His Strategy and Success Story with the MedTech Startup: FastWave — Life Sciences 360

Joovv, J-O-O-V-V, is the company that I started back in 2015. We designed and developed what are called photobiomodulation devices. So they're Class 2 devices, commonly referred to as red light therapy now. Joovv was one of the first companies to design, develop, and commercialize a full-body light therapy device or photobiomodulation device for in-home use. So we kind of created this category. It was really hard to find information online, but the science was legit. We decided to take a swing and—

What's up everybody?

This is Harsh from Cultivate.com and you're listening to the Life Sciences 360 Podcast. On this show, I chat with industry experts and thought leaders to learn about their stories, ideas, and insights, and how their role helps bring new therapies to patients. Thanks for joining us. Let's dive in.

All right. Welcome to another episode of Life Sciences 360. I'm really excited for the guests I have today on the show. Today I have Scott Nelson. He is the co-founder, president, and CEO of FastWave Medical. Welcome to the show, Scott.

Harsh. Thanks for having me on. I too am excited. Yeah, so looking forward to kind of a quick-hitting conversation here.

Yeah, I've had a lot to prepare about your journey, which is 3 pages worth here from your LinkedIn. So it is, I want to start off by asking, setting the stage right. If you were to compare your journey in medtech and healthtech to an adventure, which one would it be and why?

That's a great question. And I don't have like a perfect answer probably, but I would say it's a, it's a journey or it's an adventure that's involved taking a lot of swings, right? Which I think is probably gonna be a theme that we talk about is taking a lot of shots, taking a lot of swings, right? So it may be a journey that's kind of up and down a little bit and zigs and zags, but certainly adventurous to say the least. And, and the, and the reason I say that is just to, just to set the stage is the, the first half of my career I spent with large strategics, right? The first, call it whatever, 13, 14, 15 years of my med tech career. And the last probably close to a decade now, I've spent with, with early stage startups. So I can, I can speak to kind of both, both sides of the spectrum, right? Yeah. And I'm I'm sure we'll probably dig into that in a little bit more detail. Yeah.

And then talk to us about FastWave Medical, right? So that's where, from what I understand, you spend most of your time with FastWave Medical. So take us through behind the scenes, day in a life. What are you, what's going on with your contribution or work at FastWave Medical? You can walk us through like a happy day or a challenging day, whichever one you want to paint the picture for the audience.

Yeah. Flip a coin, right? Today may be happy, tomorrow may be, I'm putting out a lot of fires. Yeah. Talking about— Yeah. Yeah, FastWave, to, to your point, is, is where I spend the overwhelming majority of my time. It's, it's, it's been my, my, uh, my primary focus over the past, uh, 2 to 3 years now. But it, FastWave is a, is a cardiovascular startup. It's a pre, pre-revenue company. So we're kind of at, at a clinical stage now, uh, with our devices, but we're, uh, designing and developing something called intravascular lithotripsy systems, or IVL is the acronym. And, and, and I'll, I'll explain it at a high level without getting too far into the weeds, but the, the, the, The intent of these devices is to treat complex peripheral and coronary artery disease. So if you're not familiar with the space, you may have heard of like a blocked artery or something like that. Well, it's especially challenging to treat a blocked artery or a clogged pipe when the buildup is largely due to complex hard calcific plaque. There's, there's been various ways to, to, to treat that historically, balloon angioplasty, stenting, atherectomy, et cetera. All of those tools have their, have their pros and cons. And intravascular lithotripsy is a, is a relatively new kind of category. That in essence delivers shockwaves inside the blood, the blood vessel, ultrasonic shockwaves to help fracture or crack this calcific plaque to increase and increase the elasticity of the vessel in order to kind of keep it open. And so I don't want to go get too technical into the weeds, but that's what we're, that's what we're focused on at FastWave.

