BoneChat #51 - How to drive sales and investments by leverage social media with Omar Khateeb

All right, welcome to Bon Chat discussion number 51. Today we have Omar Khatib. I hope I'm pronouncing that right. Uh, yeah, you all know Omar, you've seen it, you've seen his work. He's an expert in leveraging social media to drive sales or attract funding. He's also the host of the podcast, "The State of MedTech." So Omar, welcome aboard. The mic is yours.

Fantastic. Thank you everybody for joining and thank you Tiger for the invitation. It's an honor. So a couple things. One is I'm gonna run through a quick presentation because whether you're trying to attract investors or get commercial traction, the best thing that I can do is lay a foundation of how you guys should think about these things, okay? Now, the intention of what I'm gonna show you is gonna be a little bit overwhelming 'cause it's a lot of principles, but it's gonna leave you with a certain frame to start thinking about things through. Now, to give you guys something that's gonna help more on the tactical side, go ahead and check the chat, or if you're listening to this, go to www.upgrademylinkedin.com or just click that link. Use the code Omar's Friend. So this is one of my courses that I have. I have put a lot of CEOs through this. Essentially over a weekend, I'll give you some ideas of persuasion and framing as it relates to your LinkedIn profile because it's really important, okay? So now that being said, let's jump into it. I'm gonna share my screen and I'm gonna jump around on slides a little bit just to kind of keep it high level and go through things rather quickly. Can you guys see my screen?

Yes.

Perfect, okay. So for those who don't know, I'm the host of the number one podcast in the medtech industry, "The State of MedTech." We have a lot of episodes on there with CEOs, investors, et cetera. I highly recommend you listen to it, subscribe to it. Okay, so that being said, let's jump into it. Um, I want to start putting some definitions out before we get into some charts I want to share with you guys to think. So one thing I focus on a lot is network effects. Network effects is something that becomes more valuable as more people use it. This is going to be very relevant to you as a CEO as you're trying to leverage this online. To give you an idea 2 phones, that's 1 interaction. 5 phones become 10, and you can see the scale. So there's more users, which creates more values. A lot of the biggest companies in the world, they use essentially network effects to drive product adoption, okay? And I believe that you can use these same kind of effects as a CEO, as a medtech company, to attract investors and critical adopters. The one thing I wanna address, because when people hear about this, they always say like, Does this mean you can help us go viral? All right. You don't want to have a business model on virality. Virality is like Pokémon Go, the Gangnam Style video, Ice Bucket Challenge. You don't want to build a net— a business on that. Okay. Virality does not guarantee a network effect, but if you leverage a network effect, it will guarantee virality. And so if you look at viral effects and think about this on social media, okay, viral effects means like you have one thing that goes viral, which connects to more people and more people, but it's all leveraged on that one thing happening. Versus a network effect has more of a spread out approach, as you can see based on this visual here. And this is, uh, be more specific in a moment. Okay. Now I want to walk you through the network effect framework, but real quick, just to kind of give a reason why you should listen to me. I use the same approach back in 2020 with my startup where I was at called Potrero, where essentially I put 35 hospital deals in 20 days. So these are the screenshots. Okay, now here's the, the main concept I want to introduce. Okay, I'm going to show you guys 3 charts. We're going to combine them and then I want to get into Q&A real quick. Okay, so this is a high-level strategy. Again, the more you think about things like this, I think the easier it is for you to attract investors and clinical adopters. Makes sense so far? Yes. Okay, so 3 charts. The first one If you have not seen this chart, I'm not gonna ridicule you, but you should know this, which is the technology adoption curve. Jeff Moore's work has been a big influence in my career and how I think about things. For those who are not familiar with it, again, you have a new technology, new iPhone comes out, new whatever comes out, everyone goes through a product adoption curve where at the very beginning, not a lot of people adopt it. That's considered the early market. But as you sort of grow your market share, you get to the mainstream market. The key to remember from this slide as it relates to what we're talking about today is that each one of these groups require its own messaging. So the way you frame your company, your product, et cetera, and message it to somebody who's a tech enthusiast in the early market is gonna be very different from how you frame and message things in the mainstream market. So everything changes, okay? And including your company. Your company, I mean, let's look at the best company in our industry, by market cap, in my opinion, is Intuitive Surgical. Who Intuitive Surgical was as a company, their leadership, etc., over here when they were in the 2000s is very different from where they are now and who they are today. Okay, so that's one. Second chart is the Gartner hype cycle for new technology. When a new technology comes out, there's always the spike in visibility. Think about ChatGPT. When ChatGPT came out, there's a huge spike and a peak of inflated expectations. I always tell people human misery lives like right below this peak right here. Because if you used ChatGPT a few years ago, you weren't that impressed with it. Like there was a period where you're like, wow, this is amazing. And then you start asking it to do more things and you say, oh, ChatGPT is kind of like an idiot savant. Like for me as a marketer, I'll have ChatGPT write a few ads for me and I read the ads. I'm like, all right, ChatGPT, let me take it from here., and then over time you have this adoption. Okay, the last one, one of my favorites, is the evolution of a new market. Okay, this green line is a new market. So when you start with a new market, there's like no TAM. Okay, and this is where a lot of CEOs get worried because they're like, oh, I have to, you know, come up with a big multi, multi-billion dollar TAM. The problem is that the most valuable— I mean, let's look at Intuitive Surgical as another example. When Intuitive Surgical started with robotic surgery, there was no TAM. But guess what? Over time, when you grow a market and you have a bunch of people who say they do robotic surgery, by the time you get over here with a multi, multi-billion dollar market cap, when you say robotic surgery in anywhere in medicine, people think of Da Vinci first, right? When I say electric cars, there's like 20, 30 car companies that do electric. We all thought of Tesla. Right? And so the key is how do you own a problem and the adjacent solution to that category to have this kind of ownership of a market. So why these 3 things? Okay, if you combine these 3 things, you end up with this chart. They all align very much perfectly with each other quantitatively and qualitatively. And the focus here is that when you focus in this early market, to create a strong signal-to-noise through network effects on social media and you engineer a new market, what happens is that you attract the early market easier and faster, right? And whether it's investors or clinicians, they all have their ways of adopting new technologies and/or investments. They have their networks, right? And the key is, is how do you show up consistently online through marketing So you can fill out this technology adoption curve, which by the way is applicable not just to clinical adopters. I want you to think about investors for a second. Tesla, let's look at Tesla for example. Tesla in the early days was not funded by institutional capital or companies like, or VCs like Sequoia or Andreessen Horowitz. They're funded by rich people. So just like your product or your company, Your company's in this early stage. There are certain early-stage investors that you need to think about, right? When you're in this part of your fundraising cycle, this isn't the time to think about, oh, how do I get a meeting with Sequoia, for example, right? Or even Sofi Novartis. Some of you might be able to, but that's something that you have to consider because then you're able to figure out how do I frame this investment vehicle in the right way to the investor I'm talking to. Okay. At the end of the day, it's a sale. One of the things we talked about last night for this thing that Tiger and I were on was selling to, you know, to customers. The best salespeople adapt their value proposition and their sales pitch to the customer they're talking about. As a CEO, you need to think about investors the same way. You can't take your just usual slide deck and then go and present it to every single investor. And assume that it's going to work because every investor is going to be different. So you have to keep these considerations in mind. And so if you think about this sort of approach, you can attract investors at scale, you can grow your pipeline at scale and drive product adoption at scale, and more importantly, do it in a sustainable way. So in the sense that if you have a technology adoption curve and you start using social media and digital marketing to attract clinical adopters, right? Then you fill it, fill out a very big pipeline. So instead of having 3 or 4 or 5 deals, you have 20, you have 30, you have 50, and not all of them are gonna close. So if you look at this, this graphic here, you know, let's say this hospital right here, let's say it's a Johns Hopkins, that's not gonna close in a year or two, right? It's gonna take longer. The idea is how do we just get 'em into pipeline and nurture them along versus a smaller ASC where you say, you know what, I can get these people to sign a contract and adopt my product within this quarter., right? And again, let me just go back and now I want to jump into Q&A to this chart right here. When we put this pipeline together for Potrero, which is now called Acuron, we raised $15 million that year. This slide, right, specifically this pipeline helped to do that. And the reason why is that imagine I took out all these white cards. These are all the deals that I put on. But to get all those white cards, the pipeline doesn't look good. But to an investor, when you can show a pipeline like this and say, hey, like, here's what our active pipeline looks like and the deals we're working on, that inspires a lot more confidence because an investor wants to know, well, if I give them money, which is an accelerant, what's gonna happen with it, right? And so that's the thing I want you guys to consider. And let me stop there. And I'm gonna make one last comment. One of the biggest mistakes, and in my opinion, the dumbest mistakes I see a lot of early-stage companies do, and it's usually when I talk to their, head of marketing is they say, oh, Omar, but you know, we talk to all the, you know, physicians who can adopt our product and we're in a limited market release. So we're not, we're still a little bit stealth, like we don't wanna, we don't wanna market too much. Very stupid because when it comes to be showtime and you're full on commercial, that's not the time to say, hey, let's ramp up the marketing. You wanna start it from the very beginning because guess what? It takes a lot of time and effort to get these people. And it's just like dating. What's a lot easier is to get somebody into your ecosystem, into your CRM, and you nurture them and they see more about you and your company, your product for a span of a year. And then you follow up and say, hey, I'd like to get you in a demo. 'Cause now they spent a whole year passively seeing stuff from you versus starting with commercial launch. And now you're just like, hey, let's just get a bunch of leads and just hammer them and get them into a demo. That's the wrong way to do it in my opinion. So that being said, let me pour myself a cup of coffee real quick.

