After the Capital Raise: Accelerating into Growth Stage

Ramin Mousavi  0:05  
Well, let's get to it, you know, so we can use the time. As Scott mentioned, when we talked after last year's event, we talked about how can we open up the door to get more companies involved in this event and get more of the strategics, investors, and service providers to participate. And I think, as you get to those earliest stages, and you find a way to get funders, you get to this lonely stage, which you see the club here, and and there's more of them out there that you can talk to which you start talking about, what if we knew some things earlier, you know, so that's the purpose of this panel, you know, we have a very talented group of people here that are going to share their experience. my promise to the group, as we talked was that we're going to do this a little different. So it'll be a tad more provocative. I don't plan to remove sales reps. So don't get upset about that, you know, like VP of sales is here somewhere and it will kill me if I say that. But we will, we will try to be very, you know, real. And rather than telling you between great and greater, which one we are talking about the experiences we had that you know, we can share with you. To give you the background about CathWorks, we are a non invasive platform, detecting coronary artery disease, and we are in a commercial growth stage. And our experience, we are lucky to be a large investors. We are after our series D and we have multiple strategics. So when I share with you, some of the pains that we have and pose it to the group is coming from real experience. With that, let's start with Alison, and if you can, maybe just a brief background, share with us, what is it that you do in your company, and then tell us how you ended up being the CEO of the company? I think that's always a interesting thing for everybody to know.

Allison London Brown  1:45  
Thank you. I'm Alison London Brown. I'm the CEO of Luminelle and we're a women's health company. Our focus is really on, develop developing solutions that require visualization for operative and diagnostic procedures. And our key focus right now is uterine cancer, and accurately visualizing and detecting cancerous tissues and sampling for that. So sounds simple, but all we did was add a camera and voila. So that's, that's what we do. How I became a CEO or a startup. When I joined Luminelle, it was actually my eighth startup. After a long and winding road with companies like j&j and GE, I got the entrepreneurial bug, and have done a lot of different products and different startups in men's health. But this is the first one that's gotten this far, so knock on wood. I hope we're in a good place to move forward. Awesome, Phil,

Philip Rackliffe  2:47  
Yeah, Phil, Phil Rackliffe, CEO of Centerline biomedical. We do 3d surgical navigation for endovascular repairs, we're 510 K, clear in the descending aorta, and working our way into ascending arch neuro and structural heart applications. We just closed about 90% of our B rounds. So we'll talk about that in a minute. But you take a breath and then you're back on at the next day, with potentially a new board and a new set of expectations, which is great for the company as we go forward. By way of background. Yeah, Boston Scientific ironically, I worked with Joe Urban 20, over 20 years ago in a first sales training class at Boston Scientific. So it's great. Great to see you, Joe. And we go back a long time, long career at Baxter healthcare, leading multibillion dollar global p&l and then I went to private equity, because I wanted to go faster with less bureaucracy. So at a peony company, a PE company then went to a start up in Richmond, Virginia, and then I found Centerline and I found Centerline you asked the question by executive recruiter that's placed me twice at Korn Ferry.

Joe Urban  3:45  
Awesome. Thank you, Joe urban CEO of Potrero Medical, we are pioneering a predictive health engine with a smart sensing Foley catheter. And we're starting with acute kidney injury a $24 billion problem in the US. And we are a commercial stage, entering our series D company. By background, like Phil said, we are in the same sales training class 20 years ago at Boston Scientific time at CR Bard. And then I worked with Dr. Fred Moll at Auris early as we're developing the robot. And then about four and a half years ago, I was approached to join the company and be the CEO of Potrero. And I said absolutely not. So they invited me to join the board. And I sat on the board for about seven months, and I saw how special this was, and the opportunity to really push forward medicine. So I accepted the full time role. And I wish I would have known what I know now. Otherwise I probably would have stayed at Auris and enjoyed that a little bit more but it's it's been a lot of fun over the last four and a half years. gape,

