BoneChat call #14 - Jantzen Cole - branding for ortho startups

Okay, we are live with Jansen Cole. Uh, Jansen and I go way back at Wright Medical. He was an engineer who moved into sales and then marketing, and I, I believe Jansen understands messaging and branding better than most people in our industry, especially in startups with limited resources. Um, today he's the VP of Marketing at Ardalan, and if you don't know, Ardalan's growing sales at about 50% year over year, which is really impressive. Uh, but his company's also killing it with branding and, and, and marketing messaging. So anyway, I asked Janson to come on and share his thoughts. Handing the mic over to Jansen.

Welcome aboard. Thank you. Um, I hope you guys are ready to tolerate a pretty rough Southern accent and, uh, and maybe some, some philosophical waxing that, that, uh, you may or may not agree with. Um, I'm Jansen. Uh, Tiger and I worked together a long time ago, and we've kept in contact on nearly a couple decades now. So, um, This is— these are really, uh, not so much things that I thought up and like, this is a theory I want to go— this is more about just what I've learned through trial and error, like screwing a lot of things up and then going, okay, that thing worked, let's do that again. And what you're gonna, you know, uh, even the title Ortho Startup, not marketing, uh, brand management, um, is really ties into part part of the, you know, really a journey I've been on. Because 5, 6 years ago, I would have not exchanged those words. I would use the word marketing. But, uh, 6 years in Ardalan, um, I'm gonna— I would tell you that I think focusing on brand first has been a big factor for us, uh, and that may or may not be useful to you. So I'm used to giving or getting disclosures at these talks. So 2 disclosures I had for today. I have zero academic marketing training. I've arrived at this position via engineering and about a decade in sales. And disclosure too is this beard is by Just For Men. So I'm big on authenticity. So do the touch of gray so it looks a little more authentic. But this, this is me. So now you know what you're dealing with. I can kind of get on with the messaging. So my premise is this: in early-stage med device companies, brand is more important than your marketing. And to, you know, kind of give some background to that, maybe hit a little bit of the definitions. Brand is your foundation, and this is where those that interact with your company are going to find really two critical things, authenticity and consistency. So that, that is housed by your brand. Marketing, which is, you know, kind of the output of that, is simply the tactics that promote and create engagement in alignment with your brand, or should be in alignment with your brand. I think one of the, one of the things that we see in our industry is that's not always the case. There's a lot of times where the brand and the marketing are really on, not on the same page. And that creates a lot, a lot of challenges for everybody. So if brand is the most important thing, then in the early years, I would suggest that the two most important things that you are chasing are curiosity and trust. Trust is going to be, you know, a direct result of that authenticity and consistency of your brand. And then customer curiosity, in my opinion, typically starts with curiosity around your team, their personalities, their experiences. Curiosity with your product is in the mix. But certainly early on, I think your products are not going to be as interesting as your people. A lot of it's going to be early on you going to people you know that already trust you, believe what you're saying. So I'm heavy on the people, people, you know, the stories of the personalities and things that actually guide your products. I think early on are really, really important. And recognizing, you know, if you're new coming into certain things, maybe retelling that story or starting a new story. My, my start at Arlon 6 years ago, when I arrived, we had a company that had been around for a while, but nobody really knew exactly what their, what Arlon's mission was. It had really kind of been sold as a duct tape for orthopedics. So it works everywhere, right? Which told people that it's kind of good everywhere, not great anywhere. And then behind that, from a logistics standpoint, company had been running out of product. They, you know, really over-promised, under-delivered., you know, a lot of different places. So my first year, frankly, was flying around, sitting in front of people and just simply saying, I'm sorry, uh, we screwed that up. We shouldn't have said that. Um, we don't have that yet. And it was not a fun year. Um, but if we had not Aaron and I not committed to just going and taking, you know, people needed a pound of flesh. They were frustrated. They felt, you know, left on an island. And for us to kind of go, hey, we are, we're going to be different, but we're going to sit here, we're going to take your shots, we're going to listen to what you have to say, uh, we're going to tell you that we can't fix this overnight. It's going to be a bit, bit of a journey, but we are going to try and get 1% better every day. That process, frankly, was way more important than me putting together surgical techniques and creating a new logo at that point. Because without that trust that we gained by being vulnerable, by kind of owning the fact that, you know, we had the brand, Artelon, had failed our customers a lot of ways, we would have never even got to the next step of let me show you the new things we're doing. So, you know, that, that's the part where trying to get that trust on the front side, uh, that, that to me, that, that meant everything in Argelon. So I'm gonna shift now, you know, from kind of establishing why brand is important to some critical things. Like if you are, if you're, if you are establishing your brand, if you just want to recheck your brand. I think this exercise, these next kind of 3 slides, we try to do this every 6 to 12 months and update, you know, tweak, give ourselves flexibility to, you know, kind of upgrade our brand. We're, you know, we expect to be dynamic. So these are the things we look at on a consistent basis. We wanted to find who we are as a company. But the company is people, right? So that's, that's a very, you know, personnel-driven answer. And then how do we make who we are as humans that run Ardalan, how do we make that compelling? You know, what's our CEO like? Are we funny? Are we nerdy? Are we really buttoned up? Are we laid back? It's been important to us to really define who we are, because what I'd like is that if you read our marketing and then you meet me for a cup of coffee, like, those feel the same way. I didn't, you know, it was kind of something Aaron and I've talked about often was like, how do we make every interaction feel like you're generally interacting with Aaron or myself or, you know, Mark or that sort of thing? So it's not always obvious, but this is like, these are great things to wrestle with. So I just encourage everybody, spend time like looking at your customer-facing people and, you know, kind of come up with an identity, commit to that, define it, and really exploit it. And none of those are bad. Like, you can be nerdy, and nerdy can be awesome if you're good at being nerdy. But Understanding what you are, not trying to kind of communicate something other than you are, is, is, uh, is one, it's the easiest thing to be. You don't have to make up anything. But two, I think it resonates with people.

So, so Janson, how do you, how do you figure out what your brand is in your customer's mind?

