Human Capital: Challenges and Solutions in Retention and Scalability | LSI USA '24

Charles Rohaut  0:04  
Thank you. Thank you drew. So, for this first discussion, we have one entrepreneur, one investors and 123 recruiters. So let's see how they survive. We have with Yvonne So 15 years in the industry, with an engineering background is the CEO and co founder of startup because sin tz has just been FDA approved for technology to transfer the recovery process for surgical patients. We have an investor with David, from Cincinnati with 15 years of experience in the investment community, managing partner of WinHelp ventures, focusing on medtech, and digital health and software. And he has led or CO led, you know, 250, millions of private private placements. And then you have my colleague, Jeff Malika, with 22 years of industry, medical device experience six years in executive search, who's based in Philly. And last but not least, Alex, my good friend for the past 16 years with 25 years of industry experience, 16 years and executive search former international rugby players wanted to make sure that his opponent had to use medical device after the game. So that's why he switched to the medical device industry after after his career. And I just wanted to see today, we could kick off maybe with with you, Jeff, you know, from the candidate pool today, in 2024. You know, what's the landscape looking like in 2024? You know, what are the different routes today that a candidate can take for his journey. So,

Jeff Mollica  1:50  
in today's market with top talent, a lot of the top talent are starting to navigate more to small cap and private equity back companies, as we've seen a lot of divestitures in the strategics. With private equity buying them up, it's attracting top talent out of strategics into those smaller, small cap startup private equity backed companies, when that comes into play, the top talent is constantly looking for the faster paced things that are going to make changes and impacting the industry from a patient outcome to a hospitalization to the patient care to the longtime caregiver. And a lot of that top talent is also attracted to the utilization of technology and AI in those products, where it's moving a bit at a slower pace and a larger strategic. So we're seeing a lot of that navigation moving into that and small cap private equity back, companies are able to grab gather up those top talented people. So some of that is has been really changing in a good way. But it's also leaving succession and leaving a little bit retention challenges in the strategics as well. And what it is that the small caps are actually looking for long term from these talented folks is are they going to be able to survive in that nimble, fast stage environment coming out of a strategic environment?

Alex Bennett  3:14  
Yeah, thank you, Jeff. I mean, I'll add to that until a little story, because I think that whilst the landscape is evolving, and continually changing the fundamentals of top talent and nurturing talent, developing talent, acquiring talent, and retaining talent, you know, remain the same. And the reason I actually moved into executive search, and the wonderful world of global talent solution advisory was actually because I was really poor at it in industry, and I tell the story with, you know, a smile on my face, because, you know, it, it was in the mid naughties. And, you know, we'd industrialized, and we're commercializing a med tech asset that was demonstrably advantageous to that of the competitive landscape. And, you know, it was my responsibility to kind of commercially launch the technology internationally, you know, we had our CE approvals. And we and we, we ultimately got our 510 K or FDA approval, and we were ready to go after the big golden goose, right, the, you know, the pot at the end of the rainbow. And the board had said to me, Alex, you know, amazing job, as Charles said, you know, how the Heller, an ex rugby playing kind of, you know, football Pro was, was able to, you know, to kind of transition into industry was a marvel in itself, but you've never done this before, you've never launched products into the US and, you know, we need somebody that was, you know, experienced in doing so. Well, that was absolutely 100% accurate. But then Then came the next part right where the board are there to advise you and to help counsel you as it relates to many, many facets, but talent really should be first and Central and all of those things in my mind. And, and they gave the CEO myself the rest of the executive, half a dozen names of top 10 And in their mind that they felt would be far more qualified than I certainly but, but certainly able to take a very early stage med tech company to market in the US. Anyway, I won't go into the greater detail. But the long story short was that, you know, we took the board's recommendation, we did not do the same amount of due diligence. And on the human capital side, as you might expect of, you know, another kind of acquisition. And six months later to hire that we made, you know, it was x j&j and x multinational corporate, really, really experienced guy. But he was unable to transition into what was effectively a much smaller, high growth, you know, completely different culture organization, to the one that we were building. The Long story short, and most of you guys in small cap, growth companies will know this already. It's always a roller coaster ride, and you learn and you've got to learn quick, but that mistake cost us a D round of venture capital funding, it diluted the common shareholder, which was also the executive myself included. And and it was, and it was ultimately the biggest mistake, and the biggest learning that I took from, from ultimately building and selling a company. But the fundamentals remain the same even today. So when you're thinking about top talent, are they culturally aligned to the mission and the vision of yourself, the investors, the executive, the key stakeholders? Are they ultimately going to be motivated by the technology motivated by the journey? And ultimately, do they have the skill set to be able to deliver, and I take those kind of core principles with me even to today, because the complexity that just speaks to, which is layered on has to be considered. And we've had, and we'll talk more about COVID, and the implications to talent post COVID. But But ultimately, making sure that you've got top talent aligned to the mission, the vision and the values of the organization are fundamental. Thank