Gabriel Jones  4:51  
CEO of Proprio in Seattle, Gabe Jones, nice to meet you all. Just really honored to be on this panel already at the end of the run here and here. Gearing up to try to, you know, say something interesting and with some conviction, and after that last panel, we got to take some pretty, pretty strong positions here about the rep. So the company does computer vision, real time navigation, first applications in spine surgery. So as we all know, and it's the Holy Grail of navigation is to do that in real time, immersively. And we're doing that pretty powerful. The company has opportunities beyond spine, as well as robot, robotics, AR, VR or integrated, we're doing a lot of things with machine learning and AI, in collecting pretty powerful data set in the OR, today's, we can talk more about that as we go. How I came into this job was I met a brilliant pediatric neurosurgeon, who is also one of these rare people like Fred Moll, who are very entrepreneurial and tremendous clinicians. And we need more of those people. That's a separate, unrelated topic. And we were trying to start something in the area of virtual reality and thinking that microscopy would be a good place. And in doing so, we started putting a lot of cameras, I envy you that you could, as you said, just add a camera to that. This has many, many cameras and sensors, looking at the operative scene. And over time, we realized we were doing navigation as well as visualization.

Ramin Mousavi  6:07  
Great, well, since we all started working, when we were in elementary school, on the panel, you know, you know, with five people, you have just sort of sixty years of experience at seven of the top 10 med device companies. So I think we've seen the both side of this. But let's go to the question that I think we all wake up every day with. It's the hypothesis is that you know, as you're trying to get an idea and get funding around it, a lot of milestones are in the future, you know, give me more money, I will clear IP, give me more money, I will get clinical validation, give me more money, I will get approval, give me more money, I will get reimbursement. Then you get to the commercial stage, and you can say, give me more money and then come back later. The question is like, how much did you sell last month? So as you think about where you are today, what is the one thing that if you were able to go back, you know, to that early stage, you would do different and think about this as a peer group of our CEOs that, you know, I've been listening to some really, really fantastic pitches, you know, last few days. What will we do one thing that, you know, Allison does different if you go back in time, when the time machine thing gets created?

Allison London Brown  7:16  
Can I pass? I, I'll just tell you. So I have a wonderful business partner who reminds me on a daily basis that I'm no longer at Ethicon. And it's not so easy. And I've found that out, I think the hard way that I can't just walk in, and somebody's gonna buy my thing, and everything's great, right? So I, I work with a lot of scientists, I work with a lot of nurses. And the one thing I always tell them, and it's not just about how big is your market opportunity, you know, it's not about the TAM, I mean, that's important for an investor, but it's about who's going to buy it, how they're going to buy it, how they're going to use it, and how they're going to get paid for it. And that you really have to understand that whole thing. So it's not just revenue, it's the reimbursement. But how you get to that revenue. You know, the last panel talked about Salesforce, we've been having the debate here about W2s versus 10 99's. Versus distribution. And I, I think the one thing I would have told myself earlier, is that let's raise a lot more money, and go big. Don't, don't try to dabble, I think the dabbling, it depends on your market, you gotta prove it out, you know, a little bit by little bit to have the cash so that you can when it's time, you can swing for that fence.

Ramin Mousavi  8:39  
So Joe, you know, and the disclosure is that when I was on the strategic side, I had a chance to take a closer look at what Joe does. So that's why, you know, we've become good friends, because I think the work that you've done is pretty amazing. But let's go look deeper. Because you know, not a day goes by or I opened up LinkedIn and you have, you know, 20 systems shipped somewhere, you know. So as you think about that daily activity going back in time, what was the one thing that you know, the company had prioritize that you think either was taking too much of a best case scenario, that the reality check wasn't there or knowing what you know, you would go back and do differently?

Joe Urban  9:21  
I think we underestimated the heavy lift of scaling a volume based business and you know, a lot of times Auris, we were planning on shipping a robot to a Bronx suite. And then maybe two later, we're talking about hundreds of thousands of smart sensing Foley catheters that we were going to be producing. And we had a out of control cogs problem we had, I was fortunate to have some incredible mentors on the board, Jay Watkins, who you may have met or onstage or saw him on stage the other day and Fred Moll, Dan Burnett Alan Chesler, Andrew Offer who's also here, it just great, great people. And when we dealt with those, just what should have been company ending events. I was fortunate to have guys like Fred and and Jay, specifically for that cogs issue, pull me aside, almost like taken to the woodshed it was I spent four hours at the whiteboard with them. And we looked at absolutely every single option that we could take to overcome this, what we're selling it for it cost us 10x to make. And so, it was it was terrible. And so I think I would have planned the scaling, spent more time on that we we did what we knew we scaled too fast at times. And I think we could have preserved more investor capital by looking at more methodically. So that's what I would take back.