Uh, that's a, I think on the front side you have to, I think you have to ask a lot of questions. If you're brand new and you're getting started, I think that's something you, you ask questions out to see where you're starting from. I think you have the opportunity to craft that message moving forward if everybody's on board. So surveys or dinners with kind of thought leaders and that sort of stuff, if you're, you know, if you give them the full boat and say, hey, give it to me straight, like, where are we? Who are we to you? And you're not gonna hurt my feelings and that sort of stuff that, you know, those are, those can feel unsafe, but they are really, really nutritious conversations to have. And I think you asked the good and the bad there. So what are the good things you think of? And maybe if you're struggling with that, step back a minute and just kind of go, hey, what do you like about me? Like, you took a meeting with me. Why? Because I'm nice? Because we went to the same college? Because You know, my LinkedIn post was funny. Well, you know, whatever it is, start with, you know, what are, what are people connecting with? And, and, uh, and you can start with that very personally and start to expand that and see if those traits align with other people in your organization. It's usually not uncommon at, you know, at smallish companies that, you know, your, your 4 or 5 core people are pretty similar. You know, that's kind of how we all coagulate. So it's not often, at least on the early stage, that you are trying to go, but this guy is this way and this guy— like, a lot of times that group, you know, hangs out socially as well as professionally. So that, uh, in my experience, it's not been super diverse, um, for better or for worse. That helpful, Tiger?

Yeah, it helps. I mean, friends, I mean, friends hire people like themselves. So that's it. And that dictates the culture early on. Makes a lot of sense.

And if you're confused, you can always ask your wife. She'll tell you what's likable and what isn't. I think the second part of this though is, in my own experience, has been very underutilized question. And I find it to be Very, very powerful, powerful question to wrestle with. Who aren't you? And I'm going to go to two places with this. One, from a, from a pure marketing standpoint, knowing what you're going to say no to, what isn't going to be your focus on any given day, is extremely important. And, and that was really driven home at Ardalan. You know, as I mentioned, we started here, we were, you know, our pitch was we were good at everything, right? That's a terrible message. And we ran with it for probably a year because we were trying to figure out what was sticking, what isn't. And, you know, about 9 months in, we were like, okay, we got to get this thing tighter. And then we really shifted and said, we are going to be a foot and ankle focused company regardless if we're You know, philosophically and scientifically, we're just as good in the rotator cuff or the ACL as we are the foot and ankle. But we wanted to identify an area that people would recognize us as, hey, they're the people that do this in that area and they do it well. But to do that, we had to say, we had to start saying no. Like, we're not really, I mean, if you want to do some sports medicine cases, we'll ship you the stuff, but we're not going to do a lot of brand promotion around that indication. We're not going to do education around that indication. We're— we really— it's important to us that we are known for this. So knowing exactly what you're not going to do is really, really important, both for resources, for focus, and for your customers to know who you are. What are they looking for you? What situations are they going to be looking for you in? And then secondly, in more kind of a broad brand perspective, um, you have the opportunity to I like to use this, you know, I call it kind of the anti, the anti-brand, right? You have the opportunity to look at your biggest competition and be the exact opposite. When we started here, we used to say, you know, if all we do is work with people who don't want to work with Company X, then we have a tremendous business ahead. And knowing that, we said, well, if Company X is, you know, wears suits to everything, we're not going to wear suits. If they keep a brand and a color scheme that is consistent forever, we're going to be playful with colors. We're going to maybe spell some things wrong. You know, we're, you know, we looked at our competition as a template to go, let's just be as different as possible. We want to We want everybody who doesn't want to do business with them to want to do business with us, and we don't want to be— there to be any confusion that we are not them primarily. You'll never be a better Smith Nephew than Smith Nephew already is, and you'll never be a better Arthrex than Arthrex already is, and you'll never be a better Zimmer or Striker than they already are. They have way more, uh, horsepower. They have so many more years of being that brand. So you're, you're already going to lose that battle. Don't take that fight up. Like differentiate, go to the left, even if it looks crazy, if it, you know, if it feels different, do it. Uh, it's so much more defendable when you are being authentic and unique. Um, so, you know, going through that question with us, we, we wrestled with who are we? I think Aaron and I looked across the room and said, well, I think generally we're laid back. We have a great deal of experience in the foot and ankle. You know, some days we're funny, sometimes we, and sometimes we even mean to be. And I think the other part that was important for us was we were aspiring. We were able to kind of look at where we are and then kind of see, but this is where we want to be. And we wanted to communicate that to people. We wanted people to know, hey, we're here and this is where we're at. Sometimes where we're at, it's a little messy, it's not clean. We're gonna have some bad days, and by default, that means you're going to have some bad days. We're going to go ahead and apologize for that, but we want you to know that we're going to get better, and we're going to get a little bit better this year, and then this year, and— but this is where we're headed. We'd love to have you a part of this, this ride, uh, and it's going to be bumpy, but it's going to be a lot of fun too. We're gonna have a lot of victories, so You know, I think that aspiring part was, uh, you know, you get trust and then you start to cast a vision. Then all of a sudden you have some grace while you're still messy because people are, are buying into where you're going, not where you are today. And they see today as part of the process. So those were important things for us to communicate early. Overselling ourselves early as we have solved all these problems was, wasn't true. And two, I also recognized to most people it was unbelievable that we could be that good already. We had, you know, how could we? We haven't been around long enough. So that was important for us to be that honest and that vulnerable with those things. So the second pita brand I think that we've experienced here was having great clarity on where are we going to guarantee excellence today. I just, I'm not saying anything you guys on here don't know, but you have to deliver an excellent experience somewhere in the customer journey. Doesn't have to be the entire customer journey, but you have to have an inflection point somewhere where you go, we are really good at that. And your customer knows you're really good at that. So is it medical education? I mean, think Synthys back in the day, like whether you Lights and these, bought their plates. They were where you learned to do trauma. Um, is it OR efficiency? Is it unrivaled innovation? Is it, you know, I'll give Teresa a shout out. Is it, is it their direct to consumer capabilities? Own some piece of the journey, commit to it, tell people you're good at it, and then be good at it. And it doesn't have to be the whole thing, like, but you gotta give people a place to look where they go, damn, they're really good at that. Like that, that's really important. For us, you know, I'm gonna take all these and I'm gonna go back to kind of where we are. So at Ardalan, I'll tell you present day, we think we can deliver on a, on a very efficient and uniquely kinematic lateral ankle OR experience every single day. So you see how detailed I got that? Lateral ankle in the OR experience, Kinematic, we know we can do that really, really well every single day. Now, our medical education is good. The intelligence, the foot and ankle sports intellect of our sales team is rapidly improving, but the OR experience is where we are committed. We believe that we can get in the OR and allow a surgeon to have a really, really pleasant, if not, you know, kind of novel and exciting experience every single day. And that's where we're doubling down. But that's just where we chose. We could have delivered on any of these other kind of subsets, and you guys know your own markets. But look at places where you have an opportunity to just really crush something, and maybe it's got to do with the talent you have on your team. Maybe it's got to do with your technology. Or maybe there's just a nuanced opportunity that is sitting in your lap that others have not exploited. But own that, that one place of excellence, communicate it, deliver on it. And then kind of the final thing, this is— I alluded to this earlier, this aspirational aspect. So be aware and allow this to be dynamic, but be aware of where today's excellence is taking you and be quick to share that, you know, that aspirational thing of like, this is where we are, we're doing this really well. We're, we're struggling here, but we're getting better. But these things are gonna start coalescing and, and when those things coalesce, we're gonna be here and then we're gonna be here. I think as a human trait, people like the idea of, of of being a part of something that's kind of feeling like an underdog, and they're going to be a part of the victories along the way. We have bought into that wholesale. So for us, we had to win the lateral ankle. I mean, it's the biggest soft tissue operation in, in all of medicine. It's bigger than the ACL. So we had to establish ourselves there. Having established us there, we believe— and at one point, that was the horizon. We have got to be excellent and compel and deliver on being excellent in the lateral ankle. I think we have, I think we've delivered on that. So having delivered excellence there gives us the opportunity to look forward and go, we believe kind of the, the place we are headed is to be excellent in all foot and ankle sports medicine. Like that, that's our new horizon. And, and that's important. Uh, you know, that has been dynamic. We probably redefine that or opened up that that barrier, you know, every 12 months ago, we think we can be good at lateral and maybe Achilles and then lateral and Achilles and medial ankle. And but having those discussions and letting that be a dynamic conversation, one, it communicates that you are progressing to your customers too. It lets them know they're a part of something that's just got a lot of upside. People get excited about that. And now back to the marketing part. So tactics are important. They're actually critical, but run every tactic through your brand filter to check for authenticity and consistency. These, when you have interactions with customers and your salespeople, which I would also brand as, you know, your customers, every interaction is either growing or weakening your brand trust. There, there's no such thing as an indifferent interaction. So you gotta look at every single one of these as, you know, you're either moving forward or backward. You're never staying similar. So work really hard to find your brand. And then as you come up with the tactics, make sure the tactics are in alignment with kind of who you are. What you're excellent at and where you're going. For us, uh, tactically, how we've defined this is we only do foot and ankle events. Uh, we ask a lot of questions about, you know, the things we're doing. We're always seeking to get a little bit better. Uh, we iterate and iterate and iterate. I mean, uh, I think we have, uh, I don't know, 12 products per se right now. Behind the scenes, we've iterated each one of those products 28 times. We are constantly getting feedback, going back and tweaking just a little bit, change this, move that, put a new mark there. So we are moving in that, and that's part of our engagement. We're, we're on this journey. So for us to be on this journey and commit to being dynamic, that means we're gonna take feedback and we're gonna do things about it. So those are, that's things that we live. And then in our communication, we communicate in smart but casual tones. We are often— we can be educated and intellectual, but we can also be self— you know, we make fun of ourselves. We can just be silly, you know, and, you know, we really want to just be comfortable. And we also try to get face-to-face as often as possible. We just think we're, we're better at talking to other humans than we are sending emails and making phone calls.