David Kereiakes  6:50  
you, Alex. And even what about you? So from an intrapreneur standpoint? You know, could you tell us a couple of examples, what have been the best winning approach to build a team? Any lessons learned?

Evan Luxon  7:03  
Sure, yeah. So I guess I'll start by answering that question with a slight detour and just say that, when we're hiring, the first question I asked myself is, first of all, do we actually need this role? Or is there another way to achieve the same endpoint. And so I think one common trap that we can fall into is if there's a project that we need done, but it's not an ongoing thing, that we need somebody to actually be there driving. There's other ways to go about that, whether that's consultants, other firms, whether we can buy that, whatever that may be. And the other is technology, which I think today is particularly exciting. It's Centese, we've been really adamant about trying to instill technology based systems so that as a very small team, we're only 16 people, we can run as efficiently as possible. So whether that's like our E QMs, for quality systems, we've got a very small quality team, whether that's some of the things we're doing now with software as a service on our connectivity, and not having to have a full team of software engineers. But I get really excited about that, as I think I had a little bit more with AI. And I think everybody here should be thinking about that as well. I don't know if you've heard the recent thing from Sam Altman. But I know he's got kind of a wager going on with some of his tech CEO buddies, where they're betting on when the first billion dollar solo single person company will be because of the leverage that we can generate with this, these incredible technologies. If I was gonna put a side wager on that bet, I wouldn't bet med tech is first. But the same forces are at play. And we all need to ask ourselves, what can we do to really create as much leverage as possible because we're all going to be competing for the same people and for the same capital, and those companies that can generate, the bigger returns are going to win. So with that said, we do still need people. And so for us at Centese, I think the main thing we do is just try to be as flexible as we can, across the entire continuum of what we're doing. So starting with hiring, looking at whether we want to find somebody in hire direct, whether we want to look at recruiters, we're just launching commercially now with our device. And we found this incredible firm that is a launch firm, that sales and marketing and they're exactly in our clinical space, they've got an established network of independence, they know which ones are good. And so we're tapping into that for our go to market strategy on the same that same time, we need people that can go in and train the accounts and get them up and running. And so we're hiring clinical specialists to direct so I think it's a matter of kind of being very open and creative about how you structure your strategy and then to get the best talent and to retain. It's a lot of the things that have already been said. You gotta have a challenging mission that everyone's gonna want to contribute to. You need to have people that really have buy in for what you're doing. But that's been a couple of our experiences so far. Thank

David Kereiakes  10:04  
you. And, David, from an investor standpoint, so some questions as for what would be the, you know, the key milestone checkpoints, you know, from a, you know, about to scale up a team, you know, what model would you use to, you know, optimize financings? Any question, any lessons, any particular examples?

