Stryker’s Journey to $20B and the Role of M&A | LSI USA '24

Bryant Zanko  0:05  
Thanks, everybody for joining today. It's a pleasure to be at LSI. I first came here last year just really engaged by seeing all the emerging companies and all the new technologies and really excited to be part of this journey with you. We'll talk a little bit about the role we've played in the ecosystem and the role that we all continue to play to make healthcare better. Bryant    Zanko I'm responsible corporate business development I've been at Stryker for for 20 years, came over from PepsiCo, where I was responsible for the Americas for our food businesses there and been on the part of this journey with my colleagues here. So I'll turn it over to Adam

Adam Wollowick  0:38  
Waldwick. Thanks, Brian. Yep, Adam Wallowick, nice to see some familiar faces out in the audience and a lot of new ones. I lead business development for trauma and extremities at Stryker. I've been with the company about nine and a half years, I spent most of that time in spine and enabling technologies. And my background is as an orthopedic spine surgeon, I practiced in New York City at an academic center for seven years, got my MBA and decided to leave clinical medicine behind and enjoy the industry.

Siddarth Satish  1:08  
Nice to meet all of you. We're going down and Stryker experience, so I've been in Stryker, like two and a half years. My name is Siddarth, joined Stryker through the acquisition of a company called Gauss surgical few years ago, and today, I'm happy to be leading our AI organization. So we work across all 22 business units. And we're driving some new innovations from the center.

Emily West  1:37  
Great. And Emily West. I'm a managing director with Goldman Sachs, part of our healthcare investment banking group, and honored to be here with the Stryker team. So I think we're gonna jump right into some questions, if that works, to kind of kick it off here. So we heard in the introduction, striker has really invested significant capital in m&a Over the last 20 years. And so maybe Brian, what do you think has really kind of driven strikers m&a, strategy and journey? Well, Emily,

Adam Wollowick  2:03  
first, thanks for being here as our moderator. As I think about Stryker, I think we're only looking really at a short snapshot of the time really going back from the days of John Brown. m&a has really been in our DNA. And if you look at most of our divisions, at the nucleus of that was an acquisition. And I think we've really continued that now. We've put more gas on that with with Kevin Lobo and continue to do really deploy more capital, it is our preferred focus for our capital deployment. And that combined with I think, a really deep strategic plan, and execution with our teams, and we'll talk a little bit about our decentralized nature, we've really been able to drive to drive I think, some pretty exceptional, exceptional growth. So really, again, it's been a journey. It's one that we hope to continue. And super excited again, to be here with some of the panelists here and talk about Stryker.

Emily West  2:54  
Great. And maybe as kind of a natural follow up, the key question everyone says is, what do you buy? And when do you buy it? And so how do you kind of decide?

Adam Wollowick  3:06  
It really does start with so I think it really does start with sound strategy we've, I'm responsible for, in part, our BD strategy. And it really that is the foundation we really drive an understanding of what our organic as well as our opportunities for inorganic growth at the business unit, division and group level. And that really is the foundation of where we begin our growth journey with with m&a. Obviously, then we combined with that, what our capital availability is, we roll that up, and then really prioritize that, I would tell you that all sounds really like it all fits, as you know, neatly. But as you know, companies are both bought and sold. And sometimes we've been actually over targets, right medical, which was our most recent large deal. That was 15 years in the making, we were over that target. And that target right medical went through so many changes we did as well with our needs. So I think when those times align both the buyer and seller, valuation has to align return metrics, it all has to come together. And I think, you know, it takes a lot of time over target to make that match at the right time with the right target and being ready.

