
• 8:55
  Charlie DeCook: Your job to bring in new product to market is not to worry as much about those things.
• 9:01
  Joseph M. Schwab: So you mentioned AI and robotics.
• 9:04
  Joseph M. Schwab: Why the strategic shift from, say, optimizing physical devices to these sort of more digital solutions?
• 9:11
  Joseph M. Schwab: Is it just the market that you think is driving that way, or are there other factors?
• 9:17
  Charlie DeCook: Well, physical is harder, right?
• 9:20
  Charlie DeCook: So we've sold multiple companies that are physical products, right?
• 9:25
  Charlie DeCook: They're um.
• 9:26
  Charlie DeCook: Hardware, they're difficult to do.
• 9:28
  Charlie DeCook: They're expensive to make.
• 9:31
  Charlie DeCook: Um, it, it is a much harder company to form around a hardware than it is a software.
• 9:36
  Charlie DeCook: Just ask Elon Musk in creating a car manufacturing, right?
• 9:41
  Charlie DeCook: That is a ridiculously hard thing to do, right?
• 9:45
  Charlie DeCook: It costs, it's lots of capital to do it, and software is just so much easier to do.
• 9:51
  Charlie DeCook: Now there's obviously a lot of downsides to software.
• 9:55
  Charlie DeCook: Software will, will, will ru rule out every single time.
• 9:59
  Charlie DeCook: Um, I, I just think with AI today, there's just so many incredible things AI can do for us that everyone has to pivot there now, as long as you supplement it with something else, I don't care if you're gonna create a new hip stem or a new knee femur or whatever the case may be.
• 10:17
  Charlie DeCook: It just has to be supplemented with something AI related.
• 10:20
  Charlie DeCook: Right.
• 10:22
  Charlie DeCook: It has to either work with a new robot or it has to be related to those in order for that to make sense in 2025 and beyond.
• 10:30
  Joseph M. Schwab: Hmm.
• 10:31
  Joseph M. Schwab: So is it your work in the operating room that inspires your innovations or do you try and keep those separate?
• 10:40
  Charlie DeCook: I think they totally inspire me because I, I am so terrible at picking products outside of orthopedics.
• 10:49
  Charlie DeCook: Like, forget it, like you ask me anything in general surgery or, uh, you know, dermatology or anything outside of healthcare, I just suck at it.
• 10:59
  Charlie DeCook: Right.
• 11:00
  Charlie DeCook: You, you develop this inner instinct of what will work and what will not work in an operating room.
• 11:05
  Charlie DeCook: I think.
• 11:06
  Charlie DeCook: I think the moment I ever try and, you know, work with products outside of that, it fails every time.
• 11:11
  Charlie DeCook: So, um, for me, I do get all kinds of inspiration and it's really based on the work of Clayton Christensen and his innovator's dilemma.
• 11:21
  Charlie DeCook: And he, you know, he.
• 11:23
  Charlie DeCook: Basically has the theory of jobs to be done, and that is every surgeon has a job to be done in the operating room.
• 11:31
  Charlie DeCook: And it's funny to me how many products get this wrong?
• 11:34
  Charlie DeCook: They don't really look at what we are actually doing in the operating room.
• 11:38
  Charlie DeCook: You could tell, you could see all these products that even make it the market.
• 11:42
  Charlie DeCook: You know, they may even be bought by a large company, but they end up failing because you fail to recognize the job, the true job to be done, right.
• 11:50
  Charlie DeCook: We're hiring products all day long in our operating room to do a specific task like impacting.
• 11:57
  Charlie DeCook: Right.
• 11:58
  Charlie DeCook: Surgical impaction is the perfect example of that where, listen, I've been hiring this hammer for, you know, my entire career, right?
• 12:06
  Charlie DeCook: And no one ever thought to question that job to be done, right?
• 12:10
  Charlie DeCook: Same with everything else, like how you look at a cup, or how you look at soft tissue tension, or, you know, whatever the case may be.
• 12:17
  Charlie DeCook: We're hiring things all day long in the or.