Sure. Well, thank you, for letting me on the panel. And it's great to be with you all, I think there are plenty of financial metrics, plenty of guidance and advice and and landmines to step on. But when it comes down to it, people are what make this are what ultimately lead to success. You're in here, the entrepreneurs that I've been fortunate to work with, all have an unhealthy affinity for suffering. And a prerequisite to what everyone was saying earlier to success is sacrifice and finding people, the best entrepreneurs that I've been able to work with are great communicators, and they convince a wide array of people to come on this crazy journey with them. And as I've seen with entrepreneurs, in the best investors, you have to be resilient, you have to be persistent, you have to, you know, we're taught our whole life, if you do this, you get that, if you do that, you get that over and over again, for entrepreneurs, if you do this, you may get that you also may get punched in the face, too. So you just have to be resilient in what you do. And it's important to have a talented people around you, if you're the smartest person at the table, you're sitting at the wrong table. So what we try to do is we try to see whether a business is ready to scale, and our capital is expensive, all capital now is expensive. And you have to be mindful of every dollar that you put into a company into your business to scale that you can return or meet those milestones that can take you to the next next level. So you know, some mistakes here and there that I'll throw out there are plenty of mistakes to make. So not all encompassing, but just given the general audience you know, not incorporating sales and marketing talent earlier in development can be a challenge. So your engineers your development work may be geared toward a physician, a user of that, but not the actual purchaser, that purchaser could be different in many cases. And by not incorporating that unique insight. You can miss and continue to have to learn with expensive capital. The other I constantly hear we need to raise 10 to 30 million to launch commercially and scale. And it's it is a certain companies do most don't. In fact, two to 3 million to test that go to market strategy can go a long way to preserve your equity in the business to preserve your shareholders equity, and meet these milestones that are attainable, particularly given the valuation that you might have at that point in time. And by being able to de risk and reach certain milestones on 2 million of capital and continue to build the plane as you're flying it. It's scary. I understand that I've been in the plane as well. But that's those are just a few points of

Charles Rohaut 14:14  
hopefully, there's something there. Thank you. So So that's from an executive standpoint, maybe as governance as a whole. So if we talk a bit about boards and boards constitution and when it comes to time to have a strong or stronger board. My forte is more in biotech, but you can apply the same lessons from a leadership standpoint, when I started in this business 20 years ago, it was really the funders and the investors on the board. Now you can have a lot more diverse board we can approach you know, people from all walks of life can be HR can be market access, commercial finance. You know, even what has been your experience, you know, when it comes to time to look at a an independent board member or you know, or more you know, active BOARD MEMBER What what what are the cartel Oreos and how, you know, any, any lessons learned on that front as well?

Evan Luxon  15:05  
Yeah, so we've been very fortunate to have a very solid board since the beginning, very supportive, hands on, but not too hands on, you know, there, there there, we need us. And we're able to open a lot of doors. And I think for us, one of the key elements of our board has been everyone understanding that it is subject to change over time, and that the board that we had on day one is not going to be the board that we have, you know, at exit. And so it's been a board that's changed over time, we just brought on an independent director with this latest round of funding that we raised in the fall. And there it was all about looking at the current composition of the board and figuring out where do we have gaps? Who do we need in the boardroom at this next phase in order to be successful. And so at that point in time, there were two common shareholders, me and another founder, then we had three investors who really had mostly finance experience, not a lot of operators. And so what we did is we decided we're going to bring on somebody who had grown and scaled commercial, early stage commercial med tech companies, we basically, you know, relied on our board to help find that person. And so that was a great jumping off point to get really nice, warm intros. And ultimately, we brought on a guy Tim still who's a serial CEO has had multiple exits, and really understands the exact stage that we're at, once we realized we wanted him, we also had to vet him to make sure he was going to be on board with actually providing the value, because I think one of the issues you run into sometimes is that the people that are at that level, are over committed and may not have the time to actually provide the value that you need them to provide. But with him, he's been fantastic. And we knew that from the get go, because he was very direct about his willingness to get involved. And so it's been a really great experience. So I

Jeff Mollica  16:57  
just wanted to add to that story that I had with an entrepreneur, again, out of Israel had a great medical device, product CE mark FDA approved in us ready to go launch and says to me, Jeff, we're ready, I need a CEO tomorrow, we had the funding, we gotta get a CEO, I said, Wait a second, I don't know that we need a CEO quite yet. You need, you know, distribution, you need regulatory, there's, you know, so many other things that we needed to work on. So going a step back from having the board and you don't have the board of directors, yeah, where do you start, you know, acting, you know, we we ended up moving in and putting an advisor in again, someone has commercialized the small medtech business or med tech business, got it off the ground, work with that advisor to then hire a chief transformation officer, and then you know, regulatory more of a commercial person that ended up coming into the CEO. So again, there's a cost avoidance factor, I think we've all been there where we, you know, maybe blush, too many hires are the wrong hire. And then six months later, you're really eating a lot of that money. The other thing I wanted to mention about when you're hiring talent, and it's so important, especially early stage, is that when you're going out making that hire the least most important person is the person who got the job. Because the person that got the job got what they wanted there, they're there with you, you have the right person, right. But as the 12 people that, let's say 12 other candidates at that level that didn't get the job, or now you're messengers in the market. So you're talking about building a brand, right? You're building a brand constantly when you're building this company. And those are the folks that are speaking to your brand outside in the marketplace, what the experiences are like what the process was like, what did they know about your product, your technology, your company, and they didn't receive it, if they're not getting the call back, if they're not getting the follow up, if everything just goes away, and they never hear from you again, it does say something to your brand in the background. So it's just an important note to remember, as you're going out there and hiring those first couple of hires.