Emily West  4:15  
Yep, great, and maybe just double clicking their valuation, what really matters on valuation, what metrics are you looking at? Are there any kind of internal thresholds that you need to hit? Well, I

Adam Wollowick  4:25  
think when we think about target selection, and that drives valuation, first and foremost, you'll you'll see we're not typically buying value driven plays, we're a growth company. So all the businesses that we acquire and I can't really think of an exception, have been growth accretive to Stryker, and that starts with the fundamental approach that we we have there then from that we really need to think about margin as well. It's pretty difficult to fix a business that has poor gross margins, we can do a lot below the line. General administrative have sales and marketing r&d to really drive profitability. But unless we start with a high margin product, it's really valued in the marketplace and as evidenced by gross profit, you know, that really is another key driver. And then we need to think about a return metrics. We are phenomenally focused on return on invested capital over time. Now some of our growth, your assets and those that we're building a, call it a platform around, we will accept longer ROIC longer economic returns. But we have to see that benefit longer term and ability to have a platform and then bolt onto that neurovascular was a great example. Although we did really well on that transaction, we then added to tuck in deals, and that's really when we drove profitability, and economic and economic profit for ourselves. So all those things really need to come together. And then obviously, now we're in a higher rate environment, we have to manage our EPs and our EPS commitments to Wall Street. But again, growth first, and then economic, you know, economic profitability, and UPS have to follow as well.

Emily West  6:00  
Great. And maybe we can spend a minute on the team that does all this work. And so what can you share with us kind of about how the BD team is organized on the corporate level within the business divisions, I think it's a little bit of a unique setup. So it'd be great.

Adam Wollowick  6:12  
I'll say briefly, and then I'm gonna actually turn it to to my colleague here, Dr. Wallach, and he can talk a little bit more from the divisions perspective. But again, we want to maintain that market customer intimacy, and that's really goes to how we drive business development. You know, given the breadth of Stryker now 20 billion in revenue, I, I personally don't think you can be effectively driven from the center. So we really depend on market intimacy. And that, again, happens at the BU level in the division level. So we have teams embedded in each of our divisions that are responsible for driving growth of those divisions and business units. And then obviously, we layer in all that all the really positive things about governance, best practices, we have a BD leadership team, we're constantly collaborating. So although it's very division centric, we're trying to drive again, value and understanding and governance across the organization. And I think that's that balance that we're continuing to try to hit. But it might feel a little differently from the from the perspective of the division, but we try to corporate striker, we really tried to minimize, minimize our involvement and really let the businesses run. Yeah,

I think I think there's a there's a great dynamic between corporate business development and the team that Brian's put together there, that really sort of supporting strategizing, amalgamating everything going on. But, you know, Sid mentioned, you know, we have 22 business units. And I would say just about everyone, if not everyone has a business development team. And so that decentralization allows us to have deep connections to the market, customer focus, focus on and and relationships with, with our selling channel. You know, it's not just sort of a marketer that's sitting in there trying to feed up to a big corporate group to make decisions and execute deals, we execute them from the lowest level and the divisions in the business units have the latitude to invest what they want based on their strategy and how much they expect to do in m&a. So you may have a group that has one or two people, and you can have groups that have six or seven, depending on their on their Deal, deal flow. So we find that that flexibility, and that, again, the the deep connection to those markets, being able to see trends ahead and sort of set the curve is, is what sets us apart.

Emily West  8:29  
Okay, and maybe we can talk about integration. How does your team kind of approach integration? How do you drive for real value creation with these transactions,

Adam Wollowick  8:38  
but when I when I started, we were we were really fragmented. We really did not have a robust approach to integration, we did not have best practices playbooks. And as a result, I think we under optimized some of the early acquisitions that we were doing now, since then, we've really built up at the center and really shared best practices and tools and templates. In fact, under my team, we have the Integration Center of Excellence. Now, it's been in an evolution formally for about five years, and we have not fully staffed that. And we're really benefiting again, it's in partnership not in substitute or in replace of the division. So the divisions remain responsible for the m&a they remain responsible for the decisions they make. They remain responsible for the integrations. But what we're they're here to do is work in partnership, to make sure that our integrations are maximizing value. We have that repetition we have that pattern recognition, we have that learning so we're not relearning with new team members. Each each time. I think this is going to be continued to be one of our biggest value drivers and one last commercial for the first time I actually hadn't really queued in on this, but we actually had a target come and said our bid was about equal to another but they felt so comfortable with the way we were going to approach integration that actually helped tip their their decision towards us. That is something I never really thought of as a is a competitive advantage from winning a deal. But just to hear that, and I've got tremendous partners, Tricia agile, and others that that really I'm super proud of what we're doing there, because it's really the hard work, we do pretty much the easy work. And it's really the integration that really drives value creation. So really proud of what we've what we've done in our team. And I think, Sid, you're probably a good example of how that's worked. Some, and I think, well,

