BoneChat #143 - AI-Driven MedTech Sales, Startup Traps, & Orthopedic Commercialization

Good, good. Open mic today, so anybody, you know, this is all about you guys, not me. So Kyle's coming in. I'd love to get— I was gonna— I was hoping you were gonna show up, Stephen, because I would love to get just kind of a an update on all the things you're doing, where you're— where are you getting traction, where you're not?

Yeah, I will say, uh, I mean, I can wait if you'd like, you know, or we can kind of talk.

Oh wait, we'll wait, we'll wait a couple minutes. Kyle's got to liquidate, he's got to hydrate here.

Yeah, I'm, I'm with him getting over this, like maybe it was COVID, but like 2 weeks, some, some crazy bug. Still got some coffin.

Yeah, there's a lot of stuff going around.

Yeah.

So Michael, you worked with Colleen.

Wow.

Yeah, I sure did. Feels like a, a long time ago. Yeah, that was part of the journey.

I mean, how hard is it to start a small You know, hip and knee business. I mean, I was at Wright Medical and we had, I don't know, 1%, 2% market share, and we were, we were fighting for every tenth of a point. It was just so hard. You know, the big guys just, they, they control the customers with contracts and distribution and everything. Yeah, it's so hard.

That's very, very true.

All right. Hey, all right, Stephen, give us an update. So this is open mic day, so anybody wants to talk about anything and, uh, anything— questions, comments, you know, you need advice, you need help, you, you found something really interesting. So, all right, Stephen, give us an update on your businesses.

Yeah, so, uh, InCircle is growing. We've had our 2 best months we've ever had. Um, we've really, throughout the journey of this revised our concepts, our pricing structure significantly. What we realized when we started, we had some early, some really good traction and early launch revenue, smaller subscriptions. Then at Academy, we launched and we had, InCircle had the physician early adoption side of it, and then a separate platform was RepGPT. We ended up combining 2 of the, the 2 of them after Academy and turned it really into more of like a full go-to-market solution. And gave every business function at a smaller company access to the same tools that a larger company had, essentially is what we wanted to do. And then brought our pricing structures down to a monthly payment system and as low as $500 a month and then up to $3,000 a month with additional seats and things of that nature. It has grown much faster than we ever would have thought. We're cash flow positive now.

Wow.

We've kind of halted our investment outreach just because we're growing at a great rate and kind of trying to figure out there's only 3 of us. Do we need additional investment or can we just raise, fund this ourselves? The other thing that's really changed for us is we built our own suite of AI sales development reps that live index LinkedIn for companies that would be ideal for us. So anytime someone says we're looking for distributors, Our AI development program is capturing that, writing a very non-sexy, non-AI email going out from my email. And we've got an open rate about 40%. We've got 90 leads we're working with right now.

Wow. And you're scraping, you scrape LinkedIn for that? You scrape LinkedIn?

We're working within the LinkedIn, essentially terms of service. And it is, yeah, it's looking at LinkedIn posts as they happen, which has been phenomenal. So we took that concept and said, okay, Let's give this to our customers, our clients. So now they can try to find distributors that are posting, hey, we want to find osseous companies when they're posting about it, or distributors or med artists. So they started doing that. Or I want to find digital opinion leaders that are discussing a certain procedure type. And so it'll track and it'll find it at every point, send it to your email and in there. So it's been really, really cool. And we took the same concept and said, okay, well, if we're doing that, we can then say we want to find fellows. So now we built out an entire fellowship program within the same platform that find— we have 586 fellowship programs we're tracking anytime on match day. Here are the incoming fellows. We're capturing that, but it's like LinkedIn, Instagram, Twitter, about 50 different sources to show you who those new fellows are. And then where those old fellows are going to when they're updating their job location, other job classifications. So Stryker had a whole team for this. Now we just automated the entire process.

Wow.

So it has been really, really fun. And then RepGPT, our distributor search, is also just gaining a massive amount of interest, which is part of the platform. I mean, you could find, hey, find me all of the Medacta distributors in California. Or find me foot and ankle focused distributors in Bay Area or New England, which is great. Today we're integrating, actually right now, RepGPT for hiring. Find me all of the President Club winners at Arthrex, Stryker, Smith& Nephew, and Medacta in Texas.

Here they are.

So it is really, really cool, and all of it for the cost of less than a plane ticket is what we wanted to do. Wow. No long annual contract. You can cancel at any time. But we found that it is so sticky that people are typically getting on that $500 plan, then upgrading to get the next kind of set of features, lower credit-based as well. And it's been really, really awesome.

Yeah, that's so— which— so, so go over these again. You didn't talk about backend, which I thought backend was one of the cooler ones.

Yeah, Bakken's growing slowly. It's really exciting. We just added 600 new firms onto it. So Bakken, for those who don't know, it's an investor intelligence tool for startups. It gives you access to do a natural language search for, find me orthopedic surgeon investors in New York City, and it'll go through and identify them and find all of— it'll index their whole LinkedIn and find all of the trends that present that would say that they're potentially an investor. Are they an advisory owner? Do they say that they do speeches, anything like that? So for early stage, ideal. But you can also say, well, find me angel investors in medtech in Durham, North Carolina, and it'll go find the individuals from there and you can get their contact from there. On the database side of investors, we have close to 2,100 investment firms, angel, family office, private equity, micro VC in there that we've updated as well. And you can go see some of them. their assets under management, their previous investments. We've increased our search capabilities to say, find me orthopedic investors that invest into biologics. And so that's, that's been greatly enhanced. And we're building a more robust version of our startup database. We've had some companies that just have gone stale, so we're going through and cleaning that out.