Alex Bennett  18:49  
I'll just build on a couple of things that have been said, and we'll come back to the board, everyone. But David, you made a couple of really interesting points about timing and, and talent. I think that those are what Jeff was saying. So I mean, you'll obviously all have your own individual kind of goals and priorities. But but if you're thinking about, you know, commercial talent, or you're thinking about kind of quality or r&d, depending on what lifecycle of the businesses is in, your value proposition needs to be very clear and concise and precise. And I think that's something where, you know, we as as an external partner, as an independent advisor can add value, as Jeff just said, there as it relates to kind of cost saving, efficiency and effectiveness, but it can also be the investor base, it can also be the executive and aligned with the board in terms of, you know, how are we all kind of pulling in the same direction and selling a dream, right selling a story to to a candidate pool that, you know, the last thing anybody wants is to put that round peg in a square hole. So it's so so important to identify, you know, that everybody's you know, kind of goals and objectives are aligned to just point you know, the guy that's in the chair you've been through do that part of the due diligence process. But everybody's telling a story in the market. And I would just advise you guys in the room as well to be really kind of clear and specific and purposeful in terms of what you're looking to achieve and how you're communicating to the external market. Because, you know, it may well be commercial talent, David, that needs to hear a slightly different, you know, and it could be really bullish, and it could be all about the kind of, you know, the EBIT and how we're going to drive to commercialization and profit. But equally, you could be talking to kind of quality or regulatory folk, and they do not need fear in that conversation, right? They're going to need to be kind of nurtured in a different way at a different stage and a different timing. And equally, I would layer on to that, that in different parts of the world. I mean, you mentioned Israel there, Jeff. But I'm telling you that I mean, I've done some big big searches in Germany, and the Nordics and, you know, other parts of the world Asia. And, you know, not everybody's got the same appetite for kind of risk that we might find here in the States. And, again, you need to adapt your, your kind of story as to as to how you're going to realize success, depending on where you are. Because, again, the Germans is a good example, probably Europe's biggest economy, you're going to want to be there, right? But the way you articulate that story, and you attract top talent, there will be different again.

David Kereiakes  21:18  
Yeah, I'll come back to the board. Question. I think the last thing you want. And this, this job is hard enough as it is, there's easier ways to make money and but you're here because there's a higher calling to what you're doing. And we do need innovation, we need brilliant minds going after it. But the last thing you want is to have a cap table or board, ruin that for you. And I've seen it happen far too many times where I can show up five years after you've started and all the work you've done. And I can ruin your cap table and make it challenging for you to bring a great technology that really impacts patient care and better lives because we didn't do it in the right way. And I think it is important for you to be very thoughtful about who you invite onto the board, what their motivations are, what they're incentivized by, people behave based around incentives and bias and understanding that can really help you build a good board. Oftentimes, you know, if I'm the third or fourth investor to be on the board, you don't need me. And in fact, I will end up being more disruptive. And I'm talking about myself here, too. But investors in general, will give you similar views on the financial statements on the metrics that KPIs will put similar pressure on you, there, but we'll also have our bias and our incentives. And they can vary dramatically by when we decide to invest in the business. And I think you you want to try and limit the number of investors on the board, much like you want to limit the number of independence, you don't want a board full of independence, you want people who are financially invested, deeply invested that have done this multiple times over and over you want for other management talent. And so there are there are landmines here that you can step on that, like everywhere, has an entrepreneur, but it's important just to be thoughtful of who challenges you, who makes you think differently, who views the world differently, and has different experiences that can prevent the business from being scarred along the way.