Siddarth Satish  10:26  
yeah, I think I think it's, it's a work in progress. Our integration was, yeah, heavily, you know, heavily driven by the business unit when it came to product, and, you know, the sales and marketing aspects of the business. But in our, in our specific case, we discovered, wow, there's this nascent AI capability that makes a ton of sense to take to the center and to leverage across the company. And that, too, was a collaborative exercise. So it's all about collaboration there and figuring out where those other teams are on the company, that there's there's a similar initiative. And now that there's kind of a bolus and a critical mass starting to take place, does it make sense to integrate this a little differently than, say, your, your typical acquisition? So So yeah, definitely echo with Brent.

Adam Wollowick  11:16  
Yeah. And I think there, there's a couple other points, I think that that are important, the tremendous amount of time with lessons learned post mortems check ins throughout, that are like sort of, quote, unquote, required as part of the process, too, as we go through the integration to make sure that we're hitting everything we need to and things are on tracks. It's this intense focus there. And it's also about and by the way, we then we use that to benchmark right, a lot of people benchmark financial metrics of the deals, we met benchmark integration success. And that's proving to really push a lot of dividends. I think the other thing is we, we integrate integration, at the earliest phases, the deal, it's not even at diligence, it's pre diligence, the integration planning is already starting to take place. And we no longer approach it, you know, by functional area, it's by sort of what we like to call deal drivers, right, we identify the key parts of the deal that are going to be necessary for success, put cross functional groups together, and approach it that way. So everything is based on what's going to deliver the returns that we expect. And I think that leads to a tremendous amount of success and speed.

Emily West  12:23  
Great. And maybe shifting back here to said, you know, we can kind of double click as the newest member of the Stryker team via acquisition, what can you tell us kind of about the experience of Stryker acquiring Gauss and going through that acquisition?

Siddarth Satish  12:37  
Yeah, it was. First of all, it wasn't an overnight success. It was it was like a 10 year overnight success. I'd say specific to Stryker, and I got to spend a lot of time a lot of the other great companies in our space, took sort of a similar hands on relationship building approach. But I'd say specifically with Stryker, what I what I saw early, and then was able to cultivate mutually was a commitment from the business of the businesses that we're looking at our asset or our our company, a commitment to really understand how, and when this new kind of product that we had launched into the market might make sense for Stryker. So it was, I think, end to end a seven and a half year arc. From the first meeting I had with one of the BD teams at Stryker to the day, we signed a merger agreement. And along those seven years, I mean, we I mean, we saw folks that moved out of the business and then came back to that business in a different role. There's a lot of seismic shifts, because a very dynamic environment was you said, No, right, right. Yeah, I held the strategic plan for that view, in my mind. But what was it was incredible as along those seven years, not only was it about building relationships, it was about cultivating, like, I call it the front row seat to our little story as a company, all of the key people in that business unit that I knew would have to really understand the different aspects of our business to buy it and integrate it. They had almost as much information as my board. And I'm really not saying that lightly. We'd redact confidential things and then we'd send the board deck, you know, in effect to to the BTUs every every quarter, we'd cultivate these these dialogues about that business units own strategic plan, and where they might see this digital and AI piece coming into play, and for quick context, so that the product was a way to measure surgical bleeding using an iPad and computer vision and AI. And the business unit that acquired us was the surgical technologies business which focuses on patient and provider safety. So it has major products like the surgical sponge counting product line surge account, which is a SoCal based company came out of Irwin Irvine actually. And the Neptune device switch, which is the big suction system, it's the leading fluid waste management system in the market. So, you know, it was really about us building a story together as to when these three or four products would finally fit together and match. And that took seven years as most major portfolio decisions do for it to really sit right and for all the different pieces to be in place. And so I just had to not die basically. Period.