So, so thinking about like when you started, 'cause you started like 2 or 3 years ago in that role, if I'm correct. So, how did that idea come about? Like, were you— did it come from talking to people in the industry, or did that something come from a personal experience? How was FastWave Medical born, I guess, is the question.

Yeah, yeah. No, it's a great question. And so, I think it dates back to kind of the back half of 2020. Even though FastWave as a standalone entity was technically formed in early 2021, we actually started working on the project towards the back half of 2020, largely rooted in two things. One is that there was, there's only, there, there was only one kind of incumbent in the space. And there still is to this day, a company called Shockwave Medical. And they, they've done a great job of kind of building or kind of building this category of intravascular lithotripsy within the, the broader cardiovascular space. And so we'd have been, been watching and tracking their progress. And then, and, and also based on conversations with physicians, sort of had this, had this belief that the utilization of the therapy, even though at that time it hadn't really taken off like it has today, today, but that, that it would be, that it would, that, that it, that it, that the, uh, that it would be used more and more by, by interventionalists, cardiologists, vascular surgeons, et cetera. So that was one core belief. Uh, and then secondarily, we were also watching another competitor in the, in the space, a company called Cardiovascular Solutions or CSI. That company has since been acquired by, by Abbott, but we had been tracking their progress with respect to an inter-parties review and, and their initiative to invalidate some key patents that Shockwave holds. And so when the USPTO overwhelmingly ruled in CSI's favor, that sort of served as a signal to our founding team that there might be a little bit more room to operate in this space than others would perceive. And so that was really kind of the classic why now moment for us, right? There's typically always a why now, like why should a group of people come together to pursue a certain project or idea with more rigor and throw their own resources at it? But that was kind of the why now for us is like we expected the therapy to the utilization of IVL as a therapy to only increase, but really more specifically, that inflection point and the way the USPTO ruled in favor of CSI was kind of that why now moment for us. Interesting.

And being at a startup and being at the leadership level, running the company, I'm sure you're juggling tons of tasks, but I want to focus particularly on people management or like building that dream team, if you will call it that. So can you help us understand, like, for anybody who's listening in the audience who works at a bigger corporation or a medical device or health tech company and perhaps wants to take a turn in their career, go work at a startup, whether it's Fastway Medical or something else, how is it different working? Because you worked on both sides. Like you said, you had a career for 10, 13 years, and then you started enter the world of startups. You've been very successful with your previous role at Juv and then now at Fastwave. So what can you share for somebody in the audience who wants to make that transition and enter the world of startup?

