Transcript 0:00 [upbeat music] You need to have an acceptable reimbursement pathway in front of you because it, having regulatory approval means nothing if you can't get paid for the product. 0:16 And so now what investors look for more so than the regulatory pathway is can it get reimbursed, or is it in a space that doesn't even require reimbursement that might be cash only, like aesthetics or something like that? 0:28 That's true. But they wanna be assured that the product can get paid for. Welcome to MedSider Radio, where you can learn from proven med tech and healthcare thought leaders through uncut interviews. 0:41 Now here's your host, Scott Nelson. A few years ago, I had the privilege of sitting down and talking with serial med tech entrepreneur Paul Buchman, who at the time was CEO of Conventus Orthopedics. 0:54 Prior to Conventus, Paul held CEO roles at a variety of startups, including Pathway Medical Technologies, which sold to Bayer Healthcare, and DVX, which sold to Biosensors International. 1:04 From 2004 through 2006, Paul served as president of the cardiology division of St. Jude Medical, and prior to St. 1:10 Jude, he served as chairman and CEO of EV3, a company that Buchman co-founded and was later acquired by Covidien for $2.5 billion. Yeah, that's billion with a B. Uh, that was back in 2010. 1:22 Paul's worked in the medical device industry for over 35 years, including 10 years at SciMed and Boston Scientific, where he held several executive positions before becoming president of the cardiology division at Boston Sci in January of 2000. 1:36 As you can imagine, we covered a wide variety of topics in this, uh, interview with Paul, but here are a few things that really stand out. 1:43 Of all the med tech startups that Paul's been a part of, the two that are closest to his heart [chuckles], uh, two of the many key learnings that Paul recalls during his time helping to build SciMed before Boston Scientific later acquired that company. 1:55 When it comes to product development for med tech startups, why it's critical to be ruthless about prioritization, and Paul's personal rationale for making the leap from president of Boston Scientific's cardiology business to starting EV3 in the early 2000s. 2:10 Uh, we're gonna cover a lot more in this interview with Paul, which I'm sure you'll enjoy, but before we get to it, a few quick messages. 2:16 If you're new to the MedSider interviews or if you wanna follow along, head on over to medsider.com. That's M-E-D-S-I-D-E-R dot com, and you'll be able to do two things. 2:26 One is you'll see an archive of all of the, uh, the previous MedSider interviews that I've recorded over the past, gosh, close to 10 years. So feel free to peruse those in your free time. 2:34 Uh, and then second, you'll have the opportunity to enter your email address, and we will not spam you. [chuckles] So rest assured that won't happen. 2:41 In fact, the only time you'll actually hear from us is when a new interview goes live. So head on over to medsider.com and enter your email address there. 2:48 And then lastly, it's been a couple years really since I've [chuckles] I've dusted off the podcasting mic, if you will, and there's a reason for that. 2:56 Uh, I've been knee-deep in my own startup, um, over the past, uh, gosh, it's been almost four years I think, uh, four to five years now since, uh, since initial inception. 3:05 Uh, lear- have, have learned a ton, uh, as, as you can probably guess, and if you follow along with these interviews, I'm sure, uh, I'm sure we'll be sharing even more insights. 3:13 But if you're interested in, in that particular startup, head on over to joovv.com, J-2O's, 2V's, joovv.com. 3:19 We manufacture and commercialize light therapy devices direct to consumer, photobiomodulation, as academic researchers like to call it. 3:26 But that's joovv.com if you wanna learn a little bit more about what I'm up to these days. So without further ado, let's get to this phenomenal interview with Paul Buchman. 3:35 Paul, thanks for joining, uh, the MedSider, uh, program. Appreciate you coming on. My pleasure. All right, Paul. You've been a part of, uh, several med tech startups that have gone on to, uh, successful exits. 3:44 SciMed, EV3, Pathway, et cetera. The list kinda goes on and on. 3:49 It's probably like asking which of your kids do you like the best, but is there a favorite that comes to mind or, or one that really stands out as you look back at the, uh, at the arc of your med tech career? 3:58 Well, you know, that is a hard question, Scott. I'll tell you that. 4:01 Um, I probably learned the most about building and managing a high-growth company while I was at SciMed, which was in the most of the decade of the '90s. That was a great opportunity for me. 4:13 We had a stellar group at SciMed of really competitive people, and the company culture that had been developed there was developed around high performance and high growth. So it was a interventional cardiology company. 4:27 It was a terrific time to be in interventional cardiology because the market was taking off. It was a really exciting part of the med tech market, and SciMed was not the biggest player. 4:40 We were kind of number three, I would say maybe when I joined. Maybe even number four, I can't remember. 4:45 But it was a very dynamic market, and I just learned a lot about, you know, how to manage and build a high-growth company. 4:55 And SciMed had such good people and such good leaders and such a good culture that it was a great place for someone in my position coming out of mostly a sales background to learn a lot about the, you know, how to do that on the inside of a company. 5:12 And, and SciMed was clearly a sales-driven company, but we were also product development driven because the interventional cardiology market was a product, uh, almost horse race you could call it. 5:25 Uh, you know, every company, uh, it was a race to see who could come out with the next generation product, the next iteration of a product, and it was, it was truly a race to market share and to market leadership. 5:37 And it was so fun to be in that because SciMed had this competitive nature to it and kind of a take no prisoners attitude that it was just really fun. And we grew a ton. 5:47 I would say in the, you know, nine or 10 years I was there, I think we went from probably less than 100 million in revenues to almost two billion in revenues just in that window of time. 5:58 I think it was like eight years, nine years. So you learn a lot about operating in a company that's growing at that rate, and I, I probably learned more there than I did any place. 6:08 So that, it's hard to leave that one out as a favorite. 6:10 But then, you know, EV3 also has a special place in my heart too because EV3 was just a really unique opportunity And it was the first time I had ever been involved in a company literally from scratch, where I was, like, the first person or the first employee and the first person to come in and lead it. 6:29 And that really stands out because not only was, was it a unique experience, but it maybe was the hardest job that I've had. You know, EV3 was... 6:38 I don't know how much you know about it, but it was a situation where we aggregated essentially a lot of very different early stage companies together in a really short period of time, while we were simultaneously attempting to build a strong corporate culture that would sustain a high growth vision over time. 6:57 It, it was a, it was a venture that was done in partnership with Warburg Pincus, which is a very large private equity firm out of New York. 7:05 At that time, I would say they probably had around 25 billion under management, and they were interested in doing what they termed a cardiology roll-up. 7:15 And they had, uh, Dale Spencer, who was the original CEO of SciMed, and who I had worked with at both SciMed and Boston Scientific, and who was a bit of a mentor to me. He was working with Warburg as a consultant. 