Okay.

Let's, let's see who has the first question. And, and, and by the way, the questions can be based on what I just presented or you can even get more tactical on specific things about using social media or digital channels to persuade and, and attract investors. Oh, we got one.

Asher.

So quick question, um, what are the common traits or characteristics that you see between the, the first 2%, the, you know, the, the innovators, the early adopters, um, and then like, you know, transition from the 2% to that sec— I think it's like 13% is that second bucket. What are sort of the common similarities, you know, across market segments, customer segments, you know, just in general? Yes. Yeah. So what I would say here, here's the best way I can put it, because when you look at each of them, they— their psychological profiles break down in very interesting ways. The easiest way that I can tell you is that an early adopter, like super early, they can see the future with their eyes closed. And what I mean by that is, if you go up— and we're talking about clinical adopters here— if I show up a product or something to a clinical adopter and their first question is "well, what like studies have you done on this and who else is using everything?" It's very likely that they're not the right person. But if you show that same product and someone says, "oh, you use this and you solve this problem this new way? Yes, that makes sense." Maybe they do wanna know like who uses it, et cetera. But if they get it without you having to show a bunch of stuff, that's the right person. Because essentially if you think about clinicians, and by the way, for people who don't know, I was in medical school for a few years in Texas and I dropped out. And so I know physician psychology really well. Physicians are not trained or paid to do innovative things. They're literally paid to follow the herd and do what everybody else is doing. So to find somebody who's gonna say, I'm not gonna do what my peers do, I'm gonna do something very different and risk my career, risk my, you know, brand and everything, that's a very special and unique person, right? So again, that needs to be somebody that you say, hey, you know, this old problem that has these issues with it, here's this new way of solving that problem. And by the way, we made a product that is that solution. And they say, that's exactly what I've been thinking needs to be made, right? That's the right person.

Good. Asher, you get what you needed?

Asher, you can usually find them, like if find something that wasn't used 10 years ago, 5 years ago, Find those first initial people, like disc replacements when that first came out, computer navigation, uh, now that it's getting into the users that are using it for spine, uh, because that's still relatively new, um, that's, uh, that's a really easy pathway.