Yeah, and I love this topic because I was there, right? And I've always sort of had an entrepreneurial bent throughout my career, even though the first whatever 10, 12 years of my professional time was spent at large strategics. So I always had this kind of this desire, right? To eventually kind of land at a startup, either as an early employee or as a or starting the companies myself. So the first way I guess I'd answer that is maybe a little bit atypical or contrarian is that if you're at a startup or a big company, it can feel frustrating, right? The bureaucracy, the kind of the slow moving pace, you're seeing all of these other startups kind of have like appear to have fun, et cetera. But the first thing I'd say is it's not for the faint of heart. It's very, very hard, right? Startups, they're definitely a lot of fun, but it's definitely a lot of up and down, a lot of ups and downs. A lot of times you feel uncomfortable about the decisions that are being made. You have to do a lot, wear a lot, wear many, many hats. Et cetera. So it's, it's definitely hard. So don't, don't underappreciate that aspect because there's a lot of, and there's some decent things at big companies too, right? There's a lot more, I would say not total security, but maybe a lot more security, et cetera. So that's the first way to answer that is, is go with, if you're interested in a startup and making the move from a large corporation to a startup, I would say go into it eyes wide open, right? And, and, and don't underappreciate how hard it's like it's going to be and how likely your, your, your day-to-day life is going to change. Now, having said that, it is certainly a lot of fun, right? And so I would think that if you're at a company, a large company, a large strategic, and wanting to eventually make the move into a startup, the first kind of piece of advice I'd have is go and try and do some work for free. So I'm a big fan of a book called, what was the name of it? I'm trying to remember the author's name, but the book was like the, I think it's called The Recession-Proof Graduate, right? And it speaks to more like how to basically get a job after graduating college, but the framework applies, I think, to making the move from a strategic to a startup. In the sense that you, you likely have some sort of expertise, right? Whether it's marketing, whether it's engineering, whether it's clinical, clinical and medical affairs, etc. You use that knowledge and try to lend, lend, lend that, that domain expertise for free to a startup, right? So because one, that's going to allow you to tap into a network of people and to a much greater degree that you probably wouldn't otherwise have access to, right? But then And so in addition to kind of building out that network, you also get a ton of experience, right? By just getting involved, right? Even if it's in a relatively lightweight sort of fashion. And so that's the other thing that I would probably advise people that are listening to this that want to try to make that transition is do some work for free, lend your expertise at no cost to that startup. You're going to learn a lot along the way, right? And also you're going to build a lot of invaluable relationships. That's advice that others have shared with me on the podcast that I host. In particular, there's a guy by the name of Mark Toland who spent, I think, his entire, most of his career at Boston Scientific. Then he went to a startup called Corindus, which sold to Siemens Healthcare. He's now, I think, at BioStar Capital involved in several other startups. And he mentioned that very same thing to me is that that's the one piece of advice that he wished he told himself back in his kind of late 20s is just try to get involved in startups earlier on. Not in like a full-time role or a part-time role or even expect to get paid for it. but you have some sort of experience or expertise, just lend that expertise to that startup and you're going to learn a lot. And you may, hey, you may walk away from that experience saying, I thought maybe I'd like this, but I really don't. I'm comfortable in my, in my, my job at a large strategic, or it may cause you to be, it may fuel that fire. Right. And it may cause you to kind of, want to, want to make that, that transition sooner rather than later.

Yeah, that's, that's such a great point because when, when people graduate or like I'm reflecting on my journey when I graduated, there's always this pressure, right? Like you need to get a job or maybe you have student loans or maybe you have this societal pressure to show that, oh, I have a job. I'm working at Biogen or I'm working at Abbott or I have this role. So a lot of times it's hard to like think from your perspective, like you said, try to learn or we're not saying work for free, but get that job, but also do something else on the side. Right? So I remember this quote that a friend shared with me, which is like, at any point in your career, you should be learning and earning. If you're doing both at your job, it's great. If you're doing one of either of those, that's also fine. But if you're not doing any of those, you should probably move on.

I love that. I love that quote. It's spot on. Like, I mean, I've never heard that before, but like, I'm kind of leaning into that as you were referencing that. But it's a really good framework from my perspective. Another thing that kind of, I think, aligns or kind of falls under the same topic is that one example is whenever we issue a press release announcing some news related to FastWave Medical, as an example, I'll get a lot of people that reach out, right? Whether it's someone in a CRO, right, that wants business, that wants us to do business with them for clinical affairs. Maybe it's some consultants or maybe it's someone that wants to eventually get it, maybe get a job at FastWave. And that's all great. Like, I don't, I respect people kind of reaching out when they see that news. but I don't, I have no idea who these people are, right? No idea. Right. And so that's the power of tapping it, beginning to build networks with people that are already in startups. Right. Even though, and it kind of speaks to what I mentioned earlier, like if you're at a strategic and you can lend, lend your, your expertise, lend your experiences at free, begin to build out sort of your own network. Well, when those people move on to another startup, which they most likely will, like they're going to tap into you, right? They're going to know you're— they're going to know your work. They're going to tap into you. Uh, you're going to have a much better shot at eventually making a move to a startup by taking that path versus just randomly reaching out to some startup that has no idea who you are. So anyway, I think, I think it kind of lines up to your, you know, what you just mentioned of kind of always be learning and, and earning at the same time.