Ramin Mousavi  10:58  
Thanks, Joe. Phil, you just closed around, or I know if you've announced that you're close enough, you know, which I know it's kept you up here now. Reno for a long, long time. Now that you're there, you know, you're looking at the light on the other side. What's on top of the list?

Philip Rackliffe  11:16  
For me, it's really about, we ran lean the last 12 months. So we were in this weird spot where we had an FDA approval, but yet COVID was hitting it we're kind of past A but we're at a B but we don't have revenue on the board. Somebody's like, oh, you're a B minus or A plus, we don't fit your criteria. We want to see you put up 5 million a year on a run, right? We want to we want to we want to. Well, I was stuck in this spot. Right. And so that was that was tough. But to answer your question, kind of directly. What's top of mind right now is balancing the organization for all the kind of infinite routes we can go like we're we've got 17 active programs right now we've stretched the organization very thin, and they've worked tirelessly. And they've been an amazing group to work with. We have 40 FTEs now, but you know, the weekend work can't continue and kind of the burnout. So right now it's a full fledge, you know, add 20 FTEs that lasts next nine months, and build a have a chance to pause, plan the work, then work the plan, plan the work, understand how your org is going to be structured, who are the right leaders you need, and then have them kind of go out and just begin hiring. That's, that's top of mind for me right now, for sure.

Ramin Mousavi  12:30  
And I'm gonna come back to that, because I think that's an issue that we all deal with. But I want to hear from you, Gabe, you know, on the same topic, knowing what you know, and you're in this very unique space where there's some interesting innovation happens. So maybe another lens of looking at it, knowing what you know, now, what would you have done different to differentiate your pitch today, you know, that would probably give you additional advantages.

Gabriel Jones  12:53  
Yeah, it's very comforting. By the way, I could answer a very similar answer that each of us, so that's very cool. I think if there's something valuable to say to the to the audiences, if you have an opportunity to disrupt a sales model, the gentleman from unveils comment hits home quite a bit. Lean into that earlier, right. If you're, if you're gonna come with a data play, or something that's unique, I think we waited a while to kind of really triangulate that between Pete selling a piece of hardware into the operating room that accelerates navigation and accelerates the workflow and does all these really cool things. It's a cool product, you demo it, the physician doesn't walk out of the room saying anything other than you're gonna change that paradigm, lean into that you have the impact clinically, if you're gonna go sell the data coming off of that, or some access to something unique, changed the selling model, really leaning into it. I think we've played both sides of it for too long for a while there. And if that really is going to be the thing that on top of the clinical differentiation pushes the business to faster growth and a flywheel to really we need that earlier. That was a important lesson for me.

Ramin Mousavi  13:54  
So let's go back to adding people thing and I know we have in in providers, there are different, very well known and you know, high esteem, research, the search group executive search groups, and, you know, I wouldn't be at Cathworks, if it wasn't for Bioquest, Dave Mildrew might be somewhere, so shout out to him. But you know, I believe in that long term relationship. And I think if you build it early on, when you get to that stage, somebody knowing the story of what you're trying to do becomes really helpful. Because the day after you close, you get the, "how come you haven't added people", you know, it was one of the challenges that we have, I think I spend most of my time interviewing people right now. And no matter how many people we add, we are always having a capacity problem of you know, can we go faster? So talk to me a little about the that ideal service provider I think this notion of this lonely world that we get into, what can we share with people to understand what's the value you're looking for?

Philip Rackliffe  14:53  
Yeah, for me, it's kind of twofold. One I kind of bucketize, some of the search firms as more executive related VP and above and then more general service. And I do think there are firms that are better for engineers, software engineers in particular than others, or QA reg reimbursement. That being said, for me, frankly, it's, it goes on the network of other people, I have asked who is good? I always like the one degree of separation if for me, and Joe tells me, they use x, I very much trust these two, I worked for them for a lot a long time. So I'll go there. So that in that personal kind of network is important for me. Also, the ability for them to bring it's as obvious but high quality candidates and a defined number of them and explained to me what they've went through to get to that point is really important. I know when he has time to look at five or 10 resumes, I just want the two best and you get to go with it. I do agree the long term relationship is critical. Because you don't want to really have to tell your story to then have a recruiter actually go out with the same kind of conviction we do.