Yeah.

Research agent is getting a lot of interest from some of the larger companies because that will go through and do all of the financial and the clinical due diligence due diligence of a company, of a private company. So you'll be able to see what's going on with their fundraise, not their exact cap table, but you try to get as many people from as possible. What is their— what does their clinical trial look like? What does their FDA side look like? What does the patents look like? Who are all of the physicians that are consulting with them and getting paid? And then you could click on that and then even say, okay, well, who's— who else is this physician involved with? So kind of go down this long path, but it's been really fun. I still apologize, but we've just been focusing a little bit more on, on in-circle growth, which is nice. But now we're kind of going and trying to do a little more partnerships with some of these other venture programs out there to give them access to that tool as well. But it's been pretty fun.

Yeah, I think, Michael, tell, tell us about Fairwinds. You may be intrigued by some of Stephen's offerings here.

No, a lot of it sounds very intriguing. Congratulations, Stephen.

Thank you. Thank you.

My history, probably like most of these people here, always medical device manufacturing on the marketing and sales side. Started in a small company called Encore that got transitioned to DJO. That within Spiker Spine. Opportunities came up because I was really in charge of like global sales, and so I made a lot of contacts and research opportunities with different countries with different skill sets that we had here, whether it was pediatric scoliosis or, you know, some type of hip and knee kind of surgical opportunities with countries outside that didn't have those skill sets at the time. Made a name for myself on that. And an opportunity started with Saudi Arabia where I was able to start a company called American Surgeons International, where we built surgical centers to existing hospitals in the Middle East. And then I would import the US physicians and the US products to kind of staff those organizations.

Hmm.

That went really well till it didn't, which was Arab Spring. And then I couldn't get anybody to get on a plane. And so came back and started to be the executive vice president of Consensus Orthopedics, which Tiger brought up early on, which is a small boutique hip and knee company out of California.

I sold that product in 2012.

Okay.

Well then I was there. So then I'm assuming that was with Kurt Wiedenhoffer, Steven, is that?

There is— hold on, there is Michael something perhaps. Um, let's see, I, I can't— Thomas Morancy.

Tom— Thomas Morancy.

Yeah.

And, uh, so yes, he, he was there for a time too. Um, anyway, as Tiger did point out, we couldn't compete with the big guys, the pricing, everything else that was coming in. And so we transitioned to TrackPatch, which was the first, you know, wearable sensor kind of in the orthopedic device. My perspective of that whole kind of endurance was we were a bunch of metal guys trying to act like we were software people.

Mm-hmm.

So our cost of goods were sky high and it just didn't seem like it was gonna make it. And it was also on a time where this was pre-COVID, A lot of that RPM, RTM reimbursement wasn't there. So I broke away and started Fairwinds Medical. And Fairwinds, at Consensus, I was able to raise some capital and the gentleman, Rob Nathan, was able to raise us $10 million, which I'm not sure was a good thing. It just really lengthened the pain for a little bit longer. But I kept in touch with him and we decided to start Fairwinds. He is a medtech banker out in New York City. sees 300 to 400 different, you know, medtech opportunities for people wanting to kind of get capital for whatever they're moving into. And so it kind of enabled Fairwinds to kind of cherry-pick some of this new technology that we see down the path. And, and Shay, that's kind of similar to what you're saying, is a lot of this new technology is really, really interesting and definitely something that the the patients would benefit from. But a lot of these new folks come in and have no idea how to meet the pro forma.

Yeah.

And so at Fairwinds, what we did is gather the leadership that I've worked with in the past, whether it was Heraeus or Consensus or, sorry, Conformis or Stryker, and kind of put them under our umbrella. So we have, you know, the past president of VB or Stryker Spine, Jay Lawson, all the way to Bob Colby, who was in charge, the head of sales for Heraeus at the time and then give leadership of a business development style to new and younger organizations that are coming into our market. And Tiger, it's interesting, the first client on the board was Raja with Recoup, which was right in my lane. So then we choose a limited amount of companies that we represent. Right now it's Recoup is our wearable device. We just solidified an exclusive partnership with them and VB Spine. So you're going to see that come out this month.

That's exciting.

But we're excited about that. For, for the bracing, we signed with ExoArmor. They're a 3D printing organization that has been really fun to kind of build. We're launching our orthotics this month and then we're going into AFOs and knee bracing and scoliosis and pediatric scoliosis bracing up, you know, here in 2027. And then recently we just brought on Capital Medical, which is a full DME and revenue cycle management engine out of Georgia. And what that allowed us to do is kind of create trade routes into DME. So now we're able to provide trend bracing, And also, you know, help on the reimbursement and revenue cycle side, but then really create the trade routes of what we're trying to do with XO Armor. And then the last thing to the model of Fairwinds is we're now starting what is called Fairwinds Onsite. And my thought process here, Stephen, was we, we kind of very similar to what you said. Until then, we had distributors, about 47 of them. coast to coast. But as we all know, you have your good ones, your mediocre ones, and then you have ones that you don't ever really hear from. And so—

Yeah.