7:28 He had basically left Boston Scientific, semi-retired, was working as a consultant with Warburg, and they wanted him to lead this cardiology roll-up. 7:38 Dale decided that he really didn't wanna go back into being a CEO, so he told Warburg, he said, "Look, I'll be the chairman of the board, and I've got just the guy for you to be the CEO and to run, uh, to build this thing." 7:50 And so he came to me at Boston. 7:52 I had only about a year or so, year and a half earlier, been promoted to president of Boston Scientific Cardiology, which was by far their biggest division, and it was a great opportunity for me. 8:05 And Dale came to me and he said, "Paul, I would not ask you to leave an opportunity like that if it wasn't for something really special." 8:12 And he said, "You know, these kind of opportunities are once in a career opportunities to not only build a company from scratch, to be able to do, but to be able to do that with hundreds of millions of dollars of capital committed to back you up and do it." 8:27 And he said, "That just doesn't happen very often." And, and he said, "I think it would be a terrific opportunity and, and you're the kinda guy that we need to do that." 8:35 So I went out and met with Warburg and talked to them about their vision and what they were- their expectations. 8:42 I talked to a few of other people that, you know, I kinda rely on for advice and decided to, to take the plunge and do it. 8:51 I did persuade Warburg and Dale that it might make more sense for us to not limit the venture to just cardiology, but to expand that a little bit so that as we invested in technologies and therapies, that we could maybe leverage them across different clinical opportunities in the vascular space, and therefore maybe get a better return on those investments, which as a, you know, smaller early stage venture, we needed to be able to do. 9:19 We didn't have the wherewithal of the big companies, uh, even though we had a lot of capital behind us. 9:23 So we morphed what was gonna be a cardiology roll-up into a vascular roll-up, which included neurovascular cardiology and peripheral vascular, and that's where the EV3 came from, uh, three different pathways of endovascular therapy. 9:39 Got it. That- And, uh-... such, such a good story. I remember, I remember Paul Kapstner mentioning, uh, that's where the 3 in EV3 came from. 'Cause I think a lot of people don't realize. 9:46 They think of EV3 as either a neuro or peripheral vascular company, and they forget that it kinda first started as a, uh, cardiology company. So that's, uh- Yeah... that's interesting that you, you call that out as well. 9:56 Yeah, that's right. And, uh, speaking of Paul, you know, Paul was probably, I think, the third employee of the company. Uh, it was myself and Stacy Enzing sang and then Paul Kapstner. 10:05 We all worked together at Boston Scientific and SciMed, and, uh, we really were the first three employees of the company. Um, and we came in all as consultants really, uh, to begin with. 10:16 We hadn't even formed the company yet. And so it was that early stage, that early of a stage company, and we were literally o- on the fly building the strategy and the plan to, to execute. 10:29 And so that made EV3 also a very unique opportunity that's close to my heart because it was a wonderful experience to have to do every aspect of the business creation and the business development and, and I didn't really have the experience at that point to do all that. 10:46 A lot of that was coming at me brand new and coming at all of us brand new. And so it was a huge challenge from a career standpoint as well for all of us and, and therefore it was a great learning experience. 10:58 So it's near and dear to my heart. I bet. I bet. 11:00 It's-- I wanna, I wanna circle back around and ask you for a little bit more detail in regards to, you know, what, um, sort of your mindset at the time making a leap from a very good position, I think from anyone's perspective at, you know, as the president of, of Boston Scientific's largest business unit in cardiology to a w- although well-funded, but, but, uh, you know, very, very small, uh, company in EV3. 11:20 So I wanna, I wanna get your take on that 'cause I think there, there may be some people listening that are in somewhat similar shoes and are, are wanna maybe take that leap, but, um, and, and probably are- Sure... 11:27 interested in getting your, getting your feedback on that. But, um, let, let's save that question, uh, 'cause I do wanna set- Okay... the stage for people that, um, are a little bit unfamiliar with your background. 11:35 I provided an intro to this, this interview, but you're currently the president and CEO of, of, of Conventys. 11:40 Uh, can you first kinda give us an overview of your, of your device as well as maybe the problem you're trying to solve for? 11:45 Uh, and then maybe give us a little bit of a, a better picture for where, where Conventys is at in regards to, you know, regulatory clearances and commercialization. Yeah, sure. 11:54 So Conventys, the, the co-founders of Conventys Orthopedics are a couple of engineers that I worked with at St. 12:01 Jude Medical, who I thought were just terrific engineers, terrific guys to work with, and I really enjoyed that. They basically ran a skunk works for us at St. Jude and did a really terrific job at it. 12:16 And so when they decided to leave St. Jude and start a company They asked me if I would help them do that, and I said, "Sure, I'd love to." 12:25 And so we, you know, they had a few different ideas for medical device therapies, and they went out and started kind of testing their hypotheses on those ideas. 12:35 And the one that came back that seemed to have the strongest opportunity was this implantable nitinol, uh, self-expanding nitinol cage that would be used to repair bone fractures, uh, basically periarticular fractures at the end bone. 12:52 And because these guys had a lot of expertise with nitinol specifically, and in medical device design and development, you know, more broadly, I thought it was a, a good opportunity. 13:05 And so I decided to help them raise their initial Series A funding and join their board of directors from the very outset. So that was in 2009. 13:15 And, um, I went to a couple of friends of mine who were in the venture business. One was Dan Cole, who I worked with at Edwards and SciMed and Boston Scientific, and w- he was running Spray Ventures at the time. 13:27 I also went to another friend of mine by the name of Keith Grossman, um, who was working for, uh, TPG Biotech, which was a large venture firm or private equity firm. 13:38 And those two knew each other well, so I said, "Would you guys be willing to come in and partner on this together and put the early money in?" And they agreed to do it. 13:46 They met the two co-founders and really liked them, Paul Heinrichs and Mike Brenzel. And so they put in the initial $7 million of funding, and we were off to the races. 13:55 And basically, the board of directors was myself, Dan Cole, Keith Grossman, and then the CEO, who was Paul Heinrichs, one of the co-founders. And that's how we got started. 14:05 You know, la-later on, uh, again, this was a situation where Conventus, later on, it took them three years to get their initial 510K clearance with the US FDA, and that was significantly longer than we had funded the company for and had, had anticipated. 14:21 So, as you might guess, the company ran out of money, and they still didn't have their FDA clearance, so nobody else would invest, and one thing led to another. 14:30 And Paul was a, who was a first-time CEO, technical CEO co-founder, uh, was having trouble getting the money raised because a lot of venture funds don't like to invest in first-time CEOs. That just happens. 14:43 It's nothing against him personally. It, it just happens. So the board asked me if I'd come in as CEO and take over, and I did, and we ended up recapitalizing the company, bringing in new funding, and moving forward. 14:56 And then we actually were able to get a number of regulatory clearances in succession. We now have, I think, uh, we have, uh, I think three or four. We're only concentrating on two. 15:07 Uh, one is in what's called the distal radius, which is the wrist, and the other is in the proximal humerus, which is in the shoulder. 