Alex Bennett  23:44  
consoIe Can I just also add to David's comment there. And I'm saying this from the standpoint of, you know, five, middle aged white males out on the stage, but diversity is also so important. And I don't I joke because obviously med tech, you know, it is predominantly male focus, but specifically when it comes to the board, David, and you have an opportunity there to have a different voice to have a different perspective and a different part of an experience cycle. And, you know, I feel like certainly the most successful clients that we represent, understand how diversity can really generate value and understand that it it isn't just tokenism and isn't just a nice to have, it actually does reflect the customer, the consumer, the people that ought to be gonna be buying your product. So you know, where possible, try and drive diversity into the organization at all levels, including the board. Yeah,

Jeff Mollica  24:42  
I'm glad you said that. Because the other thing I was going to add other than diversity piece which is so important is especially when you're looking for that fourth person on the board, you don't I mean, I think a lot of people already know this, but people are always looking at what is the gap that you still have what is still the unmet need you still have on the board and that doesn't always come from another med tech leader, especially with enabling technologies. And with the utilization, the right utilization of ai ai, it could be coming from Google, it could be coming from Apple, it could be coming from Amazon. And we've done these searches where they are completely outside of the med device sector, and adds so much tremendous value to the board that is unbiased, right with new ideas. So it's something to keep aware of as you're adding that extra board member or even that second board member for that matter. But obviously, diversity is a big one as well.

Charles Rohaut  25:34  
So after 20 years of doing board searches, I only know I only look at two things when I do a board search once once. The first one is the passion, like how how much you care about the project and the people. And then sometimes something that's a bit overlooked is the bandwidth, do you have the bandwidth to dedicate enough time and energy because, as you said, launching a product is one of the toughest thing you can do. So they're going to have curveballs that you have not even think of thought of yet. So do you have the bandwidth to prepare for the board to dedicate time into the thinking that's going to be necessary for the next six months, or a year to come? So you know, be careful sometime, if you're attracted by by a talent by profile, that's going to be great, but he's already she is or he is already on five boards, there's a limit to the number of boards that you can you know, spend time on?

Evan Luxon  26:26  
Well, we've talked a lot about the actual board members. But one thing to also keep in mind are the observers think sometimes it's kind of an afterthought, you focus on the board or the voting members of the board. But what I found is that the observers can be both a blessing and a curse in the sense that they can sometimes be more involved and more helpful than your actual board members. But on the flip side, they can also be more demanding, and actually take more of your time to answer specific questions to David's point about, you know, they have their own biases, their own things that they want to see. And so sometimes it feels like an observer seat is kind of a freebie, but just think carefully about that as well. Because there is effort there and it can be good. But it also can can not be so good.

Alex Bennett  27:08  
So I'll tell sorry, if I'm taking a segue here, but Evan, be really curious to hear from your perspective, how you motivate and it's not just the board, right? It's it's the executive, it's the it's all levels of the business and remuneration and compensation, both at the board level, but but also throughout the organization are really important. And Jeff, and I can speak to, you know, the different kinds of comp structures that we see in, you know, global multinationals or SMEs and the difference between listed and privately owned companies, but But certainly, I think everybody in the room is likely going to be in the same position. And also David will will will have a view from a board and an investor perspective. But but but what's your view there? Because certainly, you want to make sure that the carrot is, is is attractive enough, but but not punitive. In in terms of, you know, when we think about how do we attract talent, and how do we retain it? Obviously, you know, sometimes that that that payoff, especially when you're talking about options, or equity, you know, it gets extrapolated, it's perhaps longer than you'd hoped. And then then you think, well, we've put all this time and investment into our people, we want to keep them. So just curious on your thoughts on compound Ben?

Evan Luxon  28:17  
Yeah, so for us, it's really important that we allow everybody to have actual buy in in the company. And so we provide the ability to earn stock options for every role, including, you know, we do our own in house production currently. And so even the assembly technicians who are building their devices have the opportunity to earn equity. But for us, I think it's actually a very small portion of the motivating factor. I think part of that is because of where we're located. We're based in Omaha, Nebraska, so not a huge medtech hub. We also have a lot of people that have worked with us who are not, you know, serial startup employees and kind of understand that game. And so they, they understand it, they see that financial upside down the road. But I think what's really motivating are maybe two things. One is, I do think at syntes, we have a very good culture of communication, where everyone feels like they know what we're doing and what the vision is, and everyone's pulling in the right direction. And then second, that that vision is motivating. And so making sure that everyone understands this is a medical device, and here's the clinical benefits that we're seeing. And so, yeah, the options are important, the compensation has to be fair has to be competitive. But I think more than anything, people have to feel like they really are contributing to something that's going to have a big impact, and that they understand what decisions are being made and why. And so I think those are the two pieces for us that are really important.