I was really trying to provide some type of brick-and-mortar scenario into health systems, which would allow all of the companies that we're providing BD to opportunities to help their workflow. And so we lease space in different organizations and, and place actual Fairwinds Medical employees there that whether they're placing Recoup or scanning and fitting for XO or they're fitting on the braces, it's all under our window. And so that's, that's what we've been launching this, this last half of 2026.

That's exciting. I love the XO Armor program. I have one of their keychains. Yeah, very good.

It's a great one.

And it's really what I love about it. It's, it's truly, um, custom, right? Like right now, it's everything out there is really kind of off the shelf or custom fit. But to be custom, you have to build it from the ground up, which, which we do with us with each one of our scans of the patients. So it's, it's a very novel and exciting business.

What's probably the biggest headwind right now for all of them?

Well, right now the biggest headwind is Recoup. Recoup has done a significant job of growing my business plus opening doors across the board. And Tiger, you really learned about his work comp scenario, which was well up and running before he met Fairwinds, and that really gave us the data and, and kind of workflow that we needed to to really make a difference with the wearable device. And if you guys haven't met Rajasundaram, he's what the wearable device in our space needs. He comes from Silicon Valley. He's, you know, he's like number 5 of Cisco. And the team that he's surrounded with are laser sharp on, you know, keeping the cost of goods at a very minimal pace. And now even moving past wearables where it's computer vision and it's all just coming from the phone, It's making great strides for us.

That's exciting.

Yeah. No, it's good. Thank you. I'm very long-winded.

Yeah. 2 companies came to mind. Are you familiar with Icarus Medical? They're a startup in Virginia. They make custom knee braces.

I am.

Yes, I am familiar with them.

Okay. And then the second company is Green Sun Medical in Denver. They're a pediatric, I would call it soft bracing company. So they, yeah, it's mostly teenage girls and it's a certain correction that they can do, you know, and it's aware, it feels more like clothes. It has little actuators that pull and try to realign the child's spine. You know, it'll take a 30-degree to a 15-degree, something like that.

Wow.

It's not gonna correct it. But the, the problem they've solved at Green Sun Medical is compliance. So the girls can wear the brace underneath their clothes. They can wear it to school. They can sleep in it. And it's a— they have an enormous groundswell of parents all over the world that they have conventions and stuff. It's, it's— take a look at Green Sun Medical. It's And, uh, I will.

Thank you for—

Yeah, that's— it's one of my favorite little companies nobody knows about.

Um, yeah, it's a great little website they have.

Oh, it's— I mean, they, they have this, uh, they, they're, they're, um, mascots like green bears, and so everybody's got green teddy bears. And, uh, it's— they have Facebook groups, uh, you know, out the wazoo. It's just It is an amazing— it's one of those patient-pull products. You know, I, I love marketing. I love marketing-pull products where the company doesn't have to sell the, you know, the patients find you and call you and beg you for the product. That's, that's GreenSun Medical.

Very nice.

Yeah.

I can introduce you to the CEO founder if, if you need. He's, he's been on, On VonChat before. We'll have to get him back.

Yeah, that would be— hey, love to meet him.

Okay. Hey, Kyle, what's going on in shoulder land? Kyle's working on some stealth shoulder startups, but he can't really tell us about anything.

But yeah, I'm playing in the sandbox at the moment. So it's gonna be a little bit, but I think I'm onto something. And since I've created a company in the past, I know what to do next when the time comes, which is probably sometime in the next couple of months. And one of the, we talked about it to some degree last time, but one of the things I'll be thinking about is, and who do I get involved? Got a couple of particular people in mind, but Sometimes there's opportunity in leveraging, getting other physicians involved early, but there's downside to that as well. So, as I'm playing around with what I think the IP is going to be, I'm thinking about being very deliberate with who I include. So, if anybody has strong opinions one way or the other on any of that, I'll take them.

Well, are you looking for a partner or are you looking for a clinician that's going to spread the, spread the word and be your evaluator?

So I think the answer is I'd like both, and it doesn't have to be the same person.

Okay.

Right. So What I would, what I would probably not do with this is try and build a company and then bring a product to market. I would probably try and create an attractive position for a device and then leverage that into a partnership for someone else to launch it, maybe as a co-development along the way. And if that is the route, I can think about involving several surgeons on the front end because then they're kind of part of the package and everybody feels good about the partnership with them. But then you've got, you know, cooks in the kitchen and you're slicing up the pie and all those things.

Yeah.

It's not easy, but you take it one step, one step at a time.

Yeah, take a step at a time and don't be afraid to make mistakes. I mean, you know, I've written the articles about the, the whole one-way door versus two-way door things. And I think Bezos was the first guy to kind of talk about that. There's, there's decisions you can make that are two-way door. If you hire the person, they're terrible, you fire them. You know, or you write a contract and there's a way to get out of the contract. And then there's one-way doors, which are really dangerous. That's when you do things that you can't reverse. So you take on debt or change the structure of your company, or you spend $1 million developing something that doesn't work and the million dollars is gone. So you got to be— always think about two-door 2-door decisions are always the best. My last startup at Ellipse, our CEO always said that. He always said 80% of the time I'm right, 20% of the time I'm wrong, but I can usually reverse the decision and it doesn't hurt the company. So think about it.