Yeah, that's, that's a great point. I want to switch gears and maybe go a different angle because we did talk about professionals who want to enter the startup world. But now I want to get something from you that might help other entrepreneurs, other CEOs and executives who are working at startups. So one thing that struck out as I was looking at your track record is that your role at Juvv, you, it was somewhere I read that you helped the company grow from $0 to $20 million in like a 3-year timeframe. So give our audience maybe a fast backstory of what Juvv is, what it does, and then maybe take a deep dive into if you reflect back on those 3 years, what did you do? What are the 2 or 3 things that you did to sort of move the needle that could help other entrepreneurs who are trying to do the same right now?

Yeah, I'll try to capture all of that relatively quickly, condense sort of 3 or 4 years into maybe a 2 or 3-minute response, but it's a great topic and I'm glad you brought it up. Just to kind of take a step back, Joovv is the company that I started back in, we started, I think, working on it the back half of 2015, ended up launching our first, our first device in early '16. And we designed and developed what are called photobiomodulation devices. So they're Class 2 devices, commonly referred to as red light therapy now, right? Most people that are listening may have heard of this, you've probably seen it on Instagram. At the time, like, it was really hard to find any information whatsoever on red light therapy or photobiomodulation online. You had to sort of piecemeal things together from PubMed. I mean, there really weren't any brands talking about the, the therapy. So anyway, Joovv was one of the first companies to, to design, develop, and commercialize a full-body light therapy device or photobiomodulation device for, for in-home use. So we kind of created this, this, this category and a classic startup story, right? Thought there was a market early on back in 2015. Again, largely rooted in the fact that there, it was really hard to find information online, but the science was legit. So it was kind of like seeing, seeing a little bit of a, a little bit of a gap there, but we decided to take a swing, right? And, and, and we did, ended up again, launching those devices in, in early '16. And we did the classic kind of triple, triple, double, double in the world of, of venture that venture capitalists often look for is we tripled our, our revenue 2 years in a row and then doubled it 2 years in a row. And we did that without raising capital actually. So we, we, we bootstrapped the company entirely, ended up growing it to north of $20 million in, in annual top line revenues. Uh, and so really, really kind of interesting, interesting story, really, really a lot, a lot of not only fun learning experiences, but also challenging learning experiences, but to kind of circle back around to like what worked well, what didn't. So there's a couple things that come to mind. So one is that we built that company entirely on the backs of, of health and anti-aging influencers, right? And so, uh, we did that probably before it was maybe popular. And now, now that's definitely more of kind of, um, a lever that, that a lot of companies pull. But we did that because of probably two reasons that I can think of off the bat. One is that we did at the time we were not at the time, but we bootstrapped that entire company, right? And so throwing a ton of capital at paid search and paid social and those channels would have, would have been somewhat risky, right? We instead invested more of that capital into the product itself and, and working with influencers allowed us to kind of commercialize in a reasonably lean, lean fashion. So that, that was, that was, that was one, one reason we did that. And then secondarily, there wasn't a lot of knowledge around the space, right? At the time when, when people heard of photobiomodulation or red light therapy, there's naturally a lot of skepticism. And so by working and partnering with a lot of these anti-aging longevity, health and wellness influencers that already had a lot of trust with their audience by partnering with them to help us raise more awareness for the, for the therapy, cuz it really does work. That, that really, that, that actually ended up turning out to be a, a pretty, pretty phenomenal strategy for us as well. So it's kind of the equivalent for those listening that are in kind of the life sciences or med tech or biopharma. Of working with KOLs or key opinion leaders or thought leaders, sort of the same thing. But we, we did that with a bit with a specific target around these health, health and wellness and longevity experts. Some of them were physicians, some were not. But we did that kind of entirely online, right? We didn't work with them or partner with them in offline at offline conferences or to get on podium. We did entirely online through podcasts, through collaborative content production, et cetera. So a little bit of a different spin that was much more digitally, digitally focused, but it worked exceptionally well for, for the company.