Ramin Mousavi  15:58  
Allison, as you know, as you have looked at the experiences you've had, what stood out, you know, what's the good relationship and you look at the provider and doesn't have to be just recruiting the other, you know, we panel before was talking about digital marketing and marketing agencies, as you think about the partners that you need, when you get to that stage to commercialize what are some of the key attributes, characteristics that you feel, resonates and gives you high confidence that they understand the challenges that we have to deal with on daily basis?

Allison London Brown  16:29  
I think there's two that really come to mind. And it's interesting. And I think we think a lot of times about a regulatory consultant as a person that helps you get to the FDA, right, or get your CE mark. But if you've got a good one, they're going to help you with your strategy and figuring out how to extend the life of your product. And so I think having a really, we use an outside firm we're not using we don't have a headcount for that. And we have intentionally tried to find different outside firms to help us with various things. But I do think you've got to remember, how do you continue to get new claims? What does that look like? Your regulatory person can help you a lot to figure out how to maneuver through the FDA, to make sure your new labeling or your new claim is, you know, kosher. It's hard, I will tell you, we had four different regulatory consultants before we found one. And you know, there's always this rule of thumb, do you want somebody that has been in your space or not? I don't know what the right answer is. I think it's a lot of times it's a fit, and it can they can you work with them.

Ramin Mousavi  17:40  
So okay, of all the firm's you work with, who is your favorite partner? Why?

Gabriel Jones  17:46  
I can an echo again, a lot of what Allison said, we're working with a firm called Kindred, which is a placement firm for executives in space, and they've been fantastic. I think it's a lot of what the team has already set up here. But finding a friend that's adaptable to the way you work, getting you your two resumes, actually listening, working with you on a weekly basis, you know, if that's your, your kind of cadence, talking on weekends, if necessary, really being adaptable to just the life of a CEO of a growing company, you'd be surprised, but a lot of them don't adapt to your schedule as much as you'd like them to. That's been really important. And it's a plug for Kindred that they're quite good. Rob Langille, there's fantastic. So

Ramin Mousavi  18:26  
there's this reality of, you know, once you get, and it happens in different stages, depending on what's the technology and how well it's run, but usually, it's around Series C, and after that, where, I think is what you were just touching on did the profile of your investors change, and the profile, your company changes, you know, you go from kind of high promise to the reality and you can fall into a little bit of a, call it a bridge to nowhere, you know, we experienced that actually, at some point in Cathworks and, you know, took us a while to figure that out that you're no longer that early stage, that you can just get away with the promise of your time. And people want to see your revenue, but your revenue is not where it needs to be. So it's a big dilemma. So you know, you meet all these institutional investors, and they will tell you know, if you had only like $12 million in revenue, we will only and just let's stay in touch and, you know, our CFO is in the audience since over and you know, he can tell you that, you know, we heard that so much, you know, in three years ago at Cathworks so you think about that and the kind of challenge that you have, and it comes to the commercialization I think there's a little bit of a two sided knife in this that you want to give a huge appealing pitch before your go to market strategy. You know, I my favorite slide. pasty days is the hockey sales slide. And so if you're a first time co founder, let me ask you to explain whoever told you to show that just fire him. There's nobody believes it. I know somebody at some point said we need to see your revenue your $100,000 this year and 150,000 next year and then 12 million year four, nobody believes that, you know, all it does, it takes credibility, we, we have made that mistake. So you know, if you want to judge start with me, but as you think about that, you know, first, Has anybody seen on the panel, a perfect first draft go to market strategy? You know, I criticize mine. And man, what was I thinking, you know, when we put that together, but more important, given the importance of that, because you want to be very promising because you want the investment. But did they after you got it, you're held accountable to that? What to do? You know, what's that? What's the way to to work your way through that? Joe? Let's start with you. And then I think it's a good question for everybody on the panel.

Joe Urban  20:46  
It's kind of like building the plane as you're taking off. And that's what it feels like, a lot of times, like, we're the technology and it's okay, if you launch a technology, that's not picture perfect. The technology we have today, and that's in the market is lightyears ahead of where it was when we first went commercial. That first year, we learned a tremendous amount about our technology. And thankfully, that conversation was mentioned a second ago with Jay Watkins and Fred and Colby pulling me aside and working through the cogs issue. We were we were looking at it as the cogs reduction project. But also, as we were doing that we're looking at what the customers were saying and what they were telling us. And it was a constant, like we still tweak as we go along. And so I think from a go to market, it's you have to be prepared to quickly pivot, you have to listen to the to the customers and you have to be prepared to to understand that what you're bringing to market your your baby might not be that beautiful, I think Gary Guthart once said, all technology is born ugly. And that's the truth it is. And it's comes down to just being able to pivot.