Yeah, I like that.

Yeah, you're not gonna get married to somebody for 10 years just because You know, you're inviting them into the company early, right?

Yep, I follow that.

Yeah, you gotta, you know, the, the, all startups are messy. You know, we all, we've all done startups. They're all messy. They all make mistakes, but you gotta learn from your mistakes and you gotta, you gotta be nimble and figure out the win in among all the errors and You can't be afraid to make mistakes. You gotta make mistakes fast and then react fast. A lot of startups try to get it right. They try to get everything 100% perfect all the time and they, they overanalyze and they never get anywhere. So we see those all the time or they raise too much money and that's the other, raising too much money is the kiss of death.

Well, I mean, it's a, it's an ouroboros, right? You hire too many people, then you need to raise more money, and it just becomes its own self-consuming thing. I don't know, just, I don't know how some companies are raising so much money, um, especially if they're single product companies with limited market opportunity, but they're finding investors somewhere.

It's, you know, There's fools everywhere. Friends, families, and fools. Yeah, I just saw a company in, I think it was Spain. There's a company called Deneb Medical, D-E-N-E-B. They just raised $15 million with a bunch of buzzwords: laser, robotics, AI, and spine. I mean, The chance of that company making it is, is probably, you know, almost zero. But they just got $15 million out of nowhere. You know, oh, drives me crazy. It feels like, you know, funding was really hard ever since May of 2022. And then we started getting some momentum back in 2024. And then AI just sucked all the funding away from everybody. You know, AI, the AI distraction has been enormous.

Yeah, I still feel like the funding hasn't really opened up at all for device at all, even with— they still want more and more, uh, de-risking. And when you still de-risk, they're still, they still want more, feels like.

Oh yeah, and the strategics are, you know, Strategics don't want to make decisions, although Stryker did buy something early.

Zeromed.

Zeromed, yeah.

Which is going to be very interesting in a revision situation. I'm curious, uh, I'm wondering if they have the next Orthospace on their hands. Great in a niche market, but when it goes big, is it going to be put in the wrong people's hands? Which, not fun. I was on the Orthospace marketing team, so Oh, wow.

Really interesting. So Orthospace was that little— it was that little space. It was like a tissue augmenter. They didn't—

it was a balloon.

It blew up and then it resorbed away, right? Or did it? It would.

Yeah.

Yeah. It was great with the right patient population. It's still phenomenal. The problem when you put into all of the sales reps' hands, they've been hearing about it. patient population was just thrown out the door. So you had some not favorable results that came back. Um, and again, for the right patient, it's great. For the wrong patient, it's not ideal. The good thing is it doesn't, doesn't burn a bridge in that procedure. But, uh, Zirmed, same thing. It's, it's very good for a select patient group. So we'll, we'll see how that plays out. It's an interesting product.

Interesting, and it's just a better fixation method, right? It's really—it's—they have a patch, but it's—it's the needle that's more important than the patch. It's the needle more important.

It's—it's just like sewing biologics into the tendon, which is interesting. You know, I don't know. I'm still—they've done a great job on their sales. I still want to know more about the product and the long-term results.

Do you know the sales? Do you know Zeramed sales before? They got acquired.

I would say I think they're over $10 million right now this year.

Um, it's a good start.

Yeah, uh, distributors that have used it have loved it, but it's not for everyone, uh, is what they've kind of said. And again, that's great when it goes to the, the larger sales force. That's what I worry about with that product. But I think they're doing over $10 million this year so far.

That's, that's a good start. Yeah, it's a really good point you make about patient selection. That's a really Hey, yeah, Raymond's got a comment from behind the scenes here.

Well, actually, a question. I could probably— I haven't shaved today, so I don't know if you want to see me. You look good. All right. Anyway, I'm in Vegas for— it was a trip that popped up, for better or worse. Anyway, or the hand. Okay, the question, since you were just talking about that company, Isn't that— aren't they doing the same thing that Integrity Orthopedics did, and they sold to Smith& Nephew for $450 million? Yeah. And is that the same space? And is that why Stryker took— you know, went after them?

Stryker bought more of a biologic augment product where Integrity bought a product that I think had maybe $4 million in sales, to be honest. that was more tendon to tendon and tendon than tendon to bone. So it was like, it's— there's no biologic product in the integrity side. I think though, if I'm— if I could read between the tea leaves, they've got Regenitin, which is a great product. It's market leader in that space. Can you do something similar or have a different fixation method for Regenitin, which maybe is why they did it? And Regenitin is phenomenal product for that company, but one has regenerative property Which is Zirmed. The other one is just a tendon, the tendon suture, if you will.

But it's the same procedure or solving the same problem?

No.

No. Well, it's in the same procedure category.