Yeah. So how do you do that, Jansen? You only have 25, 30 employees and the, the big guys have hundreds of people all over the country.

Yeah, that's, that's the million dollar question. I, I think You have to take advantage of target-rich environments, uh, places, you know, Tiger and I were talking about, uh, this before we started. I'm not at AAOS right now, um, and we were kind of talking about the rise of the subspecialty meeting. Those are so rich, and so we will go full in at an AOFA or an ACFAS and just send a pop-up tent to, to AAOS because we got, you got just enough people. So you gotta make, take full advantage of the times when you have a lot of people in one place. So we work really hard at those subspecialty meetings, which is another reason to be very laser focused on what indication and what part of the world you're really gonna be focused on getting good at. The other part is, We use data. Um, we use data a lot on who is doing the real work out there, who are the most influential people, both from where they trained and, you know, how they publish and that sort of stuff. So when you are having to make choices of who to see and who not to see, we want to make sure that our impact from a marketing perspective is built around influence. I spent a lot of my career being focused on how much volume people do. My question in 2024 is, who do they influence? Because if I can get to somebody who influences a lot of people, then that magnifies my work. And so you can't shortcut that. You have to do You gotta get the data, you gotta have the time, you just gotta do the research. Every salesperson out there will tell you their guy is super busy and well connected. That's not usually the case. I shouldn't say it's not usually the case. It's always the case. So you gotta figure out which ones it's really, really the case. And so, yeah, that's a broad answer, but there is data out there that can help you figure out where time is best spent. But I would challenge, you know, everybody that is tapped on resources, be really, really in tune with people who are influencers. Not, I mean, not completely disregard who has high volume. Volume matters. That's how you pay the bills when you're, when you're growing. But don't just chase volume because there's a lot of high volume people out there who in their own communities, nobody likes them, or they're working so much that they they don't have influence, they're not out there. Um, you really gotta walk that fine line of making sure you're growing and getting the revenue, but being very efficient with your time and your conversations. And so you can get somebody and come, you know, and leave an impression on them, and then their impression hits 20 other people. Like, that's, that's magnificent. That really gets efficient if you're able to kind of really focus. That way.

So what, so what are the attributes of an influencer? And do you give the info once you, once you target an influencer, do you give them materials to reach out to other surgeons?