Adam Wollowick  15:35  
We're glad we're glad you didn't. But I think that I think that's why, you know, we we come to events like this, I mean, some people will do a meeting with Stryker, you know, you're not going to we don't give an equity investment or something. Why are you here? Why am I talking to you, but it's because we need to start to cultivate those relationships now, that translate in a few years into something meaningful. And you know, as Brian said, movie, many, many deals that we've been over targets for five 710 years and pulling the trigger. So,

Emily West  16:06  
ya know, you touched a little bit on integration, but maybe just kind of a double click there. What can you tell us about, you know, what's kind of changed since you've joined Stryker? What about retaining some of your own team and how you've been able to kind of kind of keep a lot of that team together?

Siddarth Satish  16:20  
Yeah, sure. Definitely. My wardrobe has changed substantially. At least small part of it. I would say, yeah. Wow. Going from 50 people to 50,000 people, like what, uh, you know, it was it was truly mind blowing. It is like, honestly, every day I spent it Stryker is mind blowing. And when I'm not questioning why they still keep me around, I'm sort of questioning Wow, how does this all work in such an incredible, fast paced way, despite the size and the magnitude. So a couple of things, I'd say, culture and strategy, where if you if you sort of split those apart, I think there are a lot of similarities in terms of our core values as a small startup, the one that we built, and what Stryker espouses, there's deep customer focus, we care deeply about our people. And it really does, I'm not making this up, it feels like a family, like when you walk up to someone and strike or jersey, or your, you know, we all know each other, there's so much collaboration, despite how decentralized the company is. And, and ultimately, it's, it's that driven aspect, it's a growth company. First, there's this really incredible amount of drive you see across all your colleagues. So it resonated with our startup culture, it resonated with the team we had out of the Silicon Valley, we have not lost a single person since two and a half years ago. And it's I can tell you, it's not because of some you know, golden handcuffs or comp plans or whatever is really, because of the mission, the kind of work we're doing and the people we get to work with. It's just a larger, larger team. So culturally speaking, I'd say the learnings have been a couple. The first one is decisions, they actually get made. Almost as fast as we used to make decisions in the startup we'd made we'd make, you know, five poor decisions, or Ill timed or just straight up bad decisions, and we get to the right decision. In that same timescale, Stryker will make the right decision 95% of the time, about whatever it is a program a deal, a customer. And the ingredients of that decision, though, are many fold. There's probably 10 times as many, you know, constituents and stakeholders that go into each of those strategic or operating decisions. And so once our team sort of figured out that, that gravity that that new set of parameters, that is this larger company that operates at such a bigger scale, I think things became a lot, lot more doable and easy. And we sort of got back into that pace we were used to. And then on the strategy piece, you know, creating a central AI organization was a very strong like strategic move from the top and was shared across many BTUs. And it was almost like a circular thing. So creating this organization was the way of retaining this organization. And it was also a way of launching the company into an incredible new set of futures that I know many of you that I've even spoken to the audience are part of this journey almost with us, you're exploring AI and digital and enabling tech and healthcare. And then more specifically, it was a funding behind it. So this is you know, it's an effort that's got true buy in from the businesses, deep engagement from our business units, and there's real funding and support. So those two pieces really backstopped why it's been so quote unquote, successful in terms of retention and just keeping that that's Eat alive and letting it grow.

Adam Wollowick  20:01  
And I think I think part of that part of that time over target is figuring out the detailed culture of the potential company that we're going to acquire and making sure there's a really strong fit there. And if there's a disconnect, we just know it's not going to work. And so we spent, you know, a ton of time trying to assess that. And I think, on the back end, it's taking this massive matrix that's been that Stryker is right and making it seems small, right. And we figured out through some failures, how to do that. And so being able to integrate people in very quickly, but smoothly and in a really kind of user friendly manner is another huge piece of the success.