The Zirmed is more like what Annika does. It's a patch that is added to a rotator cuff repair. It's not doing the rotator cuff repair on its own. So you've still gotta put in anchors and sutures and tie it all up. And then you put the Zyrumed products on top of that. So it's a segment of the rotator cuff repair market, and it's an optional thing. Now, I think— and I think Anika's playing this game as well— when you do it, there's a 22 modifier or something else that the surgeons can do to have an extra coded billing associated with doing an augmenting of their repair.

Yeah, I was a Regeneron rep for a while. You would always tell the doctor to use 292827 was the rotator cuff code. But you wanted to make sure that you said dictate— oh, you would dictate properly rotator cuff implant, rotator cuff repair fixated with bioinductive implant. Never use graft or patch or anything like that. Always make sure you call it the bioinductive implant. But yeah, Kyle's right. One's fixating, one's adding additional biologics to it, but they're also synthetic. And there's also PLCs, another polymer. That is in there where patients that have autoimmune diseases often have inflammatory reactions to it. Um, so that's, that's why I think patient selection is going to be very important for this one.

Oh, that's fascinating.

I have a totally unrelated question, but one for, uh, Michael, or is it Mike?

Uh, it's Michael.

Okay. Um, so first, uh, nice to meet you, and thank you for giving us a little bit of background on, uh, your history and also what you're doing now. Since you have experience over in the Middle East, which is, I know, a while ago, and maybe, Tiger, you're aware of this. Are you either of y'all familiar with a company called Saudi Orthopedics Incorporated?

Saudi Orthopedics? Nope, I do not.

Okay, so just do a Google search and it's intriguing. I just came across it this past week. There it is. You just type in Saudi Orthopedics, Incorporated.

I'm putting a link into the chat.

And my question, although it doesn't sound like anybody knows, is, are they simply a manufacturer or are they actually trying to do product development and market? And then if you look at the players, there's a lot of MDs on their board. So it seems to me they're more of a intending to be a manufacturer. Yeah, manufacturer, an OEM that is going to go market in that space or in that region.

I don't know.

So their address is the King Abdullah's, you know, hospital system, which is filled with Canadian and US physicians. But I would— I— that's interesting. So yeah, my tenure there was 2007 to 2011, and I— we were based in Riyadh. But it, you know, when we were there, it was their first medical, you know, their first physician graduates were just started. So So as far as where they were in the healthcare arena, I mean, they were importing every, every specialist, but—

I just found it interesting. Thank you. And then finally, Sheila, I tried to connect you with Dan Justin. Did he ever get in touch with you? You're on mute.

Who is Dan Justin? Because that name's not ringing a bell.

Okay. He's the guy that had, uh, some shoes that somehow or other he had a reimbursement that I thought maybe would be beneficial to you. I'm guessing it just fell below the inbox kind of thing if he never contacted you, because I said, well, do you want to talk to her? And I could bump him, but I just didn't know if he had just gone to you directly.

I think I went to LinkedIn after you told me that and reached out to connect with him, and I'm not sure if he did or not. That's how I connect with him.

But all right, I'll bump him.

Okay. Thank you. I appreciate that.

Yep. Going back to shoulders and patient selection, we've got next week, we've got Mioc Orthopedics on. And that, I mean, that's like a classic. You put it in the right patient, it works great. But man, is there a huge incentive to overuse that thing? That's gonna be interesting. They've—

it's a fun procedure to be in. Really? I've done— as I was the Regenitin rep in Steamboat, Colorado, they had a few doctors that were using it there, but they didn't have a rep, so I would just help them cover it from time to time. Wow. So it was a fair guy. Yeah, it was 3 years ago. What a cool product. Right patients are needed. It was very interesting on patient selection. In the early days of Regenitin and Rotation Medical, they had a lot of stiffness early, so they came out with this accelerated rehab protocol. In BEAR, they had a similar type of issue with pediatric patients, a little bit more stiffness. And what they realized is what I've seen from some of the doctors as well. They started moving the patients, especially the pediatric ones, a little bit earlier. in the recovery process and getting their PT going faster. And it removed some of the stiffness away.

When you say stiffness, do you mean tension? Or because when you put in an ACL, you overtension it on purpose because it's going to relax, right?

Yeah, it was tension. It was tension as you're going through. And I believe it was more of an inflammatory— an over-inflammatory response by just sitting there because of the biologics in there. Interesting. Yeah. It's such a cool product. The orthotomy is the hard part that you have to get around, but I'm sure it's not indicated for the shoulder yet.

So your segue wasn't quite right, but I, I appreciate, I'm sure they're going after that. I'm sure they're going after other indications. Yeah. I really, I had to look it up because I thought, man, did they get a new, it's, it's just for ACL so far, but it's obvious they're gonna try and platform that. Yeah.

I'm sure Sheila's done a lot of PT work with ACL patients.

And she— actually, no, less so much. I'm seeing them 20 years after ACL stuff. I'm seeing them, you know, that I'm hearing that when I was 18, I had this ACL injury and they repaired this. And then, oh, 2 years later, injured it again. And, you know, they give me the history from 20, 25 years ago, and I'm seeing them You know, or they had a meniscus removed, or, you know, scopes. I'm seeing them decades later.

Got it. Got it. Interesting. I have a question after this. Yeah, the whole MEOK thing, tell me if I'm wrong. It's basically you avoid the harvest. You're avoiding the patellar tendon or hamstring harvest, right? And, and it's a young patient, so they recruit cells. You, you probably get some good stem cells in there. Is that the whole premise, really?