• 12:20
  Charlie DeCook: Can we look at that job to be done a little bit differently than we did before?
• 12:24
  Charlie DeCook: And I think that's what Elon Musk has done a great job of.
• 12:27
  Charlie DeCook: You know, if you think about the satellites he's put up in the air, if you thought about the chip, he's put in people's brains.
• 12:34
  Charlie DeCook: I mean that that kind of looking at things from a different perspective, I think really is the key to having a unique, innovative product.
• 12:42
  Joseph M. Schwab: Hmm.
• 12:43
  Joseph M. Schwab: Is there a venture that you've participated in that didn't really go as planned?
• 12:48
  Joseph M. Schwab: And if so, were there any lessons you learned from it?
• 12:53
  Charlie DeCook: Knock on wood there has not been yet, so don't jinx me here, Joe.
• 12:57
  Charlie DeCook: I'm sure it will happen.
• 12:58
  Charlie DeCook: I think good old luck will eventually run out for me.
• 13:02
  Charlie DeCook: Um.
• 13:03
  Charlie DeCook: And I think probably the reason why is that we continue to just be super focused and I will not quit until we got a product that works.
• 13:13
  Charlie DeCook: And oftentimes that product changes, right?
• 13:17
  Charlie DeCook: Um, we have an initial idea that's like, oh yeah, that made a heck of a lot of sense.
• 13:22
  Charlie DeCook: Kinda like, um.
• 13:24
  Charlie DeCook: Airbnb is a perfect example, like Airbnb and those guys came out with this idea for just one weekend at a conference to rent an air mattress, and they called it a bed and breakfast, right?
• 13:36
  Charlie DeCook: And that name still sticks today, right?
• 13:39
  Charlie DeCook: They thought this was a one weekend thing to help pay them rent for the month, right?
• 13:43
  Charlie DeCook: And they were working on what's the next big idea, and they didn't realize that they had that big idea the whole time.
• 13:49
  Charlie DeCook: Now they pivot away from an air mattress, right?
• 13:52
  Charlie DeCook: They pivot away from.
• 13:54
  Charlie DeCook: From a lot of the core idea over time, and you'll see that in almost every product that comes to market, there is one or two major shifts or pivots when they realize that wasn't such a good idea.
• 14:09
  Charlie DeCook: There's, there's one part that really makes a hell of a lot of sense, but really we're gonna have to super pivot right now and make a different product.
• 14:19
  Charlie DeCook: Um.
• 14:20
  Charlie DeCook: So that's happened in, I would say the majority of companies we've eventually sold.
• 14:25
  Charlie DeCook: There's been a few that have been dis same the entire time.
• 14:27
  Charlie DeCook: We didn't have to make any pivots, uh, because of market pressure.
• 14:31
  Charlie DeCook: But oftentimes, listen, you have a great idea and product, but there's market pressures that start to happen, and then you realize, oh gosh, you know, AI is here now we, we no longer need that particular product, right?
• 14:42
  Charlie DeCook: Or in the world of robotics, why in the world would I develop manual instruments anymore?
• 14:47
  Charlie DeCook: That kind of thing.
• 14:48
  Joseph M. Schwab: so speaking of that, you've, you've also successfully leveraged collaborations with some large established industry partners, and if you were to give some specific advice for things like protecting your intellectual property and maintaining control of your core innovation while you're working with large device companies, what advice would you give?
• 15:13
  Charlie DeCook: Oh boy.
• 15:14
  Charlie DeCook: I've got a ton here and I'm, I, I need to do this.
• 15:16
  Charlie DeCook: So I, so, I'm politically correct here.
• 15:19
  Charlie DeCook: I, I would say, first of all, the most important thing you should do is trust.
• 15:22
  Charlie DeCook: No one.
• 15:24
  Charlie DeCook: I would not trust partners.
• 15:26
  Charlie DeCook: I would not trust, uh, collaboration of a big company, and I certainly wouldn't trust anyone within an organization with your ip.
• 15:36
  Charlie DeCook: I really wouldn't.