Ramin Mousavi  21:56  
And I echo that and it is very satisfying. When you get to the other side of it, there's light at the other end, you know, when you actually over achieve a plan, you know, and you do it a lot. It's so nice, you know, it's really good how people line up, you know, we finally got to that place, you know, last year and it's nice that you know, you have people calling on your door and say you want to be in but let's go back. And I want you to add also because you know you and I experienced a very large, strategic that was active in m&a. So as you think about this, and specifically as you think about this for strategics what advice you have, you know, what, what do you put in play knowing what you know, because you used to sit on the other side of it making decisions on? Is this appealing, you know, tucking that for my portfolio? What do you do different with your go to market plan? Now, knowing what you know?

Philip Rackliffe  22:52  
Yeah, yeah, I guess I'll answer it, I think, you know, just as hard as hindsight goes, you're you're up against, show me revenue, show me revenues, show me revenue to get funding, right. So you may begin with a spray and pray, I call it go to market doesn't work, it kind of works, you'll get some sales out there. But you're not spending the time on customer expectation setting, strict segmentation, understanding the customers that want to grow with you and believe in the broader vision of your company, that's the customer you need in the customer is going to try to be the first one to take you out of the institution. So I think that choice of customer selection early on is very important, as it relates to strategics, quite interesting, because I've had a lot of discussions both on the with imaging manufacturers and disposable manufacturers. At this point, I just keep them all warm. It's like everyone kind of wants to see what we're doing. And do you want to do device integration with sensors? That'd be cool. Do you want to have overlay with imaging technologies and our technology potentially, right now we're at a point where our value proposition is around being agnostic. And so we're trying to find ways to continue to do that to maximize valuation at the end and not be tied to one or the other. But I just say keeping close. That's our strategy, very different value for some where you'd want multiple strategics. And but for me, it's it's

Ramin Mousavi  24:11  
so Gabe. You know, when you think about go to market strategy, revenue is a lagging indicator. You know, when the PIO comes in, something has worked well and doesn't come in, and usually you're waiting. So as you think about if you are kicking the tires, have a go to market strategy and a commercial plan. What are some of the KPIs you try to built into it to clearly convey the high degree of confidence and on the other side, being able to go back and say, these are some of the leading indicators showing that, you know, that plan is working? Well? Yeah. First

Gabriel Jones  24:43  
of all, the solution to that hockey stick slide is just to remove the timeline on the bottom, show the growth and let him guests now. Yeah, I agree with a lot of what the again with the panel was said we really tried to focus on what's assumed success and plan accordingly. So get out with the right partners very early. And that's very hard to select those right? But you do the work beforehand to run that algorithm to select the right partners get the right data, and ask yourself the question of if they were using it in this way, like an overwhelmingly positive response. How would we deal with that? It's almost like your website gets, you know, overburdened on a GoFundMe or something like that, right in crashes. What would that scenario be? And actually thinking through that, like, what if they love it more than we can even support? And those kind of edge cases are the ones that we use to say, like in spine surgery? What if they're using it for every level to do the fusion? What if they're navigating more than they were navigating before? What if there instead of using navigation for 15 to 20% of the cases and standard now, what if they were navigating or utilizing a visual visualization system for 75% of the case? What would it require? For that to be the case, we try to drive those edge cases, because the result is, if you can actually achieve that you're more valuable, you're seeing more of the case, you're collecting more data, you would actually be overwhelmed with demand. So that's the kind of edge case that we try to prepare for. And then everything that you know that hangs off of that is something that we can achieve or cover for will be resilient to

Ramin Mousavi  26:07  
all sudden, we were talking a little earlier, and you were talking about the you know, you guys might be in this unique world that you proactively taking care of the reimbursement challenge that many others wait. And that's, I can tell you, that's another big differentiators that, you know, after you got your regulatory approval, then trying to answer the question of how do I get paid for this, you know, that's something that you can work in there actually new avenues to explore opportunities, if you don't know I have a met now has a Excel subdivision. For startups, it used to be a lot more expensive to be part of it, I highly encourage that you become part of that. And you can get a lot of good resources. But as you think about your technology, and where your focus, that is not a problem that you have to deal with, which was very unique, you know, but what other things so let's say if that's not an issue, what other things you are facing that you think becomes very relevant for that commercial plan to bring to life?