Alex Bennett  29:40  
Thanks. And Jeff, maybe you can also comment and then David will come to you because, I mean, we've seen so many different comp models. And again, I think it speaks to aligning the culture, the mission and the vision as you speak to heaven. But But But Jeff, in your experience, you know, what bigger role does just compensation you know, making them market and, you know, often we do hire people on far less cash, you know, and when we speak to cash, we're talking about base and bonus. But but the equity component is so important. And the balance of that being right is crucial, isn't it? Yeah,

Jeff Mollica  30:13  
yeah, no, I will say this. I mean, look, when you're going after talent, and your small cap, and you're starting up, depending on where you're going after that talent, if you're going up to the big strategic guys who are obviously very interested in some of these small cap and startups that are already making a lot more money, then you're going to be able to pay them right or you're going to pay them. If you're going to another startup or another small cap, you're gonna get a different type of talent, a different type of culture from that individual, rather than the strategic. So there's two things to think about there. The other thing is, obviously, you don't want anybody who's just looking after the compensation, because they're not in it for your mission and your values. You're looking for someone who is looking at what is the value proposition? What is the unmet need, and what is and top talent are looking for people that are action oriented? If there's action oriented items, where are they going to be getting to in the next year, the next two years and the next five years? What realistic outcomes are going to come from this? And how soon will they be coming? If it's a hope, and a dream and a product, you're not going to attract the right talent that way anyway, so your story and your unmet need has to be very clear, as we talked about earlier, from a compensation standpoint, those big strategics are willing to take the cut, they know they're not going to get paid the $500,000 basis and you know, 70% Bonus, or whatever it might be to come into your your small cap, what they're looking for is what is your story? What is your product? What is your technology? What is how is it fulfilling the unmet need? And is it action oriented, because a lot of times, they're stuck in a big strategic where they're kind of spinning their wheels, and they're kind of at a ceiling right now. And they are robbing their funding for r&d that is going to an underperforming part of the business. So they're robbing Peter to pay Paul within the organization. Now, they don't have funds to continue in their r&d. So they're stuck for the next year. So they want to know action oriented, can they move? Can they make quickly? What are the obstacles within your company in the next 12 months that they're going to need to overcome so that they can move in the market? So some of those are the things and then of course, we can speak to the smaller cap, which they're used to that nimble that fast growth, right. So there, they know already, that they're not going to be coming in with a large, you know, base and bonus, they're more in it for what's in the equity. What's the buyout? What's the return? What is your goal is that the IPO is it to get acquired is that the partners and another private equity we sold? So all the things that you see as your vision needs to be shared very clearly with those candidates to see what you're getting. So

David Kereiakes  32:30  
what is the perspective of the investors when the time comes to spend these high cost capital on talent?

Yeah, I won't add, I think you guys did a nice job sharing, I think it's not all about cash, you need to understand what is driving and motivating that person. And again, coming back to my first point, the best entrepreneurs are the ones that are able to convince and communicate to a diverse group of people on why they should come along with you on this crazy journey. So I have no problem with a sales rep making more than the CEO, some CEOs may. But that's a sign of a healthy business, and that you're motivating. Sales Reps tend to be more cash driven, and comp driven. And by doing that, you appreciate equity. And you want to try and find these markets where that are pull markets versus push. And so there's all sorts of KPIs and different financial metrics that we can analyze. But the deep down, part of it is, how well can you communicate your value prop? What is creates that poll in the market to anybody off the street? And so it's, it's a lot of the diligence that I do is can I pick up your message in two minutes? And then initial discussion? Can I then go and parrot it to a bunch of different physicians, administrative leaders, a diverse group of people and convince them on why they should purchase or or be a buyer why they need this. And when you have that you have scale, and you've have that transfer of knowledge that is so imperative, and such a prerequisite for success in this space.