• 15:37
  Charlie DeCook: And it's not because there's nefarious, you know, but, uh, these companies don't have an ethos in and of itself.
• 15:46
  Charlie DeCook: Right.
• 15:47
  Charlie DeCook: They are just acting for themselves, which I think is totally reasonable.
• 15:51
  Charlie DeCook: But don't, I mean, we have had companies yet to be named here that will not be named, that have literally tried to steal our IP and create their own companies and they're, you know, a knockout product.
• 16:03
  Charlie DeCook: Right?
• 16:04
  Charlie DeCook: We literally have had.
• 16:05
  Charlie DeCook: Several companies of which we know that have tried to do that.
• 16:09
  Charlie DeCook: You know, and again, it's nothing personal by individual people or acts, but it's, I would not trust people to do that.
• 16:19
  Charlie DeCook: Um, you know, I think the mistake you make is, um, you start to trust a big company and then you realize number, I, I think the biggest mistake you, you don't realize is that they're giving you a slow no.
• 16:34
  Charlie DeCook: Every company, um, especially if you're a surgeon, right?
• 16:37
  Charlie DeCook: If you're a surgeon, they don't want to upset you, so they're going to give you slow no.
• 16:42
  Charlie DeCook: For the, for 12, 18, 24 months, right?
• 16:45
  Charlie DeCook: They're gonna string you along because they don't wanna say no to you upfront.
• 16:50
  Charlie DeCook: Um, it's important to you recognize that very quickly.
• 16:54
  Charlie DeCook: I I, if you have a developed product and you bring that to market.
• 16:58
  Charlie DeCook: And, um, they're stringing you along.
• 17:01
  Charlie DeCook: It's either one of two things, either they're so inept internally, which often happens.
• 17:06
  Charlie DeCook: Every company, the big three, every single one of them is inept.
• 17:09
  Charlie DeCook: Internally, there's just so many different levers and so many people making decisions.
• 17:14
  Charlie DeCook: It's hard to tell, but number two, it may be that they really could care less about your product.
• 17:20
  Charlie DeCook: So you, you have to kind of tease that out early on or else you're gonna have, uh, years and years of pain.
• 17:27
  Joseph M. Schwab: Is that the most surprising thing you found on the business side compared to the clinical side, or is there something more surprising?
• 17:37
  Charlie DeCook: I think the most surprising thing is that these companies are so focused on quarterly numbers.
• 17:47
  Charlie DeCook: They're public companies.
• 17:49
  Charlie DeCook: They're so focused on their quarterly numbers that they don't have the luxury of.
• 17:56
  Charlie DeCook: Looking at this from a 5, 7, 10 year timeline, they don't have the luxury of saying, gosh, this is the product that would be really great Five years from now, they just don't.
• 18:08
  Charlie DeCook: Right?
• 18:08
  Charlie DeCook: Everyone has to have decisions.
• 18:11
  Charlie DeCook: I don't, from that CEO down, every single person can no longer make those five year calls anymore.
• 18:19
  Charlie DeCook: They are lucky if you, if you can get them to see 12 months from now.
• 18:23
  Charlie DeCook: Let alone five years from now, right.
• 18:25
  Charlie DeCook: They are dealing quarter to quarter and finances changes every quarter.
• 18:31
  Charlie DeCook: I mean, I can think of all these pro uh, projects they were involved with within these organizations, and they would kill projects based on the last quarter's numbers.
• 18:43
  Charlie DeCook: Right.
• 18:45
  Charlie DeCook: And you, I think that was the most surprising to me is that.
• 18:49
  Charlie DeCook: Their inability to look long term or even medium term.
• 18:55
  Joseph M. Schwab: Yeah.
• 18:55
  Joseph M. Schwab: So I wanna pivot a little bit to talk about the AHF Shark Tank.
• 18:59
  Joseph M. Schwab: Which you've talked with us about before.
• 19:02
  Joseph M. Schwab: 'cause this is a program that really targets kind of these early stage entrepreneurs and specifically authorpreneurs ones who are seeking sort of solutions that are kind of ready to disrupt right.