Emily West  20:43  
Great. And maybe Adam will shift to you kind of your journey to Stryker, you were a successful spine surgeon at Montefiore. And what kind of led to the decision to join Stryker BD?

Adam Wollowick  20:54  
Yeah, thanks. So, you know, when I was in practice, I was sort of looking around and, you know, seeing what the future was going to look like for me. And at that point, you know, I was about five, six years in and was sort of saying, okay, you know, how many more ACDF and T lifts can I do, and is this going to continue to stimulate and drive me at the same time, I felt like I didn't have enough reach out there, right. I was treating however many patients I could see in the clinic a year and ever many surgeries I could do, but I wanted to do more. And so thinking about leaving clinical medicine, but yet having a connection to orthopedics to spine and being able to potentially touch more lives, by being able to bring technologies to market identify technologies earlier and either bring them into strike or help them get where they needed to go, was was became really important to me. So I went and got got an MBA and Executive MBA while I was practicing, it was like having two jobs, you know, two weekends a month. And then and then I took a huge leap of faith, I literally quit my job as a surgeon before I had anywhere to go and started talking to VCs private equity investment banks, anyone who I would I could talk to, and frankly, wasn't finding any success. And then and then I, I had a good relationship with Stryker and knocked on the door and turned out they were looking for someone to do m&a and spine which was my my wheelhouse as a spine surgeon. So it was a perfect fit, and he'll sell you're in the right place at the right time. And I say now is in the perfect place at the perfect time. And it's all worked out. So it's been been quite a quite a run. And it's

quite a you know, our BD team, it's really interesting, we come from such different backgrounds. But we complement each other areas that I have weakness are supplemented by people that have deeper clinical knowledge or technology knowledge. It's a really phenomenal place I saw engaged up in there 20 years and, and just so happy to have partners like like us that we can rely on each other. It's been great. So glad, you know, I'm so glad you're not.

Me too. Yeah. Now the collaboration across the senior members, the BD team is unbelievable. And you know, someone comes to me with something that's a neurovascular and endoscopy. And I make sure it gets to the right place. And we share best practices and pick up the phone and call each other all the time. And it really makes it makes it home.

Siddarth Satish  23:13  
Just add to that. So from the perspective of the seller, or you know, the company that's looking for a strategic partnership, that also means that when a target comes to like 50 people at Stryker, they're all talking about how that target came to 50 people at Stryker. So what, what I think has worked really well is when and I live this myself as a as a target. What works really well is when you go and focus your dialogues on the right people, or you endeavor to find that right operating unit that really has the market experience and the need to look at what you're doing right and not to cast like a super wide net and just talk to anyone you can you'll typically get steered towards the right folks and that works really well.

Emily West  24:04  
Great, and maybe Adam we can spend a little bit of time your work in the spine BD sect division and leading that and kind of some of the achievements you had in spine and kind of some of your goals within TNA now.

Adam Wollowick  24:18  
Yeah, obviously, I mean, for me doing getting KTM done was huge, you know, Stryker had been looking to make a big move in spine for a while and that obsessed a number of targets in the space and was fortunate that I was able to come in and in lead that that deal, you know, working through the strategy behind it, and not only leading the deal, but also then leading the integration of K to M into Stryker. So, you know, totally transformed our business, everything from portfolio but also we relocated headquarters to Leesburg where K to M was Eric and Elaine major came in which, you know, again, sort of, maybe not the typical paradigm of having the acquired, CEO and in The second in command stay on but it was a it was an absolutely key move especially going back to that cultural piece, we knew we had to preserve a lot of KTM culture while integrating in and bringing strikers best practices. So that was, was a I think a really sound move and worked out well and paid pay dividends for us. In terms of t and e, it's a very different dynamic. TNA at Stryker is about three times as big as, as spine is. And so I've got three massive business units that are all hungry, and they're all leading, right? We have tremendous positions in all three areas, trauma, foot, and ankle and in shoulder following, right and 20 a. So now it's about being I think, a bit more of, I don't know, a visionary of sorts, right. And because I've got visionary teams and leaders that are looking not only to do that internally, but to bring innovation in through m&a. And so, you know, while we're always thinking about the next 234 years, and what deals we can do, then we're also already starting to think about what deals are we going to do 567 years from now and what technologies are going to change the game and trauma so that we remain number one and expand our share rather than contracted. So that's that's how we're looking at it. So we're going, we're trying to go go big and go futuristic.