Allison London Brown  27:01  
Yeah, I think it's, it's interesting, because when we talk to people, especially, you know, either strategics, or funders, and first, I would have to say, if you've got $12 million in revenue, why do you need to be funded somebody just better take you out, because that's crazy, right? But, you know, we're everybody says, you know, you're in that market development, or you're trying to develop a market and our challenge is that we have great reimbursement. So tissue removals, what we're talking about, and the reimbursement went up 575% for the office setting. So it was like a preferred reimbursement for the office setting for gynecologist and yet, they're not taking advantage of it. And that happened in 2017. And so I think a lot of strategics are looking to us or others to say, I can't acquire you until I see a proven commercial playbook. It's not just revenue, it's how do how are you to teach me to get from A to Z. And I think that's something we're working through and, and our thinking has certainly evolved. Our thinking has evolved over the last two days, just to be honest. But as a startup and kind of moving into that growth, that growth stage, I think you really have to figure out how do you focus, but then how do you pivot when you need to write? And I don't know if that makes sense? Because it seems a little bit schizophrenic in the head, but you do have to be there.

Ramin Mousavi  28:27  
Yeah. And then you're touching on something that, you know, as we were thinking about this panel, this idea of having the right advisors, having right partners, you know, I think all of us are pretty lucky to be have board members today are very experienced. And that's something that you want to have, because you have to be if you sell a plan, then you need to execute on it for the investors, you know, you can't pitch something and then come back to the after and say, Well, you know, we don't think that's really good. So we're going to shift away, somebody's going to call timeout and say, no, no, what's the impact of that on what we're doing? I think that's why some of the specs fall apart, because you know, what they pitch, right as you get close to going public starts falling apart. But you also need to have people that they are, you're close to that you're comfortable, if they called you stupid, you know, and doesn't hurt your feeling. But then they don't say loud enough that you know, other people hear it. So as we think about that, and there is a secret CEO club, Phil runs that, you know, so if you want to see him afterwards, you know, he will talk to you and by the way, I was just told that you are offering to buy everybody around the drinks because you hit it in one hole on Tuesday. So you know, whenever that comes, if that's true, the appropriate thing in Southern California, just so you know is that you buy drinks for everybody afterwards. But put that aside and just talk about this small group of people that you know you can bring together and bounce ideas off of and you know, some of us have known each other for a long time, I can't tell you how helpful it is to be able to pick up the phone and say, I want to do this, does this make sense? And somebody's like, Oh, my guy pitched this to my board and I got crucified, you know, don't do that. Or, you know, let me tell you how you can do that. Maybe kind of weigh in a little bit of like, what's your and this is a little different for everybody. You know, it's a balance of the network that you have your approach and your style. But how do you solve that? You know, what is the what's the magic for each of you guys? Maybe starting with Gabe?

Gabriel Jones  30:30  
Yeah, this is a big one. Building your own CEO advisory group is one of the biggest misses I had, I didn't do it soon enough. And if you do it with intent, whether you're a founder or you're coming in taking over a company, I think it's it's very revealing. Because if you say, Well, what are my strengths, and then the things I want to build, whether it's aligned to the go to market or a particular technology, whether it's deep tech, or going into a new market, or creating a new category, you want to have people around who not only can commiserate, but can help you figure out how to price that how to go to market, maybe even know some of the stuff we were talking about earlier, how do you select those early partners are gonna give you that feedback, whether you're right about that product and that pricing or not. So I think being very intentional about that, making sure the people you add to that group will call your bullshit are able to, right, and then you can have those open conversations is really, really important. What you realize is that we're all dealing with kind of similar stuff, which is very relieving. And then we can start to brainstorm about some of those solutions together. So be intentional about building that group and do it earlier than you think you will need it.

Ramin Mousavi  31:33  
And it's an annuity. So you got to pay into it for when you need it. So you know, that extra drinking, extra phone call at 9pm sometimes goes a long way. Joe?