Bridge-enhanced ACL restoration. So you're, you're, you're suturing back the ACL to the ACL with a bridge with your own whole blood soaked into it. Um, yeah, so it's growing back in. It's like a better version of a repair, if you will, um, rather than a whole recon. But you're not having to do that, so From patients' arthritic issues, yes, but you still have to make an arthroscopy in the joint. And so you have to make a pretty large incision, and that's, that's some of the pushback from it.

Yeah. Interesting.

By the way, it appears that there is a trend that kids are tearing ACLs more often now than in the past, and I think it's related to turf. I think because more high schools— I think more high schools and kids are running around on turf at a younger age and they're blowing up their ACLs. We've had, um, A 17-year-old a couple days ago and 2 15-year-olds a month before, just in my neighborhood that blew their ACLs out. Great athletes. They did strength training. They were in multiple sports and just happened to be on turf playing soccer, playing football. And I don't remember but maybe one person that I ever knew growing up tearing an ACL. And now it seems like they're everywhere.

It's because we, we were, we were playing on crappy grass and we, it was slippery.

It's slipperier. I think it's the grass is slipperier. And it's— that's why I think when your foot sticks into turf more, yep, you can move faster and cut better, but then your knee's not going to take it.

That's fascinating.

I also think that the generation now compared to my generation, we played multi-sports. We didn't start—

Specialization is not helping. You're right. Yeah. 100%. It drives me crazy.

And multi-seasons because of travel teams. I think all of that is contributing and a lack of funding for the conditioning part and the training part.

I think we're still—

again, I didn't have kids that played soccer and stuff like that, but from my friends that are coaches and stuff, they're still doing what they did back when, meaning lots of running and lots of this and lots of that, but maybe not so much stability training and plyometrics and other things that probably could help reduce the risk of injury. But anyways, just my 2 cents.

Those are probably all true.

There's, there's a market for a better— market for a better knee brace that isn't the one you see on offensive linemen to, uh, reduce it in kids that aren't— that just want to be able to run full speed.

Check out a brand called Stoko. They're like athletic.

Oh yeah.

Yeah, I love those things.

I see they're advertising to consumers like crazy.

I, uh, I, I did a little help consulting work early days with them, um, but I've worn them with a ton of injuries. They're athletic compression pants, but they have Dyneema wiring going through that acts as a dynamic brace dialed in with Boas. So when you get into a compromised position, it'll kick in and pull you back. It's pretty, pretty nice and it's great for runners.

So speed—

It actually, it actually pulls enough to make a difference.

It feels like you're wearing like an exoskeleton. It's crazy. It's, it'll keep you in play. I used it when I was skiing and snowboarding. And at the end of the day, when you're, you're tired, Dial it in for the last few runs, which is always where the, you know, the injuries come in.

Sure. Yeah.

It was— it's an amazing product. They came out with a biker short recently, which is really nice as well for the hip and lower back.

Dyneema. So when I was at Active Implants, we had Dyneema in our meniscus replacement. That stuff is so expensive. It's, it's like, it's— we used to call it crack cocaine. It was like, it was like $10,000 an ounce or something. So I can't, I can't imagine there, you, they probably don't need the medical grade Dyneema. That's what it is. They probably just, yeah.

Garment grade. Yeah. Yeah. That's what it is. It's, I, I'm no longer involved with helping at all, but like, it is, is amazing. Your HSA covers it as well, which is nice. Wow. Yeah. What a great product. As someone with a ton of knee issues, definitely still use that now, even just for hikes.

Wow, that's interesting.

Yeah, I'd love some feedback, team, if you guys don't mind. I've been working on a little fun side project here that I just put in the chat. It's a product called MD Launch. What it essentially is, is helping physicians build out their AI visibility and authority and almost vibe coding an entire website with the foundation built for SEO management and to make sure that they're actually found when patients type in find me rotator cuff doctors in Denver or bunion doctors elsewhere, as well as a writing agent built in to help write constant content for that. And it's, it's, it's an issue now with more patients searching ChatGPT. But when you look at like my practice online does a lot of websites for doctors. And when you look at that, how they actually rank, majority of them are never cited by AI. So we even built in our own AI scanner, visibility scanner. So you can put your own practice website or your personal website and see how you rank in the area, which is pretty nice. So we're getting ready, and the whole thing can be done with your LinkedIn URL, your name, and about 5 questions.

Wow.

Next thing you know, an entire website is built with— we've got templates, but we have over probably 450 different procedural pages, as well as our own database of images that we built out. So the users pay— doctors can also use it for their social media. It's been a really fun, just little side passion project. And we kind of—

It's a one-time charge or is there like a monthly subscription?

That's what I wanted to get some feedback on. There's other programs out there that are like full marketing and design houses. They are very, very expensive. My goal with this was to reduce the cost, do a one-time build fee and a lower monthly writing fee, if you will. But you have your own dashboard where you can see how you're being found, what people are looking for. And so the writing, the, the subscriptions kind of do the writing. One of 'em is $129 a month and it'll write for what you wanna be found for. The other one's $249 a month and it'll write for what you wanna be found for and it'll see what you're actually being found for and start writing more content for those programs. The build fee is $1,500 once.