Yeah, and I do want to comment on that real quick. So I, I completely agree, there's two things you need to do when you're looking for adopters, okay? The first one is what our industry does all the time, and it's not, in my opinion, the, the best way to do it, which is you go and look at like who, who's known for adopting new technology. That's a good place to start. The problem though is, think about yourself. For me, um, there, you know, like I'm an early adopter when it comes to gym equipment. I have a garage gym. So if some gym company or somebody comes out with this like very interesting gadget for, for gyms, Like I'm one of the early, early adopter. Like I'll buy it. I don't even have to know who's using it, right? But then there are other things like, for example, books. Somebody tells me about a book, I'm kind of a late adopter with them. I'm like, okay, well, how many reviews has it got? Who's endorsing it? All these different things. If I go and see a book on Amazon, it's got like 1 or 2 reviews, unless it's coming from an incredibly credible source, I'm not buying it, right? So everybody has their own adoption psychology based on certain things. One is, I agree, go and look who's adopted technology early in the past, 'cause there's some people who no matter what it is, they just wanna adopt new things. Those people exist. At the same time, this is why you have to use digital and social media early, as soon as possible, right? And this is what my company focuses on, whether it's like through our course or advising or anything else, because think of it like you're building a fire. And the bigger the fire you build and the longer it lasts, the likelihood that someone's going to see the fire and they're going to come to you. So one of the companies that we've worked with is Moon Surgical. It's a robotic company out of France. When we came up with— and actually, I want to pull that slide up real quick. Is that okay, Tiger? Am I allowed to jump back?

Okay, we got questions waiting, so go fast.

All right, I'm gonna go fast, I'm gonna go fast. All right. So look, here's how you have to think about that. Is that— can you guys see my screen? Yes. Okay. So we came up with a hypothesis of like, here's the profile of adopters that we think is good for Moon Surgical. We generated about 195 leads for them, like surgeon leads emails, and we put them into a CRM and we nurture them down through emails and videos. And so it's like some open the email, some click the video, some did this, etc. And so by the time we got to 20 who advanced to a demo, and this is within a period of 6 months, 3 closed, okay? Of those 3, one of them was not even on my, like, bingo card. And the reason why is because you can hypothesize as much as you want, but until you start putting people through and using social media, you'll never know who is out there that is, let's say, and again, even Intuitive, the best companies in the world will tell you their early adopters wasn't the chair of Hopkins. It's usually some random physician that nobody knew about, but they got activated because of your technology. And there's a lot of doctors like that who, you know, they're like, you know, doing their practice. Nobody really knows them. They don't publish papers or anything, but they see your technology and it hits on a pain point that is so important to them that they get activated and not only will they adopt your technology, they'll advocate for it. In the case of Moon Surgical, we found one of those people. We got them to post on social media. They went and said, "Hey, here's like 10 other people just like me." And now you've dramatically lowered your customer acquisition cost because unlike using digital and marketing, all these things you pay for, right? Now you have a cheat code because you paid the money and put in the time to find that one adopter who's now gonna give you a shortcut to more adopters just like them. And no amount of money is going to be able to get that unless you get that one adopter, okay? So let's move on to the next question. As you guys can tell, it's like one of my favorite topics to talk about.

Mauricio.

Hi, Omar, thank you, man. Great, great presentation. I have a couple of questions. The first one is, Like, from, from your experience, I mean, your, your course name says it all in LinkedIn, but is LinkedIn the— is LinkedIn a good tool to engage with surgeons and clinical staff, or what have you found depending on the, on the different platforms?

Yes. So, uh, I'm gonna make it more specific to you. What, what's the physician that you go after?

Oral and maxillofacial surgeon right now, a little plastic and ortho, orthopedics. A little—

okay, I'm gonna use— okay, okay. So here's, here's what I would say. LinkedIn is becoming a very valuable platform. It has over a billion users, and the reason why it's valuable is because unlike any other social media platform, they make you verify with your ID. So everybody is real on LinkedIn, number one, or most people. They— there's some fake profiles because they're older But LinkedIn actually deletes old, old profiles. That's number one. Number two, not every physician, hospital admin, everything is on LinkedIn or uses it, but the early adopters usually are, right? Depending, right? And the key is to use that to find one, one possible people. Look, do you guys go to conferences? Yeah. Do you know that every single one of the physicians that you want to reach is at that conference?

Probably not.

Probably not.

They still go there. And so marketing today is more complicated than ever. It used to be 10 years ago that you can just do some really good SEO, come up with 3, 3 targeted channels, right? And then test them and say, oh, this is the channel we get the traction on, put the money there and it'll work. Now, like this wallet I spent $100 on, these people marketed to me first on Instagram, then I saw something from them on Twitter, then I heard, I saw somebody post about it somewhere else, and then finally I bought. And that's a $100 decision, right? And so you have to figure out what are the key channels for you, no matter what the specialty is. I always tell a medtech company, 100%, you have to be active first on LinkedIn 'cause that's where your investors are. After that, have an X handle for your company and for your CEO and an Instagram, okay? And I would get these from the beginning. You don't have to have content for all these things, but definitely go and get the domains or like get the handles to start.

What about YouTube? Because I think it's underrated.

100%. YouTube is owned by Google. It's the second biggest source of search. And so on YouTube, again, you know what, I don't care at this point because I'm an investor or I'm a shareholder, but great example of what not to do, Alphateck. Alphateck is a publicly traded company. They only have LinkedIn. It's the dumbest thing I've ever seen in my life. Um, and so get a YouTube channel, and if you go on a podcast, get the raw file, publish it on your YouTube, put your, um, uh, product videos on there. And something that you should definitely invest in— if you're a CEO, you go on a podcast, right? Get the raw clips, go on Upwork or Fiverr, pay $100 to somebody or $200 get like 5 or 10 or 15 clips from me, throw them up on YouTube Shorts, right? All these things are important. And, you know, like, I hear, you know, CEOs, they, they moan and complain about it. They're like, oh, I, I don't want to do one other thing. I have this. It's like, well, you know what, as a CEO, your number one responsibility is how do I get attention for the problem that I solve and my company. That's like number one, right, before anything else.

Yeah, and the other thing is, with the early adopters, a lot of what we have seen with the— is that there's a lot of co-creation going on and riff-off. So they'll tell you like, hey, I love this, but I would like to add this and this. And I mean, one of our initial sources of traction has been like that interaction to build like initial loyalty. How do we get that like, on, on, onto our social channels? Right now it's like very in person, but what, what ways have you seen that you can like leverage those network effects to almost co-create some products with your online community?