I think we're in the midst of redefining that right now. You know, in the past, you went to, you know, you went through a certain fellowship program and This person at the program is really influential, so we really need to get to them because then every fellow or every resident comes through, thinks about things. And that's not dead. The second place you went was journals. Who's publishing a lot? Uh, and make sure that they buy into what you're doing because they're likely to be on a podium sometime, and, and that will help you as well. That, that's also good. I would say 10 years ago, those two things That was it. Like, you want influence, it's— you find those two things and that's where you go. We are now in a, in a, in an age where social media is allowing people who don't publish and aren't in a fellowship program to influence vast numbers of people. And I have doctors who have great anxiety about this, and they shouldn't be this, and, you know, they're not— they didn't fellowship train here. And that— and I'm like, maybe, but this is the world we live in. You can't stop them. Like, to the average person, like, the biggest megaphone matters. And so these people are influencers because they're making themselves influencers, and they're not having to go through, you know, all the hierarchy of societies, and they're not having to go through publishing. They are just good at social media. So For us, it's really— we have, we have to chase more things now. Like, there's the traditional routes you pay attention to, but this third group that is social media savvy and they're charming and, you know, they, they are compelling in what they're doing, like, you can't ignore those people either. That is free advertising if those people are willing to get on your train and you're able to even link your posts, your advertising to these people who have, you know, these tens of thousands of followers and that sort of stuff. Like, you, you can't deny that. That is, um, that is the world we live in. And, uh, I think as, you know, I'm 47, so I feel like I'm on the, on the back end of like trying to keep up with how all these things are moving. The generation of marketers behind us, they're probably going to be all in on that. I don't, I don't know how relevant journal articles and things will remain in 10 years because they're so slow. Like if you do a study, a real study, it doesn't get published for 5, 6 years after the start of the study. And by then it's irrelevant. I mean, this world's moving so fast. So, um, we're learning right now. For me, I'm trying all of it and it's a very inexact science. But I'll tell you, 5 years ago I didn't look at anybody's social media content or what their followers were whenever I was engaging someone. I'll tell you now, when I'm looking for consultants, I check the credentials and I check the academic side. I also go through all their social media, and it is— it can be very, you know, like, really get me excited about somebody, or it can sometimes be like, I don't know. I mean, I don't know how many years this guy's got left of being an influencer. I don't know if I want to you know, put my eggs in this basket or not. So, I suspect everybody on this call has had that same kind of tension of like, how do I weigh these things? I think it's a little messy right now, but, but you have to pay attention to it. It's, it's happening.

So what platforms, Janson? LinkedIn, Facebook, Twitter, and TikTok are probably Maybe, maybe YouTube.

Yeah, there are people who are really, really smart in this conversation. So I'm likely to be—

Don't sell yourself short.

I think so if I'm coming from the position of a startup that has any goals of being acquired or going public. I would tell you that the richest environment is LinkedIn because LinkedIn is a, is a, you know, is the mix of you're going to have your surgeons and you're going to have kind of some of your decision makers along the way. You can develop brand awareness on LinkedIn, but kind of behind that, I think you, you have a much greater visibility to the strategics, the bankers, the VC guys. They are, they live much more aggressively on LinkedIn than they would say a TikTok or an Instagram or that sort of thing. If your model is direct-to-consumer, and this is real time for me, this is, this is oversimplified, but this is how I look at things. If my product, if I want to go direct-to-consumer, my product is Medicare-based, I need to spend a lot of time on Facebook. If I'm private insurance focused, I'm probably more less Facebook, much more Instagram, maybe TikTok. Um, that's kind of how I break things down. Our world is generally private, uh, and we're kind of trying to brand ourselves into that sporty world. So, uh, our— we really committed ourselves to LinkedIn early on. That's, that's our most mature kind of platform for us. But we are spending a lot of time now trying to develop into Instagram, um, because that sports crowd, um, yeah, that, that dirt consumer there. Now for us, I think some of the things that, that we've had to be honest with ourselves, different than say a bunion or, you know, some of these other indications. A bunion is, you know, trees, one of the things I give them such credit for was they were able to look at the direct-to-consumer market from a perspective. They are treating an indication that most human beings can self-diagnose in the living room, can look down and be like, dang, that's called a bunion, I need to get that fixed. So they were poised to go straight to and know that their intervention was going to need this product. 97% of the time. And so they— I mean, I, John, I've known John for 20 years. John's a very, very smart guy. They nailed the opportunity there with direct-to-consumer because the indication was so visible. We're not, we're not quite that, right? Like, so you sprain your ankle, you kind of have to— you know, most people are going to get better, and then 30% are going to not get that much better. And then of that 30%, some of them are going to decide, I'm just fine not being mobile. And the other 25% are going to be like, nah, I don't like not doing CrossFit anymore. I don't like not— I'm gonna go get something done about it. So we can induce, like, hey, would I be a candidate for Ardalon? Um, but we're not one-to-one in the direct-to-consumer market. Like a bunion type B. So in that, we haven't committed as many, as much of a focus. For us, it's let's just kind of take some practice runs. Let's work on having some brand awareness out there so that people might think of us and mention it to the doctor and, or maybe even support driving people to a physician's office. But for us, that's how we've broken it down. I think things like TikTok, And Twitter, those are very specific types of content. I would just be honest with you, my talent, my team's talent is not really in those, in that world right now. So we just kind of want to be like, man, we're not going to be good at TikTok or Twitter. There are people much better at it than we are. Let's just leave that alone. I think those are very powerful. I think people will tell you TikTok is rapidly growing. The fastest growing platform out there is YouTube, and I haven't seen an orthopedic company really figure out how to get good at that yet. Somebody's going to, and it's probably gonna pay off for them. But that's a platform that everything I'm reading is exploding. I think it's exploding at kind of the, you know, the 15 to 25. Age group right now, but those people will be 25 and 35 here in not too long.

So, yeah, I think, well, YouTube is a monster, you know, it's the second biggest search engine in the world. And it's, it's tied into Google, obviously. But you go to YouTube when you want to know how to do something. And so there's a lot of surgeons that are, that are posting how-to surgery videos. Yeah, I think that's the— if you have a procedure or a new way of doing something in medical treatment, I think that YouTube's great. I think Stu had a comment. Are you there, Stu?