Okay.

So, um, wanted to kind of get some, some feedback on, on, I know it's very high level, but the pricing structures and I can show you what the, The website's fun. The web's— the front end's done. You can go scan anyone's website, which is nice. But we've even tried to do a lot of resources on what is GEO, which is visibility in AI. And I want to target early physicians, really ones that are getting out of their residency or their fellowship, as well as if you do have a website, we've even built it to where you can put your website URL in and we'll reverse engineer and rebuild the whole thing for you as you like it with all your writing. But the foundation is still built to make sure that even on, on this new website, you're found first on AI, on ChatGPT. So pricing is kind of what I'm still trying to dial in. I want it— well, we need to cover our costs, obviously, of building out all this content and everything like that, but make sure that we can put it at a price that is affordable.

Yeah, I would— I don't know the answer to the price, but I would A/B test it. Yeah, or ABC test it and then it'll, it'll, you'll figure it out instantly. My only experience building websites for people is they always want to customize. And so you want to put all your fees on the customization side. You want to make it real easy to press the button and get your, but you're gonna make all your money on customizing it to their needs. I would jack up the You know, the fee on the back end. Yeah.

Yeah. Yeah. It's down to the point where it's almost like Squarespace or Wix, but like we kind of say it's like vibe coding because all, I think there's 15 personal pages. It goes and gathers everything about you and writes what you've done. If you've done any research, YouTubes, all of that, your, your LinkedIn, and it'll write all of it for you. Uh, and, and there's like 5 more questions and then you can go customize it yourself internally of it. But you can be live in an hour with a whole website and a domain.

Do you, do you do unique URLs or?

Yeah, it's their own URL. It's, you know, drtigerbuford.com.

Wow. Don't, don't go see him about your medical problems.

Yeah, we've, we've kind of taken everything that is really annoying about building websites and try to make it as easy as possible and just loop it into one Platform for you, including of the domain and setting the domain up.

Interesting. Yeah. Anybody have any other comments?

A little off topic from the device side, but yeah, that's okay.

The other thing, the other thing that came to mind is that there's more money in, you know, instead of a single website for an MD, way more money in building a website for surgery center, ASC. I mean, and I mean, if you, I would, I mean, you're smart and you could probably put together a package for a, you go to, there's their ASC, you know, I'm gonna rebuild your website and you're gonna pay me a percentage of all the new business that comes through the door. I mean, I, I think there's way more upside in that.

Yeah. I just, I don't know. I feel like there's a war against private practices right now. Medicare reimbursements and And the whole goal was every individual physician should have their own brand and shouldn't just be relying on the practice website. But the more doctors out of practice that have their own website have backlinks back to the practice. So it all comes back to the mothership, if you will. But I hear you. There's, there's definitely more money there. It's just maybe the— they wanted to help out on the private practice side.

No, you're totally right. Physicians are not good at business. I mean, they spend their whole life, you know, learning medicine and And they're not good at branding themselves.

Yeah. So, Stephen, what— hey, very interesting. I think I love how you're highlighting into some type of AI feature. I mean, how many times do all of us put our company name in AI and see what comes back, right? So, yep. One thing, I don't know how you would build it, so I'm just— just an idea. Private practice, right? Their biggest pain point is they're starting— is awareness. And so you're figuring out that awareness from the patient side. Anything that you could push out that says, for $150 a month, or I also will, you know, push your services to all the primary care, local primary care folks, or any, any type of referral platform. Yeah, you're— now you're talking, right? Now you're, you're bringing patients to the door, and that's what they want to hear. If there is any— and I think your monthly rate could kind of what Tiger was saying. Yeah, then you can associate that to, hey, I brought you 50 patients. This is, you know, this is that opportunity.

Yeah, that's an interesting one that we thought of. Our RepGPT program allows you to search anybody. We have the same concept already in a code base for doctors as well, so we could probably take a snippet of that, put it in there, and say find me all the family practices in Boca Raton and send out, hey, we're here emails, almost like an email outreach campaign.

Exactly right. Right. So it finds them and then it sends them the website, maybe a single page about the guy. Yeah.

But yeah, I started in hip arthroscopy in 2015. No one knew how to diagnose it that was outside of sports medicine hip arthroscopy. So hip arthroscopists would always go try to find back doctors, pain doctors, and family practice doctors. Just try to say, if you have groin pain, more than likely back pain, come see us. We'll be able to help you with it. So you could be, you know, you could have email templates in there. I do bunions. I was trained here, whatever that might be, you know. But yeah, I like, like the concept of trying to figure out how to add it in cost effectively. Yeah, my whole thing is, I want, I want a resident to come out and feel like they, they've got an AI tool that's built for them now. Or fellow coming out saying, you know, we've got— you see all these cool vibe coding and, and all these other things. We finally have one built for us, but how much more resources can we add to them without breaking the bank? So our margins are pretty awesome. It's like, I think I've got it down to $7 per website build. Oh, that's great. Wow. That's awesome. Yeah. So that's why we can keep our prices so low.

And you've probably got a database of every fellow graduating.