Yeah, so I mean, the easiest thing is document. Just getting in a really good habit of documenting your journey. So for example, you do a lab, you go to a conference, take a picture with that person and just say, hey, are you on social? And find out like, do you have an X handle? Do you have a LinkedIn handle? And then tag them, okay? And by the way, that reminds me, I forgot another tool that I wanna give you guys access to. So for creating content on LinkedIn and managing your company page and CEO page, instead of spending money on like HubSpot and Fiverr and stuff, or HubSpot and others, there's this one called omnicreator.club. Disclosure, I'm a co-founder of it, but use the code OMNIPOST. It's a great way to get engagement. If you have questions or need help, just ask me, but I would co-create and tag them, right? So make it easy. So for example, you're gonna go observe a case, take a photo of the clinician doing their thing with your product, right? Of course, like, as it, you know, make sure that you don't see anything patient-wise, and then say, hey, I made this really nice, like, photo of you. 'Can I post it and tag you in it?' Right? And here's the interesting thing. When you do that, they're going to reshare it. People are gonna like it. And then you can open the likes and monitor the likes and be like, 'Oh, here are like 2 or 3 doctors that I don't know about that like this post, but they're the same kind of specialty as my doctor.' Now, guess what? That's a lead for you. It's so much harder and there's so much friction to, let's say, get someone to go to your website and fill out a form. But if somebody likes a post, right, that's like gold right there. There's so many ways where you could sort of unlock value and figure out how to get commercial traction. But it's these, you know, it takes time and effort, but that's the reason why it works. It's very easy for somebody like a competitor to go and buy an email, don't buy email lists by the way, it's very stupid. But buying an email list and just e-blasting a bunch of people versus creating some content, putting it out on LinkedIn and just being mindful and saying, who's liking this stuff? Who's engaging with it, right?

All right, Dr. David K. All right, thanks.

Um, okay, camera show. Okay, good. So I'm going to play contrarian, and, um, uh, imagine that. So, and I'll use, um, QTiva, which is a resi— that's a skin adhesive. Um, our issue right now is we, we're FDA approved, but the FDA got really squirrely on us. Our regulatory person did both Prenail and Dermabond, so he, he He knows the space intimately. And the FDA just decided to make us do things that nobody's ever had to do before. And that really made us incredibly cautious as far as production. So now we're cleared, we have to do production. Now the good news is the chemistry is incredibly complicated. So the chance of anybody else making this is somewhere between slim and none. It's gonna be really hard for somebody to, to duplicate the, the chemistry. The bad news is it's really complex chemistry. So we are gonna have to do a limited release. We are gonna have to be really careful about, uh, overpromising and underdelivering. And we're not talking about the usual orthopedic TAM. Remember, there's 100 million surgeries. Every one of those has an incision. 40 million skin biopsies. Okay. Most of those are closed up with 1 or 2 sutures. So that's 140 million. 1% is a massive number. Is what J&J sells in Dermabond and Perneo right now. So we've got to be really, really careful about, again, overpromising and underdelivering. And that's what's holding us out as far as broad, you know, um, marketing. We don't want to do that. We've already identified our limited release guys. We want— and we also want to be sure that all of our systems are intact and working properly. But our biggest single biggest concern is keeping up with demand. You know, we're talking about having to make 500,000, 1 million applicators a year. That's a huge number. You know, that's not a little number.

Your concern is like you agree on the marketing approach, but your thing is like on the production side, we just can't fulfill if we were to get that demand and we've been reluctant.

That's—

Yeah, yeah. Got it. Yeah. I'll tell you this. And by the way, it's nice to finally meet you because I'm seeing a lot of names I'm familiar with. Is your LinkedIn profile where you're holding glasses? Like you're holding your— Yeah, yeah, yeah, yeah.

Oh, okay.

I thought so. It's nice to finally meet you. You have a great profile photo, by the way. Yeah, thanks. So here's what I think. Look, let's look at— okay, there— if you find a company, you gotta tell me which company this is. There's no med device company where they have so much demand where doctors are like beating down the door like, why haven't you delivered this product that I wanted? Doesn't happen, right? But let's look at a different industry, okay? Fashion. So there are certain clothing brands on Instagram that they sell out, right? And the new way to drive limited production releases is you get people to sign up for any— sign up with their email and it's like, "Hey, we're gonna let you know when we're doing the drop." They do a drop and usually it lasts 24 hours and it's sold out. So of course, the people who, let's say, go to that website and they're stuck, it gets— clicks refresh, they're all out, they're upset 'cause they wanted that product, right?

Scarcity.

Yeah, yeah, it's— they're creating scarcity. But the key is they have— why do they have you sign up with the email? They have essentially all these people that whenever they want, they can just pull a, pull a lever and say, hey, we're going to email 1,000 people, 2,000 people, 10,000 people, and control and have more predictable revenue. So what I would tell you, David, is that you should still absolutely run ads, do social media marketing, all these things, and drive them to capture that attention. Because once you've captured that attention in the form of like, you know, lead gen and you get their email, etc., now you have that. Because there's no guarantee you're always going to have that. It's much easier to say, hey, let's focus on driving 1,000 people to our website this month. And of those 1,000, let's convert 10%, so we'll get 100 emails a month. That's very easy to do versus when you go full-on commercial, it's like, okay, let's drive like 100,000 people to the website and this, that's way harder and more expensive. It's better to do it over time because then you can decide like, hey, here's who we sell to, right? And personally, I think it's a good problem to have. Like, I think it's good if you have a list and you're like, hey, we're actually, you know, we're over, we have a limit on our production right now. We will let you know when we have more. I think that's a good thing because now you have a lot more predictability on your revenue. And then from an investor standpoint, if you're raising money, that's a hell of a slide to show an investor, right?

Yeah. So, so another question that this is different from normal orthopedic products and, um, where I'm pretty much incredibly negative on direct-to-consumer, but this product is really quite different as a direct-to-consumer. And for, you know, for example, who's the decision maker in medical decisions in households. It's usually the, the women, the wives, uh, or the grandmothers or the mothers. You know, they're the ones who make the decisions. And what we have, again, is a product where you don't have staples, you don't have sutures, you just kind of let the thing peel off at 2, 3 weeks. So there's no pain and the scars are, should be significantly better than what you're gonna see. So they're the decision makers. And one of the questions that I've got really is, is this something where direct-to-consumer marketing, like on Instagram, TikTok, Facebook, where that can actually drive adoption? It can, you know, because nobody likes getting sutures taken out, and especially in kids. I mean, we've already got a pediatric hospital signed up, and of course, you know, again, little concerned because they're doing 15,000 cases a year.