• 19:13
  Joseph M. Schwab: In the operating room.
• 19:15
  Joseph M. Schwab: What specific characteristics beyond, say, clinical utility, define an idea that you think is ready to, we'll say, swim with the sharks.
• 19:28
  Charlie DeCook: Yeah.
• 19:28
  Charlie DeCook: For me, I think the first, second, and third and last decision has to be the right financial model.
• 19:39
  Charlie DeCook: Um, you have to have a model in which you can't.
• 19:42
  Charlie DeCook: It's no longer the case where you can have a cool product and one of the big three is gonna buy it and they're gonna take it over from you.
• 19:50
  Charlie DeCook: That is no longer the case.
• 19:51
  Charlie DeCook: You have to, because.
• 19:54
  Charlie DeCook: It's no longer on pull through on implants anymore.
• 19:56
  Charlie DeCook: This is about can you create a product that other companies are gonna be able to sell?
• 20:03
  Charlie DeCook: So it is hard for the big three to sell anything other than an implant.
• 20:08
  Charlie DeCook: Right.
• 20:09
  Charlie DeCook: Trying to sell a technology or a robot is very hard in this market because of the constriction of price.
• 20:18
  Charlie DeCook: ASPs are dropping and there's less and less fluff in the system.
• 20:24
  Charlie DeCook: So as a result of that, your product literally, you're gonna have to be able to sell your product to, um.
• 20:31
  Charlie DeCook: Hospital organization to a surgeon.
• 20:35
  Charlie DeCook: Right.
• 20:35
  Charlie DeCook: That's, it's gonna have to be a legitimate product that surgeons are gonna actually be willing to spend money on.
• 20:41
  Charlie DeCook: Right.
• 20:42
  Charlie DeCook: And there's not a lot of products out there, right, right now.
• 20:46
  Charlie DeCook: Right.
• 20:46
  Charlie DeCook: We all know, um, at least in the US I know, Joe, you're in Europe now, but in the US you know, it's financially so tight now that, I mean, I look at how much it costs me to, for our bobi or our suction.
• 21:00
  Charlie DeCook: You know, if, if, if you expect me to buy a technology for my operating room, it better darn well make me smarter, faster, better.
• 21:10
  Charlie DeCook: It, it's gotta hit all three now.
• 21:11
  Charlie DeCook: It used to be just one, right?
• 21:15
  Charlie DeCook: You know, surgical impactions one.
• 21:17
  Charlie DeCook: Things like joint point or ortho grid, that's another one that's gonna save me time.
• 21:22
  Charlie DeCook: I'm willing to spend them money to do them, but it, it's gotta prove that pretty effectively, it can't it.
• 21:29
  Charlie DeCook: We just don't have the money anymore in healthcare to be able to do it any other way.
• 21:33
  Charlie DeCook: That means the barrier for entry is so much higher now for a product.
• 21:37
  Charlie DeCook: You have to have something pretty darn innovative in order for one of these companies to purchase it from you.
• 21:44
  Joseph M. Schwab: In terms of the pitch that they give to the sharks, what types of pitches do you see that tend to succeed and what might be some common mistakes that you see?
• 21:57
  Charlie DeCook: Yeah, it.
• 21:59
  Charlie DeCook: I, I think the best pitches that I've seen so far at Shark Tank include probably a tag team, because inevitably the personality of the surgeon, they may have a great personality, they may be great at presenting, but they literally have no idea about the business model.
• 22:15
  Charlie DeCook: Right?
• 22:16
  Charlie DeCook: So for me, I think it's a, a tag team affair where you have the right business people that can talk to the sharks.
• 22:24
  Charlie DeCook: Because I would say the vast majority of surgeons just do not have the financial backbone or a wherewithal to really play with those sharks.
• 22:33
  Charlie DeCook: So I think you have to bring your CEO with you.
• 22:36
  Charlie DeCook: You have to bring the people that are knowledgeable enough to to fight with those sharks because our sharks are getting better every year.