Joe Urban  31:42  
Yes. The I do think the having access to people that can help you is something that when I first came in as the CEO, I charged pretty hard. And and when I stopped and looked around, I was like, Oh my gosh, you know, I need some help. I don't know what I'm doing with this right now and made a ton of mistakes, still do. And you know, as I go through, and I look at the last four and a half years each, each round was a different chapter of what we're doing. And I guess the page has to be interesting for the reader to return it and to get to the next chapter. And what I found was, as we had those really incredible challenges, it was talking to guys like Jay Fred Colby, Dan, Allen Andrew on the board as expected, but then reaching out to other people. In fact, Dan Hawkins was one guy that we sat down with, when I made the mistake of stopping raising money, as soon as the Series C was over, and I built the company as building it and growing it. And then we realized that man, we're gonna run out of money, we got to raise money. And so I sat down with Dan Hawkins. And he was it was before Avail really took off. And he was like in this little rent office in Palo Alto. And he sat down and spent about two to three hours with us going through it. And so it's that network of other CEOs that have been battle tested in the past that you have to lean on and just put some pressure on just to to understand, like, how do you do this, because they're going to help you avoid that pain if they can, because they've gone through the pain and they, they understand what to do. So that's as fast as you can, if you haven't already get your network. It can be all over the world. It doesn't have to be, you know, in your backyard and just make a consistent

Philip Rackliffe  33:43  
I'd start with the, the notion that you are humble, and you don't have all the answers. That's first off, if you think you are then you got another issue. So you only learn through your peer network. So we start I mean, you know, we get on the phone, and it's the loneliest job for sure that I've had and so you know, someone external stakeholders, yeah, you're all employees, you got customers, you have investors, you've got strategic so you need to have that, or else you're gonna go crazy. So, you know, we we have our own little Yeah, CEO group that we bounce things off of and ask stupid questions. And then we started at centerline, we got a Scientific Advisory Board, which probably every company does, but then we got a business advisory council. So I just picked mentors in my past, like Frank Grillo, who worked many years at Intuitive Surgical and Typhon and Medtronic. He's on there and he was my mentor 20 plus years ago, Doug Teany, Corindus has now now startup out of Cleveland Clinic. Those types of guys that have either been there had large exits, have them on a business advisory council or call it whatever you want, but have been on quarterly meetings, be another sounding board for you can't, you can't find enough good opinions to then drive your own. You get their opinions, take that more work, synthesize it and then make a decision. Those are things I would have done earlier. Awesome.

Allison London Brown  35:02  
I think for me, it's a combination of cultivated relationships that I've had over the years and keeping up with those. And so I have different people that I'll reach out to for different topics. I also belong to a more formal CEO group, we get together every other month. But if there's something that comes up, you know, that it's, it's very truthful. Sometimes too much so and, and they pick up the phone, I mean, they'll answer your call when when you need something. And I think that's a rarity these days to feel that you can be vulnerable and transparent with people. But I would also say, it's interesting, because I was told a long time ago in my career that, you know, you got to have a female advisor, you got to have a female mentor. And I guess I just look at it, and I say, I want a guy who's going to tell me how to deal with the other guys, because we come on, let's just be honest, we come at it a different way. And so I, I have women that advise me, I have men that advise me, I have physicians that advise me. But you've got to have that diversity of thought, because you, you learn about yourself, I think, as you go through that, that process, and it has it can't be forced?

Ramin Mousavi  36:31  
Well, you know, Cathworks, we don't have much of a problem with that, you know, we are Israeli based company, and actually, just above 50% of my senior leadership team are strong women leaders, and you combine Israel and our female leaders who have no time, have not no problem telling me that I'm wrong. But I actually, you know, I will echo that. And I say, you know, one of the things that makes me very excited every single day is I'm surrounded that everybody on my senior leadership team is certifiably smarter than I am. So you know, it is very easy to be in a conversation, knowing the other person is smarter than you, you know, from our CFO, to our strategy to marketing. And that just makes you better. You know, it's not just trying to pretend to be humble, but just be surrounded by people who are better than you. Because then the advice that they give you makes you better. And it is important in the loneliest job in the you know, which is I think it is very lonely at times, because you're at that crossroad of trying to help protect your employees, create value for your investors bring new investors add a strategic steward. And that makes it even more complicated. It's important to be surrounded by people that you show up every day loving what you do. So you know, I think that's the key. At the end of the day, we are kind of blessed being in this setting that we do something that at the end of the day has a patient impact. And, you know, and for those of us who are not physicians, that's as close as we can get to actually have an impact on somebody else's life. So let's do a quick, quick round of what's the next big thing for your organization that people here should know. And make it whatever you want to be, whether it's towards investors, partners, anybody else? What's the next big thing that you guys are going to do? We'll start with get actually, let's go the other way around. We'll go with Allison

Allison London Brown  38:15  
first. Oh, goodness. Okay. So if you want to write me a check today, for $10 million, I will take it. I mean, you told me I could say, I need a $10 million check. I'm gonna go hire about 10 to 12 reps, and, and then we're gonna go change that women can get diagnosed for uterine cancer for the first time the right way. How's that for an answer? I mean, you know, who wants that to happen?