Yes, yes, yes, I'm here. Sorry about that. My comment went back to Janssen's point on influencers. Kind of reminded me of Malcolm Gladwell's book, The Tipping Point. It seems like that might be interchangeable, the connectors piece of his theory on how products and technology spread and awareness gets raised. I guess my question on the back of that comment is, how do you identify the individuals who would be potential connectors for that specific industry? My wife is in PR. She does— they have a whole department at the agency that focuses just on connecting with influencers on these social media applications. But it's a different product, right? It's direct to consumer. I feel like B2B, it's more challenging to identify. Yeah. So I'll share with you our experience. We've done it two ways. We, I've, I've engaged with, um, a couple surgeons and I frankly, I let them do the work. I did the lazy man's. I just looked for, for people that had the most followers. And my assumption is if you have a lot of followers, you're doing something consistently that people engage with and let me take advantage of, you know, the access that you've already got. And I would say that that has been pretty successful, but I've learned things along the way. You know, deeper than that, you have to figure out kind of what is their content. I want to say the most followed foot and ankle person right now is a doc, Dr. Dana, Doc Dana, she's a podiatrist out in California. She's got, I don't know, millions of followers. But, and I was like, oh, interesting. But her content's not always foot and ankle relevant. Sometimes she's talking about makeup, sometimes she's talking about, you know, vacation spots and that sort of stuff. So she, I think, I would probably be more of an influencer in general. She just happens to be a surgeon. And so I think for me, um, you set goals, right? So what do you want this influencer to get you to? More doctors? More patients? Um, and so for someone like Dr. Dana, I'm not sure I'm getting either one with that. I just may get a bunch of eyeballs. So I probably wouldn't wouldn't look at that. But I think in my world, there's probably, you know, I think to be fair, there's, call it, 5,000 human beings, 5,000 surgeons in the entire United States that, that would really have any use for me. So I don't have to have 300,000 followers, I just need the right 5,000. So trying to kind of figure out who people, who is connected to those 5,000 people, or who can get me to 300 of those people, and that sort of stuff. That, that becomes a little more nuanced than just kind of a pure beautiful metric of like, this person's got 8,000 followers. On the patient side, the other thing that we have done, um, I don't know if this is absolutely true, but I'm gonna say it because I'm kind of proud of it. I think we're the first company to ever get an NIL deal. Orthopedic company to have an NIL deal with a patient. We, we did a patient almost 3 years ago, like literally 2 months into NIL being launched. And I've learned a vast amount about that. Like, you— that can really not go well, and that can be pretty cool. Um, same thing there though. I think what we identified there was we wanted to associate ourselves with one— these are typically, if you're doing NIL stuff, these are kids. And they're likely to do kid things. So you really do need to vet their social media, because any given day they may do the things that you and I did when we were 18 and 20 and 22, uh, that we didn't— you know, fortunately there weren't cameras on us. Um, there are cameras on them, so you, you have to do some, some character vetting. But assuming you get through that, what you have access there to is you have access to these pockets of athletes um, these club athletes that play these sports year-round, and every single one of them gets injured. So when they get injured, they're trying to go back and they're trying to resource their most common source of information with social media. Who else has had this? Who else can I relate to? And they will actually work those channels and go, hey, this happened to me, what'd you do, who'd you go see, what product do they use? And so When properly placed, we've actually seen that be pretty effective. So, Stu, I don't know if that was— I know it's kind of broad. I will tell you, I don't have it. There's likely some people on here that are even better than me at that influencer thing. I'm in a place of I'm just trying to learn and I'm open to what anyone else has learned. Because I think it, whatever I learned yesterday is, is 2 weeks from being out of date. So yeah, it's like always trying to stay on top of it. Thanks. Thanks for answering the question. Yeah, I generally, I feel like orthopedics and med device has been slow to adapt to social media, but it seems like we're at a turning point with that in the last, in the last year or two. Yeah, at least people are— we're paying attention to it now. I don't know, there are some out there that are doing it very well. So one last slide, I was just gonna count through.

Go ahead, Chance, go ahead.