15:13 Then we also have the, uh, proximal radius, which is the elbow, and we have the proximal and distal ulna. 15:20 So we technically have five FDA 510K clearances, but we're really only focused on two of them from a market standpoint at this time. So that's, that's what the company has. 15:31 It's a very unique and differentiated technology, and it has a number of advantages over the current standard of care, which would be metal plates and screws. 15:41 And, you know, the challenge is going out and getting orthopedic surgeons who tend to do things the way they were trained to do them with the products they were trained to do them on. 15:52 So, you know, it's a bit of a process getting people to change how they practice and to use a new technology that looks and acts completely different. 16:00 But at the same time, we're, we've been able to show that the technology has a lot of benefits over the existing standard of care. 16:08 And slowly but surely, people are starting to convert to the Conventus cage because the clinical results are just better, and that's been very exciting to see. 16:18 It just takes a long time to do that in orthopedic surgery, uh, because people- Oh, I bet you're a-... do everything the way they're trained. [laughs] I bet. I bet. 16:27 You're, uh, you're used to probably playing in the interventional or vascular space where, you know, most physicians would naturally gravitate towards lower profile, less invasive device or therapy. 16:35 Whereas, you know, in the orthopedic space, don't wanna cast a too broad of a blanket here with, with my statement, but you know, they're used to, you know, opening someone up and having no problems with it, you know? 16:43 So I gotta think that's probably a, a decent challenge to try to, to try to tackle there at Conventus and what you guys are doing. It is. 16:49 In fact, what I've told people for o-over and over is that what orthopedic surgery needs is the orthopedic, the interventional orthopedist. [laughs] You know, someone who's gonna convert- Yeah... 17:01 surgical procedures to percutaneous procedures, 'cause that's exactly how the interventional cardiology market came to be and grew so fast, because they were taking procedures and patients away from the cardiac surgeon. 17:14 And- Sure... you know, in the case of orthopedics, if there was a specialty like that that was a threat to the current orthopedic surgeons, you'd see a different adoption profile. 17:24 But because it's the same customers and the same users, they don't need to change what they're doing. 17:31 And, you know, if you're trained to open people up and do things surgically and with an open procedure, then, then migrating to a less invasive closed procedure is, you know, it's a big jump for them. 17:41 And it happens slowly, and you have to have a lot of data and a lot of experience and a lot of peer pressure before that starts to happen. 17:48 But it is happening, and I think Conventus has a, uh, has a really good technology and a good solution for these kinds of fractures. And so that's, that's how Conventus, you know, has evolved. 18:00 They've been ar- Like I said, they've been around since 2009, and it's a, a really wonderful group of people at the company, really strong technical development and operations team, really good regulatory, uh, clinical group. 18:15 It, it's just a strong, strong organization for a small company, and they've done, done a really good job, I think. Great. 18:22 Well, I, yeah, I certainly, uh, would encourage everyone to, to, uh, we'll link, I'll link to it in the, in the show notes for this particular episode. 18:28 Uh, but check out, uh, Conventus 'cause it definitely is an interesting take on orthopedic surgery for sure. 18:32 So let's, uh, take this opportunity to kind of step in what I call the, uh, the MedSider time machine and kind of learn a little bit more about your, uh, your earlier career, uh, in med tech. 18:41 So you mentioned earlier your time with SciMed and how valuable that was from a, um, just a, a personal and professional development standpoint. 18:47 I think you mentioned you spent about eight, nine, 10 years or so, you know, from the early days of SciMed leading up to the, you know, the acquisition by Boston Scientific. 18:54 Probably experienced way too much for, you know, a 45-minute or hour-long [laughs] discussion, uh, you know, to really go too deep with that. 19:01 But are there certain, a few things that really come to mind, maybe one or two that stand out that really you still hold, that you still look back on even today that, that were really valuable learning experiences during your time at SciMed? 19:11 Yeah, e- absolutely. Um, uh, there's a few things that I, I feel like I learned a lot about. 19:17 I mean, from a business functional perspective, my background and history was always sales and commercial, so that's what I knew the best, I would say. 19:28 I, you know, I had a long sales career and marketing and all that kind of stuff, and SciMed was really good at both of those. And so I, I learned from a lot of just really good, talented people at SciMed. 19:40 And because the market we were in was so dynamic and so pressure-packed, it was a fun time to learn and even if you had a lot of experience in sales, you were still gonna learn new things because it, it was just a brand-new, different type of market. 19:55 Uh, the other area I learned a lot about, though, at SciMed was product development, and I include Boston Scientific. It's just, you know, they were-- they became a different company after that. 20:06 But product development was an area where I also thought SciMed and Boston Scientific really excelled. They had terrific engineering. They had a really good process for product development. 20:16 They had very close connections to the customers and the users, and that really influenced and drove our product development priorities and, and projects. 20:27 And what I learned at SciMed and Boston Scientific was how to do really good product development that's differentiated and meaningful to the customer, but to still do it fast and at high quality. 20:40 And it's easy to say, but it's hard to do, uh, because you have to be good at a lot of different things. 20:45 You know, you have to be really good at being able to synthesize what customers are saying into what they really mean in, uh, in terms of what is important for products. 20:56 And a lot of times, customers don't verbalize very well what they really want. What the-- what they'll typically describe to you is the best product they've seen or used in the past, and somehow that'll kinda come out. 21:08 And what you have to be able to do as a product development team or person is to be able to kinda see beyond that. A- and you can't just do it in a discussion. 21:18 You have to actually be in the lab or be in the operating room or wherever it may be. 21:22 You have to be there watching and interpreting everything they're doing during a procedure and see where they get frustrated and see what things work and don't work or see what things could be done faster or more conveniently. 21:36 And our group at SciMed was so good at that, and they were so good and quick at turning those learnings into new product improvements, product iterations, new platforms, and, and I was just always so impressed with that. 21:52 And it made it fun to be there because the customers saw it, they knew it, they wanted to work with us, and they were blown away by how fast we would come out with new products all the time. 22:02 And that was just fun to be part of that because the customers were getting so jazzed by it. 22:07 And at the same time, I thought we had a really good process for it because we got very good, I think, at being somewhat ruthless about prioritizing everything around product development, whether it was what types of features and attributes a product was gonna have, how important those were related to every other attribute and feature, how important those were relative to cost trade-offs or manufacturing trade-offs or quality trade-offs or whatever, ease of use trade-offs. 22:37 And our team was really good at that, and we had a process for constantly reassessing and reprioritizing every one of those elements, not only for a specific project, but constantly doing that for each project as it related to every other project that you had either active or in the bullpen, so that you had this constant movement of projects and priorities, and it was all driven by the return you were gonna get, the incremental market share you were gonna get, what- whatever. 