• 22:43
  Charlie DeCook: Our sharks are being tougher on our.
• 22:45
  Charlie DeCook: Our applicants and our products.
• 22:48
  Charlie DeCook: So I think you have to bring someone that really knows the finances, really can make a compelling argument to the sharks other than just a cool product, right?
• 22:58
  Charlie DeCook: Uh, US surgeons are more interested in the product than we are the financial model oftentimes, and the sharks will just eat them up.
• 23:07
  Joseph M. Schwab: So speaking of the Sharks, how important is it that these are sort of top industry executives within the orthopedic space and.
• 23:17
  Joseph M. Schwab: Does that, uh, validation by those sharks help accelerate, uh, sort of global adoption of some of these technologies?
• 23:26
  Charlie DeCook: I gotta tell you, the value to these, um, surgeons that present to the Shark Tank is so huge when I listen to these.
• 23:34
  Charlie DeCook: Sharks kind of ask questions.
• 23:36
  Charlie DeCook: Um, it is so valuable the questions they're asking because, uh, inevitably these surgeons or these, uh, entrepreneurs have never really thought about the question they get asked, and it is so valuable.
• 23:50
  Charlie DeCook: Because they have, they bring years and years of experience.
• 23:53
  Charlie DeCook: I mean, I think of some of the sharks we've had recently.
• 23:56
  Charlie DeCook: These guys have literally been in orthopedic med device space for 30 years.
• 24:02
  Charlie DeCook: The, you know, they just bring so much.
• 24:05
  Charlie DeCook: They have been pitched so many different products and they've had the.
• 24:09
  Charlie DeCook: Personal pain of having to take a product, you know, and actually sell it within their company.
• 24:15
  Charlie DeCook: They've done that so many times that they have just so many great ideas and questions for the sharks.
• 24:21
  Charlie DeCook: Um, I, I couldn't be happier with their sharks.
• 24:25
  Charlie DeCook: We've had, and we continue to have, we have super high quality sharks and they're, that brings so much value to the entrepreneur.
• 24:32
  Joseph M. Schwab: Yeah, you mentioned it, it sort of towards the beginning, AI and robotics, but are there other specific areas of innovation?
• 24:40
  Joseph M. Schwab: That you hope the AHF Shark Tank will help attract and foster say in the next five to 10 years.
• 24:48
  Charlie DeCook: I was shocked last year that we didn't have more AI type products.
• 24:51
  Charlie DeCook: So I, I am hoping for more AI type products.
• 24:55
  Charlie DeCook: Um, you know, when we think about robotics, we think about the entire platform, right?
• 25:00
  Charlie DeCook: We think about a surgical arm, but there's so much more to robotics than that.
• 25:04
  Charlie DeCook: You know, if you think about, um.
• 25:06
  Charlie DeCook: Different companies have looked at, um, pinless navigation.
• 25:11
  Charlie DeCook: They look at the changing the end effectors, changing the AC actuators.
• 25:16
  Charlie DeCook: All these things are super important for the robots.
• 25:18
  Charlie DeCook: So it doesn't have to be an entire robot.
• 25:21
  Charlie DeCook: It can be one part of a robot, right?
• 25:23
  Charlie DeCook: It doesn't have to be even a robot That.
• 25:25
  Charlie DeCook: Does the cuts.
• 25:26
  Charlie DeCook: It could be a humanoid robot that's, uh, assisting in the operating room.
• 25:31
  Charlie DeCook: It could be a humanoid robot that's mopping the floors between cases or turnover.
• 25:36
  Charlie DeCook: I think the other thing that I'd love to see more of is we've totally ignored the logistic nightmare of medical device.
• 25:44
  Charlie DeCook: By that I mean we have totally.
• 25:46
  Charlie DeCook: Turn a blind eye to the fact that we're losing so much money, bringing all these implants to every case.
• 25:53
  Charlie DeCook: I would love to see more and more technologies that are really focused on how we get the implant to that operating room.
• 26:00
  Charlie DeCook: Um, I think that is pretty critical.