What's the question, David?

Well, direct-to-consumer. Is this, you know, is this a product that is different from the usual orthopedic product —because it's about skin—where direct-to-consumer may actually be a big driver of adoption.

I didn't— I don't know if I heard a question in there, though.

Yeah, no, no. Is this a product where direct-to-consumer is a good idea versus typically, you know, I've never really understood why implants are direct-to-consumer because there's so many other decisions.

No, I can tell you why. Because patients are actually going to doctor— their doctor these days and say, hey, are you going to use this implant or whatever? And at the end of the day, a lot of these implants are the same. The patient's like, I want this. And if not, they'll go somewhere else. And it doesn't happen all the time, but often enough, because look, people like Joe Rogan, every few episodes he has a fighter on or somebody in, in athletics, and they actually talk about like implants, right? Most recently they're talking about like a cervical implant. So this thing does happen, right? And then on the direct-to-consumer side, like personally, you should have an agency to be running targeted Instagram ads and driving people, right? Because at the end of the day, for example, if you have consumer interest and you're able to sell direct, like, you know, hypothetically, your cost, I think, would be lower too, you know? So I think like if you have the opportunity to have multiple, uh, uh, multiple channels of revenue. Like, there's a B2B side, there's a B2C side. Like, why not? I would do it. So, okay, all right, who, uh, I'm gonna listen. Tiger has to manage the questions because I don't want to pick.

Actually, it's just piggybacking on what you're saying. So Treece did this very well. They, uh, showed before and after pictures, two women that were getting bunionectomies, and, uh, the lapoplasties and the before and after. And they were just doing visual representations of what the foot looked like from the exterior after the procedures. MIS did it perfectly. They're the ones that came out with this direct-to-consumer 30 years ago, the minimally invasive total knee. So the market will dictate whether or not it's valuable and scarring is very valuable for sure. The, but I also wanted to address with regards to the getting, getting awareness out there. You don't have to publish your product to be a knowledgeable source. If you publish, if you reshare things that are surrounding the thing, the issue that you're trying to solve, you're gaining followers from your information, and then it gives credence and viability to the market's understanding. For example, 5 years ago, we started educating upon bone mineral density differences in the spine versus bone mineral density issues anywhere else in the body. And it's just now starting to become a true understanding of the differences. And then I always publish and reshare information that I just find valuable. And so it gives awareness that I really, really research this stuff. I'm not just making a comment out there. And then when you're ready, you have the followers that you can talk to. And as long as you know the algorithms to get those— get the attention outside of 10% of your, your followers, which is 2 comments within an hour and 2 comments and 15 likes is the algorithm to get outside of only sharing within 10% of your network. And then also with regards to the ordering process, value analysis is going to hold you up. And that will also give you the benefit of how much to order. And so value analysis is going to take anywhere from 3 months to 2 years. So that's going to— it's going to dictate your need and the push to make— push these orders. So Omar, are you— do you agree with that or would you push back? Which part?

The whole thing? Any of it? Yeah, I agree. I agree with all that. Yeah. I, you know, and look, like, here's something like you mentioned, like, you guys are putting out some thought leadership content and it took, you know, like a year or two. This stuff takes time, my friends. And I think like you have to be patient. And the most common thing I hear when it's like, usually when a company comes to us on the agency side and they're like, you know, we want your help to use like, you know, webinars and social media, et cetera, to grow a commercial pipeline. And I'll talk about like what to do and they'll say like, oh, we already tried that. Didn't really work. And my response is like, do you know what like a potential reason for that is? Is that maybe you're just not good at what you do, which is fine. There's nothing wrong with that. But most of these companies suck at it, including the CEO's posting. We go strike for a lot of the CEOs that we work with because they're not good at it. And there's nothing wrong with that. Look, let me give you guys like, be a little vulnerable here. I think you guys would all agree, like I kind of know what I'm doing when it comes to social media. Guess who's posting on my stuff? It's not me all the time. My team helps me with that because this stuff takes a lot of time, takes a lot of effort, right? And so, you know, the thing that you have to think about, and I would recommend, I'll think of a book right now actually to recommend. If you look at the software world, right? They're very data-driven in terms of their customer lifetime value, their acquisition costs, you know, cost per meeting, all these different things, right? So take all that out. Every single one of you, I can guarantee that like the cheapest product here in this conversation, it might be $10,000 lifetime value, okay? $10,000, okay? So if you do the math, you should be willing to spend up to, you know, $8,000 to acquire that customer. Granted, yeah, like your return on things is not high because you're just profiting $2,000, but still, you're, you're still technically in, in the green, right? Too many companies essentially invest measly amount of money to get millions of dollars worth of value and then give up, right? Like, right now, for, for, from, for my own business, a customer can be anywhere from 5 to 6 figures of, of, of revenue for me. So I'm willing to spend 5 to 6 figures of paid ads to acquire that customer, right? And I'm okay with that. Sure, I don't like spending money like everybody else on here, but at the end of the day, you also have to consider like, how long does it take to acquire customers? Look, I'm very visible on LinkedIn. I run a marketing show. I do all these things. I still have to run ads. I still have to do these sales, uh, outreach and everything because Not everybody knows me, like barely scratching the surface. And this is a guy who's got a podcast, everything. So think about that for your product and ask yourself like, okay, how much do people really know about us? You know, this is why like it's, you know, like you really, like I, I love going to conferences. I think it's, it's worthwhile, but sometimes you have to think, okay, we're gonna go to 10 conferences this year. Okay, that's a lot for most of you. 10 conferences, and let's say exhibit at all 10 of them. Okay, so that's 10 times a year. So maybe what, like 20% of the time of the year you're getting in front of your customers? What are you doing for the rest of the year to stay in front of that person, right, to convert them over? Persuasion and behavior change does not happen overnight. It takes a lot of time and effort. Takes a long time.