Ramin Mousavi  38:40  
There you go. Thank you. Well,

Philip Rackliffe  38:46  
two things. Number one is the value of our platform for next indication. So we're just doing our fourth Structural Heart Study transseptal, crossing and getting the left side heart conditions and an aortic arches ascending is a growing market, and it's going to be the next gen of where they go next. Active development there, so that's the most that's very exciting, we got our current product going well, and we're going to go to other products that may even have a better product market fit. The second thing to be excited about this company and still looking for some money to round out this round, is how much do you need three to eight, but more on the side of 3. And so it's it's more like last Thursday, President Biden signed this omnibus bill for $1.5 trillion in there. We worked two years to try to get legislature and to write in verbiage that said you must use or at least strongly to use radiation reducing imaging equipment for complex surgeries. Got it in there. So just really, kudos to the government lobbying team. We hadn't we had an exciting future.

Ramin Mousavi  39:40  
That's awesome. Joe,

Joe Urban  39:43  
Well close our series D. That's priority number one today. Earlier today I announced a new product called Akron analytics and this is where we can see retrospectively over the course of the last quarter, the performance of a kidney, across different departments, different patients and provide that clinician, that Intel, which if you can see it, you can measure if you can measure it, you can improve it. This is a first step and really reducing the $24 billion problem that we're faced with and digitizing the kidney. At the end of the year, we have another major software launch that will, we believe, revolutionize the way that fluidics is administered in the operating theatre, as well as the ICU. So we're super excited for those those events get,

Gabriel Jones  40:31  
we're trying to guarantee the outcome of a spine surgery, that's the long term goal, right? Like, what if you knew the outcome and the probability before you even started, or at a certain stage, if you can evolve kind of your understanding of the procedure as you go so on that, you know, that huge moonshot mission list. This year, we're planning to do first and human. So for me, as a founder of a company, five and a half years in grinding on deep tech development, first 510 K going in very shortly, it's gonna be a big year. And that's the first major step right, followed by a lot of other really important ones

Ramin Mousavi  41:04  
Fantastic work by all of you. And I highly encourage everybody, if you want to reach out, this is a very impressive group too. And they're very real. So if you want to reach out just to connecting, you know, piggyback on your advice, that's, I think, something you should do, I want to bring it back to, you know, I think when Scott, this this did this meeting, the very first time, I think I was the very first person who signed up for Cathworks at the time, and we had a vision of Cathworks that we will be at the stage where we can actually commercially growth and you know, I think we are there. Now finally, and for us, we hope that you know, we can be in as many of the 50 States before the end of the year. And then I want to just say something about this ecosystem that we are in, you know, I live in Southern California. So, for me, this is home, 10 minutes away. But putting together these meetings, takes a lot of work, a lot of work. And what I always admire about Scott is that every year when it's done the day after, you know, we talked two days after last year, about how do we bring more people more strategics? How do we bring more investors. So my ask from everybody in the audience that you know, if you get value from this, do two things, one, connect with somebody here that you don't know. And you know, even if they don't give you anything directly, maybe you can give them some value, you know, from your experiences that goes a long way you never know I have got so much back from people that I've connected in time. So do that it's you know, to have a drink with somebody you don't know. And then take advantage of the beautiful view that is happening outside. And the second thing is that as you walk away, go free from here in a couple of days with a lot of good ideas, maybe more money, some new partners. Think about how we can actually grow this ecosystem, you know, because I think we all have a responsibility to continue shine light on what a great space it is to be. It's difficult. It's meant to be difficult. It touches people's lives, you know, but we have a responsibility to contribute back to it. You know, I am proud of being part of it and will be part of it next year and the year after that no matter what we do as Catholics, and thank you Scott for putting this meeting together.