Yeah, and like you said, today it's getting more and more popular to go that route because there's a lot of case studies, lot of examples of companies like yours, Juve has, who has done that and left those breadcrumbs for other people to analyze. But it's really interesting that you implemented that play back when 2015 or between 2015 and 2020, at least at that time, I wasn't paying attention in that area or thinking that online presence or social media could be a way to maybe take the product from the one level to the next level.

Yeah. Yeah. And I don't get me wrong, like it sounds really smart right now, right? Looking back, whatever, 7, 8 years ago now, at the time it was more of a thought, right? A kind of a sort of a rough thesis that, hey, this could work, right? This happened. But the key was actually we tried it. And I think that that's where a lot of entrepreneurs get get wrong is they think their strategy has to be perfect. It's like, no, just don't get me wrong. I'm not, I'm not, I'm not underappreciating strategy, right? You definitely should incorporate that, but there, there's a part where you just, you just need to go, right? You need to be, yeah, 80% sure of kind of the direction and then just take a shot or take a swing. And your strategy is likely going to evolve over that time based on your learnings, but you won't, you will not learn anything without, without doing right, without getting your hands dirty. And so I think that's another, another key learning for anyone. Anyone that's listening in this is that don't wait for your approach or your strategy or your mission or whatever to be perfect 'cause it's going to change a little bit naturally and you're going to learn a lot faster by just doing the work.

That is a great part that you mentioned because as you were talking about it, it reminded me of some other content that I read on social media and it was some marketing person that was breaking down all the companies and their slogan and mission statements, and he or she was saying why Nike has the slogan, "Just do it." What's the most important word? And people are like, oh yeah, it's this, it's that. He's like, no, the most important word is just. If Nike had the slogan, "Do it," it wouldn't be as powerful, but because it has the word just, it's almost like tapping into that athlete's inner Matrix to say, just do it, or do it even when you don't feel like doing it, right? Because you can do all the training and all the workouts or whatever, but sometimes you just have to do it and then play it out because you might have an equally competitive person on the other side. So that, it reminded me of that quote because like you said, sometimes you just have to go in and do it and then live with the result.

Yeah, 100%.

Yeah.

There's like an aspect of just like, there's a part where you maybe not feel, you feel uncomfortable, you may not want to do it, et cetera. I've liked to your point, you have to just do it. There's also another aspect of, of you're not going to learn until you actually just go. Right. And, and I don't want to like repeat myself, but I can't stress that enough. Momentum is so crucial in a startup and, um, actually doing the work, right. You're going to learn so much faster and you're going to learn so much more. Instead of sitting on the sidelines trying to craft your perfect strategy. That's not going to work. Right. And, and that, that, that's different. I mean, I, I, the, the best entrepreneurs that I know and are, and, and surround myself with do this really, really well where they're, they're 80% sure of their decision and they just, they just go, right. And they're used to operating in, in that level of like discomfort. And I think a lot of people, they don't, that, that's very, that's, that's very uncomfortable for them, right? They're worried about getting it wrong. And don't get me wrong, I'm not saying that you should be foolish or reckless at all, but again, momentum is so crucial and you just need to be comfortable operating in a world of imperfection.

Yeah, 100%. Yep. It's better done than being perfect or something. I don't know what the quote is, but I can't think of it, but something along those lines.

Yeah, yeah. Perfect is the enemy of good, right? I mean, it's kind of, it's in a, yeah, I mean, what we're talking about is kind of very similar. Similar vein, but I, I, it's one of the things that I often try to encourage other, like younger entrepreneurs is like, get used to being uncomfortable. 'Cause like fast decision-making is gonna be crucial for, for kind of pushing your boulder, whatever you're working on, pushing it up the hill. You're gonna run into so much friction along the way. And if you're just sitting on the sidelines, you're not gonna be able to, to push that boulder effectively uphill. I mean, you just need to, need to, need to sweat a little bit, right? Get your hands dirty. Yeah.