23:08 And, uh, a- and then you allocated and, and all your resources accordingly. 23:14 And so it was kind of a, a symphony of decision-making that was happening on a day-to-day, week-to-week basis, and I just thought that we did that well. It was very transparent. 23:25 It was very fact-based, not emotion or opinion-based, and people were expected to come in and be ready to either have a better solution, a better timeline, a lower budget, a, whatever. 23:38 It, it had to move the chains, and if you couldn't do that and couldn't defend it, then it didn't happen. And there-- it wasn't personal, and it wasn't career-ending or career-impacting. 23:48 It was just the best idea always won, and that's just how the company operated. And I found it to be an extremely refreshing environment to work in because there was no politics. 24:00 Everything stood on its own merits, and we always had vigorous debate over every little detailed decision, and we seemed to always get to good answers. 24:09 And I, I just came out of that experience, and I honestly have never, I've never experienced it to quite that same level of success or, um, you know, being really good at it. I, I just haven't experienced it- Sure... 24:22 quite like that since. And, and so that's what, that's what really impacted me from that. 24:27 And then the last thing, I guess, I also learned a lot at SciMed about mar-- uh, international because that was the first time Where I really had a dedicated international responsibility, 'cause of-- I spent a couple of years when w- it was still SciMed, and right before we got acquired by Boston Scientific, where we had decided to convert our entire international business from distribution to direct sales. 24:52 And it was a huge u-undertaking and, um, I was brought in, uh, along with Jim Corbett. I worked for Jim at the time, and the two of us, uh, kinda led that effort, uh, worldwide to convert that. 25:05 And, and I learned a ton about just selling globally and working with organizations from many, many different countries and cultures. And it was just a great learning experience for me, and has served me well also. 25:20 And that's an opportunity I, I was given at SciMed that, you know, really I think helped my career quite a bit. Yeah, I bet. 25:25 I, I, I think we could probably have a whole, uh, whole discussion around things that you learned, you know, developing some of the international markets and, and converting, you know, your, your commer-commercialization to a direct sales force. 25:36 Uh, but for the sake of time, if you're okay with it, I'd, I'd love to ask you a few follow-up questions in regards to a couple of those points you made about product development, 'cause I, I think- Sure... 25:42 there may be some, some anecdotes to pull out for other, other folks that are listening and, and maybe trying to improve or enhance or optimize their, you know, their product development e-uh, efforts. But- Sure, sure... 25:51 you mentioned something about really understanding or being able to synthesize what the customers really want, and it's just a hunch, but I, I wonder if that-- if your broad experience in sales and being really in the trenches helped you sort of enhance that ability to really try to, um, translate what customers are saying to, into what really matters. 26:08 And, you know, I personally see it all too often that a lot of upstream or classic upstream marketers will sort of gravitate towards traditional market research when maybe the appropriate next step would be, you know, really getting into the lab, as you said, uh, whether it's the OR or the cath lab or wherever, wherever it may be, and really understanding, you know, how these products succeed or where they fail, you know, in the customer's hands. 26:28 So what would your response be, be to that, uh, that statement? Sure. 26:32 Well, I think my sales background definitely helped me because, uh, you know, there's nothing like having been there where you've gotta actually persuade a physician to change what they do, which they don't do that lightly. 26:46 You know, they're, they're all about patient care and patient outcomes. 26:50 And so doctors don't change what they do very easily, and they have to be persuaded, usually with good arguments, good clinical data, a good clinical argument of some sort, and something that's either gonna make it better for the patient, safer for the patient, faster, more economical, easier, less problems, whatever. 27:11 And so if you're out there and you're in these procedures every single day like you are as a sales rep, you start to understand what things matter to the physician, what things matter to the staff, what things matter to the hospital, and probably most importantly, what matters to the patient. 27:28 And, and you see that day in and day out, so you start to develop a feel for the things that maybe sound good on paper but don't really matter, and the things that really do matter. 27:38 Now, I say that also, you know, take that with a grain of salt because there are a lot of salespeople who are harping on marketing and product development people every day saying, "I need this and I need that." 27:49 [laughs] And not all of that is good input. A lot-- some of it's pretty lousy input because it's not-- it, it doesn't encompass enough. 27:56 Because what, what product, you know, what product development experts have to do is they have to take all of that in-- all those inputs from the customer, and that customer might be a physician, it might be a sales rep, it might be a purchasing person at a hospital, and then they have to start to iterate and triage all of that input and, and prioritize it based on different, you know, levels of value. 28:19 So, you know, a purchasing person might only care about the cost. The physician cares about, is my patient gonna do better? Are they not gonna do better? 28:28 Am I gonna get out of this procedure ten minutes faster so I can do another one, and so at the end of the day I can get home for dinner at seven o'clock instead of nine o'clock? That matters. Um- Right... 28:37 and it, and, and then it might be an engineer or a quality person at the company or a manufacturing person. What they care about is, can I make this thing reliably? Can I make it in high quantity and high quality? 28:49 All those kinda things. 28:50 So all of those inputs have to be t- um, triaged and prioritized and weighted so that at the end of the day, the things you decide on and the things that you prioritize as important to that product represent all of those stakeholders in the process in the right balance. 29:08 And that's easy to say. It's hard as heck to do, though. 29:11 And, um, and then when you try to add in some level of innovation on top of that, not just using technology and know-how that you already have, but now you're gonna actually invent some things to add to that to make it even better than the customer ever knew it could be, that brings in a whole another level of risk and unknowns and things like that, and you've gotta constantly be weighing all those things. 29:35 And then, you know, you take that and it turns into a project that has a specified budget, a specified timeline, and a specified output of product, uh, attributes. 