Emily West  26:22  
Great. Maybe we'll move forward to kind of venture capital investing. Stryker doesn't really participate in terms of traditional kind of VC investing, but you have done some earlier stage acquisitions. And so what can you talk about kind of that strategy and how that impacts your m&a?

Adam Wollowick  26:39  
Yeah, we've absolutely done pre revenue, pre approval, m&a, obviously structured at that point milestone driven. But as you mentioned, we don't do corporate venture capital. And it's it's something that I think is good housekeeping is to keep reassessing that. But our experience has been, and I think our point of view is is that the ecosystem that we live in, that there's important roles that each of us can play in the ecosystem. And there's a role for early stage, there's a role for incubators, there's a role for late stage growth capital, and there's a role for us as acquirers. I think we know we do well. And I think we've, we've benefited by kind of sticking to our to our knitting. Now part of this is also a function of which segments we operate in, we're not in cardio, we are in interventional medicine with with neurovascular. But this might change over time, we might have to go earlier in m&a. And this might change as we push farther into areas like AI. I don't see it right now at this point. What that does do though, to all of us in the BD team, specifically in our r&d teams, and our marketing teams, is where you trade, I think we think of ourselves as treating monetary capital for human capital and not market knowledge. So you'll see, as we've talked about, we have relationships with our target companies for decade or more. And what does that relationship like? It's the constant check in do you need access to one of our r&d r&d members? Do you want to talk to one of our clinical regulatory folks, as you're thinking about your trial, what might be some of the things that we would be thinking about as an acquirer checking in on quality system and the evolution of that, ultimately, that's going to need to be rigorous. So what we do is to try to provide that connectivity, it may not be in the form of a board seat, but it's informed in the form of that constant interaction so that we understand you better, you understand us better as you get to that point, where an exit might make sense. And that I think just again, that trust, helps to build that marriage, and then helps also to bridge us to integration. Because now we've we've kind of been, I don't want to say we're in the car with you. But we've been watching your journey intensely. And we want to be a partner with you. And I think it just, it just helps. It puts a lot of pressure on us and our team members. But I think that's one of the reasons why we've been successful.

Emily West  28:57  
Great, maybe said question for you. You're kind of the leader of the new team Dre. Within Stryker, can you kind of share with the group? What is Dre what's kind of the role, especially in terms of m&a, and how you guys think about it? Sure,