And, and I, I know that you are also really connected with a lot of interesting entrepreneurs and companies in this space. You have a great pulse of what's going on in the medtech and healthtech space. So sitting from where you are, imagine yourself as a futurist. What's one trend or headline that you predict in 10 years in this space?

I'm going to say two. I might get myself in trouble for the second one, but the first one I would say is that, I mean, it's not really been, it's not a new trend per se, but I think it's only going to continue is this aspect of consumers patients, consumers taking more responsibility for their health, right? As, as deductibles for health insurance plans go through the roof, even if you have a great plan, you're still going to pay a ton out of pocket. I just think generally speaking, that combined with that, there are some other dynamics at play. Just more and more people are going to take more responsibility for their health and be willing to pay for cash, be willing to pay cash for, for a lot of different products, procedures, services, etc. So I think that's one trend. That's only gonna continue. Secondarily, I think this is a little bit more specific to medtech, but just, I think that the nature of like how VCs invest in startups and that whole world I think is changing, you know, quite rapidly. I'll give a shout out to Duke Rolin and what him and his team are building at Ajax Health as an example. Very, very different take on how to get companies started out of the blocks. And so I think there's gonna be a lot more of that. One of my friends, Gary McCord, I'll give another shout out to him. He's sort of got the Midas touch with a lot of investments that he's made over the investors in medtech companies that have all, not all, but a lot of them have had really good exits. And he's primarily been involved in companies that have not raised institutional capital yet has been extremely successful. And so I just think that the traditional world of how medtech VCs and just VCs as an asset class within medtech is changing and will continue to change.

Yeah, those are great ones, especially the first one. That's a very interesting one. So I really just on that note, Harsh, just, just, just real quick.

I think the reason, the reason I'm bullish on that is that we got this pushback early on with Ju because we commercialize devices entirely online, by the way, right? I mentioned those revenues, those, those top line revenues previously. We did that without a sales force. We didn't go through retail channels. It was entirely online, direct to consumer e-commerce business. And most people said, wow, your, your, your products are expensive, right? I mean, they're north of $1,000, right? Are people really going to pay for that? Sure enough, they did, right? They believed enough in the therapy and they saw enough results that, and the, and the, and the prod— the devices are much more expensive. I think upwards of close to $2,000 or $3,000, $4,000 now. And so I, I think, yeah, to my point earlier, consumers/patients are, are gonna, are willing to pay a lot of money, right? More than you think for, for product services that they, that they believe in.

Yeah, that's, that's, that's spot on. I, I know I wanna value your time. I know you have tons of stuff going on with everything you're doing. You're a very busy man, so. Thank you for coming on. It was such a lively discussion. I loved hearing your insights. Any closing statements for the audience and where can people connect with you to learn more about what you're up to?

Yes, thanks for giving me the opportunity again. I really appreciate the conversation. I learned a few things just in this short discussion with you, Harsh. I definitely appreciate it. Best places to kind of, if you're interested in kind of what I'm talking about, the most active social channel that I'm on is probably LinkedIn. I tweet every now and then, but Uh, but LinkedIn is probably my, my most active channel. If you just search Scott Nelson and, and FastWave, you'll probably find me. And then the company that, that we talked about a little bit earlier at the, at the outset of this conversation is FastWave Medical. So fastwavemedical.com. Uh, we're in the process of our, of raising our Series B round of financing right now. And we will likely maybe carve, carve out a portion of that for, for folks in our community, right? We did this about 7 months ago and, and oversubscribed way faster than, than we thought because there's a lot of physicians and other med tech, life science folks that wanted to get involved. So we'll, we'll maybe do that. So if you're interested, you go to fastwavemedical.com and you can, you can learn a little bit more there.

All right, that's it for, for this one. Thank you so much, Scott, and wish you everything, wish you best with everything at Fastway Medical and all other ventures that you're doing.

Awesome. Thanks again, Harsh. Appreciate it. Yeah, having me on.

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