29:46 And trying to meet all of those is really challenging, as you might guess, you know, because- Yeah... 29:53 you know, the more attributes you want, the more expensive it gets, and the shorter the timeline, the more expensive it gets. 29:59 And so there's always these puts and takes, which requires constant dialogue, constant refreshing of what's important, what are the priorities, what are we committing to, um, you know, and, and, and how do we make sure we deliver that? 30:14 'Cause the other thing you can't have is creep, where you start out and say, "We're gonna do X, Y, Z, and we're gonna do it in nine months," and all of a sudden everybody wants this and they want that, and, you know, now you got a project that's gonna take 15 months and it's gonna maybe give you a couple extra things, but it's gonna cost 30% more and all these other things. 30:34 And, you know, you can get out of whack very quickly if you're not diligent and kinda ruthless and disciplined about your prioritization and, and what you're willing to compromise on and not compromise on. Yep. 30:45 I don't know if that- Such as- I don't know if that makes sense, Scott, but it's- It does... 30:48 it's, to me, it's the one of the most interesting parts of the business that I like because everyone in the company is involved in it. And, and it matters- Mm-hmm... what they think, what they say, what they commit to. 30:59 And, um, I, I just think it's a great part of the business and, and You know, I, I always, I always shy away from companies or jobs or products where, or, or opportunities where the product doesn't matter or it's not that important. 31:14 You know? Like to me, going into a business where the only thing that matters is cost, no thanks. Just not interested. Right. You know? Yeah. I, I wanna, I wanna do more than that. Sure. Yep, that's, that's good stuff. 31:25 My notes here on, on my end, [laughs] I have, you know, understand, synthesize what customers really want, you know, if I could emphasize, you know, the word really in that statement, that would be imperative, and then, you know, ruthless prioritization when it comes down to kind of some of those puts and takes that you mentioned earlier. 31:39 Uh. Yeah. But, but good stuff, so. Yeah. 31:41 Really, really- And, and Scott, you know, you, you talk to anybody, you know, whether it's Stacy or, uh, Stacy Enzing saying or Paul Capps, anybody who's done this, I mean, it's not like I'm saying anything that's new. 31:52 People, people know that, and people understand it- Mm-hmm... and they respect it. It's just hard to do. And when you- Sure. Yeah... 31:58 when you get inside an organization that does it well, it's like it makes a mark on you. 32:02 You r- you don't forget it because it, you, you appreciate how hard it is to do it really well, and it's one of the things I, I liked about, a lot about SiMed, uh, and then Boston Scientific when we became that is I, I thought we did that really well, uh, in my opinion. 32:16 Mm-hmm. Yep. 32:18 And it, th- there's probably, you know, I, I'm not sure if you've heard of the, the term the PayPal Mafia, some of the, the, the folks that were really, really involved in, in PayPal, you know, Peter Thiel- Yeah... 32:26 Elon Musk- Yeah... et cetera. 32:27 I, I almost feel like, you know, I, at least maybe it's just my, my bias towards Minneapolis here, but there's like a Si, you know, a SiMed mafia where there's these, these cohorts that, you know, this group of people that experience such cool things at SiMed and were able to kind of take it to other companies. 32:39 You know, yourself, you mentioned Stacy, Paul Kapster, et cetera. The list goes on. But, um- It does... I, uh- It does... it's, it's cer- It goes on, it goes on and on. And, and, and I- Yeah... 32:47 and I, I'm so respectful of it because, you know, I like to look back on my career there and think, "Oh, geez, I was such a major part of that." 32:55 But, you know, I feel, I actually feel like I was just surrounded by terrific people who made me look good. [laughs] Mm-hmm. 33:02 [laughs] You know, I think they made me look better than I was 'cause they were just, it was, everybody was so good at what they did I, I, I thought, and I, I felt really fortunate to be part of it. 33:10 It'd be fun to go deep and almost do a, a series of discussions just on, uh, you know, ex, ex-SiMed folks just to try to r- you know, capture what, what was really imperative and important about the success there. 33:20 But, um, you know, that's- Yeah... I guess that's, that's probably for, uh [laughs], another time. But for the sake of this discussion here, let's, let's fast-forward to your time at, at EV3. 33:26 So, uh, you mentioned this earlier in the conversation how, um, you, you were recently, you know, or fairly new in your, your role as president of, uh, cardiology for Boston Scientific, you know, the largest business unit. 33:35 I think most people would be like, "Wow, you know, Paul, you've, you've reached a, uh, a mountaintop there." 33:40 But then you made the decision to take the leap, and some of that I think probably obviously is, is it- is because of your relationship with Dale Spencer. But, you know, wal- walk us through what was in your head. 33:47 You had a family. I'm not sure how old your kids were at that point in time, but it seems like despite the, how well-capitalized EV3 was at that point, that's still a pretty big risk. 33:56 So, you know, can you help us understand a little bit ab- about what w- what was in your head and, and how ul- you know, how ultimately you got to that decision, uh, to, to leave Boston Scientific and, and start EV3? 34:06 Yeah, sure. Um, you know, and, and I'll preface it by saying if you asked my wife, she'd probably tell you that, um, I've always been maybe a little too willing to take on risk instead of- [laughs]... 34:17 just staying the course somewhere and, uh, you know, because she's the one that's been at home with the kids trying to figure out where we're gonna live next and where do we have to relocate to and what have you. 34:27 Um- Sure... 34:27 and I still sometimes look back and wonder if it was the right decision to leave Boston Scientific because, you know, I left a great company and a great job and a great team of people, and I knew that as I was leaving that it was a huge risk and I was leaving a very comfortable place that I had been at for a long time and felt, you know, I knew everybody. 34:47 I just felt very comfortable there. And so I, I do sometimes still look back and say, you know, "Should I have done that?" Or, "Was that the smartest thing?" 34:54 I, I'm not one to look back, but, you know, it's easy now to look back and say if I was gonna do something different, would I have done that? I, I don't know. 35:01 As, as good of an experience as EV3 was, you know, I did walk away from a, a, uh, another great experience as well. 35:09 But EV3, I learned a lot there too because the path and the, the pace that EV3 quickly got on in terms of adding people, buying companies, integrating companies, licensing technologies, trying to build a commercial effort globally, I mean, we were doing huge initiatives simultaneously with a fairly small group of people and, uh, you know, as an early company that didn't have a lot of history. 35:39 And not only was it just difficult to do and hard work, but it was also, um, uh, it also put a lot of pressure on you and it was, you know, you, you just felt, you, you, you felt like you didn't have a huge margin for error, you know? 35:54 Because it wasn't like we had this big base of revenue like Boston Scientific had where if you bought a company and integrated it and it didn't pan out quite the way you wanted it to, didn't really matter that much because you had this big three, $4 billion a year business. 36:09 Mm-hmm. At EV3, if, when we, when we made a mistake, we felt it because we were using real money that was private equity money that not, wasn't profits we were using. 36:18 We were using somebody's investment money and, um, and we were, you know, and we were doing it at this fast pace. 36:25 I mean, you know, we probably in the first three or four years of the company, we must have acquired, oh, I don't know, 10 or 15 companies or businesses, uh, maybe more- Mm... 36:36 and integrated them all, uh, some of them more than one at a time, and we built, uh, a global, uh, sales organization as well. We had, um, you know, it wasn't just a US-based kind of effort. 