And this is just kind of an encouragement to everybody that works in marketing. I just want to encourage and challenge everybody to like Your invitation and walking into the marketing branding side of these companies is be the rebel. Like, if you're not creating somebody have a little more hypertension in their life, then I think you're missing an opportunity. Uh, things have in our space, you know, I think if we were all honest with ourselves, like those of us that have been tasked with these jobs, we are so less creative, so less progressive than our counterparts in fashion or cars, or, you know, pick your other industry. We're just really, really boring, really predictable. And I understand a lot of that is driven out of the compliance parameters around us and that sort of stuff. So I'm not, not being flippant about, you know, what our responsibilities are. But I think we also can get ourselves in places where we just kind of our bosses frankly don't ask much of us, to be fair. Just make another surgical technique and make sure the website reads okay and have 2 posts a week and you're doing a great job. Like, yes, but we, I mean, I think we over time, uh, we can absolutely lose our souls by just being boring and rubber stamping everything. So I feel like we're kind of coming into a place where med device marketing is starting to be willing to take some chances and be more fun and be more interesting and be a little less, here's my product, and be a little bit more like, and this is who we are. And so just as like a final statement, like, Allow yourself to be a little bit off the beaten path. Challenge, you know, what's always been done. Not to be a pain in the ass, but because it's worth challenging. The standard rules of branding, like your logo should never change, or except for every 10 years, and like, no, change your logo every 6 months if you feel like it. Make 5 logos, change your, you know, Don't, especially when you're small, don't just fit to the rules because they're the rules. Um, breaking the rules is going to make people notice you for better or for worse. And that's usually not a bad thing on the front side. Um, you know, I mean, just have fun, like do some things that maybe even make you a little nervous, but, um, you're going to learn stuff. You'll, you'll pick up new skills. You'll. You know, and, and truth is, you'll actually be effective just trying things. Go ahead, John. Hey, Jansen, great to see you. Awesome presentation today. Uh, it's been a year since I've seen you, and you touched on NIL, and we talked about that last year, and I, I, I love it. I love that unique take. I love the direction. I think it's fantastic. So What have you learned in the last year since our last conversation about NIL? Because we talked about some of the challenges then and you were like, hey, we'll see, you know, hopefully she stays on the court. Yeah. So here's going to be my quick list of NIL. And I'm shortcutting like probably 2 years of anxiety for you guys. One, When you have an athlete and you shoot your video of your athlete, don't premiere that video in season because you will not sleep until the season's over. Um, we, we did a basketball player. She's 6'8". Uh, she looks like a walking sprained ankle. Um, and we did both of her ankles, and then I decided I was going to launch her whole campaign right at the beginning of basketball season. And I didn't sleep the whole basketball season because I was like, man, we're running these deals and she's going to sprain her ankle on any given night and then we're going to look ridiculous. So my advice is shoot it, get the film, and then run it in the offseason where you don't have any risk of like while you're running your campaign that she's actively injured. So seems obvious. The marketer in me was wanting to align all this with season, but there's real risk in running it in season. Two, uh, I, I was, uh, not necessarily prepared for how unwilling— or I guess I'd forgotten what it was like to communicate with me when I was 18 or 20 in college. Uh, you know, these are not professional job employees. So when you need a post to go out at 2 PM on a Tuesday, like, it often doesn't go out at 2 PM on Tuesday. So I completely underestimated the management effort that it takes to get the content made, approved, get it posted on time. Do you post it from their account? Do you post it from your account? Those were, you know, I, in my mind, I thought, we'll get these kids, they're posting things all the time, it'll be super easy. Hey Kennedy, just, hey, how about shooting a video from the Oregon locker room today and, you know, talk about how your ankles are doing? Oh my gosh, like in 6 months, we still never got that accomplished. Like it was just so hard to chase that down. Uh, I think the third thing is, um, There are likes, uh, and so most of the people we have had good followers. Um, I, I think as I've gotten into this, I start to, I start to pay attention to other things. Um, are they good speaker? Are they, um, you know, is their content— are they getting followed because they're just pretty or handsome? Um, because if that's the case, like you're gonna have a hard time getting them to actually string together, you know, features and benefits, or kind of the things you want communicated about your product. Um, the kids that are maybe not like the 5-star but are working hard at school, that have aspirations to be a professional something else, speak well, they're actually going to be really good for your brand. Um, I, I think that's probably where I've I've grabbed, you know, I've kind of evolved as initially like, who's going to grab all the eyeballs? I think now, um, I want, you know, certainly want somebody interesting, but athletes that are just really well-rounded, um, they do a better job with the message, they do a better job with, uh, the campaigns that we do. People interact with them, they like, they share, uh, and they have a much longer kind of evergreen in a campaign than just kind of the, the athlete. Because the athlete, it's cool, but I mean, you show some clips and, you know, within a week that's noise. And, and, you know, because, you know, there's not, not much left on the line after that. So those would be kind of some of the few things that I learned pretty early was, you know, you're on your campaign's offseason or when they're after they've graduated, they're not like, I got a football player. We shot him after his senior year. He went into accounting. He's, he's safe forever, you know, like, but great. Yeah.

Thank you. You could.

Yeah.

Good stuff. You can do ordinary people too. I, your Jesus is Back campaign really caught my eye. Tell, tell the members what that was about. And then Mark's got a question, looks like.

Yeah, so we came across Jesus, uh, and, uh, real quick, Jesus is a, is a laborer, had his ankle done. And Jesus, um, came to me because his doctor just told me how like super grateful this guy was in the, in the room. So I reached out to Jesus and he left this huge impression on me of this guy that's like, he's a normal guy and his ankles have been hurting forever and it was compromising his life. And, and, and kind of really the thing that triggered me was He and his wife has actually decided not to have kids, simply because he was so immobile on his ankle. And this is a young guy, 30. And then he got his ankle fixed. And 10 months after, you know, finishing rehab, he has a baby daughter. And so like, when you're gifted a storyline like that, it's like, wow, we gotta, you know, and his name's Jesus, right? Like, I mean, I didn't even really have to make much stuff up, like Jesus ankle fixed and has a baby. But I think in that is trying to think about how people are going to identify with things like we all, you know, we're all young, we all want to buy Air Jordans because we think we, you know, when I was young, the kids don't even know who Air Jordan is anymore. But Um, I, you know, I was never gonna demand of my shoes what Jordan or LeBron or any of these guys do, but we aspire to that same thing. But there's also value in giving people someone they can relate to today. And Jesus was somebody who a normal person who's not trying to play football, not trying to run marathons, could go, ah, you know, I don't need to do all that, but I do want to walk and play with my kids or my grandkids, and I can identify that. So that was kind of part of the texture. We decided we, we really— we like the sporty stuff, but I think it's important from a texture standpoint to bring in, you know, the normal people of different sizes and different shapes, different colors, um, different voices, different accents, because You know, beyond all the story, like, and there's never been a time with more stimulation than right now. And so if you get too consistent with things, like, you just kind of get fall back into the noise. So, uh, as you're playing with media and the different things, you're like, keep the word texture in mind. Use video, but don't always use video. Use pictures, but sometimes use black and white pictures. Do copy, but change the font. Like, just assume that everybody's bored with your stuff all the time. And if you start there, you'll probably be able to keep up a little bit, but just be careful falling in love with— I've done this many times. I just think my stuff is awesome and I don't want to change it. And then next thing you know, like, nobody's watching it, nobody's clicking it, nobody's liking it. I'm like, okay, I'm not that good. I gotta, I gotta, you know, try some new things. So, Mark, and then Kyle.

Yep. So I got two, two quick things for you. First of all, Janson, great talk.

Thank you.

I'm actually in Marietta, and I assume you're in Atlanta. I run a veterans nonprofit in addition to my medical business. Marietta National Cemetery land was donated to the federal government in 1864 by the Cole family. And I don't know if you knew that or not. Yeah, it's on Cole Street in Marietta, but I thought you'd like to know that. Secondly, um, do you know Gavin Ferlick with TACO? I'm going to introduce you by email because Gavin's father was the team doctor for the Notre Dame And he, he invented an, he invented an over-the-shoe, super lightweight AFO brace that is in use at the University of Georgia, Alabama, a lot of teams and so forth. It's all about ankle stability. I think there'd be, be some cross-pollination of ideas there.

Okay.

Sure.