Siddarth Satish  29:09  
sure, have done one of the three leaders of Dre, Dre is led by our president of digital robotics, enabling technologies. We call it Dre internally, Robert Cohen. And so Dre is today comprised of three operating sort of units. One is AI, one is digital infrastructure, and one is robotics and enabling technology. So obviously, the robotics enabling tech pieces, a lot of our Mako r&d and navigation guidance. digital platforms is really about cloud connectivity, product security, privacy, the governance related to many of those aspects, working closely in collaboration with it, which is a totally separate organization. And then the AI team were more focused on digital innovations that productize Some sort of AI at the core. But really we focus on product launches with our BU's. So we have an AI research team, we have, you know, these brainiacs with PhDs and sometimes we it's kind of like stocking the startup companies, we stock the PhDs as well and have our have our ways of staying very close to the academic community. But we've really built a center of excellence in AI research, and then a very strong engineering team that can go all the way to an FDA cleared digital product, working closely with those AI folks and then working closely with, with our business units, the goal of Dre was really a couple of things, right? One is to look at these emerging nascent areas of technology where for instance, we may not have mature enough companies to acquire markets that are well developed yet. So things like mixed reality, spatial computing, we just launched, we actually launched the first Apple vision Pro application for really any medical or healthcare use with our Mako platform just just a few weeks ago at Ws. So new emerging sort of platforms that we have a lot of conviction in with each business. But maybe it's a little too futuristic for any single business to focus deeply on. And then the second area is almost what I call tech blocks are these common areas. If you look at pre planning, as a core technology, and AI assisted automated pre planning and segmentation and insights coming off of any sort of radiologic image, that's something we need across so many of our businesses, and it kind of doesn't make sense for each bu to go build a bespoke solution. So we try to build a platform at the center, and then fine tune it, if you will, to use an AI term for those those different views and use cases. And lastly, I'd say you know, we are big fans of BD and and inorganic activity, we work very closely with with Adam, with Brian and with a lot of our other BD leaders in helping evaluate some of the new AI driven companies that are very much maturing and starting to get on the radar of our operating businesses. We also in some cases, might help do a creative, sort of a deal structure. We've we've done SDK agreements and license agreements and per click fee API agreements with nascent startups where you know, they have a core technology block that we may want to, you know, buy instead of build, and then scale across our different product lines and programs without having to, you know, go down the the longer term BD path, which can certainly be run in parallel. So we're always thinking about these emerging areas like AI, spatial computing, and of course, robotics, enabling tech a huge focus for us. And working collaboratively. You know, with our BD and corp dev teams.

Emily West  32:59  
Great. I know we're almost at time, maybe just any last words of advice for you know, maybe folks in the off in the audience who are looking to work with a striker BD team.

Adam Wollowick  33:08  
I just wanted to say thank you, again, for being here. We've talked a lot about ourselves in our journey, we look forward to talking to all of you the journey you're on. Hopefully, those journeys come together at some point, and that we have a chance to work together, but really appreciate your being here and the engagement and I'll turn it over to Dr. Wallach.

Yeah, I think a couple things. I mean, I think patients with us in the one hand, you know, again, this whole time over target, right, you know, you're gonna get frustrated that you're you can that, you know, I gotta meet with striker again, they want to meet, you know, we just talked six months ago, and I know, they're not gonna, you know, maybe invest in my series A or something. But you know, those touch points, as Sid was saying earlier, are so critical for us. So work with us, be transparent with us, we try to be very transparent back to you. So you should know exactly where you stand with Stryker. But be transparent with us. Tell us where you're at what inflection points Have you have you hit and where are you on, on your particular journey so that we know and we can activate because we can move? Move quickly, when when we need to? And, you know, lean on the BD team, I think there is a tendency to say, Oh, well, you know, oh, I emailed Adam and he told me there was no interest so then you email Kevin Lobo right, you know, it's not hard to figure out kevin.lobo@stryker.com No, no, no, that's not his email. But, you know, it doesn't get you anywhere, right? The end of the day, So Justin, means that he's going to email Brian who's going to email my boss, he's gonna email, right and then you're just gonna have talking to me again. So you know, like, work work with your with the BD team. We're, we're, we're, we're not, we're not entirely unfriendly. And, you know, maybe some more than others, but you know, I think that's, that's the key is to kind of work with us. Let's get On the journey together, you know, starting at the earliest days, like as Sid described his his journey, and, you know, you never know where that where that ends up.

Siddarth Satish  35:08  
I would just echo everything Adam said, and just tell everyone that I've witnessed it. I bear witness, the process works. It's it's very thoughtfully built. And you learn a ton by engaging with this crew in particular. And I think I'm biased a little bit, but but I think Stryker ran just an impeccable process. It was maddening at times when, you know, it was sort of a sudden a sudden ramp up and then I'll get ramped down, oh, sudden ramp up and we got to ramp down but the learnings that happen, the cultivation that happened looking back on all of it, every single one of those points, those KPIs, they used to track them in a spreadsheet. Every single one of those touch points and deep meaningful interactions had something to do with pushing the overall strategic thinking forward. So

Emily West  36:01  
great, I think we're at time but we really appreciate everyone's time and thank you guys.