36:49 It was a global effort and, uh, and, and we were buying companies that many of them were either early stage or had some level of distress where we could afford to buy a company that maybe had something we really liked about it or something we thought we could make better, um, but we would buy it at a time when it wasn't running on all eight cylinders or hadn't achieved or proved certain things yet. 37:15 And so we were aggregating all these companies that were losing lots of money. 37:20 And we were aggregating them into a company that, as a big company, was losing all that money combined, [laughs] and we were trying to make it better. 37:29 So all of these were not only integration efforts, they were fixer-uppers, and we were trying to make the technology better or make the organization capability better or get it through a clinical study and a trial or get it through the FDA or get it through Japan or wherever we might be going. 37:47 And so we had a lot of irons in the fire all the time, and it was just a... It was a high-pressure business, I thought, and a high-pressure endeavor that, you know, felt like dog years as we were doing it, to be honest. 38:00 [clears throat] I wanna ask you, uh, um, a, a few follow-up questions post EV3, 'cause I know you, um, you left there, I think, in the mid-2000s, spent some time at St. 38:09 Jude, and then later joined DBax and then Pathway and then Centerheart, all three startups. 38:14 I think as, you know, in our, in our pre-interview discussion, you mentioned you joined, um, those companies a- as part of the board, but then later stepped in to help run those companies. 38:23 So, you know, in our little time left, I guess I wanted to ask you a, a question about financing. 38:28 Uh, but before we get there, I, I guess there's a pattern where, you know, the board or the investors ask you in your capacity to step in and take over a company and sort of redirect it, recapitalize it, et cetera. 38:38 So what do you think, you know, if I had the chance to interview some of those investors, what do you think they'd say about Paul Buchman that would say, "You know, this is why we ask him to do this, this type of stuff. 38:46 This is what he's really good at"? Well, you know, part of it might be because it's things I, I'm good at or things they have confidence I can accomplish for them. 38:55 Part of it, too, though, is just the fact that, you know, I was... 38:58 All these opportunities, I was joining boards because there was somebody, people on the board, whether it be an investor or a former colleague or executive who I knew and was friends with. 39:09 And so I was joining these boards amongst colleagues and friends, people I like, because I wanted to be part of it. I wanted to work with them. I wanted to help the company or whatever. 39:18 And so it makes it easy then when you've been work- when you've already known people and, and, and have a track record with them, and then all of a sudden... 39:26 And so you're operating with them at a board level, and then all of a sudden the company runs into some challenges, and maybe it requires new executive leadership. 39:34 It's not a big leap for that board to look at you and say, "Paul, you've done this before, and we know you, we trust you, we've worked together." You know, it's not like a... It's just a low-risk option for them- Sure... 39:46 to ask me to step in and do it because they have confidence that I can. And it's a pretty easy thing for me to wanna do because I want these people, I want their investments to turn out well. 39:56 I want the company to do well. You know, usually when you're on the board, you start to get to know the management team very well at the company. You get to know a lot of the employees. 40:06 And so you start to build up a commitment to them as well. 40:08 And when they ask you to come in and lead them so that the company doesn't, you know, go away or dis- you know, or, or go out of business or fail or whatever, it's hard to say no. 40:19 Even if it's not, you know, maybe the first choice you would have taken if you were out doing a job search, it's a very easy choice to make when these are real people and real friends and real colleagues that have money and careers at stake. 40:31 You wanna help, and you wanna say, "Yeah, I'll do it. I'll-- Let's see if we can make a go of this." And so that's what I've done. 40:37 And, and, you know, my wife sometimes will look at me and say, you know, "Why-- Uh, can't you hold a job?" [laughs] You know, you're always... But it's kinda one of those things where it's like, I like doing this. 40:48 I like being on boards and helping companies, and then it's very easy for me sometimes to step in and pick up an opportunity that presents itself to keep that company going. And that's... 40:57 You know, at Centerheart, it was a situation... Uh, well, let me start with Pathway. Pathway was a situation exactly as I described, where I was chairman of the board. I knew the investors. I knew the co-founders well. 41:10 I knew a lot of the people on the team. And the company needed a change in leadership, and I said, "I will do that. I'd love to come in and do it." 41:19 And for me, it was great 'cause I already knew the management team there, and it was a really good, strong management team. The board was really strong. I liked the technology. I knew the space. 41:30 And I thought, "I can easily step in and do this." So that's what I did. And over the course of about four years, we raised, uh, I went out and raised about forty million dollars when I came in. 41:42 We put a commercial effort together. We actually laid off about almost half the company. 41:47 We had about two hundred employees when I joined, and we very quickly laid off about a hundred over a few months to cut the burn rate of, of cash. And then we slowly started getting product approvals. 41:59 We started building a sales team. We started generating revenues. And as soon as we got up to about a thirty million dollar level of revenue, we sold the company to Bayer Healthcare out of Germany. Yep. 42:10 And then as soon as that happened, uh, during that time, I was serving on the board of Centerheart. 42:16 Again, it was a situation where I knew the investors in Centerheart very well, and I'd known them for a long time, and they had asked me to join the board. 42:24 And I was on the board, and shortly after the Pathway acquisition finalized, the CEO and one of the founders of Centerheart got sick and needed to take time off from the company. 42:37 So the board asked me if I would come in and be the CEO, and at the time, they didn't know if he was gonna be able to come back or not. So I said sure, 'cause I liked the technology. I was on the board. 42:47 I liked the company. I said, "Yeah, I'll do that." So I did that for about two years. 42:51 And during that time, we commercialized, and I built a sales team, and, uh, we got revenues up to probably a run rate of about twenty million in the first year and a half. And then the former CEO recovered and came back. 43:06 About that same time, Conventus was asking me if I could help them out. So the old CEO at Centra Heart came back and took over, and I left and went over to Conventus. Got it. Yeah. And did the exact same thing. 43:18 I was, you know, again, I was on the board. Exact same scenario. They were having trouble raising money. Conventus was getting very close to shutting the doors. 43:26 In fact, I actually was making payroll out of my bank account to keep it going- No kidding... for the last couple weeks. We finally closed- Wow... down a round of money. 43:34 We brought in a small group of investors, all who I knew and were friends of mine came in, and we brought in about eleven million dollars into Conventus to keep it going and keep the doors open. 43:45 And then that allowed, it bought us a little bit of time, and then we parlayed that into another fourteen million by bringing in two more bigger investors. And so that turned it into a twenty-five million dollar round. 