Like you said, they have to see you in multiple, uh, platforms. Let me double-click on the Direct-to-consumer question real quick. We learned this from Jansen Cole, who ran marketing for Arthelon. Direct-to-consumer only works if the patient can look at their condition and diagnose themselves. So bunions were perfect. You have a, you have a crooked toe. I need a bunion surgery. They already know that. So it works really well in that scenario. If you have a lower back pain, you're not sure what the pain's coming from. Direct-to-consumer does not know because they— does not work because they don't, they can't diagnose what they need. So I don't know if patients before surgery know that they don't want staples. That's, that's a tough one, I think.

I think you have to, you have to always test these assumptions and you'd be very surprised how well-educated people can become if they have a problem. And I think part of it is like, you know, if you think about like, let's, okay, I don't know, let's go with something like really specific, which is, okay, maybe I have, you know, ulcerative colitis or something, right? Like that's like really specific. Most patients don't know that. We'll start top of funnel. It's like, okay, the patient, if their diagnosis is this, what's the thing that they're gonna search on Google? It's like, oh, like I've had like runny, you know, runny bowel movements and like my, you know, I've had this bloating and everything. So maybe those are the things that you have to start creating content around and be patient about, hey, we're gonna put this stuff out there so that people can find us. And, and I, for me, I'm very proud of what we do as an industry. I think if you have something, you should run some paid ads at a low cost just to get the attention of patients and drive them to your website. Cause it's like, hey, you have an ethical responsibility of helping those people find you and get educated about a better solution. Right? Because we're all here, like, to get— make things better for patients. So why are we relying on hospitals and doctors to do all of that, right? Yeah. What about the patients who don't make it to that doctor that has your product?

It makes a lot of sense. All right, we got 3 questions. Mauricio's up first, then Mark, and then Asher.

So I have— I— this, this can get very tactical and very specific, but we've been hosting, like, YouTube Lives on a regular basis with surgeons presenting their use. And we've actually— it's actually been super successful at getting us leads. But we want to tweak the format and make it look more like a podcast than like an academic case presentation, because we think it's— we can, we can like cover a little more than just the clinical use, like more of the, like the practice efficiency and how to, how to alter, like how to build in a workflow and do it in a more effective way than just have a surgeon present a case. I wanted to know if you had like any off the top of your head, any tips on how to make that content more valuable. That's number one. And number two, one thing is we have, we sometimes replace downstream of a referral network. So some of our patients get surgery because they went to an orthodontist, and the orthodontist referred. Should we use the same handles and the same platforms to like market to the referrers, or should we differentiate like the way we reach each one of them?

Great question. So one, let me knock out those questions one more. So number one, same handle across all platforms, okay? Until you're making like, tens of millions of dollars in revenue, like you should not have like a company page and then like your product page. Like, don't do that. Like, social media is already complicated enough. Don't do that. That's number one. Number two, get really good at one channel before like growing to other channels. So as an example, for me, I'm still focused on really getting good at LinkedIn and Twitter. Okay. But I still like, we use OmniCreator and another software to post on multiple platforms. So that way we, you know, we kind of build the content up. So like my Instagram page on State of MedTech, it's actually over 1,000 now, but we just kept on putting up content on there just to throw it up so that way if somebody ever goes to us and finds us on Instagram, there's at least some content there, right? That's one. The second thing is you asked about how to make the live streams more engaging. Okay, so one thing I would recommend is looking into, which is how we run webinars, is doing LinkedIn Lives, like through your company page, because you can You can generate leads that way 'cause it's automatic registration. You get like all this info plus their personal email, way more valuable than a work email, right? But then while it's going live, right, there's ways that you can tactically get it more engaged. For example, if you guys just watch my livestreams, you'll learn a lot, okay? Not just for the topic I'm covering, but just how I run a stream. So when I open up a livestream, first thing I do, I put it in the chat. I have like a banner. I tell them like, hey, what city are you joining in from? Why am I doing that? Because everyone's going to comment their city, and you're going to see all these comments, which means the algorithm's like, hey, this live stream is doing really well, push it to more people. This is why on YouTube, if you watch YouTube streamers, like, they're doing the most outrageous stuff and everything. Why? Because they're trying to get people in the chat to, to engage and everything, right? And what really helps, I think, is that while you're doing the live stream You know, when I do it with surgeons, I'll monitor the questions and I'll call people out like, oh, and I'll say their whole name like, oh, John Smith out of Nebraska has a really interesting question because then people who are in the chat, they're like, oh, they're actually— this is live. They're actually pulling questions and it gets people more interested to do that. Right. So those are different tactics you can do. And then, you know, again, always explore platforms, like always be testing. So like LinkedIn is one, YouTube is another one. I use, I stream to X, you know, on occasion as well. And so at the end of the day, it's like you have to think about that and also think about like where, where is most of the attention for your prospects going? But also consider that like, look, I'll give you a great example is like, you know, yeah, the investment, you have to think about it in a more like longer time horizon. And think about what it would mean for you. So for example, for example, you know, I'm gonna mask the name of this. There's a company who partnered up with us and they invested over the period of time they worked with us about like $70 grand with us, okay? Which I told them they were gonna spend that much roughly. And they're like, that's a lot of money for us right now. I'm like, yeah, I get it. I was like, if you get one contract outta that, what is one contract worth to you? Like over a lifetime? They're like, about $2 or $3 million. I'm like, it's a pretty damn good return, isn't it? $70 grand, you get a $2 or $3 million. And guess what? They ended up closing 4 deals. So like their return on ad spend and return on investment was insane. So that's how you have to always think about these things, right? You know, even getting like social media management for your company and product, maybe you're paying anywhere from $5,000 to $7,000 a month for that, right? And so over a year, you're a little over $70,000 or $80,000. Is $70, $80 grand worth investing knowing that you're gonna have all this content and all this awareness to investors, clinical community, potential employees, all these different things? Because then what you can measure is the amount of, of lower cost to acquiring a new employee. When we're at Potrero, when we would put out a job request, we had so many people applying, and so like our recruiting costs were way lower, right? But people don't think of it like that, so That's how you have to think about these things. All right, I know we're running close to time.

Uh, yeah, Asher and then Mark.