So what helps today I think, is the fact that you today you have a flesh and blood example of top executive left no strategic organization, and had great success in a more entrepreneurial world. So you do have a track record in the industry. And so you have a lot amongst candidate I think you have a lot more indication on that front. And they're less surprises about making that switch. You know, from a cost perspective when the time comes. We have five minutes left for q&a. So if anybody would like to ask the panel any tough questions

Alex Bennett  34:55  
I'll ask a question of everyone while the room thinks it was interesting at listening to Catherine    Mohr, this morning of the keynote, talking about her intuitive journey and, and she spoke specifically about training and development. And I think it's something that we perhaps overlook, because we're we're shooting for the you know, the obvious objectives of the firm, whether that's, you know, commercial or you know, getting product developed, etc. But, but helping the talent pool understand how you're investing in their journey, and I can only speak from my own experience, but it was my real life MBA, and being in such a small organization experiencing the challenges in, you know, in r&d in quality and regulatory approvals. And, you know, being able to touch and see so many different elements of the business was, you know, it was honestly an experience that I would never give back for the world. But how do you constantly kind of look to, to motivate the guys, you know, David's point is not all about the cash, right? So it's about the journey, how do you use it? Or some other incentives?

Evan Luxon  36:02  
Yeah, so the thing that I hear most often for my team when I ask them, because I will ask them, you know, what is it that motivates you? How can I lead in a way that is conducive to the way that you want to be managed, and the most common thing is always to continue to be learning, right, and to be doing something new. And so that goes really well with our philosophy of keeping the team fairly small, and always having been off a little bit more than we can chew, because it kind of forces everybody to really step up and grow. And so it's striking that balance of them feeling out of their comfort zone, but not so much that they get burnt out. And so we've had a lot of examples like that throughout the organization where people have come on, and joined in one role. And they've shown that their ability to do more than we hired them for. And so we'll promote them on and, you know, there's ample opportunity to do more, more things. So I think just understanding what it is that motivates them, giving them the chance to really grow and learn, for us has been probably the key factor.

Alex Bennett  37:00  
Fantastic. And if there's not another question and others questions, okay. Thank you, all companies crashed quite a few wells within those 12. months for you even? Yeah,

Evan Luxon  37:15  
yeah. So I think the bigger the biggest lever there is not so much on the people, at least, what's coming to mind immediately. And it's more about having flexibility on what that rollout can look like, because we've encountered the same thing with our device, maybe not quite as long of a sales cycle, but you know, much longer than we would prefer. And so, you know, obviously, it's just staying on top of them and making sure that if the communication is slow, it's not for lack of trying, but then it's just being as flexible as we can be on how to get the device into the hospital to at least get going. Because with our device, we know that once the surgeon start to use it, there's that sticky factor, and it's going to have the pole and it's going to make its way in, but it's just getting that first device through the door. And so what we've done is looked at how can we lower the cost of the upfront equipment, get it in there on a loaner basis or on an eval basis, and just really holding their hands to along the way, jumping in wherever we can to actually be the ones helping out with some of the paperwork or whatever it takes to get that evaluation through the door. But it's a very difficult question. And so if you find a good answer, let me know.

Jeff Mollica  38:23  
I mean, the other thing I would say is, and I'm sure you've tried this, but the real targets the ASC market, right now, with a lot of the procedures going into those acute care centers, a lot of procedures are shifting is certain to the acute date, the ASC market, and also the whole market. So sometimes it's not all about getting in the hospital or the teaching institution where it actually comes from because they're going to slow you down the fastest. But ASC market would could be privately owned, it could be owned by private equity now, because they're buying them up all over the place, or just surgeons, right. And those profiles, they could get you into that market much sooner, which then obviously is affiliated with a hospital or homework. So sometimes the fast path sometimes takes you in a different direction. I hope that helps.

David Kereiakes  39:00  
Yeah, I spent five years working for a nonprofit, 180 year old faith based health system with 120,000 employees and certain things you're just not going to be able to do to shorten that sales cycle. There's meetings just to have meetings, constantly. And but what you need to do is understand the purchaser decision, and who's making that purchasing decision and how they're incentivized how their comp and is positioned, what motivates them and being smarter about the ROI and how it resonates with them as men and this goes back to an earlier comment about incorporating the sales and marketing teams earlier in development. You can't get back time. So being able to do these case studies and both clinical and economic studies that demonstrate value, you can make that second meeting a little shorter, and that third meeting a little shorter, and having friends and making champions at all different levels you can use them to pile on to and it's just a persistence game. Thank you everybody. Thanks everyone.