43:57 And then another couple years after that, we raised another twenty-five million dollar round from that same group, and that's how we got Conventus financed and, and off to the races as well. 44:08 Again, it was one of those things. I mean, the last place I thought I'd end up being a CEO was in the orthopedic space. Sure. Yeah. I knew nothing about it. I was just on the board. 44:16 So I had jumped in with both feet, and fortunately had some really smart people around me on the management team that were very good at what they did. 44:24 They understood orthopedics well, and I basically was just the, the leader of the pack, but they were the experts on the product and the space, and it was a fun, really fun opportunity for me to be involved with. 44:36 But again, it's not one I would have probably been seeking had I been doing a job search. It just kind of was serendipity. Sure. It makes sense as you explain it, for sure. 44:45 I wanna be sensitive to your time and, and leave a few minutes for the last three rapid-fire questions. But, um, specific- Okay... 44:51 to, to your, um, you know, that trend of kind of, of going from, you know, the chairman of the board or sitting on the board and then taking over the company. 44:56 It seems like raising money has been a key aspect of turning around some of these companies and, and recapitalizing them, reducing the burn rates, as you mentioned before. Sure. 45:04 So for those listening that are not necessarily struggling per se, but are at that point in the life cycle of their startup where they need to raise another round of financing or maybe raising an A round for the first time. 45:14 Clearly, your network at this point in your career helps you, uh, in, in those types of efforts. 45:17 But for those that don't have the type of network that you do, are there a few, you know, one or two pieces of advice that you would offer up? Well, I would. 45:24 And let's be honest, Scott, I think everybody's having trouble raising capital today. Sure. It's not easy, and, and myself included. 45:31 It's, it's a hard thing to do, and I think the whole med tech world has become a, a difficult place to raise money because there's fewer venture capital firms that are investing capital in medical devices, and the ones that are have become very particular on the stage of company and the part of medicine they're willing to invest in. 45:50 And so it just, you know, you end up having to talk and approach a lot of firms to be able to get anyone who might be interested. 45:57 So it's challenging, and I think the success factors, though, and the investment drivers have stayed fairly constant. 46:05 And to me, what those are is you've gotta be seeking a, an attractive and a reasonably addressable market opportunity. That's one thing they're looking for. You've gotta be providing a manageable regulatory pathway. 46:18 In other words, the ability to mitigate risks in that pathway. Approval means nothing if you can't get paid for the product. 46:24 And so now what investors look for more so than the regulatory pathway is can it get reimbursed or is it in a space that doesn't even require reimbursement that might be cash only, like aesthetics or something like that. 46:37 But they- Sure... wanna be assured that the product can get paid for. And then I think the other one is they wanna see a high quality management team, preferably one that's done it before. 46:47 And you know, there's a theme here, Scott, and that is the investors, even though they're venture capital investors, they are not willing to take too much risk anymore. Mm-hmm. 46:56 And so they're looking for all kinds of ways to mitigate risk, and these are the ones that do it. 47:00 You know, if they have a good product, a good market opportunity, and there's good intellectual property, and there's a good reimbursement pathway and a reasonable regulatory line of sight, and then I think a well-conceived business plan, which basically means show me that you're gonna be able to get this thing to some important milestone, whether that's on the pathway to an exit or all the way to an exit that's gonna use a reasonable amount of capital to get there. 47:27 Because the minute, you know, if they start seeing really long timelines or really high cash requirements, they start doing the moonwalk right away. They just don't wanna- Sure... see that. 47:37 And so, you know, none of these are, are earth-shattering things, but they're all the things that these investors are looking for, and the more of those boxes that I think a CEO can check, the higher the chances they're gonna be able to bring in some money. 47:50 And I would encourage CEOs, too, to not always just rely on venture capital. I know in today's world, more and more CEOs are looking at angel investors and things like that. 48:01 I would encourage people to really look the other direction and try to bring in strategic investors and maybe have a business plan that, and an expectation of driving an earlier exit at a lower level of money that also requires less capital to get there and then bring in a strategic to be one of those investors. 48:20 So for example, instead of maybe thinking you're gonna develop this company and product and you-- someday you're, you're gonna sell it for five hundred million dollars and, you know, those don't happen as much as they used to, and they're hard to do, and they usually require a lot of capital. 48:34 It might make more sense to say, "What would it take to sell this company for seventy-five million or a hundred million dollars, and what milestones do we have to achieve to do that? 48:45 And could we do it on a really lower scaled amount of capital where we might be able to bring in a, a Medtronic or a Boston Scientific or a Johnson & Johnson for three, four, five million dollars and not even have to have, not even have to bring in venture capital?" 49:00 And that way you have fewer mouths to feed at the end of the day, and you might have a smaller exit, but everybody makes money. And as you know, a lot of the exits today, not everybody makes money. 49:10 There might be one or two people- Right... that make money, and everybody else doesn't. Mm-hmm. 49:14 Yeah, it's really good advice, and just even listening to you, uh, articulate that, it sounds, like you said, fairly basic, fairly foundational, but yet so hard to execute on. 49:22 You know, to get all of those pieces right that, you know, leading up to, uh, either around a financing or, or ideally a, a potential expert or exit, I should say. Yeah. So really, really good stuff. 49:31 So I wanna be sensitive to your schedule, Paul, and I, I really appreciate you taking the time out of your, um, day here. Sure. But if we can just get to the last three rapid-fire questions. 49:38 The rapid fire, you know, in, in nature, your answers don't necessarily have to be rapid fire, so feel free to expound a little bit if you want to. But we'll start with number one. 49:45 What's your, uh, favorite business book? I don't know if I have a favorite, Scott, but I can tell you, you know, we talked a lot about product development. 49:52 One of the books that I recall that I really enjoyed and that I still have on my bookshelf is called The Innovator's Dilemma by Clayton Christensen. I don't know if you've ever heard of him. Mm-hmm. He's part of a... 50:01 I forget the name of it. It's a, uh... It, it used to be called he... I can't remember. It was four syllable, four letters, but it was a consulting group that focused on product development and innovation. 50:12 And when I was at Boston Scientific, we actually engaged that company for a while to help us improve our product development process, and I know Clayton Christensen, I think, was one of the founders of that firm. 50:23 But that book, Innovator's Dilemma, talks a lot about how to make innovation a systematic part of your product and development effort and not just kind of a eureka moment, but something that you actually build your business around creating innovation. 