Yeah, super quick question. So I know we've talked a lot about the social media strategies, but I want to kind of tie this back to the, uh, adoption cycle that you talked about in the very beginning. Um, you know, right now if you go on LinkedIn on like any day in time, you'll see dozens of companies with their own podcasts and they've got their own Spotify podcasts and there's all this video content. I'm gonna push back on that. Finish your question. Sorry, sorry. Okay. So I mean, I could, I could, like, when I'm at the dog park every morning, I will spend literally like an hour just scrolling through video content after video content, podcast after podcast. And it's to the point from, as a millennial, where it almost feels like everybody's now trying to do it. And so on the product adoption cycle, it almost feels like we're on the tail end of, of these companies, like, or, or individuals adopting social media and medtech to the point where if I'm a physician and I wanted to kind of go see what my favorite, you know, a couple companies are doing. You know, there's not enough time in the day to be able to watch all these podcasts and get all these updates and read all these newsletters. So do you kind of have that perspective? Do you feel like we're still very early on? And just kind of— well, I want to hear your perspective on that. Yeah. Okay. So first, I'm going to push back hard on the idea that like all these companies have— I can't name a single medtech company that has a podcast or even does podcasts actively, right? For— and think about the greater business world. It feels like it,, but you're seeing like 0.1% of the, of the people. When you scroll on LinkedIn, I'll give you a, a stat that should shock you, but it should get you excited to be more active on LinkedIn. On LinkedIn, I told you there's a billion people. The Pareto, you know, we all know the 20/80 thing. Yeah. The Pareto on LinkedIn is that a little less than 1% of all of LinkedIn posts 99% of the content on LinkedIn. Wow. Think about that. Right? And so you're right when it comes to physicians, they're super busy, which is why this is— this is why the strategy is so important because you have no idea when a physician's gonna open their email, get on LinkedIn, et cetera. And so you're never going to guess what that is. The best thing you can do is be consistent, right, over time, and then that window of time when they decide to say look at your profile or go to your company profile or scroll LinkedIn, that you know that something is there and you're gonna catch them, right? And again, this process happens over time and it's a very active sport. Look, when I publish my podcast, there's a lot of people who subscribe to it, but this is also why like I send the new episode out through email. I post it on the company channel. I reshare it on my LinkedIn. It's posted on other social media channels 'cause I have no idea where the hell these people are going to find the episode, right? And so this stuff, like marketing is not easy. Not easy though, but that's why it's a worthwhile investment, because if you don't do any marketing, like, you're screwed. Like, literally, you are in— you're in bad shape. Okay, nobody, nobody has the— oh, sorry, go ahead. Mark's up. Yeah, go ahead, Mark. Yeah, I can go a few minutes past if needed. So I like what you said about CEO's number one job is to get attention. That's a great comment.

And, uh, in every business plan I ever wrote When it came time for the competition, I just put two words. The first word began with an F and the last one was them.

Because I believe— I like that, Mark.

I believe the biggest— I believe the biggest competition is nothing. The biggest competition is they don't hear your story, they don't know your story, they don't know who you are. So with that premise in mind, where do I get my most bang on the buck? Unless I want to buy an AR-15 on LinkedIn.

Where do you get your most bang for the buck on LinkedIn? Yeah. Is it LinkedIn Live? Is it daily triple posting?

Is it hiring somebody to, to just, just be part of the 1%?

So. All right. So I'm going to give you an answer, but I'll start by saying the, the question is, is not the right question because you're trying to look for the one thing and there is no one thing. If any marketer tells you, oh, like, just do this, they're lying. There is no one thing on LinkedIn. Let's start. I'll give you a better answer though. Foundationally, I'll buy that. I'll buy that. Foundationally, the foundation, bare minimum, hire somebody to help you because it takes time to create content for your personal profile because that gets much better reach and for your company profile. And it's posting 2 to 3 times a week. Right. So that way you develop content for your company. And then Mark Maloney is known for solving a certain problem, right? And build it from there. Then after doing that for a few months, think of it like, you know, all right, so it sounds like you're—

are you a gun owner?

Yeah, I got a few, but I'm not like a gun guy. I'm a gun— I own guns as well. So think of just like owning guns where it's like, okay, I'm gonna get you like a regular gun, like a Glock or something, and you're gonna go to the range and you're gonna just practice like shooting everything. That's it. But then like after a few months, it's like, hey, maybe I'm gonna take a tactical course, right? With an instructor where I'm like running around and stuff. And so you start adding more and more advanced things. So instead of doing it all at once, first few months, quarter or two, it's like, hey, let's establish about a foundation, get in a good repetition of creating content, everything great. Now we got a good process of every month, here's how we create our content, here's how we schedule, here's how it goes out. Well, let's try and do a livestream webinar next. Great, we'll focus on that. After that, it's like, hey, we have all this content, let's go ahead and add like some awareness ads. We'll spend like $20 to $30 a day, run some ads and just drive to our website. So every month you're adding and layering different things. Too many times people try and do too much at once. Like when I go to the gym, There's some people who are just trying to bench press all of this weight. It's an advanced function. You take a few plates off, just get really good form, then you can start doing all this other crazy stuff, right? So that's what I would— that's, that's my advice.

That's what I would recommend. Thanks. It's a holistic approach. Yeah, it's not a— there's no magic bullet. It's like, how do you become, uh, how do you become an NFL football player? You wouldn't say just do a lot of push-ups. You know, that it's a holistic approach.

And, and what I would say is like, think of LinkedIn as a slot machine in the sense that you never know what post or what activity you're going to do where it's going to unlock this value. And so many people start and they just give up way too soon. Way too soon.

What's the sales cycle, Omar? I mean, when you were talking about Moon Surgical, And you took— you filled the top of the funnel and then you eventually got demos. What— how long did that take?