You know, I have all their info, which is kind of why we went that route. We have every podiatry resident ready to roll. You know, we'll just go state by state. But I've been working with Mark Maloney on it a little bit as well. But yeah, just pricing is the one question. I feel like I'm close but not quite there yet.

Yeah, don't even think of— don't overthink it. A/B test it. Yeah, you know, 3 different website versions and you'll get your answer real fast.

Yeah. And it's fun. They can click and do the whole thing themselves. We don't have to be involved at all, which is nice. Yeah. So that's, that's, and that's why we also can keep that price down. You don't have to pay for a whole marketing team as well. So, well, appreciate the feedback. Yeah. I like the referral part of it.

Yeah. The referral, the lead, lead gen is where everybody will pay. People will pay money for leads. That Michael's right on the, right on the button there. Yeah.

We can build it, we can do it. Yeah.

Because that's not, you know, how many times have we talked to the— every doctor has a young son or daughter that thinks that they can build their website for them and all those different things. You're gonna hear all that, but nobody can bring the referrals in. Yeah. And the idea, I mean, there's all kinds of things you could do. You could even say, hey, you know, for a certain time, certain cost every year, we'll We'll, we'll set up a dinner for you where you can, you know, tell all these people in a room. But yeah, yeah. Do you guys use Apollo.io at all?

We rebuilt our own version of Apollo because it's not good in the medical device space. So we kind of position ourselves as we're ZoomInfo or Apollo for medical device, specifically for distributors. Because when you look into— and we bypassed their database, we were using their data providers. And then we went to a younger, new Y Combinator company, and that team has just helped us a ton on better versions of it. And I mean, I'm happy to show it to you after or now as well. But yeah, we essentially said, whenever about 100 people on a people database that have principal in their title are medical device adjacent, how do you dive deeper in there to figure out if those are actually medical device distributors? And that's what we've done. So, hey, find all—

find— I found the same thing with Apollo. So we use it for, you know, ASC and hospital placements. You can get everybody's contact information, but if you're looking for distributors, you got nothing.

You can't do it. You can't do it. That's, that's why we rebuilt it ourselves and we've worked with this team. And, and even same thing for doctors, sometimes it's, it's challenging to do so. So, uh, we built the code base for that as well. Um, but yeah, we're, we're like the healthcare version, medical device version of Apollo. So that's kind of how we position Encircle and RepGPT.

So if I send you— I'll put it here on the chat— if I give you my email, can you send me some information on, on that?

Yeah. Can I share a screen real quick, Tiger?

Yeah, yeah, you got— you go fast. You got— we got 3 minutes before—

Yeah, here was the search: find spine distributors in Georgia. Here's ATEC. Here's Medical Integrations. Here's an Atlanta-based distributor, former Globus distributor of 24 years. You can go through here and kind of see everything about them and go to their LinkedIn, Globus, all that. It's, it's what I find to be an easier version than Apollo. You know, you can go through and find kind of really wherever, but it's really focused on finding distributors. So, and contact information and all that in here. So it's, it's pretty fun.

No, that's awesome. Yeah, I'd like to see more of that.

Yeah, it's what's nice that we just added a new CRM feature and then I'll give you back the screen. If you have— and this works same with doctors too— but if I have someone here, uh, Team 1 Jacksonville Ortho-X, I can go down to this button here and click Find Similar, and it'll go find everyone else in the distributorship in the state. So real quick additional search is nice. Same thing is true as if you have a doctor in your CRM. You said, okay, find everyone else here. It'll show you all the other doctors that are at that that practice as well. So if you're in the waiting room now, you can do a little more research on everybody else. But here you go. Yeah, names, intro, all that fun stuff.

So that's so cool.

Yeah, it's very good.

Congratulations, that's awesome.

Thank you, guys. It's similar to Apollo.

Just, I think the one thing you need, Stephen, is— it's hard to do, uh, is a reputation score. If, if every rep and distributor had a, you know, 1 through 10 You know, I'll never work with this guy again. You know, it's like Yelp, you know. Yeah, if he had a Yelp score for restaurants or, you know, yeah, it's so hard to hire an attorney first though.

Yeah, is you have so many distributors that think they're going to do well on a product, so they'll pick it up, they'll take it to 3 doctors, and they're not a bad distributor, but those doctors didn't want to use that product and they're crushing it elsewhere. So it's so tough. a hard one we've tried to figure out, and with you as well, it's, it's challenging. Oh, well, Michael, let's definitely link up afterwards if you don't mind. I'd love to show you a little more.

Yeah, no, I think it's great.

Perfect. Thank you. This is why Bone Shot's great.

Bone Shot's great. It's, yeah, has— it just brings people that help each other. Everybody's an entrepreneur, everybody's building something. And everybody needs help. Yeah. So we're back next week. We got Miok presenting. That'll be really interesting. And then I think it's open the next week after that. Right now, I'm trying to get Kinematic on. I just saw an email. We're just trying to lock in a date for Kinematic. Kinematic's my favorite business, my favorite business in orthopedics because it's all cash concierge business. I absolutely love those guys.

That's awesome.

All right. Thanks, guys. It's been an hour. Appreciate it. Keep it going, Stephen. We'll— next time we see you, you'll start another business.

We might. I appreciate it.