50:36 And I thought it was a really good book, and it's a very thought-provoking book and different. And, and so to me, it's one of the ones I really remember. You know, you... 50:44 Everybody reads a lot of business books, and they all start to run together, but that was one that really stuck out to me. Yeah. That's good stuff. It's one I, I've actually, I've read before personally, but I had... 50:52 It's been, it's been a long time, so it served me well to probably- Yeah... uh, probably dig that one out again. 50:56 Next question is, uh, is there a CEO that really inspires you or one that's, uh, uh, played a big influence in your life in the past? We talked about Dale Spencer. 51:03 He was important to me, and he inspired me and taught me a lot. 51:07 Another guy who, maybe it was 'cause it was early in my career and I was kind of in awe of the person and I, you know, I was just a j- young sales guy at the time in my 20s, but I worked at Edwards Laboratories in the early days before it became Edwards Lifesciences, and Edwards was part of American Hospital Supply. 51:25 And I was always kind of inspired by American Hospital Supply because they were such a major player in the medical supply universe. 51:34 And the CEO was a guy named Carl Bayes, who was an ex-Marine, and he was kinda one of these guys that for a 20-some-year-old kid that's early in his career in a sales job, he was bigger than life to me. 51:45 Every time I saw him talk or present somewhere or, or read something by him, it's... 51:50 I always got inspired by it because American Hospital was such a big machine and kind of the only company out there that was able to take on companies like Johnson & Johnson. 51:59 And then speaking of Edwards, there's another CEO that I continue to draw inspiration from who has ties to Edwards, and that's Mike Mussallem, who's the current CEO of Edwards Lifesciences. 52:10 Mike and I worked together side by side back, uh, when we both were at Bentley Laboratories, which was a sister company of Edwards. 52:19 And, uh, Mike was the operations VP, and I was the sales and marketing VP, and we worked together. 52:24 And even back then, I had a huge respect and regard for Mike because you could tell then that he was special and that he had a real head for business. 52:35 And I've enjoyed so much watching him succeed at Edwards and build that company into something very special and obviously create a lot of wealth for a lot of people, including himself over that time. 52:47 And yet he's maintained a level of kinda humility to me that I really admire. 'Cause I- Mm-hmm... 52:53 I can't stand it when executives, and particularly CEOs, get arrogant and start thinking that they're the reason why the company's been successful and why people are successful, and they forget about all the talented people around them. 53:06 Mike has never forgot that, and he's very humble. I really admire that in people, and he's one that I continue to hold in high respect. Hmm. Such good comments. 53:14 I'm sure he'd appreciate that, especially the, uh, the notion about humbleness. 53:17 You know, it's, it's something that I personally appreciate, especially at those, at those types of levels when everyone wants to, uh, you know, give you the glory. 53:24 But having the, uh, self-awareness to give credit where it's due, I think that's, uh, very admirable. So last question I have for you, Paul, is, um, you know, going back- Yeah... 53:31 in time, is there anything that you'd tell your, you know, your 25 or your 30-year-old self? There's probably a few things, Scott, that I think about that I... 53:39 'Cause, you know, and the reason this comes top of mind is because my kids are constantly asking me this right now. Uh, two of them are in the medical device business. Right. 53:47 Uh, one is, uh, just a lesson I learned early in my career as a sales rep that I've always continued to try to do as a CEO, is listen a lot more than I speak. 53:57 People hear CEOs talk enough, and I think listening is just a lot more important. 54:02 If you're good, you always surround yourself with really smart people, and the right answers will come up if you make people feel like they have the environment to share their thoughts and not be judged by it and offer their ideas. 54:16 And so I, I think listening is a big one. 54:19 I think you have to have a mindset, at least I tell myself going back, I've tried to do this, but I tell my kids this all the time, is that you can't let money and you can't let career opportunities compromise your beliefs. 54:34 And you can't do something just 'cause it's gonna get you further up the ladder or it's gonna make you more money if you don't think it's the right thing to do or you don't think it's the right people to do it with or the right environment to be doing it in. 54:46 I think you have to constantly focus on just doing the right thing all the time, and the money and the career and everything else will come as long as you, I think, stick to that. 54:56 And so I would tell any 30-year-old to do that because it's easy to get caught up in, oh, I can make more money if I make-- do this, or I can, you know, get this promotion if I do that. 55:06 But it's not worth it if you've gotta compromise what you think is the best thing to do. 55:11 In my opinion, one of those things that, um, rings true when you say it, but, but so hard to do when you get, you know, so easy to get caught up in the moment or maybe the culture that is around you that maybe, um- He was a little bit more in line with it. 55:22 [laughs] That's a little bit more, more ruthless and, and, and fosters, you know, the environment that forces you to make those, those tough decisions. So, uh, really, really good stuff. 55:29 I'm glad you mentioned- Well, you know, and I can, I, I can tell you, Scott, too, just to finish, that I've, like, real-life experience having done that because I've had two or three situations in my career where I left a company or left a job because I had a major philosophical difference or o- of opinion with either a board or a boss or somebody like that. 55:50 And at my own detriment, I left because I didn't wanna compromise that. And, you know, I can look back and sometimes I think, "What were you thinking? Why did you do that? Why didn't you just bite the bullet?" 56:00 But I, I still feel like it was the right thing to do because, you know, if you're gonna do something really well, and you're gonna put 150% of your effort and heart into it, you gotta really believe it's the right thing to do. 56:12 And so I've, I mean, I've personally done that. I've left some situations that were lucrative situations, but I just didn't feel like the direction I was being pushed was the one I wanted to go in. Yep. 56:23 And it obviously turned out well for you. 56:25 And I know, um, you know, leading up to this interview, I did a fair amount of research and asked, you know, within my network what I should ask you, and that's one of the things that often came up. 56:33 They said, "Paul always seems so even-keeled despite what would appear to be maybe a chaotic situation." 56:38 And, you know, maybe that's a testament to your mindset or the, you know, part of the framework that you operate within is that, you know, that attitude that I wanna feel, I want my conscience to feel good, you know, after m- [laughs] after making this, making this decision is probably one that we should all consider. 56:50 I hope that's the case. I certainly try to do that. I just... Maybe I'm just not smart enough to do it any different way, you know, 'cause if you kinda follow your heart, you tend to not have to think as hard. You know? 57:01 It just comes natural. Sure. Yeah. G- good stuff. So. Well, thanks a ton for your time, Paul. 57:05 I mean, I, I really appreciate it, you taking, you know, about an hour out of your schedule to do this, the, or have this conversation, so I can't thank you enough for doing that. 57:12 For those listening to the interview, of course, we'll link up to the Conventus website, uh, in the show notes for this episode. But, uh, until, uh, the next MedSider radio interview, uh, everyone take care. 57:23 [outro music]