Yeah, so, uh, just, just disclaimer is that like not every company is like a Moon Surgical, but we try and aim for these results. So first demo happened within 30 days. Okay. And then, uh, I think they closed their first deal— we started working with them in January. They closed their first deal I think sometime in end of July and August. So now they've, they've closed 3 deals so far. Okay, but again, the point of this— look at, look at Moon now. I mean, we've worked with them for many years. They take our playbooks and do it from the CEO to the company. And so then when you have all this awareness and content, right, your, your deal velocity is so much better because when you get a deal that qualifies and fits your ideal customer profile, the velocity through pipeline is so much faster because they've spent all this time getting nurtured and educated online that you can, you know, instead of having 2 or 3 meetings of intros and demos and everything, you can kind of have like one meeting of a demo and they're like, I'm very bought in because I saw so-and-so using it, or I saw this content and everything. And so the pipeline velocity is so much better. That's the other thing you have to consider is like, you know, time, time kills all deals, both investor and, uh, commercial. And so how do you get somebody into pipeline and they spend as small amount of time in pipeline as possible. Like, when I get people in my pipeline, if aside from close, I want to disqualify them as quickly as possible. So I'm like, oh, you know what, wrong time, put them in disqualified, we'll follow up in a quarter or two for them, right? That's the thing, is deal velocity, pipeline timeline. And I—

you, you keep, uh, referencing, uh, building an email list, and I'm, I'm a big fan of that. It's, it's a long tail, it takes a long time. Um, but I, I've seen that is very effective because you, you have direct communication with your target audience. I've got this Orthostreams blog that's free. It's been around for 15 years and there's, there's 4,000 people that have subscribed for free. No ads. Yeah. And I can, anytime I want, I can blast out a question, a useful article to 4,000 people. I feel like I, I own them even though I don't.

No, you do. I mean, look, uh, Morning Brew newsletter was purchased for $75 million. It's just a newsletter with an email list, but like, it's value. At the end of the day, the, the one thing worth competing for and fighting for is attention. Like, even money is a commodity at this time, but attention is extremely valuable.

Yeah, well said. How would you— so you're a startup company, you don't have a lot of resources. Talk about organic posting versus, you know, paid. You have a monthly budget for paid.

I would, I would, I would, as a, as a, as a startup company with a limited budget, I would not worry about paid advertising, um, yet. I would take, as a, as a startup, $3K to $7K, because again, you, you really get what you pay for, right? And get an agency or a contractor or somebody to help you to produce content and get it out organically on a consistent basis, right? You gotta build momentum from there. And then from there, once you do that well, I mean, you can be very tactical and find certain pieces of content where you're like, this is worth us paying, allocating, let's say $500 a month where we're gonna just run an ad top of funnel of this one piece of content and target our ideal user or surgeon and just get them to our website, you know? But that's how I would recommend it. Again, I know I'm biased here because I have an agency, but like even me as a marketer, when I was head of marketing in companies, I didn't do this by myself. Like I hired an agency because the agency is going to see 10x more use cases of different ways to run and execute a strategy than you. That's the thing. It's too many people that are like pennywise but pound-foolish, you know?

Yeah, it's— marketing is inherently, uh, unmeasurable, but now in digital marketing, it's infinitely measurable now. So yeah, exactly, exactly. All right, we're passing the top of the hour.

Any burning questions? I'm, I'm okay. I, I, I'm okay to answer a few more. I want to make sure that everybody gets their own questions.

Uh, Mark, Alyssa, anything more? Yeah.

Say as much time as you spend on your product through the R&D process, you should spend— you should conceptualize that that's how much time and energy should go into your marketing, because that's what's going to bring you to, to commercialization. Anybody that thinks that marketing is easy, anybody that thinks that, that their product is going to sell itself, is 100% fundamentally wrong in med tech. It is tough. You have so many barriers to entry. You have contracts that now literally lock you out. So how are you going to get around that? Is it you're gonna be your, your surgeon that's in a very tiny hospital but has a, is a big fish in a small pond there? You have to look at it from every single angle and the market will dictate itself and you have to approach it. You could be very strategic in, in your approach, but test the market. The market will always demonstrate itself and its willingness and change your— try several different things. For as long as I've been in this field, something that you think will translate well sometimes really doesn't, or it takes 10 years for it to translate. So just keep playing with it is what I would say. It's R&D. Would you— what do you think about that perspective, Omar?

Yeah, no, I completely agree. At the end of the day, I mean, you only improve by the amount of times you're able to test and adapt things. That's the biggest thing. And, you know, again, like, I'm using Moon as a great example because, like, they constantly put out— and content, like, lasts for such a short amount of time. You just have to constantly be engaging with the market and testing things and trying new things out. And again, like, this is— this, like, it does not stop. I mean, look, Intuitive has more money than God at this point. But they still put out a lot of content, you know, about their conferences, about their users, et cetera, right? There's a reason for that, you know? Coca-Cola, everybody knows Coca-Cola, but there's a reason why Coca-Cola still pays to be associated with like all these events and everything. 'Cause they're like, the moment somebody gets thirsty, the first thing we want them to think about is Coca-Cola, right? So like none of us are smarter than those, the biggest, you know, brands on planet Earth. So like there's something to be said about that.

Yeah, let me, let me, take another tack. So, in orthopedics, we're, we've been guilty of marketing features instead of what problem are we trying to solve? And you, you see this constantly where, all right, we got a new screw, a new cage, a new thing. It's got a 3-degree opening instead of a 4-degree opening, you know, Who cares? They, they get so far from what purpose are you trying to solve for the surgeon and the, and the healthcare. How do— any advice on how to market the problem that, that you're solving?

Yeah, just like literally market, literally market the problem and talk about it and amplify the pain. You know, I think there's a variety of ways and angles to talk about the problem and educate them., and some people overcomplicate this where they're like, oh, my user already knows that. It's like sometimes just posting, I mean, literally, like if you have a, I'm making this up, let's say it's knees, posting things like basics of knee anatomy, some interesting approaches, history of knee replacements, those kind of things, like we'll get the attention of those users, right? And at the end of the day, it's like you're trying to educate a market, you know? And so, Yeah, that's what I say. And again, it goes back to just engaging people and trying different things, you know, and you can't put so much pressure on, like, there's a reason why I think we call it a campaign because in a campaign there's a lot of different pieces to it. It's not like one thing, you know. All right. Well, we're losing people.

They've got other calls. This has been really good, Omer. Appreciate your time. Thank you, Tiger. Yeah, they know how to find you.

I'll send you an email with all the links that I listed just so you can email that out to everybody.

Yeah, we have a Slack channel, so I'll just share it on our Slack channel. Perfect. Okay, awesome.

Thank you, everybody. Thank you. Yeah, good stuff. Thank you. Thanks, guys. Thanks, everybody. See ya. Bye.