• 26:02
  Charlie DeCook: And then our last thing I would say is we still don't have a good data solution.
• 26:07
  Charlie DeCook: We have all these kind of sloppy post-op recovery apps and platforms, but we don't have really a good end-to-end data collection where I can really take actionable data and change how I operate.
• 26:21
  Charlie DeCook: Um, I think that.
• 26:22
  Charlie DeCook: I think that to me would be exciting.
• 26:25
  Charlie DeCook: Um, and there's obviously a thousand others that I haven't thought of.
• 26:28
  Charlie DeCook: So, um, there's a lot of incredible products out there that we don't know of yet.
• 26:34
  Charlie DeCook: Um, but we would love to, we would love to see, uh, uh, on Shark Tank.
• 26:41
  Joseph M. Schwab: you've been really generous with your time.
• 26:43
  Joseph M. Schwab: I just have two additional questions for you, um, based on your career.
• 26:48
  Joseph M. Schwab: If you were to come up with what you think might be the single most important piece of advice you could give to a surgeon currently sitting in their OR who's frustrated with inefficiency and believes they have kind of the next great orthopedic solution, but don't know how to start, what would you tell them?
• 27:11
  Charlie DeCook: Yeah, I would, I would tell them to, um, focus.
• 27:17
  Charlie DeCook: By that, I mean, you have a good idea now you have to take the next level, and I don't think surgeons realize how much time and effort is required to refining your idea.
• 27:28
  Charlie DeCook: Um, and to continue to pivot.
• 27:30
  Charlie DeCook: Continue to iterate on that idea, right?
• 27:33
  Charlie DeCook: And then once you get, once you're comfortable with your, your idea, then you need a financial model that makes sense.
• 27:39
  Charlie DeCook: You should not go to any fundraising, spend a dollar until you have a financial model that can make sense, right?
• 27:47
  Charlie DeCook: Like I said before, you can have great products that are never gonna sell.
• 27:51
  Charlie DeCook: Right.
• 27:52
  Charlie DeCook: You have to have the financial model.
• 27:54
  Charlie DeCook: Once you reach those two hurdles, a great product and a financial model, then you have to find a team that's gonna surround you, right?
• 28:01
  Charlie DeCook: Because you know very little.
• 28:04
  Charlie DeCook: I know very little.
• 28:05
  Charlie DeCook: Everyone knows very little about one particular area.
• 28:08
  Charlie DeCook: You need to surround yourselves with the right business folks and financial folks that are gonna help you.
• 28:13
  Charlie DeCook: Achieve this reality.
• 28:15
  Charlie DeCook: Um, so I would say those three things.
• 28:17
  Charlie DeCook: Make sure your product is right.
• 28:18
  Charlie DeCook: Make sure you have a financial model and surround yourself with the right team.
• 28:23
  Charlie DeCook: I think if you do that, then you can take it to market.
• 28:27
  Charlie DeCook: Then you can talk to the big three.
• 28:28
  Charlie DeCook: Then you can talk to medical device companies that may wanna buy it.
• 28:32
  Charlie DeCook: We try and exit so early in the process like, okay, I've written down a napkin idea here.
• 28:39
  Charlie DeCook: Do you think you'll buy this from me?
• 28:40
  Charlie DeCook: Now, you know that that kind of idea I is will never happen.
• 28:46
  Charlie DeCook: You have to spend literally countless hours pouring over the idea, refining it, and then putting in your own money to do it.
• 28:55
  Charlie DeCook: Don't, don't, don't, don't go to the big three, two, early in the process.
• 29:01
  Joseph M. Schwab: And I, I just want to close kind of with a single thought from you.
• 29:04
  Joseph M. Schwab: So if you could finish this sentence, innovation in orthopedics means, what would you say?
• 29:12
  Charlie DeCook: Innovation orthopedics means doing things differently than we ever have before.
• 29:18
  Charlie DeCook: Looking at jobs to be done in our operating room or outside the operating room in which we're helping patients and doing it differently and better than we have before.