Good talk. Thank you. Thank you. Mr. Laffin. Been a minute, sir. Been a long time. Um, couple things for you. Uh, after surgery, was Jesus portrayed as walking on water? For you, man, I missed that one. See, I told you I'm not a very good marketer. If I would have been one, I would have used that. So I love what you talked about related to your brand and how you can guarantee Excellence Today. Tell me about, as you organize that message, how you socialize it and build a consistency with how that is talked about across your organization. Yeah. That's a great question. For me, it all starts with like, when you commit to that, you define that thing, I think you have to have a hard talk with all the stakeholders in whatever that moment is. So for us, it's surgical efficiency. We have team meetings, and I think it's easy for Mark to go, this is what we're going to do. But if engineering's not, not behind that, like, hey, when we start to design this, we're going to get all kinds of ideas. At the end of the day, these ideas need to actually work in the OR really quickly. It may be the greatest scientific, like, instrument ever, but if it's not fast and it's not, like, simple, we're deviating from what we're telling people we're going to do. So part of that is just getting all of the stakeholders in alignment and go, okay, we're going to say this, and this is going to come from our megaphone, and then it's gonna— we say it out loud, people are going to see if we're telling the truth. So then they're going to go and try it, and engineering, now you're up. Like you're about to be tested to see if, if you're efficient and good. And, and hey, sales rep, if you're not there getting the scrub tech ready and have them in line to have things laid out, they know what they're doing, then we're gonna not actually deliver that experience. So we, we really had to kind of get all of the stakeholders together. One, two, then you build a message around it and you, you say it out loud. I mean, I think part of it is. You got to put it into the ether, uh, and that, you know, that ether is in your one-on-one conversations. It can be in social. It's implied in your techniques and that sort of stuff. So there's some part of some feeling that is left, uh, you know, with, with your, uh, with your end user. That— so for us, like, if that's my thing, then we are very gratuitous with those keywords: efficient, kinematic, natural. So we'll kind of build a whole, you know, group of synonyms that are all kind of insinuating. So even subliminally, we're just trying to lace all communication with the idea of efficiency and kinematic appreciation and that sort of stuff. So even if they don't mean to, if people are around our stuff very long, then that when they communicate it, they're gonna use those same words cuz that's the only ones we're giving them. But that's kind of, that's the process, right? That's, that's a year down the road. That's 2 years down the road. But it starts with getting everybody like you, it's gotta be real. It's gotta be true to get your stakeholders and then marketing and sales cuz they're usually the first person to disseminate this. They have to be consistent in the words like, and our team, we talk about, talk about words. Particularly at our events or at trade shows, we'll do— we kind of have a team meeting beforehand. We talk about key focuses of the meeting, anybody that we predict that's coming that's of special significance. And then we go through like, and here are the sentences that matter. And these are the words we're going to use. We're going to use this ad nauseam. Because we want everybody leaving this booth to be walking out here with this idea. And so in the things that I can control, that's kind of how we roll out that excellence is get your core team, define your language, and make sure that it is interlaced everywhere, even if you're talking about, you know, picking people up from the airport. You we'll make sure it's an efficient trip from the airport. Like, I mean, we, we just commit to it at that level. Like, we just want everything you're doing that touches us to feel like, man, that was pretty efficient. That was, that was pretty cool. That was easy. Um, because, you know, that, that's— those are things that are often, uh, within everybody's capability. That's the other thing is just make sure it's something you can control. Um, you can't always control the outcome, so claiming you're gonna have 98% success rate, like, that's scary because you, you may not. But anything that's effort-driven, anything that is, you know, you can absolutely control end-to-end, like, double down on that and tell people you're gonna do it, do it, then tell them you did it and tell them you'll do it again. You know, it's just kind of like reinforcement. Nice. Thank you.

Mm-hmm. Yeah, it's kind of been a theme on BoneChat for the startups to reduce friction for the customer. That keeps coming up over, over and over again. Friction in selling, friction in pricing, fix your— reduce friction in the procedure, less steps. So yeah, that's another way to stand out. Just be, be a company that's easy to work with.

I'll tell you this too, um, just thoughts on that. Um, I, these are just my thoughts, so feel free to disagree. I think when we've, when we service customers, and I've been really guilty of this in the past, it's easy to kind of lean in on these altruistic things. Patients are gonna have so much more happiness in their life And, and I do think that that matters, but don't ever forget you're actually talking to a human being. And as human beings, the first thing we all think about is ourselves. So even patient benefits are secondary benefits to the hospital and to the surgeon. Um, and that— I did not market that way most of my life. But in more recent years, to me, that's why efficiency matters, right? So if, if I'm just as good to the patient as 12 other products, but I make surgery go faster, a doctor gets home faster, and the OR has more time. So whatever your thing is, it's, it's For me, it's been helpful to sit back and go, what is— let's start with what the doctor or the facility gets out of my product. Because I've sent a lot of products through with all these kind of big outcome or big patient benefits. And as much as we'd all like to think the American healthcare system is really about patients, it's sometimes not. So try to think about where people are self-focused. And for me, that greases the skids for friction easier than patient-focused things.

So I, I get this question a lot, Janson. So the best content's out in the field. Obviously, it's before surgery, during surgery, after surgery. How do you get, how do you interview a surgeon? You know, about a case and post it, get, get approval to post that. You know, every hospital's different. ASCs are easier, but it's— everybody pushes back on that.

Uh, yeah. Um, I generally don't try to do much in the hospital for that reason. Um, because of efficiency, uh, you know, because it takes a lot of time to go through all that. Uh, I think it's— I think it's— I've found more success, um, asking them just to go, hey, when you get to your office, get to your house tonight, can we get on Zoom and just, you know, talk through some bit, you know, ask some questions, that sort of stuff. If we're going to do patient stuff, I still would probably have them wear their scrubs and still do it from either their office or their house. And this is not about effectiveness for me, it's about how many checkoffs I've got to go through. Um, I think, I think it's, it can be eye-grabbing to kind of see the OR background. Um, I personally, this is where I'm going to move from rebel to like old man, I'm really scared, like at some point Um, there's going to be some people get beat up for shooting in the OR that's not approved. Um, right. And I don't want to be that guy. And so I don't know. I, I, I, I get nervous in that area. I don't, I don't feel like I can control it very good.

Got it. Understood. Well, it's something the big companies cannot do. They literally can't do it.

Yeah.

You know, we talked about, you know, legal. Yeah. It's really effective, but they can't get it past their legal compliance regulatory departments. You know, it's impossible. But little companies, you're trying to be a rebel, can, you can interview a surgeon right after a case.

Here's what I would, I mean, I actually had somebody approach or offer this to me and it's, it's in my queue to give this a try. I, I, I think, I think your opportunity there would actually, as opposed to getting— I think it's like anything, it's how you position things. I think a lot of these surgery centers, um, would actually be open to free marketing. Um, and I think the— if you go to surgery center, you know, Joe's Ambulatory Surgery Center in, you know, Canton, Georgia, and say, hey, um, you have a doctor here who's doing some really great things, we'd like to just kind of capture some of these, and we want to, you know, we won't use names, we'll make sure you guys get, you know, give it to you, give a week to approve it, but we'd like to, you know, tag and call you guys out. Um, now I think you've got an advocate because they're interested in good press, and you're actually showing somebody talent in their facility like that, that can help them. I think most of these are kind of brought in as like, you're just part of here, we want to do our thing, and, and You know, not, but I think if you, if you include some of these facilities, uh, in, uh, in what you're doing, I think it actually turns it to like, oh, let's do more of that. You may find all kinds of opportunities if you were to kind of pitch it to them as a, as a co-marketing opportunity. Yeah. Like, I mean, you're not doing anything different. You're just going, hey, but we'll, we'll tag you. We'll, we'll, we'll shout you out if you, if you let us do it.

Makes sense. Totally makes sense. Any other questions? We're kind of gone over an hour.

I have one I'll throw in there very quickly. Yeah. Just so you mentioned the need to go from the we're great at everything to just focusing on one topic. How much pushback do you— did you run into with that? Because that's something that I've seen like at other companies and I have experienced even with the company I work with of going through that process and how scared everybody is of leaving business on the table, so to speak? It's terrifying. And I literally, you know, went through it this morning. It never goes away. And it's okay, right? I mean, because here's, as long as you kind of expect where it's going to come, it's going to come from sales guys who like, number one, it's going to come from the sales guys because they're always gonna see opportunity that's just, just a little bit off center and in their world, that's great opportunity. And so we've kind of had to kind of figure out how to play in the middle here, right? So what we've decided is that from a marketing, like when you see the face of the company and what we put real, like visible resources into, it's gonna be very narrow. It's gonna be very, you know, specific and we're gonna really lean on that. Um, underneath that, there is still some ability to vet opportunities. Um, but here's, here's kind of how we manage that conversation, at least for things that aren't, you know, that are, that are, they're more busy, they're not really that useful. And I do find this to be true. We, we've had multiple conversations where we go, hey, revenue, it's not that revenue doesn't matter, revenue matters. But if you're in a situation where you're trying to grow, uh, a startup and you're wanting to actually, um, you know, get to a place where your, your valuation is, is a certain point for a strategic— more, more of the more recent, uh, acquisitions in orthopedics have occurred in, in subspecialties. Things. There's not been many good-for-all-things acquisitions because my perception is that the strategics want to know that your business can go deep in a specialty. And if they can go deep in that specialty, even if you have philosophically opportunities left and right, then they're the ones— you know, Stryker is not here to innovate anymore. Stryker's here to scale. So if you can show them that you can go deep in something, your enterprise value is, is real. But your enterprise value is going to be this subspecialty. The revenue you're driving, picking up in knees and shoulders on, you know, on random Thursdays, is helping your bills right now, but it doesn't change what Stryker values you at. And so we've had to kind of have some conversations with some of our people. Like, it's not that we don't value what you see, and we know at the very local level this is helpful from our perspective in growing, you know, enterprise value. It doesn't really help us. We'll do what we can without distracting from our main goals, but a lot of this is going to have to be on you if you really want to pursue this. And most of the time we get through that conversation and people kind of go, okay, I get it, that makes sense. Um, but I think it— if it's just left with, we don't want to do that, it feels like you guys don't know what you're doing, or you don't like me, or whatever. Having that conversation with some sort of clarity of like enterprise value or focus, and it really means a lot to us that we do what we say we're going to do. We're growing trust, we're growing consistency, so we're going to stay here. And this may be useful to you and good to it, but I will tell you we manage these things, we, we measure these things. If you get in line with what we're doing, your path to increase revenue is going to happen a lot more consistently and usually at a quicker rate. So we didn't really get to that, but I think that, that other part of early on is, is you really have to set some things in place on how you measure the things you do, because that's your next thing is kind of go, but for us we can do 10 knee labs, but with no real program and no real technique, and we can't reproduce it. Scalability is meh. You got this one guy, that's what you got. In foot and ankle, I mean, I could tell you by tactic what our conversion rate is, how long it takes it, by DPM, by MD, by DO. Like, you know, so I can go to my sales rep like, you want to I hear you talking about this. What I hear you saying is you want to make more money. Let me show you the data, because I want you to make more money too. This is, this is the fastest way for that to happen. I'm not saying you couldn't do that over here, but if you do this, it's much quicker. And it, you know, the exponential side of it happens. You get this one, you just got one. That's, that's just kind of dead end. You got to maintain this person. So I think that data becomes very important.

That's great stuff. I know we're running way over, Tiger, but I gotta say, keep going.

Yeah.

Yeah. That, although I run a compliance company for over 1,000 medical practices, I also run an orthopedic business. And I took over Treece from a guy that was the first dealer here who wasted a year and a half with the Podiatry Institute, all these labs and everything else. And the day I took it over, I told Trese, I said, I'm gonna build the biggest ortho base you've got in the state, in the country, because one orthopedic surgeon will do 10 times as much surgery as one podiatrist. And we did. 2 years later, I sold it back to him for a very nice profit. And it's the Atlanta market is still the tree. Biggest ortho, uh, laparoplasty market in the United States, uh, and it's really put them on the map. But that was— that's just an example of finding, you know, the right marquee player and going really deep, you know, going vertical in that one little market. Because the only reason North Peak Surgeons had never done bunions is because they don't work the way they used to do them. And they don't like to do things that don't work, so they just wouldn't do them. But they, they do the hell out of them now. Anyway, great talk. I really enjoyed it.

Yeah, thanks for sharing, Mark. Good stuff. All right, I'll let everybody go because it's— we're past the hour. Great discussion. We may have to do a round 2 with Jansen at some point. I'd love to hear about data and analytics, but Uh, anyway, that's a wrap. Thanks everybody, we'll see you next week.

Okay.